孙 中年,肾阳虚,腰痛溶溶如坐水中,形色苍,不胜刚燥,用温养少阴,兼理奇脉。杞子、补骨脂、
核桃肉、当归、牛膝(酒蒸)、续断、杜仲(炒)、沙苑子(炒)、酒浸服,效。
耿 腹痛旧恙,行走劳倦辄发,今由少腹痛引腰,卧则少缓,脉来虚软,少神,乃冲督经病。用小茴香、
沙苑子、补骨脂、降香末、杜仲(姜汁炒)、核桃肉、鹿角霜,三服痛除。
巢氏 中年经断,两尺芤弱,下元先亏,腰膝酸痛,宜温补下焦,必月事来乃望体安。杞子、熟地(俱炒)、
牛膝(酒蒸)、当归、沙苑子、菟丝饼、茯苓、核桃肉,十数服而如常。
魏氏 秋间崩漏数次,胫膝宵热,曾用摄补而安。今经止数月,腰痛由季胁控引少腹,辄疑瘀动将崩。诊脉
左寸动,胎也,非瘀也。痛引季胁,必带脉虚为病,按冲任二脉循腹胁,夹脐旁,皆络于带,而带脉之病,实太
阴所主,故《素问》言邪客太阴之络,令人腰痛引小腹控 ,不可以养息。而王叔和谓带脉为病,左右绕脐,
腰脊痛也。宜治带脉以固胎元。如所服参、 、地、术呆补,不能入奇经,安望有效。沙苑子、杞子、小茴香、
归须、续断、杜仲、桑寄生、补骨脂、糯稻根须,数服痛止,又用膏方而胎固。
吉氏 有年,久嗽痰红,头眩脘闷,咳则腰痛若折,少腹筋掣痛注,右腿艰于起坐,卧必偏左,脉左沉弦,
右沉弱,症属肝肾亏损。但先从气分调补,勿用血药滞腻。沙苑子、橘核、当归(俱酒炒)、杜仲(盐水拌)、
茯苓、砂仁壳、川贝母、蒌霜、甜杏仁(炒)、白芍(炒)、核桃肉,三服痛止嗽稀。更订膏方,用血燕根、
猪脊髓、桑寄生、杞子、核桃肉、制首乌、玉竹、潞参、当归、茯神、湘莲子、鹿角胶收膏,每用膏六钱,
开水和服,全愈。
族兄 小腹右偏痛,直注大股正面、侧面而下至膝盖止,因行走劳顿,寒热痛发,必是小腹先受寒袭于
腿经,故痛而发寒热也。宜温通,勿使成痹,但在高年,不宜过剂。橘核酒炒、木香、木瓜、归须、牛膝、
小茴香、桑寄生、生姜、葱白,再服微汗,而痛如失。
孙某,中年男性,肾阳虚衰,腰痛绵绵不绝,感觉如同坐在水中,面色苍白无华,身体虚弱无法耐受刚燥之药。治疗宜温养少阴经,兼调理奇经八脉。方用枸杞子、补骨脂、核桃肉、当归、牛膝(酒蒸)、续断、杜仲(炒)、沙苑子(炒),以酒煎服,疗效显著。
耿某,腹痛旧疾,行走劳累时容易发作,如今疼痛由少腹牵引至腰部,卧床休息则疼痛稍缓,脉象虚软,神气不足,这是冲脉和督脉的病变。用小茴香、沙苑子、补骨脂、降香末、杜仲(姜汁炒)、核桃肉、鹿角霜,服用三剂后疼痛消除。
巢氏,中年女性,月经已断绝,两尺脉芤弱,下元先天亏损,腰膝酸痛,适宜温补下焦,必须等到月经恢复才能期望身体安康。方用枸杞子、熟地黄(均炒)、牛膝(酒蒸)、当归、沙苑子、菟丝饼、茯苓、核桃肉,服用十余剂后恢复正常。
魏氏,秋季期间崩漏(非经期大量出血或淋漓不断)数次,小腿及膝盖夜间发热,曾使用收敛补益之法而安定。如今月经停止数月,腰痛从季胁部牵引至少腹部,常常怀疑是瘀血扰动即将导致崩漏。诊察脉象左寸脉动,是怀孕之象,并非瘀血。疼痛牵引季胁,必定是带脉虚弱所致疾病,按查冲任二脉循行于腹部和胁部,夹脐旁,都联络于带脉,而带脉的疾病,实际上由太阴脾经所主,所以《素问》说邪气客居太阴的络脉,使人腰痛牵引小腹控引,不可休养。而王叔和说带脉为病,左右环绕肚脐,腰脊疼痛。适宜治疗带脉以固护胎元。如之前服用的参、[此处原文缺字,推测为黄芪或类似补气药]、地、术呆补之品,不能进入奇经,怎能期望有效?方用沙苑子、枸杞子、小茴香、归须(当归尾)、续断、杜仲、桑寄生、补骨脂、糯稻根须,数剂后疼痛停止,又用膏方使胎元稳固。
吉氏,年事已高,久咳痰中带血,头晕目眩,胃脘部闷胀,咳嗽时腰痛如折断,少腹部筋脉掣痛放射,右腿难以起坐,睡觉时必须偏向左侧,脉象左沉弦,右沉弱,症状属于肝肾亏损。但先从气分进行调补,不要用滋腻的血分药物阻碍气机。方用沙苑子、橘核、当归(均酒炒)、杜仲(盐水拌)、茯苓、砂仁壳、川贝母、瓜蒌霜、甜杏仁(炒)、白芍(炒)、核桃肉,服用三剂后疼痛停止,咳嗽减少。随后调整处方制成膏方,用药用燕窝根、猪脊髓、桑寄生、枸杞子、核桃肉、制何首乌、玉竹、党参、当归、茯神、湘莲子、鹿角胶收膏,每次服用膏方六钱,开水调和送服,完全痊愈。
族兄,小腹右侧偏痛,直接放射至大腿正面、侧面并下行至膝盖为止,因行走劳累,寒热疼痛发作,必定是小腹先受寒邪侵袭腿部经络,所以疼痛并发寒热。适宜温通经络,不要使其发展为痹证,但在高龄患者身上,不宜用药过猛。方用橘核(酒炒)、木香、木瓜、归须、牛膝、小茴香、桑寄生、生姜、葱白,再服药后微微出汗,疼痛消失如失。
