〔大〕妇人小便数者,由肾与膀胱俱主于水,肾气通于阴,此二经俱虚而有热乘之,
则小便涩,虚则小便频数也。
〔薛〕前证若肝经火动,用逍遥散(调经。)加龙胆草、车前子。膀胱火动,六味丸(杂病虚
劳。)加麦门、五味。肝肾湿热,龙胆泻肝汤。(见便毒。)郁伤肝脾,加味逍遥散、加味归脾汤。
肝脾肺气虚,补中益气汤(杂病劳倦。)加麦门、五味。肝经血虚,加味逍遥散。肾气虚败,鹿
茸散。如不应,用八味丸。一妇人患前证,小便频数,日晡热甚,此肝脾血虚气滞而兼
湿热也,用加味逍遥散加车前子而愈。一妇人患前证,发热烦躁,面目赤色,脉洪大
而虚,余谓此血虚发躁,用当归补血汤(杂病劳倦。)数剂而痊。一妇人久患前证,泥属于火,
杂用寒凉止血之剂,虚证悉具。余曰∶此脾胃亏损而诸经病也,当补中气为主。遂以六
君、补中二汤,兼服两月余,寻愈。
〔大〕鹿茸散 治妇人久虚冷,小便日夜三五十行。
鹿茸 乌贼鱼骨 桑寄生 龙骨(各一两) 白芍药 当归 附子(各七钱半) 桑螵蛸(半两)
上为细末,食前温酒调下二钱。
桑螵蛸散 治妇人虚冷,小便数。
桑螵蛸(三十枚,炒) 鹿茸 牡蛎粉(二两) 甘草(二两) 黄 (半两)
上为细末,食前姜汤调一钱服。
补遗缩泉丸 治脬气不足,小便频数。
天台乌药 益智仁(各等分)
上为末,酒煮山药为糊,丸如梧子大,临睡盐酒吞七十丸。或只为末,调酒服,如不
饮酒,以米饮调下。
又法 取糯米 一片,临睡炙令软熟啖之,仍以温酒吞,不饮酒,只汤下,多啖愈
佳,行坐良久,待心空则睡,最验。
【大论】妇女小便频数,是因为肾与膀胱都主管水液代谢。肾气通过阴部相通,这两条经脉如果都虚弱,又有热邪侵袭,就会导致小便涩滞;若以虚为主,则出现小便频数的症状。
【薛己按语】上述病症,如果是肝经火旺扰动,使用逍遥散(用于调经)加龙胆草、车前子。如果是膀胱火旺扰动,使用六味丸(用于杂病虚劳)加麦冬、五味子。如果是肝肾湿热,使用龙胆泻肝汤。(见于便毒章节)。如果是情志郁结损伤肝脾,使用加味逍遥散、加味归脾汤。如果是肝脾肺气虚,使用补中益气汤(用于杂病劳倦)加麦冬、五味子。如果是肝经血虚,使用加味逍遥散。如果是肾气虚衰,使用鹿茸散。如果无效,使用八味丸。有一位妇人患上述病症,小便频数,傍晚时发热严重,这是肝脾血虚气滞兼有湿热所致,使用加味逍遥散加车前子而痊愈。另一位妇人患上述病症,发热烦躁,面目发红,脉象洪大而虚,我认为这是血虚导致的烦躁,使用当归补血汤(用于杂病劳倦)服用数剂后康复。还有一位妇人长期患上述病症,固执地认为属于火证,乱用寒凉止血药物,导致虚证全部显现。我说:这是脾胃亏损导致各经病变,应当以补益中气为主。于是同时服用六君子汤、补中益气汤两个方剂,连续服用两个多月,不久痊愈。
【大论】鹿茸散 治疗妇人久病体虚寒冷,白天黑夜小便三五十次。
鹿茸 乌贼鱼骨 桑寄生 龙骨(各一两) 白芍药 当归 附子(各七钱半) 桑螵蛸(半两)
以上药材研成细末,饭前用温酒调服二钱。
桑螵蛸散 治疗妇人虚冷,小便频数。
桑螵蛸(三十枚,炒制) 鹿茸 牡蛎粉(二两) 甘草(二两) 黄芪(半两)
以上药材研成细末,饭前用姜汤调服一钱。
补遗缩泉丸 治疗膀胱气不足,小便频数。
天台乌药 益智仁(各等分)
以上药材研成粉末,用酒煮山药制成糊状,做成梧桐子大小的丸药,临睡前用盐水送服七十丸。或者只研成粉末,用酒调服,如果不饮酒,用米汤送服。
又一种方法 取糯米一片,临睡前烤至软熟吃下,仍用温酒吞服,不饮酒的只用汤水送服,多吃效果更好,活动行走坐卧片刻,等到心里感觉空虚饥饿时再睡觉,效果最显著。
[Da Lun] Frequent urination in women occurs because both the Kidney and the Bladder govern water metabolism. Kidney Qi connects with the yin organs; if these two meridians are both deficient and invaded by heat, it leads to difficult and scanty urination (Xiaobian Se); if deficiency predominates, it results in frequent urination (Xiaobian Pinshu).
