丹溪曰。脉必沉而弦。沉为滞。弦为虚。涩者是瘀血。缓者是湿。滑者伏者是痰。大者
是肾虚也。
夫腰乃肾之府。动摇不能。肾将惫矣。因嗜欲无节。劳伤肾经。多有为喜怒忧思。风寒
湿毒
伤之。遂致腰痛。牵引于脊背。旁及二胁下。不可俯仰。此由肾气虚弱所致。宜滋肾调气。
病可除矣。
一论常常腰痛者。肾虚也。此方主之。
补肾汤
当归（酒洗） 白芍（酒炒） 生地黄 熟地黄 陈皮 小茴香（盐酒炒） 破故纸（酒炒）
牛膝
（去芦酒洗） 杜仲（去粗皮酒炒） 白茯苓（去皮各一钱） 人参（五分） 黄柏（去皮酒洗）
知母（酒炒各七分） 甘草（炙三分）
上锉一剂。枣二枚。水煎服。痛甚者。加乳香、砂仁、沉香。去白芍、生地、陈皮。如
常服合丸药。俱为细末。炼蜜为丸。如梧桐子大。每服五十丸。米汤下。酒下亦可。
一论腰胯湿热作痛者。
清热胜湿汤
苍术（米泔制） 黄柏（盐水炒） 羌活 白芍（酒炒） 陈皮（去白） 牛膝（去芦酒洗）
木瓜 杜仲（姜汁炒） 威灵仙 泽泻（各五分） 甘草（三分）
上锉。生姜三片。水煎服。痛甚者。加乳香、没药各五分为末。水湿停下。入黑丑、槟
榔各
五分。血痛。加归尾、桃仁去皮尖各一钱。红花酒洗五分。冷风作痛。加熟附子一钱。虎胫
骨末五分。去黄柏、泽泻各三分。倦怠脚如欲坠。加苍术、防己、薏苡仁、白术各五分。游
走而痛。加紫金皮。湿热。加炒栀子。气不顺。加乌药。酸软。加牛膝、当归、地黄。肾虚
加破故纸炒五分。
一论气滞腰痛。并闪挫腰痛。肾虚腰痛。
立安散
当归 官桂 元胡索 杜仲 小茴香 木香 黑丑
上为细末。每服二匙。空心。温酒调下。一方。去黑丑。以酒煎服。
一论腰痛神方
鱼鳔炒成珠。好酒一碗淬入内。温热。通口连渣服。
一论此方专滋肾水。壮元阳。益筋骨。又能乌须。治肾虚腰痛足膝痛神效。
青娥丸
破故纸（酒炒） 川萆 （童便浸） 杜仲（姜汁炒） 牛膝（去芦酒洗） 黄柏（盐水炒）
知母（酒炒各四两） 胡桃肉（去皮泡八两）
上为细末。炼蜜为丸。如梧子大。每服八十丸。空心。酒送下。
一论肾气虚弱。肝脾之气袭之。令人腰膝作痛。伸屈不便。冷痹无力。夫肾水脏也。虚
则肝
脾之气凑之。故令腰膝实而作痛。屈伸不便者。筋骨俱病也。经曰。能屈而不能伸者。病在
筋。能伸而不能屈者。病在骨。故知屈伸不便。为筋骨之病也。冷痹者。阴邪实也。无力者
气血虚也。独活寄生汤（方见中湿）
一论元气虚弱。腰痛白浊。以补中益气汤（方见内伤）根据本方加黄柏、知母、白芍。俱酒
炒。牛膝去芦。酒洗。杜仲姜酒炒。
一论肾经虚损。腰腿遍身疼痛。
壮肾散 扶沟何晴岳传。
仙灵脾（酒浸五两） 远志（去心四两） 巴戟（去心六两） 杜仲（酒炒五两） 破故纸（酒
炒五两） 肉苁蓉（酒浸六两） 青盐（八两） 大茴香（五两） 小茴香（炒五两）
上为末。每服二钱。用猪腰切开。掺药末在内。纸裹。火烧熟。细嚼。酒下。
一论腰痛。人皆作肾虚治。诸药不效者。此瘀血痛也。以大黄半两。更入生姜半两。同
切如
小豆大。于锅内炒黄色。投水二碗煎。五更初顿服。天明取下腰间瘀血物。用盆器盛。如鸡
肝样。痛即止。
一治腰痛不能转侧。点药后。少顷复旧。神妙。
雄黄（二钱） 黄丹（一钱） 焰硝（一钱） 去黄丹。名龙火丹。
上为细末。令病患仰睡。以银簪蘸药。点眼大角头少许。一二次神效。
一治腰痛良方
杜仲（姜酒炒二钱） 破故纸（炒五分） 小茴香（盐酒炒） 人参（三分）
上为末。用猪腰子二个。切开入药。蒸熟。带水渣同食即愈。
一治腰痛秘方 王明景传。
当归（酒洗） 杜仲（酒炒） 大茴香（酒炒） 小茴香（酒炒） 羌活
上锉一大剂。用头生酒浸一宿。次早滤汁。温热服之。用渣将酒再煎。温服立效。
朱丹溪说：脉象必定沉而弦。沉脉代表气机阻滞，弦脉代表正气虚弱。涩脉是瘀血的表现，缓脉是湿邪的表现，滑脉且伏匿的是痰饮，脉大则是肾虚所致。
腰部是肾脏的外府（居所）。如果腰部动摇困难，说明肾脏即将衰败。这是因为嗜欲没有节制，劳损伤及肾经；又常因喜怒忧思等情志因素，以及风寒湿毒等外邪侵袭，从而导致腰痛，疼痛牵引至脊背，并向两侧胁下放射，无法俯身或仰头。这是由肾气虚弱引起的，应当滋补肾阴、调理气机，疾病即可消除。
第一种论述：经常腰痛的人，属于肾虚。用此方主治。
补肾汤
