风虚腰痛者,肾虚而风冷乘之也,其尺脉虚浮而痛多抽掣,或拘急且酸,而上连脊背,
不时速治,喜流入脚膝,为偏枯冷痹缓弱之疾。
独活寄生汤
独活(三两) 细辛 牛膝 桑寄生 秦艽 茯苓 白芍 人参 熟地黄 防风 杜仲
川芎 当归(各二两) 桂心 甘草
每服五钱,水煎空心服。
甘豆汤(《直指》) 治肾虚内蓄风热,腰痛,或大小便不通。
生甘草(二钱) 黑大豆(二合)
加生姜七片,水煎服。
治肾脏风,攻注脚膝痛。
连珠甘遂(一两) 木鳖子(一个雄,一个雌,去壳)
上为末, 猪腰子二个,破开,药末一钱掺匀,湿纸裹数重,慢火煨熟放温,五更初细
米饮下。如积多则利多,少则少也。宜软饭将息。若患一脚,却看左右。如左脚用左边腰子
,右用右边者,药末止一钱。壬子年在毗陵,有马姓人鬻酒,久不见,因询其亲,云∶宿患
肾脏风,今一足发肿如瓠,自腰以下,巨细通为一律,痛不可忍,卧欲转侧,必两人挟持方
可动,或者欲以铍刀决之。予曰∶未可,予有药当合以赠,如上法服之,辰巳间下脓如水晶
者数升,实时痛止肿退,一月拄拐而行。予再以赤乌散,充涂贴其膝方愈。后十年过毗陵,
率其子列拜以谢云∶向年脚疾,至今不复作,虽积年肾脏风,并已失去,今健步自若矣。
经云∶邪之所凑,其气必虚,留而不去,其病则实。若不决而去之,而欲以补药攻疾,
非徒无效而已也。余读《本事方》,有取乎此,故备录如上。
Lumbar pain due to wind deficiency arises from kidney deficiency where wind-cold pathogens take advantage of the weakness. The pulse at the chi position (尺脉, distal radial pulse reflecting kidney status) is deficient and floating, with pain often accompanied by twitching or cramping sensations, stiffness, and soreness, radiating upward to connect with the spine and back. If not treated promptly, the pathogen tends to flow downward into the feet and knees, causing conditions such as hemiplegia (偏枯), cold bi syndrome (cold obstruction syndrome), and limb flaccidity and weakness.
Duhuo Jisheng Decoction (Sanguisorba and Taxillus Decoction)
Ingredients: Radix Angelicae Pubescentis (Duhuo, 3 liang), Radix Asari (Xixin), Radix Achyranthis Bidentatae (Niuxi), Ramulus Taxilli (Sangjisheng), Herba Gentianae Macrophyllae (Qinjiao), Poria (Fuling), Radix Paeoniae Alba (Baishao), Radix Ginseng (Renshen), Radix Rehmanniae Preparata (Shudihuang), Radix Saposhnikoviae (Fangfeng), Cortex Eucommiae (Duzhong), Radix Chuanxiong (Chuanxiong), Radix Angelicae Sinensis (Danggui) (each 2 liang), Cortex Cinnamomi (Guixin), Radix Glycyrrhizae (Gancao).
Administration: Take 5 qian per dose, decoct in water, and consume on an empty stomach.
Gandou Tang (Black Soybean Decoction) (from *Zhizhi Fang*): Treats lumbar pain caused by internal accumulation of wind-heat due to kidney deficiency, or difficulty in urination and defecation.
Ingredients: Raw Radix Glycyrrhizae (Sheng Gancao, 2 qian), Black Soybeans (Hei Da Dou, 2 he).
Administration: Add 7 slices of fresh ginger, decoct in water, and drink.
This formula also treats wind pathogens affecting the kidneys that attack and cause pain in the feet and knees.
Ingredients: Lianzhu Kansui (Conjoined Kansui Root, 1 liang), Semen Momordicae (Mubiezi, one male and one female, shell removed).
Preparation and Administration: Grind the above herbs into powder. Take two pig kidneys, slice them open, sprinkle 1 qian of the herb powder evenly inside, wrap tightly in several layers of wet paper, and slow-roast until cooked. Allow to cool to a warm temperature. Ingest early in the morning (around 3-5 AM) with thin rice gruel. If there is much accumulation, there will be more diarrhea; if less accumulation, less diarrhea. Consume soft rice for dietary care after taking the medicine. If only one foot is affected, choose the corresponding side: use the left kidney for the left foot, and the right kidney for the right foot. In this case, use only 1 qian of herb powder.
Case Record: In the year Renzi, in Piling, I met a wine seller surnamed Ma whom I had not seen for a long time. I asked his relatives about him and learned that he suffered from chronic kidney wind. Now, one leg was swollen like a gourd, uniform in thickness from the waist down. The pain was unbearable; turning over required two people to support him. Some suggested incising it with a scalpel (beidao). I said, "Not yet. I have a prescription to prepare and give you. Follow the method above." By the Chen-Si hours (7-11 AM), he excreted several sheng of pus resembling crystal. Immediately, the pain ceased and the swelling subsided. Within a month, he could walk with a cane. I then advised him to apply Chiwu San (Red Bird Powder) to his knee, which led to complete recovery. Ten years later, passing through Piling again, he bowed with his son to express gratitude, saying, "The foot ailment from those years has never recurred. Although I suffered from chronic kidney wind for many years, it has now completely disappeared, and I walk vigorously and naturally."
The Classic states: "Where evil gathers, qi must be deficient; if it remains and does not depart, the disease becomes excess." If one does not decisively eliminate the pathogen but instead attempts to treat the disease with tonifying medicines, it will not only be ineffective but potentially harmful. Having read *Ben Shi Fang*, I found value in this approach, so I have recorded it in detail above.