浊属心肾，淋为肝胆。痛则为淋，不痛为浊。遗由精窍，淋在溺窍，异出同力，最宜分别，切勿混治。
浊症原分赤与白，白属气分赤属血。脾胃湿热注膀胱，水液混浊皆属热（本《内经》。主
治清心莲子饮，痰注膀胱二陈合。白由肾虚萆 饮，赤是血虚合四物。淋症血石劳气膏，滴
沥疼痛常呼号。心与小肠相表里，心火犹动相火烧。欲住不住住又至，总将津液常煎熬。八
正四苓合四物，山栀知柏淋应消。）
浊淋二症参看湿热下注
萆 木通 海金沙 赤茯 猪苓 泽泻 川黄柏 山栀 茵陈 鲜竹叶 丹皮
汉防己 子和桂苓饮 刘檀石猪肚丸
阴虚湿热淋浊
滋肾丸 丹溪大补阴丸合水陆二仙膏加牡蛎、金樱膏、六味丸，去萸肉，加车前、牛膝。
心火下陷淋浊（心阳亢而下注，利其火府）
厘清饮加山栀、丹皮、茯苓、猪苓。清利火府用导赤散加赤苓、瞿麦。又方川连、生地、人
参、桔梗、川柏、茯苓、丹参、菖蒲
气闭成淋
紫苑 栝蒌皮 郁金 降香 杏仁 枇杷叶 山栀
食入痞满便淋（照前方去紫菀、山栀，加苡仁）
膀胱蓄热血淋（小便短赤带血）
用导赤散加赤茯苓 西血珀屑（五分）
又方 黄柏 知母 山栀 生地 龙胆草 丹皮 酒大黄 淡竹叶 当归 郁李仁 元红花
精浊阴亏
炙龟版 熟地 天冬 肥知母 淡秋石 川柏 茯苓 猪脊筋
肾虚不摄，淋浊（脉细腰酸，遗沥胃减，宜收纳肝肾）
茯苓 青盐 胡桃 肾气汤加淡苁蓉鹿角 大茴香
败精浊瘀阻窍
用虎杖散加韭白汁 制大黄 麝香（少许）
入络通血 白丑 桃仁 归须 桂枝 小茴 杜牛膝 归尾 山栀 川楝子 韭白
两头尖 川柏 远志 淡苁蓉 柏仁 茯苓 生鹿角 大黄 小茴 加麝香
又方
阿胶 生地 女贞子 料豆皮 琥珀屑
淋浊（奇脉病）
败精内滞因溺强出，积久精血皆枯，当以冲督任带调理，亦如妇人之漏带也。
鹿茸 小茴香 归身 人参 杞子 龟版心 茯苓 柏霜 补骨脂 覆盆子 菟丝子
又方
鹿茸 韭子 胡桃 沙苑子 舶茴香
何书田曰∶便浊只在气虚与湿热。实者宣通水道，虚者调养中州，虚实两兼又宜益脏通
腑。精浊总由肝肾损伤，而有精瘀精滑之分。精瘀当先理离宫腐浊，然后补肾。精滑用固补
敛摄，不应，从真元气调之。张景岳所谓其无形以固有形也。然人必知八脉，治用孙真人九
法，升奇阳，固精络，使督任有权，漏卮自已。尿血一症，虚者居多，若有火亦能作痛，当与
血淋同治。如清之不愈，专究乎虚，则上注心脾，下从肝肾，久则主乎八脉。
陈参曰∶厥阴内患最急，少腹绕前阴如刺，小水点滴难通，环阴之脉络皆痹，气化机
关已息，必须仿朱南阳法，兼参李 湖意用滑利通阳，辛咸泄急，佐以循经入络之品。古
人云∶九窍不和多属胃病，六腑为治，以通为补。脾宜升则健，胃宜降则和。盖太阴之土得
阳始运，阳明之土得阴则安。脾喜刚燥，胃喜柔润，张仲景急下存津，治中胃也。李东垣大
升阳气，治在脾也。
八正散 治湿热便秘。
车前子 瞿麦 山栀 灯草 细木通 滑石 大黄 扁蓄草 甘草 木香
湿热盛而宣彻其泉源也。陈注。
Zhuo syndrome (Cloudy Urine) involves the Heart and Kidney, while Lin syndrome (Stranguria) involves the Liver and Gallbladder. Pain indicates Lin syndrome; absence of pain indicates Zhuo syndrome. Sperm leakage occurs via the spermatic orifice (Jing Qiao), whereas Lin syndrome affects the urinary orifice (Niao Qiao). Although they originate from different pathways, their pathogenic forces are similar and must be distinguished carefully; do not treat them indiscriminately.
