经曰∶腰者肾之腑。若痘疮而见前症者，皆因肾经虚怯，相火内燥，真阴不能胜邪，故腰作痛也。急服地黄丸，以
防变黑归肾，乃克有济。大抵此痘，因禀赋肾家精气不足，故目睛多白，俗谓之折腰痘是也。若平素面白，眼白睛多，
行迟语迟者，出痘必归肾经。预为调补肾气，庶免此患。
一小儿十三岁，眼睛多白，或时面赤，常患颈痛，尺脉洪数，先君谓禀肾气虚，用地黄丸料，煎服而愈。至十五岁
出痘，先君云须多服前药，仍用地黄丸、益气汤，更加倦怠，乃以地黄丸大剂，煎与恣饮，又用大剂八珍汤，痘渐出，
如式，恪服前药，至期岁，二药计十七斤余而愈。先君每见婴儿白睛多，面色白，或色赤，令其预补脾肾，以防出痘，
但信者少耳。
一小儿出痘腰痛，足热发渴。此禀肾虚火动也，先君用大剂加减八味丸料，煎与恣饮，诸症渐退，佐以大剂八珍加
紫草、糯米数剂，脓渐贯，仍以前药而结痂，用八珍汤而靥。
一小儿出痘将愈，因停食泄泻，作渴腰痛，此脾肾虚弱也，先君用加减八味丸料，及五味异功散，渴泻顿止；又与
六味丸料及八珍汤而靥。
一小儿出痘，愈后腰足作痛，此禀足三阴虚也，用六味丸料煎服，及补中益气汤而愈。后又伤食，作泻腰痛，用四
神丸、六味丸而愈。
一小儿面色常白，目睛多白，时常腰痛，两足时热，冬不衣绵，年九岁，先君谓禀肾虚，令每日服地黄丸，至十岁，
出痘腰痛，发渴面赤饮冷，用地黄丸，每剂加肉桂半钱，煎
与恣饮，数剂之后，热渴顿止，腰痛顿愈，却去肉桂，仍与服之，至五十余剂而靥。
一小儿痘愈后，腰痛口渴，两足生疮，饮水不绝，此禀足三阴虚，先君用地黄丸、益气汤。至毕姻后，不慎起居，
复患瘰 ，以致不起。
一小儿面素白，发热作渴，或面生疮，先君谓肾虚，用加味地黄丸、补中益气汤而愈。后出痘腰痛，仍用前药而痊。
次年毕姻，患肾 而卒。
加味地黄丸
熟地黄（酒浸蒸丸晒干，八两，酒杵杵膏）
山茱萸肉 干山药 五味子（炒，各四两） 泽泻 白茯苓 牡丹皮 鹿茸（炙。各三两） 肉桂（浓者去皮取肉，
一两，发热者以此加之，引虚火归肾经而热自止也）
上各另为末，入地黄和匀，量入米糊丸服，煎服更好。
六味地黄丸
五味异功散
补中益气汤
八珍汤（方见顶陷灰白）
二神丸
四神丸（二方见痘作泻）
八味丸（即六味丸加附子、肉桂，各一两，方见痘作渴）
The *Yellow Emperor's Inner Classic* states: The waist is the mansion of the Kidney. If the aforementioned symptoms appear during smallpox, it is due to deficiency and weakness of the Kidney Meridian, with ministerial fire stirring internally causing dryness, and true Yin failing to overcome the pathogenic factor, thus resulting in waist pain. One should urgently administer Dihuang Wan (Rehmannia Pill) to prevent the rash from turning black and returning to the Kidney, which will ensure efficacy. Generally, this type of smallpox arises from congenital insufficiency of essence and Qi in the Kidney, hence the eyes have more white than black, commonly known as "broken-waist smallpox." If one usually has a pale complexion, more white in the eyes, delayed walking, and delayed speech, the smallpox will inevitably return to the Kidney Meridian. Preemptively regulating and tonifying Kidney Qi may avoid this affliction.
A thirteen-year-old child had eyes with more white than black, occasional facial redness, frequent neck pain, and a chi pulse that was flooding and rapid. My late father attributed this to congenital Kidney Qi deficiency and prescribed Dihuang Wan decoction, which resulted in a cure. At fifteen years old, when he developed smallpox, my late father advised continuing the previous medication, using Dihuang Wan and Yiqi Tang (Qi-Supplementing Decoction). The child became increasingly fatigued, so a large dose of Dihuang Wan was decocted for free consumption, along with a large dose of Bazhen Tang (Eight-Treasure Decoction). The rash emerged gradually and normally. Strict adherence to these medications led to recovery after consuming over seventeen jin (approx. 8.5 kg) of the two medicines by the scabbing stage. Whenever my late father observed infants with prominent whites in the eyes, pale or reddish complexions, he advised preemptive tonification of Spleen and Kidney to prevent complications during smallpox eruption, though few believed him.
