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Kidney, Bladder, Pericardium, Sanjiao (Triple Burner)

The *Classic of Internal Medicine* (*Huangdi Neijing*) states: The Kidney is the official of strength and vigor, from which skills and dexterity arise.
It further states: The Kidney means "to bear" or "to undertake." It governs the bones and undertakes the affairs of the whole body; thus, physical strength and weakness depend on it.
[Image: Diagram of the Kidney]
The *Jia Yi Jing* (*Classics of Jia Yi*) states: The Kidney means "to guide," capable of guiding Qi to penetrate the bone marrow.
The *Zhi Yan* states: The Kidney means "Spirit" (*Shen*), wondrously generating all things and speaking thereof.
The *Classic of Internal Medicine* states: The Kidneys are attached below the fourteenth vertebra of the spine. Their exterior correspondence is the bones, their luster manifests in the hair, and they open into the two yin openings (anterior and posterior orifices).
The *Nan Jing* (*Classic of Difficult Issues*) states: There are two kidneys, weighing one jin and two liang, storing Essence (*Jing*) and Will (*Zhi*).
Hua Yuanhua stated: The Kidney is the residence of Spirit and Mind, and the root of life and nature.
There are two kidneys, shaped like cowpeas, lying side by side and curved, attached to both sides of the spine, each at a distance of one cun five fen. They are wrapped externally in yellow fat and have two ligaments each. The upper ligament connects to the Heart, and the lower ligament tends toward the large bone at the lower end of the spine, approximately half a hand's length from the tip of the spinal column. In the middle are two acupoints where the Kidney meridian passes through, ascending via the spinal cord to the brain, connecting to the Sea of Marrow.
It further states: The Gate of Life (*Mingmen*) is located in the center. The left and right kidneys open and close like the crossbar of a door, hence the name Gate of Life. One Yang line lies between two Yin lines, thereby forming the Kan trigram. In stillness, it closes, nourishing the true Water of one Yin; in movement, it opens, stirring the ministerial Fire of dragons and thunder. Stillness is the root of Yang, and Yin is the foundation of Yang.
It further states: The Foot Shaoyin Meridian belongs to the Kidney.
It further states: This meridian often presents with little blood and abundant Qi.
It further states: At the You hour (5-7 PM), Qi and Blood pour into the Kidney.
The *Huang Ting Jing* (*Yellow Court Classic*): The spirit named after the Kidney in the human body is called Xuanming, courtesy name Yuying.
The *Ling Shu* (*Spiritual Pivot*) states: The ears are the external organs of the Kidney. In Kidney disease, the cheekbones and face turn black, and the ears become dry and brittle.
Xiang Chuanweng said: Essence is generated from grains. (However, rich and sweet flavors cannot generate essence. Only bland and pure flavors can tonify Essence and generate Qi, and Qi will naturally generate Spirit.)
The *Classic of Internal Medicine* states: For those lacking Essence, tonify them with substantial flavors.
The *Huang Ting Jing* states: Guard the chamber of Essence urgently; do not recklessly leak or close it, but treasure it, and you can live long.
The *Classic of Internal Medicine* states: The Kidney governs Water and receives the Essence of the Five Zang and Six Fu organs to store it. (Original note: The Kidney is a hub and gatekeeper; it is not that only the Kidney organ possesses Essence.)
The *Zhen Quan* states: Each of the Five Zang organs stores Essence, but none has a fixed abode. Generally, before sexual intercourse, Essence is contained within the Blood, having no shape. After intercourse, when desire moves excessively, the Blood circulating throughout the body reaches the Gate of Life and transforms into Essence to be discharged. Thus, if the discharged Essence is stored in a vessel, mixed with a little salt and wine, and exposed overnight, it reverts to Blood.
The *Classic of Internal Medicine* states: The Kidney corresponds to Cold in Heaven, Water in Earth, the Kidney in Humans, Winter in Seasons, North in Directions, and Black in Colors, opening into the ears.
The *Classic of Internal Medicine* states: The North is Water, which is why all things gather and store.
