药隐老人论曰∶夫肾主于腰，女人肾脏系于胞络，若肾气虚弱，外感六淫，内伤七
情，皆致腰痛。古方亦有五种之说，如风腰痛，宜小续命汤加桃仁。杜仲煎服。脾胃气
痞，及寒湿腰痛，宜五积散（杂病中寒。）加桃仁。如虚损及五种腰痛，服青娥丸、（杂病腰痛。）神
应丸，（同上。）皆可用也。如气滞腰痛，服如神汤必效。
〔薛〕陈无择先生云∶若形体虚羸，面色黧黑，腿足痿软，不能行立，此失志所为
也。腹急胁胀，目视KT KT ，宗筋弛纵，白淫下注，此郁结所为也。肌肉不仁，饮食不化，
肠胃胀满，闭坠腰胁，此忧思所为也。皆属内，若腰冷作痛，身重不渴，小便自利，饮
食如故，因劳汗出，腰酸胁痛，或坠堕血滞，或房劳精竭，皆属不内外因也。窃谓前证失
志，肾虚热者，六味丸。（杂病虚劳。）肾虚寒者，八味丸。（杂病虚劳。）郁怒伤肝，实用龙胆泻肝
汤；（杂病淋。）虚用六味丸。补肝散。（杂病腰痛。）忧虑伤脾者，归脾汤、（杂病健忘。）逍遥散。（调
经。）肾着者，寒则术附汤；（杂病伤湿。）虚则肾着汤。（同上。）腰膝痛者，寄生汤、养肾散。（杂
病腰痛。）瘀血滞者，如神汤、舒筋散。房劳腰痛者，青娥丸、十补丸。（见前虚劳。）一妇人
腰痛三年矣，每痛必面青头晕目紧。余以为肝脾气虚，用补肝散而愈。三年后，因劳役，
患头痛兼恶心，用补中益气汤。（杂病伤劳倦。）加茯苓、半夏、蔓荆子而愈。一妇人苦腰痛，数
年不愈，余用白术一味大剂服，不三月而痊。乃胃气虚闭之证，故用白术也。
如神汤 治男子妇人气虚腰痛。（一方有杜仲，无当归。）
玄胡索 当归（去芦） 桂心（等分）
上为细末，每服三钱，温酒调下，甚者不过数服。
独活寄生汤 夫腰痛者，皆由肾气虚弱，卧冷湿地当风所得，不时速治，喜流入脚膝，
为偏枯冷痹，缓弱疼重，或腰痛拘挛，脚膝重痹，宜急服之。
独活（三两） 桑寄生 续断 杜仲（炒去丝） 北细辛 川牛膝 秦艽 茯苓 白芍药
桂心 川芎 防风 人参 熟地黄 当归（各二两）
上 咀，每服三钱，水一盏，煎至七分，去滓温服，空心。气虚下利，除地黄。
并治新产腹痛不得转动，及腰脚挛痛痹弱，不得屈伸。此药最能除风消血。《肘后》
有附子，故无寄生、人参、当归、粉草。近人将治历节风、香港脚流注亦效。
舒筋散 治腰痛神效，闪挫亦良。
玄胡索（炒） 杜仲（姜汁炒） 官桂（去粗皮） 羌活 芍药（各等分）
上为末，酒调下二钱。
又方 橘核炒香，研酒，去渣，下青木香丸。（方见。）
又方 天罗布瓜子仁炒焦，擂酒热服，留渣炒热封痛处效。
Old Man Yao Yin stated: The Kidney governs the waist. In women, the Kidney is connected to the Bao Luo (uterine network). If Kidney Qi is deficient, external invasion by the Six Evils (wind, cold, summerheat, dampness, dryness, fire) or internal injury by the Seven Emotions (joy, anger, worry, pensiveness, sorrow, fear, fright) can all lead to lower back pain. Ancient prescriptions also describe five types of lower back pain. For example, for wind-induced lower back pain, Xiaoxuming Tang (Minor Continuation Life Decoction) with added Tao Ren (Peach Seed) is suitable, taken along with a decoction of Duzhong (Eucommia Bark). For spleen and stomach qi stagnation and cold-damp induced lower back pain, Wuji San (Five Accumulations Powder) (see Miscellaneous Diseases, Cold section) with added Tao Ren is suitable. For deficiency injuries and the five types of lower back pain, Qing'e Wan (Green Youth Pill) (see Miscellaneous Diseases, Lower Back Pain section) and Shenying Wan (Divine Response Pill) (ibid.) can be used. For qi stagnation-induced lower back pain, Rushen Tang (Like God Decoction) is highly effective.
