五淋病 皆热结 淋者，小便痛涩淋沥，欲去不去，欲止不止是也，皆热气结于膀胱。
膏石劳 气与血 石淋下如沙石，膏淋下如膏脂，劳淋从劳力而得，气淋气滞不通、脐
下闷痛，血淋瘀血停蓄、茎中割痛。
五淋汤 是秘诀 石淋以此汤煎送发灰、滑石、石首鱼头内石研末。膏淋合萆 分）
清饮。气淋加荆芥、香附、生麦芽；不愈，再加升麻或用吐法。劳淋合补中益气汤。血淋加
牛膝、郁金、桃仁，入麝香少许温服。
败精淋 加味啜 过服金石药，与老人阳已痿，思色以降其精，以致内败而为淋，宜前
汤加萆 、石菖蒲、菟丝子以导之。
外冷淋 肾气咽 五淋之外，又有冷淋。其症外候恶冷，喜饮热汤，宜加味肾气丸以盐汤咽下。
点滴无 名癃闭 小便点滴不通，与五淋之短缩不同。
气道调 江河决 前汤加化气之药，或吞滋肾丸多效。《孟子》云∶若决江河，沛然莫
之能御也。引来喻小便之多也。
上窍通 下窍泄 如滴水之器，闭其上而倒悬之，点滴不能下也。去其上闭，而水自通
。宜服补中益气汤，再服以手探吐。
外窍开 水源凿 又法∶启其外窍，即以开其内窍。麻黄力猛，能通阳气于至阴之地下
；肺气主皮毛，配杏仁以降气下达州都，导水必自高原之义也，以前饮加此二味甚效。夏月
不敢用麻黄，以苏叶、防风，杏仁等分水煎服，温覆微汗，水即利矣。虚人以人参、麻黄各
一两水煎服，神效。
分利多 医便错 愈利愈闭矣。
浊又殊 窍道别 淋出溺窍，浊出精窍。
前饮投 精愈涸 水愈利而肾愈虚矣。
肾套谈 理脾恪 治浊只用肾家套药，不效。盖以脾主土，土病湿热下注，则小水混浊
。湿胜于热则为白浊，热胜于湿则为赤浊，湿热去则浊者清矣。
厘清饮 佐黄柏 萆 厘清饮加苍术、白术，再加黄柏苦以燥湿，寒以除热。
心肾方 随补缀 六八味汤丸加龙、牡，肾药也。四君子汤加远志，心药也。心肾之
药与前饮间服。
若遗精 另有设 与浊病又殊。
有梦遗 龙胆折 有梦而遗，相火旺也。余每以龙胆泻肝汤送下五倍子丸二钱，多效。
张石顽云∶肝热则火淫于内，魂不内守，故多淫梦失精。又云∶多是阴虚阳扰，其作必在黎
明阳气发动之时，可以悟矣。妙香散甚佳。
无梦遗 十全设 无梦而遗，是气虚不能摄精，宜十全大补汤，加龙骨、牡蛎、莲须、
五味子、黄柏，为丸常服。
坎离交 亦不切 时医遇此症，便云心肾不交，用茯神、远志、莲子、枣仁之类，未中
病情，皆不切之套方也。
五淋病，皆由热结所致。所谓“淋”，是指小便时疼痛、涩滞、淋漓不尽，想排却排不出，想停却停不下来的症状，这都是因为热气结聚在膀胱。
膏淋、石淋、劳淋，涉及气与血的病变。石淋表现为尿液中排出沙石；膏淋表现为尿液中流出如膏脂样的物质；劳淋是由于过度劳累而引发；气淋因气机阻滞不通，导致脐下闷痛；血淋因瘀血停滞蓄积，导致尿道中切割样疼痛。
治疗五淋的汤药是秘诀所在。石淋用此汤煎煮后，送服发灰、滑石、石首鱼头内的石头研成的粉末。膏淋配合萆薢分清饮。气淋加入荆芥、香附、生麦芽；如果无效，再加升麻或者采用催吐法。劳淋配合补中益气汤。血淋加入牛膝、郁金、桃仁，调入少许麝香温服。
败精淋，需加味服用。因过服金石类药物，或老人阳气已衰，通过色欲耗损精气，导致体内败坏而形成淋证，宜在前述汤剂基础上加入萆薢、石菖蒲、菟丝子以引导排泄。
外冷淋，肾气咽下。在五淋之外，还有冷淋。其症状表现为外部怕冷，喜欢喝热汤，宜用加味肾气丸，用盐汤送服。
点滴无出，名为癃闭。小便点滴不通，这与五淋中的尿量短少不同。
气道调畅，如江河决口。在上述汤剂中加入化气药物，或者吞服滋肾丸，多有效。《孟子》说：“就像开掘江河，浩浩荡荡没有人能阻挡。”用来比喻小便通畅之多。
上窍通利，下窍排泄。就像滴水之器，封闭上面并倒悬，水点滴也无法流下。去掉上面的闭塞，水自然流通。宜服用补中益气汤，再用手探喉催吐。
外窍开启，水源凿通。另一种方法：开启外窍，也就开启了内窍。麻黄药力猛烈，能通达阳气于至阴之地；肺主皮毛，配伍杏仁以降气下达膀胱（州都），遵循“导水必自高原”的道理，在上述方剂中加入这两味药非常有效。夏季不敢用麻黄，可用苏叶、防风、杏仁等分煎服，覆盖衣被微汗，水液即可通利。体虚之人用人参、麻黄各一两水煎服，效果神奇。
分利过多，医生便错。越利尿，小便越闭塞。
浊病又不同，窍道有别。淋证出自溺窍（尿道），浊证出自精窍。
前汤投用，精液更枯竭。水液越利，肾脏越虚。
空谈补肾，恪守理脾。治疗浊证只用补肾的老套药物，无效。因为脾属土，脾病湿热下注，则小便混浊。湿胜于热则为白浊，热胜于湿则为赤浊，湿热去除则浊者变清。
厘清饮，佐以黄柏。萆薢厘清饮加入苍术、白术，再加黄柏，苦味以燥湿，寒性以除热。
心肾方，随症补缀。六味地黄汤丸加入龙骨、牡蛎，这是补肾药。四君子汤加入远志，这是养心药。心肾药物与前文方剂交替服用。
若是遗精，另有设治。与浊病又有所不同。
有梦遗，龙胆折。有梦而遗精，是相火旺盛所致。我常用龙胆泻肝汤送服五倍子丸二钱，多有效。张石顽说：“肝热则火气淫溢于内，魂不能内守，所以多淫梦失精。”又说：“多是阴虚阳扰，发作多在黎明阳气发动之时，可以由此领悟。”妙香散也很好。
Wu Lin (Five Types of Strangury) diseases are all caused by heat accumulation. "Lin" refers to painful, astringent, and dribbling urination, where one desires to pass urine but cannot, or desires to stop but cannot; this is all due to heat qi accumulating in the Bladder.
