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Hemp Seed (Cannabis Fructus) two sheng, White Peony Root (Paeoniae Radix Alba) half jin, Immature Bitter Orange (Aurantii Fructus Immaturus) half jin, Rhubarb (Rhei Radix et Rhizoma) half jin, Magnolia Bark (Magnoliae Officinalis Cortex) one chi, Apricot Seed (Armeniacae Semen) one sheng.
The above six herbs are ground into fine powder; honey is refined to make pills, sized like sophora seeds. Take ten pills with water each time, three times a day, until the desired effect is achieved.

Kidney Fixation Disease: The patient's body feels heavy, the waist is cold, as if sitting in water. The appearance resembles edema, yet there is no thirst, urination is normal and free, and appetite remains unchanged. This disease belongs to the Lower Jiao. It arises from physical exertion causing sweating, followed by cold and dampness penetrating the inner layer of clothing over a long period. Symptoms include cold pain below the waist and abdominal heaviness as if bound with five thousand coins. Gan Jiang Ling Zhu Tang (Licorice, Dried Ginger, Poria, and Atractylodes Macrocephala Decoction) is the primary treatment.
[Note]
The two clauses regarding Kidney contracting Wind and Cold must be omissions due to bamboo slip damage.
[Annotation]
"Kidney Fixation" refers to an illness caused by the Kidney being injured by Cold-Dampness, leading to stagnation and failure of Qi movement. Because the Kidney is affected by Cold-Dampness, the body feels heavy and the waist is cold, resembling sitting in water. Although it looks like edema, the absence of thirst and normal urination indicate this is not Water retention but Dampness. Appetite remains normal because the pathology is in the Lower Jiao (Kidney) rather than the Middle Jiao (Spleen). Regarding the cause: physical exertion leads to sweating, allowing cold and dampness from clothing to penetrate over time, resulting in cold pain below the waist due to excess Cold. Abdominal heaviness is due to excess Dampness. "As if bound with five thousand coins" describes the severe sensation of heaviness. Gan Jiang Ling Zhu Tang tonifies Earth (Spleen) to control Water (Kidney) and disperses Cold to leach out Dampness.
[Collected Notes]
You Yi stated: The disease is not in the internal organs of the Kidney itself, but in its external mansion (the lower back). Therefore, treatment does not focus on warming the Kidney to disperse Cold, but on warming Earth (Spleen) to overcome Water.

Licorice Root (Glycyrrhizae Radix et Rhizoma) two liang, Atractylodes Macrocephala Rhizome (Atractylodis Macrocephalae Rhizoma) two liang, Dried Ginger (Zingiberis Rhizoma) four liang, Poria (Poria) four liang.
The above four herbs are boiled in five sheng of water to obtain three sheng of decoction. Divide into three warm doses. The waist will feel warm.

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If the Kidney's True Organ Pulse exhibits death signs, light pressure reveals hardness, while heavy pressure feels chaotic like rolling balls, extending downward into the Chi position, this indicates a fatal prognosis.
[Annotation]
When the Kidney is invaded by Wind-Cold pathogens, if the pulse is extremely hard upon light pressure, chaotic and rolling-like upon heavy pressure, and extends chaotically into the Chi position, these are all signs of the Kidney's True Organ Pulse appearing, indicating death.
[Collected Notes]
Cheng Lin stated: The death sign of the Kidney's True Organ pulse, being hard upon light pressure, agrees with the *Nei Jing* description of "pi pi like striking stones," both indicating hardness. Chaotic rolling upon heavy pressure and extension into the Chi position represent the separation of Yin and Yang, hence death. The True Organ pulses described here differ slightly from those in the *Nei Jing*. In summary, the absence of Stomach Qi manifested in the three positions results in varied descriptions of pulse images.

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Question: What does it mean when the functional zones of the San Jiao fail? If the Upper Jiao fails, frequent belching occurs. Why? Master said: The Upper Jiao receives Qi from the Middle Jiao. If the Middle Jiao is disharmonious and cannot digest grains, belching ensues. If the Lower Jiao fails, urinary incontinence and fecal incontinence occur because the Qi is disharmonious and cannot self-regulate. No specific treatment is needed; it will heal after a long time.
[Annotation]
"San Jiao functional zone failure" means that due to deficiency and exhaustion, the San Jiao cannot return to its respective zones to function, failing to support each other. The Upper Jiao receives Qi from the Middle Jiao, and the Lower Jiao generates Qi from the Middle Jiao; mutual support constitutes harmony. If the Middle Jiao is deficient and exhausted, unable to digest food and fluids, Grain Qi is not received. Consequently, the Upper Jiao cannot function properly and becomes disharmonious. Disharmony causes Grain Qi to stagnate and fail to diffuse, leading to frequent belching. If the Lower Jiao is deficient and exhausted, it cannot supply ascending and generating Qi to the Middle Jiao, leading to disharmony. Disharmony causes Kidney Qi to sink exclusively, losing self-control, resulting in anterior urinary incontinence and posterior fecal incontinence. Saying "no treatment needed, heals over time" applies to belching. However, for urinary and fecal incontinence, healing without treatment is unlikely; this may be a textual error.
[Collected Notes]
Cheng Lin stated: "Jie" means deficiency. The *Ben Jing* states: When the San Jiao does not return to its parts, if the Upper Jiao does not return, there is belching and acid regurgitation; if the Middle Jiao does not return, digestion and food intake are impaired; if the Lower Jiao does not return, there is urinary incontinence. The Upper Jiao corresponds to the upper orifice of the Stomach, the Middle Jiao to the Spleen. The Spleen tends to belch; when the Spleen is disharmonious, food and breath rush backward to the stomach orifice, causing belching. The classic states that bladder lack of constraint causes urinary incontinence; due to Qi disharmony, urine and stool lack constraint. Thus, incontinence occurs without self-control.

