平按∶此篇自篇首至末，见《素问》卷十一第四十一《刺腰痛篇》，又见《甲乙经》
卷九第八，惟编次前后略异。
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，春无见血。（项、
脊、尻皆足太阳脉行处，故腰痛相引。 中，足太阳，刺金门。足太阳在冬春时气衰，
出血恐虚，故禁之也。）少阳令人腰
痛，如以针刺其皮中，循然不可以俯仰，不可顾，刺少阳成骨之端出血，成骨在膝外
廉之骨独起，夏无见血。（少阳，足少阳也。其脉行颈循胁出气街以行腰，故腰痛不可
俯仰反顾。成骨，膝膑外侧起大骨，足少阳脉循脾出过，故腰痛刺之。足少阳在春，至
夏气衰，出血恐虚，故禁之。平按∶《素问》、《甲乙》循然作循循然。不可顾《素问》
作不可以顾，《甲乙》作不可以左右顾。成骨《甲乙》作盛骨。独起下《素问》、《甲
乙》有者字。）阳明令人腰痛不可顾，顾如有见者，喜悲，刺阳明于 前三 ，上下和
之，出血，秋无见血。（足阳明支者，循喉咙入缺盆，又支者，循腹里下气街，故腰痛
不可顾。阳明谷气虚，故妄有见。虚为肝气所克，故喜悲。下循衍外廉，故刺之以和上
下。足阳明在仲夏，至秋而衰，出血恐虚，故禁之也。平按∶《素问》、《甲乙》不可顾
作不可以顾，喜悲作善悲， 作 ，新校正云∶“《甲乙》 作 。”今本《甲乙》仍
作。又注在仲夏上袁刻有脉字。）足少阴令人腰痛引脊内痛，刺足少阴内踝下二 ，
春无出血，出血大虚，不可复也。（足少阴脉上股内后廉，贯脊属肾络膀胱，故腰痛引
脊内痛也。出然骨之下，循内踝之后，故取内踝之下。少阴与太阳在冬，至春气衰，出
血恐虚，故禁之也。平按∶脊内痛《素问》、《甲乙》作脊内廉，《素问》新校正云∶
“全元起本脊内廉作脊内痛，《太素》亦同。此前少足太阴腰痛证并刺足太阴法，应古
文脱简也。”）居阴之脉令人腰痛，腰中如张弩弦，刺居阴之脉，在 踵鱼肠之外，循
之累累然，乃针刺之，其病令人言嘿嘿然不慧，刺之三 。（居阴脉在 踵鱼肠之外，
其处唯有足太阳脉，当是足太阳络也。平按∶居阴《素问》、《甲乙》
作厥阴，王注云∶“厥阴一经作居阴，是传写草书厥字为居也。”弩上《素问》、《甲
乙》有弓字，鱼肠作鱼腹。循之《甲乙》作循循。言《素问》、《甲乙》作善言，《素
问》新校正云∶“详善言与默默二病难相兼，全元起本无善字，于义为允。”嘿嘿《素
问》、《甲乙》作默默。）解脉令人腰痛引膺，目KT KT 然，时遗溲，刺解脉，在引
筋肉分间，在郗外廉之横脉出血，血变止。（解脉行处为病，与足厥阴相似，亦有是足
厥阴络脉。平按∶《素问》、《甲乙》引膺作引肩，KT KT 作KT KT ，引筋作膝筋，
止上有而字。筋肉，袁刻肉作内。）同阴之脉令人腰痛，痛如小针居其中，弗然肿，刺
同阴之脉，在外踝上绝骨之端，为三 。（同阴脉在外踝上绝骨之端，当是足少阳络脉
也。平按∶小针《素问》、《甲乙》作小锤，《素问》新校正云∶“《太素》小锤作小
针。”弗《素问》、《甲乙》作怫。）解脉令人腰痛如别，常如折腰之状，喜怒，刺解
脉，在 中结络如黍米，刺之血射似黑，见赤血而已。（前之解脉与厥阴相似，今此刺
解脉 中，当是取足厥阴 中之络也。平按∶如别《素问》作如引带，《甲乙》作如裂。
喜怒《素问》作善恐，《甲乙》作善怒。似黑《素问》、《甲乙》作以黑。《素问》新
校正云∶“按全元起云∶有两解脉，病源各异，恐误未详。”《素问》此条在同阴之脉
上。）阳维之脉令人腰痛，上弗然脉肿，刺阳维之脉，脉与太阳合 下间，上地一尺所。
（阳维，诸阳之会，从头下至金门、阳交即是也。行腰与足太阳合于 下间，上地一尺
之中，疗阳维肿痛也。平按∶《素问》、《甲乙》腰痛下重痛字，弗作怫，下同，肿上
无脉字，上地作去地。）冲绝之脉令人腰痛，痛不可以俯，不可以仰，则恐仆，得之举
重伤腰，冲绝络，恶血归之，刺之在郗阳筋之间，上郗数寸冲居为二 出血。（冲脉
循脊里，因举重冲脉络绝，恶血归聚之处以为腰痛，可刺冲郗阳筋间，上数寸冲气居
处。平按∶冲绝《素问》、《甲乙》作衡络。“痛不可以俯，不可以仰，则恐仆”《素
问》作“不可以俯仰，仰则恐仆”，《甲乙》作“得 不得仰，仰则恐仆”。绝络《素
问》作络绝，《甲乙》作络绝伤。《甲乙》筋之间作之筋间。）会阴之病令人腰痛，痛
上漯漯然汗，汗干令人欲饮，已欲走，刺直阳之脉上二 ，在乔上 下下三寸所横居，