It further states: The True Qi of the Zang organs descends to the Kidney, which stores the Qi of bone marrow. Lung Metal is the Mother, Liver Wood is the Child, and the Bladder is the Fu organ. It overcomes Fire and governs the bones; prolonged standing injures the bones. It governs storage and Will. Its category is Water, its animal is the pig, its trigram is Kan, its nature is Wisdom, its luster is in the hair, its grain is beans, its seasonal correspondence is... [text cuts off slightly but implies winter], its celestial star is Chenxing (Mercury), its disease site is the bones, its musical note is Yu, Yu means relaxation, indicating Yang Qi is about to return and all things grow relaxed. Its number is six, its odor is putrid, its sound is groaning, its Qi is blowing, its fluid is saliva, its change is shivering, its flavor is salty, its insect is scaled creatures, its fruit is chestnut, its vegetable is huos (broad bean leaves). Below it corresponds to the waist and Kidney with black color; however, black should resemble heavy lacquer gloss, not charcoal.
The *Ling Shu* states: The Kidney corresponds to bones. Those with dense skin and fine texture have thick Sanjiao and Bladder. Furthermore, the Kidney governs Cold; however, Cold injures the Kidney, and diseases primarily manifest as hernias. In smallpox, black depression indicates severity. Excessive lust injures the bones; excessive dampness causes disease. Symptoms include black complexion, fear, cold feet, rebellious Qi, abdominal pain, diarrhea with undigested food and tenesmus, and Qi movement below the umbilicus. When the Kidney is Excess, there is abdominal distension and heaviness, shortness of breath, reluctance to speak, bone pain, diarrhea with undigested food, and scanty urination. When the Kidney is Deficient, there is a sensation of falling, curling up, blue-white complexion, open fontanelle, downward crawling, photophobia, a hanging heart feeling like hunger, chest pain radiating to the back, cold limbs, polyuria, and tinnitus. In Kidney Extinction, eyes roll back and stare straight ahead, delirious speech, enuresis, broken waist, and withered bones occur; death follows in four days. A normal pulse in winter is Wang (prosperous) for 72 days, presenting as Chen Ru Shi (Deep, Soft, Stone-like). Shi means deep, soft, and slippery, coming swiftly upon lifting the finger. The controlling pulse is slow and large with a yellowish face, both being adverse. The critical pulse is Stone-like turning like a rope, departing like a flicked stone.
It further states: The Kidney is also the organ of Qi, governing reception (Na).
It further states: Its days are Ren and Gui; the North generates Cold, Cold generates Water, Water generates Salty flavor, Salty flavor generates the Kidney. The Kidney is the Lesser Yin within Yin, communicating with Winter Qi.
The *Ru Men* states: The Kidney receives the Essence of water and grain and remains extremely still,
except for the movement of turbid Qi at the Zi hour.
It further states: The Kidney opposes the umbilicus and corresponds to the waist; the waist is the external indicator of the Kidney.
It further states: The abdomen is Yin, and the Yin within Yin is the Kidney. The Kidney is female (Pin), belonging to Yin.
It further states: The waist is the mansion of the Kidney; if one cannot twist or shake, the Kidney is about to fail.
It further states: The bones are the mansion of Marrow; if one cannot stand for long and trembles while walking, the bones are about to fail.
It further states: All cold conditions involving contraction and pulling belong to the Kidney.
The *Ling Shu* states: The Kidney governs the exterior, enabling distant hearing; observing the condition of the ears reveals its nature.
It further states: A black complexion with fine texture indicates a small Kidney; coarse texture indicates a large Kidney. High ears indicate a high Kidney; hollows behind the ears indicate a low Kidney. Firm ears indicate a firm Kidney; thin and unfirm ears indicate a fragile Kidney. Ears positioned forward near the jaw indicate an upright Kidney; ears positioned higher indicate a tilted Kidney.
It further states: A small Kidney ensures organ peace and resistance to injury; a large Kidney predisposes to lower back pain and susceptibility to pathogens. A high Kidney causes back and spine pain, preventing bending and stretching; a low Kidney causes lower back and sacral pain, or fox hernia. A firm Kidney prevents lower back and spine pain; a fragile Kidney predisposes to Xiao Dan (wasting-thirst disorders). An upright Kidney is harmonious and hard to injure; a tilted Kidney suffers from lower back and sacral pain.
It further states: Exhalation is governed by the Heart and Lungs; inhalation is governed by the Kidneys and Liver. Sweating and bathing in cold water injure the Kidney.
