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[Ping An]: This chapter, from the beginning to the end, is found in *Suwen* (Basic Questions), Volume 11, Chapter 41 "Needling for Lumbar Pain", and also in *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion), Volume 9, Chapter 8, with only slight differences in arrangement.

The Foot-Taiyang Meridian causes lumbar pain that radiates to the neck, spine, and sacrum, with a sensation of heaviness in the back as if bearing a heavy load. Needling the [Jinmen (BL60)] point of the Foot-Taiyang Regular Meridian to induce bleeding is indicated, but bleeding should be avoided in spring. (The neck, spine, and sacrum are all areas traversed by the Foot-Taiyang Meridian, hence the radiating pain. Jinmen refers to the Foot-Taiyang meridian point BL60. The Qi of the Foot-Taiyang Meridian declines in winter and spring; inducing bleeding may cause deficiency, hence it is prohibited.)

The Foot-Shaoyang Meridian causes lumbar pain, feeling as if a needle were piercing the skin, with stiffness preventing flexion and extension, and inability to look back. Needling the end of the Chenggu bone of the Foot-Shaoyang Meridian to induce bleeding is indicated, where the Chenggu bone is the solitary prominent bone on the lateral side of the knee. Bleeding should be avoided in summer. (Foot-Shaoyang refers to the Foot-Shaoyang Gallbladder Meridian. Its pathway runs through the neck and hypochondrium, emerges at the Qichuan point, and passes through the waist, causing lumbar pain with restricted movement. Chenggu refers to the large bone protruding laterally at the knee patella, which the Foot-Shaoyang Meridian passes near; thus needling it treats lumbar pain. The Qi of the Foot-Shaoyang Meridian declines from spring to summer; inducing bleeding may cause deficiency, hence it is prohibited. Ping An: In *Suwen* and *Jiayi Jing*, "xunran" is written as "xunxunran". "Cannot look back" in *Suwen* is "cannot look back", while in *Jiayi Jing* it is "cannot look left or right". Chenggu is written as "Shenggu" in *Jiayi Jing*. Below "duli" (solitary prominence), *Suwen* and *Jiayi Jing* have the character "zhe".)

The Foot-Yangming Meridian causes lumbar pain with inability to look back; when looking back, visual hallucinations may occur, accompanied by a tendency toward sadness. Needling three points anterior to the knee on the Foot-Yangming Meridian, harmonizing upper and lower, and inducing bleeding is indicated. Bleeding should be avoided in autumn. (A branch of the Foot-Yangming Meridian follows the throat into the Supraclavicular Fossa; another branch descends within the abdomen to the Qichuan point, causing lumbar pain with restricted head turning. Deficiency of Yangming Grain Qi leads to delusions. Deficiency allows Liver Qi to overact, causing sadness. Descending along the lateral aspect of the tibia, needling here harmonizes upper and lower. The Qi of the Foot-Yangming Meridian declines in mid-summer to autumn; inducing bleeding may cause deficiency, hence it is prohibited. Ping An: In *Suwen* and *Jiayi Jing*, "bu ke gu" is "bu yi ke gu", "xi bei" is "shan bei", [missing text] is [missing text]. Xin Zhengjiao states: "*Jiayi Jing* [missing text] is [missing text]." The current version of *Jiayi Jing* still uses [missing text]. Additionally, Yuan Ke's edition adds the character "mai" (meridian) before "zhongxia" (mid-summer).)

The Foot-Shaoyin Meridian causes lumbar pain radiating to the interior of the spine. Needling the Foot-Shaoyin Meridian two cun below the medial malleolus is indicated. Bleeding should be avoided in spring, as it causes severe deficiency that cannot be recovered. (The Foot-Shaoyin Meridian ascends along the posterior medial aspect of the thigh, penetrates the spine, belongs to the Kidney, and connects with the Bladder, causing lumbar pain radiating to the spinal interior. Emerging below Ran Gu and following behind the medial malleolus, the point below the medial malleolus is selected. The Qi of Shaoyin and Taiyang declines in winter to spring; inducing bleeding may cause deficiency, hence it is prohibited. Ping An: "Jinei tong" (pain inside the spine) in *Suwen* and *Jiayi Jing* is "jin nei lian". *Suwen* Xin Zhengjiao states: "Quan Qiqi's edition has 'jin nei lian' as 'jin nei tong', consistent with *Taisu*. The preceding section on Foot-Taiyin lumbar pain and its needling method is likely a missing bamboo slip in the ancient text.")

