沈朗仲治王雨泉，壮年气弱，溺后精水淋漓不断，服六味丸不应，易八味丸反加涩痛。两尺脉数而气口虚
大，此土虚不能堤水也。与补中益气加麦冬、五味，十剂而痊。（《张氏医通》。）
薛立斋治一妇人，善怒，或小腹痞闷，或寒热往来，或小便频数，时下白淫，药久不愈，面青口苦。薛以
其积愤而不能发散所致，用龙胆泻肝汤而愈。用加味逍遥散、八珍汤间服而安。
龚子才治一男子，茎中痛，出白津，小便闭，时作痒，用小柴胡加山栀、泽泻、木通、炒连、胆草、茯苓，
二剂顿愈，又兼六味地黄而痊。
司厅陈石镜，久患白浊，发热体倦，用补中益气加炮姜，四剂白浊稍止。再用六味地黄丸兼服，诸症悉愈。
少宰汪涵斋，患头晕白浊，用补中益气汤加茯苓、半夏，愈而复患腰痛。用山药、山萸、五味、萆 、远
志顿愈。又因劳心，盗汗白浊，以归脾汤加五味而愈。后不时眩晕，用八味丸全愈。
孙文垣治一人，禀质素强，纵饮无度，忽小便毕有白精数点，自以为有余之疾，不治。经三月以来，虽不
小便，时有精出，觉头目眩晕。（此上病多由下之证验也。雄按∶据服证治验，则此头晕亦非下虚使然。）
医者以固精涩脱之剂治之，两月略不见功。诊之，六脉滑大。此因酒味湿热下注精脏，遂以白术、茯苓、橘红、
甘草、干葛、白豆蔻，加黄柏少许，两剂即效，不十日全安。
潘见所患白浊，精淫淫下，治三年不效。孙诊之，两寸短弱，两关滑，两尺洪滑。曰∶疾易愈，第待来年
春仲，一剂可瘳。问故，曰∶《素问》云必先岁气，毋伐天和。今所患为湿痰下流症也，而脉洪大见于尺部，为
阳乘于阴，法当从阴引阳。今冬令为闭藏之候，冬之闭藏，实为来春发生根本，天人一理。若强升提之，是逆
天时而泄元气也。（雄按∶此治内伤之经旨也，而薛氏不拘何症，动辄补中益气。虽明知其为阴虚阳浮，亦不轻割爱。
连篇屡牍，垂训后人，余恐受其害者，不仅当时求治之人也。）后医者接踵，竟无效。至春分逆孙，以白螺蛳壳火
四两（消痰。）为君；牡蛎二两（固涩。）为臣；半夏、（消痰。）葛根、（升阳明之清气。）柴胡、（升少阳之清气。）
苦参（燥湿。）各一两为佐；黄柏坚骨。一两为使。面糊为丸，名端本丸。令早晚服之，不终剂而愈。
李士材治李郡侯，白浊，服五苓散数剂无功。诊之，两尺大而涩，是龙火虚火，精瘀窍道。用牛膝、茯苓、
黄柏、麦冬、山药、远志、细生甘草，十剂而安。
吴光禄闭精行房，患白浊，茎中痛如刀割，自服泻火疏利之剂不效，改服补肾之剂又不效。李诊之曰∶精
久蓄已足为害，况劳心之余，水火不交，坎离频用也。（有语病。）用萆 厘清饮加茯神、远志、肉桂、黄连，四
剂即效。兼服补中益气一二剂而愈。
陆祖愚治韩舜臣，年近三旬，夏月远归，连宵多事，卧当风凉，致成疟疾，间日一发。自以为虚而投参、
附，凡用参二三钱及五钱者数十剂。一医用参一两，附三钱，又八剂。服参约及二斤，其病寒轻而热重，偶于
静坐时觉阳道微湿，以纸拭视，如浆糊一点，白而光亮，讶为滑精渗漏。若此，无怪大剂补养无效，决死无疑。
及诊视，正当悲哀之后，面赤如妆，六脉洪滑而数，曰∶脉候无事，不必张惶。令将溺器涤净，次早诊之，脉
略和而仍滑大。令倾溺器中，有白腻稠粘约半碗许。乃曰∶当此短夜，去已如许之多，则从朝至暮，自当加倍。
此是白浊，非滑精也。（雄按∶此症误投温补，设无白浊，以为去路，则早殆矣。）试思少壮之时，每交感输
泄之精，能有几何？病者始大悟。乃用萆 厘清饮∶川萆 、石菖蒲、益智、乌药、茯苓、甘草，四剂其症减半。
又以二陈汤加升麻、柴胡、苍术、白术，十余剂浊净而疟亦止。夫奇经之脉，督行于背脊，任行于腹外，冲行于
腹中。溺出于前，自膀胱而来；精出于后，自夹脊肾脏而来。男浊女带，自胃家傍冲而下。盖冲为血海，其脉起
于脬中。丹溪曰∶胃中浊液下流，渗入膀胱。曾询患浊者，小水或浑或清，其浊或随泄溺而下，或不时淋沥，
可见与膀胱竟不相干。又见患此症者，经年累月，饮食照常，起居如故，非胃家湿热而何？此君加之以劳顿醉饱，阴虚
贪凉而得，故得补益甚。丹溪曰∶二陈汤加升麻，能使大便润而小便长。前后二方，昔贤所验，
第后人未知用耳。
