夫肾胀之病。腹满引背央央然。腰髀痛者是也。盖肾主腰脚。其经属足少阴。与足太阳
为表里。肾经所过抵少腹膀胱经。支内过髀枢。循髀外。是动则病髀不可以曲。今寒气积于
肾经
方
香子散（圣济总录）治肾胀气攻腰腹痛。
香子（炒） 桃仁（炒去皮尖双仁） 干姜（炒） 甘草（炙锉） 桂（去粗皮） 熟
干地黄
（焙） 石斛（去根锉） 杜仲（去粗皮切焙） 上等分捣罗为散。每服二钱。温酒调下。
空心食
前。
八味丸 治肾虚冷气攻腰腹痛。温肾经消胀满。（方见诸虚门补虚固精类）
（案原方∶熟地黄八两。山药、山茱萸各四两。交桂去皮二两。牡丹皮。泽泻各三两。
附子炮二两。白茯苓去皮三两。上为细末炼蜜为丸如桐子大。每服五十丸至七十丸。温酒送
下。或汤亦得。空服食前。妇人淡醋汤下。阳衰阴痿根据全方。夏减桂附一半。冬春秋三停
减一。痰去精走。全减桂附。只服六味地黄丸。血虚阴衰。熟地黄为君。精滑山茱萸为君。
小便或多或少。或赤或黄。白茯苓为君。小便淋涩泽泻为君。心虚肠胃间积热心火盛。心火
不足。牡丹皮为君。皮肤燥涩。干山药为君。以上但言为君者。其分两用干地黄分两。同干
地黄却根据立为臣。分两同。或曰。八味地黄丸久服可为地仙。今老者服之而腹痛。少者服之
而发疮。或小便频数。或小便结涩。或眼昏。精滑泻。其故何哉。盖八物条事非其制度。非
方之罪。今货地黄以绿矾豆豉浸蒸易失其性。干地黄性本凉。加以矾石性冷。此老人所以腹
痛。附子多是重三四钱。此是漏滥侧子。大热有毒。此少者所以发疮。小便频数。泽泻生也。
小便结涩。山茱萸不去核也。今具八味条事于后。地黄生者去土。水中浮者为天黄。中者为
人黄。沉者为地黄。先将地黄蒸良久。天黄人黄捣汁。取蒸地黄投其汁中。候冷。如此齐三
曝干。酒浸一宿。蒸曝干。山药竹刀剖去皮。布巾抓干切作片子。将皂角刺上曝干。茯苓为
末。水飞过。掠去筋膜曝干。泽泻切成块子。酒浸一宿。略蒸。山茱萸酒浸良久。取肉去核。
每十斤。得肉二斤二两。黑附子紧实重七钱。锅内以烈炭火炮裂去皮脐。牡丹皮去心及粗皮。
酒浸一宿。桂削去外粗皮不可焙。上捣为末。不可犯铜器。如是修合。服之而仙。复何疑哉。
久服去附子。拣净五味子代之）
温经汤（圣济总录）治肾虚胀。寒气不宣利。攻腹内及背腰脊髀痛。
附子（炮裂去皮脐） 杜仲（去粗皮切炒） 牛膝（酒浸别焙各一两） 干姜（炮） 桂
（去粗
皮） 续断 补骨脂（炒各三分） 上 咀。每服三钱。水一盏。生姜二片。煎至七分。临
熟
入盐
萆 丸（圣济总录）治肾虚胀。气攻腰腹髀痛。
萆 （锉） 熟干地黄（焙） 天雄（炮裂去皮脐各一两） 桂（去粗皮） 蜀椒（去
目并闭口
炒出汗） 细辛（去苗叶） 续断（锉各三分） 上为末。炼蜜和丸如梧桐子大。每服三十
丸。
温酒
鹿茸丸（圣济总录）治肾胀虚寒。痛引脐腹腰髀。
鹿茸（去毛酥炙半两） 桂（去粗皮三分） 黄 （锉） 泽泻 芍药 桑寄生 补骨
脂（炒
各一
肾胀这种病，表现为腹部胀满并牵引至背部，感觉沉重不适，腰部和大腿疼痛。这是因为肾主管腰部和下肢，其经脉属于足少阴经，与足太阳经互为表里。肾经的循行路线到达小腹，经过膀胱经；分支内部经过髋关节（髀枢），沿大腿外侧下行。当肾经发生病变时，会出现大腿不能弯曲的症状。如今寒气积聚在肾经……
方剂：香子散（出自《圣济总录》），治疗肾胀导致的气攻冲腰部及腹部疼痛。
药材：香子（炒制）、桃仁（炒制后去皮尖及双仁）、干姜（炒制）、甘草（炙制并锉碎）、桂枝（去除粗皮）、熟干地黄（焙干）、石斛（去除根部并锉碎）、杜仲（去除粗皮切段后焙干）。以上药材等分，捣碎过筛制成散剂。每次服用二钱，用温酒调服。空腹或进食前服用。
八味丸，治疗肾虚冷气攻冲腰部及腹部疼痛，温补肾经以消除胀满。（方剂详情见“诸虚门·补虚固精类”）
（按语：原方组成：熟地黄八两，山药、山茱萸各四两，交桂（肉桂）去皮二两，牡丹皮、泽泻各三两，炮附子二两，白茯苓去皮三两。以上药材研为细末，炼蜜为丸，如梧桐子大小。每次服用五十丸至七十丸，用温酒送下，或用汤药送下亦可。空腹或进食前服用。妇人可用淡醋汤送下。若阳气衰微、阳痿者，依据《全方》记载，夏季减去桂枝和附子的一半用量；春、秋、冬三季减少三分之一用量；若有痰湿且精气外泄，则完全减去桂枝和附子，只服用六味地黄丸；若血虚阴衰，以熟地黄为君药；若精气滑脱，以山茱萸为君药；若小便量或多或少，或颜色赤黄，以白茯苓为君药；若小便淋沥涩痛，以泽泻为君药；若心虚、肠胃间积热、心火旺盛或心火不足，以牡丹皮为君药；若皮肤干燥涩滞，以干山药为君药。以上仅说明作为君药的药材，其余臣药的分量参照干地黄的分量确立，分量相同。有人问：八味地黄丸久服可成地仙，为何现在老年人服用会腹痛，年轻人服用会发疮？或者出现小便频数、小便结涩、眼睛昏花、精气滑脱腹泻等症状？这是什么原因呢？这是因为八味药的炮制方法不符合规范，并非方剂的过错。现在市售的地黄是用绿矾和豆豉浸泡蒸制而成的，容易失去其本性。干地黄本性凉，加上矾石性冷，所以老人服用会腹痛。附子多重用三四钱，这是劣质侧子，大热有毒，所以年轻人服用会发疮。小便频数是因为使用了生泽泻。小便结涩是因为山茱萸未去核。现将八味药的正确炮制方法列于后文：地黄有生地黄之分，水中浮起的是天黄，中间的是人黄，下沉的是地黄。先将地黄蒸很长时间，将天黄和人黄捣汁，取蒸好的地黄投入汁中，冷却后，如此反复三次曝晒干燥。再用酒浸泡一夜，蒸晒干燥。山药用竹刀剖开去皮，用布巾擦干切成片状。皂角刺晒干。茯苓研为末，水飞法处理，掠去筋膜后晒干。泽泻切成块状，酒浸一夜，略蒸。山茱萸酒浸长时间，取肉去核。每十斤可得肉二斤二两。黑附子需紧实重七钱，在锅内用猛火炭炮裂，去皮脐。牡丹皮去心及粗皮，酒浸一夜。桂枝削去外层粗皮，不可焙干。以上药材捣为末，不可接触铜器。这样炮制服用，便可成仙，还有什么怀疑的呢？久服后可去掉附子，拣选干净的五味子替代。）
温经汤（出自《圣济总录》），治疗肾虚胀满，寒气不宣通，攻冲腹部及背腰脊、大腿疼痛。
药材：附子（炮裂去皮脐）、杜仲（去粗皮切段炒制）、牛膝（酒浸另焙，各一两）、干姜（炮制）、桂枝（去粗皮）、续断、补骨脂（炒制，各三分）。以上药材切碎。每次服用三钱，用水一盏，生姜两片，煎至七分。临熟时加入盐少许。
