脉盛大而实者生。虚细而涩者死。
夫淋者。有五淋之别。气砂血膏劳是也。皆由膏粱之味。湿热之物。或烧酒炙肉之类过
多。
或用心太过。或房劳无节。以致心肾不交。水火无制。而成五淋之症。名虽有五。大概属热
者居多。故有新久虚实之不同耳。学人审症而变通焉。慎毋胶柱以调瑟也。
一论气砂血膏劳五淋。气淋为病。小便涩滞。常有余沥不尽也。砂淋为病。阴茎中有砂
石而
痛。溺不得卒出。砂出则痛止也。膏淋为病。溺浊如膏也。劳淋为病。遇房劳即发。痛引
气冲也。血淋为病。遇热则发。甚则尿血。候其鼻准色黄者。知其为小便难也。
一论心经蕴热。脏腑闭结。小便赤涩。癃闭不通。及热淋尿淋。如酒后恣欲而得者。则
小便将出而痛。既出而痒。以此药主之。
八正散
大黄（三钱） 瞿麦（二钱） 木通（二钱） 滑石（三钱） 蓄（二钱） 栀子（二钱） 车
前（三钱） 甘草（八分）
上锉一剂。灯心水煎。空心服。
按上方治诸淋属实热者宜之。
一治五淋神方。
海金沙散
当归（二钱） 雄黄（一钱） 川牛膝（三钱去芦酒浸） 大黄（三钱） 木香（八分） 海金沙
（三钱）
上为末。每服一钱五分。临卧。酒调服。两服见效。
按上方治诸淋。不问虚实宜之。
一治淋沥疼痛。兼红淋。
滋阴清火散
当归（二钱） 生地黄（三钱） 熟地黄（三钱） 黄柏（二钱） 知母（二钱） 黄芩（三钱）
黄连（八分） 木通（三钱） 桑白皮（三钱）
上锉。水煎。空心服。
一治诸淋。久不止者。
加味滋阴散
当归（二钱） 川芎（一钱五分） 白芍（二钱） 熟地黄（三钱） 陈皮（二钱） 半夏（二钱
）白茯苓（三钱） 甘草（八分） 升麻（三分） 柴胡（五分） 牛膝（二钱） 黄柏（一钱五分）
知母（一钱五分） 白术（一钱五分） 苍术（一钱五分）
上锉。水煎。露一宿。空心服。
一论诸淋。多属膀胱之气虚弱。不能运用水道而成诸淋也。宜补中益气汤殊效。（方见
内伤）
一论下淋久不止。乃元气下陷故也。宜补中益气汤。（方见内伤）根据本方参、 减半。加
川芎、白芍、熟地、半夏、茯苓、牛膝、黄柏、知母、苍术。水煎。露一宿。空心服。
一论纵欲强留不泄。淫精渗下而作淋者。
益元固精汤
人参 白茯苓 莲蕊 巴戟 升麻 益智仁 黄柏（酒炒各二钱） 山药 泽泻（各一钱五
分） 甘草梢（三钱）
上锉。水煎。空心。温服。
一治小便淋沥不通。又治老人虚寒者。患死血作淋。痛不可忍者。宜六味地黄丸。（方
见补益）根据本方倍茯苓、泽泻。又治小便频数不禁。去泽泻。用益智仁。
一治病苦淋沥。而茎中痛不可忍者。六君子汤（方见补益）加黄柏一钱五分。知母一钱五
分。石苇三钱。滑石三钱。琥珀八分。水煎服。
一治冷淋。诸药不效者。四君子汤（方见补益）加猪苓、泽泻、木通。连进三服。又以菟
丝子研极细。用鸡翎管吹入小便孔内。极效。
一治心经积热。小便涩。及五淋。
火府丹
生地黄（一两捣膏） 木通 黄芩（炒各一两）
上为细末。炼蜜为丸。如梧桐子大。每服三十丸。木通煎汤送下。加甘草名导赤散。
学士云。一卒病渴。日饮水斗许。不食者三月。心中烦闷。时已十月。余谓心经有伏热
与火府丹数服。而渴止食进。此本治淋。用以止渴。可谓通变也。
一李司马茎中作痛。小便如淋。口干唾痰。此思色精降而内败。用补中益气汤、六味地
黄丸而愈。
一儒者发热无时。饮水不绝。每登厕。小便涩痛。大便牵痛。此精竭复耗所致。用六味
丸加五味子。及补中益气。喜其谨守。得愈。若肢体畏寒。喜热饮食。用八味丸。
一老人阴痿思色。精不出。内败。小便水道。涩痛如淋。用八味丸加车前、牛膝。立效
一老人精已竭而复耗之。大小便牵痛。愈痛愈便。愈便愈痛。服以八味丸。其功最效。
A pulse that is large, full, and solid indicates a favorable prognosis (survival). A pulse that is deficient, thin, and choppy indicates an unfavorable prognosis (death).
