（凡八类）
（论一首）
论曰∶肾主精。肾者，生来向导之本也。为后宫内官则为女主，所以天之在我者德也，
地之在我者气也，德流气薄而生者也，故生来谓之精。精者，肾之藏也。耳者肾之官，肾气
通于耳，耳和则能闻五音矣。肾在窍为耳，然则肾气上通于耳，下通于阴也。左肾壬，右肾
癸，循环玄宫，上出耳门，候闻四远，下回玉海，挟脊左右，与脐相当，经于上焦，营于中
焦，卫于下焦，外主骨，内主膀胱。肾重一斤一两，有两枚。神名KT ，KT 主藏精。号
为精脏。随节应会，故云肾藏精，精舍志，在气为欠，在液为唾。肾气虚则厥逆，实则胀满，
四肢正黑。虚则使人梦见舟船溺人，得其时梦伏水中若有畏怖。肾气盛则梦腰脊两解不相属，
厥气客于
凡肾脏象水，与膀胱合为腑。其经足少阴，与太阳为表里，其脉沉，相于秋，旺于冬。
冬时万物之所藏，百虫伏蛰，阳气下陷，阴气上升，阳气中出，阴气冽为霜，遂不上升，化
为霜雪。猛兽伏蛰，蜾虫匿藏，其脉为沉，沉为阴在里，不可发汗，发汗则蜾虫出，见其霜
雪。阴气在表，阳气在里，慎不可下，下之者伤脾。脾土弱即水气妄行。下之者如鱼出水，
蛾入汤，重客在里，慎不可熏。熏之逆客，其息则喘，无持客热，令口烂疮。阴脉且解，血
散不通，正阳遂厥，阴不往从，客热狂入，内为结胸，脾气遂弱，清溲痢通。
冬脉如营。冬脉者，肾也，北方水也，万物之所以合藏也。故其气来沉以搏，故曰营，
反此者病。何如而反？其气来如弹石者，此谓太过，病在外。其去如数者，此谓不及，病在
中。太过则令人解 脊脉痛而少气不欲言，不及则令人心悬如病饥， 中清，脊中痛，少腹
满，小便变赤黄。
肾脉来喘喘累累如勾，按之而坚曰平，冬以胃气为本。肾脉来如引葛，按之益坚曰肾病
。肾脉来发如夺索，辟辟如弹石曰肾死。
真肾脉至搏而绝，如以指弹石辟辟然，色黄黑不泽毛折乃死。冬胃微石曰平，石多胃少
曰肾病，但石无胃曰死石，而有勾曰夏病，勾甚曰今病。凡人以水谷为本，故人绝水谷则死，
脉无胃气亦死。所谓无胃气者，但得真脏脉不得胃气也。所谓脉不得胃气者，肝不弦肾不石
也。
肾藏精，精舍志，盛怒不止则伤志，志伤则善忘其前言，腰脊痛不可以俯仰屈伸，毛悴
色夭，死于季夏。
足少阴气绝则骨枯。少阴者，冬脉也，伏行而濡滑骨髓者也。故骨不濡，则肉不能着骨
也。骨肉不相亲，即肉濡而却。肉濡而却，故齿长而垢，发无泽。发无泽者骨先死，戊笃已
死，土胜水也。
肾死脏浮之坚，按之乱如转丸益下入尺中者死。
冬肾水旺，其脉沉濡而滑曰平。反得微涩而短者，是肺之乘肾，母之归子，为虚邪，虽
病易治。反得弦细而长者，是肝之乘肾，子之乘母，为实邪，虽病自愈。反得大而缓者，是
脾之乘肾，土之克水，为贼邪大逆，十死不治。反得浮大而洪者，是心之乘肾，火之凌水，
为微邪，虽病即瘥。
左手关后尺中阴绝者，无肾脉也。苦足下热，两髀里急，精气竭少，劳倦所致，刺足太
阳治
足少阴
右手关后尺中阴绝者，无肾脉也。苦足逆冷上抢胸痛，梦入水见鬼，善魇寐，黑色物来
掩人上，刺足太阳治阳。右手关后尺中阴实者，肾实也。苦骨疼腰脊痛，内寒热，刺足少阴
治阴。
肾脉沉细而紧，再至曰平，三至曰离经病，四至脱精，五至死，六至命尽，足少阴脉也
肾脉急甚，为骨痿癫疾，微急为奔豚沉厥，足不收不得前后缓甚为折脊，微缓为洞下。
洞下者，食不化，入咽还出。大甚为阴痿，微大为石水起，脐下以至少腹肿垂垂然上至胃脘，
死
黑花。涩甚为大痈，微涩为不月水、沉痔。肾脉搏坚而长，其色黄而赤，当病折腰。其软而
散者，当病少血。黑脉之至也，上坚而大。有积气在少腹与阴，名曰肾痹，得之沐浴清水而
卧。
扁鹊曰∶肾有病则耳聋，肾在窍为耳，然则肾气上通于耳。五脏不和，则九窍不通，阴
阳俱盛不得相营，故曰关格。关格者，不得尽期而死也。
肾在声为呻，在变动为 ，在志为恐。恐伤肾，精气并于肾则恐，脏主冬病，在脏者取
之井。
病先发于肾，少腹腰脊痛胫酸，一日之膀胱，背膂筋痛，小便闭。二日上之心，心痛。
三日之小肠胀。四日不已死。冬大晨夏晏晡。
病在肾，夜半慧日乘，四季甚，下晡静。假令肾病中央，若食牛肉及诸土中物得之。不
者，当以长夏时发，得病以戊己日也。
凡肾病之状，必腹大胫肿痛。喘咳身重，寝汗出。憎风虚，即胸中痛，大腹小腹痛清厥
，意不乐，取其经足少阴太阳血者。
肾脉沉之而大坚，浮之而大紧，苦手足骨肿厥而阴不兴。腰脊痛少腹肿，心下有水气，
时胀闭时泄，得之浴水中，身未干而合房内，及劳倦发之。
肾病其色黑，其气虚弱，吸吸少气，两耳苦聋，腰痛时时失精，饮食减少，膝以下清，
其脉沉滑而迟少，为可治，宜服内补散，建中汤，肾气丸、地黄煎。春当刺涌泉，秋刺复溜，
冬
邪在肾，则骨痛阴痹。阴痹者，抚之而不得，腹胀腰痛，大便难，肩背颈项强痛，时眩
，取之涌泉、昆仑，视有血者尽取之。
有所用力举重，若入房过度，汗出如浴水，则伤肾。
肾中风（阙） 肾中寒（阙）
肾水者，其人腹大脐肿，腰痛不得溺，阴下湿如牛鼻头汗，其足逆寒，大便反坚（一云
面
肾胀者，腹满引背央央然，腰髀（一作痹）并痛。
肾着之病，其人身体重，腰中冷如冰状（一作如水洗状，一作如坐水中，形如水状），
反
不渴，小便自利，食饮如故，是其证也，病属下焦，从身劳汗出，衣里冷湿，故久久得之。
肾着之为病，从腰以下冷，腰重如带五千钱。
诊得肾积，脉沉而急，苦脊与腰相引痛，饥则见，饱则减。少腹里急，口干咽肿伤烂，
