Kidney Deficiency from Overindulgence: Cough, Chest Tightness and Boils — How Do You Treat It?
Patient search terms: kidney deficiency / overindulgence in sensual life / harming the kidneys / cough with phlegm / tight stuffy chest / sores on the chest and back / sudden loss of voice
Medical terms for this condition: exhausted kidney essence (shen jing hao sun) · qi failing to return to its origin (qi bu gui yuan) · yang deficiency with phlegm-rheum (yang xu tan yin) · deep abscesses with false heat (yin zheng jia re) · turbid yin rushing upward (zhuo yin shang chong)
Opening: a patient who had everything — except money problems
Today’s story comes from the case records of Doctor Yu Jiayan, one of the great physicians of the late Ming and early Qing dynasties. Doctor Luo Dalun has given this story a title of his own — this is what happens when you squander your kidney essence.
The patient’s surname was Li, given name Jijiang. He was in his early thirties, a self-made tycoon.
💬 Note from Doctor Luo: The ancients had a special word for this kind of man — su feng (素封), literally a “plain lord.” It describes someone with no official post, no noble title, no distinguished family line — just a man who made a great fortune entirely on his own. Many rich men would buy themselves a minor office, but not this one: he held nothing at all, he was simply wealthy. Li Jijiang was a textbook su feng.
Who was the patient: a self-made tycoon, with one great sorrow — no son
Li Jijiang had money, but he carried a heavy stone in his heart — he had no children.
For years his health had also been poor: he coughed constantly, brought up phlegm, and felt his chest and diaphragm were never clear — as if phlegm and qi were blocked inside, stuffy and congested. By this summer and autumn, it had grown much worse: he was confined to bed, and several times hovered at death’s door. His family rushed about in panic, everyone convinced he was about to die.
💬 Note from Doctor Luo: Notice — the seed of the whole story is planted right here. Why should a cough with phlegm and a stuffy chest have anything to do with “having no son”? Keep listening.
No son, and afraid: he divided up the family estate — and got better
In ancient times, having no son was far more than “the family line dies out.” Li Jijiang felt wu zi zi wei — “no son, therefore in danger.” Every day a great stone hung over his heart: danger, unease.
Danger from what? Doctor Luo Dalun explains the old family rules:
💬 Note from Doctor Luo: In the old days, a great family held its property in common (gong cai). If you died without a son, your wealth would never go to your wife — she was of a different surname, and had no right of inheritance. Your cousins, your cousins’ cousins — the whole clan could come and carve it up. Your wife would get nothing, and might even be driven out of the house. Do you see now why the ancients fought so hard to have sons? The root was right here. Consider the great late-Ming literary figure Qian Qianyi — the last leader of the Donglin Party. In his old age he married the celebrated courtesan Liu Rushi. After Qian Qianyi died, the clan came to divide his possessions, and Liu Rushi, still young, hanged herself in the end. Feudal society could be that cruel.
Li Jijiang reasoned it out for himself and decided to settle his affairs while he could: “I will divide the family business myself.” This sum to his elder brother’s son, that house to his younger brother’s son, and an allowance set aside for his wife. Everything arranged, he thought: I am going to die anyway, and my estate is settled — now I can wait for death in peace.
And then something strange happened — after dividing the estate, his illness actually improved.
Doctor Yu Jiayan recorded it in eight characters: “Yi xin si, ze shen kang zhi zheng ye” — “Once the heart is dead (to attachment), it is a sign the body is recovering its health.”
💬 Note from Doctor Luo: Why? One great cause of his poor health was emotion. His relatives came every day “to visit” — but really they were watching like hawks, counting the days until he died so they could divide the house. They had already picked out which courtyard faced east and which faced west: this one for Uncle Number Two, that one I’ll take. Under that kind of pressure, how could his body get better? The moment the estate was divided, his mind relaxed, and the illness lightened at once. But before long, fresh quarrels broke out in the family — the division was unfair, the house faced the wrong way — and his illness came back. It went on like this, sometimes nearly killing him, sometimes vanishing, until people began to wonder: could this be one of those “illnesses that never kill”?
The famous doctor arrives: the root of the disease written on the patient’s face
This could not go on forever. Someone told Li Jijiang: Doctor Yu Jiayan is a master of diagnosis — his case records in Yu Yi Cao are written down with complete clarity, and his analysis of disease is extraordinarily thorough. So Li Jijiang begged relatives and friends to bring Doctor Yu Jiayan to see him.
