帝承上编腹中满痛之义，而及于腰痛，则有取刺之法也。腹者，太阴经脉之所主。腰者，足三阳三阴
之脉及奇经八脉，皆从腰而上，故举足太阳、少阳、阳明、少阴、厥阴及奇经八脉，并解脉肉理，皆系于
腰而为痛，各随其脉以刺之。太阴主腹，故不复论。然太阴之络，亦令腰痛，故终举太阴之痛以结之。
足太阳脉，令人腰痛，引项脊，尻背为重状，刺其 中，太阳正经出血，春无见血。
中，委中也。足太阳之脉，从头下项，循脊背，抵腰中，下至于尻，故足太阳脉，令人腰痛，
则上引项脊而尻背各如状，当刺其委中，委中者，太阳正经之脉也；刺委中，更当出血，若春时木王，
借水气以生，太阳主寒水之气，故春刺委中，无见其血。
少阳令人腰痛，如以针刺其皮中，循循然不可以俯仰，不可以顾，刺少
阳成骨之端出血，成骨在膝外廉之骨独起者，夏无见血。
循循，渐次貌。顾，回顾也。腰者，身半上下之交，少阳主枢，居乎上下之间，故少阳令人腰痛，如
以针刺其腰之皮中，其痛渐次而上，故循循然，痛在于背，则不可以俯仰；痛在于项，则不可以
顾，当刺少阳成骨之端，而出其血。申明成骨之端，在膝外廉之骨而独起者是也。夏时火王，少
阳主相火之气，故夏刺成骨，无见其血。
阳明令人腰痛，不可以顾，顾为有见者，善悲。刺阳明于 前
三 ，上下和之，出血，秋无见血。
阳明之脉，起于鼻 中，行身之前，故阳明令人腰痛，不可以顾。顾，犹视也。申明不可顾者，非不
可回顾，乃顾则目中为有见者，然顾而有见，则善悲，当刺阳明于 前三 ， 前三 ，三里
上廉下廉也，故曰，上下和之，乃三里合上廉下廉以和之，而出其血也。秋时金王，阳明主燥金之气，故秋
刺前三 ，无见其血。
足少阴令人腰痛，痛引脊内廉，刺少阴于内踝上二 ，春无见血，出血太多，不可复也。
足少阴之脉，上股内后廉，贯脊属肾，故足少阴令人腰痛，其痛上引脊，下引内廉，当刺少阴于内
踝上左右太溪二 ，少阴之气藏于冬，发于春，故春刺内踝，无见其血，若春时出血太多，至冬
不可复藏也。按春夏秋皆言无见血，而冬时不言，意谓冬藏之时，阴血充满，三时皆不足也。
厥阴之脉，令人腰痛，腰中为张弓弩弦，刺厥阴之脉，在 踵
鱼腹之外，循之累累然，乃刺之，其病令人善言，默默然不慧，刺之三 。
厥阴之脉，循足而上，与肾脉相合，行于腰脊，故厥阴之脉令人腰痛，腰中为张弓弩弦，痛而强硬，不
柔和也。当刺厥阴之脉，在 踵鱼腹之外。 ，足肚也。踵，足跟也。鱼腹，足肚上也。
踵鱼腹之外侧，但循结络之累累然，乃刺之，其厥阴腰痛之病，当令人善言，《灵枢·九针论》云，肝主
语，本经《宣明五气篇》云，肝病为语，言即语也。病当令人善言，则默默然不慧，默默不慧，
肝气虚矣。刺治之法，仍在 、在踵、在鱼腹之三 ，肝虚故浅刺累累之路，不言出血也。此一节言足三
阳三阴之脉，令人腰痛，而有取刺之法也。
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， 外廉之横脉，出血，血变而止。
解，音蟹，下同。解，散也。解脉，周身横纹之脉散于皮肤间，
太阳之所主也。解脉令人腰痛，不能从腰而散于上，故痛引肩，不能从肩而散于头，故目KT KT 然。膀胱
水府之气不出于皮毛，故时遗溲。刺解脉在膝后筋肉相分之间乃 中外廉之横脉，当刺出其血，
血紫黑而变赤，即当止之，不可多出也。
解脉令人腰痛，为引带，常为折腰状，善恐，刺解脉在 中，
结络为黍米，刺之，血射以黑，见赤血而已。
折，音舌。解脉散于皮肤，不但行于上下，且迥绕周身，故解脉令人腰痛，为腰引带，痛则常为折
腰状。腰者肾之外候，肾气不充于腰，故善恐。刺解脉，在太阳正经之 中，视其结络为黍米，
乃刺之。结络，则络脉结而不荣，故血射以黑，见赤血而已，即上言血变而止之谓也。此言解脉腰痛，
常循太阳 中之络脉以刺之，而出其血也。
同阴之脉，令人腰痛，痛如小锤，居其中，怫然肿，刺同阴之脉在外踝上绝骨之端，为三 。
阳跷之脉，起于跟中，循外踝上风府，从阴出阳，故曰同阴。同阴之脉，令人腰痛，则
痛如小锤居其腰中，外则怫然而肿，刺同阴之脉，当在外踝上，并绝骨之端，为三 也。
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。
阳维维于阳，今阳维腰痛，不能维于阳，故痛上怫然肿，刺阳维之脉，其脉与太阳相合，在 下
间去地一尺所，乃阳维之 ，太阳承山穴也。夫阳维与太阳合，则阴维与少阴合关。
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，恶心归之，刺之在 阳筋之间，上 数寸横居，为二 ，出血。
衡，与横同。 ，浮 也。阳，会阳也。带脉横络于腰，故曰横络之脉，腰痛不可以俯仰，言不可以
俯而复仰也。如俯而仰，则恐仆矣，此得之举重伤腰，横络脉绝，周迥无所束，恶血聚而归之，
故痛也。刺之在浮 会阳大筋之间，申明会阳之穴，上浮 数寸，
横居臀下也，刺浮 会阳为二 ，而出血。
会阴之脉，令人腰痛，痛上漯漯然汗出。汗干，令人欲饮，饮
