郎 五十六岁 便泄带血，既有膀胱之湿，又有小肠之热，用导赤合四苓汤法。
猪苓（三钱） 茯苓皮（五钱） 萆 （五钱） 泽泻（三钱） 次生地（五钱） 甘草梢（一钱）
淡竹叶（二钱） 木通（三钱） 飞滑石（五钱）
十二月初一日 少腹痛，于前方内，加∶
川楝子（三钱） 小茴香炭（三钱）
王 十七岁 湿土司天，湿热下注，致成淋症，茎肿。
萆 （三钱） 白通草（一钱） 甘草梢（三钱） 茯苓皮（五钱） 滑石（二钱） 生苡仁（五
钱） 车前子（二钱） 泽泻（三钱） 芦根（三钱）
十五日 于前方内，加∶
黄柏炭（三钱）
龚 五十八岁 先是大小便俱闭，自用大黄八钱，大便虽通而小便点滴全无，续用五苓
，仍不通，诊其六脉弦紧，病因肝郁而成，开阴络法。
降香末（三钱） 归须（三钱） 两头尖（三钱） 琥珀（三分） 丹皮（三钱） 韭白汁（三匙
，冲） 麝香（五厘，同研冲）
一帖而通，二帖而畅。
普 三十八岁 小便淋浊，茎管痛不可忍，自用五苓、八正、萆 厘清饮等渗湿，愈
利愈
痛。细询病情，由房事不遂而成。余曰∶溺管与精管异途，此症当治精管为是。用虎杖散法
，现无虎杖草，以杜牛膝代之。
杜牛膝（五钱） 当归（三钱） 降香末（三钱） 麝香（五厘） 桃仁泥（三钱） 两头尖（三
钱） 琥珀（六分） 丹皮（三钱）
一帖而痛减，五帖而痛止，七帖而浊净。后以补奇经而愈。
珍 四十五岁 血淋太多，先与导赤不应，继以脉弦，细询由怒郁而起，转方与活肝络
。
新绛纱（三钱） 苏子霜（一钱） 丹皮炭（五钱） 旋复花（三钱） 桃仁（三钱） 红花（二
钱） 片姜黄（三钱） 香附（三钱） 归须（三钱） 郁金（二钱） 降香末（三钱）
四帖而安。
王 四十五岁，小便狂血，脉弦数，病因肝郁。
新绛纱（三钱） 细生地（五钱） 青皮（二钱） 旋复花（三钱） 丹皮炭（五钱） 桃仁（三
钱） 降香末（三钱） 香附（三钱） 归须（三钱）
服四帖而血止，止后两月，又因动气而发，仍与前方，七帖而愈。
范 二十八岁 因怒郁而大小便闭，与极苦而通小肠，借火腑通胆腑法。
黄芩（三钱） 归须（三钱） 桃仁泥（三钱） 胡黄连（三钱） 龙胆草（三钱） 广郁金（二
钱）
二帖而大小皆通。
保 女 十八岁 怒郁，少腹胀大如斗，小便点滴全无，已三日矣，急不可耐，仰卧不
能转侧起立，与开经络。
降香末（三钱） 香附米（三钱） 广郁金（二钱） 龙胆草（三钱） 青皮（二钱） 韭白汁（
三匙，冲） 归须（三钱） 琥珀（五分） 两头尖（三钱） 麝香（五厘）
一帖而通，二帖而畅。
保 五岁 夏日痘后受暑，小便不通，脉洪数，玉茎肿亮，蜷曲如勾，与凉利膀胱。
白通草（钱半） 蚕砂（三钱） 滑石（六钱） 云苓皮（五钱） 苡仁（五钱） 杏仁（三钱）
一帖而通，三帖而玉茎复元。
叶 四十五岁 乙酉年七月初一日 金实无声，六脉俱弦，痰饮兼之湿痹，小便白浊，
先与行湿。
茯苓皮（五钱） 川萆 （五钱） 通草（一钱） 桂枝（五钱） 防己（三钱） 蚕砂（五钱）
半夏（五钱） 杏仁泥（四钱） 生苡仁（五钱） 甘草（一钱） 滑石（六钱）
服七帖。
十四日 复诊加∶
九月初三日 猪苓（三钱） 泽泻（三钱）
伏饮湿痹便浊，前与淡渗通阳，已服三十帖，因停药二十余日，现下饮又上泛，胸满短
气，腰酸淋浊未除，且与行心下之饮，脉弦细，阳不复。
姜半夏（五钱） 杏仁（四钱） 云苓皮（五钱） 广陈皮（三钱） 防己（四钱） 桂枝（三钱）
枳实（四钱） 萆 （五钱） 通草（钱半） 晚蚕砂（三钱）
十二日 服九帖。
去杏仁、防己，加∶
薏苡（五钱）
又服三十余帖。
十月初五日 痰饮、痹症、淋浊，皆寒湿为病，误与补阴，以致湿邪胶痼沉着，急难清楚。
前与开痹和胃，现今虽见效不少，究竟湿邪为患，阴柔之邪，久为呆补所困，难以旦夕奏功
也。
桂枝（四钱） 川萆解（五钱） 泽泻（三钱） 姜半夏（六钱） 滑石（六钱） 云苓皮（五钱）
广皮（五钱） 蚕砂（三钱） 车前子（三钱） 枳实（三钱） 猪苓（三钱） 生苡仁（五钱）
煮三杯，分三次服。
十月二十五日 浊湿误补久留，与开太阳阖阳明法，数十帖之多，虽见大效，究未清楚
，小便仍间有浊时，腿仍微有酸痛。
姜半夏（一两） 桂枝（四钱） 片姜黄（二钱） 广陈皮（五钱） 通草（一钱） 川萆 （五
钱）
晚蚕砂（三钱） 川椒炭（三钱） 生苡仁（五钱） 防己（三钱） 猪苓（三钱） 小枳实（二钱）
茯苓皮（五钱）
十一月十八日 痹症挟痰饮，小便浊，喉哑，先开上焦，后行中下之湿，余有原案。
苦桔梗（五钱） 甘草（三钱） 杏仁（五钱） 半夏（一两） 云苓皮（五钱） 生苡仁（五钱）
喉哑服此。
备用方∶
