溺与精所出之道不同。淋病在溺道,故纲目列之肝胆部。浊病在精道,故纲
目列之肾膀胱部
。今患浊者,虽便时茎中如刀割火灼,而浊自清,惟窍端时有秽物,如疮之有脓,目之有眵
,淋沥不断。初与便溺不相混滥,如河中之清也,至易辨之,每见时医,以淋法治之,五苓
、八正,杂投不已,因而增剧者,不可胜数。余每正之,其余当难以臆说也。盖由败精腐者
什九,由湿热流注而虚者什一。或曰∶昔人以赤浊为心虚有热,由思虑而得之;白浊为肾虚
有寒,由嗜欲而得之。何原病式以二浊俱属于热?丹溪亦云∶湿热有痰,子能与我折乎?曰∶
辨古今之得失,必以《内经》正之,自《巢氏病源论》,言白浊由劳伤肾虚冷,历代宗其说
有异词。不惟白浊之理未明,即治浊之法亦误。不思《内经》本无白浊之名,惟言思想无穷
,入房太甚,发为白淫,与脾移热与肾出白,少阴在泉溲白,此白浊之源也。原病式因《内
经》诸病,水液混浊,皆属于热。言天气热则水混浊,寒则清洁;又言水体清,火体浊。正
如清水为汤,自然白浊也。可谓发圣人之旨,正千秋之误。而不读其书者,犹未尽知也。丹
溪则以湿热痰虚并言,然虚寒者,不可谓尽无,但热多寒少耳。故《灵枢》有中气不足,便
溲为变之语。是当先补中气以升举之,而后分其气血施治。设肾虚甚,或火邪亢极者,不宜
峻用苦寒,必反佐治之,更在权衡轻重而已。
The pathways for urination and ejaculation are different. Lin syndrome (dysuria) occurs in the urinary pathway, so *Bencao Gangmu* (Compendium of Materia Medica) categorizes it under the Liver and Gallbladder sections. Zhuo syndrome (cloudy discharge) occurs in the seminal pathway, so *Bencao Gangmu* categorizes it under the Kidney and Bladder sections.
Currently, patients suffering from Zhuo syndrome experience pain in the urethra during urination as if cut by a knife or burned by fire, yet the urine itself remains clear. Only at the meatus is there occasional foul discharge, resembling pus from an abscess or ocular discharge from the eyes, dripping continuously. Initially, this secretion does not mix with urine or feces, remaining clear like river water, making it easy to distinguish. However, I often observe contemporary physicians treating it using methods for Lin syndrome, indiscriminately administering Wuling San (Five-Ingredient Poria Decoction) and Bazheng San (Eight-Herb Corrective Decoction), thereby exacerbating the condition; such cases are countless. Whenever I correct this practice, the remaining causes are difficult to speculate upon arbitrarily. Generally, nine-tenths are caused by degenerated semen rotting, while one-tenth is due to damp-heat flowing into the channels accompanied by deficiency.
One might ask: In the past, it was believed that red Zhuo resulted from Heart deficiency with heat, caused by excessive overthinking; white Zhuo resulted from Kidney deficiency with cold, caused by excessive sexual desire. Why does *Yuanbing Shi* (Treatise on the Original Causes of Diseases) state that both types of Zhuo belong to Heat? Danxi also stated: "Damp-heat with phlegm," can you refute this? I reply: To discern the merits and demerits of ancient and modern theories, one must verify them against the *Huangdi Neijing* (Yellow Emperor's Inner Canon). Since *Chishu Bingyaolun* (Catalogue of Pathogenesis of Various Diseases) claimed that white Zhuo results from labor injury leading to Kidney deficiency and cold, generations have followed this view, albeit with varying nuances. This has not only failed to clarify the mechanism of white Zhuo but also led to erroneous treatment methods. One fails to realize that the *Neijing* originally had no term for "white Zhuo"; it only mentioned "endless thoughts and excessive intercourse leading to Baiyin (white leukorrhea/discharge)," "Spleen transferring heat to the Kidney causing white discharge," and "Shaoyin ruling the year resulting in white urine." These constitute the origins of white Zhuo. *Yuanbing Shi*, based on the *Neijing*'s principle that "all turbid fluids belong to Heat," posited that hot weather makes water turbid while cold weather keeps it clear; furthermore, water is inherently clear, while fire is inherently turbid. Just as clear water naturally becomes cloudy when boiled, this theory elucidates the sage's intent and corrects millennia of errors. Those who do not read this work remain largely unaware.
Danxi discussed damp-heat, phlegm, and deficiency together. However, cases of deficiency-cold cannot be said to be entirely non-existent; rather, heat predominates over cold. Thus, the *Ling Shu* (Spiritual Pivot) states: "Deficiency of Middle Qi leads to changes in urination and defecation." Therefore, one should first tonify Middle Qi to raise and lift it, and subsequently treat according to the specific conditions of Qi and Blood. If Kidney deficiency is severe, or if Fire pathogen is extremely hyperactive, harsh bitter-cold herbs should not be used aggressively; instead, counter-assistance methods (fan zuo) must be employed. The key lies in weighing the severity of the condition.