(少腹下,阴毛之边际,气街穴之分也)属足少阳胆经、厥阴肝经之合(《灵枢》曰∶
足少阳之脉,绕毛际,横入髀厌中。又曰∶足厥阴之脉,循股阴入毛中。又曰∶足少阳之正,绕髀入毛际,合
于厥阴。又曰∶足厥阴之正,别跗上,上至毛际,合于少阳。《素问》曰∶下部天,足厥阴也,以候肝。注∶肝
脉在毛际外,羊矢下一寸陷中,五里穴之分,卧而取之,动应于手者是也)。又属足少阴肾经、冲脉之会(《灵
枢》曰∶冲脉与足少阴之大络,起于肾下,出于气街)。
(〔交骨附〕男子曰玉茎,女子曰玉门,门之开合者曰交骨,即小便也。旧重出者非)
统属足厥阴肝经(《灵枢》曰∶足厥阴之筋,循阴股,结于阴器,络诸筋。其病阴器不用,伤于内,则不起;伤于
寒,则阴缩入;伤于热,则挺纵不收。又曰∶足厥阴之脉过阴器所,生病者,遗溺、闭癃。《素问》曰∶厥阴之
脉者,络阴器,系于肝。《难经》曰∶假令得肝脉,其病四肢满,闭淋,溲、便难,转筋,有是者肝也。李东
垣曰∶肾主大便,肝主小便。朱丹
溪曰∶阴茎痛,是厥阴经气滞兼热,宜用甘草梢以缓其气。或问古今方论,以涩为收,芍药本收剂,而云利小
便,何谓也?东垣曰∶芍药能停诸湿,而益津液,以此补阴滋湿,故小便自行,非通利之谓也)。
又属冲、任、督三脉之会(《难经》曰∶冲、任、督与厥阴,会于曲骨,环阴器。《素问》曰∶督脉者,
起于少腹以下骨中央,女子入系廷孔,其孔溺器之端也。男子循茎下至篡,与女子等。又曰∶冲脉者,经脉之
海也,主渗灌溪谷,与阳明合于宗筋)。又属足太阳膀胱经(《灵枢》曰∶足三焦者,太阳之别也,并太阳之
正,入络膀胱约下焦。实则闭癃,虚则遗溺。《素问》曰∶膀胱不约为遗溺,水泉不止,是膀胱不藏也。不利
为癃,小便闭也。《中藏》曰∶热入膀胱,则其气急而小便黄,膀胱寒,则小便数而清白。王海藏曰∶小便不
通,宜用滑剂利窍,以通水道。滑石入足太阳经,为至燥之剂,木通、猪苓、阿胶,皆滑剂也。朱丹溪曰∶膀胱
有热者,宜用黄柏、知母之类以泻之)。又属手太阳小肠经(《灵枢》曰∶手太阳,外合于淮水,内属于小肠,
而水道出焉。朱丹溪曰∶凡小肠有气则小便胀,有血则小便涩,有热则小便痛;痛者为血淋,不痛者为溺血。
陈良甫曰∶小肠有热,入于脬内,热结甚,则小便不通。小便不通,则心胁小腹,气涩而喘急)。又属足少阴
肾经(《灵枢》曰∶足少阴之筋,并太阴之筋,而上循阴股,结于阴器。王海藏曰∶凡服泽泻散,人未有不小
便多者,小便既多,肾气安得复实。李东垣曰∶渴而小便不利者,热在上焦肺分故也,宜清肺散、猪苓汤。不
渴而小便通者,热闭于下焦,肾与膀胱也,宜滋肾丸、导气除湿汤)。兼属足少阳胆经(李东垣曰∶小便淋溲
者,邪在少阳、厥
阴。徐伯鲁曰∶少阳者,足少阳胆与足厥阴肝,相为表里也)。又属手太阴肺经(《灵枢》曰∶手太阴之别,
名曰列缺,其病虚则欠KT ,小便遗数。《素问》曰∶饮入于胃,游溢精气,上输于脾,脾气散精,上归于肺,
通调水道,下输膀胱,水精四布,五经并行,合于四时,五脏阴阳,揆度以为常也。注∶水土合化,上滋肺
金,金气通肾,故调水道。转注下焦,膀胱禀化,以为溲矣。王海藏曰∶或用栀子利小便,非利小便也,以
清肺也。肺气清而能化,膀胱为津液之腑,小便乃得出。李东垣曰∶小便遗失者,肺金虚也,宜安卧养气,
禁劳役,以参 之类补之。不愈,当责有热,加生地、黄柏。朱丹溪曰∶小便不通,如因肺燥,不能生水,
则宜清金,此隔二之治,用车前子、茯苓之类。又曰∶香薷属金与水,而有彻上彻下之功,治水甚捷。肺得
之,则清化行,而热自下。又曰∶一人小便不通,脉右寸濡滑,此积痰在肺也。肺为上焦,膀胱为下焦,上
焦闭,则下焦塞,如滴水之器,必上窍通,而后下窍之水出焉。以法大吐之,病如失。又曰∶肺中伏热,水
不能生,是绝小便之源也)。又属足太阴脾经、阳明胃经之合(《灵枢》曰∶足太阴之筋,聚于阴器。其病
阴器纽痛,上引脐。又曰∶足阳明之筋,聚于阴器,上腹。其病 疝,腹筋急。治在燔针劫刺,以知为数,
以痛为 。《素问》曰∶前阴者,宗筋之所聚,太阴、阳明之所合。又曰∶阳明者,五脏六腑之海,主润宗
筋,宗筋主束骨而利机关也。朱丹溪曰∶人因脾湿不运,而精不升,则肺不能生水,而小便不通,法宜燥胃
健脾。此隔三之治,用二术之类。又∶琥珀属阳金,以燥脾土有功,故古方利小便用之。盖脾能运化,则肺
自下降,而小便可通也。又曰∶古方有脾约症,谓胃强脾弱,约束津液,不得四布,但
输膀胱,故小便数而大便难,于是制脾约丸以下脾之结燥。肠润结化,津液入肾而愈。然既曰脾约,必阴血枯
