〔垣〕六元正纪论云∶太阳所至为腰痛。又云∶巨阳,即太阳也,虚则头项腰背痛。足太阳膀胱之脉所过,
还出别下项,循肩膊内,挟脊抵腰中,故为病项如拔,挟脊痛,腰似折,髀不可以曲,是经气虚则邪客之,痛
病生矣。夫邪者,是风热湿燥寒皆能为病,大抵寒湿多而风热少。然有房室劳伤肾虚腰痛者,是阳气虚弱不能
运动故也。经云∶腰者肾之府,转摇不能,肾将败矣。宜肾气丸、茴香丸之类,以补阳之不足也。膏粱之人,
久服汤药,醉以入房,损其真气,则肾气热,肾气热则腰脊痛而不能举,久则髓减骨枯,发为骨痿,宜六味地
黄丸、滋肾丸、封髓丹之类,以补阴之不足也。《灵枢》云∶腰痛上寒,取足太阴阳明,上热,取足厥阴,
不可俯仰,取足少阳。盖足之三阳,从头走足,足之三阴,从足走腹,经所过处,皆能为痛,治之者当审其
何经所过分野,循其空穴而刺之,审何寒热而药之。假令足太阳令人腰痛,引项脊尻背如重状,刺其 中、
太阳二经出血,余皆仿此。彼执一方治诸腰痛者,固不通矣。
〔丹〕如久腰痛,必用官桂以开之方止,腹胁痛亦然。
〔《保》〕煨肾丸 治肝肾损,及脾损,谷不化,腰痛不起者,神效。(方见治虚实法。)
〔无〕立安丸 治五种腰痛,补肾,又治香港脚。
破故纸 续断 干木瓜 牛膝(酒浸) 杜仲(去皮,锉,姜汁炒丝断。各一两) 萆 (二两)
上为细末,蜜丸,如桐子大。每服五十丸,盐汤或酒任下。
〔《本》〕又方 治五种腰痛。
狗脊 萆 菟丝子(各一两。酒浸三日,焙干别研)
上为细末,炼蜜丸,如桐子大。每服三十丸。用萆 二两,酒浸三日,取酒服药,空心食前。
〔无〕杜仲酒 治风冷伤肾,腰痛不能屈伸,并补肾虚。
取杜仲一斤,切,姜汁制,炒断丝,用好酒二升,浸十日,每服三四合,日四五服。一方为末,温酒调一
钱,空心服。
〔《验》〕治腰痛。用破故纸炒为末,温酒下三钱。
上杜仲、牛膝、萆 、破故纸治腰例。
〔《本》〕治肾虚腰痛,不能转侧,麋茸丸。
麋茸(一两,鹿茸亦可) 菟丝子(取末,一两) 舶上茴香(半两)
上为末,以羊肾二对,用酒浸煮烂,去膜,研如泥,和丸,如桐子大,阴干。如羊肾少,入酒糊
佐之。每服三五十丸,温酒或盐汤下。
戊戌年八月,淮南大水,城下浸灌者连月。予忽脏腑不调,腹中如水吼数日,调治得愈。自此腰痛
不可屈折,虽洗面亦相妨,服遍药不效,如是凡三月。予后思之,此必水气阴盛,肾经感此而得,乃灸肾
三七壮,服此药瘥。
〔《千》〕治腰痛。鹿角去上皮取白者,熬令黄,为末,酒服方寸匕,日三,特禁生鱼,余不禁。
新者良,陈不佳。角心中黄处亦不中服,大神良。(鹿角去恶血。)
治腰痛,羊肾为末,酒服二方寸匕,日三服。(本草云∶羊肾补肾气,益精髓)
上麋茸、鹿茸、羊肾治腰痛例。
〔丹〕补肾丸 治肾虚腰痛,累效。
乌药叶(本草云∶乌药嫩叶,补中益气) 侧柏叶
上酒蒸晒干为末,粥为丸,如桐子大。
〔《经》〕治肾虚脚无力。生栗子入袋盛悬干,每日平明吃十余颗,次吃猪肾粥,瘥。
〔丹〕腰痛,脉大者肾虚。
杜仲 龟板 黄柏 知母 枸杞 五味(各等分)
上为末,猪脊髓为丸。
补阴丸 治阴虚性急腰痛者。
龟板 黄柏 知母 侧柏叶
上为末,地黄膏为丸。
腰腿湿痛。
龟板(酒炙,五钱) 黄柏(酒炒,四钱) 青皮(三钱) 生甘草(一钱五分)
上为末,研姜一大片,次入前药末一钱,研细,以苍耳汁荡起,煎令沸,服之。
腰腿疼痛。
败龟板(酒炙,二两) 黄柏(酒炒) 苍术 苍耳(各一两) 扁柏(半两) 威灵仙(酒浸,二两)
上为丸,以黑豆汁兼四物汤,加陈皮、生甘草、生姜一片煎,吞下。
又方
龟板(一两半) 黄柏(炒) 白芍(各一两) 陈皮 威灵仙 知母 苍术 苍耳(各半两)
上为末,蜜丸服。
湿热腰痛,大便泄。
龟板(一两,炙) 楮皮(炒) 苍术 滑石(各半两) 芍药(酒炒) 香附(各四钱)
上为末,粥丸。如内伤,白术、山楂汤下。
〔垣〕苍术汤 治湿热腰腿疼痛。
苍术(三钱,去湿止痛) 柴胡(二钱,行经) 防风(一钱) 黄柏(一钱,始得之时寒久不愈寒化为热,
除湿止痛)
上作一服,水煎,空心服。
上龟板、黄柏、知母治腰痛例。
〔无〕牛膝酒 治肾伤,风毒攻刺,腰痛不可忍者。
牛膝 川芎 羌活 地骨皮 五加皮 薏苡仁 甘草(各一两) 海桐皮(二两) 生地(十两)
上锉,以绢袋裹,入好酒二斗,浸二七日,夏三五宿,每服一杯,日三四杯,长令酒气不绝为佳。
一法入杜仲一两,炒丝断。
〔垣〕六味地黄丸 治肾虚腰痛。(方见治法。)
〔丹〕妇人患腰痛,此血分有热。
白芍(五钱) 生地(四钱) 当归尾(三钱) 黄柏(一钱半,炒) 白术(二钱) 黄芩(一钱半) 木通(一
钱)
甘草梢(五分) 川芎(一钱)
上分四帖,煎取食前热服。
上地黄治腰痛例。
〔《千》〕治腰痛。
萆 杜仲 枸杞根(各半斤)
上三味 咀,好酒三斗渍之,纳罐内密封,投于铜器中煮一日,服之无节,取醉为度。
〔丹〕义一侄妇疟疾初安,因冲风又发腰痛白浊,已与参、术、槟榔、半夏等补方,又教以 牡蛎一钱,
木通五分,炒柏三分,粗末,入前方同煎。
痢后腰痛,两脚无力。
陈皮 半夏 白芍(一钱) 茯苓 苍术 当归 黄芩(酒,五分) 白术(二钱) 甘草(炙,一钱)
上作一服,姜三片,食前服。
妇人月经行后腰痛为虚,详气血虚,于补气血药中加杜仲、侧柏叶等药。
〔仲〕虚劳腰痛,少腹拘急,小便不利,八味肾气散主之。(方见治虚实法。)
〔世〕治腰痛。用威灵仙。丹溪云∶威灵仙治痛之要药,为细末,每服二钱,猪腰子一只,批开,掺药在
内,湿纸煨熟,五更细嚼,热酒下。《千金方》用威灵仙末一钱,温酒调下,逐日以微利为度。病患稍虚,禁用。
〔《本》〕治腰腿痛,气滞,药棋子。
牵牛不以多少,用新瓦火烧赤,便以牵牛顿在瓦上,自然一半熟一半生,不得拨动,取头末一两,入硫黄
一分同研匀,分三服,每用白面一匙,水和捏作棋子,五更初以水一盏煮熟,连汤送下。痛住即止。未住,
隔日再作。予尝有此疾,每发只一服痛止。
〔世〕治腰痛不可忍。用牵牛不以多少,研取头末,去滓不用,取大蒜,每一瓣擘开,入巴豆肉一粒在内,
用湿纸裹定,煨令蒜熟,去巴豆,将蒜研细,和牵牛为丸,如桐子大,每服五丸,醋汤茶空心食前,量虚实服。
〔《本》〕治五般腰痛。
胡桃肉(五个,去皮,研为膏) 五灵脂 黑牵牛(炒) 白牵牛(炒。各三钱) 狗脊(半两,微炒)
萆(三钱,炒) 没药(三十文) 巴豆(五粒,用湿纸裹煨,取肉去油)
上研为末,将前胡桃膏醋糊丸,如桐子大。每服十五丸。风腰疼,豆淋无灰酒下。气腰疼,煨葱白酒下。
血腰疼,当归酒下。打扑腰疼,苏木酒下。
〔子和〕赵进道病腰疼一年不愈,诊其两手脉沉重有力,以通经散下五七行,次以杜仲去粗皮细切炒断丝
为末,每服三钱,猪腰子一枚,薄批五七片,先以椒盐淹去腥水,掺药在内,裹以荷叶,以湿纸数重封,文武
火烧熟,临卧细嚼,温酒送下。每旦,以无比山药丸一服,数日而愈。(通经散,用陈皮、当归、甘遂为末,
每三钱,临卧温酒调下。)
〔罗〕独活寄生汤 治肾气虚弱.冷卧湿地,腰腿拘急,筋骨挛病,或当风取凉过度,风邪流入脚膝,
为偏枯冷痹,缓弱疼痛,或腰痛牵引脚重,行步艰难。
