牙疼。加升麻（五分）、白芷（八分）、黄连（一钱）、川椒（七粒）。
走马牙疳。以女人溺桶中白垢。火 一钱。铜绿（三分）、胆矾（二分）、麝香（一分）、研末敷
上。立效。
咽喉肿痛。加黄连、山豆根（各一钱）、玄参、桔梗（各八分）、牛蒡子（一钱五分）、升麻（
三分）、一法本方加马兰根、夏枯草（各二钱三钱）、大抵咽喉之症。所关甚急。煎药则但能拔去
火邪耳。惟以针刺出血。为急要法也。
脉 淋家之脉。尺细而数。左尺脉数。妇人则阴中生疮。男子则为气淋。肺脉浮弦而涩。为
便闭。鼻头色黄者。小便难。尺寸急数。为小便闭。右寸肺主之。左尺肾膀胱主之。尺脉芤
者。便血。尺脉实数者。热结膀胱而小便淋沥不利也。 遗精白浊。 女人带下赤白。尺寸
必洪大而涩。按之无力。或细微。或沉紧而涩。皆为元气不足。又云∶急疾者难治。迟者
易治。女人两尺弦细者。必白带。洪数者。必赤带。淋浊带下。皆下焦湿热之所为也。 疝
脉。关尺弦急。或寸口弦紧为寒。豁大急搏为热。沉迟浮涩皆为疝。痛视在何部。而知其
脏。如心肝脾肺肾之属。各按本经脉症治之。又云∶牢急者生。弱急者死。 崩漏之脉。
两尺洪数而疾为热。微迟弦细为寒。寸微。关弦。尺芤。为气盛血衰。大抵血崩之脉。属火者
脉多洪数。又云∶迟缓者易治。急疾者难治。
症 丹溪云∶淋有五。皆属于热。又云小便滴沥痛者淋。急满不痛者。谓之闭也。亦有痰气
闭塞于上。热结于下。宜吐以提其气。气升则水自降。而热自除。盖气乘其水。而气不得下
输。热结膀胱。而小便淋闭不利也。譬犹滴水之器。必上窍通而下窍之水出焉。其斯之谓欤
。戴氏云∶便浊带下。俱属湿热。虽有赤白之异。终无寒热之分。河间云∶天气热则水浑
浊。寒则澄清。由此观之。湿热明矣。盖寒则坚凝。而热则流通故也。何疑之有哉。 集成
云疝之一症。专主肝经。肾经绝无相干。或曰∶肝经与冲任督脉所会。聚于阴器。伤于寒。
则阴缩。伤于热。则纵挺不收。盖木性急速。火性暴。而痛亦暴也。前人论疝甚多。或曰膀
胱。或曰肾。或曰小肠气。其实皆归于肝经也。大抵此病始于湿热在经。遏而至久。又得寒
气外束。不得疏散。所以作痛。若只作寒论。恐为未备。必兼湿热乃可。 内经曰∶阴虚阳
抟谓之崩。按东垣论云∶由脾胃气亏。下陷于肾。与相火相合。湿热下迫。而致崩也。亦有
肾水枯竭。真阴虚损。不能镇守胞络相火。故血走而崩也。盖脾胃气血之本。心者血之府。
脉者人之神。俱不足而生火。火得以乘虚。而迫血妄行也。宜详治之。
治 治法云∶淋属湿热。宜五苓，加山栀、木通、老人血气虚而淋。宜参、 、归、术、带
木通、山栀、肾虚者补肾。兼利小便。不可独用利药。死血者。四物汤，加牛膝主之。痰气
滞于上焦。宜二陈吐之。若湿热流注下焦。热结膀胱。而小便闭涩。用益原散。以黄柏、山
栀、泽泻、煎汤调下。切当大抵淋闭之症。有肺燥不能生水。治宜清金。车前子、茯苓、麦
门冬、黄芩之类。有热结膀胱。宜泻膀胱火。黄柏、知母之类。有脾湿不运。而精不升
。故肺不能生水。当燥湿健脾。苍白术、陈皮之类。治各有别。 丹溪云∶浊与带同是湿
热。白属气。赤属血。治以清热渗湿为主。气虚入参术。血虚入芎归。甚者必用吐以提其气
。下用二陈。加二术、白芍药、黄柏、煎服。丸药以樗根、白皮、黄柏、青黛、干姜、滑石
、蛤粉、神曲、糊丸服。或用六味地黄丸尤妙。亦有思虑过度。则水火不交。快情恣欲。而
精元失守。故尿前尿后。凝结流下。名曰白浊。亦曰遗精。宜抑火养心。安脾。实肾。则水
火相交。其流固自清矣。 辨疑录云∶疝症本湿热。怒气伤肝。房劳过伤。心肾胞络之火郁
结于内。盖小肠乃多气少血之经。心气郁结。则腑受邪。肝气一盛。而子亦盛矣。故二气攻入
小肠膀胱。而痛作矣。治用五苓散。内加行气之药。乃利小便出邪之法。按药性云∶猪苓泽
泻。分阴阳以和心。心与小肠为表里。心和则小肠之气亦通矣。白术利腰脐间湿。并死血。茯
苓淡渗利窍行湿。桂伐肝邪。伐其本也。加茴香。善治小肠之气。金铃子橘核。去膀胱肾气
。槟榔坠下。少加木通。以为导引小肠之火出也。治亦近理。又法治疝、盖因湿热为寒郁而
发。用山栀子以降湿热。乌头以破寒郁。二味皆下焦之药。而乌头为栀子所引。其效甚速。
女人崩漏。多因七情之火内动。或因气所使而下。急则治其标。白芷汤。调下百草霜。甚
