病源。夫强中病者。茎长兴盛不痿。精液自出是也。由少服五石。石热住于肾中。下焦
虚热。少壮之时。血气尚丰。能制于石。及至年衰血气减少。肾虚不能制精液也。若精液竭
则诸病生矣。（出第五卷中）
千金论曰∶夫人生放恣者众。盛壮之时。不自慎惜。快情纵欲。极意房中。稍至年长。
肾气虚竭。百病滋生。又年少虑不能房。多服石散。真气既尽。石气孤立。唯有虚耗。唇口
干焦。精液自泄。或小便赤黄。大便干实。或渴而且利。日夜一石以来。或渴而不利。或不
渴而利。所食之物。皆作小便。此皆由房室不节之所致也。又强中之病者。茎长兴盛不痿精
液自出也。消渴之后。即作痈疽。皆由石热。凡如此等。宜服猪肾荠 汤。制肾中石热。又
将服白鸭通丸。便瘥。
猪肾荠 汤方。
猪肾一具（去脂膜） 大豆（一升） 荠 （三两） 人参（二两） 茯神（二两） 磁
石（二两
碎） 知母（二两） 葛根（二两） 黄芩（二两） 栝蒌（二两） 甘草（二两炙） 石
膏（三两）
上十二味切。以水一斗五升。先煮猪肾大豆取一斗以下。去滓。纳诸药煎。取三升。去
滓。分温三服。渴乃饮之。下焦热者。辄合一剂。病势渐歇即停。忌海藻菘菜酢物。
又平人夏月喜渴者。由心旺也。心旺便汗出。汗出则肾中虚燥。故令渴而小便少也。冬
月不汗出。故小便多而数也。此皆是平人之候。名曰肾渴。但小便利而不饮水者。名肾实也。
经曰∶肾实则消。消者不渴而利是也。所以服石之人。其于小便利者。石性归肾。肾得石则
实。实则能消水浆故利。利多则不得润养五脏。脏衰则生诸病也。张仲景曰∶若热结中焦则
为坚热也。热结下焦则为溺血。亦令人淋闭不通。明知不必悉患小便利。信矣。内有热气者
则喜渴也。除其热则止。渴兼虚者。须除热而兼宜补虚。则病愈。
又疗岭南山瘴气。兼风热毒瓦斯入肾中。变成寒热。脚弱虚满而渴方。
黄连（不限多少） 生栝蒌（汁） 生地黄（汁） 羊乳（无即用牛乳及人乳亦得）
上四味。取三般汁乳和黄连末。任多少。众手捻为丸。如梧子大。麦饮服三十丸。渐加
至四十丸。五十丸。日三服。轻者三日愈。重者五日愈。若药苦难服。即煮麦饮汁下亦得。
文仲云。黄连丸一名羊乳丸。肘后同忌猪肉芜荑。
又疗消渴。浮萍丸方。
浮萍 栝蒌根（等分）
上二味捣筛。以人乳汁和为丸如梧子。麦饮服二十丸。日三服。三年病。三日瘥。（肘
后文仲同主虚热甚佳）
又疗面黄。咽中干燥。手足俱黄。短气。脉如连珠。除热止渴利。补养地黄丸方。
生地黄汁（二升） 生栝蒌汁（二升） 生羊脂（三升牛脂亦得） 好蜜（四升） 黄
连（末一
斤）
上五味捣合。银锅中熬。成煎。可丸如梧子。饮汁送五丸。日三服。加至十丸。若苦冷
而渴瘥。即令别服温药。忌猪肉芜荑。（肘后同）
又疗渴小便数散方。
知母（六分） 栝蒌（一斤） 茯苓（四分） 铅丹（一分） 鸡 中黄皮（十四枚）
上五味为散。饮服方寸匕。日三禁酒生菜肉。瘥后去铅丹。以蜜和之。以麦饮。长服勿
绝。良。忌酢物。（肘后同）
[Etiology] The condition known as "Qiangzhong" (Strong Middle) is characterized by persistent erection of the penis without flaccidity and spontaneous emission of semen. This arises from taking the Five-Mineral Powder in youth, where the heat of the minerals remains lodged in the Kidneys, causing deficient-heat in the Lower Jiao. In one's vigorous youth, when Qi and Blood are abundant, they can restrain the mineral heat; however, with advancing age and depletion of Qi and Blood, Kidney deficiency fails to control the essence, leading to this condition. If the essence is exhausted, various diseases will arise. (Excerpted from Volume 5)
The *Qianjin Fang* states: Many people indulge their desires. During their prime, they fail to exercise caution or cherish their health, indulging in lust and excessive sexual activity. As they age, Kidney Qi becomes depleted and exhausted, giving rise to a hundred diseases. Furthermore, young people who lack prudence regarding sexual restraint often take mineral powders. Once the True Qi is exhausted, the mineral Qi stands alone, resulting only in consumption and wasting. Symptoms include dry and scorched lips and mouth, spontaneous leakage of semen, red and yellow urine, dry and hard stools, thirst accompanied by polyuria (drinking up to one *shi* per day), or thirst without polyuria, or no thirst but polyuria, where ingested food transforms directly into urine. All these are caused by unrestrained sexual activity. Additionally, in Qiangzhong disease, the penis remains persistently erect without flaccidity, and semen leaks spontaneously. After suffering from Xiao Ke (Wasting-Thirst), carbuncles and sores may develop, all due to the heat of the minerals. For such cases, it is appropriate to administer Zhushen Ji Tang (Pig Kidney Shepherd's Purse Decoction) to restrain the mineral heat in the Kidneys. Subsequently, taking Baiya Tong Wan (White Duck Detoxification Pill) will lead to recovery.
