《灵枢》曰∶足少阴气绝则骨枯,少阴者冬脉也,伏行而濡骨髓者也,故骨不濡,则肉不能着也,骨肉不
相亲,则肉软却,故齿长而垢,发无泽,发无泽者,骨先死,戊日笃,己日死。
仲景曰∶溲便遗失,狂言目反直视者,此为肾绝也。脉浮而洪,身汗如雨,喘而不休,水浆不下,形体不
仁,乍静乍乱者,此为命门绝也。
《脉经》曰∶肾绝四日死,何以知之?齿为暴枯,面为正黑,目中黄色,腰中欲折,自汗如流水。一云∶
人中平,十日死。
梦与鬼交泄精,名曰梦遗。专主于热。
又曰∶肾咳之状,则腰背相引而痛,甚则咳涎。(咳,音概,气逆也。)
又曰∶肾风之状,多汗恶风,面宠然浮肿,(庞,音忙,丰浓貌。)脊痛不能正立,其色 ,隐曲不利,
诊在肌上,其色黑。
又曰∶肾痹者,善胀,尻以代踵,脊以代头。(如人垂首向地寻物貌。)
又曰∶肾气盛,则梦腰脊两解不相属;虚则梦见舟船溺人;厥气客于肾,则梦临渊没居水中。
又曰∶是动病则饥不欲食,面黑如地色,咳唾则有血,喝喝而喘,坐而欲起,目KT KT 如无所见,心如
悬,病饥状,气不足则善恐,心惕惕如人将捕之,是谓骨厥,是主肾。
又曰∶所生病者,口热舌干,咽肿上气,嗌干及痛,烦心心痛,黄胆肠癖,脊臀股内后廉痛,痿厥嗜卧,
足下热而痛,盛者寸口大再倍于人迎,虚者寸口反小于人迎也。
又曰∶肾主寒,自病则足胫寒而逆,人之五脏,惟肾无实,小儿痘疮变黑陷,是肾水克退心火,多不治也。
又曰∶心乘肾微邪,内热不恶寒,桂枝丸。
又曰∶肺乘肾虚邪,喘嗽皮涩而寒,百部丸。
又曰∶肝乘肾实邪,拘急气搐身寒,理中丸。
又曰∶脾乘肾贼邪,体重泄泻身寒,理中丸。
《人镜经》曰∶五行之间,惟肾之一脏,母盛而子反受邪,是物之性有不可一概论者,肺肾是也。何则?
肺属金,应乎皮毛,所主者气,肾属水,主乎骨髓,所藏者精,气之轻浮能上而不能下,精之沉重能下而不能
上,此物性之自然,今肺盛,乃热作也,气得热而上蒸,则肺不能下生于肾,则肾受邪矣,急以凉药解之,使
脏气温和,自能下生于肾,病必先求之于肺,若肺和而肾忽受病,不过脾湿相刑,所以有解肺热去脾邪二药,
若脾肺俱和,而肾自病,亦当察其本脏虚实而治之。
足少阴肾引经药歌∶
酉肾猪肤猪(苓白)茯苓,牡丹(皮)泽泻(肉)桂阿(魏)丁(香),山(萸肉)吴茱(萸黄)柏砂
(仁)乌药,败酱天(门)冬牡蛎停,(豆)豉桔(梗五)味(子)元(参)并独活,(益)智(仁檀)香
(甘)草(地)骨(皮)或(朱)砂行,下行知(母)附地(黄地)榆(苍)术,右肾沉(香黄) 益附称。
《难经》曰∶冬脉石。
经曰∶劳而动血者,属肾。
又曰∶若喉中常有血腥,一咯血即出,或鲜或紫或细屑者,为咯血,或鲜红随唾而出,为唾血。唾中带血,
咯出有血,或血丝,皆出于肾。
又曰∶肿胀水肿,有十种之分,腰痛足冷为肾水,总而论之,肾虚不能行水,脾虚不能制水。
又曰∶诸髓者,皆属于脑。
又曰∶黑如乌羽者生,黑如煤炭者死。
又曰∶实则梦腰脊解软,虚则梦涉水恐惧。
又曰∶声喑不出,寒厥不回,二便闭,
不能泄,不能禁者,肾脏气绝,不治证。
又曰∶耳聋绝无闻,骨痛之极者,肾之经病危证。
补∶地黄、山萸肉、芡实、山药、枸杞、桑螵蛸、牡蛎、杜仲、牛膝、龙骨、锁阳、虎骨、龟版。
泻∶知母、黄柏。
温∶附子、鹿茸、破故纸、肉桂、沉香、腽肭脐。
凉∶知母、黄柏、牡丹皮、地骨皮。
引经报使∶独活、肉桂。
《灵枢》说:足少阴肾经之气断绝,则骨骼枯槁。少阴脉是冬季的脉象,潜行于体内以濡养骨髓。因此,如果骨骼得不到濡养,肌肉就无法附着;骨肉不相亲附,肌肉就会松弛退缩,所以牙齿显得变长且积满污垢,头发失去光泽。头发没有光泽,说明骨气先已死亡,到了戊日病情加重,己日死亡。
张仲景说:小便和大便失禁,胡言乱语,两眼上翻且直视不动的,这是肾气绝的表现。脉象浮而洪大,身体出汗如雨,喘息不止,水浆不能入口,形体麻木不仁,时而安静时而混乱的,这是命门火衰绝的表现。
《脉经》说:肾绝者四日后死亡,怎么知道呢?牙齿突然枯槁,面色正黑,眼中黄色,腰部像要折断一样,自汗如流水般流出。另一种说法是:人中穴部位平满(消失),十日后死亡。
梦中与鬼神交合而泄精,称为梦遗。这主要归属于热证。
又说:肾咳的症状,是腰背相互牵引而疼痛,严重时咳嗽出涎沫。(咳,音概,指气逆。)