The *Nan Jing* states: Sitting long on wet ground or forcing entry into water injures the Kidney.
It further asks: Why does each Zang have one, but the Kidney has two? The answer is: The two Kidneys are not both Kidneys. The left is the Kidney, the right is the Gate of Life (*Mingmen*). The Gate of Life is where Spirit and Mind reside and where Yuan Qi is tied. Men use it to store Essence, women use it to anchor the uterus; thus, we know there are two Kidneys.
The *Ru Men* states: The Gate of Life is not a proper Zang, and the Sanjiao is not a proper Fu.
The *Ling Shu* states: Pathogens in the Kidney cause bone pain and Yin Bi (obstruction). Yin Bi is characterized by inability to locate pain upon pressure, abdominal distension, lower back pain, difficult defecation, shoulder/back/neck pain, and occasional dizziness.
The *Classic of Internal Medicine* states: Kidney Heat manifests as black complexion and brittle teeth.
It further states: Transmission from Spleen to Kidney results in a disease named Shan Jia (hernia mass). There is heat and pain in the lower abdomen, and discharge of white fluid, also called Gu. (Note: Discharge of white refers to white fluid in urine.)
It further states: Withering of the large bones, sinking of the large muscles, internal consumption of shoulder marrow, increasing decline in activity, and appearance of the True Zang pulse indicate death within one year. Upon seeing the True Zang pulse, the specific day of death is predicted. (Note: This is Kidney exhaustion, predicting death within 365 days.)
The *Nan Jing* states: External signs include black complexion, frequent fear, and yawning. Internal signs include Qi movement below the umbilicus, tenderness upon firm pressure, rebellious Qi, acute lower abdominal pain, diarrhea with tenesmus, and cold/rebellious legs and calves.
The *Ling Shu* states: Kidney Qi Deficiency leads to Jue (cold extremities); Kidney Excess leads to distension.
It further states: Kidney Excess causes large abdomen and cavity swelling, wheezing/coughing, heavy body, night sweats, and aversion to wind. Kidney Deficiency causes chest pain, large and lower abdominal pain, cold extremities, and low spirits.
The *Ru Men* states: Kidney Deficiency causes a hanging heart feeling like hunger and frequent fear.
Taiyi Zhenren said: Abstain from lust, nourish Essence and Qi, swallow saliva, and nourish organ Qi.
Wumingzi said: Heaven generates Water first, which in humans is Essence; Earth generates Fire second, which in humans is Spirit.
The *Classic of Internal Medicine* states: The Kidney stores Essence and Will. Will is focused attention that does not shift.
It further states: When Organ Qi is exhausted, Spirit appears externally. (A son of the You family in Wuxi fell ill due to alcohol and lust, frequently seeing two women in bright clothes rising to his waist and disappearing. The doctor said: This is the Kidney Spirit. When the Kidney is exhausted, Spirit does not guard its residence, so it appears externally.)
The *Ling Shu* states: Unrelieved fear injures Essence; injured Essence causes bone soreness, pain, Jue, and spontaneous leakage of Essence.
The *Classic of Internal Medicine* states: The spermatic duct originates between the two kidneys and spine, winds around the right side of the large intestine, goes down the urinary tube, and exits together at the anterior orifice to discharge Essence.
It further states: Water prospers in Winter, is strong in Autumn,废弃 (abandoned) in Spring, imprisoned in Summer, and dies in Late Summer. Its prosperous days are Ren and Gui, prosperous hours are Ding Hai (night midnight);困 (trapped) days are Bing and Ding, trapped hours are Yu Zhong (mid-morning); dead days are Wu and Ji, dead hours are Ri Ze (afternoon sun slanting).
It further states: Shenshu acupoint is beside the fourteenth vertebra; Muacupoint is Jingmen at the waist and lateral costal margin.
It further states: The Kidney governs hibernation and is the root of sealing and storing, the place of Essence.
It further states: Northern Black color communicates internally with the Kidney, opens into the two yin openings, and stores Essence in the Kidney. (Two yin openings refer to anterior and posterior orifices.)
It further states: The Kidney's luster is in the hair. Hair lacking luster indicates Bone death first.
It further states: Two Qi communicate with the Kidney.
It further states: Essence and Qi merging in the Kidney causes fear.
