寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

The Lumbus

Yo

한글 요문  ·  Pinyin Yao

Ten kinds of low back pain, and the single claim that the kidney stands behind them all

腰

The Lumbus chapter is the most immediately practical in the whole book. It divides low back pain into ten kinds and gives each its own signs, causes, and formulas — and the distinguishing features are ones a clinician still asks about today: whether the pain moves or stays fixed, whether it worsens at night or after sitting, whether warmth relieves it, and whether it began with lifting. Underneath the ten sits a single organizing claim, stated at the outset: however the pain arrives, the Kidney must first be vacuous before anything can settle there.

5.1 The measurements of the lumbar circumference 腰圍度數

5.1.1
Source원문

腰圍四尺二寸. 《靈樞》 ○腰脊者, 身之大關節也. 《靈樞》

Translation영역
The circumference of the lumbus is four cheok two chon (Yeongchu 靈樞). — The lumbus and spine are the great joint of the body. (Yeongchu 靈樞)
Clinical note임상 주석
Two lines, and the second is the one that matters: the lumbus and spine named as *the great joint* — not one joint among many but the hinge on which the body turns. Everything the chapter says afterward follows from treating the low back as a structure that bears and pivots rather than as a place where pain happens to occur.

Yeongchu 靈樞

5.2 The lumbus is the palace of the Kidney 腰爲腎府

5.2.1
Source원문

腰者, 腎之府, 轉搖不能, 腎將憊矣. 《內經》 ○腰者, 腎之外候, 一身所恃, 以轉移開闔者也. 然諸經貫於腎, 絡於腰脊, 雖外感內傷, 種種不同, 必腎虛而後, 邪能湊之. 故不可純用涼藥, 亦不可純用參芪補氣也. 《入門》

Translation영역
The lumbus is the palace of the Kidney; when it can no longer turn and sway, the Kidney is about to give out (Naegyeong 內經). — The lumbus is the Kidney's outward sign, that on which the whole body relies for turning, shifting, opening, and closing. Now all the channels thread through the Kidney and net the lumbus and spine; and though external contraction and internal damage differ in a hundred ways, **the Kidney must first be vacuous, and only then can an evil gather there.** Therefore one must not use cooling medicines alone, nor supplement the Qi with ginseng and astragalus alone. (Immun 入門)
Clinical note임상 주석
The chapter's governing principle, and it is a claim about susceptibility rather than about cause: cold, damp, strain, and stasis can all produce back pain, but none of them settle in a lumbus that is sound. Hence the closing caution, which is really a warning against two opposite errors — treating every back pain by clearing heat, or treating every back pain by supplementing Qi. Neither addresses the ground the pain is standing on.

Naegyeong 內經 · Immun 入門

5.3 Pulse patterns 脉法

5.3.1
Source원문

按之至骨, 脉氣少者, 腰脊痛而身有痺也. 《內經》 ○尺脉沈, 腰背痛. ○腰痛之脉, 皆沈弦. 沈弦而緊者爲寒, 沈弦而浮者爲風, 沈弦而濡細者爲濕, 沈弦而實者爲挫閃. 《脉經》 ○腰痛脉必沈而弦. 沈爲滯, 弦爲虛. 澁是瘀血, 緩者是濕, 滑者伏者是痰, 大者是腎虛也. 《丹心》

Translation영역
Pressing down to the bone, where the pulse Qi is scant, there is pain of the lumbus and spine and the body has impediment (Naegyeong 內經). — Where the cubit pulse is sunken, there is pain of the lumbus and back. — The pulse in lumbar pain is in every case sunken and wiry. Sunken and wiry with tightness is cold; sunken and wiry with floating is wind; sunken and wiry with sogginess and fineness is damp; sunken and wiry with repletion is wrenching strain (Maekgyeong 脉經). — In lumbar pain the pulse must be sunken and wiry: sunken means stagnation, wiry means vacuity. Rough is static blood; moderate is damp; slippery or hidden is phlegm; large is Kidney vacuity. (Dansim 丹心)
Clinical note임상 주석
A working table rather than a theory. Sunken and wiry is the baseline for all lumbar pain; what is added to it names the kind. The two sources overlap but do not entirely agree — the Pulse Classic reads repletion as strain, while Danxi reads roughness as stasis and largeness as Kidney vacuity — and the chapter prints both without reconciling them, which is honest.

Naegyeong 內經 · Maekgyeong 脉經 · Dansim 丹心

5.4 Lumbar pain is of ten kinds 腰痛有十

5.4.1
Source원문

有腎虛, 有痰飮, 有食積, 有挫閃, 有瘀血, 有風, 有寒, 有濕, 有濕熱, 有氣, 凡十種.

Translation영역
There is Kidney vacuity, there is phlegm-rheum, there is food accumulation, there is wrenching strain, there is static blood, there is wind, there is cold, there is damp, there is damp heat, and there is Qi — ten kinds in all.
Clinical note임상 주석
The ten kinds, and their order is not arbitrary: Kidney vacuity comes first because the chapter has just argued that it underlies the rest. What follows in the sections below is a differential built almost entirely on the history — when the pain started, what makes it worse, whether it moves — which is exactly how a modern clinician sorts back pain before imaging. The classical categories translate more directly than one might expect: wrenching strain is a lifting injury, static blood is the pain that worsens at night, damp heat is the pain that comes on from sitting.

