治小便白淫不止，精气不固，及有余沥，或梦与阴人通泄。
龙骨（一两，别研） 缩砂（去皮，半两） 诃黎勒（去核，五枚） 丹砂（研，一两，
存一分为衣）
上为细末，煮糯米糊为丸，如绿豆大，以丹砂为衣，每服一丸，空心热酒送下，夜卧服
三丸，冷水送下，不可多服。或太秘欲通，用葱汤点茶服之，即通。
《内经》曰∶胞移热于膀胱则癃，溺血。《灵枢》又曰∶足厥阴肝之经，病遗溺闭癃。
戴人分析为二∶闭为小溲不行，癃为淋沥而下，诸方谓之血淋证也。《原病式》曰∶淋小便
涩痛也，因热结膀胱，郁结不能渗泄故也。以其热甚，客于肾肝，阴分血受热也。下焦有热
，则热郁膀胱，膀胱为津液之府，胞为受纳之司，故热入膀胱，胞中外热，阴络内溢，故不
得小便而溺血也。诸方论有五淋之名，所感不一，病则大同小异，皆由热郁之所致。或谓有
冷淋者，误也。殊不知溲下淋沥疼痛，忍之身必战栗而增寒，故似乎冷。若遂以为冷，此不
明矣。气运变化之机，亢则害，承乃制，战栗似寒，经属于火，反兼水化之象，乃热甚而郁
结不开，或热出砂石者，或如脂膏者，亦非冷凝也。是若热在脬中，煎熬日渍，轻则凝如脂
膏，甚则结如砂石。且如汤瓶煎炼日久，熬成汤碱，又如清水煎汤，热甚则沸溢，自然混浊
也。《脉经》曰∶少阴脉数，妇人则阴中生疮，男子则气淋，热结下焦，令人淋闭不通。淋
之为病，小便数而涩，小腹痛引脐中。《原病式》又曰∶淋小便涩而不通也为热，遗尿不
禁者为冷，岂知热甚客于肾部，干于厥阴之经，郁结极甚，而气血不能宣通则痿痹，神无所
用，故液渗入膀胱，而漩溺遗失，不能收禁也。经云∶目得血而能视，脏得血而能液，腑得
血而能气。夫血随气运，气血宣行，则其中神自清利，而应机能为用矣。《灵枢》又曰∶肾
主二阴。然水衰虚而怫，溲客其部，二阴郁结而痿痹，神无所用，溲便遗失而不能禁止，然
则热证明矣。《痹论》云∶胞痹者，少腹膀胱按之内痛，若沃以汤，涩于小便，上为清涕。
夫膀胱为州都之官，津液藏焉，气化则能出矣。今风寒湿邪，客于胞中则不能化出，故胞满
水道不通，其证少腹膀胱按之内痛，若沃以汤，涩于小便，是足太阳经。其直上行者，交额
入络，脑气下灌于鼻窍，则为清涕也。严氏有五林之分∶气石血膏劳是也。气淋为病，小便
涩，常有余沥；石淋茎中痛，尿不得率出；膏淋尿似膏出；劳淋劳倦即发，痛引气冲；血淋
遇热即发，甚则溺血，候其鼻头色黄者，小便难也。大抵此证，多由心肾不交，积蕴热毒，
或酒后房劳，服食热燥，七情郁结所致。癃闭淋闭皆一类也，世之所用黄芩、山栀、伏苓、
瞿麦、通草、生地黄、郁李仁之类寒药，治之则已，其方乃是也。或谓患淋而服茴香、益智
、滑石之药而愈者，然则非冷欤？殊不知此皆利小便之要药也。又云∶足少阴肾脉涩，则病
溲血。又论曰∶热在下焦则溺血。详此溲血者，诸方所谓尿血病也。若此，与淋血同欤异欤
？淋痛而溲不痛，得无异乎？本虽出于热淋血者，肾虚有热也。法当补益，不痛为虚，宜补
之谓也。此则多因忧劳房室过度，肾虚有热而致，陈无择治之发灰散，发乃血之余，以属补
阴甚捷。审此二说，切其所感之由，治之亦足以有考云。
治疗小便白浊不止，精气不固，以及排尿后有余沥，或者梦中与女性交合而泄精。
龙骨（一两，单独研磨） 缩砂（去皮，半两） 诃黎勒（去核，五枚） 丹砂（研磨，一两，留出一分作为包衣）
以上药物研成细末，用煮糯米糊制作成丸药，大小如绿豆，以丹砂为外衣。每次服用一丸，空腹时用热酒送服；夜间睡觉时服用三丸，用冷水送服，不可多服。如果大便太干结想要通便，用葱汤调茶服用，即可通畅。
《黄帝内经》说：胞中移热于膀胱则导致癃闭（小便不通），尿血。《灵枢》又说：足厥阴肝经发病，会出现遗尿、闭癃。戴人将其分析为两种情况：闭是指小便完全不通，癃是指淋沥而下，各方书称之为血淋证。《原病式》说：淋证是小便涩痛，因为热邪结聚在膀胱，郁结不能渗泄所致。由于热邪严重，客居于肾肝的阴分血分。下焦有热，则热邪郁结在膀胱，膀胱是津液汇聚之所，胞是受纳之司，所以热邪进入膀胱，胞内外皆热，阴络内的血液外溢，因此导致小便不通且尿血。各方书论述中有五淋的名称，致病原因不一，但病情大同小异，都是由热邪郁结所致。有人说有冷淋，这是错误的。殊不知小便淋沥疼痛，忍耐时身体必定战栗并增加寒感，所以看起来像冷证。如果就认为是冷证，这是不明智的。气运变化的机理，亢盛则为害，承制才能平衡，战栗看似寒象，但经脉属于火，反而兼有水化的表象，这是热邪极盛而郁结不开的表现，或者热邪排出砂石，或者排出如脂膏样的物质，也不是冷凝造成的。如果是热邪在胞中，日夜煎熬，轻则凝结如脂膏，重则结成如砂石。