已欲走，刺直阳之脉上三 ，在跷上 下五寸，横居，视其盛者出血。
漯，音沓。会阴在大便之前，小便之后，任督二脉相会于前后二阴间，故曰会阴。任脉统任一身之阴，
督脉总督一身之阳。会阴腰痛，阴阳皆虚，痛上漯漯然汗出，阴气虚而阴液外注也。汗干令
人欲饮，饮已欲走，阳气虚而阳热外驰也。任督腰痛，当从阳以泻阴，故刺直阳之脉。直阳太阳，与督相
合之脉也。从跷从上刺其三 。三 者，刺阳跷之申脉，太阳之 中，又跷上 下，当相去五寸之承山，皆有
血络横居。视其盛者，刺出其血。由此言之，则跷与 ，及跷上 下，但刺横居之血络，不必拘于穴也。
飞阳之脉，令人腰痛，痛上怫怫然，甚则悲以恐，刺正阳之脉，
在内踝上五寸，少阴之前，与阴维之会。
飞阳，阴维之脉也。阴维之脉，起于足少阴之筑宾，今日飞阳者，《经脉》论云，足太阳之别，名曰
飞阳，去踝七寸，别走少阴，是飞阳乃别出于太阳，而仍走少阳也。怫怫，怒貌，痛上怫怫而肿，
如怒起状。阳维腰痛，痛上怫然肿。此阴维腰痛，痛上亦怫怫然，甚则少阴心虚而恐。少阴肾虚而恐，刺
式阳之脉，在内踝上五寸，乃阴维之 ，筑宾穴也。与少阴相合，故曰少阴之前，与阴维之会。
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 ，在内踝上，大筋前，太阴后，上踝二寸所。
阴跷之脉，亦起于跟中，循内踝而上，上循胸里，出人迎，交目内 ，起于足少阴之别，合于足太阳，故
曰昌阳。腰痛则不能上循胸里，故痛引膺，不能上交于目，故目KT KT 然，甚则少阴左阳不
相交接，致病太阳之反折。少阴之舌卷，不能言，当刺足内廉之筋，左右为二 ，申明内筋在足内踝上大
筋之前，太阳所过之后，上踝二寸所，乃阴跷之 ，交信穴也。
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 。
散，上声。散脉，冲脉也。冲脉起于胞中，秉阴血而澹渗皮肤，一为太阳通体之解脉，故曰散脉，血
不充于皮肤，故腰痛而身热，脉不散于胸中，故热甚生烦，不能右循背里，故腰下如有横木居其
中，不能从胞中而四散，故甚则遗溲。刺散脉，当在膝前之骨，犊鼻穴也。及肉分间，三里穴也。络外廉，上
廉穴也。三里在肉分间，乃足阳明之合穴，故曰束脉。刺前骨、刺肉分、刺外廉，是为三 。
此一节，言奇经八脉从腰而上，令人腰痛，各有取刺之法也。
肉里之脉，令人腰痛，不可以咳，咳则筋缩急，刺肉里之脉，
为二 ，在太阳之外，少阳绝骨之后。
里，理通。肉理，肌肉之文理也。肉理之脉，外通于皮，内通于筋，腰痛不可以咳，不能外通于皮也。
咳则筋缩急，不能内通于筋也。太阳主皮毛，主筋病，故刺肉理之脉为二 。在太阳之外，
少阳绝骨之后，太阳行身之首而向外，故曰太阳之外，少阳绝骨，在足之侧，故曰绝骨之后，乃太阳附
阳穴也，左右为二 。
腰痛侠脊而痛，至头，KT KT 然，目KT KT 欲僵仆，刺足太阳 中出血。
KT ，音殊。腰痛侠脊而痛，从腰上及于脊也。至头，KT KT 然，从脊上至于头也。太阳经脉起于
目内 ，从头下项，侠脊抵腰，经脉不舒，故目KT KT 欲僵仆，当刺足太阳之 中出血。此言肌肉，文
理，脊背，头项，腰痛，当刺足太阳，不但解脉腰痛，刺足太阳也。
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。中热而喘，刺足少阴，刺 中出血。
此言腰痛寒热，亦刺三阳三阴，不但三阳三阴之脉，令人腰痛而始刺也。腰痛上寒，乃阳气不升，
故刺足太阳阳明，所以升其阳气也。腰痛上热，乃阴气不升，故刺足厥阴，所以升其阴气也，不可
以俯仰，乃阴阳枢转不和，故刺足少阳，所以和其枢而使阴阳旋转也。
中热而喘，乃阳热内乘，阴寒外闭，故刺足少阴，所以调其阴阳水火，而内外安和也。太阳阳明厥阴少
阳少阴，未知所刺之处，故申明刺 中出血，言刺太阳，则如上文之刺 中出血。则知阳明之
刺，在 前。厥阴之刺在 踵，少阳之刺在成骨，少阴之刺在内
踝。此举一以例其余，上文言穴气而不及太阴，故此亦不言太阴也。
腰痛上寒不可以顾，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。
衍文。旧本注云，古本并无，王氏所添也。
腰痛引少腹，控 ，不可以仰，刺腰尻交者，两髁胂上，以月
生死为 数，发针，立已，左取右，右取左。
髁，窠同，音科，余篇仿此。此举太阴腰痛，为缪刺之法，言太阴之脉，行于腹中，而其孙络，亦在
于外也。本经缪刺论云，邪客于足太阴之络，令人腰痛，引少腹，控 ，不可以仰息。今腰痛
引少腹，控 ，不可以仰，是邪客于足太阴之络也。又云∶刺腰尻之解，两胂之上，是腰俞，以月生死为
数，发针在已，左刺右，右刺左。今刺腰尻交者，两髁胂上，以月生死为 数，发针立已，
左取右，右取左，是亦缪刺之法，不同于上文诸经之刺也。盖缪刺者，有痛而经不病者也，病在孙络之间，
