[总诀]三焦决渎为出路，肺主通调脾转布。但治小肠与膀胱，世人那得知其故。
小便赤短，别无外证内伤者，小肠经火气也。宜加味导赤散。
生地（三钱） 木通（二钱） 草梢（一钱） 竹叶（一钱） 滑石（二钱） 山栀（三钱） 黄芩（三钱
）
歌曰∶小便缘何见赤黄，木通甘草地芩详。
山栀竹叶同锅煮，滑石煎汤病即康。
（伯未按∶以银花、生地及通天草代饮，轻者亦能已。）
小便白浊，甚则尽如米饮者∶脾经之湿气也。宜萆 厘清饮。
萆 （一钱） 菖蒲（二钱） 甘草（一钱） 益智（二钱） 乌药（三钱） 神曲（一钱） 青盐（五
分）
歌曰∶脾经湿气犯膀胱，小便虽通浊似浆。
萆 菖蒲盐曲共，草梢乌药智仁匡。
（伯未按∶宜少食油类。）
小便短涩，每溺则涩而痛者，膀胱之热淋也。宜车前五淋散。
当归（三钱） 白芍（三钱） 赤苓（三钱） 栀仁（三钱） 甘草（一钱） 灯心（三分） 车前子（
二钱）
歌曰∶热结膀胱用五淋，茎中痛涩芍归寻。
车前甘草山栀共，赤茯苓加灯草心。
小便不通，点滴俱不能出者，膀胱之热结也。宜滋肾通关丸。
黄柏（三钱） 知母（三钱） 安桂（三分）
歌曰∶膀胱热结便殊艰，知柏滋阴岂等闲。
安桂少加为反佐，蜜丸汤下号通关。
小便带血，或兼茎中割痛者，热动胞中血也。宜加味五苓散。
当归（三钱） 赤芍（二钱） 甘草（一钱） 牛膝（一钱） 郁金（一钱） 生地（三钱） 胆草（一
钱） 白芍（三钱） 栀仁（二钱） 灯心（五分） 桃仁（三钱） 木通（一钱） 车前子（一钱） 麝香（
三厘）
歌曰∶小便缘何带血丝，桃归二芍郁金施。
地前通胆栀和麝，牛膝灯心甘草随。
（伯未按∶生地汁、茅根汁和服，亦有效。）
小便不通，诸药俱不效验者，气道迫塞故也。宜通气麻杏汤。
麻黄（七分） 杏仁（三钱） 甘草（一钱）
歌曰∶小便难通治法穷，麻黄甘杏奏奇功。
只缘气道多坚阻，透达元阳水自融。
（伯未按∶当予导尿。）
小便过多，以及遗溺不禁者，膀胱与肾寒也。宜附子温肾丸。
附子（二钱） 安桂（一钱） 熟地（三钱） 山萸（三钱） 白术（三钱） 青盐（五分）
歌曰∶小便嫌多肾要温，山萸桂附术盐吞。
加来熟地兼滋补，遗溺方须究本原。
（伯未按∶初期可买缩泉丸，吞服三钱。）
[General Principle] The Sanjiao (Triple Burner) acts as the official of drainage, serving as the pathway for urine excretion; the Lung governs the unblocking and regulation of water passages, while the Spleen governs the transformation and distribution of fluids. People often only know to treat the Small Intestine and Bladder, but fail to understand the underlying principles.
If urine is red and scanty, without other external or internal injury symptoms, it is due to Fire Qi in the Small Intestine Meridian. Jiawei Daochi San (Modified Guide Out Red Powder) is suitable.
Shengdi Huang (Rehmanniae Radix Preparata, 3 qian) Mutong (Akebiae Caulis, 2 qian) Cao Shao (Glycyrrhizae Radix et Rhizoma tip, 1 qian) Zhuye (Bambusae Folium, 1 qian) Huashi (Talcum, 2 qian) Shanzhi (Gardeniae Fructus, 3 qian) Huangqin (Scutellariae Radix, 3 qian)
The song says: Why does urine appear red and yellow? Examine Mutong, Gancao, Shengdi, and Huangqin.
Boil Shanzhi and Zhuye together, decoct Huashi with soup, and the illness will recover.
(Bo'an's Note: Using Yinhua (Jasmine Flower), Shengdi, and Tongtiancao (Lycopodium clavatum herb) as a substitute for tea can also cure mild cases.)
If urine is turbid and white, severe cases resembling rice water, it is due to Dampness in the Spleen Meridian. Bixie Qingfen Yin (Grassleaf Dioscorea Decoction for Clearing Turbidity) is suitable.