当归（酒洗）、白芍（酒炒）、生地黄、熟地黄、陈皮、小茴香（盐酒炒）、破故纸（即补骨脂，酒炒）、牛膝（去芦头，酒洗）、杜仲（去粗皮，酒炒）、白茯苓（去皮，以上各一钱）、人参（五分）、黄柏（去皮，酒洗）、知母（酒炒，以上各七分）、甘草（炙，三分）。
以上药材锉碎为一剂，加红枣二枚，水煎服。疼痛剧烈的，加入乳香、砂仁、沉香，去掉白芍、生地黄、陈皮。如平时服用可制成丸药，将所有药材研为细末，用炼蜜制成梧桐子大小的丸药。每次服用五十丸，米汤送下，用酒送下也可以。
第二种论述：腰胯部因湿热引起疼痛的。
清热胜湿汤
苍术（米泔水制）、黄柏（盐水炒）、羌活、白芍（酒炒）、陈皮（去白）、牛膝（去芦头，酒洗）、木瓜、杜仲（姜汁炒）、威灵仙、泽泻（以上各五分）、甘草（三分）。
以上药材锉碎，加生姜三片，水煎服。疼痛剧烈的，加入乳香、没药各五分研为细末。若水湿停滞不下，加入黑丑（牵牛子）、槟榔各五分。若是血痛，加入归尾、桃仁（去皮尖）各一钱，红花（酒洗）五分。若是冷风引起的疼痛，加入熟附子一钱，虎胫骨末五分，去掉黄柏、泽泻各三分。若是倦怠、脚部感觉沉重欲坠，加入苍术、防己、薏苡仁、白术各五分。若是游走性疼痛，加入紫金皮。若是湿热重，加入炒栀子。若是气机不顺，加入乌药。若是酸软无力，加入牛膝、当归、地黄。若是肾虚，加入炒破故纸五分。
第三种论述：气滞腰痛，以及闪挫腰痛、肾虚腰痛。
立安散
当归、官桂、元胡索（延胡索）、杜仲、小茴香、木香、黑丑（牵牛子）。
以上研为细末。每次服用两匙，空腹时，用温酒调服。另一版本，去掉黑丑，用酒煎服。
第四种论述：治疗腰痛的神效方。
将鱼鳔炒成炭珠状，用好酒一碗淬入其中，温热后，连渣一口喝下。
第五种论述：此方专门滋补肾水，壮益元阳，补益筋骨，又能使须发变黑，治疗肾虚腰痛、足膝痛有神奇疗效。
青娥丸
破故纸（酒炒）、川萆薢（童便浸）、杜仲（姜汁炒）、牛膝（去芦头，酒洗）、黄柏（盐水炒）、知母（酒炒，以上各四两）、胡桃肉（去皮浸泡，八两）。
以上研为细末，用炼蜜制成梧桐子大小的丸药。每次服用八十丸，空腹时，用酒送下。
第六种论述：肾气虚弱，肝脾之气乘虚侵袭，导致腰膝疼痛，伸展屈曲不便，寒冷痹阻且无力。肾属水脏，肾虚则肝脾之气凑集于此，所以导致腰膝充实而疼痛。屈伸不便，是因为筋骨都生病了。医经说：能屈而不能伸的，病在筋；能伸而不能屈的，病在骨。所以知道屈伸不便是筋骨之病。寒冷痹阻，是阴邪盛实；无力，是气血虚弱。使用独活寄生汤（方剂见“中湿”章节）。
第七种论述：元气虚弱，腰痛伴白浊，使用补中益气汤（方剂见“内伤”章节），根据本方加入黄柏、知母、白芍，均酒炒。牛膝去芦头，酒洗。杜仲用姜酒炒。
第八种论述：肾经虚损，腰腿及全身疼痛。
壮肾散 扶沟人何晴岳传授。
仙灵脾（淫羊藿，酒浸五两）、远志（去心四两）、巴戟天（去心六两）、杜仲（酒炒五两）、破故纸（酒炒五两）、肉苁蓉（酒浸六两）、青盐（八两）、大茴香（五两）、小茴香（炒五两）。
以上研为末。每次服用二钱，取猪腰子切开，将药末掺入其中，用纸包裹，火烧熟透，细细咀嚼，用酒送下。
第九种论述：治疗腰痛，人们都当作肾虚来治，各种药物无效的情况，这是瘀血疼痛。用大黄半两，再加入生姜半两，一同切成如小豆大小的颗粒，在锅内炒至黄色，投入两碗水煎煮，五更初一次性顿服。天亮后排出腰间瘀血物，用盆器承接，形状如鸡肝样，疼痛随即停止。
第十种：治疗腰痛不能转侧，点药后，片刻即可恢复原状，神妙。
雄黄（二钱）、黄丹（一钱）、焰硝（一钱）。去掉黄丹，名为龙火丹。
以上研为细末。让病患仰卧，用银簪蘸取少许药粉，点在眼角大角处。一至两次即有神效。
第十一种：治疗腰痛良方。
杜仲（姜酒炒二钱）、破故纸（炒五分）、小茴香（盐酒炒）、人参（三分）。
以上研为末，用两个猪腰子，切开放入药末，蒸熟，带水和渣滓一同吃下即可痊愈。
第十二种：治疗腰痛秘方 王明景传授。
当归（酒洗）、杜仲（酒炒）、大茴香（酒炒）、小茴香（酒炒）、羌活。
以上锉一大剂，用头茬酒浸泡一夜，次日早晨滤出汁液，温热服用。用药渣再加酒煎煮，温热服用，立即见效。
