诸病水液混浊，皆属于热。（全文见诊。）小便黄者，少腹中有热也。（全文见水肿。）小便黄，无如黄柏、
知母效。
脉尺涩，足胫逆冷，小便赤，宜服附子四逆汤，足太冲补之。
脏腑小便黄有四∶一属肝热。经云∶肝热病者，小便先黄是也。二属胃实。经云∶胃足阳明之脉气盛，则
身以前皆热，其有余于胃，则消谷善饥，溺色黄是也。三属肺虚。经云∶肺手太阴之脉气虚，则肩背痛寒，少
气不足以息，溺色变故耳。四属肾虚。经云∶冬脉者，肾脉也。冬脉不及，则令人 清，脊痛，小便变是也。
运气 小便黄有二∶
一属风。经云∶厥阴之胜， 胁气并，化而为热，小便黄赤是也。
二属热。经云∶少阴司天，热淫所胜，病溺色变。又云∶少阳之胜，溺赤善惊。又云∶阳明司天，燥气下
临，暴热至，乃暑阳气郁发，小便变是也。盖暴热谓地气少阴之热也。
邪之所在，皆为不足，中气不足，溲便为之变，补足外踝下留之。（全文见刺虚实法。）
〔《甲》〕小肠有热，溺赤黄，中脘主之。溺黄，下廉主之。小便黄赤，完骨主之。小便黄，肠鸣相追
逐，上廉主之。
〔垣〕小便遗失者，肺金虚也，宜安卧养气，禁劳役。以黄 、人参之类补之。不愈，当责有热，加黄柏、
生地。（《甲乙》云∶肺脉则少气不足以息，卒遗失无度。）
下虚，谓膀胱下焦虚。经云∶水泉不止者，是膀胱不藏也。仲景云∶下焦竭，则遗溺失便，其气不能自禁
制，不须治，久则愈。又云∶下焦不归，则遗溲。世用桑螵蛸鸡 之类是也。
〔丹〕治遗溺。桑螵蛸酒炒为末，姜汤送下二钱妙。
〔无〕鸡内金散 治溺床失禁。
鸡 一具，并肠洗净烧为灰，男用雌，女用雄，即是鸡肫内黄皮研为末，每服二钱，酒饮调服妙。
又方 用羊肚系盛水满，线缚两头煮熟，取中水顿服之瘥。
〔《山》〕大人遗溺不知。蔷薇根细研酒下。
〔丹〕鹿茸丸 治久虚冷，小便自浊，滑数不禁。
鹿茸 椒红 桂 附子 牡蛎 石斛 补骨脂 肉苁蓉 鸡 沉香（各一两） 桑螵蛸（三分）
上为末，酒糊丸桐子大。食前酒下三十丸。（此方因沉香解诸涩，故丹溪取之。）
又云∶鹿角屑炒黄为末，温酒下二钱妙。本草云∶鹿角逐阴中邪气恶血。鹿茸丸（方见虚条。）
〔河〕热甚客于肾部，手足厥阴之经，廷孔郁结极甚，而气血不能宣通，则痿痹，神无所用，故津液渗入
膀胱，而旋溺遗失，不能收禁也。经曰∶目得血而能视，耳得血而能听，手指得血而能摄，掌得血而能握，足
得血而能走，脏得血而能液，腑得血而能气。然血所通流，则气亦然也。气血先行，则其中神自清和，而应机
能为用矣。故经曰∶血气者，人之神，不可不谨养也。故诸所运动，时习之，则气血通利，而能为用。闭塞之，
则气血行微，而其道不得通利，故劣弱也。若病热极，甚则郁结，而气血不能宣通，神无所用，而不遂其机，
随其郁结之微甚，而有不用之大小焉。是故目郁则不能视色，耳郁则不能听声，鼻郁则不能闻香臭，舌郁则不
能知味。至如筋痿骨痹，诸所出不能为用，皆郁结之所致也。
〔丹〕《千金翼》白薇散 治尿出不知时。
白薇（本草云∶气大寒） 白芍药（各等分）
上为末，温酒调下方寸匕，日三服，食前。
尝治一男子，遗溺不觉，脉洪大盛，以黄柏、知母、杜牛膝为君，青皮、甘草为臣，木香为佐，桂些少
反佐，服数帖，大效。此法与前白薇散皆河间所谓热甚廷孔郁结，神无所用，不能收禁之意也。
〔世〕神芎导水丸 治遗尿有实热者。每百丸，空心白汤下，若一服利，止后服。（前法河间所谓廷孔
郁结不能收禁，此所谓淫气遗溺，痹聚在肾，痹谓气血不通宣也。）
〔无〕茯苓丸 治心肾俱虚，神志不守，小便淋沥不禁，及遗泄白浊。
赤茯苓 白茯苓
上为末，以新汲水挪洗，澄去新沫，控干，别取地黄汁，同好酒，银石器内熬成膏，搜和为丸，如桐子大。
空心热酒嚼下。
〔世〕用薏苡仁，盐炒煎服效。（方见小儿。）
〔《本》〕燕蓐草，主眠中遗溺不觉，烧令黑研，水进方寸匕，亦主哕气，即燕窠中草也。
膀胱咳者，咳而遗溺。（全文见咳。）
针灸 遗溺法有四∶其一取肝，其二取督脉，其三取三焦，并见遗溺闭癃门，其四取肺。经云∶手太阴之别，
名曰列缺，其病虚则欠KT ，小便遗数，取之去腕一寸，别走阳明者是也。
〔东〕遗尿失禁∶阴陵泉 阳陵泉（二寸半）。大敦（七壮）。又方∶曲骨 阴阳二陵泉（各二寸半。）
〔《甲》〕遗溺，关门及神门、委中主之。气癃小便黄，气满，虚则遗溺，石门主之。
肝脉微滑为遗溺。（全文见治法。）
