专主乎湿热。炒黄柏坚肾，知母降火，牡蛎、蛤粉燥湿。一方治精滑∶良姜（三钱） 芍药 黄柏（各二钱，烧
灰存性） 椿根白皮（一两半） 为末，糊丸，每服三十丸。
主湿热。虽有赤白之异，终无寒热之分。河间云∶天气热，水则混浊，寒则澄澈清冷。由此观之，浊之为病，湿热
明矣。赤浊属血与热；白浊属气与痰。赤由小肠，属火故也；白由大肠，属金故也。小便混浊热也，赤者心虚，
多因思虑而得；白属肾虚，过于嗜欲而得。治法，燥湿降火，珍珠粉丸好。又有升提之法甚妙。寒则坚凝，热则流
通，大率皆是湿痰流注，宜燥中宫之湿，用二陈汤加苍术、白术，燥去其湿。赤者，乃是湿伤血，加白芍药，仍用珍珠
粉丸加椿根皮、滑石、青黛等，以曲糊作丸。一方加干姜炒黑色，固而不走。珍珠粉丸∶珍珠（二两） 真蛤粉（一
斤） 黄柏（一斤，新瓦上炒赤色） 上为末，丸如桐子大，每服百丸，空温酒送下。脉弦者，是肝病，用青黛以泻
肝。半苓丸治白浊，半夏炒燥湿，茯苓分水。一本作猪苓。白浊久不止，此系火不守耳，炒知母、炒黄柏、附子，各等
分，上末之，水丸。虚劳者用补阴丸，大概不用凉药、热药。若肥白人，必多湿痰，以二陈汤去其湿，胃弱者兼用人参，
以柴胡、升麻，升胃中之气，丸药用青黛、黄柏炒微褐色、滑石、炒干姜炒微黑色、蛤粉，上末之为丸。胃中湿浊气，
下流为赤白浊，用柴胡、升麻、苍术、白术入二陈煎服丸药，宜用樗根末、蛤粉、干姜、炒黄柏。专主胃中浊气，
下流渗入膀胱，青黛、蛤粉。一方治赤白浊∶黄柏（炒黑一两） 生黄柏（二钱半） 海石（三两） 神曲（半
两） 上末之，水丸。有热者，黄柏、滑石、青黛之类，上为末，水丸。燥湿痰方∶南星、海石、神曲、半夏，各等
分为丸，青黛为衣。张子原气血两虚，有痰，痛风时作，阴火间起，小便白浊或带下赤白，方在前痛风中。治赤浊，
五苓散合妙香散、二冬汤下定志丸方∶远志（去心苗二两） 石菖蒲（三两） 人参（三两） 白茯苓（
去皮三两） 上末之，蜜丸，如桐子大，朱砂为衣，每服二十丸，食前米饮汤下，加至三十丸。凡浊气即是湿痰，入方
丸药，用青黛、樗皮末、蛤粉、滑石、干姜炒、黄柏炒褐色、上炒神曲，糊为丸。仍用前燥湿痰丸子，亦能治带下
病。戴氏论云∶滑石利窍，黄柏治湿热，青黛解热，蛤粉咸寒入肾，炒干姜味苦，领肺气下降，使阴血，生干姜盐
制。一人便浊，常有半年，或时梦遗，形瘦作心虚，主治∶定志丸与珍珠粉丸同服。一人健忘、白浊，治法同。
尝闻之先生论曰∶白浊多因湿气下流膀胱而成，赤白浊《灵枢经》所谓∶中气不足，溲便为之变是也。先须补中气，使
升举之，而后分其脏腑气血，赤白虚实以治，与夫其他邪热所伤者，固在泻热补虚，设肾气虚甚者，或火热亢极者，则
不宜峻用寒凉，必以反佐治之，要在权量轻重而已。
主要病机在于湿热。使用炒黄柏以坚固肾气，知母以降火，牡蛎和蛤粉以燥湿。有一个方子治疗精液滑泄：良姜（三钱）、芍药、黄柏（各二钱，烧成灰但保留药性）、椿根白皮（一两半），研为细末，用糊剂制成丸药，每次服用三十丸。
病机主因是湿热。虽然有赤浊和白浊的区别，但最终没有寒证与热证的区分。刘河间说：“天气炎热时，水就会浑浊；天气寒冷时，水则清澈澄冷。”由此看来，浊病的病因显然是湿热。赤浊属于血分受热；白浊属于气分有痰。赤浊源于小肠，因为心属火；白浊源于大肠，因为肺属金。小便混浊属于热证，颜色发红的是心气虚，多因思虑过度而得病；白色的是肾虚，多因房事过度而得病。治疗方法，应燥湿降火，珍珠粉丸效果较好。又有升提之法非常巧妙。寒邪会导致凝结，热邪会导致流通，大体上都是湿痰流注所致，应当燥化中焦脾胃的湿气，使用二陈汤加苍术、白术，以燥去其湿。如果是赤浊，乃是湿气损伤了血分，加入白芍药，仍然使用珍珠粉丸加上椿根皮、滑石、青黛等，用曲糊制作成丸。另一个方子在珍珠粉丸基础上加入干姜炒至黑色，起到固涩而不走散的作用。