足太阳脉令人腰痛。引项脊尻背如重状。刺其 中。太阳正经出血。(刺委中及昆仑)春
无见
血。(肾水衰也。)少阳令人腰痛。如以针刺其皮中。循循然。(迟滞貌)不可以俯仰。不可以
顾刺少阳成骨之端(阳关)出血。夏无见血。(肝木衰也。)阳明令人腰痛。不可以顾。顾如有
见者。(见鬼怪也)善悲。(神不足也。阳明气衰而阴邪侮之。故症见若此。)刺 前三 。上
下和之出血。(三里穴。并上廉下廉)秋无见血(脾土衰也)足少阴令人腰痛。痛引脊内廉。刺
少阴于内踝上二 。(复溜)春无见血。(肾水衰也。)出血太多不可复也。厥阴之脉令人腰痛
。腰中如张弓弩弦。刺厥阴之络。(旧本脉。)在 踵鱼腹之外。(蠡沟穴)其病令人善言。嘿
嘿然不慧。(自多言语。又不能发声也)刺之三 (当三刺。其处下同)解脉令人腰痛。痛引肩
。目KT KT 然。时遗溲刺解脉在膝筋肉分间。 外廉之横络(旧本脉)出血。血变而止。(解脉
足太阳经之散行脉也当刺 中襟纹两筋间弩肉高起之处。若却之外廉有血络横见盛满而紫
黑
者刺出黑血。必候其血色变赤。乃止其针)解脉令人腰痛。如引带。常如折(音舌)腰状。善
恐。刺解脉在 中。(委中穴)结络如黍米。刺之血射以黑。见赤血而已。(复言解脉者谓太
阳支脉从腰中下挟脊贯 入 中者也故其痛若此。太阳之脉络肾故善恐。)同阴之脉令人腰
痛。痛如小锤居其中。(痛而重也)怫然肿(肿突如怒起也。)刺同阴之脉在外踝上绝骨之端。
为三 。(阳辅穴足少阳之别络于厥阴并经下络足跗故曰同阴之脉)阳维之脉令人腰痛。痛上
怫然肿。刺阳维之脉。脉与太阳合 下间。去地一尺所(承山穴。)衡络之脉令人腰痛。不可
以俯仰。仰则恐仆。得之举重伤腰。衡络绝。恶血归之。刺之在 阳筋之间。上 数寸。衡
居。(委阳殷门。二穴并居)为二 。出血。(衡。横也。足太阳之别络自腰中横出髀外后廉
□下合于 中。故曰衡络)会阴之脉令人腰痛。痛上漯漯(音沓)然汗出。(邪在阴分)汗干令
人欲饮(液亡也。)饮已欲走。(饮多则阴气下溢。故欲走也。)刺直阳之脉上三 在跷上 下
五寸。横居视其盛者出血。(会阴任脉穴也。督由此行背。故令人腰痛。直阳。谓足太阳之
脉侠脊而直行者其穴在阳跷之上 之下相去约五寸而横居须视其血络之盛者为的)飞阳之脉
令人腰痛。痛上怫怫然。甚则悲以恐。刺飞阳之脉。与阴维之会。(飞阳。足太阳络穴。别
走少阴者也阴维之会。即少阴之前。在内踝上五寸。筑宾穴也。)昌阳之脉令人腰痛。痛引
膺。目KT KT 然甚则反折。舌卷不能言。(刺复溜。阴跷脉合于足太阳。故曰昌阳。)散脉令人
腰痛而热。热甚生烦。腰下如有横。木居其中。甚则遗溲。刺散脉在膝前骨肉分间。络外廉
束脉为三 。(王甚散脉。足太阴之别。其脉散股入腹。与少阴少阳结于腰髁下。□骨之下
。后有大筋□束膝 之骨令其连属。取此筋骨系束之脉以去其病。是即地机穴三 。三刺也
吴注散脉阳明别络之散行者类经注膝前骨肉分间。络外廉束脉。似指阳明经为散脉。但本篇
独缺太阴刺法而下文有云上热刺足太阴者若与此相照应。○按地机穴治腰痛王氏注合)肉里
之脉令人腰痛。不可以咳。咳则筋缩急。(肉里谓分肉之里。足少阳脉所行主筋膜者也。)刺
肉里之脉为二 。在太阳之外。少阳绝骨之后。(阳辅穴。)腰痛侠脊而痛至头。KT KT 然。(
凭伏貌)目KT KT 。欲僵仆刺足太阳 中出血腰痛上寒。刺足太阳。(京骨穴)阳明。(冲阳穴)
腰痛上热。刺足厥阴。(大冲穴。○上寒上热。皆以上体言也。寒刺阳经去阳分之阴邪。热
刺厥阴去阴中之风热也)不可以俯仰。刺足少阳。(丘虚穴。)中热而喘。刺足少阴。(太 穴
。)刺 中出血。(委中穴。○按少阴之脉贯。肝鬲入肺中肾水不足以制火故中热而喘宜刺足
少阴俞太 又刺 中者。即足太阳委中也。吴注作少阴之 水泉穴误)腰痛上寒不可顾刺足
阳明。上热刺足太阴。(王注上寒阴市主之。不可顾。三里主之上热地机主之○阳明太阴之
脉皆不可左右顾)大便难。刺足少阴。(涌泉穴)少腹满。刺足厥阴。(太冲穴)如折不可以俯
仰。不可举。刺足太阳。(王注如折。束骨主之不可以俯仰。京骨昆仑主之。不可举。申脉
仆参主之)引脊内廉。刺足少阴(王注复溜穴○吴注有上件如折不可以俯仰。不可举。而其痛
又引及脊之内廉。足太阳络肾之脉痛也)腰痛引少腹控 不可以仰刺腰尻交者。两髁胂上发
针立已。(王注此即下 穴足太阴厥阴少阳三脉。左右交结于中也。两髁脾谓腰髁骨下坚肉
也盖腰髁下尻骨两旁有四骨空左右其八穴皆主腰痛。)