各种病证中，水液浑浊的，都属于热证。（全文见诊法章节。）小便颜色黄的，是少腹部有热邪。（全文见水肿章节。）小便发黄，没有比黄柏、知母疗效更好的了。
脉象尺部涩滞，足胫部逆冷，小便赤红，适宜服用附子四逆汤，并针刺足太冲穴用补法。
脏腑导致小便黄有四种情况：一是属于肝热。医经说：“患肝热病的人，小便先变黄。”二是属于胃实热。医经说：“足阳明胃经气盛，则身体前部皆发热，若胃气有余，则消谷善饥，小便颜色黄。”三是属于肺虚。医经说：“手太阴肺经气虚，则肩背疼痛发冷，气短不足以呼吸，小便颜色改变。”四是属于肾虚。医经说：“冬脉即肾脉。冬季脉象不及（虚弱），则使人清窍不利（此处原文缺字，据义推测为清窍或相关症状），脊痛，小便改变。”
运气学说中小便黄有两种情况：
一是属风。医经说：“厥阴风木偏胜，胁部气机郁结，化而为热，小便黄赤。”
二是属热。医经说：“少阴君天之气主事，热邪过盛，病见溺色改变。”又说：“少阳相火偏胜，小便赤红且易受惊。”又说：“阳明燥金司天，燥气下临，暴热到来，如同暑天阳气郁而发作，小便改变。”所谓暴热，是指地气中少阴的热邪。
邪气所在的部位，都是因为正气不足。中气不足，大小二便就会发生改变，应补足外踝下方的穴位并留针。（全文见刺虚实法章节。）
〔《甲乙经》〕小肠有热，小便赤黄，由中脘穴主治。小便黄，由下廉穴主治。小便黄赤，由完骨穴主治。小便黄，伴有肠鸣相互追逐，由上廉穴主治。
〔李东垣〕小便失禁的，是肺金虚弱，适宜安卧养气，禁止劳累役使。用黄芪、人参之类补益。若不愈，应当责求有热，加用黄柏、生地黄。（《甲乙经》说：“肺脉虚则少气不足以呼吸，突然失禁无度。”）
下虚，指膀胱下焦虚损。医经说：“水泉穴处尿液不止，是膀胱不能固藏。”张仲景说：“下焦衰竭，则遗尿失禁，其气不能自我控制，不需要特殊治疗，时间久了会自愈。”又说：“下焦之气不归元，则遗尿。世俗常用桑螵蛸、鸡内金之类治疗。”
〔朱丹溪〕治疗遗尿。将桑螵蛸酒炒后研为末，用姜汤送服二钱，效果奇妙。
〔滑伯仁〕鸡内金散治疗睡梦中遗尿失禁。
取一只鸡的内金，连同鸡肠洗净烧成灰，男性用雌鸡，女性用雄鸡，即是鸡肫内的黄皮研为末，每次服用二钱，用酒调服，效果奇妙。
又一方：用羊肚装满水，用线捆住两头煮熟，取出其中的水一次性服下，病愈。
〔朱丹溪〕鹿茸丸治疗久病体虚寒冷，小便自浊，滑数不禁。
鹿茸、椒红、桂枝、附子、牡蛎、石斛、补骨脂、肉苁蓉、鸡内金、沉香（各一两），桑螵蛸（三分）。
以上药物研为末，用酒糊制成梧桐子大小的丸剂。饭前用酒送服三十丸。（此方因为沉香能解各种涩症，所以丹溪取用之。）
又说：鹿角屑炒黄研为末，温酒送服二钱，效果奇妙。本草书说：鹿角逐除阴中的邪气和恶血。鹿茸丸（方剂见虚损条）。
〔刘河间〕热邪甚盛客居于肾部及手足厥阴经脉，廷孔（尿道口）郁结极甚，气血不能宣通，则出现痿痹，神机无所运用，因此津液渗入膀胱，随即遗尿失禁，不能收摄控制。医经说：“眼睛得到血滋养就能视物，耳朵得到血滋养就能听声，手指得到血滋养就能摄取，手掌得到血滋养就能握持，脚得到血滋养就能行走，内脏得到血滋养就能化生津液，腑脏得到血滋养就能运行气机。然而血液流通的地方，气也必然随之流通。气血先行，那么其中的神机自然清和，并能应对外界机能之用。所以医经说：‘血气是人的神机所在，不可不谨慎调养。’所以所有的运动，经常练习，则气血通利，就能发挥作用。如果闭塞它，则气血运行微弱，其道不得通利，所以功能劣弱。如果病热极盛，甚至郁结，气血不能宣通，神机无所运用，而不能顺应时机，随着郁结的轻微或严重，而出现功能丧失的大小不同。因此眼睛郁结就不能视物，耳朵郁结就不能听声，鼻子郁结就不能闻香臭，舌头郁结就不能知味。至于筋痿骨痹，各种排泄功能不能发挥作用，都是郁结所致。”
〔朱丹溪〕《千金翼方》白薇散治疗尿出不知时。
白薇（本草书说：气大寒）、白芍药（各等分）。
以上研为末，温酒调下方寸匕，每日三次，饭前服用。
曾治一男子，遗尿不觉，脉象洪大盛，以黄柏、知母、杜牛膝为君药，青皮、甘草为臣药，木香为佐药，少许桂枝反佐，服用数帖，大效。此法与前文白薇散皆是河间所谓热甚导致廷孔郁结，神机无所运用，不能收摄控制的意旨。
〔世传〕神芎导水丸治疗遗尿有实热者。每服一百丸，空腹用白开水送下，如果一次服药后腹泻，停止后续服用。（前法是河间所谓廷孔郁结不能收禁，此法是所谓淫气遗溺，痹聚在肾，痹谓气血不通宣也。）
