淋之为病，尝观《病源候论》谓由肾虚而膀胱热也。膀胱与肾为表里，俱主水，水入小肠与胞，
行于阴为溲便也。若饮食不节，喜怒不时，虚实不调，脏腑不和，致肾虚而膀胱热，肾虚则小便数，
膀胱热则水下涩，数而且涩，则淋沥不宣，故谓之淋。其状小腹弦急，痛引于脐，小便出少气数，及
分石淋、劳淋、血淋、气淋、膏淋、冷淋。其石淋者，有如沙石。劳淋者，劳倦即发。血淋者，心主
血，气通小肠，热甚则搏于血脉，血得热则流行，入胞中与溲俱下。膏淋者，肥液若脂膏，又名肉淋。
气淋者，胞内气胀，小腹坚满，出少喜数，尿有余沥。冷淋者，冷气客于下焦，邪正交争，满于胞内，
水道不宣，先寒战，然后便数成淋，可谓悉病情矣。考之《内经》，则淋病之因，又不止此。大纲有
二，曰湿、曰热。谓太阴作初气，病中热胀，脾受积湿之气，小便黄赤，甚则淋。少阳作二气，风火
郁于上而热，其病淋。盖五脏六腑十二经脉气皆相通移，是故足太阳主表，上行则统诸阳之气，下行
则入膀胱。又肺者，通调水道，下输膀胱。脾胃消化水谷。或在表在上在中，凡有热则水液皆热，转
输下之，然后膀胱得之而热矣。且小肠是心之腑，主热者也。其水必自小肠渗入膀胱，胞中诸热应于
心者，其小肠必热，胞受其热，经 胞移热于膀胱者，则癃溺血是也。由此而言，初起之热邪不一，
其因皆得传于膀胱而成淋。若不先治其所起之本，止从末流胞中之热施治，未为善也。予尝思之，淋
病必由热甚生湿，湿生则水液浑，凝结而为淋。不独此也，更有人服金石药者，入房太甚，败精流入
胞中，及饮食痰积渗入者，则皆成淋。丹溪尝治一小儿，在胎受久服金石药之余毒，病淋一十五年，
以紫雪治愈。凡治病不求其本可乎。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，或车前子末，或五苓散、益元散等分和服，并可吞火腑丹，佐以导赤散、石苇散。
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，仍研麦门冬草、连根
车前草、白龙草各自然汁，和蜜水调下。气淋，气壅不通，小便淋结，脐下妨闷疼痛，瞿麦汤、石苇
散、榆枝汤、木香流气饮。气虚淋，八物汤加杜牛膝、黄芩汁煎服。老人气虚亦能淋，参、术中加木
通、山栀。血受伤者，补血行血自愈，勿作
淋治。死血作淋，牛膝膏妙。但虚人能损胃，不宜食。《千金》云∶用牛膝以酒煮服，治小便淋痛。
《肘后方》用牛膝根茎叶，亦以酒煮服，治小便不利，茎中痛欲死，及治妇人血结坚痛如神。盖牛膝
治淋之圣药也。但虚人当用补剂监制之耳。血淋，用侧柏叶、生藕节、车前草等分捣汁，调益元散、
立效散、瞿麦散、小蓟饮子、柿蒂散、当归汤、羚羊角饮、鸡苏饮子、金黄散、发灰散。戴氏云∶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，不以多少，白水煎，候冷进。按∶血多有热极兼水化而黑凝者，未可便
以为冷也。膏淋，鹿角霜丸、沉香散、沉香丸、磁石丸、海金砂散、菟丝丸。戴云∶有似淋非淋，小
便色如米泔，或便中有如鼻涕之状，此乃精溺俱出，精塞溺道，故便欲出不能而痛。宜大菟丝子丸、
鹿茸丸之类。按∶此即膏淋也。沙石淋，乃是膀胱蓄热而成，正如汤瓶久在火中，底结白碱而不能去，
理宜清彻积热，使水道通则沙石出而可愈。宜神效琥珀散、如圣散、石燕丸、独圣散。石首鱼脑骨十
个，火 ，滑石二钱，琥珀三分，俱为细末。每服一钱，空心煎木通汤调下。鳖甲九肋者一个，酥炙
令脆，为细末。每服一匙，酒煎服，当下沙石。
雄鹊烧灰，淋取汁饮之，石即下。石淋，小便时沙石下流，塞其水道，痛不可忍，经及时日，水道不
通，其气上攻，头痛面肿，重则四肢八节俱肿。其石大者如梅核，坚硬如有棱角，其石小者，唯碎石
相结，通下即碎。宜服此取石方，用冬葵子、滑石、射干、知母，以上各一分，通草三分，为细末。
每服二钱半，水一盏半，苦竹叶十片同煎，取一盏，去滓，食前热服。又大腑热头痛，若体气壮健，
先进后方药两三盏，然后进取石方。用麻黄去节、羌活、射干、荆芥穗、紫菀、防风、知母、蔓荆子、
