疮疡小便不止，有膀胱气虚而不能禁止者，有膀胱虚热而自遗者，有肺经传热遗于膀胱而然者，有肺虚不能生肾而
然者，有禀肾虚早近女色而然者。治法∶膀胱气虚，用六味丸、六一散。膀胱有热，用六味丸、滋肾丸。肺经遗热，用
清肺散、六味丸。肺气虚，用益气汤、六味丸。早近女色，而小便不止，或大小便牵痛者，乃肾肝亏损所致，作渴饮冷，
属虚热，用六味丸、补中益气汤；作渴饮热，属虚寒，用八味丸、补中汤。《精血篇》云∶男子精未满而御女色，以通其
精，五脏有不满之处，异日有难状之疾。老人阴以痿而思色，以降其精，则精不出而内败，小便涩痛如淋，愈痛则愈便，
愈便则愈痛。若不条分缕析而泛投杂药则误矣。
一小儿项腋结核，溃而体瘦发热，小便不止，此禀肝胆之精血气虚热而然也，先用加味逍遥散、五味异功散为主，
以地黄丸为佐；月余以地黄丸为主，五味异功散加当归、柴胡为佐，诸症渐愈；又以四味肥儿丸，间服而愈。
─小儿阴囊时肿，余谓胎禀肝火。不信，后患便痈，溃后，小便淋沥，或时澄白，此肝火为患，溃久肝气虚弱，而
小便如斯也。盖虚则补其母，肾为肝之母，用地黄丸滋肾水以补肝，渐愈。因功课劳心兼怒，不时寒热，小便如淋，用
加味逍遥散而寒热止，却用地黄丸为主，佐以四味肥儿丸而愈。
一小儿流注久溃，面白时咳，脓水清稀，小便短少，或如淋不止，余谓脾肺气虚不能生肝肾而然，用补中益气汤、
六味地黄丸为主，佐以托里散而渐愈，又间用豆豉饼而敛。
一小儿鹤膝风久溃，小便频数，后淋沥不止，面色黑或皎白，饮食少思，四肢倦怠，此肾之脾胃虚也，朝用补中益
气汤，夕用五味异功散，饮食渐加，肢体渐健，却用地黄丸而愈。
一小儿早近女色，患胁痈溃而小便如淋，服分利之剂，更加腹胀，小便不止，茎中作痛，大便自遗，余谓禀肾阴虚
也，当急补脾肺以滋化源。不信，仍服分利之药而殁。
黄芩清肺饮
滋肾丸（二方见小便不通）
加味逍遥散（方见发热不止）
四味肥儿丸（方见贴骨痈）
豆豉饼（方见流注）
八味丸（方见大便不止）
五味异功散（方见败毒之药）
Urinary incontinence resulting from sores and ulcers may be caused by several factors: deficiency of Qi in the Bladder (Bladder) failing to maintain control; deficiency-heat in the Bladder causing spontaneous leakage; heat transmitted from the Lung Meridian (Lung Channel) to the Bladder; deficiency of Lung Qi failing to generate Kidney essence; or congenital Kidney deficiency exacerbated by early sexual activity. Treatment methods: For Bladder Qi deficiency, use Liuwei Wan (Six-Ingredient Pill with Rehmannia) and Liuyi San (Six-to-One Powder). For Bladder heat, use Liuwei Wan and Zishen Wan (Kidney-Nourishing Pill). For residual heat from the Lung Meridian, use Qingfei San (Lung-Clearing Powder) and Liuwei Wan. For Lung Qi deficiency, use Yiqi Tang (Qi-Boosting Decoction) and Liuwei Wan. If urinary incontinence results from early sexual activity, accompanied by pulling pain during urination or defecation, it is due to Liver and Kidney depletion. If thirst with a desire for cold drinks indicates deficiency-heat, use Liuwei Wan and Buzhong Yiqi Tang (Middle-Boosting and Qi-Supplementing Decoction); if thirst with a desire for hot drinks indicates deficiency-cold, use Bawei Wan (Eight-Ingredient Pill) and Buzhong Tang. The *Jingxue Pian* (Chapter on Essence and Blood) states: "When a man engages in intercourse before his essence is fully mature, forcing ejaculation, the five Zang organs will have unfulfilled needs, leading to difficult-to-describe ailments later in life." For an elderly man whose Yang is flaccid yet desires sexual gratification, forcing ejaculation without release causes essence to stagnate and spoil internally, resulting in painful, difficult urination resembling strangury; the more painful, the more frequent the urge, and the more frequent, the more painful. Without careful differentiation, indiscriminate use of miscellaneous medicines leads to error.
