通关丸
4.热实不化大便硬, 癃闭八正木香痊, 阳虚不化多厥冷, 恶寒金匮
肾气丸. 阴虚不化发午热, 不渴知柏桂通关, 气虚不化不急满, 倦怠
懒言春泽煎.
【注】小便不通热实者, 宜用八正散加木香. 阳虚者, 宜用金匮肾气
丸.阴虚者, 宜用通关丸, 即知母, 黄柏, 肉桂少许也. 气虚宜用春
泽汤, 即五苓散加人参也.
八正散
5.石淋犹如□结铛, 是因湿热炼膀胱, 一切热淋八正扁, 通滑栀瞿
草车黄.
【注】八正散, 即扁蓄, 木通, 瞿麦, 栀子, 滑石, 甘草, 车前子,
大黄也.
小蓟饮子
6.血淋心遗热小肠, 实热仍宜下之良, 清热小蓟栀滑淡, 归藕通蒲
草地黄
【注】淡, 淡竹叶也. 藕, 藕节也. 蒲, 蒲黄也.
海金沙散 鹿角霜丸
7.膏淋尿浊或如涕, 精溺俱出海草滑, 热盛八正加苍术, 虚用秋苓
鹿角佳.
【注】海, 海金沙也. 秋, 秋石也. 苓, 茯苓也. 鹿角, 鹿角霜. 糯
米糊为丸也.
加味八正散
8.气淋肺热难清肃, 八正石苇木葵沉, 内伤气虚不能化, 五苓益气
自通神.
【注】八正散, 加石苇, 木香, 冬葵子, 沉香, 五苓, 合补中益气汤
.
补中益气汤合五苓散 清心莲子饮
9.劳淋内伤补中苓, 肾气知柏过淫成, 劳心清心莲地骨, 耆芩车麦
草参苓.
【注】内伤劳脾, 用补中益气汤合五苓散. 劳肾阳虚, 用金匮肾气汤
.阴虚, 用知柏地黄汤. 思虑劳心, 用清心莲子饮, 是方即莲子, 地
骨皮, 黄耆, 黄苓, 车前子, 麦门冬, 生甘草, 人参, 白茯苓也.
琥珀散
10.痰淋七气白丸子, 热燥清热用滋阴, 诸淋平剂琥珀木, 葵蓄通滑
归郁金.
【注】七气汤见诸气门. 青州白丸子见类中风门. 滋阴, 通关丸也.
木,木香也. 葵, 冬葵子也.
桂附地黄丸 补中益气汤加白果方 坎离既济汤加山萸肉五味子方
11.遗尿不禁淋尿白, 桂附补中白果煎, 补之不应或尿赤, 生地知柏
萸味攒.
【注】遗尿不禁, 及诸淋, 尿色白者, 皆属寒虚. 寒者, 用桂附地黄
汤加白果. 虚者, 用补中益气汤加白果. 凡遗尿不禁, 诸淋, 尿色赤
者,或补之不应者, 亦有热虚, 用坎离既济汤, 即生地, 知母, 黄柏
,加山萸肉, 五味子也.