牵牛各一分，半夏二铢，为细末。每服二钱，水一盏，煎九分，去滓，食后热服。石淋，导水用蝼蛄
七枚，以盐一两，同于新瓦上铺盖焙干，研为细末。每服一钱匕，温酒调服。劳淋，地黄丸、黄 汤、
白芍药丸。冷淋，肉苁蓉丸、泽泻散、沉香散、槟榔散、生附散。戴氏云∶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，用生料鹿茸丸却愈。此皆下元虚冷之故。乃刘河间
则谓亦由热客膀胱，郁结不能渗泄，非真冷也。小便淋，茎中痛不可忍，相引胁下痛，宜参苓琥珀汤。
有小便艰涩如淋，不痛而痒者，虚证也。宜八味丸、生料鹿茸丸之类。若因思虑过度致淋，宜归脾汤、
或辰砂妙香散、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，外发为
汗，津液不通，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，收其在外者使之内，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，唯当温养润肺。
十全大补汤、养荣汤之类，自足选用。汗者心液，心主血，血荣则心得所养，汗止津生，不待通而溺
自清矣。诸失精血及患痈毒人，或有小便赤涩之证，此亦是枯竭不润之故，并宜前法。
【胞痹】痹论云∶小腹膀胱，按之内痛，若沃以汤，涩于小便，上为清涕。夫膀胱者，州都之官，津液藏
焉，气化则能出矣。今风寒湿邪气客于胞中，则气不能化出，故胞满而水道不通。其证小腹膀胱按之
内痛，若沃以汤，涩于小便，以足太阳经，其直行者，上交巅，入络脑，下灌鼻窍，则为清涕也。肾
着汤、茯苓丸、巴戟丸、肾沥汤。
【妊娠淋】乃肾与膀胱虚热，不能制水，然妊妇胞系于肾，肾间虚热而成斯证。甚者心烦闷乱，
名曰子淋也。若颈项筋挛，语涩痰甚，用羚羊角散。若小便涩少淋沥，用安荣散。若肝经湿热，用龙
胆泻肝汤。若肝经虚热，用加味逍遥散。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、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，阳无所生，
用滋肾丸。若膀胱阳虚，阴无所化，用肾气丸。
【产后淋】因热客于脬，虚则频数，热则涩痛，气虚兼热，血入胞中，则血随小便出而为血淋也。
若膀胱虚热，用六味丸。若阴虚而阳无以化，用滋阴肾气丸。盖土生金，金生水，当滋化源。陈氏云∶
治产前后淋，其法不同。产前当安胎，产后当去血。瞿麦、蒲黄，最为产后要药。茅根汤，主治产后
诸淋。
【诊】肾脉滑实为癃 。痹脉滑甚为 癃。少阴脉数，妇人则阴中生疮，男子则气淋。盛大而
实者生，虚小而涩者死。下焦气血干者死。鼻头色黄者，小便难。
《素问》奇病论，病有癃者，一日数十溲，此不足也。身热如炭，颈膺如格，人迎躁盛，喘息气逆，
此有余也。太阴脉细微如发者，此不足也。其病安在？名为何病？岐伯曰∶病在太阴，其盛在胃，颇
在肺，病名曰厥。死不治。
淋证这种疾病，我曾查阅《诸病源候论》，认为其病因是肾虚而膀胱有热。膀胱与肾互为表里，都主管水液代谢，水进入小肠和胞宫后，下行排出即为小便。如果饮食没有节制，喜怒情绪调节不当，导致虚实失调、脏腑不和，就会造成肾虚而膀胱有热。肾虚则小便频数，膀胱有热则尿液排出涩滞不畅，既频数又涩滞，排尿淋漓不尽且宣通不利，所以称为“淋”。其症状表现为小腹拘急疼痛，痛感牵引至肚脐，小便量少且次数频繁，并分为石淋、劳淋、血淋、气淋、膏淋、冷淋六种类型。
所谓石淋，排尿时感觉像有沙石排出。劳淋，是在劳累疲倦时发作。血淋，心主血脉，气通于小肠，热邪炽盛时搏结于血脉，血液受热则运行加速，流入胞中与小便一同排出。膏淋，尿液浑浊如肥腻的脂膏，又名肉淋。气淋，胞宫内气机胀满，小腹坚硬饱满，小便量少且次数多，尿后有余沥不尽之感。冷淋，冷气客居于下焦，邪气与正气交争，充满胞内，水道不通畅，先出现寒战，然后才出现尿频成淋的症状，这可以说是对病情描述得很详尽了。
