（附转脬 附不禁）
小便滴沥涩痛者。谓之淋。小便急满不通者。谓之闭淋症有五气砂血膏劳是也。其感不
一。或因房劳。或因忿怒。或饮醇酒。或食浓味所致。房劳者。阴虚火动也。忿怒者气动生火也
。醇酒浓味者。蓄成湿热流于下焦。所以小便淋沥。欲去不去。不去又来。而痛不可忍。甚
者闭塞。则令人闷绝矣。皆属于热。间有挟冷者。必先寒战。而后溲便。盖冷气与正气交争
。冷气盛。则寒战而成淋。正气盛。则寒战解而得便溺也。治宜清热利小便。开郁行气。破
血滋阴。至于调平心火。乃治淋闭之纲领也。又分在气在血而治。以渴不渴辨之。如渴而小
便不利者。热在上焦气分。宜清热不渴而小便不利者。热在下焦血分。宜滋阴养血。又云。
肾经阴虚而不利者。用八味地黄丸。热结膀胱而不利者。用五淋散。元气虚而不能输化者。
用补中益气汤。脾肺之气燥而不能化生者。用通淋琥珀丸。若转筋便闭气喘。不问男女孕妇
。急用八味丸。缓则不救矣。
举要曰。淋病之脉。细数何妨。少阴微者。气闭膀胱。阴人见之。阴内生疮。大实易愈
。虚涩其亡。又云。鼻头色黄。小便必难。脉浮弦涩见于左尺。
加味八正散 治气滞淋涩。初起茎中作痛。
车前子 瞿麦 蓄 滑石 生甘草（各一钱五分） 山栀仁 木通 大黄 赤茯苓 黄
柏（各一钱） 灯心三十茎空心服。
通淋琥珀丸 治砂石淋茎中涩痛不可忍。
琥珀（三钱） 鳖甲（五钱） 滑石 黄连（各八钱） 石首鱼脑骨（三对 ） 牛膝（八两熬
上为细末。以牛膝膏为丸。每服二钱。空心清茶下。
当归饮 治血淋。
牛膝 蒲黄 当归 黄连 生地（各二钱） 麦冬（去心） 木通 扁柏叶（微炒） 山栀仁
（各一钱） 灯心三十茎食前服。
鹿角霜丸 治膏淋。溺与精并出。混之如糊。如米泔者。
鹿角霜（四两） 白茯苓（三两） 秋石（二两五钱） 海金沙（二两）
上为末老米糊为丸。每服三钱空心白滚汤下。
苓珀丸 治劳淋。遇劳即发。痛坠及HT 。
当归 白茯苓 白芍 川芎 生地（各二两） 琥珀（一两） 鹿茸（一对酥炙） 木通（六
上为末。以木通汤为丸。每服二钱五分。空心白滚汤送下。
清肝散 治肝经气滞。积热而淋。茎中刺痛如刀割。
车前子 黄柏（各三钱） 甘草梢 青皮（各一钱） 木通 泽泻（各二钱） 灯心三十茎。
补中益气汤 治中气虚弱。不能运通水道而淋。
黄 人参（各二钱） 甘草 白术 当归 柴胡（各一钱二分） 升麻（三分） 陈皮（八
分） 水煎空心服。
清心莲子饮 治上盛下虚。心肾不交血虚内热。淋涩作痛。
麦门冬 石莲子 赤茯苓 车前子（各一钱二分） 黄 地骨皮 黄芩 人参（各一钱）
甘草（三分） 灯心三十茎空心煎服。
五淋散 治肾气不足。膀胱有热水道不通淋沥不断或尿如豆汁。或出砂石。或下膏糊。
或便鲜血。
当归 小蓟 赤芍 山栀仁（炒黑） 赤茯苓（各二钱） 甘草（八分） 灯心三十茎。空心
八味丸 治肾虚淋沥。茎中涩痛。或时作痒。
熟地（四两） 山药（炒） 泽泻（去毛） 山茱萸肉 丹皮（各二两） 白茯苓（三两） 黄柏（
盐水炒） 知母（盐酒炒各二两五钱）
上为末蜜丸。每服三钱。空心盐汤送下。
滋肾丸 治肾经不足。内热闭固。诸火不能升降。虽不甚渴。而小便不利。淋涩作痛。
黄柏（姜水炒） 知母（盐酒炒） 白芍（酒炒） 麦门冬（去心） 白茯苓（去皮） 人参（各
二两） 枸杞子 鳖甲（羊酥炙）
天门冬（去心） 生地 山茱萸（去核） 牛膝（各一两二钱） 甘草（八钱）
上为末蜜丸。每服三钱。空心盐汤送下。
（附转脬 附不禁）
小便点滴不尽、涩滞疼痛的，称为淋。
小便急迫胀满、无法排出的，称为闭。
淋症有气淋、砂淋、血淋、膏淋、劳淋五种类型。
其致病原因各不相同。
有的因房事过度所致，有的因愤怒情绪所致，有的因饮用烈酒所致，有的因食用肥厚浓味食物所致。
房事过度者，属于阴虚火旺。
愤怒情绪者，属于气机郁结化火。
饮用烈酒和食用肥厚浓味食物者，会蓄积湿热流注于下焦。
因此导致小便淋漓不尽，想排排不出，排完又来，且疼痛难忍。
严重的出现闭塞，会导致人昏闷绝倒。
这些情况大多归属于热证。
间或有夹杂寒邪的，必定先出现寒战，然后才能排尿。
这是因为冷气与人体正气相互交争。
冷气盛则寒战并引发淋症；正气盛则寒战解除而能正常排尿。
治疗宜采用清热利小便、开郁行气、破血滋阴的方法。
至于调平心火，乃是治疗淋症和闭症的根本纲领。
又需分清气分和血分来治疗，通过是否口渴来辨别。
如果口渴且小便不利，说明热在上焦气分，宜清热。
如果不渴且小便不利，说明热在下焦血分，宜滋阴养血。
又说：肾经阴虚导致小便不利的，用八味地黄丸。
热结膀胱导致小便不利的，用五淋散。
元气虚弱不能输布气化的小便不利，用补中益气汤。
脾肺之气燥热不能化生津液的小便不利，用通淋琥珀丸。