珍珠粉丸的组成：珍珠（二两）、真蛤粉（一斤）、黄柏（一斤，在新瓦上炒至红色），研为细末，制成如梧桐子大小的丸药，每次服用一百丸，空腹时用温酒送服。脉象弦的，是肝病，使用青黛以泻肝火。半苓丸治疗白浊，半夏炒制以燥湿，茯苓以利水分利。另一版本写作猪苓。白浊久治不愈，这是相火不能守位的表现，使用炒知母、炒黄柏、附子，各等分，研为细末，用水泛为丸。虚劳患者使用补阴丸，大概不使用过凉或过热的药物。如果是肥胖的人，必定多有湿痰，用二陈汤去除湿气，胃气虚弱者兼用人参，用柴胡、升麻提升胃中之气，丸药药用青黛、黄柏炒至微褐色、滑石、干姜炒至微黑色、蛤粉，研为细末制成丸药。胃中的湿浊之气下流，导致赤白浊，使用柴胡、升麻、苍术、白术加入二陈汤煎服或配合丸药，宜用樗根末、蛤粉、干姜、炒黄柏。专门针对胃中浊气下流渗入膀胱的情况，使用青黛、蛤粉。另一个方子治疗赤白浊：黄柏（炒黑一两）、生黄柏（二钱半）、海浮石（三两）、神曲（半两），研为细末，用水泛为丸。有热象者，使用黄柏、滑石、青黛之类，研为细末，用水泛为丸。燥湿痰的方子：天南星、海浮石、神曲、半夏，各等分制成丸药，以青黛为衣。张子原气血两虚，有痰，痛风时常发作，阴火间歇兴起，小便白浊或带下赤白，方子在前面的痛风篇中。治疗赤浊，五苓散合妙香散、二冬汤下定志丸。定志丸的组成：远志（去心苗二两）、石菖蒲（三两）、人参（三两）、白茯苓（去皮三两），研为细末，蜜炼为丸，如梧桐子大小，朱砂为衣，每次服用二十丸，饭前用米饮汤送服，可加至三十丸。凡浊气即是湿痰，在方剂丸药中，使用青黛、樗皮末、蛤粉、滑石、干姜炒、黄柏炒褐色、炒神曲，用糊剂制成丸药。仍然使用前文的燥湿痰丸药，也能治疗带下病。戴氏论述说：滑石通利窍道，黄柏治疗湿热，青黛解热，蛤粉咸寒入肾经，炒干姜味苦，引导肺气下降，使阴血得以生成，干姜需用盐制。有一人患便浊，已有半年，有时梦遗，形体消瘦表现为心虚，主治方法：定志丸与珍珠粉丸同服。有一人健忘、白浊，治疗方法相同。曾听老师论述说：白浊多因湿气下流膀胱而成，赤白浊即《灵枢经》所说的“中气不足，溲便为之变”。必须先补益中气，使其升举，然后分辨脏腑气血的赤白虚实进行治疗，以及其他邪热所伤的情况，固然需要泻热补虚，如果肾气极度虚弱，或者火热亢盛到了极点，则不宜峻猛使用寒凉药物，必须采用反佐的方法治疗，关键在于权衡病情的轻重而已。
The pathogenesis is primarily dominated by Damp-Heat (Shi-Re). Fried Huangbai (Phellodendri Cortex) is used to strengthen the Kidney, Zhimu (Anemarrhenae Rhizoma) to descend Fire, and Muli (Concha Ostreae) and Gafen (Calx Concha Arcae) to dry Dampness. One formula for treating seminal emission (Jinghua): Liangjiang (Rhizoma Zingiberis Preparatum, 3 qian), Shaoyao (Radix Paeoniae Alba), Huangbai (each 2 qian, burned to ash but retaining medicinal properties), and Chun Gen Bai Pi (Cortex Ailanthi Alangi Radicis, 1.5 liang), ground into powder, made into pills with paste, each dose being 30 pills.