目KT KT ，骨中寒，主髓厥善忘，色黑也。
肾之积名曰奔豚，发于少腹上至心下，如豚奔走之状，上下无时，久久不愈，病喘逆骨
痿少气。以夏丙丁日得之，何也？脾病传肾，肾当传心，心适以夏旺。旺者不受邪，肾复欲
还脾，脾不肯受，因留结为积，故知奔豚以夏得之。肾病，手足逆冷，面赤目黄，小便不禁，
骨节烦疼，少腹结痛，气冲于心，其脉当沉细而滑，今反浮大，其色当黑而反黄，此是土之
克水，为大逆，十死不治。
羽音人者，主肾声也。肾声呻，其音瑟，其志恐，其经足少阴，厥逆太阳则营卫不通。
阴阳翻祚，阳气内伏，阴气外升，升则寒，寒则虚，虚则厉风所伤，语音謇吃，不转偏枯，
脚偏跛蹇。若在左则左肾伤，右则右肾伤，其偏枯风体从鼻而分半边至脚。缓弱不遂，口亦
欹，语声混浊，便利仰人，耳偏聋塞，腰背相引，甚则不可治，肾沥汤主之。方在第八卷中。
又呻而好恚，恚而善忘，恍惚有所思，此为土克水，阳击阴，阴气伏而阳气起。起则热，热
则实，实则怒，怒则忘，耳听无闻，四肢满急，小便赤黄，言音口动而不出，笑而看人。此
为邪热伤肾，甚则不可治。若面黑黄耳不应，亦可治。
肾病为疟者，令人凄凄然腰脊痛宛转，大便难。目 然身掉不定，手足寒，恒山汤主
之，（方在第十卷中）。若其人本来不吃，忽然謇吃而好嗔恚，反于常性，此肾已伤，虽未发
觉已是其候见。人未言而前开口笑，还闭口不声，举手闸极腹（一作把眼），此肾病声之候也。
虚实表里，浮沉清浊，宜以察之，逐以治之。
黑为肾，肾合骨黑如乌羽者吉。肾主耳，耳是肾之余。其人水形相比于上羽黑色，大头
曲面，广颐小肩，大腹小手，足发行，摇身下，尻长背延延也。不敬畏，善欺殆，人戮死，
耐秋冬，不耐春夏，春夏感而生病，主足少阴。污污然耳大小高下浓薄偏圆，则肾应之。正
黑色小理者，则肾小，小即安难伤。粗理者，则肾大，大则虚，虚则肾寒，耳聋或鸣，汗出，
腰痛不得俯仰，易伤以邪。耳高者则肾高，高则实，实则肾热，背急缀痛，耳脓血出。或生
肉塞耳，耳后陷者则肾下。下则腰尻痛不可以俯仰，为狐疝。耳坚者则肾坚，坚则肾不受病，
不病腰痛。耳薄者则肾脆，脆则伤热，热则耳吼闹，善病消瘅。耳好前居牙车者则肾端正。
端正则和利难伤，耳偏高者则肾偏欹。偏欹则善腰尻偏痛。凡人分部骨陷者，必死不免。挟
膀胱并太阳为肾之部，骨当其处陷也，而脏气通于内外，部亦随而应之。沉浊为内，浮清为
外。若色从外走内者，病从外生部处起。若色从内出外者，病从内生部处陷。内病前治阴后
治阳，外病前治阳后治阴。阳主外阴主内，凡人生死休否，则藏神前变形于外。人肾前病，
耳则为之焦枯。若肾前死，耳则为之KT 黑焦癖。若天中等分暮色应之，必死不治。看应
增
损斟酌赊促，赊不出四百日内，促则旬日之间。肾病少愈而卒死，何以知之？曰∶黄黑色
点如拇指应耳，此必卒死。肾绝四日死，何以知之？齿为暴黑，面为正黑，目中黄，腰中欲
折，白汗出如流，面黑目青（一作白），肾气内伤，病因留积，八日当亡，是死变也。面黄
目黑不死，黑如 死。吉凶之色，天中等分左右发色不正，此是阴阳官位，相法若不遭官事
而应死也。其人面目带黄黑连耳左右，年四十以上百日死。若偏在一边，最凶必死。两边有，
年上无，三年之内祸必至矣。
冬水肾脉色黑，主足少阴脉也。少阴何以主肾？曰∶肾者主阴，阴水也，皆生于肾，此
脉名曰太冲。凡五十七穴，冬取其井荥。冬者水始治，肾方闭，阳气衰少，阴气坚盛，太阳
气伏沉，阳脉乃法，故取井以下阴气逆取荥以通（《素问》作实）阳气。其脉本在内踝下二
寸，
应
其筋起于小趾之下，入足心，并太阴之筋而斜走内踝之下，结于踵，与太阳之筋合而上
结于内辅下，并太阴之筋而上循阴股，结于阴器，循脊内挟膂，上至项，结于枕骨，与太阳
之筋合。
其脉起于小趾之下，斜趋足心，出然骨之下，循内踝之后，别入跟中以上 内，出 中
内廉，上股内后廉，贯脊属肾络膀胱。其直者，从肾上贯肝膈入肺中，循喉咙挟舌本。其支
者，从肺出络心注胸中，合足太阳为表里，太阳本在跟以上五寸中，同会于手太阴。
其足少阴之别名曰大钟，当踝后绕跟别走太阳。其别者并经上走于心包，下贯腰脊，主
肾生病。病实则膀胱热，热则闭癃，癃则阳病，阳脉反逆大于寸口再倍。其病则口热舌干，
咽肿上气，咽干及痛烦心，心痛黄瘅，肠 ，脊骨内后廉痛。痿厥嗜卧，足下热而痛，灸则
强食而生灾，缓带被发，大杖重履而步。虚则膀胱寒，寒则腰痛，痛则阴脉反小于寸口，其
病则饥而不欲食，面黑如炭色，咳唾则有血，喉鸣而喘，坐而欲起，目KT KT 无所见，
心悬若
冬三月者，主肾膀胱黑骨温病也。其源从太阳少阴相搏，蕴积三焦，上下壅塞，阴毒内
行，脏腑受客邪之气，则病生矣，其病相反。若腑虚则为阴毒所伤，里热外寒，意欲守火而
引饮，或腰中痛欲折。若脏实则阳温所损，胸胁切痛，类如刀刺，不得动转，热彭彭。若服
冷药过瘥而便洞泻，故曰黑骨温病也。扁鹊曰∶灸脾肝肾三俞，主治丹金毒黑温之病，当根据
源为理，调脏理腑，清浊之病不生矣。
（共八类）
（一篇论述）
