三部俱迟肾藏寒。皮肤燥涩发毛干。梦见神魂时入水。觉来情思即无欢。
肾主水。水之性也。寒迟脉为寒。三部俱迟。则知其为肾藏寒也。肾主五
液。肾病则无津液以荣养皮毛。故皮肤燥涩。发毛干也。水阴寒之物也。
梦入水。从其类也。经云。肾病者虚。则意不乐。故觉来情思即无欢也。
肾散腰间气。
肾主藏。其脉当沉而实。今脉见散。是为肾气不藏。腰者。肾之府。故腰间
生气也。他释皆以此属下文。非也。
尿多涩。滑并。其中有聚散。聚散且无凭。实滑小便涩。淋痛涩苦 。脉涩精
频漏。恍惚梦魂多。小肠疝气逐。梦里涉江河。
此言尿。多之证。当细察其寒热虚实而治之也。倘诊得其人肾病涩而
且滑。则当断之曰。必尿多也。虽然。凡脉可以兼见。滑与涩。其状相反。安
可以一部之中。而兼见也。要知涩脉为阴。当于沉中取。滑脉为阳。当于
浮中得。诊得其人轻手取之。其脉皆聚而滑。及乎重手取之。其脉复聚
而涩。浮之中聚而滑。则为火有余。沉之中散而涩。则为水不足。水不足
而火有余。故为小便频数之证也。然所谓其中有聚散。聚散且无凭者。
何也。言当诊脉之时。须于浮沉中细心审察。不可以浮中见脉道之聚。
而尽凭之为滑。亦不可以沉中见脉道之散。而尽凭之为涩也。然余何
以作如是之释也。试观下文所云。即知之矣。假令其人脉实而滑。则是
浮沉俱滑。此为实火。故当病小便涩而淋痛。若诊得其人脉浮沉俱涩。
则为伤精败血。多梦纷纭之证作矣。又肾脉而见涩。为金寒水冷。丙火
受伤。故为小肠疝气也。肾为水藏。涩为阴脉。水为阴物。故梦涉江河大
水。
实大膀胱热。小便难往通。
实大为火。为阳。肾脉见实。则为府病。为热结膀胱。故小便难往通也。
滑弦腰脚重。沉紧痛还同。
弦为寒。紧则为寒之甚。滑为水之阳。沉为水之阴。经云。北风生于冬。病
在肾俞在腰股。寒气在肾。故腰脚重也。至于沉而紧。则寒之甚矣。故腰
脚不止于重。而更痛也。按经脉篇云。肾所生病者。脊股内廉痛是矣。
单匀吉无病。浮紧耳应聋。
池氏曰。肾脉浮紧。主肾有风耳。乃肾之窍上攻于耳。是致耳聋也。
The pulse at all three positions (Cun, Guan, Chi) is slow (Chi), indicating Cold in the Kidney Zang. The skin is dry and rough, and the hair is dry. The patient dreams of their soul entering water; upon waking, they feel unhappy and depressed.
The Kidney governs Water, which is its nature. A slow pulse indicates Cold. If the pulse at all three positions is slow, it can be determined that there is Cold in the Kidney Zang. The Kidney governs the Five Fluids (Jing, Saliva, Mucus, Tears, Sweat). When the Kidney is diseased, it fails to produce Body Fluids to nourish the skin and hair, resulting in dry, rough skin and dry hair. Water is a Yin and cold substance; dreaming of entering water corresponds to its similar nature. The Classics state: "Kidney disease leads to deficiency, causing a lack of joy." Thus, upon waking, one feels unhappy.
Kidney Qi disperses in the waist region.
The Kidney governs storage, so its pulse should be deep and solid. Now, the pulse appears scattered, indicating that Kidney Qi fails to consolidate. The waist is the mansion of the Kidney; therefore, Qi stagnation occurs in the waist. Other commentators attribute this sentence to the following text, which is incorrect.
Frequent urination with dysuria; the pulse is slippery and choppy, with Qi gathering and scattering unpredictably. If the pulse is full and slippery, there is dysuria accompanied by painful strangury. If the pulse is choppy, essence leaks frequently, the spirit is vague, and dreams are numerous. When Small Intestine Hernia attacks, one dreams of wading through rivers and lakes.
This section discusses the syndrome of polyuria, which must be treated after carefully distinguishing between Cold, Heat, Deficiency, and Excess. If the pulse for Kidney disease is found to be both choppy and slippery, one can conclude that there will certainly be frequent urination. Although pulses can coexist, Slippery and Choppy pulses have opposite characteristics; how can they appear simultaneously in one position? It must be known that the Choppy pulse is Yin and should be palpated at the Deep level; the Slippery pulse is Yang and should be palpated at the Superficial level. When palpating lightly, the pulse gathers and becomes Slippery; when pressing heavily, the pulse gathers but appears Choppy. Gathering and Slipperiness at the Superficial level indicate Excess Fire; scattering and Choppy qualities at the Deep level indicate Insufficient Water. With Insufficient Water and Excess Fire, the syndrome of frequent urination arises. However, why does it say "there is gathering and scattering, and gathering/scattering is unreliable"? This means that during pulse diagnosis, one must carefully examine the Superficial and Deep levels. One cannot rely solely on the gathering of the pulse channel at the Superficial level to define it as Slippery, nor can one rely solely on the scattering at the Deep level to define it as Choppy. Why do I explain it this way? Observe the following text to understand. Suppose the patient's pulse is Full and Slippery; if it is Slippery at both Superficial and Deep levels, this indicates Excess Fire, leading to dysuria and painful strangury. If the pulse is Choppy at both Superficial and Deep levels, this indicates injury to Essence and corruption of Blood, resulting in numerous dreams. Furthermore, a Choppy pulse in the Kidney position indicates Cold Metal and Cold Water, injuring Bing Fire (Heart/Small Intestine Fire), thus causing Small Intestine Hernia. The Kidney is a Water organ; Choppy is a Yin pulse; Water is a Yin substance; hence, one dreams of traversing large rivers and waters.
A Full and Large pulse indicates Heat in the Bladder and difficulty in urination.
Full and Large pulses belong to Fire and Yang. If the Kidney pulse appears Full and Large, it indicates a Fu-organ disease, specifically Heat binding in the Bladder, causing difficulty in urination.
A Slippery and Wiry pulse indicates heaviness in the waist and legs; a Deep and Tight pulse indicates pain.
Wiry indicates Cold; Tight indicates severe Cold. Slippery is the Yang aspect of Water; Deep is the Yin aspect of Water. The Classics state: "North Wind arises in Winter, diseases affect the Shenshu points and the waist and thighs." Cold Qi in the Kidney causes heaviness in the waist and legs. If the pulse is Deep and Tight, the Cold is extreme, causing not only heaviness but also pain in the waist and legs. According to the *Jingmai* chapter, diseases generated by the Kidney include pain along the medial aspect of the spine and thigh, which is exactly this case.
A uniform and even pulse is auspicious and indicates no disease; a Floating and Tight pulse indicates deafness.
Master Chi states: A Floating and Tight pulse in the Kidney position indicates Wind in the Kidney. Since the ear is the orifice of the Kidney, the pathogen attacks upward, causing deafness.