Donguibogam · Yo

5.4.1 Kidney vacuity lumbar pain 腎虛腰痛

5.4.1.1
Source원문

脉大者, 腎虛腰痛也. 《丹心》 ○腎虛者, 疼之不已者是也. 《丹心》 ○房慾傷腎, 精血不足養筋, 陰虛悠悠痛, 不能擧者, 六味地黃元, 或八味元 方幷見虛勞, 加鹿茸ㆍ當歸ㆍ木瓜ㆍ續斷. 《東垣》 ○腎虛腰痛, 宜靑娥元ㆍ加味靑娥元ㆍ壯本丹ㆍ局方安腎丸ㆍ補髓丹. ○陽虛腰軟不能運用, 宜九味安腎丸ㆍ百倍丸ㆍ杜沖丸ㆍ補腎湯. ○腰軟者, 肝腎伏熱, 治用黃柏ㆍ防己. 《醫鑑》

Translation영역
Where the pulse is large, it is Kidney vacuity lumbar pain. — Kidney vacuity is where the aching does not let up (Dansim 丹心). — Where bedroom desire has damaged the Kidney and the essence and Blood are insufficient to nourish the sinews, the Yin being vacuous there is a long drawn-out ache and one cannot lift oneself: Yukmijihwang-won, or Palmi-won — both formulas in the Taxation chapter — with deer antler, Korean angelica, chaenomeles, and teasel root added (Dongwon 東垣). — For Kidney vacuity lumbar pain: Cheongah-won 靑娥元, Gamicheongah-won 加味靑娥元, Jangbon-dan 壯本丹, Gukbangansin-won 局方安腎元, and Bosu-dan 補髓丹. — Where the Yang is vacuous and the lumbus is soft and cannot be put to use: Gumiansin-hwan 九味安腎丸, Baekbae-hwan 百倍丸, Ducheung-hwan 杜沖丸, and Bosin-tang 補腎湯. — Where the lumbus is soft, there is hidden heat in Liver and Kidney; treat with phellodendron and stephania. (Uigam 醫鑑)
Clinical note임상 주석
The signature of this kind is *the aching does not let up* — no flare and no remission, a background ache that has been there for months. It is distinguished from the others less by what makes it worse than by what does not make it better. Note the sub-division that follows: pain is one thing, and a lumbus gone **soft** — unable to be put to use — is another, and gets a different shelf of formulas. That distinction between painful and merely weak is one the classical texts make more consistently than modern back-pain language does.

Dansim 丹心 · Dongwon 東垣 · Uigam 醫鑑

5.4.2 Phlegm-rheum lumbar pain 痰飮腰痛

5.4.2.1
Source원문

脉滑者伏者是痰飮痛也. 《丹心》 ○痰飮流注經絡, 腰背疼痛, 二陳湯, 或芎夏湯 幷見痰飮, 加南星ㆍ蒼朮ㆍ黃柏, 或用控涎丹 方見痰飮. ○痰飮腰痛, 宜南星ㆍ半夏, 加快氣藥佐之. 《丹心》

Translation영역
Where the pulse is slippery or hidden, it is phlegm-rheum pain (Dansim 丹心). — Where phlegm-rheum flows and pours into the channels and network vessels, there is aching pain of the lumbus and back: Ijin-tang, or Gunghha-tang — both in the Phlegm chapter — with arisaema, atractylodes, and phellodendron added; or use Gongyeon-dan — formula in the Phlegm chapter —. — In phlegm-rheum lumbar pain, arisaema and pinellia are appropriate, with Qi-quickening medicines added to assist them. (Dansim 丹心)
Clinical note임상 주석
The one kind identified almost entirely by pulse rather than by history, which makes it the hardest to recognize without training. What the category picks out clinically is back pain in the heavy, damp-constitution patient — often with a sense of fullness rather than sharpness, and frequently in someone whose other complaints are also phlegm-type. The instruction to add Qi-quickening herbs is the practical part: phlegm does not move unless the Qi moves it.

Dansim 丹心

5.4.3 Food accumulation lumbar pain 食積腰痛

5.4.3.1
Source원문

因醉飽入房, 濕熱乘虛入腎, 腰痛難以俛仰. 四物湯 方見血門, 合二陳湯 方見痰飮, 加麥芽ㆍ神麴ㆍ葛花ㆍ縮砂ㆍ杜沖ㆍ黃柏ㆍ官桂ㆍ枳殼ㆍ桔梗煎服. 痛甚者, 宜速效散. 《入門》

Translation영역
From entering the bedchamber while drunk and full, damp heat takes advantage of the vacuity and enters the Kidney, and the lumbar pain makes it hard to bend forward or lean back. Samul-tang — formula in the Blood chapter — combined with Ijin-tang — formula in the Phlegm chapter —, with barley sprout, medicated leaven, kudzu flower, amomum, eucommia, phellodendron, cassia, bitter orange husk, and platycodon added, decocted and taken. Where the pain is severe, Sokhyo-san 速效散 is appropriate. (Immun 入門)
Clinical note임상 주석
A category that looks strange until you read the etiology: not food accumulation in general, but the specific combination of drink, a heavy meal, and sex — after which damp heat sinks into a Kidney left open by exhaustion. What the presentation describes is back pain that arrived overnight after a night out, with difficulty bending in either direction. The kudzu flower in the formula list is the giveaway; it is the chapter's standing herb for alcohol.

Immun 入門

5.4.4 Wrenching strain lumbar pain 挫閃腰痛

5.4.4.1
Source원문

擧重勞傷, 或挫閃墜落以作痛, 亦謂之䐴腰痛. 宜獨活湯ㆍ乳香趁痛散ㆍ如神湯ㆍ舒筋散ㆍ立安散ㆍ神麴酒.

Translation영역
From lifting something heavy and straining, or from a wrench or a fall producing pain — this is also called wrenched lumbar pain. Appropriate are Dokhwal-tang 獨活湯, Yuhyangjintong-san 乳香趁痛散, Yeosin-tang 如神湯, Seogeun-san 舒筋散, Ipan-san 立安散, and Singuk-ju 神麴酒.
Clinical note임상 주석
The acute mechanical injury, and the chapter gives it six formulas — more than any other kind except Kidney vacuity. That proportion tells you how common it was. Three of the six share the same small core of corydalis, angelica, and cinnamon heart, differing only in what is added; the tradition evidently found that combination reliable for a fresh strain, and it remains a reasonable starting point today. **Note on modern practice: back pain following a fall, or with leg weakness, numbness, or bladder or bowel changes, requires prompt medical evaluation.**

