治阳分虚损，气弱不能宣通，致小便不利。
野台参（四钱） 威灵仙（钱半） 寸麦冬（六钱，带心） 地肤子（一钱）
治阴分虚损，血亏不能濡润，致小便不利。
怀熟地（一两） 生龟板（五钱，捣碎） 生杭芍（五钱） 地肤子（一钱）
阴分阳分俱虚者，二方并用，轮流换服，如下案所载服法。小便自利。
一媪，年六十余，得水肿证，延医治不效。时有专以治水肿名者，其方秘而不传。服其药自大便泻水数桶，
一身肿尽消，言忌咸百日，可保永愈。数日又见肿，旋复如故。服其药三次皆然，而病患益衰惫矣。盖未服其
药时，即艰于小便，既服药后，小便滴沥全无，所以旋消而旋肿也。再延他医，皆言服此药，愈后复发者，断
乎不能调治。后愚诊视，其脉数而无力。愚曰∶脉数者阴分虚也，无力者阳分虚也。膀胱之腑，有下口无上口，
水饮必随气血流行，而后能达于膀胱，出为小便。《内经》所谓“州都之官，津液藏焉，气化则能出”者是也。
此脉阴阳俱虚，致气化伤损，不能运化水饮以达膀胱，此小便所以滴沥全无也。一方，以人参为君，辅以麦冬
以济参之热，灵仙以行参之滞，少
加地肤子为向导药，名之曰宣阳汤。一方以熟地为君，辅以龟板以助熟地之润，芍药以行熟地之滞（芍药善利小
便，故能行熟地之泥），亦少加地肤子为向导药，名之曰济阴汤。二方轮流服之，先服济阴汤，取其贞下起元
也。服至三剂，小便稍利。再服宣阳汤，亦三剂小便大利。又再服济阴汤，小便直如泉涌，肿遂尽消。
一妇人，年三十许，因阴虚小便不利，积成水肿甚剧，大便亦旬日不通，一老医投以八正散不效。友人高
××为出方，用生白芍六两，煎汁两大碗，再用阿胶二两，熔化其中，俾病患尽量饮之。老医甚为骇疑，高××
力主服之。尽剂而二便皆通，肿亦顿消。后老医与愚觌面，为述其事，且问此等药何以能治此病？答曰∶此必
阴虚不能化阳，以致二便闭塞。白芍善利小便，阿胶能滑大便，二药并用，又大能滋补真阴，使阴分充足，以
化其下焦偏胜之阳，则二便自能通利也。
子××治一水肿证。其人年六旬，二便皆不通利，心中满闷，时或烦躁。知其阴虚积有内热，又兼气分不舒
也，投以生白芍三两，橘红、柴胡各三钱，一剂二便皆通。继服滋阴理气、少加利小便之药而愈。
一妇人，年四十许，得水肿证，百药不效。偶食绿豆稀饭，觉腹中松畅，遂连服数次，小便大利而愈。
有人向愚述其事，且问所以能愈之故。答曰∶绿豆与赤小豆同类，故能行水利小便，且其性又微凉，大能滋阴
退热。凡阴虚有热，致小便不利者，服之皆有效也。
治疗阳分虚损，气机虚弱不能宣通，导致小便不利。
野台参（四钱） 威灵仙（一钱半） 寸麦冬（六钱，带心） 地肤子（一钱）
治疗阴分虚损，血亏不能濡润，导致小便不利。
怀熟地（一两） 生龟板（五钱，捣碎） 生杭芍（五钱） 地肤子（一钱）
若阴分和阳分都虚的，两方并用，轮流交替服用，如下面医案中所记载的服法。小便自然通畅。
一位老妇人，六十多岁，患上水肿证，请医生治疗无效。当时有一位专以治疗水肿闻名的医生，他的方子保密不传。患者服用他的药后，通过大便泻出几桶水，全身浮肿全部消退，医生嘱咐忌食咸味食物一百天，可以保证永远痊愈。几天后又出现浮肿，很快又恢复原状。服用该药三次都是这样，而病人身体更加衰弱疲惫了。大概在没有服用他药之前，小便就困难，服药后，小便点滴全无，所以浮肿刚消又立即复发。再请其他医生诊治，都说服用这种药，愈后复发的，绝对无法调治。后来我诊视，她的脉象数而无力。我说：脉数说明阴分虚，无力说明阳分虚。膀胱这个腑，只有下口没有上口，水饮必须随着气血流行，然后才能到达膀胱，排出成为小便。《内经》所说的“州都之官，津液藏焉，气化则能出”就是这个道理。