诸淋与小便不利者,五脏不通,六腑不和,三焦痞涩,营卫耗失,冒热饮酒,过醉入房,
竭散精神,劳伤血气。或因色兴而败精不出,或因迷宠而真髓多输,或惊惶不定,或忧思不
宁,或饥饱过时,或奔驰不定,或瘾忍大小便,或寒入膀胱,或发泄久兴,或暑中胞囊伤,
于兹不慎,致起斯疾。状候变异者,名亦不同,则有冷、热、气、劳、膏、砂、虚、实之种
耳。冷者小便数而色白如泔也,热者小便涩而赤色如血也,气者脐腹满闷小便不通利而痛也,
劳者小便淋漓不绝,如水滴漏而不断绝也,膏者小便中出物如脂膏也,砂者脐腹隐痛小便难
,其痛不可须臾忍,小便中有砂石,有大如皂角子,色泽赤或白不定,此由肾气强,贪于女
色,闭而不泄,泄而不止,虚伤真气,邪热渐弱,结聚成砂。又如煮盐,火大水小,盐渐成
石之类。八淋之中,惟此最为危矣。其脉盛大而实者可治,虚小而湿者不可治。虚者肾与膀
胱俱虚,精滑梦泄,小便不禁。实者谓经络闭塞,水道不利,茎痛腿酸也。又诸淋之病与脉
相从者活,反者死凶。治疗之际,亦在详酌耳。
古之与今,所施药饵,有得有失者,盖以其宜不宜也。或草或木,或金或石,或单方得
力,或群队获功,或金石毒而致死,或因以长生,其验不一者何也?基本实者,得宣通之性,
必
则决矣。有年少富盛之人,恃有学力,恣其酒欲,夸弄其术,暗使精神内损,药力扶持,忽
然疾作,何能救疗。如是者岂止灾之内发,但恐药饵无功,实可叹哉!果能久明方书,熟审
其宜,人药相合,效岂妄乎?假如脏不足则养其脏,腑有余则泻其腑,外实在理外,内虚则
养内;上塞而引上,下塞而通下,中涩则解中;左通则治左,右病则治右。上下左右,内外
虚实,各称其法,安有横夭者乎。
凡是患有各种淋证(以小便频数短涩、滴沥刺痛、欲出未尽、小腹拘急或痛引腰腹为特征的病证)和小便不通利的人,都是由于五脏气机阻滞,六腑功能失调,三焦(人体上、中、下三个部位及其所属脏腑的功能总称)痞塞不畅,营卫之气耗损流失。加上感受热邪后饮酒,醉酒之后行房事,耗散精神,劳损伤及气血。或者因为性欲亢进而败精排出不畅,或者因为沉迷于宠幸而导致真髓大量流失,或者受到惊吓惶恐不安,或者忧愁思虑不得安宁,或者饥饱不按时辰,或者奔波劳累不定,或者强行忍耐大小便,或者寒气侵入膀胱,或者久持阳具发泄过度,或者中暑伤及胞囊(此处指膀胱)。在这些方面如果不谨慎,就会导致这种疾病产生。症状表现变异不同,名称也不相同,主要有冷淋、热淋、气淋、劳淋、膏淋、砂淋、虚淋、实淋这几种类型。
冷淋的症状是小便次数多且颜色白如米泔水;热淋的症状是小便涩滞且颜色红赤如血;气淋的症状是脐腹部胀满闷痛,小便不通利且疼痛;劳淋的症状是小便淋漓不尽,像水滴漏一样不断绝;膏淋的症状是小便中排出类似脂膏的物质;砂淋的症状是脐腹部隐痛,小便困难,疼痛片刻也不能忍受,小便中有砂石排出,有的大如皂角子,色泽红或白不定。这是由于肾气强盛,贪恋女色,导致精气闭结而不泄,或者泄出而不停止,虚伤了真气,邪热逐渐减弱,凝结聚集成砂石。就像煮盐时,火大水少,盐逐渐结成石头一类的情形。在八种淋证中,只有砂淋最为危险。如果脉象盛大而有力的是可以治疗的,脉象虚小且湿弱的则难以治疗。虚证是指肾与膀胱都虚弱,出现精液滑脱、梦中遗精,小便失禁。实证是指经络闭塞,水道不通利,阴茎疼痛,腿部酸软。另外,各种淋病的病情与脉象相符的预后良好,病情与脉象相反的则预后凶险。在治疗的时候,也需要详细斟酌。
古代和现代所使用的药物,有得当也有不当之处,大概是因为是否适宜的原因。或者是草类药材,或者是木类药材,或者是金石类药物,或者是单方见效,或者是复方立功,或者是金石有毒导致死亡,或者是依靠它获得长生,其验证结果不一的原因是什么呢?如果人体正气充实,得到宣通性质的药物,必然就会痊愈。有些年轻力壮富贵之人,依仗自己有学问体力,放纵酒色欲望,炫耀其房中术,暗中使精神内里受损,靠药力扶持,忽然疾病发作,怎么能救治呢?像这样的人岂止是灾祸从内部发生,只怕药物没有功效,实在令人叹息!如果能长久精通医方书籍,仔细审察药物的适宜性,人与药物相合,疗效难道会虚假吗?假如脏腑不足就滋养脏腑,腑气有余就泻除腑气,外部实证就治理外部,内部虚证就滋养内部;上部堵塞就引导向上,下部堵塞就疏通向下,中部涩滞就解除中部的阻滞;左边通则治疗左边,右边有病则治疗右边。上、下、左、右,内、外、虚、实,各自符合相应的治法,怎么会有横死夭折的情况呢。
For those suffering from various types of Lin syndrome (a group of diseases characterized by frequent, short, and scanty urination with stinging pain, incomplete emptying, urgency in the lower abdomen, or pain radiating to the lumbar region) and difficult urination, it is due to the obstruction of Qi in the Five Zang organs, dysfunction of the Six Fu organs, stagnation and astringency of the Sanjiao (Triple Burner, referring to the functions of the upper, middle, and lower body regions and their associated organs), and depletion of Ying (Nutritive) and Wei (Defensive) Qi. This is often caused by drinking alcohol while exposed to heat, engaging in sexual intercourse after excessive drunkenness, exhausting the Shen (Spirit), and injuring Blood and Qi through overwork. It may also result from sexual arousal leading to the retention of seminal fluid, indulgence in concubines causing excessive loss of essence, sudden fright and instability, chronic worry and anxiety, irregular meals, strenuous travel, forcibly holding urine or feces, cold invading the Bladder, prolonged sexual activity without ejaculation, or summerheat injuring the bladder sac. Negligence in these aspects leads to this disease. Due to variations in symptoms, the names differ, including Cold Lin, Heat Lin, Qi Lin, Labor Lin, Gao Lin (Glandular Lin), Sha Lin (Gravel Lin), Deficiency Lin, and Excess Lin.
