所问妇人血淋之症，因日久损其脾胃，饮食不化，大便滑泄，且血淋又兼砂淋，洵为难治之症。今拟一方∶
生山药一斤轧细末，每用八钱，加生车前子二钱同煮作粥，
送服三七细末、生鸡内金细末各五分，每日两次，当点心用之，日久可愈。
方中之意，用山药、车前煮粥以治泄泻。而车前又善治淋疼，又送服三七以治血淋，内金以消砂淋，且
鸡内金又善消食，与山药并用，又为健补脾胃之妙品也。惟内金生用则力大，而稍有破气之副作用，若气分过
虚时，宜先用生者轧细，焙熟用之。若服药数日而血淋不见轻者，可用荜澄茄细末一分，加西药哥拜拔油一
分同服。又此症大便不止，血淋亦无从愈，若服山药、车前粥而
泻不止，可将熟鸡子黄二三枚捻碎，调在粥中，再煮一两开服之。
详观所述病案，谓脉象滑动，且得之服六味地黄丸之余，其为热痰郁于中焦，以致胃气上逆，冲气
上冲，浸成上盛下虚之症无疑。为其上盛下虚，所以时时有荡漾之病也。法当利痰、清火、
降胃、敛冲，处一小剂，久久服之，气化归根，荡漾自愈。拟方于下∶
清半夏（三钱） 柏子仁（三钱） 生赭石（三钱轧末） 生杭芍（三钱） 生芡实（一两） 生姜（三片）
磨生铁锈浓水煎药。
方中之意，用半夏、赭石以利痰、坠痰，即以降胃，安冲。用芡实以固下焦气化，使药之降者、坠者，有
所底止，且以收敛冲气，而不使再上冲也。用芍药以清肝火、利小便，即以开痰之去路。用柏子仁以养肝血、
滋肾水，即以调半夏之辛燥。用生姜以透窍络，通神明，即以为治痰药之佐使。至用铁锈水煎药者，
诚以诸风眩晕，皆属于肝，荡漾即眩晕也。此中必有肝风萌动，以助胃气冲气之上升不已，律以金能制木之
理，可借铁锈之金气以镇肝木，更推以铁能重坠，引肝中所寄龙雷之火下降也。况铁锈为铁与养气化合而成，
最善补养人之血分，强健人之精神，即久久服之，于脏腑亦无不宜也。
您所询问的妇人血淋（小便涩痛且有出血）之症，因日久损伤了脾胃，导致饮食不消化，大便滑脱泄泻，且血淋又兼有砂淋（尿中有砂石），确实是难以治疗的病症。现在拟定一方：
生山药一斤研成细末，每次用八钱，加生车前子二钱同煮成粥，
送服三七细末、生鸡内金细末各五分，每日两次，当作点心服用，日久可以痊愈。
方中的用意，是用山药、车前子煮粥来治疗泄泻。而车前子又善于治疗淋证疼痛，又送服三七来治疗血淋，鸡内金来消除砂淋，而且
鸡内金又善于消食，与山药并用，又是健补脾胃的妙品啊。只是鸡内金生用时药力大，但稍有破气的副作用，如果气分过于虚弱时，宜先用生的研细，焙熟后使用。如果服药数日后血淋不见减轻，可用荜澄茄细末一分，加西药哥拜拔油（Copaiba balsam）一分同服。另外此症大便不止，血淋也无法痊愈，如果服用山药、车前子粥而
腹泻不止，可将熟鸡蛋黄二三枚捻碎，调在粥中，再煮一两开服下。
详细观察所述的病案，说脉象滑动，且得病于服用六味地黄丸之后，这是热痰郁结在中焦，导致胃气上逆，冲气
上冲，浸淫形成上盛下虚（上部邪气盛，下部正气虚）的病症无疑。因为上盛下虚，所以时时出现荡漾（头晕目眩、感觉身体晃动）的病状。治法应当利痰、清火、
降胃、敛冲，开一个小剂量的方子，长久服用，气化归根，荡漾自然痊愈。拟定方子如下：
清半夏（三钱） 柏子仁（三钱） 生赭石（三钱研末） 生杭芍（三钱） 生芡实（一两） 生姜（三片）
磨取生铁锈浓水煎药。
方中的用意，是用半夏、赭石来利痰、坠痰，以此来降胃气，安定冲气。用芡实来固摄下焦的气化，使药物的降者、坠者，有
所止息，并且收敛冲气，而不使其再上冲。用芍药来清肝火、利小便，以此来开通痰浊的去路。用柏子仁来养肝血、
滋肾水，以此来调和半夏的辛燥之性。用生姜来透达窍络，通神明，以此来作为治疗痰药的佐使药。至于用铁锈水煎药的原因，
确实是因为各种风病眩晕，都归属于肝，荡漾即是眩晕。这中间必有肝风萌动，以助长胃气和冲气的上升不已，依据金能克木（肺金制约肝木）
的道理，可借铁锈的金气来镇潜肝木，更推演认为铁具有重坠之性，能引肝中所寄藏的龙雷之火下降。况且铁锈是铁与氧气化合而成，
最善于补养人的血分，强健人的精神，即使长久服用，对脏腑也没有不宜之处。
Regarding the woman's hematuria with dysuria (Xuelin, a syndrome characterized by painful urination with blood), due to long-standing damage to the Spleen and Stomach, food is not transformed, resulting in loose stools and diarrhea. Moreover, hematuria with dysuria is complicated by lithiasis with sand (Shalin, urinary calculi containing sand-like particles). This is indeed a difficult-to-treat condition. I now propose the following prescription:
One jin of raw Dioscoreae Rhizoma (Shanyao) ground into fine powder; use eight qian each time, add two qian of raw Plantaginis Semen (Cheqianzi), boil together to make porridge,
and take it with five fen each of fine powder of Panax Notoginseng Radix et Rhizoma (Sanqi) and raw Endothelium Corneum Gigeriae Galli (Jineijin). Take twice daily as a meal substitute. With prolonged use, it can be cured.
