淋,古谓之癃,名称不同也。癃者,罢也;淋者,滴也。今名虽俗,于义为得。古方皆
云∶心肾气郁,致小肠膀胱不利,复有冷淋、湿淋、热淋等,属外所因;既言心肾气郁,与
夫惊忧恐思,即内所因;况饮啖冷热,房室劳逸,及乘急忍溺,多致此病,岂非不内外因。
三因备明,五淋通贯,虽证状不一,皆可类推,所谓得其要者,一言而终也。
诸淋大率有五∶曰冷,曰热,曰膏,曰血,曰石。五种不同,皆以气为本,多因淫情交
错,内外兼并,清浊相干,阴阳不顺,结在下焦,遂为淋闭。
治冷淋,小便秘涩,数起不通,窍中疼痛,憎寒凛凛。多因饮水过度,或为寒
泣,心虚志耗,皆有此证。
附子(去皮脐,生用) 滑石(各半两) 瞿麦 木通(各三分) 半夏(汤洗七次,三分)
上为末。每服二大钱,水二盏,姜七片,灯芯二十茎,蜜半匙,煎七分,空心服。
治热淋。多因肾气不足,膀胱有热,水道不通,淋沥不宣,出少起数,脐腹急
痛,蓄作有时,劳倦即发,或尿如豆汁,或便出沙石。
木通 石韦(去毛,各二两) 甘草 当归 王不留行(各一两) 滑石 白术 瞿麦 芍药
葵子(各三两)
上为细末。每服二钱,煎小麦汤调下,食前,日三。兼治大病余热不解,后为淋者。
淋证,古代称为“癃”,名称不同罢了。所谓“癃”,意为阻滞不通;所谓“淋”,意为点滴而出。现在的名称虽然通俗,但在义理上更为确切。古方都说:心肾之气郁结,导致小肠和膀胱功能不利,又有冷淋、湿淋、热淋等,属于外所因(外部致病因素);既然提到了心肾气郁,以及惊恐忧思等情绪影响,这就属于内所因(内部致病因素);况且饮食冷热不当、房事过度或劳累安逸失度,以及憋尿忍溺,都容易导致这种病,这难道不是不内外因(既非纯粹外感也非纯粹内伤的因素)吗?三因(内因、外因、不内外因)阐述得十分明确,五淋(五种淋证)的道理也就贯通了。虽然症状表现不一,但都可以类推,所谓抓住了关键,一句话就能概括终结。
各种淋证大体上有五种:即冷淋、热淋、膏淋、血淋、石淋。这五种情况各不相同,但都以气机为根本,多因情欲交错,内外邪气兼并,清浊之气相互干扰,阴阳失调,结聚在下焦,于是形成淋证和闭证。
治疗冷淋,表现为小便涩滞不畅,频繁起夜却无法排出,尿道疼痛,怕冷战栗。多因饮水过多,或因寒气凝泣,心虚志耗,都有这样的证候。
附子(去皮脐,生用) 滑石(各半两) 瞿麦 木通(各三分) 半夏(汤洗七次,三分)
以上药物研为细末。每次服用两大钱,用水二盏,生姜七片,灯芯草二十茎,蜂蜜半匙,煎至七分满,空腹服用。
治疗热淋。多因肾气不足,膀胱有热,水道不通,淋漓不尽,尿量少且次数多,脐腹部急痛,发作有时,劳累疲倦时即发,或者尿液像豆汁一样浑浊,或者排出沙石。
木通 石韦(去毛,各二两) 甘草 当归 王不留行(各一两) 滑石 白术 瞿麦 芍药 葵子(各三两)
以上药物研为细末。每次服用二钱,用小麦汤调服,饭前服用,每日三次。兼治大病后余热未清,随后转为淋证的病症。
Lin syndrome was anciently called "Long" (obstruction), differing only in name. "Long" implies stagnation and blockage; "Lin" implies dripping or trickling. Although the current name is colloquial, it is more accurate in meaning. Ancient texts state that Qi stagnation in the Heart and Kidney leads to dysfunction of the Small Intestine and Bladder. Additionally, there are Cold Lin, Damp Lin, and Heat Lin, which belong to External Etiology (external pathogenic factors). Since Qi stagnation in the Heart and Kidney, along with emotions such as fright, worry, fear, and rumination, are mentioned, these constitute Internal Etiology (internal pathogenic factors). Furthermore, improper diet (hot or cold), excessive sexual activity, imbalance of labor and rest, and holding urine often lead to this disease, which constitutes Non-Internal/External Etiology (factors neither purely external nor purely internal). The Three Causes (Etiologies) are clearly elucidated, and the principles of the Five Types of Lin are comprehensively understood. Although symptoms vary, they can be inferred analogously; grasping the essence allows one to summarize it in a single statement.
Generally, there are five types of Lin: Cold Lin, Heat Lin, Gao Lin (Paste Lin), Xue Lin (Blood Lin), and Shi Lin (Stone Lin). These five types differ but all have Qi mechanism as their root. They are mostly caused by chaotic emotional desires, combined internal and external pathogens, interference between clear and turbid Qi, and disharmony of Yin and Yang, leading to accumulation in the Lower Jiao, resulting in Lin and Bi (obstruction) syndromes.
To treat Cold Lin, characterized by scanty, difficult urination, frequent urges without passage, pain in the urethra, and aversion to cold with shivering. This is often due to excessive water intake, condensation from cold, deficiency of the Heart, and depletion of willpower.
Fuzi (Aconiti Lateralis Radix Praeparata, peeled and navel removed, raw use) 50g, Huashi (Talcum) 50g, Qumai (Diantherae Herba) 10g, Mutong (Akebiae Caulis) 10g, Banxia (Pinelliae Rhizoma Praeparatum, washed seven times in boiling water) 10g.
Grind the above into powder. Take two large qian (approx. 6-9g) per dose, decoct with two zhan (approx. 400ml) of water, seven slices of Shengjiang (Zingiberis Rhizoma Recens), twenty stems of Dengxincao (Junci Medulla), and half a spoon of Fengmi (Melle), until reduced to seventy percent. Take on an empty stomach.
To treat Heat Lin. This is mostly due to insufficiency of Kidney Qi and heat in the Bladder, causing obstruction of the urinary pathway, dribbling and incomplete voiding, small volume with high frequency, urgent pain in the umbilical and abdominal region, intermittent attacks triggered by fatigue, cloudy urine resembling bean dregs, or passage of sand and stones.
Mutong (Akebiae Caulis) 60g, Shiwei (Pyrrosiae Folium, de-haired) 60g, Gancao (Glycyrrhizae Radix et Rhizoma) 30g, Danggui (Angelicae Sinensis Radix) 30g, Wangbuliuxing (Vaccariae Semen) 30g, Huashi (Talcum) 90g, Baizhu (Atractylodis Macrocephalae Rhizoma) 90g, Qumai (Diantherae Herba) 90g, Shaoyao (Paeoniae Radix Alba) 90g, Kuizi (Abutilonis Semen) 90g.
Grind the above into fine powder. Take two qian (approx. 6g) per dose, mixed with Xiaomai (Tritici Fructus Decoctum), taken before meals, three times daily. Also treats residual heat after severe diseases that subsequently transforms into Lin syndrome.