If the area of pain is rather large it suggests either a Kidney deficiency or invasion of Cold and
Dampness. If the area of pain is small it suggests sprain.
Finally, it is essential to find the most tender points on palpation in order to identify the channel
involved and the Ah Shi points. This is most important for treatment. The points which are most
frequently tender on the back and leg are (Figure 24.5(483)):
- BL-26 Guanyuanshu
- BL-25 Dachangshu
- BL-54 Zhibian
- Tunzhong extra point
- BL-36 Chengfu
- BL-37 Yinmen.
Pulse
The pulse reflects the condition not only of the internal organs but also of areas of the body. The
lower back is reflected on the left Rear position of the pulse. This pulse reflects especially back
conditions which affect the Bladder channel in either leg. If this position is Wiry and Floating it
may indicate either acute backache or an acute exacerbation of a chronic back problem.
If the left Rear position is Fine, Deep but also slightly Wiry, it denotes chronic backache on a
background of Kidney deficiency. If this position is Tight it indicates invasion of Damp-Cold in
the Bladder channel.
According to "A Study of the Eight Extraordinary Vessels" by Li Shi Zhen, when the left pulse
feels Floating and slightly Wiry in all three positions, it reflects tension in the Governing Vessel
and acute backache from Wind-Cold.7(484)
If the pulse on the left Rear position is Weak-Floating (Soft), Fine and very slightly Wiry it
indicates chronic backache from Dampness in the back channels.
If the left-Rear position of the pulse is Wiry and the pulse is Rapid, it may denote invasion of
Damp-Heat in the back channels.
Of course, any of the above-mentioned pulse pictures may also reflect a pathological condition
of the Bladder organ itself rather than a channel problem. However, the absence of Bladder
symptoms (urinary difficulty, pain or dribbling) may confirm affection of the channel only.
Finally, something should be said about the distinction between a back pain from a channel
problem and one from an actual kidney affliction. For example, if a patient has a dull ache on the