〔薛〕 疮疡小便淋漓频数，或茎中涩者，
肾经亏损之恶症也，宜用加减八味丸以补阴；足胫逆冷者，宜用八味丸以补阳。若小便频
而黄者，宜用四物汤加参术、麦门、五味以滋肺肾。若小便短而少者，宜用补中益气加
山药、麦门、五味以补脾肺。若热结膀胱而不利者，宜用五淋散以清热。若脾气燥而不
能化者，宜用黄芩清肺饮以滋阴。若膀胱阴虚阳无以生者，宜用六味丸。若膀胱阳虚，阴
无以化者，宜用滋肾丸。肾虚之患多传此症，非滋化源不救。若用黄柏、知母反泻其阳，以
速其危。若老人阴痿思色，精内败，茎中痛而不利者，用加减八味丸加车前、牛膝。不
应，更加附子多有复生者。若精已竭而复耗之，大小便中牵痛，愈痛则愈便，愈便则愈
牵痛，以前药加附子，亦有复生者。王太仆云∶无阴则阳无以化，无阳则阴无以生，当
滋其化源。苟专用淡渗，复损真阴，乃速其危也。职方王 塘，背疽溃后，小便淋漓，或
时有自遗，作渴引饮，烦热不寐，疮口 赤，时或如灼，时或便遗。余曰∶此肾虚之恶症，
用加减八味丸，加麦门数剂而痊。驾部林汝玉，冬不衣绵，作渴饮冷，每自喜壮实，晒
余衣绵。诊其脉数大无力，余曰∶至火令，当求余也。三月间，果背热、便闭、脉涩，用
四物加芩连、山栀数剂，大便稍和，却去芩连，加参术、茯苓二十余剂及前丸半斤许，渴
减六七，背热亦退，至夏背发一疽，纯用托里之剂而敛。
托里消毒散加减法 茎中痛而小便不利，精内败也，去连翘、白芷、金银花三味，
加山茱萸、山药、泽泻。如不应，佐以六味丸。愈便则愈痛，愈痛则愈便，精复竭也，去
三味煎，送六味丸。食少体倦，口干饮热，小便黄短，脾肺虚热也，去三味加五味子，山
茱萸。如不应，暂用六味丸。劳役而小便黄，元气下陷也，去三味加升麻、柴胡。午后小
便黄短，肾虚热也，去三味加升麻、柴胡煎，送六味丸。
黄芩清肺饮 治肺经阴虚火燥而小便不通，若因脾经有热，当清其脾。若因心火克
肺，当制其心。
黄芩（一钱） 栀子（三枚，打碎）
上水煎服。
滋肾丸 治肾经阴虚发热作渴，便赤，足热腿软等证。凡不渴而小便秘，热在下焦血
分也，最宜此药。经云∶无阴则阳无以化。若脾肺燥热所遗，当滋其化源。
知母 黄柏（各酒炒，一两） 肉桂（二钱）
上为末，水丸如梧桐子大。每服百丸，空心白滚汤下。
五苓散 治下部湿热疮，每小便赤少。
泽泻（二两五钱） 猪苓（去皮，一两半） 肉桂（七钱半） 白术 赤茯苓（各一两五钱）
上为细末。每服一二钱，热汤调下。
清心莲子饮 治膀胱气虚湿热，玉茎肿痛，或茎窍涩滞，口苦咽干，小便色赤或白
浊，夜安静而昼发热。
黄芩 麦门冬 地骨皮 车前子 炙甘草（各一钱半） 石莲肉 白茯苓 黄 柴胡
人参（各一钱）
上水煎服。
五淋散 治膀胱有热，水道不通，或尿如豆汁，或如沙石，或如膏汁，或热沸便血。
赤茯苓（一钱半） 赤芍药 山栀（各二钱） 当归 甘草（各一钱五分）
上用灯心二十根，水煎服。
清肺饮 治渴而小便不利，乃肺经有热，是绝寒水生化之源，宜用此药以清化源，其
水自生而便自利矣。
茯苓（二钱） 猪苓（三钱） 泽泻 琥珀 瞿麦（各五分） 通草（六分） 木通 蓄（各七分） 车
前子（一钱） 灯草（一分）
上为细末。每服五钱，水煎服。
肾气丸 治肾经阳虚阴无所化，以致膀胱淋漓。或脾肺气虚不能通调，水无所化而
膀胱癃闭。或肾气虚热，干于厥阴之络，阴挺、痿痹而溺频数。或肾水虚弱阴亏难降，使
津液败浊而为痰水。又治肾虚便血及诸见血
发热，自汗盗汗等症之圣药也。即六味地黄丸。
琥珀散 治诸般疮疖，表里有热，小便赤涩。
白茯苓 黄芩 茵陈 紫草 瞿麦 茅根 石韦 乌药 琥珀 连翘 车前子（各等
分）
上为极细末，每服二三钱，用灯心汤调下，不拘时候。
瞿麦散 治痈疽发背，排脓止痛，利小便。
桂心 赤芍药 当归 黄 芎 瞿麦 白蔹 麦门冬（去心，各等分） 赤小豆（一合，
酒浸炒干）
上 咀。每服四钱，酒煎温服，如诸痈已溃未溃，疮中脓血不绝，痛难忍者，加细
辛、白芷、白蔹、薏苡仁。
【薛己】疮疡患者出现小便淋漓不尽、次数频繁，或者尿道中涩痛不适的，这是肾经亏损导致的危重证候，适宜使用加减八味丸来滋补阴液；如果伴有足胫逆冷的症状，适宜使用八味丸来温补阳气。若小便频数且颜色发黄，适宜使用四物汤加入人参、白术、麦门冬、五味子以滋养肺肾。若小便短少，适宜使用补中益气汤加入山药、麦门冬、五味子以补益脾肺。若因热邪结聚于膀胱导致排尿不畅，适宜使用五淋散以清热利湿。若因脾气燥热而不能正常运化水液，适宜使用黄芩清肺饮以滋阴润燥。若因膀胱阴虚导致阳气无法生化，适宜使用六味丸。若因膀胱阳虚导致阴液无法气化，适宜使用滋肾丸。肾虚引起的疾病多会传变出此类症状，如果不滋补肾精这一化源就无法挽救。如果使用黄柏、知母反而会泻损阳气，从而加速病情恶化。若是老年人因阳痿而思欲行房，导致精气内败，出现尿道疼痛且排尿不利的，使用加减八味丸加入车前子、牛膝。若无效，再加附子，多有复生的案例。若精气已经枯竭却再次耗损，大小便时牵拉疼痛，越痛越想排便，越排便越感到牵拉疼痛，用前述药物加入附子，也有复生的案例。王太仆说：“没有阴液则阳气无法气化，没有阳气则阴液无法生化”，应当滋补肾精这一化源。如果专门使用淡渗利湿的药物，反而会损伤真阴，这是加速死亡的做法。职方王塘，背疽溃烂后，小便淋漓不尽，有时甚至自遗失禁，口渴想喝水，心烦发热失眠，疮口发红，有时感觉像被灼烧，有时大小便失禁。我说：这是肾虚的危重证候，使用加减八味丸，加入麦门冬，服用数剂后痊愈。驾部林汝玉，冬天不穿棉衣，口渴想喝冷水，常常自认为身体壮实，嘲笑我穿棉衣。诊察他的脉搏数大但无力，我说：到了火令时节（夏季），您应该会来找我。三月间，果然背部发热、大便闭结、脉象涩滞，使用四物汤加入黄芩、黄连、山栀，服用数剂后大便稍通，随后去掉黄芩、黄连，加入人参、白术、茯苓，服用二十余剂及前面的药丸半斤左右，口渴减轻六七成，背部发热也消退，到了夏天背部发疽，纯用托里透脓的药物而收敛愈合。