考证《黄帝内经》，淋病的成因并不止于此。主要纲领有两个方面：湿和热。太阴湿土作为初之气，病见中焦热胀，脾受积湿之气影响，小便黄赤，严重时会发生淋证。少阳相火作为二之气，风火郁结于上而生热，其病症为淋证。因为五脏六腑及十二经脉的气机都是相通流转的，足太阳膀胱经主一身之表，上行则统摄诸阳之气，下行则进入膀胱。另外，肺能通调水道，向下输注于膀胱。脾胃负责消化水谷。无论病邪在表、在上或在中，只要有热，水液都会变热，转输下行，然后膀胱受热而形成淋证。而且小肠是心的腑，主热。水液必然从小肠渗入膀胱，胞中的热邪对应于心，则小肠必热，胞受其热，热邪由胞移入膀胱，就会出现小便不利（癃）或尿血的情况。由此而言，初起的热邪来源不一，但其病因最终都能传变到膀胱从而形成淋证。如果不先治疗其起始的根本原因，仅仅从末流的胞中之热进行治疗，这并不是好的方法。
我曾思考过，淋病必定是由热极生湿，湿气产生则水液浑浊，凝结而成淋证。不仅如此，还有人服用金石类药物，房事过度，败精流入胞中，以及饮食痰积渗入胞中，这些情况都会形成淋证。朱丹溪曾治疗过一个小孩，在母胎中受到长期服用金石类药物的残余毒性影响，患淋证长达十五年，用紫雪治愈。凡是治病不探求根本原因，可以吗？
小便涩痛，常常急切想要排尿，但只能排出点滴，尿道中疼痛难忍，这是五淋病的表现。可用生料五苓散加阿胶，或者车前子粉末，或者将五苓散、益元散等分混合服用，也可以吞服火腑丹，配合导赤散、石苇散使用。如果是热极导致的淋证，服药无效者，宜用减桂五苓散，加入木通、滑石、灯心草、瞿麦各少许，同时研磨麦门冬草、带根车前草、白龙草的新鲜汁液，调和蜂蜜水送服。
气淋，因气机壅塞不通，小便淋沥结滞，脐下感到憋闷疼痛，可用瞿麦汤、石苇散、榆枝汤、木香流气饮。气虚淋，用八物汤加杜牛膝、黄芩汁煎服。老人因气虚也能患淋证，可在人参、白术中加入木通、山栀。若因失血受伤导致的淋，补血行血即可自愈，不要当作淋证来治。若是瘀血（死血）导致的淋，用牛膝膏效果很好。但体虚之人服用可能会损伤胃气，不宜食用。《千金方》记载：用牛膝以酒煮服，治疗小便淋痛。《肘后备急方》用牛膝的根茎叶，也以酒煮服，治疗小便不利、尿道剧痛欲死，以及治疗妇人血结坚痛，效果如神。可以说牛膝是治疗淋证的圣药。但对于体虚之人，应当用补剂来制约其偏性。
血淋，用侧柏叶、生藕节、车前草等量捣汁，调入益元散、立效散、瞿麦散、小蓟饮子、柿蒂散、当归汤、羚羊角饮、鸡苏饮子、金黄散、发灰散中使用。戴氏说：血淋这一证候，必须根据血色来判断冷热。血色鲜红的，是心和小肠实热；血色暗紫瘀滞的，是肾和膀胱虚冷。如果是确凿的冷淋及下元虚冷导致的血色瘀滞，都适宜用汉椒根切碎，不限多少，用清水煎煮，待冷却后进服。按语：血液多有热极兼水化而黑凝的情况，不能轻易认为是冷证。
膏淋，可用鹿角霜丸、沉香散、沉香丸、磁石丸、海金砂散、菟丝丸。戴云说：有一种类似淋证而非淋证的情况，小便颜色像米泔水，或者便中有像鼻涕一样的物质，这是精液和小便同时排出，精液堵塞溺道，所以想排尿却排不出且疼痛。适宜用大菟丝子丸、鹿茸丸之类。按语：这就是膏淋。
沙石淋，是由于膀胱蓄积热邪而成，正如汤瓶长时间在火上烧，底部结成白色碱垢无法去除一样，理应清除积聚的热邪，使水道通畅，则沙石排出而痊愈。适宜用神效琥珀散、如圣散、石燕丸、独圣散。取石首鱼脑骨十个，火煅，滑石二钱，琥珀三分，都研为细末。每次服用一钱，空腹时用木通汤调服。取九肋鳖甲一个，用酥油炙烤至脆，研为细末。每次服用一匙，用酒煎服，可排出沙石。雄喜鹊烧成灰，淋取汁液饮用，石头即可排出。
石淋，小便时沙石流出，堵塞水道，疼痛难忍，经过一段时间后，水道不通，气机上攻，导致头痛面肿，严重时四肢和各个关节都肿胀。大的石头像梅核一样，坚硬且有棱角；小的石头则是碎石相互结合，通利下行即碎裂。适宜服用此取石方：用冬葵子、滑石、射干、知母，以上各一分，通草三分，研为细末。每次服用二钱半，用水一盏半，加苦竹叶十片同煎，取汁一盏，去渣，饭前热服。又有大便热结头痛，若体质壮健，先进服后方药两三盏，然后再进服取石方。方用麻黄去节、羌活、射干、荆芥穗、紫菀、防风、知母、蔓荆子、牵牛各一分，半夏二铢，研为细末。每次服用二钱，用水一盏，煎至九分，去渣，饭后热服。治疗石淋导水，用蝼蛄七枚，与盐一两，一同铺在新瓦上焙干，研为细末。每次服用一钱匕，温酒调服。
