论曰乳石发动小便淋沥者，石势归肾，热气所致也。盖肾主水而恶燥，水行小肠，入胞
为溲便，肾气和平则溲便顺流。肾气宿虚，复困石热，将温过度。虚热相搏，则溲便数而涩
且痛也。数为虚，涩为热，涩甚而痛，故为淋沥。
治乳石发动，患淋积年，或数日辄发。滑石散方
滑石（二两） 冬葵子（一两） 赤茯苓（去黑皮） 芍药 黄芩（去黑心） 蒲黄（微
炒） 芒
硝（各一两半） 瞿麦（穗一两） 石苇（去毛一两半） 陈橘皮（汤浸去白焙一两）
上一十味，捣罗为散，每服二钱匕，煎后方桑白皮饮调服，空心食前日二服，渐加至三
服，取利为度。
下前药，桑白皮饮方
桑根白皮（锉一两半） 木通（锉二两） 白茅根（锉二两半） 百合（二两） 甘草
（炙） 滑
石（各一两）
上六味，细锉如麻豆大，每服五钱匕，水三盏煎至二盏，去滓，每用半盏调前散，如口
干，即食前更服此饮。
治乳石发动，淋沥。滑石木通汤方
滑石（五两） 木通（锉三两） 石苇（去毛） 瞿麦（穗各二两） 冬葵子（五合）
上五味，粗捣筛，每服五钱匕，水三盏。入茅根少许锉碎，同煎至一盏半。去滓更下芒
硝少许，煎三两沸，分温二服，空心一服。如两食久再服，微利为度。
治乳石发动，热结，小便淋涩，小腹痛。大黄汤方
大黄（锉炒） 芍药 赤茯苓（去黑皮各一两） 火麻仁（半升别研每服旋入一合）
上四味，除麻仁外，粗捣筛，每服五钱匕，水三盏，入麻仁一合，同煎至一盏半，去滓
分温二服，空心一服，日午再服。
治乳石发动，热结，小便淋涩，小腹痛。螵蛸汤方
桑螵蛸（炙黄二十枚） 黄芩（去黑心一两）
上二味，细锉，每服五钱匕，水二盏，煎至一盏，去滓分作二服。空心温服，日午再服。
治乳石发动，热淋涩痛。车前汤方
车前草（去根锉） 葵根（削洗令净切片曝干各二两） 木通（锉一两半）
上三味，粗捣筛，每服四钱匕，水一盏半，煎至一盏，去滓入芒硝末半钱匕，更煎一两
沸，温服日再，取利为度。
治乳石发动，血淋不止。鸡苏汤方
鸡苏（一握去根锉曝） 石膏（碎二两） 竹叶（一握切） 蜀葵子（别为末一两） 葵
子（
为末每服旋入一钱）
上五味，除葵子外，粗捣筛，每服二钱匕，水一盏半，煎至一盏。去滓下葵子末一钱匕
，更煎至八分，温服日二。
治乳石发，卒患淋。方
船底青苔（一块如鸭子大）
上一味，以水三盏，煎至一盏半，去滓分温二服，空心日午各一。
治乳石发，热淋。茅根汤方
白茅根（净洗锉曝干半斤）
上一味，粗捣筛，每服五钱匕，水二盏，煎至一盏，去滓温服，食前日二。
治乳石石淋，状如碎砂石下者。方
车前子（一升绢囊盛）
上一味，以水五盏，煎至二盏，经宿勿食，顿服之，须臾砂石自下。
治乳石发热，小便数少如淋。葵子汤方
冬葵子（拣五合如无子切陈根一两亦得）
上一味，粗捣筛，每服四钱匕，水一盏半，煎至八分，去滓温服日三。
论述：服用石药（指魏晋南北朝时期流行的五石散等矿物药）后引发小便淋漓不畅的病症，是由于石药的药势归于肾脏，由热气所致。肾主司水液代谢而厌恶燥热，水液运行于小肠，进入膀胱化为尿液排出，肾气平和则尿液顺流而出。若肾气素来虚弱，又受石药热气困扰，导致温补过度。虚与热相互搏结，就会导致小便频数、涩滞且疼痛。频数属虚证，涩滞属热证，涩滞严重进而疼痛，所以称为淋沥。
治疗石药发动引发的淋证，患病多年，或每隔数日发作一次。滑石散方：
滑石（二两）、冬葵子（一两）、赤茯苓（去除黑皮）、芍药、黄芩（去除黑心）、蒲黄（微炒）、芒硝（各一两半）、瞿麦（穗一两）、石苇（去毛一两半）、陈橘皮（汤浸去白焙一两）。
以上十味药，捣碎过筛制成散剂，每次服用二钱匕，煎煮后方桑白皮饮调服，空腹及进食前每日两次，逐渐增加至三次，以通利为度。
在服用上述药物之后，使用桑白皮饮方：
桑根白皮（锉碎一两半）、木通（锉碎二两）、白茅根（锉碎二两半）、百合（二两）、甘草（炙）、滑石（各一两）。
以上六味药，细锉如麻豆大小，每次服用五钱匕，加水三盏煎至二盏，去渣滓，每次用半盏药汁调服前面的散剂，如果口干，就在进食前加服此饮。
治疗石药发动引起的淋沥。滑石木通汤方：
滑石（五两）、木通（锉碎三两）、石苇（去毛）、瞿麦（穗各二两）、冬葵子（五合）。