Sun, a middle-aged male, suffered from deficiency of Kidney Yang. His lower back pain was continuous and lingering, feeling as if sitting in water; his complexion was pale, and his constitution was too weak to tolerate harsh, drying herbs. The treatment should warm and nourish the Shaoyin (Lesser Yin) channel and simultaneously regulate the Extraordinary Vessels. The prescription consisted of Gouqi (Lycii Fructus), Buguzhi (Psoraleae Fructus), Hetaorou (Juglandis Semen), Danggui (Angelicae Sinensis Radix), Niuxi (Achyranthis Bidentatae Radix, steamed with wine), Xuduan (Dipsaci Radix), Duzhong (Eucommiae Cortex, stir-fried), and Shayuanzi (Astragali Complanati Semen, stir-fried), decocted with wine. It was effective.
Geng had a chronic history of abdominal pain, which tended to flare up after walking or fatigue. Currently, the pain radiated from the lower abdomen to the lower back, and eased slightly when lying down. The pulse was deficient and soft, indicating a lack of Shen (Spirit/Vitality). This indicated a disease of the Chong (Penetrating) and Du (Conception) vessels. The prescription included Xiaohuixiang (Foeniculi Fructus), Shayuanzi, Buguzhi, Jiangxiangmo (Aquilariae Lignum Resinatum Pulvis), Duzhong (stir-fried with ginger juice), Hetaorou, and Lu Jiaoshuang (Cervi Cornus Degelatinatum). After three doses, the pain was eliminated.
Chao, a middle-aged female, had ceased menstruation. Her Chi (Cubit) pulses on both sides were hollow (Kou) and weak, indicating a prior deficiency of the Lower Yuan (Lower Origin). She experienced soreness and pain in the lower back and knees. The appropriate treatment was to warm and tonify the Lower Jiao (Lower Burner). Health could only be expected once menstruation resumed. The prescription consisted of Gouqi, Shudi (Rehmanniae Radix Praeparata, both stir-fried), Niuxi (steamed with wine), Danggui, Shayuanzi, Tansibing (Cuscutae Semen Tortum), Fuling (Poria), and Hetaorou. After more than ten doses, she returned to normal.
