癃闭似淋点滴无，只求利水法全迂，柴升（补中益气汤服后，以手探吐）探吐针机转，麻黄
杏（仁加入五淋汤）行阳阴气濡，肾气（丸）龙腾泽自沛，通关（丸，又名滋肾丸）云合雨时敷，二冬杏
菀参桑白（此李士材医案，从高原以导之之法，）海蜇（一名水母）荸荠亦可需。
浊病皆湿热之病。湿胜热则为白，热胜湿则为赤。初起宜二陈汤加苍术、白术、黄柏、
萆主之，赤浊再加丹参。如若未效，宜固其精道，利其水道，用萆 厘清饮。或久而
不愈
，宜补其心气，用四君子汤加远志二钱。或水虚火旺而为浊，宜六味丸加黄柏、苍术、益智
仁之类。或火衰气不摄精，宜桂附八味丸加菟丝、车前之类。浊出精窍，与淋出溺窍不同。
总以治肾为主。然初起多由于湿热，故列于热证。
（经义）《至真要大论》曰∶“诸转反戾，水液混浊，皆属于热。”“太阳之胜，阴中乃疡
，隐曲不利，互引阴股。”《痿论》曰∶“思想无穷，所愿不得，意淫于外，入房太甚，宗
筋驰纵，发为筋痿，及为白淫。”《口问》曰∶“中气不足，溲便为之变。”《玉机真论
》曰∶“冬脉不及，则令人小腹满，小便变。”按∶宜参癃闭、遗溺各章文。
浊由湿热二陈（汤）加（味），苍白丹参柏 夸，坊本（萆 ）厘清（饮）通水道，全书（景岳）远志（四
君子
汤加此）入心家，火衰肾气丸为主，水阙（六味）地黄汤可嘉，借用遗精封髓（丹）法，时方却不悖长
沙。
呕者，呕字从沤，沤者水也，口中出水而无食也。吐者，吐字从土，土者食也，口中吐
食而无水也。呕吐者，水与食并出也。哕者，口中有秽味也，又谓之干呕者，口中有秽味，
未有不干呕也。呃逆者，气冲有声，声短而频也，昔人亦谓之哕，时书分别多误，今特正之
。统用二陈汤倍半夏加生姜为主，以统治之。热加黄连、鲜竹茹、鲜芦根；寒加吴茱萸、人
参、大枣；食积加六神曲、炒山楂、麦芽、干姜；哕加旋复花、人参、代赭石；呃逆加竹茹
四钱，倍用橘皮。如久病发呃，为脾肾之气将绝，用人参一两，干姜、附子各三钱，丁香、
沉香、柿蒂各一钱，可救十中之一。以上诸证，皆阳明气逆之病，故一方可以统治。惟吐虫
宜去甘草，加川椒、人参、吴茱萸、黄连、黄柏、干姜、乌梅肉各一钱治之。此症不尽属热
，缘《内经》有∶“诸逆上冲，皆属于火”之训，故列于热证。
Lung Bi (obstruction of urination) presents with difficulty in passing even a few drops, resembling Lin syndrome (dysuria with frequency and urgency). Relying solely on diuretic methods is overly rigid. Provoking vomiting after administering Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) can activate the mechanism of Qi transformation; adding Mahuang (Ephedrae Herba) and Xingren (Armeniacae Semen) to Wulin Tang (Five Lin Decoction) promotes Yang Qi and moistens Yin fluids. Shengqi Wan (Kidney Qi Pill) acts like a dragon rising, ensuring abundant fluid distribution; Tongguan Wan (Pass the Pass Pill, also known as Zishen Wan) facilitates urination like clouds gathering and rain falling. Additionally, Donggong (Tian Dong and Mai Dong), Xingren, Jiegeng, Renshen, Sangbaipai (a case from Li Shicai, employing the method of draining from the high source to guide flow), Haizhe (also known as Shuimu, jellyfish), and Qishi (water chestnut) may also be utilized.