槁,内火燔灼,热伤元气。故津燥金虚,势必窃母气以自救,由是土受木伤,脾失转输,肺失传送,宜乎大便
闭而难,小便数而无藏蓄也。理宜滋养阴血,使阳火不炽,金行清化,脾土精健,津液入肾,肠润而通矣。今
此丸用之热盛而气血实,与西北方人,禀赋壮实者,固无不宜,若概用之东南方人,与热虽盛而气血不实者,
虽得暂通,将见脾愈弱而肠愈燥矣。要之在西北以开结为主,在东南以润燥为主)。
(Located below the lower abdomen, at the margin of the pubic hair, this is the distribution area of Qichong ST30 (Qi Street). It belongs to the He-Sea points of the Foot-Shaoyang Gallbladder Meridian and the Foot-Jueyin Liver Meridian. *Ling Shu* states: The meridian of the Foot-Shaoyang [Gallbladder] winds around the pubic margin and enters horizontally into the hip joint. It also states: The meridian of the Foot-Jueyin [Liver] follows the medial aspect of the thigh and enters the pubic region. Furthermore: The regular pathway of the Foot-Shaoyang [Gallbladder] circles the thigh and enters the pubic margin, merging with the Jueyin. Also: The regular pathway of the Foot-Jueyin [Liver] branches from the dorsum of the foot, ascends to the pubic margin, and merges with the Shaoyang. *Su Wen* states: Heaven at the Lower Region corresponds to the Foot-Jueyin, used to inspect the Liver. Note: The Liver meridian is located outside the pubic margin, one cun below the sheep-shaped bone (os pubis) in a depression, belonging to the Wuli LR2 (Five Miles) point distribution; it should be taken while the patient is supine, where the pulse beats palpably under the fingers.) It also belongs to the intersection of the Foot-Shaoyin Kidney Meridian and the Chong Mai (Penetrating Vessel). (*Ling Shu* states: The Chong Mai and the large collateral of the Foot-Shaoyin [Kidney] originate below the kidney, emerging from Qichong ST30.)
([Note on Jiaogu/Interlocking Bones] In men, it is called Yujing (Jade Stem); in women, Yumen (Jade Gate). The part controlling the opening and closing of the gate is called Jiaogu, referring here to urination. This interpretation corrects previous erroneous duplications.)