Zhu Danxi stated: The pulse must be deep (Chen) and wiry (Xian). A deep pulse indicates stagnation, while a wiry pulse indicates deficiency. A choppy pulse (Se) signifies blood stasis; a slow pulse (Huan) signifies dampness; a slippery pulse (Hua) that is hidden (Fu) signifies phlegm; and a large pulse (Da) signifies Kidney deficiency.
The waist is the mansion of the Kidneys. If movement is difficult, it indicates that the Kidneys are on the verge of exhaustion. This results from unregulated desires and labor injuring the Kidney meridian, often compounded by emotional factors such as anger, joy, worry, and thought, as well as external pathogens like wind, cold, dampness, and toxins invading the body. Consequently, lower back pain occurs, radiating to the spine and back, extending to the hypochondrium on both sides, making flexion and extension impossible. This is caused by the weakness of Kidney Qi. It is appropriate to nourish the Kidneys and regulate Qi, after which the disease can be eliminated.
First discussion: Frequent lower back pain indicates Kidney deficiency. This formula is indicated.
Bushen Tang (Kidney-Nourishing Decoction)
Danggui (Angelicae Sinensis Radix, washed with wine), Baishao (Paeoniae Radix Alba, stir-fried with wine), Shengdihuang (Rehmanniae Radix), Shudihuang (Rehmanniae Radix Preparata), Chenpi (Citri Reticulatae Pericarpium), Xiaohuixiang (Foeniculi Fructus, stir-fried with salt and wine), Poguozhi (Psoraleae Fructus, stir-fried with wine), Niuxi (Achyranthis Bidentatae Radix, remove radicle, washed with wine), Duzhong (Eucommiae Cortex, remove rough bark, stir-fried with wine), Baifuling (Poria, remove skin, each 1 qian), Renshen (Ginseng Radix et Rhizoma, 5 fen), Huangbai (Phellodendri Cortex, remove bark, washed with wine), Zhimu (Anemarrhenae Rhizoma, stir-fried with wine, each 7 fen), Gancao (Licorice Root, honey-fried, 3 fen).
