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Knowledge on Traditional Chinese Medicine

1. What is TCM's perspective of the location and configuration of kidneys?
  With regard to the location and configuration of kidneys, the understandings in TCM are very limited, but basically in accord with what have been described in anatomy of Western Medicine. TCM holds that kidneys are located in the waist, one on either side of the spinal column.

2. What is TCM's perspective of the physiological function of kidneys? How does TCM use it in practice?
  With regard to the physiological function of kidneys, the understandings in TCM are quite different from those in Western Medicine, in which the reproductive, urinary, endocrine and nervous system are involved. The exposition of kidneys in TCM are as follows:-

① The kidneys storing the essence

Basic Theory Part One:
This function means that the kidneys can store and protect the essence.
As far as its sources is concerned, the essence stored in the kidneys falls into two kinds. Firstly,the congenital essence is inherited from parents before birth. It is the original substance for the development of human body. As its function of reproducing offspring,it is also known as reproductive essence. Secondly, the acquired essence is nutrients which are obtained from foodstuffs by our body after birth. As its derivation from foodstuffs, the acquired essence is also known as food essence.

The essence stored in the kidneys is the kidney-essence. The essence stored in the kidney can be transformed into Qi, which is named as the kidney-Qi. The kidney-essence and the kidney-Qi are the same substance in nature. But the former is material,and the latter is immaterial. Both of them continuously transform into each other. The kidney-essence disperses and transforms into the kidney-Qi, while the kidney-Qi congregates and transforms into the kidney-essence. Anyway, the relationship between the kidney-essence and kidney-Qi is just like that between water and vapor. They are the same substance, but exit in the different form. The function of the kidneys is storing and protecting the kidney-essence. This function is carried out by the kidney-Qi.

Tips:

Meaning of TCM’s terminology, such as Congenital Essense, Reproductive Essence, Acquired Essence, Food Essence, Kidney-Essence, Kidney-Qi.
The close relationship between kidney-essence and kidney-Qi.

Practical Application:

If the kidney-Qi is insufficient, this functiong of kidneys will be decreased. The symptoms such as spermatorrhea, premature ejaculation, clear and plentiful vaginal discharge, enuresis, incontinence of urine will occur. This condition is called “Instability of Kidney-Qi” in TCM. Its therapeutic method is invigorating kidney for stabilization.

Basic Theory Part Two:

However, as to the physiological function of the kidney the more important thing is that the essence stored in the kidneys can be transformed into Qi. This Qi, also called the kidney-Qi distributes all over the body through Sanjiao (Triple Energizer). By means of the kidney-Qi, the kidney can promote the growth, development and reproduction of the body, and regulate the metabolism and physiological activities of the whole body.
Firstly, the kidneys can promote the growth, development and reproduction of the body. With the kidney-essence gradually becoming abundant from childhood to puberty, the human body gradually grow and develop,and have the reproductive ability. With the kidney-essence gradually declining from middle age to old age, the human body gradually become aged, and lose the reproductive ability.

Secondly, the kidneys can regulate the metabolism and physiological activities of the whole body. The kidney-essence belongs to Yin and the kidney-Qi belongs to Yang. Meanwhile, the primary substance that is the part of congenital essence stored in the kidneys belongs to Yin and the primary motivity that is also the part of congenital essence stored in the kidneys belongs to Yang. The primary substance is also called Yuan Yin (Primordial Yin) and the primary motivity is also called Yuan Yang(Primordial Yang) in TCM. Therefore, the kidney-Yin includes the kidney-essence and Yuan Yin (Primordial Yin), and the kidney-Yang includes the kidney-Qi and Yuan Yang(Primordial Yang). The kidney-Yin that is served as the source of Yin-fluid in human body can moisten and nourish the viscera, organs and tissues. The kidney-Yang that is served as the source of Yang-Qi in human body can warm and promote the viscera, organs and tissues. In order to emphasize their importance, the kidney-Yin is also called the Zhen Yin (Genuine Yin) or Zhen Shui (Genuine Water), and the kidney-Yang is also called the Zhen Yang(Genuine Yang) or Zhen Huo (Genuine Fire). In normal condition,the balance between kidney-Yin and kidney-Yang is made to maintain the physiological activities in human body. If any of them become relatively predominant or declined, the balance between kidney-Yin and kidney-Yang will be damaged, which will lead to diseases. Meanwhile, as the kidney-Yin and kidney-Yang are the roots of Yin and Yang of other viscera, the predominance or declination of kidney-Yin or kidney-Yang will influence the status of Yin or Yang of other viscera, and vice versa.