The Juyin Meridian causes lumbar pain with tightness in the waist like a drawn bowstring. Needling the Juyin Meridian at the exterior of the heel's fish-belly area, where nodules are palpable, is indicated. This condition causes mutism and mental dullness; three needle insertions are performed. (The Juyin Meridian is located at the exterior of the heel's fish-belly area. Only the Foot-Taiyang Meridian exists there, so it is likely the collateral of the Foot-Taiyang Meridian. Ping An: Juyin in *Suwen* and *Jiayi Jing* is "Jueyin". Wang Bing's commentary states: "Jueyin was written as Juyin due to cursive script confusion between 'Jue' and 'Ju'. 'Nu' (bow) in *Suwen* and *Jiayi Jing* has the character 'gong' (bow). Yuchang is written as 'yufu'. Xun zhi in *Jiayi Jing* is 'xunxun'. Yan in *Suwen* and *Jiayi Jing* is 'shanyan'. *Suwen* Xin Zhengjiao states: "Carefully examining, 'shanyan' (speaking well) and 'momo' (silent) are difficult to coexist; Quan Qiqi's edition lacks 'shan', which is more logical." Heihe in *Suwen* and *Jiayi Jing* is "momo".)

The Jie Meridian causes lumbar pain radiating to the chest, blurred vision, and occasional urinary incontinence. Needling the Jie Meridian between the pulling muscle fibers, at the transverse vessel outside the Xi point, inducing bleeding until the blood changes color is indicated. (Pathology in the Jie Meridian pathway resembles Foot-Jueyin, possibly being its collateral. Ping An: In *Suwen* and *Jiayi Jing*, "yin ying" is "yin jian", [missing text] is [missing text], "yin jin" is "xi jin", and "zhi" has the character "er" before it. Roujin, Yuan Ke's edition writes rou as nei.)

The Tongyin Meridian causes lumbar pain feeling like a small needle stuck inside, with stagnation and swelling. Needling the Tongyin Meridian at the end of the Jiegu bone above the lateral malleolus, with three needle insertions, is indicated. (The Tongyin Meridian is at the end of the Jiegu bone above the lateral malleolus, likely the collateral of the Foot-Shaoyang Meridian. Ping An: Xiaozhen in *Suwen* and *Jiayi Jing* is "xiao chui". *Suwen* Xin Zhengjiao states: "*Taisu* writes xiao chui as xiao zhen." Fu in *Suwen* and *Jiayi Jing* is "fu".)

The Jie Meridian causes lumbar pain as if separated, resembling a broken waist, with irritability or fear. Needling the Jie Meridian at the knot-like collateral the size of a millet seed in [missing text], inducing blackish blood spray, stopping when red blood appears, is indicated. (The previous Jie Meridian resembled Jueyin; this needling of the Jie Meridian [missing text] likely targets the collateral of the Foot-Jueyin [missing text]. Ping An: Ru bie in *Suwen* is "ru yin dai", in *Jiayi Jing* is "ru lie". Xi nu in *Suwen* is "shan kong", in *Jiayi Jing* is "shan nu". Si hei in *Suwen* and *Jiayi Jing* is "yi hei". *Suwen* Xin Zhengjiao states: "According to Quan Qiqi, there are two Jie meridians with different pathologies; caution is advised regarding inaccuracies." This entry in *Suwen* precedes the Tongyin Meridian section.)

The Yangwei Meridian causes lumbar pain with upper body stagnation and vessel swelling. Needling the Yangwei Meridian where it joins the Taiyang Meridian in the [missing text] lower region, about one chi above the ground, is indicated. (Yangwei is the meeting point of all Yang meridians, extending from the head down to Jinmen and Yangjiao. It travels through the waist joining the Foot-Taiyang Meridian in the [missing text] lower region, one chi above the ground, treating Yangwei swelling and pain. Ping An: In *Suwen* and *Jiayi Jing*, "tong yao" is followed by "zhong tong". Fu is "fu". Under "zhong", the character "mai" is absent. Shang di is "qu di".)