又说:肾风的症状,是多汗怕风,面部浮肿庞然(庞,音忙,形容丰满肿胀的样子),脊痛不能直立,面色发黑,大小便不利,诊察时观察肌肉部位,其色黑。
又说:肾痹的患者,容易腹胀,臀部代替脚跟行走,脊柱代替头部前倾。(像人低头向地寻找东西的样子。)
又说:肾气盛实,则梦见腰脊断裂分离不相连接;肾气虚弱,则梦见舟船沉没、有人溺水;厥气客居于肾,则梦见临近深渊或居住在水中。
又说:肾经“是动病”表现为饥饿但不想进食,面色黑如泥土之色,咳嗽唾痰中带血,发出喝喝声而气喘,坐着想要站起,眼睛昏花视物不清,心中感觉空虚悬挂,像生病饥饿的感觉,气不足则容易恐惧,心神惕惕不安如同被人追捕,这叫做骨厥,由肾经所主。
又说:肾经“所生病”表现为口热舌干,咽喉肿痛,气机上逆,咽干及疼痛,心烦心痛,黄疸,肠癖(痢疾),脊背、臀部、大腿内侧后缘疼痛,痿证、厥冷、嗜睡,足底发热而疼痛。实证时寸口脉比人迎脉大二倍,虚证时寸口脉反而小于人迎脉。
又说:肾主寒,肾脏自病则足胫寒冷且逆冷。人的五脏中,只有肾没有实证。小儿痘疮变成黑色下陷,是肾水克制退却心火,大多无法治愈。
又说:肺乘袭肾的虚邪,表现为喘咳、皮肤干燥而寒,用百部丸治疗。
又说:肝乘袭肾的实邪,表现为拘急、气搐、身寒,用理中丸治疗。
又说:脾乘袭肾的贼邪,表现为身体沉重、泄泻、身寒,用理中丸治疗。
《人镜经》说:在五行之间,唯独肾脏这一脏,母脏(肺)盛实而子脏(肾)反而受邪,这是事物的本性有不可一概而论的情况,肺和肾就是如此。为什么呢?肺属金,对应皮毛,所主的是气;肾属水,主司骨髓,所藏的是精。气的性质轻浮,能上升而不能下降;精的性质沉重,能下降而不能上升,这是事物本性的自然规律。现在肺盛,是由于热邪作祟,气受热而上蒸,则肺不能向下滋生肾,导致肾受邪。急需使用凉药来解除,使脏气温和,自然能向下滋生肾。治病必先求之于肺,如果肺调和而肾忽然受病,不过是脾湿相刑所致,所以有解肺热、去脾邪两种药物。如果脾肺都调和,而肾自己生病,也应当考察其本脏的虚实而进行治疗。
足少阴肾经引经药歌诀:
酉时肾猪肤猪苓白茯苓,牡丹皮泽泻肉桂阿胶丁香,山萸肉吴茱萸黄柏砂仁乌药,败酱草天门冬牡蛎停,豆豉桔梗五味子元参并独活,益智仁檀香甘草地骨皮或朱砂行,下行知母附子地黄地榆苍术,右肾沉香黄芩益智附子称。
《难经》说:冬季的脉象如石。
经文说:劳累而动血的,属于肾。
又说:如果喉中常有血腥味,一咯血即出,颜色或鲜红或紫暗或呈细屑状,称为咯血;或鲜红色随唾液而出,称为唾血。唾液中带血,咯出有血,或有血丝,都出于肾。
又说:肿胀水肿,分为十种,腰痛足冷属于肾水病。总括来说,肾虚不能行水,脾虚不能制水。
又说:所有的髓,都归属于脑。
又说:面色黑如乌鸦羽毛者生,黑如煤炭者死。
又说:实证则梦见腰脊松软无力,虚证则梦见涉水恐惧。
又说:声音嘶哑说不出话,寒厥不回温,二便闭塞,既不能排泄也不能控制,是肾脏气绝,属于不治之证。
又说:耳聋完全听不见,骨痛至极的,是肾经病的危重证候。
The *Ling Shu* (Spiritual Pivot) states: When the Qi of the Foot-Shaoyin (Kidney Meridian) is exhausted, the bones become withered. The Shaoyin meridian is the pulse of winter; it runs deep within to moisten the bone marrow. Therefore, if the bones are not moistened, the flesh cannot adhere; if the flesh and bones do not adhere closely, the flesh becomes flaccid and recedes. Consequently, the teeth appear elongated and covered with dirt, and the hair loses its luster. Hair lacking luster indicates that the Qi of the bones has died first; the condition worsens on Wu days and death occurs on Ji days.
