心主血,心气热,则遗热于膀胱,阴血妄行而溺出焉。又肝主疏泄,肝火盛,亦令尿
血。清心,阿胶散主之;平肝,加味逍遥散主之。若久病气血俱虚而见此症,八珍汤主之。
凡治尿血,不可轻用止涩药,恐积瘀于阴茎,痛楚难当也。
阿胶(水化开冲服,一钱) 丹参 生地(各二钱) 黑山栀 丹皮 血余(即乱发烧灰,存性)
麦冬 当归(各八分
水煎服。
加味逍遥散 (见类中。
八珍汤 (见虚劳。
梦而遗者,谓之遗精;不梦而遗者,谓之精滑。大抵有梦者,由于相火之强;不梦者,
由于心肾之虚。然今人体薄,火旺者,十中之一,虚弱者,十中之九。予因以二丸分主之,
一曰清心丸,泻火止遗之法也;一曰十补丸,大补气血俾气旺则能摄精也。其有诵读劳心
而得者,更宜补益,不可轻用凉药。复有因于湿热者,湿热伤肾,则水不清,法当导湿为先
湿去水清,而精自固矣,秘精丸主之。
清心火,泻相火,安神定志,止梦泄。
生地(酒洗,四两) 丹参(二两) 黄柏(五钱) 牡蛎 山药 枣仁(炒) 茯苓 茯神 麦冬(各
一两五钱) 北五味 车前子 远志(各一两
用金樱膏为丸,每服三钱,开水下。
大熟地(四两) 当归(二两) 白芍(二两) 黄 (四两) 人参(二两) 白术(四两) 茯苓(二两) 山
药(三两) 枣仁(二两) 远志(一两) 山萸肉(三两) 杜仲(三两) 续断(二两) 北五味(一两) 龙骨
(一两
用石斛四两熬膏,和炼蜜为丸。每早开水下四钱。凡使煎剂,仿佛丸方。
秘精丸 (见虚证。
心主司血液运行,若心气有热,则会将热邪遗留给膀胱,导致阴血妄行而随尿液排出。另外,肝主疏泄功能,若肝火旺盛,也会引起尿血。治疗上,清心火以阿胶散为主方;平抑肝火以加味逍遥散为主方。若是久病导致气血两虚而出现此症状,则以八珍汤为主方。凡是治疗尿血,不可轻易使用收敛固涩的药物,恐怕会导致瘀血积聚在阴茎部位,造成难以忍受的疼痛。
阿胶(用水化开后冲服,一钱) 丹参 生地(各二钱) 黑山栀 丹皮 血余(即乱发烧成炭,保留药性) 麦冬 当归(各八分) 水煎服。
加味逍遥散 (参见类中风章节)。
八珍汤 (参见虚劳章节)。
做梦时遗精的,称为遗精;不做梦而遗精的,称为精滑。大体来说,有梦的情况,是由于相火亢盛所致;无梦的情况,是由于心肾虚弱所致。然而现在的人体质薄弱,火旺的占十分之一,虚弱的占十分之九。我因此用两种丸剂分别主治:一种是清心丸,这是泻火止遗的方法;另一种是十补丸,大补气血,使气旺从而能够摄持精气。其中因诵读劳累心神而患病的,更宜补益,不可轻易使用寒凉药物。又有因湿热引起的,湿热损伤肾脏,则肾水不清澈,治法应当以导利湿邪为先,湿气去除、肾水清澈,精气自然固摄,以秘精丸为主方。
清心火,泻相火,安神定志,停止梦中泄精。
生地(酒洗,四两) 丹参(二两) 黄柏(五钱) 牡蛎 山药 枣仁(炒) 茯苓 茯神 麦冬(各一两五钱) 北五味子 车前子 远志(各一两) 用金樱子膏制作丸剂,每次服用三钱,开水送下。
大熟地(四两) 当归(二两) 白芍(二两) 黄芪(四两) 人参(二两) 白术(四两) 茯苓(二两) 山药(三两) 枣仁(二两) 远志(一两) 山萸肉(三两) 杜仲(三两) 续断(二两) 北五味子(一两) 龙骨(一两) 用石斛四两熬成膏,与炼蜜混合制成丸剂。每天早晨用开水送服四钱。凡是用汤剂,剂量大致参照丸方比例。
秘精丸 (参见虚证章节)。
The Heart governs the blood. When Heart Qi is hot, it transmits heat to the Bladder, causing Yin blood to flow recklessly and be discharged in urine. Furthermore, the Liver governs dispersion and drainage; when Liver Fire is excessive, it also causes hematuria. To clear the Heart, Ejiao San (Donkey-Hide Gelatin Powder) is the principal formula; to calm the Liver, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) is the principal formula. If this symptom arises from prolonged illness resulting in both Qi and Blood deficiency, Bazhen Tang (Eight-Treasure Decoction) is the principal formula. In treating hematuria, one must not lightly use astringent drugs, for fear of accumulating stasis in the penis, leading to unbearable pain.
