大全云∶妊娠小便淋者，乃肾与膀胱虚热，不能制水。然妊娠胞系于肾，肾间虚热，而
成斯证，甚者心烦闷乱，名曰子淋也。
薛氏曰∶前证若小便涩少淋沥，用安荣散；若腿足转筋，而小便不利，急用八味丸，缓
则不救；若服燥剂而小便频数，或不利，用生地黄、茯苓、牛膝、黄柏、知母、芎、归、甘草；若
频数而色黄，用四物加黄柏、知母、五味、麦门、玄参；若肺气虚而短少，用补中益气加山
药、麦门；若阴挺痿痹而频数，用地黄丸；若热结膀胱而不利，用五淋散；若脾肺燥不能化
生，宜黄芩清肺饮；若膀胱阴虚，阳无所主，用滋肾丸；若膀胱阳虚，阴无所化，用肾气丸。
万密斋曰∶子淋之病，须分二证，一则妊
母自病，一则子为母病。然好母自病，又分二证，或服食辛热，因生内热者；或自汗自利，津
液燥者。其子为母病，亦分二证，或胎气热壅者；或胎形迫塞者。证既不同，治亦有别也，大
抵热则清之，燥则润之，壅则通之，塞则行之，此治之之法也。
五淋散 治孕妇热结膀胱，小便淋沥。
赤芍药 山栀子（各二钱） 赤茯苓（一钱二分） 当归（一钱） 子芩（六分） 甘草（五分）
上水煎服。一方加生地黄、泽泻、木通、滑石、车前子各等分。
子淋散 治妊娠小便涩痛频数。
麦门冬（去心） 赤茯苓 大腹皮 木通 甘草 淡竹叶（等分）
上锉，水煎，空心服。一方无甘草、大腹皮二味。
安荣散 治妊娠小便涩少，遂成淋沥，名曰子淋。
麦门冬（去心） 通草 滑石 人参 细辛（各二钱） 当归（酒浸） 灯草 甘草（各半两）
上为细末，每服二钱，煎麦门冬汤调下。（此用细辛自有深意，盖肾苦燥，故用辛以润
之，欲使天降之阴，沛然于阴分也）
一方无滑石、灯心，有车前、 蓄。
此方恐滑石太重而滑胎，若临月可用，若六七个月以前，宜斟酌之。
加味木通汤 治妊妇奉养太浓，喜食炙爆酒面辛热之物，以致内热，小便赤涩作痛者。
木通 生地黄 赤芍药 条芩 甘草梢（各等分）
上锉，加淡竹叶十二片，水煎服。
生津汤 治妊妇尝病自汗，或因下痢后，小便短少不痛者，此津液不足也。
当归 甘草（炙，各五钱） 麦门冬（去心） 通草 滑石（各三钱） 人参 细辛（各一钱）
上为细末，每服六七钱，灯心煎汤，空心调服。
冬葵子汤 治妊妇素淡滋味，不嗜辛酸，病小便赤涩而痛者，此胎热也，此方主之。
冬葵子（一两） 赤芍药 条芩（各半两） 赤茯苓 车前子（各三钱）
上为末，每服二钱，米饮调服，不拘时。如小便不通，恐是转胞，加发灰少许极效。（发
灰能使气血上行，故转胞加之妙）
大腹皮散 治妊妇八九月，胎形肥硕，小便短少，小腹胀，身重恶寒，起则晕眩欲倒，此
胎气逼寒，膀胱之气不行也，宜此方主之。
赤茯苓（三钱） 大腹皮 枳壳（麸炒） 甘草（炙各一钱）
上为末，每服一钱，浓煎葱白汤下。
地肤子汤 治孕妇小便涩数，名曰子淋。（此方寓升于降，妙）
地肤子 车前子 知母 黄芩 赤茯苓 白芍药 枳壳（麸炒） 升麻 通草 甘草（炙，各三分）
上切一剂，水煎服。
地肤大黄汤 治妊娠子淋，宜下。（此治实热而淋者，大便通则小便自利矣）
大黄（炒） 地肤草（各三两） 知母 黄芩（炒） 猪苓 赤芍药 通草 升麻 枳实（炒） 甘草
（各三两）
上锉，每服四五钱，水煎服。
疗妊娠数月小便淋沥疼痛心烦闷乱不思饮食方
瞿麦穗 赤茯苓 桑白皮 木通 葵子（各一两） 黄芩 芍药 枳壳 车前子（各半两）
上锉，每服四钱，水煎服。
忘忧散 治妊娠心经蕴热，小便赤涩，淋沥作痛。
琥珀（不拘多少） 萱草根（一握）