Donguibogam · Yo

5.4.5 Static blood lumbar pain 瘀血腰痛

5.4.5.1
Source원문

跌撲墜墮, 以致血瘀腰痛. 《入門》 ○晝輕夜重者是瘀血痛也. 《丹心》 ○血瀝則腰痛, 轉側如錐之所刺. 《直指》 ○瘀血腰痛, 宜破血散疼湯ㆍ川芎肉桂湯ㆍ地龍散. 實者, 桃仁承氣湯 方見寒門. 久者, 五積散 方見寒門, 去麻黃, 加桃仁ㆍ紅花ㆍ木香ㆍ檳榔ㆍ茴香(炒). 或四物湯 方見血門, 加桃仁ㆍ蘇木ㆍ酒紅花. ○腰連脇痛者, 復元通氣散 方見氣門, 加木香服之. 《入門》

Translation영역
From a stumble, a blow, or a fall, so that the blood becomes static and the lumbus pains (Immun 入門). — **Where it is light by day and heavy by night, it is static blood pain** (Dansim 丹心). — Where the blood drips and pools, the lumbus pains, and on turning to either side it is as though pierced by an awl (Jikji 直指). — For static blood lumbar pain: Pahyeolsandong-tang 破血散疼湯, Cheongungyukgye-tang 川芎肉桂湯, and Jiryong-san 地龍散. Where it is replete, Doinseunggi-tang — formula in the Cold Damage chapter —. Where it is long-standing, Ojeok-san — formula in the Cold Damage chapter — with the ephedra removed and peach kernel, safflower, aucklandia, areca nut, and dry-fried fennel added. Or Samul-tang — formula in the Blood chapter — with peach kernel, sappan wood, and wine-processed safflower added. — Where the lumbar pain extends into the flank: Bogwontonggi-san — formula in the Qi chapter — with aucklandia added. (Immun 入門)
Clinical note임상 주석
**Light by day and heavy by night** — six characters that do more diagnostic work than anything else in the chapter. Night-worse pain is still one of the first questions asked about a back, and the classical reading of it as stasis rather than as inflammation is different in vocabulary but not in what it selects for. The awl image is the other useful piece: pain that stabs specifically on turning, rather than aching throughout. **Note on modern practice: back pain that is worse at night, or that wakes a person from sleep, is also a red flag in modern practice for infection and malignancy, and warrants evaluation — particularly with fever, weight loss, or a history of cancer.**

Immun 入門 · Dansim 丹心 · Jikji 直指

5.4.6 Wind lumbar pain 風腰痛

5.4.6.1
Source원문

風傷腎而腰痛者, 或左或右, 痛無常所, 引兩足强急. 五積散 方見寒門, 加防風ㆍ全蝎, 或烏藥順氣散 方見風門, 加五加皮. 痛勢甚者, 加味龍虎散. 《入門》 ○風熱腰痛, 敗毒散 方見寒門, 加續斷ㆍ天麻ㆍ木瓜ㆍ薄荷. 《得效》

Translation영역
Where wind has damaged the Kidney and the lumbus pains: now on the left, now on the right, **the pain keeping to no fixed place**, and drawing both legs into tension and urgency. Ojeok-san — formula in the Cold Damage chapter — with saposhnikovia and scorpion added; or Oyaksungi-san — formula in the Wind chapter — with acanthopanax added. Where the force of the pain is severe, Gamiyongho-san 加味龍虎散 (Immun 入門). — For wind-heat lumbar pain, Paedok-san — formula in the Cold Damage chapter — with teasel root, gastrodia, chaenomeles, and mint added. (Deukhyo 得效)
Clinical note임상 주석
Wind is identified by movement: the pain shifts sides and keeps to no fixed place. That single feature is what separates it from stasis, which stays exactly where it is. The added detail — both legs drawn tight — suggests the presentations that would now be described as radicular or as involving muscle guarding. Note that the chapter reaches for wind-dispelling formulas from other chapters rather than building its own, which is characteristic: wind is treated as wind wherever it lands.

Immun 入門 · Deukhyo 得效

5.4.7 Cold lumbar pain 寒腰痛

5.4.7.1
Source원문

寒傷腎經, 腰痛不能轉側, 見熱則減, 遇寒則發, 脉沈弦急. 五積散, 加吳茱萸ㆍ杜沖ㆍ桃仁. 痛甚, 加黑丑頭末一錢調服. 《入門》 ○痛甚, 服加味龍虎散. 《入門》 ○代灸膏, 貼腰眼穴 方見寒門.

Translation영역
Where cold has damaged the Kidney channel, the lumbus pains and one cannot turn to either side; **meeting warmth it lessens, encountering cold it breaks out**, and the pulse is sunken, wiry, and urgent. Ojeok-san with evodia, eucommia, and peach kernel added. Where the pain is severe, add 1 don of the first-ground powder of black morning glory seed and take it stirred in (Immun 入門). — Where the pain is severe, take Gamiyongho-san 加味龍虎散. — Daegu-go, applied to the Yaoyan points — formula in the Cold Damage chapter —.
Clinical note임상 주석
The plainest of the ten to identify, and the one patients report themselves: warmth helps, cold brings it on. What the chapter adds is the pulse — sunken, wiry, and urgent — and the treatment principle, which is to warm rather than to move. The last line is worth noticing: a medicated plaster applied to the Yaoyan points, which is a heat patch on the low back by another name, and among the oldest continuously used remedies for this complaint.

