喘分内外实虚医，内（饮小半）夏（汤）外感（小青）龙两路驰，气阻实痰葶苈下（大枣泻肺汤。）肺为
实胀越婢（汤）施，虚而不运（脾虚不运）六君（子汤）助，虚若离根（肾气上奔）真武（汤）追，导引利便（小便
呼吸辨（呼气短，宜从太阳以化气；吸气短，宜从少阴以纳气，）桂甘（苓桂甘术汤）肾气丸古遗规
（此首限于字母，四字化为六字，俱要平提明提出，故不能合法。
哮症，寒邪伏于肺 ，痰窠结于肺膜，内外相应，一遇风、寒、暑、湿、燥、火六气之
伤即发，伤酒伤食亦发，动怒动气亦发，役劳房劳亦发。一发则肺 之寒气与肺膜之浊痰野狼
狈相根据，窒塞关隘，不容呼吸。而呼吸正气，转触其痰，鼾 有声，非泛常之药所能治，
宜
圣济射干丸主之。然涤痰虽为得法，又必于潜伏为援之处，断其根株，须灸肺 、膏肓、天
突诸穴。此证原非因热所致，缘《内经》有“诸逆上冲皆属于火”之句，故与喘促均列于热
证。
寒伏 中哮证根，射干丸料是专门，再将天突膏肓灸，陈饮新邪绝党援。
五淋者，小便短数，淋沥不断，茎中痛是也。癃闭者，小便点滴不通，胀闷欲死是也。
二证皆膀胱之气不化，三焦之决渎不行所致，宜五苓汤主之。尿出如膏为膏淋，加萆 ；
溺
血茎中割痛为血淋，加桃仁、郁金、牛膝，调麝香一、二厘；因劳而得为劳淋，加人参、黄
；因动气而得脐下胀痛为气淋，加紫苏、生麦芽、沉香；下如沙石为沙淋，调下黄瓜鱼脑
中之石、发灰、滑石各等分为末三、四钱。癃闭服利水药不效者，即用补中益气汤，服二时
许，二煎再服，即以手探吐，此开上窍以通下窍故也。或用麻黄三、四钱，杏仁十四粒，加
于五淋汤中，此通阳气以达阴气法也。或用天门冬、麦门冬、桑白皮各五钱，人参、杏仁、
紫菀各三钱，水煎服，此从高原以导水法也。或以白菊花根捣汁调白酒服。或以海蜇皮四两
，浸去矾味，加荸荠去皮十四个水煎服。或阴虚不能配阳以化水者，宜滋肾丸。或元气自虚
不能化水者，宜桂附八味丸。尤氏谓∶“重阴冱寒，地道闭塞，惟与白通汤多加葱白，阳气
一至，二便立通矣，再加人尿一盏尤效。”又∶有色欲过度，似淋非淋，溺短而数，茎中痛
甚，宜肉苁蓉、淫羊藿、生杜仲为主，佐以白蜜、羊脂之类方效，与淋闭之治不同。此证多
系热结膀胱，故列于热证。
经义《灵兰秘典论》曰∶“小肠者，受盛之官，化物出焉。三焦者，决渎之官，水道出
焉。膀胱者，州都之官，津液藏焉，气化则能出矣。”《宣明五气篇》曰∶“膀胱不利为癃
，不约为遗溺。”《生气通天论》曰∶“阳不胜其阴，则五脏气争，九窍不利。”《口问篇
》曰∶“中气不足，溲便为之变。”《玉机真脏论》∶“帝曰∶‘夫子言脾为孤脏，中央土
以灌四旁，其太过与不及，其病皆何如’。岐伯曰∶‘太过则令人四肢不举，不及则令人九
窍不通，名曰重强’。”《气厥论》曰∶“胞络移热于膀胱，则癃溺血。膀胱移热于小肠，
膈肠不便，上为口糜。”《经脉篇》曰∶“肝所生病者遗溺，闭癃，足少阴实则闭癃。”《
痹论》曰∶“肠痹者，数饮而出不得，中气喘争，时发飧泄。胞痹者，少腹膀胱按之内痛，
若沃以汤，涩以小便，上为清涕。”《六元正纪大论》曰∶“阳明司天之政，民病癃闭。”
五淋症用五淋汤，随证增加纪要详，欲病似淋茎割痛，苁蓉羊藿蜜脂量。
喘证需分辨内外、实虚，治疗分为两条路径：内伤多因饮邪，用小半夏汤；外感多因风寒，用小青龙汤。若肺气壅实导致胀满，可用越婢汤宣肺；若属虚证且脾失运化，可用六君子汤健脾助运；若属肾虚不纳气（肾气上奔），可用真武汤温阳追摄。此外，还有导引法及利小便以定呼吸的方法：呼气短促者，病在太阳经，宜从太阳经化气治疗；吸气短促者，病在少阴经，宜从少阴经纳气治疗。古法遗留有苓桂术甘汤和肾气丸等方剂作为准则。
哮症，是由于寒邪潜伏于肺，痰浊结聚于肺膜，内外相应，一旦遇到风、寒、暑、湿、燥、火六气的侵袭就会发作，饮酒过度、饮食积滞也会发作，发怒动气会发作，劳累或房劳过度也会发作。一旦发作，肺中的寒气与肺膜上的浊痰狼狈为奸，阻塞气道，使人无法呼吸。此时呼吸时的正气触动痰浊，发出鼾声，这不是普通药物所能治疗的，宜用圣济射干丸为主治疗。然而，虽然涤除痰浊是正确的方法，但必须切断其在潜伏之处的根源，需要艾灸肺俞、膏肓、天突等穴位。此证原本不是由热邪引起的，因为《内经》中有“各种逆气上冲都归属于火”的说法，所以将哮症与喘促都列在热证中讨论。
