枳壳 桂心 片子姜黄（各半两） 炙甘草（一钱五分）
肝气胁痛，此方主之。
肝藏血而主怒，故病则气血俱病。越人云∶东方常实，实则可以泻矣，故用枳壳破其气，
姜黄利其郁，桂心能引二物至于痛处。又曰∶木香桂而柔，以故用之。乃甘草者，取其和缓
之气，以调肝木之急尔。
叙曰∶腰者，肾之府，水火之司，有生之根也。善调之，则根固而叶荣。不善调之，则
根枯而叶萎。考方四首，而治腰之大者见矣。
破故纸（酒浸少时，略炒） 川萆 （童便浸一宿） 杜仲（姜汁炒断丝） 黄柏（盐
水炒） 知母（酒炒） 牛膝（去芦，各四两） 胡桃肉（去皮，炮，八两）
蜜丸。
肾虚腰痛者，此方主之。
肾，坎象也，水火并焉。水衰，则阳光独治，而令肾热。火衰，则阴翳袭之，而令肾寒。
水火俱衰，则土气乘之，而邪实于肾，均之令人腰痛也。是方也，破故纸、杜仲、胡桃，味
浓而温；黄柏、知母、牛膝，味浓而寒。温者可使养阳，寒者可使养阴，均之味浓，则均之
能走下部矣。若萆 者，苦燥之品，足以利水土之邪而平其气也。曰青娥者，涵阳之坎也，
假之以名方，明其全夫水火之真尔。
独活 细辛 牛膝 桑寄生（如无，用续断） 秦艽 茯苓 桂心 白芍药（酒炒） 人
参防
每服五钱。
肾气虚弱，肝脾之气袭之，令人腰膝作痛，屈伸不便，冷痹无力者，此方主之。
肾，水脏也，虚则肝脾之气凑之，故令腰膝实而作痛；屈伸不便者，筋骨俱病也。《灵
枢经》曰∶能屈而不能伸者，病在筋。能伸而不能屈者，病在骨。故知屈伸不便，为筋骨俱
病也。冷痹者，阴邪实也。无力者，气血虚也。是方也，独活、寄生、细辛、秦艽、防风、
桂心，辛温之品也，可以升举肝脾之气。肝脾之气升，则腰膝弗痛矣。当归、熟地、白芍、
川芎、杜仲、牛膝者，养阴之品也，可以滋补肝肾之阴。肝肾之阴补，则足得血而能步矣。
人参、茯苓、甘草者，益气之品也，可以长养诸脏之阳。诸脏之阳生，则冷痹去而有力矣。
Atractylodis Macrocephalae Pericarpium (Zhike), Cinnamon Twig (Guixin), Turmeric Rhizome (Pianzi Jianghuang) (each 0.5 liang), Prepared Licorice Root (Zhi Gancao) (1.5 qian).
For hypochondriac pain caused by Liver Qi stagnation, this formula is indicated.
The Liver stores Blood and governs anger; therefore, when diseased, both Qi and Blood are affected. Yue Ren (Bian Que) stated: "The East [Liver corresponds to Wood and the East] is often full; since it is full, it can be purged." Thus, Atractylodis Macrocephalae Pericarpium is used to break Qi, Curcuma Longa Rhizome (Jianghuang) is used to relieve stagnation, and Cinnamon Twig guides these two herbs to the site of pain. It is also said that "Wood fragrance harmonizes with Cinnamon," hence they are used. As for Licorice Root, its mild and緩 (huan) nature is utilized to moderate the urgency of Liver Wood.
Narrative: The waist is the mansion of the Kidney, the pivot of Water and Fire, and the root of life. If well regulated, the root remains firm and the leaves flourish; if poorly regulated, the root withers and the leaves collapse. Examining these four formulas reveals the major principles for treating waist pain.
