5. Kidney Disease Differentiation

5. Kidney Disease Differentiation

Dizziness, tinnitus, lower back pain, leg fatigue, and a weak pulse at the cun position are the basic symptom complex of kidney deficiency. If accompanied by bone-steaming heat, tidal fever, vexation in the five hearts, and night sweats, it is Kidney Yin Deficiency; if accompanied by cold intolerance and spontaneous sweating, it is Kidney Yang Deficiency. For Kidney Yin Deficiency, nourish Yin and supplement the kidneys using the Liuwei Dihuang Tang (Qian Zhongyang); Kidney Yang Deficiency can be further divided into four types, each treated separately.

① Kidney does not store essence: For the basic symptom complex of Kidney Yang Deficiency accompanied by nocturnal emission and impotence, strengthen the kidneys and solidify essence using the Bushen Wan (empirical formula).

② Kidney does not inhale qi: For the basic symptom complex of Kidney Yang Deficiency accompanied by shortness of breath and wheezing, warm the kidneys and help them inhale qi using the Duqi Wan (Yizong Yiren Bian).

③ Decline of Mingmen fire: For the basic symptom complex of Kidney Yang Deficiency accompanied by diarrhea at the fifth watch, warm the kidneys and stop the diarrhea using the Sishen Wan (Neike Zhaoyao).

④ Yang deficiency leading to water overflow: For the basic symptom complex of kidney deficiency accompanied by generalized edema, warm the yang and transform the water using the Zhenwu Tang (Zhang Zhongjing).

Appendix: ① Lower Yuan deficiency and cold: Frequent urination, enuresis, urgency, cold lower abdomen—warm and tonify the lower yuan using the Suquan Wan (Furen Liangfang). ② Bladder damp-heat: Urgent urination, frequent urination, painful urination, acute lower abdominal distension—clear heat, drain dampness, and promote urination using the Bazheng San (Jufang).

The organ-specific syndromes introduced above may appear individually in clinical practice, but in most cases, several organs’ syndromes manifest jointly. For example, Heart-Spleen Dual Deficiency, Spleen-Kidney Yang Deficiency, Liver-Kidney Yin Deficiency, and so on. Heart-Spleen Internal Deficiency represents the combined manifestation of Heart Blood Deficiency and Spleen Qi Deficiency, including both the paleness, poor appetite, fatigue, and lack of energy associated with Spleen Qi Deficiency, as well as the palpitations, forgetfulness, insomnia, and excessive dreaming characteristic of Heart Blood Deficiency. The treatment formula for this condition is the Guipai Tang, which contains both spleen-tonifying herbs like Dangshen, Baizhu, and Huangshi, and heart-tonifying herbs like Yuanzhi and Zaoren. As long as one understands the individual organ-specific syndromes, it is easy to analyze and comprehend their combined clinical presentations.

III. Progress in Integrating TCM and Western Medicine in Organ Differentiation