就像汤瓶煎炼日久，熬成汤碱，又如清水煎煮，热甚则沸腾溢出，自然变得混浊。《脉经》说：少阴脉数，妇人则阴中生疮，男子则患气淋，热邪结聚在下焦，令人淋闭不通。淋证这种病，小便频数且涩痛，小腹痛牵引至脐中。《原病式》又说：淋证小便涩而不通是因为热，遗尿不禁是因为冷，哪里知道热邪极盛客居于肾部，侵犯厥阴经，郁结极甚，气血不能宣通而导致痿痹，神机无所作用，所以津液渗入膀胱，尿液遗失，不能收禁。经文说：眼睛得到血的滋养就能视物，脏腑得到血的滋养就能化生津液，腑得到血的滋养就能化生气。血随气运行，气血宣行通畅，其中的神机自然清利，并能应机发挥作用。《灵枢》又说：肾主管二阴。然而水衰虚而怫郁，溲客居其部位，二阴郁结而痿痹，神机无所作用，小便遗失而不能禁止，那么热证明显了。《痹论》说：胞痹，少腹膀胱按压内部疼痛，感觉像浇了热水一样，小便涩滞，上部出现清涕。膀胱是州都之官，津液藏于此，气化功能正常则能排出。现在风寒湿邪客居于胞中，则不能气化排出，所以胞满水道不通，其症状是少腹膀胱按压内部疼痛，感觉像浇了热水一样，小便涩滞，这是足太阳经的病。其直行向上的经脉，交会额部入络，脑气下灌于鼻窍，则产生清涕。严氏将淋分为五种：气、石、血、膏、劳。气淋发病，小便涩滞，常有余沥；石淋茎中疼痛，尿液不能顺畅排出；膏淋尿液似膏状流出；劳淋劳累疲倦即发作，疼痛牵引至气冲穴；血淋遇热即发作，严重时尿血，观察患者鼻头色黄者，小便困难。大抵此证，多由心肾不交，积蕴热毒，或者酒后房事过度，服用热燥食物，七情郁结所致。癃闭和淋闭都是一类病，世医所用的黄芩、山栀、茯苓、瞿麦、通草、生地黄、郁李仁等寒凉药物，治疗此病有效，这些方剂是正确的。有人说患淋证服用茴香、益智、滑石等药而痊愈，那么难道不是冷证吗？殊不知这些都是利小便的要药。又云：足少阴肾脉涩，则病尿血。又论述说：热在下焦则尿血。详查此尿血，各方书所谓尿血病。如果是这样，与淋血相同还是不同呢？淋痛而尿不痛，难道没有区别吗？本虽出于热淋血，但根源是肾虚有热。治法应当补益，不痛为虚证，宜用补法。这多因忧劳房室过度，肾虚有热所致，陈无择用发灰散治疗，头发乃血之余，以此属补阴非常快捷。审察这两种说法，切中其所感的原因，治疗也足以作为考证依据。
Treats continuous leukorrhea of urine (white turbid urine), insecurity of essence and qi, residual dribbling after urination, or seminal emission during dreams involving sexual intercourse with women.
Longgu (Dragon Bone, *Fossilia Ossis Mastodi* - 1 liang, ground separately) Suosha (Amomi Fructus Rotundus - 0.5 liang, peel removed) Helile (Terminalia Chebula Retz. Fruit - 5 pieces, pits removed) Dansha (Cinnabar - 1 liang, ground, reserve 1 fen for coating)
Grind the above ingredients into a fine powder. Use rice paste made from boiling glutinous rice to form pills the size of mung beans. Coat the pills with Cinnabar (*Dansha*). Take one pill per dose, swallowed with warm wine on an empty stomach. At night before sleep, take three pills, swallowed with cold water. Do not overdose. If constipation is severe and bowel movement is desired, mix with tea using scallion decoction to drink; this will promote bowel movement.