上琥珀为细末，每服五分，浓煎萱草根调服。
补遗方 治胎前诸般淋沥，小便不通。（此可治气淋，恐与热淋无与）
槟榔 赤芍药（各等分）
上锉，每服五钱，水煎温服，甚效。
一方 治子淋，小便数出，或热疼痛，及子烦。
地肤草四两，以水四升煮取二升半，分三服，或新取地肤草捣取自然汁服亦可。不独治
子淋，凡小便淋闭，服之无不效。
杂方 治妊娠子淋。
葵子一升，以水三升煮取二升，分再服。一方葵根一把，以水三升煮取二升，分再服。一方芜菁子七合为末，水和
服方寸匕，
日三。一方猪苓为末，白汤调方寸匕，加至二匕。
《医宗必读》中说：妊娠期间出现小便淋沥不畅的症状，是由于肾与膀胱存在虚热，无法制约水液所致。然而，妊娠时胞宫系连于肾，肾间产生虚热，从而形成这种病症，严重时会出现心烦意乱、胸闷不安的症状，这被称为“子淋”。
薛己（薛氏）说：上述病症如果表现为小便涩滞量少、淋沥不尽，使用安荣散；如果出现腿足抽筋，且小便不利，必须紧急使用八味丸，若拖延不治则无法挽救；如果服用燥热药物后导致小便频数，或排尿困难，使用生地黄、茯苓、牛膝、黄柏、知母、川芎、当归、甘草；如果小便频数且颜色发黄，使用四物汤加入黄柏、知母、五味子、麦门冬、玄参；如果肺气虚弱导致尿量短少，使用补中益气汤加入山药、麦门冬；如果阴部下垂、痿痹且尿频，使用地黄丸；如果热邪结聚膀胱导致排尿不利，使用五淋散；如果脾肺干燥不能化生津液，适宜用黄芩清肺饮；如果膀胱阴虚，阳气无所依附，使用滋肾丸；如果膀胱阳虚，阴液无法气化，使用肾气丸。
万密斋说：子淋这一疾病，需要分为两种证型，一种是孕妇自身患病，另一种是胎儿影响母亲患病。如果是孕妇自身患病，又分为两种情况：或者是服食了辛热食物，因而产生内热；或者是自汗、腹泻，导致津液干燥。如果是胎儿影响母亲患病，也分为两种情况：或者是胎气热邪壅盛；或者是胎体肥大压迫阻滞。既然证候不同，治疗方法也有区别，大抵原则是：热则清热，燥则润燥，壅则通利，塞则行气，这就是治疗的方法。
五淋散：治疗孕妇因热邪结聚膀胱，导致小便淋沥不尽。
赤芍药、山栀子（各二钱）、赤茯苓（一钱二分）、当归（一钱）、子芩（六分）、甘草（五分）。
以上药材用水煎煮后服用。另一配方加入生地黄、泽泻、木通、滑石、车前子，各等分。
子淋散：治疗妊娠期间小便涩痛、频数。
麦门冬（去心）、赤茯苓、大腹皮、木通、甘草、淡竹叶（各等分）。
以上药材切碎，用水煎煮，空腹服用。另一配方没有甘草和大腹皮两味药。
安荣散：治疗妊娠期间小便涩滞量少，进而形成淋沥不尽，称为子淋。
麦门冬（去心）、通草、滑石、人参、细辛（各二钱）、当归（酒浸）、灯草、甘草（各半两）。
以上药材研为细末，每次服用二钱，用麦门冬汤调服。（此处使用细辛自有深意，因为肾怕干燥，所以用辛味药来滋润它，意图使天降之阴气，充沛地滋养阴分。）
另一配方没有滑石和灯心，有车前子和萹蓄。
此方担心滑石药性过于寒滑而致堕胎，如果在临产月可以使用，若在怀孕六七个月以前，应当斟酌使用。
加味木通汤：治疗孕妇营养过度，喜食烤炸、酒类、面食及辛热之物，导致体内生热，小便赤红涩痛者。
木通、生地黄、赤芍药、条芩、甘草梢（各等分）。
以上药材切碎，加入淡竹叶十二片，用水煎煮服用。
生津汤：治疗孕妇曾经患自汗症，或因痢疾之后，小便短少但不疼痛者，这是津液不足的表现。
当归、甘草（炙，各五钱）、麦门冬（去心）、通草、滑石（各三钱）、人参、细辛（各一钱）。
