小便不利者，邪气聚于下焦，结而不散，甚则小腹硬满而痛，此小便不通也。大抵有所不利者，
行之，取其渗利也。若引饮过多，下焦多热，或中湿发黄，水饮
停滞，皆以利小便为先。惟汗后亡津液，胃中干，与阳明汗多者，则以利小便为戒。设或小水不利，
而见头汗出者，乃阳脱关格之病笃矣。引饮过多，小便不利，下焦蓄热，浮者，五苓散；沉脉，猪
苓汤。太阳病，身黄，脉沉，小腹硬，小水不利者，知无血也，与阳明无汗，小便不利，心中懊 者，
必发黄，茵陈五苓散，黄自退而小便清矣。
小便难者，阴虚也，阳必凑之，由膀胱受热，故小便赤涩而不能流利也。又有虽不大便五六日，
而小便少者，但初硬后溏不定，或硬攻之，必溏。候小便多，屎定硬，方可攻之。乃胃中水谷少，便
虽通而不多，如猪苓汤可也。
小便自利者，为津液偏渗，大便必硬，宜药下之。太阴当发身黄，其小便自利者，则湿热内泄，
不能发黄。惟血证，小腹急而如狂，小水自利者，肾与膀胱虚而
不能约制水液，桃仁承气下之。若自汗，小便数者，虽有表证，不可用桂枝，谓其走津液也。若误
服之得厥者，以甘草干姜为治也。
舌上白苔者，以丹田有热，胸中有寒，谓其寒邪初传入里也，小柴胡汤。舌乃心之苗，色应南
方火，邪在表，则未生苔。邪入里，津液结搏，则舌上生苔而滑。热气渐深，其舌苔燥而涩。热聚
于胃，其苔为之黄矣，宜承气汤下之。若舌上黑色苔者，则热已深，病势已笃。经曰∶热病，口中
干，舌黑者，乃肾水刑于心火也。脉浮，阴阳俱紧，口中气出，舌中干燥，蜷卧足冷，鼻中涕出，
舌上滑苔，勿妄治也。到七八日以来，微发热，手足温者，此为欲解也。及或大发热者，难治。设
有恶寒者，小柴胡加干姜服之。
小便排泄不畅的，是邪气聚集在下焦，凝结而不消散，严重时小腹部坚硬胀满且疼痛，这就是小便不通。大抵凡是出现排尿不利的情况，应当采用通利的方法，取其渗湿利尿的作用。如果是饮水过多，导致下焦多热，或者因中湿而发黄，水饮停滞，都应当以通利小便为首要治疗原则。只有在发汗后津液耗伤，胃中干燥，以及阳明病发汗过多的情况下，才禁止使用利小便的方法。假如小便不利，却出现头部出汗的情况，这是阳气外脱、关格重症的表现，病情危笃。若是饮水过多，小便不利，下焦蓄积热邪，脉象浮的，用五苓散；脉象沉的，用猪苓汤。太阳病，身体发黄，脉象沉，小腹部硬，小便不利的，可知没有瘀血，若伴有阳明病无汗、小便不利、心中烦闷懊恼的，必定会发黄，用茵陈五苓散，黄色消退后小便自然清利。
小便困难的，属于阴虚，阳气必然凑合于此，因为膀胱受热，所以小便赤红涩痛而不能流利。又有虽然不大便五六天，但小便少的，只是大便初头硬而后稀溏不定，如果强行攻下，必定导致腹泻。必须等到小便增多，大便确定变硬后，才可以攻下。这是因为胃中水谷精微较少，大便虽然通畅但不多，这种情况可以用猪苓汤调理。
小便自利的（指小便频数或量多），是因为津液偏渗于前阴，大便必定干硬，适宜用药攻下。太阴病本应发生身黄，但如果小便自利，则湿热内泄，不能发黄。只有血证，小腹部急迫且神志如狂，小便自利的，是肾与膀胱虚弱而不能制约水液，用桃仁承气汤攻下。如果有自汗、小便频数的，即使有表证，也不可用桂枝汤，因为桂枝汤会耗散津液。如果误服后出现四肢厥冷的，用甘草干姜汤来治疗。
舌上白苔的，是因为丹田有热，胸中有寒，这是寒邪刚刚传入体内的表现，用小柴胡汤。舌是心的苗窍，颜色对应南方的火，邪气在体表时，尚未生苔。邪气入里，津液凝结搏结，则舌上生苔且滑润。热气逐渐加深，舌苔变得干燥涩滞。热邪聚积于胃，舌苔就会变黄，适宜用承气汤攻下。如果舌上出现黑色苔，说明热邪已经深入，病情已经危重。经书说：热病，口中干燥，舌黑的，是肾水克制心火的表现。脉象浮，阴阳两部都紧，口中呼出热气，舌中干燥，蜷缩而卧，脚冷，鼻中流涕，舌上滑苔的，不要妄加治疗。到了七八天后，轻微发热，手足温暖的，这是病情将要解除的表现。如果反而大发热的，难以治疗。假如有恶寒的，用小柴胡汤加干姜服用。
Those with difficult urination have pathogenic factors gathered in the Lower Jiao (Lower Burner), knotting and not dispersing; severely, this presents as hardness, fullness, and pain in the lower abdomen, which is termed urinary obstruction. Generally, for any difficulty in urination, one should employ methods to promote flow, utilizing diuretic and leaching properties. If excessive drinking leads to heat in the Lower Jiao, or if dampness causes jaundice, or if water retention stagnates, promoting urination should be the primary treatment. However, after sweating where body fluids are depleted and the Stomach is dry, or in Yangming disease with excessive sweating, promoting urination is contraindicated. If there is difficulty in urination accompanied by sweating only on the head, this indicates a critical condition of Yang collapse and Guan-Ge (obstruction). For excessive drinking leading to difficult urination and heat accumulation in the Lower Jiao: if the pulse is floating, use Wu Ling San (Five-Ingredient Powder with Poria); if the pulse is deep, use Zhu Ling Tang (Polyporus Decoction). In Taiyang disease, if there is yellowing of the body, a deep pulse, hardness in the lower abdomen, and difficult urination, it can be known that there is no blood stasis; combined with Yangming disease presenting with no sweat, difficult urination, and mental restlessness (Ao-Nao), jaundice will certainly occur; use Yin Chen Wu Ling San (Artemisia Capillaris Five-Ingredient Powder), after which the yellow color recedes and urination becomes clear.