以上五味药，粗捣筛过，每次服用五钱匕，加水三盏。加入少许锉碎的茅根，同煎至一盏半。去渣滓后加入少许芒硝，煎煮两三沸，分两次温服，空腹服一次。如果两次进食间隔较久再服一次，以轻微通利为度。
治疗石药发动，热结，小便淋涩，小腹痛。大黄汤方：
大黄（锉炒）、芍药、赤茯苓（去黑皮各一两）、火麻仁（半升另研，每次服用时旋入一合）。
以上四味药，除麻仁外，粗捣筛过，每次服用五钱匕，加水三盏，加入麻仁一合，同煎至一盏半，去渣滓分两次温服，空腹服一次，中午再服一次。
治疗石药发动，热结，小便淋涩，小腹痛。螵蛸汤方：
桑螵蛸（炙黄二十枚）、黄芩（去黑心一两）。
以上两味药，细锉，每次服用五钱匕，加水二盏，煎至一盏，去渣滓分两次服。空腹温服，中午再服一次。
治疗石药发动，热淋涩痛。车前汤方：
车前草（去根锉碎）、葵根（削洗令净切片曝干各二两）、木通（锉碎一两半）。
以上三味药，粗捣筛过，每次服用四钱匕，加水一盏半，煎至一盏，去渣滓加入芒硝末半钱匕，再煎一两沸，温服，每日两次，以通利为度。
治疗石药发动，血淋不止。鸡苏汤方：
鸡苏（一握去根锉碎曝干）、石膏（碎二两）、竹叶（一握切）、蜀葵子（另为末一两）、葵子（为末，每次服用时旋入一钱）。
以上五味药，除葵子外，粗捣筛过，每次服用二钱匕，加水一盏半，煎至一盏。去渣滓下葵子末一钱匕，再煎至八分，温服，每日两次。
治疗石药发，突然患淋。方：
船底青苔（一块如鸭子大）。
以上一味药，加水三盏，煎至一盏半，去渣滓分两次温服，空腹和中午各服一次。
治疗石药发，热淋。茅根汤方：
白茅根（净洗锉碎曝干半斤）。
以上一味药，粗捣筛过，每次服用五钱匕，加水二盏，煎至一盏，去渣滓温服，进食前每日两次。
治疗石药石淋，症状像碎砂石排出的。方：
车前子（一升用绢袋盛装）。
以上一味药，加水五盏，煎至二盏，隔夜不食，一次性顿服之，片刻后砂石自然排出。
治疗石药发热，小便频数量少如淋。葵子汤方：
冬葵子（拣选五合，如无子可切陈根一两也可）。
以上一味药，粗捣筛过，每次服用四钱匕，加水一盏半，煎至八分，去渣滓温服，每日三次。
Discussion: The condition of dribbling urination (strangury) triggered by the activation of mineral drugs (referring to mineral-based prescriptions like Wushi San popular in the Wei, Jin, Southern and Northern Dynasties) is caused by the pathogenic influence of the minerals settling in the Kidney and generating heat. The Kidney governs water metabolism and abhors dryness. Water flows through the Small Intestine and enters the Bladder to become urine; when Kidney Qi is harmonious, urine flows smoothly. If Kidney Qi is inherently deficient and further constrained by the heat of mineral drugs, leading to excessive warming, deficiency and heat contend with each other. This results in frequent, difficult, and painful urination. Frequency indicates deficiency, while difficulty indicates heat. Severe difficulty leading to pain constitutes strangury.
