淋病有五。一曰热淋(血淋)。二曰寒淋(膏淋)。三曰气淋。四曰劳淋。五曰石淋。五淋之中。小儿有所
患者。惟寒热气之三证外。劳石二证。虚极所致。小儿未亲色欲,故无患者。内石淋恐儿本怯肾弱者有之。亦
千人中无一矣。今并具五淋之证于下。
热淋者。因热乘小肠膀胱二经。皆主水。水入小肠。传于膀胱。行于水道。出于阴中。而为小便也。故阴为
水液之路。膀胱为津液之府。热则水道燥爆。水液行涩。致水道不利。小便淋沥。因名曰淋。其候出少而起数。
小腹急痛。引脐连茎中痛也。热甚者溺血,故亦曰血淋。血得热则流散。渗入于胞,随淋溺而下也。
寒淋者。因寒冷干于二经而作。其候先寒战而后溺之。是邪气与正气交争也。寒气胜则发寒战。正气胜则寒
战解而得溺。溺则出少涩滞。小腹连茎中而痛。寒甚者溺白如稀膏。故亦曰膏淋。亦如痢下热则便血。寒则便脓
也。痢下者寒热搏于大肠也。今淋者寒热搏于小肠也。
气淋者。小儿因怒而啼。气入二经。留滞不散。邪正相搏。胞内气胀。其候每溺则脐下憋膨。水道涩不能
下。茎中相引而痛。常有余沥也。
劳淋者。因房事过度。肾虚精竭。气通于阴。水道干涩之所为也。肾与膀胱为表里。今肾虚精竭。则膀胱亦
虚。不能约制其水。故水液频数而下。水道干燥。则不能通利。其候尿留茎内。数起不出。引小肠连茎而痛也。
石淋者。小者为沙。大者为石。皆云肾主水。水为热结。化而为石。其言虽近。而不知其本也。且肾有
二脏。左者为肾。右为命门。主水而为壬。圣济经云。壬者一水一石之谓欤。不知一水一石之道语。未达生化之
妙。本太一精真在上。兆于水。立于石。是肾中本有真之物也。患者乃真精化而真物出焉。其候沙石从水道中
出。塞痛闷绝。故痊者鲜矣。
琥珀丸
治热淋疼痛。
琥珀(半两研) 乳香(半两研) 桃胶(半两研)
上拌研匀。糊为丸绿豆大。每服一二十丸。煎萱草汤下。
又方 治如前。以黄芩二两。绢袋贮之。用水二升。煮取一升。时时服。
蒲黄散
治血淋涩痛。
蒲黄(半两) 冬葵子(半两) 生地黄(半两)
上为细末。每服一钱。水一盏。煎至六分。去滓温服。无时。
又方 治如前。以雄鸡屎尖白如粉者。炒微黄研细末。酒糊丸。绿豆大。酒下三五丸。日连连四五服。取效。
玉粉丹
治寒淋膏淋如神。又治下痢。牡蛎粉四两研。干姜末二两炮。拌匀。面糊为丸麻子大。每服一二十丸。
米饮送下。无时。
二胶散
治气淋。小肠憋膨不通。桃胶李胶等分为末。每服半钱。葱白汤调下。无时。
又方 治气淋。以蚕蜕纸烧灰研细。每服半钱或一钱。煎去心麦门冬汤调下。无时。
又方 治如前。以马兜铃炒焦黄。为细末。每服半钱或一钱。麝香酒调下。温酒亦得。无时。
葵子散
治沙石淋。痛不可忍。
冬葵子(一两) 石南叶 榆白皮(去末锉) 石苇(去毛) 木通(锉各一两)
上为细末。每服半钱。葱白汤调下。一方只煮冬葵子汁服。
二石散
治如前。
滑石 石苇(去毛各一两 一方更有栝蒌根一两)
上为末。每服半钱。煎大麦汤清调下。无大麦。米饮亦得。
治小儿淋闭 露蜂房乱发灰等分为末。每服一钱。水调服之。日二。
又方 治如前。冬葵子一两。杵粗散。每服一钱。水一小盏。煎至五分,去滓温服。无时。
又方 以衣中白鱼摩脐下。及小腹。
又方 治如前。经效小儿诸淋。
治小儿遗尿。