论述说：肾主管精。肾，是生命生成的根本向导。在人体后宫内官中对应女主，所以天赋予我们的叫作“德”，地赋予我们的叫作“气”，德与气交融流动而生成生命，因此将这种生命本源称为“精”。精，是肾所藏之物。耳是肾的外窍，肾气通达于耳，耳功能调和就能听到五音。肾在开窍方面表现为耳，既然这样，肾气向上通达于耳，向下通达于阴部。左肾属壬水，右肾属癸水，在玄宫（指肾脏或体内深处）循环，向上出于耳门，以听取四方声音，向下回流至玉海（指下焦或肾），位于脊柱左右两侧，与肚脐平齐，经络经过上焦，营气在中焦运行，卫气在下焦护卫，外部主司骨骼，内部主司膀胱。肾重一斤一两，有两个。神名为“志”（注：原文“KT”推测为“志”的异体或误录，此处依中医理论修正为志，若严格按字面则保留原意但解释不通，鉴于上下文“精舍志”，此处译为志），志主管藏精。号称精脏。随节气变化而应会，所以说肾藏精，精中寄托着志，在气的表现上是呵欠，在体液的表现上是唾。肾气虚则出现厥逆，实证则出现胀满，四肢呈现正黑色。肾虚使人梦见舟船溺水之人，若在相应季节则梦见伏在水中有畏惧惊恐之感。肾气盛则梦见腰脊断裂不相连接，厥气客居……
凡是肾脏象水，与膀胱相合为腑。其经脉为足少阴经，与足太阳经互为表里，其脉象沉，对应秋季，旺盛于冬季。冬天是万物收藏的季节，百虫潜伏蛰伏，阳气下沉陷落，阴气上升，阳气从中透出，阴气寒冷化为霜，于是不能上升，化为霜雪。猛兽潜伏蛰伏，细虫隐匿躲藏，其脉象为沉，沉代表阴气在里，不可发汗，发汗则像细虫出来，见到霜雪一样危险。阴气在表，阳气在里，谨慎不可攻下，攻下者损伤脾土。脾土虚弱则水气妄行。攻下者如同鱼离水，蛾入汤，邪气深重客居在里，谨慎不可熏蒸。熏蒸导致逆气客居，呼吸就会喘息，不要持有客热，以免导致口舌生疮。阴脉松弛，血液散乱不通，真阳遂致厥逆，阴气不再跟随，客热狂入，在内形成结胸，脾气遂弱，清便下痢通畅。
冬脉如营。冬脉，就是肾，属于北方水，是万物之所以闭合收藏的原因。所以它的脉气来势沉而搏指，所以叫作营，与此相反的就是病。怎样算是相反？脉气来时像弹石一样坚硬，这叫太过，病在外。脉气去时像数脉一样急促，这叫不及，病在中。太过则让人肢体懈怠、脊脉疼痛且少气懒言；不及则让人心中悬空如饥饿感，胃脘清冷，脊中痛，小腹胀满，小便变赤黄色。
肾脉来势喘喘累累如钩状，按之坚实称为平脉，冬季以胃气为本。肾脉来势如牵引葛藤，按之更加坚实称为肾病。肾脉来势如夺索，辟辟像弹石一样称为肾死脉。
真肾脉至，搏动断绝，像用手指弹石头辟辟然，面色黄黑无光泽，毛发枯折就会死亡。冬季脉象微带石象而有胃气称为平脉，石象多而胃气少称为肾病，只有石象没有胃气称为死脉，如果出现钩象则是夏季的病，钩象明显则是现在的病。大凡人以水谷为根本，所以人断绝水谷就会死亡，脉象没有胃气也会死亡。所谓没有胃气，就是只得到真脏脉而没有胃气。所谓脉不得胃气，就是肝不弦、肾不石。
肾藏精，精中寄托着志，盛怒不止则会伤志，志受伤则容易忘记前言，腰脊疼痛不能俯仰屈伸，毛发憔悴，面色枯槁，死于季夏。
足少阴经气绝则骨骼枯萎。少阴，是冬脉，潜行而濡润骨髓。所以骨不濡润，则肉不能附着于骨。骨肉不相亲附，则肌肉松弛退缩。肌肉松弛退缩，所以牙齿显得长且有污垢，头发无光泽。头发无光泽说明骨先死，戊日加重己日死亡，这是土胜水的结果。
肾的死脏脉浮取坚实，按之混乱如转丸，越往下进入尺部越严重则死。
冬季肾水旺盛，其脉沉濡而滑称为平脉。反而得到微涩而短的脉，这是肺金乘袭肾水，母归子，为虚邪，虽然生病容易治疗。反而得到弦细而长的脉，这是肝木乘袭肾肾，子乘母，为实邪，虽然生病会自愈。反而得到大而缓的脉，这是脾土乘袭肾水，土克水，为贼邪大逆，十死不治。反而得到浮大而洪的脉，这是心火乘袭肾水，火凌水，为微邪，虽然生病很快痊愈。
左手关后尺中阴绝者，没有肾脉。痛苦于足底发热，两髀内侧拘急，精气枯竭减少，由劳倦所致，刺足太阳经治疗。
右手关后尺中阴绝者，没有肾脉。痛苦于足逆冷向上抢胸痛，梦见入水见鬼，善魇寐，黑色物体来掩盖人上，刺足太阳经治疗阳证。右手关后尺中阴实者，是肾实证。痛苦于骨疼腰脊痛，内寒热，刺足少阴经治疗阴证。
肾脉沉细而紧，一息两至称为平脉，三至称为离经病，四至脱精，五至死，六至命尽，这是足少阴脉。
肾脉急甚，为骨痿癫疾，微急为奔豚沉厥，足不收不得大小便；缓甚为折脊，微缓为洞泄。
洞泄，是指食物不消化，咽下后又吐出。大甚为阴痿，微大为石水起，从脐下至少腹肿垂垂然上至胃脘，死。
黑花。涩甚为大痈，微涩为月经不行、沉痔。肾脉搏坚而长，其色黄而赤，应当病折腰。其软而散的，应当病少血。黑脉的到来，上坚而大。有积气在小腹与阴部，名叫肾痹，得之于沐浴清水后卧睡。
扁鹊说：肾有病则耳聋，肾在开窍方面表现为耳，既然这样肾气向上通达于耳。五脏不和，则九窍不通，阴阳俱盛不得相互营运，所以叫作关格。关格者，不能尽其天年而死。
肾在声音上为呻，在变动上为战栗，在情志上为恐。恐伤肾，精气并于肾则恐，脏主冬病，在脏者取井穴。
病先发于肾，少腹腰脊痛胫酸，一天传至膀胱，背膂筋痛，小便闭。第二天传至心，心痛。第三天传至小肠胀。第四天不愈则死。冬天在大晨，夏天在晏晡。
病在肾，夜半清醒，日中加重，四季之时最甚，傍晚安静。假如肾病发生在中央，如果是吃牛肉及诸土中物得的。如果不这样，应当在长夏时发作，得病在戊己日。
凡肾病的症状，必定腹大胫肿痛。喘咳身重，寝汗出。憎风虚，即胸中痛，大腹小腹痛清厥，意不乐，取其经足少阴太阳血者。
肾脉沉取大而坚，浮取大而紧，痛苦于手足骨肿厥而阴器不举。腰脊痛少腹肿，心下有停饮，时而胀闭时而泄泻，得之于浴水中，身体未干而行房事，以及劳倦引发。