Zhang Zhongjing stated: Incontinence of urine and feces, delirious speech, eyes turned upward and fixed straight ahead—this is Kidney exhaustion. A pulse that is floating and surging, sweating profusely like rain, unceasing wheezing, inability to take in fluids or food, insensitivity of the body, alternating between calmness and chaos—this is the exhaustion of the Gate of Vitality (Mingmen).
The *Mai Jing* (Pulse Classic) states: Death occurs four days after Kidney exhaustion. How is this known? The teeth suddenly wither, the face turns black, the eyes appear yellow, the waist feels as if it will break, and spontaneous sweat flows like water. Another version says: If the area above the upper lip (Ren Zhong) becomes flat, death occurs ten days later.
Dreaming of sexual intercourse with ghosts and releasing essence is called nocturnal emission (Meng Yi). This primarily belongs to Heat syndromes.
It further states: The manifestation of Kidney cough involves pain radiating between the lower back and shoulders, and severe cases may involve coughing up saliva. ("Cough" [gai] refers to rebellious Qi.)
It further states: The manifestations of Kidney wind include excessive sweating, aversion to wind, puffy facial edema, back pain preventing upright standing, a dark complexion, difficulty with urination and defecation, and a dark color observed upon palpation of the muscles.
It further states: Patients with Kidney Bi syndrome suffer from frequent abdominal distension, walking by dragging their buttocks instead of heels, and bending forward so the spine replaces the head (resembling a person bowing their head to the ground to search for something).
