补脾和胃，泻火消痰。
白术（三两，去梗） 枳实（一两，去瓤麸炒） 陈皮（一两） 黄连（一两，酒浸、炒）
为末，荷叶煮汤，打米糊为丸，白汤食后下五十丸。
按∶易老枳术丸方，用白术二两补脾，枳实一两消痞，取其补多消少。至东垣加橘
皮一两以和胃，名橘皮积术丸，则补消相半也。今更用白术三两、枳实一两、陈皮一
两、黄连一两，名橘连帜术丸，仍补多消少，又兼清热也。丹溪云∶心下痞，须用枳
实、炒黄连是也。
调中补气血，消痞清热。
白术（三两） 白芍药（一两五钱，酒炒） 陈皮 枳实（去瓤麸炒） 黄连（酒浸、炒，
各一两） 人参 木香（各五钱） 为末，荷叶煮浓汤，打米糊为丸，桐子大，每服五十
丸，加至六七十丸，食远米汤下。
嘈杂者，俗名心嗜。似饥非饥，似痛非痛，而有懊 不宁之状，乃痰因火动，治痰
为先，姜炒黄连，及山枝、黄芩、星半、陈皮之类。如眩晕嘈杂，若非中气不足，亦是
火动其痰，或六君子汤，或二陈汤加芩连。若嘈杂不喜食者，是湿痰气郁，及肥人嘈
杂，并用二陈少加抚芎、苍术、白术、香附以补脾而兼舒郁化痰。若心嘈索食者，是胃
虚有火也，宜用白术、黄连、陈皮作丸，白汤下之乃安。
淋者，小便淋沥，欲去不去，不去又来。《经》曰∶脾受积湿之气，小便黄赤，
甚则淋，此言湿传膀胱而成淋也。又曰∶风火郁于上而热，其病淋，此言热传膀胱而成
淋也。《内经》言∶淋无非湿与热而已，然有因忿怒，有因醇酒，有因浓味，大人则更
有因房劳者。忿怒者，气动生火也。醇酒浓味者，酿成湿热者。房劳者，阴虚火动也。
故诸淋，皆肾虚为本，而膀胱生热也。盖肾与膀胱为表里，凡水入小肠，则通于胞，行
于阴而为溲。若肾气不足，热入膀胱，故水道涩而不利，欲出不出，淋沥不断，脐腹急
痛，蕴作有时，或如豆汁膏血，甚有窒塞其间，令人闷绝者。凡小肠有气，则小便胀，
有血，则小便涩，有热，则小便痛。更有肾虚气弱，囊中受寒夹冷，而小便淋沥者，其
候必先寒战，而后溲便，盖冷气与正气交争，冷气胜则寒战，而成淋，正气胜，则战
解而得便矣。然淋有五，石膏劳热血是也。石淋者，盖肾主水，为热所乘则化为石，正
如汤瓶久在火中，底结白碱也。若遇小便，则茎中痛，不能流利，痛引膀胱里急，其砂
石乃从小便而出，甚有痛急昏闷，遍身有汗而后醒者；膏淋者，小便有肥脂如膏，浮于
小便之上，此因肾虚不能制其肥液，而下行也；劳淋者，所因有二，若因劳倦而作者，
属于脾虚也。强力入房者，属于肾虚也；热淋者，三焦有热，热气传肾，流入于胞，溺
黄而涩，间有鲜红同来者；血淋者，热之极也。盖心主血，外行经络，内行脏腑，若热
盛搏血则失其常道，心与小肠，为表里，乃下流而入于胞，与便齐出，则为血淋，脉必
数而有力，若血色黑黯，面色枯白，尺脉沉迟，此属下元虚冷也。若小腹硬满，茎中作
痛欲死者，此血瘀也。然尿血而痛者为血淋，若尿血而不痛者，则又为溺血也。五淋
之外，更有气淋、冷淋、虚淋、肉淋之别，实同候而异名，总不外乎水火不交，心肾气
郁，遂使阴阳乖舛，清浊相于，自清而浊、自柔而坚，自无形而有形，要皆一火之化，
犹水煮为盐，岂真有砂石出于水脏之内哉！治法并宜开郁行滞，破血滋阴，疏利小便，
清解邪热，调平心火，心清则小便自利，心平则血不妄行，切弗误加补剂，姑息，盖气
得补则愈胀，血得下则愈涩，热得补则愈盛，源泉欲遏，厥溃更深矣。然通淋者，更
宜清肺，盖肺为生水之源也。其药加郁金琥珀，开郁药也。青皮木香，行气药也。蒲黄
牛膝，破血药也。黄柏生地，滋阴药也。若内痛腰曲，无泪干哭，上唇焦干，脚冷额汗
者，此小肠气痛也。当用疝门之药，如橘核、青皮、茴香之类。若小便尿血而不痛
者，此为茎衄也。当用清利膀胱溺血之药，如山栀、小蓟、琥珀、归尾生地、牛膝之
