交肠者,大小便易位而出,由冷热不调,阴阳不顺,而气乱于下也。妇人多有此证。
加减四物汤
四物(五钱) 益元散(二钱五分)
水酒各半煎,空心温服。
按∶此证前人有以五苓散为法者,此又一法也。
一法 以旧乌纱帽烧灰服者。
诸淋者,由肾虚而膀胱热也。肾气通于阴,阴,津液下流之道也。膀胱与肾为表里,为
津液
之府,肾虚则小便数,膀胱热则水下涩,数而且涩,则淋沥不宣,故谓之淋。其状小便数起
少出,少腹弦急,痛引于脐,有石淋、劳淋、血淋、气淋、膏淋之异。
透格散
硝石(一两) 不夹泥土,雪白者,生研为末,每服二钱。
劳淋,劳倦虚损,小便不出,小腹急痛,葵子米煎汤下,通后便须服补虚丸散。血淋,
小便
不出,时下血,疼痛满急。热淋,小便热赤色,脐下急痛,并用冷水调下。气淋,小腹满急
,尿后常有余沥,木通煎汤下。石淋,茎内痛,尿不能出,内引小腹,膨胀急痛,尿下沙石
,令人闷绝。将药末先入铫内,隔纸炒至焦为度,再研,用温水调下,并空心调药,使消如
水,乃服之。(沈存中《灵苑方》)
淋症所感不一,或因房劳,或因忿怒,或因醇酒浓味。房劳者,阴虚火动也。忿怒者,
气动
生火也。醇酒浓味者,酿成湿热也。积热既久。热结下焦,所以淋沥作痛。初则热淋、血淋
,久则煎熬水液,稠浊如膏、如沙、如石也。夫散热利小便,只能治热淋、血淋而已,其膏
、石、沙淋,必须开郁行气,破血滋阴方可也。古方用郁金、琥珀,开郁也。青皮、木香,
行气也。蒲黄、牛膝,破血也。黄柏、生地黄,滋阴也。东垣治小腹痛,用青皮、黄柏,夫
青皮疏肝,黄柏滋肾,盖小腹乃肝肾部位也。
Jiaochang (Crossed Intestines) refers to a condition where the positions of urination and defecation are reversed, meaning urine is excreted from the anus and feces from the urethra. This is caused by an imbalance of cold and heat, disharmony of Yin and Yang, and chaotic Qi movement in the lower Jiao. Women are more prone to this syndrome.
Modified Siwu Decoction
Ingredients: Siwu Tang (Cinnamon Twig, Rehmannia Root, Angelica Sinensis, and Paeonia Root Decoction) (5 qian), Yi Yuan San (Benefit the Primordial Powder) (2.5 qian).
Preparation and Administration: Decoct with half water and half wine; take warm on an empty stomach.
Note: Previously, some physicians used Wuling San (Five-Ingredient Powder with Poria) as the treatment method; this represents another approach.
Another Method: Burn old black gauze caps to ash and ingest.
Various forms of Lin Syndrome (Dysuria) arise from Kidney deficiency combined with Heat in the Bladder. The Qi of the Kidney connects to the genital region, which serves as the pathway for the downward flow of body fluids. The Bladder and Kidney have an interior-exterior relationship; the Bladder is the mansion of body fluids. When the Kidney is deficient, urination becomes frequent; when the Bladder has Heat, the downward flow of urine becomes obstructed and difficult. The combination of frequency and obstruction leads to dribbling and incomplete emptying, hence it is called "Lin." Its manifestations include frequent urges to urinate but with small volumes each time, tension and pain in the lower abdomen radiating to the umbilicus. There are different types: Shi Lin (Stone Dysuria), Lao Lin (Fatigue Dysuria), Xue Lin (Blood Dysuria), Qi Lin (Qi Dysuria), and Gao Lin (Gelatinous Dysuria).
Touge San (Penetrating Grid Powder)
Ingredients: Xiaoshi (Niter/Sodium Nitrate) (1 liang), selected without soil impurities and pure white in color, raw and ground into powder. Dosage: 2 qian per administration.
Administration:
For Lao Lin (Fatigue Dysuria): Caused by overexertion and bodily deficiency leading to urinary retention and acute lower abdominal pain. Administer the powder with decoction of Abelmoschus manihot seeds and rice. After urination is restored, one must administer Bu Xu Wan San (Deficiency-Nourishing Pills/Powders).
For Xue Lin (Blood Dysuria): Urinary retention accompanied by intermittent bleeding, pain, and distending urgency. Administer the powder mixed with cold water.
For Re Lin (Heat Dysuria): Burning sensation during urination with red urine and acute pain below the umbilicus. Administer the powder mixed with cold water.
For Qi Lin (Qi Dysuria): Distending urgency in the lower abdomen with post-micturition dribbling. Administer the powder with decoction of Akebia Stem (Mutong).
For Shi Lin (Stone Dysuria): Pain within the penis, inability to pass urine, pain radiating inward to the lower abdomen causing distension and acute pain, and passage of sand/stones in urine, which may cause fainting. First, place the powder in a Ding (a type of bronze vessel for cooking/medicinal preparation), stir-fry over paper until charred, then grind again. Mix with warm water and ingest on an empty stomach, ensuring the medicine dissolves like water before drinking. (From Shen Cunzhong's *Lingyuan Fang*)
The causes of Lin Syndrome vary: they may result from sexual exhaustion, anger, or consumption of strong alcohol and rich/greasy foods. Sexual exhaustion leads to Yin deficiency with hyperactive Fire. Anger causes Qi stagnation transforming into Fire. Alcohol and rich foods brew Damp-Heat. Long-standing accumulation of Heat結s in the Lower Jiao, resulting in painful dribbling. Initially, this presents as Re Lin or Xue Lin; over time, the Heat boils down body fluids, making them thick and turbid, resembling gelatin, sand, or stones. Methods that clear Heat and promote diuresis can only treat Re Lin and Xue Lin. For Gao Lin, Shi Lin, and Sha Lin (Sand Dysuria), one must employ methods to resolve stagnation, move Qi, break blood stasis, and nourish Yin. Ancient formulas use Yujin (Curcuma Rhizome) and Hupo (Fossilized Wood) to resolve stagnation; Qingpi (Aged Tangerine Peel) and Muxiang (Costus Root) to move Qi; Puhuang (Pollen Typhae) and Niuxi (Achyranthes Root) to break blood stasis; Huangbai (Phellodendron Bark) and Sheng Dihuang (Rehmannia Root) to nourish Yin. Li Dongyuan treated lower abdominal pain using Qingpi and Huangbai, because Qingpi soothes the Liver and Huangbai nourishes the Kidney, noting that the lower abdomen is the anatomical region of the Liver and Kidney.