雄按∶精与溺原分二道，所云良是。至谓浊不由膀胱而出，自谓傍冲而下，然则汤饮入胃，独不可傍冲
而下乎？不知带浊之病，多由肝火炽盛，上蒸胃而乘肺。肺主气，气弱不能散布为津液，反因火性迫速而
下输，膀胱之州都本从气化，又肝疏泄，反禀其令而行，遂至淫淫不绝。使但胃气湿热，无肝火为难，则
上为痰而下为泻耳。古今医案于带、浊二门，独罕存者，亦以未得其旨而施治无验也。至单由湿热而成，
一味凉燥，虽药肆工人，亦能辨此。观其父肖愚一案，治吴南邱之子，亦疟且浊，以二妙散取效，即其症也。
立斋治光禄柴黼庵，因劳赤白浊如注，用归脾汤而愈。司厅张检斋，小腹不时作痛，茎出白淫，用小柴
胡、山栀、龙胆草、山茱、芎、归而愈。
马元仪治陈晋臣，患浊症，累月不止。后因房劳，痛益甚，浊愈频。有语以煎苏叶汤澡洗者，从之，遂致
精滑倾盆，躁扰不宁，发热烦渴。两手脉沉而微，尺脉沉而数，此阴精大伤，真阳无偶将脱。不乘此时，阴气尚
存一线，以急救其阳而通其阴，直至阴尽而欲回阳，罕克有济矣。或曰∶既有阳无阴，补阴犹恐不及，尚堪
纯阳之药，重竭其阴乎？曰∶真阳以水为宅，水足则凝然不动，水竭则不安其位，甚而飞扬屑越，孰能把握之
哉？此时阴未回而阳已绝矣。宜急摄虚阳，先归窟宅，然后补阴以配阳，此必然之次序也。煎大剂白通汤与
服，便得浓睡，诸症渐已。次服人参七味汤，使阴阳两平而愈。
萧万舆治一健卒，年甫三旬，素善饮，喜啖辛香，病浊窍痛，以二陈汤加芩、连、胆草、赤芍、车前，二
剂即止。如实症，本不难治，若概施补，必变生他症。
漳庠林震伯，素善饮，因修途劳顿，饥饱失时，复冒 ，病白浊，经年不瘥。察前治，非辛热即凉泻，或
滋补壅塞。遂至小腹胀闷，或气喘拒食，六脉滑数无力。此中宫虚热，津液下陷，膀胱气化不能分泌。以归脾
汤去木香，加炒山栀、半夏、车前、黄连，七剂而浊止便清，神思清爽矣。
施笠泽治公谟病小便黄，医欲用淡渗之剂。施曰∶《灵枢》不云乎？中气不足，溲便为之变。但当服异功散
加黄柏一二分可也。医曰∶黄柏一二分，遂足清利小便耶？曰∶子不观之漉酒者乎？浊醪数斗，投以黄柏少许，
旋澄清彻底，岂一溲不足当之？众皆大噱，用之果验。
蒋仲芳治梁敬州，年六十余，浊三年矣，淡渗、寒凉、温补俱不效。诊之，六脉俱微，惟左寸带数。此因
心火不降，致脾胃之气不升，浊物因而下渗，法当养心升补，若用本病药无益也。用丹参、茯神、远志、枣仁、
山萸、山药、黄 、白术、升麻、柴胡、甘草、陈皮、姜、枣，煎服三剂，其浊倍至。询其体健否？曰∶如故。
曰∶若便所出，尽为津液，其体必惫甚。今浊增而体健，知浊物积于其中，为药所迫而出耳。清者既升，浊者
自降，再服二剂，而病如失矣。投之果然。使无定见，再易一方，宁能愈乎？
张子和治酒监房善良之子，年十三，病沙石淋，已九年矣。初因疮疹，余毒不出，作便血。或告之，令服
太白散稍止。后又因积热未退，变成淋闷，每发则见鬼神，号则惊邻。张曰∶诸医作肾与小肠病者，非也。
《灵枢》言足厥阴肝经之病，遗溺闭癃。闭谓小便不行，癃谓淋沥也。此乙木之病也。本为所抑，火来乘之，故
热在脬中，下焦为之约，结成沙石，如汤瓶煎炼日久，熬成汤碱。今夫羊豕之脬，吹气令满，常不能透，岂真
有沙石，而能漏者邪？以此知前人所说，服五石散而致者，恐未尽然。经曰∶木郁则达之。先以瓜蒂散越之，
次以八正散加汤、碱等分，顿啜之，其沙石自化而下。
张氏儿，年十四，病约一年半矣。得之麦秋，发则小肠大痛，至握其阴跳跃旋转，号呼不已，小溲数日不
能下，下则成沙石，大便秘涩，肛门脱出一二寸，诸医莫能治。张曰∶今日治今日效，时日在辰巳间矣。以调
胃承气，仅一两，加牵牛末三钱，汲河水煎之，令作三五度咽之。又服苦末丸如芥子许六十粒，日加晡，上涌
下泻，一时齐出，有脓有血。既定，令饮新汲水一大盏，小溲已利一二次矣。是夜凡饮新水二三十遍，病去九
分，止哭一次。明日困卧如醉，自晨至暮，猛然起走索食，歌笑自得，顿失所苦。继与太白散、八正散等，调
一日大瘥。此下焦约也、不吐不下，则下焦何以开？不令饮水，则小瘦何以利？大抵源清则流清者是也。又刘
