由淋痛。渐变赤白浊。少年患此。多有欲心暗动。精离本宫。腐败凝阻溺窍
而成。乃有形精血之伤。三年久病。形消肉减。其损伤已非一脏一腑。然补精充
髓。必佐宣通为是。自能潜心安养。尚堪带病延年。
熟地 王麋角 苁蓉 远志 赤苓 牛膝
阴精上承者寿。阳火下陷者危。血淋久而成形窒痛。烦心。心火直升。老人
阴精已惫。五液化成。败浊阻窍不通。欲泄必痛。得泄痛减。即痛则不通。痛随利
缓之理。故知柏六味。及归脾逍遥之属。愈治愈剧。其守补升补滋浊涩药。决不
中病。用琥珀痛减。乃通血利窍之意。然非久进之方。以不伤阴阳之通润立方。
生地 益母草 女贞子 阿胶 琥珀 豆皮
败精宿于精关。宿腐因溺强出。新者又瘀在里。经年累月。精与血并皆枯
槁。势必竭绝成劳不治。医药当以任督冲带调理。亦如女人之崩漏带下。医者
但知八正厘清。以湿热治。亦有地黄汤益阴泄阳。总不能走入奇经。
鹿茸 龟甲 当归 杞子 茯苓 小茴 鲍鱼
案牍神耗。过动天君。阳隧直升直降。水火不交。阴精变为腐浊。精浊与便
浊异路。故宣利清解无功。数月久延。其病伤已在任督。凡八脉奇经。医每弃置
不论。考孙真人九法专究其事。欲涵阴精不漏。意在升固八脉之气。录法参末。
鹿茸 人参 生菟丝子 补骨脂 韭子 舶茴香 覆盆子 茯苓 胡桃肉 柏子霜 蒸饼为丸
用甘露饮。淋浊已止。而头晕左肢麻木。胃脘腹中饥则欲痛。咽喉中似有
物粘着。咳咯咽痛不解。诊脉左劲右濡。据症是水弱木失滋涵。肝阳化风。过膈
绕咽达巅。木乘胃土。阳明脉衰。不司束筋骨以利机关。脘腹中痛。得食则缓者。
胃虚求助也。今壮年有此。已属痱中根萌。养肝肾之液以熄虚风。补胃土以充
络脉。务在守常。勿图速效。可望全好。
制首乌 苁蓉 天冬 杞子 柏子霜 茯神 菊花炭 青盐 红枣肉丸早服 晚服猪肚丸方
丹溪谓五淋症湿热阻窍居多。三年前曾有是病。月前举发。竟有血块窒
塞。尿大痛不能溺出。想房劳强忍。败精离位。变成污浊瘀腐。且少腹坚满。大便
秘涩。脏气无权。腑气不用。考濒湖发明篇中。有外甥柳乔之病。与此适符。今仿
其义。参入朱南阳法。
两头尖 川楝子 韭白 小茴 桂枝 归尾 冲入杜牛膝根汁
肝主筋。肾主骨。阴器者。宗筋之所聚。男子天癸未至。强通其精。异时必有
难名之病。今患腰酸痛。宗筋短缩。大便结涩。小便淋沥。足腿消烁。饬肉拘挛。无
非肝亏肾损所致。按脉沉细而兼微数。乃精不营筋。又有伏火。内经所谓发为
筋痿。及为白淫者是也。治宜滋肾舒肝。使精血渐充。则筋骨亦渐和柔。但幻症
日久。非一朝一夕之功。幸弗期速效。
熟地 归身 牛膝 肉桂 黄柏 线鱼胶 续断 钩勾
久劳郁勃。夏季尿血。延及白露。溺出痛涩。血凝成块。阻着尿管。夫淋症。方
书列于肝胆部。为湿热阻其宣化气机。故治法苦辛泄肝。淡渗通竭。施于壮实
颇效。今望八老翁。上焦必惫。况加精血自败。化为瘀浊。真气日衰。机窍日闭。诊
候之际。病患自述。梦寐若有交接。未尝遗泄。心阳自动。相火随之。然清心安肾
等法。未能速效。暂以清营通瘀宣窍之剂。
天冬 生蒲黄 龙胆草 龟板 生地 阿胶 丹皮 焦黄柏
男子血淋成块。尿出痛。医治一年罔效。夫淋属肝经郁火。湿热皆有是病。
思少壮情欲勉强。必致败精凝窍。精腐变瘀。理固有诸。用虎杖散法。服五六日。
痛减血少。晨溺尚有血丝。此盖窍中有未尽之败浊。宜通不宜涩。
人中白 琥珀 沉香 白牵牛 川柏 韭菜汁丸
浊腻膏淋日下。最易损人津液。络脉遂槁。况八脉隧道纡远。泛然补剂药
