人有两腰重如带三千文，不能俯仰者。夫腰痛不同，此病因房劳力役，又感风湿而成。
伤肾之症，治须补肾矣。然有补肾而腰愈痛者，其故何也?盖腰脐之气未通，风湿入于肾而
不得出故也。法宜先利其腰脐之气，以祛风利湿，而后大补其肾中之水火，则腰轻而可以俯
仰矣。方用轻腰汤∶
白术（一两） 薏仁（一两） 茯苓（五钱） 防己（五分）
水煎服。连服二剂而腰轻矣。
此方惟利湿而不治腰，又能利腰脐之气，一方而两治之也。
然不可多服者，以肾宜补而不可泻，防己多用必至过泄肾邪。肾已无邪可祛，而反损正气，
故宜用补肾之药，而前药不可再用矣。方另用三圣汤∶
杜仲（一两） 白术（五钱） 山茱萸（四钱）
水煎服。
此方补肾中之水火，而仍利其腰脐者，肾气有可通之路，则俯仰之间，无非至适也。
此症用术桂汤亦神。
白术（三两） 肉桂（三分）
水煎服。二剂全愈，不再发。
人有动则腰痛，自觉其中空虚无着者，乃肾虚腰痛也。夫肾分水火，未可以虚字一言了
之。经谓诸痛皆属于火，独肾虚腰痛非火也。惟其无火，所以痛耳。治法似宜单补肾中之火
，然而火非水不生，若徒补火而不补水，所谓无阴不能生阳，而痛不可遽止，必须于水中补
火，水火既济，肾气足而痛自除，此即贞下起元之意也。方用
补虚利腰汤∶
熟地（一两） 杜仲（五钱） 破故纸（一钱） 白术（五钱）
水煎服。连服四剂自愈。
熟地补肾水也，得白术则利腰脐，而熟地不腻，杜仲、破故补火以止腰痛者也，得熟地
则润泽而不至干燥，调剂相宜，故取效最捷耳。
此症用实腰汤亦佳。
杜仲（一两） 白术（二两） 熟地（一两） 山茱萸（四钱） 肉桂（一钱）
水煎服。十剂全愈。
人有腰痛，日重夜轻，小水艰涩，饮食如故者，人以为肾经之虚，谁知是膀胱之水闭乎
?膀胱为肾之府，火盛则水不能化，而水反转入于肾之中。膀胱太阳之经也，水火虽犯肾阴
，而病终在阳而不在阴。若不治膀胱，而惟治肾，用补精填水，或用添薪益火，适足以增其
肾气之旺。阴旺而阳亦旺，肾热而膀胱益热，致水不流而火愈炽。膀胱之火愈炽，必更犯于
肾宫，而腰之痛何能痊乎。方用宽腰汤治之。
车前子（三钱） 薏仁（五钱） 白术（五钱） 茯苓（五钱） 肉桂（一分）
水煎服。一剂而膀胱之水大泄，二剂而腰痛顿宽也。
夫车前、茯苓以利膀胱之水，薏仁、白术以利腰脐之气，则膀胱与肾气内外相通。又得
肉桂之气，尤易引肾气而外达于小肠，从阴器而尽泄，腰痛有不速愈哉。
此症用术桂加泽泻汤亦神。
白术（一两） 泽泻（三钱） 肉桂（五分）
水煎服。一剂即通。
人有大病之后，腰痛如折，久而成为伛偻者，此乃湿气入于肾宫，误服补肾之药而成之
者也。夫腰痛明是肾虚，补肾正其所宜，何以用补肾填精之药，不受其益，而反受其损乎?