足太阳膀胱经的经脉使人发生腰痛,疼痛牵引项部、脊柱、臀部及背部,感觉像背负重物一样沉重。针刺该经的郄穴(委中穴)和经穴(昆仑穴),使太阳正经出血。(注释:此处指刺委中及昆仑穴)。春季不宜见血。(因为春季肾水气衰微的缘故。)
足少阳胆经的经脉使人发生腰痛,痛感如同有针刺在皮肤之中,感觉迟滞不畅,不能前后俯仰,也不能回头张望。针刺足少阳成骨之端(阳关穴)出血。(注释:阳关穴位于膝外侧。)夏季不宜见血。(因为夏季肝木气衰微的缘故。)
足阳明胃经的经脉使人发生腰痛,不能回头张望,回头时好像看到了什么邪祟之物。(注释:即产生幻觉看到鬼怪。)容易悲伤。(注释:神气不足。阳明经气衰微而阴邪侵犯,所以出现这种症状。)针刺前述三个穴位(三里穴,以及上廉泉、下廉泉穴),上下配合调和后出血。(注释:指足三里穴,并配合上廉、下廉穴。)秋季不宜见血。(因为秋季脾土气衰微的缘故。)
足少阴肾经的经脉使人发生腰痛,疼痛牵引脊柱内侧。针刺足少阴经在内踝上二寸处(复溜穴)。春季不宜见血。(因为春季肾水气衰微的缘故。)如果出血过多,就无法恢复了。
足厥阴肝经的经脉使人发生腰痛,腰部僵硬如同拉满弓弩的弦。针刺足厥阴经的络穴。(旧本误作“脉”。)该络穴位于外踝后方跟腱鱼腹状肌肉的外侧(蠡沟穴)。此病使人喜欢多言,但声音低微迟钝。(注释:自以为能言善辩,实则不能正常发声。)针刺三次(应当刺三次,其处下同)。
解脉使人发生腰痛,疼痛牵引肩部,眼睛昏花不明,时常遗尿。针刺解脉,位置在膝盖后侧筋肉分界之间,腘窝外缘的横络(旧本误作“脉”)出血。(注释:解脉是足太阳经的散行支脉,应当刺腘窝横纹两筋间肌肉高起之处,若向外侧看有血络横现且充盈紫黑者,刺出黑血,必须等到血色变红才停止针刺。)
解脉又使人发生腰痛,如同牵引着带子,常常感觉腰部折断(音舌)。容易惊恐。针刺解脉在腘窝中央(委中穴)。结聚的血络如黍米大小,针刺时血液喷射呈黑色,见到血色变红即可停止。(注释:再次提到解脉,是指太阳支脉从腰中下行,挟脊进入腘窝中央。所以疼痛如此。太阳脉络连接肾脏,故易惊恐。)
同阴之脉使人发生腰痛,痛感如同有小锤居住在腰部中间。(注释:疼痛且沉重。)局部浮肿突起。(注释:肿胀突起如怒起状。)针刺同阴之脉在外踝上绝骨之端(阳辅穴),针刺三次。(注释:阳辅穴是足少阳之别络,联络足厥阴经,下络足背,所以称为同阴之脉。)
阳维之脉使人发生腰痛,疼痛部位浮肿突起。针刺阳维之脉,该脉与太阳经合于腘窝下方,距离地面一尺左右(承山穴)。
衡络之脉使人发生腰痛,不能前后俯仰,仰卧时恐怕会跌倒。这是由于举重损伤腰部,导致衡络断裂,恶血积聚所致。针刺部位在腘窝外侧的筋肉之间,向上数寸,横向分布(委阳穴、殷门穴,两穴均位于此处)。(注释:衡,即横也。足太阳之别络自腰中横出至大腿外侧后缘,向下合于腘窝中央,所以称为衡络。)针刺两次,放出瘀血。
会阴之脉使人发生腰痛,疼痛部位漯漯然汗出。(注释:邪气在阴分。)汗干后使人想喝水。(注释:津液亡失。)喝水后又想走动。(注释:饮水多则阴气下溢,所以想走动。)针刺直阳之脉上方三次,位置在阳跷脉之上、腘窝之下五寸处,横向分布,观察其血络充盛者出血。(注释:会阴是任脉穴,督脉由此行于背部,所以令人腰痛。直阳,指足太阳之脉挟脊直行者,其穴位在阳跷之上、腘窝之下,相距约五寸且横向分布,须观察其血络充盛者为准确位置。)
飞阳之脉使人发生腰痛,疼痛部位怫怫然不适,严重时悲恐交加。针刺飞阳之脉,与阴维之脉交会处。(注释:飞阳是足太阳络穴,别走少阴经。阴维之会,即在少阴经之前,内踝上五寸处的筑宾穴。)
昌阳之脉使人发生腰痛,疼痛牵引胸部,眼睛昏花不明,严重时身体反折,舌头卷缩不能说话。(注释:针刺复溜穴。阴跷脉合于足太阳经,所以称为昌阳。)
散脉使人发生腰痛且发热,热甚则生烦躁,腰部以下如有横木居中,严重时遗尿。针刺散脉在膝盖前骨肉分界之间,络脉外缘束脉处,针刺三次。(注释:王冰注散脉为足太阴之别络,其脉散入股部进入腹部,与少阴、少阳结于腰髁下、髂骨之下。后方有大筋束缚膝胫之骨使其连属,取此筋骨系束之脉以去除疾病,即是地机穴。三刺,即针刺三次。吴谦注散脉为阳明别络之散行者,《类经》注认为膝前骨肉分间,络外廉束脉,似指阳明经为散脉,但本篇独缺太阴刺法,而下文有云上热刺足太阴者,若与此相照应。按:地机穴治腰痛,王氏注合。)
肉里之脉使人发生腰痛,不能咳嗽,咳嗽则筋脉收缩紧急。(注释:肉里谓分肉之里,足少阳脉所行,主筋膜者也。)针刺肉里之脉两次,位置在太阳经之外,少阳经绝骨之后(阳辅穴)。