〔滑伯仁〕茯苓丸治疗心肾俱虚，神志不守，小便淋沥不禁，以及遗泄白浊。
赤茯苓、白茯苓。
以上研为末，用新汲水揉洗，澄清去掉新产生的泡沫，控干，另取地黄汁，同好酒，在银石器内熬成膏，搜索调和做成丸，如梧桐子大。空腹用热酒嚼服。
〔《本草》〕燕蓐草，主治睡眠中遗尿不觉，烧黑研末，用水送服方寸匕，也主治呃逆气，即燕子巢中的草。
膀胱咳，表现为咳嗽而遗尿。（全文见咳嗽章节。）
针灸治疗遗尿的方法有四：其一取肝经，其二取督脉，其三取三焦经，均见遗溺闭癃门章节，其四取肺经。医经说：“手太阴肺经的别络，名叫列缺，其病症虚则呵欠，小便频数遗溺，取之去腕一寸，别走阳明经的部位。”
〔张元素〕遗尿失禁：阴陵泉、阳陵泉（进针二寸半）。大敦穴（灸七壮）。又一方：曲骨、阴阳二陵泉（各进针二寸半）。
In various diseases, turbid fluids all belong to heat syndromes. (See full text in Diagnosis chapter.) Yellow urine indicates heat in the lower abdomen. (See full text in Edema chapter.) For yellow urine, no herb is more effective than Huangbai (Phellodendri Cortex) and Zhi Mu (Anemarrhenae Rhizoma).
If the pulse at the Chi position is choppy (Se), with cold feet and calves, and red urine, Fuzi Sini Tang (Aconite Decoction to Restore the Prostrate Yin) should be taken, and Taichong (LR3, Great Surge) on the Foot Taiyin channel should be tonified via acupuncture.
There are four organ-related causes for yellow urine:
First, it belongs to Liver Heat. The classics state: "In Liver Heat disease, the urine turns yellow first."
Second, it belongs to Stomach Excess Heat. The classics state: "When Qi of the Foot Yangming Stomach channel is abundant, the anterior part of the body becomes hot; if there is excess in the stomach, digestion accelerates with frequent hunger, and urine becomes yellow."
Third, it belongs to Lung Deficiency. The classics state: "When Qi of the Hand Taiyin Lung channel is deficient, shoulder and back pain with coldness occur, shortness of breath makes breathing difficult, and urine color changes."
Fourth, it belongs to Kidney Deficiency. The classics state: "The Winter pulse is the Kidney pulse. If the Winter pulse is insufficient (deficient), it causes obstruction of clear orifices, spinal pain, and changes in urination."