劳淋，用地黄丸、黄耆汤、白芍药丸。冷淋，用肉苁蓉丸、泽泻散、沉香散、槟榔散、生附散。戴氏说：服用寒凉药物后病情加重的，这是冷淋。适宜用地髓汤送服附子八味丸。有人因服用五苓散等药无效，改用生料鹿茸丸却治愈了。这都是下元虚冷的缘故。刘河间则认为这也是热邪客居膀胱，郁结不能渗泄所致，并非真正的寒冷。
小便淋沥，尿道疼痛难忍，牵连胁下疼痛，适宜用参苓琥珀汤。有小便艰涩像淋证，但不痛而痒的，属于虚证。适宜用八味丸、生料鹿茸丸之类。如果是因思虑过度导致淋证，适宜用归脾汤，或辰砂妙香散，吞服威喜丸，或妙香散合五苓散。出汗多而小便赤涩，暑月多有此证。盛夏所饮水液过多，小便反而涩少且赤，这是因为水饮停聚于上，外发为汗，津液不通，小肠涩闭，则水液不能运化下行。五苓散又名导逆，内有白术、桂枝收敛汗液，猪苓、泽泻、茯苓分利水道，收摄在外的水液使其内入，进而加以利导。发散者收敛之，壅塞者通利之，义理在于此。然而有虚劳出汗多而小便赤涩的，却是五脏内部枯燥，滋润之物已去，不能生津，所以溺涩而赤，不宜过度使用通利小便的药物竭尽肾水，只应当温养润肺。十全大补汤、养荣汤之类，自然足够选用。汗是心之液，心主血，血充盈则心得所养，汗止津生，不需要通利小便，溺自清矣。各种失精血及患痈毒的人，或有小便赤涩之证，这也是枯竭不润的缘故，都适宜用前面的方法。
【胞痹】《痹论》说：小腹膀胱部位，按压内部疼痛，感觉像浇了热水一样，小便涩滞，上部出现清涕。膀胱是州都之官，津液藏存其中，气化功能正常才能排出。现在风寒湿邪气客居于胞中，则气不能气化排出，所以胞满而水道不通。其症状是小腹膀胱按压内部疼痛，感觉像浇了热水，小便涩滞。因为足太阳膀胱经，其直行者，上交巅顶，入络于脑，下灌鼻窍，所以会出现清涕。可用肾着汤、茯苓丸、巴戟丸、肾沥汤。
【妊娠淋】这是由于肾与膀胱虚热，不能制约水液，然而孕妇的胞系于肾，肾间虚热而形成此证。严重的出现心烦闷乱，名叫子淋。如果出现颈项筋挛，言语涩滞痰多，用羚羊角散。如果小便涩少淋沥，用安荣散。如果是肝经湿热，用龙胆泻肝汤。如果是肝经虚热，用加味逍遥散。腿足转筋，而小便不利，急用八味丸，缓则无法救治。如果服用燥剂而导致小便频数或不利，用地黄、茯苓、牛膝、黄柏、知母、川芎、当归、甘草。如果频数且色黄，用四物汤加黄柏、知母、五味子、麦门冬、玄参。如果肺气虚而尿量少，用补中益气汤加山药、麦门冬。如果阴挺痿痹而频数，用地黄丸。如果热结膀胱而不利，用五淋散。如果脾肺燥不能化生，宜用黄芩清肺饮。如果膀胱阴虚，阳无所生，用滋肾丸。如果膀胱阳虚，阴无所化，用肾气丸。
【产后淋】因热邪客居于脬（膀胱），虚则频数，热则涩痛，气虚兼热，血入胞中，则血随小便出而为血淋。如果膀胱虚热，用六味丸。如果阴虚而阳无以化，用滋阴肾气丸。盖土生金，金生水，当滋生化之源。陈氏说：治疗产前产后淋证，方法不同。产前应当安胎，产后应当去瘀血。瞿麦、蒲黄，最为产后要药。茅根汤，主治产后诸淋。
【诊法】肾脉滑实为癃闭。痹脉滑甚为癃闭。少阴脉数，妇人则阴中生疮，男子则气淋。脉象盛大而实的预后良好，虚小而涩的预后不良。下焦气血干枯的预后不良。鼻头色黄的，小便困难。
《素问·奇病论》记载，有病癃闭的，一天数十次小便，这是不足之证。身体发热如炭火，颈部胸膺如格拒不通，人迎脉躁动旺盛，喘息气逆，这是有余之证。太阴脉细微如头发，这是不足之证。病在哪里？叫什么病？岐伯说：病在太阴，其盛在胃，颇涉于肺，病名曰厥。死不治。
