淋有五，皆属热，解热利小便为主。山栀子之类同虎杖、甘草，煎汤服。小蓟汤，治下焦热结血淋。又有肾
虚极而淋者，当补肾精及利小便，不可独泻。 淋证不可发汗，汗之必便血。老人亦有气虚者，人参、白术中带木
通、山栀。亦有死血作淋者，牛膝膏亦能损胃不食，不宜
多服。治淋，山栀去皮一两炒，白汤送下。治气虚淋，八物汤加黄 同虎杖、甘草，煎汤服诸药，中加牛膝。一方
益元散加山栀、木通。夏月，以茴香煎汤调益元散服之。痰热隔滞，中焦淋涩不通，玄明粉。血气中有热者，八物
汤加黄柏、知母。妇人、男子淋闭，血药不效者，川黄柏新瓦上焙，牡蛎火 ，上为细末，食前调服，或小茴香汤
亦可。
小便不禁遗失者，属热、属虚。东垣谓∶肺气虚，宜安神养气，禁劳役。安神养气，用参、 补之，不愈则有热
加黄柏、生地。
气虚、血虚、实热、有痰，吐之以提其气，气升则水自降下，盖气承载其水也。气虚，人参、黄 、升麻等，先
服后吐，或参、 药中，探吐之；血虚，四物汤先服后吐，芎归汤亦可探吐；痰多者，二陈汤加木通、香附探吐；实热
者，当利。一妇人脾疼后，患大小便不通，此是痰隔中焦，气聚下焦，用二陈汤加木通，初服，渣煎服探吐。气
壮实热之人八正散，大便动，小便自通。小便因热郁不通，赤茯苓、黄芩、泽泻、车前子、麦门冬、桂、滑石、木通、
草梢。气虚痛者，加木香、黄 ；淋痛者，加黄柏、生地黄，夏月调益元散。痰隔中焦，二陈汤煎大碗顿服，调其真气
而吐之。否则用沙糖汤，调牵牛头末二钱服之。伤寒后，脱阳而小便不通，茴香调生姜自然汁敷小腹上，服益志茴香
丸，并益元散服之。一人燥热伤下焦，致小便不利，当养
阴，当归、地黄、知母、黄柏、牛膝、茯苓、生甘草、白术、陈皮之类。一妇人年五十，患小便涩，与八正散，则
小腹转急胀不通，身如芒刺，余以所感霖淫雨湿，邪在上表，因用苍术为君，附子佐之发其表，一服即汗，小便实时
便通。一男子年八十，患小便短涩，因服分利药太过，遂致闭塞，涓滴不出。余以饮食太过伤胃，其气陷于下焦，用
补中益气汤，一服小便即通，因先服多利药损其肾气，遂至通后遗溺，一夜不止息，补其肾然后已。有热宜清；有湿
宜燥；有气结于下宜升。有隔二隔三之治。如因肺燥不能生水，则清肺金，此隔二；如不因肺燥，但膀胱有热，则直
泻膀胱火，此正治；如因脾湿不运，精气不升，故肺不能生水，则当燥脾，此隔三也。清肺用车前子、茯苓之类；泻膀
胱用黄柏、知母之类；健脾燥脾用苍术、白术之类。又诸法治不通，则用吐法，盖气承载其水耳吐之则气升，气升则
水降。
Lin syndrome (stranguria) is divided into five types, all belonging to heat patterns. Treatment focuses on clearing heat and promoting urination. Decoctions of Gardenia (Shanzhizi) combined with Polygonum cuspidatum root (Huzhang) and Licorice root (Gancao) can be taken. Xiaojie Tang (Little Thistle Decoction) treats hematuric stranguria caused by heat accumulation in the lower jiao. There are also cases where extreme deficiency of kidney essence leads to Lin syndrome; these should be treated by tonifying kidney essence and promoting urination, avoiding pure purgative methods. Lin syndrome contraindicates diaphoresis (sweating therapy); inducing sweat will inevitably lead to blood in the stool or urine. Elderly patients may also have Qi deficiency patterns, treated with Ginseng root (Renshen) and Atractylodes macrocephala rhizome (Baizhu), supplemented with Akebia stem (Mutong) and Gardenia (Shanzhi). Cases caused by static blood (stasis) leading to Lin syndrome: Niuxi Gao (Achyranthes Bidentata Paste) can damage stomach Qi and cause loss of appetite, so it should not be taken in large amounts. To treat Lin syndrome, one ounce of Gardenia (Shanzhi) peeled and stir-fried can be taken with warm water. For Qi-deficient Lin syndrome, Baye Tang (Eight-Ingredient Decoction) is added with Phellodendron bark (Huangbai), decocted with Polygonum cuspidatum root (Huzhang) and Licorice root (Gancao); Achyranthes root (Niuxi) can also be added. Another prescription is Yiyuan San (Benefit the Prime Powder) added with Gardenia (Shanzhi) and Akebia stem (Mutong). In summer, Yiyuan San can be mixed with Fennel seed (Huixiang) decoction. If phlegm-heat obstructs the middle jiao causing difficult and painful urination, Xuanming Fen (Mirabilite) is used. For heat in blood and Qi, Baye Tang (Eight-Ingredient Decoction) is added with Phellodendron bark (Huangbai) and Anemarrhena rhizome (Zhimu). For men and women with stranguria and urinary retention unresponsive to blood-invigorating medicines, Chuan Huangbai (Sichuan Phellodendron Bark) is roasted on a new tile, Oyster shell (Muli) is calcined, both ground into fine powder, and taken before meals, optionally with Fennel seed (Huixiang) decoction.