托里消毒散加减法：尿道疼痛且小便不利，是精气内败的表现，去掉连翘、白芷、金银花这三味药，加入山茱萸、山药、泽泻。如果无效，配合使用六味丸。越排便越痛，越痛越排便，是精气再次枯竭的表现，去掉那三味药的煎剂，送服六味丸。食量减少、身体疲倦、口干想喝热水、小便黄短，是脾肺虚热的表现，去掉那三味药加入五味子、山茱萸。如果无效，暂时使用六味丸。因劳累过度导致小便发黄，是元气下陷的表现，去掉那三味药加入升麻、柴胡。午后小便黄短，是肾虚热的表现，去掉那三味药加入升麻、柴胡煎汤，送服六味丸。
黄芩清肺饮：治疗肺经阴虚火燥导致的小便不通，如果是因为脾经有热，应当清脾热。如果是因为心火克制肺金，应当制约心火。
黄芩（一钱） 栀子（三枚，打碎）
以上药材用水煎煮服用。
滋肾丸：治疗肾经阴虚发热、口渴、小便赤红、足热腿软等证候。凡是不口渴但小便便秘，热邪在下焦血分的，最适合此药。经文说：“没有阴液则阳气无法气化”。如果是脾肺燥热所遗留的问题，应当滋补肾精这一化源。
知母 黄柏（各酒炒，一两） 肉桂（二钱）
以上研为细末，用水泛丸如梧桐子大。每次服用一百丸，空腹时用白开水送服。
五苓散：治疗下部湿热疮疡，每见小便赤少。
泽泻（二两五钱） 猪苓（去皮，一两半） 肉桂（七钱半） 白术 赤茯苓（各一两五钱）
以上研为细末。每次服用一二钱，用热开水调服。
清心莲子饮：治疗膀胱气虚湿热，阴茎肿痛，或尿道涩滞，口苦咽干，小便色赤或白浊，夜间安静而白天发热。
黄芩 麦门冬 地骨皮 车前子 炙甘草（各一钱半） 石莲肉 白茯苓 黄芪 柴胡 人参（各一钱）
以上用水煎煮服用。
五淋散：治疗膀胱有热，水道不通，或者尿如豆汁，或者如沙石，或者如膏汁，或者热沸便血。
赤茯苓（一钱半） 赤芍药 山栀（各二钱） 当归 甘草（各一钱五分）
以上用灯心草二十根，加水煎煮服用。
清肺饮：治疗口渴且小便不利，这是肺经有热，断绝了寒水（肾水）生化之源，适宜用此药以清化源头，水源自然产生而小便自然通利。
茯苓（二钱） 猪苓（三钱） 泽泻 琥珀 瞿麦（各五分） 通草（六分） 木通 蓄（各七分） 车前子（一钱） 灯草（一分）
以上研为细末。每次服用五钱，加水煎煮服用。
肾气丸：治疗肾经阳虚阴无所化，以致膀胱淋漓不尽。或者脾肺气虚不能通调水道，水液无法气化而导致膀胱癃闭。或者肾气虚热，干扰厥阴之络，导致阴挺、痿痹而溺频数。或者肾水虚弱阴亏难降，使津液败浊而为痰水。又治疗肾虚便血及诸种见血发热、自汗盗汗等症的圣药。即六味地黄丸。
琥珀散：治疗各种疮疖，表里有热，小便赤涩。
白茯苓 黄芩 茵陈 紫草 瞿麦 茅根 石韦 乌药 琥珀 连翘 车前子（各等分）
以上研为极细末，每次服用二三钱，用灯心草汤调服，不限时候。
瞿麦散：治疗痈疽发背，排脓止痛，利小便。
桂心 赤芍药 当归 黄芪 川芎 瞿麦 白蔹 麦门冬（去心，各等分） 赤小豆（一合，酒浸炒干）
以上切碎。每次服用四钱，用酒煎煮温服，如果各种痈肿已溃或未溃，疮中脓血不绝，疼痛难以忍受，加细辛、白芷、白蔹、薏苡仁。
[Xue Ji] When a patient with sores and ulcers experiences dribbling, frequent urination, or astringent pain in the urethra, this is a critical syndrome caused by deficiency of the Kidney Meridian. It is appropriate to use Jiajian Bawei Wan (Modified Eight-Ingredient Pill) to nourish Yin; if accompanied by cold extremities in the lower legs and calves, it is appropriate to use Bawei Wan (Eight-Ingredient Pill) to tonify Yang. If urination is frequent and yellow, it is appropriate to use Siwu Tang (Four Substances Decoction) added with Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), Maimendong (Ophiopogon Tuber), and Wuweizi (Schisandra Fruit) to nourish the Lung and Kidney. If urine is scanty, it is appropriate to use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Shanyao (Dioscorea Rhizome), Maimendong, and Wuweizi to tonify the Spleen and Lung. If heat binds in the Bladder causing difficulty in urination, it is appropriate to use Wulin San (Five Strangury Powder) to clear heat. If Spleen Qi is dry and unable to transform fluids, it is appropriate to use Huangqin Qingfei Yin (Scutellaria Lung-Clearing Infusion) to nourish Yin. If Bladder Yin is deficient such that Yang cannot be generated, it is appropriate to use Liuwei Wan (Six-Ingredient Pill). If Bladder Yang is deficient such