膀胱主水,水入于胞为溲便。若饮食不节,喜怒不时,虚实不调,则脏不知,致肾虚膀胱有热,肾
虚则小便数,膀胱热则水涩而数,涩则淋沥不宣,故曰淋。小腹弦急,痛引于脐。又须分石、膏、血、劳、
气、冷。其石淋,如沙石;膏淋,肥腻若脂膏,又名肉淋;血淋,心主血,气通小肠,热甚则抟于血脉,
血得热则流行于胞中与溲俱下;劳淋,劳倦则发;气淋,胞内气账,小腹坚满,出少喜数,尿有余沥;冷淋,
冷气客于下焦,邪正交争,满于胞内,水道不宣,先寒颤,然后便溺成淋∶可谓得其病情矣。《内经》病
因又不止此,若太阴作初气,病中热胀,脾受积湿之气,小
便黄赤,甚则淋。少阳作二气,风火郁于上而热甚,病淋。盖五脏六腑、十二经脉,气皆相通移,是
故足太阳主表,上行则统主诸阳之气,下行则入膀胱。又肺者通调水道,下输膀胱,脾胃消化水谷,或在
表在上在中。凡有热则水液皆热,转输下之,然后膀胱得之而热矣!且小肠是心之腑,主热者也,其水
必自小肠渗入胞中。诸热应于心者,其小肠必热,胞受其热,经谓胞移热于膀胱,则癃溺血是也。是知初起
之热邪不一。皆得传于膀胱而成淋,故淋症必治其本,若止治胞中之热,未为善也。夫淋必由热甚生湿,
湿生则水液混浊,凝结为淋。又有服金石入房太甚,败精流于胞中,及饮食痰积渗入者,皆能成淋。先生治
小儿,在胎禀父母金石余毒之气,病淋十五年,治以紫雪而愈。凡治病必求其本也。
膀胱主管水液代谢,水进入胞中形成尿液。如果饮食没有节制,喜怒情绪调节不当,导致身体虚实失衡,脏腑功能就会失调,致使肾虚且膀胱有热。肾气虚弱则小便频数,膀胱有热则水道涩滞且频数,涩滞导致排尿淋漓不畅,所以称为“淋”。症状表现为小腹拘急紧绷,疼痛牵引至肚脐。此外,还需要区分石淋、膏淋、血淋、劳淋、气淋、冷淋这六种类型。其中,石淋的症状如同排出沙石;膏淋排出的液体肥腻像脂膏一样,又被称为肉淋;血淋方面,心主血脉,其气通于小肠,当热邪极盛时凝聚于血脉之中,血液受热后运行至胞中与尿液一同排出;劳淋在劳累疲倦时发作;气淋表现为胞内气机胀满,小腹坚硬饱满,排尿量少且次数频繁,尿后有余沥不尽之感;冷淋则是冷气客居于下焦,邪气与正气相互交争,充满于胞内,导致水道不通畅,先出现寒战,随后才发生排尿成淋的情况:这些描述可以说已经掌握了该病的病情特点了。《内经》中关于病因的论述不止于此,例如太阴湿土作为初之气时,病证表现为腹部胀满发热,脾脏受到积滞湿气的影响,小便黄赤,严重时发展为淋证。少阳相火作为二之气时,风火郁结于上部而热势亢盛,病证为淋证。因为五脏六腑、十二经脉的气机都是相通流转的,所以足太阳经主司体表,向上运行则统率诸阳之气,向下运行则进入膀胱。另外,肺脏负责疏通和调节水道,将水液向下输送到膀胱,脾胃负责消化水谷,其功能可能表现在体表、上部或中部。凡是体内有热,水液都会变热,经过转输下行,然后膀胱受到热邪影响而产生热症。而且小肠是心的腑,主司热邪,其水液必然从小肠渗入胞中。所有与心相应的热邪,会导致小肠必热,胞受其热,《内经》说“胞移热于膀胱”,就会出现小便不利(癃)和尿血的症状。由此可知,初起的热邪来源不一,但都能传变至膀胱从而形成淋证,所以治疗淋证必须治其根本,如果仅仅治疗胞中的热邪,并不是好的治疗方法。夫淋证必定是由热盛生湿,湿产生则导致水液混浊,凝结而成淋证。又有服用金石类药物且房事过度,败精流入胞中,以及饮食痰积渗入胞中的情况,都能形成淋证。戴先生治疗一名小儿,因禀受父母服用金石类药物后的余毒之气,患淋证长达十五年,使用紫雪丹治疗而痊愈。大凡治病,必须探求其根本原因。
The Bladder (Pang Guang) governs water metabolism; when water enters the Bao (Uterus/Bladder sac), it becomes urine. If dietary habits are irregular, emotions such as joy and anger are not regulated properly, leading to an imbalance of deficiency and excess, the Zang organs will fail to function correctly. This results in Kidney deficiency with Heat in the Bladder. Kidney deficiency causes frequent urination, while Heat in the Bladder causes urinary obstruction and frequency. The obstruction leads to dribbling and incomplete voiding, hence the term "Lin Syndrome" (Grainy or Dribbling Urination). Symptoms include tightness and urgency in the lower abdomen, with pain radiating to the umbilicus. Furthermore, one must differentiate between Stone Lin (Shi Lin), Paste Lin (Gao Lin), Blood Lin (Xue Lin), Fatigue Lin (Lao Lin), Qi Lin (Qi Lin), and Cold Lin (Leng Lin). In Stone Lin, the discharge resembles sand or stones; in Paste Lin, the discharge is greasy like fat or paste, also known as Flesh Lin (Rou Lin); regarding Blood Lin, the Heart governs blood, and its Qi connects to the Small Intestine; when Heat is severe, it coagulates in the blood vessels, and blood, heated by the pathogen, flows into the Bao and is discharged together with urine; Fatigue Lin manifests upon physical