The Chongjue Meridian causes lumbar pain preventing flexion and extension, with fear of falling. This results from heavy lifting injuring the waist, severing the Chong Meridian collaterals, causing evil blood to accumulate. Needling between the Xi-yang tendons, several cun above the Xi point at the Chong Meridian's location, inducing bleeding in two stages, is indicated. (The Chong Meridian runs along the spine. Heavy lifting severs the Chong collaterals, causing evil blood accumulation leading to lumbar pain. One can needle between the Xi-yang tendons, several cun above the Xi point where Chong Qi resides. Ping An: Chongjue in *Suwen* and *Jiayi Jing* is "Hengluo". "Tong bu ke fu, bu ke yang, ze kong pu" in *Suwen* is "bu ke fuyang, yang ze kong pu"; in *Jiayi Jing* it is "de [missing text] bu ke yang, yang ze kong pu". Jueluo in *Suwen* is "luojue", in *Jiayi Jing* is "luojue shang". *Jiayi Jing* writes "jin zhi jian" as "zhi jin jian".)

Huayin disease causes lumbar pain with profuse sweating, dryness inducing thirst, and restlessness. Needling the Shuyang Meridian three cun above, located horizontally at [missing text] three cun below the Qiao point, bleeding the full vessels, is indicated. (Needling Shuyang, some versions read Huiyang, the horizontal collateral below Qiao. Ping An: Luoluoran in *Jiayi Jing* is [missing text] ran. *Suwen* and *Jiayi Jing* add "chu" after "han", repeat "yin" after "yin", write two [missing text] as three [missing text], and Qiao as "qiao". Xi xia xia san cun suo in *Suwen* is [missing text] xia wu cun; in *Jiayi Jing* it is [missing text] xia san suo.)

Feiyang Meridian causes lumbar pain with a [missing text] sensation, progressing to sorrow and fear. Needling the Feiyang Meridian two cun above the medial malleolus, anterior to the Foot-Taiyin, where it meets the Yinwei Meridian, is indicated. (The distinct branch of Foot-Taiyang is named Feiyang; some versions write Fei as Fei. The Taiyang Meridian diverges seven cun above the lateral malleolus to the Foot-Shaoyin. At two cun above the medial malleolus, anterior to the Foot-Shaoyin, meeting the Yinwei Meridian, is the needling site. Ping An: Er cun in *Suwen* is five cun; Xin Zhengjiao states it should be two cun. Taiyin in *Suwen* and *Jiayi Jing* is Shaoyin. Based on the note "anterior to Foot-Shaoyin meeting Yinwei", Taiyin is likely a scribal error for Shaoyin.)

Changyang Meridian causes lumbar pain radiating to the chest, blurred vision, severe opisthotonos, tongue retraction, and aphasia. Needling Neijin twice, located anterior to the large tendon at the medial malleolus, posterior to the Foot-Taiyin, three cun above the ankle, is indicated. (Neijin is anterior to the large tendon at the ankle, posterior to the Foot-Taiyin, three cun above the medial malleolus. The large tendon is likely the tendon of the Foot-Taiyin. Neijin branch is anterior to the Foot-Taiyang large tendon, posterior to the Foot-Taiyin tendon, three cun above the medial malleolus. Ping An: In *Suwen*, "nei huai" is "nei huai shang", and "san cun" is "er cun".)

San Meridian causes lumbar pain with heat, severe heat causing irritability, a sensation of a horizontal wood block in the lower waist, and severe urinary incontinence. Needling the San Meridian in the muscle intervals anterior to the knee, at the outer edge of the collateral, binding the vessels for three insertions, is indicated. (Where the San Meridian is anterior to the knee, among the twelve regular meridians, only Foot-Jueyin and Foot-Shaoyang govern urination anterior to the knee; thus, these are likely aliases for these two meridians. The small tendons outside the major collaterals of these two meridians are called Shumai, also known as San Meridian. Ping An: In *Suwen* and *Jiayi Jing*, "rou" has the character "gu" before it, and "luo" lacks "zai". Note: Yuan Ke mistakenly wrote "mai qian" instead of "xi qian".)