It is collectively governed by the Foot-Jueyin Liver Meridian. (*Ling Shu* states: The sinews of the Foot-Jueyin [Liver] follow the medial aspect of the thigh, knot at the genitalia, and connect with various sinews. Its pathology involves dysfunction of the genitalia; internal injury leads to inability to erect; cold injury causes retraction; heat injury causes protrusion and flaccidity. It also states: The meridian of the Foot-Jueyin [Liver] passes through the genitalia; diseases here present as enuresis or strangury. *Su Wen* states: The meridian of Jueyin connects the genitalia and ties to the Liver. *Nan Jing* states: If the Liver pulse is obtained, symptoms include fullness in the four limbs, strangury, difficulty in urination and defecation, and tendon spasms; these indicate Liver disease. Li Dongyuan said: The Kidney governs defecation, while the Liver governs urination. Zhu Danxi said: Pain in the penis indicates stagnation of Qi and accompanying Heat in the Foot-Jueyin meridian; Gancao Shao (Licorice Root Tip) should be used to soothe the Qi. A question arises: Ancient and modern formulas use astringents for retention; Shaoyao (Peony Root) is inherently an astringent, yet it is said to promote urination. Why? Li Dongyuan explained: Shaoyao can restrain dampness and benefit fluids, thereby nourishing Yin and moistening; thus, urination proceeds naturally, not through direct diuresis.)
It also belongs to the intersection of the Chong Mai (Penetrating Vessel), Ren Mai (Conception Vessel), and Du Mai (Governor Vessel). (*Nan Jing* states: The Chong, Ren, and Du vessels intersect with the Jueyin at Qugu CV2, surrounding the genitalia. *Su Wen* states: The Du Mai originates from the central bone below the lower abdomen. In women, it enters and connects to Tingkong, which is the opening of the urethra. In men, it follows the penis down to the perineum, identical to women. It also states: The Chong Mai is the Sea of the Twelve Meridians, primarily permeating and irrigating the muscle valleys, combining with the Yangming at Zongjin (Major Tendon).)
It also belongs to the Foot-Taiyang Bladder Meridian. (*Ling Shu* states: The Foot-Sanjiao [Triple Burner] is a branch of the Foot-Taiyang [Bladder], running parallel with its regular pathway, entering to connect with the Bladder and regulating the Lower Jiao. Excess presents as strangury; deficiency presents as enuresis. *Su Wen* states: Inability of the Bladder to constrain leads to enuresis; continuous flow from Shuiquan BL58 indicates Bladder failure to store. Difficulty in urination is termed Long (strangury), meaning urinary obstruction. *Zhong Zang Jing* states: Heat entering the Bladder causes urgent breathing and yellow urine; Cold in the Bladder causes frequent, clear, and long urine. Wang Haizang said: For urinary obstruction, slippery agents should be used to open orifices and unblock water pathways. Huashi (Talcum) enters the Foot-Taiyang [Bladder] meridian and is extremely drying; Mutong (Akebia Caulis), Zhuling (Polyporus), and Ejiao (Donkey-hide Gelatin) are all slippery agents. Zhu Danxi said: For Heat in the Bladder, Huangbai (Phellodendron Bark) and Zhimu (Anemarrhena Rhizome) should be used to drain fire.)
It also belongs to the Hand-Taiyang Small Intestine Meridian. (*Ling Shu* states: The Hand-Taiyang [Small Intestine] externally combines with Huai Water and internally belongs to the Small Intestine, from which the water pathway emerges. Zhu Danxi said: If there is Qi in the Small Intestine, there is urinary distension; if there is Blood stasis, there is urinary涩 (retention/difficulty); if there is Heat, there is painful urination. Painful urination is Xuelin (Blood Strangury); painless hematuria is Xiaoxue (Urine Blood). Chen Liangfu said: Heat in the Small Intestine transmitting to the Pao (Bladder) with severe heat binding causes urinary obstruction. Urinary obstruction leads to Qi stagnation in the heart, hypochondrium, and lower abdomen, resulting in panting.)
It also belongs to the Foot-Shaoyin Kidney Meridian. (*Ling Shu* states: The sinews of the Foot-Shaoyin [Kidney] run parallel with the sinews of the Taiyin [Spleen], ascending along the medial thigh to knot at the genitalia. Wang Haizang said: Anyone taking Zexie San will experience increased urination; once urination increases, how can Kidney Qi recover? Li Dongyuan said: Thirst with urinary difficulty indicates Heat in the Upper Jiao Lung; Qingfei San or Zhuling Tang should be used. No thirst with normal urination indicates Heat closed in the Lower Jiao involving the Kidney and Bladder; Zishen Wan or Daoqi Chu Shi Tang should be used.)
It additionally belongs to the Foot-Shaoyang Gallbladder Meridian. (Li Dongyuan said: Scanty or dribbling urination indicates pathogen in the Shaoyang and Jueyin meridians. Xu Bulu said: Shaoyang refers to the Foot-Shaoyang Gallbladder and Foot-Jueyin Liver, which are exterior-interior pairs.)
