夫尿者。赖心肾二气之所传送。膀胱为传送之府。心肾气虚。阳气衰冷。致令膀胱传送
失度
则必有遗尿失禁之患矣。经云。膀胱不利为癃。不约为遗尿也。大宜温补。清心寡欲。又
有产后不顺。致伤膀胱。及小儿胞冷。俱能令人遗尿失禁。各须随症治之。
一论小便不禁。出而不觉者。是有热不禁也。宜五苓散。（方见中暑）根据本方去桂。加黄
柏、黄芩、黄连、栀子、山茱萸肉、五味子。水煎。空心服。
一治小便不禁虚弱者。用五苓散。（方见中暑）根据本方合四物汤（方见补益）加山茱萸肉、
五味子。共十一味。水煎。空心服。
一治肾气不足。小便频数。日夜百余次。
缩泉散
乌药 益智仁（各等分）
上为细末。山药糊为丸。如梧子大。每服七十丸。空心。盐汤下。
一治遗尿不禁。
鸡 （一具并晒干去秽净不用水洗男用雌鸡女用雄鸡）
上为末。每服二钱。空心滚汤送下。二三服愈。
一治遗尿失禁。
益智仁七个。桑螵蛸七个。为末。酒调服。用熟白果七个送下。
一治夜多小便。用益智仁二十四个研碎。入盐同煎服。
一治小便多。萆 夜煎服之。永不夜起。
一治夜多小便。用胡桃。灰煨熟。临卧。温酒嚼下。
一治小便内虚热者。频数不禁。用六味地黄丸服效。
一治气不足。脉微而涩。小便频数。用小茴香不拘多少。同盐炒为末。取糯米糕片炙软
热。蘸药吃。立效。
一治小便频数。用猪尿胞洗净。以糯米煮烂。入椒少许同煮。去椒。只用胞切吃。
一治小便遗尿失禁。多气虚。以益气汤去柴胡。加茯苓、熟地黄、益智仁、肉桂。
一治小便频数。或劳而益甚。属脾气虚弱。以益气汤加山药、五味子。
一论身体虚瘦。夜常遗尿失禁。
人参（八分） 白术（麸炒一钱） 山药（一钱） 益智仁（七分） 山茱萸（去核七分） 当
归（一钱） 白芍（酒炒一钱） 黄 （蜜炙一钱） 酸枣仁（炒七分） 甘草（炙四分）
上锉作一剂。水煎服。
一论遗尿失禁。身体虚瘦。补中益气汤。（方见内伤）根据本方去柴胡。加山药一钱。益智
仁七分。山茱萸一钱。
一人因劳发热。小便自遗。或时不利。余作肝火阴挺。不能约制。午前。用补中益气加
山
药、黄柏、知母。午后。服地黄丸。月余。诸症悉退。此症若服燥剂而频数或不利。用四物
、麦冬、五味、甘草。若数而黄。用四物加山茱萸、黄柏、知母、五味、麦冬。若肺虚而短
少。用补中益气加山药、麦冬。若阴挺痿痹而频数。用地黄丸而愈。
一论肾与膀胱俱虚。冷气乘之。不能约制。故遗尿不禁。或睡中自出。
加味地黄丸
怀生地黄（酒蒸四两） 怀山药（二两） 牡丹皮（一两五钱） 白茯苓（一两） 山茱萸（酒
蒸去核） 破故纸（炒二两） 益智仁（一两） 人参（一两） 肉桂（五钱）
上为细末。炼蜜为丸。如梧桐子大。每服百丸。空心。盐汤下。
一小便桶内。起泡盈桶。此肾水衰也。用红鸡冠花为末。每服三钱。空心。温酒调下。
小便的排泄，依赖于心气与肾气的传导作用。膀胱是负责传导水液的腑脏。如果心气和肾气虚弱，阳气衰微且寒冷，导致膀胱传导功能失常，就必然会出现遗尿或失禁的病患。医经说：“膀胱气化不利则形成癃闭（排尿困难），约束无力则形成遗尿。”治疗上应当以温补为主，并需清心寡欲。此外，还有因产后调理不当，损伤了膀胱，以及小儿胞宫寒冷，都能导致人出现遗尿失禁的情况。这些都需要根据具体症状进行治疗。
第一种情况论述小便不禁，尿液排出时自己却感觉不到，这是有热邪导致约束不住。适宜使用五苓散。（方剂见中暑章节）在此方基础上去掉桂枝，加入黄柏、黄芩、黄连、栀子、山茱萸肉、五味子。用水煎煮，空腹服用。
第二种情况治疗因虚弱导致的小便不禁。使用五苓散。（方剂见中暑章节）将此方与四物汤（方剂见补益章节）合用，再加入山茱萸肉、五味子。共十一味药，用水煎煮，空腹服用。
第三种情况治疗肾气不足，小便频数，白天黑夜达一百多次。
缩泉散
乌药、益智仁（各等分）
将上述药物研成细末，用山药粉糊制成丸药，大小如梧桐子。每次服用七十丸，空腹时，用盐开水送服。
第四种情况治疗遗尿不禁。
公鸡一只（连同内脏晒干，去除污秽干净，不水洗；男性患者用雌鸡，女性患者用雄鸡）
将上述药物研成粉末。每次服用二钱，空腹时用滚开水送服。服用两三次即可痊愈。
第五种情况治疗遗尿失禁。
取益智仁七个，桑螵蛸七个，研成粉末，用酒调服。再用熟白果七个送下。
