病源。夫强中病者。茎长兴盛不痿。精液自出是也。由少服五石。石热住于肾中。下焦
虚热。少壮之时。血气尚丰。能制于石。及至年衰血气减少。肾虚不能制精液也。若精液竭
则诸病生矣。（出第五卷中）
千金论曰∶夫人生放恣者众。盛壮之时。不自慎惜。快情纵欲。极意房中。稍至年长。
肾气虚竭。百病滋生。又年少虑不能房。多服石散。真气既尽。石气孤立。唯有虚耗。唇口
干焦。精液自泄。或小便赤黄。大便干实。或渴而且利。日夜一石以来。或渴而不利。或不
渴而利。所食之物。皆作小便。此皆由房室不节之所致也。又强中之病者。茎长兴盛不痿精
液自出也。消渴之后。即作痈疽。皆由石热。凡如此等。宜服猪肾荠 汤。制肾中石热。又
将服白鸭通丸。便瘥。
猪肾荠 汤方。
猪肾一具（去脂膜） 大豆（一升） 荠 （三两） 人参（二两） 茯神（二两） 磁
石（二两
碎） 知母（二两） 葛根（二两） 黄芩（二两） 栝蒌（二两） 甘草（二两炙） 石
膏（三两）
上十二味切。以水一斗五升。先煮猪肾大豆取一斗以下。去滓。纳诸药煎。取三升。去
滓。分温三服。渴乃饮之。下焦热者。辄合一剂。病势渐歇即停。忌海藻菘菜酢物。
又平人夏月喜渴者。由心旺也。心旺便汗出。汗出则肾中虚燥。故令渴而小便少也。冬
月不汗出。故小便多而数也。此皆是平人之候。名曰肾渴。但小便利而不饮水者。名肾实也。
经曰∶肾实则消。消者不渴而利是也。所以服石之人。其于小便利者。石性归肾。肾得石则
实。实则能消水浆故利。利多则不得润养五脏。脏衰则生诸病也。张仲景曰∶若热结中焦则
为坚热也。热结下焦则为溺血。亦令人淋闭不通。明知不必悉患小便利。信矣。内有热气者
则喜渴也。除其热则止。渴兼虚者。须除热而兼宜补虚。则病愈。
又疗岭南山瘴气。兼风热毒瓦斯入肾中。变成寒热。脚弱虚满而渴方。
黄连（不限多少） 生栝蒌（汁） 生地黄（汁） 羊乳（无即用牛乳及人乳亦得）
上四味。取三般汁乳和黄连末。任多少。众手捻为丸。如梧子大。麦饮服三十丸。渐加
至四十丸。五十丸。日三服。轻者三日愈。重者五日愈。若药苦难服。即煮麦饮汁下亦得。
文仲云。黄连丸一名羊乳丸。肘后同忌猪肉芜荑。
又疗消渴。浮萍丸方。
浮萍 栝蒌根（等分）
上二味捣筛。以人乳汁和为丸如梧子。麦饮服二十丸。日三服。三年病。三日瘥。（肘
后文仲同主虚热甚佳）
又疗面黄。咽中干燥。手足俱黄。短气。脉如连珠。除热止渴利。补养地黄丸方。
生地黄汁（二升） 生栝蒌汁（二升） 生羊脂（三升牛脂亦得） 好蜜（四升） 黄
连（末一
斤）
上五味捣合。银锅中熬。成煎。可丸如梧子。饮汁送五丸。日三服。加至十丸。若苦冷
而渴瘥。即令别服温药。忌猪肉芜荑。（肘后同）
又疗渴小便数散方。
知母（六分） 栝蒌（一斤） 茯苓（四分） 铅丹（一分） 鸡 中黄皮（十四枚）
上五味为散。饮服方寸匕。日三禁酒生菜肉。瘥后去铅丹。以蜜和之。以麦饮。长服勿
绝。良。忌酢物。（肘后同）
【病因】所谓强中病，是指阴茎持续勃起不萎软，精液自行流出的病症。这是由于年轻时服用五石散，石药的热气滞留于肾中，导致下焦产生虚热。在年少力壮之时，气血充沛，尚能制约石药的燥热；等到年老体衰，气血减少，肾虚无法固摄精液，从而导致此症。如果精液枯竭，就会引发各种疾病。（出自第五卷）
《千金方》论述说：世人放纵欲望者众多，在身体盛壮之时，不知谨慎爱惜，尽情纵欲，沉溺于房事。稍至年长，肾气虚竭，百病由此滋生。另外，年少时不懂节制房事，多服用石散，致使真气耗尽，石气孤立无依，只造成身体的虚耗。表现为嘴唇和口舌干燥焦枯，精液自行泄出，或者小便赤黄，大便干结坚硬，或者口渴且多尿，一天饮水达一石左右；或者口渴但不多尿，或者不渴却多尿，吃下的食物都变成小便排出。这些都是由房事不节所致。还有强中病，表现为阴茎持续勃起不萎软，精液自行流出。患消渴病之后，随即发生痈疽，这都是由于石药热气所致。凡属此类情况，适宜服用猪肾荠汤，以制约肾中的石热。接着再服用白鸭通丸，病情即可痊愈。
猪肾荠汤方剂组成：
猪肾一个（去除脂膜），大豆一升，荠三两，人参二两，茯神二两，磁石二两（捣碎），知母二两，葛根二两，黄芩二两，栝蒌二两，甘草二两（炙），石膏三两。
以上十二味药切碎，用水一斗五升，先煮猪肾和大豆，取汁一斗以下，去渣，加入其余药物煎煮，取汁三升，去渣。分三次温服，感到口渴时饮用。若属下焦热盛，则连续服用一剂，待病势逐渐缓解即停药。忌食海藻、菘菜（白菜类）及醋制品。
