瘰 一证，先贤名曰九漏，究其所因似热，稽考形状非一，不过随象命名大概初发
于颈项肌肉之间，未成脓者，从本引末，可使衰去，针之灸之敷之，从其所因而施疗。然
小儿幼弱，岂堪针灸，但以服饵涂贴之剂为治。此疾多生于耳后及颈项两旁，初发止是
一枚，次必连生，大小十数，缠绕项下，累累如贯珠，逐个先肿。作脓穿破，轻者可
愈重者难除，先穴漏脓，长岁不干，谓之漏项。原其得病之初，自足三阳感受风热，与
血气相搏而成。治以百解散加当归散，水、姜、葱、灯心煎服。次用玄参饮及牛蒡汤、木通
散、内消丸，与之宣热化毒，洗以槲皮散，涂用白芨散、二香散，使气顺血行，脓干汁尽，
则自愈矣。仍忌臊毒野味，其证不致再作。
《巢氏病源》曰∶诸淋皆肾虚所致，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。淋有五名∶曰膏、曰冷、曰热、曰血、曰石，各
具于后。膏淋，见小便有肥脂似膏，而浮于小便之上，此肾虚不能制其肥液而下行也。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。热
淋，下焦有热，热气传于肾，流入于胞，其溺黄，多而涩，间有鲜血同来者。血淋，热
之极也，心者血之主，外行经络，内行脏腑，热盛则失其常道，心与小肠为表里，故下流
而入于胞，则为血淋。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，甚至塞痛，令人昏闷，遍身有汗而后醒，此痛之使然。盖五淋者，虽曰肾虚所致，
然小肠为受盛之府，气通于膀胱，膀胱为津液之府，气通于肾，余化下流而不通，皆曰肾气不足。热
入膀胱，水道涩而不利，出入起数，脐腹急痛，蕴作有时，或如豆汁膏血，并以《局
方》五淋散，下龙脑鸡苏丸，自然平愈。及香芎丸、补肾地黄丸，与之疏导补益为上。
有癃闭遗溺二证，与淋不同，《内经·宣明五气篇》曰∶膀胱不利为癃，不约为遗溺。盖
癃者，乃内藏气虚受热，壅滞宣化不行，非涩非痛，但闭不通，腹肚紧满，宜用 咀五
苓散加木通、车前子煎服。遗溺者，乃心肾传送失度，小肠膀胱关键不能约束。有睡梦
而遗者，有不知而遗者，皆是下元虚冷所致，亦因禀受阳气不足，用三因方家韭子丸治之，
及参苓白术散、补肾地黄丸。然此证法当实土以存水，乃免渗泄之患，所谓补肾不如补
脾是也。平胃散倍加益智仁，锉碎，水、姜、枣、烧盐煎，空心温服。又有阴阳二闭证，阴
闭者，为冷湿乘虚入里，因而不通，名曰阴闭，以白芍药汤加南木香，水煎服，及用炒
盐，以绢帕兜令带温熨脐四围，并投五苓散，入灵砂末，温盐汤空心调下，其效尤速。阳
闭者，因暴热所逼。涩而不通，名为阳闭，以 咀五苓散加车前子，灯心水煎服，及木通
散、玉露饮、益元散，皆可用之，或贴姜豉饼于脐上取效，不拘阴阳二证，悉能疗之，并投万安饮。
瘰疬这一病症，先贤称之为“九漏”，探究其病因似乎与热邪有关，考察其形态并不单一，大体上都是根据症状特征来命名。它最初多发于颈部和项部的肌肉之间，尚未化脓时，可以通过从本源引导至末梢的方法，使其消退，采用针刺、艾灸或外敷的方法，根据其病因进行治疗。然而小儿体质幼弱，怎能承受针灸治疗呢？因此主要以服用内服药和外涂贴剂作为治疗方法。这种病多生于耳后及颈项两侧，初起时只是一枚，随后必定接连生长，大小有十数个，缠绕在项下，像串珠一样累累相连，逐个先肿胀。化脓穿破后，轻症可以痊愈，重症难以根除，如果先穴口漏出脓液，长年不愈合，就称为“漏项”。追溯其发病之初，是由于足三阳经感受风热，与血气相互搏结而形成的。治疗用百解散加当归散，用水、生姜、葱白、灯心草煎服。接着使用玄参饮以及牛蒡汤、木通散、内消丸，用来宣散热邪、化解毒邪，外用槲皮散清洗，涂抹白芨散、二香散，使气顺血行，脓干汁尽，则自然痊愈。仍然要忌食腥膻有毒的野味，这样病症就不会再发作。
《巢氏病源》说：各种淋证都是由肾虚引起的，肾与膀胱互为表里，水液下行进入小肠，通达胞宫，流经阴部成为小便，肾气通达于阴部，这是下行的通道。淋证有五种名称：即膏淋、冷淋、热淋、血淋、石淋，各自详情如下。膏淋，表现为小便中有类似油脂的肥脂，漂浮在小便上面，这是肾虚不能制约肥液而下流所致。冷淋，先出现战栗发抖然后才排尿，这也是肾虚且下焦受寒，冷气进入胞宫，与正气交争，所以小便涩滞且伴有战栗。热淋，下焦有热，热气传导至肾脏，流入胞宫，导致尿液黄赤，量多且涩痛，偶尔有鲜血一同排出。血淋，是热邪极盛的表现，心是血液的主宰，外行于经络，内行于脏腑，热盛则血液失去常道，心与小肠互为表里，所以热邪下流进入胞宫，就成为血淋。石淋，肾主水，水液凝结则化为石头，肾被热邪所乘，遇到小便时尿道中疼痛，不得流利，疼痛牵引小腹，则沙石从小便排出，甚至堵塞疼痛，令人昏闷，全身出汗后才苏醒，这是疼痛导致的。大概这五淋证，虽然说是由肾虚引起，但小肠是受盛之腑，气通于膀胱，膀胱是津液之腑，气通于肾，余下的浊液下流而不通畅，都说是肾气不足。热邪进入膀胱，水道涩滞而不通利，排尿次数频繁，脐腹部急痛，蕴积有时发作，或者像豆汁、膏血一样，都用《局方》的五淋散，配合龙脑鸡苏丸，自然平复痊愈。还有香芎丸、补肾地黄丸，用来疏导补益为上策。有癃闭和遗溺两种证候，与淋证不同，《内经·宣明五气篇》说：膀胱不利为癃，不约为遗溺。所谓癃，乃是内脏气虚受热，壅滞宣化不行，不是涩也不是痛，只是闭塞不通，腹肚紧满，宜用咀碎的五苓散加木通、车前子煎服。遗溺，乃是心肾传送失度，小肠膀胱的关键部位不能约束。有睡梦中遗尿的，有不知不觉遗尿的，都是下元虚冷所致，也因为是禀受阳气不足，用三因方的韭子丸治疗，以及参苓白术散、补肾地黄丸。然而此证治法应当实土以存水，以免渗泄之患，所谓补肾不如补脾就是这个道理。平胃散加倍加入益智仁，锉碎，用水、生姜、大枣、烧盐煎煮，空腹温服。又有阴阳二闭证，阴闭者，是因为冷湿乘虚入里，因而导致不通，名叫阴闭，用白芍药汤加南木香，水煎服，以及用炒盐，用绢帕兜住令其带温热熨烫脐周四周，并投服五苓散，加入灵砂末，用温盐水空腹调下，效果尤其迅速。阳闭者，因为暴热逼迫，涩滞而不通，名叫阳闭，用咀碎的五苓散加车前子，灯心草水煎服，以及木通散、玉露饮、益元散，都可以使用，或者贴姜豉饼于脐上取效，不拘泥于阴阳二证，都能治疗，并投服万安饮。