第六种情况治疗夜间小便多。取益智仁二十四个研碎，加盐一同煎服。
第七种情况治疗小便多。用萆薢夜间煎服，可以永不夜起。
第八种情况治疗夜间小便多。用胡桃，在灰中煨熟，临睡前，用温酒嚼服。
第九种情况治疗小便内有虚热者，频数且不禁。服用六味地黄丸有效。
第十种情况治疗气不足，脉象微而涩，小便频数。用小茴香不拘多少，同盐炒后研成粉末，取糯米糕片烤软热，蘸药吃，立即见效。
第十一种情况治疗小便频数。用猪膀胱洗净，用糯米煮烂，放入少许花椒同煮，去花椒，只吃切碎的膀胱。
第十二种情况治疗小便遗尿失禁，多因气虚所致。使用益气汤去掉柴胡，加入茯苓、熟地黄、益智仁、肉桂。
第十三种情况治疗小便频数，或者劳累后加重，属于脾气虚弱。使用益气汤加入山药、五味子。
第十四种情况论述身体虚瘦，夜间常遗尿失禁。
人参（八分） 白术（麸炒一钱） 山药（一钱） 益智仁（七分） 山茱萸（去核七分） 当归（一钱） 白芍（酒炒一钱） 黄芪（蜜炙一钱） 酸枣仁（炒七分） 甘草（炙四分）
将上述药物切碎为一剂，用水煎服。
第十五种情况论述遗尿失禁，身体虚瘦。补中益气汤。（方剂见内伤章节）在此方基础上去掉柴胡，加入山药一钱，益智仁七分，山茱萸一钱。
第十六例：一人因劳累发热，小便自行遗出，有时排尿不畅。我认为是肝火导致阴挺（前阴突出），不能约制。午前，服用补中益气汤加山药、黄柏、知母。午后，服用地黄丸。一个月后，各种症状全部消退。此症如果服用燥湿药而尿频或排尿不畅，用四物汤、麦冬、五味子、甘草。如果尿频且尿黄，用四物汤加山茱萸、黄柏、知母、五味子、麦冬。如果肺虚而尿短少，用补中益气汤加山药、麦冬。如果阴挺痿痹而尿频，用地黄丸治愈。
第十七种情况论述肾与膀胱都虚弱，冷气侵袭，不能约制，所以遗尿不禁，或者睡中自出。
加味地黄丸
怀生地黄（酒蒸四两） 怀山药（二两） 牡丹皮（一两五钱） 白茯苓（一两） 山茱萸（酒蒸去核） 破故纸（炒二两） 益智仁（一两） 人参（一两） 肉桂（五钱）
将上述药物研成细末，用炼蜜制成丸药，大小如梧桐子。每次服用一百丸，空腹时，用盐开水送服。
The excretion of urine relies on the transmission and conduction of Heart Qi and Kidney Qi. The Bladder is the fu-organ responsible for this transmission. If Heart and Kidney Qi are deficient, and Yang Qi is weak and cold, leading to a loss of regulation in the Bladder's transmission function, there will inevitably be the affliction of enuresis or urinary incontinence. The Classics state: "If the Bladder is not smooth, it results in strangury (difficulty in urination); if it lacks restraint, it results in enuresis." Treatment should primarily focus on warming and tonifying, along with clearing the Heart and reducing desires. Furthermore, there are cases where improper postpartum care damages the Bladder, or in children, a cold womb can cause enuresis and incontinence. Each case must be treated according to its specific symptoms.