Lin syndrome (dysuria) is divided into five types: Qi Lin (Qi-type dysuria), Sha Lin (Sand-type dysuria), Xue Lin (Blood-type dysuria), Gao Lin (Paste-type dysuria), and Lao Lin (Exhaustion-type dysuria). These conditions are often caused by excessive consumption of rich, greasy foods, damp-heat inducing substances, or overindulgence in distilled spirits and roasted meats. They may also result from excessive mental exertion or unregulated sexual activity, leading to a lack of communication between the Heart and Kidney, and a loss of regulation between Water and Fire, thereby forming the five types of Lin syndrome. Although there are five names, most cases belong to heat patterns; thus, there are differences between new and chronic cases, as well as excess and deficiency patterns. Practitioners should examine symptoms and apply flexible treatment strategies, avoiding rigid adherence to fixed methods.
Discussion on the Five Types of Lin Syndrome (Qi, Sand, Blood, Paste, Exhaustion):
Symptoms of Qi Lin: Dysuria with a sensation of incomplete emptying after urination.
Symptoms of Sha Lin: Sensation of sand or stones in the penis accompanied by pain; urine cannot be expelled suddenly; pain ceases when the stone passes.
Symptoms of Gao Lin: Urine is turbid and resembles paste or fat.
Symptoms of Lao Lin: Symptoms flare up upon sexual exhaustion; pain radiates to the Qichong point.
Symptoms of Xue Lin: Flares up upon exposure to heat; severe cases present with hematuria. Upon examination, if the tip of the nose appears yellow, it indicates difficulty in urination.
Discussion on Heat Accumulation in the Heart Meridian:
When heat accumulates in the Heart meridian and internal organs become obstructed, resulting in red, scanty, and painful urination, or retention of urine (Long Bi), as well as Re Lin (Heat-type dysuria) and Niao Lin (Urinary-type dysuria)—often caused by indulgence in alcohol and sex—the patient experiences pain before urination and itching after urination. The following formula is indicated:
Ba Zheng San (Eight Upright Powder)
Da Huang (Rhubarb Root and Rhizome, 3 qian)
Qu Mai (Dianthera Herb, 2 qian)
Mu Tong (Akebia Stem, 2 qian)
Hua Shi (Talcum, 3 qian)
Bian Xu (Knotweed Herb, 2 qian)
Zhi Zi (Gardenia Fruit, 2 qian)
Che Qian Zi (Plantago Seed, 3 qian)
Gan Cao (Licorice Root, 8 fen)
Process: Coarsely crush the ingredients for one dose. Decoct with water infused with Jixin (Centipeda Herb) and take on an empty stomach.
Note: This formula is suitable for treating Lin syndromes characterized by excess-heat patterns.