独活 桑寄生 杜仲 牛膝 细辛 秦艽 茯苓 桂心 防风 芎 人参 甘草(以上各一两半)
当归 芍药 干地黄(各二两) 一方用续断(三两)
上为粗末,每服三钱,水二大盏,生姜五片,同煎至七分,食前服。
〔海〕防风汤 治伤寒后腰痛,或皮肉 痹,腿膝疼痛,行履艰难,不可俯仰。
防风(一两) 麻黄(去节) 桂枝(去皮) 杜仲(炙。各七钱半) 牛膝 五加皮 丹参(各半两)
芎 附子(炮,去皮脐,一两) 当归 芍药 羌活 续断(各一两)
上 咀,每服五钱,水一盏半,姜二钱,同煎,食前服。
〔垣〕川芎肉桂汤 丁未年冬,曹通甫自河东来,有役人小翟宿于寒湿之地,腰痛不能转侧,两胁搐急
作痛,月余不愈。腰痛论中所说皆为足太阳足少阴血络中有凝血作痛,间有一二症属少阳胆经外络脉病,
皆宜去血络之凝乃愈。其《内经》有云∶冬三月禁不得针,只宜服药通其经络,破其血络中败血,以此
方主之。
羌活(一钱半) 柴胡(一钱) 独活(五分) 肉桂 苍术(各一钱) 防风 汉防己(各三分) 桃仁(五
个,去皮,另研如泥) 归梢 甘草(炙。各一钱) 炒曲(五分) 川芎(一钱)
上 咀,水酒煎,去渣,食远热服。
〔无〕小续命汤 加炒去皮桃仁,治风腰痛最妙。(方见中风。)五积散加桃仁,治寒湿腰痛最效。(方见
伤寒发热。)
〔《千》〕杜仲酒 治肾脉逆小于寸口,膀胱虚寒,腰痛,胸中动,通四时用之方。
杜仲 地黄(各四两) 萆 羌活 天雄 蜀椒 芎 桂心 防风 秦艽 乌头(各三两)
五加皮 石斛(各五两) 细辛(三两) 栝蒌根 地骨皮 续断(炒) 桔梗 甘草(各一两)
上十九味 咀,以酒四斗,渍四宿,初服五合,加至七八合,日再。
〔《本》〕治久患腰痛。
石甜瓜(一两,出蜀中) 附子(炮,五钱) 冬瓜皮 冬瓜仁 槟榔 没药 乌药(各五钱)
上为细末,每服四钱,温酒调下,临卧时服。服日只午后申时,先可晚食,申时后不可食,专候临卧服。
平日膏粱浓味之人,腰痛皆是湿热阴虚,治见前阴虚。
〔垣〕如身重腰沉沉然,乃经中有湿热也,于羌活胜湿汤中加黄柏一钱,附子五分,苍术二钱。(羌活胜湿汤方
见肾条。)
独活汤 治因劳役得腰痛如折,沉重如山。
羌活(二钱) 防风 独活 肉桂(各三钱) 甘草(炙,二钱) 归梢(五钱) 桃仁(五十) 连翘(五钱)
汉防己 黄柏(酒。各一两) 泽泻 大黄(煨。各三钱)
上 咀,每服五钱,如麻头大,酒半盏,水一盏,去渣,热服立愈。
羌活汤 治腰膝无力沉重。
羌活(三钱) 防风(一钱五分) 甘草(生熟各五分) 草豆蔻 黄柏 葛根(各五分) 砂仁(一钱) 陈皮
(六分)
知母(二钱五分) 黄 (二钱) 苍术 升麻 独活 柴胡(各一钱)
上为粗末,作二服,水二盏,煎至一盏,去渣,空心热服。
〔仲〕肾着汤 治身重,腰冷如冰,痛重如带千钱。(方见身重。)
〔丹〕脉涩者瘀血,用补阴丸中加桃仁、红花。(补阴丸方见脉大条。)
〔世〕橘核散 治腰痛,诸般滞气。
山楂子(一两) 橘核(五钱) 破故纸(二两) 乳香(五钱) 玄胡索 没药 五加皮 红曲(各一两)
上为末,酒调下。
〔云〕如神汤 治男子妇人腰痛。
玄胡索 当归 桂心 杜仲(各等分)
上为末,温酒调下三钱。甚者不过数服。
〔无〕桃仁酒 治肾虚风劳所伤,毒肿掣痛,牵引小腹连腰痛。
用桃仁麸皮炒去皮尖,研细,每服一钱匕,热酒调下,有汗即愈。
〔垣〕地龙汤 治腰脊痛,或打扑伤损,从高坠下,恶血在太阳经中,令人腰脊痛,或胫 臂膊中痛,
不可忍,鼻壅塞不通。
中桂(四分) 桃仁(六个) 羌活(二钱) 独活 甘草 黄柏(各一钱) 麻黄(五分) 地龙(四分)
苏木(六分) 归梢(一钱)
上为粗末,每服五钱,水二盏,煎至一盏,去滓,食远热服。
〔无〕橘核酒 治打扑腰痛,恶血瘀蓄,痛不可忍。
用橘核炒去皮,研细,每服二钱匕,酒调服。或用猪腰子一个,去筋膜,破开入药,同葱白、茴香、
盐,湿纸裹煨熟,细嚼,温酒下。
熟大黄汤 治坠堕闪挫,腰痛不能屈伸。
大黄(切如指大) 生姜(切。各半两)
上同炒,令焦黄,以水一盏,浸一宿,五更去渣服,天明取下如鸡肝者,即恶物也。
〔丹〕徐质夫年六十,因坠马,腰痛不可转侧,六脉散大,重取则弦小而长,稍坚。予以为恶血虽有,未
可驱逐,且以补接为先。遂令煎苏木、人参、黄 、川芎、当归、陈皮、甘草,服至半月后渐散大,饮食亦进,
遂与前药调下自然铜等药,服一月而安。
治老人因 扑腰痛。
苏木(一钱) 人参(五分) 归头身(一钱) 黄 (五分) 陈皮(一钱) 木通(五分) 木香(五分)
上研桃仁九枚,下接骨药。
食积腰腿痛。
【李东垣】在《六元正纪大论》中说:太阳经气所至,会导致腰痛。又说:巨阳,就是太阳经,如果虚弱,就会出现头项、腰背疼痛。足太阳膀胱经的循行路线,从头部出来,向下经过颈部,沿着肩膊内侧,夹着脊柱到达腰部中间,所以生病时会出现脖子像被拔除一样的感觉,夹脊疼痛,腰部好像要折断一样,大腿不能弯曲。这是因为经络之气虚弱,邪气乘虚而入,从而产生痛病。所谓的邪气,是指风、热、湿、燥、寒都能致病,大体上是寒湿多而风热少。然而,也有因为房事过度劳伤导致肾虚腰痛的情况,这是由于阳气虚弱,不能推动气血运行所致。医经说:腰是肾的外府,如果腰部转动摇动困难,说明肾气即将败绝。适宜使用肾气丸(温补肾阳的方剂)、茴香丸等方剂,来补充阳气的不足。
那些饮食肥甘厚味的人,长期服用汤药,醉酒后行房,损伤了真气,导致肾气有热。肾气有热则腰脊疼痛且不能抬举,时间久了就会髓减骨枯,发展为骨痿(骨骼枯萎无力之症)。适宜使用六味地黄丸(滋补肾阴的方剂)、滋肾丸、封髓丹等方剂,来补充阴液的不足。《灵枢》说:腰痛伴有上部发冷的,取足太阴脾经和足阳明胃经的穴位;上部发热的,取足厥阴肝经的穴位;腰部不能前俯后仰的,取足少阳胆经的穴位。大概足部的三条阳经从头走向足,足部的三条阴经从足走向腹,经络经过的地方,都可能成为疼痛的部位。治疗时应当仔细审查是哪条经络的病变范围,顺着相应的穴位进行针刺,并审察是寒证还是热证来进行药物治疗。例如足太阳经引起的腰痛,牵引项部、脊柱、尻部和背部感觉沉重,应刺委中穴和太阳经出血,其余情况都仿照此法。那些拿着一个固定方子治疗所有腰痛的人,固然不通达变通。
【朱丹溪】如果是长期的腰痛,必须用官桂(肉桂的一种)来开通阻滞,疼痛才会停止,腹部和胁部的疼痛也是如此。
【《保命集》】煨肾丸:治疗肝肾受损,以及脾脏受损,食物不消化,腰痛起不来的人,效果神奇。(方剂见治虚实法章节。)
【王好古】立安丸:治疗五种腰痛,补肾,又治疗脚气病。
药材:破故纸(补骨脂)、续断、干木瓜、牛膝(酒浸)、杜仲(去皮,锉碎,姜汁炒至丝断。各一两)、萆薢(二两)。
以上药物研成细末,用蜂蜜制成丸药,如梧桐子大小。每次服用五十丸,用盐汤或酒送服均可。
【《本草衍义》】又一方:治疗五种腰痛。
药材:狗脊、萆薢、菟丝子(各一两。酒浸三日,焙干后单独研细)。
以上药物研成细末,用炼蜜制成丸药,如梧桐子大小。每次服用三十丸。用萆薢二两,酒浸三日,取药酒送服药丸,空腹饭前服用。
【王好古】杜仲酒:治疗风寒湿气伤害肾脏,腰痛不能屈伸,并补肾虚。
