《原病式》云∶遗尿不禁者为冷。《内经》云∶不约为遗溺。仁斋曰∶小便者，
津液之余也，肾主水，膀胱为津液之府，肾与膀胱俱虚，而冷气乘之，故不能拘制
其水，出而不禁，谓之遗尿，睡里自出者，谓之尿床。此皆肾与膀胱俱虚，而挟冷
所致也，以鸡肠散主之。亦有热客于肾部，干于足厥阴之经，挺孔郁结极甚，而气
血不能宣通，则痿痹而神无所用，故液渗入膀胱，而旋溺遗失，不能收禁也。薛
氏用六味地黄丸。脾肺气虚者用补中益气汤加补骨脂、山茱萸。曾氏谓∶乃心肾
传送失度，小肠膀胱关键不能约束，有睡梦而遗者，皆是下元虚冷所致，亦因禀受
阳气不足，用《三因方》家韭子丸治之，及参苓白术散、补肾地黄丸，然又当实土
以存水，乃免渗泄之患，所谓补肾不如补脾，是也。平胃散倍加益智仁锉碎，姜枣
烧盐煎，空心温服。
鸡肠散
鸡肠（一具，男用雌鸡，女用雄鸡，烧、存性） 牡蛎 茯苓（去皮） 桑螵蛸（炒。各五钱）
桂（去粗皮） 龙肾（各二钱半）
上为极细末，仍以鸡 一具，鸡肠一具，烧存性，研极细末。每用前药末一
钱，用温酒调化，食前服。
〔张〕鸡肠散 治因膀胱有热，服冷药过多，小便不能禁止，或遗尿病。
鸡肠草 龙骨 麦门冬（去心，焙） 白茯苓 桑螵蛸（各半两） 牡蛎粉（七钱半）
上件药，捣为粗散。每服一钱，水一小盏，入生姜少许，枣二枚，煎至六分，
去滓，温服。量儿大小加减。
按∶此与前方，盖一方而传写之讹，窃详用鸡肠较是，而张氏、娄氏、薛氏、
皆主用草，今两存之。
益智丸 治脾肾虚热，心气不足，遗尿白浊。
益智仁 茯苓 茯神（各等分）
上为末，炼蜜丸，桐子大。每服五六十丸，空心、白滚汤下。
破故纸散 治膀胱虚冷，夜间遗尿，或小便不禁。用破故纸为末，每服一钱，热汤
调下。
又方 破故纸，炒为末，黄柏汤调下。
《外台》疗小儿睡中遗尿不自觉，桂末、雄鸡肝等分，捣，丸如小豆大。温水下，
日三服。
初虞世治小儿遗尿。薏苡仁一合，去心不去壳，敲碎，入盐一小撮，同炒黄色，
用水二钟，煎至半钟，空心服之。累效。
《三因》家韭子丸（方见杂病小便不禁）
《原病式》说：遗尿且不能控制的是因为寒证。《内经》说：约束无力导致的失禁称为遗溺。仁斋说：小便，是津液的剩余部分，肾主管水液，膀胱是津液储存的府库，肾与膀胱都虚弱，寒气趁机侵袭，所以不能制约水液，流出而不可控制，这叫做遗尿；在睡梦中自行流出的，叫做尿床。这些都是肾与膀胱俱虚，夹杂寒气所致，用鸡肠散主治。也有热邪客居于肾部，干扰足厥阴肝经，导致生殖器部位郁结阻滞极其严重，气血不能宣通，从而出现痿痹且神志功能无法运用，所以液体渗入膀胱，随即发生溺遗失禁，不能收摄控制。薛氏使用六味地黄丸。脾肺气虚者使用补中益气汤加补骨脂、山茱萸。曾氏认为：这是心肾传导失去节制，小肠和膀胱的关键部位不能约束，有在睡梦中遗尿的，都是下元虚冷所致，也由于禀受阳气不足，用《三因方》中的韭子丸治疗，以及参苓白术散、补肾地黄丸，然而又应当实土（健脾）以存水，以免发生渗泄的祸患，这就是所谓“补肾不如补脾”的道理。平胃散加倍加入益智仁锉碎，用生姜、大枣、烧盐煎煮，空腹温服。
鸡肠散
鸡肠（一具，男性用雌鸡，女性用雄鸡，烧制存性） 牡蛎 茯苓（去皮） 桑螵蛸（炒。各五钱）
桂枝（去粗皮） 龙骨（各二钱半）
以上药物研成极细末，仍然取鸡内脏一具、鸡肠一具，烧制存性，研成极细末。每次使用前药末一钱，用温酒调化，饭前服用。
〔张〕鸡肠散 治疗因膀胱有热，服用过多寒凉药物，小便不能禁止，或遗尿病。
鸡肠草 龙骨 麦门冬（去心，焙干） 白茯苓 桑螵蛸（各半两） 牡蛎粉（七钱半）
上述药物，捣成粗散。每次服用一钱，水一小盏，加入少许生姜，枣二枚，煎至六分，去除药渣，温服。根据患儿大小加减剂量。
按语：此方与前一方，大概是一方而在传抄中产生的讹误，仔细推敲使用鸡肠较为合理，而张氏、娄氏、薛氏，都主张使用鸡肠草，现在将两种情况并存保留。
益智丸 治疗脾肾虚热，心气不足，遗尿及白浊。
益智仁 茯苓 茯神（各等分）
以上研为末，炼蜜制成丸，如梧桐子大。每次服用五六十丸，空腹时，用白开水送服。
破故纸散 治疗膀胱虚冷，夜间遗尿，或小便不禁。用破故纸（补骨脂）研为末，每次服用一钱，用热汤调下。
又一方 破故纸，炒后研为末，用黄柏汤调下。
《外台秘要》治疗小儿睡中遗尿不知觉，桂末、雄鸡肝等分，捣烂，制成如小豆大的丸剂。温水送下，每日三次服用。
初虞世治疗小儿遗尿。薏苡仁一合，不去心也不去壳，敲碎，加入一小撮盐，同炒至黄色，用水二钟，煎至半钟，空腹服用。多次见效。
According to *Yuan Bing Shi* (Treatise on the Origins of Diseases): Enuresis with incontinence is caused by cold. *Nei Jing* (The Inner Canon) states: Incontinence resulting from lack of restraint is called "yi ni" (involuntary urination). Ren Zhai stated: Urine is the residue of body fluids. The Kidney governs water, and the Bladder is the mansion of body fluids. When both the Kidney and Bladder are deficient, and cold qi takes advantage of this, they cannot restrain the water, causing it to flow out uncontrollably; this is called enuresis. When it occurs spontaneously during sleep, it is called bedwetting. These conditions are all caused by deficiency of both the Kidney and Bladder accompanied by cold. They should be treated with Jichang San (Chicken Intestine Powder). There are also cases where heat pathogens lodge in the Kidney region, interfering with the Foot-Jueyin Liver Meridian, causing extreme stagnation and obstruction in the genital area. Consequently, Qi and Blood cannot circulate freely, leading to flaccidity and numbness where spiritual function is impaired. Thus, fluids seep into the Bladder, resulting in immediate loss of urine that cannot be retained. Xue Shi used Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). For those with deficiency of Spleen and Lung Qi, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was used with added Gubuzhi (Fructus Psoraleae) and Shanzhuyu (Fructus Corni). Zeng Shi argued: This is due to a loss of coordination in transmission between the Heart and Kidney, and the inability of the key gates of the Small Intestine and Bladder to maintain restraint. Cases of enuresis during dreams are all caused by deficiency and cold in the Lower Yuan (Lower Burner), as well as