治肾气不足，膀胱有热，水道不通，淋沥砂石，痛不可忍，或出鲜血，并皆治
通草（二两，切作片，以糯米饮拌，日中晒干） 白芍药 石苇（去毛） 蒲黄（炒）
桂心（以上各一两） 王不留行 滑石（各半两） 葵子（一两半） 甘遂（三钱）
上为细末，每服三钱，食前用沸汤调服。
治小便淋沥，茎中痛不可忍，相引胁下痛。
人参（五分） 茯苓（去皮，四钱） 琥珀 当归梢 柴胡 泽泻（以上各三分） 玄
胡索（
上 咀，作一服，长流水三盏，煎至一盏，去滓，食前温服，数服大效。中统三年六
月中，黄明之小便淋沥，茎中痛不可忍，相引胁下痛，制以参苓琥珀散治之。
中书右丞相合剌合孙，病小便数而欠，昼夜约二十余行，脐腹胀满，腰脚沉疰，不得
安卧。至元癸未季春一日，奉劝治之，遂往诊脉，得沉缓，时时带数。尝记小便不利有三，
不可一概而论。津液偏渗于肠胃，大便泄泻而小便涩少者一也，宜分利而已；热搏下焦，随
湿而不行者二也，必渗泄而愈；脾胃气涩，不能通调水道，下输膀胱者三也，可顺气令施化
而出。右丞公平素膏粱，湿热内蓄，不得施化，膀胱窍涩，是以起数而见少也，非渗泄分利
，则不能快利。遂处一方，名曰茯苓琥珀汤，《内经》曰∶甘缓而淡渗热搏，津液内蓄，脐
腹胀满，当须缓之泄之，必以甘淡为主，是以茯苓为君；滑石甘寒，滑以利窍涩，猪苓琥珀
之淡以渗泄，以利水道，故以三味为臣；脾恶湿，湿气内蓄，则脾气不治，益脾胜湿，必以
甘为助，故以甘草白术为佐；咸入肾，咸味下泄为阴，泽泻之咸，以泄伏水，肾恶燥，急食
辛以润之，津液不行，以辛散之桂枝，味辛散湿以润燥，此为因用，故以二味为使。煎长流
甘烂水，使不助其肾气，大作汤剂，令直达于下而急速也，两服减半，旬日良愈。
治疗肾气不足，膀胱有热，导致水道不通，排尿时滴沥不尽并伴有砂石排出，疼痛难以忍受，或者尿出鲜血，这些症状均可用此方治疗。
通草（二两，切成片，用糯米水拌湿，在太阳下晒干） 白芍药 石苇（去除绒毛） 蒲黄（炒制）
桂心（以上各一两） 王不留行 滑石（各半两） 葵子（一两半） 甘遂（三钱）
将上述药材研成细末，每次服用三钱，饭前用沸水冲服。
治疗小便滴沥不尽，尿道中疼痛难以忍受，疼痛牵引至胁下部位。
人参（五分） 茯苓（去皮，四钱） 琥珀 当归梢 柴胡 泽泻（以上各三分） 玄胡索（缺重量，原文此处似有脱漏，依文意推断为适量或与前文同量，但严格按原文提取实体，此处仅列名）
将药材切碎，作为一剂服用，用长流水三盏，煎煮至一盏，去渣，饭前温服，服用数次后效果显著。中统三年六月，黄明之患小便滴沥不尽，尿道中疼痛难以忍受，疼痛牵引至胁下，医生用参苓琥珀散治疗他。
中书右丞相合剌合孙，患病表现为小便频数且伴有哈欠，白天黑夜大约二十多次，脐部和小腹胀满，腰部和腿部沉重困倦，无法安卧。至元癸未年季春的一天，受劝请去诊治，诊脉发现脉象沉缓，时常带有数脉。曾记得小便不利有三种情况，不能一概而论。津液偏渗于肠胃，大便泄泻而小便涩少，这是一类，适宜用分利的方法；热邪搏结于下焦，随湿气阻滞而不运行，这是第二类，必须通过渗泄才能痊愈；脾胃之气涩滞，不能通调水道，向下输注到膀胱，这是第三类，可以通过顺气使其气化而出。右丞相平素饮食肥甘厚味，湿热内蕴，不能正常气化，膀胱窍道涩滞，所以起夜频繁且尿量少，如果不是用渗泄和分利的方法，就不能畅快利尿。于是开出一个方子，名叫茯苓琥珀汤，《内经》说：甘味能缓和，淡味能渗泄，热邪搏结，津液内蓄，导致脐腹胀满，应当用缓和和渗泄的方法，必须以甘淡为主，所以用茯苓作为君药；滑石味甘性寒，滑利以通窍涩，猪苓、琥珀的淡味以渗泄，来通利水道，所以用这三味药作为臣药；脾恶湿，湿气内蕴，则脾气不运，补益脾气胜除湿气，必须以甘味为辅助，所以用甘草、白术作为佐药；咸味入肾，咸味下行属阴，泽泻的咸味，以泄伏留之水，肾恶燥，急食辛味以润之，津液不行，用辛味发散，桂枝味辛，能散湿以润燥，这是因势利导的作用，所以用这两味药作为使药。用长流的甘烂水煎煮，以免助长肾气，制成大剂量的汤剂，使药力直达下部并迅速发挥作用，服用两剂后症状减半，十天痊愈。
Treats insufficient Kidney Qi, heat in the Bladder, obstruction of the water passages, dribbling urination with sandstones, unbearable pain, or passage of fresh blood; all these conditions are treated by this formula.