Crush these ingredients for one dose, add two jujubes, decoct in water, and take orally. For severe pain, add Xurong (Boswelliae Resina), Sharen (Amomi Fructus Rotundus), and Chenxiang (Aquilariae Lignum Resinatum); remove Baishao, Shengdihuang, and Chenpi. For daily maintenance, process into pills: grind all ingredients into fine powder, mix with refined honey to form pills the size of paulownia seeds. Take 50 pills per dose, downed with rice soup or wine.
Second discussion: Lower back and hip pain caused by damp-heat.
Qingre Shengshi Tang (Heat-Clearing and Damp-Overcoming Decoction)
Cangzhu (Atractylodis Rhizoma, processed with rice wash water), Huangbai (Phellodendri Cortex, stir-fried with salt water), Qianghuo (Notopterygii Rhizoma et Radix), Baishao (Paeoniae Radix Alba, stir-fried with wine), Chenpi (Citri Reticulatae Pericarpium, remove white pith), Niuxi (Achyranthis Bidentatae Radix, remove radicle, washed with wine), Mugua (Chaenomelis Fructus), Duzhong (Eucommiae Cortex, stir-fried with ginger juice), Weilingxian (Salviae Miltiorrhizae Radix et Rhizoma? *Note: Standard is Clematidis Radix*, but text says Weilingxian usually implies Clematis), Zexie (Alismatis Rhizoma, each 5 fen), Gancao (Licorice Root, 3 fen).
Crush these ingredients, add three slices of fresh ginger, decoct in water, and take orally. For severe pain, add Xurong (Boswelliae Resina) and Moyao (Myrrhae Resina), each ground to 5 fen powder. If water-dampness fails to descend, add Heiqiu (Pharbitidis Semen) and Binglang (Arecae Semen), each 5 fen. For blood-related pain, add Guiwei (Angelicae Sinensis Radix), Taoren (Persicae Semen, remove skin and tip), each 1 qian, and Honghua (Carthami Flos, washed with wine), 5 fen. For pain caused by cold wind, add Shufuzi (Aconiti Lateralis Radix Preparata), 1 qian, and Hu Jinggu Mo (Tiger Tibia Bone Powder), 5 fen; remove Huangbai and Zexie, each 3 fen. For fatigue and a sensation of heaviness in the legs as if falling, add Cangzhu (Atractylodis Rhizoma), Fangji (Stephaniae Tetrandrae Radix), Yiyiren (Coicis Semen), and Baizhu (Atractylodis Macrocephalae Rhizoma), each 5 fen. For wandering pain, add Zijin Pi. For heavy damp-heat, add Chao Zhizi (Gardeniae Fructus, stir-fried). For stagnant Qi, add Wuyao (Linderae Radix). For soreness and weakness, add Niuxi (Achyranthis Bidentatae Radix), Danggui (Angelicae Sinensis Radix), and Dihuang (Rehmanniae Radix). For Kidney deficiency, add stir-fried Poguozhi (Psoraleae Fructus), 5 fen.
Third discussion: Qi-stagnation lower back pain, as well as sprain/trauma lower back pain and Kidney-deficiency lower back pain.
Li'an San (Stability Powder)
Danggui (Angelicae Sinensis Radix), Guangui (Cinnamomi Ramulus), Yuanhusuo (Corydalis Rhizoma), Duzhong (Eucommiae Cortex), Xiaohuixiang (Foeniculi Fructus), Muxiang (Aucklandiae Radix), Heiqiu (Pharbitidis Semen).
Grind into fine powder. Take two teaspoons per dose, on an empty stomach, mixed with warm wine. Another variation removes Heiqiu and decocts with wine.
Fourth discussion: Divine prescription for lower back pain.
Stir-fry fish bladder until it turns into charcoal beads. Quench it in one bowl of good liquor. When warm, consume the liquid along with the residue in one go.
Fifth discussion: This formula specifically nourishes Kidney Water, strengthens Original Yang, benefits sinews and bones, darkens hair, and is highly effective for Kidney-deficiency lower back pain and knee/foot pain.
Qing'e Wan (Green Wall Pill)
Poguozhi (Psoraleae Fructus, stir-fried with wine), Chuanchixie (Dioscoreae Hypoglaucae Rhizoma, soaked in child's urine), Duzhong (Eucommiae Cortex, stir-fried with ginger juice), Niuxi (Achyranthis Bidentatae Radix, remove radicle, washed with wine), Huangbai (Phellodendri Cortex, stir-fried with salt water), Zhimu (Anemarrhenae Rhizoma, stir-fried with wine, each 4 liang), Hutaorou (Juglandis Semen, remove skin and soak, 8 liang).