Tips:
The functions of kidney-Qi mainly fall into two aspects: promoting the growth,development and reproduction of the body, and regulating the metabolism and physiological activities of the whole body.
Meaning of TCM’s terminology, such as Yuan Yin (Primordial Yin), Yuan Yang (Primordial Yang), kidney-Yin, kidney-Yang, Zhen Yin (Genuine Yin), Zhen Shui (Genuine Water), Zhen Yang (Genuine Yang), Zhen Huo (Genuine Fire).
The balance between kidney-Yin and kidney-Yang must be maintained. The kidney-Yin, kidney-Yang and the Yin, Yang of other viscera complement each other.

Practical Application:

With regard to promoting the growth, development and reproduction of the body, if the kidney-essence is insufficient, the growing and developmental retardation in the childhood, the delayed sexual maturity in the youth, the declined sexual function or premature senility in the middle-aged will occur. Its therapeutic method is invigorating kidney and replenishing the essence.
The balance between kidney-Yin and kidney-Yang must be maintained. When the kidney-Yin is insufficient, the symptoms such as dysphoria with feverish sensation in chest, palms and soles, hectic fever, night sweat, forgetfulness, insomnia, dry mouth and throat, emaciation, uterine bleeding (metrorrhagia and metrostaxis), amenorrhea, or spermatorrhea, premature ejaculation will occur. Its therapeutic method is invigorating kidney and nourishing the kidney-Yin. When the kidney-Yang is insufficient, the symptoms such as mental and physical exhaustion, pale complexion, cold trunk and limbs, sore and cold waist and knees, infertility due to cold womb, or impotency, premature ejaculation will occur. Its therapeutic method is invigorating kidney and warming the kidney-Yang.

It is said in TCM that “the prolonged diseases involve the kidneys”, which means that insufficient Yin or Yang of other viscera can eventually lead to the kidney-Yin or kidney-Yang deficient.


② The kidneys governing the water metabolism

Basic Theory:

This function means that the kidneys can control and regulate the water metabolism.
When taken into the stomach,the water is transmitted up to the lungs by means of transportation and transformation of the spleen. Then it is distributed all over the body through the Sanjiao (Triple Energizer) by means of dispersing and descending function of the lungs. The water will converge at the kidneys after being used by all tissues and organs of the body. With the function of kidney-Yang, the useful part of the water will be steamed and transformed, and be elevated to the lungs again to be distributed all over the body. The useless part of the water will be transformed into urine, and be decended to the urinary bladder to be excreted out of the body.

Tips:

The kidneys governing the water metabolism depends on the sufficient kidney-Yang in the body.

Practical Application:

If the kidney-Yang is insufficient, its steaming and transforming function will be incapable. The urine will become clear and abundant as lots of useful part of water is decended to the urinary bladder and excreted out of the body accompanying with useless part. Therefore, the clear and abundant urination is one of the key manifestations for deficiency of the kidey-Yang.
In addition, when we are getting older and older, the kidney-Yang in our body will become declined gradually as essence and Qi in the kidneys are on the wane. So we often have the experience of clear and abundant urination, especially at night.



③ The kidneys governing the reception of Qi

Basic Theory:

This function means that the kidneys can assist the lungs to govern respiration and keep the respiration into a certain depth.
The lungs govern the respiration. The respiratory activity is controlled by the lungs, in which the exhalation depends on the dispersing function of lungs and inhalation the descending function of lungs. However, only assisting by the kidneys, can the inhalation of lungs be completed properly. This means that the fresh air inhaled by the lungs from the natural world has to be descended into the kidneys so as to keep the respiration into a certain depth and ensure free and smooth respiration. Subsequently, the need of various visera and tissues for fresh air can be met. So there is a close relationship between the function of the lungs to govern the respiration and the function of the kidneys to govern the reception of Qi. The former is prerequisite to the latter and the latter is the basic condition of the former. Normal respiration in human body is accomplished by coordinative action of both lungs and kidneys.

The function of the kidneys governing the reception of Qi depends on the kidney-Qi. Only when the kidney-Qi is abundant, can the function of the kidneys governing the receiption of Qi be normal. Subsequently, the respiratory activity will be even, and the air passage will be clear.

Tips:

Normal respiration in human body is accomplished by coordinative action of both lungs and kidneys.
The function of the kidneys governing the reception of Qi depends on the kidney-Qi.

