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Medical texts state: "The waist is the mansion of the Kidney; if the waist aches, the Kidney Qi is about to fail." To say that waist pain indicates failing Kidney Qi is indeed an accurate assertion. However, regarding the statement that the waist is the mansion of the Kidney, further research is needed. Why? In all cases of human waist pain, the pain occurs at the spine, which is actually governed by the Du Mai (Governing Vessel). The Du Mai is the spinal canal within the spine, connecting inferiorly to the Mingmen acupoint (Gate of Life), serving as the body's accessory kidney (therefore, it cannot be called the mansion of the Kidney). When the Kidney is deficient, the Du Mai must also be deficient, leading to waist pain. To treat this syndrome, one should use formulas that tonify the Kidney and guide them into the Du Mai. I once formulated the Yidu Wan (Benefit the Du Pill), which, when taken slowly, cures waist pain caused by Kidney deficiency after about a month.

[Yidu Wan]: Duzhong Cortex Eucommiae (4 liang), soaked in wine and stir-fried until yellow; Tusizi Semen Cuscutae (3 liang), soaked in wine and steamed until cooked; Xuduan Radix Dipsaci (2 liang), soaked in wine and steamed until cooked; Lujiaojiao Colla Cornu Cervi (2 liang). Grind the first three herbs into fine powder, dissolve the Lujiaojiao in water, and form pills the size of soybeans. Take 3 qian per dose, twice daily. After taking the medicine, chew and swallow one ripe Juglans regia kernel (walnut).

Various materia medica texts claim that Duzhong should be stir-fried until the fibers break. However, upon investigation, even when stir-fried to charcoal, the fibers remain intact, making such processing inappropriate. Therefore, this formula uses raw Duzhong processed only until it turns yellow. Walnut kernels are originally excellent medicines for tonifying the Kidney, but due to their high oil content, they are unsuitable for pill formation; thus, they are taken separately after taking the pills.

If the syndrome is accompanied by Qi deficiency, Huangqi Radix Astragali and Renshen Radix Ginseng decoction can be used to send down the pills. If accompanied by Blood deficiency, Shudihuang Rhizoma Rehmanniae Praeparata and Danggui Radix Angelicae Sinensis decoction can be used.

For those with waist pain due to blood stasis, the patient may have overburdened themselves with heavy loads, fallen from a height, or suffered a sprain or fall, resulting in blood stasis within the spine causing pain. It is appropriate to treat with Huoluo Xiaoling Dan (Activate the Collaterals and Relieve Pain Elixir), adding 3 qian of Banchong (Eupolyphaga/Swallowtail), decocted in water for oral administration; using Congbai Scallion Stem as a guiding herb yields better results.

Patient Li XX suffered from waist pain for several years without cure. During severe pain episodes, he constantly felt chest fullness and oppression; during mild episodes, the pain was vague and lingering; yet there were also periods of several days without pain. His pulse was deep and wiry on the left, and deep and firm on the right. He stated he had suffered for three years, taking hundreds of prescriptions, yet the pain never lessened. Observing his previous prescriptions, although varied, they largely consisted of herbs that tonify the Liver and Kidney and strengthen sinews and bones, occasionally mixed with wind-dispelling herbs. Recalling the *Neijing* stating "patency leads to no pain," this case demonstrates "pain implies lack of patency." Furthermore, given the deep/wiry and deep/firm pulses, along with constant chest fullness, it is evident that his joints and collaterals have stagnation and obstruction. Thus, I prescribed a formula to benefit the joints and unblock the collaterals, supplemented with herbs to tonify healthy Qi.

Sheng Huai Shanyao Rhizoma Dioscoreae (1 liang), Da Gan Gouqizi Fructus Lycii (8 qian), Danggui Radix Angelicae Sinensis (4 qian), Danshen Radix Salviae Miltiorrhizae (4 qian), Sheng Ming Moyao Resina Mastichis (4 qian), Sheng Wulingzi Faeces Trogopterori (4 qian), Chanshanjia Squama Manis (2 liang, stir-fried and crushed), Taoren Semen Persicae (2 qian), Honghua Flos Carthami (1.5 qian), Banchong Insectus Eupolyphagae (5 specimens), Guang Sanqi Radix Notoginseng (2 qian, finely crushed).

Total eleven ingredients. First, decoct the initial ten ingredients in a large cup of water, and take half of the finely crushed Sanqi powder with the decoction. When decocting the dregs for the second dose, take the remaining half of the Sanqi powder.

After taking three doses, the waist pain ceased, chest fullness disappeared, and the pulse became more relaxed, no longer exclusively deep. Subsequently, remove Chanshanjia from the original formula and add 4 qian of walnut kernels. After continuously taking ten doses, he felt physically light and refreshed. Upon re-examination, the pulses in all six positions were balanced, and the waist pain was eradicated. From this case, we observe that for individuals who are not emaciated but suffer from waist pain, it is largely due to obstruction in the joints and collaterals; for those who are obviously emaciated with waist pain, it is likely due to depletion of the Liver and Kidney.

In women, waist pain often occurs during menstruation. I once treated a woman over thirty years old who habitually experienced shortness of breath and seemed to fear cold foods/drinks. During menstruation, she felt a bearing-down sensation and pain in the waist. Her pulse was forceless and slightly slow. I determined that her Upper Jiao Great Qi was deficient and sinking, causing shortness of breath; during menstruation, as Qi and Blood descended, the Great Qi sank with it, causing the bearing-down pain in the waist. I prescribed: Sheng Jian Huangqi Radix Astragali (1 liang), Guizhi Ramulus Cinnamomi Acuminati Apices, Danggui Radix Angelicae Sinensis, and Sheng Ming Moyao Resina Mastichis, each 3 qian. After seven to eight doses, the illness was cured.

I also treated a woman who suffered from waist pain and abdominal pain during menstruation. Her pulse exhibited a choppy quality, indicating Blood stasis in the Blood aspect. Treatment used Danggui Radix Angelicae Sinensis and Sheng Jineijin Gizzard Membrane Gallus Galli Jasmatis, each 3 qian; Sheng Ming Moyao Resina Mastichis, Sheng Wulingzi Faeces Trogopterori, Sheng Jian Huangqi Radix Astragali, and Tianhuafen Radix Trichosanthis, each 4 qian. After several doses, she was completely cured.