Immun 入門

5.4.8 Damp lumbar pain 濕腰痛

5.4.8.1
Source원문

久處卑濕, 雨露浸淫, 腰重痛如石, 冷如氷. 五積散, 加桃仁ㆍ吳茱萸最效. 《得效》 ○濕腰痛, 宜朮附湯ㆍ通經散. ○川芎肉桂湯 方見上, 治露宿寒濕之地, 腰痛不能轉側. 《醫鑑》 ○腎着證, 同參治之. ○又方, 坐臥濕地, 濕入腎經, 外腎腫, 腰背曲, 痛楚甚. 用五苓散煎水 方見寒門, 入胚子少許, 呑下靑木香元方見氣門 三五十粒, 數服, 藏府微動, 腫消腰直, 其痛立止. 《得效》

Translation영역
From long dwelling in low damp places, soaked and steeped by rain and dew, the lumbus is heavy and **pains like a stone, cold as ice**. Ojeok-san with peach kernel and evodia added is most effective (Deukhyo 得效). — For damp lumbar pain: Chulbu-tang 朮附湯 and Tonggyeong-san 通經散. — Cheongungyukgye-tang — formula above — treats lodging out overnight in a cold damp place, with lumbar pain and inability to turn to either side (Uigam 醫鑑). — Consider the Kidney Fixity pattern alongside this in treating it. — Another method: from sitting and lying on damp ground, damp enters the Kidney channel: the external kidney swells, the lumbus and back bend, and the pain is severe. Use Oryeong-san decocted in water — formula in the Cold Damage chapter —, put in a little 胚子, and swallow down 30–50 pellets of Cheongmokhyang-won — formula in the Qi chapter —; after several doses the bowels stir slightly, the swelling resolves and the lumbus straightens, and the pain stops at once (Deukhyo 得效).
Clinical note임상 주석
Heavy like a stone, cold as ice — the two similes do the identifying, and they describe weight rather than sharpness. The etiology is environmental and specific: living in a low damp place, or sleeping out in one. Modern equivalents are not hard to find. The cross-reference at the end is the useful part: damp lumbar pain and the Kidney Fixity pattern in the next section overlap heavily, and the chapter says so rather than pretending they are separate.

Deukhyo 得效 · Uigam 醫鑑

5.4.9 Damp heat lumbar pain 濕熱腰痛

5.4.9.1
Source원문

平日膏粱厚味之人腰痛, 皆是濕熱陰虛. 《綱目》 ○濕熱腰痛者, 遇天陰, 或久坐而發者是也. 《丹心》 ○脉緩或沈, 是濕腰痛. 《丹心》 ○濕熱腰痛, 實者, 二炒蒼柏散 方見足部, 虛者, 七味蒼柏散, 或當歸拈痛湯 方見足部. 如諸藥不效, 用三花神祐丸 方見下門, 或煨腎散下之. 《入門》

Translation영역
In one whose daily fare is rich and fatty, lumbar pain is in every case damp heat with Yin vacuity (Gangmok 綱目). — **Damp heat lumbar pain is that which breaks out in overcast weather, or after sitting a long while** (Dansim 丹心). — Where the pulse is moderate or sunken, it is damp lumbar pain (Dansim 丹心). — For damp heat lumbar pain: where replete, Ichochangbaek-san — formula in the Feet section —; where vacuous, Chilmichangbaek-san 七味蒼柏散, or Dangguiyeomtong-tang — formula in the Feet section —. Where none of the medicines take effect, use Samhwasinu-hwan — formula in the Purgation chapter —, or Oesin-san 煨腎散 to bring it down. (Immun 入門)
Clinical note임상 주석
Two identifying features, and both are still asked about: **worse in overcast weather, and worse after sitting a long time.** The second is the most common presentation in any modern clinic, and finding it named as its own category in 1613 is striking. The remark about rich food is the chapter's version of a metabolic observation — that back pain in the well-fed and sedentary is a different animal from back pain in the labourer — which is a distinction worth keeping.

Deukhyo 得效 · Gangmok 綱目 · Dansim 丹心 · Immun 入門

5.4.10 Qi lumbar pain 氣腰痛

5.4.10.1
Source원문

凡人失志, 則心血不旺, 不養筋脉, 氣滯腰痛, 不能久立遠行. 七氣湯 方見氣門, 倍加茯苓, 加沈香ㆍ乳香 各少許, 煎服. 《入門》 ○憂思傷脾則腰痛, 忿怒傷肝亦作腰痛, 俱宜沈香降氣湯 方見氣門, 合調氣散, 入薑三片ㆍ棗二枚煎服. 《直指》

Translation영역
Whenever a person **loses their purpose**, the Heart Blood is not exuberant and does not nourish the sinews and vessels; the Qi stagnates and the lumbus pains, and one cannot stand long or walk far. Chilgi-tang — formula in the Qi chapter — with the poria doubled and a little aquilaria and frankincense added, decocted and taken (Immun 入門). — Where worry and thought have damaged the Spleen there is lumbar pain, and where indignation and anger have damaged the Liver there is likewise lumbar pain: for both, Chimhyanggangi-tang — formula in the Qi chapter — combined with Jogi-san 調氣散, with 3 slices of ginger and 2 jujubes, decocted and taken. (Jikji 直指)
Clinical note임상 주석
The tenth kind, and the reason to read the whole list: back pain from **losing one's purpose**. Not stress in general but a specific state — 失志, the will gone out of a person — producing Heart Blood that no longer nourishes the sinews, and a back that cannot stand long or walk far. The second passage adds worry and anger as separate routes to the same complaint. This is the same etiological move the Spirit and Womb chapters make, applied here to a musculoskeletal symptom, and it is why this chapter belongs in a discussion of stress as much as of injury.

Immun 入門 · Jikji 直指

5.5 The Kidney Fixity pattern 腎着證

5.5.1
Source원문

病人身體重, 腰中冷如坐水, 形如水狀, 反不渴, 小便自利, 飮食如故, 腰以下冷痛, 腰重如帶五千錢, 腎着湯主之. 《仲景》 ○大抵與濕同治.

Translation영역
The sick person's body is heavy; the lumbus is cold within as though sitting in water, and the form is as though waterlogged — yet on the contrary there is no thirst, the urine passes freely, and eating and drinking are as usual; below the lumbus there is cold pain, and **the lumbus is as heavy as though five thousand cash were strung about it**. Sinchak-tang 腎着湯 governs it (Junggyeong 仲景). — In the main, treat it as damp.
Clinical note임상 주석
One of the most quoted lines in East Asian medicine, and deservedly: *as heavy as though five thousand cash were strung about the waist.* Zhang Zhongjing's description is a complete differential in three clauses — heavy and cold below, but no thirst, normal urine, and normal appetite, which excludes the interior patterns it might otherwise resemble. What he is describing is cold damp lodged in the lumbar tissues rather than in the organ, and the formula that follows warms and dries without touching the Kidney at all.

