王左 三焦者，决渎之官，水道出焉。上焦不宣，则下焦不通，以肺为水之上源，不能通调水道，下输膀胱
也。疏其源则流自洁，开其上而下自通，譬之沉竹管于水中，一指遏其上窍，则滴水不坠，去其指则管无余水
矣，治癃闭不当如是乎？
苦桔梗（一钱） 带皮杏仁（三钱） 赤茯苓（三钱） 六一散（包，三钱） 炙升麻（八分） 黑山栀（一钱五
分） 黄
柏（盐水炒，一钱） 知母（盐水炒，一钱） 肉桂心（饭丸吞服，二分） 土牛膝根（三钱） 鲜车前
草汁（二两） 鲜藕汁（二味炖温冲服，二两）
沈左 小溲频数，少腹胀痛。经云∶下焦络肾属膀胱，别于回肠而渗入焉，此证少阴真火不充，太阳之寒
水，转为湿热所阻，少阴无火，故小溲数而不畅，太阳为湿热阻滞，故气不通而胀痛。法当暖脏泄热，冀火归其
源，水得其道，拟滋肾通关饮。
肥知母（三钱） 川黄柏（三钱） 肉桂心（三分）
朱左 中气不足，溲便为之变。小溲频数，入夜更甚，延今一载余，症属缠绵。姑拟补中益气，滋肾通关。
炒潞党参（一钱五分） 清炙草（五分） 云茯苓（三钱） 陈广皮（一钱） 川升麻（三分） 清炙黄 （二钱）
苦桔梗（一钱） 全当归（二钱） 生白术（一钱五分） 生蒲黄（包，三钱） 小蓟根（二钱） 滋肾通关
丸（包，三钱）
王左：三焦是主持水液运行的官职，水道由此而出。上焦之气不能宣发，就会导致下焦不通。因为肺是水之上源，若肺不能通调水道，向下输注至膀胱，那么疏通源头则水流自然清澈，开启上部通道则下部自然通畅。这就好比将一根中空的竹管插入水中，如果用手指堵住上面的孔窍，水滴就不会落下；一旦移开手指，管中的积水就会流尽。治疗癃闭（小便不通）不应当像这样吗？
苦桔梗（一钱） 带皮杏仁（三钱） 赤茯苓（三钱） 六一散（包裹煎煮，三钱） 炙升麻（八分） 黑山栀（一钱五分） 黄柏（用盐水炒制，一钱） 知母（用盐水炒制，一钱） 肉桂心（做成饭丸吞服，二分） 土牛膝根（三钱） 鲜车前草汁（二两） 鲜藕汁（这两味药炖温后冲服，二两）
沈左：小便次数频繁，小腹部胀满疼痛。《内经》说：下焦联络肾脏并归属于膀胱，从回肠分出而渗入其中。此证因少阴真火不足，太阳经的寒水转化为湿热所阻滞。少阴无火，所以小便频数但不畅快；太阳经被湿热阻滞，所以气机不通导致胀痛。治法应当温补脏腑、清泄热邪，希望肾火回归其本源，水液运行恢复正道，拟定滋肾通关饮。
朱左：中气不足，导致大小便异常。小便频数，入夜更加严重，延续至今一年多，病症属于缠绵难愈。暂拟补中益气、滋肾通关之法。
炒潞党参（一钱五分） 清炙甘草（五分） 云茯苓（三钱） 陈广陈皮（一钱） 川升麻（三分） 清炙黄芪（二钱） 苦桔梗（一钱） 全当归（二钱） 生白术（一钱五分） 生蒲黄（包裹煎煮，三钱） 小蓟根（二钱） 滋肾通关丸（包裹煎煮，三钱）
Wang, Left: The Sanjiao (Triple Burner) is the official in charge of irrigation, and the water passages emerge from it. If the Qi of the Upper Jiao fails to disperse, the Lower Jiao will not be unobstructed. Since the Lung is the upper source of water, if it cannot regulate the water passages and transport them downward to the Bladder, then clearing the source makes the flow pure, and opening the upper part allows the lower part to drain naturally. This is like immersing a hollow bamboo tube in water; if one finger blocks the upper orifice, no drop of water falls; once the finger is removed, the remaining water in the tube drains out. Should not the treatment of Lin syndrome (dysuria/urinary retention) follow this principle?
Bunge's Platycodon Root (Jiegeng), 1 qian; Almond with peel (Xingren), 3 qian; Red Poria (Chifuling), 3 qian; Liu Yi San (Six-to-One Powder), wrapped, 3 qian; Prepared Cimicifugae Rhizoma (Shengma), 8 fen; Black Gardenia Fruit (Heishanzhi), 1.5 qian; Phellodendri Cortex (Huangbai), stir-fried with salt water, 1 qian; Anemarrhenae Rhizoma (Zhimu), stir-fried with salt water, 1 qian; Cinnamomi Cortex (Rouguixin), taken as rice pills, 2 fen; Achyranthis Bidentatae Radix et Caulis (Tuniuxigen), 3 qian; Fresh Juice of Plantaginis Herba (Cheqiancao), 2 liang; Fresh Juice of Nelumbinis Rhizoma (Ouzhi), these two decocted warm and taken mixed, 2 liang.
Shen, Left: Frequent urination, distending pain in the hypogastrium. The Classic states: The Lower Jiao connects to the Kidney and belongs to the Bladder, branching off from the Large Intestine and渗 (seeping) into it. In this case, the True Fire of Shaoyin is insufficient, causing the Cold Water of Taiyang to transform into Damp-Heat obstruction. With no Fire in Shaoyin, urination is frequent but not smooth; with Taiyang obstructed by Damp-Heat, Qi circulation is blocked, leading to distension and pain. The method should be to warm the Zang organs and drain heat, hoping for the Fire to return to its source and Water to find its path. Prescribe Zishen Tongguan Yin.
Prepared Anemarrhenae Rhizoma (Zhimu), 3 qian; Sichuan Phellodendri Cortex (Huangbai), 3 qian; Cinnamomi Cortex (Rouguixin), 3 fen.
Zhu, Left: Deficiency of Middle Qi leads to abnormalities in urination and defecation. Frequent urination, worse at night, persisting for over a year, the condition is lingering. Tentatively prescribe Bu Zhong Yi Qi [to tonify the Middle and augment Qi] and Zishen Tongguan [to nourish the Kidney and unblock the passage].
Stir-fried Codonopsis Radix (Dangshen), 1.5 qian; Prepared Glycyrrhizae Radix et Rhizoma (Gancao), 5 fen; Cloud Poria (Fuling), 3 qian; Aged Tangerine Peel (Chenpi), 1 qian; Cimicifugae Rhizoma (Shengma), 3 fen; Prepared Astragali Radix (Huangqi), 2 qian; Bunge's Platycodon Root (Jiegeng), 1 qian; Whole Angelicae Sinensis Radix (Danggui), 2 qian; Raw Atractylodis Macrocephalae Rhizoma (Baizhu), 1.5 qian; Raw Typhae Pollen (Puhuang), wrapped, 3 qian; Small Thistle Root (Xiaojigen), 2 qian; Zishen Tongguan Wan (Pill), wrapped, 3 qian.