脉∶淋病之脉，细数何妨；少阴微者，气闭膀胱。女人见之，阴中生疮。大实易愈，虚
涩其亡。
气淋者，小便涩，常有余沥也。沙淋者，茎中痛，努力如沙石也。血淋者，尿血结热，
茎痛也。膏淋者，尿出似膏也。劳淋者，劳倦即发也。五淋者，皆膀胱蓄热也。
五淋散 治肺气不足，膀胱有热，水道不通，淋沥不出，或尿如豆汁，或如沙石，或冷
淋如膏，或热淋尿血，皆效。
赤茯苓（六两） 赤芍（十两） 山栀（十两） 当归（去芦，五两） 条芩（三两） 生甘草（五两）
上锉。水煎，空心服。一方有生地、泽泻、木通、滑石、车前子。
八正散 治心经蕴热，脏腑闭结，小便赤涩，癃闭不通及热淋、血淋。如酒后恣欲而得
者，则小便将出而痛，既出而痛，以此药主之。
大黄 瞿麦 木通 滑石 蓄 栀子 车前子 甘草（各等分）
上锉一剂。灯心水煎，空心服。
五淋者，因酒色劳力伤肾，虚中有热也。
必效散 治一切淋症，随症加减。
当归 生地黄（酒洗） 赤茯苓（去皮） 滑石 牛膝（去芦） 山栀 麦门冬（去心） 枳壳
黄柏（酒炒） 知母（酒炒） 蓄 木通（各等分） 甘草减（生）
上锉一剂。灯草一团，水煎，空心服。血淋，加菖蒲、茅根汁；膏淋，加萆 ；气
淋，加青皮；劳淋，加人参；热淋，加黄连；肉淋，加连翘；石淋，加石苇；尿淋，加车前
；死血淋，加桃仁、牡丹皮、玄胡索、琥珀，去黄柏、知母；老人气虚作淋，加人参、黄
、升麻少许，去黄柏、知母、滑石、 蓄。
海金沙散 治五淋，一服如神。
当归（酒洗） 大黄（酒浸） 川牛膝（酒洗） 木香 雄黄 海金沙（各等分）
上为细末。每服一钱半，临卧好酒调服。两服痊愈。
酒欲过伤而成淋者，宜升补真气也。补中益气汤治五淋有效。然淋症多是膀胱之气虚损
，不能运用，水道固滞不通而成诸淋也。此方补元气，故有效焉（方见内伤）。
益元固真汤 治纵欲强留不泄，淫精渗下而作淋者。
人参 白茯苓 莲蕊 巴戟 升麻 益智仁 黄柏（酒炒，各二钱） 山药 泽泻（各一钱半
甘草稍（二钱）
上锉一剂。水煎，空心服。
补遗方
治淋兼红淋。
当归 生地黄 熟地黄（各二钱） 黄柏 知母 黄芩（各一钱） 黄连（炒） 木通 桑白皮（各
一钱半）
上锉一剂。水煎，空心服。
治小便淋沥不通，用六味丸倍茯苓、泽泻（方见补益）。若小便涩滞，或茎中作痛，属肝
经湿热者，用龙胆泻肝汤（方见下疳）。
李司马，茎中作痛，小便如淋，口干唾痰，此思色，精降而火败。用补中益气汤、六味
地黄丸而愈（方见补益）。
男子茎中痛，出白津，小便闭，时作痒，用小柴胡（方见伤寒）加山栀、泽泻、炒黄连、
木通、胆草、茯苓，又兼六味丸而痊（方见补益）。
Pulse: In strangury (Lin syndrome), a fine and rapid pulse is not necessarily detrimental; if it belongs to Shaoyin disease with mild symptoms, it indicates Qi obstruction in the Bladder. If seen in women, sores may arise in the vagina. Excess patterns are easy to cure, while deficiency and choppy pulses indicate danger of death.
Qi strangury is characterized by difficult urination with a sensation of incomplete emptying.
