左归（饮）去茯古传心（加入）生地当归养胃阴，病重必须求峻剂，三（一承）气（汤）通结得良箴。
食入反出胃家寒，信服吴萸（茱萸汤）治不难，更有下焦之火化，理中（汤加入）椒附令加餐。
胃反（《金匮》以吐逆名“胃反”。）首推半夏汤，厥名曰大迈寻常，阳明能纳冲能降，不
在寒温论短长。
隔证，余宗《经》文“三阳结”一句为主，以大便如羊矢为死证。今考《灵枢·邪气脏
腑病形篇》曰∶“肾脉微缓为洞，洞者食不化，下咽还出”此三句，堪为隔证对面诊法。骆
龙吉遵《内经》专立病名曰“洞”。注云∶“肾主二便。”今肾脉少缓，则肾气虚矣。肾气
既虚，则大便不能禁固，所以食饮不化，一下咽噎，旋即吐出。“旋”与“还”同，名为洞
，风是也。洞当作“ ”，风气洞彻五脏也。《史记·太仓公》曰∶“ 风者，食饮下
嗌而
辄出不留，病得之溷。”又曰∶“ 风之状，饮食下嗌辄后之，病得之饱食而疾走。”注
谓
∶后，如厕也。马元台注为洞泄，少误，况下文又有小甚焉。《仁斋直指》以不换金正气散
送下安肾丸，又用二神丸收功。
腰痛证。《内经·刺腰痛篇》曰∶“足太阳脉浮，令人腰痛。”言外感也，以五积散主
之。《脉要精微论》曰∶“腰者，肾之府，转摇不动，肾将惫矣。”言内虚也，以六味地黄
丸、桂附八味丸加牛膝、杜仲、淫羊藿、鹿茸、补骨脂主之。痛如刺者为死血，以鹿角为末
，又以肉桂、牛膝、乳香、没药、元胡、桃仁、红花酒煎送下四钱。痛而重着，如带五千钱
者为湿气，宜肾着汤，痛而游走，或作止不定者为痰积，宜二陈汤加南星及快气之品，使痰
随气运。又白术能利腰剂？之死血，凡腰痛诸药罔效者，用白术两许，少佐他药，一服如神。
《太平圣惠方》治风冷，寒痹，腰痛，用川草乌三个，生捣为末，少加盐水，摊于纸上，贴
痛处即愈。以腰为肾府，故列于里证。
左归饮去掉茯苓，加入生地、当归以滋养胃阴；若病情严重，必须寻求峻猛的方剂，使用三承气汤（大承气汤、小承气汤、调胃承气汤）来通下结滞，这是很好的准则。
食物吃进去又反吐出来，是胃中虚寒所致，信服吴茱萸汤治疗并不困难；更有下焦火化（肾阳不足导致虚火上浮或真寒假热）的情况，在理中汤中加入花椒、附子，以增加食欲和温补之力。
对于胃反病（《金匮要略》中将呕吐逆出称为“胃反”），首选半夏汤，其疗效远超寻常药物；只要阳明经能受纳、冲脉能降逆，就不必拘泥于寒证或温证的争论长短。
关于噎膈证，我主要依据《内经》中“三阳结”这一句经文，认为大便像羊屎一样干结是死证。现在考证《灵枢·邪气脏腑病形篇》说：“肾脉微缓为洞，洞者食不化，下咽还出”，这三句话，可以作为噎膈病的对面诊法。骆龙吉遵循《内经》，专门设立病名叫做“洞”。注释说：“肾主管二便。”如今肾脉微缓，说明肾气虚弱了。肾气既然虚弱，就不能固摄大便，所以饮食不能消化，一下咽就噎住，随即吐出。“旋”与“还”意思相同，这种病叫作“洞”，属于风邪。 “洞”应当写作“飧”（sūn），指风气洞彻五脏。《史记·仓公列传》说：“飧风者，饮食下嗌而辄出不留，病得之溷（hùn，污秽之处）。”又说：“飧风的症状，饮食下咽后随即排出，病是因为饱食后疾走引起的。”注解说：后，指如厕排便。马元台将其注为洞泄，稍微有误，况且下文还有更严重的情况。《仁斋直指方》用不换金正气散送服安肾丸，又用二神丸收功。
腰痛证。《内经·刺腰痛篇》说：“足太阳脉浮，令人腰痛。”这是指外感引起的，用五积散主治。《素问·脉要精微论》说：“腰是肾的府邸，转动摇晃不动，说明肾将要衰败了。”这是指内伤虚损，用六味地黄丸、桂附八味丸加牛膝、杜仲、淫羊藿、鹿茸、补骨脂主治。疼痛如针刺的是死血（瘀血），将鹿角研成末，再用肉桂、牛膝、乳香、没药、延胡索、桃仁、红花酒煎送服四钱。疼痛且沉重，像带着五千铜钱一样的是湿气，适宜用肾着汤。疼痛且游走不定，或发作停止没有规律的是痰积，适宜用二陈汤加天南星及行气的药物，使痰随气运行。另外，白术能利腰吗？针对死血，凡是各种腰痛药物无效时，使用一两左右的白术，稍加其他药物辅助，一服药后效果神奇。《太平圣惠方》治疗风冷、寒痹、腰痛，用川草乌三个，生捣成末，少加盐水，摊在纸上，贴在痛处即可痊愈。因为腰是肾的府邸，所以将其列在里证中。
Zuo Gui Yin (Left-Restoring Decoction) with Fu Ling (Poria) removed, and Sheng Di Huang (Rehmanniae Radix Preparata) and Dang Gui (Angelicae Sinensis Radix) added to nourish the Stomach Yin. If the condition is severe, a potent formula must be sought; San Cheng Qi Tang (Three Inheriting Qi Formulas: Da Cheng Qi Tang, Xiao Cheng Qi Tang, Tiao Wei Cheng Qi Tang) should be used to unblock accumulation, which serves as an excellent guideline.