取杜仲一斤,切碎,用姜汁炮制,炒至丝断,用好酒二升,浸泡十天。每次服用三四合,每天服用四五次。另一方法是将药研成粉末,用温酒调服一钱,空腹服用。
【《验方》】治疗腰痛。用破故纸炒后研成粉末,用温酒送服三钱。
以上是杜仲、牛膝、萆薢、破故纸治疗腰痛的常规用法。
【《本草衍义》】治疗肾虚腰痛,不能转身侧卧,用麋茸丸。
药材:麋茸(一两,鹿茸也可以)、菟丝子(取粉末,一两)、舶上茴香(半两)。
以上药物研成粉末,用羊肾二对,用酒浸泡煮烂,去掉筋膜,研磨成泥状,混合药末制成丸药,如梧桐子大小,阴干。如果羊肾不够,加入酒糊辅助制作。每次服用三五十丸,用温酒或盐汤送服。
戊戌年八月,淮南发生大水,城墙下被浸泡连续数月。我突然脏腑不调,腹中如水声轰鸣数日,调理治疗后痊愈。从此以后腰痛,不能屈折,即使是洗脸也受影响,遍服各种药物无效,这样持续了三个月。我后来思考,这一定是水气阴盛,肾经感受此邪而得病,于是灸肾俞穴三七壮,服用此药后痊愈。
【《千金方》】治疗腰痛。鹿角去掉上皮取白色的部分,熬制变黄,研成粉末,用酒送服方寸匕,每天三次,特别禁止吃生鱼,其他不禁。新产的鹿角效果好,陈年的不好。角中心黄色的部分也不适合服用,非常有效。(鹿角需去除恶血。)
治疗腰痛,将羊肾研成粉末,用酒送服两个方寸匕,每天三次。(《本草》说:羊肾能补肾气,益精髓。)
以上是麋茸、鹿茸、羊肾治疗腰痛的常规用法。
【朱丹溪】补肾丸:治疗肾虚腰痛,屡试有效。
药材:乌药叶(《本草》说:乌药嫩叶,补中益气)、侧柏叶。
以上药物用酒蒸晒后研成粉末,用米粥作为粘合剂制成丸药,如梧桐子大小。
【《经效产宝》】治疗肾虚脚无力。将生栗子装入袋子悬挂晾干,每天黎明时分吃十余颗,接着吃猪肾粥,即可痊愈。
【朱丹溪】腰痛,脉象大的,属于肾虚。
药材:杜仲、龟板、黄柏、知母、枸杞、五味子(各等分)。
以上药物研成粉末,用猪脊髓作为粘合剂制成丸药。
补阴丸:治疗阴虚性急导致的腰痛。
药材:龟板、黄柏、知母、侧柏叶。
以上药物研成粉末,用地黄膏作为粘合剂制成丸药。
腰腿湿痛。
药材:龟板(酒炙,五钱)、黄柏(酒炒,四钱)、青皮(三钱)、生甘草(一钱五分)。
以上药物研成粉末,取生姜一大片研细,再加入上述药末一钱,一起研细,用苍耳汁搅拌,煎至沸腾,服用。
腰腿疼痛。
药材:败龟板(酒炙,二两)、黄柏(酒炒)、苍术、苍耳(各一两)、扁柏(半两)、威灵仙(酒浸,二两)。
以上药物制成丸药,用黑豆汁兼四物汤,加入陈皮、生甘草、生姜一片煎煮,吞服丸药。
又一方
药材:龟板(一两半)、黄柏(炒)、白芍(各一两)、陈皮、威灵仙、知母、苍术、苍耳(各半两)。
以上药物研成粉末,用蜜丸服用。
湿热腰痛,大便泄泻。
药材:龟板(一两,炙)、楮皮(炒)、苍术、滑石(各半两)、芍药(酒炒)、香附(各四钱)。
以上药物研成粉末,用米粥制成丸药。如果是内伤引起,用白术、山楂汤送服。
【李东垣】苍术汤:治疗湿热腰腿疼痛。
药材:苍术(三钱,祛湿止痛)、柴胡(二钱,疏通经络)、防风(一钱)、黄柏(一钱,初得病时因寒久不愈,寒化为热,除湿止痛)。
以上为一服的量,水煎,空腹服用。
以上是龟板、黄柏、知母治疗腰痛的常规用法。
【王好古】牛膝酒:治疗肾伤,风毒攻刺,腰痛不可忍受。
药材:牛膝、川芎、羌活、地骨皮、五加皮、薏苡仁、甘草(各一两)、海桐皮(二两)、生地(十两)。
以上药物切碎,用绢袋包裹,放入好酒二斗中,浸泡两个七天,夏季三五个晚上。每次服用一杯,每天三四杯,最好让酒气不断为佳。
另一种方法加入杜仲一两,炒至丝断。
【朱丹溪】妇人患腰痛,这是血分有热。
药材:白芍(五钱)、生地(四钱)、当归尾(三钱)、黄柏(一钱半,炒)、白术(二钱)、黄芩(一钱半)、木通(一钱)、甘草梢(五分)、川芎(一钱)。
以上药物分成四帖,煎煮后在饭前热服。
以上是地黄治疗腰痛的常规用法。
【《千金方》】治疗腰痛。
药材:萆薢、杜仲、枸杞根(各半斤)。
以上三味药切碎,用好酒三斗浸泡,放入罐内密封,投入铜器中煮一天,随意服用,以喝醉为限度。
【朱丹溪】我的侄妇疟疾刚安定,因为受风又发作腰痛和白浊,已经给予人参、白术、槟榔、半夏等补益方剂,又教她服用牡蛎一钱、木通五分、炒黄柏三分,粗末,加入前面的方剂中同煎。
痢疾后腰痛,两脚无力。
药材:陈皮、半夏、白芍(一钱)、茯苓、苍术、当归、黄芩(酒洗,五分)、白术(二钱)、甘草(炙,一钱)。
以上为一服的量,加生姜三片,饭前服用。
妇人月经结束后腰痛属于虚证,详细辨别气血虚弱,在补气血的药物中加入杜仲、侧柏叶等药。
【张仲景】虚劳腰痛,少腹拘急,小便不利,用八味肾气散主治。(方剂见治虚实法章节。)
【世传方】治疗腰痛。用威灵仙。丹溪说:威灵仙是治疗疼痛的要药,研成细末,每次服用二钱,猪腰子一只,剖开,将药掺在里面,用湿纸包裹煨熟,五更天细细咀嚼,用热酒送下。《千金方》用威灵仙末一钱,温酒调下,每天逐渐以轻微腹泻为度。病人稍微虚弱者,禁用。
【《本草衍义》】治疗腰腿痛,气滞,用棋子药。
牵牛子不限多少,用新瓦烧红,立刻将牵牛子倒在瓦上,自然一半熟一半生,不得拨动,取头末一两,加入硫黄一分共同研匀,分成三份服用。每次用白面一匙,和水捏成棋子形状,五更初用水一盏煮熟,连汤送下。疼痛停止就停药。如果未停,隔日再做。我曾有此病,每次发作只需一服疼痛即止。
【世传方】治疗腰痛不可忍受。用牵牛子不限多少,研取头末,去渣不用。取大蒜,每一瓣掰开,放入巴豆肉一粒在内,用湿纸包裹定,煨至蒜熟,去掉巴豆,将蒜研细,与牵牛粉混合制成丸药,如梧桐子大小。每次服用五丸,醋汤或茶,空腹饭前服用,根据虚实调整剂量。
【《本草衍义》】治疗五种腰痛。
药材:胡桃肉(五个,去皮,研为膏)、五灵脂、黑牵牛(炒)、白牵牛(炒。各三钱)、狗脊(半两,微炒)、萆薢(三钱,炒)、没药(三十文)、巴豆(五粒,用湿纸包裹煨,取肉去油)。
以上研成粉末,将前面的胡桃膏用醋糊制成丸药,如梧桐子大小。每次服用十五丸。风邪腰痛,用豆淋无灰酒送服。气滞腰痛,用煨葱白酒送服。血瘀腰痛,用当归酒送服。跌打损伤腰痛,用苏木酒送服。
【刘完素】赵进道患腰痛一年不愈,诊察其两手脉象沉重有力,先用通经散下服五七行,其次用杜仲去掉粗皮细切炒断丝为粉末,每次服用三钱,猪腰子一枚,薄切五七片,先用椒盐腌制去腥水,将药掺入其中,用荷叶包裹,用湿纸多层封口,用文武火烤熟,临睡前细细咀嚼,温酒送下。每天早上,服用无比山药丸一服,数日后痊愈。(通经散,用陈皮、当归、甘遂为粉末,每三钱,临睡前温酒调服。)
【罗天益】独活寄生汤:治疗肾气虚弱,冷卧湿地,腰腿拘急,筋骨挛病,或者当风取凉过度,风邪流入脚膝,导致偏枯冷痹,缓弱疼痛,或者腰痛牵引脚重,行走艰难。
药材:独活、桑寄生、杜仲、牛膝、细辛、秦艽、茯苓、桂心、防风、川芎、人参、甘草(以上各一两半)、当归、芍药、干地黄(各二两)。另一方用续断(三两)。
以上药物切成粗末,每次服用三钱,水两大盏,生姜五片,同煎至七分,饭前服用。
【王海藏】防风汤:治疗伤寒后腰痛,或者皮肉麻木不仁,腿膝疼痛,行走艰难,不能俯仰。
