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When pathogenic factors invade the Kidney, bone pain and Yin Bi (a type of bi-syndrome characterized by deep-seated pain without obvious external signs) occur. Yin Bi is characterized by pain that cannot be pinpointed by pressure, accompanied by abdominal distension, lower back pain, difficult defecation, stiffness and pain in the shoulder, back, neck, and nape, and occasional dizziness. Treatment involves selecting Yongquan (KI1) and Kunlun (BL60). Observe for blood stasis; if present, puncture to release all stagnant blood. If the lower abdomen pulls on the testis, radiating to the lumbar spine and rushing upward to the heart and lungs, this indicates pathogenic invasion of the Small Intestine. The Small Intestine connects to the testicular ligaments, attaches to the spine, penetrates the Liver and Lungs, and networks with the Heart system. When Qi is excessive, it causes reversal (Jue), rushing upward to attack the Stomach and Intestines, steaming the Liver and Lungs, dispersing in the chest, and knotting at the umbilicus. Therefore, treat by selecting Huanyuan (CV12) to dissipate the pathogen, puncture the Hand Taiyin Lung Meridian to tonify, select the Foot Jueyin Liver Meridian to descend rebellious Qi, select Shangjuxu (ST37) to eliminate the pathogen, and regulate according to the meridians traversed. Symptoms of Small Intestine disease include lower abdominal pain, lumbar spine pain radiating to the testis, frequent urgency and heaviness in the rectum, heat in front of the ears, severe cold, isolated heat in the shoulder, heat between the little finger and ring finger, or a sunken pulse. These are its indicators.

The Yellow Emperor asked: "There is a patient with Jue syndrome. The right pulse is deep and firm, while the left pulse is floating and slow. Where does the disease originate?" Qibo replied: "In winter, the right pulse should naturally be deep and firm, which corresponds to the four seasons. The left pulse being floating and slow goes against the seasonal pattern. The left side governs the disease. Diagnosis of the left side relates to the Kidney, but also involves the Lung, indicating lower back pain." Asked: "Why do you say so?" Replied: "The Foot Shaoyin Kidney Meridian passes through the Kidney and connects to the Lung. Now that a Lung pulse is obtained, the disease lies in the Kidney, hence the lower back pain."

The Foot Taiyang Bladder Meridian causes lower back pain radiating to the neck, spine, and sacrum, with the back feeling swollen. Puncture the main channel of the Foot Taiyang to release blood; in spring, avoid bleeding.

The Foot Shaoyang Gallbladder Meridian causes lower back pain, feeling like a needle prick in the skin, with sluggish movement unable to bend or extend, and unable to look left or right. Puncture the end of the Shenggu (fibular head) of the Foot Shaoyang to release blood; in summer, avoid bleeding.

The Foot Yangming Stomach Meridian causes lower back pain, inability to look back, visual hallucinations upon looking back, and propensity for sadness. Puncture the Foot Yangming at Zusanli (ST37) above and below to harmonize and release blood; in autumn, avoid bleeding.

The Foot Shaoyin Kidney Meridian causes lower back pain radiating to the inner aspect of the spine. Puncture the Foot Shaoyin two cun above the medial malleolus; in spring, avoid bleeding. Excessive bleeding leads to deficiency that cannot be restored.

The Foot Jueyin Liver Meridian causes lower back pain, with the waist feeling tight like a drawn bowstring. Puncture the Foot Jueyin meridian outside the gastrocnemius muscle near the heel, along the palpable nodules. This condition causes the patient to speak excessively yet remain silent and confused. Puncture three times.

Xie Mai (Resolving Vessel) causes lower back pain radiating to the shoulder, blurred vision, and occasional urinary incontinence. Puncture Xie Mai between the knee tendons and muscles, on the transverse vessel on the lateral side; release blood until it changes color.

Tongyin Mai causes lower back pain, feeling as if a small hammer is lodged within, with郁结 swelling. Puncture Tongyin Mai at the end of the Jiegu (fibular styloid process) above the lateral malleolus; puncture twice.

Xie Mai causes lower back pain as if tearing (Suwen describes it as pulling like a belt), often feeling like the waist is broken, with irritability. Puncture Xie Mai where the collaterals knot like a millet grain; blood will shoot out blackly. Stop when red blood appears. (Quan Yuanqi stated there are two Xie Mai vessels with different etiologies; doubt exists regarding errors.)

Yangwei Mai causes lower back pain with郁结 swelling above. Puncture Yangwei Mai where it merges with the Taiyang vessel below the popliteal fossa, about one chi from the ground.

Hengluo Mai causes lower back pain, ability to bend but not extend, fear of falling when extending. This results from heavy lifting injuring the waist, severing Hengluo, causing evil blood to gather. Puncture between the Jin (muscle/tendon) of Chengfu (BL36) above, horizontally positioned several cun up; puncture twice to release blood.