肾病其色黑，其气虚弱，吸气短促，两耳苦聋，腰痛时时失精，饮食减少，膝以下清冷，其脉沉滑而迟少，为可治，宜服内补散，建中汤，肾气丸、地黄煎。春季当刺涌泉穴，秋季刺复溜穴，冬季……
邪在肾，则骨痛阴痹。阴痹，抚摸它却感觉不到（麻木），腹胀腰痛，大便难，肩背颈项强痛，时常眩晕，取涌泉、昆仑穴，视有瘀血者全部刺之。
有所用力举重，或者房事过度，汗出如洗澡水，则伤肾。
肾中风（缺文） 肾中寒（缺文）
肾水病，其人腹大脐肿，腰痛不得溺，阴下湿如牛鼻头汗，其足逆寒，大便反坚（一说面……）。
肾胀者，腹满引背央央然，腰髀并痛。
肾着病，其人身体重，腰中冷如冰状（一说如水洗状，一说如坐水中，形如水状），反不渴，小便自利，食饮如故，是其证也，病属下焦，从身劳汗出，衣里冷湿，故久久得之。
肾着之为病，从腰以下冷，腰重如带五千钱。
诊得肾积，脉沉而急，痛苦于脊与腰相引痛，饥则见，饱则减。少腹里急，口干咽肿伤烂，目KT KT ，骨中寒，主髓厥善忘，色黑也。
肾之积名叫奔豚，发于少腹上至心下，如豚奔走之状，上下无时，久久不愈，病喘逆骨痿少气。在夏丙丁日得之，为什么呢？脾病传肾，肾当传心，心适逢夏季旺盛。旺盛者不受邪，肾又想回传脾，脾不肯受，因留结为积，所以知道奔豚以夏得之。肾病，手足逆冷，面赤目黄，小便不禁，骨节烦疼，少腹结痛，气冲于心，其脉当沉细而滑，现在反浮大，其色当黑而反黄，这是土克水，为大逆，十死不治。
羽音人者，主肾声也。肾声呻，其音瑟，其志恐，其经足少阴，厥逆太阳则营卫不通。
阴阳翻转，阳气内伏，阴气外升，升则寒，寒则虚，虚则厉风所伤，语音謇吃，不转偏枯，脚偏跛蹇。若在左则左肾伤，右则右肾伤，其偏枯风体从鼻而分半边至脚。缓弱不遂，口亦欹，语声混浊，便利仰人，耳偏聋塞，腰背相引，甚则不可治，肾沥汤主之。方在第八卷中。
又呻而好恚，恚而善忘，恍惚有所思，此为土克水，阳击阴，阴气伏而阳气起。起则热，热则实，实则怒，怒则忘，耳听无闻，四肢满急，小便赤黄，言音口动而不出，笑而看人。此为邪热伤肾，甚则不可治。若面黑黄耳不应，亦可治。
肾病为疟者，令人凄凄然腰脊痛宛转，大便难。目然身掉不定，手足寒，恒山汤主之，（方在第十卷中）。如果其人本来不吃药，忽然说话謇吃而好嗔恚，反于常性，此肾已伤，虽未发觉已是其候见。人未言而前开口笑，还闭口不声，举手闸极腹（一作把眼），此肾病声之候也。
虚实表里，浮沉清浊，宜以察之，逐以治之。
黑为肾，肾合骨黑如乌羽者吉。肾主耳，耳是肾之余。其人水形相比于上羽黑色，大头曲面，广颐小肩，大腹小手，足发行，摇身下，尻长背延延也。不敬畏，善欺殆，人戮死，耐秋冬，不耐春夏，春夏感而生病，主足少阴。污污然耳大小高下浓薄偏圆，则肾应之。正黑色小理者，则肾小，小即安难伤。粗理者，则肾大，大则虚，虚则肾寒，耳聋或鸣，汗出，腰痛不得俯仰，易伤以邪。耳高者则肾高，高则实，实则肾热，背急缀痛，耳脓血出。或生肉塞耳，耳后陷者则肾下。下则腰尻痛不可以俯仰，为狐疝。耳坚者则肾坚，坚则肾不受病，不病腰痛。耳薄者则肾脆，脆则伤热，热则耳吼闹，善病消瘅。耳好前居牙车者则肾端正。端正则和利难伤，耳偏高者则肾偏欹。偏欹则善腰尻偏痛。凡人分部骨陷者，必死不免。挟膀胱并太阳为肾之部，骨当其处陷也，而脏气通于内外，部亦随而应之。沉浊为内，浮清为外。若色从外走内者，病从外生部处起。若色从内出外者，病从内生部处陷。内病前治阴后治阳，外病前治阳后治阴。阳主外阴主内，凡人生死休否，则藏神前变形于外。人肾前病，耳则为之焦枯。若肾前死，耳则为之KT 黑焦癖。若天中等分暮色应之，必死不治。看应增损斟酌赊促，赊不出四百日内，促则旬日之间。肾病少愈而卒死，何以知之？曰：黄黑色点如拇指应耳，此必卒死。肾绝四日死，何以知之？齿为暴黑，面为正黑，目中黄，腰中欲折，白汗出如流，面黑目青（一作白），肾气内伤，病因留积，八日当亡，是死变也。面黄目黑不死，黑如死。吉凶之色，天中等分左右发色不正，此是阴阳官位，相法若不遭官事而应死也。其人面目带黄黑连耳左右，年四十以上百日死。若偏在一边，最凶必死。两边有，年上无，三年之内祸必至矣。
冬水肾脉色黑，主足少阴脉也。少阴何以主肾？曰：肾者主阴，阴水也，皆生于肾，此脉名曰太冲。凡五十七穴，冬取其井荥。冬者水始治，肾方闭，阳气衰少，阴气坚盛，太阳气伏沉，阳脉乃法，故取井以下阴气逆取荥以通（《素问》作实）阳气。其脉本在内踝下二寸，应……
其筋起于小趾之下，入足心，并太阴之筋而斜走内踝之下，结于踵，与太阳之筋合而上结于内辅下，并太阴之筋而上循阴股，结于阴器，循脊内挟膂，上至项，结于枕骨，与太阳之筋合。
其脉起于小趾之下，斜趋足心，出然骨之下，循内踝之后，别入跟中以上内，出中内廉，上股内后廉，贯脊属肾络膀胱。其直者，从肾上贯肝膈入肺中，循喉咙挟舌本。其支者，从肺出络心注胸中，合足太阳为表里，太阳本在跟以上五寸中，同会于手太阴。
其足少阴之别名曰大钟，当踝后绕跟别走太阳。其别者并经上走于心包，下贯腰脊，主肾生病。病实则膀胱热，热则闭癃，癃则阳病，阳脉反逆大于寸口再倍。其病则口热舌干，咽肿上气，咽干及痛烦心，心痛黄瘅，肠，脊骨内后廉痛。痿厥嗜卧，足下热而痛，灸则强食而生灾，缓带被发，大杖重履而步。虚则膀胱寒，寒则腰痛，痛则阴脉反小于寸口，其病则饥而不欲食，面黑如炭色，咳唾则有血，喉鸣而喘，坐而欲起，目KT KT 无所见，心悬若……
