治膏淋，并治诸淋。
萆 （三钱） 文蛤粉（研细） 石苇 车前子 茯苓（各一钱五分） 灯心（二十节） 莲子心 石
菖蒲 黄柏（各八分
治气淋。
荆芥 陈皮 香附 麦芽（炒） 瞿麦 木通 赤茯苓
各等分为末。每服三钱，开水下。
生地四物汤 （即四物汤以生地易熟地见虚劳。
生地 当归 赤芍（各一两） 川芎 五灵脂（各七钱五分） 大黄（酒蒸，一两五钱
砂糖为丸。每服三钱、开水下。
补中益气汤 （见类中。
金匮肾气汤 （见水肿。
（关格 孕妇转脬
小便不通，谓之癃闭。癃闭与淋症不同，淋则便数而茎痛；癃闭则小便点滴而难通。东
垣云∶渴而小便不利者，热在上焦气分也，宜用四苓散加山栀、黄芩等药以分利之。若大便
亦闭，加大黄、元明粉之类。不渴而小便不利者，热在下焦血分也，宜用滋阴化气之法，若
滋肾丸之类是已。大法，无阳，则阴无以生；无阴，则阳无以化。下元真阴不足，则阳气不
化，必滋其阴；若下之真阳不足，则阴气不生，必补其阳。譬如水肿鼓胀，小便不通者，服
金匮肾气丸，而小便自行，阴得阳以生也；复有除桂、附服之而亦效者，阳得阴而化也。
此阴阳气化之精义也。更有小便不通，因而吐食者，名曰关格。经云∶关则不得小便，格则
吐逆，关格者，不得尽其命矣。宜用假苏散治之。又丹溪治孕妇转脬，小便不通者，用补中
益气汤，随服而探吐之，往往有效。譬如滴水之器，上窍闭则下窍不通，必上窍开然后下窍
之水出焉。丹溪初试此法，以为偶中，后来屡用屡验，遂恃为救急良法。每见今人治转脬症
投补中益气，而不为探吐，且曰古法不效，有是理乎？予尝用茯苓升麻汤，治此有验。盖
用升麻以举其胎气，用茯苓以利小便，用归、芎以活其胎，用苎根理胞系之撩乱，此以升剂
为通之法也。附录于此以俟明哲。
四苓散 （即五苓散去桂枝 方见太阳腑病。
治疗膏淋，以及治疗各种淋证。
萆薢（三钱） 文蛤粉（研细） 石苇 车前子 茯苓（各一钱五分） 灯心草（二十节） 莲子心 石菖蒲 黄柏（各八分）。
治疗气淋。
荆芥 陈皮 香附 麦芽（炒制） 瞿麦 木通 赤茯苓。
以上药物各等份研为细末。每次服用三钱，用开水送服。
生地四物汤（即四物汤以生地黄代替熟地黄，见虚劳病篇）。
生地黄 当归 赤芍（各一两） 川芎 五灵脂（各七钱五分） 大黄（酒蒸，一两五钱）。
用砂糖制成丸剂。每次服用三钱，用开水送服。
补中益气汤（见类中风病篇）。
金匮肾气汤（见水肿病篇）。
（关格病 孕妇转脬病）
小便不通利，称为癃闭。癃闭与淋证不同，淋证表现为小便频数且尿道疼痛；癃闭则表现为小便点滴而出且难以通畅。李东垣说：口渴而小便不利，是热邪在上焦气分，适宜使用四苓散加入山栀、黄芩等药物来分消渗利。如果大便也闭塞，加大黄、元明粉之类的药物。不口渴而小便不利，是热邪在下焦血分，适宜采用滋阴化气的方法，如滋肾丸之类就是此类治法。大原则是：没有阳气，阴精就无法生成；没有阴精，阳气就无法化生。下元真阴不足，则阳气无法化生，必须滋养其阴；如果下元真阳不足，则阴气无法生成，必须温补其阳。例如水肿鼓胀，小便不通的患者，服用金匮肾气丸后，小便自然通畅，这是阴得阳气而生化的道理；又有除去桂枝、附子服用也有效的情况，这是阳得阴精而化生的道理。这是阴阳气化理论的精髓所在。更有小便不通，进而导致呕吐食物的，称为关格。经书说：关则小便不通，格则呕吐逆乱，患关格病的人，性命难保。适宜使用假苏散治疗。另外朱丹溪治疗孕妇转脬导致小便不通的，使用补中益气汤，服药后立即探吐，往往有效。这就像滴水之器，上窍闭塞则下窍不通，必须打开上窍然后下窍的水才能流出。丹溪初次尝试此法，以为偶然奏效，后来多次使用都验证有效，于是将其视为救急良法。我常见如今医生治疗转脳症投用补中益气汤，却不进行探吐，还说古法无效，有这样的道理吗？我曾经使用茯苓升麻汤治疗此症，有疗效。因为用升麻来提升胎气，用茯苓来利小便，用当归、川芎来活血安胎，用苎麻根来调理胞系之紊乱，这是以升提之法作为通利的办法。附录于此以等待明智者参考。
四苓散（即五苓散去桂枝，方见太阳腑病篇）。
Treats gao lin (glandular strangury) and various types of lin syndrome (strangury).