Gao Lin (Semen-like Strangury), Shi Lin (Stone Strangury), and Lao Lin (Fatigue Strangury) involve Qi and Blood. Shi Lin presents with sand-like stones passing in the urine; Gao Lin presents with substance resembling semen or fat passing in the urine; Lao Lin arises from physical overexertion; Qi Lin results from Qi stagnation and obstruction, causing stifling pain below the umbilicus; Xue Lin (Blood Strangury) results from stasis of blood accumulating, causing cutting pain in the urethra.
The decoction for Wu Lin is the secret method. For Shi Lin, take this decoction and administer it with Fa Hui (Calcined Hair), Hua Shi (Talcum), and powder ground from the stones inside the head of the Stonefish (Shi Shou Yu). For Gao Lin, combine with Bi Xie Fen Qing Yin (Dioscorea Hypoglauca Decoction for Clearing Turbidity). For Qi Lin, add Jing Jie (Schizonepeta Herb), Xiang Fu (Cyperus Rhizome), and Sheng Mai Ya (Unsprouted Hordeum Fructus); if ineffective, add Sheng Ma (Cimicifugae Rhizoma) or employ vomiting therapy. For Lao Lin, combine with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). For Xue Lin, add Niu Xi (Achyranthes Root), Yu Jin (Curcuma Tuber), and Tao Ren (Persicae Semen), with a small amount of She Xiang (Musk) added for warm administration.
Bai Jing Lin (Decayed Essence Strangury) requires modified administration. It arises from excessive intake of metallic/mineral drugs, or in the elderly whose Yang Qi is already atrophied, inducing essence loss through sexual desire, leading to internal decay and strangury. It is appropriate to add Bi Xie (Dioscorea Hypoglauca Rhizome), Shi Chang Pu (Acori Tatarinowii Rhizoma), and Tu Si Zi (Cuscutae Semen) to the aforementioned decoction to guide the discharge.
Wai Leng Lin (External Cold Strangury) is swallowed with Kidney Qi Pill. Besides the five types of Lin, there is also Leng Lin. Its symptoms include external aversion to cold and a preference for drinking hot soup. It is appropriate to use Jia Wei Shen Qi Wan (Modified Kidney Qi Pill), swallowed with salt water.
Dian Di Wu (No Dribbling/Flow), named Long Bi (Retention). Urine flows drop by drop without passage, which differs from the shortness of urine volume seen in Wu Lin.
Qi Dao Tiao (Regulation of Qi Pathway), like the bursting of rivers. Add Qi-transforming herbs to the previous decoction, or swallow Zi Shen Wan (Nourish Kidney Pill); this is often effective. As stated in *Mencius*: "Like opening up rivers, vast and mighty, none can withstand them." This metaphor illustrates the abundance of free-flowing urine.