Practical Application:

If the kidney-Qi is deficient, the function of the kidneys governing the reception of Qi becomes declined, in which the respiration of lungs can not be kept into a certain depth. The symptoms such as shallow breath, more exhalation and less inhalation, shortness of breath, liability to dyspea on slight exertion will occur, which is called “the failure of the kidneys in reception of Qi” in TCM.

In clinical practice, we not only regulate the function of lungs, but also kidneys in treating the respiratory diseases to get better effect. For example, based on the theory of “kidneys governing the reception of Qi”, we adopt the therapeutic method of “regulating the lungs in attack and regulating the kidneys in alleviation” to treat the chronic bronchitis.The effectiveness is improved dramatically.



④ The kidneys governing the bones

Basic Theory:

This function means that the kidneys can promote the growth and development of the bones
The kidneys store the essence.The essence can be transformed into the bone marrow to nourish the bones, promote their growth and development and strengthen them.

Tips:

The kidney-essence can be transformed into the bone marrow to nourish the bones.

Practical Application:

If the kidney-essence is insufficient, the bone marrow will also be deficient in turn, which will lead to the malnutrition of bones. The symptoms such as flaccidity of the skeleton and deleyed closure of fontanel in childhood, brittleness of bones and susceptibility to fracture in the old-aged will occur.
In clinical practice, medicines with the effect of tonifying kidneys can accelerate the healing process of fracture.



⑤ The kidneys opening into the ears,the external genitals and the anus

Basic Theory:

The kidneys store the essence, which can be transformed into marrow. The ears are connected with the cerebral marrow. Therefore, whether the ears function properly depends on the state of kidney-essence. When the kidney-essence is sufficient,the cerebral marrow will also be sufficient in turn. So the ears will be well-nourished, and the sense of hearing will be sensitive.

Two Yin refer to the anterior Yin and the posterior Yin. The former includes the urethra and the external genitals. The latter is the anus.
With regard to the kidneys opening into the anterior Yin, we can understand it from the functions of the kidneys governing the reproduction and water metabolism. The kidneys govern the reproduction. When the kidney-essence is abundant,the sexual ability in human body become mature and the reproductive ability are equipped. The kidneys govern the water metabolism. The excretion of urine must depend on the functions of kidney-Qi and kidney-Yang.

With regard to the kidneys opening into the posterior Yin, we can understand it from the functions of the kidney-Yin and kidney-Yang. The kidney-Yang can absorb water by warming and transforming it so as to promote the formation of faeces. The kidney-Yin can moisten the intestines so as to smooth defecation.

Tips:

The function of ears has a close relationship with the kidney-essence.
The kidneys open into the external genital,because the kidneys have a close relationship with the functions of reproduction and urination.
The kidneys open into the anus, because the kidneys have a close relationship with the function of defecation.

Practical Application:

With regard to the kidneys opening into the ears, if the kidney-essence is insufficient, the cerebral marrow will also be deficient in turn. The ears will not be nourished sufficiently, which can lead to weakness in hearing, tinnitus or deafness. In addition, the reason that the old people tend to be poor in hearing lies in the fact that the kidney-essence declines naturally when people are growing old.

With regard to the kidneys opening into the external genital, if the kidney-essence is insufficient, genital dysplasia and congenital infertility in the youth, sexual dysfunction and impotence in the middle-aged will occur. If the kidney-Qi is insufficient, its stabilizing ability will become weak. The symptoms such as spermatorrhea, premature ejaculation or enuresis in the childhood, incontinence of urine in the old-aged will occur. If the kidney-Yang is insufficient, its warming and transforming ability will become weak. The symptoms such as clear abundant urine will occur. If the kidney-Yang is insufficient, its ability to promote the distribution and discharge of water will become weak. The symptoms such as oliguria, edema will occur.
With regard to the  kidneys opening into the anus, if the kidney-Yang is insufficient, the insufficiency of spleen-Yang will be made subsequently. As disorder in transportation and transformation of spleen, diarrhea will occur. If the kidney-Yin is insufficient, the dryness of intestines will be made subsequently. The constipation will occur.


⑥ The external manifestation of the kidneys being on the hair

Basic Theory:

The hair depends on blood to nourish, which is called that “the hair is the extension of blood”. The kidneys store the essence, which can be transformed into blood. When the essence and blood are abundant, the hair will be well-nourished. Therefore, the state of hair is closely related to the kidney-essence.

Tips:

The hair depends on blood to nourish, which is transformed from the kidney-essence.

Practical Application:

If the kidney-essence is insufficient and blood is deficient, the hair will not be nourished sufficiently. The hair will appear thin, dry, grey and be easy to lose.