小便多者。乃下元虚冷。肾不摄水。以致渗泄。宜菟丝子丸八味丸。玄兔丹。生料鹿茸
丸。
有人每日从早至午前。定尿四次。一日之间。又自无事。此肾虚所致。亦由脾肾泄。早
泄而晚愈。次日又复然者也。
若小便常急。遍数虽多。而所出常少。放了复急。不涩痛。却非淋证。亦有小便毕。少
顷忽
再出些小者。多因自忍尿。或忍尿行房事而然。宜生料五苓散。减泽泻之半。加阿胶一钱。
吞八味丸。此丸须用五味子者。
睡着遗尿者。此亦下元冷。小便无禁而然。宜大菟丝子丸。猪胞炙碎煎汤下。（凡遗尿
皆属虚。古书云。实则失气虚则遗尿。）
有盛喜致小便多。日夜无度。乃喜极伤心。心与小肠为表里。宜厘清饮。四七汤。各半
帖。和煎。仍以辰砂妙香散。吞小菟丝子丸。或玄兔丹。
古名曰癃者。罢也。不通为癃。不约为遗。小便滴沥。涩痛者。谓之淋。小便急满不通
者。
谓之闭。宜五苓散。灯心汤调服。暑月多有此患。止宜本药。闭而不通。脐下胀为癃起。以
灯心汤。五苓散。或洗慈汤。调独味琥珀末。仍令其以盐填脐下。更滴之以水。
若服凉药不效。审是冷秘。宜炒盐熨其小腹。或洗慈汤熏洗。有腹急而小便若不通。用
剂愈甚。宜以盐实脐中。就盐上灼艾。十来壮。
有淋病。下诸通便剂愈。不通。用木香流气饮。或别用通气香剂才愈者。此乃气淋。出
于冷热淋之外。
有似淋非淋。小便色如米泔。或便中有如鼻涕之状。此乃精尿俱出。精塞窍道。故便欲
出不
能而痛。宜大丝子丸。鹿茸丸之类。然此即膏淋。谓其非淋。亦不可。血淋一证。须看血
色。分冷热。色鲜者。心小肠实热。色瘀者。肾膀胱虚冷。若的是冷淋。及下元虚冷。血色
瘀者。并宜汉椒根。锉碎。不拘多少。白水煎候冷进。
小便涩痛。常急欲溺。及去点滴。茎中痛不可忍者。此五淋病。生料五苓散。加阿胶七
分。
或五苓散。加车前子末少许。或五苓散和益元散等分。或五苓散。并可吞火府丹。佐以导赤
散。
若热极成淋。服药不效者。宜减桂五苓散。加木通滑石灯心瞿麦各少许。仍令其研麦门
冬草。连根车前草。白龙草蜜水调下。
若淋沥有血者。宜加五苓散。或生料五苓饮。和五淋饮。或导赤散。仍研地锦草水解服
进
冷剂愈甚者。此是冷淋。宜地髓汤。下附子八味丸。有因服五苓散等药不效者。用生料鹿茸
丸却愈。此证病。于下元虚冷之故。有小便艰涩如淋。不痛而痒者。此亦属虚。宜八味丸。
生料
鹿茸丸之类。若因思虑用心过度。致淋。辰砂妙香散。吞威喜丸。或妙香散。和五苓散。
汗多而小便赤涩。暑月多有此证。盛暑所饮既多。小便反涩少而赤。缘上停为饮。外发
于汗
津道不通。小肠涩闭。则水不运。下五苓散。一名导逆。内有术桂收汗。猪苓泽泻茯苓分
水道。收在其外者。使之内。又从而利导焉。发者敛之。壅者通之。义取于此。然有虚劳汗
多。而小便赤涩者。却是五内枯燥。滋腴既去。不能生津。故溺涩而赤。不宜过用通小便之
剂。竭其肾水。惟当温养润肺。十全大补汤。养荣汤之类。自足选用汗者。心液。心主血。
养血则心得所养。汗止津生。不待通溺。而自清矣。诸失精血。及患痈毒人。忽有小便赤涩
之证。此亦是枯竭不润之故。
小便频多者，乃下元虚冷，肾不摄水，以致渗泄。宜用菟丝子丸、八味丸、玄兔丹、生料鹿茸丸。
有人每日从早至午前，固定排尿四次，一日之间并无其他不适。此由肾虚所致，亦属于脾肾泄（此处指脾肾气虚导致的滑泄），表现为早晨严重而晚上缓解，次日又复发的情况。
若小便经常急迫，次数虽多，但每次排出量常少，排完后又觉急迫，并不涩痛，这并非淋证。也有小便结束后，过一会儿又少量排出一些的情况，多因强忍尿液，或忍尿行房事所致。宜用生料五苓散，减去一半泽泻，加阿胶一钱，吞服八味丸。此丸剂必须使用五味子。
睡着时遗尿者，这也是下元寒冷，小便失禁所致。宜用大菟丝子丸，以猪膀胱炙碎煎汤送服。（凡遗尿皆属虚证，古书云：实则失气，虚则遗尿。）
有因大喜导致小便频多，日夜无度，这是喜极伤心，心与小肠相表里所致。宜用厘清饮、四七汤，各取半帖，合煎服用。仍以辰砂妙香散吞服小菟丝子丸，或玄兔丹。
古称“癃”者，意为罢止不通。不通为癃，不约（约束无力）为遗。小便滴沥、涩痛者，称为淋。小便急满不通者，称为闭。宜用五苓散，灯心草汤调服。暑月多有此患，只宜用本药。闭而不通，脐下胀满为癃证起始，可用灯心草汤、五苓散，或洗慈汤，调服独味琥珀末。仍令患者用盐填满脐下，再滴水其上。
若服用凉药无效，确认为冷秘，宜用炒盐熨烫小腹，或用洗慈汤熏洗。若有腹急而小便似不通，用药后症状反而加重，宜用盐填实脐中，在盐上施灸艾炷十余壮。
有淋病，服用各种通便剂后病情加重，不通；用木香流气饮，或另用通气香剂才痊愈的，此为气淋，出于冷热淋之外。
有类似淋证而非淋证，小便色如米泔水，或便中有如鼻涕状物。此为精尿俱出，精液堵塞窍道，故欲便而不能且疼痛。宜用大菟丝子丸、鹿茸丸之类。然而这就是膏淋，说它不是淋证也不对。血淋一证，须看血色，分寒热。色鲜红者，为心与小肠实热；色瘀暗者，为肾与膀胱虚冷。若确实是冷淋，及下元虚冷，血色瘀暗者，并宜用汉椒根，锉碎，不拘多少，白水煎煮，候冷后服用。
小便涩痛，经常急欲排尿，且去之点滴，尿道中疼痛不可忍受，此为五淋病。宜用生料五苓散，加阿胶七分。或五苓散，加车前子末少许。或五苓散和益元散等分。或五苓散，并可吞服火府丹，佐以导赤散。
