薛立斋曰∶经云∶膀胱不约为遗溺。小便不禁，常常出而不觉也。人之漩溺，赖心肾二
气之所传送。盖心与小肠为表里，肾与膀胱为表里，若心肾气亏，传送失度，故有此证，治
宜温暖下元，清心寡欲。又有产育不顺，致伤膀胱，若内虚寒者，秘元丹、韭子丸之类；若
内虚湿热者，六味地黄丸，或加五味、杜仲、补骨脂；年老者，八味丸。产育收生不谨，损
破尿胞者，参术补胞汤加猪羊胞煎之。窃谓肝主小便，若肝经血虚，用四物山栀。若小便涩
滞，或茎中作痛，属肝经湿热，用龙胆泻肝汤。若小便频数，或劳而益甚，属脾气虚弱，用
补中益气汤加山药、五味子。若小便无度，或淋沥不禁，乃阴挺痿痹也，用六味地黄丸。若
小便涩滞，或补而益甚，乃膀胱热结也，用五淋散。其脾肺燥，不能化生者，黄芩清肺饮。
膀胱阴虚，阳无所生者，滋肾丸。膀胱阳虚，阴无所化者，六味丸。若阴痿思色，精不出，
茎道涩痛如淋，用加减八味丸料加车前、牛膝。若老人精竭复耗，大小便牵痛如淋，亦用前
药，不应，急加附子，多有生者。
理中汤（热一） 温胃饮（新热五） 四味回阳饮（新热一） 右归饮（新补三） 八味丸（补
一二一） 六味回阳饮（新热二） 四维散（新热十二） 滋肾丸（寒一六三） 补中益气汤（补三
十） 归脾汤（补三二） 固脬丸（固六三） 大菟丝子丸（固三六） 二气丹（热一八六） 五子
丸（固四六） 济生菟丝丸（固三七） 缩泉丸（固六一） 五淋散（寒百十七） 参术补胞汤（未
收） 秘元丹（固三二） 牡蛎丸（固六四） 茴香益智丸（固六五） 固真散（固二八） 大补
元煎（新补一） 加减八味丸（补一二二） 家韭子丸（固三四） 五君子煎（新热六） 黄芩清肺
饮（寒八三） 龙胆泻肝汤（寒六三） 《集要》四神丸（补一五八） 巩堤丸（新固九）
薛立斋说：医经记载：膀胱约束功能失常会导致遗尿。小便失禁，是指尿液常常不由自主地流出而本人没有察觉。人的尿液排泄，依赖于心气和肾气的传导与推动。因为心与小肠互为表里，肾与膀胱互为表里，如果心气、肾气亏虚，传导功能失去节制，所以出现这种病症，治疗应当温补下焦元气，清心寡欲。又有因分娩不顺，导致损伤膀胱的情况，如果是体内虚寒的，可用秘元丹、韭子丸之类的方剂；如果是体内虚兼有湿热的，可用六味地黄丸，或者加入五味子、杜仲、补骨脂；对于年老体弱者，用八味丸。因接生不慎，破损膀胱（尿胞）的，用参术补胞汤加猪羊膀胱煎服。我认为肝主司小便，如果肝经血虚，用四物汤加山栀。如果小便涩滞不畅，或尿道中疼痛，属于肝经湿热，用龙胆泻肝汤。如果小便频数，或劳累后加重，属于脾气虚弱，用补中益气汤加山药、五味子。如果小便无度，或淋漓不禁，这是阴挺痿痹的症状，用六味地黄丸。如果小便涩滞，或经过补益治疗后反而加重，这是膀胱热结所致，用五淋散。脾肺燥热，不能化生津液的，用黄芩清肺饮。膀胱阴虚，阳气无法生成的，用滋肾丸。膀胱阳虚，阴液无法转化的，用六味地黄丸。如果因阳痿而思慕色欲，精液排不出，尿道涩痛如淋证，用加减八味丸料加车前子、牛膝。如果老人精气枯竭又受耗损，大小便牵拉疼痛如淋证，也用上述药物，如果无效，紧急加入附子，多有救活的。
理中汤（热一） 温胃饮（新热五） 四味回阳饮（新热一） 右归饮（新补三） 八味丸（补一二一） 六味回阳饮（新热二） 四维散（新热十二） 滋肾丸（寒一六三） 补中益气汤（补三十） 归脾汤（补三二） 固脬丸（固六三） 大菟丝子丸（固三六） 二气丹（热一八六） 五子丸（固四六） 济生菟丝丸（固三七） 缩泉丸（固六一） 五淋散（寒百十七） 参术补胞汤（未收） 秘元丹（固三二） 牡蛎丸（固六四） 茴香益智丸（固六五） 固真散（固二八） 大补元煎（新补一） 加减八味丸（补一二二） 家韭子丸（固三四） 五君子煎（新热六） 黄芩清肺饮（寒八三） 龙胆泻肝汤（寒六三） 《集要》四神丸（补一五八） 巩堤丸（新固九）
Xue Lizhai stated: The medical classics record: Incontinence of urine (Yi Ni) occurs when the bladder fails to maintain its constraining function. Urinary incontinence refers to the involuntary leakage of urine without the patient's awareness. The excretion of urine relies on the transmission and propulsion of Heart Qi and Kidney Qi. Since the Heart and Small Intestine are interior-exteriorly related, and the Kidney and Bladder are interior-exteriorly related, if Heart Qi and Kidney Qi are deficient, leading to a loss of control over transmission, this condition arises. Treatment should focus on warming the lower Yuan (Primordial Origin) and clearing the Heart while reducing desires. Additionally, difficult childbirth may cause injury to the Bladder. If there is internal deficiency-cold, formulas such as Miyuan Dan (Secreted Essence Pill) or Jiu Zi Wan (Leek Seed Pill) may be used; if there is internal deficiency with damp-heat, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) can be used, possibly added with Wuweizi (Schisandra), Duzhong (Eucommia), or Buguzhi (Psoralea). For elderly patients, Bawei Wan (Eight-Ingredient Pill) is indicated. If the bladder (urinary sac) is damaged due to careless midwifery, Shenzhu Baopao Tang (Ginseng and Atractylodes Bladder-Reinforcing Decoction) decocted with pig or sheep bladders should be administered. I hold that the Liver governs urination. If there is Blood deficiency in the Liver Meridian, Siwu Tang (Four-Substance Decoction) added with Zhizi (Gardenia) is used. If urination is obstructed or painful in the