肾脏对分之。膀胱其合宜。
四十二难曰。肾有两枚。重一斤二两。主藏志。血气形志论云。足太阳与
少阴为表里。谓肾与膀胱为表里也。
按阴阳应象大论云。北方生寒。寒生水。水生咸。咸生肾。肾生骨髓。骨髓
生肝。肾主耳。其在天为寒。在地为水。在体为骨。在脏为肾。在色为黑。在
音为羽。在声为呻。在变动为栗。在窍为耳。在味为咸。在志为恐。恐伤肾。
思胜恐。寒伤血。燥胜寒。咸伤血。甘胜咸。金匮真言论云。北方黑色。入通
于肾。开窍于二阴。藏精于肾。故病在溪。其味咸。其类水。其畜彘。其谷豆。
其应四时。上为辰星。是以知病之在骨也。其音羽。其数六。其臭腐。
旺冬身属水。位北定无欺。
阴阳应象大论云。北方生寒。塞生水。水生咸。咸生肾。肾生骨髓。
两耳通为窍。
阴阳应象大论云。肾主耳。又云在窍为耳。
三 附在斯。
古之言三焦者不一。其说或云无状有名。或云有状有名。诸论纷然。千
载莫决。所谓无状有名者。其说起于秦越人。所谓有状有名者。其说起
于三因方。不知三焦。原自有二。皆本之于内经。奈后之学人。执一不分。
随成疑案。至以手少阳之三 。混而为上中下之三焦。何其谬也。特未
取内经诸篇。反复之耳。其一见于内经营卫生会篇曰。上焦如雾。中焦
如沤。下焦如渎。观其如雾。如沤。如渎。而且判之以上中下。则其为无状
有名可知矣。其二见于内经本藏篇曰。密理浓皮者。三 膀胱浓。粗理
薄皮者。三 膀胱薄。疏腠理者。三 膀胱缓。皮急而无毫毛者。三 膀
胱急。毫毛美而粗者。三 膀胱直。稀毫毛者。三 膀胱结也。观其与膀
胱同其浓薄。同其缓急。同其直结。则其为有状有名。又可知矣。要知营
卫生会篇所云。乃无状有名之三焦。主营气卫气宗气者也。本藏篇所
云。乃有状有名之三 。与手厥阴为表里。配十二经络者也。若云手少
阳之三 。即上中下之三焦。则是五脏五腑。皆在手少阳之中矣。假令
手少阳有病为热。当治之以寒。俾十二经俱寒之可乎。又令手少阳有
病为寒。当治之以热。俾十二经俱热之可乎。若云自有手少阳引经之
药。不犯他经。则非上中下之三焦。不辨而自明矣。大抵无状有名之焦
字。无有月傍。当以平声读。有状有名之 字。从以月傍。当以去声读。或
曰三 既与手厥阴为表里。而又曰附于肾者何也。以灵枢本藏篇有
曰。肾合三 膀胱。本输篇亦曰。少阳属肾。故诀曰。三 附在斯也。戴起
宗不玩本藏本输二篇之旨。谓三 非肾所附。而据改为二阴窍附。何
其 也。
按三十一难曰。三焦何禀何生。何始何终。其治常在何许。可晓以不。然
三焦者。水谷之道路。气之所终始也。上焦者。在心下。下膈在胃上口。主
纳而不出。其治在膻中。玉堂下一寸六分。直雨乳。间陷者是。中焦者。在
胃中脘。不上不下。上腐熟水谷。其治在脐傍。下焦者。在脐下。当膀胱上
口出。分别清浊。主出而不内。以传导也。其治在脐下一寸。故名曰三焦。
其府在气街。一本云冲字。
味咸归藿豆。
洁古曰。肾象水而味咸。藿与豆皆咸。故归之也。藏气法时论云。脾色黄。
宜食咸大豆。豕肉栗藿皆咸。而此谓归肾者。何也。王冰注云。乃谓利关
机之义也。肾为胃关。脾与胃合。故假咸柔 以利其关。关利而胃气乃
行。胃行而脾气方化。故应脾宜味与众不同也。
精志自相随。
三十四难曰。肾藏精与志也。
沉滑当时本。
肾脉当沉实而滑。平人气象论云。平肾脉来喘喘累累。如钩按之而坚。
曰肾平。按之而坚者。沉而实也。喘喘累累者。滑也。
按人镜经云。肾脉沉而软滑。肾合骨。肾脉循骨而行。持脉指法。按至骨
上而得者为沉。次重以按之。脉道无力而濡。举指来疾流利者为滑。
浮摊厄在脾。
摊。缓也。云岐子曰。肾旺冬。其脉当沉而滑。今反浮而缓。是土来乘水。故
云厄在脾。
色同乌羽吉。形似炭煤危。
五脏生成篇云。黑如乌羽者生。谓黑而明润也。又云黑如 者死。谓黑
而惨暗也。
按玉机真藏论云。真肾脉至。如指弹石。辟辟然。色黑黄不泽。毛折乃死。
冷即多成唾。焦烦水易亏。
四十九难曰。肾主液。自入为唾。张世贤曰。水盛则火灭。火灭则气冷。气
冷。则水溢于上而多唾。火盛则水干于内而烦躁。烦躁则津液衰而好
饮也。
奔豚脐下积。究竟骨将痿。
五十六难曰。肾之积名曰奔豚。发于少腹。上至心下。若豚状。或上或下。
无时令人喘逆。骨痿少气。以夏丙丁日得之。何以言之。脾病传肾。肾病
传心。心以夏适旺。旺者不受邪。肾复欲还脾。脾不肯受。故留结为积。故
知奔豚以夏丙丁日得之。
实梦腰难解。虚行溺水湄。
淫邪发梦篇云。肾气盛则梦腰春雨解。不属厥气。客于肾。则梦临渊。没
居水中。
按中藏经云。肾虚梦船溺。人得其时。梦伏水中。盛实则梦临渊投水中。
一斤余二两。胁下对相垂。
说见首节。
The kidneys are divided into left and right, positioned symmetrically. The bladder is its paired organ (Fu-organ), forming an appropriate interior-exterior relationship.
Chapter 42 of the *Nan Jing* (Classic of Difficult Issues) states: There are two kidneys, weighing one jin and two liang. They are primarily responsible for storing "Zhi" (Willpower/Mental Resolve). The *Su Wen: Xue Qi Xing Zhi Lun* (Treatise on Blood, Qi, Form, and Spirit) says: The Foot-Taiyang Bladder Meridian and the Foot-Shaoyin Kidney Meridian are exteriorly-interiorly related. This refers to the interior-exterior relationship between the Kidney and the Bladder.