另外，普通人夏季喜欢口渴，是因为心火旺盛。心火旺则汗出，汗出则肾中虚燥，所以导致口渴且小便少。冬季不出汗，所以小便多且频数。这些都是正常人的生理征候，称为“肾渴”。但如果小便通利却不饮水的，称为“肾实”。医经说：“肾实则消”，消的表现是不口渴而多尿。所以服用石药的人，如果小便通利，是因为石性归于肾，肾得到石药则变实，实则能消化水浆，所以小便多。小便过多则不能滋润滋养五脏，脏腑衰弱就会产生各种疾病。张仲景说：“如果热邪结聚在中焦，就会形成坚热证；热邪结聚在下焦，就会导致尿血，也会使人淋沥闭塞不通。”明确知道并非所有服用石药的人都一定会出现小便通利的症状，确实如此。体内有热气的人喜欢口渴，清除热气则口渴停止。如果口渴兼有虚象，必须清热并兼顾补虚，病才能痊愈。
又治疗岭南地区山瘴气，兼风热毒瓦斯侵入肾中，变成寒热交替，脚部软弱、腹部虚胀且口渴的方剂：
黄连（用量不限），生栝蒌（取汁），生地黄（取汁），羊乳（若无可用牛乳或人乳代替）。
以上四味，取三种汁液与羊乳混合，加入黄连末，根据适量，众人用手捻制成丸，如梧桐子大小。用麦饮送服三十丸，逐渐增加至四十丸、五十丸，每日三次服用。轻症三天痊愈，重症五天痊愈。如果药苦难以服用，也可以煮麦饮汁送服。
文仲说，黄连丸又名羊乳丸，《肘后备急方》相同，忌食猪肉、芜荑。
又治疗消渴病的浮萍丸方剂：
浮萍，栝蒌根（等分）。
以上两味药捣碎过筛，用人乳汁调和制成丸，如梧桐子大小。用麦饮送服二十丸，每日三次服用。三年病程，三天可愈。（《肘后备急方》、文仲记载相同，主治虚热甚佳）
又治疗面色发黄，咽喉干燥，手足均发黄，气短，脉象如连珠状，具有清热止渴利尿功效的补养地黄丸方剂：
生地黄汁二升，生栝蒌汁二升，生羊脂三升（牛脂也可），好蜂蜜四升，黄连末一斤。
以上五味药捣合，在银锅中熬炼成膏状，可制成如梧桐子大小的丸药。用饮汁送服五丸，每日三次，逐渐加至十丸。如果因药性苦冷导致口渴未愈，则另服温性药物。忌食猪肉、芜荑。（《肘后备急方》相同）
又治疗口渴、小便频数散乱的方剂：
知母六分，栝蒌一斤，茯苓四分，铅丹一分，鸡内金十四枚。
以上五味药研为散剂，用饮汁送服一方寸匕，每日三次。禁酒、生菜、肉类。痊愈后去掉铅丹，用蜂蜜调和，以麦饮送服，长期服用不要间断，效果良好。忌食醋制品。（《肘后备急方》相同）
[Etiology] The condition known as "Qiangzhong" (Strong Middle) is characterized by persistent erection of the penis without flaccidity and spontaneous emission of semen. This arises from taking the Five-Mineral Powder in youth, where the heat of the minerals remains lodged in the Kidneys, causing deficient-heat in the Lower Jiao. In one's vigorous youth, when Qi and Blood are abundant, they can restrain the mineral heat; however, with advancing age and depletion of Qi and Blood, Kidney deficiency fails to control the essence, leading to this condition. If the essence is exhausted, various diseases will arise. (Excerpted from Volume 5)
The *Qianjin Fang* states: Many people indulge their desires. During their prime, they fail to exercise caution or cherish their health, indulging in lust and excessive sexual activity. As they age, Kidney Qi becomes depleted and exhausted, giving rise to a hundred diseases. Furthermore, young people who lack prudence regarding sexual restraint often take mineral powders. Once the True Qi