Regarding Six Qi transformation (Yunqi), there are two causes for yellow urine:
First, related to Wind. The classics state: "When Jueyin wind prevails, Qi stagnates in the hypochondrium, transforms into heat, and urine becomes yellow and red."
Second, related to Heat. The classics state: "When Shaoyin governs the year, excessive heat causes disease manifesting as changed urine color." It also states: "When Shaoyang prevails, urine is red and prone to fright." It further states: "When Yangming governs, dryness descends, sudden heat arrives, resembling summer heat where Yang Qi is stagnant and erupts, causing urine changes." This sudden heat refers to the Shaoyin heat from Earth Qi.
Where pathogenic factors reside, there is always a deficiency. Deficiency of Middle Qi causes changes in urination and defecation; one should tonify the point below the outer ankle and retain the needle. (See full text in Acupuncture for Deficiency and Excess chapter.)
[From *Jia Yi Jing*] Heat in the Small Intestine causes red-yellow urine; Zhongwan (CV12, Middle Elixir) treats it. Yellow urine is treated by Xialian (ST34, Lower Limb Abyss). Red-yellow urine is treated by Wangu (GB12, Complete Bone). Yellow urine accompanied by borborygmus (intestinal rumbling) chasing each other is treated by Shanglian (ST33, Upper Limb Abyss).
[Li Dongyuan] Urinary incontinence is due to deficiency of Lung Metal. One should rest quietly to nourish Qi and avoid overexertion. Tonify with herbs like Huangqi (Astragali Radix) and Renshen (Ginseng Radix et Rhizoma). If ineffective, suspect heat and add Huangbai (Phellodendri Cortex) and Shengdihuang (Rehmanniae Radix). (*Jia Yi Jing* states: "Lung pulse deficiency leads to shortness of breath and sudden uncontrollable incontinence.")
