通关丸
热实不化大便硬,癃闭八正木香痊,阳虚不化多厥冷,恶寒金匮肾气丸。阴虚不化
发午热,不渴知柏桂通关,气虚不化不急满,倦怠懒言春泽煎。
【注】小便不通∶热实者,宜用八正散加木香。阳虚者,宜用金匮肾气丸。阴虚者,宜
用通关丸,即知母、黄柏、肉桂少许也。气虚宜用春泽汤,即五苓散加人参也。
八正散
石淋犹如 结铛,是因湿热炼膀胱,一切热淋八正扁,通滑栀瞿草车黄。
【注】八正散,即 蓄、木通、瞿麦、栀子、滑石、甘草、车前子、大黄也。
小蓟饮子
血淋心遗热小肠,实热仍宜下之良,清热小蓟栀滑淡,归藕通蒲草地黄。
【注】淡,淡竹叶也。藕,藕节也。蒲,蒲黄也。
海金沙散 鹿角霜丸
膏淋尿浊或如涕,精尿俱出海草滑,热盛八正加苍术,虚用秋苓鹿角佳。
【注】海,海金沙也,秋,秋石也。苓,茯苓也。鹿角,鹿角霜。糯米糊为丸也。
加味八正散
气淋肺热难清肃,八正石韦木葵沉,内伤气虚不能化,五苓益气自通神。
【注】八正散,加石韦、木香、冬葵子、沉香、五苓,合补中益气汤。
补中益气汤合五苓散 清心莲子饮
劳淋内伤补中苓,肾气知柏过淫成,劳心清心莲地骨, 芩车麦草参苓。
【注】内伤劳脾,用补中益气汤合五苓散。劳肾阳虚,用金匮肾气汤。阴虚,用知柏地
黄汤。思虑劳心,用清心莲子饮,是方即莲子、地骨皮、黄 、黄芩、车前子、麦门冬、
生甘草、人参、白茯苓也。
琥珀散
痰淋七气白丸子,热燥清热用滋阴,诸淋平剂琥珀木,葵蓄通滑归郁金。
【注】七气汤见诸气门。青州白丸子见类中风门。滋阴,通关丸也。木,木香也。葵,
冬葵子也。
桂附地黄丸 补中益气汤加白果方 坎离既济汤加山萸肉五味子方
遗尿不禁淋尿白,桂附补中白果煎,补之不应或尿赤,生地知柏萸味攒。
【注】遗尿不禁,及诸淋、尿色白者,皆属寒虚。寒者,用桂附地黄汤加白果。虚者,
用补中益气汤加白果。凡遗尿不禁、诸淋、尿色赤者,或补之不应者,亦有热虚,用坎离
既济汤,即生地、知母、黄柏,加山萸肉、五味子也。
通关丸
热实导致气化不利,大便干硬,癃闭(小便不通)可用八正散加木香治愈;阳虚导致气化不利,多伴有四肢厥冷、恶寒,宜用金匮肾气丸治疗;阴虚导致气化不利,发于午后的发热,口不渴,宜用知柏地黄汤合通关丸治疗;气虚导致气化不利,小便并不急迫胀满,但伴有倦怠乏力、懒言,宜用春泽煎治疗。
【注】小便不通:属于热实证者,适宜使用八正散加木香。属于阳虚者,适宜使用金匮肾气丸。属于阴虚者,适宜使用通关丸,即由知母、黄柏及少许肉桂组成。属于气虚者,适宜使用春泽汤,即五苓散加人参组成。
八正散
石淋(以尿中夹有砂石为特征的小便淋沥涩痛病证)犹如铁锅结垢,这是因为湿热煎熬膀胱所致,一切热淋(以小便短数灼热刺痛为主症的热性病证)均宜用八正散治疗,方中包含瞿麦、滑石、栀子、车前子、甘草梢、大黄。
【注】八正散,即由扁蓄、木通、瞿麦、栀子、滑石、甘草、车前子、大黄组成。
小蓟饮子
血淋(以小便赤涩热痛,尿色红或夹血块为特征的小便淋沥涩痛病证)因心经移热于小肠所致,实热证仍宜采用泻下法治疗为宜,清热用小蓟饮子,方中含栀子、滑石、淡竹叶、当归、藕节、木通、蒲黄、甘草、生地黄。
海金沙散 鹿角霜丸
膏淋(以小便浑浊如米泔水或滑腻如脂膏为特征的小便淋沥涩痛病证)尿浊或如鼻涕状,精液与尿液俱出,宜用海金沙、滑石治疗;若热盛者,在八正散基础上加苍术;若属虚证,用秋石茯苓丸合鹿角霜疗效佳。
【注】海,指海金沙。秋,指秋石。苓,指茯苓。鹿角,指鹿角霜。用糯米糊制作成丸剂。
加味八正散
气淋(以小便涩滞,淋漓不畅,少腹满痛为主症的小便淋沥涩痛病证)因肺热难以清肃所致,可用八正散加石韦、木香、冬葵子、沉香;若因内伤气虚导致气化无力,用五苓散合补中益气汤自能通利神奇。
【注】八正散,加入石韦、木香、冬葵子、沉香、五苓散,并合用补中益气汤。
补中益气汤合五苓散 清心莲子饮
劳淋(遇劳即发的小便淋沥涩痛病证)因内伤脾虚者,用补中益气汤合五苓散;因肾虚、阳气过耗而成者,用金匮肾气丸;阴虚者,用知柏地黄汤。思虑过度劳伤心神者,用清心莲子饮,此方即由莲子、地骨皮、黄芪、黄芩、车前子、麦门冬、生甘草、人参、白茯苓组成。
【注】内伤劳倦伤脾,用补中益气汤合五苓散。劳倦伤肾致阳虚,用金匮肾气汤。阴虚,用知柏地黄汤。思虑劳心,用清心莲子饮,该方即由莲子、地骨皮、黄芪、黄芩、车前子、麦门冬、生甘草、人参、白茯苓组成。
琥珀散