此患者阴阳俱虚，导致气化功能受损，不能运化水饮到达膀胱，这就是小便点滴全无的原因。一方，以人参为君药，辅以麦冬来制约人参的热性，威灵仙来疏通人参的滞涩，少加地肤子作为向导药，命名为宣阳汤。另一方以熟地为君药，辅以龟板来增强熟地的滋润作用，芍药来疏通熟地的滞涩（芍药善于利小便，所以能化解熟地的滋腻），也少加地肤子作为向导药，命名为济阴汤。两方轮流服用，先服济阴汤，取其贞下起元（阴极阳生）的意思。服用三剂后，小便稍微通畅。再服宣阳汤，也是三剂，小便非常通畅。又再服济阴汤，小便直如泉水涌出，浮肿随即全部消退。
一位三十岁左右的妇女，因阴虚导致小便不利，积聚成严重的水肿，大便也有十天不通，一位老医生投用八正散无效。友人高××为她开方，使用生白芍六两，煎汁两大碗，再用阿胶二两，在其中熔化，让患者尽量喝下。老医生对此感到非常惊疑，高××极力主张服用。喝完一剂药后，大小便都通了，浮肿也顿时消退。后来老医生与我见面，讲述了这件事，并问这些药为什么能治这种病？我回答说：这一定是阴虚不能化阳，导致大小便闭塞。白芍善于利小便，阿胶能润滑大便，两药合用，又能大补真阴，使阴分充足，从而化除下焦偏胜的阳热，那么大小便自然就能通利了。
子××治疗一例水肿证。患者六十岁，大小便都不通利，心中满闷，有时烦躁。知道他阴虚积有内热，又兼气分不畅，投用生白芍三两，橘红、柴胡各三钱，一剂药后大小便都通了。继服滋阴理气、稍加利小便的药物而痊愈。
一位四十岁左右的妇女，患上水肿证，各种药物都无效。偶然吃了绿豆稀饭，觉得腹中松畅，于是连续吃了几次，小便非常通畅而痊愈。
有人向我讲述这件事，并问之所以痊愈的原因。我回答说：绿豆与赤小豆同类，所以能行水利小便，而且它的性质微凉，大能滋阴退热。凡是阴虚有热，导致小便不利的，服用它都有效。
Treatment for deficiency and damage in the Yang aspect, where Qi is weak and unable to circulate freely, resulting in difficult urination.
Ye Taishen (Wild Ginseng) (4 qian) Weilingxian (Clematis Root) (1.5 qian) Cun Maidong (Ophiopogon Tuber with heart) (6 qian) Difuzi (Kochia Fruit) (1 qian).
Treatment for deficiency and damage in the Yin aspect, where Blood is deficient and unable to moisten, resulting in difficult urination.
Huai Shudi (Prepared Rehmannia Root) (1 liang) Sheng Guiban (Tortoise Shell) (5 qian, crushed) Sheng Hangshao (White Peony Root) (5 qian) Difuzi (Kochia Fruit) (1 qian).
For cases where both Yin and Yang aspects are deficient, use both formulas alternately, as described in the following case record. Urination will naturally become free.