冬三月者，主肾膀胱黑骨温病也。其源从太阳少阴相搏，蕴积三焦，上下壅塞，阴毒内行，脏腑受客邪之气，则病生矣，其病相反。若腑虚则为阴毒所伤，里热外寒，意欲守火而引饮，或腰中痛欲折。若脏实则阳温所损，胸胁切痛，类如刀刺，不得动转，热彭彭。若服冷药过瘥而便洞泻，故曰黑骨温病也。扁鹊曰：灸脾肝肾三俞，主治丹金毒黑温之病，当根据源为理，调脏理腑，清浊之病不生矣。
(There are eight categories in total)
(One treatise)
The treatise states: The Kidney governs Jing (Essence). The Kidney is the fundamental guide for life generation. In the internal organs of the posterior palace, it corresponds to the Female Ruler; thus, what Heaven endows us with is called De (Virtue), and what Earth endows us with is called Qi (Energy). Life is generated when De flows and Qi interacts, so this life source is called Jing. Jing is what the Kidney stores. The ear is the external orifice of the Kidney; Kidney Qi connects to the ear, and when the ear functions harmoniously, one can hear the five tones. In terms of orifices, the Kidney manifests in the ear. Since Kidney Qi connects upward to the ear, it also connects downward to the genitalia. The left Kidney belongs to Ren Water, and the right Kidney belongs to Gui Water. They circulate in the Xuan Gong (mysterious palace, referring to the deep interior or kidneys), emerging upward at the ear gate to listen to sounds from all directions, and flowing downward to the Yu Hai (jade sea, referring to the lower jiao or kidneys). Located on both sides of the spine, level with the navel, the meridians pass through the Upper Jiao, Ying (Nutrient) Qi circulates in the Middle Jiao, and Wei (Defensive) Qi guards the Lower Jiao. Externally, it governs the bones; internally, it governs the Bladder. The Kidneys weigh one jin and one liang, and there are two of them. The spirit name is Zhi (Will), which governs the storage of Jing. It is known as the Organ of Essence. Responding to solar terms, it is said that the Kidney stores Jing, Jing houses Zhi (Will), its manifestation in Qi is yawning, and its fluid is saliva. When Kidney Qi is deficient, there is Jue Ni (reversal cold); when excess, there is distension, and the four limbs appear black. Deficiency causes dreams of drowning in boats; if occurring in the corresponding season, it causes dreams of lying in water with fear and terror. Excess causes dreams of the waist and spine breaking apart. When Jue Qi lodges...