The disease of Lin (strangury) has been observed in the *Treatise on Pathogenesis and Symptoms* (*Bingyuan Shoulun*), which attributes it to Kidney deficiency with Bladder heat. The Bladder and Kidney are exterior-interiorly related and both govern water metabolism. Water enters the Small Intestine and Bao (uterus/bladder), and flows downward as urine. If diet is irregular, emotions of joy and anger are unregulated, leading to imbalance of deficiency and excess and disharmony of the Zang-Fu organs, it results in Kidney deficiency and Bladder heat. Kidney deficiency causes frequent urination, while Bladder heat causes difficult and astringent urination. When frequency is combined with astringency, urination becomes dribbling and incomplete, hence termed "Lin." Its manifestations include urgency and pain in the lower abdomen radiating to the umbilicus, scanty and frequent urination, and it is classified into six types: Shi Lin (Stone Lin), Lao Lin (Exhaustion Lin), Xue Lin (Blood Lin), Qi Lin (Qi Lin), Gao Lin (Grease Lin), and Leng Lin (Cold Lin).
Shi Lin (Stone Lin) feels like sand or stones are passing. Lao Lin (Exhaustion Lin) occurs upon fatigue. Xue Lin (Blood Lin): The Heart governs blood, and its qi connects to the Small Intestine. When heat is severe, it binds to the blood vessels; blood heated by fire flows rapidly, entering the Bao and exiting with urine. Gao Lin (Grease Lin): The urine is turbid like fatty grease, also known as Rou Lin (Flesh Lin). Qi Lin (Qi Lin): Qi distension within the Bao, hardness and fullness in the lower abdomen, scanty and frequent urination with post-void dribbling. Leng Lin (Cold Lin): Cold qi lodges in the Lower Jiao, pathogenic factors contend with healthy qi, filling the Bao, obstructing the water passages. It begins with chills, followed by urinary frequency becoming Lin. This describes the pathology comprehensively.