The intention of this formula is to use Dioscoreae Rhizoma and Plantaginis Semen porridge to treat diarrhea. Plantaginis Semen is also good at treating pain in strangury (Linzheng). Fine powder of Panax Notoginseng is taken to treat hematuria with dysuria, and Endothelium Corneum Gigeriae Galli is used to dissolve urinary calculi. Furthermore,
Endothelium Corneum Gigeriae Galli is excellent for promoting digestion. Used together with Dioscoreae Rhizoma, it is an excellent product for strengthening and tonifying the Spleen and Stomach. However, when Endothelium Corneum Gigeriae Galli is used raw, its potency is strong but has the side effect of breaking Qi. If the Qi level is extremely deficient, it should first be ground finely while raw, then roasted before use. If after several days of taking the medicine, hematuria with dysuria does not improve, one can take one fen of fine powder of Fructus Piperis Longi (Bichengqie) mixed with one fen of Copaiba Balsam oil (Gebeiba oil) and ingest them together. Additionally, since this condition involves unceasing diarrhea, hematuria with dysuria cannot heal. If diarrhea persists after taking the Dioscoreae and Plantaginis porridge, crush two or three cooked egg yolks, mix them into the porridge, boil for another one or two hours, and then administer.
Upon detailed observation of the described medical case, the pulse is described as slippery and rolling (Huadong), and the illness arose after taking Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia). It is undoubtedly that hot phlegm is stagnant in the Middle Jiao, causing Stomach Qi to rebel upward and Chong Qi to surge upward, gradually forming a syndrome of excess above and deficiency below (Shangsheng Xiaxu). Because of this excess above and deficiency below, the patient experiences frequent sensations of dizziness and swaying (Dangyang). The treatment method should involve resolving phlegm, clearing heat/fire, descending Stomach Qi, and restraining Chong Qi. A small dosage formula is prescribed for long-term consumption. Once Qi transformation returns to its root, the dizziness and swaying will heal spontaneously. The proposed formula is as follows:
Processed Pinelliae Tuber (Banxia) (3 qian), Biota Seed (Baiziren) (3 qian), raw Oolithus (Heshi) (3 qian, ground to powder), raw Paeoniae Radix Alba (Baishao) (3 qian), raw Euryales Semen (Qianshi) (1 liang), Fresh Ginger (Shengjiang) (3 slices).
Decoct the herbs in concentrated water from rusted iron (Tieshui).
The intention of this formula is to use Banxia and Heshi to resolve and sink phlegm, thereby descending Stomach Qi and calming Chong Qi. Qianshi is used to consolidate Qi transformation in the Lower Jiao, ensuring that the descending and sinking actions of the medicines have a place to rest, and to restrain Chong Qi so it does not surge upward again. Baishao is used to clear Liver Fire and promote urination, thereby opening a pathway for the elimination of phlegm. Baiziren is used to nourish Liver Blood and moisten Kidney Water, thereby moderating the acrid-drying nature of Banxia. Shengjiang is used to penetrate collaterals and clarify the mind, serving as an assistant and guide for the phlegm-resolving drugs. As for using iron rust water to decoct the herbs, it is because all wind diseases involving vertigo belong to the Liver. Dangyang is essentially vertigo. There must be stirring of Liver Wind within, assisting the continuous upward surge of Stomach and Chong Qi. According to the principle that Metal controls Wood, the metallic Qi of iron rust can be borrowed to suppress Liver Wood. Furthermore, since iron has heavy-sinking properties, it can guide the Dragon-Fire and Thunder-Fire lodged in the Liver downward. Moreover, iron rust is formed by the combination of iron and oxygen; it is best at nourishing the Blood aspect of the human body and strengthening the spirit. Even with long-term consumption, it is suitable for the Zang-Fu organs.