The pathogenesis is dominated by Damp-Heat. Although there are differences between Red Turbid Urine (Chi Zhuo) and White Turbid Urine (Bai Zhuo), ultimately there is no distinction between Cold and Heat syndromes. Hejian (Liu Wansu) stated: When the weather is hot, water becomes turbid; when cold, it becomes clear and cold. From this perspective, it is evident that the disease of Turbid Urine is caused by Damp-Heat. Red Turbid Urine belongs to Blood and Heat; White Turbid Urine belongs to Qi and Phlegm-Damp. Red originates from the Small Intestine, belonging to Fire; White originates from the Large Intestine, belonging to Metal. Cloudy urine indicates Heat; red color implies Heart deficiency, often resulting from excessive overthinking; white color implies Kidney deficiency, often resulting from excessive sexual desire. The treatment method involves drying Dampness and descending Fire; Zhenzhu Fen Wan (Pearl Powder Pill) is effective. There is also a lifting method that is very clever. Cold causes coagulation, while Heat allows flow. Generally, these are cases of Damp-Phlegm flowing and accumulating. It is appropriate to dry the Dampness in the Middle Jiao (Spleen and Stomach) using Er Chen Tang (Two-Cured Decoction) added with Cangzhu (Atractylodis Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) to dry away the Dampness. For Red Turbid Urine, it is Dampness injuring the Blood, so add Baishaoyao (Radix Paeoniae Alba), and still use Zhenzhu Fen Wan (Pearl Powder Pill) added with Chun Gen Pi (Cortex Ailanthi Alangi Radicis), Huashi (Talcum), and Qingdai (Indici Folium), made into pills with Qu paste. Another formula adds Ganjiang (Zingiberis Rhizoma) fried until black to secure and prevent dispersion. Composition of Zhenzhu Fen Wan (Pearl Powder Pill): Zhenzhu (Margarita, 2 liang), Zhen Gafen (Calx Concha Arcae, 1 jin), Huangbai (Phellodendri Cortex, 1 jin, fried on a new tile until red). Ground into powder, made into pills the size of Sophora seeds, each dose 100 pills, taken with warm wine on an empty stomach. If the pulse is Wiry (Xian), it indicates Liver disease, treat with Qingdai (Indici Folium) to drain Liver Fire. Banling Wan (Half-Poria Pill) treats White Turbid Urine; Banxia (Pinelliae Rhizoma) fried to dry Dampness, Fuling (Poria) to separate clear and turbid fluids. Some versions write Zhuling (Polyporus). If White Turbid Urine persists for a long time, it is because the Fire does not remain in its position; use fried Zhimu (Anemarrhenae Rhizoma), fried Huangbai (Phellodendri Cortex), and Fuzi (Aconiti Lateralis Radix Praeparata) in equal parts, ground into powder, made into water pills. For patients with Consumption (Xu Lao), use Buyin Wan (Nourish Yin Pill), generally avoiding overly cooling or heating medicines. For obese individuals, there is likely much Damp-Phlegm; use Er Chen Tang (Two-Cured Decoction) to remove Dampness. If the Stomach is weak, add Renshen (Ginseng Radix et Rhizoma); use Chaihu (Bupleuri Radix) and Shengma (Cimicifugae Rhizoma) to lift the Qi in the Stomach. The pill ingredients include Qingdai (Indici Folium), Huangbai (Phellodendri Cortex) fried to light brown, Huashi (Talcum), Ganjiang (Zingiberis Rhizoma) fried to light black, and Gafen (Calx Concha Arcae), ground into powder and made into pills. When turbid Qi from the Stomach flows downward causing Red and White Turbid Urine, use Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma), Cangzhu (Atractylodis Rhizoma), and Baizhu (Atractylodis Macrocephalae Rhizoma) added to Er Chen Tang (Two-Cured Decoction) for decoction or combined with pills. It is