肾象水。旺于冬。其脉如石而沉。其候耳。其声呻。其臭腐。其味咸。其液唾。其养骨
其
色黑。其神志。足少阴其经也。与膀胱合。膀胱为腑主表。肾为脏主里。肾气盛。为志有余
则病腹胀飧泄。体肿喘咳。汗出憎风。面目黑。小便黄。是肾气之实也。则宜泻之。肾气
不足。则厥。腰背冷。胸内痛。耳鸣苦聋。是为肾气之虚也。则宜补之。肾病者腹大体肿喘
咳
汗出憎风。虚则胸中痛。于四时病在肾愈在春。春不愈。甚于长夏。长夏不死。持于秋。
起于冬。于日愈于甲乙。甲乙不愈。甚于戊己。戊己不死。持于庚辛。起于壬癸。无犯尘垢
无衣炙衣。于时夜半慧。日中甚。下晡静。肾欲坚。急食苦以坚之。咸以泄之。苦以补
之。
肾部在左手关后尺中是也。肾脉来。如引葛。按之益坚。曰肾病。肾属水。其脉大紧。
身无
痛。形不瘦。不能食。善惊悸。以心萎者死。冬肾水旺。其脉沉濡而滑。名曰平脉也。反得
浮大而缓者。是脾之乘肾。土之克水。为大逆不治。反得浮涩而短者。是肺乘肾。母之归子
为虚邪。虽病可治。反得弦细而长者。是肝之乘肾。子之乘母。为实邪。虽病自愈。反得
浮大而洪者。是心之乘肾。火之凌水。虽病不死。死肾脉来。发如夺索。辟辟如弹石。曰肾
死。冬胃微石曰平。胃少石多曰肾病。但石无胃气死。石而有钩曰夏病。钩甚曰今病。藏真
下于肾藏骨髓之气。真肾脉至。搏而绝。如弹石。辟辟然。其色黄黑不泽。毛折乃死。
诸真脏脉见者。皆不治。
肾脏的象类同于水。在冬季最为旺盛。其脉象像石头一样沉潜。其外在征候反映在耳朵。其声音表现为呻吟。其气味为腐臭。其味道对应咸味。其体液为唾液。其滋养骨骼。其颜色为黑色。其神志由肾所主。足少阴肾经是其经脉，与膀胱相表里配合。膀胱作为腑属阳主表，肾脏作为脏属阴主里。
如果肾气过盛，导致志气有余，就会发生腹胀、完谷不化的泄泻（飧泄）、身体浮肿、气喘咳嗽、出汗且怕风、面色发黑、小便黄赤等症状，这是肾气实证的表现，治疗应当采用泻法。
如果肾气不足，就会出现四肢厥冷、腰背寒冷、胸中疼痛、耳鸣且听力痛苦下降，这是肾气虚证的表现，治疗应当采用补法。
患有肾病的人，腹部胀大、身体浮肿、气喘咳嗽、出汗且怕风；如果是虚证，则表现为胸中疼痛。肾病在四季中的变化规律是：痊愈多在春季；若春季不愈，病情会在长夏加重；若长夏不死，病情在秋季维持稳定；到了冬季开始好转。在一日之中的变化规律是：痊愈多在甲乙日（东方木日）；若甲乙日不愈，病情会在戊己日（中央土日）加重；若戊己日不死，病情在庚辛日（西方金日）维持稳定；到了壬癸日（北方水日）开始好转。患病期间不要沾染尘土污垢，也不要穿刚晒热的衣服。在一天之中，半夜时精神清爽，中午时症状加重，傍晚时分安静平稳。
肾的特性喜坚固，急需食用苦味食物来使其坚固，食用咸味食物来使其泄降，食用苦味食物来补益它。（注：此处原文逻辑似有矛盾或特定语境，通常“肾欲坚”急食苦以坚之，“肾苦燥”急食辛以润之，“肾欲闭”急食酸以收之。但依原文直译：用苦味药坚之，咸味药泄之，苦味药补之。）
肾的脉诊部位在左手关后尺部。肾脉来时，像牵引葛藤一样连绵不断，按压后感觉更加坚实，这称为肾病。肾属水，若脉象大而紧，身体没有疼痛，形体也不消瘦，但不能进食，容易惊悸，若兼见心气萎弱则预后不良致死。冬季肾水旺盛，脉象沉濡而滑，这叫做平脉（正常脉象）。
如果反而得到浮大而缓的脉象，这是脾土乘袭肾水，属于土克水的逆证，为大逆之症，难以治愈。如果反而得到浮涩而短的脉象，这是肺金乘袭肾水，母病及子，属于虚邪，虽然生病但可以治愈。如果反而得到弦细而长的脉象，这是肝木乘袭肾水，子病犯母，属于实邪，虽然生病也会自愈。如果反而得到浮大而洪的脉象，这是心火乘袭肾水，火凌水，虽然生病也不会死亡。
死肾的脉象，来时如同争夺绳索般紧绷杂乱，或者像弹击石头一样辟辟作响，这称为肾死。冬季脉象微带石意（沉实）而有胃气，称为平脉；胃气少而石气多，称为肾病；只有石气而无胃气，则主死亡。石脉中带有钩脉（夏季脉象），表示夏季会发病；钩脉明显，表示现在就会发病。脏腑的真气下行藏于肾和骨髓之气中。真肾脉出现时，搏动强劲而断绝，像弹击石头一样辟辟然作响，面色黄黑无光泽，毛发枯折，此时病人将死亡。凡是五脏的真脏脉出现的，都属于不治之症。
The Kidney corresponds to Water. It is most prosperous in Winter. Its pulse is like a stone, deep and sunken. Its sensory orifice is the ear. Its vocalization is groaning. Its odor is putrid. Its taste is salty. Its fluid is saliva. It nourishes the bones. Its color is black. Its spirit is governed by it. The Foot-Shaoyin Kidney Meridian is its channel, which combines with the Bladder. The Bladder, as a Fu-organ, governs the exterior; the Kidney, as a Zang-organ, governs the interior.