Junggyeong 仲景 · Donguibogam · Yo

5.6 General treatment of lumbar pain 腰痛通治

5.6.1
Source원문

六氣皆能爲痛, 大抵寒濕多而風熱少. 又有房室勞傷, 腎虛腰痛者居多, 是陽氣虛弱, 不能運動故也. 《入門》 ○久腰痛, 必用官桂以開之, 腹脇痛皆然. 《丹心》 ○諸腰痛, 不可用補氣藥, 亦不宜峻用寒涼藥. 《丹心》 ○補腎湯, 治一切腰痛 方見上.

Translation영역
All six Qi can produce pain, but in the main cold and damp are many while wind and heat are few. There are also those damaged by bedroom taxation, and Kidney vacuity lumbar pain is the most numerous of all — this being that the Yang Qi is vacuous and weak and cannot move things along (Immun 入門). — In long-standing lumbar pain one must use cassia to open it; the same holds for pain of the abdomen and flanks (Dansim 丹心). — **In all lumbar pain one must not use Qi-supplementing medicines, nor is it appropriate to use cold and cooling medicines aggressively** (Dansim 丹心). — Bosin-tang 補腎湯 treats every kind of lumbar pain — formula above —.
Clinical note임상 주석
Danxi's prohibition is the line to carry: neither supplement the Qi nor cool aggressively. Read against the chapter's opening — that the Kidney must be vacuous before an evil can settle — the two together describe a narrow path: the ground needs filling, but filling with Qi tonics does not do it, and clearing what has settled must not be done hard enough to empty the ground further. The note about cassia in chronic cases is a practical addition most practitioners end up rediscovering.

Immun 入門 · Dansim 丹心

5.7 Inauspicious signs in lumbar pain 腰痛凶證

5.7.1
Source원문

腰痛, 面上忽見紅點, 人中黑者, 死. 《入門》

Translation영역
In lumbar pain, where red points suddenly appear on the face and the philtrum is black — death.
Clinical note임상 주석
A single line, and its function is to mark the boundary of the chapter. Red points appearing on the face with a darkened philtrum, in a patient whose complaint is back pain, told the physician that something else entirely was underway. **Note on modern practice: back pain with fever, unexplained weight loss, night pain that wakes from sleep, leg weakness, numbness in the saddle region, or loss of bladder or bowel control requires urgent evaluation — spinal infection, malignancy, and cauda equina syndrome all present as back pain first.**

Immun 入門

5.8 Guiding and pulling exercises 導引法

5.8.1
Source원문

理腰背痛. 病人正東坐, 收手抱心, 一人於前據躡其兩膝, 一人後捧其頭, 徐牽令偃臥, 頭到地, 三起三臥便差. 《得效》

Translation영역
To put right pain of the lumbus and back: the patient sits facing due east, draws the hands in and clasps them over the heart; one person kneels in front and holds down both knees, another supports the head from behind and slowly draws the patient back to lie down until the head reaches the ground. Three risings and three lyings, and it is put right.
Clinical note임상 주석
A two-assistant passive extension, described precisely enough to reconstruct: knees pinned, head supported, the trunk drawn slowly backward into extension and returned, three times. Modern manual therapy does something recognizably similar for the same complaint, though usually with one clinician and a table. The instruction to face east belongs to its era; the mechanics do not.

Deukhyo 得效

5.9 Simple medicinals 單方

5.9.1
Source원문

凡二十二種. 有固陽丹ㆍ煨腎丸.

Translation영역
Twenty-two kinds in all. There are Goyang-dan 固陽丹, Make the Yang Firm Elixir, and Oesin-hwan 煨腎丸, Roasted Kidney Pill.

Donguibogam · Yo

5.9.2
Source원문

磁石 補腎, 治腰痛. 火煆醋淬九次爲末, 水飛作丸服, 或入補腎藥皆佳. 《本草》 ○腎虛腰不利, 宜用. 《本草》

Translation영역
Magnetite (磁石): Supplements the kidney and treats lumbar pain. Calcine it in fire and quench it in vinegar nine times, powder it, levigate it in water and make pills to take; or put it into kidney-supplementing medicines — either is good. ○ Where the kidney is vacuous and the lumbus does not move freely, it is the drug to use.
Clinical note임상 주석
火煆醋淬九次, calcined and vinegar-quenched nine times, is the standard processing for the mineral drugs and it does real work: repeated heating and acid quenching cracks the stone and converts the surface to a soluble salt, so what the patient swallows is iron the body can take up rather than inert magnetite. The chapter opens its simples with a weight, as the Spirit chapter does, but for a different reason — here the heaviness is meant to sink into the kidney, which is the organ this chapter holds behind every kind of low back pain.

Boncho 本草

5.9.3
Source원문

菟絲子 治腰痛膝冷. 酒煮作末, 溫酒下二錢. ○又菟絲子ㆍ牛膝 各一兩, 酒浸五日, 曝乾爲末, 酒糊丸服. ○又菟絲子末 二兩ㆍ杜沖 蜜灸, 末, 一兩, 山藥末酒煮爲糊作丸, 酒下五七十丸, 名固陽丹. 《本草》

Translation영역
Cuscuta (菟絲子): Treats lumbar pain with cold knees. Boil it in wine, powder it, and take 2 don down with warm wine. ○ Or cuscuta and achyranthes, 1 nyang each, steeped in wine for five days, sun-dried and powdered, made into pills with wine paste and taken. ○ Or powdered cuscuta 2 nyang and eucommia — honey-roasted and powdered — 1 nyang, made into pills with a paste of yam powder boiled in wine, 50 to 70 pills taken down with wine; it is called Goyang-dan 固陽丹.
Clinical note임상 주석
Three recipes in one entry, and they build: the single drug, then the pair with achyranthes, then the three-drug pill with eucommia and yam that earns a name of its own — 固陽丹, the elixir that makes the yang firm. Cuscuta, achyranthes, eucommia: these three and 破故紙 below are the backbone of the whole section, and every one of them is classed as a kidney supplement. The chapter's organizing claim is doing the prescribing.