Wei experienced several episodes of Benglou (metrorrhagia and metrostaxis) in autumn, accompanied by night heat in the calves and knees. She had previously stabilized with astringent and tonifying methods. Now, having been amenorrheic for several months, her lower back pain radiated from the hypochondrium to the lower abdomen, leading her to suspect that blood stasis was disturbing the uterus and impending another episode of bleeding. Palpation revealed a moving pulse at the Left Cun (Inch) position, indicating pregnancy, not blood stasis. Pain radiating to the hypochondrium suggested a deficiency of the Dai (Belt) vessel. According to meridian pathways, the Chong and Ren (Conception) vessels circulate around the abdomen and hypochondrium, adjacent to the umbilicus, and all connect to the Dai vessel. Diseases of the Dai vessel are actually governed by the Taiyin (Spleen/Lung) system. Thus, *Suwen* states: "When pathogenic factors invade the collaterals of Taiyin, it causes lower back pain radiating to the lower abdomen... requiring rest." Wang Shuhe stated that diseases of the Dai vessel involve pain winding around the umbilicus and affecting the lower back and spine. The treatment should focus on the Dai vessel to secure the fetal origin. Previous prescriptions containing Ginseng, [missing character, likely Huangqi], Di (likely Dihuang), and Zhu (likely Baizhu) were static tonics that failed to enter the Extraordinary Vessels, hence their ineffectiveness. The new prescription used Shayuanzi, Gouqi, Xiaohuixiang, Guixu (Radix Angelicae Sinensis caulis), Xuduan, Duzhong, Sangjisheng (Taxilli Herba), Buguzhi, and Nuodaogenxu (Sagittaria Sagittifoliae Rhizoma Stamen). After several doses, the pain stopped. A paste formula was subsequently used to secure the fetus.
Ji, an elderly patient, suffered from chronic cough with blood-streaked sputum, dizziness, and epigastric fullness. Coughing caused severe lower back pain as if broken, spasmodic pain in the lower abdomen radiating downwards, and difficulty rising or sitting with the right leg. He had to sleep leaning to the left. The pulse was deep and wiry on the Left, and deep and weak on the Right. The syndrome belonged to Liver and Kidney deficiency. However, treatment should first tonify the Qi aspect, avoiding cloying Blood tonics that might stagnate Qi. The prescription included Shayuanzi, Juhe (Citri Reticulatae Pericarpium Viride), Danggui (both stir-fried with wine), Duzhong (mixed with salt water), Fuling, Sharenqiao (Amomi Fructus Pericarpium), Chuanbeimu (Fritillariae Thunbergii Bulbus), Lou Shuang (Trichosanthis Pericarpium), Tian Xingren (Armeniacae Semen Amarum, stir-fried), Baishao (Paeoniae Radix Alba, stir-fried), and Hetaorou. After three doses, the pain stopped and cough decreased. The prescription was revised into a paste formula using Yanyangen (Hirundo Nidus Radix?), Zhuijingsui (Porci Medulla Spinalis), Sangjisheng, Gouqi, Hetaorou, Zhi Shouwu (Polygoni Multiflori Radix Praeparata), Yuzhu (Polygonati Odorati Rhizoma), Lushen (Codonopsis Radix), Danggui, Fushen (Poria cum Radice), Xianglianzi (Nelumbinis Semen), and Lu Jiao Jiao (Cervi Cornus Colla). Six qian of paste were taken each time, mixed with boiling water, resulting in complete recovery.
The author's clan brother experienced pain in the right side of the lower abdomen, radiating directly down the front and side of the thigh to the knee. Triggered by walking and fatigue, this was accompanied by chills and fever. This indicated that cold pathogens had first invaded the lower abdomen and then the leg meridians, causing pain accompanied by chills and fever. The treatment should warm and unblock the meridians to prevent Bi (Obstruction) syndrome, but given his advanced age, strong medication should be avoided. The prescription included Juhe (stir-fried with wine), Muxiang (Aucklandiae Radix), Mugua (Chaenomelis Fructus), Guixu, Niuxi, Xiaohuixiang, Sangjisheng, Shengjiang (Zingiberis Rhizoma Recens), and Congbai (Allii Fistulosi Bulbus). After further doses, slight sweating occurred, and the pain disappeared completely.