若热极成淋，服药无效者，宜用减桂五苓散，加木通、滑石、灯心草、瞿麦各少许。仍令其研麦门冬草、连根车前草、白龙草，蜜水调下。
若淋沥有血者，宜在五苓散基础上加减，或生料五苓饮，和五淋饮，或导赤散。仍研地锦草水解服。进冷剂后病情加重的，此为冷淋，宜用地髓汤，下附子八味丸。有因服用五苓散等药无效者，用生料鹿茸丸却痊愈了。此证病因在于下元虚冷。有小便艰涩如淋，不痛而痒者，这也属虚证，宜用八味丸、生料鹿茸丸之类。若因思虑用心过度致淋，宜用辰砂妙香散，吞服威喜丸，或妙香散，和五苓散。
汗多而小便赤涩，暑月多有此证。盛暑所饮既多，小便反涩少而赤，缘于上停为饮，外发于汗，津道不通，小肠涩闭，则水不运。下五苓散，一名导逆。内有术、桂收汗，猪苓、泽泻、茯苓分水道，收在其外者，使之内，又从而利导焉。发者敛之，壅者通之，义取于此。然有虚劳汗多，而小便赤涩者，却是五内枯燥，滋腴既去，不能生津，故溺涩而赤。不宜过用通小便之剂，竭其肾水，惟当温养润肺，十全大补汤、养荣汤之类，自足选用。汗者，心液也，心主血，养血则心得所养，汗止津生，不待通溺，而自清矣。诸失精血，及患痈毒人，忽有小便赤涩之证，此亦是枯竭不润之故。
Frequent urination is caused by deficiency-cold of the lower yuan (lower source, referring to the kidneys and bladder), where the Kidney fails to control water, leading to leakage. Suitable formulas include Tusizi Wan (Cuscuta Pill), Bawei Wan (Eight-Ingredient Pill), Xuantu Dan (Black Rabbit Pellet), and Shengliao Lurong Wan (Raw Deer Antler Pill).
Some individuals urinate four times regularly from morning until noon, with no other discomfort throughout the day. This is caused by Kidney deficiency, also categorized as Spleen-Kidney leakage (slippage due to Spleen-Kidney Qi deficiency), characterized by severity in the morning and relief in the evening, recurring the next day.
If urination is frequently urgent, with many episodes but small volume each time, followed by renewed urgency without dysuria or pain, it is not Lin syndrome (dysuria). There are cases where a small amount of urine is discharged shortly after finishing urination; this is often due to holding urine or engaging in sexual intercourse while holding urine. The appropriate treatment is Shengliao Wuling San (Raw Five-Ingredient Powder for Resolving Dampness), with half the dosage of Zexie removed, plus one qian of Ejiao (Donkey-hide Gelatin), taken with Bawei Wan. This pill must contain Wuweizi (Schisandra Berry).
Nocturnal enuresis during sleep is also due to cold of the lower yuan causing loss of bladder control. The recommended treatment is Da Tusizi Wan (Large Cuscuta Pill), taken with decoction made from roasted pig bladder. (All enuresis belongs to deficiency; ancient texts state: excess leads to flatus, deficiency leads to enuresis.)
