经曰∶膀胱者，州都之官，津液藏焉，气化则能出矣。又曰∶膀胱不利为癃，不约为遗溺。又曰∶肝有热则
小便先赤。陈飞霞曰∶凡小便赤涩为热，小便自遗为寒。热者火有余，水不足，治宜泻心火，滋肾水，加味导
赤散。寒者火不足，水有余，治宜温肾水，益心火，益智散。小便不通，乃由肾脏气虚，受热壅滞，宣化不行，
非塞非痛，但闭而不痛，腹胀紧满，宜五苓散加车前、灯心。大病之后，气虚津液不足，而小便闭者，不可利之。
利则中气日虚，津液愈涸，宜人参散。小儿患淋，小便淋沥作痛，不必分五种，然皆属于火热，宜清利之，海
金砂散。小儿久病气虚而淋病者，不可利小便，宜六味地黄丸，滋其化源。小便自出而不禁者，谓之遗尿；睡
中自出者，谓之尿床。此皆肾与膀胱虚寒也，益智散加附桂龙骨。
小便初起黄赤，落地良久，凝如白膏者，谓之尿白。伤脾所致，久而成疳，胃苓散盐汤下。
小儿小便出时，色白混浊，随尿而来，谓之白浊。此心经虚热，宜清心莲子饮。
加味导赤散 治心热肝热，小便赤涩用。
木通 生地 炙甘草 枯黄芩 黑栀仁 泽泻 柴胡（各一钱） 淡竹叶（七片） 灯心（十根）
水煎，空心热服。
益智散 治水有余，火不足，而遗溺用。
益智（五钱，盐水炒） 补骨脂（三钱，盐水炒） 茯苓（五钱，酒炒）
上共细末，每服一钱，盐水调下。
五苓散 （见前咳嗽方内。）
《集成》人参散 治气虚津液不足，小便不通用。
人参（一钱） 麦冬（一钱） 黄柏（一钱） 炙甘草（一钱） 生姜（一钱）
《集成》海金砂散 治小儿诸淋，皆属于热。
香附米（酒炒） 川芎（酒炒） 赤茯苓（酒炒，各五钱） 海金砂（一两） 滑石（一两，小飞）
陈枳壳 泽泻（炒） 石苇（焙） 槟榔（炒。各二钱）
上共为细末，每服一钱，淡盐汤调下。
六味地黄丸（见前喘哮方内）
《集成》清心莲子饮 专治白浊。
茯苓（一钱五分） 建莲子（二钱） 益智仁（一钱） 寸冬 人参 远志肉 石菖蒲 车前子（各五分）
白术（六分） 泽泻（四分） 甘草（五分） 灯心（十茎）
水煎，空心服。
胃苓汤 （见前泄泻方内）
涂蔚生曰∶浊固关于小便病症之一种，而飞霞所举之清心莲子饮，则未可治浊之要药。今将唐容川之白浊症
论简略治法，妥善者摘入，以为治浊之补助。容川曰∶浊者小便不清，或白、或黄、或青、或赤。此如暑天洪水
泥潦之类，乃湿热为之也。湿甚用胃苓汤，加黄芩、黄连、黄柏、白芍治之，热甚用茵陈蒿、栀子、黄柏、秦皮、
木通、车前子、防己、甘草梢治之。又有败精为浊者，或由思淫不遂，或由淫而精停，治宜萆 厘清饮加鹿角
屑、桑螵蛸、白芍、肉苁蓉治之。本其前者，以为加减，颇为治浊良方。至其后者之浊，诚为少数云耳。
胃芩汤（见前泄泻方内）
萆 厘清饮
萆 （三钱） 菖蒲（一钱） 甘草梢（一钱） 乌药（一钱） 益智（五分） 青盐（一钱）
《黄帝内经》说：膀胱是州都之官，津液在此储藏，经过气化作用才能排出。又说：膀胱气化不利则导致癃闭（小便不通），约束无力则导致遗溺（尿失禁）。还说：肝脏有热则小便先变红赤。陈飞霞说：凡是小便红赤涩痛属于热证，小便自行遗出属于寒证。热证是火有余而水不足，治疗应当泻心火、滋肾水，使用加味导赤散。寒证是火不足而水有余，治疗应当温肾水、益心火，使用益智散。小便不通，是由于肾脏气虚，受热邪壅滞，宣发肃降功能不行，并非堵塞也非疼痛，只是闭塞而不痛，伴有腹胀紧满，适宜用五苓散加车前子、灯心草。大病之后，气虚津液不足而导致小便闭结的，不可使用利尿药。如果利尿，会使中气日益虚弱，津液更加枯竭，适宜用人参散。小儿患淋证，小便淋漓作痛，不必区分五种类型，但都属于火热之邪，适宜清利湿热，使用海金砂散。小儿久病气虚而患淋证的，不可利尿，适宜用六味地黄丸，以滋养化源。小便自行流出且不受控制的，称为遗尿；睡眠中自行流出的，称为尿床。这些都属于肾与膀胱虚寒，可用益智散加附子、肉桂、龙骨。
小便初起黄赤，落地良久，凝结如白膏样的，称为尿白。这是损伤脾脏所致，日久可发展为疳积，可用胃苓散配合盐汤送服。
小儿小便排出时，颜色白而混浊，随尿而来，称为白浊。这是心经虚热所致，适宜用清心莲子饮。
加味导赤散：治疗心热肝热，小便红赤涩痛。
木通、生地、炙甘草、枯黄芩、黑栀仁、泽泻、柴胡（各一钱）、淡竹叶（七片）、灯心（十根）。
水煎，空腹热服。
益智散：治疗水有余、火不足，以及遗溺。
益智仁（五钱，盐水炒）、补骨脂（三钱，盐水炒）、茯苓（五钱，酒炒）。
以上共研为细末，每次服用一钱，用盐水调下。
五苓散：（见前文咳嗽方剂内。）
《集成》人参散：治疗气虚津液不足，小便不通。
人参（一钱）、麦冬（一钱）、黄柏（一钱）、炙甘草（一钱）、生姜（一钱）。
《集成》海金砂散：治疗小儿各种淋证，皆属于热。
香附米（酒炒）、川芎（酒炒）、赤茯苓（酒炒，各五钱）、海金砂（一两）、滑石（一两，小飞）、陈枳壳、泽泻（炒）、石苇（焙）、槟榔（炒，各二钱）。
以上共为细末，每次服用一钱，用淡盐汤调下。
六味地黄丸：（见前文喘哮方剂内。）
《集成》清心莲子饮：专门治疗白浊。
茯苓（一钱五分）、建莲子（二钱）、益智仁（一钱）、寸冬、人参、远志肉、石菖蒲、车前子（各五分）、白术（六分）、泽泻（四分）、甘草（五分）、灯心（十茎）。
水煎，空腹服用。
胃苓汤：（见前文泄泻方剂内。）