An elderly woman, over sixty years old, suffered from edema. Medical treatment was ineffective. At that time, there was a physician famous specifically for treating edema, whose prescription was kept secret. After taking his medicine, the patient passed several buckets of water through stool, and all swelling disappeared. The doctor advised avoiding salty food for one hundred days, promising a permanent cure. However, within a few days, the swelling returned, reverting to its previous state. This happened after three courses of this medication, leaving the patient increasingly weak and exhausted. Before taking this medicine, she already had difficulty urinating; after taking it, urination ceased completely, which is why the swelling subsided only to return immediately. Other physicians consulted stated that patients who relapsed after taking such medicines were absolutely untreatable. Later, I examined her and found her pulse rapid and powerless. I said: A rapid pulse indicates Yin deficiency, while a powerless pulse indicates Yang deficiency. The Bladder (Zang-Fu organ responsible for storing and excreting urine) has an outlet but no inlet. Water and fluids must circulate with Qi and Blood to reach the Bladder and be excreted as urine. This corresponds to what the *Neijing* states: "The Officer of the State Capital stores body fluids; when Qi transformation occurs, they can be excreted." In this case, the deficiency of both Yin and Yang damaged Qi transformation, preventing the transportation and transformation of water and fluids to the Bladder, hence the complete absence of urination. One formula uses Ren Shen (Ginseng Root) as the sovereign drug, assisted by Maidong (Ophiopogon Tuber) to counteract the heat of Ren Shen, and Weilingxian (Clematis Root) to move the stagnation caused by Ren Shen, with a small amount of Difuzi (Kochia Fruit) as a guiding drug; it is named Xuan Yang Tang (Yang-Revealing Decoction). The other formula uses Shu Di Huang (Prepared Rehmannia Root) as the sovereign drug, assisted by Guiban (Tortoise Shell) to enhance the moistening property of Shu Di Huang, and Shaoyao (Peony Root) to move the stagnation of Shu Di Huang (Shaoyao is good at promoting urination, thus resolving the cloying nature of Shu Di Huang), also with a small amount of Difuzi (Kochia Fruit) as a guiding drug; it is named Ji Yin Tang (Yin-Nourishing Decoction). These two formulas are taken alternately, starting with Ji Yin Tang, to utilize the principle of generating Yuan Qi from the depth of Yin. After three doses, urination became slightly freer. Then Xuan Yang Tang was taken for another three doses, resulting in significantly freer urination. Subsequently, Ji Yin Tang was taken again, causing urination to flow like a spring, and the swelling completely disappeared.
A woman, around thirty years old, suffered from severe edema due to Yin deficiency causing difficult urination, accompanied by constipation for ten days. An old physician prescribed Ba Zheng San (Eight-Herb Powder for Rectification) without effect. My friend Gao XX prescribed a formula using 6 liang of raw Bai Shao (White Peony Root), decocted into two large bowls of liquid, into which 2 liang of E Jiao (Donkey-hide Gelatin) was melted, instructing the patient to drink as much as possible. The old physician was greatly skeptical, but Gao XX strongly advocated for its use. After completing one dose, both bowel movements and urination cleared, and the swelling vanished instantly. Later, the old physician met me face-to-face, recounted this event, and asked how these medicines could treat this disease. I replied: This must be due to Yin deficiency failing to transform Yang, leading to obstruction of both bowels and bladder. Bai Shao (White Peony Root) is excellent at promoting urination, and E Jiao (Donkey-hide Gelatin) lubricates the bowels. Used together, they greatly tonify True Yin, enriching the Yin aspect to transform the excess Yang in the Lower Jiao, thereby allowing both bowels and bladder to function freely.
Zi XX treated a case of edema. The patient was sixty years old, suffering from obstructed urination and defecation, chest fullness, and occasional irritability. Knowing that the patient had Yin deficiency with accumulated internal heat, combined with stagnant Qi, Zi XX administered 3 liang of raw Bai Shao (White Peony Root), along with 3 qian each of Ju Hong (Tangerine Peel) and Chai Hu (Bupleurum Root). After one dose, urination and defecation resumed. The patient recovered after continuing with medications that nourished Yin, regulated Qi, and mildly promoted urination.
A woman, around forty years old, suffered from edema unresponsive to various medicines. Accidentally eating mung bean porridge made her abdomen feel relaxed and comfortable, so she continued to eat it several times. Her urination became very free, and she recovered.
Someone told me this story and asked for the reason behind the recovery. I answered: Mung beans belong to the same category as Adzuki beans, so they can promote water metabolism and urination. Moreover, their nature is slightly cool, effectively nourishing Yin and clearing heat. For any case of difficult urination caused by Yin deficiency with heat, taking them is effective.