者棕榈灰。莲蓬灰。血余灰。俱妙。
缓则治其本。以四物汤。加参术、黄 、便制香附、地榆、蒲黄、荆芥穗（各等分）、升麻、
（五分）、屡治有效。宜随症加减用之。
方 加减五苓散治诸淋。及小便闭涩随症加减用。
白术（一钱） 赤茯苓（一钱） 泽泻（一钱） 木通（一钱五分） 滑石（一钱） 桂（三分） 郁李
仁（八分） 黄芩（一钱） 山栀子（一钱） 甘草梢（五分） 秋石（一钱） 黄柏（童便炒一钱）
上作一服。水一钟半。灯心一握。煎八分空心服。
血淋。加当归（一钱五分）、生地黄（一钱）、牛膝（一钱）、藕节、侧柏叶（各一钱），去桂。
气淋。加青皮、香附、海石（各一钱）、沉香（五分）。
结热蓄于下焦。成砂石淋。加归尾（一钱）、黄柏（加一倍）、大黄（三钱）。
小便血出如淋。加归身尾、小蓟根、生地黄、侧柏叶、藕节、蒲黄（生用各等分）、小便前后
血。加同上。
小便闭不通。加车前子（一钱五分）、大黄（生三钱或五钱）、海金砂（一钱）、小便涩。加青皮
（七分）、黄连（八分）、枳壳（七分）。
小便多。或不禁。或不时遗出。以八味丸。减泽泻一半。
黄柏、知母、煎汤吞下。一月即效。亦可治久远遗精白浊。
又方 加减厘清饮治赤白浊。梦遗精滑。及女人赤白带下。
白术 白茯神 麦门冬 黄连 黄柏 益智仁 川萆 石菖蒲 乌药 泽泻 牡蛎 石莲
肉（各等分）。
上作一服。水一钟半。姜枣煎。食前服。
血虚。加当归、地黄（各等分）。
气虚。加黄 、人参（各等分）。
阴火动。加黄柏、知母（各等分）、桂（三分）。
日久者。加升麻、柴胡（各五分）、龙骨（ 一钱）。
女人赤白带。加樗根、白皮、赤石脂（各等分）。
肥人带是湿痰。加海石、半夏、苍术、川芎、香附（各等分）。
瘦人无带。有即是热。加香附、山栀、青黛（各等分）。
思想无穷。所欲不遂。梦遗精滑。治在心脾。加半夏、陈皮、甘草、人参、远志、酸枣仁、
（各等分）、夜服安神丸。晨服坎离丸。莲肉汤下。或以黄柏知母。煎汤吞下八味丸亦可。
女人夜梦鬼交。四物。加香附。茯神、远志、石菖蒲、牡蛎（ ）、赤石脂（各等分）、清晨用
莲肉汤调下妙香散。
又方 橘核顺气汤治疝偏坠。此药劫痛行。渗湿清热。
白术 白茯苓（各一钱） 泽泻（七分） 木通（一钱） 青皮（七分） 桂枝（五分） 橘核（一钱
）川楝子（一钱） 山栀（一钱五分） 川乌（八分） 木香（五分不见火） 槟榔（七分）
上作一服。水一钟半。煎。空心服。
血滞。加桃仁、当归（各等分）。
气滞。加沉香（五分）、小茴香（七分）。
寒疝。加吴茱萸（一钱）、山栀、川乌、倍用。
湿郁疝。加苍术（一钱五分）、木瓜（一钱）
食积滞而成疝。加山楂、枳实（各一钱）。
痰涎流注成疝。加半夏、南星、海石、香附（各等分）。
又方 四物调中汤治血崩。因七情所伤。脾胃不运。肾水亏损。不能镇守胞络相火。以致
水火不交。而血妄下。此缓则治其本也。必多服乃效。
川芎（一钱） 当归 白芍药 生地黄 熟地黄 人参 黄 白术 麦门冬 阿胶（炒） 香
附（各一钱五分） 荆芥穗 黄柏 黄连 地榆（各八分） 升麻（三分） 柴胡（五分） 陈皮（
一钱）
上十八味作一服。姜枣。水二钟。煎。食前服。渣煎食远服。
又方 凉血地黄汤治症同前。此急则治其标也。二三服即效。
川芎（一钱） 当归 白芍药 生地黄 黄芩（各一钱五分） 黄柏 知母 本 荆芥穗 蔓
荆子（各一钱） 细辛（五分） 黄连 羌活 防风（各八分） 升麻 柴胡（各五分） 甘草 红
花（各三分）
上十八味作一服。姜枣煎。空心服。渣食远服。
牙痛。在原方基础上加升麻（五分）、白芷（八分）、黄连（一钱）、川椒（七粒）。
走马牙疳（一种发病迅速、腐蚀严重的口腔疾病）。取女性尿桶中的白色垢物，经火煅烧后得一钱，配合铜绿（三分）、胆矾（二分）、麝香（一分），研成细末敷于患处。立即见效。
咽喉肿痛。加黄连、山豆根（各一钱）、玄参、桔梗（各八分）、牛蒡子（一钱五分）、升麻（三分）。另一种方法是在本方中加入马兰根、夏枯草（各二钱至三钱）。大抵咽喉病症，关系非常紧急。煎服汤药只能去除火邪，唯有针刺出血，才是急救的重要方法。