瞿麦穗 龙胆草(去芦) 皂荚(去皮弦) 桂心(各半两) 人参(去芦一两) 鸡肠草(一两) 车前
子(一两炒一分) 石苇(去毛半两)
上同为末。炼蜜和丸小豆大。每服五丸。食分,日三。
又方 以小豆叶捣汁服之。以鸡肠烧灰研末。浆水调服一钱。日三。
淋病共有五种。第一种叫热淋(即血淋)。第二种叫寒淋(即膏淋)。第三种叫气淋。第四种叫劳淋。第五种叫石淋。在五种淋证中,小儿患病的,除了寒、热、气这三种证候外,劳淋和石淋这两种证候,是由于极度虚弱所致。小儿未曾有过房事,所以没有患劳淋的。至于石淋,恐怕只有那些先天体质怯弱、肾脏虚弱的儿童才会有,但也千中无一了。现在将五种淋证的证候一并列述如下:
热淋,是因为热邪侵袭小肠和膀胱两条经脉,这两条经脉都主管水液。水进入小肠后,传导至膀胱,沿水道运行,从尿道排出体外,从而形成小便。因此,尿道是水液通行的道路,膀胱是津液汇聚的府库。如果有热邪,水道就会变得燥热爆裂,水液运行涩滞,导致水道不通利,小便淋漓不尽,因此称为“淋”。其症状表现为尿量少且排尿次数频繁,小腹部拘急疼痛,疼痛牵引至肚脐并牵连到阴茎内部。热邪严重时会出现尿血,所以也称为血淋。血液遇到热邪就会流散,渗入胞宫(此处指下焦血室),随着淋沥的小便一起排出。
寒淋,是因为寒冷之邪干扰这两条经脉而发作。其症状是先出现寒战,然后才能排尿,这是邪气与正气相互交争的表现。寒气胜则发生寒战;正气胜则寒战解除并能排尿。排尿时尿量少且涩滞不畅,小腹牵连阴茎内部疼痛。寒邪严重时,尿液白色如稀薄的膏脂,所以也称为膏淋。这就像痢疾一样,热邪盛则大便带血,寒邪盛则大便排脓。痢疾是寒热邪气搏结于大肠,而现在的淋证是寒热邪气搏结于小肠。
气淋,是因为小儿因愤怒而啼哭,气机逆乱进入这两条经脉,停留阻滞不能消散,邪气与正气相搏结,导致胞内气机胀满。其症状是每次排尿时脐下憋胀膨隆,水道涩滞无法下行,阴茎内部相互牵引疼痛,常有余沥不尽的感觉。
劳淋,是因为房事过度,导致肾虚精竭,气机通于阴部,水道干枯涩滞所致。肾与膀胱互为表里,现在肾虚精竭,则膀胱也随之虚弱,不能约束控制水液,所以水液频数而下。水道干燥,就不能通利。其症状是尿液滞留于阴茎内,多次起夜却尿不出来,疼痛牵引小肠并牵连阴茎。
石淋,小的称为沙,大的称为石。都说肾主水,水被热邪凝结,化而为石。这种说法虽然接近事实,但不知其根本原因。况且肾有两脏,左边的是肾,右边的是命门,主管水液并对应天干中的壬。《圣济经》说:“壬者,是一水一石的意思吗?”不知道这一水一石的道理,未能通达生化变化的奥妙。其实,太一真精在上,兆始于水,确立于石,这是肾中本有的真元之物。患者则是真精转化而真物排出。其症状是沙石从水道中排出,堵塞引起剧烈疼痛甚至昏厥,所以痊愈的人很少。
琥珀丸
治疗热淋引起的疼痛。
琥珀(半两,研细) 乳香(半两,研细) 桃胶(半两,研细)
以上药物拌合研匀,用面糊制成如绿豆大小的丸药。每次服用一二十丸,用萱草汤煎送服。
又一方,治疗同上。用黄芩二两,装入绢袋中,用水二升,煮取一升药液,时时服用。
蒲黄散
治疗血淋引起的涩痛。
蒲黄(半两) 冬葵子(半两) 生地黄(半两)
以上药物研为细末。每次服用一钱,用水一盏,煎至六分,去渣温服,不拘时候。
