唐（左） 小溲淋痛，闭癃不爽，甚至涓滴不通。脉细而沉候弦硬。此湿热蕴结膀胱。恐至癃闭。
滑石块 甘草梢 泽泻 瞿麦 磨湘军（三分） 黑山栀 车前子 蓄 滋肾通关丸（盐汤送下）
二诊 涩痛大退，而尿管气坠难忍，无形之热稍化，而有形之湿压滞府气。再标本并顾。
炙黄 （三钱） 于术（一钱五分） 党参（三钱） 炙升麻（七分） 炙柴胡（七分） 甘草（三分）
西血珀五分，上沉香二分，生湘军一钱五分，三味研细末，用茯苓五钱，煎浓汁作丸，微烘令干，药汁送下。
师云、此湿与气并坠，又以身之火与热与湿与气交注膀胱，药难突围而入，未有不为气湿火热恋住者。用三
味外，复以升柴提之，如滴水器开其上而下自注也。（清儒附志）
三诊 呕吐以提其气，泄泻以泄其湿，滞坠顿退，而仍闭癃不爽。膀胱之气不化，还难许治。
桔梗 赤白苓 猪苓 冬葵子 车前子 木通
甘草梢 泽泻 滋肾通关丸
四诊 闭癃已通，而尿管时仍作痛，小溲亦时通时阻。膀胱湿热未清。再为疏利。
木通 蓄 甘草梢 车前子 磨湘军（三分） 瞿麦 滑石 黑山栀 牛膝梢 泽泻
五诊 小便时通时阻，总由膀胱蕴结未清。再为分利，而参苦辛开通。
黑山栀 木猪苓 甘草梢 车前子 牛膝梢 福泽泻 茯苓 蓄 冬葵子 滋肾通关丸
六诊 癃淋之证，本由湿热蕴结而来，不为清利，而以针导，湿热依然蕴结，元气陡伤，辗转而致成损，奈何。
上安桂（后入） 川黄柏（盐水炒） 肥知母 滑石 泽泻 车前子 细木通 蓄 甘草稍 黑山栀
西人用银针针进尺许，尿血俱出，随后复闭，邪不得楚，元气转伤矣。（正蒙志）
Mr. Tang (recorded on the left) experienced dysuria with pain, incomplete emptying of the bladder, and even anuria (complete inability to pass urine). The pulse was fine and thin; at the deep level, it was wiry and hard. This indicates Damp-Heat accumulating in the Bladder. There is a fear that it may progress to severe retention of urine (Long Bi).
Prescription: Hua Shi (Talcum), Gan Cao Shao (Terminal part of Licorice Root), Ze Xie (Alisma Rhizome), Qu Mai (Dianthus Herb), Mo Xiang Jun (Prepared Rhubarb Root and Rhizome, 3 fen), Hei Shan Zhi (Gardenia Fruit), Che Qian Zi (Plantago Seed), Xu Zhong (Shepherd's Purse Herb). Zishen Tongguan Wan (Kidney-Nourishing Passage-Unblocking Pill, taken with salt water).
Second visit: The painful dribbling has largely subsided, but there is an unbearable sensation of Qi sinking in the urethra. The formless Heat has slightly dissipated, but the有形 (form-solid) Dampness is obstructing the Qi of the Fu organs. Treatment again addresses both root and branch.
Prescription: Zhi Huang Qi (Honey-fried Astragalus Root, 3 qian), Yu Zhu (Atractylodes Macrocephala Rhizome, 1.5 qian), Dang Shen (Codonopsis Root, 3 qian), Zhi Sheng Ma (Honey-fried Cimicifuga Rhizome, 7 fen), Zhi Chai Hu (Honey-fried Bupleurum Root, 7 fen), Gan Cao (Licorice Root, 3 fen). Xi Xue Po (Amber, 5 fen), Shang Chen Xiang (Agarwood, 2 fen), Sheng Xiang Jun (Raw Rhubarb Root and Rhizome, 1.5 qian). These three are ground into fine powder. Use Fu Ling (Poria, 5 qian) decocted in thick liquid to make pills, dried slightly by warming, and taken with the decoction juice.