力罔效。难经谓十二经属通渠。旋转循环无端。惟奇经如沟渠满溢。流入深河。
不与十二经并行者也。树根草皮。此症亦难奏效。须用血肉填补固涩。庶可希
其获效。
麋茸 河车 人参 蒸黑于术 茯苓 湘莲 缩砂 雀卵 茹 乌贼骨 雀卵河车膏为丸
淋属肝胆。而酒性湿热之气。肝胆先受滓汁。次及肠胃。湿甚热郁。溺窍气
阻。茎管窄溢。久病积热愈深。不受温补。当忌酒肉浓味。分利虽投。不能却病。从
经义苦味祛湿。参以解毒。
料豆皮 牡丹皮 黑山栀 芦荟 龙胆草 真青黛 金银花 胡黄连
由淋证疼痛,逐渐转变为赤白浊。少年患此病,多因情欲暗动,精气离位,腐败凝滞阻塞溺窍而成。这是有形精血的损伤,病程长达三年,形体消瘦、肌肉减少,其损伤已不止于一脏一腑。然而,补益精髓时,必须辅以宣通之法,才能潜心安养,尚可带病延年。
熟地黄、鹿角胶、肉苁蓉、远志、赤茯苓、牛膝
阴精上承者长寿,阳火下陷者危险。血淋日久形成瘀阻疼痛,心烦,心火直升。老人阴精已疲惫,五液化生败浊,阻塞窍道不通,欲排泄则必痛,排泄后疼痛减轻,即“痛则不通,痛随利缓”的道理。因此,知柏地黄丸及归脾汤、逍遥散之类,越治越重。那些守补、升补、滋腻、固涩的药物,决不能对症。使用琥珀后疼痛减轻,这是通血利窍的意思。但这并非久服之方,应以不伤阴阳的通畅滋润之法立方。
生地黄、益母草、女贞子、阿胶、琥珀、豆皮(此处指大豆皮或相关药材,依原文保留)
败精宿留在精关,腐败之物因排尿强行排出,新的精血又瘀滞在体内。经年累月,精与血都枯槁,势必枯竭成劳损,难以治愈。医药应当调理任脉、督脉、冲脉、带脉,也如同女子崩漏、带下病一样。医者只知道用八正散、厘清汤等以湿热论治,也有用地黄汤滋阴泄阳的,总不能进入奇经系统。
鹿茸、龟甲、当归、枸杞子、茯苓、小茴香、鲍鱼
处理文书耗神,过度动用心神(天君),阳气隧道直升直降,水火不交,阴精变为腐浊。精浊与便浊路径不同,所以宣利清解的方法无效。数月拖延,病情损伤已在任督二脉。凡是八脉奇经,医生往往弃置不论。考察孙思邈真人九法专门研究此事,想要涵养阴精不漏,意在升固八脉之气。记录方法参见于文末。
鹿茸、人参、生菟丝子、补骨脂、韭菜子、舶茴香、覆盆子、茯苓、胡桃肉、柏子霜,蒸饼为丸
使用甘露饮,淋浊已止,但出现头晕、左肢麻木,胃脘腹部饥饿时欲痛,咽喉中有似有物粘着,咳嗽咯痰咽痛不解。诊脉左脉劲急,右脉濡软。据症状分析,是水弱木失滋涵,肝阳化风,过膈绕咽达于头顶。木气乘克胃土,阳明脉衰,不能束筋骨以利关节,导致脘腹中痛,得食则缓解,这是胃虚求助的表现。如今壮年有此症,已属痱中风根萌发的征兆。滋养肝肾之液以熄虚风,补益胃土以充络脉,务必遵守常规,不要图求速效,可望痊愈。
制何首乌、肉苁蓉、天冬、枸杞子、柏子霜、茯神、菊花炭、青盐,红枣肉丸早服;晚服猪肚丸方
丹溪说五淋症多由湿热阻窍引起。三年前曾患此病,月前复发,竟有血块堵塞,尿出大痛不能溺出。想是房劳强忍,败精离位,变成污浊瘀腐。且少腹坚满,大便秘涩,脏气无权,腑气不用。考濒湖《发明篇》中,有外甥柳乔的病,与此完全相符。现在仿照其义,参入朱南阳的方法。
两头尖、川楝子、韭白、小茴香、桂枝、当归尾,冲入杜牛膝根汁