以上药材研为细末，每次服用六七钱，用灯心煎汤，空腹调服。
冬葵子汤：治疗孕妇平时饮食清淡，不嗜食辛辣酸味，患病后小便赤红涩痛者，这是胎热的表现，此方主治。
冬葵子（一两）、赤芍药、条芩（各半两）、赤茯苓、车前子（各三钱）。
以上药材研为细末，每次服用二钱，用米饮调服，不拘时间。如果小便不通，恐怕是转胞病，加入少许发灰效果极佳。（发灰能使气血上行，所以治疗转胞加入此药很妙。）
大腹皮散：治疗孕妇怀孕八九月时，胎儿形体肥硕，小便短少，小腹胀满，身体沉重恶寒，起身时头晕目眩欲跌倒，这是胎气逼迫寒气，导致膀胱之气运行不畅，适宜用此方主治。
赤茯苓（三钱）、大腹皮、枳壳（麸炒）、甘草（炙，各一钱）。
以上药材研为细末，每次服用一钱，用浓煎的葱白汤送服。
地肤子汤：治疗孕妇小便涩滞频数，称为子淋。（此方寓升提于降泄之中，颇为巧妙。）
地肤子、车前子、知母、黄芩、赤茯苓、白芍药、枳壳（麸炒）、升麻、通草、甘草（炙，各三分）。
以上药材切制为一剂，用水煎煮服用。
地肤大黄汤：治疗妊娠子淋，适宜采用攻下法。（此方治疗实热导致的淋证，大便通畅后小便自然流利。）
大黄（炒）、地肤草（各三两）、知母、黄芩（炒）、猪苓、赤芍药、通草、升麻、枳实（炒）、甘草（各三两）。
以上药材切碎，每次服用四五钱，用水煎煮服用。
治疗妊娠数月小便淋沥疼痛、心烦意乱、胸闷不安、不思饮食的方剂：
瞿麦穗、赤茯苓、桑白皮、木通、葵子（各一两）、黄芩、芍药、枳壳、车前子（各半两）。
以上药材切碎，每次服用四钱，用水煎煮服用。
忘忧散：治疗妊娠心经蕴积热邪，小便赤红涩滞，淋沥作痛。
琥珀（不限多少）、萱草根（一握）。
将琥珀研为细末，每次服用五分，用浓煎的萱草根汤调服。
补遗方：治疗产前各种淋沥不尽，小便不通。（此方可治气淋，恐怕对热淋无效。）
槟榔、赤芍药（各等分）。
以上药材切碎，每次服用五钱，用水煎煮温服，效果很好。
另一方：治疗子淋，小便频数，或有热感疼痛，以及子烦（妊娠心烦）。
地肤草四两，用水四升煮取二升半，分三次服用；或者新采的地肤草捣取自然汁服用也可以。不仅治疗子淋，凡是小便淋闭，服用此方无不有效。
杂方：治疗妊娠子淋。
葵子一升，用水三升煮取二升，分两次服用。另一方用葵根一把，用水三升煮取二升，分两次服用。另一方用芜菁子七合研为末，用水调和服用一方寸匕，每日三次。另一方用猪苓研为末，用白开水调服一方寸匕，可加至二方寸匕。
The *Yi Zong Bi Du* states: During pregnancy, if urinary dribbling and difficulty occur, it is due to deficiency-heat in the Kidney and Bladder, which fails to control water metabolism. However, since the uterus (Bao) is connected to the Kidney during pregnancy, deficiency-heat arising from the Kidney leads to this syndrome. In severe cases, it manifests as mental restlessness and chest oppression, known as "Zi Lin" (Subling).
