黄帝问曰∶少阴何以主肾,肾何以主水?岐伯对曰∶肾者至阴也,至阴者盛水也,
肺者太阴也,少阴者冬脉也,其本在肾,其末在肺,皆积水也。曰∶肾何以聚水而生病
?曰∶肾者胃之关也。关门不利,故聚水而从其类。上下溢于皮肤,故为 肿。
肿者,聚水而生病也。曰∶诸水皆主于肾乎?曰∶肾者牝藏也,地气上者属于肾而生
水液,故曰至阴。勇
里,传为 肿,本之于肾,名曰风水。曰∶有病肾风者,面 庞然肿(《素问》
无肿字)壅害于言,可刺否?曰∶虚不当刺,不当刺而刺,后五日其气必至。曰∶其至何如
?曰∶至必少气,时从胸背上至头汗出,手热,口干苦渴,小便黄,目下肿,腹中鸣,
身重难行,月事不来,烦而不能食,食不能正偃,正偃则咳甚,病名曰风水。曰∶愿闻其说
。曰∶邪之所凑,其气必虚,阴虚者阳必凑之,故少气时热而汗出,小便黄。小便黄者,
少腹气热也。不能正偃者,胃中不和也。正偃则咳甚,上迫肺也。诸有水气者,微肿见于目
下。曰∶何以言之?曰∶水者阴也,目下亦阴也,腹者至阴之所居。故水在腹者,必
使目下肿。真气上逆,故口苦舌干,卧不得正偃,则咳出清水也。诸水病者,皆不得卧,卧
则惊,惊则咳甚也。腹中鸣者,脾本于胃也。传脾则烦不能食。食不下者,胃脘隔也。身重
难以行者,胃脉在足也。月事不来者,胞脉闭也。胞脉者,属心而络于胞中,今气上迫肺
,心气不得下通,故月事不来也。曰∶有病庞然如水气状,切其脉大紧,身无痛者
形不瘦,不能食,食少,名为何病?曰∶病主(《素问》作生)在肾,名曰肾风。肾风而不能
食,善惊不已(《素》无不字),心气痿者死。
风水膝肿,巨虚上廉主之。面 肿,上星主之,先取噫嘻,后取天牖、
风池主之。风水面 ( 一作浮)肿,冲阳主之。风水面 肿,颜黑,解溪主之。
黄帝问道:少阴经为什么与肾相应,而肾又为什么主管水液代谢?岐伯回答说:肾属于至阴之脏,至阴之脏能够盛纳水液;肺属于太阴经,少阴经对应冬季的脉象。水液的根源在肾,标末在肺,两者都涉及水液积聚的问题。黄帝问:肾为什么能聚集水液从而引发疾病?岐伯说:肾是胃的关口。如果这个关口功能失常,水液就会停滞并同类相聚,向上向下溢于皮肤,所以形成水肿。所谓水肿,就是水液积聚而引发的疾病。黄帝问:所有的水肿病都主要归责于肾吗?岐伯说:肾是阴脏(牝藏),地气上升归属于肾而生生水液,所以称肾为至阴。若体内精气内郁,传变而为水肿,其根本在于肾,这种病名叫风水。
黄帝问:患有肾风的人,面部浮肿,肿胀妨碍言语,可以针刺治疗吗?岐伯说:虚证不应当针刺。如果不当刺而误刺,五天后邪气必然到来。黄帝问:邪气到来后会有什么表现?岐伯说:到来后必定感到气短,时常从胸背直到头部出汗,手部发热,口干且苦渴,小便黄赤,眼睑下方浮肿,腹中肠鸣,身体沉重难以行走,月经停止,心中烦闷不能进食,不能仰卧,如果仰卧咳嗽就会加重,这种病名叫风水。
黄帝说:希望听听其中的道理。岐伯说:邪气聚集的地方,正气必然虚弱;阴虚则阳邪必凑集于此,所以出现气短、定时发热和出汗,小便黄赤。小便黄赤是因为下腹部有热。不能仰卧,是因为胃中不和。仰卧时咳嗽加重,是因为邪气上迫于肺。凡是患有水气病的,眼睑下方都会有轻微浮肿。黄帝问:为什么这样说?岐伯说:水属阴,眼睑下方也属阴,腹部是至阴之气所居之处。所以水邪在腹部,必然导致眼睑下方浮肿。真气上逆,所以口苦舌干,卧倒不能仰卧,则会咳出清水。所有患水病的人,都不能仰卧,仰卧就会惊悸,惊悸则咳嗽加重。腹中肠鸣,是因为脾的功能依赖于胃。邪气传及脾,就会出现心烦不能进食。食物不下咽,是因为胃脘部阻隔不通。身体沉重难以行走,是因为胃的经脉行于足部。月经不来,是因为胞脉闭塞。胞脉隶属于心并联络于子宫,如今气机上逆压迫肺脏,心气不能下行通达,所以月经不来。
黄帝问:有一种病表现为面部浮肿像水气状,切按脉搏大而紧,身体没有疼痛感,形体也不消瘦,但不能进食或吃得很少,这叫什么病?岐伯说:这种病的根本在肾,名叫肾风。肾风患者如果不能进食,并且经常惊恐不止,导致心气衰败的,预后不良,将会死亡。
风水引起的膝盖肿胀,由巨虚上廉穴主治。面部浮肿,由上星穴主治,先取膈俞穴,后取天牖穴和风池穴主治。风水面部浮肿,由冲阳穴主治。风水面部浮肿且面色发黑,由解溪穴主治。
Huangdi asked: Why does the Shaoyin meridian correspond to the Kidney, and why does the Kidney govern water metabolism? Qibo replied: The Kidney is the organ of Supreme Yin (Zhiyin). The organ of Supreme Yin abounds in water. The Lung belongs to the Taiyin meridian. The Shaoyin meridian corresponds to the pulse of winter. The root of water accumulation lies in the Kidney, while its branches extend to the Lung; both are involved in water retention. Huangdi asked: Why can the Kidney accumulate water and thereby cause disease? Qibo said: The Kidney serves as the gate of the Stomach. If this gate fails to function properly, water accumulates and gathers according to its kind, overflowing upward and downward into the skin, thus causing edema. Edema refers to disease caused by the accumulation of water. Huangdi asked: Are all water diseases primarily attributed to the Kidney? Qibo said: The Kidney is a Yin organ (Pin Zang). Earthly Qi ascends and belongs to the Kidney, generating fluid; therefore, it is called Supreme Yin. If internal essence stagnates and transforms into edema, with its root in the Kidney, it is named Fengshui (Wind Water).