Sha (sand) strangury is characterized by pain in the urethra and a sensation of sand or stones when straining to urinate.
Xue (blood) strangury is characterized by hematuria with heat accumulation and pain in the urethra.
Gao (paste) strangury is characterized by urine resembling paste or fat.
Lao (fatigue) strangury is characterized by onset triggered by physical exhaustion.
The five types of strangury are all caused by heat accumulation in the Bladder.
Wu Lin San (Five Stranguries Powder): Treats insufficient Lung Qi, heat in the Bladder, obstruction of the water passages, dribbling inability to urinate, urine resembling bean dregs, urine resembling sand/stones, cold strangury with discharge resembling paste, or heat strangury with hematuria. All are effective.
Ingredients: Chi Fuling (Red Poria, 6 liang), Chi Shao (Red Peony Root, 10 liang), Shan Zhi (Gardenia Fruit, 10 liang), Dang Gui (Angelica Sinensis, de-rooted, 5 liang), Tiao Qin (Scutellaria Baicalensis, 3 liang), Sheng Gan Cao (Raw Licorice Root, 5 liang).
Preparation and Administration: Coarsely crush the herbs. Decoct in water and take on an empty stomach. Another version includes Sheng Di Huang (Rehmannia Root), Ze Xie (Alisma Rhizome), Mu Tong (Akebia Stem), Hua Shi (Talcum), and Che Qian Zi (Plantago Seed).
Ba Zheng San (Eight Uprightnesses Powder): Treats heat retained in the Heart Meridian, closure of the Zang-Fu organs, red and difficult urination, retention of urine (Long Bi), heat strangury, and blood strangury. For cases caused by excessive alcohol consumption and sexual indulgence, where pain occurs before and after urination, this formula is indicated.
Ingredients: Da Huang (Rhubarb Root), Qu Mai (Dianthus Herb), Mu Tong (Akebia Stem), Hua Shi (Talcum), Pian Xu (Persicaria Herb), Zhi Zi (Gardenia Fruit), Che Qian Zi (Plantago Seed), Gan Cao (Licorice Root) (equal parts).
Preparation and Administration: Coarsely crush one dose. Decoct with Deng Xin Cao (Juncus Effusus Pith) water and take on an empty stomach.
The cause of the five stranguries is damage to the Kidney due to excessive alcohol, sexual activity, and overexertion, resulting in deficiency with internal heat.
Bi Xiao San (Absolutely Effective Powder): Treats all types of strangury, modified according to symptoms.
Ingredients: Dang Gui (Angelica Sinensis), Sheng Di Huang (Rehmannia Root, wine-washed), Chi Fuling (Red Poria, peeled), Hua Shi (Talcum), Niu Xi (Achyranthes Root, de-rooted), Shan Zhi (Gardenia Fruit), Mai Men Dong (Ophiopogon Tuber, heart removed), Zhi Ke (Bitter Orange), Huang Bo (Phellodendron Bark, wine-fried), Zhi Mu (Anemarrhena Rhizome, wine-fried), Pian Xu (Persicaria Herb), Mu Tong (Akebia Stem) (equal parts); Gan Cao (Raw Licorice Root, reduced amount).
Preparation and Administration: Coarsely crush one dose. Decoct with a bundle of Deng Cao (Juncus Effusus Pith) in water and take on an empty stomach. Modifications: For blood strangury, add Chang Pu (Acorus Rhizome) and Mao Gen (Imperata Rhizome) juice; for paste strangury, add Bi Xie (Dioscorea Hypoglauca Rhizome); for Qi strangury, add Qing Pi (Citrus Reticulata Green Peel); for fatigue strangury, add Ren Shen (Ginseng Root); for heat strangury, add Huang Lian (Coptis Rhizome); for meat strangury, add Lian Qiao (Forsythia Fruit); for stone strangury, add Shi Wei (Pyrrosia Leaf); for urine strangury, add Che Qian Zi (Plantago Seed); for dead-blood strangury (stasis), add Tao Ren (Peach Kernel), Mu Dan Pi (Moutan Cortex), Yan Hu Suo (Corydalis Rhizome), Hu Po (Amber), and remove Huang Bo and Zhi Mu; for elderly patients with Qi deficiency causing strangury, add Ren Shen (Ginseng Root), Huang Qi (Astragalus Root), and Sheng Ma (Cimicifuga Rhizome) in small amounts, and remove Huang Bo, Zhi Mu, Hua Shi, and Pian Xu.