The *Huangdi Neijing* states: "Heat transferring from the Bao (uterus/bladder area) to the Bladder causes Long (retention of urine) and hematuria." The *Lingshu* further states: "Diseases of the Foot Jueyin Liver Meridian manifest as enuresis and Long (urinary retention)." Dai Ren analyzed this into two categories: Bi (obstruction) refers to complete inability to urinate, while Long refers to dribbling discharge. Various medical texts refer to this as Blood Lin syndrome. The *Yuanbing Shi* states: "Lin syndrome involves painful and difficult urination, caused by heat accumulation in the Bladder leading to stagnation and failure of permeation and excretion." Because the heat is severe, it lodges in the Yin aspect of the Kidney and Liver blood levels. Heat in the Lower Jiao causes heat stagnation in the Bladder. The Bladder is the reservoir of fluids, and the Bao is responsible for reception. Thus, when heat enters the Bladder, causing internal and external heat in the Bao, blood from the Yin collaterals overflows, resulting in urinary retention and hematuria. Various texts discuss five types of Lin syndromes with different etiologies but similar clinical presentations, all caused by heat stagnation. Some claim there is Cold Lin, which is erroneous. One must realize that painful dribbling urine, when endured, causes shivering and increased cold sensation, mimicking cold. Assuming it is cold is ignorant. The mechanism of Qi transformation follows the principle that excess leads to harm, and control restores balance. Shivering resembling cold is actually associated with Fire meridians, presenting a superficial Water-like manifestation due to extreme heat stagnation. This may manifest as passing sand/stones or greasy substances, not cold condensation. If heat resides in the Bao, simmering day and night, it may coagulate like grease (mild) or stones (severe). Just as boiling water in a pot eventually leaves alkaline residue, or clear water becomes turbid when boiled vigorously, so too does heat cause turbidity. The *Maijing* states: "A rapid Shaoyin pulse indicates genital sores in women and Qi Lin in men. Heat knotting in the Lower Jiao causes Lin and obstruction. Lin disease presents with frequent, difficult urination and lower abdominal pain radiating to the umbilicus." The *Yuanbing Shi* further states: "Lin with difficulty and obstruction is due to heat; enuresis is due to cold." However, extreme heat lodging in the Kidney region and affecting the Jueyin meridian can cause severe stagnation, preventing Qi and Blood circulation, leading to flaccidity and numbness. When Shen (spirit/mind) loses its function, fluids seep into the Bladder, causing involuntary urination. The classics state: "The eyes see when nourished by Blood; Zang organs generate fluids when nourished by Blood; Fu organs generate Qi when noured by Blood." Blood follows Qi; when Qi and Blood circulate freely, Shen remains clear and functional. The *Lingshu* states: "The Kidney governs the two yin openings (urethra and anus)." If Water deficiency leads to constraint, and pathogens affect these areas, stagnation and flaccidity occur, Shen fails, and urination cannot be controlled, proving a heat pattern. The *Bilun* states: "Bao Bi (Bladder obstruction) presents with deep pain upon pressing the lower abdomen/Bladder, feeling like hot water pouring, with difficult urination and clear nasal discharge above." The Bladder is the official of the capital, storing fluids; Qi transformation allows excretion. When Wind-Cold-Damp pathogens lodge in the Bao, transformation fails, causing fullness and obstruction. Symptoms include lower abdominal pain, sensation of hot water, and difficult urination, indicating involvement of the Foot Taiyang Bladder Meridian. Its straight branch ascends to the forehead, connects to the brain, and descends to the nasal cavity, causing clear nasal discharge. Yan’s classification divides Lin into five: Qi, Stone, Blood, Grease, and Labor. Qi Lin presents with difficult urination and residual dribbling. Stone Lin causes penile pain and inability to pass urine smoothly. Grease Lin presents with urine resembling grease. Labor Lin occurs upon fatigue, with pain radiating to the Qichong point. Blood Lin is triggered by heat, potentially causing hematuria; yellow discoloration of the nose tip indicates difficult urination. Generally, this condition arises from Heart-Kidney non-interaction, accumulated heat-toxins, excessive sexual activity after drinking, consumption of hot-drying foods, or emotional stagnation. Long Bi and Lin Bi are essentially the same category. Commonly used cooling herbs such as Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus), Fuling (Poria), Qumai (Dianthi Herba), Tongcao (Tetrapanacis Medulla), Shengdihuang (Rehmanniae Radix Recens), and Yuliren (Pruni Semen) are effective, validating these formulas. Some argue that recovery after using Huixiang (Foeniculi Fructus), Yizhi (Alpiniae Oxyphyllae Fructus), and Huashi (Talcum) proves a cold pattern. This is incorrect; these are key herbs for promoting diuresis. It is also stated: "A choppy Shaoyin pulse indicates hematuria." And: "Heat in the Lower Jiao causes hematuria." Hematuria described here corresponds to the disease known as Urinary Bleeding. Is this identical to Blood Lin? There is a difference: Lin involves pain, whereas pure hematuria may not. Although originating from Heat Lin/Blood, the root is Kidney Deficiency with Heat. Treatment should involve tonification; absence of pain indicates deficiency, warranting tonifying methods. This often results from worry, labor, and excessive sexual activity leading to Kidney Deficiency with Heat. Chen Wuzhe treated this with Fahuisan (Hair Ash Powder). Hair is the surplus of Blood, making it highly effective for nourishing Yin. Examining these two perspectives helps clarify the etiology and provides a basis for treatment.