脉象：患淋证者的脉象，尺部脉细而数。左尺脉数，妇人则阴中生疮，男子则为气淋。肺脉浮弦而涩，主大便闭塞。鼻头色黄者，小便困难。寸关尺三部脉急数，主小便闭塞。右寸脉由肺所主，左尺脉由肾和膀胱所主。尺脉芤者，主便血。尺脉实数者，为热结膀胱而小便淋漓不畅。遗精和白浊，女人赤白带下，寸关尺脉必洪大而涩，按之无力；或细微；或沉紧而涩，这些都是元气不足的表现。又说：脉象急疾的难治，脉象迟缓的易治。女人两尺脉弦细的，必有白带；脉洪数的，必有赤带。淋证、白浊、带下，都是下焦湿热所致。疝气的脉象，关部和尺部脉弦急，或寸口脉弦紧为寒证；脉形豁大且急搏为热证；脉沉迟或浮涩皆为疝气。疼痛部位视病在何部，从而知道涉及哪个脏腑，如心、肝、脾、肺、肾等，分别按照各自经脉的症状治疗。又说：脉牢急者生，脉弱急者死。崩漏的脉象，两尺脉洪数而疾为热证；脉微迟弦细为寒证。寸脉微，关脉弦，尺脉芤，为气盛血衰。大抵血崩的脉象，属火的多见洪数脉。又说：脉迟缓的易治，脉急疾的难治。
症状：朱丹溪说：淋证有五种，都归属于热证。又说小便滴沥疼痛的叫淋证，急满但不痛的叫闭证。也有因痰气闭塞于上焦，热结于下焦，宜用吐法以提举其气，气升则水自降，而热自除。这是因为气乘于水，气不能下行输布，热结膀胱，导致小便淋闭不利。好比滴水之器，必须上窍通畅，下窍的水才能流出，说的就是这个道理。戴氏说：便浊和带下，都属于湿热，虽然有赤白之分，但最终没有寒热之别。河间刘完素说：天气热则水浑浊，天冷则水澄清，由此看来，湿热是明确的。因为寒则坚凝，而热则流通，有什么可怀疑的呢？《集成》说疝气这一病症，专门主责于肝经，与肾经绝无关系。有人说：肝经与冲脉、任脉、督脉交会，聚于阴器，受寒则阴囊收缩，受热则弛纵不收。因为木性急速，火性暴烈，所以疼痛也来得突然。前人论述疝气很多，有的说是膀胱病，有的说是肾病，有的说是小肠气，其实都归结于肝经。大抵此病始于湿热在经络中，郁遏日久，又得寒气外束，不得疏散，所以作痛。如果只当作寒证论治，恐怕不够全面，必须兼治湿热才行。《内经》说：阴虚阳搏谓之崩。按李东垣的论述说：由于脾胃气虚，下陷于肾，与相火相合，湿热下迫，而导致崩漏。也有因肾水枯竭，真阴虚损，不能镇守胞络中的相火，故血液妄行而崩漏。脾胃是气血的根本，心是血的府库，脉是人的神气所在，这些都不足而生火，火得以乘虚而入，逼迫血液妄行。应当详细治疗。
治法：治法云：淋证属于湿热，宜用五苓散，加山栀、木通；老人气血虚弱而患淋证，宜用人参、[缺字]、当归、白术，加木通、山栀；肾虚者补肾，兼利小便，不可单独使用利尿药。有瘀血者，用四物汤加牛膝为主治。痰气滞于上焦，宜用二陈汤催吐。若湿热流注下焦，热结膀胱，导致小便闭涩，用益元散，以黄柏、山栀、泽泻煎汤调服。切要的是：大抵淋闭之症，有因肺燥不能生水，治宜清金，用车前子、茯苓、麦门冬、黄芩之类；有因热结膀胱，宜泻膀胱之火，用黄柏、知母之类；有因脾湿不运，导致精微不升，故肺不能生水，当燥湿健脾，用苍术、白术、陈皮之类。治疗各有不同。朱丹溪说：白浊与带下同是湿热，白色属气分，红色属血分，治疗以清热渗湿为主。气虚加入人参、白术，血虚加入川芎、当归。严重者必须用吐法以提举其气，下部用二陈汤，加二术、白芍药、黄柏，煎服。丸药用樗根白皮、黄柏、青黛、干姜、滑石、蛤粉、神曲，糊丸服用。或用六味地黄丸尤其好。也有因思虑过度，导致水火不交，纵欲过度，导致精元失守，所以在尿前尿后，凝结流下，名叫白浊，也叫遗精。宜抑火养心，安脾，实肾，则水火相交，其流自然清澈。《辨疑录》说：疝症本是湿热，怒气伤肝，房劳过伤，心肾胞络之火郁结于内。盖小肠是多气少血的经络，心气郁结，则腑受邪，肝气一盛，子脏亦盛。故二气攻入小肠膀胱，而疼痛发作。治疗用五苓散，内加行气药，这是利小便排出邪气的方法。按《药性论》说：猪苓、泽泻分阴阳以调和心，心与小肠互为表里，心和则小肠之气也通。白术利腰脐间的湿，并除死血；茯苓淡渗利窍行湿；桂枝伐肝邪，治其根本。加小茴香，善治小肠之气；金铃子、橘核，去膀胱肾气；槟榔坠下，少加木通，作为引导小肠之火排出的引经药。治疗也很合理。又有法治疝气，盖因湿热被寒邪郁遏而发，用山栀子以降湿热，乌头以破寒郁，两味都是下焦的药，而乌头被栀子所引导，疗效很快。女人崩漏，多因七情之火内动，或因气机失调而下陷。急则治其标，用白芷汤，调下百草霜，甚者用棕榈灰、莲蓬灰、血余灰，都很妙。缓则治其本，用四物汤，加人参、白术、黄芪、酒制香附、地榆、蒲黄、荆芥穗（各等分）、升麻（五分），屡治有效。宜随症状加减使用。