药材:防风(一两)、麻黄(去节)、桂枝(去皮)、杜仲(炙。各七钱半)、牛膝、五加皮、丹参(各半两)、川芎、附子(炮,去皮脐,一两)、当归、芍药、羌活、续断(各一两)。
以上切碎,每次服用五钱,水一盏半,姜二钱,同煎,饭前服用。
【李东垣】川芎肉桂汤:丁未年冬天,曹通甫从河东来,有个役人小翟住在寒湿之地,腰痛不能转侧,两胁抽搐作痛,月余不愈。腰痛论中所说的都是足太阳、足少阴血络中有凝血作痛,间有一二症状属于少阳胆经外络脉病,都应该去除血络中的凝滞才能痊愈。《内经》说:冬三月禁止针刺,只宜服药疏通经络,破除血络中的败血,以此方为主治。
药材:羌活(一钱半)、柴胡(一钱)、独活(五分)、肉桂、苍术(各一钱)、防风、汉防己(各三分)、桃仁(五个,去皮,另研如泥)、归梢、甘草(炙。各一钱)、炒曲(五分)、川芎(一钱)。
以上切碎,水酒煎煮,去渣,饭后热服。
【王好古】小续命汤:加入炒去皮桃仁,治疗风腰痛最妙。(方剂见中风章节。)五积散:加入桃仁,治疗寒湿腰痛最有效。(方剂见伤寒发热章节。)
【《千金方》】杜仲酒:治疗肾脉逆小于寸口,膀胱虚寒,腰痛,胸中悸动,通用于四季的方剂。
药材:杜仲、地黄(各四两)、萆薢、羌活、天雄、蜀椒、川芎、桂心、防风、秦艽、乌头(各三两)、五加皮、石斛(各五两)、细辛(三两)、栝蒌根、地骨皮、续断(炒)、桔梗、甘草(各一两)。
以上十九味药切碎,用酒四斗,浸泡四个晚上。初次服用五合,加至七八合,每天两次。
【《本草衍义》】治疗久患腰痛。
药材:石甜瓜(一两,出蜀中)、附子(炮,五钱)、冬瓜皮、冬瓜仁、槟榔、没药、乌药(各五钱)。
以上研成细末,每次服用四钱,温酒调下,临卧时服用。服药那天只在午后申时,可以先晚食,申时后不可进食,专门等候临卧时服用。
平日饮食肥甘厚味的人,腰痛多是湿热阴虚,治疗方法见前文阴虚部分。
【李东垣】如果身体沉重,腰部沉沉然,这是经络中有湿热,在羌活胜湿汤中加入黄柏一钱、附子五分、苍术二钱。(羌活胜湿汤方见肾条章节。)
独活汤:治疗因劳役导致的腰痛如折断,沉重如山。
药材:羌活(二钱)、防风、独活、肉桂(各三钱)、甘草(炙,二钱)、归梢(五钱)、桃仁(五十个)、连翘(五钱)、汉防己、黄柏(酒洗。各一两)、泽泻、大黄(煨。各三钱)。
以上切碎,每次服用五钱,如麻头大小,酒半盏,水一盏,去渣,热服立即痊愈。
羌活汤:治疗腰膝无力沉重。
药材:羌活(三钱)、防风(一钱五分)、甘草(生熟各五分)、草豆蔻、黄柏、葛根(各五分)、砂仁(一钱)、陈皮(六分)、知母(二钱五分)、黄芪(二钱)、苍术、升麻、独活、柴胡(各一钱)。
以上切成粗末,分成两份,水二盏,煎至一盏,去渣,空腹热服。
【张仲景】肾着汤:治疗身体沉重,腰部冷如冰,痛重如带千钱。(方剂见身重章节。)
【朱丹溪】脉涩者是瘀血,用补阴丸中加入桃仁、红花。(补阴丸方见脉大条章节。)
【世传方】橘核散:治疗腰痛,各种气滞。
药材:山楂子(一两)、橘核(五钱)、破故纸(二两)、乳香(五钱)、玄胡索、没药、五加皮、红曲(各一两)。
以上研成粉末,酒调服。
【云岐子】如神汤:治疗男子妇人腰痛。
药材:玄胡索、当归、桂心、杜仲(各等分)。
以上研成粉末,温酒调下三钱。严重的不过数服。
【王好古】桃仁酒:治疗肾虚风劳所伤,毒肿掣痛,牵引小腹连腰痛。
用桃仁麸皮炒去皮尖,研细,每次服用一钱匕,热酒调下,有汗即愈。
【李东垣】地龙汤:治疗腰脊痛,或者打扑伤损,从高坠下,恶血在太阳经中,令人腰脊痛,或者小腿、臂膊中痛,不可忍受,鼻壅塞不通。
药材:中桂(四分)、桃仁(六个)、羌活(二钱)、独活、甘草、黄柏(各一钱)、麻黄(五分)、地龙(四分)、苏木(六分)、归梢(一钱)。
以上切成粗末,每次服用五钱,水二盏,煎至一盏,去滓,饭后热服。
【王好古】橘核酒:治疗打扑腰痛,恶血瘀蓄,痛不可忍受。
用橘核炒去皮,研细,每次服用二钱匕,酒调服。或者用猪腰子一个,去掉筋膜,剖开入药,同葱白、茴香、盐,湿纸包裹煨熟,细细咀嚼,温酒送下。
熟大黄汤:治疗坠堕闪挫,腰痛不能屈伸。
药材:大黄(切如指大)、生姜(切。各半两)。
以上同炒,令焦黄,用水一盏,浸泡一夜,五更时去渣服用,天明排出如鸡肝样物质,即为恶物。
【朱丹溪】徐质夫六十岁,因坠马,腰痛不可转侧,六脉散大,重按则弦小而长,稍坚。我认为虽然有恶血,但不可急于驱逐,暂且以补接为先。于是让他煎苏木、人参、黄芪、川芎、当归、陈皮、甘草,服用半月后脉象渐散大,饮食也进,于是给前面的药调下自然铜等药,服用一月而安。
治疗老人因跌扑导致的腰痛。
药材:苏木(一钱)、人参(五分)、归头身(一钱)、黄芪(五分)、陈皮(一钱)、木通(五分)、木香(五分)。
以上研桃仁九枚,作为接骨药。
[Li Dongyuan] In the *Da Lun* (Great Treatise) of the *Liu Yuan Zheng Ji*, it is stated: "When the Taiyang qi arrives, it manifests as lower back pain." It further states: "Ju Yang, which is Taiyang, when deficient, causes pain in the head, nape, lower back, and spine." The Foot-Taiyang Bladder Meridian passes through these areas; it emerges from the head, descends to the nape, runs along the medial aspect of the shoulder blades, flanks the spine, and reaches the middle of the waist. Therefore, when diseased, symptoms include a sensation of the neck being pulled out, pain flanking the spine, a sensation that the waist is about to break, and the inability to flex the thighs. This occurs because when the meridian qi is deficient, pathogenic factors invade, generating pain. Pathogenic factors refer to Wind, Heat, Dampness, Dryness, and Cold, all of which can cause disease; generally, Cold-Dampness is more common than Wind-Heat. However, there are cases of lower back pain due to Kidney deficiency caused by sexual exhaustion. This is because Yang Qi is weak and unable to move and transform. The Classics state: "The waist is the mansion of the Kidney; if turning and shaking become difficult, the Kidney Qi is failing." Suitable formulas include Shenqi Wan (Kidney Qi Pill) and Huixiang Wan (Fennel Pill) to supplement insufficient Yang Qi.