氏子年六岁、病沙石淋，张以苦剂三涌之，以益肾散三下之，立愈。
一人年二十三岁，病膏淋三年矣。医不能效，多作虚损，补以温燥，灼以针艾，无少减。张曰∶惑蛊之疾
也，亦曰白淫。实由少腹寓热，非虚也，可以涌以泄。其人以时暑，惮其法峻，不决者三日。浮屠一僧曰∶
予以有暑病，近觉头痛。张曰∶亦可涌，愿与君同之，毋畏也。于是涌痰三升，色如黑矾汁，内有死血并黄绿
水。又泻积秽数行，寻觉病去。方其来时，面无人色，及治毕，次日面如醉。虑其暑月路远，又处数方，使
归以自备云。
一男子病淋，张令顿食咸鱼，少顷大渴，又令恣意饮水，然后以药治，淋立通。淋者无水，故涩也。
一妇人患淋久，诸药不效。其夫夜告予，予按既效方治诸淋，用剪金花十余叶煎汤，遂令服之。明早来云，
病减八分矣，再服而愈。剪金花，一名禁宫花，一名金盏银台，一名王不留行。（王执中《资生经》，《本草纲目》。）
叶朝议亲人患血淋，流下小便在盆内凝如 ，久而有变如鼠形，但无足耳，百治不效。一村医用牛膝
根煎汁，日饮五服，名地髓汤，虽未即愈，而血色渐淡，久乃复旧。后十年病沙石胀痛，用川牛膝一两，水二
盏，煎一盏温服。一妇患此十年，服之得效。土牛膝亦可，入麝香、乳香尤良。（《本草纲目》。）
薛立斋治一妇人，患小便淋沥，内热体倦，以为肝火血少，脾气虚弱，用八珍、逍遥二散，兼服月余，而
小便利，又用八珍汤而气血复。
一妇人素善小便淋沥不利，月经不调半载矣。或两胁脉闷，或小腹作痛，或寒热往来，或胸乳作痛，或咽
喉噎塞，或两脚筋牵，或肢节结核，面色青黄不泽，形气日瘦，左关弦洪，右关弦数。此郁怒伤肝脾，血虚气
滞为患。朝用加味归脾汤，以补脾气，解脾郁，祛肝火；夕用滋肾丸、生肝散，滋肾水以生肝血，抑肝火，舒
筋膜。兼服月余而愈。
一妇人小便淋涩，小腹胀闷，胸满喘急，诸药不应。以为转筋之症，用八味丸一服，小便如涌而安。
孙文垣治祝芝冈，酒后近日每行三峰采战，对景忘情之法，致成血淋。自仲夏至岁杪未愈，便下或红或紫，
中有块如筋膜状，或如苏木汁，间有小黑子。三五日一发，或劳心力，或久坐立亦发，百治不痊。诊之，其色
白而青，肌肉削甚，脉左寸沉弱，关尺弦细，右寸略滑，此必肺经有浊痰，肝经有瘀血。良由酒后竭力纵欲，
淫火交煽，精欲出而强忍之，致凝滞经络，流于溺道，瘀血阻塞而成此症也。三五日一至者，盈科满溢故耳。
先与丹参加茅根浓煎服，其小便解后，以瓦器盛之，少顷即成金色黄沙。乃用肾气丸加琥珀、海金沙、黄柏，
以杜牛膝连叶捣汁熬膏为丸调理。外以川芎三钱，当归七钱，杜牛膝煎服。临发时以滑石、甘草梢、桃仁、海
金沙、麝香为末，以韭菜汁调服。去其凝精败血，则新血始得归源，而病根可除矣。三月全愈。
族侄善饮好内，病血淋，与滑石、甘草梢、海金沙、琥珀、山栀、青蒿、茅根，煎膏为丸梧子大，每空心
及食前，灯心汤送下三钱，不终剂而愈。后数年服补下元药过多，血淋又作，小便痛极亦不能出，必蹲便乃得
出，所出皆血块，每行必一二碗许，已半月，诸通利清热之剂不应。脉洪数，以五灵脂、蒲黄、甘草梢各二钱，
水煎空心服，二帖痛减半。改用瞿麦、山栀、甘草各二钱，茅根、杜牛膝连叶、车前草各三钱，生地、柴胡、
木通、黄柏各一钱，四帖痛全减，血止。惟小便了而不了，以人参、葛根、青蒿、白术、茯苓、甘草、白芍、
升麻、黄柏、知母而痊。
康侯云∶治暑气在内，小便血淋，用白虎汤加麦冬煎，屡取其效。此亦有理。（《志雅堂杂抄》周密。）
李时珍治一男子，病血淋，痛胀祈死。李以藕汁、发灰，每服一钱，服三日而血止痛除。（《本草纲目》。）
深师疗淋，用葛上亭长折断腹，腹中有白子如小米，取三二分安白版上阴干，二三日收之。若有人患十年