Food entering the mouth but being regurgitated indicates Cold in the Stomach family; trusting Wu Zhu Yu Tang (Evodiae Fructus Decoction) for treatment is not difficult. Furthermore, in cases of Fire transformation in the Lower Jiao (deficiency fire arising from Kidney Yang deficiency), Li Zhong Tang (Regulate the Middle Decoction) with Hua Jiao (Zanthoxyli Pericarpium) and Fu Zi (Aconiti Lateralis Radix Preparata) added can enhance appetite and provide warming tonification.
For Wei Fan (Stomantic Regurgitation, named "Wei Fan" in *Jin Gui Yao Lue* referring to vomiting and reflux), Ban Xia Tang (Pinelliae Rhizoma Decoction) is recommended first, its efficacy far exceeding ordinary remedies. As long as the Yangming channel can receive and the Chong vessel can descend, there is no need to argue over whether the syndrome is Cold or Warm.
Regarding Ge Zheng (Dysphagia/Obstruction Syndrome), I primarily follow the *Nei Jing* statement "San Yang Jie" (Binding of the Three Yang channels), considering feces resembling sheep droppings as a sign of death. Examining the *Ling Shu · Xie Qi Zang Fu Bing Xing Pian* chapter, it states: "If the Kidney pulse is slightly slow, it indicates Dong (Cavity/Leakage); Dong means food is not digested and comes back out immediately after swallowing." These three sentences serve as a diagnostic method opposite to Ge Zheng. Luo Longji, following the *Nei Jing*, specifically established the disease name as "Dong". The annotation states: "The Kidney governs the two lower orifices." Since the Kidney pulse is slightly slow, Kidney Qi is deficient. Once Kidney Qi is deficient, it cannot secure the stool, so food and drink are not digested; upon swallowing, there is choking, followed by immediate vomiting. "Xuan" (soon/immediately) is synonymous with "Huan" (return). This condition is called "Dong," attributed to Wind pathogen. "Dong" should be written as "Sun" (Sunning/Diarrhea), meaning Wind Qi penetrates the Five Zang organs. *Shi Ji · Cang Gong Lie Zhuan* states: "Sun Feng (Wind of Sunning) causes food and drink to pass down the throat and come out without staying; the illness arises from filth." It also states: "The manifestation of Sun Feng is that food and drink are expelled shortly after swallowing; the illness arises from walking rapidly after a full meal." The annotation explains: "Hou" refers to defecating. Ma Yuantai annotated this as Dong Xie (Loose Stool), which is slightly inaccurate, especially given the subsequent mention of more severe cases. *Ren Zhai Zhi Zhi Fang* uses Bu Huan Jin Zheng Qi San (Metal-Unchanging Upright Qi Powder) administered with An Shen Wan (Kidney-Anchoring Pill), concluding treatment with Er Shen Wan (Two Spirit Pill).
Yao Tong Zheng (Lower Back Pain Syndrome). The *Nei Jing · Ci Yao Tong Pian* states: "Foot Taiyang pulse floating causes lower back pain," indicating external contraction, treated primarily with Wu Ji San (Five Accumulations Powder). *Su Wen · Mai Yao Jing Wei Lun* states: "The waist is the mansion of the Kidney; if turning and shaking are impossible, the Kidney is about to fail," indicating internal deficiency, treated with Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) or Gui Fu Ba Wei Wan (Cinnamon and Aconite Eight-Ingredient Pill) added with Niu Xi (Achyranthis Bidentatae Radix), Du Zhong (Eucommiae Cortex), Yin Yang Huo (Epimedii Folium), Lu Rong (Cervi Cornu Pantotrichum), and Gu Sui Bu (Psoraleae Fructus). Pain like stabbing indicates Si Xue (Dead Blood/Stasis); Cervi Cornu (Deer Antler) powder is taken, along with Rou Gui (Cinnamomi Cortex), Niu Xi, Ru Xiang (Olibanum), Mo Yao (Myrrha), Yuan Hu (Corydalis Rhizoma), Tao Ren (Persicae Semen), and Hong Hua (Carthami Flos) decocted in wine and taken with four qian. Pain that is heavy and fixed, feeling like carrying five thousand coins, indicates Dampness, suitable for Shen Zhuo Tang (Kidney-Dampness Resolving Decoction). Pain that wanders or fluctuates irregularly indicates Phlegm accumulation, suitable for Er Chen Tang (Two-Aged Decoction) added with Nan Xing (Arisaematis Rhizoma Preparatum) and Qi-moving herbs to allow Phlegm to move with Qi. Additionally, can Bai Zhu (Atractylodis Macrocephalae Rhizoma) benefit the waist? For Si Xue, when all other medicines for lower back pain fail, using approximately one liang of Bai Zhu, assisted by a few other herbs, yields miraculous results after one dose. *Tai Ping Sheng Hui Fang* treats Feng Leng (Wind-Cold), Han Bi (Cold Bi), and lower back pain using Chuan Cao Wu (Aconiti Kusnezoffii Radix) three pieces, raw ground into powder, mixed with a little salt water, spread on paper, and applied to the painful area until cured. Since the waist is the mansion of the Kidney, it is listed among Interior Syndromes.