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The nine orifices of the human body consist of seven governed by Yang and two governed by Yin, all under the control of the Five Zang Organs (Zang organs), while the Six Fu Organs (Fu organs) do not directly govern them. However, clear Yang Qi emerges from the upper orifices, and turbid Yin descends to the lower orifices, presenting a distinction between the formless and the formed. Now, since it is said that the Kidney opens into the ears, why does it also open into the two lower orifices? Some say: The Bladder is the official of the capital, storing fluids; only through Qi transformation can they be excreted. The San Jiao (Triple Burner) is the official of irrigation, where water pathways emerge. The Bladder is the Fu organ of the Kidney, and the San Jiao is the envoy of the Gate of Vitality (Mingmen); thus, they are subordinated to the Kidney. The Small Intestine is the official of reception and containment, transforming substances and separating the clear from the turbid. The Large Intestine is the official of transmission, changing and excreting waste. The Kidney acts as the gate of the Stomach, and the lower part corresponds to Earth; thus, they are also subordinated to the Kidney. Moreover, the Lung governs the free flow of water passages, transporting fluids downward to the Bladder; thus, this is further subordinated to the Hand Taiyin Lung Meridian. The Spleen governs the digestion of grains and manages the granary; thus, this is further subordinated to the Foot Taiyin Spleen Meridian. Then why is it solely attributed to the Kidney? One must understand that North corresponds to Black, opens into the two lower orifices, and connects internally with the Kidney. This is because Yin orifices differ from Yang orifices. The Five Zang Organs store essence without draining, so essence flows through empty orifices in a formless manner, becoming the residence of clarity and spirit. The Six Fu Organs drain without storing, so waste flows through turbid orifices in a formed manner, serving as pathways for transformation. What, after all, does this have to do with the Kidney? Essentially, the function of transformation belongs to Yang, but that which enables transformation belongs to Yin. Without Yin, Yang cannot transform; this is what is meant by the Kidney governing the five fluids. Observe those with Kidney deficiency: their urination is inevitably dribbling, and their defecation is dry and constipated. They also present symptoms of Kidney diarrhea and urinary incontinence. This confirms that the Kidney governs both urine and feces, a fact that is obvious. Urinary retention is more severe than fecal retention. Fecal retention merely suffers from difficulty due to the loss of essence and blood, whereas urinary retention causes unbearable distension and discomfort, leading to physical deterioration due to failed Qi transformation. Therefore, when treating, should one focus exclusively on the Kidney, or not? The answer is: If caused by Kidney deficiency, treat the Kidney; if caused by other Zang or Fu organs, treat those organs. Yin and Yang are the parents of change and the origin of life and death. Disease above should be treated by taking points below; disease below should be treated by taking points above. Whether excess or deficiency, heat or cold, the pathology differs between the young and old, and the presentation varies with duration. Acute cases require different management than chronic ones. The divine and illuminating principles depend on the individual practitioner. This can only be discussed with those who understand.

An elderly man in his seventies, having been immoderate after drinking alcohol, suffered from urinary retention. After ten days, he passed no drops, his lower abdomen was distended and full, extending to the waist and hips, making sitting and lying impossible. He finally sought treatment. His pulse was either rapid or knotted, irregular and inconsistent. Reviewing his previous medications, including Wu Ling San (Five-Ingredient Powder with Poria), Ba Zheng San (Eight-Right Powder), Liu Yi San (Six-to-One Powder), Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), and Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet), none had any effect. I recalled that Yu Tianmin had successfully used the natural juice of *Kochia scoparia* (Difukcao, 地肤草) to treat cases unresponsive to hundred medicines. I instructed his servant to collect it. It was early summer, and the herb was still tender, so we gathered it and crushed it to extract the juice. Following my own judgment, I added one liang of salt-fried *Bianxu* (Chuanbihe, 川萆薢) and decocted it with water, mixing it with the juice for oral administration, as it can eliminate stagnant water in the Bladder. Upon trial, urine gushed out like a spring, day and night, and his abdomen gradually flattened. However, his scrotum, having been fumigated by previous doctors, was red and swollen like a bean bag. We invited surgeons from our county to treat it; they used Bian fa (scarification therapy) to drain fluid, but it recurred the next day. He then sought my treatment again. I said: "Urinary difficulty responds to one dose of medicine; this is a sign of Scrotal Abscess (Nangyong, 囊痈). It will take approximately sixty doses over two months for complete recovery." The old man asked, "How about taking two doses daily?" I replied, "Then it will heal in one month." Thus, I prescribed fried black *Gentiana scabra* (Longdancao, 龙胆草), *Bupleurum chinense* (Chaihu, 柴胡), *Gardenia jasminoides* (Shanzhi, 山栀), *Angelica sinensis* (Danggui, 当归), *Paeonia lactiflora* (Shaoyao, 芍药), *Rehmannia glutinosa* (Shudi, 熟地), *Poria cocos* (Fuling, 茯苓), *Alisma orientale* (Zexie, 泽泻), *Achyranthes bidentata* (Niuxi, 牛膝), and *Moutan cortex* (Danpi, 丹皮), among others, to drain Liver fire and nourish Yin. Indeed, the swelling subsided daily, and he recovered as scheduled.

Another elderly man in his sixties developed urinary retention due to practicing Zen meditation and dangerous sitting breathing exercises in his youth. At that time, Mr. Shicai and Mr Lizé prescribed Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet), but he refused it and instead experienced chest oppression and suffocation for three days. In his later years, every day before the Winter Solstice, his urine would become blocked. Straining to pass it, he would expel blood clots resembling clam meat, after which the blockage would return. If there was no passage for three days, he would suffer from chest oppression and faint unconsciousness. I said: "This is stasis in the lower abdomen. Straining to pass it causes Qi transformation to fail, leading to upward attack and dizziness." I prescribed three qian of *Panax ginseng* (Renshen, 人参), one qian and five fen of *Succinum* (Hupo, 琥珀), one qian and five fen of *Achyranthes bidentata* (Niuxi, 牛膝), one qian of *Moutan cortex* (Danpi, 丹皮), two qian of *Plantago seed* (Cheqianzi, 车前子), and half a qian of *Cimicifuga heracleifolia* (Shengma, 升麻). This formula simultaneously attacks pathogenic factors and tonifies deficiency, lowering and ascending Qi. It proved effective. Subsequent recurrences were all miraculously cured by this prescription. Other medications had no relevance or effect.