类，务使脏腑和平，其血不治自愈。一加止遏，即为痛为淋矣，淋证无出于热，大法流
行滞气，疏利小便，清解邪热，调平心火，然有隔二隔三之分，如膀胱有热不渴，则宜
泻膀胱火，乃正治也。如口渴而肺燥，不能生水，宜清金，此隔二也。如脾湿不运，而
清气不升，故肺不能生水，则当燥脾渗湿，宣扬胃气，此隔三也。大忌发汗，以阴虚故
耳。亦忌补气，以胀满故耳。又当分在气在血，渴者在上焦气分，宜黄芩、茯苓、泽
泻、灯心、瞿麦、 蓄淡渗之剂，以降肺金之火，以清膀胱之源。不渴在下焦血分，宜
知毋、黄柏、牛膝、发灰、茅根行血之剂，以补肾水之源。色欲过度，或体瘦之人，日
久不愈，属虚火，坎离丸主之。色白气虚，小水不通，宜吐，病在下，取之上也，清心
莲子散主之。一老人气虚，不能施化，补中益气汤，加淡渗。有虚劳汗多而赤涩者，却
是五内枯燥，滋腴既去，不能生津，不宜过通小便，竭其肾水，惟当温养润肺，并诸失
精血，及患痈毒人，或有便赤之证，亦是枯竭不润之故，并宜前法。至于不通为闭，
《经》云∶肝足厥阴之脉过阴器，所生病者，闭癃；又云∶督脉者，女子入系廷孔，（廷，
正也，直也，言正中之直孔，即溺窍也。）其孔，溺孔之端也。（女人溺孔在前阴中横骨
之下也。孔之上际，谓之端，乃督脉外起之所，此虽以女人为言。然男子溺孔亦在横骨下
中央。）其男人循茎下至纂，与女子等，此生病不得前后。（茎，阴茎也。不得前后，二
便俱团也。此虽督脉所生而实亦冲任之病，盖此三脉皆由阴中而上行，故为病如此。）又云∶
膀胱不利为癃，不约为遗溺。（不约者，不能约束收摄也。）又曰∶实则闭癃，虚则遗溺。
夫闭与癃二证也。新病为溺闭，盖点滴难通也。久病为溺癃，盖屡出而短少也，然太阳膀胱，
但主藏溺，其主出者，皆肝经及督脉及三焦也，故曰∶气化则能出，夫气化者，太阴肺也。
以肺为气之主，而能生水也。若肺燥不能生水，气化不及州都矣。脾为肺之母，湿不运而精不
升，不能生水之源，要皆热盛，而气不能通调也。夫肾肝在下，地道也。心肺在上，天
道也。脾胃居中，气分之交也。故天之阳绝，而不交于地者，白露不下，人同乎天，
其在上之阳，不交于阴，则在下之阴，无以为化，小便其能出乎，史国信曰∶若欲便
清，先分肝火，以其失疏泄之职也。然肝火之旺，更由于癸水之失养也。故有实热者，
非与纯阴之剂，则阳无以化，有大虚者，非与温补之剂，则水不能行。《别录》云∶小
便不利，审是气虚，独参汤，如神。《集验》云∶中焦气不升降，为寒所隔，惟服附子，
小便自通，丹溪以吐法通小便，如滴水之器，使上窍开，而下窍之水自出焉。然病源
霄壤不同，治法亦贵揆情处变，岂可概以清热疏肝导水为事乎？
脉盛而大实者，生。虚小而涩者，死。下焦气血干者，死。
补益脾胃，清泻火热，消除痰浊。
白术（三两，去芦头） 枳实（一两，去瓤后麸皮炒） 陈皮（一两） 黄连（一两，酒浸后炒）
研为细末，用荷叶煮汤，调和米糊制成丸药，饭后用温开水送服五十丸。
按语：易老（张元素）的枳术丸方，用白术二两以补脾，枳实一两以消痞满，取其补益多于消导之意。到了李东垣，加入陈皮一两以和胃，命名为橘皮枳术丸，则补益与消导各占一半。现在进一步使用白术三两、枳实一两、陈皮一两、黄连一两，命名为橘连枳术丸，依然保持补多消少的原则，又兼有清热的作用。朱丹溪说：“心下痞满，必须使用枳实、炒黄连”，说的就是这个道理。
调和中焦，补益气血，消除痞满，清泻热邪。
白术（三两） 白芍药（一两五钱，酒炒） 陈皮 枳实（去瓤后麸皮炒） 黄连（酒浸后炒，各一两） 人参 木香（各五钱）
研为细末，用荷叶煮浓汤，调和米糊制成丸药，大小如梧桐子，每次服用五十丸，逐渐加至六七十丸，饭后较远时用米汤送服。
