Library

The *Neijing* states: The Foot-Taiyang meridian causes lower back pain that radiates to the nape, spine, buttocks, and back, with a sensation of heaviness. The Shaoyang meridian causes lower back pain as if pricked by needles in the skin, accompanied by stiffness preventing flexion, extension, or turning the head. The Yangming meridian causes lower back pain where one cannot turn the head; when attempting to do so, visual hallucinations may occur, along with a tendency toward sorrow. The Foot-Shaoyin meridian causes lower back pain radiating inward along the spine. The Jueyin meridian causes lower back pain where the waist feels stiff and tense, like the string of a drawn bow. The Taiyin meridian causes lower back pain with a sensation of a horizontal blockage in the lower waist, which may lead to urinary incontinence in severe cases.

Consulting this treatise, it elaborately details the lower back pain caused by various meridians and the extraordinary vessels (such as Tongyin and Xie Mai), including their acupuncture methods, which is worth careful study of the original text.

It further states: Abnormalities in the Taiyang qi manifest as lower back pain; deficiency of Ju Yang (Taiyang) leads to pain in the waist, back, head, and nape. If it is a "meridian movement disease" (Shi Dong Bing), the neck feels rigid as if pulled out, there is pain flanking the spine, the waist feels as if it will break, and the thighs cannot be bent. The waist is the external residence of the Kidney; if rotation becomes difficult, it indicates impending failure of Kidney Qi.

The *Mai Jing* (Pulse Classic) states: Excessive physical exertion, heavy lifting, excessive sexual activity, or profuse sweating akin to bathing can damage the Kidneys. In cases of Kidney distension (Shen Zhang), there is abdominal fullness radiating to the back, a sense of oppression, and pain in the waist and thighs. In Kidney-dampness (Shen Zhuo), the area below the waist feels cold, and the waist feels heavy, as if burdened by five thousand coins.

Reviewing this passage, excessive effort constitutes internal injury to the Kidney, whereas Shen Zhuo represents external constraint.

The *Mai Jing* states: A deep pulse at the Chi position, accompanied by lower back pain, frequent seminal emission during lower back pain episodes, and reduced appetite, is curable if the pulse is surging, slippery, yet slow.

Liu Sandian stated: Pulses associated with lower back pain are generally deep and wiry. Deep, wiry, and tight indicates Cold; deep, wiry, and floating indicates Wind; deep, wiry, moist, and fine indicates Dampness; deep, wiry, and excess/solid indicates sprain or stasis.

Li Dongyuan stated: When Taiyang Qi is deficient, pathogenic factors invade, causing pain. Pathogens such as Wind, Heat, Cold, Dampness, and Dryness can all cause disease, though Cold and Dampness are more common than Wind and Heat. However, lower back pain due to Kidney deficiency from sexual exhaustion occurs because Yang Qi is weak and unable to move/warm. Deficiency of Yang should be treated by tonifying Yang. For instance, individuals consuming rich foods who long-term use warming herbs and engage in intercourse while intoxicated may damage True Yin. If Kidney Qi is heated, it causes lower back and spinal pain with inability to lift the body; over time, marrow decreases and bones wither, leading to Bone Withering Disease (Gu Wei). Deficiency of Yin should be treated by tonifying Yin.

The classic states: For lower back pain with upper-body coldness and inability to turn the head, treat the Foot-Taiyang and Foot-Yangming meridians. For lower back pain with upper-body heat, treat the Foot-Jueyin meridian. For inability to flex or extend, treat the Foot-Shaoyang meridian. Li Dongyuan stated: The three Foot-Yang meridians run from head to foot, and the three Foot-Yin meridians run from foot to abdomen; pain can occur anywhere along these pathways. Treatment requires identifying the affected meridian, locating the corresponding acupoints for needling, and prescribing herbs based on Cold or Heat patterns. For example, if Foot-Taiyang causes lower back pain radiating to the nape, spine, and buttocks with heaviness, needle Weizhong (BL40) to bleed both the Taiyang and Shaoyang meridians. Other cases follow this pattern.

This chapter details acupuncture methods extensively, warranting careful study. However, for Taiyang lower back pain, bleeding at Weizhong (BL40) yields rapid results. Wang Bing’s mention of moxibustion in his commentary may be an error. If moxibustion is indicated, Shenshu (BL23) and Yaoshu (DU2) are appropriate points.