通关丸
4. 热实证导致气化不利、大便干硬，癃闭（小便不通）可用八正散加木香治愈；阳虚证导致气化不利、多伴有四肢厥冷和恶寒，宜用《金匮要略》中的肾气丸；阴虚证导致气化不利、出现午后发热且不口渴，宜用知柏地黄汤合肉桂的通关丸；气虚证导致气化不利、小腹胀满不急迫，伴有倦怠乏力、懒言少语，宜用春泽煎。
【注】小便不通属于热实证的，适宜使用八正散加木香。属于阳虚的，适宜使用金匮肾气丸。属于阴虚的，适宜使用通关丸，即由知母、黄柏及少许肉桂组成。属于气虚的，适宜使用春泽汤，即由五苓散加人参组成。
八正散
5. 石淋（尿路结石）如同沙石凝结在锅中，是因为湿热煎熬膀胱所致，一切热淋（以尿热涩痛为特征的淋证）均可用八正散治疗，其药物包括扁蓄、木通、瞿麦、栀子、滑石、甘草、车前子、大黄。
【注】八正散，即由扁蓄、木通、瞿麦、栀子、滑石、甘草、车前子、大黄组成。
小蓟饮子
6. 血淋（尿中带血且疼痛的淋证）源于心火遗热于小肠，若是实热证仍宜采用泻下法治疗为宜，清热方剂用小蓟饮子，包含小蓟、栀子、滑石、淡竹叶、当归、藕节、木通、蒲黄、甘草、生地黄。
【注】“淡”指淡竹叶。“藕”指藕节。“蒲”指蒲黄。
海金沙散 鹿角霜丸
7. 膏淋（尿液浑浊如米泔或如脂膏）或尿浊，有时像鼻涕一样，精液与溺液均出自海金沙与滑石，若热盛可用八正散加苍术，若属虚证则用秋石茯苓配鹿角霜疗效佳。
【注】“海”指海金沙。“秋”指秋石。“苓”指茯苓。“鹿角”指鹿角霜。用糯米糊制作成丸剂。
加味八正散
8. 气淋（因气机阻滞引起的小便涩滞不畅）因肺热难以清肃所致，可用八正散加石苇、木香、冬葵子、沉香；若因内伤气虚导致不能气化，用五苓散合补中益气汤自然通畅有神效。
【注】八正散，加入石苇、木香、冬葵子、沉香；五苓散，合补中益气汤。
补中益气汤合五苓散 清心莲子饮
9. 劳淋（因劳累诱发或加重的淋证）因内伤脾虚者，用补中益气汤合五苓散；因肾虚阳虚过度淫佚而成者，用金匮肾气汤；阴虚者，用知柏地黄汤；思虑劳心者，用清心莲子饮，此方即由莲子、地骨皮、黄耆、黄芩、车前子、麦门冬、生甘草、人参、白茯苓组成。
【注】内伤劳脾，用补中益气汤合五苓散。劳肾阳虚，用金匮肾气汤。阴虚，用知柏地黄汤。思虑劳心，用清心莲子饮，这个方子就是莲子、地骨皮、黄耆、黄芩、车前子、麦门冬、生甘草、人参、白茯苓。
琥珀散
10. 痰淋（因痰湿阻滞引起的小便不利）可用七气汤或青州白丸子，若因热燥所致则清热滋阴，诸淋的平和剂型可用琥珀散，包含琥珀、木香、冬葵子、扁蓄、木通、滑石、当归、郁金。
【注】七气汤见诸气门。青州白丸子见类中风门。滋阴，指通关丸。木，指木香。葵，指冬葵子。
桂附地黄丸 补中益气汤加白果方 坎离既济汤加山萸肉五味子方
11. 遗尿不禁（无法控制排尿）及淋证尿色发白，可用桂附地黄丸、补中益气汤加白果煎服；若补益无效或尿色发红，可用生地、知母、黄柏、山萸肉、五味子攒集而成的方剂。
【注】遗尿不禁，以及各类淋证，尿色白的，都属于寒证和虚证。寒证，用桂附地黄汤加白果。虚证，用补中益气汤加白果。凡是遗尿不禁，各类淋证，尿色红的，或者补益无效的，也有热证和虚证，用坎离既济汤，即由生地、知母、黄柏，加上山萸肉、五味子组成。
Tongguan Wan (Passage-Opening Pill)
4. In cases of excess heat syndrome leading to impaired qi transformation and hard stool, strangury (difficulty in urination) can be cured with Bazen San (Eight-Right Powder) added with Muxiang (Aucklandiae Radix). In cases of yang deficiency syndrome leading to impaired qi transformation accompanied by cold limbs and aversion to cold, Shenqi Wan (Kidney Qi Pill) from the *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) should be used. In cases of yin deficiency syndrome leading to impaired qi transformation with afternoon fever and absence of thirst, Tongguan Wan composed of Zhibai Dihuang Wan (Anemarrhena, Phellodendron, and Rehmannia Pill) plus a small amount of Rougui (Cinnamon Bark) should be used. In cases of qi deficiency syndrome leading to impaired qi transformation with non-urgent abdominal fullness, fatigue, and reluctance to speak, Chunze Jian (Chunze Decoction) should be used.
