治小便频数疼涩,遗精白浊,脉洪滑有力,确系实热者。
知母(四钱) 黄柏(四钱) 生龙骨(四钱,捣细) 生牡蛎(三钱,炒捣) 海螵蛸(三钱,捣细)
茜草(二钱) 生杭芍(四钱) 生山药(四钱) 泽泻(一钱半)
或问∶龙骨、牡蛎收涩之品也。子治血淋,所拟理血汤中用之,前方治小便频数或兼淋涩用之,此方治
小便频数疼涩亦用之,独不虑其收涩之性有碍于疼涩乎?答曰∶龙骨、牡蛎敛正气而不敛邪气,凡心气耗散、
肺气息贲、肝气浮越、肾气滑脱,用之皆有捷效。即证兼瘀、兼疼或兼外感,放胆用之,毫无妨碍。拙拟补络
补管汤、理郁升陷汤、从龙汤、清带汤,诸方中论之甚详,皆可参观。
一叟,年七十余,遗精白浊、小便频数,微觉疼涩。诊其六脉平和,两尺重按有力,知其年虽高,而肾
经确有实热也。投以此汤,五剂全愈。
一人,年三十许,遗精白浊,小便时疼如刀 ,又甚涩数。诊其脉滑而有力,知其系实热之证。为其年
少,疑兼花柳毒淋,遂投以此汤,加没药(不去油)三钱、鸭蛋子(去皮)四十粒(药汁送服),数剂而愈。
治小便遗精白浊,因受风寒者,其脉弦而长,左脉尤甚。
桂枝尖(四钱) 生黄 (三钱) 续断(三钱) 桑寄生(三钱) 知母(三钱)
服此汤数剂后病未全愈者,去桂枝,加龙骨、牡蛎(皆不用 )各六钱。
东海渔者,年三十余,得骗白证甚剧。旬日之间,大见衰惫,惧甚,远来求方。其脉左右皆弦,而左部
弦而兼长。夫弦长者,肝木之盛也。木与风为同类,人之脏腑,无论何处受风,其风皆与肝木相应。《内经》
阴阳应象论所谓“风气通于肝”者是也。脉之现象如此,肝因风助,倍形其盛,而失其和也。况病患自言,因
房事后小盒饭风,从此外肾微肿,遂有此证,尤为风之明征乎。盖房事后,肾脏经络虚而不闭,风气乘虚袭入,
鼓动肾脏不能蛰藏(《内经》谓肾主蛰藏),而为肾行气之肝木,又与风相应,以助其鼓动,而大其疏泄
(《内经》肝主疏泄),故其病若是之剧也。为拟此汤,使脉之弦长者,变为舒和。服之一剂见轻,数剂后遂
全愈。以后凡遇此等症,其脉象与此同者,投以此汤无不辄效。
治疗小便频数且伴有疼痛涩滞,遗精及白浊,脉象洪大滑利而有力,确属实热证候的方剂。
知母(四钱) 黄柏(四钱) 生龙骨(四钱,捣碎成细粉) 生牡蛎(三钱,炒后捣碎) 海螵蛸(三钱,捣碎成细粉)
茜草(二钱) 生杭芍(四钱) 生山药(四钱) 泽泻(一钱半)
有人问道:龙骨、牡蛎属于收敛固涩的药物。您治疗血淋时,在拟定的理血汤中使用它们;前一方治疗小便频数或兼有淋证涩滞时使用它们;这一方治疗小便频数且疼痛涩滞也使用它们,难道不担心它们的收涩性质会妨碍疼痛和涩滞症状的缓解吗?回答说:龙骨、牡蛎能够收敛正气而不敛留邪气。凡是心气耗散、肺气上逆、肝气浮越、肾气滑脱的情况,使用它们都有显著的疗效。即使证候兼夹瘀血、疼痛或外感,也可以大胆使用,毫无妨碍。我在拙作《补络补管汤》、《理郁升陷汤》、《从龙汤》、《清带汤》等方的论述中对此解释得非常详细,都可以参考阅读。
一位七十多岁的老人,出现遗精、白浊、小便频数,略微感到疼痛涩滞。诊察其六部脉象平和,但两尺脉重按有力,知道他虽然年事已高,但肾经确实存在实热。投以此方,服用五剂后完全痊愈。
另一位三十岁左右的男子,出现遗精、白浊,小便时疼痛如刀割,且非常涩滞频数。诊察其脉象滑利而有力,知道这是实热证候。因为他年纪尚轻,怀疑兼有花柳病(性传播疾病)引起的毒淋,于是投以此方,加入没药(不去油)三钱、鸭蛋子(去皮)四十粒(用药汁送服),服用几剂后痊愈。
治疗因感受风寒而导致的小便频数、遗精、白浊,其脉象弦长,左脉尤为明显。
桂枝尖(四钱) 生黄芪(三钱) 续断(三钱) 桑寄生(三钱) 知母(三钱)
服用此方数剂后病情未完全痊愈者,去掉桂枝,加入龙骨、牡蛎(均不用煅制)各六钱。
东海的一位渔民,三十多岁,患上严重的“骗白”证(指严重的遗精白浊病症)。十天之内,身体极度衰弱疲惫,非常恐惧,远道而来求取药方。他的左右脉象皆呈弦象,且左部脉象弦而兼长。所谓弦长脉,是肝木之气旺盛的表现。木与风同类,人的脏腑无论何处受风邪侵袭,风邪都与肝木相应。这就是《内经·阴阳应象大论》中所说的“风气通于肝”。脉象呈现这种特征,说明肝因风邪相助而更加亢盛,从而失去了平和的状态。况且患者自述,是在房事后小解时受了风寒,从此外肾轻微肿胀,才导致此证,这更是风邪致病的明确证据。大概是因为房事后,肾脏经络空虚而不能闭合,风邪乘虚侵入,鼓动肾脏不能执行蛰藏功能(《内经》说肾主蛰藏),而作为肾脏气化辅助的肝木,又与风邪相应,助长风势以加强鼓动,并加剧疏泄功能(《内经》说肝主疏泄),所以病情如此严重。为此拟定此方,使原本弦长的脉象变为舒缓调和。服用一剂后症状减轻,服用数剂后完全痊愈。此后凡遇到此类症候,脉象与此相同的,投以此方无不立即见效。
