（小便自利有在表者有在里者有因热者有因寒者六经俱有此症宜详
考而条分之 小便数者频欲去而不多也在三阳经有表里之分在三阴经并无此症不可不详辨也
太阳病六七日。表症仍在。脉微而沉。反不结胸。其人发狂。以热在下焦。小腹硬满。小
便自利。（抵当汤）伤寒有热。应少腹满。小便不利。今反利者。为有血也。（宜抵当丸不宜他药）
十三日过经谵语。小便利。大便亦利。脉反和。（调胃承气汤）不大便六七日。小便少者。初
硬后溏未可攻。如小
导）小便自利而大汗。下利清谷。内寒外热。脉微欲绝。（四逆汤）脉浮自汗。小便数。心烦
。微恶寒。脚挛急。慎不可行桂枝汤。（甘草干姜汤芍药甘草汤）脉浮而涩。浮则胃气强。
涩则小便数。浮涩相搏。大便则难。其脾为约。（麻仁丸）太阳汗吐下后。微烦。小便数。大便
因硬。（小承气汤和之则愈）
按小便不利者。初硬后溏。未可下。小便已利而汗多。津液已竭。不可下。小便不利而
小腹硬者。溺也。当渗泄之。小便利而少腹硬者。非血则屎也。当疏利之。发黄而小便利。则为
可治。腹满而小便利。则为欲解。湿热而小便利。则不能发黄。发谵而至循衣摸床。小便利
。为可治。则小便之当察也审矣。小便数者。太阳阳明。治各有条。若肾虚有热者。生脉散
。加知柏莲子。脾肾俱虚者。补中益气。加生脉知柏。而法无遗用矣。
【小便自利】在表证有，在里证也有；因热邪所致者有，因寒邪所致者也有。六经病证中均可见此症状，应当详细考证并分类辨析。所谓“小便数”，是指频繁想排尿但尿量不多。在三阳经病证中有表证与里证之分，而在三阴经病证中则没有此症，不可不仔细辨别。
太阳病经过六七天，表证依然存在，脉象微而沉，反而没有形成结胸证。病人出现发狂的症状，这是因为热邪在下焦。表现为小腹硬满，小便自利。（适用抵当汤）伤寒伴有发热，本应少腹满闷，小便不利；现在反而小便通利，说明体内有瘀血。（适宜用抵当丸，不宜用其他药物）病程超过十三日，邪气已传入他经，出现谵语（胡言乱语），小便利，大便也通畅，脉象反而平和。（适用调胃承气汤）不大便六七天，如果小便量少，说明大便初头硬后溏薄，此时不可攻下。如用小导赤散之类调理。若小便自利且大汗出，下利清谷（完谷不化），内寒外热，脉微欲绝。（适用四逆汤）脉浮、自汗、小便频数、心烦、轻微恶寒、脚部拘挛急迫。切记不可使用桂枝汤。（可用甘草干姜汤、芍药甘草汤）脉象浮而涩，浮表示胃气强盛，涩表示小便频数。浮与涩相互搏结，导致大便困难，这是脾脏功能被约束（脾约）。（适用麻仁丸）太阳病经过汗法、吐法、下法治疗后，出现轻微烦躁，小便频数，大便因此变硬。（用小承气汤调和即可痊愈）
按语：小便不利，大便初硬后溏，不可攻下。小便已通利且汗多，津液已经枯竭，不可攻下。小便不利且小腹硬满的，是溺涩之证，应当采用渗湿泄浊的方法治疗。小便利而小腹硬满的，不是瘀血就是燥屎，应当采用疏通利下的方法治疗。发黄而小便利的，为可治之证。腹部胀满而小便利的，为病情将要解除。湿热蕴结而小便利的，则不会发黄。出现谵语甚至循衣摸床（意识障碍，手抓衣物床沿），但小便利的，为可治之证。由此可见，观察小便的情况必须审慎细致。至于小便频数，在太阳病和阳明病的治疗中各有条理。若是肾虚有热者，用生脉散加知母、黄柏、莲子；若是脾肾俱虚者，用补中益气汤加生脉散、知母、黄柏，这样治疗方法就没有遗漏了。
[Spontaneous Urination] It occurs in exterior syndromes and interior syndromes; it is caused by heat pathogen or cold pathogen. This symptom can be seen in all six meridians, so it should be carefully examined and differentiated. "Frequent urination" refers to the frequent urge to urinate but with small volume. In the three Yang meridians, there is a distinction between exterior and interior syndromes; however, this symptom does not occur in the three Yin meridians, so careful differentiation is essential.
