产后淋证，此亦血去阴虚生内热也。盖肾为至阴，主行水道，去血过多，真阴
亏损，故生内热，小便成淋而涩痛。是以热客于脬，虚则频数，热则涩痛也。气血兼热，血入胞中，则血
随小便而为血淋。但小便淋 ，却与不通当分别而治。不通者属气虚，淋属内热涩痛。故密斋治淋，用
知柏导赤散，调益元散治之。冯氏云∶血虚热郁，当用六味丸、逍遥散补阴养血，滋其化源，佐以导血
药可也。《医通》云∶膀胱阴虚而小便淋沥，生料六味合生脉散，大剂煎成，隔汤炖热，续续进之，
以滋化源。或补中益气汤，兼服六味地黄丸。更有收生不谨，以致损胞而得淋沥者，应用峻补，宜参术汤，
或用参术膏，煎以猪羊胞汤，极饥时饮之，令气血骤长，不过月余，其胞可完。丹溪曾治一妇，诊其脉虚
甚，用参、 为君，芎、归为臣，桃仁、陈皮、茯苓为佐，煎以猪羊胞汤服之，一月而愈。又有茅根汤，
并加味茅根汤、《济阴》加味四物汤，俱治淋方也。附录以备择用。
知柏导赤散
生地 赤芍 木通 麦冬（去心） 黄柏 知母（炒） 桂心 甘草（生。各一钱）
灯心四十九寸，水煎，调益元散二钱服。
益元散（一名天水散，一名六一散。） 治暑月小水不利。
滑石（六两，水飞） 甘草（炙六钱，生四钱）
为散，清水调服。老人虚人及病后伤津，小便不利禁用。加水飞辰砂一钱，名
辰砂六一散，治暑月惊悸多汗，小便涩痛。
参术汤 治妇人生产，稳婆误用手指掐胞损破，以致小便不禁。
人参（二钱五分） 白术（二钱，土炒） 黄 （一钱五分，蜜炙） 陈皮（去白） 桃仁（去
皮尖） 茯苓（各一钱） 炙草（五分）
先用猪胞或羊胞一个，洗净，水二盏，煮至一盏，去胞。入药，煎七分，食前服，多剂乃佳。
茅根汤 治赤、白、砂、石诸淋。
茅根（一两） 滑石（一钱， ） 甘草（五分） 紫贝（一个， ） 石首鱼脑砂（一个，焙
干，研为末。一方用二个， 。） 阙字姜（一块）
灯心三十寸，煎入鱼头末，空心温服。
加减茅根汤 治产后淋，小便痛及血淋等证。
白茅根（一两） 瞿麦 车前 冬葵子 通草（各一钱） 鲤鱼齿（一百个，为末）
水煎，入鱼齿末，空心温服。
济阴加味四物汤 诸淋皆属于热，用此累效。
当归 川芎 赤芍 生地 杜牛膝 木通 甘草梢（各一钱） 桃仁（五个，去皮尖） 滑石
（一钱五分） 木香（二分）
水煎服。
六味地黄丸（见上卷诸痛门，附六味地黄汤下。） 补中益气汤（见上卷诸痛门。）
逍遥散（见上卷胎逆上逼门。） 生脉散（见本卷晕厥门。） 参术膏（见本卷类疟
及寒热往来门。）
产后淋证，这是由于失血过多导致阴虚，进而产生内热所致。肾为至阴之脏，主管水液代谢通道，若失血过多，真阴亏损，因此产生内热，使小便变成淋证并伴有涩痛。这是因为热邪客居于膀胱（脬），虚则导致小便频数，热则导致涩痛。若气血兼有热邪，血液进入胞宫，则血液随小便排出而形成血淋。但是，小便淋沥不畅与小便完全不通应当分别进行治疗。小便不通属于气虚，而淋证属于内热引起的涩痛。因此，密斋治疗淋证，使用知柏导赤散，配合益元散调理治疗。冯氏说：血虚且热邪郁结，应当使用六味丸、逍遥散来补阴养血，滋养化源，辅以导血药物即可。《医通》说：膀胱阴虚导致小便淋沥不尽，可用生料六味丸合生脉散，大剂量煎煮后，隔水炖热，连续服用，以滋养化源。或者服用补中益气汤，同时兼服六味地黄丸。更有因接生不谨慎，以致损伤胞宫而得淋沥不尽的，应用峻补之法，宜用参术汤，或用参术膏，用猪羊胞汤煎服，在极度饥饿时饮用，使气血迅速增长，不过一个月左右，其胞宫可恢复完整。丹溪曾治疗一位妇女，诊察其脉象非常虚弱，用人参、[缺字]为君药，川芎、当归为臣药，桃仁、陈皮、茯苓为佐药，用猪羊胞汤煎服，一个月痊愈。又有茅根汤，以及加味茅根汤、《济阴》加味四物汤，都是治疗淋证的方剂。附录于此以备选用。
知柏导赤散
生地、赤芍、木通、麦冬（去心）、黄柏、知母（炒）、桂心、甘草（生，各一钱）。灯心草四十九寸，水煎，调服益元散二钱。
益元散（一名天水散，一名六一散。）治疗暑月小便不利。
滑石（六两，水飞法处理）、甘草（炙六钱，生四钱）。
研为散剂，用清水调服。老人、体虚者及病后伤津者，小便不利者禁用。加水飞辰砂一钱，名为辰砂六一散，治疗暑月惊悸多汗，小便涩痛。
参术汤 治疗妇人生产时，稳婆误用手指掐破胞宫，以致小便不禁。
人参（二钱五分）、白术（二钱，土炒）、黄芪（一钱五分，蜜炙）、陈皮（去白）、桃仁（去皮尖）、茯苓（各一钱）、炙甘草（五分）。
先用猪胞或羊胞一个，洗净，加水两盏，煮至一盏，去掉胞衣。加入药物，煎至七分，饭前服用，多服几剂效果更佳。
茅根汤 治疗赤淋、白淋、砂淋、石淋等各种淋证。
白茅根（一两）、滑石（一钱，[缺字]）、甘草（五分）、紫贝（一个，[缺字]）、石首鱼脑砂（一个，焙干，研为末。另一方案用二个，[缺字]）。[缺字]姜（一块）。
灯心草三十寸，煎入鱼头末，空腹温服。
加减茅根汤 治疗产后淋证，小便疼痛及血淋等证候。
白茅根（一两）、瞿麦、车前子、冬葵子、通草（各一钱）、鲤鱼齿（一百个，研为末）。
水煎，加入鱼齿末，空腹温服。
济阴加味四物汤 各种淋证皆属于热，使用此方屡见疗效。
当归、川芎、赤芍、生地、杜牛膝、木通、甘草梢（各一钱）、桃仁（五个，去皮尖）、滑石（一钱五分）、木香（二分）。
水煎服。
六味地黄丸（见上卷诸痛门，附六味地黄汤下。）补中益气汤（见上卷诸痛门。）逍遥散（见上卷胎逆上逼门。）生脉散（见本卷晕厥门。）参术膏（见本卷类疟及寒热往来门。）