如果出现转筋、大便闭塞、气喘，不论男女孕妇，急用八味丸，若拖延则无法救治了。
举要曰：淋病的脉象，细数脉并无妨碍。
少阴脉微弱者，是气闭于膀胱。
女性见到这种脉象，提示阴部内生疮疡。
实证容易治愈，虚证兼涩脉则预后不良（主亡）。
又说：鼻头颜色发黄，小便必定困难。
左尺部脉象浮、弦、涩。
加味八正散：治疗气滞引起的淋症涩痛。初起尿道内部作痛。
车前子、瞿麦、萹蓄、滑石、生甘草（各一钱五分），山栀仁、木通、大黄、赤茯苓、黄柏（各一钱）。灯心草三十茎，空腹服用。
通淋琥珀丸：治疗砂石淋，尿道涩痛难忍。
琥珀（三钱）、鳖甲（五钱）、滑石、黄连（各八钱）、石首鱼脑骨（三对）、牛膝（八两，熬制成膏）。
上药研为细末，以牛膝膏为丸。每服二钱，空腹清茶送下。
当归饮：治疗血淋。
牛膝、蒲黄、当归、黄连、生地（各二钱），麦冬（去心）、木通、侧柏叶（微炒）、山栀仁（各一钱）。灯心草三十茎，饭前服用。
鹿角霜丸：治疗膏淋。尿液与精液同时排出，混合后如糊状，或如米泔水样。
鹿角霜（四两）、白茯苓（三两）、秋石（二两五钱）、海金沙（二两）。
上药研为细末，用老米糊为丸。每服三钱，空腹白开水送下。
苓珀丸：治疗劳淋。遇劳累即发作，疼痛坠胀波及小腹及前阴。
当归、白茯苓、白芍、川芎、生地（各二两），琥珀（一两）、鹿茸（一对，酥炙）、木通（六两，原文此处似缺单位或数值，依上下文推测为剂量较大或笔误，按原文保留“六”字语境，实际应为剂量，此处依原文转录为“六”后接下文，通常此类方剂木通用量适中，但古籍常有脱漏，此处忠实原文结构，假设“六”后缺字或即为六两/钱，结合前后文多为两/钱，暂按原文“六”处理，但在翻译中体现为药材列表）。*注：原文“木通（六”后直接换行“上为末”，疑有脱文，此处按原文直译。*
上药研为细末，以木通汤为丸。每服二钱五分，空腹白开水送下。
清肝散：治疗肝经气滞，积热成淋。尿道刺痛如刀割。
车前子、黄柏（各三钱），甘草梢、青皮（各一钱），木通、泽泻（各二钱）。灯心草三十茎。
补中益气汤：治疗中气虚弱，不能运通水道而致淋。
黄芪、人参（各二钱），甘草、白术、当归、柴胡（各一钱二分），升麻（三分），陈皮（八分）。水煎，空腹服用。
清心莲子饮：治疗上盛下虚，心肾不交，血虚内热，淋症涩痛。
麦门冬、石莲子、赤茯苓、车前子（各一钱二分），黄芪、地骨皮、黄芩、人参（各一钱），甘草（三分）。灯心草三十茎，空腹煎服。
五淋散：治疗肾气不足，膀胱有热，水道不通，淋沥不断。或尿如豆汁，或出砂石，或下膏糊，或便鲜血。
当归、小蓟、赤芍、山栀仁（炒黑）、赤茯苓（各二钱），甘草（八分）。灯心草三十茎，空腹服用。
八味丸：治疗肾虚淋沥，尿道涩痛，或时而发痒。
熟地黄（四两）、山药（炒）、泽泻（去毛）、山茱萸肉、丹皮（各二两），白茯苓（三两），黄柏（盐水炒）、知母（盐酒炒，各二两五钱）。
上药研为细末，蜜丸。每服三钱，空腹盐汤送下。
滋肾丸：治疗肾经不足，内热闭固，诸火不能升降。虽然不甚口渴，但小便不利，淋症涩痛。
黄柏（姜水炒）、知母（盐酒炒）、白芍（酒炒）、麦门冬（去心）、白茯苓（去皮）、人参（各二两），枸杞子、鳖甲（羊酥炙）、天门冬（去心）、生地、山茱萸（去核）、牛膝（各一两二钱），甘草（八钱）。
上药研为细末，蜜丸。每服三钱，空腹盐汤送下。
(Attached: Retention of Urine with Bladder Displacement [Zhuan Pao]; Attached: Incontinence)
When urine is passed drop by drop with astringency and pain, it is called Lin syndrome (strangury).
When there is urgent fullness and inability to urinate, it is called Bi syndrome (obstruction).
There are five types of Lin syndrome: Qi Lin (Qi strangury), Sha Lin (Gravel strangury), Xue Lin (Blood strangury), Gao Lin (Gum/Paste strangury), and Lao Lin (Labor/Fatigue strangury).
The causes of infection vary.