视其盛者出血。（刺直阳者，有本作会阳，乔上 下横居络脉也。平按∶漯漯然《甲乙》
作 然。《素问》、《甲乙》汗下有出字，饮下重一饮字，二 作三 ，乔作跷。郗
下下三寸所《素问》作 下五寸，《甲乙》作 下三所。）飞扬之脉令人腰痛，痛上弗
弗然，甚则悲以恐，刺飞扬之脉，在内踝上二寸太阴之前，与阴维会。（足太阳别，名
曰飞扬，有本飞作蜚。太阳去外踝上七寸，别走足少阴。当至内踝上二寸，足少阴之前，
与阴维会处，是此刺处也。平按∶二寸《素问》作五寸，新校正云∶当作二寸。太阴
《素问》、《甲乙》作少阴，据本注足少阴之前与阴维会处，则太阴恐系少阴传写之误。）
昌阳之脉令人腰痛，痛引膺，目KT KT 然，甚则反折，舌卷不能言，刺内筋为二 ，
在内踝大筋前太阴后，上踝三寸所。（内筋在踝大筋前太阴后，内踝上三寸所。大筋，
当是足太阴之筋。内筋支筋，在足太阳大筋之前，足太阴筋之后，内踝上三寸也。平按∶
《素问》内踝作内踝上，三寸作二寸。）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
膝前肉分间，在络外廉束脉为三 。（散脉在膝前肉分间者，十二经脉中，惟足厥阴、
足少阳在膝前主溲，故当是此二经之别名。在二经大络外廉小筋名束脉，亦名散脉也。
平按∶《素问》、《甲乙》肉上有骨字，络上无在字。注膝前袁刻误作脉前。）肉里之
脉令人腰痛，不可以咳，咳则筋挛急，刺肉里之脉为二 ，在太阳之外，少阳绝骨之后。
（太阳外，绝骨后，当是少阴为肉里脉也。平按∶筋挛急，《素问》挛作缩，《甲乙》
无急字。《甲乙》之后作之端。）腰痛挟脊而痛至头沉沉然，目HT HT 欲僵，刺足阳明
出血。（足阳明在头下，支者起胃下口，循腹里下至气街，腹里近脊，故腰痛刺足阳明
中出血也。平按∶《素问》、《甲乙》沉沉作几几，HT HT 作KT KT ，僵下有仆字，
下有中字。《素问》新校正云∶《太素》作头沉沉然。）腰痛上寒，刺足太阳、阳明；
上热，刺足厥阴；不可以俯仰，刺足少阳；中热如喘，刺足少阴，刺 中出血。（腰痛
上热，补当腰足太阳足阳明脉。腰痛上寒，泻当腰足厥阴脉。足少阳主机关，不可俯
仰，取足少阳。腰痛中热□如喘气动，可取足少阴 中出血也。平按∶如喘《素问》、
《甲乙》作而喘。注机下袁刻脱关字。中热下原缺一字，原抄旁注极字。又按注上热上
寒，与经文不合，疑有误。）腰痛引少腹控 ，不可仰，刺腰尻交者两胂上，以月生死
为数，发针立已。（ ，以沼反。胂，脊骨两箱肉也。平按∶两胂上《素问》、《甲
乙》作两踝胂上。《素问》立已下有“左取右，右取左”六字。）腰痛痛上寒，取足太
阳；痛上热，取足厥阴；不可以俯仰，取足太阳；中热而喘，取足少阴、 中血络。（前
腰痛刺 中，此刺 中也。平按∶此段《甲
乙》无，《素问》在腰痛引少腹一段之前，其文意亦小异。《素问》云∶“腰痛，上寒
不可顾，刺足阳明；上热，刺足太阴；中热而喘，刺足少阴。大便难，刺足少阴。少腹
满，刺足厥阴。如折不可以俯仰，不可举，刺足太阳。引脊内廉，刺足少阴。”新校正
云∶“按全元起本及《甲乙经》并《太素》自腰痛上寒至此并无，乃王氏所添。”再检
本书此段如上腰痛上寒一段，仅不可以俯仰刺足太阳，与刺足少阳不同。注云前条为刺
中，此刺 中，则此条与上条，亦可互相发明也。）
【平按】：本篇从篇首到篇末，见于《素问》卷十一第四十一《刺腰痛篇》，又见于《甲乙经》卷九第八，只是编排顺序略有不同。
足太阳经脉使人腰痛，疼痛牵引项部、脊背和尻骨，背部感觉像负重一样沉重，针刺其中（金门穴）的足太阳正经使其出血，春季禁止放血。（项、脊、尻都是足太阳经脉循行的部位，所以腰痛会相互牵引。中，指足太阳经的金门穴。足太阳经在冬季和春季时气机衰弱，放血恐怕导致虚损，所以禁止。）
足少阳经脉使人腰痛，痛感如同针刺皮肤之中，身体拘急不能前后俯仰，也不能回头看，针刺足少阳成骨之端出血，成骨位于膝盖外侧单独高起的骨头处，夏季禁止放血。（足少阳，指足少阳胆经。其经脉循行颈部、胁肋，出于气街以经过腰部，所以腰痛不能俯仰和回头。成骨，即膝膑外侧隆起的大骨，足少阳脉循脾脏外出经过此处，所以腰痛时针刺它。足少阳经在春季至夏季时气机衰弱，放血恐怕导致虚损，所以禁止。平按：《素问》、《甲乙经》中“循然”作“循循然”。不可顾，《素问》作“不可以顾”，《甲乙经》作“不可以左右顾”。成骨，《甲乙经》作“盛骨”。独起之下，《素问》、《甲乙经》有“者”字。）