[Xue Ji's Commentary] Mr. Chen Wuyue said: If the body is emaciated and weak, the complexion is dark, the legs and feet are flaccid and weak, making standing and walking impossible, this is caused by loss of will (frustration/disappointment). Abdominal urgency and hypochondriac distension, blurred vision, flaccidity of the Zong Jin (major sinews/genitals), and downward leakage of white turbid discharge, this is caused by emotional depression (stagnation). Muscle insensibility, indigestion, abdominal and intestinal fullness, and a feeling of heaviness and pain in the lower back and hypochondrium, this is caused by excessive worry and overthinking. All these belong to internal causes. If the lower back feels cold and painful, the body feels heavy without thirst, urination is normal, and appetite remains unchanged, but it occurs after sweating from exertion, or involves soreness of the lower back and hypochondrium, or blood stasis from falling, or essence depletion from sexual excess, these belong to neither-internal-nor-external causes. I believe that for the aforementioned conditions: if loss of will leads to Kidney deficiency with heat, Liuwei Wan (Six-Ingredient Pill with Rehmannia) (see Miscellaneous Diseases, Consumption section) should be used; if Kidney deficiency with cold, Bawei Wan (Eight-Ingredient Pill with Rehmannia) (ibid.) should be used. If depression and anger injure the Liver, for excess patterns use Longdan Xiegan Tang (Gentian Liver-Draining Decoction) (see Miscellaneous Diseases, Strangulation section); for deficiency patterns, use Liuwei Wan combined with Bugan San (Liver-Nourishing Powder) (see Miscellaneous Diseases, Lower Back Pain section). If worry injures the Spleen, use Guipi Tang (Restore the Spleen Decoction) (see Miscellaneous Diseases, Forgetfulness section) and Xiaoyao San (Free and Easy Wanderer Powder) (see Menstrual Regulation section). For Shen Zhuo disease (Cold-Damp Lodging in the Kidney region), for cold patterns use Shu Fu Tang (Atractylodes and Aconite Decoction) (see Miscellaneous Diseases, Cold-Damp Injury section); for deficiency patterns, use Shen Zhuo Tang (ibid.). For lower back and knee pain, use Jisheng Tang (Viscum Decoction) and Yangshen San (Kidney-Nourishing Powder) (see Miscellaneous Diseases, Lower Back Pain section). For blood stasis stagnation, use Rushen Tang and Shujin San (Sinew-Relaxing Powder). For lower back pain due to sexual exhaustion, use Qing'e Wan and Shibu Wan (Ten-Tonifying Pill) (see previous Consumption section).
One woman suffered from lower back pain for three years. Every time she had pain, her face would turn green, she would feel dizzy, and her eyes would feel tight. I diagnosed this as Liver and Spleen Qi deficiency and prescribed Bugan San, which cured her. Three years later, due to overwork, she developed headache accompanied by nausea. I prescribed Buzhong Yiqi Tang (Middle-Journey Boosting Qi Decoction) (see Miscellaneous Diseases, Fatigue and Exhaustion section) with added Fuling (Poria), Banxia (Pinellia Tuber), and Manjingzi (Bukyo Fruit), which cured her. Another woman suffered from persistent lower back pain for many years. I prescribed a large dose of Baizhu (Atractylodes Macrocephala Rhizome) alone, and she recovered within three months. This was a pattern of Stomach Qi deficiency with closure, hence Baizhu was used.
Rushen Tang: Treats Qi deficiency-induced lower back pain in men and women. (Another version contains Duzhong and no Danggui.)
Yanhusuo (Corydalis Rhizome), Danggui (Angelica Sinensis Root, remove radicle), Guixin (Cinnamon Twig Heart) (equal parts).
Grind into fine powder. Take 3 qian each time, mixed with warm wine. For severe cases, a few doses are sufficient.
Duhuo Jisheng Tang: Lower back pain is generally caused by Kidney Qi deficiency, sleeping on cold and damp ground while exposed to wind. If not treated promptly, the pathogen tends to flow into the legs and knees, causing hemiplegia, cold bi-syndrome, weakness, and heavy pain, or lower back stiffness and pain, and heavy numbness in the legs and knees. It should be taken immediately.
Duhuo (Salvia Root) (3 liang), Sangjisheng (Taxillus Branch), Xuduan (Dipsacus Root), Duzhong (Eucommia Bark, stir-fried to remove silk fibers), Beixixin (Asarum Root), Chuan Niuxi (Cyathula Root), Qinjiao (Gentiana Macrophylla Root), Fuling (Poria), Baishaoyao (White Peony Root), Guixin (Cinnamon Twig Heart), Chuanxiong (Ligusticum Rhizome), Fangfeng (Saposhnikovia Root), Renshen (Ginseng Root), Shudihuang (Rehmannia Root, prepared), Danggui (Angelica Sinensis Root) (2 liang each).
Chop coarsely. Take 3 qian each time, with one cup of water, decoct until reduced to 70%, strain, and take warm on an empty stomach. If there is Qi deficiency with diarrhea, omit Dihuang.
It also treats postpartum abdominal pain preventing turning, and lower back/leg spasms, numbness, weakness, and inability to flex or extend. This medicine is most effective at dispelling wind and resolving blood stasis. The *Zhouhou Fang* (Handbook of Prescriptions for Emergencies) includes Fuzi (Aconite Lateral Root), thus excluding Sangjisheng, Renshen, Danggui, and Gancao (Licorice Root). Modern practitioners find it effective for treating Li Jie Feng (Rheumatoid Arthritis/Joint Bi) and Hong Kong Foot (Gouty Arthritis) with flowing obstruction.
Shujin San: Highly effective for lower back pain, and good for sprains and strains.
Yanhusuo (Corydalis Rhizome, stir-fried), Duzhong (Eucommia Bark, stir-fried with ginger juice), Guanzi Gui (Cinnamon Bark), Qianghuo (Notopterygium Rhizome), Shaoyao (Peony Root) (equal parts).
Grind into powder. Take 2 qian mixed with wine.
Another prescription: Stir-fry Juhe (Tangerine Seed) until fragrant, grind, and take with wine. Strain, then administer Qingmuxiang Wan (Blue Magnolia Berry Pill) (formula see above).
Another prescription: Stir-fry Tianluobu Gua Zi Ren (Luffa Seed Kernel) until charred, grind, and take with hot wine. Retain the dregs, stir-fry them until hot, and apply as a compress to the painful area for good effect.