经曰∶腰者肾之腑。若痘疮而见前症者，皆因肾经虚怯，相火内燥，真阴不能胜邪，故腰作痛也。急服地黄丸，以
防变黑归肾，乃克有济。大抵此痘，因禀赋肾家精气不足，故目睛多白，俗谓之折腰痘是也。若平素面白，眼白睛多，
行迟语迟者，出痘必归肾经。预为调补肾气，庶免此患。
一小儿十三岁，眼睛多白，或时面赤，常患颈痛，尺脉洪数，先君谓禀肾气虚，用地黄丸料，煎服而愈。至十五岁
出痘，先君云须多服前药，仍用地黄丸、益气汤，更加倦怠，乃以地黄丸大剂，煎与恣饮，又用大剂八珍汤，痘渐出，
如式，恪服前药，至期岁，二药计十七斤余而愈。先君每见婴儿白睛多，面色白，或色赤，令其预补脾肾，以防出痘，
但信者少耳。
一小儿出痘腰痛，足热发渴。此禀肾虚火动也，先君用大剂加减八味丸料，煎与恣饮，诸症渐退，佐以大剂八珍加
紫草、糯米数剂，脓渐贯，仍以前药而结痂，用八珍汤而靥。
一小儿出痘将愈，因停食泄泻，作渴腰痛，此脾肾虚弱也，先君用加减八味丸料，及五味异功散，渴泻顿止；又与
六味丸料及八珍汤而靥。
一小儿出痘，愈后腰足作痛，此禀足三阴虚也，用六味丸料煎服，及补中益气汤而愈。后又伤食，作泻腰痛，用四
神丸、六味丸而愈。
一小儿面色常白，目睛多白，时常腰痛，两足时热，冬不衣绵，年九岁，先君谓禀肾虚，令每日服地黄丸，至十岁，
出痘腰痛，发渴面赤饮冷，用地黄丸，每剂加肉桂半钱，煎
与恣饮，数剂之后，热渴顿止，腰痛顿愈，却去肉桂，仍与服之，至五十余剂而靥。
一小儿痘愈后，腰痛口渴，两足生疮，饮水不绝，此禀足三阴虚，先君用地黄丸、益气汤。至毕姻后，不慎起居，
复患瘰 ，以致不起。
一小儿面素白，发热作渴，或面生疮，先君谓肾虚，用加味地黄丸、补中益气汤而愈。后出痘腰痛，仍用前药而痊。
次年毕姻，患肾 而卒。
加味地黄丸
熟地黄（酒浸蒸丸晒干，八两，酒杵杵膏）
山茱萸肉 干山药 五味子（炒，各四两） 泽泻 白茯苓 牡丹皮 鹿茸（炙。各三两） 肉桂（浓者去皮取肉，
一两，发热者以此加之，引虚火归肾经而热自止也）
上各另为末，入地黄和匀，量入米糊丸服，煎服更好。
六味地黄丸
五味异功散
补中益气汤
八珍汤（方见顶陷灰白）
二神丸
四神丸（二方见痘作泻）
八味丸（即六味丸加附子、肉桂，各一两，方见痘作渴）
《黄帝内经》说：腰是肾的外府。如果患痘疮时出现上述症状，都是因为肾经虚弱怯弱，相火在内燥动，真阴不能制约邪气，所以腰部疼痛。应当急服地黄丸，以防止痘毒变黑归入肾经，这样才能取得疗效。大抵这类痘证，是因为先天禀赋中肾家精气不足，所以眼睛白多黑少，俗称“折腰痘”。如果平时面色苍白，眼白部分较多，走路晚、说话晚的，出痘时必然归入肾经。预先调理补益肾气，或许能避免这种祸患。
有一个十三岁的儿童，眼睛白多黑少，有时面部发红，经常患颈部疼痛，尺脉洪大而数。先父认为这是禀受肾气虚弱，用地黄丸的药料煎服而痊愈。到十五岁出痘时，先父说必须多服用前面的药物，仍然使用地黄丸、益气汤。患儿更加倦怠无力，于是用大剂量的地黄丸，煎好后让患儿随意大量饮用，又用大剂量的八珍汤，痘疹逐渐发出，形态正常，严格服用前面的药物，等到结痂期，两种药合计服用十七斤多才痊愈。先父每次见到婴儿白睛多，面色白，或者面色红，都让他们预先补益脾肾，以防出痘时发生病变，但相信的人很少。
有一个儿童出痘时腰痛，足部发热并感到口渴。这是禀受肾虚导致虚火妄动。先父用大剂量的加减八味丸药料，煎好后让患儿随意大量饮用，各种症状逐渐消退，配合大剂量的八珍汤加入紫草、糯米等几剂药，脓液逐渐充盈饱满，仍然用前面的药物使痘疮结痂，最后用八珍汤使痘疮脱落愈合。
有一个儿童出痘即将痊愈时，因为停食导致泄泻，出现口渴和腰痛，这是脾肾虚弱所致。先父用加减八味丸药料，以及五味异功散，口渴和泄泻立刻停止；又给予六味丸药料及八珍汤，使痘疮脱落愈合。
有一个儿童出痘，痊愈后腰部和足部疼痛，这是禀受足三阴经（肝、脾、肾）虚损所致。用六味丸药料煎服，以及补中益气汤而痊愈。后来又因伤食，出现腹泻和腰痛，用四神丸、六味丸而痊愈。
有一个儿童面色常白，眼睛白多黑少，时常腰痛，两足时常发热，冬天不穿棉衣，九岁时，先父认为这是禀受肾虚，命令每天服用地黄丸。到十岁出痘时腰痛，发热口渴想喝冷水，使用地黄丸，每剂药加入半钱肉桂，煎好后让患儿随意大量饮用，服用几剂之后，发热口渴立刻停止，腰痛立刻痊愈，随后去掉肉桂，继续服用该药，直到服用五十多剂后才使痘疮脱落愈合。
有一个儿童痘疮痊愈后，腰痛口渴，两足生疮，喝水不停，这是禀受足三阴虚损所致。先父使用地黄丸、益气汤。到了结婚后，不注意起居调摄，又患瘰疬，以致最终死亡。
有一个儿童平时面色白，发热口渴，有时面部生疮，先父认为是肾虚，用加味地黄丸、补中益气汤而痊愈。后来出痘腰痛，仍然用前面的药物而康复。次年结婚后，患肾脏疾病而去世。
加味地黄丸
熟地黄（用酒浸泡蒸熟后晒干，制成丸或捣成膏，八两）
山茱萸肉 干山药 五味子（炒，各四两） 泽泻 白茯苓 牡丹皮 鹿茸（炙，各三两） 肉桂（浓者去皮取肉，一两，发热者以此加之，引虚火归肾经而热自止也）