First, regarding urinary incontinence where urine is expelled without awareness, this indicates heat causing a lack of restraint. Wuling San (Five-Ingredient Powder with Poria) is suitable. (Formula see Heatstroke chapter). Based on this formula, remove Guizhi (Cinnamon Twig), and add Huangbai (Phellodendron Bark), Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), Zhizi (Gardenia Fruit), Shanzhuyu (Cornus Fruit), and Wuweizi (Schisandra Berry). Decoct in water and take on an empty stomach.
Second, for treating urinary incontinence due to weakness, use Wuling San (Five-Ingredient Powder with Poria). (Formula see Heatstroke chapter). Combine this formula with Siwu Tang (Four-Substance Decoction). (Formula see Tonification chapter), and add Shanzhuyu (Cornus Fruit) and Wuweizi (Schisandra Berry). There are eleven ingredients in total. Decoct in water and take on an empty stomach.
Third, for treating insufficient Kidney Qi, frequent urination, occurring over a hundred times day and night.
Suosheng San (Bladder-Constricting Powder)
Wuyao (Lindera Root) and Yizhiren (Bitter Apricot Seed) (equal parts)
Grind into fine powder. Form pills using yam paste, sized like wu-tong seeds. Take seventy pills per dose, on an empty stomach, with salted water.
Fourth, for treating enuresis and incontinence.
Rooster (one whole, dried thoroughly, cleaned of impurities, not washed; males use hen, females use rooster)
Grind into powder. Take two qian per dose, on an empty stomach, with boiling water. Two or three doses will cure it.
Fifth, for treating enuresis and incontinence.
Take seven Yizhiren (Bitter Apricot Seeds) and seven Sangpiaoxiao (Mantis Egg-case), grind into powder, mix with wine to take. Follow with seven cooked Ginkgo nuts (Baiguo).
Sixth, for treating frequent nighttime urination. Take twenty-four Yizhiren (Bitter Apricot Seeds), crush them, decoct with salt, and take.
Seventh, for treating frequent urination. Decoct Bibi (Dioscorea Hypoglauca Rhizome) at night; this will prevent nocturia forever.
Eighth, for treating frequent nighttime urination. Use Walnut kernels, roasted in ashes until cooked. Before sleep, chew with warm wine.
Ninth, for treating internal deficiency-heat in the urinary tract, resulting in frequency and incontinence. Taking Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) is effective.
Tenth, for treating Qi insufficiency, with a faint and choppy pulse, and frequent urination. Use Xiao Huixiang (Fennel Fruit) in any amount, stir-fry with salt, and grind into powder. Take slices of glutinous rice cake, toast until soft and hot, dip in the powder, and eat. Immediate effect.
Eleventh, for treating frequent urination. Clean a pig bladder thoroughly, boil with glutinous rice until soft, add a little Sichuan pepper (Huajiao) and boil further. Remove the pepper, only consume the chopped bladder.
Twelfth, for treating urinary enuresis and incontinence, mostly due to Qi deficiency. Use Yiqi Tang (Qi-Supplementing Decoction), remove Chaihu (Bupleurum Root), and add Fuling (Poria), Shudihuang (Prepared Rehmannia Root), Yizhiren (Bitter Apricot Seed), and Rougui (Cinnamon Bark).