肝主筋,肾主骨。阴器是宗筋汇聚之处。男子天癸未至时,强行通泄精气,异时必有难名之病。如今患腰酸痛,宗筋短缩,大便结涩,小便淋沥,足腿消瘦,肌肉拘挛。无非是肝亏肾损所致。按脉沉细而兼微数,乃精不营筋,又有伏火。《内经》所谓发为筋痿,及为白淫者是也。治疗宜滋肾舒肝,使精血渐充,则筋骨亦渐和柔。但幻症日久,非一朝一夕之功,幸好不要期望速效。
熟地黄、当归身、牛膝、肉桂、黄柏、线鱼胶、续断、钩藤
长期劳累郁勃,夏季尿血,延及白露时节,溺出痛涩,血凝成块,阻着尿管。夫淋症,方书列于肝胆部,为湿热阻其宣化气机,故治法苦辛泄肝,淡渗通竭,施于壮实之人颇有效。如今望八老翁,上焦必疲惫,况且加精血自败,化为瘀浊,真气日衰,机窍日闭。诊候之际,病患自述梦寐若有交接,未曾遗泄,心阳自动,相火随之。然而清心安肾等方法,未能速效。暂以清营通瘀宣窍之剂。
天冬、生蒲黄、龙胆草、龟板、生地黄、阿胶、牡丹皮、焦黄柏
男子血淋成块,尿出痛,医治一年无效。夫淋属肝经郁火,湿热皆有此病。思虑少壮时情欲勉强,必致败精凝窍,精腐变瘀,理固有诸。用虎杖散法,服五六日,痛减血少,晨起溺出尚有血丝。这大概是窍中有未尽之败浊,宜通不宜涩。
人中白、琥珀、沉香、白牵牛、川柏,韭菜汁丸
浊腻膏淋日下,最易损伤人津液,络脉遂干枯。何况八脉隧道迂曲深远,泛然补剂药力无效。《难经》谓十二经属通渠,旋转循环无端,惟奇经如沟渠满溢,流入深河,不与十二经并行者也。树根草皮类药物,此症亦难奏效。须用血肉有情之品填补固涩,庶可希望获效。
麋茸、紫河车、人参、蒸黑于术、茯苓、湘莲、缩砂仁、雀卵、茹(此处疑为某药或笔误,依原文保留)、乌贼骨,雀卵河车膏为丸
淋属肝胆,而酒性湿热之气,肝胆先受滓汁,次及肠胃。湿甚热郁,溺窍气阻,茎管窄溢。久病积热愈深,不受温补,当忌酒肉浓味。分利虽投,不能却病。从经义苦味祛湿,参以解毒。
料豆皮、牡丹皮、黑山栀、芦荟、龙胆草、真青黛、金银花、胡黄连
From strangury with pain, it gradually transforms into red and white turbidity. Young people suffering from this condition often have hidden desires stirring within, causing essence to leave its original palace, become corrupt, coagulate, and obstruct the urinary orifice. This is an injury to tangible essence and blood. After three years of chronic illness, with emaciation and flesh wasting, the damage has affected more than just one zang or fu organ. However, when tonifying essence and filling marrow, it is necessary to assist with unblocking methods. Only then can one calm the mind and nourish oneself, still capable of extending life while carrying the disease.