腰痛挟脊而痛,直至头部,眼睛昏花不明(凭伏貌),眼睛昏花,想要僵仆倒地。针刺足太阳经腘窝中央出血。
腰痛上部发热,针刺足厥阴经(大冲穴)。(注释:上寒上热,皆以上体而言。寒证刺阳经以去阳分之阴邪,热证刺厥阴以去阴中之风热。)
腰痛中部发热而气喘,针刺足少阴经(太溪穴)。(注释:刺腘窝中央出血,即委中穴。按:少阴之脉贯肝肾入肺中,肾水不足以制火,故中热而喘,宜刺足少阴俞。太溪又刺腘中者,即足太阳委中也。吴谦注作少阴之水泉穴,误。)
腰痛上部寒冷不能顾盼,刺足阳明经;上部发热刺足太阴经。(王冰注:上寒用阴市穴主治,不可顾用三里穴主治;上热用地机穴主治。○阳明、太阴之脉皆不可左右顾盼。)
腰痛如折断般不能俯仰,不能抬举,刺足太阳经。(王冰注:如折,用束骨穴主治;不可以俯仰,用京骨、昆仑穴主治;不可举,用申脉、仆参穴主治。)
疼痛牵引脊柱内侧,刺足少阴经(王冰注:复溜穴。○吴谦注:有上述如折断、不可以俯仰、不可举的症状,而其痛又引及脊之内廉,这是足太阳络肾之脉痛的缘故。)
腰痛牵引少腹,控引睾丸,不可以仰卧。针刺腰尻交会处,两髁胂肉上方,发针后立即痊愈。(王冰注:此即下髎穴,足太阴、厥阴、少阳三脉左右交结于其中。两髁,指腰髁骨下的坚肉。盖腰髁下、尻骨两旁有四骨空,左右共八穴,皆主治腰痛。)
The meridians of the Foot-Taiyang Bladder cause lower back pain. The pain radiates to the nape, spine, buttocks, and back, feeling as if bearing a heavy burden. Puncture the Xi-cleft point (Weizhong BL60) and Jing-River point (Kunlun BL60) of this meridian to bleed the Foot-Taiyang regular meridian. (Commentary: Refers to puncturing Weizhong BL60 and Kunlun BL60.) Do not allow bleeding in Spring. (Because Kidney Water Qi is deficient in Spring.)
The meridians of the Foot-Shaoyang Gallbladder cause lower back pain. The pain feels as if needles are pricking the skin, with a sensation of sluggishness. One cannot flex or extend the waist, nor can one turn the head to look back. Puncture the end of the Chenggu bone of the Foot-Shaoyang (Yangguan EX-B9) to bleed. (Commentary: Yangguan EX-B9 is located on the lateral side of the knee.) Do not allow bleeding in Summer. (Because Liver Wood Qi is deficient in Summer.)
The meridians of the Foot-Yangming Stomach cause lower back pain. One cannot turn the head to look back; when turning, one may see hallucinations. (Commentary: Seeing ghosts or monsters.) One tends to feel sorrowful. (Commentary: Divine spirit is insufficient. Yangming Qi is deficient and Yin pathogens invade, hence these symptoms appear.) Puncture the aforementioned three points (Zusanli ST36, Shanglianquan ST34, and Xialianquan ST35), harmonize the upper and lower, and bleed. (Commentary: Refers to Zusanli ST36, combined with Shanglianquan ST34 and Xialianquan ST35.) Do not allow bleeding in Autumn. (Because Spleen Earth Qi is deficient in Autumn.)
