KIDNEY 9

Moisten the kidney (tonify kidney yin) (zi yin; bu shen yin): rehmannia (dihuang), tortoise shell (guiban), asparagus root (tianmendong), lycium fruit (gouqizi), morus fruit (sangshenzi), ligustrum (nuzhenzi).

Warm the kidney (strengthen yang; tonify the vital flame of life) (wen shen; zhuang yang; bu ming huo): aconite (fuzi), cinnamon bark (rougui), sulphur (liuhuang), morinda (bajitian), deer antler (lurong), cnidium fruit (shechuangzi), cistanche (roucongrong).

Complement jing and tonify the marrow (tian jing bu sui): animal bone marrow (dongwu jisui), animal brain (naosui), placenta (ziheche), deer antler (lurong), antler gelatin (lujiaojiao), tortoise plaster gelatin (guijiao), cordyceps (dongchong xiacao).

Restore the storing action of the kidney (astringe jing; stop vaginal discharge; curb frequent and profuse urination) (gu shen; se jing; zhi dai; shou se xiao bian): schizandra (wuweizi), cornus (shanzhuyu), alpinia (yizhiren), rubia (fupenzi), mantis egg case (sangpiaoxiao), rose hips (jinyingzi).

Restore the kidney's function of grasping and retaining qi (na qi gui shen): schizandra (wuweizi), psoralea (buguzhi), gecko (gejie), cornus (shanzhuyu), aquilaria (chenxiang).

Aid the transformation of bladder qi (hua pangguang qi): cinnamon twig (guizhi) and hoelen (fuling), cinnamon bark (rougui), lindera (wuyao), fennel (xiao huixiang), saussurea (muxiang), citrus seed (juhe), litchi seed (lizhihe).

Open and disinhibit the water passages of the bladder and the triple burner (tongli pangguang, sanjiao): alisma (zexie), hoelen (fuling), polyporus (zhuling), talc (huashi), akebia (mutong), tetrapanax (tongcao), tokoro (pixie), polygonum (bianxu), lygodium (haijinsha).

Clear kidney heat (moisten yin and descend deficiency fire) (qing shen re; zi yin jiang huo): anemarrhena (zhimu), phellodendron (huangbai), morus bark (digupi), eclipta (hanliancao).

Discharge kidney fire (purge fire with salty and cold materials) (xie shen huo; xian han xie huo): salt (qingyan), halite (qingyan), urine (tongbian), calcitum (hanshuishi).

Since the kidney is the representative lower burner organ, it generally needs to be addressed with high amounts of heavy and sticky substances. The 18th century fever school authority Wu Jutong once described this characteristic in graphic terms: "Lower burner therapy is like a weight-if it is not heavy enough, it does not reach the bottom."

Kidney disorders are generally of a cold and deficient nature. Kidney therapy, therefore, needs to focus primarily on the tonification of deficiency; purging of excess is a definite taboo. If kidney water is deficient, the kidney needs to be tonified by moistening yin. If kidney jing is deficient, it needs to be replenished by supplementing jing and tonifying the bone marrow. If kidney yang is deficient, the kidney needs to be tonified by using modalities that strengthen yang. In the more advanced scenario of mingmen fire exhaustion, materials that warm and tonify the vital flame of life need to be employed.

Since the kidney has both yin and yang aspects, pathological situations may arise from an imbalance in the ratio of kidney yin and kidney yang. The most typical example is the upflaring of deficiency fire due to a deficiency in kidney water, which calls for a descending action that re-anchors the floating fire in the yin waters of the kidney. This is primarily achieved by the use of yin tonics which will bring the diminished yin level back to full capacity and thus naturally extinguish the deficiency type of pathological heat. If yang deficiency has begun to implicate yin, both jing and marrow should be supplemented and the vital flame of life be warmed and tonified. If both kidney yin and yang are deficient, both the various aspects of the kidney and the vital flame of life should be tonified. 

In the common scenario of spleen and kidney deficiency, both spleen and kidney yang need to be tonified. In case of lung and kidney deficiency, both lung and kidney yin need to be moistened. In chronic asthma patients where kidney deficiency results in an inability of the kidney to grasp the descending qi from the lung, the kidney needs to be warmed with substances that specifically assist with the action of grasping and retaining qi, such as gecko (gejie) and schizandra (wuweizi). If lung metal fails to properly generate kidney water, kidney yin needs to be moistened indirectly by nourishing the yin of its mother system, the lung. If kidney water fails to nourish its son, liver wood, the liver needs to be supported by moistening kidney yin and/or kidney jing. In the case that kidney deficiency has caused an exhaustion of the earth network, the lower burner's vital flame of life needs to be rekindled with warming substances in order to provide the transformative forces of the middle burner above with the activating heat they require.

