原病式云淋小便涩痛也热客膀胱郁结不能渗泄故也巢氏病源曰诸淋皆肾虚所致肾与膀胱
为表
里至水下入小肠通行胞行于阴而为溲肾气通于阴下流之道也淋有五名曰膏曰冷曰热曰血曰石
膏淋者见小便有肥脂似膏而浮于小便之上此肾虚不能制水其肥液而下行也冷淋者必先战栗而
后小便此亦肾虚而下焦受冷冷气入胞与正气交争故小便涩而战栗也热淋者是下焦有热热气传
于肾流入于胞其溺黄多而涩间有鲜血同来者也血淋者乃热之极也心者血之主外行经络内行脏
腑热盛则失其常道心与小肠为表里故下流而渗入于胞则为血也石淋者肾主水水结则化为石盖
肾为热所乘遇小便则茎中痛不得流利痛引小腹则砂石从小便出甚至寒痛令人昏闷遍身有汗而
后醒此痛之使然五淋虽曰肾虚所致然小肠为受盛之腑气通于膀胱膀胱为津液之腑气通于胃余
化下流而不通皆曰肾气不足热入膀胱水道涩而不利出入起数脐腹急痛蕴作有时或似豆汁膏血
并以局方五淋散下龙脑鸡苏丸自然平愈及香芎丸补肾地黄丸与之疏导补益为上
曾氏曰婴儿小便闭而不通者有阴阳二证阴闭者为冷湿乘虚入里因而不通名曰阴闭以白芍
药汤
加南木香及用炒盐以绢帕兜令带热熨脐四围并投五苓散入灵砂末温盐汤空心调服其效尤速阳
闭者因暴热所逼涩而不通名曰阳闭又有癃闭与淋不同内经宣明五气篇曰膀胱不利为癃盖癃者
乃五内气虚受热壅滞宣化不行非涩非痛但闭不通腹胀紧满并以 咀五苓散加车前子灯心之类
及投木通散玉露饮益元散皆可用之或贴姜豉饼于脐上取效不拘阴阳二证悉能疗之并与万安饮
尤妙
《原病式》记载：淋证是指小便涩滞且疼痛。这是因为热邪客居于膀胱，郁结阻滞，导致水液无法正常渗泄所致。巢元方在《诸病源候论》中说：各种淋证都是由于肾虚引起的。肾与膀胱互为表里关系。当水液下入小肠，通过胞宫，运行于阴部而成为尿液时，肾气通达于阴部，向下流注的通道即是如此。
膏淋的表现是小便中有类似脂肪膏样的物质浮在小便表面，这是肾虚不能制约水液，导致肥腻之液下行所致。
冷淋发作前必定先出现战栗发抖，随后才排尿。这也是因为肾虚，下焦受寒，寒气侵入胞宫，与正气相互交争，所以小便涩滞并伴有战栗。
热淋是因为下焦有热，热气传导至肾脏，流入胞宫，导致尿液颜色黄赤且涩滞，偶尔会有鲜血一同排出。
血淋是热邪极盛的结果。心主血脉，外行于经络，内行于脏腑。热盛则血液失去正常的运行轨道。心与小肠互为表里，所以热邪下流渗入胞宫，就形成了血淋。
石淋是因为肾主水，水液凝结则化为石头。大概是因为肾被热邪所乘，遇到小便时尿道中疼痛，无法流利排出，疼痛牵引小腹，砂石随小便排出。甚至会出现寒战剧痛使人昏闷，全身出汗后才苏醒，这是疼痛导致的。
虽然五淋都说源于肾虚，但小肠是受盛之腑，气通于膀胱；膀胱是津液之腑，气通于胃。其余化生之物下流而不通畅，都称为肾气不足。热邪进入膀胱，水道涩滞而不通利，出现尿频尿急、脐腹急痛等症状，有时发作，或尿液像豆汁、膏血一样浑浊。治疗可用局方五淋散，配合龙脑鸡苏丸，自然平复痊愈；或者用香芎丸、补肾地黄丸进行疏导和补益，以补益为上策。
曾氏说：婴儿小便闭塞不通的，有阴阳两种证型。阴闭是由于冷湿乘虚侵入体内，因而导致不通，名叫阴闭。可以用白芍药汤加入南木香，并用炒热的盐装在绢帕里，趁热熨烫脐周四周，同时服用五苓散，加入灵砂末，用温盐水空腹调服，效果尤其迅速。阳闭是由于暴热逼迫，导致涩滞不通，名叫阳闭。又有癃闭与淋证不同，《内经·宣明五气篇》说：膀胱不利叫做癃。所谓癃，是五脏之气虚弱，受热邪壅滞，宣发气化功能不行，既不是涩也不是痛，只是闭塞不通，腹胀紧满。治疗可用切碎的五苓散，加入车前子、灯心草之类，以及服用木通散、玉露饮、益元散都可以使用。或者将姜豉饼贴在脐上取效。不论阴阳二证，都能治疗，再配合万安饮，尤为奇妙。
The *Yuan Bing Shi* (Treatise on the Original Nature of Diseases) states: Lin syndrome (stranguria, characterized by painful and difficult urination) refers to urine that is astringent and painful. This occurs because heat pathogens lodge in the Bladder, causing stagnation and preventing normal seepage and excretion. Chao Yuan-fang in the *Zhu Bing Yuan Hou Lun* (Source Book of All Categories of Disease) says: All types of Lin syndrome are caused by Kidney deficiency. The Kidney and the Bladder have an interior-exterior relationship. When water enters the Small Intestine, passes through the Paom (urinary bladder/uterus region), circulates via the Yin organs to become urine, the Kidney Qi connects to the Yin organs, and the downward flow channel is thus established.