For those who consume rich and greasy foods, long-term use of decoctions, and engaging in sexual activity while drunk damages True Qi, leading to Heat in the Kidney Qi. When Kidney Qi is hot, the lower back and spine ache and cannot be lifted. Over time, Marrow diminishes and bones wither, developing into Gu Wei (Bone Withering). Suitable formulas include Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia), Zishen Wan (Nourishing Kidney Pill), and Fengsui Dan (Sealing Marrow Elixir) to supplement insufficient Yin fluids. The *Ling Shu* states: "For lower back pain with cold above, select points on the Foot-Taiyin Spleen and Foot-Yangming Stomach meridians; for heat above, select points on the Foot-Jueyin Liver meridian; for inability to bend or extend, select points on the Foot-Shaoyang Gallbladder meridian." Generally, the three Foot-Yang meridians run from head to foot, and the three Foot-Yin meridians run from foot to abdomen. Pain can occur wherever the meridians pass. Treatment requires carefully determining which meridian's domain is affected, needling the corresponding acupoints, and prescribing herbs based on Cold or Heat patterns. For example, lower back pain caused by the Foot-Taiyang meridian, radiating to the nape, spine, sacrum, and back with a heavy sensation, should be treated by bleeding the Weizhong point and the Taiyang meridian. Other cases follow this pattern. Those who insist on using a single formula for all types of lower back pain are indeed inflexible.
[Zhu Danxi] For chronic lower back pain, Guigui (Cinnamon Twig/Cassia Bark) must be used to open the obstruction for the pain to cease; the same applies to abdominal and hypochondriac pain.
(*Baoming Ji*) Weishen Wan: Treats damage to the Liver and Kidney, as well as Spleen damage, indigestion, and severe lower back pain preventing rising. It is highly effective. (Formula see Chapter on Treating Deficiency and Excess.)
[Wang Haogu] Li'an Wan: Treats five types of lower back pain, tonifies the Kidney, and also treats Jiaogong (Beriberi/Foot Rot).
Ingredients: Pugongzi (Burmese Dogwood Fruit), Xuduan (Teasel Root), Gan Mugua (Dried Quince), Niuxi (Achyranthes Root, soaked in wine), Duzhong (Eucommia Bark, peeled, cut, stir-fried with ginger juice until fibers break. Each 1 liang), Bibi (Dioscorea Hypoglauca Rhizome, 2 liang).
Grind into fine powder, make pills with honey, size of paulownia seeds. Take 50 pills per dose, with salt water or wine as desired.
(*Bencao Yanyi*) Another Formula: Treats five types of lower back pain.