Urinary incontinence and leakage belong to heat or deficiency patterns. Li Dongyuan stated that Lung Qi deficiency requires calming the mind and nourishing Qi, while avoiding overexertion. Calming the mind and nourishing Qi involves tonifying with Ginseng root (Renshen) and Astragalus root (Huangqi); if ineffective, indicating heat, add Phellodendron bark (Huangbai) and Rehmannia root (Shengdi).
For Qi deficiency, Blood deficiency, excess heat, or phlegm, emesis (vomiting therapy) can be used to raise Qi; when Qi rises, water naturally descends because Qi carries water. For Qi deficiency, take Ginseng root (Renshen), Astragalus root (Huangqi), and Cimicifuga rhizome (Shengma) first, then induce vomiting; or add emetic agents to Ginseng and Astragalus decoctions. For Blood deficiency, take Siwu Tang (Four-Substance Decoction) first, then induce vomiting; Xiong Gui Tang (Angelica and Ligusticum Decoction) can also be used for emesis. For excessive phlegm, Erchen Tang (Two-Aged Decoction) added with Akebia stem (Mutong) and Cyperus rhizome (Xiangfu) is used for emesis. For excess heat, promote urination. A woman who developed urinary and fecal retention after spleen pain suffered from phlegm obstruction in the middle jiao and Qi stagnation in the lower jiao; she was treated with Erchen Tang (Two-Aged Decoction) plus Akebia stem (Mutong). After the initial dose, the dregs were decocted and taken to induce vomiting. For robust individuals with excess heat, Bazheng San (Eight-Herb Powder) is used; once bowel movements occur, urination naturally clears. For urinary retention due to heat stagnation, use Red Poria (Chifuling), Scutellaria root (Huangqin), Alisma tuber (Zexie), Plantago seed (Cheqianzi), Ophiopogon tuber (Maidong), Cinnamon twig (Gui), Talcum (Huashi), Akebia stem (Mutong), and Licorice tip (Caogao). For Qi-deficiency pain, add Costus root (Muxiang) and Astragalus root (Huangqi); for stranguria pain, add Phellodendron bark (Huangbai) and Rehmannia root (Shengdi), mixing with Yiyuan San (Benefit the Prime Powder) in summer. For phlegm obstruction in the middle jiao, decoct a large bowl of Erchen Tang (Two-Aged Decoction) and drink it at once to regulate true Qi through emesis. Alternatively, use sugar water mixed with 2 qian of Qianniu head powder. After cold damage, Yang collapse causing urinary retention can be treated by applying fresh Ginger juice mixed with Fennel seed (Huixiang) to the lower abdomen, taking Yizhi Huixiang Wan (Yizhi Fennel Pill), and concurrently taking Yiyuan San (Benefit the Prime Powder). One man suffered lower jiao injury from dryness-heat causing difficult urination; Yin should be nourished using Danggui (Angelica sinensis), Dihuang (Rehmannia), Zhimu (Anemarrhena), Huangbai (Phellodendron), Niuxi (Achyranthes), Fuling (Poria), Sheng Gancao (Raw Licorice), Baizhu (Atractylodes), and Chenpi (Citrus peel). A fifty-year-old woman with difficult urination experienced acute abdominal distension and retention, and body sensations like thorns, after taking Bazheng San (Eight-Herb Powder). I attributed this to dampness-evil from prolonged rainy weather affecting the exterior upper body, so I used Cangzhu (Atractylodes lancea) as the sovereign herb with Fuzi (Prepared Aconite) as assistant to release the exterior. After one dose, sweating occurred, and urination immediately cleared. An eighty-year-old man with short, difficult urination became completely blocked with no drops passing after excessive use of diuretics. I reasoned that excessive food intake damaged Stomach Qi, causing Qi to sink to the lower jiao. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was administered, and urination cleared after one dose. However, prior excessive diuretic use had damaged Kidney Qi, leading to post-obstructive incontinence lasting all night. The condition ceased only after Kidney Qi was tonified. Heat should be cleared; dampness should be dried; Qi knotting in the lower jiao should be raised. There are treatments involving "separated two" and "separated three" principles. If Lung dryness prevents generating Water, clear Lung Metal (Separated Two); if not due to Lung dryness but Bladder heat, directly purge Bladder Fire (Direct Treatment); if Spleen dampness fails to transport, preventing Jing-Qi ascent and thus Lung water generation, dry the Spleen (Separated Three). Clearing Lung uses Cheqianzi (Plantago seed) and Fuling (Poria); purging Bladder uses Huangbai (Phellodendron) and Zhimu (Anemarrhena); strengthening and drying Spleen uses Cangzhu (Atractylodes lancea) and Baizhu (Atractylodes macrocephala). If other methods fail to resolve retention, use emesis, because Qi carries water; emesis raises Qi, and rising Qi causes water to descend.