毫毛之气，不相通贯，故以毫针通其孙络，左取右，右取左，刺数宜多，不循俞穴，故但以月生死为 数。一
日一 ，二日二 ，渐多之十五日，十五 ，十六日十四 ，渐少之，与解脉腰痛，刺太阳之 中者，又不同也。
黄帝承袭前篇关于腹部胀满疼痛的义理，进而论述腰痛，指出可以采用针刺的方法治疗。腹部，是太阴经脉所主管的区域。腰部，足三阳经、足三阴经以及奇经八脉，都从腰部向上延伸，因此，涉及足太阳、足少阳、足阳明、足少阴、足厥阴以及奇经八脉，还有解脉和肉理之脉，都与腰部相连并引起疼痛，应当根据各自所属的经脉进行针刺。太阴经主管腹部，所以不再单独论述。然而，太阴经的络脉也能导致腰痛，所以在最后列举太阴经引起的腰痛以作总结。
足太阳经脉，使人腰痛，疼痛牵引项部和脊背，臀部背部感觉沉重，应针刺委中穴，使足太阳正经出血，春季不宜放血。
委中，即委中穴。足太阳经脉，从头下行至项部，沿脊背，抵达腰部，向下至于臀部，所以足太阳经脉使人腰痛，就会向上牵引项脊，而臀部和背部呈现上述症状，应当针刺委中穴，委中穴是足太阳正经的脉气汇聚处；针刺委中穴，更应当放出血液，如果在春季，木气旺盛，借水气来生发，足太阳主寒水之气，所以春季针刺委中穴，不要使其出血。
足少阳经使人腰痛，痛感如同有针刺在皮肤中，逐渐地不能前后俯仰，也不能回头看，应针刺足少阳成骨端的穴位使其出血，成骨位于膝盖外侧突起独高的骨头处，夏季不宜放血。
循循，是逐渐的样子。顾，是回头看。腰部，是人体上下半身的交汇之处，足少阳主枢机，居于上下之间，所以足少阳使人腰痛，痛感如同针刺腰部皮肤之中，疼痛逐渐向上蔓延，所以感到“循循然”，疼痛在背部，就不能俯仰；疼痛在颈部，就不能回头，应当针刺足少阳成骨的末端，放出其血液。申明成骨的末端，就是膝盖外侧突起独高的骨头。夏季火气旺盛，足少阳主相火之气，所以夏季针刺成骨端，不要使其出血。
足阳明经使人腰痛，不能回头看，回头看时眼中似有幻视，且容易悲伤。应针刺足阳明经的前三里穴（上廉、下廉），上下调和，放出血液，秋季不宜放血。
足阳明经脉，起于鼻旁，行于身体前方，所以足阳明经使人腰痛，不能回头看。顾，犹可视作看。申明不能回头的意思，并非不能回顾，而是回顾时眼中会有所见（幻视），然而回顾且有见象时，就容易悲伤，应当针刺足阳明经的前三里穴，“前三里”指足三里穴的上廉和下廉，所以说“上下和之”，即通过足三里配合上廉、下廉来调和气血，并放出血液。秋季金气旺盛，足阳明主燥金之气，所以秋季针刺前三里，不要使其出血。
足少阴经使人腰痛，疼痛牵引脊骨内侧，应针刺足少阴经在内踝上方二寸处的穴位，春季不宜放血，如果出血过多，就无法恢复了。
足少阴经脉，上行于大腿内侧后缘，贯穿脊柱，属于肾脏，所以足少阴经使人腰痛，疼痛向上牵引脊骨，向下牵引内侧，应当针刺足少阴经在内踝上方左右各二寸处的太溪穴，少阴之气潜藏于冬季，发用于春季，所以春季针刺内踝，不要使其出血，如果在春季出血过多，到了冬季就无法再潜藏了。按春夏秋三季都说不要放血，而冬季没有说，意思是冬季是闭藏的时候，阴血充满，其他三季都不足。
足厥阴经的经脉，使人腰痛，腰部像拉紧的弓弩弦一样，应针刺足厥阴经的脉，位置在足跟鱼腹肌肉的外侧，顺着摸到有结节累累的地方，就进行针刺，这种病使人喜欢多说话，但又沉默痴呆，针刺三次。
足厥阴经脉，沿足部上行，与肾脉相合，行于腰脊，所以足厥阴经使人腰痛，腰部像拉紧的弓弩弦，疼痛且僵硬，不柔和。应当针刺足厥阴经的脉，位置在足肚（腓肠肌）鱼腹肌肉的外侧。“踵”指足跟，“鱼腹”指足肚上部。在足跟鱼腹的外侧，只要顺着摸到结络处累累突起，就进行针刺，这种厥阴腰痛病，应当使人喜欢多说话，《灵枢·九针论》说，肝主言语，本经《宣明五气篇》说，肝病表现为多语，言即语。病当使人喜欢多语，却又沉默痴呆，这是肝气虚的表现。针刺治疗的方法，仍在足跗、足跟、鱼腹这三个部位，因为肝虚所以浅刺这些路径，不说放血。这一节讲的是足三阳和三阴经的经脉，使人腰痛，并有相应的针刺方法。
解脉使人腰痛，疼痛牵引肩部，眼睛昏花不明，时常遗尿，应针刺解脉在膝后筋肉分界间，腘窝外廉的横脉，放出血液，血色变红即可停止。
解，音同蟹，下文相同。解，意为散。解脉，是周身横纹的脉散在于皮肤间的，由太阳经所主。解脉使人腰痛，疼痛不能从腰部散于上部，所以疼痛牵引肩部，不能从肩部散于头部，所以眼睛昏花不明。膀胱水府之气不出于皮毛，所以时常遗尿。针刺解脉的位置在膝后筋肉相分的中间，乃腘中外廉的横脉，应当刺出其血，血色紫黑变为红色，就应当停止，不可多出。
解脉使人腰痛，如带子牵引，常呈折腰状，容易恐惧，应针刺解脉在腘中，结络如黍米大小，针刺时，射出的血黑色，见到赤血就停止。
折，音同舌。解脉散于皮肤，不仅行于上下，而且环绕周身，所以解脉使人腰痛，如腰被带子牵引，疼痛时常常呈折腰状。腰部是肾脏的外候，肾气不充于腰部，所以容易恐惧。针刺解脉，在太阳正经的腘中，观察其结络如黍米大小，就进行针刺。结络，是指络脉结聚而不荣养，所以射出的血黑色，见到赤血就停止，即上面说的血变色就停止的意思。这说的是解脉腰痛，常沿着太阳腘中的络脉进行针刺，并放出血液。