Luo Li (Scrofula) is a condition that ancient sages called "Jiu Lou" (Nine Leaks). Investigating its etiology, it seems related to Heat; examining its morphology, it is not uniform, but generally named according to its manifestations. It initially occurs between the muscles of the neck and nape. If abscessation has not yet formed, one can cause regression by treating from the root to branch, using acupuncture, moxibustion, or topical applications, prescribing therapy based on the specific etiology. However, children are frail and young, unable to withstand acupuncture and moxibustion; therefore, treatment relies mainly on oral medications and topical pastes. This disease often arises behind the ears and on both sides of the neck. Initially, there is only one nodule, which subsequently multiplies, numbering in the dozens, encircling the neck like beads strung together, swelling individually. After suppuration and rupture, mild cases can be cured, while severe cases are difficult to eradicate. If the lesion leaks pus and fails to heal for years, it is called "Lou Xiang" (Leaking Neck). Tracing the onset of the disease, it originates from Wind-Heat invading the Foot-Taiyang, Foot-Yangming, and Foot-Shaoyang meridians, clashing with Qi and Blood. Treatment involves Baie San (Hundred Dissolution Powder) combined with Danggui San (Angelica Sinensis Powder), decocted with water, ginger, scallion, and Jiedixin (Centella asiatica herb). Subsequently, Xuanshen Yin (Scrophularia Decoction), Niubang Tang (Arctium Decoction), Mutong San (Akebia Powder), and Neixiao Wan (Internal Resolution Pill) are used to vent Heat and resolve toxicity. The area is washed with Hu Pi San (Oak Bark Powder) and applied with Baiji San (Bletilla Powder) and Erxiang San (Two Fragrances Powder) to promote smooth Qi flow and blood circulation. When pus dries and discharge ceases, spontaneous recovery occurs. One must avoid game meat and other pungent/toxic foods to prevent recurrence.