嘈杂感，俗称“心嗜”。感觉像饿又不是饿，像痛又不是痛，伴有心中烦闷不安的症状，这是由于痰因火动所致，治疗应以治痰为先，可用姜炒黄连，以及山栀、黄芩、制南星、半夏、陈皮等药物。如果伴有眩晕和嘈杂，如果不是中气不足，也是火动其痰，可用六君子汤，或在二陈汤中加入黄芩、黄连。如果嘈杂且不喜欢进食，这是湿痰气郁，以及肥胖之人出现的嘈杂，均使用二陈汤少量加入抚芎（川芎）、苍术、白术、香附，以补脾并兼舒解郁结、化痰。如果心中嘈杂想要进食，这是胃虚有火，宜用白术、黄连、陈皮制成丸药，用温开水送服才能安宁。
淋证，指小便淋漓不尽，想排却排不出，排不出后又再次产生尿意。《内经》说：“脾受到积滞湿气的侵袭，小便黄赤，严重时发展为淋证”，这是说湿气传入膀胱而成为淋证。又说：“风火郁结于上而生热，其病表现为淋证”，这是说热邪传入膀胱而成为淋证。《内经》指出：“淋证无非是湿与热罢了”，然而有的因愤怒引起，有的因酗酒引起，有的因厚味饮食引起，成年人还有因房劳过度引起的。愤怒会导致气机逆乱而生火；酗酒和厚味饮食会酿成湿热；房劳过度会导致阴虚火旺。所以各种淋证，都以肾虚为本，而膀胱生热为标。肾与膀胱互为表里，凡水液进入小肠，则通达于胞宫（此处指泌尿系统相关部位），行于阴部而为尿液。如果肾气不足，热邪侵入膀胱，导致水道涩滞而不通畅，想排尿却排不出，淋漓不断，脐腹部急痛，有时蕴结发作，或者排出如豆汁或膏血样物质，甚至有阻塞其间，令人昏闷欲绝的情况。凡是小肠有气，则小便胀满；有血，则小便涩滞；有热，则小便疼痛。更有肾虚气弱，阴囊受寒夹冷，而导致小便淋漓的，其症状必然是先出现寒战，然后才排尿，这是冷气与正气交争，冷气胜则寒战，形成淋证；正气胜，则寒战解除而得以排尿。然而淋证分为五种，即石淋、膏淋、劳淋、热淋、血淋。石淋，是因为肾主水，被热邪所乘则化为石，正如汤瓶久在火中，底部结成白色碱垢一样。若遇排尿时，则尿道疼痛，不能流利，疼痛牵引膀胱内部急迫，其中的砂石乃随小便而出，甚至疼痛剧烈导致昏闷，全身出汗后才苏醒；膏淋，是指小便中有肥脂状物质如膏脂，浮于小便之上，这是因为肾虚不能制约其肥液，而下行的缘故；劳淋，其成因有二，若因劳累倦怠而发作者，属于脾虚；强力入房者，属于肾虚；热淋，是三焦有热，热气传肾，流入于胞，尿液黄而涩滞，间或有鲜红色血液一同排出；血淋，是热邪极盛的表现。心主血，外行经络，内行脏腑，若热盛搏结血液则使其失去常道，心与小肠互为表里，热邪下流而入于胞，与尿液一起排出，则为血淋，脉象必然数而有力；若血色黑黯，面色枯白，尺脉沉迟，这属于下元虚冷。若小腹硬满，尿道疼痛欲死，这是血瘀。然而尿血且痛的称为血淋，若尿血而不痛的，则称为溺血。在五淋之外，更有气淋、冷淋、虚淋、肉淋的区别，实质相同而名称不同，总不外乎水火不交，心肾气郁，致使阴阳乖舛，清浊相混，自清变浊、自柔变坚、自无形变有形，要皆是一火之化，犹如水煮成盐，难道真有砂石出于水脏之内吗！治疗方法都宜开郁行滞，破血滋阴，疏利小便，清解邪热，调平心火，心清则小便自然通利，心平则血液不妄行，切忌错误地加入补剂姑息养奸，因为气得补则更加胀满，血得补则更加涩滞，热得补则更加旺盛，源泉被遏制，溃决会更深重。然而通淋者，更宜清肺，因为肺为生水之源。药物可加郁金、琥珀，这是开郁的药物；青皮、木香，这是行气的药物；蒲黄、牛膝，这是破血的药物；黄柏、生地，这是滋阴的药物。若出现内痛、腰曲、无泪干哭、上唇焦干、脚冷额汗等症状，这是小肠气痛。应当使用疝门类药物，如橘核、青皮、茴香之类。若小便尿血而不痛的，这称为茎衄。应当使用清利膀胱溺血的药物，如山栀、小蓟、琥珀、归尾、生地、牛膝之类，务必使脏腑和平，其血不治自愈。