方剂：加减五苓散治疗各种淋证，及小便闭涩，随症加减使用。
白术（一钱） 赤茯苓（一钱） 泽泻（一钱） 木通（一钱五分） 滑石（一钱） 桂枝（三分） 郁李仁（八分） 黄芩（一钱） 山栀子（一钱） 甘草梢（五分） 秋石（一钱） 黄柏（童便炒一钱）
以上为一服，用水一钟半，灯心草一握，煎至八分，空腹服用。
血淋，加当归（一钱五分）、生地黄（一钱）、牛膝（一钱）、藕节、侧柏叶（各一钱），去掉桂枝。
气淋，加青皮、香附、海浮石（各一钱）、沉香（五分）。
热结蓄于下焦，形成砂石淋，加归尾（一钱）、黄柏（加倍）、大黄（三钱）。
小便出血如淋状，加归身尾、小蓟根、生地黄、侧柏叶、藕节、蒲黄（生用各等分），小便前后出血，加上述药物。
小便闭不通，加车前子（一钱五分）、大黄（生用三钱或五钱）、海金沙（一钱），小便涩痛，加青皮（七分）、黄连（八分）、枳壳（七分）。
小便多，或不禁，或不时遗出，用八味丸，减去一半泽泻。
黄柏、知母，煎汤吞服八味丸，一个月即见效。也可治疗久远的遗精白浊。
又一方：加减厘清饮治疗赤白浊、梦遗精滑，及女人赤白带下。
白术 白茯神 麦门冬 黄连 黄柏 益智仁 川萆薢 石菖蒲 乌药 泽泻 牡蛎 石莲子肉（各等分）。
以上为一服，用水一钟半，生姜、大枣煎，饭前服用。
血虚，加当归、地黄（各等分）。
气虚，加黄芪、人参（各等分）。
阴火动，加黄柏、知母（各等分）、桂枝（三分）。
病程日久者，加升麻、柴胡（各五分）、龙骨（一钱）。
女人赤白带，加樗根白皮、赤石脂（各等分）。
肥胖之人带下是湿痰，加海浮石、半夏、苍术、川芎、香附（各等分）。
瘦人无带，若有即是热，加香附、山栀、青黛（各等分）。
思想无穷，欲望不遂，梦遗精滑，治疗在心脾，加半夏、陈皮、甘草、人参、远志、酸枣仁（各等分），夜服安神丸，晨服坎离丸，莲子肉汤送下。或以黄柏、知母煎汤吞服八味丸亦可。
女人夜梦鬼交，用四物汤，加香附、茯神、远志、石菖蒲、牡蛎（煅）、赤石脂（各等分），清晨用莲子肉汤调下妙香散。
又一方：橘核顺气汤治疗疝气偏坠。此药能劫痛行气，渗湿清热。
白术 白茯苓（各一钱） 泽泻（七分） 木通（一钱） 青皮（七分） 桂枝（五分） 橘核（一钱） 川楝子（一钱） 山栀（一钱五分） 川乌（八分） 木香（五分，不见火） 槟榔（七分）
以上为一服，用水一钟半，煎煮，空腹服用。
血滞，加桃仁、当归（各等分）。
气滞，加沉香（五分）、小茴香（七分）。
寒疝，加吴茱萸（一钱）、山栀、川乌，加倍使用。
湿郁疝，加苍术（一钱五分）、木瓜（一钱）。
食积滞而成疝，加山楂、枳实（各一钱）。
痰涎流注成疝，加半夏、南星、海浮石、香附（各等分）。
又一方：四物调中汤治疗血崩，因七情所伤，脾胃不运，肾水亏损，不能镇守胞络相火，以致水火不交，而血液妄下。这是缓则治其本的方法，必须多服才见效。
川芎（一钱） 当归 白芍药 生地黄 熟地黄 人参 黄芪 白术 麦门冬 阿胶（炒） 香附（各一钱五分） 荆芥穗 黄柏 黄连 地榆（各八分） 升麻（三分） 柴胡（五分） 陈皮（一钱）
以上十八味为一服，生姜、大枣，水二钟，煎煮，饭前服用。药渣再煎，饭后服用。
又一方：凉血地黄汤治疗症状同上。这是急则治其标的方法，二三服即见效。
川芎（一钱） 当归 白芍药 生地黄 黄芩（各一钱五分） 黄柏 知母 藁本 荆芥穗 蔓荆子（各一钱） 细辛（五分） 黄连 羌活 防风（各八分） 升麻 柴胡（各五分） 甘草 红花（各三分）
以上十八味为一服，生姜、大枣煎，空腹服用。药渣饭后服用。
Toothache. Add Shengma (Rhizoma Cimicifugae, 5 fen), Baizhi (Radix Angelicae Dahuricae, 8 fen), Huanglian (Rhizoma Coptidis, 1 qian), and Chuanjiao (Pericarpium Zanthoxyli, 7 grains).