寒邪潜伏是哮证的根源，射干丸的药材是专门针对此症的，再艾灸天突、膏肓穴，以断绝陈年饮邪与新感邪气的勾结。
五淋症，表现为小便短少频数，淋漓不断，尿道疼痛。癃闭症，表现为小便点滴不通，腹胀闷痛欲死。这两种病症都是因为膀胱气化不利，三焦水道不通所致，宜用五苓散主治。尿出如膏状的是膏淋，加萆薢；尿血且尿道刺痛的是血淋，加桃仁、郁金、牛膝，调入麝香一、二厘；因劳累而得的是劳淋，加人参、黄芪；因动气而得、脐下胀痛的是气淋，加紫苏、生麦芽、沉香；尿出沙石的是沙淋，调入黄瓜鱼脑中的石头、头发灰、滑石各等分研末，每次服三、四钱。癃闭服用利水药无效者，立即改用补中益气汤，服用约两小时，第二次煎煮后再服，并用手探喉催吐，这是通过开通上窍来通利下窍的方法。或者用麻黄三、四钱，杏仁十四粒，加入五淋汤中，这是通阳气以达阴气的方法。或者用天门冬、麦门冬、桑白皮各五钱，人参、杏仁、紫菀各三钱，水煎服，这是从上游源头引导水流的方法。或者用白菊花根捣汁调白酒服用。或者用海蜇皮四两，浸去矾味，加去皮荸荠十四个水煎服。或者是阴虚不能配阳以化水者，宜用滋肾丸。或者是元气自虚不能化水者，宜用桂附八味丸。尤氏说：“重阴严寒，地道闭塞，只需用白通汤多加葱白，阳气一到，大小便立刻通畅，再加人尿一盏尤其有效。”又说：“有色欲过度，似淋非淋，尿短而频，尿道剧痛者，宜以肉苁蓉、淫羊藿、生杜仲为主药，佐以白蜜、羊脂之类才有效，这与淋闭的治疗不同。此证多系热结膀胱，所以列在热证中。”
经典理论方面，《灵兰秘典论》说：“小肠是受盛之官，负责消化食物转化精微。三焦是决渎之官，负责水道的通行。膀胱是州都之官，储存津液，经过气化作用才能排出。”《宣明五气篇》说：“膀胱不利则发生癃闭，约束无力则发生遗尿。”《生气通天论》说：“阳气不胜阴气，则五脏之气争乱，九窍不通利。”《口问篇》说：“中气不足，大小便会发生变化。”《玉机真脏论》记载：“黄帝问：‘先生说脾是孤脏，居中央土以灌溉四方，其太过和不足，疾病表现如何？’岐伯回答：‘太过则让人四肢不能举动，不足则让人九窍不通，名叫重强。’”《气厥论》说：“胞络移热于膀胱，则发生癃闭和尿血。膀胱移热于小肠，膈肠不便，向上发展为口舌生疮。”《经脉篇》说：“肝所生的疾病包括遗尿、闭癃，足少阴肾经实证也会导致闭癃。”《痹论》说：“肠痹者，频繁饮水却排不出尿，腹中气机争鸣，时常发生完谷不化的泄泻。胞痹者，小腹部膀胱按压内部疼痛，感觉像灌了热水一样，小便涩滞，向上发展为清涕。”《六元正纪大论》说：“阳明司天的政令下，民众易患癃闭病。”
五淋症使用五淋汤，根据症状增减用药，医籍记载详细，若想预防类似淋证且尿道刺痛的情况，可斟酌使用肉苁蓉、淫羊藿、蜂蜜、羊脂。
Asthma (Chuan) must be differentiated into internal and external, excess and deficiency. Treatment follows two paths: internally, due to fluid retention, use Ban Xia Tang (Pinellia Decoction); externally, due to wind-cold, use Xiao Qing Long Tang (Minor Blue Dragon Decoction). If lung Qi is obstructed by excess phlegm causing distension, Yue Bi Tang (Yuebi Decoction) is applied. If it is deficiency with spleen failing to transport, Liu Jun Zi Tang (Six Gentlemen Decoction) aids the spleen. If it is kidney deficiency with Qi rushing upward (failure to grasp Qi), Zhen Wu Tang (True Warrior Decoction) is pursued. Additionally, there