《原病式》云∶遗尿不禁者为冷。《内经》云∶不约为遗溺。仁斋曰∶小便者，
津液之余也，肾主水，膀胱为津液之府，肾与膀胱俱虚，而冷气乘之，故不能拘制
其水，出而不禁，谓之遗尿，睡里自出者，谓之尿床。此皆肾与膀胱俱虚，而挟冷
所致也，以鸡肠散主之。亦有热客于肾部，干于足厥阴之经，挺孔郁结极甚，而气
血不能宣通，则痿痹而神无所用，故液渗入膀胱，而旋溺遗失，不能收禁也。薛
氏用六味地黄丸。脾肺气虚者用补中益气汤加补骨脂、山茱萸。曾氏谓∶乃心肾
传送失度，小肠膀胱关键不能约束，有睡梦而遗者，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，然又当实土
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，姜枣
烧盐煎，空心温服。
鸡肠散
鸡肠（一具，男用雌鸡，女用雄鸡，烧、存性） 牡蛎 茯苓（去皮） 桑螵蛸（炒。各五钱）
桂（去粗皮） 龙肾（各二钱半）
上为极细末，仍以鸡 一具，鸡肠一具，烧存性，研极细末。每用前药末一
钱，用温酒调化，食前服。
〔张〕鸡肠散 治因膀胱有热，服冷药过多，小便不能禁止，或遗尿病。
鸡肠草 龙骨 麦门冬（去心，焙） 白茯苓 桑螵蛸（各半两） 牡蛎粉（七钱半）
上件药，捣为粗散。每服一钱，水一小盏，入生姜少许，枣二枚，煎至六分，
去滓，温服。量儿大小加减。
按∶此与前方，盖一方而传写之讹，窃详用鸡肠较是，而张氏、娄氏、薛氏、
皆主用草，今两存之。
益智丸 治脾肾虚热，心气不足，遗尿白浊。
益智仁 茯苓 茯神（各等分）
上为末，炼蜜丸，桐子大。每服五六十丸，空心、白滚汤下。
破故纸散 治膀胱虚冷，夜间遗尿，或小便不禁。用破故纸为末，每服一钱，热汤
调下。
又方 破故纸，炒为末，黄柏汤调下。
《外台》疗小儿睡中遗尿不自觉，桂末、雄鸡肝等分，捣，丸如小豆大。温水下，
日三服。
初虞世治小儿遗尿。薏苡仁一合，去心不去壳，敲碎，入盐一小撮，同炒黄色，
用水二钟，煎至半钟，空心服之。累效。
《三因》家韭子丸（方见杂病小便不禁）
《原病式》说：遗尿且不能控制的是因为寒冷。《内经》说：约束无力导致的排尿失禁称为遗溺。仁斋说：小便，是津液的剩余部分，肾主管水液代谢，膀胱是储存津液的府库，肾与膀胱都虚弱，寒气侵袭它们，所以不能制约水液，导致尿液流出无法控制，这叫做遗尿；在睡眠中自行流出的，叫做尿床。这些都是肾与膀胱俱虚，并夹杂寒气所致，用鸡肠散主治。也有热邪客居于肾部，侵犯足厥阴肝经，导致生殖器部位郁结阻滞极其严重，气血不能宣通，从而出现痿痹而神志功能丧失，因此液体渗入膀胱，随即发生溺尿遗失，无法收摄控制。薛氏使用六味地黄丸。脾肺气虚者使用补中益气汤加补骨脂、山茱萸。曾氏认为：这是心肾传导失去节制，小肠和膀胱的关键部位不能约束，有在睡梦中遗尿的，都是下元虚冷所致，也由于禀受阳气不足，用《三因方》中的韭子丸治疗，以及参苓白术散、补肾地黄丸，然而又应当充实脾胃（土）以保存肾水，这样才能避免渗泄的祸患，这就是所谓的“补肾不如补脾”。平胃散加倍加入益智仁切碎，用生姜、大枣、烧过的盐煎煮，空腹温服。
鸡肠散
鸡肠（一具，男性患者用雌鸡，女性患者用雄鸡，烧制存性） 牡蛎 茯苓（去皮） 桑螵蛸（炒。各五钱）
桂枝（去粗皮） 龙骨（各二钱半）
以上药物研成极细末，另外再用一只公鸡或母鸡的肠子，烧制存性，研成极细末。每次取前药末一钱，用温酒调化，饭前服用。
〔张〕鸡肠散 治疗因膀胱有热，服用过多寒凉药物，导致小便不能禁止，或者遗尿病症。
鸡肠草 龙骨 麦门冬（去心，焙干） 白茯苓 桑螵蛸（各半两） 牡蛎粉（七钱半）
上述药物，捣碎成粗散。每次服用一钱，用水一小盏，加入少许生姜，枣二枚，煎至六成，滤去渣滓，温服。根据患儿大小增减剂量。
按语：此方与前一方，大概是一方但传抄产生的错误，仔细推敲使用鸡肠较为合理，而张氏、娄氏、薛氏，都主张使用鸡肠草，现在将两种情况都保留下来。
益智丸 治疗脾肾虚热，心气不足，遗尿及白浊。
益智仁 茯苓 茯神（各等分）
以上研成末，炼蜜为丸，如梧桐子大。每次服用五六十丸，空腹时，用白开水送服。
破故纸散 治疗膀胱虚冷，夜间遗尿，或者小便不禁。用破故纸（补骨脂）研成末，每次服用一钱，用热汤调下。
又一方 破故纸，炒后研成末，用黄柏汤调下。
《外台秘要》治疗小儿睡中遗尿不知觉，桂末、雄鸡肝等分，捣碎，制成如小豆大的丸剂。温水送下，每日三次服用。
初虞世治疗小儿遗尿。薏苡仁一合，不去心也不去壳，敲碎，加入一小撮盐，同炒至黄色，用水二钟，煎至半钟，空腹服用。屡次见效。
According to *Yuan Bing Shi* (Treatise on the Original Causes of Disease), enuresis with incontinence is caused by cold. *Nei Jing* (The Inner Canon) states that inability to restrain urination is called "yi ni" (involuntary urination). Ren Zhai stated: Urine is the residue of body fluids. The Kidney governs water metabolism, and the Bladder is the mansion storing body fluids. When both the Kidney and Bladder are deficient, and cold pathogenic factors invade them, they cannot control the water, leading to uncontrolled outflow of urine, which is termed "yi niao" (enuresis); when it occurs spontaneously during sleep, it is called "chuang" (bedwetting). These conditions are all caused by deficiency of both the Kidney and Bladder accompanied by cold. They should be treated primarily with Jichang San (Chicken Intestine Powder). There are also cases where heat pathogens lodge in the Kidney region, affecting the Foot-Jueyin Liver Channel, causing extreme stagnation and obstruction in the genital area. As a result, Qi and Blood cannot circulate freely, leading to flaccidity and paralysis where spiritual consciousness loses its function; thus, fluids seep into the Bladder, resulting in immediate leakage of urine that cannot be retained. Xue Shi used Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). For those with deficiency of Spleen and Lung Qi, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was used with added Gubuzhi (Fructus Psoraleae) and Shanzhuyu (Fructus Corni). Zeng Shi believed that this condition arises from a loss of coordination in the transmission between the Heart and Kidney, and the constraining mechanisms of the Small Intestine and Bladder fail to hold. Cases of bedwetting during dreams are all due to deficiency-cold of the Lower Yuan (Lower Burner/Kidney system), often