痰淋(以小便浑浊如米泔,或滑腻如脂,伴胸闷苔腻为特征的小便淋沥涩痛病证)可用七气汤合青州白丸子治疗;热燥者清热用滋阴法(通关丸);诸淋的平和之剂用琥珀散,方含木香、冬葵子、扁蓄、木通、滑石、当归、郁金。
【注】七气汤见诸气门章节。青州白丸子见类中风门章节。滋阴,指通关丸。木,指木香。葵,指冬葵子。
桂附地黄丸 补中益气汤加白果方 坎离既济汤加山萸肉五味子方
遗尿不禁(小便不能控制而自行排出)及淋证尿色白,用桂附地黄丸、补中益气汤加白果煎服;若补益无效或尿色变赤,则用地黄丸加知母、黄柏、山萸肉、五味子攒集而成。
【注】遗尿不禁,以及各类淋证、尿色白者,皆属于寒证和虚证。寒证,用桂附地黄汤加白果。虚证,用补中益气汤加白果。凡遗尿不禁、各类淋证、尿色赤者,或者补益治疗无效的,也有热证和虚证,用坎离既济汤,即由生地、知母、黄柏,加山萸肉、五味子组成。
Guizhi Tang (Cinnamon Twig Decoction) [Note: Text actually refers to Tongguan Wan, see below]
When heat and excess cause failure of transformation, with hard stool, strangury (癃闭 - difficulty in urination) can be cured by Bazheng San (Eight-Right Powder) added with Muxiang (Aucklandiae Radix). When yang deficiency causes failure of transformation, accompanied by cold extremities and aversion to cold, Jinkui Shenqi Wan (Kidney Qi Pill from the Golden Cabinet) should be used. When yin deficiency causes failure of transformation, with afternoon fever and no thirst, Zhibai Dihuang Wan (Anemarrhena, Phellodendron and Rehmannia Pill) combined with Tongguan Wan (Passage-Opening Pill) is indicated. When qi deficiency causes failure of transformation, without urgent fullness but with fatigue and reluctance to speak, Chunze Jian (Spring Spring Decoction) is appropriate.
[Note] Strangury (urinary obstruction): For heat-excess patterns, Bazheng San (Eight-Right Powder) added with Muxiang (Aucklandiae Radix) is suitable. For yang-deficiency patterns, Jinkui Shenqi Wan (Kidney Qi Pill from the Golden Cabinet) is suitable. For yin-deficiency patterns, Tongguan Wan (Passage-Opening Pill) is suitable, which consists of Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), and a small amount of Rougui (Cinnamomi Cortex). For qi-deficiency patterns, Chunze Tang (Chunze Decoction) is suitable, which is Wuling San (Five-Ingredient Powder with Poria) added with Renshen (Ginseng Radix et Rhizoma).