The Master commented: This is Dampness and Qi sinking together, compounded by the body's Fire, Heat, Dampness, and Qi intermingling and pouring into the Bladder. It is difficult for medicines to break through and reach the site; they will inevitably be detained by the Qi, Dampness, Fire, and Heat. Besides the aforementioned herbs, Sheng Ma and Chai Hu are used to lift the Qi, similar to how opening the top of a water dropper allows flow from the bottom. (Recorded by Qing Ru)
Third visit: Vomiting was induced to raise the Qi, and diarrhea occurred to drain the Dampness. The sensation of stagnation and sinking suddenly receded, yet urinary retention and difficulty persist. The Qi transformation of the Bladder is impaired; thus, a cure cannot be guaranteed at this stage.
Prescription: Jie Geng (Platycodon Root), Chi Fu Ling (Red Poria), Bai Fu Ling (White Poria), Zhu Ling (Polyporus), Dong Kui Zi (Malva Seed), Che Qian Zi (Plantago Seed), Mu Tong (Akebia Stem), Gan Cao Shao (Terminal part of Licorice Root), Ze Xie (Alisma Rhizome), Zishen Tongguan Wan (Kidney-Nourishing Passage-Unblocking Pill).
Fourth visit: Urinary retention has been relieved, but the urethra still occasionally hurts, and urination remains intermittent. The Damp-Heat in the Bladder has not been cleared. Continue to promote drainage and unblocking.
Prescription: Mu Tong (Akebia Stem), Xu Zhong (Shepherd's Purse Herb), Gan Cao Shao (Terminal part of Licorice Root), Che Qian Zi (Plantago Seed), Mo Xiang Jun (Prepared Rhubarb Root and Rhizome, 3 fen), Qu Mai (Dianthus Herb), Hua Shi (Talcum), Hei Shan Zhi (Gardenia Fruit), Niu Xi Shao (Terminal part of Achyranthes Root), Ze Xie (Alisma Rhizome).
Fifth visit: Intermittent urination persists, primarily because the accumulation in the Bladder has not been cleared. Continue to separate and drain, while using Ren Shen (Ginseng Root) and bitter-pungent herbs to open and unblock.
Prescription: Hei Shan Zhi (Gardenia Fruit), Mu Zhu Ling (Polyporus with Mycelium), Gan Cao Shao (Terminal part of Licorice Root), Che Qian Zi (Plantago Seed), Niu Xi Shao (Terminal part of Achyranthes Root), Fu Ze Xie (Alisma Rhizome from Fujian), Fu Ling (Poria), Xu Zhong (Shepherd's Purse Herb), Dong Kui Zi (Malva Seed), Zishen Tongguan Wan (Kidney-Nourishing Passage-Unblocking Pill).
Sixth visit: The syndrome of Long Lin (retention and dribbling) originates from Damp-Heat accumulation. Instead of clearing and draining, needle catheterization was used. Consequently, Damp-Heat remained accumulated, and the Yuan Qi (Original Qi) was suddenly damaged. The condition辗转 (worsened/lingered) leading to a consumptive disease (Sun). How lamentable.
Prescription: Shang An Gui (Cinnamon Bark, added later), Chuan Huang Bo (Phellodendron Bark, stir-fried with salt water), Fei Zhi Mu (Anemarrhena Rhizome), Hua Shi (Talcum), Ze Xie (Alisma Rhizome), Che Qian Zi (Plantago Seed), Xi Mu Tong (Akebia Stem), Xu Zhong (Shepherd's Purse Herb), Gan Cao Shao (Terminal part of Licorice Root), Hei Shan Zhi (Gardenia Fruit).
Western physicians inserted silver needles about one chi deep. Hematuria and urine were discharged, but obstruction recurred subsequently. The pathogenic factors could not be expelled, and the Original Qi was further injured. (Recorded by Zheng Meng Zhi)