足阳明经脉使人腰痛，不能回头看，回头看时如有幻觉看见东西，喜欢悲伤，针刺足阳明经在膝前三个穴位处，上下调和后放血，秋季禁止放血。（足阳明经的支脉，循喉咙进入缺盆，另一支脉，循腹里下行至气街，所以腰痛不能回头。阳明谷气虚弱，所以产生妄见。虚证被肝气克制，所以喜欢悲伤。向下循行于胫骨外廉，所以针刺此处以调和上下。足阳明经在仲夏至秋季时气机衰弱，放血恐怕导致虚损，所以禁止。平按：《素问》、《甲乙经》中“不可顾”作“不可以顾”，“喜悲”作“善悲”，[阙文]作[阙文]，新校正说：“《甲乙经》[阙文]作[阙文]。”今本《甲乙经》仍作[阙文]。另外注文中在“仲夏”上袁刻本有“脉”字。）
足少阴经脉使人腰痛，疼痛牵引脊内，针刺足少阴经在内踝下二寸处，春季禁止放血，放血会导致严重虚损，无法恢复。（足少阴经脉上行大腿内侧后缘，贯穿脊柱属于肾，联络膀胱，所以腰痛牵引脊内疼痛。出然骨之下，循内踝之后，所以取内踝之下。少阴与太阳经在冬季至春季时气机衰弱，放血恐怕导致虚损，所以禁止。平按：脊内痛，《素问》、《甲乙经》作“脊内廉”，《素问》新校正说：“全元起本‘脊内廉’作‘脊内痛’，《太素》也相同。此前关于足太阴腰痛的证候并针刺足太阴的方法，应该是古文脱简。”）
居阴之脉使人腰痛，腰部中间像拉开的弩弓弦一样紧绷，针刺居阴之脉，在足跟鱼肠之外，顺着摸上去有颗粒状突起的地方，然后针刺，这种病使人说话沉默迟钝不聪明，针刺三次。（居阴脉在足跟鱼肠之外，该处只有足太阳脉，应当是足太阳的络脉。平按：居阴，《素问》、《甲乙经》作“厥阴”，王冰注说：“厥阴一经写作居阴，是传写草书‘厥’字为‘居’字。”弩上，《素问》、《甲乙经》有“弓”字，鱼肠作“鱼腹”。循之，《甲乙经》作“循循”。言，《素问》、《甲乙经》作“善言”，《素问》新校正说：“详查善言与默默两种病难兼得，全元起本无‘善’字，于义理为允当。”嘿嘿，《素问》、《甲乙经》作“默默”。）
解脉使人腰痛，疼痛牵引胸部，眼睛视物模糊不清，时常遗尿，针刺解脉，在牵拉筋肉的分间，在郗穴外廉的横脉出血，血色变红即止。（解脉循行处发病，与足厥阴相似，也有说是足厥阴的络脉。平按：《素问》、《甲乙经》中“引膺”作“引肩”，[阙文]作[阙文]，引筋作“膝筋”，止上有“而”字。筋肉，袁刻本肉作内。）
同阴之脉使人腰痛，痛如小针扎在其中，郁结不舒且肿胀，针刺同阴之脉，在外踝上绝骨的末端，针刺三次。（同阴脉在外踝上绝骨的末端，应当是足少阳的络脉。平按：小针，《素问》、《甲乙经》作“小锤”，《素问》新校正说：“《太素》小锤作小针。”弗，《素问》、《甲乙经》作“怫”。）
解脉使人腰痛像被分开一样，常常像腰折断的状态，易怒或恐惧，针刺解脉，在[阙文]中的结络如黍米大小，针刺时血液喷射似黑色，见到红色血液就停止。（之前的解脉与厥阴相似，现在此条刺解脉[阙文]中，应当是取足厥阴[阙文]中的络脉。平按：如别，《素问》作“如引带”，《甲乙经》作“如裂”。喜怒，《素问》作“善恐”，《甲乙经》作“善怒”。似黑，《素问》、《甲乙经》作“以黑”。《素问》新校正说：“按全元起说：有两解脉，病源各异，恐怕有误未详。”《素问》此条在同阴之脉之前。）
阳维之脉使人腰痛，上部郁结不舒且脉肿，针刺阳维之脉，脉与太阳经合于[阙文]下间，距离地面一尺左右。（阳维，是诸阳之会，从头下至金门、阳交即是。行于腰部与足太阳经合于[阙文]下间，距离地面一尺之中，治疗阳维肿痛。平按：《素问》、《甲乙经》腰痛下有“重痛”字，弗作“怫”，下同，肿上无“脉”字，上地作“去地”。）
冲绝之脉使人腰痛，痛得不能俯身，不能仰身，则害怕跌倒，这是由于举重重伤腰部，冲脉绝络，恶血归聚于此，针刺在郗阳筋之间，向上郗穴数寸处的冲脉居处，分两次出血。（冲脉循行脊里，因举重导致冲脉络绝，恶血归聚之处形成腰痛，可刺冲郗阳筋间，向上数寸冲气居处。平按：冲绝，《素问》、《甲乙经》作“衡络”。“痛不可以俯，不可以仰，则恐仆”，《素问》作“不可以俯仰，仰则恐仆”，《甲乙经》作“得[阙文]不得仰，仰则恐仆”。绝络，《素问》作“络绝”，《甲乙经》作“络绝伤”。《甲乙经》筋之间作“之筋间”。）