If the extended water network (including the kidney, the bladder, and the triple burner) is compromised by a damp heat condition, the dampness should be disinhibited with materials of a cooling nature that have a specific affinity to the lower burner, such as alisma (zexie), polyporus (zhuling), and talc (huashi). If the transformative powers of the bladder and the triple burner fail due to an exhaustion of the kidney's vital flame of life, then this type of pathological water accumulation needs to be transformed by primarily warming kidney qi, and secondarily by adding several herbs that directly move out the pathological water. If phlegm, dampness, or water rheum stagnate internally, phlegm damp needs to be disinhibited, and water rheum driven out.

If the kidney has been damaged due to chronic illness, exaggerated emotions, or excessive sexual activity, a change of the situation or life style that has originally caused the condition is imperative. Simultaneously, the recovery of the kidney system can be supported by prescribing a selection of tonic agents that moisten yin, strengthen yang, or nourish jing and marrow.

As the water network, the kidney has an aversion to dry influences. It would be particularly detrimental to exclusively employ bitter and drying substances in a situation where the kidney yin is deficient. Perhaps unexpectedly, the Neijing recommends pungent flavors to counteract dryness in the kidney; these pungent flavors aid the lung in distributing moisture to the kidney. In clinical reality, herbs like cuscuta (tusizi) and cnidium fruit (shechuangzi) fit this category. The kidney strives for a state of guarded firmness and tight solidity. If the storage fortress of the kidney is properly buttressed, precious essence will not leak out. Many bitter materials, although they should be used cautiously for the reasons just mentioned, have a stabilizing affect on kidney yin. Anemarrhena (zhimu), an herb that is both bitter and moistening, and phellodendron (huangbai) are the prime substances used in situations of continuous jing leakage, particularly lower burner deficiency fire fueling obsessive sexual urges, excessive masturbation, recurrent sexual dreams, spermatorrhea, or certain types of leukorrhea. 

Salty flavors have a direct affinity to the kidney network, and are generally beneficial when used in moderation. "Salty flavors generate the kidney," comments the Neijing. Increased dietary intake of salt, usually obtained from stored foods with salt as the preserving element, taken during the water season (winter) contributes to preserving the kidney against the cold. On the other hand, salt has a percolating and leakage-promoting affect that is overall unsuitable for an organ system that is in charge of storing and metabolizing physiological jing, humors, and fluids. Therefore, excessive consumption of salty foods is discouraged, as it will harm the kidney and its affiliated body layer. "If the disease is in the bone layer," the Neijing points out elsewhere, "do not eat salty foods." 

If the kidney root is damaged, many of the body's stem and branch organs have already entered a pathological state first. If kidney yin-that is the base substance from which liver yin, stomach yin, heart yin, lung yin, and the body's humors and fluids are formed-is deficient, it usually means that the condition is preceded by a yin deficiency in other organs. Similarly, the essential flame of the lower burner only flickers after the light in the upper levels has grown dim. This situation has given rise to a school of medicine that favors kidney tonification in most deficiency situations. Tonifying kidney yin and kidney yang, proponents have argued since the 13th century, means to moisten and strengthen the body's source yin/yang and thereby the yin/yang of all organ networks. However, the root status of the kidney also implies that kidney deficiency is often accompanied by inadequate spleen/stomach function. This poses a problem in light of the fact that herbal kidney therapy requires heavy amounts of sticky substances that are generally hard to digest. One attempt to remedy this situation was the addition of herbal "digestive aids" to kidney formulas such as Rehmannia Six Formula (Liuwei Dihuang Wan). Pharmacists at the renowned Beijing herb emporium Tongren Tang, for instance, used to automatically add small amounts of the aromatic cardamon (sharen) if the patient's prescription called for large amounts of the greasy kidney tonic rehmannia (dihuang). Proponents of the spleen/stomach school, on the other hand, have argued that kidney deficiency is often the result of a deficiency of its controlling network, namely spleen earth. Spleen tonification advocates have said for more than half a millennium that this should be the primary modality to regenerate the kidney system. In any case, caution needs to be exercised regarding the prescription of heavy "water" substances to patients who show signs of digestive weakness, such as poor appetite, bloating, and tendency to experience diarrhea or loose stool. A safe method for the direct tonification of lower burner source qi has been developed by the ancestors of Chinese medicine, namely Daoist practitioners of "inner alchemy." The term inner alchemy refers to Qigong exercises of the quiet, meditative kind that focus on generating warmth and fullness in the lower dantian.