萆薢丸（出自《圣济总录》），治疗肾虚胀满，气攻冲腰部、腹部及大腿疼痛。
药材：萆薢（锉碎）、熟干地黄（焙干）、天雄（炮裂去皮脐，各一两）、桂枝（去粗皮）、蜀椒（去目及闭口者，炒出汗）、细辛（去苗叶）、续断（锉碎，各三分）。以上药材研为末，炼蜜和丸，如梧桐子大小。每次服用三十丸，温酒送下。
鹿茸丸（出自《圣济总录》），治疗肾胀虚寒，疼痛牵引至脐腹、腰部及大腿。
药材：鹿茸（去毛，酥炙，半两）、桂枝（去粗皮，三分）、黄芪（锉碎）、泽泻、芍药、桑寄生、补骨脂（炒制，各一……
Kidney distension is a disease characterized by abdominal fullness radiating to the back, accompanied by a sensation of heaviness and discomfort, along with pain in the lower back and thighs. This is because the Kidney governs the lower back and legs; its meridian belongs to the Foot-Shaoyin (Lesser Yin) channel and stands in an exterior-interior relationship with the Foot-Taiyang (Greater Yang) channel. The Kidney meridian passes through to the lower abdomen, traversing the Bladder meridian; its branch enters internally passing through the hip joint (Bishu), and follows the lateral aspect of the thigh. When the Kidney meridian is disturbed, it causes pathology such as the inability to flex the thigh. Currently, cold pathogenic qi accumulates in the Kidney meridian...
Formula: Xiangzi San (Cumin Powder, from *Shengji Zonglu*), treating kidney distension where qi attacks causing pain in the waist and abdomen.
Ingredients: Cumin seed (Xiangzi, stir-fried), Peach kernel (Taoren, stir-fried, skin and tips removed, double kernels discarded), Dried ginger (Ganjiang, stir-fried), Licorice root (Gancao, honey-fried and chopped), Cinnamon twig (Guizhi, coarse bark removed), Prepared Rehmannia root (Shu Gan Dihuang, baked), Dendrobium stem (Shihu, roots removed and chopped), Eucommia bark (Duzhong, coarse bark removed, cut into pieces and baked). Equal parts of the above ingredients are crushed and sifted to make a powder. Take two qian per dose, mixed with warm wine. Take on an empty stomach or before meals.
Bawei Wan (Eight-Ingredient Pill), treating kidney deficiency with cold qi attacking the waist and abdomen, warming the Kidney meridian and dissipating distension. (See "Categories of Various Deficiencies - Tonifying Deficiency and Consolidating Essence" for the formula details.)
(Note: Original prescription: Prepared Rehmannia root 8 liang, Chinese yam (Shanyao) and Cornus fruit (Shanzhuyu) each 4 liang, Cassia bark (Jiaogui, peeled) 2 liang, Moutan bark (Mudanpi) and Alisma rhizome (Zexie) each 3 liang, Processed Aconite root (Fuzi) 2 liang, Poria cocos (Baifuling, peeled) 3 liang. The above ingredients are ground into fine powder, mixed with refined honey, and formed into pills the size of paulownia