一旦加以止遏，就会变为疼痛和淋证。淋证没有超出热邪的范围，大法在于流行滞气，疏利小便，清解邪热，调平心火。然而有隔二、隔三之分，如膀胱有热但不口渴，则宜泻膀胱之火，这是正治法。如口渴而肺燥，不能生水，宜清金（清肺），这是隔二法。如脾湿不运，清气不升，故肺不能生水，则当燥脾渗湿，宣扬胃气，这是隔三法。大忌发汗，因为阴虚的缘故。也忌补气，因为胀满的缘故。又当分在气在血，口渴者在上焦气分，宜用黄芩、茯苓、泽泻、灯心草、瞿麦、萹蓄等淡渗之剂，以降肺金之火，以清膀胱之源。不渴者在在下焦血分，宜用知母、黄柏、牛膝、发灰、茅根等行血之剂，以补肾水之源。色欲过度，或身体瘦弱之人，日久不愈，属虚火，用坎离丸主治。面色白、气虚、小便不通者，宜用吐法，病在下，取之上，用清心莲子散主治。一位老人气虚，不能施化，用补中益气汤，加淡渗之品。有虚劳汗多而小便赤涩者，却是五脏内里枯燥，滋润既去，不能生津，不宜过分通利小便，竭尽肾水，只应当温养润肺，以及诸失精血，及患痈毒的人，或有便赤之证，也是枯竭不润的缘故，都适宜用前法。至于不通称为闭，《内经》说：“肝足厥阴之脉过阴器，所生病者，闭癃”；又说：“督脉者，女子入系廷孔（廷，正也，直也，言正中之直孔，即溺窍也。）其孔，溺孔之端也。（女人溺孔在前阴中横骨之下也。孔之上际，谓之端，乃督脉外起之所，此虽以女人为言。然男子溺孔亦在横骨下中央。）其男人循茎下至纂，与女子等，此生病不得前后。（茎，阴茎也。不得前后，二便俱团也。此虽督脉所生而实亦冲任之病，盖此三脉皆由阴中而上行，故为病如此。）”又说：“膀胱不利为癃，不约为遗溺。（不约者，不能约束收摄也。）”又说：“实则闭癃，虚则遗溺。”夫闭与癃是两个证候。新病为溺闭，点滴难通也。久病为溺癃，屡出而短少也。然而太阳膀胱，只主藏溺，其主出者，皆肝经及督脉及三焦也，所以说：“气化则能出”，所谓气化者，太阴肺也。以肺为气之主，而能生水也。若肺燥不能生水，气化不及州都（膀胱）。脾为肺之母，湿不运而精不升，不能生水之源，要皆热盛，而气不能通调也。夫肾肝在下，地道也。心肺在上，天道也。脾胃居中，气分之交也。故天之阳绝，而不交于地者，白露不下，人同乎天，其在上之阳，不交于阴，则在下之阴，无以为化，小便其能出乎？史国信说：“若欲便清，先分肝火，以其失疏泄之职也。”然肝火之旺，更由于癸水之失养也。故有实热者，非与纯阴之剂，则阳无以化，有大虚者，非与温补之剂，则水不能行。《别录》云：“小便不利，审是气虚，独参汤，如神。”《集验》云：“中焦气不升降，为寒所隔，惟服附子，小便自通。”丹溪以吐法通小便，如滴水之器，使上窍开，而下窍之水自出焉。然病源霄壤不同，治法亦贵揆情处变，岂可概以清热疏肝导水为事乎？
脉盛而大实者，预后良好。虚小而涩者，预后不良。下焦气血干涸者，预后不良。
Tonify the Spleen and harmonize the Stomach, purge fire and eliminate phlegm.
Bai Zhu (Atractylodis Rhizoma, 3 liang, remove rhizome base) Zhi Shi (Immature Bitter Orange, 1 liang, remove pith and stir-fry with bran) Chen Pi (Tangerine Peel, 1 liang) Huang Lian (Coptidis Rhizoma, 1 liang, soak in wine and stir-fry)