are guiding exercises and methods to promote urination to regulate breathing: shortness of exhalation indicates pathology in the Taiyang channel, requiring transformation of Qi from Taiyang; shortness of inhalation indicates pathology in the Shaoyin channel, requiring grasping of Qi from Shaoyin. Ancient prescriptions include Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractodes, and Licorice Decoction) and Shen Qi Wan (Kidney Qi Pill) as traditional guidelines.
Xiao Syndrome (Wheezing/Asthma with wheezing sound) arises when cold pathogens lie latent in the Lung, and phlegm nests form on the lung membrane, corresponding internally and externally. Upon invasion by the six qi (wind, cold, summer heat, dampness, dryness, fire), it triggers an attack. It also triggers upon excessive alcohol consumption, food stagnation, anger moving Qi, or physical/sexual exhaustion. Once triggered, the cold Qi in the Lung and turbid phlegm on the lung membrane conspire, blocking airways and preventing respiration. The righteous Qi during respiration touches the phlegm, producing a snoring sound. This cannot be treated with ordinary medicines; Sheng Ji She Gan Wan (Holy Relief Belamcanda Pill) is indicated. Although clearing phlegm is correct, one must cut off its root at its hiding place by moxibustion on Fei Shu (BL13), Gao Huang (BL43), and Tian Tu (CV22). This condition is originally not caused by heat; however, because *Nei Jing* states "all rebellious upward rushing belongs to fire," Xiao is listed alongside Chuan under heat syndromes.
Cold lying latent is the root of Xiao syndrome; the ingredients of She Gan Wan are specialized for this. Moxibustion on Tian Tu and Gao Huang cuts off the alliance between old fluid retention and new pathogenic factors.