The moment Doctor Yu Jiayan walked through the door, before the patient had even spoken a word, one glance — this is the ancient art of inspection (wang zhen) — showed him that Li Jijiang’s two cheeks were studded with dozens of small lumps, one little knob after another, thickly clustered.
Doctor Yu Jiayan understood at once: where the disease is, one glance reveals it.
💬 Note from Doctor Luo: Chinese medicine says: “Wang er zhi zhi wei zhi shen” — “to know by looking is the level of the sage.” The four diagnostic methods — inspection, listening, questioning, and pulse-taking — are ranked as shen, sheng, gong, qiao (divine, sagely, skilled, clever): to know by looking is divine, to know by listening is sagely, to know by questioning is skilled, to know by pulse-taking is clever. Inspection comes first — one look and you know where the disease is; that is the highest skill. The contemporary master of inspection, the elderly Wang Hongmo, was a close friend of mine across the generations. He used to say that when he looks at a face, he sees it “in color” — where we see an ordinary face, he sees different regions and different hues telling him what is wrong with each organ. An experienced old physician will glance at your face as you come in and already know, in his heart, roughly where your problem lies. Doctor Yu Jiayan was exactly such a master.
What did the lumps on the two cheeks mean?
💬 Note from Doctor Luo: In the inspection tradition, the two cheeks (liang yi) belong to the kidney. Around the lips — the philtrum, for instance — relates to the reproductive system: in a woman the philtrum (ren zhong) represents the uterus. So the cheeks, the upper and lower lip, these regions are all connected to the kidney and to reproduction. Li Jijiang’s cheeks were covered in dozens of little lumps — the kidney region is in trouble. Remember this; it is the key to everything that follows.
One sentence at the pulse, and the patient’s face changed
Doctor Yu Jiayan asked him: “What is your illness now? A cough, you say? Then describe your cough for me.”
Li Jijiang answered in a flippant, almost teasing tone: “The things going on in here — a doctor of limited skill wouldn’t understand even if I explained. What I want is someone with real understanding to look at me.”
Doctor Yu Jiayan was not offended. He said quietly: “You do not even know yourself whether you are cold or hot, hungry or thirsty.” Then he took the pulse and spoke without flattery:
“Your kidney pulse is strong — you must be a man of great indulgence.” In other words: you love sensual pleasure.
💬 Note from Doctor Luo: In those days that was a heavy accusation. But Doctor Yu Jiayan pressed on: you are given to indulgence, and you also love to rush about — busy making money everywhere. Both of these are forms of “labor”: one is the labor of the bedroom (fang lao), the other is the labor of rushing about (xing lao) — both consume you! By all rights, a body like yours should have erupted in deep abscesses (yong ju) — those great sores. Why have they not erupted, and you only cough instead? Because you are thrifty: you have not eaten rich, greasy delicacies — the good food was never taken in enough, so the sores never fully erupted. But you have one failing: the moment desire stirs, it is drained away immediately — like premature ejaculation, it all goes out. The root of the disease is here, and it sinks deeper every day.
Doctor Yu Jiayan went into even greater detail: “On your chest, back and shoulder blades, lumps grow one after another — like jagged rocks stabbing at the sky, like bamboo shoots bursting from the ground; hollow inside, like a honeycomb; pointed, like thorns. Whenever desire stirs, qi rises, and phlegm surges, your bones lock together — you cannot live, and you cannot die — ten times more agonizing than a criminal on the rack! Do you not know this yourself?”
At these words, Li Jijiang’s face changed completely. He stamped his feet and wept: “It is exactly so, exactly so! But I could never put it into words — no doctor has ever told me these things!”
Only then did he reveal the truth: years ago his back had indeed erupted in many deep abscesses. Fortunately they had not killed him; but after the sores healed, the cough began — and it had never stopped since. He had suspected the original doctor treated him wrongly.
Doctor Yu Jiayan said: No, the treatment was not wrong. The root is this — indulgence plus toil; qi no longer returns to its origin.
Qi failing to return to its origin: kidney qi rushes upward, and both the phlegm and the sores come from this
What does “qi failing to return to its origin” (qi bu gui yuan) mean? Doctor Yu Jiayan analyzed it thoroughly: kidney qi is meant to be sealed and stored in the kidneys. But now your kidney qi is badly depleted — it cannot hold, cannot store. So the deficient fire and deficient qi leap upward, and where do they land? In the spaces between the lobes of the liver and lungs, within the membrane-source (mo yuan) — that is, the region of the chest and diaphragm.