Huiyin Mai causes lower back pain with profuse sweating above the pain site. After sweat dries, thirst arises; after drinking, restlessness occurs. Puncture Zhiyang Mai three cun above, horizontally positioned three spaces above and below the Qiao Mai. Bleed where vessels are full. (Suwen describes sweating as 'lettle'; ...).

Feiyang Mai causes lower back pain with郁结 discomfort above, progressing to fear and sorrow. Puncture Feiyang Mai two cun above the medial malleolus (Suwen says five cun), anterior to Shaoyin, at the intersection with Yinwei Mai.

Changyang Mai causes lower back pain radiating to the chest, blurred vision, severe opisthotonos, and tongue retraction with inability to speak. Puncture Neijin twice, posterior to the large tendon above the medial malleolus, one cun above the ankle. (Suwen refers to the large tendon as...).

San Mai causes lower back pain with heat; severe heat causes irritability. A sensation of a horizontal wood block in the lower back; severe cases involve urinary incontinence. Puncture San Mai between the bone and muscle anterior to the knee, binding the outer collateral vessels; puncture three times.

Rouli Mai causes lower back pain, inability to cough (coughing causes tendon spasm). Puncture Rouli Mai twice, lateral to the Foot Taiyang, at the end of the Jiegu of Foot Shaoyang.

Lower back pain flanking the spine radiating to the head, with neck stiffness, blurred vision, and desire to collapse. Puncture Weizhong (BL40) of the Foot Taiyang to release blood. Lower back pain radiating to the lower abdomen and testis, inability to lie supine. Puncture Jiaoxu (BL34); above the swollen ankles, determine the number of punctures based on the lunar cycle; effect is immediate upon needle removal. (Suwen states: treat left with right, right with left).

For upper cold in lower back pain, select Foot Taiyang and Yangming; for upper heat, select Foot Jueyin; for inability to bend/extend, select Foot Shaoyang; for middle heat with panting, select the blood collaterals of Foot Shaoyin.

For upper cold in lower back pain, excess presents as spinal rigidity; Changqiang (GV1) is the primary point. For lower abdominal pain pulling the testis and lumbar spine, hernia pain rushing to the heart, spinal rigidity, yellow-red urine, dry mouth; Xiaochangshu (BL27) is the primary point. For spinal pain radiating to back and lower abdomen, difficulty bending/extending, inability to breathe lying down, leg weakness/heaviness, immovable sacrum, red urine, cold/numbness from waist to feet, inability to sit long; Pangguangshu (BL28) is the primary point. For lower back pain preventing bending/extending; Zhonglü Neishu (BL29) is the primary point. For lower back/foot pain with cold, preference for supine position, testicular jumping/curling; Zubin (KI9) is the primary point. For lower back pain with depression preventing bending/extending, numbness from waist to feet, spinal involvement, back cold; Cishi (BL27 - *Note: Context implies Cili BL27 or similar, text says Ci*) is the primary point, first...

For fullness in hypochondrium and hardness/urgency in lower abdomen; Zhishi (BL52) is the primary point. For spinal pain, aversion to wind, lower abdominal fullness/hardness, strangury/heaviness, inability to urinate; Baohuang (BL54) is the primary point. For lower back pain with cold, urgent/difficult bending/extending, yin pain with heaviness/inability to urinate; Zhibian (BL54) is the primary point. For lower back pain pulling testis, lower abdomen, and thigh, sudden inability to bend/extend; Qichuan (ST30) is needled. For lower back pain preventing turning/side-bending; Zhangmen (LR13) is the primary point. For lower back pain preventing standing/bending long-term; Jingmen (GB25) and Xingjian (LR2) are the primary points. For lower back/lower abdominal pain; [Missing Point] is the primary point. For Kidney lower back pain preventing bending/extending; Yinlingquan (SP9) is the primary point. For spinal pain radiating as if untied, lower back/abdominal fullness, strangury-like difficulty urinating, emaciation, fear, Qi deficiency, abdominal depression; Taichong (LR3) is the primary point. For lower back/lower abdominal pain; Yinbao (LR9) is the primary point. For lower back pain with difficult defecation; Yongquan (KI1) is the primary point. For spinal pain radiating as if untied, excess presents as closure/strangury, chills, rolling spinal pain, blurred vision/somnolence, oral heat; deficiency presents as lower back pain, cold Jue... Shaoyin pain. For lower back pain preventing... pain... pain, leg weakness; Pugen (BL60) is the primary point. For lower back pain flanking spine to head, blurred vision, eyes blurry; Weizhong (BL40) is the primary point (referring to previous bleeding of Foot Taiyang Weizhong). For lower back pain allowing bending but not extension, fear of falling, caused by heavy lifting with evil blood accumulation; Yinmen (BL37) is the primary point (referring to previous Hengluo vessel lower back pain). For spinal/sacral/thigh/gluteal cold/pain, deficiency causes blood movement, excess causes combined heat/pain, hemorrhoid pain/sacral swelling...