According to the *Su Wen: Yin Yang Ying Xiang Da Lun* (Great Treatise on Yin and Yang Correspondences): In the North, Cold generates Water; Water generates Salty flavor; Salty flavor nourishes the Kidney; Kidney essence generates Marrow; Marrow nourishes the Liver. The Kidney opens into the ears. In Heaven it corresponds to Cold; in Earth to Water; in the body structure to Bones; in the Zang-Fu organs to the Kidney; in colors to Black; in musical notes to Yu (Pitch); in vocalizations to Moaning/Shen; in pathological changes to Shivering/Li; orifices to the Ears; flavors to Salty; emotions to Fear. Fear injures the Kidney Qi, while Thought (Si) can overcome Fear. Cold injures Blood, while Dryness can overcome Cold. Salty flavor injures Blood, while Sweet flavor can overcome Salty.
The *Su Wen: Jin Gui Zhen Yan Lun* (True Words on the Golden Cabinet) states: The color of the North is Black, and its qi connects to the Kidney. It opens into the two yin orifices (urethra and anus). It stores Essence within the Kidney. Therefore, diseases of the Kidney often manifest in the sinews and joints (Xi Gu). Its flavor is Salty, its category is Water, its associated animal is the Pig, and its grain is the Bean. It corresponds to the Winter season, and in the heavens, it corresponds to Chen Xing (Mercury). Thus, we know that disease resides in the bones. Its note is Yu, its number is Six, and its odor is Rotten.
When prosperous in Winter, the body belongs to Water, and its position is in the North, which is undeniable truth.
The *Su Wen: Yin Yang Ying Xiang Da Lun* states: In the North, Cold generates Water; Water generates Salty flavor; Salty flavor generates the Kidney; the Kidney generates Marrow.
The two ears serve as the orifice for the Kidney.
The *Su Wen: Yin Yang Ying Xiang Da Lun* states: The Kidney governs the ears. It also states that the orifice is the ear.
The San Jiao (Triple Burner) attaches here [to the Kidney].
Ancient descriptions of the San Jiao vary. Some say it has form but no name? No, some say it has no form but only a name, while others say it has both form and name. These discussions are numerous and unresolved for millennia. The theory of "no form, only name" originated with Qin Yueren (Bian Que). The theory of "form and name" originated with the *San Yin Fang*. However, the San Jiao originally had two interpretations, both rooted in the *Nei Jing* (Inner Canon). Later scholars, sticking to one view without distinction, created confusion, even conflating the Hand-Shaoyin San Jiao with the Upper, Middle, and Lower San Jiao, which is highly erroneous. This stems from a failure to repeatedly examine various chapters of the *Nei Jing*.