that Yin cannot be transformed, it is appropriate to use Zishen Wan (Kidney-Nourishing Pill). Diseases originating from Kidney deficiency often transmit to this syndrome; without nourishing the source of transformation (Jihua Yuan), rescue is impossible. Using Huangbai (Phellodendron Bark) and Zhimu (Anemarrhena Rhizome) will instead drain Yang and accelerate danger. For elderly men with impotence who indulge in sexual desire, leading to internal corruption of essence, resulting in penile pain and difficult urination, use Jiajian Bawei Wan added with Cheqianzi (Plantago Seed) and Niuxi (Achyranthes Root). If ineffective, add Fuzi (Aconite Lateral Root) and there are cases of recovery. If essence is already exhausted yet further depleted, causing dragging pain during defecation and urination—the more painful the more one desires to pass stool/urine, and the more one passes it the more painful it becomes—using the aforementioned medicines added with Fuzi has also led to recovery. Wang Taipu said: "Without Yin, Yang cannot be transformed; without Yang, Yin cannot be generated." One must nourish the source of transformation. If one exclusively uses bland-draining diuretics, it will further damage True Yin, thereby accelerating death. Official Wang Tang, after his back carbuncle ulcerated, experienced dribbling urination, sometimes spontaneous incontinence, thirst with excessive drinking, irritability, fever, insomnia, redness of the wound, sometimes feeling as if burning, and sometimes urinary/fecal incontinence. I said: This is a critical syndrome of Kidney deficiency. Use Jiajian Bawei Wan added with Maimendong; after several doses, he recovered. Official Lin Ruyu, did not wear cotton in winter, felt thirsty and drank cold water, often prided himself on being robust, and mocked my wearing cotton. His pulse was rapid and large but empty. I said: When the Fire season arrives, you will come to me. In March, indeed, he had back heat, constipation, and a choppy pulse. I used Siwu Tang added with Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), and Zhizi (Gardenia Fruit) for several doses; bowel movements became slightly regular. Then I removed Huangqin and Huanglian, added Renshen, Baizhu, and Fuling (Poria), for over twenty doses, along with about half a jin of the previous pill; thirst decreased by six or seven tenths, and back heat subsided. In summer, a carbuncle erupted on his back; using purely Tuoli (Supporting Interior) agents, it healed.
Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder) Modification Method: Penile pain with difficult urination indicates internal corruption of essence. Remove Qiaoyao (Forsythia Fruit), Baizhi (Angelica Dahurica Root), and Jinyinhua (Honeysuckle Flower). Add Shanzhuyu (Cornus Fruit), Shanyao, and Zexie (Alisma Rhizome). If ineffective, assist with Liuwei Wan. The pattern of "more urination leads to more pain, more pain leads to more urination" indicates re-exhaustion of essence. Stop the decoction of the three removed herbs, and take Liuwei Wan with it. Decreased appetite, fatigue, dry mouth desiring hot drinks, yellow and scanty urine indicate Deficient-Heat of Spleen and Lung. Remove the three herbs and add Wuweizi and Shanzhuyu. If ineffective, temporarily use Liuwei Wan. Yellow urine due to overwork indicates sinking of Original Qi. Remove the three herbs and add Shengma (Cimicifuga Rhizome) and Chaihu (Bupleurum Root). Yellow and scanty urine in the afternoon indicates Kidney Deficient-Heat. Remove the three herbs, add Shengma and Chaihu to decoct, and take Liuwei Wan with it.
Huangqin Qingfei Yin (Scutellaria Lung-Clearing Infusion): Treats obstruction of urination due to Yin deficiency and Fire-Dryness of the Lung Meridian. If due to Heat in the Spleen Meridian, clear Spleen Heat. If due to Heart Fire suppressing Lung Metal, restrain Heart Fire.
Huangqin (1 qian) Zhizi (3 fruits, crushed)
Decoct in water and take orally.
Zishen Wan (Kidney-Nourishing Pill): Treats syndromes of Kidney Meridian Yin deficiency with fever, thirst, red urine, hot feet, and weak legs. For those who are not thirsty but have constipated urine, indicating Heat in the Blood aspect of the Lower Jiao, this medicine is most suitable. The Classic states: "Without Yin, Yang cannot be transformed." If left over from Spleen-Lung Dryness-Heat, nourish the source of transformation.
Zhimu (Anemarrhena Rhizome) Huangbai (Phellodendron Bark) (each wine-fried, 1 liang) Rougui (Cinnamon Twig) (2 qian)
Grind into powder, make pills with water the size of Sophora seeds. Take 100 pills each time, swallowed with plain boiled water on an empty stomach.
Wuling San (Five-Aromatic Powder): Treats damp-heat sores in the lower body, characterized by red and scanty urine.
Zexie (Alisma Rhizome) (2 liang 5 qian) Zhuling (Polyporus) (peeled, 1 liang 5 qian) Rougui (Cinnamon Twig) (7 qian 5 fen) Baizhu (Atractylodes Rhizome) Chi Fuling (Red Poria) (each 1 liang 5 qian)
Grind into fine powder. Take 1-2 qian each time, mixed with hot water.