Grind into powder, decoct Lotus Leaf (Nelumbinis Folium) in water to make a soup, mix with rice paste to form pills. Take 50 pills after meals with warm water.
Note: Yi Lao's (Zhang Yuansu) Zhi Zhu Wan formula uses 2 liang of Bai Zhu to tonify the Spleen and 1 liang of Zhi Shi to dissipate fullness, taking advantage of more tonification than dissipation. Later, Dong Yuan (Li Dongyuan) added 1 liang of Chen Pi to harmonize the Stomach, naming it Ju Pi Zhi Zhu Wan, where tonification and dissipation are equal. Now, further using 3 liang of Bai Zhu, 1 liang of Zhi Shi, 1 liang of Chen Pi, and 1 liang of Huang Lian, named Ju Lian Zhi Zhu Wan, it still maintains more tonification than dissipation, and additionally clears heat. Dan Xi (Zhu Danxi) said: "For epigastric fullness, one must use Zhi Shi and stir-fried Huang Lian," which refers to this principle.
Regulate the Middle Jiao, tonify Qi and Blood, dissipate fullness and clear heat.
Bai Zhu (Atractylodis Rhizoma, 3 liang) Bai Shao Yao (Paeoniae Radix Alba, 1.5 liang, stir-fry with wine) Chen Pi (Tangerine Peel) Zhi Shi (Immature Bitter Orange, remove pith and stir-fry with bran) Huang Lian (Coptidis Rhizoma, soak in wine and stir-fry, each 1 liang) Ren Shen (Ginseng Radix et Rhizoma) Mu Xiang (Aucklandiae Radix, each 5 qian)
Grind into powder, decoct Lotus Leaf (Nelumbinis Folium) in thick water to make a soup, mix with rice paste to form pills the size of tung tree seeds. Take 50 pills per dose, gradually increasing to 60-70 pills, taken with rice soup far from meals.
