麻疹腰痛症候恶。婴儿罕有男妇多。男为肾败女血耗。治法不同切莫错。
麻疹之症。原系胎毒所感而发。而脏腑所蓄之毒。因之而泄。故诸经皆有见症。惟肾为清净
之府。不宜见症。腰者属肾。膀胱之络系焉。故凡麻症。多忌腰痛。如见腰痛。则为逆候。然腰痛之
症。幼孩罕有。惟男妇多有腰痛者。何则。盖男人有五劳六欲之伤。肾多虚弱。麻乃火候。丙丁
熬煎。壬癸必涸。麻收之后。阴血必亏。津精重耗。故多见斯症。乃为肾败之候。最为难治。宜以四
物汤（见二十五条）合六味地黄汤（见七十八条）加枸杞、杜仲、故纸之类主之。如尚有余毒未尽
者。更加牛蒡子、连翘、治之。如兼有潮热者。加酒炒黄连、黄芩、盐酒炒黄柏、地骨皮等药治之。
如初热正出已出之时腰痛者。则于宣发清解药中多加生地黄、当归、以滋养之。若妇人出麻之
际。或值经来之时。或因热重。迫血妄行。天癸非期而来。血既下行。已经暴耗。兼之毒火熬煎。耗
中加耗。人身之血。能有几许。当此重耗。未有不生腰痛之疾者。凡有此候。急宜以四物汤（见二
十五条）多加元胡索主之。倘仍有余毒未清者。或兼有潮热者。则仍加炒黄连、炒牛蒡、连翘之
类。以解其余毒。清其余热。如见于初潮已出之间者。则亦于宣发清解药中。多加生地黄、元胡
索、当归治之。总宜急为调治。免致夺血而亡之患。
朱曰 治腰痛法。皆井井有条。
麻疹引起的腰痛症状较为凶险。婴儿中很少出现，而成年男女则多见。男性多因肾气败损所致，女性多因阴血耗伤引起。两者的治疗方法不同，务必不可混淆。
麻疹这种病症，原本是由于胎毒（胎儿时期体内蓄积的毒素）感受外邪而引发。脏腑中蓄积的毒素，因此得以宣泄，所以各条经络都可能出现相应的症状。唯独肾脏是清净之府，不适宜出现病变症状。腰部归属于肾，膀胱的络脉也系连于此。因此，凡是患麻疹的人，大多忌讳出现腰痛。如果见到腰痛，就属于逆证（病情恶化、预后不良的征象）。然而，腰痛这一症状，在幼儿中很少见，只有成年男女多有腰痛的情况。为什么呢？大概是因为男子有五劳（久视伤血、久卧伤气、久坐伤肉、久立伤骨、久行伤筋）和六欲（眼、耳、鼻、舌、身、意等感官欲望）的损伤，肾脏多处于虚弱状态。麻疹发作如同火刑煎熬，心火（丙丁属火）猛烈熬煎，必然导致肾水（壬癸属水）枯竭。麻疹消退之后，阴血必定亏损，津液和精气再次大量消耗，所以多见此症，这是肾气败损的征象，最为难治。应当以四物汤（参见原文第二十五条）合用六味地黄汤（参见原文第七十八条），加入枸杞子、杜仲、补骨脂（故纸）等药物为主进行治疗。如果还有余毒未尽，再加牛蒡子、连翘来治疗。如果兼有潮热（定时发热或午后发热）的症状，加入酒炒黄连、黄芩，盐酒炒黄柏、地骨皮等药物治疗。如果在初热期、疹点刚发出或已发出的时候出现腰痛，则在宣发透疹、清热解毒的药物中，多加生地黄、当归，以滋养阴血。如果是妇女在出麻疹期间，正值月经来潮，或者因为热势过重，逼迫血液妄行，导致天癸（指与月经相关的物质或功能）非正常周期而来，血液已经下行流失，造成突然的大量耗损，再加上毒火煎熬，使体内的损耗雪上加霜。人身中的血液能有多少呢？面对如此严重的耗损，没有不发生腰痛疾病的。凡是有这种情况，应当紧急使用四物汤（参见原文第二十五条），多加延胡索（元胡索）为主治疗。倘若仍有残余毒素未清，或者兼有潮热的症状，则仍然加入炒黄连、炒牛蒡子、连翘等药物，以解除剩余的毒素，清除剩余的热邪。如果出现在初潮刚过、疹点已出的阶段，也在宣发清解的药物中，多加生地黄、延胡索、当归来治疗。总之应当紧急进行调理治疗，以免导致因失血过多而死亡的祸患。
The syndrome of lower back pain caused by measles is ominous. It is rare in infants but common in adult men and women. In men, it is due to the failure of the Kidney; in women, it is due to the consumption of Blood. The treatment methods differ, so one must not make mistakes.
