淋有五，皆属热，解热利小便为主。山栀子之类同虎杖、甘草，煎汤服。小蓟汤，治下焦热结血淋。又有肾
虚极而淋者，当补肾精及利小便，不可独泻。 淋证不可发汗，汗之必便血。老人亦有气虚者，人参、白术中带木
通、山栀。亦有死血作淋者，牛膝膏亦能损胃不食，不宜
多服。治淋，山栀去皮一两炒，白汤送下。治气虚淋，八物汤加黄 同虎杖、甘草，煎汤服诸药，中加牛膝。一方
益元散加山栀、木通。夏月，以茴香煎汤调益元散服之。痰热隔滞，中焦淋涩不通，玄明粉。血气中有热者，八物
汤加黄柏、知母。妇人、男子淋闭，血药不效者，川黄柏新瓦上焙，牡蛎火 ，上为细末，食前调服，或小茴香汤
亦可。
小便不禁遗失者，属热、属虚。东垣谓∶肺气虚，宜安神养气，禁劳役。安神养气，用参、 补之，不愈则有热
加黄柏、生地。
气虚、血虚、实热、有痰，吐之以提其气，气升则水自降下，盖气承载其水也。气虚，人参、黄 、升麻等，先
服后吐，或参、 药中，探吐之；血虚，四物汤先服后吐，芎归汤亦可探吐；痰多者，二陈汤加木通、香附探吐；实热
者，当利。一妇人脾疼后，患大小便不通，此是痰隔中焦，气聚下焦，用二陈汤加木通，初服，渣煎服探吐。气
壮实热之人八正散，大便动，小便自通。小便因热郁不通，赤茯苓、黄芩、泽泻、车前子、麦门冬、桂、滑石、木通、
草梢。气虚痛者，加木香、黄 ；淋痛者，加黄柏、生地黄，夏月调益元散。痰隔中焦，二陈汤煎大碗顿服，调其真气
而吐之。否则用沙糖汤，调牵牛头末二钱服之。伤寒后，脱阳而小便不通，茴香调生姜自然汁敷小腹上，服益志茴香
丸，并益元散服之。一人燥热伤下焦，致小便不利，当养
阴，当归、地黄、知母、黄柏、牛膝、茯苓、生甘草、白术、陈皮之类。一妇人年五十，患小便涩，与八正散，则
小腹转急胀不通，身如芒刺，余以所感霖淫雨湿，邪在上表，因用苍术为君，附子佐之发其表，一服即汗，小便实时
便通。一男子年八十，患小便短涩，因服分利药太过，遂致闭塞，涓滴不出。余以饮食太过伤胃，其气陷于下焦，用
补中益气汤，一服小便即通，因先服多利药损其肾气，遂至通后遗溺，一夜不止息，补其肾然后已。有热宜清；有湿
宜燥；有气结于下宜升。有隔二隔三之治。如因肺燥不能生水，则清肺金，此隔二；如不因肺燥，但膀胱有热，则直
泻膀胱火，此正治；如因脾湿不运，精气不升，故肺不能生水，则当燥脾，此隔三也。清肺用车前子、茯苓之类；泻膀
胱用黄柏、知母之类；健脾燥脾用苍术、白术之类。又诸法治不通，则用吐法，盖气承载其水耳吐之则气升，气升则
水降。
淋证分为五种，均归属于热证，治疗以清热利小便为主。可用山栀子等药配合虎杖、甘草，煎汤服用。小蓟汤，用于治疗下焦热结导致的血淋。又有因肾精极度亏虚而致淋者，应当补肾精并利小便，不可单纯使用泻法。淋证禁止发汗，若误用发汗法必然导致便血。老年人中也有气虚类型的，用人参、白术为主，配伍木通、山栀。也有因瘀血阻滞而致淋者，牛膝膏虽然有效但会损伤胃气导致食欲不振，不宜多服。治疗淋证，可将山栀子去皮一两炒制，用白开水送服。治疗气虚型淋证，用八物汤加入黄柏，同虎杖、甘草一起煎汤服用，方中也可加入牛膝。另一方案是益元散加入山栀、木通。夏季，可用茴香煎汤调服益元散。痰热阻隔停滞于中焦，导致淋涩不通的，用玄明粉。血气中有热的，用八物汤加入黄柏、知母。妇女、男子患淋闭，使用血分药物治疗无效的，将川黄柏在新瓦上焙干，牡蛎火煅，研成细末，饭前调服，或者用小茴香汤送服亦可。
小便不禁、遗尿漏出者，属于热证或虚证。李东垣认为：肺气虚，宜安神养气，禁止劳累过度。安神养气，用人参、黄芪补益，若无效则说明有热，加黄柏、生地。
气虚、血虚、实热、有痰，可采用吐法以提举其气，气升则水液自然下降，因为气承载水液。气虚者，先服人参、黄芪、升麻等药，然后再催吐；或在参、芪药中加入探吐之品；血虚者，先服四物汤再催吐，芎归汤也可用于探吐；痰多者，用二陈汤加入木通、香附进行探吐；实热者，应当利小便。有一位妇人脾痛后，出现大小便不通，这是痰浊阻隔中焦，气聚于下焦所致，用二陈汤加入木通，初次服药后，将药渣煎汤服用以探吐。气壮实热之人，用八正散，大便通畅后，小便自然通利。小便因热郁而不通的，用赤茯苓、黄芩、泽泻、车前子、麦门冬、桂枝、滑石、木通、甘草梢。气虚疼痛者，加木香、黄芪；淋痛者，加黄柏、生地黄，夏季调服益元散。痰浊阻隔中焦，用二陈汤煎一大碗顿服，通过吐法调理真气。否则用砂糖汤，调服牵牛头末二钱服用。伤寒后，阳气脱失导致小便不通的，用茴香调生姜自然汁敷于小腹上，服用益志茴香丸，并配合益元散服用。有一人燥热损伤下焦，导致小便不利，应当滋养阴液，用当归、地黄、知母、黄柏、牛膝、茯苓、生甘草、白术、陈皮之类。一位五十岁的妇人，患小便涩滞，给予八正散后，小腹反而急胀不通，身体如芒刺在背，我认为这是由于感受霖雨湿气，邪气在上部肌表，因此用苍术为君药，附子为佐药发散表邪，一服药即出汗，小便随即通利。一位八十岁的男子，患小便短少涩滞，因服用分利药物太过，导致闭塞，滴水不出。我认为这是因为饮食过多损伤胃气，气陷于下焦，用补中益气汤，一服药小便即通，但因先前服用过多利药损伤了肾气，所以在通利之后出现遗尿，一夜不止，补益肾气后才停止。有热宜清；有湿宜燥；有气结于下宜升。还有隔二、隔三的治疗方法。如因肺燥不能生水，则清肺金，这叫隔二；如不因肺燥，仅是膀胱有热，则直接泻膀胱之火，这叫正治；如因脾湿不运，精气不升，导致肺不能生水，则应当燥脾，这叫隔三。清肺用车前子、茯苓之类；泻膀胱用火柏、知母之类；健脾燥脾用苍术、白术之类。另外诸法治不好不通的，则用吐法，因为气承载水液，吐之则气升，气升则水降。