Zhuo syndrome is originally divided into Red Zhuo and White Zhuo. White Zhuo belongs to the Qi level, and Red Zhuo belongs to the Blood level. Damp-heat in the Spleen and Stomach pouring downward into the Bladder causes turbid fluids, all of which belong to Heat (based on *Huangdi Neijing*). The primary treatment is Qingxin Lianzi Yin (Clear the Heart with Lotus Seed Decoction); if phlegm obstructs the Bladder, combine Erchen Tang (Two-Cured Decoction). White Zhuo due to Kidney deficiency uses Bibi Fenqing Yin (Bibee Decoction for Separating the Clear); Red Zhuo due to Blood deficiency combines Siwu Tang (Four Substances Decoction). Lin syndrome includes Xue Lin (Blood Stranguria), Shi Lin (Stone Stranguria), Lao Lin (Labor Stranguria), and Qi Lin (Qi Stranguria); patients often cry out in pain from dribbling and discomfort. The Heart and Small Intestine are exterior-interior related; Heart Fire can stir up Ministerial Fire. Urination is interrupted and recurrent, constantly consuming Body Fluids. Bazen San (Eight-Right Powder), Siling San (Four-Ingredient Powder for Eliminating Water), combined with Siwu Tang, or Zhi Mu (Anemarrhenae Rhizoma) and Huangbai (Phellodendri Cortex) with Zhizi (Gardeniae Fructus) should resolve Lin syndrome.
For Zhuo and Lin syndromes, refer to "Damp-Heat Pouring Downward":
Bibi (Dioscoreae Hypoglaucae Rhizoma), Mutong (Akebiae Caulis), Haijinsha (Lygodii Spora), Chi Fuling (Poria with Red Hostwood), Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Chuan Huangbai (Phellodendri Chinensis Cortex), Zhizi (Gardeniae Fructus), Yichen (Coix Seed), Xian Zhuye (Fresh Bamboo Leaf), Danpi (Moutan Cortex).
Han Fangji (Stephaniae Tetrandrae Radix), Hezi Gu Ling Yin (Hezi's Cinnamon and Polyporus Decoction), Liu Tan Shi Zhu Du Wan (Liu Tan Stone Pig Stomach Pill).
Yin Deficiency with Damp-Heat causing Lin/Zhuo:
Zishen Wan (Kidney-Nourishing Pill); Danxi Dabu Yin Wan (Danxi's Great Tonification Yin Pill) combined with Shuilu Erxian Gao (Water and Land Two Immortals Paste), plus Muli (Ostreae Concha), Jinying Gao (Chrysanthemi Fructus Paste), and Liujun Wan (Six-Ingredient Pill), removing Yurou (Corni Fructus), adding Cheqian (Plantaginis Semen) and Niuxi (Achyranthis Bidentatae Radix).
