钱仲阳云∶肾主虚，无实症。惟痘疮实则黑陷，更当分别症之虚实。假如肺病又见肝症，咬
牙呵欠者易治，肝虚不能胜肺也；若目直视大叫哭，项急烦闷者难治，盖肺病虚冷肝强实而
胜肺也。视病新久虚实，虚则补其母，实则泻其子。夫肾虚者，由胎气不盛，则神短囟开，
目多白睛，面色 白，此皆难养，纵长不过八八之数。若恣色欲，不及四旬而亡，或有因病
而致肾虚者。又云∶肾气不足则下窜。盖肾虚骨重，惟欲坠下而缩身也。肾水阴也，肾虚则
目无精光畏明，皆用地黄丸。肾病见夏，水胜火也，轻者病自退，重者当惊发搐。又张洁古
云∶肾主寒，自病则足胫寒而逆。肾无实，疮疹黑陷乃实，是水制火也。若心乘肾为微邪，
肺乘肾为虚邪，肝乘肾为实邪，脾乘肾为贼邪，本脏虚弱，正令不行，鬼贼克害，当补本脏
之正气。假令肺病喘嗽，见于初春，当补肾；见于夏，救肺；见于秋，救脾；见于冬，补心
泻本脏，乃名寒嗽。大抵五脏，各至本位，即气盛不可更补，到所克部位，不可更泻。然五
行之中，惟肾水一脏，母盛而反受邪，何则？肺属金射于皮毛，所主者气。肾属水主于骨髓
，所藏者精，气之轻浮能上而不能下，精之沉重能下而不能上，此物性之自能。今肺气得热
而上蒸则不能下，生于肾而受邪矣，急服凉药解之。此肾病必先求肺。或脾经之湿刑克于肾
，宜去脾湿，若脾肺平和而肾自病，则察其本脏而治之。窃谓∶下窜等症，足不喜覆者，盖
腰以下皆肾所主，乃心气下行于肾部也，法用地黄丸壮肾水以制心火。若因脾肺虚而不能生
肾水者，用补中益气汤、六味地黄丸以滋化源。其疮疹黑陷，乃肾虚而邪气实也，尤当用地
黄丸。
地黄丸
熟地黄（八钱，杵膏） 山茱萸（肉） 干山药（各四钱） 泽泻 牡丹皮 白茯苓（各三钱）
上为末，入地黄膏量加米糊丸，桐子大。每服数丸，温水空心化下。行迟鹤膝加鹿茸、牛膝
、五加皮。
愚按∶前丸治肾肝血虚，燥热作渴，小便淋秘，痰气上壅；或风客淫气，患瘰结核；或四肢
发搐，眼目 动；或咳嗽吐血，头目眩晕；或咽喉燥痛，口舌疮裂；或自汗盗汗，便血诸血
；或禀赋不足，肢体瘦弱，解颅失音；或畏明下窜，五迟五软，肾疳肝疳；或早近女色，精
血亏耗，五脏齐损；或属肾肝诸症不足之症，宜用此以滋化源。其功不可尽述。
补中益气汤（方见虚羸）
钱仲阳说：肾主要表现为虚证，没有实证。只有痘疮出现黑色下陷时属于实证，此时更应当辨别症状的虚实。假如肺病又见到肝的症状，如咬牙、呵欠的容易治疗，这是因为肝虚不能克制肺；如果眼睛直视、大声哭叫、颈部僵硬、烦躁闷乱，则难治，这是因为肺病虚冷而肝气强盛且克制肺。观察疾病的久暂和虚实，虚证则补其母脏，实证则泻其子脏。
凡是肾虚，是由于胎气不旺盛，导致神气短少、囟门迟开、眼中白睛多、面色苍白，这些都属于难以养育的情况，即使长大也不超过六十四岁（八八之数）。如果纵欲过度，不到四十岁就会死亡；或者因为患病而导致肾虚。又说：肾气不足则会出现“下窜”的症状。这是因为肾虚骨重，只想下垂缩身。肾水属阴，肾虚则目光无神、畏光，都使用地黄丸治疗。肾病出现在夏季，是水克火的表现，轻者病自退，重者会发生惊风抽搐。
张洁古说：肾主寒，本脏发病则足胫寒冷逆冷。肾没有实证，疮疹黑陷才是实证，这是水制火的表现。如果心乘袭肾为微邪，肺乘袭肾为虚邪，肝乘袭肾为实邪，脾乘袭肾为贼邪。本脏虚弱，正常的气化功能不行，受到鬼贼之气的克制伤害，应当补益本脏的正气。
假如肺病出现喘咳，见于初春，应当补肾；见于夏季，救肺；见于秋季，救脾；见于冬季，补心并泻本脏（肾），这名叫寒嗽。大抵五脏，各至本位时，即气盛不可再补；到了被克制的部位，不可再泻。然而五行之中，唯独肾水这一脏，母脏（肺）盛反而受邪，为什么呢？肺属金，外合皮毛，所主的是气。肾属水，内主骨髓，所藏的是精。气轻浮能上而不能下，精沉重能下而不能上，这是物性的自然规律。现在肺气受热而上蒸，则不能下行，生于肾而受邪了，急需服用凉药来解除。这就是肾病必先求之于肺。或者是脾经的湿气刑克肾脏，应当去除脾湿；如果脾肺平和而肾自己生病，则检查本脏进行治疗。
我认为：下窜等症状，脚不喜欢盖东西的，是因为腰以下皆由肾所主，这是心气下行于肾部的缘故，法度上使用地黄丸壮肾水以制约心火。如果是因脾肺虚而不能生肾水的，使用补中益气汤、六味地黄丸以滋养化源。那些疮疹黑陷，是肾虚而邪气实，尤其应当使用地黄丸。
地黄丸
熟地黄（八钱，捣成膏状） 山茱萸（取肉） 干山药（各四钱） 泽泻 牡丹皮 白茯苓（各三钱）
以上药物研为细末，加入地黄膏，适量加米糊制成丸剂，大小如梧桐子。每次服用数丸，温水空腹送服。行走迟缓、鹤膝风者，加鹿茸、牛膝、五加皮。