Examining the *Neijing*, the causes of Lin are not limited to this. The main principles are two: Dampness and Heat. When Taiyin acts as the first Qi, disease involves mid-jiao heat and distension; the Spleen receives accumulated dampness, causing yellow-red urine, progressing to Lin in severe cases. When Shaoyang acts as the second Qi, wind-fire stagnates upward generating heat, resulting in Lin. Since the qi of the five Zang and six Fu organs and twelve meridians interconnects, the Foot-Taiyang Bladder Meridian governs the exterior; ascending, it commands Yang qi; descending, it enters the Bladder. Furthermore, the Lung regulates water passages, transmitting downward to the Bladder. The Spleen and Stomach digest food and fluids. Whether the pathogen is in the exterior, upper, or middle jiao, if there is heat, all body fluids become hot, transmit downward, and thus the Bladder becomes heated. Moreover, the Small Intestine is the Fu organ of the Heart and governs heat. Water must seep from the Small Intestine into the Bladder. Heat in the Bao corresponding to the Heart makes the Small Intestine hot; the Bao receives this heat, and heat transfers from the Bao to the Bladder, causing Long (difficulty voiding) or hematuria. Thus, initial heat pathogens vary, but their etiology transmits to the Bladder to form Lin. If one does not treat the root cause initially, but only treats the branch heat in the Bao, it is not an optimal approach.
I have pondered that Lin disease must arise from extreme heat generating dampness; when dampness arises, body fluids become turbid, condensing to form Lin. Not only this, those who ingest mineral drugs, engage in excessive sexual activity, allowing essence residue to flow into the Bao, or where dietary phlegm accumulation seeps in, all can result in Lin. Danxi once treated a child who, due to residual toxicity from long-term mineral drug use in utero, suffered from Lin for fifteen years, cured by Zi Xue (Purple Snow). Is it acceptable to treat disease without seeking its root?
Scanty painful urination, urgent desire to void, yet only drops pass, with unbearable pain in the urethra, constitutes the Five Lin diseases. Use Sheng Liao Wu Ling San (Raw Material Five-Ling Decoction) plus E Jiao (Donkey-Hide Gelatin), or Che Qian Zi powder, or equal parts Wu Ling San and Yi Yuan San taken together. Huo Fu Dan can be swallowed, assisted by Dao Chi San and Shi Wei San. If extreme heat causes Lin and medication fails, use Jian Gui Wu Ling San (Cinnamon-Reduced Five-Ling Decoction), adding Mu Tong, Hua Shi, Deng Xin Cao, and Qu Mai in small amounts. Also, grind fresh juice from Mai Men Dong Cao, Che Qian Cao (with roots), and Bai Long Cao, mix with honey water, and take orally.
For Qi Lin, caused by Qi stagnation and obstruction, urinary dribbling and knotting, oppression and pain below the umbilicus, use Qu Mai Tang, Shi Wei San, Yu Zhi Tang, or Mu Xiang Liu Qi Yin. For Qi Deficiency Lin, use Ba Wu Tang plus Du Niu Xi and Huang Qin juice. Elderly people with Qi deficiency can also suffer from Lin; add Mu Tong and Shan Zhi to Ren Shen and Bai Zhu. If injured by blood loss, tonifying and moving blood will heal it spontaneously; do not treat as Lin. If caused by dead blood (stasis), Niu Xi Gao is excellent. However, it may damage the Stomach in deficient persons and should not be eaten. *Qian Jin Fang* states: Boil Niu Xi in wine and take it to treat Lin pain. *Zhou Hou Bei Ji Fang* uses Niu Xi roots, stems, and leaves boiled in wine to treat difficult urination, unbearable urethral pain, and women's blood-stagnation hard pain, effectively. Niu Xi is indeed the sacred herb for treating Lin. But for deficient persons, it should be controlled with tonic formulas.
For Xue Lin, use Ce Bai Ye, Sheng Ou Jie, and Che Qian Cao in equal parts, crush to extract juice, and mix with Yi Yuan San, Li Xiao San, Qu Mai San, Xiao Ji Yin Zi, Shi Di San, Dang Gui Tang, Ling Yang Jiao Yin, Ji Su Yin Zi, Jin Huang San, or Fa Hui San. Dai says: In Xue Lin, distinguish cold and heat by blood color. Bright red indicates Heart and Small Intestine Excess Heat. Dark/stagnant indicates Kidney and Bladder Deficiency Cold. If it is truly Cold Lin or Lower Yuan Deficiency Cold with stagnant blood, boil Han Jiao Gen (root of Zanthoxylum) in plain water, cool, and administer. Note: Blood often turns black and coagulates due to extreme heat combining with water transformation; do not hastily assume it is cold.
