腰痛肾虚风寒湿，痰饮气滞与血瘀，湿热闪挫凡九种，面忽红黑定难医。
【注】腰痛之证，其因不同，有肾虚、有风，有寒、有湿、有痰饮、有气滞、有血瘀、
有湿热、有闪挫，凡患腰痛极甚，而面色忽红忽黑，是为心肾交争，难治之证也。
安肾丸
腰痛悠悠虚不举，寄生青娥安肾丸，胡芦骨脂川楝续，桃杏茴苓山药盐。
【注】寄生，谓独活寄生汤。青娥丸，即补骨脂、杜仲、核桃仁也。安肾丸，即胡芦
巴、补骨脂、川楝肉、川续断、桃仁、杏仁、小茴香、茯苓，山药也。盐，盐汤为引也。
羌活胜湿汤 通经丸
腰痛属寒得热减，五积吴萸桃杜安，寒湿重着胜湿附，内实通经硫面牵，风痛无常
掣引足，经虚当用寄生痊，经实非汗不能解，续命汤加牛杜穿。
【注】五积散，加吴茱萸、桃仁、杜仲。羌活胜湿汤，即防风通气汤加附子也，通经
丸，即硫黄、黑牵牛头末，麦面合丸煮，浮起服，方出《本草》。小续命汤加牛膝，杜仲、
炒穿山甲也。
通气散 活络丹
气滞闪挫通气散，木陈穿索草茴牵，血瘀不移如锥刺，日轻夜重活络丹。
【注】通气散，即木香、陈皮、穿山甲、元胡索、甘草、小茴香、白牵牛也。活络丹，
即川乌、草乌、南星、地龙、乳香、没药也。加五灵脂、麝香尤效。
苍柏散 煨肾散
湿热热注足苍柏，二妙牛杜己瓜芎，腰如物覆湿痰蓄，煨肾椒盐遂有功。
【注】苍柏散，即苍术、黄柏、牛膝、杜仲、防己、木瓜、川芎也。煨肾散，即猪腰
子剖开，入川椒、食盐、甘遂末，湿纸裹煨，熟酒食之。
Lumbago is primarily caused by Kidney deficiency, Wind-Cold-Dampness pathogenic factors, as well as Phlegm-Fluid retention, Qi stagnation, and Blood stasis. Combined with Damp-Heat and traumatic injury (Flash trauma), there are nine types in total. If the patient's complexion suddenly turns red or black, it indicates a critical condition that is difficult to treat.
[Note] The etiology of lumbago varies. Causes include Kidney deficiency, Wind, Cold, Dampness, Phlegm-Fluid retention, Qi stagnation, Blood stasis, Damp-Heat, and traumatic injury. In cases of severe lumbago where the facial complexion fluctuates between red and black, this signifies a struggle between Heart and Kidney energies, representing a refractory syndrome.
Anshen Wan (Kidney-Anchoring Pill)
For lingering lumbago accompanied by deficiency and weakness, one may use Du Huo Ji Sheng Tang (Radix Angelicae Pubescentis and Radix Salviae Decoction) combined with Qing E Wan (Black-Eyed Bean Pill), formulated as Anshen Wan. The ingredients include: Semen Phaseoli Volubilis (Huluba), Fructus Psoraleae (Bogushizi), Fructus Toosendanii (Chuanlianzhou), Radix Datiscae Caulis (Xuanduan), Semen Persicae (Taoren), Semen Armeniacae Amarum (Xingren), Fructus Foeniculi (Xiaohuixiang), Poria (Fuling), Rhizoma Dioscoreae (Shanyao), taken with Salt Water as a guide.
[Note] "Jisheng" refers to Du Huo Ji Sheng Tang (Radix Angelicae Pubescentis and Radix Salviae Decoction). "Qing E Wan" consists of Fructus Psoraleae (Bogushizi), Cortex Eucommiae (Duzhong), and Semen Juglandis (Hetaoren). "Anshen Wan" comprises Semen Phaseoli Volubilis (Huluba), Fructus Psoraleae (Bogushizi), Fructus Toosendanii (Chuanlianzhou), Radix Datiscae Caulis (Xuanduan), Semen Persicae (Taoren), Semen Armeniacae Amarum (Xingren), Fructus Foeniculi (Xiaohuixiang), Poria (Fuling), and Rhizoma Dioscoreae (Shanyao). "Salt" indicates using Salt Water as a medicinal guide.