A child presented with tubercles (swollen lymph nodes) in the neck and axillae, which ulcerated, accompanied by emaciation, fever, and urinary incontinence. This was attributed to deficiency-heat of Liver and Gallbladder essence and blood. Initially, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder) were used as the main formula, with Dihuang Wan (Rehmannia Pill) as an adjunct. After over a month, Dihuang Wan became the main formula, while Wuwei Yigong San supplemented with Danggui (Angelica Sinensis Root) and Chaihu (Bupleurum Root) served as the adjunct. Symptoms gradually resolved. Subsequently, Simei Fei'er Wan (Four-Ingredient Child-Nourishing Pill) was administered intermittently until cure.
Another child presented with intermittent scrotal swelling. I attributed this to innate Liver fire. The family did not believe this; later, the child developed a perianal abscess. After ulceration, urine dribbled continuously, sometimes turbid and white. This indicated Liver fire pathology; prolonged ulceration led to weak Liver Qi, causing these symptoms. According to the principle "tonify the mother when deficient," since the Kidney is the mother of the Liver, Dihuang Wan was used to nourish Kidney water to benefit the Liver, leading to gradual recovery. Due to mental exertion from studies and anger, the child experienced alternating chills and fever, and stranguria-like urination. Jiawei Xiaoyao San stopped the chills and fever. Thereafter, Dihuang Wan was used as the main formula, supplemented by Simei Fei'er Wan, resulting in a cure.
A child with long-standing deep-seated abscesses (Liuzhu) presented with pale complexion, occasional cough, thin purulent discharge, scanty urine, or continuous stranguria-like urination. I attributed this to Spleen and Lung Qi deficiency failing to generate Liver and Kidney essence. Buzhong Yiqi Tang and Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) were used as the main formulas, supplemented by Tuoli San (Interior-Supporting Powder) for gradual improvement. Intermittent application of Douchi Bing (Fermented Soybean Cake) promoted wound healing.
A child with chronic knee tuberculosis (Crane-Knee Wind) presented with frequent urination progressing to continuous dribbling, dark or sallow complexion, poor appetite, and limb fatigue. This indicated deficiency of the Kidney and Spleen-Stomach. Buzhong Yiqi Tang was administered in the morning, and Wuwei Yigong San in the evening. Diet improved, limbs strengthened, and finally, Dihuang Wan cured the condition.
A child who engaged in early sexual activity developed an ulcerated hypochondriac abscess with stranguria-like urination. After taking diuretic agents (Fenli), abdominal distension worsened, urinary incontinence persisted, penile pain occurred, and fecal incontinence appeared. I diagnosed congenital Kidney Yin deficiency and advised urgent tonification of Spleen and Lung to nourish the source of transformation. The family refused, continuing diuretics, leading to death.
Huangqin Qingfei Yin (Scutellaria Lung-Clearing Decoction)
Zishen Wan (see "Urinary Obstruction" chapter)
Jiawei Xiaoyao San (see "Continuous Fever" chapter)
Simei Fei'er Wan (see "Deep-Seated Abscess" chapter)
Douchi Bing (see "Liuzhu" chapter)
Bawei Wan (see "Fecal Incontinence" chapter)
Wuwei Yigong San (see "Toxin-Resolving Medicines" chapter)