Grind into fine powder, mix with refined honey to form pills the size of paulownia seeds. Take 80 pills per dose, on an empty stomach, downed with wine.
Sixth discussion: Weakness of Kidney Qi allows Liver and Spleen Qi to invade, causing pain in the waist and knees, difficulty in flexion and extension, cold bi-syndrome, and weakness. The Kidney is a Water organ; when deficient, Liver and Spleen Qi converge there, causing fullness and pain in the waist and knees. Difficulty in flexion and extension indicates pathology in both sinews and bones. The Classics state: "Ability to flex but not extend indicates pathology in sinews; ability to extend but not flex indicates pathology in bones." Thus, difficulty in flexion and extension is a disease of sinews and bones. Cold bi-syndrome indicates excess Yin pathogenic factors; weakness indicates deficiency of Qi and Blood. Use Duhuo Jisheng Tang (See "Zhong Shi" chapter).
Seventh discussion: Weakness of Original Qi, lower back pain with white turbid urine. Use Buzhong Yiqi Tang (See "Nei Shang" chapter), modified by adding Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), and Baishao (Paeoniae Radix Alba), all stir-fried with wine. Niuxi (Achyranthis Bidentatae Radix) should have its radicle removed and be washed with wine. Duzhong (Eucommiae Cortex) should be stir-fried with ginger and wine.
Eighth discussion: Damage to the Kidney Meridian, causing pain throughout the waist, legs, and body.
Zhuangshen San (Kidney-Strengthening Powder)
Transmitted by He Qingyue of Fugou.
Xianlingpi (Epimedii Folium, soaked in wine, 5 liang), Yuanzhi (Polygalae Radix, remove heart, 4 liang), Bajitian (Morindae Officinalis Radix, remove heart, 6 liang), Duzhong (Eucommiae Cortex, stir-fried with wine, 5 liang), Poguozhi (Psoraleae Fructus, stir-fried with wine, 5 liang), Roucongrong (Cynomorii Herba, soaked in wine, 6 liang), Qingyan (Halitum, 8 liang), Dahuixiang (Foeniculi Fructus, 5 liang), Xiaohuixiang (Foeniculi Fructus, stir-fried, 5 liang).
Grind into powder. Take 2 qian per dose. Cut open a pig kidney, insert the powder inside, wrap in paper, roast over fire until cooked. Chew thoroughly and swallow with wine.
Ninth discussion: Regarding lower back pain, people often treat it as Kidney deficiency, but if various medicines fail, this is pain due to blood stasis. Use Banliang (half tael) of Dahuang (Rhei Radix et Rhizoma), plus Banliang of Shengjiang (Zingiberis Rhizoma Recens). Chop them together into pieces the size of small beans. Stir-fry in a pot until yellow. Add two bowls of water, decoct, and take in one dose at dawn (Wugeng). By morning, expel the blood stasis from the waist using a basin. If it resembles a chicken liver, the pain will stop immediately.
Tenth: Treatment for lower back pain preventing turning of the body. After applying the medicine, recovery occurs shortly thereafter. Highly miraculous.
Xionghuang (Realgar, 2 qian), Huangdan (Lead Monoxide, 1 qian), Yanxiao (Potassium Nitrate, 1 qian). Remove Huangdan; this is named Longhuo Dan (Dragon Fire Pill).
Grind into fine powder. Have the patient lie supine. Dip a silver hairpin into the powder and apply a small amount to the outer canthus of the eye. One or two applications yield miraculous results.
Eleventh: Good prescription for lower back pain.
Duzhong (Eucommiae Cortex, stir-fried with ginger and wine, 2 qian), Poguozhi (Psoraleae Fructus, stir-fried, 5 fen), Xiaohuixiang (Foeniculi Fructus, stir-fried with salt and wine), Renshen (Ginseng Radix et Rhizoma, 3 fen).
Grind into powder. Take two pig kidneys, cut open, insert the powder, steam until cooked. Consume with the broth and residue to achieve cure.
Twelfth: Secret recipe for lower back pain. Transmitted by Wang Mingjing.
Danggui (Angelicae Sinensis Radix, washed with wine), Duzhong (Eucommiae Cortex, stir-fried with wine), Dahuixiang (Foeniculi Fructus, stir-fried with wine), Xiaohuixiang (Foeniculi Fructus, stir-fried with wine), Qianghuo (Notopterygii Rhizoma et Radix).
Crush into a large dose. Soak in first-run liquor overnight. Filter the liquid the next morning and drink warm. Re-decoct the dregs with wine and drink warm for immediate effect.