桂枝（四钱） 广皮（三钱） 生苡仁（五钱） 云苓皮（六钱） 半夏（六钱） 蚕砂（三钱）
川萆 （五钱） 车前子（四钱） 滑石（一两） 川黄柏（三钱，盐水炒）
便浊服此。
Patient Lang, aged fifty-six. Diarrhea with blood in the stool; there is dampness in the Bladder and heat in the Small Intestine. Treatment method: Combination of Dao Chi San (Guide Out the Red Powder) and Si Ling Tang (Four-Ingredient Poria Decoction).
Polyporus (3 qian), Poria Peel (5 qian), Dioscorea Hypoglauca Rhizome (5 qian), Alisma Fruit (3 qian), Prepared Rehmannia Root (5 qian), Licorice Tip (1 qian), Light Bamboo Leaf (2 qian), Akebia Stem (3 qian), Calcined Talcum (5 qian).
On the first day of the twelfth lunar month, lower abdominal pain occurred. Add to the previous prescription:
Toosendan Fruit (3 qian), Charred Fennel Seed (3 qian).
Patient Wang, aged seventeen. With Damp Earth ruling the year, damp-heat flows downward, resulting in Lin Syndrome (dysuria/painful urination), with swelling of the penis.
Dioscorea Hypoglauca Rhizome (3 qian), White Tongcao (1 qian), Licorice Tip (3 qian), Poria Peel (5 qian), Talcum (2 qian), Coix Seed (5 qian), Plantago Seed (2 qian), Alisma Fruit (3 qian), Reed Rhizome (3 qian).
On the fifteenth day, add to the previous prescription:
Charred Phellodendron Bark (3 qian).
Patient Gong, aged fifty-eight. Initially, both defecation and urination were obstructed. He self-administered 8 qian of Rhubarb; although defecation resumed, urination ceased completely. Subsequently, he took Wu Ling San (Five-Ingredient Poria Pill), but obstruction persisted. Pulse diagnosis revealed wiry and tight pulses in all six positions. The etiology was Liver Qi Stagnation. Treatment method: Opening the Yin Collaterals.
Red Sandalwood Powder (3 qian), Safflower Root (3 qian), Two-ended Acute Thorn (3 qian), Amber (3 fen), Moutan Cortex (3 qian), Leek Juice (3 spoons, mixed in), Musk (5 li, ground together and mixed in).
After one dose, patency was achieved; after two doses, flow was smooth.