Clanging sensation (Zaocha), commonly known as "Xin Shi." It feels like hunger but is not hunger, feels like pain but is not pain, accompanied by a state of restlessness and discomfort. This is caused by phlegm stirred by fire; treatment should prioritize resolving phlegm. Use ginger-stir-fried Huang Lian, along with Shan Zhi (Gardeniae Fructus), Huang Qin (Scutellariae Radix), Xing Ban (Pinelliae Rhizoma Preparatum), Chen Pi (Tangerine Peel), etc. If accompanied by dizziness and clanging, if not due to deficiency of Middle Qi, it is also phlegm stirred by fire. Use Liu Jun Zi Tang (Six Gentlemen Decoction) or Er Chen Tang (Two Aged Things Decoction) added with Huang Qin (Scutellariae Radix) and Huang Lian (Coptidis Rhizoma). If clanging is accompanied by dislike for food, it is damp-phlegm and Qi stagnation, and clanging in obese people. Use Er Chen Tang (Two Aged Things Decoction) with small amounts of Fu Xiong (Chuan Xiong, Ligusticum Chuanxiong Rhizoma), Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Rhizoma), and Xiang Fu (Cyperi Rhizoma) to tonify the Spleen while simultaneously soothing depression and resolving phlegm. If heart clanging leads to desire for food, it is Stomach deficiency with fire. Use Bai Zhu (Atractylodis Rhizoma), Huang Lian (Coptidis Rhizoma), and Chen Pi (Tangerine Peel) made into pills, taken with warm water for relief.
Lin syndrome (Strangury) refers to dribbling urination, wanting to pass urine but unable to, unable to pass then coming again. The Classic says: "When the Spleen receives accumulated damp qi, urination becomes yellow and red, severe cases develop into Lin syndrome." This states that dampness transmits to the Bladder causing Lin syndrome. It also says: "Wind and fire stagnate above generating heat, the disease manifests as Lin syndrome." This states that heat transmits to the Bladder causing Lin syndrome. The Neijing states: "Lin syndrome is nothing but dampness and heat." However, some are caused by anger, some by strong alcohol, some by rich flavors, and adults may also be caused by sexual exhaustion. Anger causes Qi movement generating fire. Strong alcohol and rich flavors brew damp-heat. Sexual exhaustion causes Yin deficiency with fire stirring. Therefore, all Lin syndromes have Kidney deficiency as the root and Bladder heat as the branch. The Kidney and Bladder are exterior-interior pairs. When water enters the Small Intestine, it connects to the Bao (uterus/bladder area), travels through the yin channels to become urine. If Kidney Qi is insufficient and heat enters the Bladder, the water pathway becomes obstructed and difficult to flow, wanting to exit but not exiting, dribbling continuously, urgent pain in the umbilical and abdominal regions, sometimes accumulating and erupting, or discharging like bean curd dregs or creamy blood, even blocking in between, causing suffocation and fainting. Whenever there is Qi in the Small Intestine, urination is distended; there is Blood, urination is astringent; there is heat, urination is painful. Furthermore, Kidney deficiency and weak Qi, cold invading the scrotum mixed with cold, leading to dribbling urination, symptoms必先 (must first) present with chills, then urination. This is cold qi fighting with healthy Qi; when cold qi prevails, chills occur forming Lin syndrome; when healthy Qi prevails, chills resolve and urination occurs. However, there are five types of Lin: Shi Lin (Stone Lin), Gao Lin (Paste Lin), Lao Lin (Exhaustion Lin), Re Lin (Heat Lin), and Xue Lin (Blood Lin). Shi Lin (Stone Lin): The Kidney governs water; when attacked by heat, it transforms into stones, just like a pot left on fire for a long time, forming white alkali at the bottom. Upon urination, the penis hurts, flow is not smooth, pain radiates to the Bladder causing internal urgency, sand and stones are expelled via urine, sometimes severe pain and fainting, waking only after sweating all over; Gao Lin (Paste Lin): Urine contains fatty substance like paste floating on top, caused by Kidney deficiency failing to control fatty fluids, which descend; Lao Lin (Exhaustion Lin): Two causes, if caused by labor and fatigue, belongs to Spleen deficiency; if caused by strenuous intercourse, belongs to Kidney deficiency; Re Lin (Heat Lin): Heat in the San Jiao, heat qi transmits to the Kidney, flows into the Bao, urine is yellow and astringent, occasionally bright red blood comes together; Xue Lin (Blood