【纲】仲景曰。阳明病。自汗出。若发汗。小便自利。此为津液内竭。大便虽硬。不可攻之。
当须自欲大便。宜蜜煎导而通之。若土瓜根。及与大猪胆汁。皆可为导。
【目】柯琴曰。本自汗。更发汗。则上焦之液已外竭。小便自利。则下焦之液又内竭。
【纲】仲景曰。伤寒脉浮缓。手足自温者。系在太阴。太阴者。身自发黄。若小便自利者。不
能发黄。至七八日大便硬者。为阳明病。阳明病。反无汗而小便利。二三日呕而咳。手足厥者。必
苦头痛。
【目】柯琴曰。首条。小便自利。是津液越出。故燥土受病。病在胃也。次条。小便利则里无
瘀热可知矣。
【纲】仲景曰。太阳病。若吐。若下。若发汗。微烦。小便数。大便因硬者。小承气汤和之。
愈。
【目】王肯堂曰。阳明皆以小便自利为病。盖以验病之下与不当下也。若小便不利而少腹硬者。
屎也。当渗泄之。若小便自利而少腹硬者。非血则粪也。当通利之。且病之发黄与不发黄。及病
之死与不死。皆可于此验之。
吴绶曰。小便数者。频欲去而不多也。太阳阳明。治各有条。凡肾虚有热。小便频数者。清心
莲子饮。或人参三白汤加知、柏、麦冬、石莲之类。或滋补丸。补中益气汤加知、柏、麦冬、生地。
柯琴曰。此用小承气以润燥。是亦和剂。不专是下剂。
【纲】张仲景说：阳明病，出现自汗出的症状。如果又用了发汗法，导致小便通畅量多，这是体内津液枯竭的表现。虽然大便坚硬，但不可使用攻下法。应当等待患者有便意时，适宜用蜜煎栓剂纳入肛门以通便。也可以使用土瓜根，或者给予大猪胆汁，都可以作为导引通便的方法。
【目】柯琴说：原本就有自汗出，如果再发汗，那么上焦的津液已经向外耗竭；小便通畅量多，说明下焦的津液又在内部枯竭。
【纲】张仲景说：伤寒病，脉象浮而缓，手足自然温暖的，病位关联在太阴经。太阴病，身体自然会发黄；但如果小便通畅量多，就不能发黄。到了七八天，大便变硬的，就转化为阳明病。阳明病，反而无汗且小便通畅，两三天后出现呕吐兼咳嗽，手足厥冷，必定伴有剧烈的头痛。
【目】柯琴说：第一条中，小便通畅量多，是津液外越流失，所以燥土受邪，病位在胃。第二条中，小便利说明体内没有瘀滞的热邪，可以由此知晓。
【纲】张仲景说：太阳病，如果用吐法、下法或发汗法治疗后，出现轻微心烦，小便频数，大便因此变得坚硬，用小承气汤调和即可痊愈。
【目】王肯堂说：阳明病都以小便通畅为病变指征，以此来验证病情是否应当使用攻下法。如果小便不利且少腹部硬满，那是屎结，应当采用渗湿泄热的方法。如果小便通畅且少腹部硬满，那不是蓄血就是燥屎，应当采用通利的方法。而且疾病是否发黄，以及疾病的预后生死，都可以据此来验证。
吴绶说：小便频数，是指频繁想排尿但尿量不多。太阳病和阳明病的治疗各有条理。凡是肾虚有热导致小便频数的，可用清心莲子饮，或在人参三白汤中加入知母、黄柏、麦冬、石莲子等药物，或者服用滋补丸、补中益气汤加入知母、黄柏、麦冬、生地黄。
[Outline] Zhang Zhongjing stated: In Yangming disease, with spontaneous sweating, if diaphoresis (sweating therapy) is applied again, resulting in free urination (profuse and uncontrolled urination), this indicates exhaustion of body fluids internally. Although the stool is hard, purgation should not be used. One must wait for the natural urge to defecate; then, honey suppositories are suitable to guide and relieve the obstruction. Alternatively, Trichosanthes root (Tugua Gen) or large pig bile can also be used as guiding agents.
[Commentary] Ke Qin stated: Since there was already spontaneous sweating, applying diaphoresis again exhausts the fluids of the Upper Jiao outwardly. Free urition indicates that the fluids of the Lower Jiao are exhausted inwardly.
[Outline] Zhang Zhongjing stated: In Cold Damage disease, with a floating and moderate pulse, and naturally warm hands and feet, the condition is associated with the Taiyin channel. In Taiyin disease, jaundice naturally appears; however, if there is free urination, jaundice cannot develop. After seven or eight days, if the stool becomes hard, it transforms into Yangming disease. In Yangming disease, if there is paradoxically no sweat but free urination, and after two or three days vomiting and coughing occur along with cold extremities, severe headache will inevitably ensue.
[Commentary] Ke Qin stated: In the first case, free urination indicates fluids leaking outwards, causing dry earth to be affected, with the pathology located in the Stomach. In the second case, free urination indicates that there is no stagnant heat within, which can be deduced.
[Outline] Zhang Zhongjing stated: In Taiyang disease, if emesis, purgation, or diaphoresis has been applied, leading to slight irritability, frequent urination, and consequently hard stool, Xiao Chengqi Tang should be used to harmonize the condition, leading to recovery.
[Commentary] Wang Kentang stated: Yangming diseases all take free urination as a pathological sign, to verify whether the disease requires purgation. If urination is obstructed and the lower abdomen is hard, it is fecal impaction, requiring diuresis and drainage. If urination is free and the lower abdomen is hard, it is either blood stasis or dry stool, requiring unblocking and draining. Furthermore, whether jaundice develops or not, and the prognosis of life or death, can all be verified through this.
Wu Shou stated: Frequent urination refers to the frequent desire to void but with small volume. For Taiyang and Yangming diseases, treatments have specific guidelines. For cases of frequent urination due to Kidney deficiency with heat, Qingxin Lianzi Yin may be used, or Renshen Sanbai Tang added with Zhi Mu, Huang Bai, Mai Dong, Shi Lian Zi, etc., or Buzhi Wan, or Buzhong Yiqi Tang added with Zhi Mu, Huang Bai, Mai Dong, Sheng Di Huang.
Ke Qin stated: The use of Xiao Chengqi Tang here is to moisten dryness; it is also a harmonizing formula, not exclusively a purgative one.