Psoraleae Fructus (Po Gu Zhi) (soaked in wine briefly, lightly stir-fried), Dioscoreae Hypoglaucae Rhizome (Chuan Bi Xie) (soaked in children's urine overnight), Eucommiae Cortex (Du Zhong) (stir-fried with ginger juice until fibers break), Phellodendri Cortex (Huang Bo) (stir-fried with salt water), Anemarrhenae Rhizome (Zhi Mu) (stir-fried with wine), Achyranthis Bidentatae Radix (Niu Xi) (remove radicle, each 4 liang), Juglandis Semen (Hu Tao Rou) (peeled, processed, 8 liang).
Form pills with honey.
For lumbar pain due to Kidney Deficiency, this formula is indicated.
The Kidney symbolizes the Kan trigram, containing both Water and Fire. If Water declines, Yang Fire dominates alone, causing Kidney Heat; if Fire declines, Yin Cold invades, causing Kidney Cold. If both Water and Fire decline, Earth Qi takes advantage, leading to Excess pathogenic factors in the Kidney, all resulting in lumbar pain. In this formula, Psoraleae Fructus, Eucommiae Cortex, and Juglandis Semen are rich in flavor and warm; Phellodendri Cortex, Anemarrhenae Rhizome, and Achyranthis Bidentatae Radix are rich in flavor and cold. Warm substances nourish Yang, while cold substances nourish Yin. Since all are rich in flavor, they all act on the lower part of the body. As for Dioscoreae Hypoglaucae Rhizome, it is a bitter-drying substance sufficient to promote the drainage of Damp-Water pathogens and calm their Qi. Named "Qing E" (Blue Aphrodisiac), referring to the Kan trigram containing Yang, the name implies the completeness of true Water and Fire.
Angelicae Pubescentis Radix (Duhuo), Asari Radix et Rhizoma (Xixin), Achyranthis Bidentatae Radix (Niu Xi), Taxilli Herba (Sang Jisheng) (if unavailable, use Dipsaci Radix Xu Duan), Gentianae Macrophyllae Radix (Qin Jiao), Poria (Fuling), Cinnamon Twig (Guixin), Paeoniae Radix Alba (Baishao) (stir-fried with wine), Ginseng Radix et Rhizoma (Renshen), Angelicae Sinensis Radix (Danggui), Rehmanniae Radix Praeparata (Shudi), Chuanxiong Rhizoma (Chuanxiong), Saposhnikoviae Radix (Fangfeng), Glycyrrhizae Radix et Rhizoma (Gancao) [Note: Original text lists ingredients partially or with formatting errors, translated based on standard context where implied].
Take 5 qian per dose.
For lumbar and knee pain, difficulty in flexion and extension, cold bi-syndrome with weakness, caused by Kidney Qi Deficiency with invasion by Liver and Spleen Qi, this formula is indicated.
The Kidney is a Water organ; when deficient, Liver and Spleen Qi converge upon it, causing Excess and pain in the waist and knees. Difficulty in flexion and extension indicates disease in both sinews and bones. The *Ling Shu* states: "Ability to flex but not extend indicates disease in sinews; ability to extend but not flex indicates disease in bones." Thus, difficulty in flexion and extension signifies disease in both sinews and bones. Cold bi-syndrome indicates Excess of Yin pathogens; weakness indicates Deficiency of Qi and Blood. In this formula, Angelicae Pubescentis Radix, Taxilli Herba, Asari Radix et Rhizoma, Gentianae Macrophyllae Radix, Saposhnikoviae Radix, and Cinnamon Twig are acrid-warm substances that can raise Liver and Spleen Qi. When Liver and Spleen Qi rise, lumbar and knee pain ceases. Angelicae Sinensis Radix, Rehmanniae Radix Praeparata, Paeoniae Radix Alba, Chuanxiong Rhizoma, Eucommiae Cortex, and Achyranthis Bidentatae Radix are Yin-nourishing substances that can tonify Liver and Kidney Yin. When Liver and Kidney Yin are tonified, the feet receive Blood and can walk. Ginseng Radix et Rhizoma, Poria, and Glycyrrhizae Radix et Rhizoma are Qi-boosting substances that can nurture the Yang of various organs. When the Yang of various organs grows, cold bi-syndrome dissipates and strength returns.