There are five named types of Lin: Gao Lin (paste stranguria), Leng Lin (cold stranguria), Re Lin (heat stranguria), Xue Lin (blood stranguria), and Shi Lin (stone stranguria).
Gao Lin manifests as fat-like paste floating on the surface of the urine; this is due to Kidney deficiency failing to control water, allowing fatty fluids to descend.
Leng Lin is preceded by shivering and chills before urination occurs. This is also due to Kidney deficiency with cold invading the Lower Jiao; cold qi enters the Paom and contends with healthy Qi, resulting in astringent urination accompanied by chills.
Re Lin arises from heat in the Lower Jiao; heat transmits to the Kidney, flows into the Paom, causing yellow, scanty, and astringent urine, occasionally mixed with fresh blood.
Xue Lin represents the extreme of heat. The Heart governs Blood, circulating externally in the meridians and internally in the Zang-Fu organs. When heat is excessive, blood loses its normal pathway. Since the Heart and Small Intestine have an interior-exterior relationship, heat flows downward and infiltrates the Paom, resulting in blood stranguria.
Shi Lin occurs because the Kidney governs water; when water coagulates, it transforms into stones. Generally, when the Kidney is attacked by heat, urination causes pain in the glans penis, preventing smooth flow. Pain radiates to the lower abdomen, and sand/stones are passed in the urine. Severe cases may involve cold-induced severe pain leading to fainting and confusion, followed by waking after profuse sweating throughout the body; this is caused by the pain itself.
Although the five types of Lin are said to stem from Kidney deficiency, the Small Intestine is the organ of reception and storage, connecting Qi to the Bladder; the Bladder is the organ of fluid metabolism, connecting Qi to the Stomach. If other transformed substances fail to flow downward smoothly, it is termed insufficient Kidney Qi. Heat entering the Bladder causes the water passages to become astringent and obstructed, leading to frequent and urgent urination, acute pain in the umbilical and abdominal regions, intermittent onset, or turbid urine resembling bean juice, paste, or blood. Treatment may employ Ju Fang Wu Lin San (Local Formula Five-Lin Powder), combined with Long Nao Ji Su Wan (Borneol Chicken-Su Pill) for natural resolution. Alternatively, Xiang Xiong Wan (Atractylodes and Ligusticum Pill) or Bu Shen Di Huang Wan (Kidney-Nourishing Rehmannia Pill) can be used for guidance and tonification, prioritizing tonification.
Zeng Shi stated: Infants suffering from urinary retention have two syndromes: Yin obstruction and Yang obstruction. Yin obstruction occurs when cold-dampness invades the interior due to deficiency, causing blockage, named Yin Bi. It can be treated with Bai Shao Yao Tang (White Peony Decoction) added with Nan Mu Xiang (Southern Costus Root), and applying hot fried salt wrapped in silk cloth to warm-moxibustion around the navel, while administering Wu Ling San (Five-Ingredient Powder with Poria) mixed with Ling Sha powder (Cinnabar and Sulfur preparation), taken with warm salt water on an empty stomach for rapid effect. Yang obstruction is caused by sudden heat forcing blockage, named Yang Bi. There is also Long Bi (difficulty in urination) which differs from Lin. The *Nei Jing · Xuan Ming Wu Qi Pian* (Inner Canon · Chapter on Five Qi Manifesting) states: Impaired function of the Bladder is called Long. Long refers to deficiency of Qi in the five internal organs, blocked by heat stagnation, failing to diffuse and transform. It is neither astringent nor painful, but simply closed and obstructed, with abdominal distension and tight fullness. Treatment involves finely chopped Wu Ling San added with Che Qian Zi (Plantago Seed) and Deng Xin Cao (Juncus Effusus), along with Mu Tong San (Akebia Powder), Yu Lu Yin (Jade Dew Drink), or Yi Yuan San (Benefit Origin Powder). Applying Jiang Chi Bing (Ginger and Fermented Soybean Cake) to the navel can also be effective. Regardless of Yin or Yang syndromes, all can be treated, and combining with Wan An Yin (Ten-Thousand Safety Drink) is particularly excellent.