淋病。小便滴沥涩痛。欲去不去。欲止不止是也。古人分为五种。石淋。下如沙石。膏
淋。下如膏脂。劳淋。从劳役而得。气淋。气滞不通。脐下闷痛。血淋。瘀血停蓄。茎中割
痛。皆为热结膀胱所致。而治者。却不重在膀胱。而重在三焦。经云。膀胱者。州都之官津
液藏焉。气化则能出矣。又云。三焦者。决渎之官。水道出焉。此数语。数百年来注家俱误。
不知津液为汗之源。膀胱气化。则能出汗故仲景发汗法。必取之太阳也水道为行水之道。三
焦得职。则小水通调。须知外出为膀胱之津液。下出为三焦之水道也。又有清心之法。以心
与小肠相表里也。又有清肝之法。以肝主疏泄也。又有补肾之法。以肾为司水之脏也。治三
焦与膀胱之正法。则用五淋散。清心滋肾。则用导赤散。清肝。则用龙胆泻肝汤之类。至于
癃闭症。小便点滴不通。甚则胀闷欲死。其病源亦同前症。而治法更进一步。有用八味丸。
倍桂附。蒸动肾气以开关者有用滋肾丸。滋阴以化阳者。有用补中益气汤。服后以手探吐者。
（如滴水之器。闭其上窍而倒悬之。点滴不能下也。去其上闭。则下窍通矣。）有用五淋散。
加入麻黄杏仁。以取微汗。（麻黄力猛。能通阳气于至阴之地。下肺气。主皮毛。配杏仁以
降气下达州都。导水必自高原之义也。）有用人参麻黄各一两。水煎服者。夏月不敢用麻黄
。有用紫苏防风杏仁各三钱水煎服温覆取微汗者。有用白菊花根捣烂。以生白酒冲和取汁温
饮者有用水母四两。 荠十四粒。水煎服者。有用皂角葱头王不留行各数两。煎汤一盆。令
病者坐浸其中。熏洗小腹下体。久之热气内达。壅滞自开而便通者。务宜审其脉症而施治。
不可执一。
脉宜浮大。忌细小。
五淋散。（五十通治五淋癃闭。）
加减法。气淋。加荆芥香附生麦芽。○血淋。加牛膝桃仁红花生地。入麝香少许。○石
淋。送下六一散三钱。○膏淋。合萆 厘清饮。○劳淋。合补中益气汤。○如过服金石药。
与老人阳已痿。思色以降其精。致精内败而为淋。加萆 石菖蒲菟丝子以导之。
六一散。（五十二石淋） 萆 厘清饮。（八十三膏淋） 导赤散。（四十九赤淋。） 龙
胆
泻肝汤。（九十七茎肿茎中痛甚宜之） 补中益气汤。（五气淋。） 六味丸（十四水虚。） 八
味丸。（十五冷淋。） 济生肾气丸。（一百零二扶阳以化阴。） 滋肾丸。（九十四滋阴以化
阳。） 四生丸（一百血淋。） 百合汤。（九十三气淋。）
淋病，表现为小便滴沥不尽、涩滞疼痛，想排却排不出，想止却止不住。古人将其分为五种类型：石淋，排出物如沙石；膏淋，排出物如膏脂；劳淋，因过度劳累而引发；气淋，因气机阻滞不通，导致脐下闷痛；血淋，因瘀血停滞蓄积，尿道中如刀割般疼痛。这些病症皆由热邪结聚于膀胱所致。然而治疗时，并不着重于膀胱，而是着重于三焦。《内经》记载：“膀胱者，州都之官，津液藏焉，气化则能出矣。”又说：“三焦者，决渎之官，水道出焉。”这几句话，数百年来注家都理解错误，不知道津液是汗液的源头，膀胱通过气化作用，能够化生汗液，所以张仲景的发汗法，必定取法于太阳经。水道是运行水液的通道，三焦功能正常，则小便通调。必须明白，向外排出的是膀胱的津液，向下排出的是三焦的水道。又有清心的方法，因为心与小肠相表里。又有清肝的方法，因为肝主疏泄。又有补肾的方法，因为肾是主管水液的脏腑。治疗三焦与膀胱的正法，使用五淋散；清心滋肾，使用导赤散；清肝，使用龙胆泻肝汤之类。至于癃闭症，小便点滴不通，甚至胀闷欲死，其病源与前症相同，但治疗方法更进一步。有用八味丸，加倍桂枝、附子，蒸动肾气以开通关窍的；有用滋肾丸，滋阴以化阳的；有用补中益气汤，服用后用手探喉催吐的。（这就像滴水之器，封闭上窍并倒悬，水滴无法流下。去掉上部的闭塞，下部窍道就通了。）有用五淋散加入麻黄、杏仁，以取得微汗。（麻黄药力猛烈，能通达阳气至阴之地，降肺气，主皮毛，配伍杏仁以降气下达至膀胱，符合“导水必自高原”的道理。）有用的人参、麻黄各一两，水煎服用的。夏季不敢用麻黄。有用紫苏、防风、杏仁各三钱，水煎服，温覆取微汗的。有用白菊花根捣烂，用生白酒冲和取汁温饮的。有用海螵蛸四两、荠菜十四粒，水煎服用的。有用皂角、葱头、王不留行各数两，煎汤一盆，让病人坐浸其中，熏洗小腹及下体，久而久之热气内达，壅滞自开而小便通畅的。务必仔细审查脉象症状而施治，不可固执一端。
脉象宜浮大，忌细小。
五淋散。（五十 通治五淋癃闭。）
加减法。气淋，加荆芥、香附、生麦芽。○血淋，加牛膝、桃仁、红花、生地，入麝香少许。○石淋，送服六一散三钱。○膏淋，合用萆薢分清饮。○劳淋，合用补中益气汤。○如过服金石类药物，以及老人阳气已痿废，思色欲以泄精，导致精液内败而成淋证，加萆薢、石菖蒲、菟丝子以引导之。
六一散。（五十二 石淋）
萆薢分清饮。（八十三 膏淋）
导赤散。（四十九 赤淋。）
龙胆泻肝汤。（九十七 茎肿，茎中痛甚宜之）
补中益气汤。（五 气淋。）
六味丸（十四 水虚。）
八味丸。（十五 冷淋。）
济生肾气丸。（一百零二 扶阳以化阴。）
滋肾丸。（九十四 滋阴以化阳。）
四生丸（一百 血淋。）
百合汤。（九十三 气淋。）
Lin syndrome (Strangury) is characterized by dribbling, astringent pain in urination, the desire to void but inability to do so, and the inability to stop once started. The ancients divided it into five types: Shilin (Stone Strangury), where excretions resemble sand or stones; Gaolin (Gelatinous Strangury), where excretions resemble gelatinous fat; Laolin (Labor-induced Strangury), arising from overexertion; Qilin (Qi Strangury), caused by Qi stagnation and blockage, resulting in stifling pain below the umbilicus; and Xuelin (Blood Strangury), caused by stasis of blood accumulating, with cutting pain in the urethra. All these conditions are caused by heat binding in the Bladder (Bladder). However, in treatment, emphasis is not placed on the Bladder, but rather on the Sanjiao (Triple Burner). The Classics state: "The Bladder is the official of the capital, storing fluids; when Qi transformation occurs, they can be expelled." It also says: "The Sanjiao is the