我按语：前面的方子治疗肝肾血虚，燥热口渴，小便淋漓闭塞，痰气上壅；或者风邪客居淫乱之气，患瘰疬结核；或者四肢抽搐，眼目跳动；或者咳嗽吐血，头目眩晕；或者咽喉干燥疼痛，口舌生疮裂口；或者自汗盗汗，便血及各种出血症；或者禀赋不足，肢体瘦弱，解颅失音；或者畏光下窜，五迟五软，肾疳肝疳；或者过早接近女色，精血亏耗，五脏俱损；或者属于肾肝诸症不足之症，适宜用此方以滋养化源。其功效无法尽述。
Qian Zhongyang stated: The Kidney primarily manifests as deficiency (Xu), with no excess (Shi) patterns. Only in the case of smallpox where lesions turn black and sink inward is it considered an excess pattern; in such cases, one must further distinguish between deficiency and excess symptoms. For instance, if a Lung disease presents with Liver symptoms, such as teeth grinding and yawning, it is easy to treat because the Liver is deficient and cannot overcome the Lung. However, if there is staring eyes, loud crying, neck stiffness, and irritability, it is difficult to treat, as this indicates the Lung is deficient and cold while the Liver is strong and excessive, thereby overcoming the Lung. Observe whether the disease is new or old, and whether it is deficiency or excess. In deficiency, tonify its mother organ; in excess, drain its child organ.
Generally, Kidney deficiency arises from weak prenatal Qi, leading to shortness of spirit, delayed closure of the fontanelle, excessive white sclera, and pale complexion. These are all difficult to nurture, and even if they survive, they rarely live beyond sixty-four years (the number of eight times eight). If one indulges in sexual desires excessively, death may occur before forty; alternatively, Kidney deficiency may result from illness. It is also said that insufficient Kidney Qi leads to "downward dragging" symptoms. This is because Kidney deficiency causes heavy bones, making the body desire to droop and curl up. Kidney Water belongs to Yin. When the Kidney is deficient, the eyes lack luster and fear light; in such cases, Dihuang Wan (Rehmannia Pill) is used. When Kidney disease appears in summer, it represents Water overcoming Fire. Mild cases resolve spontaneously, while severe cases may develop into convulsions due to fright.