Excessive joy causing frequent urination, day and night without limit, results from extreme joy injuring the Heart. Since the Heart and Small Intestine are exterior-interior partners, suitable treatments include Liqing Yin (Clearing Decoction) and Siqi Tang (Four-Seven Decoction), mixed in equal halves and decocted together. Additionally, Chen Sha Miaoxiang San (Cinnabar Wonderful Fragrance Powder) should be used to swallow Xiao Tusizi Wan (Small Cuscuta Pill) or Xuantu Dan.
In ancient terminology, "Long" (stagnation) means cessation or blockage. Blockage is Long, lack of restraint is Enuresis. Urine dripping with dysuria and pain is called "Lin" (grain-like obstruction). Urgent fullness with inability to urinate is called "Bi" (closure). The recommended treatment is Wuling San, taken with Jiedixin Tang (Centella Decoction). This condition is common in summer months, and only this formula should be used. For closure without passage, accompanied by distension below the umbilicus indicating the onset of Long, use Jiedixin Tang, Wuling San, or Xici Tang (Washing Benevolence Decoction) to mix with powdered Hupo (Amber). The patient should also have salt filled into the umbilical region, with water dripped onto it.
If cooling herbs are ineffective and the condition is confirmed as cold constipation/closure, apply fried salt to warm the lower abdomen, or fumigate/wash with Xici Tang. If abdominal urgency accompanies apparent urinary retention, and medication worsens symptoms, fill the umbilicus with salt and moxibustion on top of the salt for about ten moxa cones.
For Lin syndrome that worsens with purgatives but improves with Muxiang Liuqi Yin (Aucklandia Flowing Qi Drink) or other Qi-moving aromatic agents, this is Qi Lin (Qi-type Dysuria), distinct from Cold-Lin and Heat-Lin.
Conditions resembling Lin but not being Lin, where urine resembles rice washings or contains mucus-like strands, indicate simultaneous discharge of essence and urine. Essence blocking the orifices causes pain and difficulty in voiding. Suitable treatments include Da Tusizi Wan and Lurong Wan. However, this is actually Gao Lin (Essence-type Dysuria); denying it is Lin is incorrect. For Blood Lin, observe the blood color to differentiate cold and heat. Bright red indicates Excess-Heat in the Heart and Small Intestine; dark/clotted blood indicates Deficiency-Cold in the Kidney and Bladder. For confirmed Cold-Lin and lower yuan deficiency-cold with dark blood, use Hanjiaogen (Zanthoxylum Root Bark), chopped, boiled in plain water, and taken when cool.
Dysuria with burning pain, frequent urgency, scanty output, and unbearable pain in the urethra constitutes the Five Types of Lin. Treatments include Shengliao Wuling San with Ejiao; or Wuling San with Cheqianzi powder; or an equal mixture of Wuling San and Yiyuan San; or Wuling San taken with Huofu Dan, assisted by Daochi San.
If extreme heat causes Lin and medication fails, use Jian Gui Wuling San (Cinnamon-Reduced Five-Ingredient Powder) with Mutong, Huashi, Dengxincao, and Qumai added in small amounts. Also, grind Menmendong Cao (Ophiopogon Herb), Cheqiancao (Plantain Herb with roots), and Bailong Cao, mixed with honey water.
For Lin with hematuria, modify Wuling San, or use Shengliao Wuling Yin mixed with Wulin Yin or Daochi San. Grind Dijinc Cao (Polygonum Aviculare) and take the juice. If cooling agents worsen the condition, it is Cold-Lin; treat with Disui Tang and Fuzi Bawei Wan. Some cases unresponsive to Wuling San respond to Shengliao Lurong Wan. The etiology is deficiency-cold of the lower yuan. Scanty, difficult urination resembling Lin but without pain, only itching, also belongs to deficiency; treat with Bawei Wan or Shengliao Lurong Wan. For Lin caused by excessive mental exertion, use Chen Sha Miaoxiang San to swallow Weixi Wan, or mix Miaoxiang San with Wuling San.
Profuse sweating with dark, scanty, and difficult urination is common in summer. Although fluid intake is high in intense heat, urine becomes scanty, dark, and difficult because fluids stagnate above, sweat emerges externally, fluid pathways are blocked, and the Small Intestine becomes obstructed, preventing water metabolism. Administer Wuling San (also known as Daonixia). It contains Baizhu and Guizhi to consolidate sweat, and Zhuling, Zexie, and Fuling to separate turbid from clear, drawing fluids back inward and promoting diuresis. The principle is to restrain what disperses and unblock what stagnates. However, in consumptive diseases with profuse sweating and dark, difficult urination, the internal organs are dry, nourishment is depleted, and fluids cannot be generated. Overusing diuretics will deplete Kidney Water. Instead, warm and nourish the Lungs; Shiquan Dabu Tang (Ten Complete Tonifying Decoction) or Yangying Tang (Nourishing Vigor Decoction) are sufficient choices. Sweat is the fluid of the Heart; the Heart governs Blood. Nourishing Blood nourishes the Heart, stopping sweat and generating fluids. Without needing to force diuresis, clarity returns naturally. In cases of lost essence/blood or patients with carbuncles/toxins, sudden dark and difficult urination is also due to depletion and lack of lubrication.