Ingredients: Gouji (Ridgeback Fern Rhizome), Bibi, Tusizi (Dodder Seed, each 1 liang. Soak in wine for 3 days, dry, and grind separately).
Grind into fine powder, make pills with refined honey, size of paulownia seeds. Take 30 pills per dose. Use 2 liang of Bibi, soak in wine for 3 days, take the wine to swallow the pills, on an empty stomach before meals.
[Wang Haogu] Duzhong Jiu (Eucommia Wine): Treats Kidney injury from Wind-Cold-Dampness, lower back pain with inability to flex/extend, and tonifies Kidney deficiency.
Take 1 jin of Duzhong, cut, process with ginger juice, stir-fry until fibers break. Soak in 2 sheng of good wine for 10 days. Take 3-4 he per dose, 4-5 times daily. Another method: grind into powder, mix with warm wine, take 1 qian, on an empty stomach.
(*Yanfang*) Treats lower back pain. Use Pugongzi, stir-fry, grind into powder, take 3 qian with warm wine.
These are examples of Duzhong, Niuxi, Bibi, and Pugongzi treating lower back pain.
(*Bencao Yanyi*) Mijun Wan: Treats Kidney deficiency lower back pain with inability to turn or side-bend.
Ingredients: Mirou Rong (Milky Deer Antler, 1 liang, Deer Antler may also be used), Tusizi (Powder, 1 liang), Bo Shang Huixiang (Imported Fennel, 0.5 liang).
Grind into powder. Use 2 pairs of Sheep Kidneys, soak in wine, boil until soft, remove membranes, grind into paste. Mix with powder to make pills, size of paulownia seeds, dry in shade. If sheep kidneys are insufficient, add wine paste. Take 30-50 pills per dose, with warm wine or salt water.
In the 8th month of the Wuxu year, heavy floods occurred in Huainan, inundating the city walls for months. I suddenly experienced internal organ dysfunction, with roaring water sounds in my abdomen for several days. After treatment, I recovered. Since then, I suffered from lower back pain, unable to flex or extend, even affecting washing my face. Various medicines were ineffective for three months. I later reasoned that this was likely due to excessive Yin Water Qi invading the Kidney Meridian. I moxa'd the Shenshu acupoint 37 moxibustions and took this medicine, resulting in recovery.
(*Qianjin Fang*) Treats lower back pain. Remove the outer skin of Deer Antler, take the white inner part, roast until yellow, grind into powder. Take 1 fangcun bi with wine, 3 times daily. Strictly avoid raw fish; other foods are permitted. Fresh antlers are good; aged ones are poor. The yellow center of the antler is not suitable for consumption but is very effective. (Remove blood from deer antler.)
Treat lower back pain: Grind Sheep Kidney into powder, take 2 fangcun bi with wine, 3 times daily. (*Bencao* states: Sheep Kidney tonifies Kidney Qi and benefits Essence and Marrow.)
These are examples of Mirou Rong, Lurong, and Sheep Kidney treating lower back pain.
[Zhu Danxi] Bushen Wan: Treats Kidney deficiency lower back pain, with repeated efficacy.
Ingredients: Wuyao Ye (Wuyao Leaves, *Bencao* states: Young leaves tonify Middle Jiao and boost Qi), Ce Bai Ye (Biota Leaf).
Steam with wine, dry, grind into powder. Make pills with rice porridge paste, size of paulownia seeds.
(*Jing Xiao Chan Bao*) Treats Kidney deficiency causing weak legs. Hang fresh chestnuts in a bag to dry. Eat over ten every dawn, followed by Pig Kidney Porridge. Recovery ensues.
[Zhu Danxi] Lower back pain with a large pulse indicates Kidney deficiency.
Ingredients: Duzhong, Guiban (Tortoise Shell), Huangbai (Phellodendron Bark), Zhimu (Anemarrhena Rhizome), Gouqi (Goji Berry), Wuweizi (Schisandra Berry, equal parts).
Grind into powder. Make pills with Pig Spinal Cord.
Buyin Wan: Treats lower back pain due to Yin deficiency with irritability.
Ingredients: Guiban, Huangbai, Zhimu, Ce Bai Ye.
Grind into powder. Make pills with Rehmannia Paste.
Lower back and leg damp-pain.
Ingredients: Guiban (wine-fried, 5 qian), Huangbai (wine-fried, 4 qian), Qingpi (Green Tangerine Peel, 3 qian), Sheng Gancao (Raw Licorice Root, 1.5 qian).
Grind into powder. Grind one large slice of fresh Ginger finely. Add 1 qian of the powder. Stir with Xier汁 (Xanthium Juice), boil until bubbling, and drink.
Lower back and leg pain.
Ingredients: Baiguiban (Old Tortoise Shell, wine-fried, 2 liang), Huangbai (wine-fried), Cangzhu (Atractylodes Rhizome), Cang'er (Xanthium Fruit, each 1 liang), Bianbai (Biota Leaf, 0.5 liang), Weilingxian (Clematis Root, wine-soaked, 2 liang).
Make pills. Decoct Black Bean Juice combined with Siguo Tang (Four Substances Decoction), add Chenpi (Tangerine Peel), Sheng Gancao, and one slice of fresh Ginger. Swallow pills with the decoction.
Another Formula
Ingredients: Guiban (1.5 liang), Huangbai (stir-fried), Baishao (White Peony Root, each 1 liang), Chenpi, Weilingxian, Zhimu, Cangzhu, Cang'er (each 0.5 liang).
Grind into powder. Make honey pills.
Damp-Heat lower back pain with diarrhea.
Ingredients: Guiban (roasted, 1 liang), Chu Pi (Paper Mulberry Bark, stir-fried), Cangzhu, Huashi (Talcum, each 0.5 liang), Shaoyao (Peony Root, wine-fried), Xiangfu (Cyperus Rhizome, each 4 qian).
Grind into powder. Make pills with porridge paste. If due to internal injury, take with Baizhu (Atractylodes Macrocephala) and Shanzha (Hawthorn) decoction.
[Li Dongyuan] Cangzhu Tang: Treats Damp-Heat lower back and leg pain.
Ingredients: Cangzhu (3 qian, dispels dampness and stops pain), Chaihu (Bupleurum Root, 2 qian, moves meridians), Fangfeng (Saposhnikovia Root, 1 qian), Huangbai (1 qian, initially Cold turns to Heat due to prolonged Cold, dispels dampness and stops pain).
One dose. Decoct in water, take on an empty stomach.
These are examples of Guiban, Huangbai, and Zhimu treating lower back pain.
[Wang Haogu] Niuxi Jiu: Treats Kidney injury, Wind-Toxin attacking/stabbing, unbearable lower back pain.
Ingredients: Niuxi, Chuanxiong (Ligusticum Rhizome), Qianghuo (Notopterygium Rhizome), Digupi (Dogwood Root Bark), Wujia Pi (Acanthopanax Bark), Yiyiren (Coix Seed), Gancao (Licorice Root, each 1 liang), Haitong Pi (Tectona Bark, 2 liang), Shengdi (Rehmannia Root, 10 liang).
Cut coarsely, wrap in silk bag. Soak in 2 dou of good wine for 14 days (3-5 nights in summer). Take 1 cup per dose, 3-4 cups daily. Ideally, maintain a continuous alcohol effect.
Alternative: Add 1 liang of Duzhong, stir-fried until fibers break.
[Li Dongyuan] Liuwei Dihuang Wan: Treats Kidney deficiency lower back pain. (Formula see Chapter on Treatment Methods.)
[Zhu Danxi] Women suffering from lower back pain have Heat in the Blood Division.
