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Treats diseases caused by damp-heat, with pain throughout the limbs, joints, shoulders, back, and whole body. The pain flows into the hands and feet, unbearable in intensity.

Bai Zhu (Atractylodis Rhizoma, 1.5 qian), Qiang Huo (Notopterygii Rhizoma et Radix), Huang Qin (Scutellariae Radix, wine-fried), Yin Chen (Artemisiae Scopariae Herba, wine-fried), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 5 qian), Ren Shen (Ginseng Radix), Dang Gui (Angelicae Sinensis Radix), Ku Shen (Sophorae Flavescentis Radix, wine-washed), Sheng Ma (Cimicifugae Rhizoma), Ge Gen (Puerariae Lobatae Radix), Cang Zhu (Atractylodis Rhizoma, each 2 qian), Zhu Ling (Polyporus), Fu Ling (Poria), Ze Xie (Alismatis Rhizoma), Zhi Mu (Anemarrhenae Rhizoma), Fang Feng (Saposhnikoviae Radix, each 3 qian). Use one liang per dose, decoct in water and take orally.

Jiang Huang (Curcumae Longae Rhizoma, 4 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), Qiang Huo (Notopterygii Rhizoma et Radix), Bai Zhu (Atractylodis Rhizoma, each 1 liang). Take one liang per dose, decoct in water and take orally.

Wei Ling Xian (Clematidis Radix et Rhizoma, 8 fen), Nan Xing (Arisaematis Rhizoma preparatum), Ban Xia (Pinelliae Rhizoma preparatum), Bai Zhu (Atractylodis Rhizoma), Xiang Fu (Cyperi Rhizoma), Jiu Qin (Scutellariae Radix, wine-fried, each 1 qian), Cang Zhu (Atractylodis Rhizoma, 2 qian), Chen Pi (Citri Reticulatae Pericarpium), Fu Ling (Poria, each 5 fen), Gan Cao (Glycyrrhizae Radix et Rhizoma, a little). Decoct in wine and water and take orally.

Treats arm pain preventing lifting, and various ailments of the shoulder and back.

Pian Zi Jiang Huang (Curcumae Longae Rhizoma, 4 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), Qiang Huo (Notopterygii Rhizoma et Radix, each 1 liang), Chi Shao Yao (Paeoniae Radix Rubra), Hai Tong Pi (Sarcandae Cortex, remove outer bark), Bai Zhu (Atractylodis Rhizoma), Dang Gui (Angelicae Sinensis Radix, each 2 liang). Take five qian per dose, decoct in ginger water. Before taking, grind in a small amount of Chen Xiang (Aquilariae Lignum Resinatum). For conditions below the waist, take before meals; for conditions above the waist, take after meals.

