仁斋曰∶小儿尿白如米泔状，由乳哺失节，有伤于脾，致令清白不分而色白也，
久则成疳，此亦心膈伏热，兼而得之。《全婴方》云∶小便初出微赤，良久白浊者，
乃热疳之邪也。初出黄白，久白浊者，乃冷疳之候也。冷者，益黄散主之。热者，
牛黄丸主之。冷热者，芦荟丸主之。纯下白浊者，浓朴丸主之。诸失津液欲成疳而
小便白者，茯苓散主之。薛氏曰∶小便如泔，或良久变白，亦有脾虚食积，湿热
下注者，先用茯苓散五七服，次用四味肥儿丸。若乳食少思，或肚腹胀大，小便频
数，此脾虚元气下陷也，朝用五味异功散，夕用四味肥儿丸。若肥体色黄，小便不
调，发黄脱落，鼻下疮痍，嗜土少食，大便青褐者，用栀子茯苓汤。仍审其乳母饮
食七情，治之。一小儿发热懒食，小便良久变白。余用四味肥儿丸即愈。或误以
为积热，用清凉祛逐之剂，形体顿弱，虚证悉至，小便如疳，用补中益气汤及四味
肥儿丸而愈。一小儿面色痿黄，眼胞微肿，作渴腹胀，饮食少思，小便澄白，大
便不实。此脾疳之证也。用四君子加山栀、芜荑，兼用四味肥儿丸而愈。一小儿
白浊，两耳内、耳外生疮，脓水淋漓。用大芦荟丸而愈。后遍身如疥，肌体消瘦，
发热作渴，大便酸臭，小便白浊。用九味芦荟丸、五味异功散、而愈。一小儿白
浊，发热口干，体瘦骨立。余谓肾经虚羸，朝用补中益气汤，夕用六味地黄丸而愈。
后两目或生白翳，面黄浮肿，小便仍白。此变肝脾疳证，用四味肥儿丸、月余渐瘥。
益黄散（方见脾脏） 牛黄丸（方见疳积） 芦荟丸（方见疳）
君朴丸 治小儿小便白浊，久则黄瘦，不长肌肉。
使君子（煨，去壳） 浓朴（制） 黄连（各一两） 木香（三钱）
上为末，蒸饼糊丸，桐子大。每服一二十丸，米汤下。
茯苓散 治乳食伤脾，或心经伏热，小便白浊。
三棱（煨） 蓬莪术（煨） 砂仁 赤茯苓（各半两） 青皮 陈皮 滑石 甘草（各一钱半）
上为末。每服一钱，灯心汤、调下。
三棱散 治小儿尿白，久则成疳，宜补脾消食化积。
三棱（炒） 蓬莪术（炒。各一两） 益智仁 甘草 神曲（炒） 麦芽 橘皮（各半两）
上为末。每服一钱，白汤，点下。
清心莲子饮（见前）
又方 用大甘草头，煎汤服。
栀子茯苓汤即大芜荑汤（方见疳）
香砂丸 治婴孩小便白浊。
香附子（炒，一两） 缩砂（去壳，五钱） 三棱（煨） 蓬莪术（煨） 陈皮 麦 （炒）
芦荟（各五钱半）
上为极细末，煮面糊，丸如黍米大。用米饮、盐汤，食前服。
仁斋说：小儿尿液白色如同米泔水状，是由于哺乳喂养没有节制，损伤了脾胃，导致清浊不分而呈现白色。时间久了会形成疳积，这也是心膈间有伏热，兼夹此证所致。《全婴方》记载：小便刚排出时微红，过一会儿变白浑浊的，是热疳的邪气。刚排出时黄白，久后变白浑浊的，是冷疳的征候。属于冷疳的，用益黄散主治。属于热疳的，用牛黄丸主治。冷热夹杂的，用芦荟丸主治。纯下白浊的，用浓朴丸主治。各种因津液亏损欲成疳积且小便发白的，用茯苓散主治。
薛氏说：小便像米泔水一样，或者过一会儿变白，也有是因为脾虚食积，湿热下注造成的。先用茯苓散服用五到七次，接着用四味肥儿丸。如果乳食减少不想吃，或者肚腹胀大，小便频数，这是脾虚元气下陷的表现，早晨服用五味异功散，晚上服用四味肥儿丸。如果身体肥胖但面色发黄，小便不调，头发发黄脱落，鼻子下方生疮，嗜吃泥土且食欲减退，大便呈青褐色的，用栀子茯苓汤治疗。同时还要审察乳母的饮食和情绪变化，一并治疗。
有一个小儿发热、懒于进食，小便过一会儿变白。我用四味肥儿丸治愈。有人误以为是积热，使用清凉祛逐的药物，导致孩子形体顿时虚弱，虚证全部出现，小便如疳积状，后来用补中益气汤及四味肥儿丸才治愈。
有一个小儿面色萎黄，眼睑微肿，口渴腹胀，饮食少思，小便澄清色白，大便不成形。这是脾疳的证候。用四君子汤加上山栀、芜荑，同时服用四味肥儿丸而治愈。
有一个小儿白浊，两耳内、外生疮，脓水淋漓。用大芦荟丸治愈。后来遍身像疥疮，肌体消瘦，发热口渴，大便酸臭，小便白浊。用九味芦荟丸、五味异功散治愈。