**Zhushen Ji Tang Formula:**
One Pig Kidney (remove fatty membrane), Soybeans (Shengdou, 1 *sheng*), Shepherd's Purse (Ji, 3 *liang*), Ginseng (Renshen, 2 *liang*), Spirit of Poria (Fushen, 2 *liang*), Magnetite (Cishi, 2 *liang*, crushed), Anemarrhena Root (Zhimu, 2 *liang*), Kudzu Root (Gegen, 2 *liang*), Scutellaria Root (Huangqin, 2 *liang)*, Trichosanthes Fruit (Gualou, 2 *liang)*, Licorice Root (Gancao, 2 *liang*, honey-fried), Gypsum (Shigao, 3 *liang*).
Chop the above twelve ingredients. Use fifteen *dou* of water. First decoct the pig kidney and soybeans until the liquid reduces to less than ten *dou*. Strain out the dregs. Add the remaining herbs and decoct again to obtain three *sheng* of liquid. Strain out the dregs. Divide into three warm doses. Drink when thirsty. If the heat is concentrated in the Lower Jiao, prepare a full dose consecutively. Stop administration as the pathological trend subsides. Avoid eating seaweed, Chinese cabbage (*Songcai*), and vinegar products.
Furthermore, ordinary people who feel thirsty in summer do so because Heart Fire is flourishing. Flourishing Heart Fire causes sweating; sweating leads to deficiency and dryness in the Kidneys, thus causing thirst and oliguria. In winter, without sweating, urination is frequent and copious. These are physiological signs of healthy individuals, termed "Kidney Thirst." However, if urination is free-flowing without drinking water, it is termed "Kidney Excess." The Classics state: "When the Kidney is in excess, there is consumption." Consumption manifests as no thirst but polyuria. Therefore, for those taking mineral powders, if urination is free-flowing, it is because the nature of the minerals returns to the Kidney. When the Kidney receives the minerals, it becomes excess. Excess allows for the digestion of fluids, hence polyuria. Excessive urination fails to moisten and nourish the Zang-Fu organs. As the organs decline, various diseases arise. Zhang Zhongjing said: "If heat binds in the Middle Jiao, it forms firm heat; if heat binds in the Lower Jiao, it causes hematuria and also leads to strangury and urinary retention." It is clear that not everyone taking minerals necessarily experiences free-flowing urination; this is indeed true. Those with internal heat tend to feel thirsty; clearing the heat stops the thirst. If thirst is accompanied by deficiency, one must clear the heat while simultaneously tonifying deficiency for recovery.
Another formula for treating mountain miasma in Lingnan, combined with wind-heat toxic qi invading the Kidneys, transforming into alternating chills and fever, weak legs, abdominal distension, and thirst:
Coptis Rhizome (Huanglian, amount unlimited), Fresh Trichosanthes Root (Gualougen, juice), Fresh Rehmannia Root (Shengdihuang, juice), Sheep Milk (Yangru; if unavailable, cow's milk or human milk is acceptable).
Take the juices of the three plant materials and mix them with sheep milk and Coptis powder. Roll into pills the size of wu-tzu seeds. Administer thirty pills with Mai Yin (wheat drink), gradually increasing to forty or fifty pills. Take three times daily. Mild cases resolve in three days; severe cases in five days. If the bitter taste is difficult to swallow, boiling wheat drink can be used for administration.
Wen Zhong stated that Huanglian Wan (Coptis Pill) is also known as Yangru Wan. The *Zhouhou Fang* agrees; avoid pork and coriander.
Another formula for treating Xiao Ke (Wasting-Thirst): Fuping Wan (Duckweed Pill).
Floating Duckweed (Fuping), Trichosanthes Root (Gualougen) in equal parts.
Pulverize and sieve the two ingredients. Mix with human milk to form pills the size of wu-tzu seeds. Administer twenty pills with wheat drink, three times daily. A three-year illness resolves in three days. (The *Zhouhou Fang* and Wen Zhong agree; excellent for treating severe deficient-heat).
Another formula for treating sallow complexion, dry throat, yellowing of hands and feet, shortness of breath, pulse resembling linked pearls, which clears heat, stops thirst, promotes urination, and tonifies: Buyang Dihuang Wan (Nourishing Rehmannia Pill).
Fresh Rehmannia Juice (Shengdihuangzhi, 2 *sheng*), Fresh Trichosanthes Juice (ShengGualouzhi, 2 *sheng*), Fresh Mutton Fat (Shengyangzhi, 3 *sheng*; beef fat is acceptable), Fine Honey (4 *sheng*), Coptis Powder (Huanglianmo, 1 *jin*).
Mash and combine the five ingredients. Simmer in a silver pot until it becomes a paste. Form into pills the size of wu-tzu seeds. Administer five pills with fluid drink, three times daily, gradually increasing to ten pills. If cold-induced thirst persists, administer warming medicines separately. Avoid pork and coriander. (Agrees with *Zhouhou Fang*).
Another formula for treating thirst and frequent, scattered urination:
Anemarrhena Root (Zhimu, 6 fen), Trichosanthes Fruit (Gualou, 1 *jin*), Poria (Fuling, 4 fen), Lead Monoxide (Qiandan, 1 fen), Chicken Gizzard Lining (Jineijin, 14 pieces).
Pulverize the five ingredients into a powder. Administer one *cunbi* (square-inch scoop) with fluid drink, three times daily. Abstain from alcohol, raw vegetables, and meat. After recovery, remove the lead monoxide, mix with honey, and administer with wheat drink. Long-term continuous use is effective. Avoid vinegar products. (Agrees with *Zhouhou Fang*).