Bixie (Radix Dioscoreae Hypoglaucae, 3 qian), Wen Ge Fen (Concha Arcae Pulverized, finely ground), Shi Wei (Folium Pyrrosiae), Che Qian Zi (Semen Plantaginis), Fu Ling (Poria, each 1.5 qian), Deng Xin Cao (Medulla Junci, 20 joints), Lian Zi Xin (Plumula Nelumbinis), Shi Chang Pu (Rhizoma Acori Tatarinowii), Huang Bo (Cortex Phellodendri, each 8 fen).
Treats qi lin (gas strangury).
Jing Jie (Herba Schizonepetae), Chen Pi (Pericarpium Citri Reticulatae), Xiang Fu (Rhizoma Cyperi), Mai Ya (Fructus Hordei Germinatus, stir-fried), Qu Mai (Herba Stellariae), Mu Tong (Caulis Akebiae), Chi Fu Ling (Poria with Red Hosta Root, equal parts).
Grind all ingredients into a fine powder. Take 3 qian per dose, washed down with boiled water.
Sheng Di Si Wu Tang (Rehmannia Four-Substance Decoction: i.e., Si Wu Tang replacing Shu Di Huang with Sheng Di Huang; see Xu Lao [Deficiency and Emaciation]).
Sheng Di Huang (Radix Rehmanniae Recens), Dang Gui (Radix Angelicae Sinensis), Chi Shao Yao (Radix Paeoniae Rubra, each 1 liang), Chuan Xiong (Rhizoma Chuanxiong), Wu Ling Zhi (Faeces Troglodytis, each 7.5 qian), Da Huang (Radix et Rhizoma Rhei, steamed with wine, 1.5 liang).
Form pills with brown sugar. Take 3 qian per dose, washed down with boiled water.
Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction; see Lei Zhong Feng [Stroke-like Syndromes]).
Jin Kui Shen Qi Tang (Kidney Qi Pill from the Golden Cabinet; see Shui Zhong [Edema]).
(Guan Ge [Obstruction and Rejection] / Pregnant Women's Zhuan Pao [Displacement of the Bladder])
Impaired urination is called Long Bi (retention of urine). Long Bi differs from Lin syndrome: Lin syndrome presents with frequent urination and penile pain; Long Bi presents with dribbling and difficulty in voiding. Li Dongyuan stated: "Thirst accompanied by impaired urination indicates heat in the qi level of the upper jiao; it is appropriate to use Si Ling San plus Gardenia and Scutellaria to promote differentiation and diuresis." If constipation is also present, add Rhubarb and Mirabilite. Absence of thirst with impaired urination indicates heat in the blood level of the lower jiao; it is appropriate to employ methods of nourishing yin and transforming qi, such as Zi Shen Wan (Nourish Kidney Pill). The general principle is: without yang, yin cannot be generated; without yin, yang cannot transform. Deficiency of the primordial yin in the lower origin leads to failure of yang transformation, requiring nourishment of yin; deficiency of the primordial yang in the lower origin leads to failure of yin generation, requiring tonification of yang. For instance, in cases of edema or drum distension with urinary retention, taking Jin Kui Shen Qi Wan results in spontaneous urination, illustrating that yin is generated through yang; conversely, efficacy is sometimes achieved even after removing Cinnamon Twig and Aconite, illustrating that yang transforms through yin. This is the profound meaning of yin-yang qi transformation. Furthermore, when urinary retention leads to vomiting of food, it is termed Guan Ge. The Classics state: "Guan implies inability to urinate; Ge implies vomiting and reflux. One suffering from Guan Ge shall not survive." It is appropriate to treat with Jia Su San. Additionally, Zhu Danxi treated pregnant women with Zhuan Pao causing urinary retention using Bu Zhong Yi Qi Tang, followed immediately by inducing vomiting, which was often effective. This is analogous to a dripping vessel: if the upper orifice is blocked, the lower orifice cannot flow; only by opening the upper orifice can water exit from the lower. Danxi initially tried this method, believing it to be a lucky success, but later repeated uses confirmed its efficacy, establishing it as an excellent emergency method. I often observe contemporary physicians treating Zhuan Pao with Bu Zhong Yi Qi Tang but failing to induce vomiting, claiming ancient methods are ineffective—is this logical? I have used Fu Ling Sheng Ma Tang to treat this condition with verified results. Sheng Ma is used to lift fetal qi, Fu Ling to promote diuresis, Dang Gui and Chuan Xiong to invigorate blood and secure the fetus, and Zhu Gen (Rhizoma Boehmeriae/Nephrolepidis) to regulate the disordered uterine ligaments. This employs ascending agents as a method of unblocking. It is appended here for the reference of wise practitioners.
Si Ling San (i.e., Wu Ling San minus Gui Zhi; formula seen in Tai Yang Fu Bing [Tai Yang Organ Disease]).