Shen Langzhong treated Wang Yuquan, a man in his prime but with weak constitution, who suffered from continuous dripping of essence after urination. Taking Liuwei Wan (Six-Ingredient Pill with Rehmannia) was ineffective; switching to Bawei Wan (Eight-Ingredient Pill) aggravated the sensation of astringency and pain. The pulses at both chi positions were rapid, while the qi-kou pulse was deficient and large. This indicated that Spleen Earth deficiency failed to control Water. He was prescribed Buzhong Yiqi Tang (Decoction to Boost the Middle and Augment Qi) with added Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus). After ten doses, he recovered. (From *Zhangshi Yitong*)
Xue Lizhai treated a woman prone to anger, who sometimes experienced epigastric fullness and stuffiness, alternating chills and fever, frequent urination, and occasional discharge of white turbid fluid (Baiyin). Despite prolonged treatment, she did not improve, presenting with a bluish complexion and bitter taste in the mouth. Xue attributed this to accumulated resentment causing Qi stagnation that could not be dispersed. He used Longdan Xiegan Tang (Gentian Liver-Draining Decoction), which cured her. She then alternated taking Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Bazhen Tang (Eight-Treasure Decoction) to stabilize her condition.
Gong Zicai treated a man suffering from pain in the urethra, discharge of white fluid, urinary retention, and intermittent itching. He prescribed Xiao Chaihu Tang (Minor Bupleurum Decoction) with added Zhizi (Gardeniae Fructus), Zexie (Alismatis Rhizoma), Mutong (Akebiae Caulis), fried Huanglian (Coptidis Rhizoma), Dancao (Gentianae Radix), and Fuling (Poria). After two doses, he recovered instantly, followed by concurrent use of Liuwang Dihuang Wan (Six-Ingredient Pill with Rehmannia) for complete recovery.
