Kidney Shen
The kidney (Table 2.6) is said to be the root of life and it is responsible for storing the essence. Kidney yin is said to be the fundamental substance (structure) of birth and growth, while kidney yang is the motive force (function). The kidney therefore dominates both reproduction and development. Kidney essence may be either congenital (from parents) or acquired (from essential substances transformed by the spleen and stomach). Essence is said to follow a seven year cycle for women, and an eight year cycle for men. Essence lourishes at age 14 in females and declines at age 49. In males it flourishes at 16 and declines at age 56 and is inally gone at age 64. Kidney yin is the foundation of all yin fluids in the body which moisten the Zang Fu organs. If kidney yin is deicient it will fail to control kidney yang and symptoms are heat in the chest, palms and soles, night sweats and seminal emission. If kidney yang is deicient, leading to a failure of warming and promoting, there will be coldness and pain in the lumbar region, and possibly impotence.
Table 2.6. Kidney Shen (the root of life).
Stores essence.
Dominates reproduction and development. Dominates water metabolism. Receives the qi. Dominates bone.
Manufactures marrow to fill the brain. Manifests in the hair. Opens to the ear.
Dominates anterior and posterior orifices.
The kidney is said to dominate water metabolism. Water is received by the stomach and then transmitted by the spleen to the lung, which disperses and descends it. Part of the luid reaches the kidney where it is divided into clear and turbid (unclean) portions. The clear portion goes to the lung to be circulated to the organs and tissues. The turbid portion goes to the bladder to form urine. If the kidney fails to open and close one of the results will be oedema and/or abnormal micturition.
The kidney is said to receive the qi, and works with the lung in this function. It is said that 'the lung is the governor of qi and the kidney is the root of qi'. The lung receives the clear qi from the air and passes it down to the kidney which holds it. Kidney qi must be strong for the passage of qi to be free and for respiration to be smooth. If kidney qi is weak (deficient), the root of qi is not firm and the kidney will fail to hold the qi, giving shortness of breath especially on exertion. This is often seen in chronic asthma (also called deiciency-type asthma in TCM), for example, where lung points (LU-9 or BL-13, back shu point of the lung) and kidney points (KI-3) may be combined in order to treat with acupuncture needles .
Case history
An elderly, frail patient presented with long-standing asthma.She had a slightly stooped appearance with a flattened anterior chest suggesting a history of breathing difficulties.Her tongue examination revealed a normal tongue body with a thin white coating.The tongue was larger than normal giving the appearance of filling the mouth, and there were a number of lateral cracks on either side of the tongue.The patient described dryness of her throat with a desire to drink, especially during the evening and at night.The patient woke two or three times at night to go to the toilet.The urine was clear with no recent change in volume.The patient's sleep was disturbed by palpitations, and she was breathless on exertion.
To palpation, the chest was quite rigid with poor expansion.Breathing was isolated to the upper regions.Pulse examination showed a deep slippery pulse with the lung level weak and the kidney level moderately weak.
This clinical picture shows deficiency.The history and pulse suggest deficiency in the lung and kidney.The aim of treatment is to tonify the lung and kidney with acupuncture needles, and release the tightness in the chest.
