腰为肾府。肾与膀胱为表里。在经属太阳。在脏属肾气。诸脉皆贯于肾。而络于腰脊。故腰
痛悠悠不止乏力酸软者肾虚也。遇阴雨久坐。则冷痛沉重者。湿也。遇寒而痛。足冷背强者
。寒也。遇热而痛者热也。郁怒而痛者气滞也。忧愁思虑而痛者气虚也。劳动则痛者肝肾衰
也。风痛则牵连左右。脚膝强急。挫闪痛者。举身不能俯仰转侧。瘀血作痛。昼轻夜重。便
黑溺清。(刺委中)。肾着腰痛身重。腰冷如冰。亦由湿也。
跌扑伤而腰痛者此伤在筋骨。而血脉凝滞也。用酒糟葱姜捣烂罨之最效。
俗以身痛呼为箭风者。因其人卫气虚腠理不密。贼风乘虚而入客于经络营卫不通。则痛
处按之用针挑出形如羊毛。此即闭塞结硬之络脉也而挑时暂快。过则依然。治法或燃麻油灯
淬之或用艾叶温散或用白芥子为末调敷。或用金银花内服取效。
五脏之滞。皆为心痛。肾心痛者。多由阴邪上冲。故善螈如从后触其心。胃心痛者。多由停
滞。故胸腹胀满。脾心痛者。多由寒逆中焦。故其痛甚。肝心痛者。多由木火之郁。病在血
分。故色苍苍如死状。肺心痛者。多由上焦不清。病在气分。故动作则病益甚。(以上刺法
见灵枢厥病篇)知其在气则顺之。在血则行之。郁则开之滞则逐之。火多实则或散或清之。
寒多虚。则或温或补之。得其本。可随手而应也。真心痛者。不可治。(金匮要略心痛章沈
氏注曰五脏胃府心痛并痰虫食积即为九痛)外台九种心痛之名一虫二注。三气四悸。五食六
饮七冷。八热。九去来痛。
心痛有上中下三焦之别上焦痛者。在膈上。内经所谓胃脘当心而痛。时人以此为心痛非
也。中焦痛者。在中脘。脾胃间病也。下焦痛者。在脐下肝肾大小肠病也。
The waist is the mansion of the Kidney. The Kidney and Bladder are exterior-interiorly related. In terms of meridian affiliation, it belongs to the Taiyang (Greater Yang) channel; in terms of zang-organ affiliation, it pertains to Kidney Qi. All meridians penetrate the Kidney and connect with the lumbar spine. Therefore, lingering lower back pain accompanied by fatigue, soreness, and weakness indicates Kidney deficiency. Cold pain and heaviness occurring after exposure to rainy weather or prolonged sitting indicate Dampness. Pain exacerbated by cold, accompanied by cold feet and a stiff back, indicates Cold. Pain exacerbated by heat indicates Heat. Pain caused by anger and depression indicates Qi stagnation. Pain caused by worry and overthinking indicates Qi deficiency. Pain aggravated by labor indicates decline of the Liver and Kidney. Wind-induced pain radiates to both sides, causing stiffness and urgency in the legs and knees. Sprain or contusion pain manifests as an inability to bend, extend, or turn the body. Blood stasis pain is characterized by being lighter during the day and heavier at night, with dark stools but clear urine. (Treatment: puncture Weizhong [BL-40]). Lower back pain due to "Kidney Fixation" (Shenzhuo), characterized by heavy body sensation and a waist feeling cold as ice, is also caused by Dampness.
Lower back pain resulting from falls or blows indicates injury to the sinews and bones, leading to coagulation and stagnation of blood vessels. Applying a paste made of fermented rice wine lees, fresh ginger, and scallions is most effective.
Commonly, generalized body pain is referred to as "Arrow Wind." This occurs because the patient's Defensive Qi (Wei Qi) is deficient and the interstices (cou li) are not tight, allowing pathogenic winds to enter vacuously and lodge in the meridians, obstructing the flow of Ying (Nutritive) and Wei (Defensive) Qi. Pressing on the painful area and picking with a needle may extract wool-like filaments, which represent blocked and hardened collateral vessels. Although relief is temporary after picking, the condition returns. Treatment methods include cauterization with a burning sesame oil lamp, warming and dispersing with mugwort (Ai Ye), applying a poultice of white mustard seed powder, or internally administering Honeysuckle Flower (Jinyinhua).
Stagnation in any of the Five Zang organs can cause Heart pain. Kidney Heart pain is often caused by Yin pathogens rushing upward, manifesting as spasms and a sensation as if being struck from behind. Stomach Heart pain is often caused by food stagnation, manifesting as chest and abdominal fullness. Spleen Heart pain is often caused by Cold rebellion in the Middle Jiao, manifesting as severe pain. Liver Heart pain is often caused by the depression of Wood and Fire, affecting the Blood level, manifesting as a pale cyan complexion resembling death. Lung Heart pain is often caused by turbidity in the Upper Jiao, affecting the Qi level, manifesting as worsening symptoms upon movement. (The above needling methods are detailed in the *Ling Shu: Jue Bing* chapter). If the disease is in the Qi, regulate its flow; if in the Blood, invigorate it; if depressed, open it; if stagnant, expel it. For excess Fire patterns, use dispersing or clearing methods; for deficiency Cold patterns, use warming or tonifying methods. Grasping the root allows for immediate efficacy. True Heart pain is incurable. (Shen’s commentary on the *Heart Pain* chapter of the *Jin Gui Yao Lue* states that heart pain involving the five zang organs and stomach fu, accompanied by phlegm, parasites, or food accumulation, constitutes the nine types of pain. The *Wai Tai Mi Yao* lists nine names for heart pain: 1. Parasite, 2. Impression/Transmission, 3. Qi, 4. Palpitation, 5. Food, 6. Drink, 7. Cold, 8. Heat, 9. Wandering).
Heart pain is distinguished by the Upper, Middle, and Lower Jiao. Upper Jiao pain is located above the diaphragm; the *Nei Jing* refers to this as "epigastric pain striking the heart center." It is incorrect for contemporary people to label this simply as heart pain. Middle Jiao pain is located at the Zhongwan region, indicating pathology between the Spleen and Stomach. Lower Jiao pain is located below the umbilicus, indicating pathology of the Liver, Kidney, Large Intestine, and Small Intestine.