以上各药分别研为细末，加入地黄混合均匀，根据情况加入米糊制成丸剂服用，煎汤服用效果更好。
六味地黄丸
五味异功散
补中益气汤
八珍汤（方剂见顶陷灰白章节）
二神丸
四神丸（两个方剂见痘作泻章节）
八味丸（即六味丸加附子、肉桂，各一两，方剂见痘作渴章节）
The *Yellow Emperor's Inner Classic* states: The waist is the mansion of the Kidney. If the aforementioned symptoms appear during smallpox, it is due to deficiency and weakness of the Kidney Meridian, with ministerial fire stirring internally causing dryness, and true Yin failing to overcome the pathogenic factor, thus resulting in waist pain. One should urgently administer Dihuang Wan (Rehmannia Pill) to prevent the rash from turning black and returning to the Kidney, which will ensure efficacy. Generally, this type of smallpox arises from congenital insufficiency of essence and Qi in the Kidney, hence the eyes have more white than black, commonly known as "broken-waist smallpox." If one usually has a pale complexion, more white in the eyes, delayed walking, and delayed speech, the smallpox will inevitably return to the Kidney Meridian. Preemptively regulating and tonifying Kidney Qi may avoid this affliction.
A thirteen-year-old child had eyes with more white than black, occasional facial redness, frequent neck pain, and a chi pulse that was flooding and rapid. My late father attributed this to congenital Kidney Qi deficiency and prescribed Dihuang Wan decoction, which resulted in a cure. At fifteen years old, when he developed smallpox, my late father advised continuing the previous medication, using Dihuang Wan and Yiqi Tang (Qi-Supplementing Decoction). The child became increasingly fatigued, so a large dose of Dihuang Wan was decocted for free consumption, along with a large dose of Bazhen Tang (Eight-Treasure Decoction). The rash emerged gradually and normally. Strict adherence to these medications led to recovery after consuming over seventeen jin (approx. 8.5 kg) of the two medicines by the scabbing stage. Whenever my late father observed infants with prominent whites in the eyes, pale or reddish complexions, he advised preemptive tonification of Spleen and Kidney to prevent complications during smallpox eruption, though few believed him.