Boncho 本草

5.9.4
Source원문

牛膝 除腰脊痛. 煮汁飮, 或酒浸服幷良. 又取嫩葉和米醬, 空心作粥服. 《本草》

Translation영역
Achyranthes (牛膝): Removes pain of the lumbus and spine. Boil it and drink the liquid, or steep it in wine and take — both are good. Or take the young leaves, mix them with rice and bean paste, and make a gruel to take on an empty stomach.
Clinical note임상 주석
牛膝, ox knee, is named for the swollen nodes on its stem, and the materia medica holds that it leads the other drugs downward — which is why it appears in almost every formula in this chapter and in the Knee chapter too. The gruel made from its young leaves is the reminder that this was a wayside plant before it was a drug.

Boncho 本草

5.9.5
Source원문

石斛 治腰痛脚弱. 煮服ㆍ末服ㆍ浸酒服皆佳. 《本草》

Translation영역
Dendrobium (石斛): Treats lumbar pain with weak legs. Decocted, powdered, or steeped in wine — all are good.

Boncho 本草

5.9.6
Source원문

蒺藜子 治腰脊痛. 爲末蜜丸服, 或作末和酒服幷佳. 《本草》

Translation영역
Tribulus (蒺藜子): Treats pain of the lumbus and spine. Powder it and take it as honey pills, or powder it and take it in wine — both are good.

Boncho 本草

5.9.7
Source원문

肉蓯蓉 主腰痛. 作丸服之. 《本草》

Translation영역
Cistanche (肉蓯蓉): Governs lumbar pain. Make pills of it and take them.

Boncho 本草

5.9.8
Source원문

續斷 主腰痛. 煮服末服幷佳. 《本草》

Translation영역
Dipsacus (續斷): Governs lumbar pain. Decocted or powdered, both are good.
Clinical note임상 주석
續斷 means to join what is broken, and the name is the indication: the drug is given for fracture and for sinew and bone injury as much as for pain, and it is still the reference medicinal for a healing bone in Korean and Chinese practice.

Boncho 本草

5.9.9
Source원문

萆薢 主䐴腰痛. 酒浸服之. ○又萆薢 三兩ㆍ杜沖 一兩, 擣爲末, 空心酒服二錢, 禁食牛肉. 《本草》

Translation영역
Fish-poison yam (萆薢): Governs wrenched lumbar pain. Steep it in wine and take. ○ Or fish-poison yam 3 nyang and eucommia 1 nyang, pounded to a powder, 2 don taken in wine on an empty stomach; beef is to be avoided.
Clinical note임상 주석
䐴腰痛 is the chapter's own term for the back wrenched in a single movement — lifting, twisting, a misstep — and it is the kind of low back pain a clinician sees most. The prohibition on beef is the sort of dietary rule that attaches to a particular drug rather than to a pattern, and the Bogam records several; no mechanism is offered and none is obvious.

Boncho 本草

5.9.10
Source원문

威靈仙 治腰痛. 生爲末, 酒調二錢服. 《丹心》 ○又方, 細末二錢, 猪腰子一隻批, 藥在內, 濕紙裹煨熟, 早晨細嚼, 熱酒下. 《綱目》 ○又酒浸爲末, 麪糊和丸梧子大, 酒下八十丸至百丸, 大便下靑膿是效也. 《本草》

Translation영역
Clematis (威靈仙): Treats lumbar pain. Powder it raw and take 2 don stirred into wine. ○ Another method: 2 don of fine powder, with one pig's kidney split open and the medicine placed inside, wrapped in damp paper and baked through; chew it finely in the early morning and take it down with hot wine. ○ Or steep it in wine, powder it, make pills the size of paulownia seeds with wheat-flour paste, and take 80 to 100 pills down with wine; green pus passing in the stool is the sign that it has worked.
Clinical note임상 주석
大便下靑膿是效也 — green pus in the stool is the proof of effect. This is the tradition's habit of reading an eliminated product as evidence that the disease has left, and it is worth naming plainly: pus in the stool is not a sign of recovery from back pain. It indicates bleeding, infection or inflammation in the bowel and needs investigating. The pig's kidney method in the middle is the chapter's signature delivery vehicle, and it recurs below under 猪腎.

Dansim 丹心 · Gangmok 綱目 · Boncho 本草

5.9.11
Source원문

牽牛子 治腰痛下冷膿. ○半生半炒, 取頭末一兩, 入硫黃一分, 同硏, 分三服. 每一服白麪一匙, 水和捏作碁子, 五更初以水一盞煮熟, 連湯送下, 只一服痛止. 《綱目》

Translation영역
Morning glory seed (牽牛子): Treats lumbar pain and brings down cold pus. ○ Half raw and half parched, take 1 nyang of the first powder, add 1 pun of sulphur, grind them together and divide into three doses. For each dose take a spoonful of white flour, mix it with water and pinch it into a shape like a go stone, boil it through in 1 jan of water at the first watch before dawn, and send it down together with the liquid; after only one dose the pain stops.
Clinical note임상 주석
**This is not to be used.** Morning glory seed is a drastic purgative and sulphur taken internally is a second irritant; the combination empties the bowel violently, and the relief of back pain claimed here is the aftermath of a purge rather than a treatment. 取頭末, the first powder, means only the flour that passes the sieve first, which is the most active part of the seed — so the dose is concentrated deliberately. 五更初, the first watch before dawn, is around four in the morning: the dose is timed to act as the bowel wakes.

Gangmok 綱目

5.9.12
Source원문

破故紙 治腰痛神妙. 炒爲末, 酒下二錢. 《本草》

Translation영역
Psoralea (破故紙): Treats lumbar pain with marvellous effect. Parch it, powder it, and take 2 don down with wine.
Clinical note임상 주석
Psoralea contains psoralen and the related furanocoumarins, which are strongly photosensitizing — the same compounds used medically with controlled ultraviolet light for psoriasis and vitiligo. A patient taking it should be told to keep out of strong sun. The drug has also been implicated in liver injury, so long courses are not for the unmonitored.

