病源血淋者,是热淋之甚者,则尿血,谓之血淋,心主血,血之行身,通遍经络,循环
腑脏,劳热甚者,则散失其常经,溢渗入胞而成血淋也。(出第十四卷中)
广济疗血淋不绝,鸡苏饮子方。
鸡苏(一握) 竹叶(一握切) 石膏(八分碎) 生地黄(一升切) 蜀葵子(四分
末汤成
下)
上五味,以水六升,煮取二升,去滓,和葵子末,分温二服,如人行四五里久,进一服
。(古今录验范汪同)
又疗血淋小便碜痛方
鸡苏(二两) 滑石(五两碎) 生地黄(半斤) 小苏根(一两) 竹叶(二两) 通
草(五
两) 石膏(五两碎)
上七味细锉,以水九升,煎取三升,去滓,分温三服,如人行四五里进一服。(并出第
四卷中)
千金疗血淋方。
石苇(去毛) 当归 芍药 蒲黄(各等分)
上四味为散,酒服方寸匕,日三服。(肘后文仲同出第二十一卷中)
备急陶氏疗淋下血二升者方。
取苎麻根十枝,以水五升,煮取二升,一服血止,神验。(肘后古今录验同)
又方
灸足大趾前节上十壮良。(并出第六卷中)
延年论曰,疗小便赤色如浅红花汁,此是忧愁惊恐,心气虚热,客邪气与热传搏心,所
以小便赤,心主南方火,旺在四月五月六月,其色赤,惊恐动于心,心不受邪,邪即传于小
肠,渗入胞中,所以小便赤,此为微邪,其病犹轻,今服丸子,即得渐瘥,心即是火,火恶
于清,清即是水,水能灭火,既损心气,即不得食热及冷水,并勿忧愁,如不慎,恐小便色
赤如血,渐即难愈,今处干地黄丸,补心神,益脾气,散客热,自然调和,小便色即自变如
常,第一不得忧愁在心,并勿食热食及冷水等方。
干地黄 黄 (各六分) 防风 远志 茯神 栝蒌 子芩(各四分) 鹿茸(炙三
分) 龙骨(四分五色者) 人参(五分) 滑石(十二分) 石苇(汤渍一宿刮去皮) 当
归
(各二分) 芍药 蒲黄 甘草(炙) 戎盐(各三分) 车前子(八分)
上十八味筛为末,以蜜及枣膏各半相和,煎令消,散和药为丸,如梧桐子大,每食后少
时,以粥清下十丸,日二三,稍加至十五二十丸,以知为度。(许孝璋处)
又茅根饮子,疗胞络中虚,热时小便如血色方
茅根(一升) 茯苓(三两) 人参 干地黄(二两)
上四味切,以水五升,煮取一升五合,去滓,分温五六服,一日食尽。(文仲处)
文仲通草饮子,主热气淋涩,小便赤如红花汁色方。
通草 葵子 茅根 王不留行 蒲黄(炮) 桃胶 瞿麦 滑石(各两) 甘草(七
钱)
上九味切,以水一斗,煮取六升,去滓,分温五六服。忌如药法。
病因学说认为,血淋是热淋的严重阶段,表现为尿血,因此称为血淋。心主血脉,血液运行于全身,贯通经络,循环于脏腑之间。若劳倦与热邪极盛,则血液会散乱失其常道,溢出并渗入膀胱(胞),从而形成血淋。(出自第十四卷中)
《广济方》治疗血淋出血不止的鸡苏饮子方。
鸡苏(一握) 竹叶(一握,切碎) 石膏(八分,捣碎) 生地黄(一升,切碎) 蜀葵子(四分,研末,在汤药煮成时下入)
以上五味药,用水六升,煎煮至二升,去渣,加入蜀葵子末,分两次温服。服药后约行走四五里的时间,再服用一次。(《古今录验》和范汪方的记载相同)
又一方治疗血淋小便涩痛如砂石摩擦感。
鸡苏(二两) 滑石(五两,捣碎) 生地黄(半斤) 小苏根(一两) 竹叶(二两) 通草(五两) 石膏(五两,捣碎)
以上七味药细切,用水九升,煎煮至三升,去渣,分三次温服。服药后约行走四五里的时间,再服用一次。(均出自第四卷中)
《千金方》治疗血淋的方剂。
石苇(去毛) 当归 芍药 蒲黄(各等分)
以上四味药研为散剂,用酒送服一方寸匕,每日三次。(《肘后方》文仲本及第二十一卷中的记载相同)
《备急方》陶氏治疗淋证下血达二升的方剂。
取苎麻根十枝,用水五升,煎煮至二升,一次服用即可止血,效果神验。(《肘后方》和《古今录验》记载相同)
又一方
灸足大趾前节上方十壮,疗效良好。(均出自第六卷中)