It further states: The Kidney dislikes Dryness.
It further states: Salty flavor travels to Blood; in Blood diseases, do not eat too much salty.
It further states: Prolonged standing injures bones, laboring the Kidney.
It further states: To repair the Kidney, benefit its Essence.
It further states: Kidney color is black; it should resemble heavy lacquer, not earth-gray.
It further states: Black like crow feathers indicates survival; black like moss indicates death. (Moss, pronounced Tai.)
It further states: In Kidney Heat, the chin turns red first.
It further states: In Kidney Heat disease, there is initially lower back pain and leg soreness, bitter thirst with frequent drinking, body heat. If Heat contends, there is neck pain and stiffness, aversion to cold and soreness, hot soles, reluctance to speak. If rebellious, there is neck pain and dizziness. (Yuan Yuan means resembling urgency; Dan Dan means resembling insufficiency.) Symptoms worsen on Wu/Ji days, sweat profusely on Ren/Gui days, and death occurs on Wu/Ji days if Qi is rebellious. Acupuncture the Foot Shaoyin and Taiyang meridians.
It further states: The Kidney opens into the two yin openings; Excess causes fullness.
It further states: In Kidney Zhuo disease, the person feels cold from the waist down, and the waist feels heavy as if carrying five thousand coins.
It further states: In Kidney Zhang (distension), there is abdominal fullness radiating to the back, and central lower back/thigh pain.
It further states: In Kidney Water disease, there is abdominal enlargement, swollen umbilicus, heavy waist, painful inability to urinate, dampness in the genital area, sweating like a bull's nose, cold reverse feet, and hard stool.
It further states: In Kidney disease, the complexion is black, Qi is weak, breathing is short, ears seem deaf, lower back pain occurs with frequent loss of Essence and reduced appetite, knees and below feel cold. A deep and slow pulse is treatable and requires tonification. (Cold, pronounced Qing.)
It further states: Kidney Malaria causes shivering, lower back and spine pain, difficulty turning and defecating, eye twitching, and cold hands and feet. Acupuncture the Foot Taiyang and Shaoyin meridians. (Xuan, pronounced Xuan. Eye twitching.)
It further states: Lung transmitting Cold to the Kidney creates Yong Shui (gushing water). In Yong Shui, the abdomen is not firm upon pressure; Water Qi lodges in the Large Intestine, making gurgling sounds when walking quickly, like a bag wrapping soup. Treatment focuses on the Lung. Lung transmitting Heat to the Kidney transmits to Rou Chi (soft spasm). (Chi, pronounced Ci. Evil/Disease.)
It further states: Essence depletion causes deafness.
The *Xian Jing* states: There are three gates behind the back: Yuzhen Gate at the back of the head, Lulu Gate at the夾脊 (paraspinal) region, and Weilu Gate at the junction of Water and Fire. These are all pathways for Essence and Qi. If one obtains the mechanism of the Big Dipper to rotate them, circulation occurs up and down like the Milky Way.
Qianfu said: The Kidney houses Tianyi and acts with stinginess. If Will and Intent are regulated internally, Essence is complete and retained. If thoughts indulge externally and sexual activity is excessive, inherent licentiousness is not guarded, and Essence flows out with urine. However, this stems from flaccidity of the sinews due to relaxation of the Zong Jin (converging sinews).
The *Classic of Internal Medicine* states: Those who do not engage in coitus but leak Essence, either by hearing obscene matters, seeing beautiful colors, endless thoughts, unfulfilled desires, or excessive sexual activity, causing Zong Jin relaxation, develop Jin Wei (sinew flaccidity) and spontaneous Essence discharge, called Bai Yin (white turbidity). Leakage is inevitable and unceasing.
Danxi said: Slippage of Essence is primarily due to Damp-Heat; use Zhi Mu, Huang Bai, Mu Li, and Ge Ke.
The *Classic of Internal Medicine* states: Endless thoughts, unfulfilled desires, mental indulgence externally, and excessive sexual activity cause Zong Jin relaxation, leading to Jin Wei and Bai Yin.
The *Ru Men* states: For young people with excessive desire leading to intestinal prolapse and leakage, use Jin Suo Zheng Yuan Dan.