*Chao Shi Bing Yuan* (Source of Diseases by Chao Yuanfang) states: All types of Lin Syndrome (Dysuria) are caused by Kidney Deficiency. The Kidney and Bladder are exterior-interior partners. Water descends into the Small Intestine, communicates with the Bao Palace (Uterus/Bladder), flows through the yin region, and becomes urine. Kidney Qi connects to the yin region, serving as the pathway for downward flow. There are five names for Lin Syndrome: Gao Lin (Fatty Dysuria), Leng Lin (Cold Dysuria), Re Lin (Hot Dysuria), Xue Lin (Bloody Dysuria), and Shi Lin (Stony Dysuria), detailed below.
Gao Lin: Fat-like substances float on top of the urine. This is due to Kidney Deficiency failing to control fatty fluids, causing them to descend.
Leng Lin: Chills precede urination. This is also due to Kidney Deficiency and Cold invading the Lower Jiao; Cold Qi enters the Bao Palace and contends with Healthy Qi, resulting in dysuria accompanied by chills.
Re Lin: Heat exists in the Lower Jiao. Heat transmits to the Kidney and flows into the Bao Palace, causing yellow, frequent, and painful urination, occasionally mixed with fresh blood.
Xue Lin: This represents extreme Heat. The Heart is the master of Blood, circulating externally in meridians and internally in Zang-Fu organs. When Heat is excessive, Blood loses its normal path. Since the Heart and Small Intestine are exterior-interior partners, Heat flows downward into the Bao Palace, resulting in Bloody Dysuria.
Shi Lin: The Kidney governs Water; when Water coagulates, it transforms into stones. If the Kidney is attacked by Heat, urination causes pain in the urethra, obstructing smooth flow. Pain radiates to the lower abdomen, and sand/stones pass out with urine. Severe obstruction causes pain leading to faintness and sweating before waking, solely due to pain.
Although these Five Lins are said to stem from Kidney Deficiency, the Small Intestine is the organ of reception and transformation, communicating with the Bladder. The Bladder is the reservoir of fluids, communicating with the Kidney. If residual turbid fluids fail to flow downward smoothly, it is attributed to insufficient Kidney Qi. Heat entering the Bladder makes the water passages astringent and obstructed, causing frequent urination, urgent abdominal pain, and intermittent accumulation resembling bean curd juice or bloody mucus. Treatment employs Wulin San (Five Lin Powder) from *Ju Fang*, followed by Longnao Jisu Wan (Borneol Mint Pill) for natural resolution. Additionally, Xiangxiong Wan (Costus and Ligusticum Pill) and Bushen Dihuang Wan (Kidney-Nourishing Rehmannia Pill) are used for dredging and tonification.
Two conditions, Long Bi (Urinary Retention) and Yi Ni (Enuresis), differ from Lin Syndrome. *Neijing · Xuanming Wuqi Pian* states: "Obstruction of the Bladder is Long; lack of restraint is Yi Ni." Long refers to internal organ Qi deficiency combined with Heat, causing stagnation and failure of diffusion/transformation. It is neither astringent nor painful, but simply blocked and unpassable, with tightness and fullness in the abdomen. Treatment uses Juzui Wuling San (Crushed Five Ling Powder) added with Mutong (Akebia) and Cheqianzi (Plantago Seed), decocted and taken orally. Yi Ni results from disordered transmission between the Heart and Kidney, where the "key" of the Small Intestine and Bladder fails to restrain. It may occur during sleep or unconsciously, all caused by deficiency-cold of the Lower Yuan and insufficient congenital Yang Qi. Treatment uses Jiuzi Wan (Allium Tuberosum Pill) from *San Yin Fang*, along with Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) and Bushen Dihuang Wan. However, the therapeutic principle for this condition should be to solidify Earth (Spleen) to preserve Water, avoiding leakage issues—hence the saying "Tonifying the Spleen is better than Tonifying the Kidney." Pingwei San with doubled Yizhiren (Alpinia Oxyphylla Fruit), crushed and decocted with water, ginger, jujube, and roasted salt, is taken warm on an empty stomach.
There are also Yin-Bi (Yin Obstruction) and Yang-Bi (Yang Obstruction). Yin-Bi occurs when Cold-Dampness invades the interior due to deficiency, causing obstruction. It is treated with Baishaoyao Tang (White Peony Decoction) added with Nanmuxiang (Aquilaria Wood), decocted in water. Additionally, fried salt wrapped in silk is used for warm compresses around the umbilicus, and Wuling San added with Lingsha powder (Cinnabar and Sulphur mixture) is taken with warm salt water on an empty stomach for rapid effect. Yang-Bi is caused by sudden Heat forcing obstruction, making flow astringent and blocked. It is treated with Juzui Wuling San added with Cheqianzi, decocted with Jiedixin water. Mutong San, Yulu Yin (Jade Dew Drink), and Yiyuan San (Origin-Essence Powder) are also applicable. Applying Jiangchi Bing (Ginger and Fermented Soybean Cake) to the umbilicus can also be effective. These methods apply to both Yin and Yang obstructions, utilizing Wan'an Yin (Ten-Thousand Peace Drink).