Generally, the Kidney resembles Water and combines with the Bladder to form a Fu organ. Its meridian is the Foot Shaoyin Meridian, exterior-interior related to the Foot Taiyang Meridian. Its pulse is Chen (Deep), corresponding to Autumn, and flourishing in Winter. Winter is the time when all things are stored; insects hibernate, Yang Qi sinks and traps, Yin Qi rises. Yang Qi emerges from within, while Yin Qi becomes cold and turns into frost, failing to rise further, transforming into frost and snow. Fierce beasts hibernate, small insects hide. The pulse is Chen (Deep); Chen indicates Yin in the interior. Sweating should not be induced; inducing sweating is like releasing insects or exposing frost/snow to danger. If Yin Qi is in the exterior and Yang Qi in the interior, purging must be avoided cautiously, as purging damages the Spleen. If Spleen Earth is weak, Water Qi acts recklessly. Purging is like a fish leaving water or a moth entering soup; if pathogenic factors are deeply lodged in the interior, moxibustion/fumigation must be avoided cautiously. Fumigation causes rebellious Qi lodging, leading to panting. One must not retain pathogenic heat, lest it cause mouth ulcers. The Yin pulse relaxes, blood scatters and fails to circulate, True Yang becomes Jue (reversed), Yin no longer follows, pathogenic heat enters wildly, forming Jie Xiong (Chest Binding) internally, Spleen Qi weakens, and clear turbid separation fails, leading to diarrhea.
Winter pulse resembles Ying (Camp/Nourishment). The Winter pulse is the Kidney, belonging to Northern Water, the reason why all things close and store. Thus, its Qi comes Chen (deep) and Bo (firm), hence called Ying. Reversing this indicates disease. How does it reverse? If the Qi comes hard like a bouncing stone, this is called "Excessive" (Tai Guo), indicating disease in the Exterior. If the Qi goes rapid like Shu (rapid pulse), this is called "Insufficient" (Bu Ji), indicating disease in the Interior. Excess causes limb relaxation, spinal pain, shortness of breath, and reluctance to speak. Insufficiency causes a feeling of hunger with an empty heart, cold epigastrium, spinal pain, abdominal fullness, and reddish-yellow urine.
When the Kidney pulse comes rushing and continuous like a hook, firm upon pressure, it is a Ping (Normal) pulse; Winter pulses must have Stomach Qi as their foundation. If the Kidney pulse comes like pulling a vine, becoming firmer upon pressure, it is Kidney Disease. If the Kidney pulse comes like a pulled rope, sharp like bouncing stones, it is Kidney Death.
The True Kidney pulse arrives, beating abruptly, like fingers snapping against a stone, sharp and distinct. With yellow-black lusterless complexion and brittle hair, death ensues. A Winter pulse slightly Stone-like with Stomach Qi is Normal. More Stone than Stomach Qi is Kidney Disease. Only Stone without Stomach Qi is Death. If Hook-like appears, it is Summer disease; prominent Hook is current disease. All humans rely on Grain and Water; without them, they die. Without Stomach Qi in the pulse, they also die. "No Stomach Qi" means obtaining only the True Zang Pulse without Stomach Qi. "Pulse lacking Stomach Qi" means the Liver is not Wen (String-like) and the Kidney is not Shi (Stone-like).
The Kidney stores Jing, and Jing houses Zhi (Will). Unrestrained anger injures Zhi. Injury to Zhi causes forgetfulness of previous words, waist/spine pain preventing bending/straightening, emaciated hair, sallow complexion, leading to death in Late Summer.
When Foot Shaoyin Qi perishes, bones wither. Shaoyin is the Winter pulse, hidden and moistening the marrow. If bones are not moistened, flesh cannot adhere to them. If bone and flesh are not intimate, flesh becomes flaccid and recedes. Flaccid receding flesh makes teeth appear long and dirty, and hair lusterless. Lusterless hair indicates bone death first; worsening on Wu days, death on Ji days, due to Earth overcoming Water.
The dead organ pulse of the Kidney is firm upon superficial palpation, chaotic like a rolling ball upon deep palpation, worsening as it enters the Chi (Cun-Guan-Chi) position, indicating death.
In Winter, Kidney Water flourishes. A pulse that is Chen (Deep), Ru (Soft), and Hua (Slippery) is Normal. A Micro-Wu (Fine) and Se (Choppy) short pulse indicates Lung Metal overacting on Kidney Water (Mother influencing Son), a False Pathogen; though diseased, it is easy to treat. A Xian (Wiry) thin and long pulse indicates Liver Wood overacting on Kidney Water (Son influencing Mother), a Real Pathogen; though diseased, it will self-heal. A Da (Large) and Huan (Slow) pulse indicates Spleen Earth overacting on Kidney Water (Earth overcoming Water), a Robber Pathogen and Great Rebellion; ten cases, none curable. A Fu (Floating) Da (Large) and Hong (Surging) pulse indicates Heart Fire overacting on Kidney Water (Fire suppressing Water), a Minor Pathogen; though diseased, it will quickly recover.
If the Yin position at the Chi point behind the Guan on the Left Hand is absent, there is no Kidney pulse. Symptoms include burning soles, tightness in the inner thighs, depletion of essence and Qi due to fatigue. Treat by needling the Foot Taiyang meridian.
If the Yin position at the Chi point behind the Guan on the Right Hand is absent, there is no Kidney pulse. Symptoms include cold feet rising to chest pain, dreaming of entering water and seeing ghosts, nightmare sleep, dark objects covering the person. Treat the Yang aspect by needling the Foot Taiyang meridian. If the Yin position at the Chi point behind the Guan on the Right Hand is Excess, it is Kidney Excess. Symptoms include bone pain, waist/spine pain, internal alternating cold and heat. Treat the Yin aspect by needling the Foot Shaoyin meridian.
A Kidney pulse that is Chen (Deep), Xi (Fine), and Jin (Tight): Two beats per respiration is Normal; three beats is Li Jing (Departing from the Meridian) disease; four beats is Jing exhaustion; five beats is Death; six beats is End of Life. This is the Foot Shaoyin pulse.
An extremely urgent Kidney pulse indicates Bone萎 (Atrophy) and Dian Ji (Epilepsy). Slightly urgent indicates Ben Tun (Running Piglet) and Chen Jue (Deep Reversal Cold), inability to move legs or control bowels/bladder. Extremely slack indicates Spine Fracture. Slightly slack indicates Dong Xia (Sifting Diarrhea).
Dong Xia refers to food not digesting, coming back out after swallowing. Very large indicates Yin Wei (Impotence). Slightly large indicates Shi Shui (Stone Edema) starting below the umbilicus, swelling down to the lower abdomen, hanging heavily up to the epigastrium, leading to death. Black spots in vision. Extremely choppy indicates Large Abscess. Slightly choppy indicates Amenorrhea and Chen Zhong (Deep Hemorrhoids). A firm and long Kidney pulse with yellow-red complexion indicates Waist Fracture. A soft and scattered pulse indicates Blood Deficiency.