《延年方》论述说:治疗小便颜色像浅红花汁一样,这是由于忧愁惊恐导致心气虚热,外来的邪气与热邪搏结于心,所以小便发红。心属南方火,在四月、五月、六月旺盛,其色赤。惊恐扰动心神,心不受邪,邪气即传于小肠,渗入膀胱,所以小便发红。这属于轻微的邪气,病情尚轻。现在服用丸子,即可逐渐痊愈。心即是火,火厌恶清凉,清凉即是水,水能灭火,既然损伤了心气,就不得食用热性食物及冷水,并且不要忧愁。如果不谨慎,恐怕小便颜色红如血,逐渐难以治愈。现在处方干地黄丸,以补养心神,益脾气,散除客热,自然调和,小便颜色即可自行恢复正常。第一不得心中忧愁,并勿食热食及冷水等方。
干地黄 黄芪(各六分) 防风 远志 茯神 栝蒌 子芩(各四分) 鹿茸(炙,三分) 龙骨(四分,五色者最佳) 人参(五分) 滑石(十二分) 石苇(汤浸一夜,刮去皮) 当归(各二分) 芍药 蒲黄 甘草(炙) 戎盐(各三分) 车前子(八分)
以上十八味药筛为末,用蜂蜜及枣膏各半量相和,煎令融化,混合药粉制成丸药,如梧桐子大小。每餐饭后稍顷,用米汤送服十丸,每日二至三次,逐渐增加至十五至二十丸,以见效为度。(许孝璋提供)
又一方茅根饮子,治疗胞络中虚,热时小便如血色。
茅根(一升) 茯苓(三两) 人参 干地黄(二两)
以上四味药切碎,用水五升,煎煮至一升五合,去渣,分五至六次温服,一日内吃完。(文仲提供)
文仲通草饮子,主治热气淋涩,小便赤如红花汁色。
通草 葵子 茅根 王不留行 蒲黄(炮制) 桃胶 瞿麦 滑石(各一两) 甘草(七钱)
以上九味药切碎,用水一斗,煎煮至六升,去渣,分五至六次温服。禁忌同一般服药法。
The etiology of Blood Lin (Blood strangury) states that it is a severe form of Heat Lin (Heat strangury), characterized by hematuria, hence the name. The Heart governs blood; blood circulates throughout the body, penetrating the meridians and cycling through the zang-fu organs. When labor and heat are extreme, blood loses its normal pathway, overflows, and seeps into the bladder (bao), resulting in Blood Lin. (From Volume 14)
Guangji Fang treats persistent Blood Lin with Jisu Yinzi Decoction.
Jisu (one handful) Zhuye (one handful, cut) Shigao (8 fen, crushed) Sheng Dihuang (1 sheng, cut) Shuhui Zi (4 fen, powdered, added when the decoction is ready)
Take the above five herbs, add six sheng of water, boil to obtain two sheng, remove the dregs, mix in the Shuhui Zi powder, and divide into two warm doses. After walking for the distance covered in four or five li, take one dose. (Same as Gujin Lu Yan and Fan Wang)
Another formula treats Blood Lin with gritty pain during urination.