For treating strangury caused by the activation of mineral drugs, where the patient has suffered for years or experiences attacks every few days, use the Huashi San (Talcum Powder):
Huashi (Talcum, 2 liang), Dongkuizi (Malva Seed, 1 liang), Chifuling (Red Poria, remove black skin), Shaoyao (Peony Root), Huangqin (Scutellaria Root, remove black heart), Puhuang (Lychnis Pollen, lightly stir-fried), Mangxiao (Mirabilite, 1.5 liang each), Qumai (Herba Dianthi, spikes 1 liang), Shiwei (Leaf of Pyrola, remove hairs 1.5 liang), Chenjupi (Dried Tangerine Peel, soaked in water, remove white pith and baked, 1 liang).
The above ten ingredients are crushed, sifted, and made into a powder. Take 2 qianbi per dose, mixed with Sangbaipi Yin (Mulberry Root Bark Decoction) prepared as follows, taken on an empty stomach and before meals twice daily, gradually increasing to three doses, stopping when urination becomes unobstructed.
After taking the above medicine, use Sangbaipi Yin (Mulberry Root Bark Decoction):
Sanggenbaidpi (Cortex Morus Radicis, cut 1.5 liang), Mutong (Caulis Akebiae, cut 2 liang), Baimaogen (Rhizoma Imperatae, cut 2.5 liang), Baihe (Bulbus Lilii, 2 liang), Gancao (Radix Glycyrrhizae, honey-fried), Huashi (Talcum, 1 liang each).
The above six ingredients are finely cut to the size of hemp seeds. Take 5 qianbi per dose, add 3 zhan of water, boil down to 2 zhan, remove dregs. Use half a zhan to mix with the aforementioned powder. If there is dry mouth, take this decoction additionally before meals.
For treating strangury caused by the activation of mineral drugs, use Huashi Mutong Tang (Talcum and Caulis Akebiae Decoction):
Huashi (Talcum, 5 liang), Mutong (Caulis Akebiae, cut 3 liang), Shiwei (Leaf of Pyrola, remove hairs), Qumai (Herba Dianthi, spikes, 2 liang each), Dongkuizi (Malva Seed, 5 he).
The above five ingredients are coarsely crushed and sifted. Take 5 qianbi per dose, add 3 zhan of water. Add a small amount of chopped Maogen (Rhizoma Imperatae), boil together until 1.5 zhan remains. Remove dregs, add a small amount of Mangxiao (Mirabilite), boil for two or three boils, divide into two warm doses. Take one dose on an empty stomach. If it has been a long time since the last meal, take another dose. Stop when mild purgation occurs.
For treating activation of mineral drugs, heat accumulation, difficult and scanty urination, and lower abdominal pain, use Dahuang Tang (Rhubarb Decoction):
Dahuang (Radix et Rhizoma Rhei, cut and stir-fried), Shaoyao (Peony Root), Chifuling (Red Poria, remove black skin, 1 liang each), Huomaren (Fructus Cannabis, half sheng, ground separately, add one he at the time of administration).