Boncho 本草

5.9.13
Source원문

五加皮 治腰脊痛及䐴腰痛. 細剉酒浸服之. 《本草》

Translation영역
Acanthopanax bark (五加皮): Treats pain of the lumbus and spine and wrenched lumbar pain. Cut it fine, steep it in wine and take.

Boncho 本草

5.9.14
Source원문

杜沖 治腰脊痛及䐴腰痛. 又治腎勞腰脊攣. 《本草》 ○薑汁炒爲末, 空心酒下一錢. ○又一兩炒去絲, 浸二升酒中, 每服三合, 日三服. 《綱目》

Translation영역
Eucommia bark (杜沖): Treats pain of the lumbus and spine and wrenched lumbar pain. It also treats kidney taxation with the lumbus and spine drawn up in spasm. ○ Parch it in ginger juice, powder it, and take 1 don down with wine on an empty stomach. ○ Or parch 1 nyang and remove the threads, steep it in 2 seung of wine, and take 3 hop a dose, three times a day.
Clinical note임상 주석
Eucommia is the chapter's chief drug — it appears in four of these twenty-two entries, more than any other — and 去絲, removing the threads, is its distinguishing processing: the bark is full of white latex strands, and parching makes them brittle enough to break and be picked out. The strands are also how the article is authenticated at purchase. 腎勞腰脊攣, kidney taxation with the back drawn up in spasm, is the chronic end of this chapter's range.

Boncho 本草 · Gangmok 綱目

5.9.15
Source원문

橘核 治腰痛. 微炒去殼爲末, 空心酒下二錢良. 《本草》

Translation영역
Tangerine seed (橘核): Treats lumbar pain. Parch it lightly, remove the husk, powder it, and take 2 don down with wine on an empty stomach — good.

Boncho 本草

5.9.16
Source원문

胡桃 治虛損腰痛. 取肉和杜沖ㆍ茴香, 浸酒空心服. 《入門》

Translation영역
Walnut flesh (胡桃): Treats lumbar pain from vacuity detriment. Take the kernels, combine them with eucommia and fennel fruit, steep in wine and take on an empty stomach.
Clinical note임상 주석
The walnut's resemblance to the kidney is the usual explanation offered for its place in the kidney-supplementing drugs, and the resemblance is real enough that the correspondence needs no argument. The walnut is also the one entry here a reader can act on without qualification: nuts, eucommia aside, are good for people.

Immun 入門

5.9.17
Source원문

芡仁 主腰脊痛. 爲末煮粥, 空心服. 《入門》

Translation영역
Euryale seed (芡仁): Governs pain of the lumbus and spine. Powder it, boil it into a gruel and take it on an empty stomach.

Immun 入門

5.9.18
Source원문

胡麻 治腰痛. 熬令香爲末, 以酒飮ㆍ蜜湯ㆍ薑湯調下三錢, 日三服, 卽永差. 《本草》

Translation영역
Black sesame (胡麻): Treats lumbar pain. Roast it until fragrant, powder it, and take 3 don stirred down in wine, honey water or ginger decoction, three times a day; it is cured for good.
Clinical note임상 주석
熬令香, roast until fragrant — the instruction is to judge the processing by smell, which is how a cook works and how most of the Bogam's parching instructions are actually given. Three vehicles are offered and the patient may choose, which is unusual: most entries specify one.

Boncho 本草

5.9.19
Source원문

鹿茸 主腰脊痛. 酥灸紫色去毛爲末, 每日空心溫酒下一錢. 《本草》

Translation영역
Deer velvet antler (鹿茸): Governs pain of the lumbus and spine. Roast it with butter until it is purple, remove the hair, powder it, and take 1 don down with warm wine on an empty stomach each day.
Clinical note임상 주석
酥灸, roasting with clarified butter, is the processing reserved for the most valuable animal drugs, and 去毛, removing the hair, is not cosmetic: the velvet is furred, and the hairs are an irritant that must be singed and scraped off before the antler is used. Korean deer antler is farmed and harvested under veterinary regulation, and the drug remains in licensed use.

Boncho 本草

5.9.20
Source원문

鹿角 除腰脊痛. 熬黃爲末, 溫酒一盃調一錢, 日二服. 《本草》

Translation영역
Deer antler (鹿角): Removes pain of the lumbus and spine. Roast it to a yellow colour, powder it, and take 1 don stirred into a cup of warm wine, twice a day.
Clinical note임상 주석
The ossified antler, shed naturally, as against the velvet above — a cheaper drug from the same animal, and the pair is a good illustration of how the materia medica graded a single source by the stage at which it was taken.

Boncho 本草

5.9.21
Source원문

羊脊骨 治腰痛轉搖不得. 脊骨一具槌碎, 爛煮和五味食之, 因飮酒少許. 《本草》

Translation영역
Sheep's spine (羊脊骨): Treats lumbar pain with inability to turn or shift. Take one whole spine, pound it to pieces, boil it soft, dress it with the five flavours and eat it, and drink a little wine with it.
Clinical note임상 주석
轉搖不得, unable to turn or shift — the patient who cannot roll over in bed, which is the sign that distinguishes a severe mechanical back from a merely painful one. Spine for spine, and what the patient actually got was a long-boiled bone broth, which is good food for someone laid up.

Boncho 本草

5.9.22
Source원문

黃狗肉 煖腰膝止痛. 取淨肉和五味煮熟, 空心食之. 《本草》

Translation영역
Yellow dog meat (黃狗肉): Warms the lumbus and knees and stops pain. Take clean meat, dress it with the five flavours, boil it through and eat it on an empty stomach.
Clinical note임상 주석
Recorded as the Bogam gives it. The slaughter of dogs for meat is now prohibited in Korea under the 2024 act, with the ban taking full effect in 2027, and the entry stands here as text about the period rather than as anything to act on.