suitable to use Chu Gen Mo (Powder of Ailanthus Root Bark), Gafen (Calx Concha Arcae), Ganjiang (Zingiberis Rhizoma), and fried Huangbai (Phellodendri Cortex). Specifically targeting turbid Qi from the Stomach flowing downward and infiltrating the Bladder, use Qingdai (Indici Folium) and Gafen (Calx Concha Arcae). Another formula for treating Red and White Turbid Urine: Huangbai (Phellodendri Cortex) fried black (1 liang), raw Huangbai (Phellodendri Cortex) (2.5 qian), Haishi (Lapis Calcitae, 3 liang), Shenqu (Massa Medicata Fermentata) (0.5 liang). Ground into powder, made into water pills. For those with Heat, use Huangbai (Phellodendri Cortex), Huashi (Talcum), Qingdai (Indici Folium), etc., ground into powder, made into water pills. Formula for drying Damp-Phlegm: Nanxing (Arisaematis Rhizoma), Haishi (Lapis Calcitae), Shenqu (Massa Medicata Fermentata), Banxia (Pinelliae Rhizoma) in equal parts made into pills, coated with Qingdai (Indici Folium). Zhang Zi had both Qi and Blood deficiency, with Phlegm, intermittent gout attacks, occasional rising of Deficient Fire, white turbid urine or red-white leukorrhea. The formula is in the previous section on Gout. To treat Red Turbid Urine, combine Wuling San (Five-Ingredient Powder with Poria), Miaoxiang San (Wonderful Incense Powder), Er Dong Tang (Two Winter Decoction), and Xianding Wan (Stabilize Will Pill). Composition of Xianding Wan (Stabilize Will Pill): Yuanzhi (Polygalae Radix, dehearted and without sprouts, 2 liang), Shichangpu (Acori Tatarinowii Rhizoma, 3 liang), Renshen (Ginseng Radix et Rhizoma, 3 liang), Baifuling (Poria, peeled, 3 liang). Ground into powder, honey-made pills the size of Sophora seeds, coated with Zhusha (Cinnabar), each dose 20 pills, taken with rice water before meals, can increase to 30 pills. All turbid Qi is essentially Damp-Phlegm. In formulas and pills, use Qingdai (Indici Folium), Chu Pi Mo (Powder of Ailanthus Bark), Gafen (Calx Concha Arcae), Huashi (Talcum), fried Ganjiang (Zingiberis Rhizoma), fried Huangbai (Phellodendri Cortex to brown), and fried Shenqu (Massa Medicata Fermentata), made into pills with paste. Still using the previous Damp-Phlegm drying pills can also treat leukorrhea. Dai Shi's discussion states: Huashi (Talcum) benefits orifices, Huangbai (Phellodendri Cortex) treats Damp-Heat, Qingdai (Indici Folium) resolves Heat, Gafen (Calx Concha Arcae) is salty and cold entering the Kidney, fried Ganjiang (Zingiberis Rhizoma) is bitter, guiding Lung Qi downward to generate Yin Blood. Ganjiang should be salt-processed. One person had turbid urine for half a year, sometimes with nocturnal emissions, emaciated indicating Heart deficiency. Main treatment: Take Xianding Wan (Stabilize Will Pill) and Zhenzhu Fen Wan (Pearl Powder Pill) together. One person had amnesia and white turbid urine, treated similarly. I once heard my teacher discuss: White Turbid Urine is mostly due to Dampness flowing downward to the Bladder. Red and White Turbid Urine is what the *Ling Shu* (Spiritual Pivot) refers to as: "Insufficiency of Central Qi leads to changes in urination and defecation." First, one must tonify Central Qi and lift it, then differentiate the Zang-Fu organs, Qi and Blood, and Red/White and Deficiency/Excess to treat accordingly. For other injuries by pathogenic Heat, although clearing Heat and tonifying Deficiency is necessary, if Kidney Qi is extremely deficient or Fire is excessively hyperactive, harsh cooling medicines should not be used vigorously. Instead, counter-assistance methods should be employed. The key lies in weighing the severity of the condition.