A prescription for treating frequent urination accompanied by painful and difficult voiding, seminal emission, and white turbidity, where the pulse is surging, slippery, and forceful, indicating a definite excess-heat syndrome.
*Zhimu* (Tianhuafen Rhizome, *Anemarrhenae Rhizoma*) [4 qian]
*Huangbai* (Phellodendri Cortex, *Phellodendri Chinensis Cortex*) [4 qian]
Raw *Longgu* (Fossilized Mammal Bones, *Os fossile Mamuthi*) [4 qian, crushed into fine powder]
Raw *Muli* (Oyster Shell, *Concha Ostreae*) [3 qian, stir-fried and crushed]
*Haipiaoxiao* (Cuttlefish Bone, *Endoconcha Sepiae*) [3 qian, crushed into fine powder]
*Qiancao* (Rubia Root, *Radix Rubiae Cordifoliae*) [2 qian]
Raw *Hangshaoyao* (White Peony Root, *Radix Paeoniae Alba*) [4 qian]
Raw *Shanyao* (Dioscorea Rhizome, *Rhizoma Dioscoreae Oppositae*) [4 qian]
*Zexie* (Alisma Rhizome, *Rhizoma Alismatis*) [1.5 qian]
A question was raised: Longgu and Muli are astringent herbs. You used them in your proposed Lixue Tang (Blood Regulating Decoction) to treat blood strangury; you used them in the previous formula for frequent urination possibly complicated by strangury and difficulty; and now you use them in this formula for frequent urination with painful and difficult voiding. Are you not worried that their astringent nature might hinder the relief of pain and difficulty? The answer is: Longgu and Muli consolidate the righteous qi without retaining the pathogenic factors. They yield rapid effects in cases of dissipating heart qi, rebellious lung qi, floating liver qi, and slipping kidney qi. Even if the syndrome involves blood stasis, pain, or external contraction, they can be used boldly without any hindrance. This has been discussed in detail in my works Bu Luo Bu Guan Tang (Decoction for Supplementing Collaterals and Vessels), Li Yu Sheng Xian Tang (Decoction for Resolving Stagnation and Raising Sinking Qi), Cong Long Tang (Decoction Following the Dragon), and Qing Dai Tang (Decoction for Clearing Leukorrhea). Readers may consult those texts for reference.