Lower Deficiency refers to deficiency of the Bladder and Lower Jiao. The classics state: "Unceasing urine flow indicates the Bladder's failure to store." Zhang Zhongjing stated: "When Lower Jiao fails, urinary incontinence occurs because Qi cannot control itself spontaneously; no specific treatment is needed, and it will heal after time." He also said: "When Lower Jiao Qi does not return, urinary incontinence results. The world commonly uses Sangpiaoxiao (Mantis Egg Case) and Jineijin (Chicken Gizzard Membrane) for this."
[Zhu Danxi] To treat incontinence: Stir-fry Sangpiaoxiao (Mantis Egg Case) with wine, grind into powder, and take 2 qian with ginger decoction for excellent effect.
[Hua Bolin] Jineijin Powder treats bedwetting.
Take one Ji Nei Jin (Chicken Gizzard Membrane), wash clean with the intestine, burn to ash. Use female chicken for male patients, male chicken for female patients. Grind the yellow skin inside the gizzard into powder. Take 2 qian per dose, mixed with wine for best results.
Another prescription: Fill a sheep stomach with water, tie both ends with thread, boil until cooked. Take the water inside once to cure.
[From *Shan*] For adults with unconscious incontinence: Grind Qiangweigen (Rose Root) finely and take with wine.
[Zhu Danxi] Lurong Wan (Deer Antler Pill) treats chronic deficiency-cold, spontaneous turbid urine, and slippery/frequent incontinence.
Ingredients: Lurong (Cervi Cornu Pantotrichum), Jiaohong (Zanthoxyli Pericarpium), Guizhi (Cinnamomi Ramulus), Fuzi (Aconiti Lateralis Radix Praeparata), Muli (Ostreae Concha), Shihu (Dendrobii Caulis), Buguzhi (Psoraleae Fructus), Roucongrong (Cynomorphi Herba), Jineijin (Gigastri Mesogastri Endothelium), Chenxiang (Aquilariae Lignum Resinatum) (each 1 liang); Sangpiaoxiao (Mantis Egg Case) (3 fen).
Grind all into powder, mix with wine paste to make pills the size of tung seeds. Take 30 pills before meals with wine. (Danxi adopted this formula because Chenxiang resolves various obstructions.)
Also stated: Roast Lu Jiaoxie (Cervi Cornu Degelatinatum) until yellow, grind into powder, and take 2 qian with warm wine for good effect. Materia Medica states: Deer antlers expel evil qi and bad blood from the yin regions. Lurong Wan (see Deficiency section).
[Liu Wansu] When extreme heat lodges in the Kidney region and the Jueyin meridians of the hands and feet, the Ting Kong (urethral meatus) becomes extremely congested, preventing the free flow of Qi and Blood. This leads to flaccidity and numbness, rendering the Shen (Spirit/Mind) useless. Consequently, fluids seep into the Bladder, causing immediate urinary incontinence that cannot be controlled. The classics say: "The eyes see when nourished by blood; ears hear when nourished by blood; fingers grasp when nourished by blood; palms hold when nourished by blood; feet walk when nourished by blood; Zang organs produce fluids when nourished by blood; Fu organs generate Qi when nourished by blood. Wherever Blood flows, Qi follows. When Qi and Blood move forward, the Shen within remains clear and harmonious, enabling responsive function. Thus, the classics say: 'Qi and Blood are the Spirit of humans; they must be carefully nurtured.' Therefore, regular movement promotes smooth Qi and Blood flow, enabling function. Obstruction leads to weak Qi and Blood flow and blocked pathways, resulting in weakness. If pathological heat is extreme, congestion occurs, blocking Qi and Blood, rendering Shen useless and unresponsive. Depending on the severity of congestion, functional loss varies. Thus, eye congestion prevents vision; ear congestion prevents hearing; nose congestion prevents smelling; tongue congestion prevents tasting. Flaccidity and bone bi syndrome, and inability to excrete, are all caused by congestion."