Lin syndrome (stranguria) is divided into five types, all belonging to heat patterns. Treatment focuses on clearing heat and promoting urination. Decoctions of Gardenia (Shanzhizi) combined with Polygonum cuspidatum root (Huzhang) and Licorice root (Gancao) can be taken. Xiaojie Tang (Little Thistle Decoction) treats hematuric stranguria caused by heat accumulation in the lower jiao. There are also cases where extreme deficiency of kidney essence leads to Lin syndrome; these should be treated by tonifying kidney essence and promoting urination, avoiding pure purgative methods. Lin syndrome contraindicates diaphoresis (sweating therapy); inducing sweat will inevitably lead to blood in the stool or urine. Elderly patients may also have Qi deficiency patterns, treated with Ginseng root (Renshen) and Atractylodes macrocephala rhizome (Baizhu), supplemented with Akebia stem (Mutong) and Gardenia (Shanzhi). Cases caused by static blood (stasis) leading to Lin syndrome: Niuxi Gao (Achyranthes Bidentata Paste) can damage stomach Qi and cause loss of appetite, so it should not be taken in large amounts. To treat Lin syndrome, one ounce of Gardenia (Shanzhi) peeled and stir-fried can be taken with warm water. For Qi-deficient Lin syndrome, Baye Tang (Eight-Ingredient Decoction) is added with Phellodendron bark (Huangbai), decocted with Polygonum cuspidatum root (Huzhang) and Licorice root (Gancao); Achyranthes root (Niuxi) can also be added. Another prescription is Yiyuan San (Benefit the Prime Powder) added with Gardenia (Shanzhi) and Akebia stem (Mutong). In summer, Yiyuan San can be mixed with Fennel seed (Huixiang) decoction. If phlegm-heat obstructs the middle jiao causing difficult and painful urination, Xuanming Fen (Mirabilite) is used. For heat in blood and Qi, Baye Tang (Eight-Ingredient Decoction) is added with Phellodendron bark (Huangbai) and Anemarrhena rhizome (Zhimu). For men and women with stranguria and urinary retention unresponsive to blood-invigorating medicines, Chuan Huangbai (Sichuan Phellodendron Bark) is roasted on a new tile, Oyster shell (Muli) is calcined, both ground into fine powder, and taken before meals, optionally with Fennel seed (Huixiang) decoction.