Shu Di Huang (Prepared Rehmanniae Radix), Wang Mi Jiao (Cervus Nippon Antler Gelatin), Cong Rong (Cistanche Deserticola), Yuan Zhi (Polygalae Radix), Chi Ling (Poria Cocos with Red Core), Niu Xi (Achyranthis Bidentatae Radix)
Those whose yin essence ascends enjoy longevity; those whose yang fire sinks downward face danger. When hematuric strangury persists for a long time, it forms stasis and painful obstruction, causing vexation in the heart as heart fire rises directly. In the elderly, yin essence is already exhausted, and the five fluids transform into敗浊 (defective turbidity), blocking the orifices so they do not flow freely. Attempting to urinate causes pain, which is relieved after urination, illustrating the principle that "pain indicates obstruction, and pain eases with free flow." Therefore, formulas such as Zhi Bai Liu Wei Wan (Anemarrhenae et Phellodendri Six-Ingredient Pill) and Gui Pi Tang (Restore the Spleen Decoction) or Xiao Yao San (Free Wander Powder) will only worsen the condition upon treatment. Medicines that strictly tonify, ascend, are cloying, or astringent will certainly not hit the target. Using Hu Po (Amber) reduces pain, reflecting the intent to unblock blood and benefit the orifices. However, this is not a formula for long-term use. One must formulate based on principles that do not injure yin and yang, favoring unblocking and moistening.
Sheng Di Huang (Rehmanniae Radix), Yi Mu Cao (Leonuri Herba), Nu Zhen Zi (Ligustri Lucidi Fructus), E Jiao (Asini Corii Colla), Hu Po (Electrum/Amber), Dou Pi (Soybean Peel)
Defective semen lingers in the spermatic gate, and putrefied matter is forced out during urination, while new essence and blood remain stagnant inside. Year after year, both essence and blood become withered. Eventually, exhaustion leads to consumptive disease, which is incurable. Medical treatment should regulate the Ren, Du, Chong, and Dai meridians, similar to treating menorrhagia and leukorrhea in women. Physicians often only know to use Ba Zheng San (Eight-Herb Corrective Powder) or Li Qing Tang (Clear Turbidity Decoction) to treat damp-heat, or use Di Huang Tang (Rehmannia Decoction) to nourish yin and drain yang, but they fail to enter the extraordinary vessels.
Lu Rong (Cervi Cornu Pantotrichum), Gui Jia (Testudinis Carapax et Plastrum), Dang Gui (Angelicae Sinensis Radix), Qi Zi (Lycii Fructus), Fu Ling (Poria Cocos), Xiao Hui Xiang (Foeniculi Fructus), Bao Yu (Abalone Meat)
Mental exertion depletes spirit, overusing the Heavenly Lord (Mind). The Yang tunnels rise and descend directly without interaction, water and fire do not communicate, and yin essence transforms into corrupt turbidity. Essence turbidity follows a different path from fecal turbidity; therefore, methods of promoting drainage and clearing heat are ineffective. After months of delay, the disease has damaged the Ren and Du meridians. Physicians often disregard the eight extraordinary vessels. Examining Sun Simiao’s Nine Methods reveals a focus on this issue: to nourish yin essence and prevent leakage, the intent is to ascend and secure the qi of the eight vessels. The method is recorded at the end.
Lu Rong (Cervi Cornu Pantotrichum), Ren Shen (Ginseng Radix), Sheng Tu Si Zi (Cuscutae Semen), Bu Gu Zhi (Psoraleae Fructus), Jiu Zi (Allium Tuberosum Semen), Bo Hui Xiang (Foeniculi Fructus - imported), Fu Pen Zi (Rubiae Fructus), Fu Ling (Poria Cocos), Hu Tao Rou (Juglandis Semen Endocarpum), Bai Zi Shuang (Biota Seed Frost), made into pills with steamed wheat cake.