Lumbago (lower back pain) may be due to Kidney deficiency, damp-heat, phlegm, Qi stagnation, or blood stasis from trauma. A pulse that is large but forceless indicates deficiency; a wiry pulse indicates Yin deficiency; a choppy pulse indicates dead blood (blood stasis); a deep and slippery pulse indicates phlegm-fluids; a deep and fine pulse indicates Qi stagnation; a soggy and weak pulse indicates dampness; a tight and rapid pulse indicates wind. Pain from cold sensation必然 presents with a tight pulse; the waist feels as if immersed in water; pain decreases with heat and increases with cold. Pain from dampness feels like sitting in water; the body feels heavy, the pulse is slow, and it invariably occurs on cloudy days. Wind causes a floating pulse, pain without fixed location, radiating to both legs. Heat causes a surging and rapid pulse, thirst, constipation, and pain upon movement as if pierced by needles; the pulse is choppy and stool is black. Urine may be yellow or black; symptoms are lighter during the day and heavier at night, indicating blood stasis. Pain from Qi stagnation involves unbearable distension and fullness; the pulse is necessarily deep and wiry or hidden and knotted. If accompanied by phlegm accumulation, the pulse will additionally be slippery. In women, lumbago may accompany irregular menstruation with heat signs, or turbid Qi sinking with excessive leukorrhea; a bout of lower back pain followed by discharge of white matter exemplifies this. Lumbago in boys is due to congenital insufficiency. Lumbago and back pain from prolonged reading/sitting or playing chess belong to deficiency. However, obese individuals may have concurrent damp-phlegm, while thin individuals have insufficient Blood and Yin deficiency. If all pains are severe and red spots suddenly appear on the face, death is likely. Severe lumbago should not be treated with Qi-tonifying or cold/cooling herbs. Initially, warm-dispersing herbs must be added to harmonize Blood and promote Qi circulation; later, Kidney-tonifying herbs are essential. Examples include Xu Duan (Dipsaci Radix), Tu Si Zi (Cuscutae Semen), Rou Gui (Cinnamomi Cortex), Gou Qi (Lycii Fructus), Du Zhong (Eucommiae Cortex), Niu Xi (Achyranthis Bidentatae Radix), etc., with a small amount of Zhi Fu Zi (Aconiti Lateralis Radix Preparata) added as a guiding herb to direct action downward, which is optimal. Wind is dispersed using Ma Huang (Ephedrae Herba), Fang Feng (Saposhnikoviae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix). Cold is warmed using Jiang (Zingiberis Rhizoma), Fu Zi (Aconiti Lateralis Radix Preparata), Gui (Cinnamomi Cortex), Rong (Cervi Cornu Pantotrichum). Sprains and strains are treated by promoting circulation using Dang Gui (Angelicae Sinensis Radix), Tao Ren (Persicae Semen), Hong Hua (Carthami Flos), Gu Sui Bu (Drynariae Rhizoma). Blood stasis is expelled using Qian Niu (Pharbitidis Semen), Tao Ren (Persicae Semen), Da Huang (Rhei Radix et Rhizoma), Yan Hu Suo (Corydalis Rhizoma), Ju He (Citri Reticulatae Pericarpium Viride), Xue Jie (Santalum Rubrum). Damp-phlegm flowing and accumulating is guided out using Cang Zhu (Atractylodis Rhizoma), Xiang Fu (Cyperi Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), Ju Pi (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Rhizoma preparatum), Fu Ling (Poria); however, Qi-promoting herbs must assist so that phlegm moves with Qi.

The *Ling Shu* states: "If the Kidney is small, the zang organs are secure and difficult to injure; if the Kidney is large, lumbago easily occurs." There are also differences such as high Kidney, low Kidney, firm Kidney, fragile Kidney, upright Kidney, and tilted Kidney. Observing these reveals that many cases stem from congenital constitution. If disease arises from disharmony and pathogen invasion, the *Classic* states: "What arrives at Tai Yang manifests as lumbago." This is because the Foot-Taiyang Bladder Meridian passes through the waist; when the meridian is deficient, pathogens lodge therein. Li Dongyuan stated: "Generally, cold-dampness is more common than wind-heat; both cold and heat lumbago originate from Kidney deficiency. However, if pathogens are involved, they must be eliminated. If there are no external pathogens, only Kidney tonification is needed." Thus, lumbago from sexual exhaustion is due to Kidney deficiency, where Yang Qi is weak and unable to move. The *Classic* states: "The waist is the mansion of the Kidney; inability to twist and turn indicates the Kidney is failing." Suitable formulas include Shen Qi Wan (Kidney Qi Pill), Lu Rong Wan (Deer Antler Pill), Yang Shen Wan (Sheep Kidney Pill), Hui Xiang Wan (Fennel Pill), etc., to supplement insufficient Yang. Individuals consuming rich foods who take herbal decoctions long-term, or engage in sex while drunk, damage their True Qi, leading to Kidney heat causing lumbago and spinal pain preventing lifting. Prolonged cases result in reduced marrow and withered bones, developing into bone萎 (bone atrophy/withering). Suitable formulas include Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia), Feng Sui Dan (Phoenix Marrow Pill), etc., to supplement insufficient Yin. Anger injuring the Liver and worry injuring the Spleen can also cause lumbago; treat according to the affected organ. However, Tai Yang lumbago refers to external contraction of the six climatic factors; Kidney Meridian lumbago refers to internal injury from sexual desire. The waist is the external manifestation of the Kidney; all meridians penetrate the Kidney and network the waist. Once Kidney Qi is deficient, the waist inevitably hurts. Trauma does not involve deficiency, but even if wind-cold-damp-heat pathogens exist externally, they invade via deficiency. Ultimately, the invading pathogen is the branch (biao), while Kidney deficiency is the root (ben). Sexual excess depletes essence and scatters true Yuan Qi; if the Kidneys are injured, how can the Bladder remain sufficient? One must distinguish between Yin and Yang syndromes: fatigue, clear and profuse urination, and a fine, forceless pulse indicate Yang deficiency; yellow-red urine, occasional deflagration of deficient fire, and a surging but forceless pulse indicate Yin deficiency. Zhu Danxi said: "Chronic lumbago must use Guan Gui (Cinnamomi Cortex) to open the channels."