is exhausted, the mineral Qi stands alone, resulting only in consumption and wasting. Symptoms include dry and scorched lips and mouth, spontaneous leakage of semen, red and yellow urine, dry and hard stools, thirst accompanied by polyuria (drinking up to one *shi* per day), or thirst without polyuria, or no thirst but polyuria, where ingested food transforms directly into urine. All these are caused by unrestrained sexual activity. Additionally, in Qiangzhong disease, the penis remains persistently erect without flaccidity, and semen leaks spontaneously. After suffering from Xiao Ke (Wasting-Thirst), carbuncles and sores may develop, all due to the heat of the minerals. For such cases, it is appropriate to administer Zhushen Ji Tang (Pig Kidney Shepherd's Purse Decoction) to restrain the mineral heat in the Kidneys. Subsequently, taking Baiya Tong Wan (White Duck Detoxification Pill) will lead to recovery.
**Zhushen Ji Tang Formula:**
One Pig Kidney (remove fatty membrane), Soybeans (Shengdou, 1 *sheng*), Shepherd's Purse (Ji, 3 *liang*), Ginseng (Renshen, 2 *liang*), Spirit of Poria (Fushen, 2 *liang*), Magnetite (Cishi, 2 *liang*, crushed), Anemarrhena Root (Zhimu, 2 *liang*), Kudzu Root (Gegen, 2 *liang*), Scutellaria Root (Huangqin, 2 *liang)*, Trichosanthes Fruit (Gualou, 2 *liang)*, Licorice Root (Gancao, 2 *liang*, honey-fried), Gypsum (Shigao, 3 *liang*).
Chop the above twelve ingredients. Use fifteen *dou* of water. First decoct the pig kidney and soybeans until the liquid reduces to less than ten *dou*. Strain out the dregs. Add the remaining herbs and decoct again to obtain three *sheng* of liquid. Strain out the dregs. Divide into three warm doses. Drink when thirsty. If the heat is concentrated in the Lower Jiao, prepare a full dose consecutively. Stop administration as the pathological trend subsides. Avoid eating seaweed, Chinese cabbage (*Songcai*), and vinegar products.