It further states: When Kidney Qi is exuberant, one dreams of the waist and spine being separated and disconnected; when deficient, one dreams of boats sinking and people drowning; when Jue Qi invades the Kidney, one dreams of approaching an abyss or living underwater.
It further states: The "Disease of Movement" of the Kidney meridian manifests as hunger without desire to eat, a complexion as dark as earth, blood in sputum during coughing, harsh wheezing, a desire to rise while sitting, blurred vision as if unable to see, a sensation of the heart hanging empty resembling hunger, and fearfulness due to insufficient Qi, with a startled feeling as if someone were chasing them. This is called Bone Jue, governed by the Kidney.
It further states: Diseases generated by the meridian manifest as heat in the mouth and dry tongue, swelling and pain in the throat with rebellious Qi, dry and painful pharynx, vexation and heart pain, jaundice, intestinal dysentery, pain along the posterior aspect of the spine, buttocks, and thighs, wasting-heat syndrome, cold extremities, lethargy, and hot painful soles. In excess conditions, the Cun Kou pulse is twice as large as the Ren Ying pulse; in deficiency conditions, the Cun Kou pulse is smaller than the Ren Ying pulse.
It further states: The Kidney governs Cold. Self-disease of the Kidney results in cold and reversal in the lower legs and calves. Among the five Zang organs, only the Kidney does not have Excess conditions. When childhood smallpox lesions turn black and sink inward, it is because Kidney Water suppresses Heart Fire, which is mostly incurable.
It further states: Heart invading Kidney with minor pathogenic factors presents with internal heat but no aversion to cold; treat with Guizhi Wan (Cinnamon Twig Pill).
It further states: Lung invading Kidney with deficiency pathogenic factors presents with wheezing, cough, dry skin, and cold; treat with Baibu Wan (Stemona Pill).
It further states: Liver invading Kidney with excess pathogenic factors presents with spasms, convulsions, and cold body; treat with Lizhong Wan (Regulate the Middle Pill).
It further states: Spleen invading Kidney with thief pathogenic factors presents with heavy body, diarrhea, and cold body; treat with Lizhong Wan (Regulate the Middle Pill).
The *Ren Jing Jing* (Human Mirror Classic) states: Among the Five Elements, only the Kidney organ exhibits a phenomenon where the Mother organ (Lung) is exuberant yet the Child organ (Kidney) suffers from pathogenic factors. This illustrates that the nature of things cannot be generalized uniformly. Lung and Kidney exemplify this. Why? Lung belongs to Metal, corresponds to skin and hair, and governs Qi; Kidney belongs to Water, governs bone marrow, and stores Essence. Qi is light and floating, able to ascend but not descend; Essence is heavy and dense, able to descend but not ascend. This is the natural law of material nature. Now, Lung exuberance is caused by Heat. Qi heated steams upward, preventing the Lung from generating downward to nourish the Kidney, thus causing the Kidney to suffer from pathogenic factors. Urgently use cooling medicines to resolve this, allowing the Zang Qi to become harmonious and naturally descend to nourish the Kidney. Treatment must first seek the Lung. If the Lung is harmonized but the Kidney suddenly suffers disease, it is merely due to Spleen Dampness punishing the Kidney. Hence, there are two types of medicines: those that clear Lung Heat and those that remove Spleen pathogenic factors. If both Spleen and Lung are harmonized, yet the Kidney itself becomes diseased, one must examine the deficiency or excess of the primary organ and treat accordingly.