不知病有不同，药有各异。大病之后，腰痛如折者，乃脾湿而非肾虚也。脾湿当去湿，而乃
用熟地、山茱一派滋润之药，虽非克削之味，而湿以加湿，正其所恶，故不特无益，而反害
之也。医工不悟，而以为
补肾之药尚少用之也，益多加其分两，则湿以助湿，腰骨河车之路，竟成泛滥之乡矣，欲不
成伛偻不可得也。方用起伛汤∶
薏仁（三两） 白术（二两） 黄 （一两） 防风（三分） 附子（一分）
水煎服。日用一剂，服一月而腰轻，服两月而腰可伸矣，服三月而全愈。
此方利湿而又不耗气，气旺则水湿自消，加入防风、附子于 、术之中，有鬼神不测之
机，相畏而相使，建功实奇。万不可疑药剂之大，而少减其品味，使废人不得为全人也。
此症用 术防桂汤亦可。
白术（四两） 黄 （二两） 防己（一钱） 肉桂（一钱）
水煎服。十剂轻，二十剂愈。
人有跌打闪挫，以至腰折不能起床，状似伛偻者，人以为此腰痛也，而不可作腰痛治。
然腰已折矣，其痛自甚，何可不作腰痛治哉。或谓腰折而使之接续，其中必有瘀血在内，宜
于补肾补血之中，而少加逐瘀治血之药，似未可止补其肾也，而不知不然。夫肾有补而无泻
，加逐瘀之味，必转伤肾脏矣。折腰之痛，内伤肾脏，而非外伤阴血，活血之药不能入于肾
之中，皆不可用，而必须独补肾也。惟是补肾之剂，小用
熟地（一斤） 白术（半斤）
水大碗数碗，煎服。一连数剂，而腰如旧矣。
夫熟地原能接骨，不止补肾之功，白术善通腰脐之气，气通则接续更易，但必须多用为
神耳。使加入大黄、白芍、桃仁、红花之药，则反败事。若恐其腰痛而加杜仲、破故、胡桃
等品，转不能收功矣。
人有露宿于星月之下，感犯寒湿之气，腰痛不能转侧，人以为血凝于少阳胆经也，谁知
是邪入于骨髓之内乎。夫腰乃肾堂至阴之宫也，霜露寒湿之气，乃至阴之邪也。以至阴之邪
，而入至阴之络，故搐急而作痛。惟是至阴之邪，易入而难散。盖肾宜补而不宜泻，散至阴
之邪，必泻至阴之真矣。然而得其法，亦正无难也。方
用转腰汤∶
白术（一两） 杜仲（五钱） 巴戟天（五钱） 防己（五分） 肉桂（一钱） 苍术（三钱） 羌活（五分） 桃
仁
水煎服。一剂而痛轻，再剂而痛止也。
此方以白术为君者，利湿而又通其腰脐之气，得杜仲之相佐，则攻中有补，而肾气无亏
。且益之巴戟、肉桂以祛其寒，苍术、防己以消其水，更得羌活、桃仁逐其瘀而行其滞，虽
泻肾而实补肾也。至阴之邪既去，而至阴之真无伤，故能止痛如神耳。
此病用术桂防 汤亦佳。
白术（二两） 肉桂（三钱） 防己（一钱） 草（五钱）
水煎服。十剂见效。
There are cases where a person feels heaviness in both loins as if bound by three thousand cash coins, unable to bend forward or extend backward. Loyn pain varies in etiology; this specific condition arises from excessive sexual activity and physical labor, compounded by the invasion of wind-dampness pathogens.
When the Kidney is injured, treatment must focus on tonifying the Kidney. However, there are instances where taking Kidney-tonifying herbs exacerbates the loyn pain. What is the reason? It is because the Qi of the loins and umbilicus has not yet circulated freely, allowing wind-dampness to enter the Kidney but preventing its expulsion. The method should first be to unblock the Qi of the loins and umbilicus to dispel wind and promote diuresis, followed by vigorously tonifying the Water (Yin) and Fire (Yang) within the Kidney. Consequently, the loins will feel light, allowing free movement. The prescription used is Qingyao Tang (Lighten the Loin Decoction):
Atractylodis Macrocephalae Rhizoma (30g) Coicis Semen (30g) Poria (15g) Stephaniae Tetrandrae Radix (2g)
Decoct with water and take orally. After two doses, the loins feel light.
This formula primarily promotes diuresis rather than directly treating the loins, yet it also unblocks the Qi of the loins and umbilicus, achieving two effects with one prescription.
However, it should not be taken for long periods, as the Kidney is suited for tonification but not for purging. Excessive use of Stephaniae Tetrandrae Radix may lead to over-draining the Kidney's healthy Qi. Once the pathogenic factors in the Kidney have been expelled, further use would only damage the healthy Qi. Therefore, one should switch to Kidney-tonifying herbs, and the previous prescription should no longer be used. A new prescription, Sansheng Tang (Three Saints Decoction), is used:
Eucommiae Cortex (30g) Atractylodis Macrocephalae Rhizoma (15g) Corni Fructus (12g)
Decoct with water and take orally.
This formula tonifies the Kidney's Water and Fire while still benefiting the Qi of the loins and umbilicus. When the Kidney Qi has a clear pathway for circulation, bending and extending become perfectly comfortable.
For this condition, Shugui Tang (Atractylodes and Cinnamon Decoction) is also miraculous.
Atractylodis Macrocephalae Rhizoma (90g) Cinnamomi Cortex (1g)
Decoct with water and take orally. Two doses result in complete recovery with no recurrence.