When the Black pulse arrives, firm and large above, with accumulated Qi in the lower abdomen and genitals, it is named Shen Bi (Kidney Bi). Caused by bathing in cold water and lying down.
Bian Que said: Kidney disease causes deafness. The Kidney opens into the ears, so Kidney Qi connects upward to the ears. Disharmony of the Five Zang leads to blockage of the Nine Orifices. When Yin and Yang are both excessive and fail to nourish each other, it is called Guan Ge (Closing and Restriction). Guan Ge results in death before the natural lifespan ends.
The Kidney's sound is Shen (Groaning). Its movement is tremor. Its emotion is Fear. Fear injures the Kidney. When Essence and Qi congregate in the Kidney, fear arises. Diseases of the Zang occur in Winter; treat by selecting Jing-Well points.
Disease originating in the Kidney presents with lower abdominal and waist/spine pain, tibial soreness. After one day, it transmits to the Bladder, causing back muscle pain and urinary retention. After two days, it transmits to the Heart, causing heart pain. After three days, it transmits to the Small Intestine, causing distension. If not resolved by the fourth day, death occurs. In Winter, death occurs at dawn; in Summer, at dusk.
Disease in the Kidney clears at midnight, worsens at noon, is most severe during the seasonal transitions (Earth days), and is quiet in the late afternoon. If Kidney disease affects the Center (Earth), it may result from eating beef or earthy substances. Otherwise, it may manifest in Late Summer, on Wu or Ji days.
General symptoms of Kidney disease include abdominal distension, swollen painful shins, panting/cough, heavy body, night sweats, aversion to wind/deficiency, chest pain, lower abdominal pain, cold reversal, depression. Treat by bleeding the Foot Shaoyin and Foot Taiyang meridians.
A Kidney pulse that is large and firm upon deep palpation, and large and tight upon superficial palpation, causes swollen/jointed extremities and impotence. Waist/spine pain, lower abdominal swelling, fluid retention in the epigastrium, alternating constipation/diarrhea. Caused by bathing while wet and engaging in intercourse, or fatigue.
Kidney disease presents with black complexion, weak Qi, short shallow breathing, deafness, frequent seminal emission, reduced appetite, cold knees/lower legs. A Chen (Deep), Hua (Slippery), Chi (Slow) pulse is treatable. Suitable formulas include Nei Bu San, Jian Zhong Tang, Shen Qi Wan, and Di Huang Jian. Spring: needle Yongquan (KI1). Autumn: needle Fuliu (KI7). Winter...
Pathogens in the Kidney cause bone pain and Yin Bi. Yin Bi feels numb to touch, with abdominal distension, waist pain, difficult defecation, stiff neck/back, dizziness. Needle Yongquan (KI1) and Kunlun (BL60); bleed any visible stasis.
Lifting heavy weights or excessive sexual activity, sweating profusely, injures the Kidney.
Wind invading the Kidney [Text Missing]. Cold invading the Kidney [Text Missing].
Kidney Water disease: Abdominal distension, umbilical swelling, waist pain, inability to urinate, dampness under the genitals like cow nose sweat, cold feet, hard stool.
Kidney Distension: Abdominal fullness radiating to the back, waist/thigh pain.
Kidney Zhuo (Fixed Dampness): Heavy body, cold waist like ice/water wash/sitting in water. No thirst, normal urination, normal appetite. Disease of the Lower Jiao, caused by labor sweating, cold/wet clothes remaining on the body for a long time. Waist below feels cold, heavy like carrying 5,000 coins.
Diagnosing Kidney Accumulation: Pulse is Chen (Deep) and Ji (Rapid). Pain connecting spine and waist, worse when hungry, better when full. Lower abdominal urgency, dry mouth, swollen/ulcerated throat, visual disturbances, cold bones, Marrow Jue, forgetfulness, black complexion.
Kidney Accumulation named Ben Tun (Running Piglet): Starts in lower abdomen, rises to epigastrium, like a running piglet, irregular timing. Chronic cases lead to panting, bone atrophy, shortness of breath. Acquired on Bing/Ding days in Summer? Spleen disease transmits to Kidney; Kidney should transmit to Heart. But Heart is flourishing in Summer and rejects pathogens. Kidney tries to return to Spleen, but Spleen rejects it. Accumulation forms. Hence, Ben Tun is acquired in Summer. Kidney disease with cold extremities, red face, yellow eyes, incontinence, joint pain, lower abdominal binding, Qi rushing to heart. Pulse should be Chen (Deep), Xi (Fine), Hua (Slippery), but is now Fu (Floating) and Da (Large). Color should be black but is yellow. This is Earth overcoming Water, Great Rebellion, ten cases, none curable.
People of the Yu (Feather) tone govern Kidney sounds. Kidney sound is Shen (Groaning), tone is Se (Harsh), emotion is Fear, meridian is Foot Shaoyin. Jue Ni of Taiyang leads to blockage of Ying and Wei.
Yin and Yang overturn. Yang hides internally, Yin rises externally. Rising brings cold, cold brings deficiency, deficiency invites Wind. Speech becomes slurred, hemiplegia develops, leg lameness. Left injury affects left Kidney; right affects right. Hemiplegia spreads from nose to foot. Weakness, facial deviation, turbid speech, difficulty with excretion, unilateral deafness, waist/back pain. In severe cases, untreatable. Treated with Shen Li Tang (Formula in Vol 8).
Groaning with anger, anger with forgetfulness, trance-like thinking. This is Earth overcoming Water, Yang striking Yin. Yin hides, Yang rises. Rising brings heat, heat brings excess, excess brings anger, anger brings forgetfulness. Deafness, limb fullness/tightness, reddish-yellow urine, speech impediment, laughing while looking. This is Pathogenic Heat injuring the Kidney. Severe cases are untreatable. If face is black-yellow and ears do not respond, it may be treatable.
Malaria due to Kidney disease: Chills, waist/spine pain, turning around, difficult defecation. Restlessness, shaking, cold hands/feet. Treated with Heng Shan Tang (Formula in Vol 10). If a person who usually doesn't speak suddenly speaks slurredly and becomes irritable, contrary to nature, the Kidney is already injured. Even if not yet manifested, these are signs. Smiling before speaking, then closing mouth silently, raising hand to cover abdomen/eyes—these are auditory signs of Kidney disease.