Song of Channel-Guiding Herbs for the Foot-Shaoyin Kidney:
At You hour, Kidney uses Pig Skin, Zhu Ling (Polyporus), Bai Fu Ling (Poria), Mu Dan Pi (Moutan Cortex), Ze Xie (Alisma), Rou Gui (Cinnamon Bark), E Jiao (Donkey-Hide Gelatin), Ding Xiang (Clove), Shan Yu Rou (Cornus Fructus), Wu Zhu Yu (Evodiae Fructus), Huang Bo (Phellodendri Cortex), Sha Ren (Amomi Fructus), Wu Yao (Linderae Radix), Bai Jiang Cao (Patriniae Herba), Tian Dong (Asparagi Radix), Mu Li (Ostreae Concha); Dou Chi (Sojae Semen Praeparatum), Jie Geng (Platycodonis Radix), Wu Wei Zi (Schisandrae Fructus), Yuan Shen (Ginseng Radix Rubra) and Du Huo (Angelicae Pubescentis Radix); Yi Zhi Ren (Alpiniae Oxyphyllae Fructus), Tan Xiang (Santalum Album Lignum), Gan Cao (Licorice Root), Di Gu Pi (Lycii Cortex), or Zhu Sha (Cinnabaris) circulate; Descending action uses Zhi Mu (Anemarrhenae Rhizoma), Fu Zi (Aconiti Lateralis Radix Praeparata), Di Huang (Rehmanniae Radix), Di Yu (Sanguisorbae Radix), Cang Zhu (Atractylodis Rhizoma); For the Right Kidney, Chen Xiang (Aquilariae Lignum), Huang Qin (Scutellariae Radix), Yi Zhi Ren (Alpiniae Oxyphyllae Fructus), and Fu Zi (Aconiti Lateralis Radix Praeparata) are praised.
The *Nan Jing* (Classic of Difficult Issues) states: The Winter pulse is like Stone.
The Classics state: Bleeding triggered by labor/burnout belongs to the Kidney.
It further states: If there is always a metallic taste in the throat, and blood is expectorated immediately upon coughing, appearing fresh, purple, or as fine particles, it is called Hemoptysis (Ke Xue); if bright red blood comes out mixed with saliva, it is called Salivous Hemorrhage (Tuo Xue). Blood in saliva, blood expectorated, or blood threads all originate from the Kidney.
It further states: Edematous swelling is divided into ten types; lower back pain and cold feet belong to Kidney Water pathology. Generally speaking, Kidney deficiency fails to move Water, and Spleen deficiency fails to control Water.
It further states: All Marrow belongs to the Brain.
It further states: Complexion black like crow feathers indicates survival; black like coal indicates death.
It further states: Excess conditions manifest as dreams of loose waist and spine; deficiency conditions manifest as dreams of wading through water and fear.
It further states: Hoarseness with inability to speak, cold Jue not returning warmth, closure of both urine and feces, inability to expel or retain—these are signs of Kidney Qi exhaustion, untreatable conditions.
It further states: Deafness with complete loss of hearing, extreme bone pain—these are critical conditions of the Kidney meridian.
Supplemental (Tonifying) herbs: Di Huang (Rehmanniae Radix), Shan Yu Rou (Corni Fructus), Qian Shi (Euryales Semen), Shan Yao (Dioscoreae Rhizoma), Gou Qi (Lycii Fructus), Sang Piao Xiao (Mantis Ootheca), Mu Li (Ostreae Concha), Du Zhong (Eucommiae Cortex), Niu Xi (Achyranthis Bidentatae Radix), Long Gu (Fossilia Ossis Mastodi et Scapulae), Suo Yang (Cynomorii Herba), Hu Gu (Tiger Bone - *Note: Historically used, now prohibited*), Gui Ban (Testudinis Carapax et Plastrum).
Draining (Clearing) herbs: Zhi Mu (Anemarrhenae Rhizoma), Huang Bo (Phellodendri Cortex).
Warming herbs: Fu Zi (Aconiti Lateralis Radix Praeparata), Lu Rong (Cervi Cornu Pantotrichum), Po Gu Zhi (Bursae Semen), Rou Gui (Cinnamomi Cortex), Chen Xiang (Aquilariae Lignum), A Na Qi (Viverridae Gland).
Cooling herbs: Zhi Mu (Anemarrhenae Rhizoma), Huang Bo (Phellodendri Cortex), Mu Dan Pi (Moutan Cortex), Di Gu Pi (Lycii Cortex).
Channel-Guiding and Messenger herbs: Du Huo (Angelicae Pubescentis Radix), Rou Gui (Cinnamomi Cortex).