Some result from excessive sexual activity, some from anger, some from drinking strong wine, and some from consuming rich and heavy foods.
Excessive sexual activity leads to Yin deficiency with hyperactive fire.
Anger leads to Qi stagnation generating fire.
Drinking strong wine and eating rich foods leads to the accumulation of damp-heat flowing into the Lower Jiao (Lower Burner).
Therefore, urine is passed dribblingly; one wishes to pass it but cannot, or after passing, it returns again, accompanied by unbearable pain.
In severe cases, obstruction occurs, causing fainting and collapse.
All these conditions belong to Heat syndromes.
Occasionally, Cold pathogens are involved, characterized first by chills and rigors before urination.
This is because Cold Qi contends with Healthy Qi (Zheng Qi).
When Cold Qi is predominant, chills occur leading to Lin syndrome; when Healthy Qi is predominant, the chills subside and normal urination resumes.
Treatment should focus on clearing Heat and promoting diuresis, resolving depression and moving Qi, breaking blood stasis and nourishing Yin.
Regulating Heart Fire is the general principle for treating Lin and Bi syndromes.
Furthermore, treatment should distinguish between Qi and Blood levels, identified by the presence or absence of thirst.
If thirsty with difficulty in urination, the Heat is in the Qi level of the Upper Jiao (Upper Burner); clearing Heat is appropriate.
If not thirsty with difficulty in urination, the Heat is in the Blood level of the Lower Jiao (Lower Burner); nourishing Yin and tonifying Blood is appropriate.
It is also stated that for difficulty in urination due to Kidney Yin deficiency, Ba Wei Di Huang Wan (Eight-Ingredient Pill with Rehmannia) is used.
For difficulty in urination due to Heat binding in the Bladder, Wu Lin San (Five-Strangury Powder) is used.
For difficulty in urination due to Yuan Qi (Primal Qi) deficiency failing to transform and transport, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is used.