seeds. Take 50 to 70 pills per dose, delivered with warm wine or decoction. Take on an empty stomach or before meals. Women may take with light vinegar water. For cases of yang deficiency and impotence, according to *Quanfang*, reduce Guizhi and Fuzi by half in summer; reduce by one-third in spring, autumn, and winter; if there is phlegm and essence leakage, completely remove Guizhi and Fuzi and only take Liuwei Dihuang Wan; for blood deficiency and yin decline, use Prepared Rehmannia root as the Jun (Emperor) herb; for seminal emission, use Cornus fruit as the Jun herb; for variable urine volume or red/yellow color, use Poria cocos as the Jun herb; for dysuria and涩 (astringency), use Alisma rhizome as the Jun herb; for heart deficiency, accumulation of heat in the intestines/stomach, excessive heart fire, or insufficient heart fire, use Moutan bark as the Jun herb; for dry and rough skin, use dried Chinese yam as the Jun herb. The above only specifies the Jun herbs; the dosage of the Chen (Minister) herbs follows that of dried Rehmannia, with equal dosages. Some ask: Why do elderly people experience abdominal pain and young people develop sores when taking Bawei Dihuang Wan for longevity? Or why do symptoms like frequent urination, difficult urination, blurred vision, seminal emission, and diarrhea occur? The reason lies not in the formula itself, but in improper processing of the eight ingredients. Current market Rehmannia is soaked in green vitriol and fermented soybean paste, losing its natural properties. Dried Rehmannia is naturally cool; combined with the cold nature of alum, it causes abdominal pain in the elderly. Fuzi is often used in heavy doses of 3-4 qian; these are inferior side-roots, which are extremely hot and toxic, causing sores in the young. Frequent urination results from using raw Alisma. Difficult urination results from not removing the pits of Cornus fruit. The correct processing methods for the eight ingredients are listed below: Raw Rehmannia varies; floating ones are Tianhuang, middle ones Renhuang, sinking ones Dihuang. Steam the Rehmannia for a long time. Crush Tianhuang and Renhuang to extract juice. Immerse the steamed Dihuang in this juice. Cool, then sun-dry three times. Soak in wine overnight, steam, and sun-dry again. Cut Chinese yam with a bamboo knife, peel, wipe dry with cloth, and slice. Sun-dry Gleditsia sinensis spine. Grind Poria into powder, process by water flotation, remove fibrous membranes, and sun-dry. Cut Alisma into chunks, soak in wine