Heart Fire sinking causing Lin/Zhuo (Heart Yang hyperactive pouring downward, clear the Fire Mansion):
Li Qing Yin (Clarifying Decoction) plus Zhizi (Gardeniae Fructus), Danpi (Moutan Cortex), Fuling (Poria), Zhuling (Polyporus). To clear and drain the Fire Mansion, use Daochi San (Guide Out Redness Powder) plus Chi Fuling (Poria with Red Hostwood) and Qumai (Dianthi Herba). Another prescription: Chuanlian (Coptidis Rhizoma), Shengdi (Rehmanniae Radix), Renshen (Ginseng Radix et Rhizoma), Jiegeng (Platycodonis Radix), Chuanbai (Phellodendri Chinensis Cortex), Fuling (Poria), Danshen (Salviae Miltiorrhizae Radix et Rhizoma), Changpu (Acori Tatarinowii Rhizoma).
Qi Obstruction causing Lin:
Ziwan (Asari Radix et Rhizoma), Gualou Pi (Trichosanthis Pericarpium), Yujin (Curcumae Radix), Jiangxiang (Daemonorops Draco), Xingren (Armeniacae Semen Amarum), Pipaye (Eriobotryae Folium), Zhizi (Gardeniae Fructus).
Postprandial fullness and dribbling (Refer to previous formula, remove Ziwan and Zhizi, add Yiren [Coicis Semen]):
Bladder Accumulation of Hot Blood causing Xue Lin (Urine short, red, with blood):
Use Daochi San (Guide Out Redness Powder) plus Chi Fuling (Poria with Red Hostwood) and Xi Xu Po Xie (Tiger Blood Amber Dust, 5 fen).
Another formula: Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Zhizi (Gardeniae Fructus), Shengdi (Rehmanniae Radix), Longdancao (Gentianae Radix), Danpi (Moutan Cortex), Jiu Dahuang (Rhei Radix et Rhizoma processed with wine), Dan Zhuye (Bambusae Folium), Danggui (Angelicae Sinensis Radix), Yuliren (Pruni Semen), Yuan Honghua (Carthami Flos).
Essence Turbidity due to Yin Deficiency:
Zhi Guiban (Testudinis Carapax et Plastron processed), Shudi (Rehmanniae Radix Preparata), Tiandong (Asparagi Radix), Fei Zhimu (Anemarrhenae Rhizoma), Dan Qiushi (Halitum), Chuanbai (Phellodendri Chinensis Cortex), Fuling (Poria), Zhu Jijin (Porcine Spinal Cord).
Kidney Deficiency failing to secure, causing Lin/Zhuo (Fine pulse, sore waist, post-void dribbling, reduced appetite, appropriate to gather and secure Liver and Kidney):
Fuling (Poria), Qingyan (Halitum), Hetao (Juglandis Semen), Shenqi Tang (Kidney-Qi Decoction) plus Rongrong (Cynomorii Fructus), Lujiao (Cervi Cornus Degelatinatum), Da Huixiang (Foeniculi Fructus).
Stagnant Essence and Turbidity blocking the orifices:
Use Huzhang San (Polygoni Divaricati Powder) plus Jiubaiju (Allium Tuberosum Juice), Zhi Dahuang (Rhei Radix et Rhizoma processed), Shexiang (Moschus, a small amount).
Meridian-penetrating Blood-invigorating formula: Baiqiu (Strychni Semen), Taoren (Persicae Semen), Guixu (Angelicae Sinensis Radix tip), Guizhi (Cinnamomi Ramulus), Xiaohui (Foeniculi Fructus), Du Niuxi (Cyathulae Radix), Guiwei (Angelicae Sinensis Radix tail), Zhizi (Gardeniae Fructus), Chuanlianzi (Meliae Fructus), Jiubai (Allium Tuberosum), Liangtoujian (Euodiae Fructus), Chuanbai (Phellodendri Chinensis Cortex), Yuanzhi (Polygalae Radix), Rongrong (Cynomorii Fructus), Bairén (Ziziphi Spinosae Semen), Fuling (Poria), Sheng Lujiao (Cervi Cornus Degelatinatum raw), Dahuang (Rhei Radix et Rhizoma), Xiaohui (Foeniculi Fructus), plus Shexiang (Moschus).
