经云∶膀胱不利为癃，不约为遗溺。所以不约者，其因有三。一曰肝热，肝气热则阴挺
失职，书云∶肝主疏泄是已，加味逍遥散主之。二曰气虚，中气虚则不能统摄，以致遗溺，
十补汤主之。大抵老幼多见此症，悉属脬气不固。老人挟寒者多，婴儿挟热者众，挟寒者，
用本方，挟热者，六味地黄丸。三曰肾败，狂言反目，溲便自遗者，此肾绝也。伤寒曰久见
之，多难救。中症见之，随用大剂附子理中汤，频灌间有得生者，盖暴脱者可以暴复，若病
势曰深则不可为也。然中症亦有阴虚而遗溺者，不宜偏用热药，治者详之。
加味逍遥散 （见类中。
十全大补汤 （见虚劳。
六味地黄丸 （见虚劳。
附子理中汤 （见中寒。
便血症，有肠风、有脏毒，有热、有寒。病患脏腑有热，风邪乘之，则下鲜血，此名肠
风，清魂散主之。若肠胃不清，下如鱼肠，或如豆汁，此名脏毒，芍药汤主之。凡下血症，
脉数有力，唇焦、口燥、喜冷、畏热，是为有火，宜用前方加黄芩、丹皮、生地之属。若脉
细无力，唇淡、口和，喜热、畏寒，或四肢厥冷，是为有寒，宜用温药止之，理中加归、芍
主之。若便久不止，气血大虚，宜用归脾、十全辈统血归经。血本属阴，生于阳气，治者宜
《黄帝内经》说：膀胱气化不利导致小便不通称为癃闭，约束无力导致小便失禁称为遗溺。之所以出现约束无力的情况，原因主要有三种。第一种是肝热，肝气郁结化热则阴部器官功能失职，医书说：“肝主疏泄”，对此症用加味逍遥散治疗。第二种是气虚，中气虚弱则不能统摄固摄，导致遗尿，大多见于老人和幼儿，都属于膀胱之气不固。老年人多兼夹寒邪，婴儿多兼夹热邪；兼夹寒邪的，用十全大补汤（原注：十补汤）治疗；兼夹热邪的，用六味地黄丸治疗。第三种是肾气败绝，出现胡言乱语、双目上视、大小便自遗的症状，这是肾气绝灭的表现。伤寒病中若久见此症，大多难以救治；在中风病中见到此症，随即使用大剂量的附子理中汤，频频灌服，偶尔有救活的，这是因为暴脱之证可以迅速恢复，但如果病势已经深入，就无法治好了。然而中风病中也有因阴虚而遗尿的，不宜偏用热药，诊治者需仔细辨别。
加味逍遥散 （详见类中风章节）。
十全大补汤 （详见虚劳章节）。
六味地黄丸 （详见虚劳章节）。
附子理中汤 （详见中寒章节）。
便血这一病症，分为肠风和脏毒两种，病因有热证和寒证之分。如果患者脏腑有热，风邪乘虚侵袭，则排出鲜血，这叫做肠风，用清魂散治疗。如果肠胃不清净，排出的血液像鱼肠一样，或者像豆汁一样浑浊，这叫做脏毒，用芍药汤治疗。凡是便血症，如果脉象数而有力，嘴唇焦裂、口干舌燥、喜欢冷饮、畏惧热邪，这是体内有火，适宜在前方基础上加入黄芩、丹皮、生地等药物。如果脉象细弱无力，嘴唇色淡、口中平和、喜欢热饮、畏惧寒冷，或者四肢厥冷，这是体内有寒，适宜用温性药物来止血，用理中汤加入当归、白芍治疗。如果便血日久不止，气血严重亏虚，适宜用归脾汤、十全大补汤这类方剂来统摄血液，使其回归经脉。血本属阴，由阳气生化，诊治者应当……
荆芥（三钱） 当归（五钱）
水煎服。
芍药汤 （详见腹痛章节）。
理中汤 （详见中寒章节）。
归脾汤、十全大补汤 （均详见虚劳章节）。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "When the bladder fails to promote Qi transformation, it results in strangury (long bi); when it fails to constrain, it results in enuresis (yi ni)." The reasons for this failure of constraint are threefold. First is Liver Heat: when Liver Qi becomes hot, the function of the yin organs is impaired. As medical texts state, "the Liver governs free flow and discharge," this condition is treated with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). Second is Qi Deficiency: when Middle Qi is deficient, it cannot control and secure fluids, leading to enuresis. This is mostly seen in the elderly and infants, all belonging to insecurity of Bladder Qi. The elderly often have accompanying Cold, while infants often have accompanying Heat; those with Cold are treated with Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction), and those with Heat are treated with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). Third is Kidney Exhaustion: symptoms such as delirious speech, eyes rolling back, and involuntary urination and defecation indicate that Kidney Qi is exhausted. In Shaoyang disease, if these symptoms persist for a long time, they are difficult to save. In Zhongfeng (Wind Stroke), if these symptoms appear, immediately administer a large dose of Fuzi Lizhong Tang (Aconite and Ginger Decoction for the Middle Jiao), frequently灌ing it; occasionally, survival is achieved because sudden collapse can be rapidly restored. However, if the pathological trend has deepened, it is incurable. Nevertheless, in Zhongfeng, there are also cases of enuresis due to Yin Deficiency, where one should not bias towards using hot medicines; practitioners must examine carefully.
Jiawei Xiaoyao San (See Wind Stroke chapter).
Shiquan Dabu Tang (See Consumption chapter).
Liuwei Dihuang Wan (See Consumption chapter).
Fuzi Lizhong Tang (See Cold Damage chapter).
The syndrome of blood in stool includes Changfeng (Intestinal Wind) and Zangdu (Visceral Toxin), with etiologies involving either Heat or Cold. If the patient's Zang-Fu organs have Heat, and Wind pathogen takes advantage of it, bright red blood is discharged; this is named Changfeng, treated with Qinghun San (Clear Soul Powder). If the intestines and stomach are impure, discharging blood resembling fish intestines or bean dregs, this is named Zangdu, treated with Shaoyao Tang (Peony Decoction). In all cases of blood in stool, if the pulse is rapid and forceful, lips are scorched, mouth is dry, preference is for cold drinks, and aversion to heat exists, this indicates Fire within. It is appropriate to add Huangqin (Scutellariae Radix), Danpi (Moutan Cortex), and Shengdi (Rehmanniae Radix) to the aforementioned formula. If the pulse is fine and weak, lips are pale, mouth feels neutral, preference is for hot drinks, aversion to cold exists, or limbs are cold, this indicates Cold within. It is appropriate to use warm medicines to stop bleeding, treating with Lizhong Tang (Ginger Decoction for the Middle Jiao) added with Danggui (Angelicae Sinensis Radix) and Shaoyao (Paeoniae Radix). If hematochezia persists for a long time, causing severe deficiency of Qi and Blood, it is appropriate to use Guipi Tang (Restore the Spleen Decoction) or Shiquan Dabu Tang to control blood and return it to the vessels. Blood belongs to Yin and is generated by Yang Qi; practitioners should...
Jingjie (Sanqian / Three Qian) Danggui (Wuqian / Five Qian)
Decoct in water and take orally.
Shaoyao Tang (See Abdominal Pain chapter).
Lizhong Tang (See Cold Damage chapter).
Guipi Tang, Shiquan Dabu Tang (Both see Consumption chapter).