Urinary incontinence and leakage belong to heat or deficiency patterns. Li Dongyuan stated that Lung Qi deficiency requires calming the mind and nourishing Qi, while avoiding overexertion. Calming the mind and nourishing Qi involves tonifying with Ginseng root (Renshen) and Astragalus root (Huangqi); if ineffective, indicating heat, add Phellodendron bark (Huangbai) and Rehmannia root (Shengdi).
For Qi deficiency, Blood deficiency, excess heat, or phlegm, emesis (vomiting therapy) can be used to raise Qi; when Qi rises, water naturally descends because Qi carries water. For Qi deficiency, take Ginseng root (Renshen), Astragalus root (Huangqi), and Cimicifuga rhizome (Shengma) first, then induce vomiting; or add emetic agents to Ginseng and Astragalus decoctions. For Blood deficiency, take Siwu Tang (Four-Substance Decoction) first, then induce vomiting; Xiong Gui Tang (Angelica and Ligusticum Decoction) can also be used for emesis. For excessive phlegm, Erchen Tang (Two-Aged Decoction) added with Akebia stem (Mutong) and Cyperus rhizome (Xiangfu) is used for emesis. For excess heat, promote urination. A woman who developed urinary and fecal retention after spleen pain suffered from phlegm obstruction in the middle jiao and Qi stagnation in the lower jiao; she was treated with Erchen Tang (Two-Aged Decoction) plus Akebia stem (Mutong). After the initial dose, the dregs were decocted and taken to induce vomiting. For robust individuals with excess heat, Bazheng San (Eight-Herb Powder) is used; once bowel movements occur, urination naturally clears. For urinary retention due to heat stagnation, use Red Poria (Chifuling), Scutellaria root (Huangqin), Alisma tuber (Zexie), Plantago seed (Cheqianzi), Ophiopogon tuber (Maidong), Cinnamon twig (Gui), Talcum (Huashi), Akebia stem (Mutong), and Licorice tip (Caogao). For Qi-deficiency pain, add Costus root (Muxiang) and Astragalus root (Huangqi); for stranguria pain, add Phellodendron bark (Huangbai) and Rehmannia root (Shengdi), mixing with Yiyuan San (Benefit the Prime Powder) in summer. For phlegm obstruction in the middle jiao, decoct a large bowl of Erchen Tang (Two-Aged Decoction) and drink it at once to regulate true Qi through emesis. Alternatively, use sugar water mixed with 2 qian of Qianniu head powder. After cold damage, Yang collapse causing urinary retention can be treated by applying fresh Ginger juice mixed with Fennel seed (Huixiang) to the lower abdomen, taking Yizhi Huixiang Wan (Yizhi Fennel Pill), and concurrently taking Yiyuan San (Benefit the Prime Powder). One man suffered lower jiao injury from dryness-heat causing difficult urination; Yin should be nourished using Danggui (Angelica sinensis), Dihuang (Rehmannia), Zhimu (Anemarrhena), Huangbai (Phellodendron), Niuxi (Achyranthes), Fuling (Poria), Sheng Gancao (Raw Licorice), Baizhu (Atractylodes), and Chenpi (Citrus peel). A fifty-year-old woman with difficult urination experienced acute abdominal distension and retention, and body sensations like thorns, after taking Bazheng San (Eight-Herb Powder). I attributed this to dampness-evil from prolonged rainy weather affecting the exterior upper body, so I used Cangzhu (Atractylodes lancea) as the sovereign herb with Fuzi (Prepared Aconite) as assistant to release the exterior. After one dose, sweating occurred, and urination immediately cleared. An eighty-year-old man with short, difficult urination became completely blocked with no drops passing after excessive use of diuretics. I reasoned that excessive food intake damaged Stomach Qi, causing Qi to sink to the lower jiao. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was administered, and urination cleared after one dose. However, prior excessive diuretic use had damaged Kidney Qi, leading to post-obstructive incontinence lasting all night. The condition ceased only after Kidney Qi was tonified. Heat should be cleared; dampness should be dried; Qi knotting in the lower jiao should be raised. There are treatments involving "separated two" and "separated three" principles. If Lung dryness prevents generating Water, clear Lung Metal (Separated Two); if not due to Lung dryness but Bladder heat, directly purge Bladder Fire (Direct Treatment); if Spleen dampness fails to transport, preventing Jing-Qi ascent and thus Lung water generation, dry the Spleen (Separated Three). Clearing Lung uses Cheqianzi (Plantago seed) and Fuling (Poria); purging Bladder uses Huangbai (Phellodendron) and Zhimu (Anemarrhena); strengthening and drying Spleen uses Cangzhu (Atractylodes lancea) and Baizhu (Atractylodes macrocephala). If other methods fail to resolve retention, use emesis, because Qi carries water; emesis raises Qi, and rising Qi causes water to descend.