Ingredients: Baishao (5 qian), Shengdi (4 qian), Danggui Wei (Angelica Sinensis Tail, 3 qian), Huangbai (1.5 qian, stir-fried), Baizhu (2 qian), Huangqin (Scutellaria Root, 1.5 qian), Mutong (Akebia Stem, 1 qian), Gancao Shao (Licorice Tip, 0.5 fen), Chuanxiong (1 qian).
Divide into four doses. Decoct and take hot before meals.
These are examples of Rehmannia treating lower back pain.
(*Qianjin Fang*) Treats lower back pain.
Ingredients: Bibi, Duzhong, Gouqi Gen (Goji Root, each half jin).
Chop the three ingredients. Soak in 3 dou of good wine. Seal in a jar, place in a copper vessel, and boil for one day. Drink freely until intoxicated.
[Zhu Danxi] My nephew's wife had just recovered from malaria but developed lower back pain and white turbidity due to wind exposure. She was given tonifying formulas containing Ginseng, Atractylodes, Areca Nut, and Pinellia. I also instructed her to take Musli (Oyster Shell) 1 qian, Mutong 0.5 fen, and stir-fried Huangbai 0.3 fen, coarse powder, decocted together with the previous formula.
Lower back pain and weak legs after dysentery.
Ingredients: Chenpi, Banxia (Pinellia Tuber), Baishao (1 qian), Fuling (Poria), Cangzhu, Danggui, Huangqin (wine-washed, 0.5 fen), Baizhu (2 qian), Gancao (roasted, 1 qian).
One dose. Add 3 slices of fresh Ginger. Take before meals.
Lower back pain after menstruation in women is due to deficiency. Carefully distinguish Qi and Blood deficiency. Add Duzhong and Ce Bai Ye to Qi and Blood tonifying formulas.
[Zhang Zhongjing] Xu Lao (Consumptive Disorder) lower back pain, with tightness in the lower abdomen and difficulty urinating, is primarily treated with Bawei Shenqi San (Eight-Ingredient Kidney Qi Powder). (Formula see Chapter on Treating Deficiency and Excess.)
[Worldly Formulas] Treats lower back pain. Use Weilingxian. Danxi said: Weilingxian is a key herb for pain. Grind into fine powder, take 2 qian per dose. Cut one pig kidney open, sprinkle powder inside, wrap in wet paper, roast until cooked. Chew thoroughly at dawn, swallow with hot wine. *Qianjin Fang* uses 1 qian of Weilingxian powder, mixed with warm wine. Gradually induce mild purgation daily. Contraindicated for slightly deficient patients.
(*Bencao Yanyi*) Treats lower back and leg pain with Qi stagnation, using "Medicine Chess Pieces".
Qian Niu (Morning Glory Seed) as needed. Heat a new tile red-hot. Place Qian Niu on the tile; naturally, half will cook and half remain raw. Do not disturb. Take the top powder (1 liang), mix with 1 fen of Sulfur, grind evenly. Divide into three doses. For each dose, use one spoonful of white flour, mix with water to form chess pieces. At dawn, boil one cup of water, cook the pieces, and swallow with the soup. Stop when pain ceases. If not stopped, repeat every other day. I once had this ailment; one dose always stopped the pain.
[Worldly Formulas] Treats unbearable lower back pain. Use Qian Niu powder (top grade only). Take garlic cloves, split each, insert one kernel of Croton Seed (Badou) inside. Wrap in wet paper, roast until garlic is cooked. Remove Badou. Grind garlic finely, mix with Qian Niu powder to make pills, size of paulownia seeds. Take 5 pills per dose, with vinegar water or tea, on an empty stomach before meals. Adjust according to deficiency/excess.
(*Bencao Yanyi*) Treats five types of lower back pain.
Ingredients: Hetao Rou (Walnut Kernel, 5, peeled, ground into paste), Wulingzhi (Trogopterus Dung), Hei Qian Niu (Black Morning Glory Seed, stir-fried), Bai Qian Niu (White Morning Glory Seed, stir-fried, each 3 qian), Gouji (0.5 liang, lightly stir-fried), Bibi (3 qian, stir-fried), Moyao (Myrrh, value 30 wen), Badou (Croton Seed, 5 kernels, wrapped in wet paper, roasted, meat taken, oil removed).
Grind into powder. Use the walnut paste and vinegar paste to make pills, size of paulownia seeds. Take 15 pills per dose. For Wind lower back pain, take with Doulin Wuhui Jiu (Bean-dreg non-alcoholic wine). For Qi lower back pain, take with roasted scallion and white wine. For Blood lower back pain, take with Danggui wine. For trauma lower back pain, take with Sumu (Sappan Wood) wine.
[Liu Wansu] Zhao Jindao suffered from lower back pain for a year without cure. Pulse was heavy and forceful in both hands. First administered Tongjing San (Meridian-Unblocking Powder) 5-7 doses. Then, Duzhong (peeled, cut, stir-fried until fibers broken) powder, 3 qian per dose. One pig kidney, sliced thinly 5-7 pieces, marinated in pepper-salt to remove fishiness. Sprinkle powder inside, wrap in lotus leaf, seal with multiple layers of wet paper. Roast with gentle fire. Chew thoroughly before bed, swallow with warm wine. Every morning, take Wubi Shanyao Wan (Peerless Yam Pill). Recovered in a few days. (Tongjing San: Chenpi, Danggui, Gansui powder. Take 3 qian with warm wine before bed.)
[Luo Tianyi] Duhuo Jisheng Tang: Treats Kidney Qi deficiency, lying on cold/damp ground, lower back/leg stiffness, tendon spasms, or excessive cooling in wind, allowing Wind pathogen to enter legs/knees, causing hemiplegia, cold bi, weakness/pain, or lower back pain radiating to heavy legs, making walking difficult.
Ingredients: Duhuo, Sangjisheng (Taxillus Branch), Duzhong, Niuxi, Xixin (Asarum), Qinjiao (Gentiana Macrophylla Root), Fuling, Guixin (Cinnamon Heart), Fangfeng, Chuanxiong, Renshen (Ginseng), Gancao (Licorice Root, each 1.5 liang), Danggui, Shaoyao, Shengdi (Rehmannia Root, each 2 liang). Alternative: Xuduan (3 liang).
Coarse powder. Take 3 qian per dose. Decoct with 2 large bowls of water and 5 slices of fresh Ginger until reduced to 0.7. Take before meals.
[Wang Haizang] Fangfeng Tang: Treats lower back pain after Typhoid Fever, or numbness of skin/flesh, leg/knee pain, difficulty walking, inability to bend/extend.
Ingredients: Fangfeng (1 liang), Mahuang (Ephedra Stem, nodes removed), Guizhi (Cinnamon Twig, bark removed), Duzhong (roasted, each 0.75 liang), Niuxi, Wujia Pi, Danshen (Salvia Root, each 0.5 liang), Chuanxiong, Fuzi (Prepared Aconite Root, peeled, umbilicus removed, 1 liang), Danggui, Shaoyao, Qianghuo, Xuduan (each 1 liang).
Chop. Take 5 qian per dose. Decoct with 1.5 bowls of water and 2 qian of Ginger. Take before meals.
[Li Dongyuan] Chuanxiong Rougui Tang: In winter of Dingwei year, Cao Tongfu came from Hedong. A laborer, Xiao Zhai, lived in a cold/damp place, suffering from lower back pain unable to turn, with spasmodic pain in both hypochondria lasting over a month. Theories on lower back pain state that pain is usually due to stagnant blood in the blood collaterals of Foot-Taiyang and Foot-Shaoyin meridians, occasionally involving Foot-Shaoyang Gallbladder external collaterals. Removing stagnant blood cures it. *Neijing* states: "In the three winter months, acupuncture is prohibited; only medication to unblock meridians and break stagnant blood is suitable." This formula is used.