Using Gan Lu Yin (Sweet Dew Drink), the strangury and turbidity have stopped, but dizziness and numbness in the left limbs appear. There is hunger-pain in the epigastrium and abdomen, a sensation of something sticking in the throat, and unresolved cough, expectoration, and sore throat. The pulse is forceful on the left and soggy on the right. Based on symptoms, this is water deficiency failing to nourish wood, leading to liver yang transforming into wind. The wind passes through the diaphragm, winds around the throat, and reaches the vertex. Wood overacts on stomach earth, the Yangming pulse declines, failing to bind sinews and bones to facilitate joint movement, causing abdominal pain relieved by eating, indicating stomach deficiency seeking help. A young person having this condition already shows roots of feizhong (stroke-like syndrome). Nourish liver and kidney fluids to extinguish deficient wind, tonify stomach earth to fill collateral vessels. Adhere to standard protocols, do not seek quick effects, and full recovery is possible.
Zhi Shou Wu (Prepared Polygoni Multiflori Radix), Cong Rong (Cistanche Deserticola), Tian Dong (Asparagi Radix), Qi Zi (Lycii Fructus), Bai Zi Shuang (Biota Seed Frost), Fu Shen (Poria Cocos with Pine Root), Ju Hua Tan (Chrysanthemi Flos Charred), Qing Yan (Natrii Chloridum), made into pills with red date meat for morning intake; evening intake uses Pig Stomach Pills.
Danxi stated that most cases of the five types of strangury are due to damp-heat obstructing the orifices. Three years ago, I had this disease. It flared up recently, with blood clumps causing blockage, severe pain during urination making it impossible to void. This was likely due to sexual fatigue with forced retention, causing defective semen to leave its position, turning into filthy turbidity and stasis. The lower abdomen is firm and full, stool is constipated, zang qi lacks authority, and fu qi does not function. Examining Binhu’s *Fa Ming Pian*, the case of his nephew Liu Qiao matches this perfectly. Now imitating its meaning, incorporating Zhu Nanyang’s method.
Liang Tou Jian (Galii Herba), Chuan Lian Zi (Toosendan Fructus), Jiu Bai (Allium Tuberosum White Part), Xiao Hui Xiang (Foeniculi Fructus), Gui Zhi (Cinnamomi Ramulus), Gui Wei (Angelicae Sinensis Radix), mixed with Du Niu Xi Gen Zhi (Achyranthidis Radix Juice)
The liver governs sinews, the kidney governs bones. The external genitalia are where the great sinews gather. If a man forces ejaculation before the arrival of Tian Gui (menstrual essence/spermatic maturity), he will inevitably suffer from unnamed diseases later. Currently suffering from sore and aching waist, shortening of the great sinews, constipation, dribbling urine, emaciation of legs and feet, and muscle spasms. This is none other than caused by liver deficiency and kidney damage. The pulse is deep, fine, and slightly rapid, indicating essence failing to nourish sinews, with latent fire present. As stated in the *Neijing*, this manifests as tendon-withering (jin wei) and white discharge (bai yin). Treatment should nourish the kidney and soothe the liver, allowing essence and blood to gradually replenish, so sinews and bones become flexible. Since this phantom-like condition has persisted for a long time, it requires more than a day or night to cure. Fortunately, do not expect quick results.