A Divine Formula for Treating the Five Types of Lin:
Hai Jin Sha San (Lygodium Spore Powder)
Dang Gui (Angelicae Sinensis Radix, 2 qian)
Xiong Huang (Realgar, 1 qian)
Chuan Niu Xi (Cyathulae Radix, 3 qian, remove root crown, soak in wine)
Da Huang (Rhubarb Root and Rhizome, 3 qian)
Mu Xiang (Costus Root, 8 fen)
Hai Jin Sha (Lygodii Spora, 3 qian)
Process: Grind into fine powder. Take 1.5 qian per dose, mixed with wine, just before bedtime. Improvement is expected after two doses.
Note: This formula is suitable for treating various Lin syndromes, regardless of excess or deficiency patterns.
For treating dribbling Lin with pain, combined with Hong Lin (Red/Blood Lin):
Zi Yin Qing Huo San (Nourish Yin and Clear Fire Powder)
Dang Gui (Angelicae Sinensis Radix, 2 qian)
Sheng Di Huang (Rehmanniae Radix, 3 qian)
Shu Di Huang (Prepared Rehmanniae Radix, 3 qian)
Huang Bo (Phellodendri Cortex, 2 qian)
Zhi Mu (Anemarrhenae Rhizoma, 2 qian)
Huang Qin (Scutellariae Radix, 3 qian)
Huang Lian (Coptidis Rhizoma, 8 fen)
Mu Tong (Akebia Stem, 3 qian)
Sang Bai Pi (Mori Cortex, 3 qian)
Process: Coarsely crush and decoct in water. Take on an empty stomach.
For treating various Lin syndromes that persist for a long time:
Jia Wei Zi Yin San (Modified Nourish Yin Powder)
Dang Gui (Angelicae Sinensis Radix, 2 qian)
Chuan Xiong (Ligustici Chuanxiong Rhizoma, 1.5 qian)
Bai Shao (Paeoniae Radix Alba, 2 qian)
Shu Di Huang (Prepared Rehmanniae Radix, 3 qian)
Chen Pi (Citri Reticulatae Pericarpium, 2 qian)
Ban Xia (Pinelliae Tuber, 2 qian)
Bai Fu Ling (Poria, 3 qian)
Gan Cao (Licorice Root, 8 fen)
Sheng Ma (Cimicifugae Rhizoma, 3 fen)
Chai Hu (Bupleuri Radix, 5 fen)
Niu Xi (Achyranthis Bidentatae Radix, 2 qian)
Huang Bo (Phellodendri Cortex, 1.5 qian)
Zhi Mu (Anemarrhenae Rhizoma, 1.5 qian)
Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1.5 qian)
Cang Zhu (Atractylodis Rhizoma, 1.5 qian)
Process: Coarsely crush, decoct in water, and leave exposed overnight (to absorb dew). Take on an empty stomach.
Discussion on Various Lin Syndromes:
Most Lin syndromes are due to weakness of Qi in the Bladder, which fails to properly regulate the water passages. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is highly effective. (Formula see "Internal Injury" chapter).
Discussion on Chronic Lower Jiao Lin:
Chronic Lin in the lower jiao is caused by the sinking of Yuan Qi (Primary Qi). Bu Zhong Yi Qi Tang is indicated. (Formula see "Internal Injury" chapter). Modify this formula by halving the Ren Shen (Ginseng Root), and adding Chuan Xiong, Bai Shao, Shu Di Huang, Ban Xia, Fu Ling, Niu Xi, Huang Bo, Zhi Mu, and Cang Zhu. Decoct in water, leave exposed overnight, and take on an empty stomach.