Another formula: Ejiao (Colla Corii Asini), Shengdi (Rehmanniae Radix), Nvzhenzi (Ligustri Lucidi Fructus), Liaodoupi (Sojae Semen Nigrum Pericarpium), Hupo Xie (Ambarum Pulvis).
Lin/Zhuo (Extraordinary Vessel Disease):
Stagnant essence inside, forced out during urination, leading to exhaustion of essence and blood over time. Regulate Chong, Du, Ren, and Dai vessels, similar to treating leukorrhea and metrorrhagia in women.
Lurong (Cervi Cornu Cornu), Xiaohui (Foeniculi Fructus), Guishen (Angelicae Sinensis Radix tip), Renshen (Ginseng Radix et Rhizoma), Qizi (Lycii Fructus), Guiban Xin (Testudinis Carapax et Plastron heart part), Fuling (Poria), Baishuang (Juniperi Fructus powder), Buguzhi (Psoraleae Fructus), Fupenzi (Rubiae Fructus), Tusizi (Cuscutae Semen).
Another formula: Lurong (Cervi Cornu Cornu), Jiuizi (Allii Tuberosi Semen), Hetao (Juglandis Semen), Shayuanzi (Astragali Complanati Semen), Bo Huixiang (Foeniculi Fructus imported).
He Shutian said: Cloudy urine relates only to Qi Deficiency and Damp-Heat. Excess patterns require unblocking the water passages; deficiency patterns require nourishing the Middle Jiao. Mixed excess-deficiency requires tonifying viscera and draining bowels. Essence turbidity stems from Liver-Kidney damage, divided into Essence Stasis and Essence Slippage. For Essence Stasis, first clear the corruption in the Li Gong (Heart/Small Intestine), then tonify the Kidney. For Essence Slippage, use astringent tonification; if ineffective, regulate the True Original Qi. This is what Zhang Jingyue meant by "formless becoming formed." However, physicians must understand the Eight Extraordinary Vessels and apply Sun Simiao's Nine Methods to raise Odd Yang, secure the Essence Collaterals, empower the Du and Ren vessels, and stop the leak. Hematuria is mostly deficiency; if heat causes pain, treat it as Xue Lin. If clearing heat fails, investigate deficiency: upper involvement in Heart-Spleen, lower in Liver-Kidney, chronic cases involve the Eight Extraordinary Vessels.
Chen Can said: Jueyin internal pathology is most urgent. Lower abdomen and anterior yin feel like stabbing; urine passes drop by drop with difficulty; meridians around the yin are blocked; Qi transformation mechanisms have ceased. One must imitate Zhu Nanyang's method, referencing Li Dongyuan's intent, using slippery and unblocking Yang-promoting agents, pungent-salty drugs to relieve urgency, assisted by meridian-penetrating herbs. Ancients said: Disharmony of the nine orifices mostly belongs to Stomach disease. Treating the Six Fu organs, unblocking is tonification. Spleen thrives on ascending; Stomach harmonizes on descending. Taiyin Earth moves with Yang; Yangming Earth rests with Yin. Spleen likes dryness; Stomach likes moistness. Zhang Zhongjing's rapid purgation to preserve fluids treats the Stomach. Li Dongyuan's great raising of Yang Qi treats the Spleen.
Bazen San (Eight-Right Powder): Treats Damp-Heat constipation.
Cheqianzi (Plantaginis Semen), Qumai (Dianthi Herba), Zhizi (Gardeniae Fructus), Dengcao (Junci Medulla), Mutong (Akebiae Caulis), Huashi (Talcum), Dahuang (Rhei Radix et Rhizoma), Bianxu (Polygoni Avicularis Herba), Gancao (Glycyrrhizae Radix et Rhizoma), Muxiang (Aucklandiae Radix).
When Damp-Heat is abundant, vent its source (Chen's annotation).