Shu Di Huang (Prepared Rehmanniae Radix), Gui Shen (Angelicae Sinensis Radix), Niu Xi (Achyranthis Bidentatae Radix), Rou Gui (Cinnamomi Cortex), Huang Bo (Phellodendri Cortex), Xian Yu Jiao (Fish Maw/Collagen), Xu Duan (Dipsaci Radix), Gou Gou (Uncariae Ramulus cum Uncis)
Long-term labor and depression/stagnation led to hematuria in summer, extending until the White Dew solar term. Urination is painful and astringent, blood coagulates into clumps blocking the urethra. Strangury is listed in the liver and gallbladder section in medical texts, attributed to damp-heat obstructing the diffusion and transformation of qi mechanism. Thus, the treatment method involves bitter and pungent draining of liver, and light and permeating unblocking of exhaustion. This is effective for robust individuals. However, an eighty-year-old gentleman surely has upper jiao exhaustion, compounded by self-destruction of essence and blood, transforming into stasis and turbidity. True qi declines daily, orifices close daily. During consultation, the patient described dreams of intercourse without actual emission, heart yang moving spontaneously, followed by ministerial fire. However, methods like calming the heart and nourishing the kidney have not yielded quick results. Temporarily use agents to clear the nutritive level, unblock stasis, and open orifices.
Tian Dong (Asparagi Radix), Sheng Pu Huang (Polygoni Citrini Pollen), Long Dan Cao (Gentianae Radix), Gui Ban (Testudinis Carapax et Plastrum), Sheng Di Huang (Rehmanniae Radix), E Jiao (Asini Corii Colla), Dan Pi (Moutan Cortex), Jiao Huang Bo (Charred Phellodendri Cortex)
Male hematuric strangury with clumps and painful urination has been treated ineffectively for a year. Strangury belongs to liver meridian depressed fire; both damp-heat and this condition exist. Reflecting on youth, forced sexual activity必然 leads to defective semen coagulating in the orifices, corruption turning to stasis, which is theoretically sound. Using Hu Zhang San (Persicaria Bistorta Powder) method, after taking it for five or six days, pain decreased and blood reduced, though traces of blood remained in morning urine. This suggests remaining defective turbidity in the orifice; it should be unblocked, not astringed.
Ren Zhong Bai (Unguis Humanis Depuratus), Hu Po (Electrum/Amber), Chen Xiang (Aquilariae Lignum Resinatum), Bai Qian Niu (Ipomoeae Semen), Chuan Bai (Phellodendri Amurense Cortex), made into pills with Chinese Chive Juice.
Daily discharge of greasy turbid strangury easily damages body fluids, causing collaterals to wither. Moreover, the tunnels of the eight extraordinary vessels are tortuous and distant; general tonic medicines are ineffective. The *Nan Jing* states that the twelve regular meridians are like channels rotating endlessly, whereas the extraordinary vessels are like overflowing ditches flowing into deep rivers, not traveling together with the twelve regular meridians. Herbal roots and barks are difficult to achieve efficacy in this condition. One must use animal-derived substances to fill and secure, hoping for success.
Mi Rong (Cervi Cornu Pantotrichum), He Che (Placenta Humana), Ren Shen (Ginseng Radix), Zheng Hei Yu Zhu (Atractylodis Macrocephalae Rhizoma Charred), Fu Ling (Poria Cocos), Xiang Lian (Nelumbinis Semen), Suo Sha (Amomi Fructus), Que Luan (Sprow Egg), Ru (likely a typo or specific ingredient, kept as is), Ou Gu (Sepiae Endoconcha), made into pills with Sprow Egg and Placenta Paste.
Strangury belongs to the liver and gallbladder. The damp-heat nature of alcohol first affects the liver and gallbladder, then the intestines and stomach. Severe dampness and depressed heat cause qi obstruction in the urinary orifice, narrowing the urethra. Chronic accumulation of heat deepens, resisting warm tonification. Alcohol, meat, and rich flavors must be avoided. Although diaphoretic and draining methods are administered, they cannot eliminate the disease. Following classic theory, bitter flavors remove dampness, combined with detoxification.
Dou Pi (Vicia Fabae Integumentum), Mu Dan Pi (Moutan Cortex), Hei Shan Zhi (Gardeniae Fructus Charred), Lu Hui (Aloe), Long Dan Cao (Gentianae Radix), Zhen Qing Dai (Lapis Ultramarini), Jin Yin Hua (Lonicerae Japonicae Flos), Hu Huang Lian (Coptidis Chinensis Rhizoma - note: usually Huang Lian, Hu Huang Lian may refer to a specific variant or preparation, kept as per text context implying heat-clearing)