同阴之脉，使人腰痛，痛如小锤敲击其中，怫然肿胀，应针刺同阴之脉在外踝上绝骨的末端，针刺三次。
阳跷脉，起于脚跟中部，沿外踝上行至风府，从阴出阳，所以叫同阴。同阴之脉使人腰痛，则痛如小锤居在腰部中间，外部则怫然肿胀，针刺同阴之脉，应当在外踝上，并绝骨的末端，针刺三次。
阳维之脉，使人腰痛，疼痛上部怫然肿胀，应针刺阳维之脉，该脉与太阳经相合，在腘下间，距离地面一尺左右。
阳维维系阳气，现在阳维腰痛，不能维系阳气，所以疼痛上部怫然肿胀，针刺阳维之脉，其脉与太阳经相合，在腘下间距离地面一尺左右，乃是阳维的附阳穴，也是太阳经的承山穴。夫阳维与太阳经相合，则阴维与少阴经相合关。
衡络之脉，使人腰痛，不能俯仰，仰视则恐跌倒，这是由于举重损伤腰部所致。衡络断绝，恶血归聚于此，针刺它在浮郄与会阳大筋之间，向上数寸横居处，针刺两次，放出血液。
衡，与横同。浮郄，浮郄穴。阳，会阳穴。带脉横络于腰部，所以叫横络之脉，腰痛不能俯仰，是说不能俯而复仰。如果俯而仰，则恐怕跌倒，这是因举重损伤腰部，横络脉断绝，周围无处束缚，恶血聚积而归于此，所以疼痛。针刺在浮郄与会阳大筋之间，申明会阳穴的位置，在浮郄上方数寸，横居在臀部下方，针刺浮郄、会阳为两次，并放出血液。
会阴之脉，使人腰痛，疼痛上部漯漯然汗出。汗干后，令人想喝水，喝完后想走动，应针刺直阳之脉上方三次，位置在阳跷上腘下五寸，横居处，观察其盛者放出血液。
漯，音同沓。会阴在大便之前，小便之后，任督二脉相会于前后二阴之间，所以叫会阴。任脉统任一身之阴，督脉总督一身之阳。会阴腰痛，阴阳皆虚，疼痛上部漯漯然汗出，是阴气虚而阴液外注。汗干令人想喝水，喝完后想走动，是阳气虚而阳热外驰。任督腰痛，应当从阳以泻阴，所以针刺直阳之脉。直阳是太阳经与督脉相合的脉。从阳跷向上刺其三次。三次，是指刺阳跷的申脉穴，太阳经的腘中穴，又在阳跷上腘下五寸的承山穴，都有血络横居。观察其盛的，刺出其血。由此而言，则阳跷、腘中，及阳跷上腘下，只要刺横居的血络，不必拘泥于穴位。
飞阳之脉，使人腰痛，疼痛上部怫怫然，严重时悲伤且恐惧，应针刺正阳之脉，在内踝上五寸，足少阴之前，与阴维脉交会处。
飞阳，是阴维之脉。阴维之脉，起于足少阴的筑宾穴，今日称飞阳者，《经脉》论说，足太阳之别，名叫飞阳，去踝七寸，别走少阴，是飞阳乃别出于太阳，而仍走少阴。怫怫，是怒的样子，疼痛上部怫怫而肿，如怒起状。阳维腰痛，痛上部怫然肿。此阴维腰痛，痛上部亦怫怫然，严重时少阴心虚而恐。少阴肾虚而恐，刺飞阳之脉，在内踝上五寸，乃是阴维的筑宾穴。与少阴相合，所以叫少阴之前，与阴维之会。
昌阳之脉，使人腰痛，疼痛牵引胸部，眼睛昏花不明，严重时角弓反张，舌头卷缩不能说话，应针刺内筋两处，在内踝上，大筋前，太阴经后，上踝二寸处。
阴跷之脉，也起于脚跟中部，沿内踝上行，上循胸里，出人迎，交于目内眦，起于足少阴之别，合于足太阳，所以叫昌阳。腰痛则不能上循胸里，所以疼痛牵引胸部，不能上交于目，所以眼睛昏花不明，严重时少阴与太阳不相交接，致病太阳经的角弓反张。少阴的舌卷，不能说话，应当刺足内廉的筋，左右共两处，申明内筋在足内踝上大筋之前，太阳经经过之后，上踝二寸处，乃是阴跷的交信穴。
散脉使人腰痛，且发热，热甚生烦，腰部下方如有横木居在其中，严重时遗尿，应针刺散脉，在膝前骨，筋肉分间，络脉外廉，束脉，针刺三次。
散，读上声。散脉，即冲脉。冲脉起于胞中，秉受阴血而澹渗皮肤，一为太阳通体的解脉，所以叫散脉，血不充于皮肤，所以腰痛且身热，脉不散于胸中，所以热甚生烦，不能右循背里，所以腰部下方如有横木居在其中，不能从胞中而四散，所以严重时遗尿。针刺散脉，应当在膝前的骨，犊鼻穴。及筋肉分间，足三里穴。络外廉，上廉穴。三里在筋肉分间，是足阳明的合穴，所以叫束脉。刺前骨、刺肉分、刺外廉，这就是三次。
这一节，讲的是奇经八脉从腰部向上，使人腰痛，各有取刺的方法。
肉里之脉，使人腰痛，不能咳嗽，咳嗽则筋脉收缩紧急，应针刺肉里之脉，为两次，在太阳经之外，少阳绝骨之后。
里，与理通。肉理，肌肉的纹理。肉理之脉，外通于皮，内通于筋，腰痛不能咳嗽，是不能外通于皮。咳嗽则筋缩急，是不能内通于筋。太阳主皮毛，主筋病，所以刺肉理之脉为两次。在太阳经之外，少阳绝骨之后，太阳行于身之首向外，所以叫太阳之外，少阳绝骨，在足的侧面，所以叫绝骨之后，乃是太阳经的附阳穴，左右共两次。
腰痛夹脊而痛，直到头部，头目昏花不明，眼睛昏花欲僵仆，应针刺足太阳经的腘中穴出血。
KT，音殊。腰痛夹脊而痛，是从腰上及于脊。至头，KT然，是从脊上至于头。太阳经脉起于目内眦，从头下项，夹脊抵腰，经脉不舒，所以眼睛昏花欲僵仆，应当刺足太阳的腘中穴出血。这说的是肌肉、文理、脊背、头项、腰痛，应当刺足太阳，不仅是解脉腰痛刺足太阳。
腰痛上部寒冷，针刺足太阳、阳明经，上部发热，针刺足厥阴经，不能俯仰，针刺足少阳经。中部发热而气喘，针刺足少阴经，刺腘中穴出血。