For Gao Lin, use Lu Jiao Shuang Wan, Chen Xiang San, Chen Xiang Wan, Ci Shi Wan, Hai Jin Sha San, or Tu Si Wan. Dai Yun says: There is a condition resembling Lin but not Lin, where urine is like rice washings or contains mucus-like strands. This is essence and urine exiting together, blocking the urinary pathway, causing pain and inability to void. Use Da Tu Si Zi Wan or Lu Rong Wan. Note: This is Gao Lin.
Sha Shi Lin (Sand-Stone Lin) is formed by accumulated heat in the Bladder, like a pot left on fire forming white scale at the bottom. One must clear accumulated heat so water passages open, allowing stones to exit and healing to occur. Use Shen Xiao Hu Po San, Ru Sheng San, Shi Yan Wan, or Du Sheng San. Take ten Stonefish brain bones, calcined, 2 qian of Hua Shi, and 3 fen of Hu Po, all powdered. Take 1 qian per dose, mixed with Tong Cao decoction on an empty stomach. Take one nine-rib softshell turtle shell, fried in butter until crisp, powdered. Take one spoonful per dose, decocted in wine, to expel stones. Burn male magpie to ash, collect juice, and drink to expel stones.
In Shi Lin, sand and stones flow during urination, blocking the passage, causing unbearable pain. After time, blockage causes Qi to attack upward, leading to headache and facial swelling; severely, limbs and joints swell. Large stones resemble plum pits, hard with angles; small stones are fragments binding together, breaking upon passage. Use this stone-expelling formula: Dong Kui Zi, Hua Shi, She Gan, Zhi Mu (each 1 fen), Tong Cao (3 fen), powdered. Take 2.5 qian per dose, decoct with 1.5 cups of water and 10 bitter bamboo leaves, reduce to 1 cup, strain, and take hot before meals. For large bowel heat and headache in robust individuals, take the following prescription 2-3 cups first, then the stone formula. Ma Huang (de-jointed), Qiang Huo, She Gan, Jing Jie Sui, Zi Wan, Fang Feng, Zhi Mu, Man Jing Zi, Qian Niu (each 1 fen), Ban Xia (2 zhu), powdered. Take 2 qian per dose, decoct 1 cup of water to 0.9 cup, strain, take hot after meals. For Shi Lin water-guiding, use 7 earthworms, 1 liang salt, spread on new tile, bake dry, powder. Take 1 qian per dose, mixed with warm wine.
For Lao Lin, use Di Huang Wan, Huang Qi Tang, or Bai Shao Yao Wan. For Leng Lin, use Rou Cong Rong Wan, Ze Xie San, Chen Xiang San, Bing Lang San, or Sheng Fu San. Dai says: If cold medicines worsen the condition, it is Leng Lin. Use Di Sui Tang to deliver Fu Zi Ba Wei Wan. Some cured by Raw Material Lu Rong Wan after Wu Ling San failed, due to Lower Yuan Deficiency Cold. Liu Hejian argues it is also due to heat lodging in the Bladder, stagnating and failing to excrete, not true cold.
Urinary dribbling with unbearable urethral pain radiating to hypochondriac pain: Can Shen Ling Hu Po Tang. Urinary difficulty like Lin but painless and itchy is a deficiency syndrome. Use Ba Wei Wan or Raw Material Lu Rong Wan. If caused by overthinking, use Gui Pi Tang, or Chen Sha Miao Xiang San, swallow Wei Xi Wan, or Miao Xiang San combined with Wu Ling San. Profuse sweating with red-scanty urine is common in summer. Excessive drinking in heat leads to scanty red urine because fluid stops above, sweats out externally, fluids fail to circulate, Small Intestine closes, and water fails to transport down. Wu Ling San (also called Dao Ni) contains Bai Zhu and Gui Zhi to retain sweat, Zhu Ling, Ze Xie, and Fu Ling to separate water passages, drawing external fluids inward and promoting diuresis. Disperse what needs gathering, unblock what is congested. For deficiency consumption with profuse sweat and red-scanty urine, internal organs are dry, nourishment gone, unable to generate fluids, causing scanty red urine. Do not overuse diuretics to deplete Kidney water; instead, warm-nourish and moisten the Lung. Shi Quan Da Bu Tang or Yang Rong Tang are sufficient. Sweat is Heart fluid; Heart governs blood. When blood is abundant, Heart is nourished, sweat stops, fluids generate, and urine clears without diuretics. Those losing essence/blood or suffering carbuncles with red-scanty urine also suffer from dryness; use previous methods.