Shang Qiao Tong (Upper Orifice Unblocked), Xia Qiao Xie (Lower Orifice Draining). Like a vessel for dripping water: if the top is closed and it is inverted, not a single drop can flow down. Remove the blockage at the top, and water flows naturally. It is appropriate to take Bu Zhong Yi Qi Tang, followed by inducing vomiting with a finger to stimulate the throat.
Wai Qiao Kai (Outer Orifice Opened), Shui Yuan Zao (Water Source Dug). Another method: opening the outer orifices opens the inner orifices. Ma Huang (Ephedrae Herba) has potent force and can unblock Yang Qi reaching the deepest Yin levels; the Lung governs skin and hair, paired with Xing Ren (Armeniacae Semen Amarum) to descend Qi to the Zhou Du (Bladder), following the principle that "guiding water must start from high plateaus." Adding these two herbs to the previous drink is very effective. In summer, Ma Huang is avoided; instead, Su Ye (Perillae Folium), Fang Feng (Saposhnikoviae Radix), and Xing Ren are taken in equal parts, decocted in water, covered warmly to induce slight sweating, and water will then flow freely. For deficient persons, taking Ren Shen (Ginseng Radix) and Ma Huang each in 1 liang, decocted in water, yields miraculous effects.
Fen Li Duo (Excessive Diuresis), Yi Bian Cuo (Doctor Errs). The more diuretics used, the more blocked the urine becomes.
Zhuo You Shu (Turbidity is Different), Qiao Dao Bie (Orifices Distinct). Lin discharges from the Miao Qiao (Urethral orifice), while Zhuo discharges from the Jing Qiao (Essence orifice).
Qian Yin Tou (Previous Decoction Administered), Jing Yu He (Essence Further Depleted). The more water is drained, the more deficient the Kidney becomes.
Kun Tao Tan (Empty Talk on Tonifying Kidney), Li Pi Ke (Strictly Managing Spleen). Treating Zhuo only with standard Kidney-tonifying medicines is ineffective. Since the Spleen governs Earth, when Spleen pathology involves Damp-Heat pouring downward, the urine becomes turbid. When Dampness exceeds Heat, it manifests as Bai Zhuo (White Turbidity); when Heat exceeds Dampness, it manifests as Chi Zhuo (Red Turbidity). Once Damp-Heat is removed, the turbid becomes clear.
Li Qing Yin (Clearing Turbidity Decoction), Zuo Huang Bo (Assisted by Phellodendron Bark). Bi Xie Li Qing Yin combined with Cang Zhu (Atractylodis Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma), plus Huang Bo (Phellodendri Cortex); bitter to dry Dampness, cold to eliminate Heat.
Xin Shen Fang (Heart-Kidney Formula), Sui Bu Zhui (Supplemented According to Symptoms). Liu Wei Di Huang Wan/Pill (Six-Ingredient Rehmannia Pill) added with Long Gu (Fossilized Bones) and Mu Li (Ostrea Shell), these are Kidney tonics. Si Jun Zi Tang (Four Gentlemen Decoction) added with Yuan Zhi (Polygalae Radix), these are Heart tonics. Heart and Kidney medicines are taken alternately with the previous decoction.
Ruo Yi Jing (If Seminal Emission), Ling You She (Has Separate Treatment). It differs further from Zhuo disease.
You Meng Yi (Dream-related Emission), Long Dan Zhe (Subdued by Gentian). Emission with dreams indicates Hyperactivity of Ministerial Fire. I commonly use Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction) to administer Wu Bei Zi Wan (Gallnut Pill), 2 qian, which is often effective. Zhang Shiwan said: "Liver Heat causes Fire to overflow internally, Hun (Ethereal Soul) fails to remain within, hence frequent erotic dreams and seminal emission." He also said: "It is mostly Yin Deficiency with Yang disturbance, occurring when Yang Qi activates at dawn; this can be understood." Miao Xiang San (Wonderful Fragrance Powder) is also excellent.
Wu Meng Yi (Non-dream Emission), Shi Quan She (Set by Ten Complete). Non-dream emission indicates Qi Deficiency failing to secure essence. It is appropriate to use Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction), added with Long Gu, Mu Li, Lian Xu (Nelumbinis Stamen), Wu Wei Zi (Schisandrae Fructus), and Huang Bo, made into pills for regular consumption.
Kan Li Jiao (Interaction of Kan and Li), Yi Bu Qie (Also Not Accurate). Contemporary physicians encountering this syndrome immediately claim Heart-Kidney Non-Interaction, using formulas containing Fu Shen (Poria Cum Radix), Yuan Zhi, Lian Zi (Nelumbinis Semen), and Zao Ren (Ziziphi Spinosae Semen). These miss the actual condition and are merely formulaic clichés lacking precision.