Discussion on Lin caused by forced retention of semen during excessive sexual desire:
Yi Yuan Gu Jing Tang (Benefit Origin and Secure Essence Decoction)
Ren Shen (Ginseng Root)
Bai Fu Ling (Poria)
Lian Rui (Nelumbinis Plumula)
Ba Ji Tian (Morinda Officinalis Root)
Sheng Ma (Cimicifugae Rhizoma)
Yi Zhi Ren (Alpiniae Oxyphyllae Fructus)
Huang Bo (Phellodendri Cortex, wine-fried, 2 qian each)
Shan Yao (Dioscoreae Rhizoma)
Ze Xie (Alismatis Rhizoma, 1.5 qian each)
Gan Cao Shao (Licorice Root Tip, 3 qian)
Process: Coarsely crush, decoct in water, and take warm on an empty stomach.
For treating urinary dribbling and obstruction, and for elderly patients with deficiency-cold suffering from blood stasis causing Lin with unbearable pain, Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) is indicated. (Formula see "Tonification" chapter). Modify this formula by doubling the dosage of Fu Ling and Ze Xie. For frequent and incontinent urination, remove Ze Xie and add Yi Zhi Ren.
For patients suffering from persistent dribbling and unbearable pain in the urethra, use Liu Jun Zi Tang (Six Gentlemen Decoction) (Formula see "Tonification" chapter) added with Huang Bo (1.5 qian), Zhi Mu (1.5 qian), Shi Wei (3 qian), Hua Shi (3 qian), and Hu Po (Amber, 8 fen). Decoct in water and take orally.
For treating Cold Lin where other medicines have failed, use Si Jun Zi Tang (Four Gentlemen Decoction) (Formula see "Tonification" chapter) added with Zhu Ling (Polyporus), Ze Xie, and Mu Tong. Take three consecutive doses. Additionally, grind Tu Si Zi (Cuscutae Semen) into an extremely fine powder and insufflate it into the urethral opening using a chicken feather tube. This is highly effective.
For treating heat accumulation in the Heart meridian, scanty/difficult urination, and the five types of Lin:
Huo Fu Dan (Fire Mansion Pill)
Sheng Di Huang (Rehmanniae Radix, 1 liang, pounded into paste)
Mu Tong (Akebia Stem)
Huang Qin (Scutellariae Radix, fried, 1 liang each)
Process: Grind into fine powder, bind with refined honey to make pills the size of Sophora seeds. Take 30 pills per dose, washed down with a decoction of Mu Tong. Adding Gan Cao creates Dao Chi San (Guide Out Redness Powder).
Scholar's Note: A soldier suffered from extreme thirst, drinking about one dou of water daily and not eating for three months, accompanied by mental restlessness. It was October. I diagnosed latent heat in the Heart meridian and administered several doses of Huo Fu Dan. His thirst ceased, and he could eat. Although originally a formula for Lin, its use here to stop thirst demonstrates flexibility in application.
Case: Director Li experienced pain in the urethra and urinary symptoms resembling Lin, along with dry mouth and phlegm. This was caused by longing for sexual intercourse leading to essence depletion and internal decay. He was cured using Bu Zhong Yi Qi Tang and Liu Wei Di Huang Wan.
Case: A scholar suffered from intermittent fever, constant thirst, and painful, difficult urination and defecation upon visiting the toilet. This resulted from essence depletion followed by further consumption. He was treated with Liu Wei Wan (Six-Ingredient Pill) added with Wu Wei Zi (Schisandrae Chinensis Fructus) and Bu Zhong Yi Qi Tang. Fortunately, he adhered strictly to the prescription and recovered. If the patient presents with aversion to cold and preference for hot drinks, Ba Wei Wan (Eight-Ingredient Pill / Jin Gui Shen Qi Wan) should be used.
Case: An elderly man with impotence desired sexual activity but could not ejaculate, leading to internal decay. His urinary tract was obstructed and painful like Lin. He was treated with Ba Wei Wan added with Che Qian Zi and Niu Xi, resulting in immediate effect.
Case: An elderly man whose essence was already depleted suffered further consumption, leading to pulling pain in both urination and defecation ("the more painful, the more he wants to go; the more he goes, the more painful it becomes"). Taking Ba Wei Wan yielded the best results.