有一个小儿白浊，发热口干，身体瘦弱骨立。我认为这是肾经虚羸，早晨服用补中益气汤，晚上服用六味地黄丸而治愈。后来两眼有时生白翳，面黄浮肿，小便仍然发白。这是转变为肝脾疳证，用四味肥儿丸，一个多月逐渐痊愈。
【方剂】
益黄散（方见脾脏） 牛黄丸（方见疳积） 芦荟丸（方见疳）
君朴丸 治疗小儿小便白浊，日久则身体黄瘦，不长肌肉。
使君子（煨，去壳） 浓朴（制） 黄连（各一两） 木香（三钱）
以上研为末，用蒸饼糊制作药丸，如梧桐子大。每次服用一二十丸，米汤送服。
茯苓散 治疗乳食伤脾，或心经伏热，小便白浊。
三棱（煨） 蓬莪术（煨） 砂仁 赤茯苓（各半两） 青皮 陈皮 滑石 甘草（各一钱半）
以上研为末。每次服用一钱，灯心草汤调下。
三棱散 治疗小儿尿白，日久则成疳，宜补脾消食化积。
三棱（炒） 蓬莪术（炒。各一两） 益智仁 甘草 神曲（炒） 麦芽 橘皮（各半两）
以上研为末。每次服用一钱，白开水点服。
香砂丸 治疗婴孩小便白浊。
香附子（炒，一两） 缩砂（去壳，五钱） 三棱（煨） 蓬莪术（煨） 陈皮 麦 （炒） 芦荟（各五钱半）
以上研为极细末，煮面糊，制成如黍米大的药丸。用米饮、盐汤，饭前服用。
Ren Zhai stated: When a child's urine is white like rice wash water, it is caused by irregular breastfeeding and feeding, which damages the Spleen and Stomach, leading to the failure of separating clear from turbid substances, resulting in white color. If prolonged, this may develop into *Gan* syndrome (chronic malnutrition syndrome in children). This condition is also attributed to latent heat in the Heart and Diaphragm, combined with this pathology. The *Quan Ying Fang* records: If urine is slightly reddish upon initial discharge but turns white and turbid after a while, it indicates the pathogenic factor of Heat *Gan*. If it is yellowish-white initially and becomes white and turbid later, it is a sign of Cold *Gan*. For Cold *Gan*, Yihuang San (Benefit Yellow Powder) is the primary treatment. For Heat *Gan*, Niuhuang Wan (Calculus Bovis Pill) is used. For mixed cold-heat conditions, Lushui Wan (Aloe Pill) is indicated. For pure white turbidity, Nongpo Wan (Magnolia Bark Pill) is prescribed. For various cases where body fluids are depleted, approaching *Gan* syndrome, with white urine, Fuling San (Poria Powder) is the main formula.