Boncho 本草

5.9.23
Source원문

猪腎 治腎虛腰痛. 取腰子一枚薄批, 以椒鹽末淹過, 糝杜沖末三錢在內, 包以荷葉或濕紙, 慢火煨熟, 以酒嚼下, 名曰煨腎丸. 《入門》 ○又方, 童便二盞ㆍ好酒一盞ㆍ腰子一對, 盛磁缸, 黃泥封口, 日晩以慢火養熟, 至中夜待五更初, 以火溫之, 發甁飮酒食腰子. 此以血養血, 絶勝金石草木之藥. 《入門》

Translation영역
Pig kidney (猪腎): Treats lumbar pain from kidney vacuity. Take one kidney, split it thin, salt it through with powdered pepper and salt, sprinkle 3 don of powdered eucommia inside, wrap it in a lotus leaf or damp paper, bake it through over a slow fire, and chew it down with wine; it is called Oesin-hwan 煨腎丸. ○ Another method: 2 jan of a child's urine, 1 jan of good wine and a pair of kidneys, put into a porcelain jar, the mouth sealed with yellow clay, left to cook over a slow fire from late evening, and at midnight, waiting for the first watch before dawn, warmed up again over the fire; open the jar, drink the wine and eat the kidneys. This is nourishing blood with blood, and it far surpasses the medicines of mineral, stone, herb and tree.
Clinical note임상 주석
此以血養血, 絶勝金石草木之藥 — nourishing blood with blood, far surpassing the drugs of mineral and stone and herb and tree. The section opened with magnetite and closes by dismissing it, and the sentence is the clearest statement in the chapter of the principle that like feeds like: for a kidney that is empty, give a kidney. The first method is a real dish and a named formula; the second adds 童便, a child's urine, which was a standard drug of the period and is not one now. Sterile when voided but not thereafter, and it carries no benefit to set against the hazard.

Immun 入門

5.10 Acupuncture and moxibustion 鍼灸法

5.10.1
Source원문

腰痛, 灸腎兪三七壯卽差. 《綱目》 ○腰曲不能伸, 鍼委中出血立愈. 《丹心》 ○腰背痛, 以鍼決膝腰句畫中靑赤絡脉出血便差. 《得效》 ○腰痛不得俛仰, 令患人正立, 以竹拄地度至臍斷竹, 乃以度背脊, 灸竹上頭盡處, 隨年壯. 灸訖, 藏竹勿令人知. 《資生》

Translation영역
For lumbar pain, moxa BL23 Sinsu twenty-one cones and it is put right (Gangmok 綱目). — Where the lumbus is bent and cannot be straightened, needle BL40 Wijung to let blood and it is cured at once (Dansim 丹心). — For pain of lumbus and back, open with a needle the blue and red network vessels within the crease at the knee and lumbus, let blood, and it is put right (Deukhyo 得效). — For lumbar pain with inability to bend forward or lean back: have the patient stand upright, set a bamboo rod on the ground and measure up to the navel, cut the bamboo there, then measure that length up the spine from below and moxa at the point where the top of the bamboo ends, as many cones as the patient's years. When the moxa is done, hide the bamboo and let no one know of it. (Jasaeng 資生)
Clinical note임상 주석
BL40 Wijung for a back that will not straighten is among the most-used points in all of acupuncture, and here it is with the classic instruction — needle to let blood. The bamboo measurement is the chapter's most charming entry: the patient's own navel height, transferred to the spine, locates the point. Measuring by the body rather than by a ruler is the standard classical method, and the final instruction to hide the bamboo afterward is pure folk practice and preserved here as such.

Gangmok 綱目 · Dansim 丹心 · Deukhyo 得效 · Jasaeng 資生

5.10.2
Source원문

神仙灸法, 治腰痛, 灸曲䐐兩文頭左右脚四處各三壯. 每灸一脚, 二火齊下, 艾炷纔燒至肉, 初覺痛, 便用二人兩邊齊吹至火滅. 午時着灸, 至人定已來, 藏府自動一二行, 或轉動如雷聲, 其疾立愈. 此法神效. 《綱目》 ○腎虛腰痛, 取腎兪ㆍ人中ㆍ委中ㆍ肩井. ○挫閃腰痛, 取尺澤(勿灸)ㆍ委中ㆍ人中ㆍ陽陵泉ㆍ束骨ㆍ崑崙ㆍ下髎ㆍ氣海. ○腰痛, 崑崙ㆍ委中出血. 又取腎兪ㆍ中膂兪ㆍ腰兪. ○腰强痛, 命門ㆍ崑崙ㆍ志室ㆍ行間ㆍ復溜. 《綱目》

Translation영역
The Divine Immortal moxa method treats lumbar pain: moxa three cones at each of four places, at the two ends of the crease behind the knee, left leg and right. For each leg the two fires are set down together; as soon as the moxa cone burns down to the flesh and pain is first felt, two people blow from either side together until the fire is out. Apply the moxa at midday, and by the time people have settled for the night the bowels stir of themselves once or twice, or turn over with a sound like thunder — and the illness is cured at once. This method has divine efficacy (Gangmok 綱目). — For Kidney vacuity lumbar pain: BL23 Sinsu, GV26 Insu, BL40 Wijung, GB21 Gyeonjeong. — For wrenching strain lumbar pain: LU5 Cheokdaek (do not moxa), BL40 Wijung, GV26 Insu, GB34 Yangneungcheon, BL65 Sokgol, BL60 Gonryun, BL34 Haryo, CV6 Gihae. — For lumbar pain: bleed BL60 Gonryun and BL40 Wijung; also BL23 Sinsu, BL29 Jungnyeosu, GV2 Yosu. — For lumbar rigidity and pain: GV4 Myeongmun, BL60 Gonryun, BL52 Jisil, LR2 Haenggan, KI7 Bongnyu.
Clinical note임상 주석
The point prescriptions at the end are the practical core, and they are still teachable: Sinsu and Wijung for the deficient back, Wijung and Insu with the ankle points for the acute wrench, and the note **do not moxa LU5** — one of the chapter's few explicit contraindications. The Divine Immortal method above is worth reading for the choreography alone: two fires lit together, two people blowing them out in unison the moment pain is felt, applied at noon so that the effect arrives by nightfall.

Gangmok 綱目

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), External Bodily Form, Volume 3, The Lumbus chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.