这说的是腰痛寒热，也刺三阳三阴经，不仅是三阳三阴经的经脉使人腰痛才刺。腰痛上部寒冷，是阳气不升，所以刺足太阳阳明经，用来升其阳气。腰痛上部发热，是阴气不升，所以刺足厥阴经，用来升其阴气，不能俯仰，是阴阳枢转不和，所以刺足少阳经，用来和其枢机而使阴阳旋转。
中部发热而气喘，是阳热内乘，阴寒外闭，所以刺足少阴经，用来调其阴阳水火，而内外安和。太阳、阳明、厥阴、少阳、少阴，不知所刺之处，所以申明刺腘中穴出血，说刺太阳，就如上文之刺腘中穴出血。则知阳明的刺，在胫前。厥阴的刺在足跟，少阳的刺在成骨，少阴的刺在内踝。此举一例以类推其余，上文讲穴位气而不及太阴，所以此处也不言太阴。
腰痛上部寒冷不能回顾，针刺足阳明经，上部发热刺足太阴经。中部发热而气喘，刺足少阴经。大便困难，刺足少阴经。小腹胀满，刺足厥阴经，如折断不能俯仰，不能举起，刺足太阳经；疼痛牵引脊骨内侧，刺足少阴经。
衍文。旧本注云，古本并无，王氏所添也。
腰痛牵引少腹，控引睾丸，不可以仰卧，应刺腰尻交者，两髁胂上，以月亮的盈亏决定针刺次数，发针后，立刻痊愈，左病取右，右病取左。
髁，同窠，音科，余篇仿此。此举太阴腰痛，为缪刺之法，言太阴之脉，行于腹中，而其孙络，也在外面。本经缪刺论说，邪客于足太阴之络，使人腰痛，牵引少腹，控引睾丸，不可以仰息。今腰痛牵引少腹，控引睾丸，不可以仰，是邪客于足太阴之络也。又说：刺腰尻之解，两胂之上，是腰俞穴，以月亮的盈亏决定次数，发针在已，左刺右，右刺左。今刺腰尻交者，两髁胂上，以月亮的盈亏决定针刺次数，发针立愈，左取右，右取左，这也是缪刺之法，不同于上文诸经的刺法。盖缪刺者，是有痛而经不病者也，病在孙络之间，毫毛之气，不相通贯，所以用毫针通其孙络，左取右，右取左，刺数宜多，不循俞穴，所以但以月亮的盈亏决定次数。一日一针，二日两针，渐多至十五日十五针，十六日十四针，渐少之，与解脉腰痛，刺太阳经的腘中者，又不同也。
The Yellow Emperor, following the principles of abdominal fullness and pain discussed in the previous chapter, proceeds to discuss lower back pain, indicating that acupuncture can be employed. The abdomen is governed by the Taiyin (Great Yin) meridians. The lower back is where the Foot Triple Yang (Taiyang, Shaoyang, Yangming), Foot Triple Yin (Taiyin, Shaoyin, Jueyin) meridians, and the Eight Extraordinary Vessels ascend. Therefore, pathologies involving the Foot Taiyang, Foot Shaoyang, Foot Yangming, Foot Shaoyin, Foot Jueyin, the Eight Extraordinary Vessels, as well as the Xie Mai (Resolving Vessels) and Rouli Mai (Muscle Interior Vessels), all relate to the lower back and cause pain; treatment should follow the specific meridian involved. Since the Taiyin governs the abdomen, it is not discussed separately here. However, the collaterals of the Taiyin can also cause lower back pain, so Taiyin-induced pain is listed at the end for summary.
Foot Taiyang Meridian pathology causes lower back pain, with radiation to the neck and spine, and a heavy sensation in the buttocks and back. Acupuncture should be applied to Weizhong (BL32) to bleed the main channel of the Foot Taiyang. Bleeding should be avoided in Spring.