An elderly man in his seventies suffered from seminal emission, white turbidity, and frequent urination, with slight pain and difficulty in voiding. His six pulses were generally harmonious, but the two chi positions were forceful upon heavy pressure. This indicated that although he was advanced in age, there was indeed excess heat in the Kidney channel. This decoction was administered, and he was completely cured after five doses.
Another man, around thirty years old, suffered from seminal emission and white turbidity. His urination was extremely painful, as if cut by a knife, and very difficult and frequent. His pulse was slippery and forceful, indicating an excess-heat syndrome. Because he was young, it was suspected that he might also have toxic strangury caused by sexually transmitted diseases. Therefore, this decoction was administered with the addition of Moyao (Myrrh, *Resina Myrrhae*) [3 qian, oil not removed] and Yadanzi (Strychnos Seed, *Semen Strychni*) [40 grains, peeled], taken with the decoction juice. He was cured after several doses.
For frequent urination, seminal emission, and white turbidity caused by contracting wind-cold, the pulse is wiry and long, especially on the left side.
Guizhi Jian (Tip of Cinnamon Twig, *Ramulus Cinnamomi Cassiae*) [4 qian]
Raw *Huangqi* (Astragalus Root, *Radix Astragali Membranacei*) [3 qian]
*Xuduan* (Teasel Root, *Radix Dipsaci*) [3 qian]
*Sangjisheng* (Taxillus Branch, *Ramulus Taxilli*) [3 qian]
*Zhimu* (Tianhuafen Rhizome, *Anemarrhenae Rhizoma*) [3 qian]
If the illness is not fully cured after several doses of this decoction, remove Guizhi and add Longgu and Muli (both uncalcined) [6 qian each].
A fisherman from the East Sea, in his thirties, suffered severely from "Pianbai" syndrome (severe seminal emission and white turbidity). Within ten days, he became extremely weak and fatigued. Fearing greatly, he traveled far to seek a prescription. His left and right pulses were both wiry, with the left position being wiry and long. A wiry and long pulse indicates hyperactivity of Liver Wood. Wood and Wind are of the same category; regardless of which organ or part of the body contracts Wind, the Wind corresponds to the Liver Wood. This is what the *Neijing* (Inner Canon) states in the chapter "Yin Yang Ying Xiang Da Lun": "Wind Qi communicates with the Liver." Given such pulse manifestations, the Liver becomes excessively active due to the assistance of Wind, losing its harmony. Moreover, the patient stated that after sexual intercourse, he contracted wind while urinating, leading to slight swelling of the external genitals, which confirmed the presence of Wind. After sexual activity, the Kidney channels and collaterals are deficient and open, allowing Wind to invade vacuously. The Wind agitates the Kidney, preventing it from performing its function of storing and hiding (as the *Neijing* states, the Kidney governs storage and hiding). Meanwhile, the Liver Wood, which assists the Kidney's qi transformation, responds to the Wind, further aiding the agitation and exacerbating the dispersing and draining functions (as the *Neijing* states, the Liver governs dispersing and draining). Thus, the disease became so severe. This decoction was prescribed to transform the wiry and long pulse into a relaxed and harmonious one. After one dose, symptoms improved; after several doses, he was completely cured. Henceforth, whenever encountering similar syndromes with identical pulse characteristics, administering this decoction invariably yields immediate results.