Si Ting Chen Shijing suffered from chronic Bai Zhuo (white turbidity), fever, and fatigue. He was given Buzhong Yiqi Tang with Pao Jiang (Prepared Ginger). After four doses, the turbidity subsided slightly. Subsequent concurrent use of Liuwang Dihuang Wan resolved all symptoms.
Shaozai Wang Hanzhai suffered from dizziness and Bai Zhuo. He was treated with Buzhong Yiqi Tang plus Fuling and Banxia, recovering initially. However, lower back pain recurred. Treatment with Shanyao (Dioscoreae Rhizoma), Shanzhuyu (Corni Fructus), Wuweizi, Bibi (Dioscoreae Hypoglaucae Rhizoma), and Yuanzhi (Polygalae Radix) brought immediate relief. Later, due to mental overwork, he developed night sweats and Bai Zhuo, cured by Guipi Tang (Restore the Spleen Decoction) with added Wuweizi. Intermittent vertigo was subsequently fully cured by Bawei Wan (Eight-Ingredient Pill).
Sun Wen yuan treated a man who was naturally strong but indulged excessively in alcohol and sex. Suddenly, after urination, a few drops of white essence appeared. He considered it a sign of excess vitality and ignored it. Three months later, although he did not urinate frequently, essence leaked out intermittently, accompanied by dizziness and vertigo. (Note: Upper symptoms often result from lower jiao pathology. According to the response to medication, this dizziness is not caused by lower deficiency.) Doctors treated him with astringents to consolidate essence, with little effect over two months. Pulses were slippery and large throughout. This was due to damp-heat from alcohol sinking into the Essence Viscera. Sun prescribed Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling, Juhong (Citri Reticulatae Pericarpium Rubrum), Gancao (Glycyrrhizae Radix et Rhizoma), Gange (Puerariae Radix), and Baidoukou (Amomi Fructus Rotundus), with a small amount of Huangbai (Phellodendri Cortex). Two doses showed effect, and full recovery occurred within ten days.
Pan Jian suffered from Bai Zhuo with continuous seminal leakage, untreated effectively for three years. Sun diagnosed short and weak pulses at both cun positions, slippery pulses at both guan positions, and surging-slippery pulses at both chi positions. He stated, "The disease is easy to cure, but wait until mid-spring next year; one dose will suffice." When asked why, he replied, "*Suwen* states: 'First consider the seasonal Qi, do not violate the Harmony of Heaven.' You suffer from damp-phlegm sinking downward. The surging pulse at the chi position indicates Yang invading Yin; the method should be to draw Yang from Yin. Winter is the season of closure and storage, which serves as the root for spring's generation. Heaven and humanity follow the same principle. Forcibly lifting Qi now would go against the seasonal trend and deplete Yuan Qi." (Commentary: This reflects the classic principle for treating internal injury. However, Xue Lizhai indiscriminately used Buzhong Yiqi Tang for various conditions, even when Yin deficiency and floating Yang were evident. His repeated prescriptions may have harmed patients beyond his own time.) Other doctors failed. At the Spring Equinox, following Sun's advice, Duanchen Wan (Root-Correcting Pill) was prepared: Calcined Concha Meretricis (4 liang, to resolve phlegm) as Sovereign; Oyster Shell (2 liang, to astringe) as Minister; Banxia, Gegen, Chaihu, and Kushen (each 1 liang, to resolve phlegm, raise clear Yang, and dry dampness) as Assistants; Huangbai (1 liang, to strengthen bones) as Envoy. Made into pills with paste, taken morning and evening, the patient recovered before finishing one dose.
Li Shicai treated Marquis Li of Junhou with Bai Zhuo. Wuling San (Five-Ingredient Powder for Draining Dampness) failed. Pulses at both chi positions were large and choppy, indicating deficient fire of the Gate of Vitality and stasis of essence in the orifices. He prescribed Niuxi (Achyranthis Bidentatae Radix), Fuling, Huangbai, Maidong, Shanyao, Yuanzhi, and raw Gancao. Ten doses brought stability.
Guanglu Wu suffered from Bai Zhuo and severe urethral pain like knife-cutting after abstaining from sex. Self-medication with heat-clearing and draining agents failed, as did kidney-tonifying agents. Li diagnosed that retained essence had become harmful, compounded by mental labor causing failure of Water and Fire interaction. He prescribed Bixie Fenqing Yin (Bibee Clearing Decoction) plus Fushen, Yuanzhi, Rougui (Cinnamomi Ramulus), and Huanglian. Four doses showed effect, followed by Buzhong Yiqi Tang for complete recovery.