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Master said: Heat in the Upper Jiao causes Lung萎 (Lung Atrophy) via coughing; Heat in the Middle Jiao leads to firmness (constipation); Heat in the Lower Jiao causes hematuria and also induces strangury and urinary obstruction. Cold in the Large Intestine results in many duck-dung-like loose stools; Heat in the Large Intestine results in sticky intestinal mucus. Cold in the Small Intestine causes bearing-down sensation and bloody stools; Heat in the Small Intestine inevitably leads to hemorrhoids.
[Annotation]
Heat in the Upper Jiao refers to Lung Atrophy with salivary foam mentioned earlier; Heat in the Middle Jiao refers to abdominal fullness, firmness, and pain; Heat in the Lower Jiao refers to dribbling urination. Externally, Cold in the Large Intestine causes clear, duck-dung-like loose stools (diarrhea). Heat causes sticky, viscous intestinal mucus (dysentery with pus and blood). Cold in the Small Intestine causes bearing-down and bloody stools (Yin-binding bloody stools). Heat flowing into the Large Intestine and accumulating in the anus inevitably causes hemorrhoids.
[Collected Notes]
Xu Bin stated: The Small Intestine is the Official of Reception and Transformation, interior-exterior related to the Heart. Bing Fire corresponds to the Small Intestine. It carries Fire to nourish Yin, preventing Yin stagnation; it carries Qi to transform Blood, ensuring Blood returns to its vessels. Cold prevents Qi from ascending smoothly, causing bearing-down; without Qi mastery, Blood wanders recklessly. The rectum is the head of the Large Intestine, and the anus is the gate. Heat in the Small Intestine is transmitted by the Large Intestine, causing Qi to knot at the anus, thus forming hemorrhoids. Hemorrhoids are the stagnation of Bing Small Intestine Heat in this location.

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Question: Diseases include Ji (Accumulation), Ju (Aggregate), and Qi (Qi Distension). What do these mean? Master said: Ji is a Zang organ disease, fixed in place and unchanging. Ju is a Fu organ disease, occurring at intervals, with pain shifting around; it is treatable. Qi Distension involves pain under the hypochondrium, which relieves upon pressure but recurs; this is Qi Distension. The general principle for diagnosing Ji: A pulse that is thin and adheres closely to the bone indicates Ji. If the pulse appears at the Cun position, the accumulation is in the chest; slightly beyond Cun, in the throat; at the Guan position, beside the umbilicus; slightly above Guan, in the epigastrium; slightly below Guan, in the lower abdomen. At the Chi position, the accumulation is at the Qichong point. If the pulse appears on the left, the accumulation is on the left; if on the right, on the right; if on both sides, in the center. Diagnose the location of the accumulation according to the pulse position. (The character "□" is interpreted as "Qi", see the first chapter).
[Annotation]
Diseases include Ji, Ju, and Qi; they must be distinguished. Ji is a Zang disease, always present, without positional change. Ju is a Fu disease, occurring intermittently, with migrating pain. "Treatable" means Fu diseases are easier to treat. Deep Qi involves fluid accumulation causing pain under the hypochondrium; pressing stops the pain, releasing brings it back. Fluid Qi dissipates temporarily upon pressure, so pain stops temporarily; this describes the symptoms. However, the general principle for Ji relies heavily on pulse diagnosis. A pulse that is deep, hidden, adheres to the bone, and is thin indicates various accumulations. If seen at both Cun positions, accumulation is in the chest; slightly beyond near the radial styloid process, in the throat; at both Guan positions, beside the umbilicus; slightly above Guan near Cun, in the epigastrium; slightly below near Chi, in the lower abdomen; at the Chi position, at the Qichong point. Pulse on the left indicates accumulation on the left; pulse on the right indicates accumulation on the right; pulse on both sides indicates accumulation in the center. One diagnoses the location of the accumulation based on these positions.
[Collected Notes]
Xu Bin stated: Ji implies traces; pathogenic Qi belongs to Yin. Zang organs belong to Yin; two Yins combine, hence immobility. Immobile means there is a specific painful spot without migration. Ju is like goods in a market, gathering occasionally; pathogenic Qi belongs to Yang. Fu organs belong to Yang; two Yangs compare, unlike Yin's coagulation. Thus, Cold sensation triggers onset, otherwise cessation. Hence "occasional." Without fixed shape, pain has no fixed location, hence migrating pain. Its root is shallow, making it more treatable than Ji.
Li [Name Missing] stated: Ji is a Zang disease, deep inside, hence the pulse is thin and adheres to the bone. Cun, Guan, Chi, up, down, left, right distinguish the location of Ji. All refer to the specific parts where the thin, bone-adhering pulse is felt, consistent with the *Nei Jing*: "Front to front, back to back; top to top concerns chest and throat; bottom to bottom concerns lower abdomen, waist, thighs, knees, shins, and feet."