会阴之病使人腰痛，痛处漯漯然出汗，汗干令人想喝水，已想走动，针刺直阳之脉上三寸处，在跷脉上[阙文]下三寸处横向居处，观察其充盛者放血。（刺直阳者，有本作会阳，跷上[阙文]下横居络脉也。平按：漯漯然，《甲乙经》作[阙文]然。《素问》、《甲乙经》汗下有“出”字，饮下重一“饮”字，二[阙文]作三[阙文]，乔作“跷”。郗下下三寸所，《素问》作[阙文]下五寸，《甲乙经》作[阙文]下三所。）
飞扬之脉使人腰痛，痛处弗弗然，严重时悲伤且恐惧，针刺飞扬之脉，在内踝上二寸足太阴之前，与阴维脉交会处。（足太阳之别，名叫飞扬，有版本飞作蜚。太阳经去外踝上七寸，别走足少阴。当至内踝上二寸，足少阴之前，与阴维会处，就是此刺处。平按：二寸，《素问》作五寸，新校正说：当作二寸。太阴，《素问》、《甲乙经》作少阴，据本注足少阴之前与阴维会处，则太阴恐怕系少阴传写之误。）
昌阳之脉使人腰痛，疼痛牵引胸部，眼睛视物模糊不清，严重时身体反折，舌卷缩不能言语，针刺内筋为两次，在内踝大筋前、足太阴后，上踝三寸处。（内筋在踝大筋前、足太阴后，内踝上三寸处。大筋，应当是足太阴之筋。内筋支筋，在足太阳大筋之前，足太阴筋之后，内踝上三寸。平按：《素问》内踝作“内踝上”，三寸作“二寸”。）
散脉使人腰痛且发热，热甚生烦闷，腰部下面如有横木居其中，严重时遗尿，针刺散脉，在膝前肉分间，在络外廉束脉为三次。（散脉在膝前肉分间者，十二经脉中，只有足厥阴、足少阳在膝前主司小便，所以应当是此二经的别名。在二经大络外廉的小筋名束脉，也称散脉。平按：《素问》、《甲乙经》肉上有“骨”字，络上无“在”字。注膝前袁刻误作“脉前”。）
肉里之脉使人腰痛，不可以咳嗽，咳嗽则筋挛急，刺肉里之脉为两次，在足太阳之外，足少阳绝骨之后。（太阳外，绝骨后，应当是少阴为肉里脉。平按：筋挛急，《素问》挛作“缩”，《甲乙经》无“急”字。《甲乙经》之后作“之端”。）
腰痛挟脊而痛至头，头部沉沉然，眼睛视物模糊欲僵，针刺足阳明经出血。（足阳明经在头下，支脉起于胃下口，循腹里下至气街，腹里近脊，所以腰痛刺足阳明中出血。平按：《素问》、《甲乙经》沉沉作“几几”，[阙文]作[阙文]，僵下有“仆”字，[阙文]下有“中”字。《素问》新校正说：《太素》作“头沉沉然”。）
腰痛上部寒冷，针刺足太阳、足阳明；上部发热，针刺足厥阴；不能俯仰，针刺足少阳；中部发热如喘，针刺足少阴，刺[阙文]中出血。（腰痛上热，补当腰足太阳足阳明脉。腰痛上寒，泻当腰足厥阴脉。足少阳主机关，不可俯仰，取足少阳。腰痛中热[阙文]如喘气动，可取足少阴[阙文]中出血。平按：如喘，《素问》、《甲乙经》作“而喘”。注机下袁刻脱“关”字。中热下原缺一字，原抄旁注“极”字。又按注上热上寒，与经文不合，疑有误。）
腰痛牵引少腹控引[阙文]，不能仰，针刺腰尻交者两胂上，以月亮的盈亏变化决定针刺次数，发针后病立愈。（[阙文]，以沼反。胂，脊骨两侧的肉。平按：两胂上，《素问》、《甲乙经》作“两踝胂上”。《素问》立已下有“左取右，右取左”六字。）
腰痛痛处寒冷，取足太阳；痛处发热，取足厥阴；不能俯仰，取足太阳；中部发热而喘，取足少阴、[阙文]中血络。（前腰痛刺[阙文]中，此刺[阙文]中。平按：此段《甲乙经》无，《素问》在腰痛引少腹一段之前，其文意亦小异。《素问》云：“腰痛，上寒不可顾，刺足阳明；上热，刺足太阴；中热而喘，刺足少阴。大便难，刺足少阴。少腹满，刺足厥阴。如折不可以俯仰，不可举，刺足太阳。引脊内廉，刺足少阴。”新校正说：“按全元起本及《甲乙经》并《太素》自腰痛上寒至此并无，乃王氏所添。”再检本书此段如上腰痛上寒一段，仅不可以俯仰刺足太阳，与刺足少阳不同。注云前条为刺[阙文]中，此刺[阙文]中，则此条与上条，亦可互相发明也。）
[Ping An]: This chapter, from the beginning to the end, is found in *Suwen* (Basic Questions), Volume 11, Chapter 41 "Needling for Lumbar Pain", and also in *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion), Volume 9, Chapter 8, with only slight differences in arrangement.