One instance is found in the *Ling Shu: Ying Wei Sheng Hui Pian* (Chapter on the Generation and Meeting of Ying and Wei Qi), which states: "The Upper Jiao is like mist; the Middle Jiao is like foam/maceration; the Lower Jiao is like a ditch." Observing these metaphors of mist, foam, and ditch, and distinguishing them as upper, middle, and lower, it is clear that this refers to the San Jiao of "no form, only name."
A second instance is found in the *Ling Shu: Ben Cang Pian* (Chapter on Root and Storage), which states: "Those with dense skin and thick pores have thick San Jiao and Bladder walls; those with coarse skin and thin pores have thin San Jiao and Bladder walls; those with loose pores have relaxed San Jiao and Bladder; those with tight skin and no hair have tense San Jiao and Bladder; those with beautiful and coarse hair have straight San Jiao and Bladder; those with sparse hair have knotted San Jiao and Bladder." Observing that it shares thickness, tension, straightness, and knotting with the Bladder, it is evident that this refers to the San Jiao of "form and name."
It must be understood that what is described in the *Ying Wei Sheng Hui Pian* is the San Jiao of "no form, only name," which primarily governs Ying Qi (Nutritive Qi), Wei Qi (Defensive Qi), and Zong Qi (Gathering Qi). What is described in the *Ben Cang Pian* is the San Jiao of "form and name," which is exteriorly-interiorly related to the Hand-Jueyin Pericardium Meridian and is paired with the twelve meridians. If the Hand-Shaoyang San Jiao were identical to the Upper, Middle, and Lower San Jiao, then all five Zang and five Fu organs would reside within the Hand-Shaoyang. For example, if the Hand-Shaoyang had a Heat pathogen, it should be treated with Cold herbs; would this make all twelve meridians cold? Conversely, if it had a Cold pathogen, treated with Heat herbs, would this make all twelve meridians hot? If one argues there are specific guiding herbs for the Hand-Shaoyang that do not affect other meridians, then the concept of Upper, Middle, and Lower San Jiao becomes self-evident and distinct.
Generally, the character "Jiao" (Burner) in "no form, only name" lacks the moon radical (肉/月) and should be read in the level tone. The character referring to "form and name" [Note: Text implies a character with moon radical, likely referring to anatomical structures like 'Huang' or specific tissue layers, though text says 'San '] contains the moon radical and should be read in the departing tone.
Someone asks: Since the San Jiao is exteriorly-interiorly related to the Hand-Jueyin, why does it say it attaches to the Kidney? Because the *Ling Shu: Ben Cang Pian* states: "The Kidney combines with the San Jiao and Bladder," and the *Ling Shu: Ben Shu Pian* also states: "Shaoyang belongs to the Kidney." Hence the verse says: "The San Jiao attaches here." Dai Qizong failed to appreciate the purport of the *Ben Cang* and *Ben Shu* chapters, claiming the San Jiao is not attached to the Kidney, and erroneously changed it to attaching to the two yin orifices. How ignorant!
According to Chapter 31 of the *Nan Jing*: From what does the San Jiao originate and grow? Where does it begin and end? Where is its treatment located? Can this be explained? The answer is: The San Jiao is the pathway for water and grain, and the beginning and end of Qi. The Upper Jiao is located below the heart, above the diaphragm, at the upper opening of the stomach. It governs reception and does not discharge. Its treatment point is Dan Zhong (Conception Vessel 17), which is 1.5 cun below Yu Tang (CV 19), directly opposite the nipple in the depression. The Middle Jiao is located at the mid-stomach (Zhong Wan), neither high nor low, governing the rotting and ripening of water and grain. Its treatment area is beside the umbilicus. The Lower Jiao is located below the umbilicus, at the upper opening of the bladder. It separates the clear from the turbid, governs excretion without intake, and serves for conduction. Its treatment area is 1 cun below the umbilicus. Hence it is called the San Jiao. Its Fu organ location is at Qi Jie (Stomach 30/Qichong), though one version says Chong Zi (Chong Men).
Salty flavor returns to Huoxiang (Patchouli) and Beans.
