王太仆注曰∶“得气海之气施化，则溲便注泄，气海之气不及，则 隐不通，故曰气化则能出矣。”王太仆为注释之
开山，宋、元、明历代诸家，各仍其说，莫不以津液即为溲便。殊不思气化则能出者，言膀胱之津液，得太阳之气而后
能出于皮毛，非津液下出之谓也。且津自津，液自液，小便自小便，逐字考之，《内经》各有明文。《灵枢·决气篇》曰∶
“腠理发泄，汗出溱溱，是谓津”。“谷入气满，淖泽注于骨，骨属屈伸，泄泽补益脑髓，皮肤润泽，是谓液。”又曰∶“津
脱者，腠理开，汗大泄。液脱者，骨属屈伸不利。”又《五癃津液别篇》曰∶“三焦出气，以温肌肉，充皮肤，为其津，
其流而不行者为液。”是《经》文津液二字，各有着实注解者，不得以津液小便混而莫辨矣。自古以来，接《内经》之统，
以继往开来者，其惟仲景先师《伤寒论》乎。其治太阳病，无汗用麻黄汤，有汗用桂枝汤，此津藏于膀胱，气化则能出
之一证也。《金匮》用栝蒌桂枝汤以治柔 ，葛根汤以治刚 ，因邪伤太阳，液不养筋，故助太阳之气化以营运于皮毛，
以流通津液，则筋脉得以濡润，此液藏于膀胱，气化则能出之又一证也。以《经》注《经》，己甚明矣。而仲景治法，又
与《经》旨符合，则津液之非小便，尚何疑哉，又水饮入于胃，上升于肺，以下布于三焦者，谓之水。水湿壅而不通，
则小便不利，轻为腹膨，重为肿胀，此水在三焦，而未入膀胱者也；其既入膀胱以后，水之上升而汗出溱溱者谓之津，
所谓“下输膀胱，水精四布”也。贮于膀胱而下出者，则谓之溺；溺孔闭涩，则为癃秘，《内经》之胞痹等症是也。《素
问·宣明五气篇》曰∶“膀胱不利为癃，不约为遗溺”，《灵枢·本输篇》曰∶“实则闭癃，虚则遗溺”，《经脉篇》曰∶“肝
所生病者、遗溺闭癃。”又曰∶“足少阴之别，实则闭癃。”窃意三焦不能化入膀胱者，其病多虚，故历来治水肿水胀者，
总以气不化水为主也；因溺窍不通，膀胱之内水胀者，其病多实。故统观《内经》诸篇，癃闭则皆有实而无虚也。又按∶
津之外出者为汗，津之内出者为溺，故汗多不得利小便，恐阴从下脱也；失小便者亦不得发汗，虑其阳从上脱也。小便
之与汗，俱为津之所化，是同出而异名者也。液为水谷之精华，即津之流而不行，随气以运于周身，则润皮肤，泽筋骨，
补脑髓，聚于膀胱，布于经络，宜藏而不宜出，故十二官之神明等俱言出，而此独曰藏者，言津之液藏也。“气化则
能出”者，但可指津而言也，若液从溺窍而出，则为膏淋等症矣，尚得谓之气化哉？
王冰（王太仆）注释说：“得到气海之气的施予和转化，就能使大小便通畅排泄；如果气海之气不足，就会隐涩不通，所以说‘气化则能出’。”王冰是开注释先河的人，宋、元、明历代各家都沿袭他的说法，没有不把津液等同于小便和大便的。殊不知“气化则能出”的意思是说膀胱中的津液，得到太阳经之气的作用后才能出于皮毛，并不是指津液从下窍排出。况且津与液各自不同，小便是小便，逐字考证，《内经》中都有明确的文字记载。《灵枢·决气篇》说：“腠理发泄，汗出淋漓，这叫做津。”“谷气入胃充满体内，滋润灌注于骨骼，使骨节屈伸自如，渗注滋润以补益脑髓，使皮肤润泽，这叫做液。”又说：“津脱，表现为腠理开张，大汗淋漓。液脱，表现为骨节屈伸不利。”又《五癃津液别篇》说：“三焦发出气，用来温煦肌肉，充实皮肤，这部分称为津，流动而不停滞的部分称为液。”因此《内经》原文中“津”和“液”二字，各有确切的注解，不能把津液和小便混淆而分辨不清。自古以来，承接《内经》道统，继往开来的，大概只有张仲景先师的《伤寒论》吧。他治疗太阳病（太阳经受邪所致的病证），无汗的用麻黄汤（发汗解表剂），有汗的用桂枝汤（调和营卫剂），这就是津藏于膀胱，通过气化作用出于皮毛的一个例证。《金匮要略》用栝蒌桂枝汤（瓜蒌根与桂枝组成的方剂）治疗柔痉（以汗出、项背强直为特征的痉病），用葛根汤（葛根、麻黄等组成的方剂）治疗刚痉（以无汗、项背强直为特征的痉病），因为邪气伤害太阳经，导致液不能滋养筋脉，所以辅助太阳经的气化功能以运行于皮毛，流通津液，从而使筋脉得到濡润，这是液藏于膀胱，通过气化作用出于皮毛的又一个例证。用《内经》经文来解释《内经》，已经非常明白了。而张仲景的治疗方法，又与《内经》的宗旨相符合，那么津液并非小便，还有什么可怀疑的呢？另外，水饮进入胃中，上升于肺，向下布散于三焦的，称为水。如果水湿壅滞而不通，就会导致小便不利，轻者腹部膨隆，重者全身肿胀，这是水在三焦，尚未进入膀胱的情况；当它进入膀胱以后，水气上升并化为汗液淋漓而出的，称为津，这就是所谓的“下输膀胱，水精四布”。贮存在膀胱并从下窍排出的，称为溺；如果溺窍闭塞涩滞，就形成癃秘（排尿困难或尿闭），这是《内经》中胞痹等症状。《素问·宣明五气篇》说：“膀胱功能不利则形成癃，约束无力则形成遗溺（尿失禁）”，《灵枢·本输篇》说：“实证则闭癃，虚证则遗溺”，《经脉篇》说：“肝所生的疾病包括遗溺和闭癃。”又说：“足少阴肾经的别络，实证则闭癃。”我私下认为，三焦不能将水气转化输入膀胱的，其病症多属虚证，所以历来治疗水肿、水胀，总以气不化水为主要病机；因为溺窍不通，导致膀胱内部积水胀满的，其病症多属实证。因此纵观《内经》各篇，癃闭症似乎都是实证而没有虚证。另外，津向外排出的称为汗，津向内（向下）排出的称为溺，所以出汗多时不能使用利小便的方法，恐怕阴液会从下窍脱失；丢失小便时也不可使用发汗的方法，担心阳气会从上窍脱失。小便与汗，都是津所化生，是同出一源而异名的东西。液是水谷的精华，也就是津中流动而不停滞的部分，随着气运行于周身，从而滋润皮肤，润泽筋骨，补益脑髓，汇聚于膀胱，布散于经络，适宜收藏而不宜外泄，所以十二官的神明等功能都说“出”，唯独这里说“藏”，是说津和液应当收藏。“气化则能出”这句话，只能针对津而言，如果液从溺窍排出，那就成为膏淋（尿液浑浊如脂膏的病证）等疾病了，还能称之为气化吗？