Measles originates from the sensation of fetal toxin (toxins accumulated in the body during fetal development) and subsequent pathogenic factors. The toxins stored in the Zang-Fu organs are thereby discharged. Therefore, symptoms can appear in all meridians. However, the Kidney is the organ of purity and clarity, and it is inappropriate for pathological symptoms to manifest here. The waist belongs to the Kidney, and the collaterals of the Bladder are connected to it. Thus, in cases of measles, lower back pain is generally contraindicated as a symptom. If lower back pain appears, it indicates a adverse prognosis (a sign of worsening condition and poor outcome). Nevertheless, this symptom is rare in young children but common in adults. Why? This is because men often suffer from injuries due to the Five Labors (injuries caused by prolonged looking damaging Blood, prolonged lying damaging Qi, prolonged sitting damaging flesh, prolonged standing damaging bones, and prolonged walking damaging tendons) and Six Desires (sensory desires), leading to frequent Kidney deficiency. Measles acts like a fire trial; the intense heat of the Heart Fire (Bing-Ding belong to Fire) boils and fries, inevitably depleting the Kidney Water (Ren-Gui belong to Water). After the measles resolve, Yin-Blood is inevitably deficient, and Body Fluids and Essence are heavily consumed. Hence, this symptom is common, representing a sign of Kidney failure, which is the most difficult to treat. One should use Siwu Tang (Four Substance Decoction) combined with Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill), adding Gouqizi (Lycium Fruit), Duzhong (Eucommia Bark), and Gubuzi (Psoralea Fruit) as the main treatment. If residual toxins remain, add Niubangzi (Arctii Fructus) and Lianqiao (Forsythiae Fructus). If accompanied by tidal fever (fever that occurs at specific times or in the afternoon), add Huanglian (Coptidis Rhizoma) stir-fried with wine, Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex) stir-fried with salt and wine, and Digupi (Lycii Cortex) for treatment. If lower back pain occurs during the initial heat phase, when the rash is just emerging or has emerged, add more Shengdi Huang (Rehmanniae Radix) and Danggui (Angelicae Sinensis Radix) to the formulas that promote eruption and clear heat/toxins, to nourish the Yin-Blood.
In the case of women suffering from measles, if menstruation coincides with the eruption, or if the heat is severe enough to force blood to flow recklessly, causing Tian Gui (substances/functions related to menstruation) to arrive out of cycle, the blood flows downward, resulting in sudden heavy loss. Coupled with the boiling of toxic fire, the consumption within the body increases further. How much blood can the human body possess? Under such heavy consumption, it is inevitable that lower back pain will develop. For any such presentation, one should urgently use Siwu Tang (Four Substance Decoction) with added large amounts of Yuanhusuo (Cyperi Rhizoma) as the primary treatment. If residual toxins remain unclarified, or if tidal fever is present, continue to add Chao Huanglian (Stir-fried Coptidis Rhizoma), Chao Niubangzi (Stir-fried Arctii Fructus), and Lianqiao (Forsythiae Fructus) to resolve remaining toxins and clear residual heat. If this occurs between the onset of menstruation and the emergence of the rash, also add Shengdi Huang (Rehmanniae Radix), Yuanhusuo (Cyperi Rhizoma), and Danggui (Angelicae Sinensis Radix) to the eruptive and heat-clearing formulas. In all cases, urgent regulation and treatment are necessary to avoid the danger of death due to blood loss.
Zhu commented: The methods for treating lower back pain are all well-ordered and systematic.