Ejiao (Dissolved in water and taken with the decoction, 1 qian) Danshen (Salviae Miltiorrhizae Radix et Rhizoma) Shengdi (Rehmanniae Radix, each 2 qian) Heishanzhi (Fructus Gardeniae Preparatus) Danpi (Moutan Cortex) Xueyu (Scorched human hair, preserved efficacy) Maidong (Ophiopogonis Radix) Danggui (Angelicae Sinensis Radix, each 8 fen) Decoct in water and take orally.
Jiawei Xiaoyao San (See section on Stroke-like syndromes).
Bazhen Tang (See section on Deficiency Labor).
Nocturnal emission occurring during dreams is called "Yijing" (Spermatorrhea); emission without dreams is called "Jinghua" (Slipping of Essence). Generally, cases with dreams are due to strong Ministerial Fire; cases without dreams are due to deficiency of the Heart and Kidney. However, people nowadays have thin constitutions; those with excessive fire account for one in ten, while those with deficiency account for nine in ten. Therefore, I use two pills to treat them respectively: one is Qingxin Wan (Clear Heart Pill), which is the method for draining fire and stopping emission; the other is Shibu Wan (Ten-Nourishing Pill), which greatly tonifies Qi and Blood so that abundant Qi can control the essence. For those caused by mental labor from reading and studying, tonification is more appropriate, and cold medicines should not be used lightly. There are also cases caused by Damp-Heat; Damp-Heat damages the Kidney, causing the Water to become turbid. The treatment method should prioritize guiding out the Dampness. Once Dampness is removed and Water becomes clear, the Essence will naturally consolidate, using Bijiang Wan (Secret Essence Pill) as the principal formula.
Clear Heart Fire, drain Ministerial Fire, calm the Spirit and stabilize the Will, stop dream-related leakage.
Shengdi (Washed with wine, 4 liang) Danshen (2 liang) Huangbai (Phellodendri Cortex, 5 qian) Muli (Concha Ostreae) Shanyao (Dioscoreae Rhizoma) Zaoren (Carpobambos Semen, stir-fried) Fuling (Poria) Fushen (Poria with Hostwood) Maidong (each 1 liang 5 qian) Beiwuwei (Schisandrae Fructus) Cheqianzi (Plantaginis Semen) Yuanzhi (Polygalae Radix, each 1 liang) Make pills using Jin Ying Gao (Cherokee Rose Fruit Paste). Take 3 qian per dose, washed down with boiled water.
Da Shudi (Prepared Rehmanniae Radix, 4 liang) Danggui (2 liang) Baishao (Paeoniae Radix Alba, 2 liang) Huangqi (Astragali Radix, 4 liang) Renshen (Ginseng Radix, 2 liang) Baizhu (Atractylodis Macrocephalae Rhizoma, 4 liang) Fuling (2 liang) Shanyao (3 liang) Zaoren (2 liang) Yuanzhi (1 liang) Shanyurou (Corni Fructus, 3 liang) Duzhong (Eucommiae Cortex, 3 liang) Xuduan (Dipsaci Radix, 2 liang) Beiwuwei (1 liang) Longgu (Fossilized Mammoth Bones, 1 liang) Use 4 liang of Shihu (Dendrobii Caulis) to make a paste, mix with refined honey to form pills. Take 4 qian every morning with boiled water. When using decoctions, follow the proportions of the pill formula approximately.
Bijiang Wan (See section on Deficiency Syndromes).