Zouma Yagan (Rapidly progressing cancrum oris). Use the white scum from a woman's urine bucket, calcined by fire to obtain 1 qian, combined with Tonglü (Malachite, 3 fen), Danfan (Alumen, 2 fen), and Muxiang (Musk, 1 fen). Grind into powder and apply to the affected area. Immediate effect.
Sore throat and swelling. Add Huanglian (Rhizoma Coptidis), Shandougen (Radix Sophorae Tonkinensis) (1 qian each), Xuanshen (Radix Scrophulariae, 8 fen), Jiegeng (Radix Platycodonis, 8 fen), Niubangzi (Fructus Arctii, 1.5 qian), and Shengma (Rhizoma Cimicifugae, 3 fen). Another method is to add Malangen (Radix Kalimeritidis) and Xiakucao (Herba Prunellae) (2-3 qian each) to the base formula. Generally, throat conditions are critical. Decoction can only clear fire pathogens; pricking to bleed is the urgent and essential method.
Pulse: The pulse of patients with Lin syndrome (dysuria) is fine and rapid at the Chi position. A rapid Left Chi pulse in women indicates sores in the vagina, while in men it indicates Qi Lin (Qi-type dysuria). The Lung pulse is floating, wiry, and choppy, indicating constipation. Yellow color on the nose tip indicates difficult urination. Rapid and forceful pulses at Cun, Guan, and Chi positions indicate urinary retention. The Right Cun pulse is governed by the Lung, and the Left Chi pulse is governed by the Kidney and Bladder. A Khao (hollow) Chi pulse indicates blood in stool. A solid and rapid Chi pulse indicates heat accumulation in the Bladder causing dribbling and incomplete urination. Spermatorrhea and white turbidity, as well as red and white leukorrhea in women, present with surging, large, and choppery pulses at Cun, Guan, and Chi, which feel weak upon pressure; or they may be fine and minute, or deep, tight, and choppy. These all indicate insufficiency of Yuanqi (Original Qi). It is also said that rapid pulses are difficult to treat, while slow pulses are easy to treat. In women, wiry and fine pulses at both Chi positions indicate white leukorrhea, while surging and rapid pulses indicate red leukorrhea. Lin syndrome, white turbidity, and leukorrhea are all caused by Damp-Heat in the Lower Jiao. The pulse for Shan syndrome (hernia) is wiry and urgent at the Guan and Chi positions, or wiry and tight at the Cun position, indicating Cold; a wide and forceful pulse indicates Heat; deep-slow or floating-choppy pulses all indicate Shan. Pain location determines the involved Zang-Fu organs (Heart, Liver, Spleen, Lung, Kidney), treated according to their respective meridians and symptoms. It is also said that firm and urgent pulses indicate survival, while weak and urgent pulses indicate death. The pulse for Benglou (metrorrhagia and metrostaxis) shows surging, rapid, and疾 (hurried) pulses at both Chi positions for Heat; micro-slow, wiry, and fine pulses for Cold. Micro pulse at Cun, wiry at Guan, and Khao at Chi indicate Excess Qi and Deficient Blood. Generally, pulses for blood beng belong to Fire and are often surging and rapid. It is also said that slow pulses are easy to treat, while rapid pulses are difficult to treat.