Qiang Huo Sheng Shi Tang (Notopterygium Decoction for Overcoming Dampness) & Tongjing Wan (Meridian-Penetrating Pill)
Lumbago due to Cold pathogens improves with heat application. If associated with Wuji San (Five Accumulations Powder), add Radix Coptidis (Wuzhuyu - *Correction: Evodiae Fructus*), Semen Persicae (Taoren), and Cortex Eucommiae (Duzhong). For heavy Cold-Dampness causing stiffness, use Qiang Huo Sheng Shi Tang (Notopterygium Decoction for Overcoming Dampness) with Radix Aconiti Lateralis Preparata (Fuzi). For internal excess obstructing meridians, use Tongjing Wan (Meridian-Penetrating Pill): Sulfur (Liuhuang) and Black Morning Glory Seed powder (Heiqianniu Toumo) mixed with Wheat Flour (Maimian), boiled into pills; consume those that float. This formula originates from Bencao. For wind-induced pain that is erratic and radiates to the feet, if the meridians are deficient, Du Huo Ji Sheng Tang (Radix Angelicae Pubescentis and Radix Salviae Decoction) should be used for recovery. If the meridians are excess, diaphoresis is required to resolve it; use Xiao Xuming Tang (Minor Rescue Life Decoction) added with Radix Achyranthis Bidentatae (Niuxi), Cortex Eucommiae (Duzhong), and Stir-fried Squama Manitis (Chuanshanjia).
[Note] Wuji San (Five Accumulations Powder) is modified with Fructus Evodiae (Wuzhuyu), Semen Persicae (Taoren), and Cortex Eucommiae (Duzhong). Qiang Huo Sheng Shi Tang (Notopterygium Decoction for Overcoming Dampness) is Fangfeng Tongqi Tang (Saposhnikovia Decoction for Ventilating Qi) plus Radix Aconiti Lateralis Preparata (Fuzi). Tongjing Wan (Meridian-Penetrating Pill) consists of Sulfur (Liuhuang) and Black Morning Glory Seed powder (Heiqianniu Toumo) mixed with Wheat Flour (Maimian), boiled into pills; consume those that float. The formula is cited from Bencao. Xiao Xuming Tang (Minor Rescue Life Decoction) is added with Radix Achyranthis Bidentatae (Niuxi), Cortex Eucommiae (Duzhong), and Stir-fried Squama Manitis (Chuanshanjia).
Tongqi San (Qi-Ventilating Powder) & Huoluo Dan (Meridian-Unblocking Pill)
Lumbago due to Qi stagnation or traumatic injury (Flash trauma) can be treated with Tongqi San (Qi-Ventilating Powder). Ingredients: Radix Aucklandiae (Muxiang), Pericarpium Citri Reticulatae (Chenpi), Squama Manitis (Chuanshanjia), Radix Corydalis Yanhusuo (Yanhusuo), Radix Glycyrrhizae (Gancao), Fructus Foeniculi (Xiaohuixiang), and White Morning Glory Seed (Baiqianniu). For fixed Blood stasis with stabbing pain, worse at night than during the day, use Huoluo Dan (Meridian-Unblocking Pill).
[Note] Tongqi San (Qi-Ventilating Powder) contains Radix Aucklandiae (Muxiang), Pericarpium Citri Reticulatae (Chenpi), Squama Manitis (Chuanshanjia), Radix Corydalis Yanhusuo (Yanhusuo), Radix Glycyrrhizae (Gancao), Fructus Foeniculi (Xiaohuixiang), and White Morning Glory Seed (Baiqianniu). Huoluo Dan (Meridian-Unblocking Pill) contains Radix Aconiti Karakolicum (Chuanwu), Radix Aconiti Kusnezoffii (Caowu), Rhizoma Pinelliae Preparatum (Nanxing), Pheretima (Dilong), Resina Boswelliae (Ruxiang), and Resina Myrrhae (Moyao). Adding Pilula Astagi (Wulingzhi) and Moschus (Shexiang) enhances efficacy.
Cangbai San (Atractylodes and Phellodendron Powder) & Weishen San (Roasted Kidney Powder)
Damp-Heat pouring down to the lower limbs is treated with Cangbai San (Atractylodes and Phellodendron Powder). Ingredients: Rhizoma Atractylodis Macrocephalae (Cangzhu), Cortex Phellodendri (Huangbai), Radix Achyranthis Bidentatae (Niuxi), Cortex Eucommiae (Duzhong), Radix Stephaniae Tetrandrae (Fangji), Fructus Chaenomelis (Mugua), and Radix Chuanxiong (Chuanxiong). A sensation of heaviness on the waist like an object covering it indicates accumulation of Damp-Phlegm, which can be effectively treated with Weishen San (Roasted Kidney Powder).
[Note] Cangbai San (Atractylodes and Phellodendron Powder) consists of Rhizoma Atractylodis Macrocephalae (Cangzhu), Cortex Phellodendri (Huangbai), Radix Achyranthis Bidentatae (Niuxi), Cortex Eucommiae (Duzhong), Radix Stephaniae Tetrandrae (Fangji), Fructus Chaenomelis (Mugua), and Radix Chuanxiong (Chuanxiong). Weishen San (Roasted Kidney Powder) involves slicing a pig kidney, inserting Zanthoxylum Bungeanum (Chuanjiao), Sodium Chloride (Yan), and Rhizoma Kansui (Gansui) powder, wrapping it in wet paper, roasting until cooked, and consuming it with wine.