Difficulty in urination indicates Yin deficiency, where Yang Qi inevitably congregates there due to heat in the Bladder, resulting in red, astringent, and non-smooth urination. There are cases where there has been no bowel movement for five or six days, yet urine output is scant; the stool may be hard initially but loose later, and if forced with purgatives, it will become loose. One must wait until urine output increases and the stool is confirmed to be hard before employing purgation. This occurs because there is little food and fluid in the Stomach; although the bowels move, the volume is small, and Zhu Ling Tang (Polyporus Decoction) may be used.
Spontaneous frequent urination indicates that body fluids are leaking preferentially to the anterior, causing the stool to become hard; purgative medication is appropriate. In Taiyin disease, jaundice should develop; however, if urination is spontaneous and frequent, damp-heat drains internally, preventing jaundice. In cases of blood disorders, with urgency in the lower abdomen and manic behavior, if urination is spontaneous and frequent, it indicates deficiency of the Kidney and Bladder failing to control fluids; use Tao Ren Cheng Qi Tang (Peach Kernel Da Huang Decoction) to purge. If there is spontaneous sweating and frequent urination, even if exterior symptoms exist, Gui Zhi Tang (Cinnamon Twig Decoction) should not be used, as it consumes body fluids. If mistakenly administered leading to cold limbs (Jue), treat with Gan Cao Gan Jiang Tang (Licorice and Dried Ginger Decoction).
White coating on the tongue indicates heat in the Dan Tian (Elixir Field/Lower Abdomen) and cold in the Chest, signifying that cold pathogenic factors have just entered the interior; use Xiao Chai Hu Tang (Minor Bupleurum Decoction). The tongue is the sprout of the Heart, corresponding to the Fire of the South; when pathogens are at the exterior, no coating forms. When pathogens enter the interior and body fluids knot and bind, a slippery coating forms on the tongue. As heat intensifies, the coating becomes dry and rough. When heat gathers in the Stomach, the coating turns yellow; use Cheng Qi Tang (Order the Qi Decoction) to purge. If a black coating appears on the tongue, the heat has penetrated deeply and the disease is critical. The Classics state: in heat diseases, if the mouth is dry and the tongue is black, it indicates Kidney Water punishing Heart Fire. With a floating pulse, tightness in both Yin and Yang positions, warm breath from the mouth, dryness in the center of the tongue, curling up in bed, cold feet, nasal discharge, and a slippery tongue coating, do not treat rashly. After seven or eight days, if there is slight fever and warmth in the hands and feet, this indicates the disease is about to resolve. If instead there is high fever, it is difficult to treat. If there is aversion to cold, administer Xiao Chai Hu Tang (Minor Bupleurum Decoction) with added Sheng Jiang (Dried Ginger).