Lin): Extreme heat. The Heart governs Blood, circulating externally in meridians and internally in Zang-Fu organs. If heat is excessive and clashes with Blood, it loses its normal path. The Heart and Small Intestine are exterior-interior pairs, heat flows down into the Bao, exits with urine, becoming Xue Lin (Blood Lin). Pulse must be rapid and forceful. If blood color is dark black, complexion is withered and pale, Chi pulse is deep and slow, this belongs to Lower Origin cold deficiency. If lower abdomen is hard and full, penis hurts to the point of death, this is Blood stasis. However, hematuria with pain is called Xue Lin (Blood Lin); hematuria without pain is called Niao Xue (Urinary Hemorrhage). Besides the five Lin syndromes, there are differences in Qi Lin (Qi Lin), Leng Lin (Cold Lin), Xu Lin (Deficiency Lin), and Rou Lin (Flesh Lin). The reality is the same but names differ, generally not exceeding the non-interaction of Water and Fire, Heart-Kidney Qi stagnation, causing Yin-Yang deviation, mixing clear and turbid, turning from clear to turbid, soft to hard, formless to formed. All are transformations of one Fire, like boiling water to make salt, how can there truly be sand and stones inside the Water Organ! Treatment methods should all open depression and move stagnation, break Blood and nourish Yin, unblock and promote urination, clear and resolve pathogenic heat, regulate and calm Heart Fire. When Heart is clear, urination naturally benefits; when Heart is calm, Blood does not run wild. Do not mistakenly add tonics for indulgence, because Qi gets more distended with tonification, Blood gets more astringent with tonification, Heat gets more vigorous with tonification. If the source is blocked, the breach will be deeper. However, those treating Lin syndrome should better clear the Lung, as the Lung is the source of generating Water. Add drugs like Yu Jin (Curcumae Radix) and Hu Po (Amber), which are opening-depression drugs; Qing Pi (Citri Reticulatae Pericarpium Viride) and Mu Xiang (Aucklandiae Radix), which are Qi-moving drugs; Pu Huang (Typhae Pollen) and Niu Xi (Achyranthis Bidentatae Radix), which are Blood-breaking drugs; Huang Bo (Phellodendri Cortex) and Sheng Di Huang (Rehmanniae Radix), which are Yin-nourishing drugs. If there is internal pain, curved waist, dry crying without tears, scorched and dry upper lip, cold feet and sweaty forehead, this is Small Intestine Qi pain. Use hernia category drugs, such as Ju He (Nucis Juglandis Semen), Qing Pi (Citri Reticulatae Pericarpium Viride), Hui Xiang (Foeniculi Fructus), etc. If urination has blood but no pain, this is Jing Nu (Penile Hemorrhage). Use drugs to clear and promote urination for Bladder hemorrhage, such as Shan Zhi (Gardeniae Fructus), Xiao Ji (Cirsii Herba), Hu Po (Amber), Gui Wei (Angelicae Sinensis Radix), Sheng Di Huang (Rehmanniae Radix), Niu Xi (Achyranthis Bidentatae Radix), etc., ensuring Zang-Fu harmony, so the blood heals itself without specific treatment. Once stopped or restrained, it becomes pain and Lin syndrome. Lin syndrome does not go beyond heat. The general method is to circulate stagnant Qi, unblock and promote urination, clear and resolve pathogenic heat, regulate and calm Heart Fire. However, there are distinctions of Ge Er (Indirectly Treating the Second Organ) and Ge San (Indirectly Treating the Third Organ). If Bladder has heat but no thirst, purge Bladder fire, this is direct treatment. If thirsty and Lung dry, unable to generate Water, clear Metal (Lung), this is Ge Er. If Spleen dampness fails to transport, Clear Qi does not ascend, thus Lung cannot generate Water, then dry Spleen and leach dampness, promote Stomach Qi, this is Ge San. Strictly forbid sweating, due to Yin deficiency. Also forbid tonifying Qi, due to distension. Differentiate whether in Qi or Blood. Thirst indicates Upper Jiao Qi level, use Huang Qin (Scutellariae Radix), Fu Ling (Poria), Ze Xie (Alismatis Rhizoma), Deng Xin Cao (Junci Medulla), Qu Mai (Polygoni Avicularis Herba), Bian Xu (Polygoni Hyperstriati Herba) and other bland-draining agents to descend Lung Metal fire and clear Bladder source. No thirst indicates Lower Jiao Blood level, use Zhi Mu (Anemarrhenae Rhizoma), Huang Bo (Phellodendri Cortex), Niu Xi (Achyranthis Bidentatae Radix), Fa Hui (Hair Ash), Mao Gen (Imperatae Rhizoma) and other Blood-moving agents to tonify Kidney Water source. Excessive sexual desire or thin individuals, chronic