Weizhong refers to Weizhong (BL37). The Foot Taiyang meridian descends from the head through the neck, follows the spine, reaches the waist, and continues to the buttocks. Thus, Foot Taiyang lower back pain radiates upward to the neck and spine, presenting with heaviness in the buttocks and back. One should needle Weizhong, which is the convergence point of the Foot Taiyang main channel. When needling Weizhong, bleeding is indicated. However, in Spring, when Wood Qi is dominant and generates Water Qi, and since Foot Taiyang governs Cold Water Qi, bleeding should be avoided at Weizhong during Spring.
Foot Shaoyang Meridian pathology causes lower back pain, feeling like a needle prick in the skin, gradually preventing flexion and extension, and inability to look back. Acupuncture should be applied to the end of the Chenggu bone on the Foot Shaoyang to induce bleeding. The Chenggu bone is the solitary prominence on the lateral side of the knee. Bleeding should be avoided in Summer.
"Xunxun" describes a gradual progression. "Gu" means looking back. The waist is the junction of the upper and lower body. Foot Shaoyang governs the pivot mechanism, situated between the upper and lower parts. Therefore, Foot Shaoyang lower back pain feels like a needle prick in the skin, with pain gradually ascending ("Xunxun"). If pain is in the back, flexion and extension are restricted; if in the neck, looking back is restricted. One should needle the end of the Chenggu bone of the Foot Shaoyang and bleed. The Chenggu bone end is the solitary prominence on the lateral knee. In Summer, when Fire Qi is dominant, and Foot Shaoyang governs Ministerial Fire Qi, bleeding should be avoided at the Chenggu point during Summer.
Foot Yangming Meridian pathology causes lower back pain, with inability to look back. Looking back may present with visual disturbances and a tendency toward sadness. Acupuncture should be applied to the anterior Sanli points (Shanglian and Xiaolian) of the Foot Yangming to harmonize up and down and induce bleeding. Bleeding should be avoided in Autumn.
The Foot Yangming meridian originates beside the nose and runs along the front of the body. Thus, Foot Yangming lower back pain prevents looking back. "Gu" implies seeing. The inability to look back does not mean physical impossibility, but rather that looking back induces visual phenomena ("you jian"), which leads to sadness. One should needle the anterior Sanli points. "Qian Sanli" refers to Shanglian and Xiaolian above and below Zusanli (ST36). Harmonizing up and down involves combining Zusanli with Shanglian and Xiaolian to regulate Qi and blood, inducing bleeding. In Autumn, when Metal Qi is dominant, and Foot Yangming governs Dry Metal Qi, bleeding should be avoided at the anterior Sanli points during Autumn.
Foot Shaoyin Meridian pathology causes lower back pain, with pain radiating to the medial aspect of the spine. Acupuncture should be applied to the Foot Shaoyin two cun above the medial malleolus. Bleeding should be avoided in Spring. Excessive bleeding cannot be replenished.
The Foot Shaoyin meridian ascends along the posterior medial thigh, penetrates the spine, and connects to the Kidney. Thus, Foot Shaoyin lower back pain radiates up the spine and down the medial aspect. One should needle Taixi (KI3), located two cun above the medial malleolus on both sides. Shaoyin Qi stores in Winter and emerges in Spring. Therefore, bleeding should be avoided at the medial malleolus in Spring. If excessive bleeding occurs in Spring, it cannot be stored in Winter. Note that while Spring, Summer, and Autumn advise against bleeding, Winter does not; this implies that during Winter's storage phase, Yin blood is abundant, whereas in the other three seasons, it is insufficient.
Foot Jueyin Meridian pathology causes lower back pain, with the waist feeling tight like a bowstring. Acupuncture should be applied to the Foot Jueyin meridian on the lateral side of the calf muscle (Yu Fu), beyond the Achilles tendon area. Where nodules are palpable, needle them. This condition causes excessive talking yet mental dullness. Needle three times.
The Foot Jueyin meridian ascends along the foot, merges with the Kidney meridian, and runs along the waist and spine. Thus, Foot Jueyin lower back pain makes the waist feel tight like a bowstring, painful and stiff, lacking flexibility. Needle the Foot Jueyin meridian on the lateral side of the calf muscle ("Zhong" refers to the calf/Achilles area; "Yu Fu" refers to the belly of the calf). Beyond the Yu Fu, palpate for nodular collaterals and needle them. This Jueyin lower back pain causes excessive talking ("shan yan"). *Ling Shu: Nine Needles* states the Liver governs speech; *Su Wen: Xuan Ming Wu Qi Pian* states Liver disease manifests as excessive speech. Yet the patient appears silent and dull, indicating Liver Qi deficiency. Treatment involves shallow needling at the foot dorsum, heel, and Yu Fu areas without bleeding due to Liver deficiency. This section discusses how the Foot Triple Yang and Triple Yin meridians cause lower back pain and their respective acupuncture methods.
Xie Mai (Resolving Vessel) pathology causes lower back pain, radiating to the shoulder, with blurry vision ("Ku Ku") and occasional urinary incontinence. Acupuncture should be applied to the transverse vessel outside the lateral margin of the popliteal crease between muscle and tendon divisions. Induce bleeding until the blood color changes.
"Xie" sounds like "xie" (crab). "Xie" means scattered. Xie Mai refers to vessels scattered in the skin along transverse lines, governed by the Taiyang. Xie Mai lower back pain cannot disperse upward from the waist, hence radiation to the shoulder; it cannot disperse from the shoulder to the head, hence blurry vision. Bladder Water Qi fails to emerge through the skin, causing urinary incontinence. Needle the transverse vessel in the popliteal crease, lateral to the center. Bleed until the dark purple-black blood turns red, then stop; do not bleed excessively.
Xie Mai pathology causes lower back pain, feeling like a band pulling the waist, often presenting as a bent-waist posture, with frequent fear. Acupuncture should be applied to the Xie Mai in the popliteal crease where nodules resemble millet grains. Bleed black blood until red blood appears.