[Zhu Danxi] *Qianjin Yi Fang* Baiwei San (Baiwei Powder) treats involuntary urination.
Ingredients: Baiwei (Cynanchi Atrati Radix - noted in Materia Medica as having great cold property), Baishao Yao (Paeoniae Radix Alba) (equal parts).
Grind into powder, mix with warm wine, take one cun bi (square inch measure) per dose, three times daily before meals.
I once treated a man with unconscious incontinence; his pulse was large and vigorous. I used Huangbai (Phellodendri Cortex), Zhi Mu (Anemarrhenae Rhizoma), and Duniu Xi (Achyranthis Bidentatae Radix) as sovereign herbs, Qingpi (Citri Reticulatae Pericarpium Viride) and Gancao (Glycyrrhizae Radix et Rhizoma) as minister herbs, and Muxiang (Aucklandiae Radix) as assistant herb, with a small amount of Guizhi (Cinnamomi Ramulus) as counter-agent. After several doses, there was a significant effect. This method aligns with Liu Wansu's concept that extreme heat causes congestion in the Ting Kong, rendering Shen useless and unable to control retention.
[Worldly/Popular] Shenxiong Dao Shui Wan (Shenxiong Water-Guiding Pill) treats enuresis with excess heat. Take 100 pills on an empty stomach with plain boiled water. If diarrhea occurs after one dose, stop subsequent doses. (The previous method refers to Liu Wansu's concept of Ting Kong congestion preventing control; this method refers to "profluvial Qi causing incontinence, Bi syndrome gathering in the Kidney," where Bi means blockage of Qi and Blood flow.)
[Hua Bolin] Fuling Wan (Poria Pill) treats dual deficiency of Heart and Kidney, unsettled Shen, dribbling incontinence, and seminal emission with white turbidity.
Ingredients: Chi Fuling (Poria with Red Hosta Wood), Bai Fuling (White Poria).
Grind into powder, wash with fresh well water, clarify to remove new foam, drain dry. Take fresh Dihuang juice (Rehmanniae Radix) and good wine, boil in a silver or ceramic vessel until thickened into a paste. Mix with the powder to form pills the size of tung seeds. Chew and swallow with hot wine on an empty stomach.
[Worldly/Popular] Coix Seed (Yiyiren), stir-fried with salt and decocted, is effective. (See Pediatric section.)
[From *Ben Cao*] Yan Ru Cao (Swallow Nest Grass) treats sleepwalking incontinence. Burn until black, grind, and take one cun bi with water. It also treats hiccups. This is the grass found in swallow nests.
Bladder Cough manifests as coughing with urinary incontinence. (See full text in Cough chapter.)
Acupuncture methods for incontinence include four approaches: First, select Liver channel points; second, Du Meridian points; third, Sanjiao channel points (see Incontinence and Dysuria chapter); fourth, Lung channel points. The classics state: "The collateral of the Hand Taiyin Lung channel is named Lieque (LU7). Its pathology includes yawning due to deficiency and frequent/incontinent urination. Treat at the point one cun from the wrist, which connects to the Yangming channel."
[Zhang Yuansu] Enuresis and incontinence: Yinlingquan (SP9) and Yanglingquan (GB34) (depth 2.5 cun). Dazhun (LR1) (7 moxa cones). Another prescription: Qugu (CV2), Yin-Lingquan, and Yang-Lingquan (each 2.5 cun depth).
[From *Jia Yi Jing*] Incontinence is treated by Guanmen (ST22) and Shenmen (HT7), Weizhong (BL40). Qi stagnation with yellow urine, abdominal fullness, and deficiency leading to incontinence is treated by Shimen (CV5).
A slightly slippery Liver pulse indicates incontinence. (See full text in Treatment Methods chapter.)