Except for Huomaren (Fructus Cannabis), the above four ingredients are coarsely crushed and sifted. Take 5 qianbi per dose, add 3 zhan of water, add one he of Huomaren (Fructus Cannabis), boil together until 1.5 zhan remains. Remove dregs, divide into two warm doses. Take one dose on an empty stomach and another at noon.
For treating activation of mineral drugs, heat accumulation, difficult and scanty urination, and lower abdominal pain, use Piaoxiao Tang (Mantis Egg Case Decoction):
Sangpiaoxiao (Ootheca Mantidis, honey-fried until yellow, 20 pieces), Huangqin (Scutellaria Root, remove black heart, 1 liang).
The above two ingredients are finely cut. Take 5 qianbi per dose, add 2 zhan of water, boil down to 1 zhan. Remove dregs, divide into two doses. Take warm on an empty stomach, and again at noon.
For treating heat strangury with difficulty and pain caused by the activation of mineral drugs, use Cheqian Tang (Plantago Decoction):
Cheqiancao (Herba Plantaginis, remove roots and cut), Kuigen (Radix Malvae, peel, wash clean, slice, and sun-dry, 2 liang each), Mutong (Caulis Akebiae, cut 1.5 liang).
The above three ingredients are coarsely crushed and sifted. Take 4 qianbi per dose, add 1.5 zhan of water, boil down to 1 zhan. Remove dregs, add 0.5 qianbi of Mangxiao (Mirabilite) powder, boil for one or two boils. Take warm, twice daily, stop when unobstructed.
For treating continuous bloody strangury caused by the activation of mineral drugs, use Jisu Tang (Elsholtzia Decoction):
Jisu (Herba Elsholtziae, one handful, remove roots, cut, and sun-dry), Shigao (Gypsum Fibrosum, crushed 2 liang), Zhuye (Folium Bambusae, one handful, cut), Shukuizi (Fructus Malvae Parviflorae, ground separately into powder, 1 liang), Kuizi (Malva Seed, ground into powder, add one qian at the time of administration).
Except for Kuizi (Malva Seed), the above five ingredients are coarsely crushed and sifted. Take 2 qianbi per dose, add 1.5 zhan of water, boil down to 1 zhan. Remove dregs, add one qian of Kuizi (Malva Seed) powder, boil until 0.8 zhan remains. Take warm, twice daily.
For treating sudden strangury caused by the activation of mineral drugs, use the following prescription:
Chuandi Qingtai (Green Moss from Ship Bottom, one piece the size of a duck egg).
Add 3 zhan of water to this single ingredient, boil down to 1.5 zhan. Remove dregs, divide into two warm doses. Take one dose on an empty stomach and one at noon.
For treating heat strangury caused by the activation of mineral drugs, use Maogen Tang (Imperata Rhizome Decoction):
Baimaogen (Rhizoma Imperatae, washed clean, cut, and sun-dried, 0.5 jin).
Coarsely crush and sift this single ingredient. Take 5 qianbi per dose, add 2 zhan of water, boil down to 1 zhan. Remove dregs, take warm, twice daily before meals.
For treating stone strangury caused by mineral drugs, characterized by the passage of fragments resembling gravel, use the following prescription:
Cheqianzi (Seed Plantaginis, 1 sheng, contained in a silk bag).
Add 5 zhan of water to this single ingredient, boil down to 2 zhan. Fast overnight, then take all at once. Gravel will pass naturally shortly thereafter.
For treating fever and frequent, scanty urination resembling strangury caused by the activation of mineral drugs, use Kuizi Tang (Malva Seed Decoction):
Dongkuizi (Malva Seed, selected 5 he; if seeds are unavailable, aged root 1 liang may be used).
Coarsely crush and sift this single ingredient. Take 4 qianbi per dose, add 1.5 zhan of water, boil down to 0.8 zhan. Remove dregs, take warm, three times daily.