Shen Zhuo (Kidney Fixation) disease arises from meridian deficiency and dampness invasion. Symptoms include heavy body, cold waist, feeling as if sitting in water, normal diet, spontaneous diarrhea without thirst, and a waist feeling heavy as if carrying five thousand coins. Treatment should focus on draining dampness and using warm, mild herbs so that sufficient Yang Qi naturally restores movement and health.

Lumbago may belong to dampness: six pulses are deep, soggy, or hidden; knees ache faintly or feel numb/swollen; the whole body feels heavy, worsening on cloudy days. Initially, mild exterior-releasing methods are suitable, followed by diuresis. It may belong to damp-heat: pulse is soggy, fine, and rapid; pain extends from waist and hips to swollen feet, moving up or down, swelling or reddening, with red and scanty urination. Suitable treatment is to leach out dampness and clear heat using Dang Gui Nian Tong Tang (Angelica Ligusticiloides Decoction for Relieving Pain). It may belong to phlegm-flowing: pulse is deep, slippery, or wiry; pain alternates between waist and umbilicus; nausea and dizziness indicate phlegm. Those who were fat but are now thin have phlegm. Suitable treatment is to resolve phlegm and move Qi using modified Huo Tan Tang (Phlegm-Resolving Decoction) with Qiang Huo, Du Huo, Er Zhu (two Atractylodes), and Er Chen Tang. It may belong to Yin deficiency: pulse is fine and rapid, or both Chi pulses are surging; body is emaciated; soles of feet and calves hurt, making standing impossible. Suitable treatment is to nourish Yin and descend fire using Si Wu Tang (Four Substances Decoction) plus Zhi Mu (Anemarrhenae Rhizoma), Huang Bo (Phellodendri Cortex), Niu Xi (Achyranthis Bidentatae Radix), Du Zhong (Eucommiae Cortex). It may belong to Yang deficiency: pulse is deep, weak, or hollow-large; both feet are edematous; stool is loose; urine is short; pain prevents movement. This belongs to Ming Men Fire decline and extreme True Yang deficiency. Use Bu Zhong Yi Qi Tang plus Gui (Cinnamomi Cortex) and Fu Zi (Aconiti Lateralis Radix Preparata), or Jin Kui Shen Qi Wan (Kidney Qi Pill from Golden Cabinet). Because the lower part is distant, Wu Tou (Aconiti Radix) and Fu Zi cannot reach effectively. Damp-heat, turbid phlegm, and long-standing stagnation require Wu Tou and Fu Zi to open the pathways. If the anterior aspect belongs to Yangming, use Bai Zhi (Angelicae Dahuricae Radix) and Sheng Ma (Cimicifugae Rhizoma) as guides; posterior aspect belongs to Taiyang, use Qiang Huo (Notopterygii Rhizoma et Radix) and Fang Feng (Saposhnikoviae Radix) as guides; lateral aspect belongs to Shaoyang, use Chai Hu (Bupleuri Radix) as guide; medial aspect belongs to Jueyin, use Qing Pi (Citri Reticulatae Pericarpium Viride) and Wu Zhu Yu (Evodiae Fructus) as guides; medial-anterior aspect belongs to Taiyin, use Cang Zhu (Atractylodis Rhizoma) and Bai Shao (Paeoniae Radix Alba) as guides. Thus, treatment methods are comprehensive.