【歌】血石膏劳肉五淋，便时滴沥痛难禁。细微实滑求虚实，死血阴寒气滞并。
【论】夫淋沥者，滴沥涩痛也。闭者，急胀不通也。盖心肾气郁，使阴阳乖舛，清浊相干，膀胱蓄热而
水道涩焉，所以滴沥涩痛，欲通不通，甚则窒塞其间，令人闷绝。故小便血热，则为血淋。火气煎灼，而为砂
石淋，如汤罐中煎之日久而生碱也。气血结聚，而为肉淋。气血凝如膏糊，为膏淋。因劳而作，为劳淋。丹溪
云∶淋有五，皆属于热，斯得其旨矣。然有气滞而淋者，有气虚而淋者，有死血而淋者。
亦有冷气滞于膀胱而作淋者，盖十无一、二也。然此之类，有冷、热、虚、实之不同，尤当参之以脉证，则有
余不足之候，无所逃也。
【脉】淋病之脉，细数何妨。少阴微者，气闭膀胱。女人见之，阴中生疮。大实易愈，虚涩者亡。
血淋
不痛者，为溺血；痛者，血淋也，通闭散。死血作淋，地髓汤。
通闭散
治血热成淋。
香附（五钱） 陈皮（五钱） 赤茯苓（一两）
上，末之，每服二钱，水煎，空心服。
地髓汤
治瘀血成淋。
杜牛膝（一合）
水五钟，煎耗其半，去滓，入麝香少许，空心服。
热淋
热淋而痛者，五淋散，或四苓散（即五苓散去桂，方见脾胃。）加木通、车前子、滑石、灯心、瞿麦、
蓄，末之，蜜水调下。
五淋散
治诸淋。
赤茯苓（八分） 赤芍药（八分） 山栀仁（八分） 生甘草（七分） 当归（五分） 黄芩（五分）
水煎，空心服。
砂石淋
砂石淋，草豆饮或用寒水石 研，水飞，温水调下。
草豆饮
治砂石淋。
黑豆（一百二十粒） 生粉草（一寸）
水煎，乘热入滑石末一钱，空心服。
虚淋
肾虚成淋者，八味丸或六味地黄丸。（方见劳瘵。）
八味丸
即六味地黄丸加肉桂五钱、黑附子（炮，去皮、脐）五钱。（方见劳瘵。）
劳淋（附气淋）
劳淋，四物汤加黄柏、知母、石苇、滑石、琥珀。（方见血证。）气淋，沉香散。
沉香散
治气淋。
沉香（半两） 石苇（去毛，半两） 王不留行（半两） 当归（半两） 滑石（半两） 葵子（七钱半）
白芍药（七钱半） 甘草（三钱半） 陈皮（一两）
末之，每服二钱，大麦汤下。
阴寒
冷气凝滞，小便淋痛，木香散。内积寒冷，淋凝如膏糊者，生附汤。凝白如油，萆 厘清饮。
木香散
治冷淋。
木香（五分） 木通（五分） 槟榔（五分） 大茴香（四分） 当归（五分） 赤芍药（五分） 青皮
（七分） 泽泻（七分） 橘皮（五分） 甘草（四分）
水煎服。
生附汤
治寒淋。
附子（半两） 滑石（半两） 瞿麦（七钱半） 木通（七钱半） 半夏（四钱）
每三钱，灯心、姜、蜜水煎服。
萆 厘清次
益智（一钱） 萆 （一钱） 石菖蒲（一钱） 乌药（一钱） 茯苓（八分） 甘草（七分）
上锉，水煎，入盐一捻，空心服。
[Verse]
Blood lin (Lin syndrome with blood),膏 lin (Lin syndrome with paste-like urine), and the five types of Lin syndromes present with dribbling and difficult urination, accompanied by unbearable pain. Differentiate between deficiency and excess through fine or solid and slippery pulses; stasis blood, yin-cold, and qi stagnation can all cause this disease.
[Dissertation]
"Lin" refers to dribbling, astringent pain during urination. "Bi" refers to urgent distension and obstruction of urination. This is caused by the depression of Heart and Kidney Qi, leading to disharmony of Yin and Yang, interference between clear and turbid Qi, accumulation of heat in the Bladder, and subsequent astringency of the water passages. Thus, there is dribbling, astringent pain, difficulty in initiating flow, and even complete blockage, causing severe distress and fainting. Therefore, when hematuria results from blood-heat, it is called Blood Lin. When fire-qi scorches fluids, similar to alkali forming in a boiling pot over time, it forms Stone/Sand Lin. When Qi and Blood accumulate, it forms Flesh Lin. When Qi and Blood coagulate like paste, it forms Paste Lin. When triggered by fatigue, it is called Fatigue Lin. Zhu Danxi stated: "The five types of Lin all belong to Heat," which grasps the essence of the disease. However, there are cases caused by Qi stagnation, Qi deficiency, and stasis blood. There are also rare cases (one or two in ten) caused by cold-Qi stagnating in the Bladder. Nevertheless, these conditions vary in Cold, Heat, Deficiency, and Excess. It is crucial to correlate pulse and symptoms to reveal whether there is excess (repletion) or deficiency (insufficiency).
[Pulse Diagnosis]
For Lin diseases, a fine and rapid pulse is not necessarily adverse. A slight pulse at Shaoyin indicates Qi obstruction in the Bladder. In women, this pulse suggests sores in the genital region. Excess patterns are easy to cure, while deficient and astringent pulses indicate poor prognosis (potential death).