Furthermore, ordinary people who feel thirsty in summer do so because Heart Fire is flourishing. Flourishing Heart Fire causes sweating; sweating leads to deficiency and dryness in the Kidneys, thus causing thirst and oliguria. In winter, without sweating, urination is frequent and copious. These are physiological signs of healthy individuals, termed "Kidney Thirst." However, if urination is free-flowing without drinking water, it is termed "Kidney Excess." The Classics state: "When the Kidney is in excess, there is consumption." Consumption manifests as no thirst but polyuria. Therefore, for those taking mineral powders, if urination is free-flowing, it is because the nature of the minerals returns to the Kidney. When the Kidney receives the minerals, it becomes excess. Excess allows for the digestion of fluids, hence polyuria. Excessive urination fails to moisten and nourish the Zang-Fu organs. As the organs decline, various diseases arise. Zhang Zhongjing said: "If heat binds in the Middle Jiao, it forms firm heat; if heat binds in the Lower Jiao, it causes hematuria and also leads to strangury and urinary retention." It is clear that not everyone taking minerals necessarily experiences free-flowing urination; this is indeed true. Those with internal heat tend to feel thirsty; clearing the heat stops the thirst. If thirst is accompanied by deficiency, one must clear the heat while simultaneously tonifying deficiency for recovery.
Another formula for treating mountain miasma in Lingnan, combined with wind-heat toxic qi invading the Kidneys, transforming into alternating chills and fever, weak legs, abdominal distension, and thirst:
Coptis Rhizome (Huanglian, amount unlimited), Fresh Trichosanthes Root (Gualougen, juice), Fresh Rehmannia Root (Shengdihuang, juice), Sheep Milk (Yangru; if unavailable, cow's milk or human milk is acceptable).
Take the juices of the three plant materials and mix them with sheep milk and Coptis powder. Roll into pills the size of wu-tzu seeds. Administer thirty pills with Mai Yin (wheat drink), gradually increasing to forty or fifty pills. Take three times daily. Mild cases resolve in three days; severe cases in five days. If the bitter taste is difficult to swallow, boiling wheat drink can be used for administration.
Wen Zhong stated that Huanglian Wan (Coptis Pill) is also known as Yangru Wan. The *Zhouhou Fang* agrees; avoid pork and coriander.
Another formula for treating Xiao Ke (Wasting-Thirst): Fuping Wan (Duckweed Pill).
Floating Duckweed (Fuping), Trichosanthes Root (Gualougen) in equal parts.
Pulverize and sieve the two ingredients. Mix with human milk to form pills the size of wu-tzu seeds. Administer twenty pills with wheat drink, three times daily. A three-year illness resolves in three days. (The *Zhouhou Fang* and Wen Zhong agree; excellent for treating severe deficient-heat).
Another formula for treating sallow complexion, dry throat, yellowing of hands and feet, shortness of breath, pulse resembling linked pearls, which clears heat, stops thirst, promotes urination, and tonifies: Buyang Dihuang Wan (Nourishing Rehmannia Pill).
Fresh Rehmannia Juice (Shengdihuangzhi, 2 *sheng*), Fresh Trichosanthes Juice (ShengGualouzhi, 2 *sheng*), Fresh Mutton Fat (Shengyangzhi, 3 *sheng*; beef fat is acceptable), Fine Honey (4 *sheng*), Coptis Powder (Huanglianmo, 1 *jin*).
Mash and combine the five ingredients. Simmer in a silver pot until it becomes a paste. Form into pills the size of wu-tzu seeds. Administer five pills with fluid drink, three times daily, gradually increasing to ten pills. If cold-induced thirst persists, administer warming medicines separately. Avoid pork and coriander. (Agrees with *Zhouhou Fang*).
Another formula for treating thirst and frequent, scattered urination:
Anemarrhena Root (Zhimu, 6 fen), Trichosanthes Fruit (Gualou, 1 *jin*), Poria (Fuling, 4 fen), Lead Monoxide (Qiandan, 1 fen), Chicken Gizzard Lining (Jineijin, 14 pieces).
Pulverize the five ingredients into a powder. Administer one *cunbi* (square-inch scoop) with fluid drink, three times daily. Abstain from alcohol, raw vegetables, and meat. After recovery, remove the lead monoxide, mix with honey, and administer with wheat drink. Long-term continuous use is effective. Avoid vinegar products. (Agrees with *Zhouhou Fang*).