Postpartum strangury (Lin syndrome) arises from Yin deficiency due to excessive blood loss, which generates internal heat. The Kidney is the organ of extreme Yin and governs the water passages. Excessive blood loss depletes True Yin, thereby generating internal heat, causing urine to become strangury with astringency and pain. This occurs because heat pathogen lodges in the bladder (Pao); deficiency leads to frequent urination, while heat leads to astringency and pain. If Qi and Blood are combined with heat, and blood enters the uterus (Bao), blood follows the urine to form bloody strangury (Xue Lin). However, strangury with dribbling must be distinguished from and treated differently from urinary retention. Urinary retention belongs to Qi deficiency, whereas strangury belongs to internal heat causing astringency and pain. Therefore, Mizhai treats strangury using Zhi Bai Dao Chi San, regulating it with Yi Yuan San. Feng Shi stated: For Blood deficiency with heat stagnation, Liu Wei Wan and Xiao Yao San should be used to tonify Yin and nourish Blood, nourishing the source of transformation, assisted by blood-guiding herbs. *Yi Tong* states: Bladder Yin deficiency causing dribbling urine can be treated with Sheng Liao Liu Wei He Sheng Mai San, decocted in large doses, warmed by steaming in hot water, and taken continuously to nourish the source of transformation. Alternatively, Bu Zhong Yi Qi Tang can be taken concurrently with Liu Wei Di Huang Wan. Furthermore, if careless midwifery causes damage to the uterus resulting in dribbling urine, severe tonification is required. Shen Zhu Tang or Shen Zhu Gao should be used, decocted with pig or sheep bladder soup, and drunk when extremely hungry to cause a rapid increase in Qi and Blood; within about a month, the uterus can recover its integrity. Danxi once treated a woman whose pulse was very deficient; he used Ren Shen and [missing character] as Sovereign herbs, Chuan Xiong and Dang Gui as Minister herbs, and Tao Ren, Chen Pi, and Fu Ling as Assistant herbs, decocted with pig or sheep bladder soup, resulting in recovery after one month. There is also Mao Gen Tang, along with Jia Wei Mao Gen Tang and *Ji Yin* Jia Wei Si Wu Tang, all formulas for treating strangury. These are appended for reference.