"Zhe" sounds like "she". Xie Mai scatters in the skin, running not only up and down but also around the body. Thus, Xie Mai lower back pain feels like a band pulling the waist, often causing a bent-waist posture. The waist is the external manifestation of the Kidney; insufficient Kidney Qi in the waist causes fear. Needle the Xie Mai in the popliteal crease of the main Taiyang channel. Observe nodular collaterals resembling millet grains and needle them. Nodular collaterals indicate stagnation without nourishment, so black blood shoots out; stop when red blood appears, as stated previously. This describes treating Xie Mai lower back pain by needling the Taiyang collateral in the popliteal crease and bleeding.
Tongyin Mai pathology causes lower back pain, feeling like a small hammer striking the center, with sudden swelling. Acupuncture should be applied to the Tongyin Mai at the end of the Juegu bone above the lateral malleolus. Needle three times.
The Yang Qiao meridian originates in the heel, ascends along the lateral malleolus to Fengfu, emerging from Yin to Yang, hence called Tongyin. Tongyin Mai lower back pain feels like a hammer strike in the waist center, with external swelling. Needle the Tongyin Mai at the end of the Juegu bone above the lateral malleolus, three times.
Yang Wei Mai pathology causes lower back pain, with sudden swelling at the painful site. Acupuncture should be applied to the Yang Wei Mai, which combines with the Taiyang, in the popliteal space, about one chi above the ground.
Yang Wei maintains Yang Qi. Yang Wei lower back pain indicates failure to maintain Yang, causing swelling. Needle the Yang Wei Mai, which merges with Taiyang, in the popliteal space one chi above the ground. This is the Fuyang point of Yang Wei, also known as Chengshan of the Taiyang. Yang Wei merges with Taiyang, just as Yin Wei merges with Shaoyin.
Heng Luo Mai pathology causes lower back pain, preventing flexion and extension. Extension may cause fear of falling. This results from lifting heavy weights injuring the waist. Heng Luo vessels are severed, and evil blood gathers there. Acupuncture should be applied between the large tendons of Fupi and Huiyang, horizontally located several cun above Fupi. Needle twice and bleed.
"Heng" is synonymous with "Huo" (transverse). "Fupi" is Fupi (BL58). "Yang" is Huiyang (BL35). The Dai Mai crosses the waist, hence Heng Luo Mai. Lower back pain prevents flexion and re-extension. Attempting to extend after flexion causes fear of falling. This is caused by heavy lifting severing the Heng Luo vessels, leaving no binding force, allowing evil blood to gather and cause pain. Needle between the large tendons of Fupi and Huiyang. Huiyang is located several cun above Fupi, horizontally in the gluteal region. Needle Fupi and Huiyang twice and bleed.
Huiyin Mai pathology causes lower back pain, with profuse sweating ("Taota") over the painful area. After sweat dries, thirst arises; after drinking, restlessness ensues. Acupuncture should be applied to the Zhiyang Mai three times above, located five cun below the popliteal crease on the Yang Qiao, horizontally. Bleed where vessels are prominent.
"Ta" sounds like "ta". Huiyin is anterior to the anus and posterior to the urethra, where Ren and Du meridians meet. Ren governs Yin; Du governs Yang. Huiyin lower back pain indicates Yin and Yang deficiency. Profuse sweating indicates Yin deficiency with leakage of Yin fluids. Thirst after drying sweat and restlessness after drinking indicate Yang deficiency with outward rushing of Yang heat. For Ren-Du lower back pain, treat from Yang to drain Yin. Needle the Zhiyang Mai, which combines Taiyang and Du. Needle three times above the Yang Qiao. These three points are Shenmai (BL62) of Yang Qiao, Weizhong (BL40) of Taiyang, and Chengshan (BL57) five cun below the popliteal crease on Yang Qiao, all having horizontal blood vessels. Bleed prominent vessels. Thus, for Yang Qiao, Weizhong, and Chengshan, needle horizontal vessels regardless of specific acupoints.
Feiyang Mai pathology causes lower back pain, with swelling and anger-like appearance ("Fufu") at the painful site. Severe cases involve sadness and fear. Acupuncture should be applied to the Zhengyang Mai, five cun above the medial malleolus, anterior to the Shaoyin, at the intersection with the Yin Wei.
Feiyang is the Yin Wei meridian. Yin Wei originates at Zhubin (KI9) of Foot Shaoyin. Today called Feiyang, *Jing Mai* states Foot Taiyang branch is named Feiyang, seven cun from the ankle, diverging to Shaoyin. Feiyang diverges from Taiyang but still travels to Shaoyin. "Fufu" describes anger/swelling. Yang Wei lower back pain causes swelling. This Yin Wei lower back pain also causes swelling; severe cases involve Shaoyin Heart deficiency leading to fear, and Kidney deficiency leading to fear. Needle Feiyang, five cun above the medial malleolus, which is Zhubin of Yin Wei. It merges with Shaoyin, hence "anterior to Shaoyin, meeting Yin Wei."
Changyang Mai pathology causes lower back pain, radiating to the chest, with blurry vision ("Ku Ku"). Severe cases involve opisthotonos and tongue retraction preventing speech. Acupuncture should be applied to the inner tendon twice, above the medial malleolus, anterior to the large tendon, posterior to Taiyin, two cun above the ankle.
Yin Qiao originates in the heel, ascends along the medial malleolus, follows the chest interior, passes Yingchang, meets at the inner canthus, originates from Foot Shaoyin branch, and merges with Foot Taiyang, hence Changyang. Lower back pain prevents ascent to the chest, radiating to the chest; prevents connection to the eyes, causing blurry vision. Severe cases involve failure of Shaoyin and Taiyang interaction, causing opisthotonos. Shaoyin tongue retraction prevents speech. Needle the inner tendon of the foot twice. Inner tendon is anterior to the large tendon, posterior to Taiyang passage, two cun above the medial malleolus, which is Jiaoxin (KI8) of Yin Qiao.