又一方,治疗同上。用雄鸡屎尖部白如粉的部分,炒至微黄后研成细末,用酒糊制成如绿豆大小的丸药。每次服用三五丸,用酒送下,每天连续服用四五次,以见效为度。
玉粉丹
治疗寒淋、膏淋效果神奇,又治疗下痢。牡蛎粉四两研细,干姜末二两炮制过,拌匀后用面糊制成如麻子大小的丸药。每次服用一二十丸,用米饮送下,不拘时候。
二胶散
治疗气淋,缓解小肠憋胀不通。桃胶和李胶等分为末。每次服用半钱,用葱白汤调下,不拘时候。
又一方,治疗气淋。用蚕蜕纸烧成灰研细。每次服用半钱或一钱,用煎好的去心麦门冬汤调下,不拘时候。
又一方,治疗同上。用马兜铃炒至焦黄,研成细末。每次服用半钱或一钱,用麝香酒调下,温酒也可以,不拘时候。
葵子散
治疗沙石淋,疼痛难以忍受。
冬葵子(一两) 石南叶 榆白皮(去掉末端锉碎) 石苇(去掉毛) 木通(锉碎,各一两)
以上药物研为细末。每次服用半钱,用葱白汤调下。另一方法只煮冬葵子汁服用。
二石散
治疗同上。
滑石 石苇(去掉毛,各一两,另一方法还有栝蒌根一两)
以上药物研为细末。每次服用半钱,用大麦汤清调下。如果没有大麦,用米饮也可以。
治疗小儿淋闭症。露蜂房和乱发灰等分为末。每次服用一钱,用水调服,每天两次。
又一方,治疗同上。用冬葵子一两,捣成粗散。每次服用一钱,用水一小盏,煎至五分,去渣温服,不拘时候。
又一方,用衣中白鱼摩擦脐下及小腹部。
又一方,治疗同上。此方对治疗小儿各种淋证有特效。
治疗小儿遗尿。
瞿麦穗 龙胆草(去掉芦头) 皂荚(去掉皮和弦) 桂心(各半两) 人参(去掉芦头一两) 鸡肠草(一两) 车前子(一两,炒一分) 石苇(去掉毛半两)
以上药物共同研为细末,用炼蜜调和制成如小豆大小的丸药。每次服用五丸,在饭时服用,每天三次。
Lumbago (Lin syndrome) encompasses five types. The first is called Heat Lin (Blood Lin). The second is Cold Lin (Gao Lin). The third is Qi Lin. The fourth is Labor Lin. The fifth is Stone Lin. Among the five types of Lin, children are prone to the Cold, Heat, and Qi syndromes. The Labor Lin and Stone Lin syndromes are caused by extreme deficiency. Since children have not engaged in sexual activity, they do not suffer from Labor Lin. As for Stone Lin, it may occur only in those with innate frailty and weak Kidneys, but this is extremely rare, perhaps one in a thousand. The manifestations of all five types of Lin are detailed below.