Lu Zuyu treated Han Shunchen, nearly thirty, who returned in summer after long travel, engaged in excessive nocturnal activity, and slept facing cool wind, contracting malaria occurring every other day. Believing it to be deficiency, he took Ginseng and Aconite. Various dosages of Ginseng (2-5 qian) were taken for dozens of doses. One doctor used 1 liang of Ginseng and 3 qian of Aconite for eight doses. Total Ginseng intake reached about 2 jin. Symptoms shifted to mild chills and heavy heat. During quiet sitting, he noticed slight moisture at the genitals, wiping revealed a white, shiny paste-like spot, mistaking it for seminal emission. He feared death due to ineffective tonic therapy. Upon examination, after grief, his face was flushed like makeup, and pulses were surging, slippery, and rapid. Lu said, "The pulse pattern is normal, do not panic." He ordered the urinal cleaned. The next morning, pulses were slightly harmonious but still slippery and large. Pouring out the urine revealed about half a bowl of white, greasy, viscous fluid. Lu said, "In this short night, such loss implies double during the day. This is Bai Zhuo, not seminal emission." (Commentary: Misusing warm tonics without this outlet would have been fatal.) The patient realized his error. Lu prescribed Bixie Fenqing Yin: Chuan Bixie, Shichangpu (Acori Tatarinowii Rhizoma), Yizhi (Alpiniae Oxymatæ Fructus), Wuyao (Linderae Radix), Fuling, Gancao. Four doses halved symptoms. Then Erchen Tang (Two-Aged Decoction) with Shengma (Cimicifugae Rhizoma), Chaihu, Cangzhu (Atractylodis Rhizoma), and Baizhu was taken for over ten doses, clearing turbidity and stopping malaria. Lu explained that the Du meridian runs along the spine, Ren along the front abdomen, and Chong along the middle abdomen. Urine comes from the Bladder; essence from the Kidneys/spine. Male turbidity and female leukorrhea flow down from the Stomach via the Chong vessel. As Danxi noted, turbid fluids from the Stomach sink into the Bladder. Patients' urine varies, but turbidity flows independently, unrelated to the Bladder itself. Chronic cases eat and sleep normally, indicating Stomach damp-heat. This case involved exhaustion, drunkenness, Yin deficiency, and cold exposure, responding well to tonification. Danxi noted Erchen Tang with Shengma moistens bowels and promotes urination. These formulas are validated by ancients but rarely used today.
Commentary: Essence and urine originate from separate pathways, which is correct. However, claiming turbidity bypasses the Bladder via the Chong vessel ignores that ingested liquids also follow similar paths. Leukorrhea/turbidity often stems from fierce Liver Fire steaming the Stomach and attacking the Lungs. Weak Lung Qi fails to distribute fluids, instead rushing downward due to fire. The Bladder, governed by Qi transformation, follows Liver regulation, leading to continuous leakage. If only Stomach damp-heat existed without Liver fire, phlegm and diarrhea would occur instead. Ancient records lack cases on leukorrhea/turbidity due to misunderstanding treatment principles. Pure damp-heat cases are easily identified. See Xiao Yu's case treating Wu Nanqiu's son with malaria and turbidity using Ermiao San (Two Marvels Powder).
Xue Lizhai treated Guanglu Chai Fu'an with profuse red and white turbidity due to labor, cured by Guipi Tang. Si Ting Zhang Jianzhai suffered from intermittent lower abdominal pain and white discharge, cured by Xiao Chaihu Tang, Zhizi, Dancao, Shanzhuyu, Xiong (Chuanxiong Rhizoma), and Danggui (Angelicae Sinensis Radix).
Ma Yuanyi treated Chen Jinchen with turbidity lasting months. Post-coital exacerbation caused severe pain and frequent discharge. Following advice to bathe in Perilla leaf decoction led to massive seminal emission, restlessness, fever, and thirst. Pulses were deep, faint, and rapid at chi, indicating severe Yin depletion and impending collapse of True Yang. Ma argued for urgently securing deficient Yang before tonifying Yin. He prescribed large-dose Baitong Tang (White Connection Decoction), inducing deep sleep and symptom relief. Subsequent Renshen Qiwei Tang (Ginseng Seven-Ingredient Decoction) balanced Yin and Yang for recovery.