Patient Pu, aged thirty-eight. Dysuria with turbid urine, unbearable pain in the urethra. He self-administered diuretic-damp-draining formulas such as Wu Ling San, Ba Zheng San, and Bi Xie Fen Qing Yin, but the more he urinated, the more painful it became. Upon detailed inquiry, the cause was unsatisfactory sexual activity. I stated: The urinary tract and seminal tract have different pathways; this condition should be treated by addressing the seminal tract. Treatment method: Hu Zhang San (Knotweed Powder). As Knotweed was unavailable, Achyranthes Bidentata Root (Du Niu Xi) was substituted.
Achyranthes Bidentata Root (5 qian), Angelica Sinensis Root (3 qian), Red Sandalwood Powder (3 qian), Musk (5 li), Peach Kernel Paste (3 qian), Two-ended Acute Thorn (3 qian), Amber (6 fen), Moutan Cortex (3 qian).
After one dose, pain decreased; after five doses, pain stopped; after seven doses, turbidity cleared. Later, tonification of the Eight Extraordinary Vessels led to recovery.
Patient Zhen, aged forty-five. Excessive hematuria. Initial treatment with Dao Chi San was ineffective. The pulse was wiry. Detailed inquiry revealed onset due to anger and stagnation. Prescription changed to treat the Liver Collaterals.
New Crimson Gauze (3 qian), Perilla Seed Frost (1 qian), Charred Moutan Cortex (5 qian), Inula Flower (3 qian), Peach Kernel (3 qian), Safflower (2 qian), Turmeric Tuber (3 qian), Cyperus Rhizome (3 qian), Safflower Root (3 qian), Curcuma Aromatica Rhizome (2 qian), Red Sandalwood Powder (3 qian).
After four doses, the condition stabilized.
Patient Wang, aged forty-five. Severe hematuria, wiry and rapid pulse. Etiology: Liver Qi Stagnation.
New Crimson Gauze (3 qian), Prepared Rehmannia Root (5 qian), Green Tangerine Peel (2 qian), Inula Flower (3 qian), Charred Moutan Cortex (5 qian), Peach Kernel (3 qian), Red Sandalwood Powder (3 qian), Cyperus Rhizome (3 qian), Safflower Root (3 qian).
After four doses, bleeding stopped. Two months later, relapse occurred due to emotional agitation. The same prescription was used again; after seven doses, full recovery was achieved.
Patient Fan, aged twenty-eight. Anger and stagnation caused obstruction of both defecation and urination. Administration of extremely bitter herbs to unblock the Small Intestine, borrowing the method of "Fire Fu Unblocking Gallbladder Fu."
Scutellaria Root (3 qian), Safflower Root (3 qian), Peach Kernel Paste (3 qian), Picrorhiza Rhizome (3 qian), Gentian Root (3 qian), Curcuma Aromatica Rhizome (2 qian).
After two doses, both defecation and urination resumed.
Bao, female, eighteen years old. Anger and stagnation resulted in a lower abdomen swollen like a bucket, with no urine output for three days. The urgency was unbearable; she lay supine unable to turn or stand. Treatment method: Opening the Collaterals.
Red Sandalwood Powder (3 qian), Cyperus Rhizome (3 qian), Curcuma Aromatica Rhizome (2 qian), Gentian Root (3 qian), Green Tangerine Peel (2 qian), Leek Juice (3 spoons, mixed in), Safflower Root (3 qian), Amber (5 fen), Two-ended Acute Thorn (3 qian), Musk (5 li).
After one dose, patency was achieved; after two doses, flow was smooth.
Bao, five years old. After summer chickenpox, exposure to summer-heat caused urinary retention. Pulse was surging and rapid; the penis was swollen, bright, and curled like a hook. Treatment method: Cooling and draining the Bladder.
White Tongcao (1.5 qian), Mulberry Silkworm Frass (3 qian), Talcum (6 qian), Poria Peel (5 qian), Coix Seed (5 qian), Apricot Kernel (3 qian).
After one dose, patency was achieved; after three doses, the penis returned to normal.
Ye, aged forty-five. First day of the seventh lunar month in the Yihai year. Metal is solid and silent (loss of voice due to excess), all six pulses are wiry. Accompanied by phlegm-fluid retention and damp-bi syndrome, with white turbid urine. Initial treatment focused on moving dampness.