overnight, and slightly steam. Soak Cornus fruit in wine for a long time, extract flesh, and remove pits. From every 10 jin, obtain 2 jin 2 liang of flesh. Black Fuzi should be compact and weigh 7 qian; roast over strong charcoal until cracked, remove skin and navel. Remove heart and coarse bark from Moutan, soak in wine overnight. Peel outer coarse bark from Cassia, do not roast. Grind all into powder, avoiding copper vessels. If processed thus, one may attain immortality. After long-term use, replace Fuzi with clean Schisandra chinensis fruit.)
Wenjing Tang (Warming the Meridians Decoction, from *Shengji Zonglu*), treating kidney deficiency distension, failure of cold qi to circulate freely, attacking the abdomen, back, waist, spine, and thighs.
Ingredients: Processed Aconite root (Fuzi, roasted until cracked, skin and navel removed), Eucommia bark (Duzhong, coarse bark removed, cut and stir-fried), Achyranthes root (Niuxi, wine-soaked and separately roasted, each 1 liang), Dried ginger (Ganjiang, roasted), Cinnamon twig (Guizhi, coarse bark removed), Dipsacus root (Xuduan), Psoralea fruit (Buguzhi, stir-fried, each 3 fen). The above ingredients are chopped. Take 3 qian per dose, with one sheng of water and two slices of fresh ginger, decoct until reduced to 0.7 sheng. Add a pinch of salt near the end of decoction.
Bixie Wan (Dioscorea Hypoglauca Pill, from *Shengji Zonglu*), treating kidney deficiency distension, qi attacking the waist, abdomen, and thighs.
Ingredients: Dioscorea hypoglauca rhizome (Bixie, chopped), Prepared Rehmannia root (Shu Gan Dihuang, baked), Aconitum kusnezoffii root (Tianxiong, roasted until cracked, skin and navel removed, each 1 liang), Cinnamon twig (Guizhi, coarse bark removed), Sichuan pepper (Shujiao, remove eyes and closed-mouth ones, stir-fry to release moisture), Asarum root (Xixin, remove stems and leaves), Dipsacus root (Xuduan, chopped, each 3 fen). Grind the above into powder, mix with refined honey, and form pills the size of paulownia seeds. Take 30 pills per dose, delivered with warm wine.
Lurong Wan (Deer Antler Pill, from *Shengji Zonglu*), treating kidney distension due to deficiency-cold, with pain radiating to the umbilicus, abdomen, waist, and thighs.
Ingredients: Deer antler (Lurong, remove hair, roast with butter, 0.5 liang), Cinnamon twig (Guizhi, coarse bark removed, 3 fen), Astragalus root (Huangqi, chopped), Alisma rhizome (Zexie), Peony root (Shaoyao), Taxillus branch (Sangjisheng), Psoralea fruit (Buguzhi, stir-fried, each 1...)