Bazheng San (Eight-Right Powder)
Shi Lin (Lithiasis strangury - strangury characterized by stones in urine) resembles scale forming on a pot; this is due to damp-heat refining the bladder. All types of Re Lin (Heat strangury - strangury characterized by short, frequent, burning, and painful urination) are best treated with Bazheng San (Eight-Right Powder), containing Bianxu (Polygoni Avicularis Herba), Mutong (Akebiae Caulis), Qumai (Dianthi Herba), Zhizi (Gardeniae Fructus), Huashi (Talcum), Gancao (Glycyrrhizae Radix et Rhizoma), Cheqianzi (Plantaginis Semen), and Dahuang (Rhei Radix et Rhizoma).
[Note] Bazheng San (Eight-Right Powder) consists of Bianxu (Polygoni Avicularis Herba), Mutong (Akebiae Caulis), Qumai (Dianthi Herba), Zhizi (Gardeniae Fructus), Huashi (Talcum), Gancao (Glycyrrhizae Radix et Rhizoma), Cheqianzi (Plantaginis Semen), and Dahuang (Rhei Radix et Rhizoma).
Xiaoji Yinzi (Small Thistle Decoction)
Xue Lin (Bloody strangury - strangury characterized by red or bloody urine) results from heart heat transferring to the small intestine. For excess-heat patterns, purgation is still beneficial. To clear heat, use Xiaoji Yinzi (Small Thistle Decoction), containing Xiaojishao (Leonuri Herba), Zhizi (Gardeniae Fructus), Huashi (Talcum), Danzhuye (Lophatheri Herba), Danggui (Angelicae Sinensis Radix), Oujie (Nelumbinis Node), Mutong (Akebiae Caulis), Puhuang (Typhae Pollen), Gancao (Glycyrrhizae Radix et Rhizoma), and Shengdihuang (Rehmanniae Radix).
[Note] Dan refers to Danzhuye (Lophatheri Herba). Ou refers to Oujie (Nelumbinis Node). Pu refers to Puhuang (Typhae Pollen).
Haijinsha San (Gold Sand Powder) & Lujiaoshuang Wan (Deer Antler Frost Pill)
Gao Lin (Milky strangury - strangury characterized turbid urine resembling rice water or fat) presents with turbid urine or discharge like mucus, where essence and urine both exit. Haijinsha (Lygodii Spora) and Huashi (Talcum) are used. If heat is excessive, Cangzhu (Atractylodis Rhizoma) is added to Bazheng San (Eight-Right Powder). For deficiency patterns, Qiuling (Autumn Stone and Poria) combined with Lujiaoshuang (Deer Antler Frost) yields good results.
[Note] Hai refers to Haijinsha (Lygodii Spora). Qiu refers to Qiushi (Ashes of Human Urine Precipitate). Ling refers to Fuling (Poria). Lujiao refers to Lujiaoshuang (Cornus Cornu Degelatinatum). Made into pills with glutinous rice paste.
Jiawei Bazheng San (Modified Eight-Right Powder)
Qi Lin (Qi strangury - strangury characterized by difficult and incomplete urination with lower abdominal distension) is caused by lung heat that is difficult to clear and descend. Use Bazheng San (Eight-Right Powder) added with Shiwei (Pyri Folium), Muxiang (Aucklandiae Radix), Dongkuizi (Malvae Semen), and Chenxiang (Aquilariae Lignum Resinatum). If internal injury and qi deficiency lead to inability to transform, Wuling San (Five-Ingredient Powder with Poria) combined with Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi) will miraculously restore flow.
[Note] Bazheng San (Eight-Right Powder) is added with Shiwei (Pyri Folium), Muxiang (Aucklandiae Radix), Dongkuizi (Malvae Semen), Chenxiang (Aquilariae Lignum Resinatum), and Wuling San (Five-Ingredient Powder with Poria), combined with Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi).
Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi) combined with Wuling San (Five-Ingredient Powder with Poria); Qingxin Lianzi Yin (Heart-Clearing Lotus Seed Decoction)
Lao Lin (Fatigue strangury - strangury recurring after exertion) due to internal injury and spleen deficiency is treated with Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi) combined with Wuling San (Five-Ingredient Powder with Poria). Due to kidney deficiency and excessive consumption of yang, Jinkui Shenqi Wan (Kidney Qi Pill from the Golden Cabinet) is used. For yin deficiency, Zhibai Dihuang Wan (Anemarrhena, Phellodendron and Rehmannia Pill) is used. For mental labor and heart strain, Qingxin Lianzi Yin (Heart-Clearing Lotus Seed Decoction) is used. This formula consists of Lianzi (Nelumbinis Semen), Digupi (Lycii Cortex), Huangqi (Astragali Radix), Huangqin (Scutellariae Radix), Cheqianzi (Plantaginis Semen), Maidong (Ophiopogonis Tuber), Shenggancao (Raw Glycyrrhizae Radix et Rhizoma), Renshen (Ginseng Radix et Rhizoma), and Baifuling (White Poria).
[Note] Internal injury from fatigue damaging the spleen is treated with Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi) combined with Wuling San (Five-Ingredient Powder with Poria). Kidney damage from fatigue causing yang deficiency is treated with Jinkui Shenqi Tang (Kidney Qi Decoction from the Golden Cabinet). For yin deficiency, Zhibai Dihuang Tang (Anemarrhena, Phellodendron and Rehmannia Decoction) is used. Mental labor damaging the heart is treated with Qingxin Lianzi Yin (Heart-Clearing Lotus Seed Decoction), which consists of Lianzi (Nelumbinis Semen), Digupi (Lycii Cortex), Huangqi (Astragali Radix), Huangqin (Scutellariae Radix), Cheqianzi (Plantaginis Semen), Maidong (Ophiopogonis Tuber), Shenggancao (Raw Glycyrrhizae Radix et Rhizoma), Renshen (Ginseng Radix et Rhizoma), and Baifuling (White Poria).
Hupo San (Amber Powder)
Tan Lin (Phlegm strangury - strangury characterized by turbid urine resembling rice water or phlegm) is treated with Qiqi Tang (Seven-Qi Decoction) combined with Qingzhou Baiwanzi (Qingzhou White Pills). For heat-dryness, clearing heat using nourishing-yin methods (Tongguan Wan) is applied. A balanced formula for various stranguries uses Hupo San (Amber Powder), containing Muxiang (Aucklandiae Radix), Dongkuizi (Malvae Semen), Bianxu (Polygoni Avicularis Herba), Mutong (Akebiae Caulis), Huashi (Talcum), Danggui (Angelicae Sinensis Radix), and Yujin (Curcumae Radix).
[Note] Qiqi Tang (Seven-Qi Decoction) is found in the section on Qi disorders. Qingzhou Baiwanzi (Qingzhou White Pills) is found in the section on Stroke-like disorders. Nourishing yin refers to Tongguan Wan (Passage-Opening Pill). Mu refers to Muxiang (Aucklandiae Radix). Kui refers to Dongkuizi (Malvae Semen).
Guifu Dihuang Wan (Cinnamon and Aconite Rehmannia Pill); Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi) added with Baiguo (Ginkgo Seed); Kanli Jizhi Tang (Kan-Li Equilibrium Decoction) added with Shanzhuyu (Corni Fructus) and Wuweizi (Schisandrae Fructus)
Enuresis (involuntary urination) and strangury with white urine are treated with Guifu Dihuang Wan (Cinnamon and Aconite Rehmannia Pill), Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi) added with Baiguo (Ginkgo Seed). If tonification fails or urine becomes red, use Dihuang Wan (Rehmannia Pill) added with Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), Shanzhuyu (Corni Fructus), and Wuweizi (Schisandrae Fructus).
[Note] Enuresis (involuntary urination) and various stranguries with white urine all belong to cold-deficiency patterns. For cold patterns, use Guifu Dihuang Tang (Cinnamon and Aconite Rehmannia Decoction) added with Baiguo (Ginkgo Seed). For deficiency patterns, use Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi) added with Baiguo (Ginkgo Seed). For enuresis, various stranguries, or red urine, or cases where tonification is ineffective, there may also be heat-deficiency patterns. In such cases, use Kanli Jizhi Tang (Kan-Li Equilibrium Decoction), which consists of Shengdihuang (Rehmanniae Radix), Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), added with Shanzhuyu (Corni Fructus) and Wuweizi (Schisandrae Fructus).