Cold Lin presents with frequent urination and white turbid urine resembling rice wash water. Heat Lin presents with obstructed urination and red urine resembling blood. Qi Lin presents with fullness and oppression in the umbilical and abdominal regions, with difficult and painful urination. Labor Lin presents with continuous dribbling of urine, like a leaking drip that does not stop. Gao Lin presents with the discharge of substance resembling grease or paste in the urine. Sha Lin presents with dull pain in the umbilical and abdominal regions, difficulty in urination, and unbearable pain at any moment; gravel stones are passed in the urine, some as large as gleditsia seeds, varying in color between red or white. This occurs because Kidney Qi is strong but suppressed due to lust for women, leading to closure without emission, or emission without cessation, which injures true Qi. As pathogenic heat gradually weakens, it condenses into gravel. This is similar to salt turning into stone when boiling with high fire and little water. Among the eight types of Lin, Sha Lin is the most critical. If the pulse is large and excess, it is treatable; if the pulse is deficient, small, and damp, it is untreatable. Deficiency type indicates both Kidney and Bladder deficiency, manifesting as seminal slipperiness, nocturnal emission, and urinary incontinence. Excess type indicates blockage of meridians and collaterals, with impaired water pathways, penile pain, and leg soreness. Generally, if the symptoms of Lin correspond with the pulse, survival is likely; if they contradict, death or misfortune is predicted. Treatment requires careful deliberation.
The administration of medicines in ancient and modern times has had both successes and failures, largely depending on appropriateness. Whether using herbs, trees, metals, or minerals; whether single prescriptions prove effective or compound formulas achieve success; whether mineral drugs cause death due to toxicity or promote longevity—the varied outcomes raise the question: why? If the patient's fundamental Qi is solid and receives herbs with dispersing and unblocking properties, recovery will surely occur. However, young, wealthy, and vigorous individuals who rely on their learning and physical strength, indulge in wine and desires, boast of their techniques, and secretly damage their internal Spirit, relying on medicinal support, may suddenly fall ill. How can such cases be cured? Such situations not only involve internal disasters but also the futility of medication, which is truly lamentable. If one can thoroughly understand medical texts, carefully assess appropriateness, and ensure harmony between the person and the medicine, how could efficacy be false? For example, if Zang organs are deficient, nourish them; if Fu organs have excess, drain them; if exterior excess exists, treat the exterior; if interior deficiency exists, nourish the interior; if upper obstruction exists, guide upwards; if lower obstruction exists, unblock downwards; if middle stagnation exists, resolve the middle; if left side is open, treat the left; if right side is diseased, treat the right. By applying methods appropriate to the upper, lower, left, right, interior, exterior, deficiency, and excess, how could premature death occur?