[Note] For strangury due to excess heat, Bazheng San (Eight-Right Powder) added with Muxiang is appropriate. For yang deficiency, Jingui Shenqi Wan (Golden Cabinet Kidney Qi Pill) is appropriate. For yin deficiency, Tongguan Wan (Passage-Opening Pill), consisting of Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), and a small amount of Rougui (Cinnamomi Ramulus et Cortex), is appropriate. For qi deficiency, Chunze Tang (Chunze Decoction), consisting of Wuling San (Five-Ingredient Powder with Poria) added with Renshen (Ginseng Radix et Rhizoma), is appropriate.
Bazheng San
5. Shilin (Stone Strangury) resembles sand and stones condensing in a pot; it arises because damp-heat refines and boils the Bladder. All types of Relin (Heat Strangury) can be treated with Bazheng San, which contains Bianxu (Polygoni Avicularis Herba), Mutong (Akebiae Caulis), Qumai (Dianthi Herba), Zhizi (Gardeniae Fructus), Huashi (Talcum), Gancao (Glycyrrhizae Radix et Rhizoma), Cheqianzi (Plantaginis Semen), and Dahuang (Rhei Radix et Rhizoma).
[Note] Bazheng San consists of Bianxu (Polygoni Avicularis Herba), Mutong (Akebiae Caulis), Qumai (Dianthi Herba), Zhizi (Gardeniae Fructus), Huashi (Talcum), Gancao (Glycyrrhizae Radix et Rhizoma), Cheqianzi (Plantaginis Semen), and Dahuang (Rhei Radix et Rhizoma).
Xiaoji Yinzi
6. Xuelin (Bloody Strangury) stems from heart fire transmitting heat to the Small Intestine. If it is an excess heat pattern, purgation is still beneficial. The heat-clearing formula is Xiaoji Yinzi (Little Shepherd's Purse Decoction), containing Xiaoji (Leonuri Herba), Zhizi (Gardeniae Fructus), Huashi (Talcum), Danzhu Ye (Lophatheri Herba), Danggui (Angelicae Sinensis Radix), Oujie (Nelumbinis Node), Mutong (Akebiae Caulis), Puhuang (Typhae Pollen), Gancao (Glycyrrhizae Radix et Rhizoma), and Shengdihuang (Rehmanniae Radix).
[Note] "Dan" refers to Danzhu Ye (Lophatheri Herba). "Ou" refers to Oujie (Nelumbinis Node). "Pu" refers to Puhuang (Typhae Pollen).
Haijinsha San and Lujiaoshuang Wan
7. Gaolin (Milky Strangury) or turbid urine may resemble mucus. Essence and urine both derive from Haijinsha (Lygodii Spora) and Huashi (Talcum). If heat is excessive, Bazheng San (Eight-Right Powder) added with Cangzhu (Atractylodis Rhizoma) can be used. If it is a deficiency pattern, Qiushi (Autumn Stone) and Fuling (Poria) combined with Lujiaoshuang (Cornu Cervi Pantotrichum Preparatum) yield excellent results.
[Note] "Hai" refers to Haijinsha (Lygodii Spora). "Qiu" refers to Qiushi (Autumn Stone). "Ling" refers to Fuling (Poria). "Lujiao" refers to Lujiaoshuang (Cornu Cervi Pantotrichum Preparatum). Made into pills with glutinous rice paste.
Jiawei Bazheng San
8. Qilin (Qi Strangury) caused by lung heat that is difficult to clear and descend can be treated with Bazheng San (Eight-Right Powder) added with Shiwei (Pyrosiae Folium), Muxiang (Aucklandiae Radix), Dongkuizi (Malvae Semen), and Chenxiang (Aquilariae Lignum Resinatum). If it is due to internal injury and qi deficiency failing to transform fluids, using Wuling San (Five-Ingredient Powder with Poria) combined with Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi) will naturally restore smooth urination with miraculous effect.
[Note] Bazheng San (Eight-Right Powder) added with Shiwei (Pyrosiae Folium), Muxiang (Aucklandiae Radix), Dongkuizi (Malvae Semen), and Chenxiang (Aquilariae Lignum Resinatum); Wuling San (Five-Ingredient Powder with Poria) combined with Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi).