exhaustion; Qi Lin presents with distension of Qi within the Bao, hardness and fullness of the lower abdomen, small volume but frequent urination, and residual dripping after voiding; Cold Lin occurs when Cold Qi lodges in the Lower Jiao, where Evil and Righteous Qi contend, filling the Bao, obstructing the water passages, causing chills first, followed by dribbling urination: these descriptions can be said to have grasped the pathology of the disease. The *Neijing* (Classic of Internal Medicine) does not limit etiologies to these alone. For instance, when Taiyin (Too Yin) acts as the initial Qi phase, the disease presents with abdominal heat and distension; the Spleen is affected by accumulated dampness, causing yellow-red urine, which may progress to Lin syndrome. When Shaoyang (Lesser Yang) acts as the second Qi phase, Wind-Fire stagnates upward causing severe Heat, resulting in Lin syndrome. Since the Qi of the Five Zang and Six Fu organs and the Twelve Meridians is interconnected and circulating, the Foot-Taiyang (Greater Yang) meridian governs the exterior; ascending, it commands the Qi of all Yang meridians; descending, it enters the Bladder. Moreover, the Lung regulates and unblocks the water passages, transporting fluids downward to the Bladder. The Spleen and Stomach digest food and fluids; their functions may manifest at the exterior, upper, or middle Jiao. Whenever there is Heat, body fluids become hot, are transported downward, and thus the Bladder acquires Heat. Additionally, the Small Intestine is the Fu organ of the Heart and governs Heat; its fluids necessarily seep from the Small Intestine into the Bao. All Heat corresponding to the Heart causes the Small Intestine to be hot; the Bao receives this Heat. As stated in the classics, "when Heat transfers from the Bao to the Bladder," it results in difficult urination (Long) and hematuria. Thus, it is known that the initial pathogenic Heat sources vary, but all can transmit to the Bladder to form Lin syndrome. Therefore, treating Lin syndrome requires addressing the root cause; merely treating the Heat in the Bao is insufficient. Lin syndrome inevitably arises from severe Heat generating Dampness; when Dampness is produced, body fluids become turbid, congealing to form Lin. There are also cases where excessive consumption of mineral drugs and sexual indulgence lead to degenerated essence flowing into the Bao, or where phlegm and food retention seep in, all capable of causing Lin syndrome. Master Dai treated a child who, due to inheriting the residual toxic Qi from parents' consumption of mineral substances, suffered from Lin syndrome for fifteen years, and cured him using Zi Xue San (Purple Snow Powder). In all medical treatment, one must seek the root cause.