Some patients experience loyn pain upon movement, feeling a sense of emptiness and lack of support in the center of the loins; this is Kidney-deficiency loyn pain. The Kidney is divided into Water (Yin) and Fire (Yang); it cannot be simply summarized as "deficiency." The Classics state that most pains belong to Fire, but Kidney-deficiency loyn pain is an exception—it does not belong to Fire. Precisely because there is a lack of Fire (Yang), pain occurs. The treatment seems to require solely tonifying the Kidney's Fire (Yang). However, Fire cannot be generated without Water (Yin). If one merely tonifies Fire without nourishing Water, it violates the principle that "without Yin, Yang cannot be generated," and the pain will not cease abruptly. One must tonify Fire within Water, achieving the harmony of Water and Fire. When Kidney Qi is sufficient, the pain naturally disappears. This embodies the concept of "Zhen Xia Qi Yuan" (the cycle of renewal, like spring following winter). The prescription used is Buxu Liyao Tang (Tonify Deficiency and Benefit the Loin Decoction):
Rehmanniae Radix Preparata (30g) Eucommiae Cortex (15g) Psoraleae Fructus (3g) Atractylodis Macrocephalae Rhizoma (15g)
Decoct with water and take orally. Self-healing occurs after four consecutive doses.
Rehmanniae Radix Preparata tonifies Kidney Water; combined with Atractylodis Macrocephalae Rhizoma, it benefits the loins and umbilicus, preventing Rehmannia from being cloying. Eucommia and Psoralea tonify Fire to stop loyn pain; combined with Rehmannia, they remain moist and do not cause dryness. The harmonious combination yields rapid results.
For this condition, Shiyao Tang (Solidify the Loin Decoction) is also excellent.
Eucommiae Cortex (30g) Atractylodis Macrocephalae Rhizoma (60g) Rehmanniae Radix Preparata (30g) Corni Fructus (12g) Cinnamomi Cortex (3g)
Decoct with water and take orally. Ten doses result in complete recovery.
Some patients suffer from loyn pain that is worse during the day and lighter at night, accompanied by difficult and scanty urination, while appetite remains normal. People assume this is Kidney Meridian deficiency, but who would guess it is actually obstruction of Water in the Bladder? The Bladder is the exterior mansion of the Kidney. When Fire is excessive, Water cannot be transformed, causing Water to reverse and enter the Kidney. The Bladder belongs to the Taiyang (Greater Yang) Meridian. Although Water and Fire pathogens invade Kidney Yin, the disease ultimately resides in the Yang aspect, not the Yin. If one treats only the Kidney without addressing the Bladder, using formulas to fill essence and nourish Water, or adding fuel to the fire, it merely increases the exuberance of Kidney Qi. As Yin becomes excessive, Yang also becomes excessive; Kidney heat causes Bladder heat, leading to stagnant Water and blazing Fire. The more blazing the Bladder Fire, the more it invades the Kidney Palace, making loyn pain incurable. The prescription used is Kuanyao Tang (Widen the Loin Decoction):
Plantaginis Semen (9g) Coicis Semen (15g) Atractylodis Macrocephalae Rhizoma (15g) Poria (15g) Cinnamomi Cortex (0.3g)
Decoct with water and take orally. After one dose, Bladder Water is largely discharged; after two doses, loyn pain is instantly relieved.
Plantago and Poria promote diuresis in the Bladder; Coix Seed and Atractylodes benefit the Qi of the loins and umbilicus, allowing internal and external communication between the Bladder and Kidney Qi. With the aid of Cinnamon, it is easier to guide Kidney Qi outward to the Small Intestine and exit through the genitalia, ensuring rapid recovery from loyn pain.
For this condition, Shugui Jia Zexie Tang (Shugui Decoction plus Alisma) is also miraculous.
Atractylodis Macrocephalae Rhizoma (30g) Alismatis Rhizoma (9g) Cinnamomi Cortex (1.5g)
Decoct with water and take orally. Patency is achieved in one dose.
After severe illness, some patients experience loyn pain as if broken, which over time leads to kyphosis (stooping). This is caused by dampness invading the Kidney Palace due to the mistaken use of Kidney-tonifying herbs. Loyn pain is clearly due to Kidney deficiency, so tonifying the Kidney seems appropriate. Why does using Kidney-tonifying and essence-filling herbs fail to benefit and instead cause harm? One must understand that diseases differ, and thus treatments vary. After severe illness, loyn pain resembling a fracture is due to Spleen Dampness, not Kidney deficiency. Spleen Dampness requires dampness-resolving treatment, yet formulas containing Rehmannia and Cornus (moisturizing herbs) were used. Although these are not harsh draining agents, adding moisture to existing dampness is abhorrent to the body. Thus, they provide no benefit and cause harm. Physicians, failing to comprehend this, believe the Kidney-tonifying dosage was insufficient and increase the amount. This adds dampness to dampness, turning the pathways of the loins and bones into a flooded region. Kyphosis becomes inevitable. The prescription used is Qiyu Tang (Upright the Stoop Decoction):
Coicis Semen (90g) Atractylodis Macrocephalae Rhizoma (60g) Astragali Radix (30g) Saposhnikoviae Radix (1g) Aconiti Lateralis Radix Preparata (0.3g)
Decoct with water and take orally. One dose per day. After one month, the loins feel light; after two months, the back can straighten; after three months, full recovery is achieved.