Wu Lin (Five Types of Strangury) presents with short, frequent urination, continuous dripping, and pain in the urethra. Long Bi (Urinary Retention) presents with droplet-by-droplet inability to urinate, severe abdominal distension and distress. Both conditions result from failure of Bladder Qi transformation and obstruction of San Jiao water pathways. Wu Ling San (Five-Ingredient Poria Powder) is indicated. Urine resembling paste is Gao Lin (Greasy Strangury); add Bi Xie (Dioscorea Hypoglauca Rhizome). Blood in urine with cutting pain is Xue Lin (Bloody Strangury); add Tao Ren (Prunus Persica Seed), Yu Jin (Curcuma Wenyujin Rhizome), Niu Xi (Achyranthes Bidentata Root), mixed with 1-2 li of She Xiang (Musk). Obtained through labor is Lao Lin (Fatigue Strangury); add Ren Shen (Panax Ginseng Radix), Huang Qi (Astragalus Membranaceus Radix). Obtained through moving Qi with umbilical distension and pain is Qi Lin (Qi Strangury); add Zi Su (Perilla Frutescens Leaf), Sheng Mai Ya (Hordeum Vulgare Sprout), Chen Xiang (Aquilaria Lignum). Passing sand/stones is Sha Lin (Sand Strangury); mix Huang Gua Yu Nao Zhong Shi (Stone from Cucumis Melo Brain), Fa Hui (Ash of Hair), Hua Shi (Talcum) in equal parts into powder, take 3-4 qian per dose. For Long Bi unresponsive to diuretics, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). Take for about two hours, then take the second decoction, and induce vomiting by probing the throat; this opens the upper orifice to unblock the lower orifice. Alternatively, use Ma Huang (Ephedrae Herba) 3-4 qian, Xing Ren (Prunus Armeniaca Semen) 14 grains, added to Wu Lin Tang; this is the method of unblocking Yang Qi to reach Yin Qi. Alternatively, use Tian Men Dong (Asparagi Radix), Mai Men Dong (Ophiopogonis Radix), Sang Bai Pi (Mori Cortex) each 5 qian, Ren Shen 3 qian, Xing Ren 3 qian, Zi Wan (Asteris Radix) 3 qian, decocted in water; this is the method of guiding water from the high source. Alternatively, crush Bai Ju Hua Gen (Chrysanthemi Indici Radix) for juice, mix with white wine. Or soak Hai Zhe Pi (Metapenaeus Ensis Carapace) 4 liang to remove alum taste, add 14 peeled Bi Qi (Dioscorea opposita Tuber), decoct in water. For Yin deficiency unable to coordinate with Yang to transform water, use Zi Shen Wan (Nourish Kidney Pill). For Yuan Qi deficiency unable to transform water, use Gui Fu Ba Wei Wan (Cinnamon and Aconite Eight-Ingredient Pill). You Shi stated: "When heavy Yin freezes cold and Earthly channels are blocked, only Bai Tong Tang (White Connective Decoction) with extra Cong Bai (Allium Fistulosum Bulb) should be used; once Yang Qi arrives, urination and defecation immediately clear; adding one cup of Ren Nao (Human Urine) is especially effective." Also: "For those with excessive sexual desire, presenting as strangury but not quite strangury, short frequent urine, severe urethral pain, use Rou Cong Rong (Cistanche Deserticola Caulis), Yin Yang Huo (Epimedii Folium), Sheng Du Zhong (Eucommiae Cortex) as main herbs, assisted by Bai Mi (Honey), Yang Zhi (Sheep Fat) for efficacy. This differs from the treatment of Lin and Bi. This condition is mostly due to heat binding in the Bladder, hence listed under heat syndromes."
Classics: *Ling Lan Mi Dian Lun* states: "The Small Intestine is the official of reception and storage, transforming substances. The San Jiao is the official of drainage, where water passages emerge. The Bladder is the official of the metropolitan area, storing fluids, which can be excreted through Qi transformation." *Xuan Ming Wu Qi Pian* states: "Bladder dysfunction leads to Long; lack of restraint leads to Yi Ni (involuntary urination)." *Sheng Qi Tong Tian Lun* states: "If Yang cannot overcome Yin, the Qi of the five Zang organs contends, and the nine orifices become obstructed." *Kou Wen Pian* states: "Deficiency of Middle Qi causes changes in urination and defecation." *Yu Ji Zhen Zang Lun*: Emperor asked: "You said the Spleen is the solitary organ, central Earth irrigating the four sides. How do excess and deficiency manifest?" Qibo replied: "Excess causes inability to move limbs; deficiency causes obstruction of the nine orifices, named Chong Qiang." *Qi Jue Lun* states: "Heat transferring from Bao Luo to Bladder causes Long and bloody urine. Heat transferring from Bladder to Small Intestine causes difficulty in bowel movement and mouth ulcers above." *Jing Mai Pian* states: "Diseases generated by Liver include Yi Ni and Bi Long. Excess in Foot Shaoyin causes Bi Long." *Bi Lun* states: "Chang Bi involves frequent drinking but inability to urinate, abdominal Qi contention, and occasional undigested stool. Bao Bi involves internal pain upon pressing the lower abdomen Bladder, feeling like hot water,涩 (astringent/difficult) urination, and clear nasal discharge above." *Liu Yuan Zheng Ji Da Lun* states: "When Yangming governs the heaven, people suffer from Long Bi."
Wu Lin syndrome uses Wu Lin Tang, with additions based on symptoms detailed in records. To prevent conditions resembling strangury with urethral cutting pain, consider Rou Cong Rong, Yin Yang Huo, honey, and sheep fat.