The meridians of the Foot-Shaoyin Kidney cause lower back pain. The pain radiates to the medial aspect of the spine. Puncture the Foot-Shaoyin meridian two cun above the medial malleolus (Fuliu KI7). Do not allow bleeding in Spring. (Because Kidney Water Qi is deficient in Spring.) If too much blood is lost, it cannot be restored.
The meridians of the Foot-Jueyin Liver cause lower back pain. The waist feels stiff like the string of a drawn bow. Puncture the Luo-connecting vessel of the Foot-Jueyin meridian. (Old texts erroneously read "meridian".) This point is located outside the fleshy part of the calf near the heel (Ligou LR5). This disease causes excessive talking but with low, dull speech. (Commentary: Believing oneself to be eloquent, yet unable to produce normal sound.) Puncture three times (should be punctured three times; same for subsequent locations).
Jie Mai (Resolving Vessel) causes lower back pain. The pain radiates to the shoulder. The eyes are dim and unclear, and there is occasional enuresis. Puncture Jie Mai at the space between muscles and tendons behind the knee, specifically the transverse collateral on the lateral margin of the popliteal fossa. (Old texts erroneously read "meridian".) Bleed until the blood changes color. (Commentary: Jie Mai is a divergent branch of the Foot-Taiyang Bladder meridian. It should be punctured at the high muscular area between the two tendons at the popliteal crease. If transverse collaterals are visible laterally, full and purple-black, puncture to release black blood. Stop only when the blood turns red.)