It further states: When desire moves, Essence follows the thought. Obstruction over time causes pain in the penis, often feeling like the need to urinate, resulting in urination or spontaneous flow. This is called Yi Jing (spontaneous emission), worse than nocturnal emission. (*Ben Cao Gang Mu* states: A man with deficiency and seminal emission had a string-taut and large pulse. Using one liang of Wu Bei Zi and two liang of Bai Fu Ling made into pills cured him well. The astringent power is more敏捷 (agile/effective) than Long Gu and Mu Li.)
It further states: Spontaneous leakage without dreams is called Jing Hua (Essence slipping), all caused by Minister Fire moving.
Dongyuan said: A pale and lusterless complexion, sorrowfulness, desire to cry, and a pulse that is empty upon pressure indicate Exhaustion of Essence and Spirit. Tonify Liver and Kidney vigorously, astringe and tonify Qi, and supplement Yuan Yang.
The *Yi Jian* states: Young men have vigorous Yang. Emotion moves internally, will admires something unattainable, leading to nocturnal seminal emission. Do not tonify; instead, clear the Heart and stabilize the Will.
Zhang Hezi said: Pain in the penis, extreme pain causing itching, or persistent erection, or discharge of white fluid like Essence with urine, caused by sexual fatigue and evil arts, is called Bai Yin. Use formulas to descend Heart Fire.
The *Zhen Gao* states: Essence is the Spirit of man; Clarity is the treasure of the body. Overwork scatters Essence; struggle dims Clarity.
The *Classic of Internal Medicine* states: Excessive Heart Fire and insufficient Kidney Water, with desires in the Heart, lead to rapid emotional disturbance and swift discharge.
It further states: The Kidney's emotion is Fear.
It further states: The Stomach is associated with Fear. (Note: Stomach Heat makes Kidney Qi weak, hence fear.)
It further states: Essence and Qi merging in the Kidney causes fear because Heart Deficiency allows Kidney Qi to merge, causing fear.
The *Ling Shu* states: Disease of the Foot Shaoyin meridian causes frequent fear.
It further states: Unrelieved fear injures Essence.
It further states: Fear causes Spirit to scatter and dissipate.
It further states: Fear causes Qi to sink. (Note: Upper Jiao restricts Lower Jiao Qi from returning, so Qi does not move upward.)
Hezi said: The Liver stores Blood; insufficient Blood causes fear.
The *Gang Mu* states: Fear and Startle are similar, but Startle arises from ignorance. Fear arises from awareness. Startle is reacting to noise; Fear is knowing oneself as if someone were catching them, unable to sit or lie alone, requiring companionship to avoid fear, or needing lights at night.
The *Ling Shu* states: Unrestrained anger in the Kidney injures Will; injured Will causes forgetfulness of previous words.
The *Classic of Internal Medicine* states: The Kidney's emotion is Fear; Fear injures the Kidney; Thought overcomes Fear.
Danxi said: To counteract Fear injuring the Kidney, use Thought to overcome it and Sorrow to resolve it.
The *Classic of Internal Medicine* states: The Kidney governs sealing and storing; the Liver governs dispersion and drainage. Both organs possess Minister Fire, connected superiorly to the Heart. The Heart is Sovereign Fire; moved by objects, it easily stirs, causing Minister Fire to stir. Stirring causes Essence to walk away. Minister Fire rises suddenly; even without intercourse, Essence secretly flows and drains. Thus, sages teach people to collect and nourish the Heart; the principle is subtle.
The *Zhi Zhi* states: The Heart masters Essence; the Kidney controls Essence. Qi Deficiency fails to manage and hold, causing Essence to exit with urine (called Niao Jing) or with sights/sounds (called Lou Jing).
The *Ru Men* states: Initially due to unsettled Sovereign Fire, later Minister Fire takes authority. Essence flows unrestrained and unstable, leading to continuous nocturnal emissions and daily slipping. Use Kan Li Wan. Zhi Mu and Huang Bai steamed, dried, and dew-exposed nine times each, combined with Rehmannia paste into pills, taken with salt water.
It further states: Nocturnal emission should not always be treated as Cold Deficiency; some are caused by Heat in the meridians.
The *Mai Jing* states: A weak and choppy pulse in men indicates infertility due to cold and clear Essence.