Thirteenth, for treating frequent urination, which worsens with exertion, belonging to Spleen Qi deficiency. Use Yiqi Tang (Qi-Supplementing Decoction) with added Shanyao (Chinese Yam) and Wuweizi (Schisandra Berry).
Fourteenth, discussing emaciation and frequent nighttime enuresis/incontinence.
Renshen (Ginseng Root) (8 fen) Baizhu (Atractylodes Macrocephala Rhizome, stir-fried with bran, 1 qian) Shanyao (Chinese Yam, 1 qian) Yizhiren (Bitter Apricot Seed, 7 fen) Shanzhuyu (Cornus Fruit, pitted, 7 fen) Danggui (Angelica Sinensis Root, 1 qian) Baishao (White Peony Root, stir-fried with wine, 1 qian) Huangqi (Astragalus Root, honey-roasted, 1 qian) Suanzaoren (Ziziphus Seed, stir-fried, 7 fen) Gancao (Licorice Root, roasted, 4 fen)
Cut into pieces as one dose. Decoct in water and take.
Fifteenth, discussing enuresis and incontinence with emaciation. Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment Qi). (Formula see Internal Injury chapter). Based on this formula, remove Chaihu (Bupleurum Root), add 1 qian of Shanyao (Chinese Yam), 7 fen of Yizhiren (Bitter Apricot Seed), and 1 qian of Shanzhuyu (Cornus Fruit).
Sixteenth case: A person suffered fever due to overwork, with spontaneous urinary leakage and occasional difficulty in urination. I diagnosed it as Liver Fire causing Yin Ting (prolapse of the external genitalia), unable to restrain. In the morning, administer Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment Qi) with added Shanyao (Chinese Yam), Huangbai (Phellodendron Bark), and Zhimu (Anemarrhena Rhizome). In the afternoon, take Dihuang Wan (Rehmannia Pill). After more than a month, all symptoms receded. If this condition involves dryness agents leading to frequency or obstruction, use Siwu Tang (Four-Substance Decoction), Maidong (Ophiopogon Tuber), Wuweizi (Schisandra Berry), and Gancao (Licorice Root). If frequent and yellow urine, use Siwu Tang (Four-Substance Decoction) with added Shanzhuyu (Cornus Fruit), Huangbai (Phellodendron Bark), Zhimu (Anemarrhena Rhizome), Wuweizi (Schisandra Berry), and Maidong (Ophiopogon Tuber). If Lung deficiency leads to short, scanty urine, use Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment Qi) with added Shanyao (Chinese Yam) and Maidong (Ophiopogon Tuber). If Yin Ting (prolapse) and flaccidity/numbness accompany frequency, cure with Dihuang Wan (Rehmannia Pill).
Seventeenth, discussing deficiency of both Kidney and Bladder, with Cold Qi invading, unable to restrain, thus causing enuresis and incontinence, or spontaneous leakage during sleep.
Jiawei Dihuang Wan (Modified Rehmannia Pill)
Huaishengdihuang (Raw Rehmannia Root from Huaiqing, steamed with wine, 4 liang) Huaishanyao (Chinese Yam from Huaiqing, 2 liang) Mudanpi (Tree Peony Bark, 1.5 liang) Bai Fuling (Poria, 1 liang) Shanzhuyu (Cornus Fruit, steamed with wine, pitted) Poguzhi (Cibotium Barometz, stir-fried, 2 liang) Yizhiren (Bitter Apricot Seed, 1 liang) Renshen (Ginseng Root, 1 liang) Rougui (Cinnamon Bark, 5 qian)
Grind into fine powder. Form pills using refined honey, sized like wu-tong seeds. Take one hundred pills per dose, on an empty stomach, with salted water.
Eighteenth case: Bubbles filling the urinal indicate depletion of Kidney Water. Use Hong Jiguanhua (Red Cockscomb Flower) ground into powder. Take three qian per dose, on an empty stomach, mixed with warm wine.