Symptoms: Zhu Danxi stated: There are five types of Lin syndrome, all belonging to Heat. He also stated: Dribbling and painful urination is called Lin; sudden fullness without pain is called Bi (retention). There are cases where Phlegm-Qi blocks the Upper Jiao and Heat accumulates in the Lower Jiao; vomiting should be induced to raise the Qi. When Qi rises, Water descends, and Heat is eliminated. This is because Qi acts upon Water, preventing Qi from descending and transporting, leading to Heat accumulation in the Bladder and obstructed urination. It is like a water-dropping vessel: if the upper orifice is open, water flows out from the lower orifice. Dai Shi stated: White turbidity and leukorrhea both belong to Damp-Heat. Although there are differences between red and white, there is ultimately no distinction between Cold and Heat. Liu Wan-su (Hejian) stated: Hot weather makes water turbid, while cold weather makes it clear. Thus, Damp-Heat is evident. Cold causes coagulation, while Heat causes flow, so what is there to doubt? *Jicheng* stated that Shan syndrome primarily involves the Liver Meridian and has nothing to do with the Kidney Meridian. Some say: The Liver Meridian intersects with the Chong, Ren, and Du meridians and gathers at the genitalia. Injury by Cold causes retraction; injury by Heat causes flaccidity and prolapse. Wood nature is swift, Fire nature is violent, so pain is also sudden. Predecessors discussed Shan extensively, attributing it to the Bladder, Kidney, or Small Intestine Qi, but it essentially归于 (belongs to) the Liver Meridian. Generally, this disease begins with Damp-Heat stagnating in the meridians, persisting for a long time, compounded by external Cold constraining it, preventing dispersion, thus causing pain. Treating it solely as Cold is insufficient; one must address both Cold and Damp-Heat. *Neijing* states: Yin deficiency with Yang pounding is called Beng. Li Dongyuan argued: Due to Spleen-Stomach Qi deficiency sinking into the Kidney, combining with Ministerial Fire, Damp-Heat forces downward, causing Beng. Also, when Kidney Water is exhausted and True Yin is damaged, it cannot control the Ministerial Fire in the Bao Luo (uterine network), causing blood to rush and Beng. The Spleen and Stomach are the root of Qi and Blood; the Heart is the mansion of Blood; the Pulse is the spirit of humans. Insufficiency in these generates Fire, which takes advantage of deficiency to force blood to move recklessly. Detailed treatment is required.
Treatment Methods: Treatment methods state: Lin syndrome belongs to Damp-Heat, suitable for Wuling San (Five-Ingredient Powder with Poria), adding Zhizi (Fructus Gardeniae) and Mutong (Caulis Akebiae); for elderly patients with Qi and Blood deficiency suffering from Lin, use Renshen (Radix Ginseng), [missing character], Danggui (Radix Angelicae Sinensis), Baizhu (Rhizoma Atractylodis Macrocephalae), plus Mutong and Zhizi; for Kidney deficiency, tonify the Kidney and promote urination simultaneously; do not use diuretics alone. For stasis blood, use Siwu Tang (Four-Substance Decoction) added with Niuxi (Radix Achyranthis Bidentatae). For Phlegm-Qi stagnation in the Upper Jiao, induce vomiting with Erchen Tang (Two-Aged Decoction). If Damp-Heat flows to the Lower Jiao and Heat accumulates in the Bladder causing obstructed urination, use Yiyuan San (Benefit Origin Powder), administered with a decoction of Huangbai (Cortex Phellodendri), Zhizi, and Zexie (Rhizoma Alismatis). Crucially, for Lin and Bi syndromes: if caused by Lung Dryness failing to generate Water, treat by clearing Metal using Qiancaizi (Semen Plantaginis), Fuling (Poria), Maidong (Radix Ophiopogonis), and Huangqin (Radix Scutellariae); if caused by Heat accumulation in the Bladder, purge Bladder Fire using Huangbai and Zhimu (Radix Anemarrhenae); if caused by Spleen Dampness failing to transport, leading to failure of Essence to ascend and thus Lung failing to generate Water, dry Dampness and strengthen the Spleen using Cangzhu (Rhizoma Atractylodis) and Baizhu, plus Chenpi (Pericarpium Citri Reticulatae). Treatments differ. Zhu Danxi stated: Turbidity and leukorrhea are both Damp-Heat. White belongs to Qi, Red belongs to Blood. Treatment focuses on clearing Heat and leaching out Dampness. Add Renshen and Baizhu for Qi deficiency; add Xiong (Chuanxiong Rhizome) and Danggui for Blood deficiency. Severe cases require vomiting to raise Qi, followed by Erchen Tang below, added with Er Zhu (Cangzhu and Baizhu), Shaoyao (Radix Paeoniae Alba), and Huangbai, decocted and taken. Pills made from Chugen Baipi (Cortex Eucommiae/Phellodendri - context implies bark), Huangbai, Qingdai (Indigo Naturalis), Ganjiang (Rhizoma Zingiberis), Huashi (Talcum), Ge Fen (Concha Mercariae), Shenqu (Massa Medicata Fermentata), bound with paste. Alternatively, Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) is excellent. Cases of excessive