Xiao Wanyu treated a healthy soldier, thirty, fond of alcohol and spicy food, suffering from turbid orifice pain. Erchen Tang with Huangqin (Scutellariae Radix), Huanglian, Dancao, Chishao (Paeoniae Radix Rubra), and Cheqian (Plantaginis Semen) stopped symptoms in two doses. Real cases are easy to treat; indiscriminate tonification causes complications.
Lin Zhenbo from Zhangzhou, fond of alcohol, suffered from exhaustion, irregular meals, and wind-cold invasion, leading to chronic Bai Zhuo. Previous treatments were either too hot, too cold, or clogging tonics, causing abdominal distension, asthma, and anorexia. Pulses were slippery, rapid, and powerless. Diagnosed as Middle Jiao deficient heat with sinking fluids and impaired Bladder Qi transformation. Guipi Tang minus Muxiang (Exocarpio Citri Grandis), plus fried Zhizi, Banxia, Cheqian, and Huanglian cleared turbidity in seven doses, restoring mental clarity.
Shi Lizet treated Gong Mo with yellow urine. Physicians wanted diuretics. Shi cited *Lingshu*: "Deficiency of Middle Qi causes changes in urination and defecation." He prescribed Yigong San (Extraordinary Power Powder) with a tiny amount of Huangbai. Skeptics laughed, but it worked, clarifying turbid liquor like filtering wine.
Jiang Zhongfang treated Liang Jingzhou, sixty-plus, with three-year Bai Zhuo unresponsive to diuretics, cooling, or warming. Pulses were faint except for a rapid left cun. Heart fire failing to descend prevented Spleen/Stomach Qi from ascending, causing turbid sinking. Treatment focused on nourishing Heart and raising Qi. Danshen (Salviae Miltiorrhizae Radix), Fushen, Yuanzhi, Suanzaoren (Ziziphi Spinosae Semen), Shanzhuyu, Shanyao, Huangqi (Astragali Radix), Baizhu, Shengma, Chaihu, Gancao, Chenpi (Citri Reticulatae Pericarpium), Ginger, and Jujube were administered. Turbidity doubled after three doses. Jiang reasoned that since the body remained strong, the turbidity was accumulated waste being expelled by medicine, not vital essence. Clear Qi rose, turbid Qi sank. Two more doses cured the disease.
Zhang Zihe treated the thirteen-year-old son of Fang Shanliang with gravel strangury for nine years, starting from residual toxins of pox causing blood in stool. Later, unresolved heat transformed into strangury with hallucinations. Zhang rejected Kidney/Small Intestine diagnoses, citing *Lingshu*: Liver meridian disease causes enuresis and strangury. Heat in the bladder formed stones like boiling tea residue. He used Genti San (Melon Stalk Powder) to induce vomiting, followed by Bazheng San (Eight-Righteous Decoction) with mineral alkali, dissolving the stones.
Zhang treated a fourteen-year-old boy with strangury for 1.5 years, worsening during wheat harvest. Severe lower abdominal pain, jumping, inability to urinate for days, passing gravel, constipation, and rectal prolapse. Zhang used Tiaowei Chengqi Tang (Regulate the Stomach and Order the Qi Decoction) with Qian Niu (Pharbitidis Semen) to induce vomiting and purging, releasing pus and blood. Heavy water intake restored urination. The boy recovered quickly. Follow-up with Taibai San and Bazheng San completed recovery. He also treated a six-year-old with gravel strangury using emetics and Yi Shen San (Kidney-Benefiting Powder) for purgation.
A twenty-three-year-old suffered from semen strangury for three years, misdiagnosed as deficiency and treated with warming/drying herbs and moxibustion without success. Zhang diagnosed it as "Gu" disease or Baiyin, caused by heat in the lower abdomen, not deficiency. He recommended emesis. The patient hesitated due to summer heat. A monk with summer heat agreed to undergo emesis together. Three sheng of black vomitus containing dead blood and yellow-green fluid was expelled, along with feces. The patient recovered. Zhang provided additional prescriptions for the journey home.
Zhang treated a man with strangury by having him eat salted fish rapidly, inducing thirst, then allowing free water drinking, followed by medication, which immediately relieved strangury. Strangury results from lack of water, causing obstruction.
Zhang treated a woman with chronic strangury unresponsive to drugs. Using Jianjin Hua (Calendula flower, also known as Jinzhan Yintai or Wangbuliuxing) boiled in water, she improved by 80% after one dose and recovered after a second.