💬 Note from Doctor Luo: Day after day, this scattered qi beats out a “well-worn road.” The slightest stir of kidney qi and it pours out like ten thousand horsemen — it enters but never exits, like a tide that never ebbs; the front wave has not receded before the next wave comes. Over time, the upper body becomes a disaster zone of deficient fire: phlegm, stuffiness, all manner of lumps and sores. Doctor Yu Jiayan said that from antiquity to the present, who knows how many people have been done to death by this disease. But your constitution is sturdy — it can take a beating; otherwise you would have been gone long ago. “I should long since have broken through your Kunlun Pass” — the gate at the crown of the head.
Finally Doctor Yu Jiayan gave his prescription — not medicine, but first a speech:
“Go home at once. Cultivate your mind and nourish your spirit. Do not let a single lustful thought arise again. Regard yourself as already dead — when the heart is dead, desire does not rise; when desire does not rise, fire does not rage wildly; when fire does not rage wildly, phlegm and qi cannot steam and stir inside you, and those lumps on your chest and back will at last have a crack through which healing can enter. I will go back and prepare your medicine. I am going to ‘overturn the nest and destroy the lair’ (dao chao fu xue) — smash these bandits’ dens to pieces — and only then can your disease be cured.”
Li Jijiang was astonished and overjoyed — he thought he had met an immortal. He immediately sent someone to prepare the medicine: five catties of herbs were bought, and another ten catties’ worth of silver was set aside as a gift of gratitude. Happily he saw Doctor Yu Jiayan off.
The moment desire stirs, the body quietly makes its preparations
At this point you may ask: what does this have to do with “indulgence” at all? Why should kidney deficiency make sores grow on the body and cause a cough?
Doctor Luo Dalun devoted a whole passage to unpacking it for us:
💬 Note from Doctor Luo: When people see sores on the body, they usually assume it is a heat pattern — “excess fire.” But in fact, a great many of these people are deficient — the problem is insufficient kidney qi. Chinese medicine teaches that the moment desire stirs — even if you do nothing at all — your body is already affected and begins consuming kidney essence. Modern medicine might find this hard to believe: “Just having a thought gives my body a reaction?” Consider an analogy. In primitive times, you are grazing in the wild, and suddenly you catch sight of a tiger’s shadow — the tiger has not chased you, has not eaten you, but the instant you see that shadow, your heart races, adrenaline surges, your entire metabolism shifts, ready to flee. If merely seeing a shadow does that, imagine what “thinking about doing something” does. So when the ancients said “the stirring of desire secretly drains the kidney essence,” they were not frightening people for fun. Some people say they “feast their eyes on pretty women for their health” — health? The moment desire stirs, your body starts preparing for what you intend to do — day after day, the body is being consumed. It is exactly like seeing a tiger’s shadow every day. Could you stay normal? The things the ancients taught will, one by one, be confirmed by modern medicine — just as the Nobel Prize confirmed that “sleeping at night is better than sleeping in the day,” something the ancients had already said with “rise at sunrise, rest at sunset.”
So where does all that prepared “energy” go, when it never gets used?
💬 Note from Doctor Luo: It piles up! It is like war: the grain is stocked, the troops assembled — and then the battle is called off. The grain sits there, and in time it rots. The body’s energy is the same: it is prepared, then never used, so it congests and stagnates locally — and finally turns into sores and abscesses. I have seen patients with abscesses on their backs; very often there is a connection to kidney deficiency and indulgence. And this man’s phlegm is the same — this is what we call deficiency phlegm (xu tan): when the kidneys are weak, they cannot control dampness, and dampness congeals into phlegm; the weaker the kidneys, the more phlegm. Some people drift toward kidney-yin deficiency; some toward kidney-yang deficiency — Li Jijiang was actually yang deficient, with cold phlegm. On the surface the lumps looked like a heat pattern, but that appearance was false.
One fatal detour: he went to collect rent first, and died in the countryside two days later
The story should have continued as “go home, take the medicine, recuperate slowly.” But Mr. Li Jijiang did something that broke Doctor Yu Jiayan’s heart.
