寒动乎中因肾虚，肾虚阳脱气难拘，须知地户宜常闭，失禁令人必丧躯。责者，责肾水
之虚
之开窍处。故知两肾，乃先天水火之窟。元气之浓薄，于此分焉；形躯之寿夭，由此判焉。
善保养者，使火不妄动，真气不损，存守于中，乾坤不息，与胃气相接，何病之有？（王胥山
曰∶真气即是肾中元阴元阳之气，相火一动，真气自泄，相火不动，则真气静存于内，生化
无穷，尽根于此。）不善养者，劳欲过度，真气漏泄，相火横行，邪气无制，于是百病生焉
。又肾虚则寒起，若真阳脱而作泻者，是门户不禁也。脉存者生，脉脱者死。药宜峻补于下
，迟则不能斡旋矣。经云∶热之不热，是无火也。食入反出，是亦无火也，并温也。温之不
愈，其死速矣。（一作“温而不愈者有之，未有不温而能愈者也。”）
久而增气理悠长，缓治中和物化常，脾胃相通辨谷气，药如偏胜不为良。经云∶久而增
气，物化之常，气增之久，夭之由也。此言药之气味，治之缓急，出乎医之调燮也。盖胃中清纯
委和之气，偏与谷肉果菜相宜，即参术亦有偏胜。此先哲之格言，自当视其病之缓急而治亦
如之。夫病有新久，新则势急，宜治以重剂，久则势缓，宜调以轻剂。一切内外伤，邪气已
退，药宜间服，当以饮食调之，于中有缓急之意存焉。若服药过度，反伤其气，病益绵延不
愈，或者反致增添新病。医须识此，庶无虚虚之害矣。（张东扶曰∶此条乃治病最要之法，
寒邪内生是由于肾虚，肾气虚则阳气外脱，元气难以固摄。必须知道肾之阴窍（地户）应当经常闭合，若出现失禁症状，人必将丧命。“责”字，意为责备肾水之虚弱及其开窍之处失控。因此要明白，两肾是先天水火交汇的窟穴。元气的浓厚或薄弱，由此区分；形体的长寿或夭折，由此判定。善于保养的人，使相火不妄动，真气不受损，将其存守于体内，使生命活动不息，并与胃气相接，会有什么疾病呢？（王胥山说：真气就是肾中的元阴和元阳之气，相火一旦发动，真气就会泄漏；相火不动，则真气静存于内，生化无穷，生命的根本就在这里。）不善于保养的人，因劳累和房事过度，导致真气泄漏，相火横行，邪气无法制约，于是百病丛生。另外，肾虚则寒气内生，如果是真阳外脱而导致的腹泻，这是门户不能禁固的表现。脉象尚存者生，脉象消失者死。用药应当在下焦进行峻补，如果迟缓就不能挽回局面了。医经说：用热药治疗却不发热，是无火的表现。食物吃进去反而吐出来，也是无火的表现，都应当温补。如果温补后仍不痊愈，死亡就会很快到来。（另一种说法是：“有温补而不愈的情况，但没有不温补就能痊愈的。”）
时间久了会增加某种气机，这是事物变化的常理，缓慢治疗以达中和，是万物化生的常态。脾胃相通，需辨别谷气，药物如果有偏胜之性就不算是好药。医经说：时间久了会增加气机，这是事物变化的常理；气机增加久了，就是短命的缘由。这是指药物的气味和治疗缓急，取决于医生的调理燮理。大概胃中清纯温和之气，与谷物、肉类、水果、蔬菜相适应，即使是人参、白术也有偏胜之性。这是先哲的格言，当然应当根据病情的缓急来治疗，也是如此。疾病有新发和久病之分，新病则病势急迫，宜用重剂治疗；久病则病势缓和，宜用轻剂调理。一切内外伤，当邪气已退时，药物宜间隔服用，应当以饮食来调养，其中蕴含着缓急之意。如果服药过度，反而损伤正气，病情会更加拖延不愈，或者反而导致增添新的疾病。医生必须认识这一点，才不会有“虚其虚”（使虚者更虚）的危害。（张东扶说：这一条是治病最重要的法则，）
Cold arises internally due to Kidney Deficiency (Shen Xu); when Kidney Qi is deficient, Yang escapes, and Yuan Qi (Primal Qi) becomes difficult to restrain. One must know that the "Earth Door" (Yin orifice of the Kidney, referring to the lower orifices such as the urethra and anus) should remain closed frequently; incontinence leads inevitably to death. The term "Ze" (Reproach/Blame) refers to blaming the deficiency of Kidney Water and the dysfunction of its orifices. Thus, it is understood that the two Kidneys are the caverns of innate Fire and Water. The thickness or thinness of Yuan Qi is distinguished here; the longevity or premature death of the physical body is judged by this. Those who are good at preservation ensure that Ministerial Fire (Xiang Huo) does not move recklessly, Yuan Qi is not damaged, and is preserved within, allowing the dynamics of Heaven and Earth to ceaseless, connecting with Stomach Qi—what illness would there be? (Wang Xushan said: True Qi is precisely the Primal Yin and Primal Yang Qi within the Kidney. When Ministerial Fire moves, True Qi leaks; when Ministerial Fire remains still, True Qi rests quietly within, generating endless transformations; the root of life lies here.) Those who are not good at preservation suffer from excessive labor and sexual indulgence, causing Yuan Qi to leak, Ministerial Fire to run rampant, pathogenic factors to go unchecked, and thus hundreds of diseases arise. Furthermore, when Kidney Deficiency occurs, cold arises internally. If diarrhea results from the escape of True Yang, this indicates the failure of the gates to hold. If the pulse remains, there is life; if the pulse vanishes, there is death. Medication should employ severe tonification at the Lower Jiao (Lower Burner); delay will make it impossible to rescue the situation. The Classics state: "If heat therapy fails to produce warmth, it is because there is no Fire." "If food is ingested but vomited back up, it is also because there is no Fire"; both cases require warming. If warming fails to cure, death will come swiftly. (Another version states: "There are cases where warming fails to cure, but there are none that can cure without warming.")
Prolonged use increases Qi, which is a long-standing principle; slow treatment achieves harmony, which is the constant of transformation. The Spleen and Stomach are connected; one must distinguish Grain Qi. If medicine has an excessive bias, it is not considered good. The Classics state: "Prolonged use increases Qi, which is the norm of transformation; prolonged increase of Qi is the cause of premature death." This refers to the flavors and properties of medicines and the urgency or slowness of treatment, depending on the physician's regulation and adjustment. Generally, the pure, clear, and harmonious Qi in the Stomach is compatible with grains, meats, fruits, and vegetables; even herbs like Ginseng (Renshen) and Atractylodes Macrocephala Baizhu have biased properties. This is a maxim of the sages; one ought to treat according to the urgency or slowness of the disease accordingly. Diseases have new and old stages. New diseases have urgent patterns and should be treated with heavy doses; old diseases have mild patterns and should be regulated with light doses. For all internal and external injuries, once pathogenic factors have retreated, medication should be taken intermittently, and nourishment should be adjusted through diet, embodying the intent of slowness and urgency. If medication is overused, it damages Qi instead, causing the illness to linger and not heal, or potentially leading to new diseases. Physicians must understand this, so as to avoid the harm of "making the deficient more deficient." (Zhang Dongfu said: This clause is the most important method for treating diseases,)