Jie Mai also causes lower back pain, feeling as if pulled by a belt, often as if the waist is broken (pronounced 'she'). One easily becomes frightened. Puncture Jie Mai in the center of the popliteal fossa (Weizhong BL60). The knotted collaterals resemble millet grains; upon puncture, blood shoots out black. Stop when red blood appears. (Commentary: Reiterating Jie Mai refers to the Taiyang branch descending from the waist, passing along the spine into the center of the popliteal fossa. Hence the pain is thus. The Taiyang meridian connects with the Kidney, hence fear.)
Tongyin Mai (Same Yin Vessel) causes lower back pain. The pain feels as if a small hammer is lodged in the middle of the waist. (Commentary: Painful and heavy.) There is sudden swelling. (Commentary: Swelling protrudes as if angry.) Puncture Tongyin Mai at the end of the fibular head above the lateral malleolus (Yangfu GB38), puncturing three times. (Commentary: Yangfu GB38 is a Luo-connecting vessel of the Foot-Shaoyang Gallbladder, connecting with the Foot-Jueyin Liver meridian and descending to connect with the dorsum of the foot, hence called Tongyin Mai.)
Yangwei Mai (Yang Linking Vessel) causes lower back pain. The painful area is swollen and protruding. Puncture the Yangwei Mai where it joins with the Taiyang meridian below the popliteal fossa, about one chi from the ground (Chengshan BL57).
Hengluo Mai (Transverse Collateral Vessel) causes lower back pain. One cannot flex or extend the waist; lying supine, one fears falling. This results from lifting heavy objects and injuring the waist, causing Hengluo to rupture and evil blood to accumulate. Puncture at the space between tendons and muscles on the lateral side of the popliteal fossa, several cun upward, horizontally distributed (Weiyang BL39 and Yinmen BL37, both located here). (Commentary: Heng means transverse. A collateral of the Foot-Taiyang Bladder emerges horizontally from the waist to the posterior-lateral thigh, merging into the popliteal fossa, hence called Hengluo.) Puncture twice to bleed.
Huiyin Mai (Meeting Yin Vessel) causes lower back pain. The painful area sweats profusely. (Commentary: Pathogen in the Yin division.) When sweat dries, one desires to drink. (Commentary: Body fluids are depleted.) After drinking, one desires to move about. (Commentary: Excessive drinking causes Yin Qi to overflow downward, hence the desire to move.) Puncture Zhiyang Mai (Straight Yang Vessel) three times above, located five cun above the popliteal fossa on the Yangqiao vessel, horizontally distributed. Observe the prominent collaterals and bleed. (Commentary: Huiyin is an Renmai point; Du Mai runs along the back from here, causing lower back pain. Zhiyang refers to the Foot-Taiyang Bladder meridian running straight along the spine. Its point is above Yangqiao and below the popliteal fossa, about five cun apart and horizontally distributed. Observe prominent collaterals for accuracy.)
Feiyang Mai (Flying Yang Vessel) causes lower back pain. The painful area feels uncomfortable and distended; severely, one experiences grief and fear. Puncture Feiyang Mai at its intersection with the Yinwei Mai. (Commentary: Feiyang BL58 is the Luo-connecting point of the Foot-Taiyang Bladder, diverging to the Shaoyin. The intersection with Yinwei Mai is anterior to Shaoyin, five cun above the medial malleolus, Zhubin KI7.)
Changyang Mai (Bright Yang Vessel) causes lower back pain. The pain radiates to the chest. The eyes are dim and unclear; severely, the body arches backward (opisthotonos), the tongue curls, and speech is impossible. (Commentary: Puncture Fuliu KI7. Yinqiao merges with the Foot-Taiyang Bladder meridian, hence called Changyang.)