涂蔚生说：浊证固然是小便病症的一种，但陈飞霞所列举的清心莲子饮，并不是治疗浊证的关键药物。现将唐容川关于白浊症的论述及简略治法中妥善者摘录进来，作为治疗浊证的辅助。唐容川说：浊证是小便不清，或白、或黄、或青、或赤。这就像暑天洪水泥泞一样，是由湿热引起的。湿重者用胃苓汤，加黄芩、黄连、黄柏、白芍治疗；热重者用茵陈蒿、栀子、黄柏、秦皮、木通、车前子、防己、甘草梢治疗。又有因败精导致浊证的，有的因思淫不遂，有的因行房后精液停滞，治疗适宜用萆薢分清饮加鹿角屑、桑螵蛸、白芍、肉苁蓉治疗。根据前面的情况加以加减，是很好的治疗浊证的方子。至于后面的那种浊证，确实为数很少。
胃芩汤：（见前文泄泻方剂内。）
The *Huangdi Neijing* states: The Bladder is the official of the "State Capital" (Zhou Du), where body fluids are stored; only through Qi transformation can they be excreted. It also states: When Bladder Qi transformation is impaired, it leads to Long syndrome (urinary retention); when its constraining function is deficient, it leads to Yi Niao (urinary incontinence). Furthermore, it states: If there is heat in the Liver, the urine will first become red and dark. Chen Feixia stated: Whenever urine is red, dark, and difficult to pass, it indicates Heat; spontaneous urinary leakage indicates Cold. Heat syndromes involve excess Fire and deficient Water; treatment should focus on draining Heart Fire and nourishing Kidney Water, using Jiawei Daochi San (Modified Guide Out Red Decoction). Cold syndromes involve deficient Fire and excess Water; treatment should focus on warming Kidney Water and benefiting Heart Fire, using Yizhi San (Yi Zhi Ren Powder). Urinary obstruction arises from Kidney Qi deficiency combined with Heat pathogen stagnation, impairing diffusion and transformation. It is not caused by blockage or pain, but rather by closure without pain, accompanied by abdominal distension and tightness; Wuling San (Five-Ingredient Powder with Poria) added with Cheqianzi (Plantago Seed) and Dengxincao (Juncus Effusus) is appropriate. After a severe illness, if urinary obstruction occurs due to Qi deficiency and insufficient body fluids, diuretics must not be used. Using diuretics would further deplete Middle Qi and dry up body fluids; Renshen San (Ginseng Powder) is appropriate. For children suffering from Lin syndrome (strangury), characterized by dribbling and painful urination, it is unnecessary to distinguish among the five types, as all belong to Fire-Heat; clear and promote urination using Haijinsha San (Lysimachiae Powder). For children with chronic illness leading to Qi deficiency and subsequent Lin syndrome, diuretics should not be used; Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) should