Qingxin Lianzi Yin (Heart-Clearing Lotus Seed Infusion): Treats Qi deficiency and damp-heat in the Bladder, swelling and pain of the penis, or astringency in the urethral orifice, bitter taste in the mouth, dry throat, red or turbid white urine, quiet at night but feverish during the day.
Huangqin (Scutellaria Root) Maimendong (Ophiopogon Tuber) Digupi (Lycium Bark) Cheqianzi (Plantago Seed) Zhi Gancao (Honey-fried Licorice Root) (each 1 qian 5 fen) Shilianrou (Lotus Plumule) Baifuling (White Poria) Huangqi (Astragalus Root) Chaihu (Bupleurum Root) Renshen (Ginseng Root) (each 1 qian)
Decoct in water and take orally.
Wulin San (Five-Strangury Powder): Treats Heat in the Bladder with blocked water pathways, urine resembling bean juice, sand/stones, paste/juice, or boiling blood in urine.
Chi Fuling (Red Poria) (1 qian 5 fen) Chi Shaoyao (Red Peony Root) Zhizi (Gardenia Fruit) (each 2 qian) Danggui (Angelica Sinensis Root) Gancao (Licorice Root) (each 1 qian 5 fen)
Decoct with 20 roots of Dengxincao (Juncus Medulla) in water and take orally.
Qingfei Yin (Lung-Clearing Infusion): Treats thirst with difficult urination, which is Heat in the Lung Meridian cutting off the source of generation of Cold Water (Kidney Water). Use this medicine to clear the source; then water will generate naturally and urination will become smooth.
Fuling (Poria) (2 qian) Zhuling (Polyporus) (3 qian) Zexie (Alisma Rhizome) Hupo (Amber) Qumai (Dianthus Herb) (each 5 fen) Tongcao (Tetrapanax Medulla) (6 fen) Mutong (Akebia Stem) Jian Shicao (Polygonum Aviculare Herb) (each 7 fen) Cheqianzi (Plantago Seed) (1 qian) Dengcao (Juncus Herb) (1 fen)
Grind into fine powder. Take 5 qian each time, decoct in water and take orally.
Shenqi Wan (Kidney-Qi Pill): Treats Kidney Meridian Yang deficiency where Yin cannot be transformed, leading to dribbling urination. Or Spleen-Lung Qi deficiency unable to regulate water passages, causing water stagnation and Bladder retention. Or Kidney Qi deficiency with Heat interfering with the Jueyin collaterals, causing prolapse, flaccidity, numbness, and frequent urination. Or Kidney Water weakness with Yin deficiency making descent difficult, causing fluids to become turbid and form phlegm-water. It is also a sacred medicine for treating hematochezia due to Kidney deficiency, various bleeding syndromes with fever, spontaneous sweating, and night sweats. This is Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia).
Hupo San (Amber Powder): Treats various boils and furuncles with exterior-interior Heat, and red, astringent urination.
Baifuling (White Poria) Huangqin (Scutellaria Root) Yichen (Artemisia Capillaris Herb) Zicao (Arnebia Root) Qumai (Dianthus Herb) Maogen (Imperata Rhizome) Shiwei (Pyrrosia Leaf) Wuyao (Lindera Root) Hupo (Amber) Qiaoyao (Forsythia Fruit) Cheqianzi (Plantago Seed) (equal parts)
Grind into extremely fine powder. Take 2-3 qian each time, mixed with Dengxincao (Juncus Medulla) decoction, at any time.
Qumai San (Dianthus Powder): Treats carbuncles and back sores, expels pus, relieves pain, and promotes urination.
Guixin (Cinnamon Heart) Chi Shaoyao (Red Peony Root) Danggui (Angelica Sinensis Root) Huangqi (Astragalus Root) Xiong (Ligusticum Rhizome) Qumai (Dianthus Herb) Bailian (Trollius Chinensis Bulb) Maimendong (Ophiopogon Tuber) (decocted, equal parts) Chixiaodou (Adzuki Bean) (1 he, soaked in wine, stir-fried until dry)
Chop ingredients. Take 4 qian each time, decoct in wine and take warm. If various abscesses are ulcerated or not, with continuous pus and blood from the wound and unbearable pain, add Xixin (Asarum Root), Baizhi (Angelica Dahurica Root), Bailian (Trollius Chinensis Bulb), and Yiyiren (Coix Seed).