Zhang Jiegu stated: The Kidney governs Cold. Disease originating in the organ itself causes coldness and reversal in the lower legs. The Kidney has no excess patterns; only black sinking of sores/rashes constitutes excess, which is Water controlling Fire. If the Heart overcomes the Kidney, it is a minor pathogenic factor; if the Lung overcomes the Kidney, it is a deficient pathogenic factor; if the Liver overcomes the Kidney, it is an excess pathogenic factor; if the Spleen overcomes the Kidney, it is a thief pathogenic factor. When the home organ is weak and normal regulations fail, suffering from the attack of thief-pathogens, one should tonify the righteous Qi of the home organ.
For example, if Lung disease presents with wheezing and coughing: appearing in early spring, tonify the Kidney; appearing in summer, rescue the Lung; appearing in autumn, rescue the Spleen; appearing in winter, tonify the Heart and drain the home organ (Kidney); this is named Cold Cough. Generally, when each of the Five Zang organs reaches its own position, Qi is abundant and should not be further tonified; when reaching the position it controls, it should not be further drained. However, among the Five Elements, only the Kidney Water organ suffers pathology despite its mother being abundant. Why? The Lung belongs to Metal and connects to the skin and hair, governing Qi. The Kidney belongs to Water and governs bone marrow, storing Essence. Qi is light and floating, able to ascend but not descend; Essence is heavy and solid, able to descend but not ascend. This is the natural property of these substances. Now, if Lung Qi becomes heated and steams upward, it cannot descend, thus generating in the Kidney and becoming pathogenic. One must urgently administer cooling medicines to resolve this. Hence, for Kidney disease, one must first seek the Lung. Alternatively, if Dampness from the Spleen channel attacks the Kidney, one should remove Spleen Dampness. If the Spleen and Lung are harmonious and the Kidney falls ill on its own, then examine the home organ and treat accordingly.
I opine: Regarding downward dragging and other symptoms where the feet dislike being covered, this is because the area below the waist is governed by the Kidney, representing Heart Qi descending into the Kidney region. The method is to use Dihuang Wan (Rehmannia Pill) to strengthen Kidney Water to control Heart Fire. If the cause is Spleen and Lung deficiency failing to generate Kidney Water, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) to nourish the source of transformation. For black sinking of rashes, which indicates Kidney deficiency with excess pathogens, Dihuang Wan (Rehmannia Pill) is especially indicated.
Dihuang Wan (Rehmannia Pill)
Prepared Rehmanniae Radix (Shu Dihuang) (8 qian, pounded into paste)
Cornus Officinalis Fruit (Shanzhuyu) (flesh only)
Chinese Yam (Gan Shanyao) (each 4 qian)
Alisma Rhizome (Zexie)
Moutan Cortex (Mudanpi)
Poria (Baifuling) (each 3 qian)
Grind the above into powder, add the Rehmannia paste, and mix with appropriate amounts of rice paste to form pills, sized like paulownia seeds. Take several pills each time, dissolved in warm water on an empty stomach. For delayed walking or crutch knee (He Xi Feng), add Antler of Cervus Nippon (Lurong), Achyranthes Root (Niuxi), and Acanthopanacis Senticosi Cortex (Wujiapi).
My commentary: The aforementioned pill treats Blood and Yin deficiency of the Liver and Kidney, dryness-heat causing thirst, dribbling urinary retention, and phlegm-Qi obstructing upwards; or wind pathogens invading chaotic Qi, resulting in scrofula and nodules; or spasms of the four limbs, twitching of the eyes; or coughing with hemoptysis, dizziness of the head and eyes; or dry painful throat, cracked mouth and tongue; or spontaneous sweating and night sweats, blood in stool and various bleeding disorders; or congenital insufficiency, emaciated limbs, open fontanelle and aphonia; or fear of light and downward dragging, five delays and five softnesses, Kidney and Liver malnutrition syndromes; or premature sexual activity leading to depletion of essence and blood, damaging all five Zang organs; or any deficiency syndrome of the Liver and Kidney. It is suitable to use this formula to nourish the source of transformation. Its merits cannot be fully described.
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (See formula under "Emaciation")