Jiegu (Zhang Yuansu) said: The Kidney resembles Water and tastes Salty. Huoxiang and beans are both salty, hence they return to the Kidney. The *Su Wen: Zang Qi Fa Shi Lun* states: "The spleen's color is yellow; it is suitable to eat salty large beans, pork, chestnuts, and huoxiang, all of which are salty." Why does this text say they return to the Kidney? Wang Bing's annotation explains: This refers to the meaning of benefiting the gate mechanisms. The Kidney is the gate of the Stomach; the Spleen and Stomach are combined. Therefore, salty flavor is used to soften the gate and facilitate its opening. When the gate is open, Stomach Qi can move; when Stomach Qi moves, Spleen Qi can transform. Thus, it should be known that the flavor suitable for the Spleen is different from others.
Essence and Will naturally follow each other.
Chapter 34 of the *Nan Jing* states: The Kidney stores Essence and Will.
The pulse is sinking and slippery, conforming to the seasonal root.
The Kidney pulse should be sinking, solid, and slippery. The *Su Wen: Ping Ren Qi Xiang Lun* (Treatise on the Signs of Healthy People's Qi) states: A normal Kidney pulse comes rushing and continuous, like a hook, firm upon pressure. This is called a Normal Kidney Pulse. Firm upon pressure means sinking and solid. Rushing and continuous means slippery.
According to the *Ren Jing Jing* (Mirror of Man Classic): The Kidney pulse is sinking, soft, and slippery. The Kidney combines with Bone, and the Kidney pulse runs along the bone. In pulse diagnosis, pressing until the bone to feel the pulse is called "Sinking." Pressing heavier, if the pulse channel feels weak and moist, and rising quickly and smoothly upon lifting the finger is called "Slippery."
Floating and slow pulses bring disaster to the Spleen.
Tan means Slow. Yun Qizi said: The Kidney prospers in Winter, and its pulse should be sinking and slippery. Now it floats and slows instead; this is Earth overcoming Water (Spleen Earth overcoming Kidney Water). Hence, it is said that the disaster lies in the Spleen.
Complexion black like crow feathers is auspicious; shape dark like charcoal coal is critical.
The *Su Wen: Wu Zang Sheng Cheng Pian* (Treatise on the Generation and Formation of the Five Zang) states: Black like crow feathers indicates life, meaning black and lustrous. It also states: Black like [ochre/dull stone] indicates death, meaning black and dull/gloomy.
According to the *Su Wen: Yu Ji Zhen Zang Lun* (True Treatise on Jade Machine and True Zang Pulses): When the True Kidney Pulse arrives, it feels like fingers striking stone, crackling. The complexion is black-yellow without luster; when hair breaks, death occurs.
Cold leads to excessive saliva; dryness and vexation lead to easy depletion of fluids.
Chapter 49 of the *Nan Jing* states: The Kidney governs Fluids; entering the mouth, it becomes saliva. Zhang Shixian said: When Water is excessive, Fire is extinguished; when Fire is extinguished, Qi becomes cold. Cold Qi causes water to overflow upwards, leading to excessive saliva. When Fire is excessive, Water dries up internally, causing vexation. Vexation leads to decline of body fluids and thirst.
Ben Tun (Running Piglet) involves accumulation below the navel; ultimately, the bones become flaccid.
Chapter 56 of the *Nan Jing* states: The accumulation disease of the Kidney is named Ben Tun. It arises in the lower abdomen, extends up to below the heart, resembling a running piglet. It moves up and down unpredictably, causing panting and rebellion of Qi, bone flaccidity, and shortness of breath. It is contracted on Bing and Ding days in Summer. Why? Because Spleen disease transmits to the Kidney, and Kidney disease transmits to the Heart. The Heart is prosperous in Summer; prosperous organs do not accept pathogens. The Kidney tries to transmit the pathogen back to the Spleen, but the Spleen refuses to accept it. Thus, the pathogen remains and knots to form an accumulation. Therefore, it is known that Ben Tun is contracted on Bing and Ding days in Summer.
Excess conditions dream of waist loosening difficulties; deficiency conditions dream of walking by water drowning.
The *Su Wen: Yin Xie Fa Meng Pian* (Treatise on Pathogenic Factors Causing Dreams) states: When Kidney Qi is excessive, one dreams of waist loosening [interpretation varies, literally 'waist spring rain unties']; this does not belong to Jue Qi. When pathogenic Qi invades the Kidney, one dreams of approaching an abyss, submerged in water.
According to the *Zhong Zang Jing* (Middle Organ Classic): Kidney deficiency dreams of boat urination/submersion; people in such dreams lie in water. Excess and reality dream of approaching an abyss and throwing oneself into water.
Weighing over one jin and two liang, hanging symmetrically under the ribs.
This explanation is seen in the first section.