insufficient congenital Yang Qi. Treatment involves Jiuzi Wan (Leek Seed Pill) from *San Yin Fang*, or Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), and Bushen Dihuang Wan (Kidney-Tonifying Rehmannia Pill). However, one must also strengthen Earth (Spleen) to conserve Water, thereby avoiding the hazard of leakage. This aligns with the principle that "tonifying the Kidney is inferior to tonifying the Spleen." Pingwei San (Peace the Stomach Powder) with doubled Yizhiren (Fructus Alpiniae Oxyphyllae), crushed, decocted with fresh ginger, jujube, and roasted salt, should be taken warm on an empty stomach.
Jichang San (Chicken Intestine Powder)
Jichang (Chicken Intestine, one piece; males use hen intestines, females use rooster intestines, calcined to retain its nature) Muli (Ostreae Concha) Fuling (Poria) (peeled) Sangpiaoxiao (Cicada Slough) (fried. Each 5 qian)
Guizhi (Ramulus Cinnamomi) (bark removed) Longgu (Fossilia Ossis Mastodi et Scapulae) (Each 2.5 qian)
Grind the above medicines into an extremely fine powder. Still take one piece of chicken viscera and one piece of chicken intestine, calcine them to retain their nature, and grind into an extremely fine powder. Each time, take 1 qian of the aforementioned powder, dissolve it in warm wine, and take before meals.
[Zhang's] Jichang San Treats conditions where there is heat in the Bladder, excessive intake of cold medicines, inability to control urination, or enuresis.
Jichangcao (Herba Centipedae) Longgu (Fossilia Ossis Mastodi et Scapulae) Maidong (Radix Ophiopogonis) (heart removed, baked) Bai Fuling (Poria) (each half liang) Muli Fen (Concha Ostreae) (7.5 qian)
The above ingredients are pounded into a coarse powder. Take 1 qian per dose, with one small cup of water, add a little fresh ginger and two jujubes, decoct until reduced to 60%, strain, and take warm. Adjust dosage according to the child's age and size.
Note: This formula and the previous one are likely the same formula with errors introduced during transcription. Upon careful examination, using chicken intestines seems more appropriate, whereas Zhang Shi, Lou Shi, and Xue Shi all advocated using Jichangcao. Both versions are preserved here.
Yizhi Wan (Alpinia Pill) Treats deficiency-heat of the Spleen and Kidney, insufficiency of Heart Qi, enuresis, and leukorrhea/turbid urine.
Yizhiren (Fructus Alpiniae Oxyphyllae) Fuling (Poria) Fushen (Poria cum Radix) (Equal parts)
Grind into powder, make pills with refined honey, sized like paulownia seeds. Take 50-60 pills each time, on an empty stomach, washed down with plain boiled water.
Pogu Zhi San (Psoralea Powder) Treats deficiency-cold of the Bladder, nocturnal enuresis, or urinary incontinence. Use Poguzhi (Fructus Psoraleae) ground into powder, take 1 qian per dose, mixed with hot water.
Another prescription: Poguzhi, fried and ground into powder, mixed with Huangbai Tang (Phellodendron Decoction).
*Waitai Mi Yao* (Essential Prescriptions Worth a Thousand Gold for Emergencies) treats children who wet the bed during sleep without awareness. Gui Mo (Cinnamon Bark Powder) and Xiongji Gan (Male Chicken Liver) in equal parts, pounded together, made into pills the size of small beans. Take with warm water, three times a day.
Chu Yushi treated pediatric enuresis. Yiyiren (Semen Coicis) one he, do not remove the heart or shell, crush it, add a small pinch of salt, stir-fry until yellow. Add two zhong of water, decoct until half remains, take on an empty stomach. Repeatedly effective.
San Yin Fang family's Jiuzi Wan (Leek Seed Pill) (Formula see Miscellaneous Diseases: Urinary Incontinence)