Xue Shi stated: Urine resembling rice wash water, or turning white after some time, can also result from Spleen deficiency with food stagnation and damp-heat pouring downward. Initially, administer Fuling San five to seven doses, followed by Simwei Fei'er Wan (Four-Ingredient Fat-Nourishing Pill). If there is poor appetite for milk and food, abdominal distension, and frequent urination, this indicates Spleen deficiency with sinking of Yuan Qi (Original Qi). In the morning, use Wuyi Yigong San (Five-Ingredient Extraordinary Merit Powder), and in the evening, Simwei Fei'er Wan. If the child is obese but has a sallow complexion, irregular urination, yellowing and loss of hair, sores under the nose, pica (craving earth), reduced food intake, and dark green-brown stools, Zhizi Fuling Tang (Gardenia and Poria Decoction) should be used. One must also examine the diet and emotional state of the nursing mother and treat accordingly.
One case involved a child with fever and reluctance to eat, whose urine turned white after a while. I cured him using Simwei Fei'er Wan. Another practitioner mistakenly diagnosed it as accumulated heat and used cooling purgatives, causing the child's physique to weaken instantly, with all deficiency symptoms appearing and urine resembling that of *Gan* syndrome. He was subsequently cured using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) combined with Simwei Fei'er Wan.
Another case presented with a sallow complexion, slightly swollen eyelids, thirst, abdominal distension, poor appetite, clear white urine, and loose stools. This was diagnosed as Pi Gan (Spleen *Gan*). It was cured using Sijunzi Tang (Four Gentlemen Decoction) supplemented with Zhizi (Gardeniae Fructus) and Wuyi (Meliae Semen), along with Simwei Fei'er Wan.
In another case, a child had white turbidity and sores inside and outside both ears with dripping pus. This was cured using Da Lushui Wan (Great Aloe Pill). Later, the child developed widespread scabies-like lesions, emaciation, fever, thirst, sour-smelling stools, and white turbid urine. This was cured using Jiwei Lushui Wan (Nine-Ingredient Aloe Pill) and Wuyi Yigong San.
In yet another case, a child suffered from white turbidity, fever, dry mouth, and extreme emaciation. I diagnosed this as deficiency and wasting of the Kidney Channel. The child was treated with Buzhong Yiqi Tang in the morning and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) in the evening, resulting in recovery. Subsequently, the child developed leukoma (white opacities on the cornea) occasionally, facial swelling, and persistent white urine. This transformed into Liver-Spleen *Gan* syndrome and was cured over a month using Simwei Fei'er Wan.
[Formulas]
Yihuang San (See Spleen Organ section); Niuhuang Wan (See Gan Accumulation section); Lushui Wan (See Gan section).
Junpu Wan: Treats pediatric white turbid urine; if prolonged, leads to sallow emaciation and failure to gain muscle mass.
Shijunzi (Roasted, shelled), Nongpo (Processed), Huanglian (each 1 liang), Muxiang (3 qian).
Grind into powder, make pills with steamed bread paste, size of wutong seeds. Take 10-20 pills per dose, washed down with rice soup.
Fuling San: Treats spleen injury from milk/food or latent heat in the Heart Channel, causing white turbid urine.
Sanleng (Roasted), Peng'ezhu (Roasted), Sharen, Chifuling (each 0.5 liang), Qingpi, Chenpi, Huashi, Gancao (each 1.5 qian).
Grind into powder. Take 1 qian per dose, mixed with Dengxincao (Juncus effusus) decoction.
Sanleng San: Treats pediatric white urine; if prolonged, leads to *Gan*. Suitable for tonifying the Spleen, resolving food stagnation, and transforming accumulation.
Sanleng (Stir-fried), Peng'ezhu (Stir-fried, each 1 liang), Yizhiren, Gancao, Shenqu (Stir-fried), Maiya, Jupi (each 0.5 liang).
Grind into powder. Take 1 qian per dose, taken with plain warm water.
Qingxin Lianzi Yin (See previous section).
Another prescription: Use large licorice roots, decoct in water and drink.
Zhizi Fuling Tang is identical to Dawuyi Tang (See Gan section).
Xiangsha Wan: Treats infantile white turbid urine.
Xiangfu (Stir-fried, 1 liang), Suosha (Shelled, 5 qian), Sanleng (Roasted), Peng'ezhu (Roasted), Chenpi, Mai (Stir-fried), Lushui (each 5.5 qian).
Grind into extremely fine powder, make pills with boiled wheat paste, size of millet grains. Take before meals with rice drink or salted water.