Buzhong Yiqi Tang Combined with Wuling San and Qingxin Lianzi Yin
9. Laolin (Fatigue Strangury) due to internal injury and spleen deficiency should be treated with Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi) combined with Wuling San (Five-Ingredient Powder with Poria). Due to kidney yang deficiency from overindulgence, use Jingui Shenqi Tang (Golden Cabinet Kidney Qi Decoction). For yin deficiency, use Zhibai Dihuang Tang (Anemarrhena, Phellodendron, and Rehmannia Decoction). For mental labor and heart strain, use Qingxin Lianzi Yin (Heart-Clearing Lotus Seed Decoction), which consists of Lianzi (Nelumbinis Semen), Digupi (Lycii Cortex), Huangqi (Astragali Radix), Huangqin (Scutellariae Radix), Cheqianzi (Plantaginis Semen), Maidong (Ophiopogonis Tuber), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Renshen (Ginseng Radix et Rhizoma), and Baifuling (White Poria).
[Note] Internal injury damaging the spleen through fatigue: use Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi) combined with Wuling San (Five-Ingredient Powder with Poria). Kidney yang deficiency due to fatigue: use Jingui Shenqi Tang (Golden Cabinet Kidney Qi Decoction). Yin deficiency: use Zhibai Dihuang Tang (Anemarrhena, Phellodendron, and Rehmannia Decoction). Mental labor affecting the heart: use Qingxin Lianzi Yin (Heart-Clearing Lotus Seed Decoction), comprising Lianzi (Nelumbinis Semen), Digupi (Lycii Cortex), Huangqi (Astragali Radix), Huangqin (Scutellariae Radix), Cheqianzi (Plantaginis Semen), Maidong (Ophiopogonis Tuber), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Renshen (Ginseng Radix et Rhizoma), and Baifuling (White Poria).
Hupo San
10. Tanlin (Phlegm Strangury) can be treated with Qiqi Tang (Seven-Qi Decoction) or Qingzhou Baiwanzi (Qingzhou White Pills). If caused by heat and dryness, clear heat and nourish yin. A balanced formula for various stranguries is Hupo San (Amber Powder), containing Hupo (Succinum), Muxiang (Aucklandiae Radix), Dongkuizi (Malvae Semen), Bianxu (Polygoni Avicularis Herba), Mutong (Akebiae Caulis), Huashi (Talcum), Danggui (Angelicae Sinensis Radix), and Yujin (Curcumae Longae Radix).
[Note] Qiqi Tang (Seven-Qi Decoction) is found under the section on Qi Disorders. Qingzhou Baiwanzi (Qingzhou White Pills) is found under the section on Stroke-like Syndromes. "Nourishing yin" refers to Tongguan Wan (Passage-Opening Pill). "Mu" refers to Muxiang (Aucklandiae Radix). "Kui" refers to Dongkuizi (Malvae Semen).
Guifu Dihuang Wan, Buzhong Yiqi Tang Added with Baiguo Formula, Kanli Jiji Tang Added with Shanzhuyu and Wuweizi Formula
11. Enuresis (involuntary urination) and strangury with white urine can be treated with Guifu Dihuang Wan (Cinnamon and Aconite Rehmannia Pill) or Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi) added with Baiguo (Ginkgo Semen). If tonification fails or the urine is red, use a formula comprising Shengdi (Rehmanniae Radix), Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), Shanzhuyu (Corni Fructus), and Wuweizi (Schisandrae Fructus).
[Note] Enuresis and various stranguries with white urine all belong to cold and deficiency patterns. For cold patterns, use Guifu Dihuang Tang (Cinnamon and Aconite Rehmannia Decoction) added with Baiguo (Ginkgo Semen). For deficiency patterns, use Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi) added with Baiguo (Ginkgo Semen). For enuresis, various stranguries, red urine, or cases where tonification is ineffective, there may also be heat and deficiency patterns. Use Kanli Jiji Tang (Kanli Equilibrium Decoction), consisting of Shengdi (Rehmanniae Radix), Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), added with Shanzhuyu (Corni Fructus) and Wuweizi (Schisandrae Fructus).