Tongcao (2 liang, sliced, moistened with rice water, dried in the sun) Baishao Yao (Radix Paeoniae Alba) Shiwei (Herba Pyrosiae, de-haired) Puhuang (Caulis Pollen Typhae, stir-fried)
Guixin (Cortex Cinnamomi, each 1 liang above) Wangbuliuxing (Semen Viscariae) Huashi (each half liang) Kuizi (Semen Malvae, 1.5 liang) Gansui (Radix Euphorbiae Kansui, 3 qian)
Grind the above herbs into a fine powder. Take 3 qian per dose, mixed with boiling water before meals.
Treats dribbling urination, unbearable pain in the urethra, radiating to the hypochondrium.
Renshen (Radix Ginseng, 5 fen) Fuling (Poria, peeled, 4 qian) Hupo (Fossilized Wood) Danggui Shao (Radix Angelicae Sinensis, caudex part) Chaihu (Radix Bupleuri) Zexie (Rhizoma Alismatis, each 3 fen above) Xuanhusuo (Rhizoma Corydalis)
Cut the herbs into small pieces, as one dose. Decoct with 3 bowls of running water until reduced to 1 bowl. Strain and take warm before meals. Several doses yield great effect. In the sixth month of Zhongtong Year 3, Huang Mingzhi suffered from dribbling urination, unbearable pain in the urethra radiating to the hypochondrium. He was treated with Shenling Hupo San (Ginseng and Poria Amber Powder).
Heila Hesun, Right Chancellor of the Secretariat, suffered from frequent urination accompanied by yawning, occurring about twenty times day and night. His umbilical and abdominal region was distended and full, his waist and legs felt heavy and dragging, and he could not lie down comfortably. On a day in the late spring of Guiwei Year of Zhiyuan, upon request, I went to diagnose him. The pulse was deep and slow, occasionally rapid. I recall that there are three types of difficult urination, which cannot be generalized. First, when body fluids leak abnormally into the intestines and stomach, causing diarrhea and scanty, obstructed urination; this requires diuresis and separation of turbid fluids. Second, when heat binds in the Lower Jiao, obstructed by dampness and failing to circulate; this must be cured by渗泄 (osmotic drainage/diuresis). Third, when Spleen and Stomach Qi is stagnant, unable to regulate water passages and transport downwards to the Bladder; this can be resolved by promoting Qi movement to facilitate transformation and excretion. The Chancellor usually consumes rich and greasy foods, leading to internal accumulation of damp-heat, failure of transformation, and stenosis of the Bladder orifice, hence frequent but scanty urination. Without osmotic drainage and diuresis, relief cannot be achieved. Thus, a formula named Fuling Hupo Tang (Poria and Amber Decoction) was prescribed. As stated in *Neijing*: "Sweet flavors relax and bland flavors drain; when heat binds and body fluids accumulate internally causing abdominal distension, one must relax and drain it, primarily using sweet and bland substances." Therefore, Fuling (Poria) is used as the Sovereign herb; Huashi (Talcum) is sweet and cold, slippery to unblock orifices; Zhu Ling (Polyporus) and Hupo (Fossilized Wood) are bland to drain and promote water passages, so these three are used as Ministers; the Spleen dislikes dampness; internal dampness hinders Spleen Qi; to tonify the Spleen and overcome dampness, sweet substances are necessary as assistants, so Gancao (Radix Glycyrrhizae) and Baizhu (Rhizoma Atractylodis Macrocephalae) are used as Auxiliaries; salty flavors enter the Kidney; salty flavors descend and belong to Yin; Zexie's (Rhizoma Alismatis) salty flavor drains retained water; the Kidney dislikes dryness, so pungent flavors should be eaten urgently to moisten it; when body fluids fail to circulate, use pungent flavors to disperse them; Guizhi (Ramulus Cinnamomi) is pungent, disperses dampness to moisten dryness, utilizing this mechanism, so these two are used as Envoys. Decoct with long-flowing, bitter-decayed water (Ganlan Shui) to avoid assisting Kidney Qi. Prepare a large decoction to ensure the medicine reaches the lower body rapidly. After two doses, symptoms halved; within ten days, full recovery was achieved.