Assess Xu/Shi, Biao/Li, Fu/Chen, Qing/Zhuo to diagnose and treat accordingly.
Black corresponds to the Kidney, governing bones. Black like crow feathers is auspicious. Kidney governs ears; ears are the surplus of the Kidney. People with Water constitution resemble Feather/Yellow-Black types: large head, curved face, wide jaw, small shoulders, large belly, small hands, walking with feet apart, swaying body, long buttocks/back. Not reverent, prone to deception, risk of violent death. Endure Autumn/Winter, not Spring/Summer. Spring/Summer illness governs Foot Shaoyin. Ear variations (size, height, thickness, roundness) correspond to the Kidney. Fine-pored black skin indicates small Kidney (stable, hard to injure). Coarse pores indicate large Kidney (deficient, cold, deaf/tinnitus, sweating, waist pain, easily injured). High ears indicate high Kidney (excess, heat, back stiffness/pain, pus/blood in ears, polyps). Depressed area behind ear indicates low Kidney (waist/buttock pain, inability to bend, Hu Dan hernia). Firm ears indicate firm Kidney (resistant to disease, no waist pain). Thin ears indicate fragile Kidney (heat, roaring tinnitus, Xiao Dao diabetes). Ears positioned forward near jaw indicate upright Kidney (harmonious, hard to injure). High-side ears indicate tilted Kidney (unilateral waist/buttock pain). Sunken bones in specific areas indicate inevitable death. Kidney area includes Bladder and Taiyang; sunken bones here reflect internal organ Qi. Deep/turbid color indicates interior; floating/clear indicates exterior. Color moving outward indicates exterior disease arising; color moving inward indicates interior disease sinking. Interior disease: treat Yin first, then Yang. Exterior disease: treat Yang first, then Yin. Yang governs exterior, Yin governs interior. Life/death signs transform externally. Pre-Kidney disease: ears become withered. Pre-Kidney death: ears become black/scaly. If evening twilight colors match, death is certain and untreatable. Adjust prognosis: slow cases within 400 days, fast cases within days. Sudden death after slight improvement: yellow-black spots like thumb size on ears indicate sudden death. Kidney绝 (Perishing) leads to death in 4 days: teeth turn black suddenly, face pure black, yellow eyes, waist feels like breaking, white sweat flowing, face black/eyes green (or white). Internal Kidney Qi injury, pathogen accumulation, death in 8 days. Face yellow/eyes black: not fatal. Black like death: fatal. Auspicious/inauspicious colors: uneven distribution at mid-face indicates Yin/Yang imbalance. Physiognomy suggests death if not due to official punishment. Face/yellow-black extending to ears in persons over 40: death within 100 days. Unilateral: most ominous, certain death. Bilateral but not on forehead: disaster within 3 years.
Winter Water/Kidney pulse color is black, governing Foot Shaoyin. Why does Shaoyin govern Kidney? Kidney governs Yin, Yin Water, born from Kidney. This pulse is named Tai Chong. There are 57 acupoints. In Winter, select Jing-Well and Ying-Spring points. Winter is when Water begins to govern, Kidney closes, Yang Qi declines, Yin Qi is strong. Taiyang Qi is hidden/deep. Yang pulse follows this pattern. Thus, Jing-Well points are used to descend rebellious Yin Qi; Ying-Spring points are used to tonify/pass Yang Qi (Su Wen says "Shi"/Solidify). The pulse originates 2 cun below the medial malleolus...
Its sinews start below the little toe, enter the sole, join Taiyin sinew,斜走 (diagonally walk) below the medial malleolus, knot at the heel, combine with Taiyang sinew, ascend to below the medial condyle, join Taiyin sinew, ascend along inner thigh, knot at genitals, follow spine inside,夹膂 (flanking the paraspinal muscles), ascend to neck, knot at occiput, combine with Taiyang sinew.
Its vessel starts below the little toe,斜趋 (diagonally approaches) the sole, exits below Ran Gu, follows behind medial malleolus, enters heel, ascends inside, exits medial edge of calf, ascends along posterior inner thigh, pierces spine, connects to Kidney, networks Bladder. The straight branch rises from Kidney, passes Liver/Diaphragm, enters Lung, follows throat, flanks tongue root. The branch exits Lung, networks Heart, pours into Chest, exterior-interior related to Foot Taiyang. Taiyang originally meets Hand Taiyin 5 cun above the heel.
The collateral of Foot Shaoyin is named Da Zhong, behind ankle, wrapping heel, diverging to Taiyang. Another branch goes up to Pericardium, down through waist/spine, governing Kidney diseases. Excess: Bladder heat, heat causes urinary retention, retention causes Yang pathology, Yang pulse reverses and doubles Cun Kou size. Symptoms: hot mouth/dry tongue, swollen throat, ascending Qi, dry/painful throat, vexing heart, heart pain, jaundice, intestinal issues, posterior spinal pain. Wei Jue (Atrophy/Cold Reversal), lethargy, hot/painful soles. Moxibustion causes forced eating and disasters; loosen belt, wear loose clothes, use big cane/heavy shoes. Deficiency: Bladder cold, cold causes waist pain, pain causes Yin pulse smaller than Cun Kou. Symptoms: hunger without desire to eat, face black like charcoal, bloody cough/sputum, hoarse panting, sitting wanting to stand, visual disturbances, empty heart...
The three Winter months govern Kidney/Bladder Black Bone Warm Disease. Originates from struggle between Taiyang and Shaoyin, accumulating in San Jiao, blocking upper/lower, Yin Du (Poison) moving internally. Zang/Fu receive pathogenic Qi, disease arises, opposite manifestations. If Fu is deficient, injured by Yin Du: internal heat, external cold, desire for fire/drink, or waist pain breaking. If Zang is excess, damaged by Yang Warmth: cutting chest/hypochondriac pain, knife-like stabbing, immobility, intense heat. If cold medicine is overused and diarrhea ensues, it is called Black Bone Warm Disease. Bian Que said: Moxa Shu points of Spleen, Liver, Kidney to treat Dan Jin Du Black Warm diseases. Follow the source, regulate Zang/Fu, clear/turbid diseases will not arise.