Jisu (2 liang) Huashi (5 liang, crushed) Sheng Dihuang (0.5 jin) Xiaosugen (1 liang) Zhuye (2 liang) Tongcao (5 liang) Shigao (5 liang, crushed)
Finely chop the above seven herbs, add nine sheng of water, boil to obtain three sheng, remove the dregs, and divide into three warm doses. After walking for the distance covered in four or five li, take one dose. (All from Volume 4)
Qianjin Fang treats Blood Lin.
Shiwei (remove hairs) Danggui Shaoyao Puhuang (equal parts each)
Grind the above four herbs into powder, take one fangcun bi with wine, three times daily. (Same as Zhouhou Wen Zhong edition, from Volume 21)
Beiji Taoshi treats strangury with bleeding up to two sheng.
Take ten stalks of Zhuma Gen, add five sheng of water, boil to obtain two sheng. One dose stops the bleeding; it is miraculous. (Same as Zhouhou and Gujin Lu Yan)
Another method:
Moxibustion on the proximal phalanx of the great toe, ten moxa cones, is effective. (All from Volume 6)
Yannan Lun states: To treat urine colored like light red flower juice, this is due to worry and fright causing Heart Qi deficiency and heat. Exogenous pathogens combine with heat to attack the Heart, so the urine becomes red. The Heart belongs to Fire in the South, flourishing in the fourth, fifth, and sixth months, with the color red. Fright disturbs the Heart; if the Heart does not accept the pathogen, it transmits to the Small Intestine and seeps into the bladder, causing red urine. This is a mild pathogen, and the disease is still light. Taking pills now will lead to gradual recovery. The Heart is Fire; Fire dislikes cooling. Cooling is Water; Water extinguishes Fire. Since Heart Qi is damaged, one must avoid hot foods and cold water, and refrain from worry. If not careful, the urine may become red like blood, becoming difficult to cure later. Now prescribing Gan Dihuang Wan to nourish Heart Spirit, benefit Spleen Qi, and dissipate exogenous heat, naturally harmonizing the condition so that urine color returns to normal. First, do not harbor worries in the heart, and avoid hot foods and cold water.
Gan Dihuang Huangqi (each 6 fen) Fangfeng Yuanzhi Fushen Gualou Ziqin (each 4 fen) Lurong (roasted, 3 fen) Longgu (4 fen, five-colored ones preferred) Renshen (5 fen) Huashi (12 fen) Shiwei (soaked in decoction overnight, scraped clean) Danggui (each 2 fen) Shaoyao Puhuang Gancao (roasted) Rongyan (each 3 fen) Cheqianzi (8 fen)
Sift the above eighteen herbs into powder. Mix with honey and jujube paste in equal amounts, boil until dissolved, mix with the powder to make pills the size of Sophora japonica seeds. Take ten pills with clear rice gruel shortly after meals, two or three times daily, gradually increasing to fifteen or twenty pills, stopping when efficacy is achieved. (Provided by Xu Xiaozhang)
Another recipe, Maogen Yinzi, treats deficiency in the Bao Luo (bladder collaterals) where urine resembles blood color during heat.
Maogen (1 sheng) Fuling (3 liang) Renshen Gan Dihuang (2 liang each)
Cut the above four herbs, add five sheng of water, boil to obtain one sheng and five he, remove dregs, and divide into five or six warm doses, consumed within one day. (Provided by Wen Zhong)
Wen Zhong's Tongcao Yinzi treats heat qi strangury with dysuria, where urine is red like red flower juice.
Tongcao Kuizi Maogen Wangbuliuxing Puhuang (processed) Taojiao Qumai Huashi (each 1 liang) Gancao (7 qian)
Cut the above nine herbs, add one dou of water, boil to obtain six sheng, remove dregs, and divide into five or six warm doses. Observe dietary restrictions as per general medication rules.