巢元方曰。诸淋症。皆肾虚所致。肾与膀胱为表里。至水下入小肠。通于胞。行于阴。而为溲。
肾气通于阴。下流之道也。淋有五。曰膏淋。小便有肥脂似膏。浮在上。此肾虚不能制其肥液而下
行也。曰冷淋。先战栗而后小便。此亦肾虚而下焦受冷。冷气入胞。与正气交争。故小便涩而战
栗。曰热淋。下焦有热。热气传于肾。流入于胞。其溺黄多而涩。间有鲜血。曰血淋。热之极也。心
主血。外行经络。内行脏腑。热盛则失其常道。心与小肠表里。故下流入胞。为血淋。曰石淋。肾主
水。水结则化为石。肾为热所乘。遇小便则茎中痛。不得流利。痛引小腹。则沙石从小便出。甚至
寒痛。令人昏闷。遍身有汗而后醒也。并以局方五淋散。下龙脑鸡苏丸。自愈。
刘完素曰。遗尿不禁者。为冷。肾主水。膀胱为津液之腑。肾与膀胱俱虚。而冷气乘之。故不
能拘制其水。出而不禁。谓之遗尿。睡中自出者。名尿床。此皆肾与膀胱俱虚。而挟冷所致也。以
鸡肠散主之。亦有热客于肾部。干于足厥阴之经。廷孔郁结极甚。而气血不能宣通。则痿痹而神
无所用。故液渗入膀胱。而旋溺遗失。不能收禁也。
薛己曰。小便如泔。或良久变白。亦有脾虚食积。湿热下注者。先用茯苓散五七服。次用四味
肥儿丸。
王肯堂曰。小便初出微赤。良久白浊者。乃热疳之邪也。初出黄白。久白浊者。乃冷疳之候
也。冷者益黄散。热者牛黄丸。冷热兼者芦荟丸。纯下白浊者。浓朴丸。
巢元方说：各种淋证，都是由肾虚引起的。肾与膀胱互为表里关系。当水液进入小肠后，通达于胞宫（此处指下焦泌尿生殖区域），流经阴部，从而形成尿液排出。
肾气通于阴部，这是尿液向下排泄的通道。淋证分为五种：第一种叫膏淋，小便中混有像油脂一样的脂状物，漂浮在表面，这是因为肾虚无法固摄脂液导致其下行；第二种叫冷淋，先出现寒战发抖，然后才排尿，这也是因为肾虚且下焦受寒，寒气侵入胞宫，与人体正气相互抗争，所以小便涩滞并伴有寒战；第三种叫热淋，下焦有热邪，热气传导至肾脏，流入胞宫，导致尿液颜色深黄且涩痛，偶尔伴有鲜血；第四种叫血淋，是热邪极盛的表现。心主血脉，外行于经络，内行于脏腑，热邪过盛则使血液失去正常的运行轨道。心与小肠互为表里，所以热邪下流入胞宫，形成血淋；第五种叫石淋，肾主水液，水液凝结就会化为结石。肾脏被热邪侵袭，排尿时尿道疼痛，尿流不畅，疼痛牵引小腹，随后沙石随小便排出，严重时甚至出现寒冷剧痛，使人昏闷，全身出汗后才苏醒。以上情况均使用局方五淋散，配合服用龙脑鸡苏丸，即可自愈。
刘完素说：遗尿且不能控制，属于寒证。肾主水，膀胱是储存津液的腑器。肾与膀胱都虚弱，寒气乘虚而入，所以无法约束水液，导致尿液流出而失控，这叫做遗尿。睡梦中自行排尿的，称为尿床。这些都是肾与膀胱俱虚，且夹杂寒气所致。用鸡肠散主治。也有热邪客居在肾部，干扰足厥阴肝经，导致前阴部位郁结严重，气血不能宣通，从而引起痿痹，神志功能无法正常运用，因此液体渗入膀胱，随即发生溺尿遗失，无法收住。
薛己说：小便像米泔水一样，或者放置许久后变白，也有因脾虚食积、湿热下注引起的。先用茯苓散服用五到七剂，接着服用四味肥儿丸。
王肯堂说：小便刚排出时微红，放置许久后变浑浊发白的，是热疳的邪气所致。刚排出时黄白，久置后变白浊的，是冷疳的征候。属冷的用益黄散，属热的用牛黄丸，冷热兼有的用芦荟丸，纯下白浊的用浓朴丸。
Chao Yuanfang stated: All types of Lin syndrome (stranguria) are caused by Kidney deficiency. The Kidney and Bladder have a interior-exterior relationship. When water enters the Small Intestine, it communicates with the Bao (uterus/lower jiao), flows through the Yin region, and becomes urine for excretion.