The Foot-Taiyang Meridian causes lumbar pain that radiates to the neck, spine, and sacrum, with a sensation of heaviness in the back as if bearing a heavy load. Needling the [Jinmen (BL60)] point of the Foot-Taiyang Regular Meridian to induce bleeding is indicated, but bleeding should be avoided in spring. (The neck, spine, and sacrum are all areas traversed by the Foot-Taiyang Meridian, hence the radiating pain. Jinmen refers to the Foot-Taiyang meridian point BL60. The Qi of the Foot-Taiyang Meridian declines in winter and spring; inducing bleeding may cause deficiency, hence it is prohibited.)
The Foot-Shaoyang Meridian causes lumbar pain, feeling as if a needle were piercing the skin, with stiffness preventing flexion and extension, and inability to look back. Needling the end of the Chenggu bone of the Foot-Shaoyang Meridian to induce bleeding is indicated, where the Chenggu bone is the solitary prominent bone on the lateral side of the knee. Bleeding should be avoided in summer. (Foot-Shaoyang refers to the Foot-Shaoyang Gallbladder Meridian. Its pathway runs through the neck and hypochondrium, emerges at the Qichuan point, and passes through the waist, causing lumbar pain with restricted movement. Chenggu refers to the large bone protruding laterally at the knee patella, which the Foot-Shaoyang Meridian passes near; thus needling it treats lumbar pain. The Qi of the Foot-Shaoyang Meridian declines from spring to summer; inducing bleeding may cause deficiency, hence it is prohibited. Ping An: In *Suwen* and *Jiayi Jing*, "xunran" is written as "xunxunran". "Cannot look back" in *Suwen* is "cannot look back", while in *Jiayi Jing* it is "cannot look left or right". Chenggu is written as "Shenggu" in *Jiayi Jing*. Below "duli" (solitary prominence), *Suwen* and *Jiayi Jing* have the character "zhe".)