The next morning, he thought to himself: my illness is not going to kill me this minute — it’s not that serious! And there is still a great deal of land in the countryside — the rents have not been collected yet! Money must be collected first! So he put aside the matter of buying medicine, and went to the countryside to collect rent, thinking: in ten days or so I’ll be back, and it will still be early enough to buy the medicine.
But in the countryside, exhausted from rushing about, with his kidney qi already depleted, the disease struck suddenly: he lost his voice — could not speak at all; phlegm gushed out like a spring; his breathing made a sawing, rasping sound; his face swelled, his tongue enlarged, his throat was blocked, and his eyeballs bulged outward…
Within two days, he was dead in the countryside.
💬 Note from Doctor Luo: Doctor Yu Jiayan sighed over this in the case record: “Qi ren yu er bu yu” — “He met me, and yet it was as if he had never met me.” And “gu jia bu gu shen” — “he cared for his estate but not for his own body.” What a glaring negative example! A single mistaken thought, and he never took that one dose of medicine — and he died far from home. What a waste.
Turbid yin rushing upward: how would Doctor Yu Jiayan have rescued this emergency?
Why did Li Jijiang suddenly die in the end? Doctor Yu Jiayan explained it clearly in the case record, using the theory of “the yin disease” (yin bing lun) from his own work Yi Men Fa Lü (The Laws of Medicine):
💬 Note from Doctor Luo: This man’s kidney qi and kidney essence were insufficient — his kidney yang was also depleted. When kidney yang is depleted, and then toil and sudden change strike, turbid yin rushes upward. Turbid yin enters from the front of the chest — the throat swells and blocks, suddenly choking off speech, the tongue swells, the eyes protrude; entering from the back — the sinews of the neck thicken, the head and neck turn cold as ice, and within moments the whole body turns blue-black and he dies. For this kind of emergency there is only one method: warm the yang! Use pure yang herbs such as dried ginger and aconite to drive out the yin. The formula he had been preparing for Li Jijiang was most likely Zhen Wu Tang (True Warrior Decoction) or something of that family — warm the yang, tonify the kidney qi, dispel cold-dampness, and slowly restore the kidney essence. All these methods Doctor Yu Jiayan had distilled from Shang Han Za Bing Lun (the Treatise on Cold Damage and Miscellaneous Diseases). He was a master of the Shang Han tradition — a leading figure of the “corrected-text” (cuo jian) school, profoundly learned in the classics, and especially skilled at treating illnesses of yang deficiency. He said he had treated several dozen patients like Li Jijiang, and by following Zhang Zhongjing’s approach, he had pulled almost all of them back from the brink — except this one, who lost his life over a single mistaken thought, before the medicine was ever taken.
What would modern medicine call this illness? Doctor Luo Dalun says:
💬 Note from Doctor Luo: This was most likely a problem of heart and lung function — the heart may have been failing, and the lungs were choked with phlegm. The immediate cause of death was probably cardio-pulmonary collapse — the heart suddenly gave out, and within two days the man was gone. But Chinese medicine treats the root in the kidneys — kidney essence is the foundation of a human being, and the slightest breeze can bring down a man whose foundation is unsteady.
Kidney essence is the foundation of a human being
Li Jijiang’s whole case, from beginning to end, is one sentence: kidney essence is the foundation of a human being — do not squander it.
The lumps on his chest and back looked like heat toxin on the surface, but in truth they were deficiency — kidney qi scattered and rushing upward, and only then condensing into these things. To truly treat it, you must tonify the kidneys and lead the fire back to its origin — gather the qi back in, and only then will the lumps slowly settle. His cough, his excess phlegm, his stuffy chest — all of it was the kidney qi in disorder.
💬 Note from Doctor Luo: The most important thing in this story is to make clear what is so deadly about indulgence. When the bedroom drains a man for years, and his foundation is down to the last sliver, then the slightest breeze can bring disaster — not just to the heart and lungs, but to every organ. So I keep saying: clear the heart, reduce desires, rest and recuperate — protect yourself appropriately. That is the essential business. I hope none of you become a Li Jijiang, and I hope this negative example serves as a warning to us all.
Compiled from Doctor Luo Dalun’s commentary on the case records of Doctor Yu Jiayan, from Yu Yi Cao (Yu Jiayan 1585–c. 1664, late Ming to early Qing physician and master of the Shang Han tradition).