Zhi Bai Dao Chi San
Shu Di Huang, Chi Shao, Mu Tong, Mai Dong (heart removed), Huang Bo, Zhi Mu (stir-fried), Gui Xin, Gan Cao (raw, each 1 qian). Deng Xin Cao (49 cun), decocted in water, mixed with 2 qian of Yi Yuan San for administration.
Yi Yuan San (also known as Tian Shui San or Liu Yi San.) Treats difficult urination during summer months.
Hua Shi (6 liang, processed by water flying), Gan Cao (roasted 6 qian, raw 4 qian).
Grind into powder, take with clear water. Contraindicated for the elderly, deficient persons, and those with fluid injury post-illness presenting with difficult urination. Add 1 qian of Chen Sha (processed by water flying), named Chen Sha Liu Yi San, to treat palpitations and excessive sweating during summer months with astringent and painful urination.
Shen Zhu Tang Treats women whose bladders were accidentally punctured by fingers of midwives during childbirth, leading to urinary incontinence.
Ren Shen (2.5 qian), Bai Zhu (2 qian, stir-fried with soil), Huang Qi (1.5 qian, honey-roasted), Chen Pi (white part removed), Tao Ren (skin and tip removed), Fu Ling (each 1 qian), Zhi Gan Cao (0.5 qian).
First, take one pig or sheep bladder, wash clean, add two cups of water, boil down to one cup, remove the bladder. Add the herbs, decoct to 0.7 parts, take before meals; multiple doses yield better results.
Mao Gen Tang Treats red, white, sand, and stone stranguries.
Bai Mao Gen (1 liang), Hua Shi (1 qian, [missing character]), Gan Cao (0.5 qian), Zi Bei (one piece, [missing character]), Shi Shou Yu Nao Sha (one piece, baked dry and ground to powder. Another prescription uses two pieces, [missing character]). [Missing character] Jiang (one piece).
Deng Xin Cao (30 cun), decocted with fish head powder, taken warm on an empty stomach.
Jia Wei Mao Gen Tang Treats postpartum strangury, painful urination, and bloody strangury.
Bai Mao Gen (1 liang), Qu Mai, Che Qian, Dong Kui Zi, Tong Cao (each 1 qian), Li Yu Chi (100 pieces, ground to powder).
Decoct in water, add fish tooth powder, take warm on an empty stomach.
Ji Yin Jia Wei Si Wu Tang All types of strangury belong to heat; this formula has proven effective repeatedly.
Dang Gui, Chuan Xiong, Chi Shao, Shu Di Huang, Du Niu Xi, Mu Tong, Gan Cao Shao (each 1 qian), Tao Ren (five pieces, skin and tip removed), Hua Shi (1.5 qian), Mu Xiang (0.2 fen).
Decoct in water and take.
Liu Wei Di Huang Wan (See Upper Volume, Section on Various Pains, attached under Liu Wei Di Huang Tang.) Bu Zhong Yi Qi Tang (See Upper Volume, Section on Various Pains.) Xiao Yao San (See Upper Volume, Section on Fetal Reversal Pressing Upward.) Sheng Mai San (See This Volume, Section on Syncope.) Shen Zhu Gao (See This Volume, Section on Malaria-like Conditions and Alternating Chills and Fever.)