The Foot-Yangming Meridian causes lumbar pain with inability to look back; when looking back, visual hallucinations may occur, accompanied by a tendency toward sadness. Needling three points anterior to the knee on the Foot-Yangming Meridian, harmonizing upper and lower, and inducing bleeding is indicated. Bleeding should be avoided in autumn. (A branch of the Foot-Yangming Meridian follows the throat into the Supraclavicular Fossa; another branch descends within the abdomen to the Qichuan point, causing lumbar pain with restricted head turning. Deficiency of Yangming Grain Qi leads to delusions. Deficiency allows Liver Qi to overact, causing sadness. Descending along the lateral aspect of the tibia, needling here harmonizes upper and lower. The Qi of the Foot-Yangming Meridian declines in mid-summer to autumn; inducing bleeding may cause deficiency, hence it is prohibited. Ping An: In *Suwen* and *Jiayi Jing*, "bu ke gu" is "bu yi ke gu", "xi bei" is "shan bei", [missing text] is [missing text]. Xin Zhengjiao states: "*Jiayi Jing* [missing text] is [missing text]." The current version of *Jiayi Jing* still uses [missing text]. Additionally, Yuan Ke's edition adds the character "mai" (meridian) before "zhongxia" (mid-summer).)
The Foot-Shaoyin Meridian causes lumbar pain radiating to the interior of the spine. Needling the Foot-Shaoyin Meridian two cun below the medial malleolus is indicated. Bleeding should be avoided in spring, as it causes severe deficiency that cannot be recovered. (The Foot-Shaoyin Meridian ascends along the posterior medial aspect of the thigh, penetrates the spine, belongs to the Kidney, and connects with the Bladder, causing lumbar pain radiating to the spinal interior. Emerging below Ran Gu and following behind the medial malleolus, the point below the medial malleolus is selected. The Qi of Shaoyin and Taiyang declines in winter to spring; inducing bleeding may cause deficiency, hence it is prohibited. Ping An: "Jinei tong" (pain inside the spine) in *Suwen* and *Jiayi Jing* is "jin nei lian". *Suwen* Xin Zhengjiao states: "Quan Qiqi's edition has 'jin nei lian' as 'jin nei tong', consistent with *Taisu*. The preceding section on Foot-Taiyin lumbar pain and its needling method is likely a missing bamboo slip in the ancient text.")
The Juyin Meridian causes lumbar pain with tightness in the waist like a drawn bowstring. Needling the Juyin Meridian at the exterior of the heel's fish-belly area, where nodules are palpable, is indicated. This condition causes mutism and mental dullness; three needle insertions are performed. (The Juyin Meridian is located at the exterior of the heel's fish-belly area. Only the Foot-Taiyang Meridian exists there, so it is likely the collateral of the Foot-Taiyang Meridian. Ping An: Juyin in *Suwen* and *Jiayi Jing* is "Jueyin". Wang Bing's commentary states: "Jueyin was written as Juyin due to cursive script confusion between 'Jue' and 'Ju'. 'Nu' (bow) in *Suwen* and *Jiayi Jing* has the character 'gong' (bow). Yuchang is written as 'yufu'. Xun zhi in *Jiayi Jing* is 'xunxun'. Yan in *Suwen* and *Jiayi Jing* is 'shanyan'. *Suwen* Xin Zhengjiao states: "Carefully examining, 'shanyan' (speaking well) and 'momo' (silent) are difficult to coexist; Quan Qiqi's edition lacks 'shan', which is more logical." Heihe in *Suwen* and *Jiayi Jing* is "momo".)
The Jie Meridian causes lumbar pain radiating to the chest, blurred vision, and occasional urinary incontinence. Needling the Jie Meridian between the pulling muscle fibers, at the transverse vessel outside the Xi point, inducing bleeding until the blood changes color is indicated. (Pathology in the Jie Meridian pathway resembles Foot-Jueyin, possibly being its collateral. Ping An: In *Suwen* and *Jiayi Jing*, "yin ying" is "yin jian", [missing text] is [missing text], "yin jin" is "xi jin", and "zhi" has the character "er" before it. Roujin, Yuan Ke's edition writes rou as nei.)
The Tongyin Meridian causes lumbar pain feeling like a small needle stuck inside, with stagnation and swelling. Needling the Tongyin Meridian at the end of the Jiegu bone above the lateral malleolus, with three needle insertions, is indicated. (The Tongyin Meridian is at the end of the Jiegu bone above the lateral malleolus, likely the collateral of the Foot-Shaoyang Meridian. Ping An: Xiaozhen in *Suwen* and *Jiayi Jing* is "xiao chui". *Suwen* Xin Zhengjiao states: "*Taisu* writes xiao chui as xiao zhen." Fu in *Suwen* and *Jiayi Jing* is "fu".)