This formula resolves dampness without depleting Qi. When Qi is robust, Water-Dampness dissipates naturally. Adding Saposhnikovia and Aconite to Astragalus and Atractylodes creates a mysterious synergy where herbs mutually restrain and assist each other, achieving remarkable results. Do not doubt the large dosage or reduce the ingredients, lest the disabled fail to regain their health.
For this condition, Shufanggui Tang (Atractylodes, Saposhnikovia, and Cinnamon Decoction) is also effective.
Atractylodis Macrocephalae Rhizoma (120g) Astragali Radix (60g) Stephaniae Tetrandrae Radix (3g) Cinnamomi Cortex (3g)
Decoct with water and take orally. Lightening occurs in ten doses; recovery in twenty doses.
Following trauma or sprain, some patients suffer a sensation of the loins breaking, unable to rise from bed, resembling kyphosis. People consider this loyn pain but advise against treating it as such. However, since the loins are "broken," the pain is severe; how can it not be treated as loyn pain? Some argue that for the loins to reconnect, blood stasis must exist internally, so one should add blood-invigorating and stasis-resolving herbs to Kidney- and Blood-tonifying formulas, rather than tonifying the Kidney alone. They are unaware this is incorrect. The Kidney is suited for tonification, not purging. Adding stasis-resolving herbs will inevitably injure the Kidney. The pain from a fractured loins involves internal injury to the Kidney, not external injury to Yin-Blood. Blood-invigorating herbs cannot penetrate the interior of the Kidney and are therefore contraindicated. One must solely tonify the Kidney. However, the dosage of the Kidney-tonifying agent should be small:
Rehmanniae Radix Preparata (300g) Atractylodis Macrocephalae Rhizoma (150g)
Decoct in several bowls of large-volume water and take orally. After several consecutive doses, the loins return to normal.
Rehmannia can originally unite bones, possessing not only Kidney-tonifying properties. Atractylodes excels at unblocking the Qi of the loins and umbilicus; when Qi flows, reconnection is easier. However, high dosages are essential for efficacy. Adding Rhubarb, White Peony Root, Peach Kernel, or Safflower would ruin the treatment. If one fears the loyn pain and adds Eucommia, Psoralea, or Walnut, it may also prevent successful outcomes.
Those who sleep outdoors under stars and moonlight may contract Cold-Dampness, resulting in loyn pain that prevents turning or side-lying. People assume this is Blood stagnation in the Shaoyang Gallbladder Meridian, but who would guess the pathogen has entered the Marrow? The loins are the palace of the Kidney, the realm of Extreme Yin. Frost, dew, Cold, and Dampness are also Extreme Yin pathogens. When Extreme Yin pathogens enter Extreme Yin collaterals, spasms and pain occur. Extreme Yin pathogens are easy to enter but hard to disperse. Since the Kidney is suited for tonification and not purging, dispersing Extreme Yin pathogens would drain the True Qi of Extreme Yin. However, with the correct method, it is not difficult. The prescription used is Zhuanyao Tang (Turn the Loin Decoction):
Atractylodis Macrocephalae Rhizoma (30g) Eucommiae Cortex (15g) Morindae Officinalis Radix (15g) Stephaniae Tetrandrae Radix (2g) Cinnamomi Cortex (3g) Atractylodis Rhizoma (9g) Notopterygii Rhizoma et Radix (2g) Persicae Semen (appropriate dose)
Decoct with water and take orally. Pain lightens after one dose; pain ceases after two doses.
In this formula, Atractylodes serves as the Sovereign herb, resolving dampness and unblocking the Qi of the loins and umbilicus. Assisted by Eucommia, it attacks pathogens while tonifying, preserving Kidney Qi. Added Morinda and Cinnamon dispel Cold; Atractylodes (Rhizoma) and Stephania eliminate Water-Dampness. Notopterygium and Persica Seed drive out stasis and move stagnation. Although it appears to purge the Kidney, it actually tonifies it. Once the Extreme Yin pathogen is removed, the True Qi of Extreme Yin remains undamaged, hence the miraculous pain relief.
For this disease, Shugui Fangcao Tang (Atractylodes, Cinnamon, Stephania, and Licorice Decoction) is also good.
Atractylodis Macrocephalae Rhizoma (60g) Cinnamomi Cortex (9g) Stephaniae Tetrandrae Radix (3g) Glycyrrhizae Radix et Rhizoma (15g)
Decoct with water and take orally. Effects are seen in ten doses.