[Bao Bi] The *Bi Lun* states: Pressing the lower abdominal Bladder causes internal pain, feeling like pouring hot water, with difficult urination and clear nasal discharge above. The Bladder is the Official of the Metropolis, storing fluids; Qi transformation allows excretion. Now, Wind-Cold-Damp pathogens lodge in the Bao, preventing Qi transformation, causing Bao fullness and blocked water passages. Symptoms: lower abdominal Bladder tenderness, feeling of hot water, difficult urination. Because the Foot-Taiyang Meridian goes up to the vertex, connects to the brain, and descends to irrigate nasal cavities, clear discharge occurs. Treat with Shen Zhuo Tang, Fu Ling Wan, Ba Ji Wan, or Shen Li Tang.
[Pregnancy Lin] Due to Kidney and Bladder deficiency-heat failing to control water. Pregnant women's Bao is tied to the Kidney; deficiency-heat in the Kidney creates this syndrome. Severe cases involve mental restlessness, named Zi Lin. If neck stiffness, slurred speech, and phlegm occur, use Ling Yang Jiao San. If urinary difficulty and dribbling, use An Rong San. If Liver Meridian Damp-Heat, use Long Dan Xie Gan Tang. If Liver Meridian Deficiency-Heat, use Jia Wei Xiao Yao San. Leg cramps with urinary difficulty require urgent Ba Wei Wan, or rescue is impossible. If dry herbs cause frequency or difficulty, use Sheng Di, Fu Ling, Niu Xi, Huang Bai, Zhi Mu, Chuan Xiong, Dang Gui, Gan Cao. If frequent and yellow, use Si Wu Tang plus Huang Bai, Zhi Mu, Wu Wei Zi, Mai Men Dong, Xuan Shen. If Lung Qi deficiency with short volume, use Bu Zhong Yi Qi Tang plus Shan Yao, Mai Men Dong. If vaginal prolapse/numbness with frequency, use Di Huang Wan. If heat knotting in Bladder causing difficulty, use Wu Lin San. If Spleen/Lung dryness failing to transform, use Huang Qin Qing Fei Yin. If Bladder Yin deficiency lacking Yang generation, use Zi Shen Wan. If Bladder Yang deficiency lacking Yin transformation, use Shen Qi Wan.
[Postpartum Lin] Due to heat lodging in the Pao (Bladder); deficiency causes frequency, heat causes astringent pain. Qi deficiency with heat, blood entering the Bao, exits with urine as Xue Lin. If Bladder deficiency-heat, use Liu Wei Wan. If Yin deficiency failing to transform Yang, use Zi Yin Shen Qi Wan. Earth generates Metal, Metal generates Water; nourish the source. Chen says: Treating pre/post-partum Lin differs. Pre-partum: calm fetus; Post-partum: remove stasis. Qu Mai and Pu Huang are key post-partum herbs. Mao Gen Tang treats various post-partum Lin.
[Diagnosis] Kidney pulse slippery and solid indicates Long (obstruction). Bi pulse very slippery indicates Long. Shao Yin pulse rapid: women get genital sores, men get Qi Lin. Pulse large, strong, and solid indicates survival; small, weak, and astringent indicates death. Dryness of Qi and Blood in Lower Jiao indicates death. Yellow nose tip indicates difficult urination.
*Suwen: Qibing Lun*: Disease with Long, urinating dozens of times daily, is deficiency. Body hot as charcoal, neck/chest like a barrier, Ren Ying pulse restless and vigorous, panting with reversed Qi, is excess. Tai Yin pulse fine as hair is deficiency. Where is the disease? Name? Qibo says: Disease in Taiyin, excess in Stomach, involvement in Lung, named Jue. Death, untreatable.