The Jie Meridian causes lumbar pain as if separated, resembling a broken waist, with irritability or fear. Needling the Jie Meridian at the knot-like collateral the size of a millet seed in [missing text], inducing blackish blood spray, stopping when red blood appears, is indicated. (The previous Jie Meridian resembled Jueyin; this needling of the Jie Meridian [missing text] likely targets the collateral of the Foot-Jueyin [missing text]. Ping An: Ru bie in *Suwen* is "ru yin dai", in *Jiayi Jing* is "ru lie". Xi nu in *Suwen* is "shan kong", in *Jiayi Jing* is "shan nu". Si hei in *Suwen* and *Jiayi Jing* is "yi hei". *Suwen* Xin Zhengjiao states: "According to Quan Qiqi, there are two Jie meridians with different pathologies; caution is advised regarding inaccuracies." This entry in *Suwen* precedes the Tongyin Meridian section.)
The Yangwei Meridian causes lumbar pain with upper body stagnation and vessel swelling. Needling the Yangwei Meridian where it joins the Taiyang Meridian in the [missing text] lower region, about one chi above the ground, is indicated. (Yangwei is the meeting point of all Yang meridians, extending from the head down to Jinmen and Yangjiao. It travels through the waist joining the Foot-Taiyang Meridian in the [missing text] lower region, one chi above the ground, treating Yangwei swelling and pain. Ping An: In *Suwen* and *Jiayi Jing*, "tong yao" is followed by "zhong tong". Fu is "fu". Under "zhong", the character "mai" is absent. Shang di is "qu di".)
The Chongjue Meridian causes lumbar pain preventing flexion and extension, with fear of falling. This results from heavy lifting injuring the waist, severing the Chong Meridian collaterals, causing evil blood to accumulate. Needling between the Xi-yang tendons, several cun above the Xi point at the Chong Meridian's location, inducing bleeding in two stages, is indicated. (The Chong Meridian runs along the spine. Heavy lifting severs the Chong collaterals, causing evil blood accumulation leading to lumbar pain. One can needle between the Xi-yang tendons, several cun above the Xi point where Chong Qi resides. Ping An: Chongjue in *Suwen* and *Jiayi Jing* is "Hengluo". "Tong bu ke fu, bu ke yang, ze kong pu" in *Suwen* is "bu ke fuyang, yang ze kong pu"; in *Jiayi Jing* it is "de [missing text] bu ke yang, yang ze kong pu". Jueluo in *Suwen* is "luojue", in *Jiayi Jing* is "luojue shang". *Jiayi Jing* writes "jin zhi jian" as "zhi jin jian".)
Huayin disease causes lumbar pain with profuse sweating, dryness inducing thirst, and restlessness. Needling the Shuyang Meridian three cun above, located horizontally at [missing text] three cun below the Qiao point, bleeding the full vessels, is indicated. (Needling Shuyang, some versions read Huiyang, the horizontal collateral below Qiao. Ping An: Luoluoran in *Jiayi Jing* is [missing text] ran. *Suwen* and *Jiayi Jing* add "chu" after "han", repeat "yin" after "yin", write two [missing text] as three [missing text], and Qiao as "qiao". Xi xia xia san cun suo in *Suwen* is [missing text] xia wu cun; in *Jiayi Jing* it is [missing text] xia san suo.)
Feiyang Meridian causes lumbar pain with a [missing text] sensation, progressing to sorrow and fear. Needling the Feiyang Meridian two cun above the medial malleolus, anterior to the Foot-Taiyin, where it meets the Yinwei Meridian, is indicated. (The distinct branch of Foot-Taiyang is named Feiyang; some versions write Fei as Fei. The Taiyang Meridian diverges seven cun above the lateral malleolus to the Foot-Shaoyin. At two cun above the medial malleolus, anterior to the Foot-Shaoyin, meeting the Yinwei Meridian, is the needling site. Ping An: Er cun in *Suwen* is five cun; Xin Zhengjiao states it should be two cun. Taiyin in *Suwen* and *Jiayi Jing* is Shaoyin. Based on the note "anterior to Foot-Shaoyin meeting Yinwei", Taiyin is likely a scribal error for Shaoyin.)
Changyang Meridian causes lumbar pain radiating to the chest, blurred vision, severe opisthotonos, tongue retraction, and aphasia. Needling Neijin twice, located anterior to the large tendon at the medial malleolus, posterior to the Foot-Taiyin, three cun above the ankle, is indicated. (Neijin is anterior to the large tendon at the ankle, posterior to the Foot-Taiyin, three cun above the medial malleolus. The large tendon is likely the tendon of the Foot-Taiyin. Neijin branch is anterior to the Foot-Taiyang large tendon, posterior to the Foot-Taiyin tendon, three cun above the medial malleolus. Ping An: In *Suwen*, "nei huai" is "nei huai shang", and "san cun" is "er cun".)