stemming from insufficient innate Yang Qi. Treatment involves Jiuzi Wan (Leek Seed Pill) from *San Yin Fang*, as well as Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) and Bushen Dihuang Wan (Kidney-Nourishing Rehmannia Pill). However, one must also strengthen the Earth (Spleen) to preserve Water (Kidney), thereby avoiding the hazard of leakage. This aligns with the principle that "tonifying the Kidney is inferior to tonifying the Spleen." Pingwei San (Calm the Stomach Powder) with doubled Yizhiren (Fructus Alpiniae Oxyphyllae), crushed, decocted with fresh ginger, jujube, and burnt salt, should be taken warm on an empty stomach.
Jichang San (Chicken Intestine Powder)
Chicken intestine (one piece; for male patients, use hen intestines; for female patients, use rooster intestines; calcined to retain efficacy) Ostreae Concha (Oyster Shell) Poria (with skin removed) Sangpiaoxiao (Mantispidae Ootheca) (stir-fried. Each 5 qian) Cinnamomi Ramulus (bark removed) Longgu (Fossilized Bones) (Each 2.5 qian)
Grind the above ingredients into an extremely fine powder. Additionally, take one chicken or rooster intestine, calcine it to retain efficacy, and grind it into an extremely fine powder. Each time, take 1 qian of the aforementioned powder, dissolve it using warm wine, and administer before meals.
[Zhang's] Jichang San Treats conditions where heat exists in the Bladder, excessive intake of cold medicines leads to inability to restrain urination, or enuresis.
Jichangcao (Herba Desmodii Styraacifolii) Longgu (Fossilized Bones) Ophiopogonis Radix (heart removed, baked) Bai Fuling (Poria) Sangpiaoxiao (Mantispidae Ootheca) (Each half liang) Muli Fen (Oyster Shell Powder) (7.5 qian)
Crush the listed herbs into a coarse powder. Each dose consists of 1 qian, decocted with one small cup of water, adding a little fresh ginger and two jujubes. Simmer until reduced to 60%, strain, and take warm. Adjust dosage according to the child's age and size.
Note: This formula and the previous one are likely variants of the same prescription with transcription errors. Upon careful examination, the use of chicken intestine seems more appropriate, whereas Zhang Shi, Lou Shi, and Xue Shi all advocated using Jichangcao. Both versions are preserved here.
Yizhi Wan (Alpinia Seed Pill) Treats deficiency-heat of the Spleen and Kidney, insufficiency of Heart Qi, enuresis, and leukorrhea/cloudy urine.
Yizhiren (Fructus Alpiniae Oxyphyllae) Fuling (Poria) Fushen (Poria with Hostwood) (Equal parts)
Grind into powder, mix with refined honey to form pills the size of tung tree seeds. Take 50–60 pills each time, on an empty stomach, washed down with plain boiled water.
Poguzhi San (Psoralea Powder) Treats deficiency-cold of the Bladder, nocturnal enuresis, or urinary incontinence. Use Poguzhi (Fructus Psoraleae) ground into powder. Take 1 qian each time, mixed with hot water.
Another Prescription: Poguzhi (Fructus Psoraleae), stir-fried and ground into powder, mixed with Huangbai Tang (Phellodendron Bark Decoction).
*Waitai Mi Yao* (Essential Prescriptions Worth a Thousand Gold for Emergencies) treats children who wet the bed during sleep without awareness. Equal parts of Guixin (Cinnamon Twig Powder) and Xiongji Gan (Rooster Liver) are pounded together and formed into pills the size of mung beans. Taken with warm water, three times daily.
Chu Yushi treated pediatric enuresis with Yiyiren (Coix Seed) one he, keeping the heart and shell intact, cracked open, stir-fried with a pinch of salt until yellow. Decocted with two zhong of water until reduced to half a zhong. Taken on an empty stomach. Repeatedly effective.
Jiuzi Wan (Leek Seed Pill) from *San Yin Fang* (see section on Incontinence in Miscellaneous Diseases)