Wang Bing (Grand Master Wang) commented: "Receiving the qi of the Qi Sea for transformation and distribution, urine and stool can be excreted freely; if the qi of the Qi Sea is insufficient, there will be hidden obstruction and inability to pass, hence it is said that 'qi transformation enables exit.'" Wang Bing was the pioneer in commentary. The scholars of the Song, Yuan, and Ming dynasties all followed his theory, none failing to equate Jin-Ye (Body Fluids) with urine and stool. They failed to realize that "qi transformation enables exit" refers to the Jin (Thin Fluids) in the Bladder being able to emerge from the skin and hair follicles after receiving the qi of the Taiyang (Greater Yang) channel, not referring to the downward discharge of fluids. Moreover, Jin and Ye are distinct, and urine is urine. Examining character by character, the *Neijing* (Classic of Internal Canon) has explicit texts for each. The *Ling Shu · Jue Qi Chapter* states: "When interstices open and sweat flows profusely, this is called Jin." "When grain enters and qi fills the body, moistening and nourishing the bones, allowing flexion and extension of bone joints, seeping into and nourishing the brain marrow, and making the skin lustrous, this is called Ye." It further says: "Jin depletion manifests as open interstices and massive sweating. Ye depletion manifests as difficulty in flexion and extension of bone joints." The *Wu Long Jin Ye Bie Chapter* also states: "San Jiao (Triple Burner) emits qi to warm the muscles and fill the skin; this portion is called Jin, while the part that flows but does not stagnate is called Ye." Thus, the terms "Jin" and "Ye" in the *Jing* (Canon) have specific annotations and should not be confused with urine. Since ancient times, the one who inherited the lineage of the *Neijing* and carried forward the past to open up the future is undoubtedly our master Zhang Zhongjing's *Shang Han Lun* (Treatise on Cold Damage). In treating Taiyang disease, he used Mahuang Tang (Ephedra Decoction) for cases without sweat, and Guizhi Tang (Cinnamon Twig Decoction) for cases with sweat. This is an example of Jin stored in the Bladder exiting through qi transformation. In the *Jin Gui Yao Lue*, he used Gualou Guizhi Tang (Trichosanthes Root and Cinnamon Twig Decoction) to treat Rou Jing (Soft Spasm) and Gegen Tang (Kudzu Decoction) to treat Gang Jing (Hard Spasm). Because pathogenic factors injured the Taiyang channel, causing Ye to fail to nourish the sinews, he assisted the qi transformation of the Taiyang channel to circulate in the skin and hair follicles, thereby circulating Jin-Ye so that the sinews could be moistened. This is another example of Ye stored in the Bladder exiting through qi transformation. Using the *Jing* to explain the *Jing* makes it very clear. Furthermore, Zhang Zhongjing's treatment methods conform to the principles of the *Jing*, so what doubt remains that Jin-Ye is not merely urine? Additionally, when water-drink enters the Stomach, rises to the Lung, and spreads downward