Xue Ji (Mr. Xue) stated: For the aforementioned symptoms, if there is urinary astringency, scantiness, and dribbling, use Anrong San; if there are convulsions of the legs and feet accompanied by difficult urination, Bawei Wan (Eight-Ingredient Pill with Rehmannia) must be used urgently, otherwise it will be incurable; if frequent urination or difficulty arises after taking drying agents, use Sheng Dihuang (Rehmanniae Radix), Fuling (Poria), Niuxi (Achyranthis Bidentatae Radix), Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Xiong (Chuanxiong Rhizoma), Guizhi Tang (Cinnamon Twig Decoction - *Note: Text says 'Gui', likely Danggui/Angelicae Sinensis Radix given context, but literal translation keeps name*), Gancao (Licorice Root); if urination is frequent and yellow, use Siwu Tang (Four-Substance Decoction) added with Huangbai, Zhimu, Wuweizi (Schisandrae Fructus), Maimendong (Ophiopogonis Radix), and Xuanshen (Scrophulariae Radix); if lung Qi deficiency causes shortness of urine, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Shanyao (Dioscoreae Rhizoma) and Maimendong; if vaginal prolapse, flaccidity, numbness, and frequency occur, use Dihuang Wan (Rehmannia Pill); if heat accumulation in the Bladder causes obstruction, use Wulin San (Five-Dribbles Powder); if Spleen and Lung dryness prevents fluid transformation, Huangqin Qingfei Yin (Scutellaria Lung-Clearing Drink) is suitable; if Bladder Yin deficiency leaves Yang without mastery, Zishen Wan (Nourish Kidney Pill) should be used; if Bladder Yang deficiency prevents Yin transformation, Shenqi Wan (Kidney Qi Pill) is indicated.
Wan Mizhai stated: Zi Lin must be differentiated into two syndromes: one where the mother is ill herself, and one where the fetus affects the mother. If the mother is ill herself, it divides into two: either internal heat generated from consuming pungent and hot foods, or dryness of fluids due to spontaneous sweating and diarrhea. If the fetus affects the mother, it also divides into two: either heat stagnation of fetal Qi, or physical obstruction by a large fetus. Since the syndromes differ, treatments vary. Generally, heat is cleared, dryness is moistened, stagnation is unblocked, and obstruction is moved. This is the method of treatment.
**Wulin San**: Treats pregnant women with heat accumulation in the Bladder causing urinary dribbling.
Chi Shaoyao (Red Peony Root), Shanzhizi (Gardeniae Fructus) (each 2 qian), Chifuling (Red Poria) (1.2 qian), Danggui (Angelicae Sinensis Radix) (1 qian), Ziqin (Scutellariae Radix) (0.6 qian), Gancao (Licorice Root) (0.5 qian).
Decoct in water and take. Another formula adds Sheng Dihuang (Rehmanniae Radix), Zexie (Alismatis Rhizoma), Mutong (Akebiae Caulis), Huashi (Talcum), Cheqianzi (Plantaginis Semen) in equal parts.
**Zilin San**: Treats pregnancy with astringent, painful, and frequent urination.
Maimendong (Ophiopogonis Radix, heart removed), Chifuling, Dafupi (Arecae Pericarpium), Mutong, Gancao, Danzhuye (Lophatheri Folium) (equal parts).
Cut into pieces, decoct in water, and take on an empty stomach. Another formula omits Gancao and Dafupi.
**Anrong San**: Treats pregnancy with astringent, scanty urination leading to dribbling, called Zi Lin.
Maimendong (heart removed), Tongcao (Tetrapanacis Medulla), Huashi, Renshen (Ginseng Radix), Xixin (Asari Radix et Rhizoma) (each 2 qian), Danggui (soaked in wine), Dengcao (Junci Medulla), Gancao (each half liang).
Grind into fine powder, take 2 qian per dose, mixed with Maimendong decoction. (The use of Xixin here has deep meaning: the Kidney dislikes dryness, so pungent herbs are used to moisten it, intending to let heavenly Yin descend abundantly into the Yin aspect.)
Another formula omits Huashi and Dengxin, adding Cheqianzi and Pianca (Polygoni Avicularis Herba).
This formula may worry that Huashi is too slippery and causes miscarriage; it can be used near term, but for before six or seven months, caution is advised.
**Jiawei Mutong Tang**: Treats pregnant women who have rich nourishment, prefer roasted/fried foods, alcohol, wheat products, and pungent/hot items, resulting in internal heat, red and astringent painful urination.
Mutong, Sheng Dihuang, Chi Shaoyao, Tiaoqin (Scutellariae Radix), Gancao Shao (Licorice Root tip) (equal parts).
Cut into pieces, add 12 slices of Danzhuye, decoct in water, and take.
**Shengjin Tang**: Treats pregnant women who previously suffered from spontaneous sweating or had dysentery, resulting in short, non-painful urination, indicating insufficient body fluids.