Another child presented with waist pain, hot feet, and thirst during smallpox. This indicated congenital Kidney deficiency with stirring of deficient fire. My late father administered a large dose of Jiawei Bawei Wan (Modified Eight-Ingredient Pill) decoction for free consumption, leading to gradual subsidence of symptoms. He supplemented this with several doses of a large dose of Bazhen Tang added with Zicao (Arnebiae Radix seu Rhizoma) and Nuomi (Oryzae Semen Glutinosum), allowing pus to fill the lesions. The scabs formed using the previous medication, and the crusts fell off using Bazhen Tang.
A third child, nearing recovery from smallpox, suffered from food stagnation-induced diarrhea, thirst, and waist pain, indicating Spleen and Kidney deficiency. My late father used Jiawei Bawei Wan decoction and Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder), which immediately stopped the thirst and diarrhea. Subsequently, Liuwei Wan (Six-Ingredient Pill) decoction and Bazhen Tang were given to facilitate crust shedding.
A fourth child experienced waist and foot pain after recovering from smallpox, attributed to congenital deficiency of the Foot Three Yin meridians (Liver, Spleen, Kidney). Treatment with Liuwei Wan decoction and Buzhong Yiqi Tang (Middle-Warmer Qi-Supplementing Decoction) resulted in recovery. Later, following dietary injury causing diarrhea and waist pain, Sishen Wan (Four-Spirit Pill) and Liuwei Wan cured the condition.
A fifth child, aged nine, often had a pale face, eyes with more white than black, frequent waist pain, hot feet, and refused cotton clothing in winter. My late father diagnosed congenital Kidney deficiency and ordered daily Dihuang Wan. At ten years old, during smallpox onset with waist pain, fever, thirst, and desire for cold drinks, Dihuang Wan was prescribed with half a qian (approx. 2.5g) of Rougui (Cinnamomi Cortex) per dose, taken freely. After several doses, fever and thirst ceased, and waist pain resolved. Rougui was then removed, and the base formula continued for over fifty doses until crust shedding.
A sixth child suffered from waist pain, thirst, and ulcers on both feet with incessant drinking after smallpox recovery, indicating congenital deficiency of the Foot Three Yin meridians. My late father treated with Dihuang Wan and Yiqi Tang. After marriage, neglecting lifestyle regulation, he contracted scrofula (luoli) and eventually died.
A seventh child, usually pale-faced, presented with fever, thirst, and occasional facial sores. My late father attributed this to Kidney deficiency and prescribed Jiawei Dihuang Wan (Modified Rehmannia Pill) and Buzhong Yiqi Tang, resulting in recovery. Later, during smallpox with waist pain, the same medications cured him. He married the following year, developed kidney disease, and died.
**Jiawei Dihuang Wan (Modified Rehmannia Pill)**
Shudihuang (Prepared Rehmanniae Radix, soaked in wine, steamed, dried, pounded into paste, 8 liang)
Shanzhuyu (Corni Fructus)
Ganshan Yao (Dioscoreae Rhizoma)
Wuweizi (Schisandrae Fructus, stir-fried, 4 liang each)
Zexie (Alismatis Rhizoma)
Baifuling (Poria with Hostwood)
Mudanpi (Moutan Cortex)
Lurong (Cervi Cornu Pantotrichum, roasted, 3 liang each)
Rougui (Cinnamomi Cortex, peeled meat from thick bark, 1 liang; add if feverish to guide deficient fire back to the Kidney meridian, stopping heat naturally)
Grind all ingredients separately into fine powder, mix evenly with Shudihuang, form pills with rice paste for oral administration; decoction is also effective.
**Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill)**
**Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder)**
**Buzhong Yiqi Tang (Middle-Warmer Qi-Supplementing Decoction)**
**Bazhen Tang (Eight-Treasure Decoction)** (See formula for depressed gray-white rash)
**Ershen Wan (Two-Spirit Pill)**
**Sishen Wan (Four-Spirit Pill)** (See formulas for smallpox-induced diarrhea)
**Bawei Wan (Eight-Ingredient Pill)** (i.e., Liuwei Wan plus Fuzi (Aconiti Lateralis Radix Preparata) and Rougui (Cinnamomi Cortex), 1 liang each; See formula for smallpox-induced thirst)