San Meridian causes lumbar pain with heat, severe heat causing irritability, a sensation of a horizontal wood block in the lower waist, and severe urinary incontinence. Needling the San Meridian in the muscle intervals anterior to the knee, at the outer edge of the collateral, binding the vessels for three insertions, is indicated. (Where the San Meridian is anterior to the knee, among the twelve regular meridians, only Foot-Jueyin and Foot-Shaoyang govern urination anterior to the knee; thus, these are likely aliases for these two meridians. The small tendons outside the major collaterals of these two meridians are called Shumai, also known as San Meridian. Ping An: In *Suwen* and *Jiayi Jing*, "rou" has the character "gu" before it, and "luo" lacks "zai". Note: Yuan Ke mistakenly wrote "mai qian" instead of "xi qian".)
Rouli Meridian causes lumbar pain preventing coughing; coughing induces tendon spasms. Needling the Rouli Meridian twice, located external to Foot-Taiyang and posterior to the Foot-Shaoyang Jiegu, is indicated. (External to Taiyang, posterior to Jiegu, likely refers to Shaoyin as the Rouli Meridian. Ping An: Jin luanji, in *Suwen* "luan" is "suo"; *Jiayi Jing* lacks "ji". *Jiayi Jing* writes "zhi hou" as "zhi duan".)
Lumbar pain involving the spine radiating to the head, with a heavy sensation, blurred vision, and stiffness, is treated by needling the Foot-Yangming Meridian to induce bleeding. (The Foot-Yangming Meridian is below the head; its branch originates from below the stomach mouth, descends through the abdomen to Qichuan, near the spine. Thus, lumbar pain is treated by needling the Foot-Yangming to induce bleeding. Ping An: In *Suwen* and *Jiayi Jing*, "chen chen" is "jiji", [missing text] is [missing text], "jiang" has "pu" after it, and [missing text] has "zhong" after it. *Suwen* Xin Zhengjiao states: "*Taisu* writes 'tou chen chen ran'.")
For lumbar pain with cold in the upper part, needle Foot-Taiyang and Foot-Yangming; for heat in the upper part, needle Foot-Jueyin; for inability to flex/extend, needle Foot-Shaoyang; for heat in the middle part with panting, needle Foot-Shaoyin, and bleed at [missing text]. (For upper heat, tonify the Foot-Taiyang and Foot-Yangming meridians at the waist. For upper cold, sedate the Foot-Jueyin meridian at the waist. Foot-Shaoyang governs joint mechanics; for restricted movement, select Foot-Shaoyang. For middle heat with panting, bleed at [missing text] of Foot-Shaoyin. Ping An: Ru chuan in *Suwen* and *Jiayi Jing* is "er chuan". Note: "guan" is missing after "ji" in Yuan Ke's edition. The character missing after "zhong re" was annotated as "ji" in the original copy. Also, the note on upper heat/cold contradicts the text, suggesting an error.)
Lumbar pain radiating to the hypochondrium preventing extension is treated by needling the intersection of the lumbar and sacral regions at the upper gluteal muscles, using the number of needles based on the waxing/waning moon, with immediate relief upon withdrawal. ([Missing text], pronounced zhao. Shen refers to the muscles on both sides of the spinal column. Ping An: Liang shen shang in *Suwen* and *Jiayi Jing* is "liang huai shen shang". *Suwen* adds "left take right, right take left" after "li yi".)
For lumbar pain with cold in the painful area, select Foot-Taiyang; for heat, select Foot-Jueyin; for inability to flex/extend, select Foot-Taiyang; for middle heat with panting, select Foot-Shaoyin and bleed the [missing text] collateral. (Previous lumbar pain involved bleeding [missing text]; this involves [missing text]. Ping An: This section is absent in *Jiayi Jing*. In *Suwen*, it precedes the "lumbar pain radiating to hypochondrium" section, with slight textual differences. *Suwen* states: "Lumbar pain, upper cold unable to look back, needle Foot-Yangming; upper heat, needle Foot-Taiyin; middle heat with panting, needle Foot-Shaoyin. Difficulty in defecation, needle Foot-Shaoyin. Hypogastric fullness, needle Foot-Jueyin. Like breaking, unable to flex/extend or lift, needle Foot-Taiyang. Radiating to inner spine, needle Foot-Shaoyin." Xin Zhengjiao states: "According to Quan Qiqi's edition, *Jiayi Jing*, and *Taisu*, there is no text from 'lumbar pain upper cold' to here; it was added by Wang Bing." Re-examining this book, this section on upper cold matches the previous one, except for flexion/extension where Foot-Taiyang is needled, differing from Foot-Shaoyang. The note says the previous line bleeds [missing text], this line [missing text], implying they complement each other.)