to the San Jiao, it is called Water. If Water-Dampness becomes obstructed and fails to flow, it leads to difficult urination; mildly causing abdominal distension, severely causing edema. This is Water in the San Jiao, which has not yet entered the Bladder. After entering the Bladder, the part of the water that rises and emerges as profuse sweat is called Jin, as described by "transported downward to the Bladder, water essence distributed everywhere." What is stored in the Bladder and exits downward is called Niao (Urine); if the urethral orifice is closed and astringent, it results in Long Mi (dysuria or retention), such as the symptoms of Bao Bi (Bladder Bi-syndrome) in the *Neijing*. The *Su Wen · Xuan Ming Wu Qi Chapter* states: "If the Bladder is not smooth, it forms Long; if it lacks control, it forms Yi Niao (urinary incontinence)." The *Ling Shu · Ben Shu Chapter* states: "Excess patterns lead to Bi Long (retention), deficiency patterns lead to Yi Niao." The *Jing Mai Chapter* states: "Diseases generated by the Liver include urinary incontinence and retention." It also says: "The divergent channel of Foot Shaoyin, when in excess, leads to Bi Long." I suspect that when the San Jiao cannot transform and input into the Bladder, the pathology is mostly deficiency; thus, historically, treating edema and water swelling always focused on qi failing to transform water. Conversely, when the urethral orifice is blocked, causing water distension inside the Bladder, the pathology is mostly excess. Therefore, reviewing all chapters of the *Neijing*, Long Bi (retention) seems to be exclusively excess without deficiency. Furthermore, Jin exiting outward is Sweat, and Jin exiting inward (downward) is Urine. Therefore, when sweating is excessive, diuresis should not be used, fearing Yin depletion from below; when urine is lost excessively, sweating should not be induced, fearing Yang depletion from above. Urine and Sweat are both transformed from Jin; they share the same origin but have different names. Ye is the essence of food and drink, which is the flowing but non-stagnant part of Jin. Following Qi to circulate throughout the body, it moistens the skin, nourishes sinews and bones, supplements brain marrow, gathers in the Bladder, and distributes in the meridians. It is suitable for storage rather than discharge. Hence, although the divine functions of the Twelve Officials all mention "exit," here it uniquely mentions "storage," implying that Jin and Ye should be stored. The phrase "qi transformation enables exit" applies only to Jin. If Ye were discharged from the urethral orifice, it would become diseases like Gao Lin (milky turbid urine), and could it still be called qi transformation?