For difficulty in urination due to dryness of Spleen and Lung Qi failing to generate fluids, Tong Lin Hu Po Wan (Unblocking Strangury Amber Pill) is used.
If convulsions of the tendons, constipation, and panting occur, regardless of gender or pregnancy, Ba Wei Wan (Eight-Ingredient Pill) must be used urgently; if delayed, rescue is impossible.
Essentials state: The pulse in Lin disease, even if fine and rapid, is not necessarily ominous.
A slight pulse in the Shao Yin (Lesser Yin) channel indicates Qi obstruction in the Bladder.
In women, seeing this pulse suggests sores arising internally in the yin region.
Excess patterns are easy to cure; deficiency with a choppy pulse indicates decline (death).
It is also said: Yellow color of the nose tip indicates difficult urination.
A floating, wiry, and choppy pulse seen at the Left Chi (Cun-Guan-Chi position corresponding to Kidney/Bladder).
Jia Wei Ba Zheng San (Modified Eight-Rectification Powder): Treats Qi stagnation causing strangury and astringency. Initially, pain arises in the urethra.
Qian Hai Zi (Plantago Seed), Qu Mai (Dianthus Herb), Bian Xu (Knotweed Herb), Hua Shi (Talcum), Sheng Gan Cao (Raw Licorice Root) (each 1.5 qian); Shan Zhi Ren (Gardenia Seed), Mu Tong (Akebia Stem), Da Huang (Rhubarb Root), Chi Fu Ling (Red Poria) (each 1 qian). Deng Xin Cao (Juncus Effusus Pith) 30 stems. Take on an empty stomach.
Tong Lin Hu Po Wan (Unblocking Strangury Amber Pill): Treats Sha Lin (Gravel Strangury) with unbearable astringent pain in the urethra.
Hu Po (Amber) (3 qian), Bie Jia (Tartaric Shell) (5 qian), Hua Shi (Talcum), Huang Lian (Coptis Rhizome) (each 8 qian), Shi Shou Yu Nao Gu (Stonefish Brain Bone) (3 pairs), Niu Xi (Achyranthes Root) (8 liang, boiled down to paste).
Grind the above into fine powder, form pills using the Niu Xi paste. Take 2 qian per dose, with clear tea on an empty stomach.
Dang Gui Yin (Angelica Decoction): Treats Xue Lin (Blood Strangury).
Niu Xi (Achyranthes Root), Pu Huang (Typha Pollen), Dang Gui (Angelica Sinensis Root), Huang Lian (Coptis Rhizome), Sheng Di Huang (Rehmannia Root) (each 2 qian); Mai Dong (Ophiopogon Tuber, heart removed), Mu Tong (Akebia Stem), Bai Bo Ye (Platycladi Leaf, lightly fried), Shan Zhi Ren (Gardenia Seed) (each 1 qian). Deng Xin Cao (Juncus Effusus Pith) 30 stems. Take before meals.
Lu Jiao Shuang Wan (Deer Horn Frost Pill): Treats Gao Lin (Gum/Paste Strangury). Urine and essence are discharged together, mixing like paste or rice water.
Lu Jiao Shuang (Deer Horn Frost) (4 liang), Bai Fu Ling (White Poria) (3 liang), Qiu Shi (Mineral Salt) (2.5 liang), Hai Jin Sha (Lygodium Spore) (2 liang).
Grind the above into powder, form pills using old rice paste. Take 3 qian per dose, with plain boiling water on an empty stomach.
Ling Po Wan (Poria-Amber Pill): Treats Lao Lin (Fatigue Strangury), which flares up upon exertion, with pain and bearing-down sensation extending to the lower abdomen and genitals.
Dang Gui (Angelica Sinensis Root), Bai Fu Ling (White Poria), Bai Shao (White Peony Root), Chuan Xiong (Ligusticum Rhizome), Sheng Di Huang (Rehmannia Root) (each 2 liang); Hu Po (Amber) (1 liang), Lu Rong (Deer Antler without Bone, roasted with butter) (1 pair), Mu Tong (Akebia Stem) (6 [unit missing in source, assumed proportional]).
Grind the above into powder, form pills using Mu Tong decoction. Take 2.5 qian per dose, with plain boiling water on an empty stomach.
Qing Gan San (Clear Liver Powder): Treats Liver channel Qi stagnation and accumulated heat causing strangury. Stabbing pain in the urethra like a knife cut.