It also belongs to the Hand-Taiyin Lung Meridian. (*Ling Shu* states: The branch of the Hand-Taiyin [Lung] is named Lieque LU7. Deficiency presents with yawning and frequent enuresis. *Su Wen* states: Water drunk enters the Stomach, its essence floats up, is transported to the Spleen, scattered by the Spleen, and returns upward to the Lung. The Lung regulates water passages, transporting downward to the Bladder. Water essence distributes everywhere, flowing through the five meridians, harmonizing with the four seasons and the Yin-Yang of the five Zang organs. Note: Earth and Water combine to transform, nourishing Lung Metal upwards; Metal Qi connects to the Kidney, thus regulating water passages. Transforming downward to the Lower Jiao, the Bladder receives transformation to form urine. Wang Haizang said: Using Zhizi (Gardenia) to promote urination is actually clearing the Lung. When Lung Qi is clear and transformative, and the Bladder is the Fu organ of fluids, urine can be excreted. Li Dongyuan said: Enuresis indicates deficiency of Lung Metal; rest and conserve Qi, avoid labor, and tonify with Ginseng. If ineffective, check for Heat and add Dihuang (Rehmannia) and Huangbai. Zhu Danxi said: Urinary obstruction due to Lung Dryness failing to generate Water requires clearing Metal (Ge Er Zhi - treating two organs away), using Cheqianzi (Plantago Seed) and Fuling (Poria). Also: Xiangru (Elsholtzia) possesses properties of Metal and Water, acting from top to bottom, effective for water disorders. When the Lung receives it, clear transformation occurs, and Heat descends. Also: A case of urinary obstruction with a soft-slippery Right Cun pulse indicated phlegm accumulation in the Lung. The Lung is Upper Jiao, Bladder is Lower Jiao; closure of Upper Jiao blocks Lower Jiao, like a dripping vessel requiring the upper orifice to open before water flows out. Treating with emetics cured the patient. Also: Latent Heat in the Lung prevents Water generation, cutting off the source of urine.)
It also belongs to the He-Sea points of the Foot-Taiyin Spleen Meridian and Foot-Yangming Stomach Meridian. (*Ling Shu* states: The sinews of the Foot-Taiyin [Spleen] gather at the genitalia. Pathology involves twisting pain in the genitalia radiating to the umbilicus. It also states: The sinews of the Foot-Yangming [Stomach] gather at the genitalia and ascend to the abdomen. Pathology involves hernia and abdominal tendon spasm. Treatment uses burning needle puncture, stopping when improvement is noted, using the painful point as the acupoint. *Su Wen* states: The anterior yin is the gathering place of Zongjin (Major Tendons), the convergence of Taiyin and Yangming. It also states: Yangming is the Sea of the Five Zang and Six Fu, primarily moistening Zongjin, which binds bones and facilitates joint movement. Zhu Danxi said: Spleen Dampness failing to transport prevents Essence from rising, so Lung cannot generate Water, causing urinary obstruction. Treatment requires drying Stomach and strengthening Spleen (Ge San Zhi - treating three organs away), using Baizhu (Atractylodes) and Baizhu variants. Also: Hupo (Amber) belongs to Yang Metal and benefits drying Spleen Earth; thus ancient formulas used it for diuresis. Because Spleen transport allows Lung descent, urine flows. Also: Ancient texts mention Pi Yue (Spleen Constriction), where Strong Stomach and Weak Spleen constrain fluids, preventing distribution, sending them only to the Bladder, causing frequent urination and difficult defecation. Thus, Pi Yue Wan was created to purge Spleen dryness. When intestines are moistened and knots resolved, fluids enter the Kidney and health returns. However, since it is called Spleen Constriction, Yin Blood must be depleted and Internal Fire blazing, damaging Yuan Qi. Thus, fluid dryness and Metal weakness lead to stealing Mother Qi for self-rescue; Earth suffers Wood attack, Spleen loses transport, Lung loses transmission, leading to constipation and frequent, uncontrolled urination. Ideally, nourish Yin Blood to suppress Fire, clear Metal, strengthen Spleen Earth, allow fluids to enter Kidney, and moisten intestines. This pill suits those with excess Heat and robust Qi/Blood, typical of Northwest natives. Applying it universally to Southeast natives or those with Heat but deficient Qi/Blood may provide temporary relief but worsen Spleen weakness and intestinal dryness. Generally, in the Northwest, focus on resolving knots; in the Southeast, focus on moistening dryness.)