Bixie (Dioscoreae Hypoglaucae Rhizoma, 1 qian) Changpu (Acori Tatarinowii Rhizoma, 2 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian) Yizhi (Alpiniae Oxyphyllae Fructus, 2 qian) Wuyao (Linderae Radix, 3 qian) Shenqu (Massa Medicata Fermentata, 1 qian) Qingyan (Halitum, 5 fen)
The song says: Spleen Meridian Dampness invades the Bladder, urine flows freely yet is turbid like paste.
Bixie, Changpu, Qingyan, and Shenqu are used together, assisted by Caoshao, Wuyao, and Yizhi.
(Bo'an's Note: One should consume less oily food.)
If urine is short and涩 (astringent/stagnant), painful and difficult during urination, it is Heat Lin Syndrome (Strangury) of the Bladder. Cheqian WuLin San (Plantago Five-Strangury Powder) is suitable.
Danggui (Angelicae Sinensis Radix, 3 qian) Baishao (Paeoniae Radix Alba, 3 qian) Chifuling (Poria Cocos with Red Host, 3 qian) Zhiren (Gardeniae Fructus core, 3 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian) Dengxin (Junci Medulla, 3 fen) Cheqianzi (Plantaginis Semen, 2 qian)
The song says: For Heat binding the Bladder, use WuLin San; for pain and astringency in the urethra, seek Shaoyao and Danggui.
Cheqian, Gancao, and Zhiri are combined, adding Chifuling and Dengxin.
If urine cannot pass at all, not even drops, it is Heat Binding in the Bladder. Zishen Tongguan Wan (Kidney-Nourishing Pass-Gate Pill) is suitable.
Huangbai (Phellodendri Cortex, 3 qian) Zhimu (Anemarrhenae Rhizoma, 3 qian) Angui (Cinnamomi Cortex, 3 fen)
The song says: Heat binding the Bladder makes urination extremely difficult; Zhi and Bai nourish Yin, is this trivial?
Adding a small amount of Angui serves as a counter-agent; made into honey pills and taken with soup, it is called Tongguan.
If urine contains blood, or is accompanied by cutting pain in the urethra, it is Blood disturbance caused by Heat moving within the Baozhong (Lower Jiao Blood Chamber). Jiawei Wuling San (Modified Five-Ingredient Powder with Poria) is suitable.
Danggui (Angelicae Sinensis Radix, 3 qian) Chishao (Paeoniae Radix Rubra, 2 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian) Niuxi (Achyranthis Bidentatae Radix, 1 qian) Yujin (Curcumae Longae Radix, 1 qian) Shengdi (Rehmanniae Radix Preparata, 3 qian) Dancao (Gentianae Radix, 1 qian) Baishao (Paeoniae Radix Alba, 3 qian) Zhiren (Gardeniae Fructus core, 2 qian) Dengxin (Junci Medulla, 5 fen) Taoren (Persicae Semen, 3 qian) Mutong (Akebiae Caulis, 1 qian) Cheqianzi (Plantaginis Semen, 1 qian) Shexiang (Moschus, 3 li)
The song says: Why does urine contain blood threads? Apply Tao Ren, Gui, two types of Shao, and Yujin.
Di, Qian, Tong, Dan, Zhi, and She are harmonized, followed by Niuxi, Dengxin, and Gancao.
(Bo'an's Note: Taking juice of Shengdi and Maogen (Imperatae Rhizoma) mixed together is also effective.)
If urine cannot pass and all medicines fail, it is due to obstruction of the Qi mechanism. Tongqi Maxing Tang (Qi-Unblocking Ephedra and Apricot Kernel Decoction) is suitable.
Mahuang (Ephedrae Herba, 7 fen) Xingren (Armeniacae Semen Amarum, 3 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian)
The song says: When urination is difficult, treatments seem exhausted, but Mahuang, Gancao, and Xingren achieve miraculous results.
It is merely because the Qi mechanism has firm blockages; penetrating and reaching the Yuan Yang allows water to melt and flow naturally.
(Bo'an's Note: Catheterization should be performed.)
If there is excessive urination, or enuresis (involuntary urination), it is Cold of the Bladder and Kidney. Fuzi Wenshen Wan (Aconite Kidney-Warming Pill) is suitable.
Fuzi (Aconiti Lateralis Radix Preparata, 2 qian) Angui (Cinnamomi Cortex, 1 qian) Shudi (Rehmanniae Radix Preparata, 3 qian) Shanyuzhu (Corni Fructus, 3 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, 3 qian) Qingyan (Halitum, 5 fen)
The song says: Disliking excessive urination requires warming the Kidney; swallow Shanyuzhu, Angui, Fuzi, Baizhu, and Yan.
Adding Shudi provides additional nourishment; treating enuresis requires investigating the root cause.
(Bo'an's Note: In the early stage, Suoquan Wan (Urinary-Retarding Pill) can be purchased and taken orally, 3 qian per dose.)