worry causing Water and Fire not interacting, or excessive desire causing loss of Jing Yuan (Essence Original), result in condensation and flow before and after urination, named Bai Zhuo (White Turbidity) or Yi Jing (Spermatorrhea). Suppress Fire, nourish Heart, calm Spleen, and solidify Kidney so Water and Fire interact, ensuring clear flow. *Bianyilu* stated: Shan syndrome is originally Damp-Heat. Anger injures the Liver, sexual exhaustion injures deeply, causing Fire from Heart, Kidney, and Bao Luo to knot internally. The Small Intestine is a meridian of much Qi and little Blood. Heart Qi stagnation affects the Fu organ; Liver Qi excess leads to Son (Small Intestine) excess. Thus, both energies attack the Small Intestine and Bladder, causing pain. Treatment uses Wuling San with Qi-moving herbs to promote urination and expel pathogens. According to *Yaoxing Lun*: Zhuling (Polyporus) and Zexie divide Yin and Yang to harmonize the Heart; Heart and Small Intestine are exterior-interior pairs; when Heart is harmonized, Small Intestine Qi flows. Baizhu removes Dampness in the waist/navel and stasis blood; Fuling promotes urination and moves Dampness via mild seepage; Guizhi (Ramulus Cinnamomi) subdues Liver pathogen, treating the root. Add Huixiang (Fructus Foeniculi) to treat Small Intestine Qi; Jinlingzi (Fructus Toosendan) and Juhe (Semen Citri Reticulatae) remove Bladder and Kidney Qi; Binglang (Areca Seed) directs downward; add Mutong to guide Small Intestine Fire out. This treatment is reasonable. Another method for Shan: caused by Damp-Heat constrained by Cold, use Zhizi to descend Damp-Heat and Wutou (Radix Aconiti Lateralis Preparata) to break Cold constraint. Both are Lower Jiao herbs, with Wutou guided by Zhizi, yielding rapid effects. Women's Benglou is often due to internal movement of Fire from Seven Emotions or Qi sinking. Urgent treatment addresses the branch: Baixia Tang (Decoction of Angelica Dahurica) with Baixiaoshuang (Fuliginis Carbonis) is used; severe cases use Zongluzhui (Cortex Trichiocarpi Carbonis), Lianpeng Hui (Calyx Nelumbinis Carbonis), or Xueyu Hui (Calces Capillorum Humanorum). Slow treatment addresses the root: Siwu Tang added with Renshen, Baizhu, Huangqi (Radix Astragali), Jiuzhi Xiangfu (Rhizoma Cyperi Preparated with Vinegar), Diyü (Radix Sanguisorbae), Puhuang (Pollinis Typhae), and Jingjie Sui (Herba Schizonepetae) (equal parts), plus Shengma (5 fen). Repeatedly effective. Adjust according to symptoms.
Formulas: Jiajian Wuling San (Modified Five-Ingredient Powder with Poria) treats various Lin syndromes and obstructed urination, adjusted per symptoms.
Baizhu (1 qian) Chifuling (Red Poria, 1 qian) Zexie (1 qian) Mutong (1.5 qian) Huashi (1 qian) Gui (3 fen) Yuliren (Semen Pruni Armeniacae, 8 fen) Huangqin (1 qian) Zhizi (1 qian) Gancao Shao (Tip of Licorice Root, 5 fen) Qiushi (1 qian) Huangbai (Stir-fried with Child's Urine, 1 qian)
Take as one dose. Add 1.5 zhong of water and a handful of Dengxincao (Herba Junci). Decoct to 0.8 zhong. Take on an empty stomach.
For Xue Lin (Blood Dysuria), add Danggui (1.5 qian), Shengdihuang (Radix Rehmanniae Recens, 1 qian), Niuxi (1 qian), Ou jie (Node of Lotus Rhizome), and Ce bai ye (Cacumen Platycladi) (1 qian each). Remove Gui.
For Qi Lin (Qi Dysuria), add Qingpi (Pericarpium Citri Reticulatae Viride), Xiangfu (Rhizoma Cyperi), Haishi (Lapis Calcitae/Floating Stone) (1 qian each), and Chenxiang (Lignum Aquilariae Resinatum, 5 fen).
For Heat accumulating in the Lower Jiao forming Stone Lin, add Guiwei (Tail of Angelica Root, 1 qian), Huangbai (double dose), and Dahuang (Radix et Rhizoma Rhei, 3 qian).
For urination resembling blood discharge, add Guishenwei (Body and Tail of Angelica Root), Xiaoji Gen (Radix Cirsii Japonici), Shengdihuang, Ce bai ye, Ou jie, and Puhuang (raw, equal parts). For blood before and after urination, add the above.
For complete urinary obstruction, add Qiancaizi (1.5 qian), Dahuang (raw, 3 or 5 qian), Haijinsha (Spora Lygodii, 1 qian). For astringent urination, add Qingpi (7 fen), Huanglian (8 fen), Zhike (Fructus Aurantii, 7 fen).
For frequent urination, incontinence, or involuntary leakage, use Bawei Wan (Eight-Ingredient Pill), reducing Zexie by half.
Huangbai and Zhimu decocted to swallow Bawei Wan shows effect within one month. Also treats chronic spermatorrhea and white turbidity.
Another Formula: Jiajian Liqing Yin (Modified Clearing Turbidity Decoction) treats red/white turbidity, nocturnal emission, seminal slip, and red/white leukorrhea in women.
Baizhu Baifushen (Poria with Hostwood) Maidong Huanglian Huangbai Yizhiren (Fructus Alpiniae Oxyphyllae) Chuanbi (Rhizoma Dioscoreae Hypoglaucae) Shichangpu (Rhizoma Acori Tatarinowii) Wuyao (Radix Linderae) Zexie Muli (Concha Ostreae) Shilianrou (Seed Flesh of Nelumbo Nucifera) (equal parts)
Take as one dose. Add 1.5 zhong of water, Jiang (Ginger), and Zao (Jujube). Decoct. Take before meals.