[Blood Lin]
Urination without pain is called Ni Xiao (Hematuria); urination with pain is Blood Lin, treated with Tongbi San. Lin caused by stasis blood is treated with Disui Tang.
Tongbi San
Treats Lin caused by blood-heat.
Xiangfu (Cyperus Rhizoma, 5 qian) Chenpi (Citri Reticulatae Pericarpium, 5 qian) Chifuling (Poria Cocos with Red Cortex, 1 liang)
Grind into powder. Take 2 qian per dose, decoct in water, take on an empty stomach.
Disui Tang
Treats Lin caused by stasis blood.
Du Niuxi (Achyranthis Bidentatae Radix, 1 he)
Decoct in 5 zhong of water until half remains. Strain, add a small amount of Shexiang (Musk), take on an empty stomach.
[Heat Lin]
Heat Lin with pain is treated with Wulin San, or Siling San (Wuling San minus Guizhi, see Piwei chapter), added with Mutong, Cheqianzi, Huashi, Dengxincao, Qumai, and Pianchu. Grind into powder, mix with honey water for administration.
Wulin San
Treats various Lin syndromes.
Chifuling (Poria Cocos with Red Cortex, 8 fen) Chishao (Paeoniae Radix Rubra, 8 fen) Shanzhiren (Gardeniae Fructus, 8 fen) Sheng Gancao (Glycyrrhizae Radix et Rhizoma, 7 fen) Danggui (Angelicae Sinensis Radix, 5 fen) Huangqin (Scutellariae Radix, 5 fen)
Decoct in water, take on an empty stomach.
[Stone/Sand Lin]
Stone/Sand Lin is treated with Caodou Yin, or by grinding Hanshuishi (Calcitum), processing via water-flying method, and mixing with warm water.
Caodou Yin
Treats Stone/Sand Lin.
Heidou (Sojae Semen Nigrum, 120 grains) Sheng Fugan (Glycyrrhizae Radix et Rhizoma, 1 cun)
Decoct in water. While hot, add 1 qian of Huashi powder, take on an empty stomach.
[Deficient Lin]
Lin caused by Kidney deficiency is treated with Bawei Wan or Liuwei Dihuang Wan. (See Laozai chapter)
Bawei Wan
Consists of Liuwei Dihuang Wan plus Rougui (Cinnamomi Cortex, 5 qian) and Heifuzi (Aconiti Lateralis Radix Praeparata, processed, peeled and de-navelled, 5 qian). (See Laozai chapter)
[Fatigue Lin (with Qi Lin)]
Fatigue Lin is treated with Siwu Tang added with Huangbai, Zhimu, Shiwei, Huashi, and Hupo. (See Xuezheng chapter) Qi Lin is treated with Chenxiang San.
Chenxiang San
Treats Qi Lin.
Chenxiang (Aquilariae Lignum Resinatum, 0.5 liang) Shiwei (Pyrospermae Folium, de-hairy, 0.5 liang) Wangbuliuxing (Vaccariae Semen, 0.5 liang) Danggui (Angelicae Sinensis Radix, 0.5 liang) Huashi (Talcum, 0.5 liang) Kuizi (Abutilonis Semen, 7.5 qian) Baishao (Paeoniae Radix Alba, 7.5 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 3.5 qian) Chenpi (Citri Reticulatae Pericarpium, 1 liang)
Grind into powder. Take 2 qian per dose, swallow with Barley Decoction.
[Yin-Cold]
Cold-Qi stagnation causing painful Lin is treated with Muxiang San. Internal cold accumulation causing urine to coagulate like paste is treated with Shengfu Tang. Urine coagulating white like oil is treated with Bixie Fenqing Yin.
Muxiang San
Treats Cold Lin.
Muxiang (Aucklandiae Radix, 5 fen) Mutong (Akebiae Caulis, 5 fen) Binglang (Arecae Semen, 5 fen) Da Huixiang (Foeniculi Fructus, 4 fen) Danggui (Angelicae Sinensis Radix, 5 fen) Chishao (Paeoniae Radix Rubra, 5 fen) Qingpi (Citri Reticulatae Pericarpium Viride, 7 fen) Zexie (Alismatis Rhizoma, 7 fen) Jupi (Citri Reticulatae Pericarpium, 5 fen) Gancao (Glycyrrhizae Radix et Rhizoma, 4 fen)
Decoct in water and take.
Shengfu Tang
Treats Cold Lin.
Fuzi (Aconiti Lateralis Radix Praeparata, 0.5 liang) Huashi (Talcum, 0.5 liang) Qumai (Dianthi Herba, 7.5 qian) Mutong (Akebiae Caulis, 7.5 qian) Banxia (Pinelliae Tuber, 4 qian)
Take 3 qian per dose, decoct with Dengxincao, Shengjiang, and honey water.
Bixie Fenqing Yin
Yizhi (Alpiniae Oxyphyllae Fructus, 1 qian) Bixie (Dioscoreae Hypoglaucae Rhizoma, 1 qian) Shichangpu (Acori Tatarinowii Rhizoma, 1 qian) Wuyao (Linderae Radix, 1 qian) Fuling (Poria Cocos, 8 fen) Gancao (Glycyrrhizae Radix et Rhizoma, 7 fen)
Cut into pieces, decoct in water, add a pinch of salt, take on an empty stomach.