Ye Chaoyi's relative suffered from hematuria where urine coagulated in a basin like fat, eventually resembling a mouse shape without legs. A village doctor used Niuxi (Achyranthes root) decoction, named Disui Tang (Earth Marrow Decoction), reducing blood color gradually. Ten years later, stone pain was treated with Chuan Niuxi, effective for another woman with ten-year history. Tu Niuxi (Cyathulae Radix) with Moschus and Ru Xiang (Frankincense) is also excellent.
Xue Lizhai treated a woman with dribbling urination, internal heat, and fatigue, diagnosing Liver fire, Blood deficiency, and Spleen Qi weakness. Bazhen Tang and Xiaoyao San stabilized urination; Bazhen Tang restored Qi and Blood.
Another woman suffered from dribbling urination and irregular menstruation for half a year, with hypochondriac stuffiness, abdominal pain, alternating chills/fever, chest/breast pain, throat obstruction, leg tendon pulling, joint nodules, sallow complexion, and thinning. Left guan pulse was wiry-surging; right guan was wiry-rapid. Diagnosed as Liver/Spleen injury from depression/anger, Blood deficiency, and Qi stagnation. Morning: Jiawei Guipi Tang to tonify Spleen Qi, resolve Spleen depression, and clear Liver fire. Evening: Zishen Wan (Nourish Kidney Pill) and Shenggan San (Generate Liver Powder) to nourish Kidney Water, generate Liver Blood, suppress Liver fire, and relax sinews. Recovery after one month.
A woman with painful urination, lower abdominal distension, chest fullness, and wheezing unresponsive to drugs was diagnosed with muscle twitching. One dose of Bawei Wan caused urine to flow freely, resolving the issue.
Sun Wen yuan treated Zhu Zhigang with hematuria due to post-alcohol sexual indulgence. From mid-summer to year-end, urine contained red/purple clots resembling fascia or Sappan wood juice, with small black spots, occurring every 3-5 days or after exertion. Pulse: left cun deep-weak, guan-chi wiry-fine; right cun slightly slippery. Diagnosis: turbid phlegm in Lung meridian, blood stasis in Liver meridian. Caused by forced retention of essence after vigorous desire, leading to stasis in channels flowing into the urinary tract. First, Danshen and Mashen (Imperatae Rhizoma) concentrated decoction turned urine into golden sand in a jar. Then, Shenqi Wan (Kidney Qi Pill) with Hupo (Fossilized Wood), Haijinsha (Lygodii Spora), and Huangbai, formulated with Tudunxi (Achyranthis Bidentatae) juice paste. External: Chuanxiong, Danggui, and Tudunxi decoction. At onset: Huashi (Talcum), Gancao Gao (Licorice tip), Taoren (Pruni Semen), Haijinsha, and Moschus powder mixed with Chinese leek juice to expel congealed essence and bad blood, allowing new blood to return to its source. Full recovery in three months.
A nephew fond of alcohol and sex suffered hematuria. Treated with Huashi, Gancao Gao, Haijinsha, Hupo, Zhizi, Qinghao (Artemisiae Annuae Herba), and Mashen, made into pills. Taken with Dengxin Cao (Junci Medulla) decoction on an empty stomach, he recovered before finishing the dose. Years later, excessive kidney tonics caused recurrence with extreme pain and difficulty urinating, requiring squatting, passing blood clots. Pulses were surging-rapid. Wulingzhi (Trogopterori Faeces), Puhuang (Typhae Pollen), and Gancao Gao reduced pain. Modified with Qumai (Diantherae Herba), Zhizi, Gancao, Mashen, Tudunxi, Cheqiancao (Plantaginis Herba), Shengdi (Rehmanniae Radix), Chaihu, Mutong, and Huangbai stopped bleeding. Final resolution of incomplete voiding achieved with Renshen (Ginseng), Gegen, Qinghao, Baizhu, Fuling, Gancao, Baishao (Paeoniae Radix Alba), Shengma, Huangbai, and Zhimu (Anemarrhenae Rhizoma).
Kang Hou stated that for summer-heat internal, hematuria, Baihu Tang (White Tiger Decoction) with Maidong is effective.
Li Shizhen treated a man with painful hematuria desiring death. Lotus root juice and burnt hair ash (Fa Hui), 1 qian per dose for three days, stopped bleeding and pain.
Shen Shi treated strangury using Ge Shang Ting Chang (a type of caterpillar). Its abdomen contains white seeds like millet. Dried and powdered, used for chronic cases.