[Xue Ji's Commentary] For the aforementioned symptoms: If Liver Meridian fire is agitated, use Xiaoyao San (Free and Easy Wanderer Powder) [for regulating menstruation] added with Longdan Cao (Gentian Root) and Cheqianzi (Plantago Seed). If Bladder fire is agitated, use Liuwei Wan (Six-Ingredient Rehmannia Pill) [for miscellaneous diseases and deficiency exhaustion] added with Maimen Dong (Ophiopogon Tuber) and Wuweizi (Schisandra Fruit). If there is damp-heat in the Liver and Kidney, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction). [See section on "Bi Du" / Carbuncles]. If emotional stagnation injures the Liver and Spleen, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) or Jiawei Guipi Tang (Modified Restore the Spleen Decoction). If there is Qi deficiency of the Liver, Spleen, and Lung, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) [for miscellaneous diseases due to fatigue and overwork] added with Maimen Dong and Wuweizi. If there is Blood deficiency of the Liver Meridian, use Jiawei Xiaoyao San. If Kidney Qi is severely deficient and failing, use Lurong San (Deer Antler Powder). If there is no improvement, use Bawei Wan (Eight-Ingredient Pill).
Case 1: A woman suffered from the aforementioned symptoms, with frequent urination and severe fever in the late afternoon. This was due to Liver and Spleen Blood deficiency, Qi stagnation, combined with damp-heat. She was cured using Jiawei Xiaoyao San added with Cheqianzi.
Case 2: A woman suffered from the aforementioned symptoms, presenting with fever, restlessness, redness of the face and eyes, and a pulse that was flooding yet empty. I diagnosed this as irritability caused by Blood deficiency. She recovered after taking several doses of Danggui Buxue Tang (Angelica Tonify the Blood Decoction) [for miscellaneous diseases due to fatigue and overwork].
Case 3: A woman had long suffered from the aforementioned symptoms. Adhering rigidly to the theory that it was a Fire syndrome, she indiscriminately used cold-natured hemostatic agents, resulting in the manifestation of all deficiency symptoms. I stated: "This is damage to the Spleen and Stomach leading to disorders in various meridians; the primary treatment should be tonifying Middle Qi." Consequently, she took Liujun Zi Tang (Six-Gentlemen Decoction) and Buzhong Yiqi Tang concurrently for over two months, and was soon cured.
[Da Lun] Lurong San (Deer Antler Powder) treats chronic deficiency-cold in women, with urination occurring thirty to fifty times day and night.
Lurong (Cervi Cornus Pantotrichum), Wuzheiyugu (Sepia Ecripus), Sangjisheng (Taxilli Herba), Longgu (Fossilia Ossis Mastodi et Scapulae) (each 1 liang); Baishaoyao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix), Fuzi (Aconiti Lateralis Radix Praeparata) (each 7 qian 5 fen); Sangpiaoxiao (Ovi Mantidis Oötheca) (0.5 liang).
Grind into fine powder. Take 2 qian before meals, mixed with warm wine.
Sangpiaoxiao San (Mantis Egg-case Powder) treats deficiency-cold in women, causing frequent urination.
Sangpiaoxiao (Ovi Mantidis Oötheca) (30 pieces, stir-fried), Lurong (Cervi Cornus Pantotrichum), Muli Fen (Concha Ostreae) (2 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (2 liang), Huangqi (Astragali Radix) (0.5 liang).
Grind into fine powder. Take 1 qian before meals, mixed with ginger decoction.
Supplementary Suoquan Wan (Lock the Urine Pill) treats insufficient Qi of the Pao (Bladder), causing frequent urination.
Tiantai Weiyao (Stellariae Radix), Yizhiren (Alpiniae Oxyphyllae Semen) (equal parts).
Grind into powder. Boil Shanyao (Dioscoreae Rhizoma) in wine to make a paste, form pills the size of wutong seeds. Swallow 70 pills before sleep with salted wine. Alternatively, take as powder mixed with wine. If unable to drink alcohol, mix with rice water.
Another method: Take one piece of Nuomi (Glutinous Rice). Before sleep, roast until soft and cooked, then eat it. Swallow with warm wine; if not drinking alcohol, swallow with water. Consuming more is better. Walk or sit for a while until feeling an empty sensation in the heart/stomach, then sleep. This is highly effective.