Ingredients: Qianghuo (1.5 qian), Chaihu (1 qian), Duhuo (0.5 fen), Rougui (Cinnamon Bark), Cangzhu (each 1 qian), Fangfeng, Han Fangji (Stephania Tetrandra Root, each 0.3 fen), Taoren (Peach Kernel, 5, peeled, ground to paste), Guishao (Angelica Sinensis tip), Gancao (roasted, each 1 qian), Chao Qu (Stir-fried Leaven, 0.5 fen), Chuanxiong (1 qian).
Chop. Decoct with water and wine. Strain. Take hot after meals.
[Wang Haogu] Xiaoxuming Tang: Add stir-fried, peeled Taoren. Best for Wind lower back pain. (Formula see Stroke chapter.) Wuji San: Add Taoren. Most effective for Cold-Damp lower back pain. (Formula see Typhoid Fever chapter.)
(*Qianjin Fang*) Duzhong Jiu: Treats Kidney pulse weaker than Cun Kou, Bladder deficiency-cold, lower back pain, palpitations in chest. A formula usable in all seasons.
Ingredients: Duzhong, Dihuang (Rehmannia Root, each 4 liang), Bibi, Qianghuo, Tianxiong (Aconite Lateral Root), Shujiao (Sichuan Pepper), Chuanxiong, Guixin, Fangfeng, Qinjiao, Wutou (Aconite Root, each 3 liang), Wujia Pi, Shihu (Dendrobium Stem, each 5 liang), Xixin (3 liang), Gualou Gen (Trichosanthes Root), Digupi, Xuduan (stir-fried), Jiegeng (Platycodon Root), Gancao (each 1 liang).
Nineteen ingredients chopped. Soak in 4 dou of wine for 4 nights. Initial dose 5 he, increase to 7-8 he. Twice daily.
(*Bencao Yanyi*) Treats chronic lower back pain.
Ingredients: Shitian Gua (Stone Sweet Melon, 1 liang, from Sichuan), Fuzi (prepared, 5 qian), Dongguapi (Winter Melon Peel), Dongguaren (Winter Melon Seed), Binglang (Areca Nut), Moyao, Wuyao (each 5 qian).
Fine powder. Take 4 qian per dose with warm wine, before bed. On the day of taking medicine, eat dinner late, but no food after Shen hour (3-5 PM). Wait until bedtime to take.
People accustomed to rich/greasy foods often have Damp-Heat/Yin deficiency lower back pain. See Yin deficiency treatment above.
[Li Dongyuan] If body feels heavy and lower back feels sinking, it is Damp-Heat in the meridians. Add Huangbai 1 qian, Fuzi 0.5 fen, Cangzhu 2 qian to Qianghuo Shengshi Tang. (Qianghuo Shengshi Tang formula see Kidney section.)
Duhuo Tang: Treats lower back pain like breaking, heavy as a mountain, due to overwork.
Ingredients: Qianghuo (2 qian), Fangfeng, Duhuo, Rougui (each 3 qian), Gancao (roasted, 2 qian), Guishao (5 qian), Taoren (50), Lianqiao (Forsythia Fruit, 5 qian), Han Fangji, Huangbai (wine-washed, each 1 liang), Zexie (Alisma Rhizome), Dahuang (Rhubarb Root, roasted, each 3 qian).
Chop. Take 5 qian per dose (size of hemp seed). Decoct with half bowl of wine and one bowl of water. Strain. Take hot for immediate relief.
Qianghuo Tang: Treats weak/heavy lower back and knees.
Ingredients: Qianghuo (3 qian), Fangfeng (1.5 qian), Gancao (raw/roasted 0.5 fen each), Caodoukou (Cardamom), Huangbai, Gegen (Pueraria Root, each 0.5 fen), Sharen (Amomum Fruit, 1 qian), Chenpi (0.6 fen), Zhimu (2.5 qian), Huangqi (Astragalus Root, 2 qian), Cangzhu, Shengma (Cimicifuga Rhizome), Duhuo, Chaihu (each 1 qian).
Coarse powder. Two doses. Decoct 2 bowls of water to 1 bowl. Strain. Take hot on empty stomach.
[Zhang Zhongjing] Shen Zhuo Tang: Treats body heaviness, lower back cold as ice, pain heavy as carrying thousand coins. (Formula see Body Heaviness section.)
[Zhu Danxi] Choppy pulse indicates Blood Stasis. Add Taoren and Honghua (Safflower) to Buyin Wan. (Buyin Wan formula see Large Pulse section.)
[Worldly Formulas] Juzhe San: Treats lower back pain and various Qi stagnations.
Ingredients: Shanzha Zi (Hawthorn Seed, 1 liang), Juzhe (Tangerine Seed, 0.5 liang), Pugongzi (2 liang), Ruxiang (Frankincense, 0.5 liang), Yanhusuo (Corydalis Rhizome), Moyao, Wujia Pi, Hongqu (Red Yeast Rice, each 1 liang).
Powder. Take with wine.
[Yun Qizi] Rushen Tang: Treats lower back pain in men and women.
Ingredients: Yanhusuo, Danggui, Guixin, Duzhong (equal parts).
Powder. Take 3 qian with warm wine. Severe cases resolve in a few doses.
[Wang Haogu] Taoren Jiu: Treats Kidney deficiency injured by Wind-Lao, toxic swelling/tugging pain radiating to lower abdomen and lower back.
Stir-fry Taoren with bran, peel/remove tips, grind fine. Take 1 qian bi with hot wine. Sweating indicates cure.
[Li Dongyuan] Dilong Tang: Treats lower back/spine pain, or trauma from falls, where evil blood remains in Taiyang meridian causing unbearable lower back/spine pain, or shin/arm pain, or nasal congestion.
Ingredients: Zhonggui (Cinnamon, 0.4 fen), Taoren (6), Qianghuo (2 qian), Duhuo, Gancao, Huangbai (each 1 qian), Mahuang (0.5 fen), Dilong (Earthworm, 0.4 fen), Sumu (0.6 fen), Guishao (1 qian).
Coarse powder. Take 5 qian per dose. Decoct 2 bowls of water to 1 bowl. Strain. Take hot after meals.
[Wang Haogu] Juzhe Jiu: Treats trauma lower back pain with evil blood stasis, unbearable pain.
Stir-fry Juzhe, peel, grind fine. Take 2 qian bi with wine. Or use one pig kidney, remove membrane, split open, add medicine, green onion, fennel, salt. Wrap in wet paper, roast. Chew thoroughly, swallow with warm wine.
Shu Dahuang Tang: Treats fall/sprain lower back pain with inability to flex/extend.
Ingredients: Dahuang (cut finger-sized), Shengjiang (fresh Ginger, cut, each half liang).
Stir-fry together until scorched yellow. Soak in 1 bowl of water overnight. At dawn, strain and drink. By morning, expel material resembling chicken liver (evil matter).
[Zhu Danxi] Xu Zifu, age 60, fell from horse, lower back pain unable to turn. Six pulses were scattered and large; deep pressure revealed string-tiny-long and slightly firm. I believed evil blood existed but should not be aggressively expelled yet; tonification first. Prescribed Sumu, Renshen, Huangqi, Chuanxiong, Danggui, Chenpi, Gancao decoction. After half a month, pulses became less scattered, appetite improved. Then added natural pyrite (Ziran Tong) to the previous formula. Recovered after one month.
Treating elderly lower back pain from falls.
Ingredients: Sumu (1 qian), Renshen (0.5 fen), Guitou/Shen (Angelica Head/Body, 1 qian), Huangqi (0.5 fen), Chenpi (1 qian), Mutong (0.5 fen), Muxiang (Aucklandia Root, 0.5 fen).
Grind 9 Taoren. Used as bone-knitting medicine.
Food Stagnation lower back and leg pain.