be used to nourish the source of transformation. Spontaneous, uncontrolled urination is called Yi Niao (enuresis/incontinence); involuntary urination during sleep is called Nao Chuang (bedwetting). These all indicate deficiency-cold of the Kidney and Bladder; Yizhi San added with Fuzi (Aconite), Rougui (Cinnamon Bark), and Longgu (Fossilized Bones) is appropriate.
If urine is initially yellow-red and coagulates into a white paste-like substance after remaining on the ground for some time, it is called Niao Bai (white urine). This results from Spleen injury and may develop into Gan disease (malnutrition syndrome) over time; Weiling San (Weiling Decoction) taken with salt water is appropriate.
When a child's urine is white and turbid upon discharge, coming along with the stream, it is called Bai Zhuo (white turbidity). This is caused by deficiency-heat in the Heart channel; Qingxin Lianzi Yin (Clear Heart Lotus Seed Decoction) is appropriate.
**Jiawei Daochi San (Modified Guide Out Red Decoction):** Treats Heart and Liver heat causing red, dark, and difficult urination.
Mu Tong (Akebia Caulis), Sheng Di Huang (Rehmanniae Radix), Zhi Gan Cao (Prepared Licorice Root), Ku Huang Qin (Scutellaria Root), Hei Zhi Ren (Black Gardenia Seed), Ze Xie (Alisma Rhizome), Chai Hu (Bupleuri Radix) (each 1 qian), Dan Zhu Ye (Lophatherum Herb) (7 leaves), Deng Xin Cao (Junci Medullae) (10 stems).
Decoct in water, take warm on an empty stomach.
**Yizhi San (Yi Zhi Ren Powder):** Treats excess Water, deficient Fire, and urinary incontinence.
Yi Zhi Ren (Alpiniae Oxyphyllae Fructus) (5 qian, stir-fried with salt water), Bu Gu Zhi (Psoraleae Fructus) (3 qian, stir-fried with salt water), Fu Ling (Poria) (5 qian, stir-fried with wine).
Grind into fine powder, take 1 qian per dose, mixed with salt water.
**Wuling San (Five-Ingredient Powder with Poria):** (See formula for cough mentioned previously.)
**Renshen San (Ginseng Powder) from *Jicheng*:** Treats urinary obstruction due to Qi deficiency and insufficient body fluids.
Ren Shen (Ginseng Radix et Rhizoma) (1 qian), Mai Dong (Ophiopogonis Tuber) (1 qian), Huang Bo (Phellodendri Cortex) (1 qian), Zhi Gan Cao (Prepared Licorice Root) (1 qian), Sheng Jiang (Fresh Ginger Rhizome) (1 qian).