Poria Peel (5 qian), Sichuan Dioscorea Hypoglauca Rhizome (5 qian), Tongcao (1 qian), Cinnamon Twig (5 qian), Stephania Root (3 qian), Mulberry Silkworm Frass (5 qian), Pinellia Tuber (5 qian), Apricot Kernel Paste (4 qian), Raw Coix Seed (5 qian), Licorice Root (1 qian), Talcum (6 qian).
Seven doses administered.
Re-examination on the fourteenth day, additions made on the third day of the ninth lunar month:
Polyporus (3 qian), Alisma Fruit (3 qian).
Hidden fluid retention, damp-bi syndrome, and turbid urine. Previously treated with mild leaching and yang-unblocking methods, totaling thirty doses. Due to stopping medication for over twenty days, lower fluids have now risen upward, causing chest fullness and shortness of breath. Lower back soreness and dysuria with turbidity persist. Temporarily treating fluid retention in the epigastrium. Pulse is wiry and fine; Yang Qi has not recovered.
Ginger-processed Pinellia Tuber (5 qian), Apricot Kernel (4 qian), Poria Peel (5 qian), Broad-leaved Citrus Peel (3 qian), Stephania Root (4 qian), Cinnamon Twig (3 qian), Immature Bitter Orange (4 qian), Dioscorea Hypoglauca Rhizome (5 qian), Tongcao (1.5 qian), Late-season Mulberry Silkworm Frass (3 qian).
Twelfth day, nine doses administered.
Remove Apricot Kernel and Stephania Root, add:
Coix Seed (5 qian).
Another thirty-plus doses administered.
Fifth day of the tenth lunar month. Phlegm-fluid retention, bi syndrome, and lin/turbid urine are all caused by cold-dampness. Misuse of yin-tonifying herbs has caused damp pathogens to become stubborn and entrenched, making them difficult to clear urgently.
Previous treatment opened bi syndrome and harmonized the stomach. Although significant improvement is seen, the root issue remains dampness. Yin-nourishing pathogens, trapped by stagnant tonification, cannot be resolved overnight.
Cinnamon Twig (4 qian), Sichuan Dioscorea Hypoglauca Rhizome (5 qian), Alisma Fruit (3 qian), Ginger-processed Pinellia Tuber (6 qian), Talcum (6 qian), Poria Peel (5 qian), Broad-leaved Citrus Peel (5 qian), Mulberry Silkworm Frass (3 qian), Plantago Seed (3 qian), Immature Bitter Orange (3 qian), Polyporus (3 qian), Raw Coix Seed (5 qian).
Boil to yield three cups, divide into three doses.
Twenty-fifth day of the tenth lunar month. Turbid dampness, prolonged due to mistaken tonification. Treatment method: Opening Taiyang and Closing Yangming. After dozens of doses, although great effect was seen, complete clearance was not achieved. Urine still occasionally turbid; legs still slightly sore and achy.
Ginger-processed Pinellia Tuber (1 liang), Cinnamon Twig (4 qian), Turmeric Tuber (2 qian), Broad-leaved Citrus Peel (5 qian), Tongcao (1 qian), Sichuan Dioscorea Hypoglauca Rhizome (5 qian).
Late-season Mulberry Silkworm Frass (3 qian), Charred Sichuan Pepper (3 qian), Raw Coix Seed (5 qian), Stephania Root (3 qian), Polyporus (3 qian), Small Immature Bitter Orange (2 qian), Poria Peel (5 qian).
Eighteenth day of the eleventh lunar month. Bi syndrome complicated by phlegm-fluid retention, turbid urine, hoarseness. First open the Upper Jiao, then move dampness in the Middle and Lower Jiao. See original case record.
Bitter Platycodon Root (5 qian), Licorice Root (3 qian), Apricot Kernel (5 qian), Pinellia Tuber (1 liang), Poria Peel (5 qian), Raw Coix Seed (5 qian).
For hoarseness, take this formula.
Alternative Formula:
Cinnamon Twig (4 qian), Broad-leaved Citrus Peel (3 qian), Raw Coix Seed (5 qian), Poria Peel (6 qian), Pinellia Tuber (6 qian), Mulberry Silkworm Frass (3 qian), Sichuan Dioscorea Hypoglauca Rhizome (5 qian), Plantago Seed (4 qian), Talcum (1 liang), Sichuan Phellodendron Bark (3 qian, stir-fried with salt water).
For turbid urine, take this formula.