San Mai pathology causes lower back pain with heat. Severe heat causes irritability. A sensation of a horizontal wood block in the lower waist. Severe cases involve urinary incontinence. Acupuncture should be applied to San Mai at the anterior knee bone, between muscle and tendon, lateral to the collateral, binding the vessel. Needle three times.
"San" is pronounced with rising tone. San Mai is Chong Mai. Chong originates in the Baozhong, carries Yin blood, and permeates the skin. It is one of the Taiyang resolving vessels, hence San Mai. Insufficient blood in the skin causes lower back pain and body heat. Failure to disperse in the chest causes irritability. Failure to follow the back causes the sensation of a horizontal block in the lower waist. Failure to disperse from Baozhong causes urinary incontinence. Needle San Mai at the anterior knee bone (Dubi/ST35), between muscle and tendon (Zusanli/ST36), and lateral collateral (Shanglian/ST34). Zusanli is the He-Sea point of Foot Yangming, hence "binding the vessel." Needling anterior bone, muscle-tendon junction, and lateral collateral constitutes three needles. This section discusses how the Eight Extraordinary Vessels ascending from the waist cause lower back pain with specific acupuncture methods.
Rouli Mai pathology causes lower back pain, preventing coughing. Coughing causes tendon contraction and urgency. Acupuncture should be applied to Rouli Mai twice, outside Taiyang, posterior to Shaoyang Juegu.
"Li" is synonymous with "Li" (texture). Rouli refers to muscle texture. Rouli Mai connects externally to skin and internally to tendons. Lower back pain preventing coughing indicates failure to connect to skin. Coughing causing tendon contraction indicates failure to connect to tendons. Taiyang governs skin and tendons. Needle Rouli Mai twice. Outside Taiyang, posterior to Shaoyang Juegu. Taiyang runs outward on the body's surface; Shaoyang Juegu is on the lateral foot. This is Fuyang (BL59) of Taiyang, left and right twice.
Lower back pain flanking the spine, extending to the head, with blurry vision and desire to collapse. Acupuncture should be applied to Weizhong of Foot Taiyang to bleed.
"Shu" sounds like "shu". Lower back pain flanking the spine extends to the back. Extending to the head causes blurry vision and desire to collapse. Taiyang originates at the inner canthus, descends from head through neck, flanks spine to waist. Meridian stagnation causes blurry vision and desire to collapse. Needle Weizhong of Foot Taiyang to bleed. This covers muscle, texture, spine, head/neck, and lower back pain, requiring needling Foot Taiyang, not just for Xie Mai lower back pain.
Upper cold in lower back pain: needle Foot Taiyang and Yangming. Upper heat: needle Foot Jueyin. Inability to flex/extend: needle Foot Shaoyang. Internal heat with panting: needle Foot Shaoyin. Bleed Weizhong.
This addresses cold/heat in lower back pain, needling Triple Yang and Triple Yin, not just meridian pathologies. Upper cold indicates failing Yang Qi ascent; needle Taiyang/Yangming to raise Yang. Upper heat indicates failing Yin Qi ascent; needle Jueyin to raise Yin. Inability to flex/extend indicates disharmony of Yin-Yang pivot; needle Shaoyang to harmonize pivot and rotate Yin-Yang. Internal heat with panting indicates internal attacking Yang heat and external closing Yin cold; needle Shaoyin to regulate Yin-Yang water-fire and harmonize interior/exterior. Regarding Taiyang, Yangming, Jueyin, Shaoyang, Shaoyin locations, Weizhong bleeding is clarified. Taiyang needles Weizhong. Yangming needles Tibia anterior. Jueyin needles heel. Shaoyang needles Chenggu. Shaoyin needles medial malleolus. This example illustrates the rest. Previous text mentioned acupoint Qi excluding Taiyin; this excludes Taiyin too.
Upper cold in lower back pain preventing looking back: needle Foot Yangming. Upper heat: needle Foot Taiyin. Internal heat with panting: needle Foot Shaoyin. Difficulty defecating: needle Foot Shaoyin. Lower abdominal fullness: needle Foot Jueyin. Broken-like inability to flex/extend or lift: needle Foot Taiyang. Pain radiating to medial spine: needle Foot Shaoyin.
Apocryphal text. Old editions note this is absent in ancient texts, added by Wang Bing.
Lower back pain radiating to lower abdomen, controlling the testicles, preventing supine position. Acupuncture should be applied to the crossing of Yaoqi, above the two condyles and gluteal muscles. Number of needles based on moon waxing/waning. Upon needle withdrawal, cure is immediate. Left take Right, Right take Left.
"He" is same as "Ke", sound "ke". This illustrates Taiyin lower back pain using Miao Ci (Counter-point) method. Taiyin meridian runs in abdomen, its fine collaterals are external. *Su Wen: Miao Ci Lun* states Evil invading Foot Taiyin collateral causes lower back pain radiating to lower abdomen, controlling testicles, preventing supine breathing. Current symptoms indicate Evil in Foot Taiyin collateral. Also: needle solution of Yaoqi, above two gluteal muscles, Yaoshu point. Number of needles by moon phase. Upon withdrawal, cure. Left needle Right, Right needle Left. Current instruction: needle crossing of Yaoqi, above two condyles/gluteal muscles, number by moon phase, immediate cure, Left take Right, Right take Left. This is Miao Ci, different from previous meridian needling. Miao Ci treats pain without meridian disease, pathology in fine collaterals. Hair-skin Qi is not connected, so use fine needle to open fine collaterals, Left take Right, Right take Left. Needle count should be high, not following acupoints, thus using moon phase. One day one needle, two days two needles, increasing to fifteen days fifteen needles. Sixteen days fourteen needles, decreasing. This differs from Xie Mai lower back pain needling Taiyang Weizhong.