Rouli Meridian causes lumbar pain preventing coughing; coughing induces tendon spasms. Needling the Rouli Meridian twice, located external to Foot-Taiyang and posterior to the Foot-Shaoyang Jiegu, is indicated. (External to Taiyang, posterior to Jiegu, likely refers to Shaoyin as the Rouli Meridian. Ping An: Jin luanji, in *Suwen* "luan" is "suo"; *Jiayi Jing* lacks "ji". *Jiayi Jing* writes "zhi hou" as "zhi duan".)

Lumbar pain involving the spine radiating to the head, with a heavy sensation, blurred vision, and stiffness, is treated by needling the Foot-Yangming Meridian to induce bleeding. (The Foot-Yangming Meridian is below the head; its branch originates from below the stomach mouth, descends through the abdomen to Qichuan, near the spine. Thus, lumbar pain is treated by needling the Foot-Yangming to induce bleeding. Ping An: In *Suwen* and *Jiayi Jing*, "chen chen" is "jiji", [missing text] is [missing text], "jiang" has "pu" after it, and [missing text] has "zhong" after it. *Suwen* Xin Zhengjiao states: "*Taisu* writes 'tou chen chen ran'.")

For lumbar pain with cold in the upper part, needle Foot-Taiyang and Foot-Yangming; for heat in the upper part, needle Foot-Jueyin; for inability to flex/extend, needle Foot-Shaoyang; for heat in the middle part with panting, needle Foot-Shaoyin, and bleed at [missing text]. (For upper heat, tonify the Foot-Taiyang and Foot-Yangming meridians at the waist. For upper cold, sedate the Foot-Jueyin meridian at the waist. Foot-Shaoyang governs joint mechanics; for restricted movement, select Foot-Shaoyang. For middle heat with panting, bleed at [missing text] of Foot-Shaoyin. Ping An: Ru chuan in *Suwen* and *Jiayi Jing* is "er chuan". Note: "guan" is missing after "ji" in Yuan Ke's edition. The character missing after "zhong re" was annotated as "ji" in the original copy. Also, the note on upper heat/cold contradicts the text, suggesting an error.)

Lumbar pain radiating to the hypochondrium preventing extension is treated by needling the intersection of the lumbar and sacral regions at the upper gluteal muscles, using the number of needles based on the waxing/waning moon, with immediate relief upon withdrawal. ([Missing text], pronounced zhao. Shen refers to the muscles on both sides of the spinal column. Ping An: Liang shen shang in *Suwen* and *Jiayi Jing* is "liang huai shen shang". *Suwen* adds "left take right, right take left" after "li yi".)

For lumbar pain with cold in the painful area, select Foot-Taiyang; for heat, select Foot-Jueyin; for inability to flex/extend, select Foot-Taiyang; for middle heat with panting, select Foot-Shaoyin and bleed the [missing text] collateral. (Previous lumbar pain involved bleeding [missing text]; this involves [missing text]. Ping An: This section is absent in *Jiayi Jing*. In *Suwen*, it precedes the "lumbar pain radiating to hypochondrium" section, with slight textual differences. *Suwen* states: "Lumbar pain, upper cold unable to look back, needle Foot-Yangming; upper heat, needle Foot-Taiyin; middle heat with panting, needle Foot-Shaoyin. Difficulty in defecation, needle Foot-Shaoyin. Hypogastric fullness, needle Foot-Jueyin. Like breaking, unable to flex/extend or lift, needle Foot-Taiyang. Radiating to inner spine, needle Foot-Shaoyin." Xin Zhengjiao states: "According to Quan Qiqi's edition, *Jiayi Jing*, and *Taisu*, there is no text from 'lumbar pain upper cold' to here; it was added by Wang Bing." Re-examining this book, this section on upper cold matches the previous one, except for flexion/extension where Foot-Taiyang is needled, differing from Foot-Shaoyang. The note says the previous line bleeds [missing text], this line [missing text], implying they complement each other.)