小便不禁者，属热属虚。热者，五苓散加解毒；虚者，五苓加四物。
戴云∶小便不禁，出而不觉，赤者有热，白者气虚也。
〔附录〕小便不禁，有虚热、虚寒之分。内虚寒自汗者，秘元丹、《三因》韭子丸；内
虚湿热者，六味地黄丸或八味丸，加杜仲、骨脂、五味。老人，宜八味丸减泽泻为妙。
附方
秘元方 助阳消阴，正气温中，内虚里寒，冷气攻心，胀痛泄泻，自汗时出，小便不禁
，阳衰足冷，真气不足，一切虚冷。
白龙骨（三两，烧） 诃子（十个，炮，去核） 砂仁（一两） 灵砂（二两）
上四味为末，煮糯米粥丸，如麻子大。空心温酒送下二丸，临卧冷水送下三丸。忌葱茶
暖肾丸 治肾虚多溺，或小便不禁而浊。
胡芦巴（炒） 故纸（炒） 川楝（用牡蛎炒，去牡蛎） 熟地黄 益智 鹿茸（酒炙） 山茱
（烧醋淬七次，另研） 赤石脂（各七钱半） 龙骨 海螵蛸 熟艾（醋拌炙焦） 丁香 沉香 乳
香（各五钱） 禹余粮（ ，醋淬，七钱半）
上为末，糯米粥丸如梧子大。服五十丸，煎菖蒲汤空心送下。
《三因》家韭子丸 治下元虚冷，小便不禁，或成白浊。
韭子（六两，炒） 鹿茸（四两，酥炙） 苁蓉（酒浸） 牛膝 熟地黄 当归（各二两） 巴戟（去
心） 菟丝子（酒浸，各一两半） 杜仲 石斛 桂心 干姜（炮，各一两）
上为末，酒糊丸如梧子大。每服一百丸，空心汤酒任下。
六味地黄丸（见补损） 八味丸（见补损。）
小便不禁（指尿液无法控制地自行流出），其病机属于热证或虚证。热证者，使用五苓散加入解毒药物；虚证者，在五苓散基础上加入四物汤。
戴元礼说：小便不禁，表现为尿液流出而患者自身没有知觉。尿色赤红的属于有热，尿色白清的属于气虚。
〔附录〕小便不禁，分为虚热和虚寒两种类型。体内虚寒且伴有自汗者，使用秘元丹、《三因方》中的韭子丸；体内虚热兼夹湿热者，使用六味地黄丸或八味丸，并加入杜仲、骨碎补、五味子。老年人，适宜使用八味丸减去泽泻，效果更佳。
附方
秘元方：具有助阳消阴、正气温中、治疗内虚里寒、冷气攻心、胀痛泄泻、自汗不时发作、小便不禁、阳气衰弱足部发冷、真气不足以及一切虚寒证的功效。
药材组成：白龙骨（三两，煅烧）、诃子（十个，炮制，去核）、砂仁（一两）、灵砂（二两）。
制法与用法：将上述四味药研为细末，用煮熟的糯米粥调和制成丸剂，大小如麻子。空腹时用温酒送服两丸，临睡前用冷水送服三丸。忌食葱和茶。
药材组成：胡芦巴（炒制）、故纸（即补骨脂，炒制）、川楝子（用牡蛎炒，去牡蛎）、熟地黄、益智仁、鹿茸（酒炙）、山茱萸（烧后醋淬七次，另研）、赤石脂（各七钱半）、龙骨、海螵蛸、熟艾（醋拌后炙焦）、丁香、沉香、乳香（各五钱）、禹余粮（醋淬，七钱半）。
制法与用法：将上述药物研为细末，用糯米粥调和制成如梧桐子大小的丸剂。每次服用五十丸，煎菖蒲汤在空腹时送服。
药材组成：韭子（六两，炒制）、鹿茸（四两，酥炙）、肉苁蓉（酒浸）、牛膝、熟地黄、当归（各二两）、巴戟天（去心）、菟丝子（酒浸，各一两半）、杜仲、石斛、桂心、干姜（炮制，各一两）。
制法与用法：将上述药物研为细末，用酒糊调和制成如梧桐子大小的丸剂。每次服用一百丸，空腹时随个人喜好用汤剂或酒送服。
Incontinence of urine refers to the involuntary leakage of urine. Its pathogenesis belongs to Heat or Deficiency. For Heat patterns, Wuling San (Five-Ingredient Powder with Poria) is used with added heat-clearing and detoxifying herbs; for Deficiency patterns, it is used with Siwu Tang (Four-Substance Decoction).