urethra, it belongs to damp-heat in the Liver Meridian, treated with Longdan Xiegan Tang (Gentian Decoction to Drain the Liver). If urination is frequent or worsens with exertion, it belongs to Spleen Qi deficiency, treated with Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) added with Shanyao (Dioscorea) and Wuweizi (Schisandra). If urination is uncontrolled or dribbles involuntarily, this is Yin Ting Wei Bi (prolapse and flaccidity), treated with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). If urination is obstructed or worsens after supplementation, it indicates heat accumulation in the Bladder, treated with Wulin San (Five-Difficulty Powder). If Spleen and Lung dryness prevents transformation, Huangqin Qingfei Yin (Scutellaria Lung-Clearing Infusion) is used. If Bladder Yin deficiency leads to an inability to generate Yang, Zishen Wan (Kidney-Nourishing Pill) is indicated. If Bladder Yang deficiency leads to an inability to transform Yin, Liuwei Wan (Six-Ingredient Pill) is used. If impotence involves longing for sexual gratification but ejaculation does not occur, accompanied by urethral pain resembling strangury, Jiaban Bawei Wan Liao (Modified Eight-Ingredient Pill Material) added with Cheqianzi (Plantago Seed) and Niuxi (Achyranthes Root) is used. If elderly patients suffer from exhaustion of essence and further depletion, causing pulling pain in both large and small bowel movements resembling strangury, the aforementioned medicines are also used; if ineffective, Fuzi (Aconite) should be urgently added, often resulting in survival.
Lizhong Tang (Regulate the Middle Decoction) [Re 1] Wenwei Yin (Warm Stomach Infusion) [New Re 5] Sima Huiyang Yin (Four-Ingredient Return-Yang Infusion) [New Re 1] Yougui Yin (Right-Restoring Infusion) [New Ton 3] Bawei Wan (Eight-Ingredient Pill) [Ton 121] Liuhui Huiyang Yin (Six-Return Return-Yang Infusion) [New Re 2] Siwei San (Four-Extremities Powder) [New Re 12] Zishen Wan (Kidney-Nourishing Pill) [Cold 163] Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) [Ton 30] Guipi Tang (Restore the Spleen Decoction) [Ton 32] Gupao Wan (Bladder-Securing Pill) [Sec 63] Datiansizi Wan (Great Cuscuta Pill) [Sec 36] Erqi Dan (Two-Qi Elixir) [Re 186] Wuzi Wan (Five-Seed Pill) [Sec 46] Jisheng Tiansi Wan (Life-Preserving Cuscuta Pill) [Sec 37] Suoquan Wan (Water-Constricting Pill) [Sec 61] Wulin San (Five-Difficulty Powder) [Cold 117] Shenzhu Baopao Tang (Ginseng and Atractylodes Bladder-Reinforcing Decoction) [Not Collected] Miyuan Dan (Secreted Essence Pill) [Sec 32] Moli Wan (Oyster Shell Pill) [Sec 64] Huixiang Yizhi Wan (Fennel and Alpinia Pill) [Sec 65] Guzhen San (Secure the True Powder) [Sec 28] Dabu Yuanjian (Great Tonification of the Primal Decoction) [New Ton 1] Jiaban Bawei Wan (Modified Eight-Ingredient Pill) [Ton 122] Jiajiu Zi Wan (Home Leek Seed Pill) [Sec 34] Wujunzi Jian (Five-Gentlemen Decoction) [New Re 6] Huangqin Qingfei Yin (Scutellaria Lung-Clearing Infusion) [Cold 83] Longdan Xiegan Tang (Gentian Decoction to Drain the Liver) [Cold 63] "Jiyao" Sishen Wan (Essential Collection Four-Spirit Pill) [Ton 158] Gongdi Wan (Embankment-Securing Pill) [New Sec 9]