It further states: Choppy pulse indicates insufficiency of Essence and Blood; in men, a choppy pulse signifies injured Essence.
It further states: Choppy indicates Essence exhaustion and Blood withering.
The *Mai Jue* states: For seminal emission and turbid blood, examine the Chi position. Knot, Kou, Dong, and Jin pulses are definitive for these conditions.
The *Yi Jian* states: Subtle choppy pulse injures Essence.
Dai Shi said: Nocturnal emission and Essence slipping are all moved by Minister Fire; long-term results in Deficiency, not Cold.
It further states: For long-standing nocturnal emission with sinking Qi, raise and lift Kidney Qi to return to the source.
The *Ben Shi* states: When Kidney Qi is closed, Essence leaks.
It further states: The Kidney stores Essence; the Kidney captures Essence and Qi to reproduce humanity. Whether nurturing or scattering, it is governed by the Kidney. Now, with declining Kidney Qi, the Essence and Qi of the whole body lack management, thus leaking irregularly.
The *Gang Mu* states: Most cases of nocturnal emission belong to Stagnation. Quack doctors do not recognize the stagnation but use astringents to secure collapse, not realizing that more astringency increases stagnation and worsens the disease.
Zhongjing said: In those losing Essence, there is tightness in the lower abdomen, coldness at the glans, dizziness, and hair loss. The pulse is extremely deficient, Kou, and slow, indicating cold diarrhea, blood loss, and essence loss. Men lose Essence; women have dream intercourse.
The *Classic of Internal Medicine* states: Kidney Qi communicates with the ears; when harmonious, one can hear the five tones.
The *Ling Shu* states: Straining to lift heavy weights, excessive sexual activity, sweating and bathing in water injure the Kidney.
The *Classic of Internal Medicine* states: Diseases in the Kidney heal in Spring; if not healed in Spring, they worsen in Late Summer; if not dying in Late Summer, they persist in Autumn and rise in Winter.
It further states: Kidney disease heals on Jia/Yi days; if not healed, it worsens on Wu/Ji days; if not dying, it persists on Geng/Xin days and rises on Ren/Gui days.
It further states: Kidney disease improves at midnight, worsens during the four seasons (transition periods), and is quiet in the late afternoon.
It further states: The Kidney suffers from Dryness; urgently eat Pungent to moisten it, open the pores, produce fluids, and circulate Qi. The Kidney desires firmness; urgently eat Bitter to firm it. Use Bitter to tonify, Salty to drain.
It further states: Kidney disease prohibits exposure to HT (Heat/Cold extremes?), hot food, and warm roasted clothing.
The *Gang Mu* states: The Kidney essentially has no Excess; do not drain it.
Qian Shi said: There is only Bu Shen Di Huang Wan (Tonify Kidney Rehmannia Pill); there are no drugs to drain the Kidney.
The *Gang Mu* states: The Left Kidney belongs to Water; insufficient Water leads to Yin Deficiency, suitable for Liu Wei Di Huang Wan. The Right Kidney belongs to Fire; insufficient Fire leads to Yang Deficiency, suitable for Ba Wei Wan or Jia Jian Ba Wei Wan.
It further states: In Liu Wei Di Huang Wan: For Blood Deficiency and Yin Decline, Shu Di Huang is the Sovereign herb; for Essence slipping, Shan Zhu Yu is the Sovereign herb; for frequent, scanty, red, or white urine, Fu Ling is the Sovereign herb; for dysuria and astringency, Ze Xie is the Sovereign herb; for Heart Qi Deficiency, Dan Pi is the Sovereign herb; for dry and rough skin, Shan Yao is the Sovereign herb.
The *Ru Men* states: Clear and free urination with a deep, slow pulse indicates Cold Qi returning to the Kidney. Red and astringent urination with a deep, rapid pulse indicates Heat Qi returning to the Gate of Life. The pulses of the Kidney and Gate of Life are the same because the diseases they receive ultimately converge in the Bladder Fu organ.
The *Classic of Internal Medicine* states: At the end of Shaoyin, there is black complexion, elongated and dirty teeth, abdominal distension and blockage, failure of communication between upper and lower, and death ensues.
The *Jin Kui Zhen Yan Lun* states: Winter Qi causes disease in the four limbs, corresponding to the Kidney.