If Kidney Qi is excessive, leading to an excess of Will (Zhi), diseases such as abdominal distension, undigested food diarrhea (Sun-xie), bodily edema, asthma and coughing, sweating with aversion to wind, dark complexion, and yellow urine will occur. This is an Excess pattern of Kidney Qi, and treatment should employ draining methods.
If Kidney Qi is insufficient, there will be cold extremities (Jue), coldness of the waist and back, pain inside the chest, tinnitus with painful deafness. This is a Deficiency pattern of Kidney Qi, and treatment should employ tonifying methods.
Patients with Kidney disease present with abdominal enlargement, bodily edema, asthma and coughing, sweating with aversion to wind. If it is a Deficiency pattern, there is pain in the chest. Regarding seasonal prognosis: recovery occurs in Spring; if not recovered in Spring, the condition worsens in Late Summer; if not fatal in Late Summer, it stabilizes in Autumn; improvement begins in Winter. Regarding daily prognosis: recovery occurs on Jia-Yi days; if not recovered on Jia-Yi days, the condition worsens on Wu-Ji days; if not fatal on Wu-Ji days, it stabilizes on Geng-Xin days; improvement begins on Ren-Gui days. Avoid dust and dirt; do not wear clothes that have been heated by fire/sun. In a day, the patient feels clear-headed at midnight, symptoms worsen at noon, and become quiet in the late afternoon.
The Kidney desires firmness; urgently consume Bitter substances to firm it, Salty substances to drain it, and Bitter substances to tonify it. (Note: Textual logic varies, but translated literally).
The Kidney pulse region is located at the Chi position behind the Guan position on the left hand. When the Kidney pulse arrives, it feels like pulling a vine, and pressing it makes it feel even more firm; this is called Kidney disease. The Kidney belongs to Water. If the pulse is large and tight, the body has no pain, the form is not emaciated, but the patient cannot eat and is prone to palpitations and fright; if accompanied by heart atrophy, death ensues. In Winter, when Kidney Water is prosperous, the pulse is deep, soft, and slippery; this is called a Normal Pulse (Ping Mai).
If instead a floating, large, and slow pulse is obtained, this is Spleen Earth overacting on Kidney Water, representing Earth overcoming Water, which is a Major Reversal (Da Ni) and untreatable. If instead a floating, choppy, and short pulse is obtained, this is Lung Metal overacting on Kidney Water; Mother returning to Son constitutes a False Pathogen (Xu Xie); although ill, it is treatable. If instead a wiry, thin, and long pulse is obtained, this is Liver Wood overacting on Kidney Water; Son overacting on Mother constitutes an Excess Pathogen (Shi Xie); although ill, it will heal spontaneously. If instead a floating, large, and surging pulse is obtained, this is Heart Fire overacting on Kidney Water; Fire suppressing Water; although ill, death will not occur.
The pulse of a dying Kidney arrives like ropes being pulled in contention, or crackling like stones being struck; this is called Kidney Death. In Winter, a pulse slightly resembling Stone (deep/firm) indicates health; less Stomach Qi and more Stone Qi indicates Kidney disease; only Stone Qi without Stomach Qi indicates death. A Stone pulse containing Hook (Summer pulse) indicates disease in Summer; prominent Hook indicates disease now. The True Essence descends to the Kidneys and Marrow. When the True Kidney pulse appears, it beats strongly and abruptly, crackling like stones; the complexion is yellow-black and lusterless, hair breaks, and death follows. Whenever any of the Five True Zang pulses appear, the condition is untreatable.