Heat Lin arises when heat pathogens invade the Small Intestine and Bladder meridians, both of which govern water metabolism. Water enters the Small Intestine, transmits to the Bladder, travels through the water pathways, and exits via the urethra as urine. Thus, the urethra serves as the pathway for fluid passage, and the Bladder is the reservoir for body fluids. When heat is present, the water pathways become dry and irritated, causing fluid flow to be sluggish and obstructed, resulting in dribbling urination, hence termed "Lin." Symptoms include scanty urine output with frequent voiding, urgency and pain in the lower abdomen radiating to the umbilicus and penis. If heat is severe, hematuria occurs, thus it is also called Blood Lin. Blood exposed to heat scatters and infiltrates the bladder/pelvic cavity, discharging along with the dribbling urine.
Cold Lin results from cold pathogens interfering with these two meridians. Its hallmark is chills preceding urination, indicating a struggle between pathogenic factors and healthy Qi. When cold dominates, chills occur; when healthy Qi prevails, chills subside and urination becomes possible. Urination is scanty and obstructed, with pain in the lower abdomen radiating to the penis. In cases of severe cold, the urine appears white and viscous like thin paste, hence also called Gao Lin. This parallels dysentery: heat causes bloody stools, while cold causes purulent stools. Dysentery involves the binding of cold and heat in the Large Intestine, whereas Lin syndrome involves their binding in the Small Intestine.
Qi Lin occurs when children cry out of anger, causing Qi to reverse and enter these meridians, where it stagnates and fails to disperse. Pathogenic and healthy Qi clash, leading to abdominal distension within the pelvic cavity. Symptoms include a feeling of fullness and bloating below the umbilicus during urination, obstruction in the water pathways preventing smooth flow, pulling pain in the penis, and often post-void dribbling.
Labor Lin is caused by excessive sexual activity leading to Kidney deficiency and essence depletion. Qi connects to the genital region, causing the water pathways to become dry and sluggish. The Kidney and Bladder are exterior-interior paired organs; thus, Kidney deficiency leads to Bladder deficiency, impairing its ability to control water retention. Consequently, urine flows frequently. Dryness of the water pathways prevents free flow. Symptoms include urine retention within the penis, frequent urges without voiding, and pain radiating from the Small Intestine to the penis.
Stone Lin refers to small particles as sand and larger ones as stones. It is commonly said that the Kidney governs water, and when water is bound by heat, it transforms into stones. While this view is close to reality, it misses the root cause. There are two aspects of the Kidney: the left is the Kidney proper, and the right is the Mingmen (Gate of Life), governing water and corresponding to the Heavenly Stem Ren. The *Shengji Jing* asks: "Does Ren imply one water and one stone?" This understanding fails to grasp the subtleties of generation and transformation. Fundamentally, the Supreme One's true essence resides above, manifesting in water and establishing itself in stone; this is the true substance inherent in the Kidney. Patients expel this true substance transformed from their true essence. Symptoms involve sand or stones passing through the water pathways, causing blockage, severe pain, and even fainting; recovery is rare.
Hupo Wan (Amber Pill)
Treats pain due to Heat Lin.
Hupo (Amber, 15g, ground) Xurong (Olibanum, 15g, ground) Taojiao (Peach Gum, 15g, ground)
Mix and grind uniformly. Form pills the size of mung beans using wheat paste. Take 10–20 pills per dose, administered with decoction of Hemerocallis citrina (Daylily).
Another prescription, treating as above: Use Huangqin (Scutellariae Radix, 60g) stored in a silk bag. Boil in 400ml water until reduced to 200ml. Take frequently throughout the day.
Puhuang San (Pollen Typhae Powder)
Treats painful and obstructive Blood Lin.
Puhuang (Pollen Typhae, 15g) Dongkuizi (Fructus Abutilonis, 15g) Shengdihuang (Radix Rehmanniae Recens, 15g)
Grind into fine powder. Take 3g per dose with 200ml water, decoct until reduced to approximately 120ml. Strain and take warm. No specific timing required.