**Haijinsha San (Lysimachiae Powder) from *Jicheng*:** Treats various Lin syndromes in children, all belonging to Heat.
Xiang Fu Mi (Cyperi Rhizoma) (wine-fried), Chuan Xiong (Ligustici Chuanxiong Rhizoma) (wine-fried), Chi Fu Ling (Red Poria) (wine-fried, each 5 qian), Hai Jin Sha (Lygodii Spora) (1 liang), Hua Shi (Talcum) (1 liang, finely processed), Chen Zhi Ke (Aurantii Fructus Pericarpium), Ze Xie (Alisma Rhizome) (stir-fried), Shi Wei (Pyrrosiae Folium) (baked), Bing Lang (Arecae Semen) (stir-fried, each 2 qian).
Grind into fine powder, take 1 qian per dose, mixed with light salt water.
**Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill):** (See formula for asthma/wheezing mentioned previously.)
**Qingxin Lianzi Yin (Clear Heart Lotus Seed Decoction) from *Jicheng*:** Specifically treats Bai Zhuo (white turbidity).
Fu Ling (Poria) (1.5 qian), Jian Lian Zi (Nelumbinis Semen) (2 qian), Yi Zhi Ren (Alpiniae Oxyphyllae Fructus) (1 qian), Cun Dong (Ophiopogonis Tuber), Ren Shen (Ginseng Radix et Rhizoma), Yuan Zhi Rou (Polygalae Radix flesh), Shi Chang Pu (Acori Tatarinowii Rhizoma), Che Qian Zi (Plantaginis Semen) (each 0.5 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (0.6 qian), Ze Xie (Alisma Rhizome) (0.4 qian), Gan Cao (Licorice Root) (0.5 qian), Deng Xin Cao (Junci Medullae) (10 stems).
Decoct in water, take on an empty stomach.
**Weiling Tang (Weiling Decoction):** (See formula for diarrhea mentioned previously.)
Tu Weisheng stated: Turbidity syndromes are indeed a type of urinary disorder, but the Qingxin Lianzi Yin cited by Feixia is not the primary herb for treating turbidity. I have excerpted concise and appropriate treatments from Tang Rongchuan's discussion on Bai Zhuo syndrome to serve as auxiliary treatment for turbidity. Tang Rongchuan stated: Turbidity refers to unclear urine, which may be white, yellow, green, or red. This is like muddy floodwaters in summer, caused by Damp-Heat. For severe Dampness, use Weiling Tang added with Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Huang Bo (Phellodendri Cortex), and Bai Shao (Paeoniae Radix Alba). For severe Heat, use Yin Chen Hao (Artemisiae Scopariae Herba), Zhi Zi (Gardeniae Fructus), Huang Bo (Phellodendri Cortex), Qin Pi (Fraxini Cortex), Mu Tong (Akebiae Caulis), Che Qian Zi (Plantaginis Semen), Fang Ji (Stephaniae Tetrandrae Radix), and Gan Cao Shao (Licorice Root tip). There is also turbidity caused by stale essence, resulting from unfulfilled sexual desire or retained semen after intercourse; treatment should use Bi Xie Fen Qing Yin (Bi Xie Clarifying Turbidity Decoction) added with Lu Jiao Xie (Deer Horn Chips), Sang Piao Xiao (Mantis Egg Case), Bai Shao (Paeoniae Radix Alba), and Rou Cong Rong (Cistanche Stem). Based on previous conditions, these can be modified and constitute an excellent formula for treating turbidity. The latter type of turbidity is indeed rare.
**Weiqin Tang:** (See formula for diarrhea mentioned previously.)
**Bixie Fenqing Yin (Bi Xie Clarifying Turbidity Decoction)**
Bi Xie (Dioscoreae Hypoglaucae Rhizoma) (3 qian), Chang Pu (Acori Tatarinowii Rhizoma) (1 qian), Gan Cao Shao (Licorice Root tip) (1 qian), Wu Yao (Linderae Radix) (1 qian), Yi Zhi (Alpiniae Oxyphyllae Fructus) (0.5 qian), Qing Yan (Rock Salt) (1 qian).