身重之症，时师止知燥湿，而不知补虚。《素问·示从容论》篇。历言肝虚、肾虚、脾
虚，皆令人体重烦冤，足知身重乃虚症也。宜补中益气汤加减，八味丸消息与之。正所虚则
邪易侵感，治标不治本，非法也。
《九灵山房集》云∶昔钟姓者一男子，病胁痛，众医以为痈也。设诸香、姜、桂之属益
甚。
项彦章
诊其脉告曰∶此肾邪病，法当先温利而后补之，投神保丸，下黑溲痛止。即令更服神芎丸。
若疑其太过。彦章曰∶向用神保丸，以肾邪透膜，非全蝎不能导引，然巴豆性热，非得芒硝
、
大黄荡涤
之，后遇热必再作，乃大泄数次病已。项彦章所以知男子之病，以阳脉弦，阴脉微涩，弦者
痛也
，涩者，肾邪有余也。肾邪上薄于胁不能下，且肾恶燥，热方发之，非得利不愈，经曰∶痛
随利
减，殆谓此也。房劳过度，肾虚羸怯之人，胸胁之间，每有隐隐微痛，此肾虚不能约，气虚
不能生
血之故。气与血犹水也，盛则流畅，少则壅滞。故气血不虚则不滞，既虚则鲜有不滞者。所
以作痛，宜用破故纸之类补肾，芎、归之类和血，若作寻常胁痛治，则殆矣。
当辨左右气血而施治，痛在左，肝火挟气也。痛在右，脾火挟痰食也。治从润肺柔肝，
而得捷效，乃肝移邪于肺之明证也。
身重这一病症，当时的医生只知道用燥湿的方法治疗，却不知道要补虚。《素问·示从容论》篇中，详细论述了肝虚、肾虚、脾虚，都会导致人体身体沉重且心中烦闷冤屈，由此可知身重属于虚证。适宜使用补中益气汤（具有补中益气、升阳举陷功效的方剂）进行加减化裁，并配合八味丸（即金匮肾气丸，具有温补肾阳功效的方剂）斟酌病情给予服用。正气虚弱则邪气容易侵袭感染，如果只治疗表面症状而不治根本，是不符合医道的。
《九灵山房集》记载：从前有个姓钟的男子，患胁痛病，众位医生认为是痈疽。使用了各种香燥药、干姜、肉桂等药物后，病情反而更加严重。项彦章诊察他的脉象后告诉他说：这是肾邪致病，治疗方法应当先温通利下，然后再进补。投予神保丸（具有温通攻积功效的方剂），排出黑色小便后疼痛停止。随即命令他继续服用神芎丸（具有清热泻火、通便功效的方剂）。有人怀疑这样用药太过猛烈。项彦章说：先前使用神保丸，是因为肾邪透达膜原，非全蝎不能引导药力直达病所，然而巴豆性热，如果不借助芒硝、大黄来荡涤肠胃，日后遇到热邪必定再次发作，于是通过多次大泄后病愈。项彦章之所以知道这名男子的病因，是因为其阳脉呈弦象，阴脉微涩。弦脉主痛，涩脉表示肾邪有余。肾邪上迫于胁部而不能下行，且肾脏厌恶干燥，热邪刚刚发作，必须通过通利才能痊愈。经书说：疼痛随着通利而减轻，大概说的就是这个道理。房事过度，肾虚体弱的人，胸胁之间，常常有隐隐的轻微疼痛，这是肾虚不能约束、气虚不能生血的原因。气和血就像水一样，旺盛时流畅，稀少时就会壅滞。所以气血不虚就不会壅滞，既然虚了，很少有不通畅的。因此产生疼痛，适宜使用破故纸（补骨脂）之类补肾，川芎、当归之类和血，如果当作寻常胁痛来治疗，那就危险了。应当辨别左右气血的不同而施治，疼痛在左侧，是肝火挟带气滞；疼痛在右侧，是脾火挟带痰食。治疗从润肺柔肝入手，得到了迅速的效果，这是肝将邪气转移给肺的明显证据。
The symptom of heaviness in the body, contemporary physicians only know to use methods for drying dampness, but do not know to tonify deficiency. The *Suwen · Shi Congrong Lun* chapter extensively discusses how liver deficiency, kidney deficiency, and spleen deficiency all cause heaviness in the body and mental vexation, thus proving that heaviness is a deficiency syndrome. It is appropriate to use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with modifications, and to administer Bawei Wan (Eight-Ingredient Pill) according to the patient's condition. When righteous qi is deficient, pathogenic factors easily invade; treating only the branch symptoms without addressing the root is not the correct method.
The *Jiuling Shanfang Ji* records: In the past, a man surnamed Zhong suffered from hypochondriac pain. Many physicians believed it was an abscess. They administered various aromatic drugs, dried ginger, cinnamon twig, etc., which made the condition even worse. Xiang Yanzhang examined his pulse and told him: This is a disease caused by kidney pathogenic factors. The treatment should first involve warming and promoting urination/drainage, followed by tonification. He administered Shenbao Wan (Divine Preservation Pill), after which black urine was discharged and the pain stopped. He then ordered the patient to continue taking Shenxiong Wan (Divine Xiongan Pill). Some doubted this approach was too aggressive. Xiang Yanzhang said: Previously, Shenbao Wan was used because the kidney pathogen had penetrated the membrane source; only full scorpion can guide the medicinal action. However, croton seed is hot in nature; without mangstone and rhubarb to purge the bowels, the heat would inevitably cause recurrence later. Thus, after several episodes of severe purging, the illness was cured. Xiang Yanzhang knew the cause of the man's illness because the yang pulse was wiry and the yin pulse was slightly choppy. A wiry pulse indicates pain; a choppy pulse indicates excess kidney pathogen. The kidney pathogen presses upward on the hypochondrium but cannot descend downward. Moreover, the kidney dislikes dryness; when heat just erupts, it must be relieved through purgation/urination to heal. The classics state: Pain diminishes with relief/purgation; this likely refers to this case. Due to excessive sexual activity, individuals with kidney deficiency and frailty often have faint, slight pain between the chest and hypochondrium. This is due to kidney deficiency failing to constrain and qi deficiency failing to generate blood. Qi and blood are like water: when abundant, they flow smoothly; when scarce, they stagnate. Therefore, if qi and blood are not deficient, there is no stagnation; once deficient, stagnation is rare to avoid. Hence, pain arises. It is appropriate to use herbs like Pogostemonis Herba (Bu Gu Zhi) to tonify the kidney, and Chuanxiong Rhizome and Angelicae Sinensis Radix to harmonize the blood. If treated as ordinary hypochondriac pain, it would be dangerous. One must differentiate based on left/right qi and blood to apply treatment. Pain on the left is liver fire accompanying qi stagnation. Pain on the right is spleen fire accompanied by phlegm and food retention. Treatment focused on moistening the lung and softening the liver, achieving rapid effect, which is clear evidence of liver transferring pathogen to the lung.