Qian Hai Zi (Plantago Seed), Huang Bo (Phellodendron Bark) (each 3 qian); Gan Cao Shao (Licorice Root Tip), Qing Pi (Citrus Aurantium Peel) (each 1 qian); Mu Tong (Akebia Stem), Ze Xie (Alisma Rhizome) (each 2 qian). Deng Xin Cao (Juncus Effusus Pith) 30 stems.
Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction): Treats Lin caused by Middle Qi deficiency failing to transport and unblock the water passages.
Huang Qi (Astragalus Root), Ren Shen (Ginseng Root) (each 2 qian); Gan Cao (Licorice Root), Bai Zhu (Atractylodes Rhizome), Dang Gui (Angelica Sinensis Root), Chai Hu (Bupleurum Root) (each 1.2 qian); Sheng Ma (Cimicifuga Rhizome) (0.3 qian); Chen Pi (Citrus Aurantium Peel) (0.8 fen). Decoct in water, take on an empty stomach.
Qing Xin Lian Zi Yin (Clear Heart Lotus Seed Decoction): Treats excess above and deficiency below, Heart-Kidney non-interaction, Blood deficiency with internal heat, causing strangury and pain.
Mai Men Dong (Ophiopogon Tuber), Shi Lian Zi (Stone Lotus Seed), Chi Fu Ling (Red Poria), Qian Hai Zi (Plantago Seed) (each 1.2 qian); Huang Qi (Astragalus Root), Di Gu Pi (Lycium Bark), Huang Qin (Scutellaria Root), Ren Shen (Ginseng Root) (each 1 qian); Gan Cao (Licorice Root) (0.3 fen). Deng Xin Cao (Juncus Effusus Pith) 30 stems. Decoct and take on an empty stomach.
Wu Lin San (Five-Strangury Powder): Treats insufficiency of Kidney Qi, Heat in the Bladder, unblocked water passages, continuous dribbling. Or urine like bean dregs, or gravel discharge, or gum/paste discharge, or fresh blood in stool.
Dang Gui (Angelica Sinensis Root), Xiao Ji (Cirsium Herba), Chi Shao (Red Peony Root), Shan Zhi Ren (Gardenia Seed, stir-fried until black), Chi Fu Ling (Red Poria) (each 2 qian); Gan Cao (Licorice Root) (0.8 fen). Deng Xin Cao (Juncus Effusus Pith) 30 stems. Take on an empty stomach.
Ba Wei Wan (Eight-Ingredient Pill): Treats Kidney deficiency causing dribbling strangury, astringent pain in the urethra, or occasional itching.
Shu Di Huang (Prepared Rehmannia Root) (4 liang); Shan Yao (Dioscorea Rhizome, stir-fried), Ze Xie (Alisma Rhizome, de-haired), Shan Zhu Yu (Cornus Fruit Flesh), Dan Pi (Moutan Cortex) (each 2 liang); Bai Fu Ling (White Poria) (3 liang); Huang Bo (Phellodendron Bark, salt-water fried), Zhi Mu (Anemarrhena Rhizome, salt-wine fried) (each 2.5 liang).
Grind the above into powder, form honey pills. Take 3 qian per dose, with salt water on an empty stomach.
Zi Shen Wan (Nourish Kidney Pill): Treats Kidney channel insufficiency, internal heat blocking retention, failure of various Fires to ascend and descend. Although not very thirsty, there is difficulty in urination, and strangury with astringent pain.
Huang Bo (Phellodendron Bark, ginger-water fried), Zhi Mu (Anemarrhena Rhizome, salt-wine fried), Bai Shao (White Peony Root, wine-fried), Mai Men Dong (Ophiopogon Tuber, heart removed), Bai Fu Ling (White Poria, peeled), Ren Shen (Ginseng Root) (each 2 liang); Gou Qi Zi (Goji Berry), Bie Jia (Tartaric Shell, roasted with sheep fat), Tian Men Dong (Asparagus Tuber, heart removed), Sheng Di Huang (Rehmannia Root), Shan Zhu Yu (Cornus Fruit, pitted), Niu Xi (Achyranthes Root) (each 1.2 liang); Gan Cao (Licorice Root) (0.8 qian).
Grind the above into powder, form honey pills. Take 3 qian per dose, with salt water on an empty stomach.