Another prescription, treating as above: Use the tip of male chicken droppings that is white and powdery. Stir-fry until slightly yellow, then grind into fine powder. Form pills the size of mung beans using wine paste. Take 3–5 pills per dose with wine. Administer 4–5 times daily continuously until efficacy is achieved.
Yufen Dan (Jade Powder Pill)
Effectively treats Cold Lin and Gao Lin; also treats dysentery. Mo Li Fen (Concha Ostreae Powder, 120g, ground) Ganjiang Wei (Rhizoma Zingiberis Preparatum, 60g, processed) Mix evenly. Form pills the size of hemp seeds using wheat paste. Take 10–20 pills per dose with rice water. No specific timing required.
Erjiao San (Two Gums Powder)
Treats Qi Lin, relieving Small Intestine distension and obstruction. Taojiao (Peach Gum) and Lijiao (Plum Gum) in equal parts, ground into powder. Take 1.5g per dose mixed with Scallion White Decoction. No specific timing required.
Another prescription, treating Qi Lin: Burn Can Tuizhi (Silkworm Cast Skin) to ash and grind finely. Take 1.5g or 3g per dose mixed with decoction of Maimendong (Radix Ophiopogonis) with hearts removed. No specific timing required.
Another prescription, treating as above: Chao Jiao Huang Mai (Fried Aristolochiae Fructus, scorched yellow), ground into fine powder. Take 1.5g or 3g per dose mixed with Moschus Wine. Warm wine is acceptable. No specific timing required.
Kuizi San (Abutilon Seed Powder)
Treats Sand/Stone Lin with unbearable pain.
Dongkuizi (Fructus Abutilonis, 30g) Shinanye (Folium Nandinae) Yupibai Pi (Cortex Ulmi Campestres, outer layer removed and cut) Shiwei (Folium Pyri) Mutong (Caulis Akebiae, cut, each 30g)
Grind into fine powder. Take 1.5g per dose mixed with Scallion White Decoction. Alternatively, decoct Dongkuizi alone and drink the juice.
Ersan San (Two Stones Powder)
Treats as above.
Huashi (Talcum) Shiwei (Folium Pyri, de-haired, each 30g; another version adds Gualou Gen (Radix Trichosanthis), 30g)
Grind into powder. Take 1.5g per dose mixed with clear Barley Decoction. If barley is unavailable, Rice Water may be used.
Treatment for Pediatric Lin Obstruction:
Lu Feng Fang (Nidus Vespae) and Luan Fa Hui (Ash of Disordered Hair) in equal parts, ground into powder. Take 3g per dose mixed with water. Twice daily.
Another prescription, treating as above: Dongkuizi (Fructus Abutilonis, 30g), crushed into coarse powder. Take 3g per dose with 50ml water, decoct until reduced to 25ml. Strain and take warm. No specific timing required.
Another prescription: Rub Yizhong Baiyu (Thysanoura inermis/Clothes Moth Larvae) on the lower abdomen around the umbilicus and the hypogastric region.
Another prescription, treating as above: This formula is highly effective for various pediatric Lin syndromes.
Treatment for Pediatric Enuresis:
Qumai Sui (Spica Lygodii) Longdan Cao (Radix Gentianae, rhizome removed) Zao Jiao (Fructus Gleditsiae Sinensis, skin and thorns removed) Guixin (Cortex Cinnamomi, each 15g) Renshen (Radix Ginseng, rhizome removed, 30g) Jichangcao (Herba Siegesbeckiae Orientalis, 30g) Cheqianzi (Semen Plantaginis, 30g, stir-fried with 3g salt) Shiwei (Folium Pyri, de-haired, 15g)
Grind all ingredients into powder. Bind with refined honey to form pills the size of adzuki beans. Take 5 pills per dose at meal times, three times daily.
Another prescription: Drink juice extracted from Adzuki Bean Leaves. Or, burn Jichang (Intestinum Galli) to ash, grind into powder, and take 3g mixed with Fermented Grain Water (Jiangshui). Three times daily.