Danggui, Gancao (roasted, each 5 qian), Maimendong (heart removed), Tongcao, Huashi (each 3 qian), Renshen, Xixin (each 1 qian).
Grind into fine powder, take 6-7 qian per dose, mixed with Dengxin decoction, on an empty stomach.
**Dongkuizi Tang**: Treats pregnant women with bland diets, no preference for pungent/sour flavors, suffering from red, astringent, painful urination, indicating fetal heat. This formula treats it.
Dongkuizi (Malvae Semen) (1 liang), Chi Shaoyao, Tiaoqin (each half liang), Chifuling, Cheqianzi (each 3 qian).
Grind into powder, take 2 qian per dose, mixed with rice drink, at any time. If urination is completely blocked, suspect Zhuantao (Bladder displacement); add a small amount of Fahui (Hair Ash) for excellent effect. (Hair Ash promotes upward movement of Qi and Blood, making it effective for Zhuantao.)
**Dafupi San**: Treats pregnant women in the 8th or 9th month with large fetuses, short urination, lower abdominal distension, heavy body, aversion to cold, dizziness upon standing. This indicates fetal Qi pressing on Cold, blocking Bladder Qi. This formula treats it.
Chifuling (3 qian), Dafupi, Zhike (Bitter Orange Peel, bran-fried), Gancao (roasted, each 1 qian).
Grind into powder, take 1 qian per dose, taken with strong Congbai (Scallion White) decoction.
** Difuzi Tang**: Treats pregnant women with astringent, frequent urination, called Zi Lin. (This formula contains lifting within lowering, which is ingenious.)
Difuzi (Kochiae Fructus), Cheqianzi, Zhimu, Huangqin (Scutellariae Radix), Chifuling, Baishaoyao (White Peony Root), Zhike (bran-fried), Shengma (Cimicifugae Rhizoma), Tongcao, Gancao (roasted, each 0.3 qian).
Cut one dose, decoct in water, and take.
**Difuda Huang Tang**: Treats pregnancy Zi Lin, suitable for purging. (This treats excess heat causing dribbling; once bowels move, urination naturally flows.)
Dahuang (Rhubarb Rhizome and Stem, fried), Difucacao (Kochiae Herba) (each 3 liang), Zhimu, Huangqin (fried), Zhuling (Polyporus), Chi Shaoyao, Tongcao, Shengma, Zhishi (Immature Bitter Orange Fruit, fried), Gancao (each 3 liang).
Cut into pieces, take 4-5 qian per dose, decoct in water, and take.
**Formula for treating several months of pregnancy with dribbling, pain, mental restlessness, chest oppression, and loss of appetite**:
Qumai (Diantherae Herba), Chifuling, Sangbaipi (Mori Cortex), Mutong, Kuizi (Malvae Semen) (each 1 liang), Huangqin, Shaoyao, Zhike, Cheqianzi (each half liang).
Cut into pieces, take 4 qian per dose, decoct in water, and take.
**Wangyou San**: Treats pregnancy with heat accumulation in the Heart Meridian, red/astringent urination, dribbling pain.
Hupo (Fossilized Wood), Xuancagen (Daylily Root) (one handful).
Grind Hupo into fine powder, take 0.5 qian per dose, mixed with strong Xuancagen decoction.
**Supplementary Formula**: Treats various types of dribbling before delivery and urinary obstruction. (This treats Qi Lin, likely ineffective for Heat Lin.)
Bolang (Areca Seed), Chi Shaoyao (equal parts).
Cut into pieces, take 5 qian per dose, decoct in water, take warm. Very effective.
**Another Formula**: Treats Zi Lin with frequent urination, heat/pain, and Zi Fan (pregnancy-related irritability).
Difucacao 4 liang, boil in 4 sheng of water to obtain 2.5 sheng, divide into three doses. Or crush fresh Difucacao to extract natural juice and take. Effective not only for Zi Lin but for all urinary retention/dribbling.
**Miscellaneous Formulas**: Treat pregnancy Zi Lin.
Kuizi 1 sheng, boil in 3 sheng of water to obtain 2 sheng, divide into two doses. Another formula uses Kuigen (Malvae Radix) one handful, boil in 3 sheng of water to obtain 2 sheng, divide into two doses. Another formula uses Wujingzi (Brassicae Semens) 7 ge ground into powder, mix with water and take 1 Fangcunbi, three times daily. Another formula uses Zhuling ground into powder, mix with plain water and take 1 Fangcunbi, up to 2 Fangcunbi.