non-healing, belongs to Deficient Fire, treat with Kan Li Wan. Pale complexion, Qi deficiency, inability to urinate, induce vomiting, disease below, treat from above, use Qing Xin Lian Zi San. An elderly person with Qi deficiency unable to transform, use Bu Zhong Yi Qi Tang (Center-Supplementing and Qi-Boosting Decoction) added with bland-draining herbs. Those with consumptive fever, excessive sweating, and red/astringent urination, actually have dryness in the Five Viscera, nourishment gone, unable to generate fluids, do not overly promote urination to exhaust Kidney Water, only warm and nourish Lung Yin. For all loss of essence and blood, and patients with carbuncles/toxins having red urination, it is also due to dryness and lack of moisture, all suitable for previous methods. As for obstruction being Bi (Retention), the Classic says: "The Foot Jueyin Liver Meridian passes through the genitalia, diseases generated include Bi Long (Obstruction and Strangury)." It also says: "The Du Meridian enters and connects to the Ting Kong (Direct Hole) in women... (Ting means straight/direct, referring to the central straight hole, i.e., urethral orifice.) ... Its hole is the end of the urethral orifice. (Women's urethral orifice is below the transverse bone in the anterior yin. The upper edge of the hole is called the end, where the Du Meridian originates externally. Although stated for women, men's urethral orifice is also centrally below the transverse bone.) Men follow the penis down to the scrotum, equal to women. Diseases here cause inability to pass stool and urine. (Penis is the male organ. Inability to pass front and back means both stool and urine are retained. Although generated by Du Meridian, it is actually a Chong and Ren disease, as these three meridians all rise from the yin center, hence such diseases.)" It also says: "Bladder dysfunction leads to Long (Strangury), lack of constraint leads to Yi Ni (Incontinence). (Lack of constraint means inability to restrain and collect.)" It also says: "Excess leads to Bi Long (Obstruction and Strangury), Deficiency leads to Yi Ni (Incontinence)." Bi and Long are two conditions. New disease is Niao Bi (Urinary Retention), drops are difficult to pass. Old disease is Niao Long (Urinary Strangury), frequent but scanty discharge. However, Taiyang Bladder only stores urine; its function of expelling is governed by the Liver Meridian, Du Meridian, and San Jiao. Hence it says: "Qi transformation allows expulsion." Qi transformation refers to Taiyin Lung. The Lung is the master of Qi and generates Water. If Lung is dry and cannot generate Water, Qi transformation does not reach Zhou Du (Bladder). Spleen is the mother of Lung; if dampness fails to transport and Essence does not ascend, the source of Water generation is lacking. All are due to excessive heat and inability of Qi to regulate and unblock. Kidney and Liver are below, the Earth Path. Heart and Lung are above, the Heaven Path. Spleen and Stomach are in the middle, the intersection of Qi level. Thus, if Heaven Yang is cut off and does not interact with Earth, White Dew does not fall. Humans correspond to Heaven; if Yang above does not interact with Yin, then Yin below has no basis for transformation, how can urine emerge? Shi Guoxin said: "To clear urination, first differentiate Liver Fire, as it loses its function of free flow and drainage." However, exuberant Liver Fire is further due to Gui Water (Kidney Water) failing to nourish. Thus, for excess heat, without pure Yin agents, Yang cannot transform; for great deficiency, without warm-tonic agents, Water cannot flow. Bie Lu says: "If urination is difficult and confirmed as Qi deficiency, Du Shen Tang (Single Ginseng Decoction) is miraculous." Ji Yan says: "Middle Jiao Qi fails to ascend and descend, blocked by cold, only take Fu Zi (Aconiti Lateralis Radix Praeparata), urination naturally unblocks." Dan Xi used vomiting method to unblock urination, like a dripping vessel, opening the upper orifice so water from the lower orifice flows out naturally. However, disease origins are vastly different, treatment methods value adapting to circumstances and changing situations, how can one generally focus only on clearing heat, soothing Liver, and guiding water?
Pulse盛大 (vigorous and large/excess) indicates survival. Pulse虚小 (deficient, small) and涩 (choppy) indicates death. Dryness of Qi and Blood in Lower Jiao indicates death.