Zhuo disease (turbid urine or seminal turbidity) is caused by damp-heat. When dampness exceeds heat, the discharge is white; when heat exceeds dampness, it is red. In the initial stage, Erchen Tang (Two Aged Substances Decoction) combined with Cangzhu, Baizhu, Huangbai, and Bibi is indicated. For Chi Zhuo (red turbidity), Danshen is added. If ineffective, one should secure the essence pathway and promote water passage using Bibi Qingfen Yin (Bibi Clearing and Separating Decoction). If the condition persists for a long time without resolution, supplement Heart Qi using Sijunzi Tang (Four Gentlemen Decoction) with two qian of Yuanzhi. If caused by Kidney Yin deficiency with hyperactive fire, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) combined with Huangbai, Cangzhu, and Yizhiren is appropriate. If caused by declining Fire of the Gate of Vitality failing to control the essence, Guifu Bawei Wan (Cinnamon Twig and Aconite Eight-Ingredient Pill) with Tusizi and Cheqianzi is suitable. Turbid discharge exits through the essence orifice, differing from Lin syndrome which exits through the urinary orifice. The primary treatment focuses on the Kidneys. However, since initial cases are often due to damp-heat, they are categorized under Heat Syndromes.
(Classical Basis) *Suwen: Zhentyao Dalun* states: "All cases of twisting, convulsions, and muscle cramps, as well as turbid body fluids, belong to Heat." "When Taiyang cold-water qi prevails, ulcers occur in the yin region, dysfunction of concealed areas arises, and pain radiates to the inner thighs." *Suwen: Feilun* states: "Endless thoughts, unfulfilled desires, mental wandering outward, and excessive sexual intercourse cause the Zongjin (major sinews) to relax, leading to Jin Wei (sinew flaccidity) and Baiyin (white efflorescence/seminal emission)." *Lingshu: Kouwen* states: "Deficiency of Middle Qi leads to abnormalities in urination and defecation." *Suwen: Yuji Zhenlun* states: "If the Winter pulse is insufficient, it causes fullness in the lower abdomen and changes in urination." Note: Refer to chapters on Lung Bi and Yini (involuntary urination).
Zhuo disease stems from damp-heat; Erchen Tang modified with Cangzhu, Baizhu, Danshen, and Huangbai is praised. Folk editions advocate Bibi Qingfen Yin to clear the water passages. Zhang Jingyue's works emphasize adding Yuanzhi to Sijunzi Tang to benefit the Heart. Declining Fire is treated primarily with Shengqi Wan; Water Deficiency is addressed commendably with Dihuang Tang (Liuwei Dihuang Wan). Borrowing the Fengsui Dan method for treating spermatorrhea, contemporary formulas do not contradict the Changsha school (Zhang Zhongjing).
Ou (vomiting water) derives from 'ou' (bubbles), referring to expelling water without food. Tu (spitting up food) derives from 'tu' (earth), referring to expelling food without water. Ou Tu involves both water and food. Yue (dry heaving/hiccough sound) refers to a foul odor in the mouth; it is also called Gan Ou (dry retching), implying that foul odor always accompanies dry heaving. E Ni (hiccups) refers to air rushing out with sound, short and frequent. Ancients also called this Yue, but contemporary books often distinguish them incorrectly; this text corrects such errors. Generally, Erchen Tang with doubled Banxia and added Shengjiang serves as the master formula. For Heat, add Huanglian, fresh Zhuru, and fresh Lugen; for Cold, add Wuzhuyu, Renshen, and Dazao; for Food Stagnation, add Liushenqu, fried Shanzha, Maiya, and Ganjiang; for Yue, add Xuanfuhua, Renshen, and Daizheshi; for E Ni, add four qian of Zhuru and double the amount of Chuanpi. If hiccups occur in chronic illness, indicating impending exhaustion of Spleen and Kidney Qi, use one liang of Renshen, three qian each of Ganjiang and Fuzi, and one qian each of Dingxiang, Chenxiang, and Shidi, saving one in ten patients. All above syndromes are diseases of Yangming Qi rebellion, hence one formula governs them. For vomiting worms, remove Gancao, and add one qian each of Chuanjiao, Renshen, Wuzhuyu, Huanglian, Huangbai, Ganjiang, and Wuumei. This syndrome is not entirely Heat-related; given the *Neijing* maxim "all rebellious upward movement belongs to Fire," it is listed under Heat Syndromes.