（遗溺者小便自出而不知也夫膀胱所以潴水者也下焦虚故不能约摄也）
三阳合病。腹满。身重。口中不仁面垢。谵语。遗尿。（白虎汤）邪中下焦。阴气为栗。
足冷遗溺。（四逆汤）太阳病。火熨其背。大汗。谵语。振栗。下利。欲小便不得。反呕而失溲。
此为欲解。遗溲狂言。目反直视。此为肾绝。
按阳症热甚。神昏而遗尿者易治。阴症逆冷。脉微而遗尿者难治。宜益智桂附以温其下
。若厥阴囊缩逆冷。四逆加吴茱萸。汗下后阴虚。宜参芍术草知柏。经曰。水泉不止者。膀胱不
藏也。肾虚。则膀胱之气。不能约束也。东垣又谓遗溺属肺虚气陷。宜补中益气。合生脉知
柏。更以他证。及色脉详之。则自无遁情矣。
（咽通六经口为脾窍舌为心苗津为肾液俱属热而无寒也惟误汗误下
及虚人久病者方与温经耳有因汗下者有不因汗下者或和或解或微汗或微下或急下当考兼见之症而为
施治也）
太阳咽干。不可发汗。（津液竭也）脉浮自汗。小便数。心烦。微恶寒。脚挛急。本桂枝
附子症。反与桂枝汤攻表。便厥。咽干。烦躁。吐逆。（甘草干姜汤）吐下后不解。表里俱热。恶
风。大渴。舌干而烦。（白虎加人参汤）太阳病。重发汗。复下之。不大便五六日。舌燥干。
日晡潮热。心腹硬满痛。（大陷胸汤）阳明病。口干燥。漱水不欲咽。必衄。（犀角地黄汤）
阳明汗下后。口干舌燥渴。（白虎加人参汤）少阳口苦。咽干。目眩。（小柴胡汤）少阴自利。
清水。色纯青。心下痛。口干燥。急下之。（大承气汤）少阴病。二三日。便口燥咽干。急下
之。（大承气汤）按活人谓脾热则津枯。固矣。然白虎汤症。言表里俱热。则三阳俱矣。口燥咽
干。及自利纯青。皆急下者。救少阴也。脉沉者。附子汤。加知柏门冬五味花粉。汗下后。
大虚脉微。古人尝以补中益气。合生脉知柏。安可专主脾热一症哉。
（遗尿是指小便自行流出而患者不知晓。膀胱是储存尿液的器官，下焦虚弱导致无法约束和控制。）
三阳合病。腹部胀满。身体沉重。口中感觉迟钝、味觉不灵，面色污垢。胡言乱语。遗尿。（白虎汤）邪气侵入下焦。阴气战栗。
足部冰冷并遗尿。（四逆汤）太阳病。用火熨烫背部。大汗淋漓。胡言乱语。寒战发抖。腹泻。想小便却排不出。反而呕吐且失禁小便。
这是病情将要缓解的表现。遗尿伴狂言乱语。眼睛向后翻斜视。这是肾气绝灭的征象。
按：阳证热势炽盛，神志昏迷而遗尿者容易治疗。阴证四肢厥冷，脉象微弱而遗尿者难以治疗。宜用益智仁、桂枝、附子以温补下焦。若是厥阴病出现睾丸收缩、四肢厥冷，用四逆汤加吴茱萸。汗法或下法之后导致阴虚，宜用人参、芍药、白术、甘草、知母、黄柏。经书说：尿液不止，是膀胱不能固藏。肾虚，则膀胱之气不能约束。李东垣又说遗尿属于肺气虚陷，宜用补中益气汤，合生脉散、知母、黄柏。再结合其他症状及面色脉象详细诊察，自然就没有隐瞒的病情了。
（咽部通连六经，口为脾之窍，舌为心之苗，津液为肾之液，这些都属于热证而无寒证。只有误用发汗、误用攻下以及体虚久病的人，才适用温经之法。有的因汗下所致，有的不因汗下。或和解，或解表，或微发汗，或微攻下，或急攻下，应当考察兼见症状来施治。）
太阳病咽干。不可发汗。（因为津液枯竭）脉浮自汗出，小便频数，心烦，轻微恶寒，脚部拘挛急迫。本是桂枝附子证，反而给予桂枝汤攻表，导致四肢厥冷。咽干，烦躁，呕吐逆气。（甘草干姜汤）吐下之后病不解，表里俱热，恶风，大渴，舌头干燥而烦。（白虎加人参汤）太阳病，重发汗，又攻下，五六日不大便，舌头燥干。下午申时发热如潮，心腹硬满疼痛。（大陷胸汤）阳明病，口干燥，含水漱口但不欲咽下，必定发生鼻衄。（犀角地黄汤）阳明病汗下后，口干舌燥渴。（白虎加人参汤）少阳病口苦，咽干，目眩。（小柴胡汤）少阴病自利，排泄清水，颜色纯青，心下疼痛，口干燥，需急下之。（大承气汤）少阴病，二三天，出现口燥咽干，需急下之。（大承气汤）按：《活人书》认为脾热则津液枯涸，确实如此。然而白虎汤证，言表里俱热，则涉及三阳经。口燥咽干，以及自利纯青色，都是需要急下的情况，目的是救少阴。脉沉者，用附子汤，加知母、麦冬、五味子、天花粉。汗下之后，大虚脉微，古人曾用补中益气汤，合生脉散、知母、黄柏，怎么可以专门主治脾热一症呢。
(Enuresis refers to the involuntary discharge of urine without the patient's awareness. The Bladder is the organ that stores water; deficiency in the Lower Jiao leads to an inability to constrain and control it.)
