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Chapter 41 To Pierce lower Back Pain 41-227-5 When it is the foot major yang vessel that lets a person’s lower back ache, [then there is pain] pulling on the nape, the spine, the sacrum, and the back as if there was a heavy [weight].1 Pierce the major yang [vessel] in the cleft right into the conduit.let blood.2 In spring, avoid the appearance of blood.3 When it is the minor yang [vessel] that lets a person’s lower back ache, [then there is pain] as if someone had pierced with a needle into this [person’s] skin, and [the patient is] continously unable to bend down and up and cannot look back.4 1 Wang Bing: “The foot major yang vessel divides [into two courses] moving downwards into the nape, following the shoulder, inside the shoulder blade, paralleling the spine on both sides, finally reaching the center of the lower back. It divides and moves down to penetrate the sacrum. Hence, if it causes one to have lower back pain, [the pain] pulls on the nape, the spine, the sacrum, and the back as if there was a heavy weight.” 2 “Cleft” is possibly a reference to the popliteal fossa. 3 yang shangshan: “The foot major yang qi is weak in winter and spring.To let blood [at this time] may lead to depletion. Hence, [the text] warns against it.” Wang Bing: “‘In the cleft’ is the Bend Middle (委中) [hole]. It is located on the moving vessel in the central line (i.e., fold) of the depression at the back of the knee, where the foot major yang vessel enters. .. The major yang is linked to the kidneys. The kidneys rule in winter. [Their] water is weakened in spring. Hence, in spring one should avoid the appearance of blood.” 4 Wang Bing: “The foot minor yang vessel makes a circle at the [pubic] hair line, moves horizontally and enters the center of the concave part of the lower back.Hence, it causes lower back pain as if one had been pierced with a needle into the skin. ..The minor yang vessel emerges from the pointed canthus of the eye, reaches to the corners of the [fore]head, descends behind the ear, follows the neck, runs in front of the hand yang brilliance [conduit], reaches the shoulder and crosses over to behind the hand yang brilliance [conduit]. Its branch course descends from below the pointed canthus of the eye and enters the Great facing (大迎) [hole], merges with the hand minor yang [conduit] below the cheekbone, moves down, joins the cheek carriage (頰車), descends along the neck and merges with the broken basin. Hence, one cannot look back.”Zhang Jiebin: “The minor yang qi corresponds to wind and wood; it is received by the yang section. Hence, it is as if one had pierced a needle into the [patient’s] skin. 循循然 is 遲滯貌, ‘as if obstructed.’ That is to say, [the patient] cannot lift [something ], or move, with ease.”Zhang Zhicong: “循循 is 漸次, ‘gradually.’ ”Wu Kun: “循 614 Huang Di nei jing su wen Pierce the minor yang [vessel] at the tip of the support bone5 . let blood. {The ‘support bone’ is the bone rising alone at the outer edge of the knee.} In summer, avoid the appearance of blood.6 41-227-9 When it is the yang brilliance [vessel] that lets a person’s lower back ache, [then that person is] unable to look back and, when he looks back as if he had seen [something], he tends to be sad.7 Pierce the yang brilliance [vessel] at the front side of the shins. [Generate] three wounds8 循 is 漸. That is to say, [patients] are gradually unable to bown down and straighten themselves again.”The Jia yi jing has the two characters 左右 above the character 顧: “one cannot turn left or right to look back.” 2167/48: “循循然 is to describe a state where any movement causes discomfort.” Huai nan zi, yuan dao 原道, has 循 in the meaning of “to rub.” In this sense, 循循然 may also be read here in conjunction with the preceding statement as referring to a “pricking” sensation on or in the skin. 5 This could be a reference to the upper outer edge of the fibula. 6 yang shangshan: “The foot minor yang qi is weak from spring to summer. To let blood [during this time] may lead to depletion. Hence, [the text] warns against it.” Wang Bing: “成骨 is to say: the depression holding a finger between...

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