For Blood deficiency, add Danggui and Dihuang (equal parts).
For Qi deficiency, add Huangqi and Renshen (equal parts).
For Yin Fire moving, add Huangbai and Zhimu (equal parts), Gui (3 fen).
For chronic cases, add Shengma and Chaihu (Bupleuri Radix, 5 fen each), Longgu (Os Draconis/Fossilia Ossis Mastodi, 1 qian).
For women's red/white leukorrhea, add Chugen Baipi and Chishizhi (Lapis Rubus, equal parts).
For obese individuals with Damp-Phlegm leukorrhea, add Haishi, Banxia (Rhizoma Pinelliae), Cangzhu, Chuanxiong, and Xiangfu (equal parts).
For thin individuals, lack of leukorrhea is normal; presence indicates Heat. Add Xiangfu, Zhizi, and Qingdai (equal parts).
For endless thoughts and unfulfilled desires causing nocturnal emission and slip, treat Heart and Spleen. Add Banxia, Chenpi, Gancao, Renshen, Yuanzhi (Radix Polygalae), and Suanzaoren (Semen Ziziphi Spinosae) (equal parts). Take Anshen Wan (Calming Spirit Pill) at night and Kanli Wan (Kidney-Heart Pill) in the morning, washed down with Lotus Seed Decoction. Alternatively, swallow Bawei Wan with Huangbai and Zhimu decoction.
For women experiencing nocturnal dreams of sexual intercourse, use Siwu Tang added with Xiangfu, Baifushen, Yuanzhi, Shichangpu, Muli (calcined), and Chishizhi (equal parts). Take Miaoxiao San (Wonderful Efficacy Powder) washed down with Lotus Seed Decoction early in the morning.
Another Formula: Juhe Shunqi Tang (Tangerine Seed Regulating Qi Decoction) treats Shan hernia with descent. This herb forcefully relieves pain, moves Qi, leaches Dampness, and clears Heat.
Baizhu Baifuling (Poria) (1 qian each) Zexie (7 fen) Mutong (1 qian) Qingpi (7 fen) Guizhi (5 fen) Juhe (1 qian) Chuanlianzi (Fructus Toosendan, 1 qian) Zhizi (1.5 qian) Chuanwu (Radix Aconiti Carminati, 8 fen) Muxiang (Radix Aucklandoniae, 5 fen, not roasted over fire) Binglang (7 fen)
Take as one dose. Add 1.5 zhong of water. Decoct. Take on an empty stomach.
For Blood stasis, add Taoren (Semen Persicae) and Danggui (equal parts).
For Qi stagnation, add Chenxiang (5 fen) and Xiaohuixiang (Fructus Foeniculi, 7 fen).
for Cold Shan, add Wuzhuyu (Fructus Evodiae, 1 qian), Zhizi, and Chuanwu, doubling the dosage.
For Damp-constrained Shan, add Cangzhu (1.5 qian) and Mugua (Fructus Chaenomelis, 1 qian).
For Shan caused by Food Stagnation, add Shanzha (Fructus Crataegi) and Zhishi (Fructus Aurantii Immaturus, 1 qian each).
For Shan caused by Phlegm-Saliva flowing, add Banxia, Nanxing (Rhizoma Arisaematis), Haishi, and Xiangfu (equal parts).
Another Formula: Siwu Tiaozhong Tang (Four-Substance Harmonizing Middle Decoction) treats blood beng caused by emotional injury, Spleen-Stomach dysfunction, Kidney Water deficiency failing to control Ministerial Fire in the Bao Luo, leading to non-interaction of Water and Fire and reckless blood descent. This is slow treatment addressing the root; multiple doses are needed for efficacy.
Chuanxiong (1 qian) Danggui Baishaoyao (Radix Paeoniae Alba) Shengdihuang Shudihuang (Radix Rehmanniae Preparata) Renshen Huangqi Baizhu Maidong Ejiao (Stir-fried) Xiangfu (1.5 qian each) Jingjie Sui Huangbai Huanglian Diyü (0.8 qian each) Shengma (3 fen) Chaihu (5 fen) Chenpi (1 qian)
Take eighteen ingredients as one dose. Add Jiang and Zao. Add 2 zhong of water. Decoct. Take before meals. Decoct dregs again and take after meals.
Another Formula: Liangxue Dihuang Tang (Cool Blood Rehmannia Decoction) treats the same symptoms. This is urgent treatment addressing the branch; effect seen in 2-3 doses.
Chuanxiong (1 qian) Danggui Baishaoyao Shengdihuang Huangqin (1.5 qian each) Huangbai Zhimu Gaoben (Radix Ligustici Chuanxiong) Jingjie Sui Manjingzi (Fructus Viticis Expansa, 1 qian each) Xixin (Radix et Rhizoma Asari, 5 fen) Huanglian Qianghuo (Rhizoma Notopterygii) Fangfeng (Radix Saposhnikoviae, 0.8 qian each) Shengma Chaihu (5 fen each) Gancao Honghua (Flos Carthami, 3 fen each)
Take eighteen ingredients as one dose. Decoct with Jiang and Zao. Take on an empty stomach. Decoct dregs and take after meals.