Combined disease of the Three Yang channels. Abdominal fullness. Heaviness of the body. Numbness or loss of taste sensation in the mouth, with a greasy appearance of the face. Delirium. Enuresis. (Baihu Tang / White Tiger Decoction) Pathogenic factors invade the Lower Jiao. Yin Qi trembles.
Cold feet accompanied by enuresis. (Sini Tang / Four Reversal Decoction) Taiyang disease. The back was scorched with fire. Profuse sweating. Delirium. Shivering chills. Diarrhea. Inability to urinate despite the urge. Vomiting and urinary incontinence occur instead.
This indicates that the condition is about to resolve. Enuresis accompanied by wild talk. Eyes rolling backward and staring straight ahead. This is a sign of Kidney Qi exhaustion.
Note: In Yang syndromes with intense heat, where delirium and enuresis occur, treatment is relatively easy. In Yin syndromes with cold extremities, faint pulse, and enuresis, treatment is difficult. It is appropriate to use Yizhi Ren (Alpinia Oxyphylla Fructus), Guizhi (Cinnamon Twig), and Fuzi (Aconite Lateral Root Preparata) to warm the Lower Jiao. If Jueyin disease presents with testicular retraction and cold extremities, Sini Tang added with Wuzhuyu (Evodia Fruit) should be used. After sweating or purging methods leading to Yin deficiency, Renshen (Ginseng Radix), Shaoyao (Paeoniae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Licorice Radix et Rhizoma), Zhimu (Anemarrhenae Rhizoma), and Huangbai (Phellodendri Cortex) are suitable. The Classics state: "If water springs do not cease, it is because the Bladder cannot store." Kidney deficiency causes the Qi of the Bladder to fail in its constraining function. Li Dongyuan also stated that enuresis belongs to Lung Qi deficiency and sinking; Bu Zhong Yi Qi Tang combined with Sheng Mai San, Zhimu, and Huangbai is indicated. By examining other symptoms along with complexion and pulse in detail, no hidden pathology will remain undetected.
(The throat connects to the Six Channels; the mouth is the opening of the Spleen; the tongue is the sprout of the Heart; saliva/fluids are the essence of the Kidney. These all relate to Heat patterns rather than Cold patterns. Only in cases of erroneous sweating, erroneous purging, or chronic illness in deficient individuals is warming the meridians applicable. Some cases arise from sweating/purging, others do not. Treatment may involve harmonizing, releasing the exterior, mild sweating, mild purging, or urgent purging, depending on concurrent symptoms.)
Taiyang disease with dry throat. Sweating is contraindicated. (Due to exhaustion of Body Fluids). Floating pulse, spontaneous sweating, frequent urination, irritability, slight aversion to wind, and cramping of the legs. This was originally a Guizhi Fuzi pattern, but Guizhi Tang was erroneously administered to attack the exterior, resulting in cold extremities. Dry throat, irritability, vomiting, and regurgitation. (Gancao Ganjiang Tang / Licorice and Dried Ginger Decoction) After vomiting and purging, the disease persists with heat in both interior and exterior, aversion to wind, severe thirst, dry tongue, and irritability. (Baihu Jiasharen Tang / White Tiger Decoction plus Ginseng) Taiyang disease, subjected to heavy sweating followed by purging, leading to constipation for five to six days, dry and parched tongue. Tidal fever in the afternoon (Shi hour), hardness, fullness, and pain in the heart and abdomen. (Da Xiexiong Tang / Major Archaic Chest Decoction) Yangming disease, dry mouth, rinsing the mouth with water but unwilling to swallow, inevitably leading to epistaxis. (Xijiao Dihuang Tang / Rhinoceros Horn and Rehmannia Decoction - *Note: Xijiao is now substituted with Shuiniujiao/Bovis Cornu*) Yangming disease after sweating and purging, dry mouth, dry tongue, and thirst. (Baihu Jiasharen Tang / White Tiger Decoction plus Ginseng) Shaoyang disease, bitter taste in the mouth, dry throat, and vertigo/dizziness. (Xiaochaihu Tang / Minor Bupleurum Decoction) Shaoyin disease with spontaneous diarrhea, clear watery stool of pure green color, pain in the epigastrium, dry mouth, requiring urgent purging. (Dachengqi Tang / Major Order the Qi Decoction) Shaoyin disease, on the second or third day, presenting with dry mouth and dry throat, requiring urgent purging. (Dachengqi Tang / Major Order the Qi Decoction) Note: The *Huo Ren Shu* states that Spleen Heat causes fluid exhaustion, which is correct. However, Baihu Tang patterns describe heat in both interior and exterior, involving the Three Yang channels. Dry mouth and throat, as well as pure green diarrhea, are indications for urgent purging to save the Shaoyin. With a deep pulse, Fuzi Tang is used, added with Zhimu, Maidong, Wuweizi, and Huafen. After sweating and purging, if there is severe deficiency and a faint pulse, ancients used Bu Zhong Yi Qi Tang combined with Sheng Mai San, Zhimu, and Huangbai. How can one solely focus on the Spleen Heat pattern?