Hai Jin Sha San (Semina Lygodii Powder): Treats the five stranguries; effective after one dose.
Ingredients: Dang Gui (Angelica Sinensis, wine-washed), Da Huang (Rhubarb Root, wine-soaked), Chuan Niu Xi (Cyathula Root, wine-washed), Mu Xiang (Saussurea Root), Xiong Huang (Realgar), Hai Jin Sha (Lygodium Spore) (equal parts).
Preparation and Administration: Grind into a fine powder. Take 1.5 qian each time, mixed with good wine before going to bed. Cure achieved after two doses.
Strangury caused by excessive alcohol and sexual indulgence should be treated by raising and tonifying true Qi. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is effective for the five stranguries. However, strangury is mostly due to deficiency and damage of Qi in the Bladder, leading to failure of function and stagnation of water passages, resulting in various stranguries. This formula tonifies Yuan Qi, hence its efficacy (see Internal Injury section).
Yi Yuan Gu Zhen Tang (Benefit Essence and Solidify True Decoction): Treats strangury caused by excessive sexual desire and forced retention of semen, leading to leakage of essence downward.
Ingredients: Ren Shen (Ginseng Root), Bai Fu Ling (White Poria), Lian Rui (Lotus Plumule), Ba Ji Tian (Morinda Officinalis Root), Sheng Ma (Cimicifuga Rhizome), Yi Zhi Ren (Alpinia Oxyphylla Fruit), Huang Bo (Phellodendron Bark, wine-fried, 2 qian each), Shan Yao (Dioscorea Rhizome), Ze Xie (Alisma Rhizome, 1.5 qian each), Gan Cao Shao (Licorice Root Tip, 2 qian).
Preparation and Administration: Coarsely crush one dose. Decoct in water and take on an empty stomach.
Supplementary Formulas:
To treat strangury accompanied by red strangury (hematuria):
Ingredients: Dang Gui (Angelica Sinensis), Sheng Di Huang (Rehmannia Root), Shu Di Huang (Prepared Rehmannia Root) (2 qian each), Huang Bo (Phellodendron Bark), Zhi Mu (Anemarrhena Rhizome), Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome, stir-fried), Mu Tong (Akebia Stem), Sang Bai Pi (Mulberry Root Bark) (1.5 qian each).
Preparation and Administration: Coarsely crush one dose. Decoct in water and take on an empty stomach.
For difficulty in urination with dribbling, use Liu Wei Wan (Six-Ingredient Pill with Rehmannia) with doubled amounts of Fu Ling (Poria) and Ze Xie (Alisma) (see Tonification section). If urination is obstructed or painful in the urethra, belonging to Damp-Heat in the Liver Meridian, use Long Dan Xie Gan Tang (Gentian Decoction to Drain the Liver) (see Chancre section).
Li Sima suffered from pain in the urethra, urination resembling strangury, dry mouth, and phlegm in saliva. This was due to mental preoccupation with sex, causing essence to descend and ministerial fire to fail. He was cured using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) and Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) (see Tonification section).
Men suffering from pain in the urethra, discharge of white fluid, urinary retention, and occasional itching should use Xiao Chai Hu Tang (Minor Bupleurum Decoction) (see Cold Damage section) added with Shan Zhi (Gardenia Fruit), Ze Xie (Alisma Rhizome), Chao Huang Lian (Stir-fried Coptis Rhizome), Mu Tong (Akebia Stem), Dan Cao (Gentiana Root), and Fu Ling (Poria), combined with Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) for recovery (see Tonification section).