Kidney Qi connects to the Yin region, which is the pathway for downward flow. There are five types of Lin syndrome: First is Gao Lin (fatty stranguria), where urine contains lipid-like substances resembling fat floating on the surface; this occurs because Kidney deficiency fails to control the downward flow of fatty fluids. Second is Leng Lin (cold stranguria), characterized by chills preceding urination; this is also due to Kidney deficiency and cold invading the Lower Jiao, where cold Qi enters the Bao and contends with healthy Qi, causing dysuria accompanied by chills. Third is Re Lin (heat stranguria), where heat in the Lower Jiao transmits to the Kidney and flows into the Bao, resulting in dark yellow, dysuric urine, occasionally mixed with fresh blood. Fourth is Xue Lin (blood stranguria), which represents extreme heat. The Heart governs Blood, circulating externally through meridians and internally through zang-fu organs; when heat is excessive, blood loses its normal pathway. Since the Heart and Small Intestine are interior-exterior partners, heat flows downward into the Bao, causing Xue Lin. Fifth is Shi Lin (stone stranguria). The Kidney governs water; when water coagulates, it transforms into stones. If the Kidney is attacked by heat, pain occurs in the urethra during urination, preventing smooth flow. Pain radiates to the lower abdomen, followed by the passage of sand and stones in urine. In severe cases, cold pain may cause faintness, with perspiration over the whole body before recovery. These conditions can be cured by using Ju Fang Wu Lin San (Five Strangurias Powder from the Imperial Pharmacy Formulary) combined with Long Nao Ji Su Wan (Borneol and Perilla Pill).
Liu Wansu stated: Enuresis with inability to control urination belongs to Cold patterns. The Kidney governs Water, and the Bladder is the fu-organ of Jin-Ye (body fluids). When both the Kidney and Bladder are deficient, cold Qi takes advantage, making them unable to restrain water, leading to involuntary leakage, termed enuresis. Nocturnal enuresis occurring during sleep is called bedwetting. These are all caused by dual deficiency of the Kidney and Bladder complicated by cold. Treat with Ji Chang San (Chicken Intestine Powder). Alternatively, if heat pathogen lodges in the Kidney region and interferes with the Foot Jueyin Liver Meridian, causing severe stagnation at the anterior orifice (Yin Kou), Qi and Blood cannot circulate freely. This leads to flaccidity and numbness, rendering Shen (spirit/mind) ineffective, so fluids seep into the Bladder, resulting in sudden urinary loss that cannot be controlled.
Xue Ji stated: Urine resembling rice washings, or turning white after some time, may also result from Spleen deficiency with food retention and damp-heat pouring downward. Initially administer Fu Ling San (Poria Powder) for five to seven doses, followed by Si Wei Fei Er Wan (Four-Ingredient Child-Nourishing Pill).
Wang Kentang stated: Urine initially slightly red, becoming turbid and white after standing, indicates pathogenic factors of Heat Gan (childhood malnutrition/parasitic disease). Urine initially yellow-white, becoming turbid and white after standing, indicates Cold Gan. For cold patterns, use Yi Huang San (Benefit Yellow Powder); for heat patterns, use Niu Huang Wan (Calculus Bovis Pill); for mixed cold-heat patterns, use Lu Hui Wan (Aloe Vera Pill); for pure white turbidity, use Hou Po Wan (Magnolia Bark Pill).