In Taiyang disease (Taiyang Syndrome), after six or seven days, if the exterior syndrome persists, the pulse is faint and deep, and contrary to expectation, no Jie Xiong (Chest Binding) syndrome forms. The patient becomes manic because of heat in the Lower Jiao (Lower Burner). Symptoms include hardness and fullness in the lower abdomen and spontaneous urination. (Diding Tang [Echinospermum Pill]) In Shanghan (Cold Damage) with fever, one would expect lower abdominal fullness and difficulty in urination; now that urination is free, it indicates the presence of blood stasis. (Diding Wan [Echinospermum Pill] is suitable, other medicines are not.) After passing the meridian stage for thirteen days, if there is Shen Yu (delirious speech), free urination, free defecation, and the pulse is harmonious, (Tiaowei Chengqi Tang [Regulate the Stomach and Order Qi Decoction] is indicated.) If there is no defecation for six or seven days, but urine output is scant, the stool is initially hard and later loose; attack therapy should not be used. (Use Xiao Dao Chi San [Minor Guide Red Powder] for regulation.) If urination is free accompanied by profuse sweating, diarrhea with undigested food, internal cold with external heat, and a pulse that is faint and nearly imperceptible, (Sini Tang [Counterflow Decoction] is indicated.) If the pulse is floating, there is spontaneous sweating, frequent urination, mental restlessness, slight aversion to cold, and spasmodic cramping of the feet, Guizhi Tang (Cinnamon Twig Decoction) must absolutely not be used. (Gancao Ganjiang Tang [Licorice and Dried Ginger Decoction] and Shaoyao Gancao Tang [Peony and Licorice Decoction] may be used.) If the pulse is floating and choppy, floating indicates strong Stomach Qi, and choppy indicates frequent urination. The interaction of floating and choppy pulses leads to difficult defecation, known as Pi Yue (Spleen Constriction). (Maren Wan [Apricot Seed Pill] is indicated.) After diaphoresis, emesis, or purgation in Taiyang disease, if there is slight irritability, frequent urination, and consequently hard stool, (Xiao Chengqi Tang [Minor Order Qi Decoction] harmonizes the condition and leads to recovery.)
Commentary: When urination is obstructed and stool is initially hard then loose, purgation is contraindicated. When urination is free and sweating is profuse, body fluids are exhausted, so purgation is contraindicated. When urination is obstructed with hardness and fullness in the lower abdomen, it is a disorder of urinary flow; treatment should involve promoting diuresis and draining turbidity. When urination is free with hardness and fullness in the lower abdomen, it is either blood stasis or dry feces; treatment should involve unblocking and purging. Jaundice with free urination indicates a treatable condition. Abdominal fullness with free urination indicates the disease is about to resolve. With damp-heat accumulation, free urination prevents jaundice. Delirium progressing to grasping at clothing and bedrails, accompanied by free urination, indicates a treatable condition. Thus, the examination of urination must be thorough and prudent. Regarding frequent urination, treatments for Taiyang and Yangming diseases have their specific protocols. For Kidney deficiency with heat, Shengmai San (Generate Pulse Powder) plus Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), and Lianzi (Nelumbinis Semen) is used. For simultaneous Spleen and Kidney deficiency, Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) plus Shengmai San, Zhimu, and Huangbai is used. In this way, therapeutic methods are comprehensive.