Huangdi asked: For a patient suffering from Kidney Wind, whose face is swollen and speech is impaired due to swelling, can acupuncture be used? Qibo said: Deficiency patterns should not be treated with acupuncture. If one mistakenly punctures a deficiency pattern, the pathogenic Qi will inevitably arrive after five days. Huangdi asked: What will happen when the pathogenic Qi arrives? Qibo said: Upon arrival, there will definitely be shortness of breath, sweating from the chest and back up to the head, heat in the hands, dry mouth with bitter taste and thirst, yellow urine, swelling under the eyes, borborygmus in the abdomen, heaviness of the body making movement difficult, amenorrhea, irritability with inability to eat, and an inability to lie flat on the back. Lying flat exacerbates coughing. This disease is named Fengshui (Wind Water).
Huangdi said: I wish to hear the explanation. Qibo said: Wherever pathogenic factors gather, the healthy Qi must be deficient. When Yin is deficient, Yang pathogenic factors inevitably converge here, resulting in shortness of breath, periodic fever, and sweating. Yellow urine indicates heat in the lower abdomen. The inability to lie flat is due to disharmony in the Stomach. Coughing worsens when lying flat because the pathogen presses upward upon the Lung. In all cases of water qi disease, slight swelling appears under the eyes. Huangdi asked: Why do you say so? Qibo said: Water belongs to Yin, and the area under the eyes also belongs to Yin. The abdomen is the residence of Supreme Yin. Therefore, if water resides in the abdomen, it necessarily causes swelling under the eyes. When True Qi rebels upward, it causes bitter taste in the mouth and dry tongue. Inability to lie flat leads to coughing up clear fluid. All patients with water diseases cannot lie flat; lying flat causes palpitations, which in turn exacerbate coughing. Borborygmus occurs because the Spleen's function depends on the Stomach. Transmission to the Spleen causes irritability and anorexia. Food impaction is due to obstruction in the epigastrium. Heaviness of the body and difficulty walking are due to the Stomach meridian running along the foot. Amenorrhea is due to the closure of the Bao Mai (Uterine Vessels). The Bao Mai connects to the Heart and links to the uterus. Now, since Qi rebels upward and presses upon the Lung, the Heart Qi cannot descend and communicate smoothly, hence amenorrhea.
Huangdi asked: There is a condition where the face looks swollen like water qi. The pulse is large and tight, the body has no pain, the form is not emaciated, but the patient cannot eat or eats very little. What is this disease called? Qibo said: The root of this disease lies in the Kidney, and it is named Kidney Wind. If a patient with Kidney Wind cannot eat and suffers from incessant fright, leading to atrophy of Heart Qi, death will ensue.
For knee swelling caused by Fengshui (Wind Water), Juxu Shanglian (ST37) is the primary point. For facial swelling, Shangxing (GV23) is the primary point; first select Ge Shu (BL17), then Tianyou (TE16) and Fengchi (GB20). For facial swelling caused by Fengshui (Wind Water), Chongyang (ST42) is the primary point. For facial swelling accompanied by black complexion caused by Fengshui (Wind Water), Jiexi (ST41) is the primary point.