Dai Yuanli stated: Incontinence of urine manifests as the flow of urine without the patient's awareness. Red urine indicates Heat, while white urine indicates Qi Deficiency.
[Appendix] Incontinence of urine is divided into Deficient Heat and Deficient Cold types. For internal Deficient Cold accompanied by spontaneous sweating, Miyuan Dan (Secret Origin Pill) or Jiuzi Wan (Leek Seed Pill) from *San Yin Fang* is indicated; for internal Deficient Heat combined with Damp-Heat, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) or Bawei Wan (Eight-Ingredient Pill) are indicated, with added Duzhong (Eucommia Bark), Gubujie (Bone Breaker), and Wuweizi (Schisandra Fruit). For the elderly, it is advisable to use Bawei Wan minus Zexie (Alisma Rhizome) for optimal effect.
Attached Formulas
Miyuan Fang (Secret Origin Formula): Assists Yang and eliminates Yin, corrects Qi and warms the Middle, treats internal Deficiency with interior Cold, Cold Qi attacking the Heart, distension, pain, diarrhea, spontaneous sweating occurring intermittently, incontinence of urine, Yang deficiency with cold feet, insufficiency of True Qi, and all kinds of Deficient-Cold conditions.
Ingredients: Baigu Long (White Dragon Bone, 3 liang, calcined), Hezi (Chebula Fruit, 10 pieces, processed, pitted), Sharen (Amomum Fruit, 1 liang), Lingsha (Cinnabar Mercury, 2 liang).
Preparation and Administration: Grind the above four ingredients into powder. Mix with cooked glutinous rice porridge to form pills the size of hemp seeds. Take two pills with warm wine on an empty stomach, and three pills with cold water before bed. Avoid green onions and tea.
Nuanshen Wan (Kidney-Warming Pill): Treats polyuria due to Kidney Deficiency, or incontinence of urine with turbidity.
Ingredients: Huluba (Phanerae Semen, stir-fried), Gu Zhi (Psoraleae Fructus, stir-fried), Chuanlian Zi (Toosendan Fruit, stir-fried with Ostrea Shell, discard shell), Shu Dihuang (Prepared Rehmanniae Radix), Yizhi Ren (Alpiniae Oxyphyllae Fructus), Lurong (Cervi Cornu Colla, prepared with wine), Shanzhuyu (Corni Fructus, calcined and quenched with vinegar seven times, ground separately), Chishizhi (Halloysit Rubra, each 7 qian 5 fen), Longgu (Fossilized Bones), Haipiaoxiao (Sepiae Endoconcha), Shuai Ai (Artemisia Argyi Folium, mixed with vinegar and roasted until scorched), Dingxiang (Caryophylli Flos), Chenxiang (Aquilariae Lignum Resinatum), Ruxiang (Olibanum, each 5 qian), Yuyuliang (Hematitum, quenched with vinegar, 7 qian 5 fen).
Preparation and Administration: Grind the above ingredients into powder. Mix with glutinous rice porridge to form pills the size of sophora seeds. Take 50 pills per dose, administered with Acorus decoction on an empty stomach.
*San Yin Fang* Jiuzi Wan (Leek Seed Pill from *Treatise on Causation and Manifestations of Diseases*): Treats deficiency-cold of the Lower Source, incontinence of urine, or formation of white turbidity.
Ingredients: Jiuzi (Allii Tuberosi Semen, 6 liang, stir-fried), Lurong (Cervi Cornu Colla, 4 liang, roasted with butter), Rongrong (Cistanches Herba, soaked in wine), Niuxi (Achyranthis Bidentatae Radix), Shu Dihuang (Prepared Rehmanniae Radix), Danggui (Angelicae Sinensis Radix, each 2 liang), Bajitian (Morinda Officinalis Radix, heart removed), Tusizi (Cuscutae Semen, soaked in wine, each 1.5 liang), Duzhong (Eucommiae Cortex), Shihu (Dendrobii Caulis), Guixin (Cinnamomi Ramulus), Ganjiang (Zingiberis Rhizoma, processed, each 1 liang).
Preparation and Administration: Grind the above ingredients into powder. Mix with wine paste to form pills the size of sophora seeds. Take 100 pills per dose, administered with broth or wine at will on an empty stomach.
Liuwei Dihuang Wan (See "Tonifying Loss" chapter)
Bawei Wan (See "Tonifying Loss" chapter)