Another child presented with waist pain, hot feet, and thirst during smallpox. This indicated congenital Kidney deficiency with stirring of deficient fire. My late father administered a large dose of Jiawei Bawei Wan (Modified Eight-Ingredient Pill) decoction for free consumption, leading to gradual subsidence of symptoms. He supplemented this with several doses of a large dose of Bazhen Tang added with Zicao (Arnebiae Radix seu Rhizoma) and Nuomi (Oryzae Semen Glutinosum), allowing pus to fill the lesions. The scabs formed using the previous medication, and the crusts fell off using Bazhen Tang.
A third child, nearing recovery from smallpox, suffered from food stagnation-induced diarrhea, thirst, and waist pain, indicating Spleen and Kidney deficiency. My late father used Jiawei Bawei Wan decoction and Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder), which immediately stopped the thirst and diarrhea. Subsequently, Liuwei Wan (Six-Ingredient Pill) decoction and Bazhen Tang were given to facilitate crust shedding.
A fourth child experienced waist and foot pain after recovering from smallpox, attributed to congenital deficiency of the Foot Three Yin meridians (Liver, Spleen, Kidney). Treatment with Liuwei Wan decoction and Buzhong Yiqi Tang (Middle-Warmer Qi-Supplementing Decoction) resulted in recovery. Later, following dietary injury causing diarrhea and waist pain, Sishen Wan (Four-Spirit Pill) and Liuwei Wan cured the condition.
A fifth child, aged nine, often had a pale face, eyes with more white than black, frequent waist pain, hot feet, and refused cotton clothing in winter. My late father diagnosed congenital Kidney deficiency and ordered daily Dihuang Wan. At ten years old, during smallpox onset with waist pain, fever, thirst, and desire for cold drinks, Dihuang Wan was prescribed with half a qian (approx. 2.5g) of Rougui (Cinnamomi Cortex) per dose, taken freely. After several doses, fever and thirst ceased, and waist pain resolved. Rougui was then removed, and the base formula continued for over fifty doses until crust shedding.
A sixth child suffered from waist pain, thirst, and ulcers on both feet with incessant drinking after smallpox recovery, indicating congenital deficiency of the Foot Three Yin meridians. My late father treated with Dihuang Wan and Yiqi Tang. After marriage, neglecting lifestyle regulation, he contracted scrofula (luoli) and eventually died.
A seventh child, usually pale-faced, presented with fever, thirst, and occasional facial sores. My late father attributed this to Kidney deficiency and prescribed Jiawei Dihuang Wan (Modified Rehmannia Pill) and Buzhong Yiqi Tang, resulting in recovery. Later, during smallpox with waist pain, the same medications cured him. He married the following year, developed kidney disease, and died.
**Jiawei Dihuang Wan (Modified Rehmannia Pill)**
Shudihuang (Prepared Rehmanniae Radix, soaked in wine, steamed, dried, pounded into paste, 8 liang)
Shanzhuyu (Corni Fructus)
Ganshan Yao (Dioscoreae Rhizoma)
Wuweizi (Schisandrae Fructus, stir-fried, 4 liang each)
Zexie (Alismatis Rhizoma)
Baifuling (Poria with Hostwood)
Mudanpi (Moutan Cortex)
Lurong (Cervi Cornu Pantotrichum, roasted, 3 liang each)
Rougui (Cinnamomi Cortex, peeled meat from thick bark, 1 liang; add if feverish to guide deficient fire back to the Kidney meridian, stopping heat naturally)
Grind all ingredients separately into fine powder, mix evenly with Shudihuang, form pills with rice paste for oral administration; decoction is also effective.
**Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill)**
**Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder)**
**Buzhong Yiqi Tang (Middle-Warmer Qi-Supplementing Decoction)**
**Bazhen Tang (Eight-Treasure Decoction)** (See formula for depressed gray-white rash)
**Ershen Wan (Two-Spirit Pill)**
**Sishen Wan (Four-Spirit Pill)** (See formulas for smallpox-induced diarrhea)
**Bawei Wan (Eight-Ingredient Pill)** (i.e., Liuwei Wan plus Fuzi (Aconiti Lateralis Radix Preparata) and Rougui (Cinnamomi Cortex), 1 liang each; See formula for smallpox-induced thirst)