San Mai (Scattered Vessel) causes lower back pain accompanied by heat. Severe heat causes irritability. Below the waist, it feels as if a horizontal piece of wood is lodged there; severely, there is enuresis. Puncture San Mai between the bone and muscle anterior to the knee, at the outer margin of the collateral vessels binding the meridians, puncturing three times. (Commentary: Wang Bing notes San Mai is a branch of the Foot-Taiyin Spleen meridian, scattering into the thigh and abdomen, joining with Shaoyin and Shaoyang under the iliac bone. Large tendons bind the tibial bones. Taking these tendon-bone binding meridians treats the disease, which is Diji SP8. Three punctures mean three needle insertions. Wu Qian notes San Mai is a scattered branch of the Foot-Yangming Stomach meridian's Luo vessel. Leijing notes that "between bone and muscle anterior to the knee, outer margin of collateral binding meridians" seems to refer to the Yangming meridian as San Mai, but this chapter lacks Taoyin puncture methods. However, later text mentions "upper heat puncture Foot-Taiyin," which corresponds. Note: Diji SP8 treats lower back pain, consistent with Wang Bing's note.)
Rouli Mai (Muscle Interior Vessel) causes lower back pain. One cannot cough; coughing causes muscle spasms and tightness. (Commentary: Rouli refers to the interior of muscle compartments, traversed by the Foot-Shaoyang Gallbladder meridian, governing fascia and tendons.) Puncture Rouli Mai twice, located lateral to the Taiyang meridian and posterior to the Shaoyang meridian's fibular head (Yangfu GB38).
Lower back pain flanking the spine radiating to the head, eyes dim and unclear (looking down posture), eyes blurry, desire to collapse and fall. Puncture the center of the popliteal fossa of the Foot-Taiyang Bladder meridian to bleed.
Upper back coldness: Puncture Foot-Taiyang (Jinggu BL64) and Foot-Yangming (Chongyang ST42).
Upper back heat: Puncture Foot-Jueyin Liver (Dachong LR3). (Commentary: Upper cold/heat refers to the upper body. Cold is treated by puncturing Yang meridians to expel Yin pathogens from Yang divisions; heat is treated by puncturing Jueyin to expel wind-heat from Yin.)
Inability to flex or extend: Puncture Foot-Shaoyang Gallbladder (Qiuxu GB40).
Mid-body heat with panting: Puncture Foot-Shaoyin Kidney (Taixi KI3). (Commentary: Puncture the center of the popliteal fossa to bleed [Weizhong BL60]. Note: The Shaoyin meridian passes through the liver and diaphragm into the lungs. Insufficient Kidney Water fails to control Fire, causing mid-heat and panting; thus puncture the Shu-stream of Foot-Shaoyin. Taixi KI3 is correct. Puncturing the popliteal center refers to Foot-Taiyang Weizhong BL60. Wu Qian's note suggesting Shuiquan KI6 of Shaoyin is incorrect.)
Upper back coldness with inability to look around: Puncture Foot-Yangming Stomach. Upper back heat: Puncture Foot-Taiyin Spleen. (Wang Bing note: Upper cold treated by Yinshi ST8; inability to look treated by Zusanli ST36; upper heat treated by Diji SP8. ○ Both Yangming and Taiyin meridians cannot look left or right.)
Difficulty defecating: Puncture Foot-Shaoyin Kidney (Yongquan KI1).
Fullness in the lower abdomen: Puncture Foot-Jueyin Liver (Taichong LR3).
Lower back pain as if broken, unable to flex/extend or lift: Puncture Foot-Taiyang Bladder. (Wang Bing note: As if broken, treat with Shugu BL65; inability to flex/extend, treat with Jinggu BL64 and Kunlun BL60; inability to lift, treat with Shenmai BL62 and Pucan BL59.)
Pain radiating to the medial spine: Puncture Foot-Shaoyin Kidney. (Wang Bing note: Fuliu KI7. ○ Wu Qian note: Having symptoms of breaking, inability to flex/extend/lift, with pain radiating to the medial spine, this is pain of the Foot-Taiyang Bladder meridian connecting to the Kidney.)
Lower back pain radiating to the hypochondrium/groin, unable to lie supine: Puncture the crossing points of the lumbar and sacral regions, above the gluteal muscles on both sides. Release the needle immediately for cure. (Wang Bing note: This refers to the Xiagao BL34 point, where Foot-Taiyin Spleen, Foot-Jueyin Liver, and Foot-Shaoyang Gallbladder meridians cross. The "two knees" refer to the firm flesh below the iliac crest. There are four bony depressions on either side of the sacrum below the iliac crest, eight points total, all treating lower back pain.)