official of irrigation, through which water passages flow." These few sentences have been misunderstood by commentators for hundreds of years. They did not realize that body fluids are the source of sweat; when the Bladder undergoes Qi transformation, it can produce sweat. Therefore, Zhang Zhongjing's method of inducing sweating must take its cue from the Taiyang (Greater Yang) channel. Water passages are the channels for conducting water; when the Sanjiao performs its duties, urine flows smoothly. One must understand that what exits outwardly is the fluid of the Bladder, while what exits downwardly is the water passage of the Sanjiao. There is also the method of clearing the Heart, because the Heart and Small Intestine are exterior-interior related. There is the method of clearing the Liver, because the Liver governs free flow and drainage. There is the method of tonifying the Kidney, because the Kidney is the organ responsible for managing water. For the standard treatment of the Sanjiao and Bladder, Wulin San (Five-Strangury Powder) is used. To clear the Heart and nourish the Kidney, Daochi San (Guide Out Redness Powder) is used. To clear the Liver, Longdan Xiegan Tang (Gentian Decoction to Drain the Liver) and similar formulas are used. As for Ongbi syndrome (Retention of Urine), where urine passes drop by drop or not at all, and even causes distension and stifling sensation as if dying, the pathological origin is the same as the aforementioned syndromes, but the treatment methods go a step further. Some use Bawei Wan (Eight-Ingredient Pill) with doubled Guizhi (Cinnamon Twig) and Fuzi (Aconite Root) to steam and activate Kidney Qi to open the orifices. Some use Zishen Wan (Kidney-Nourishing Pill) to nourish Yin and transform Yang. Some use Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi), followed by stimulating vomiting with fingers after ingestion. (This is like a vessel dripping water: if the upper orifice is closed and it is inverted, no drops fall. Removing the upper closure allows the lower orifice to open.) Some use Wulin San added with Mahuang (Ephedra Herb) and Xingren (Apricot Seed) to induce slight sweating. (Mahuang has potent force, capable of penetrating Yang Qi to the deepest Yin locations, descending Lung Qi, governing the skin and hair; paired with Xingren to descend Qi to the Bladder, following the principle that 'conducting water must start from high places.') Some use Renshen (Ginseng Root) and Mahuang each in one liang, decocted in water and taken orally. In summer months, Mahuang is not dared to be used. Some use Zisu (Perilla Leaf), Fangfeng (Saposhnikovia Root), and Xingren each in three qian, decocted in water and taken orally, covered warmly to induce slight sweating. Some use Baijuhua Gen (White Chrysanthemum Root) mashed, mixed with raw Baijiu (Chinese Liquor), taking the juice warm. Some use Haipiaoxiao (Cuttlefish Bone) in four liang and Jicai (Shepherd's Purse) in fourteen grains, decocted in water and taken orally. Some use Zaojiao (Gleditsia Sinensis Fruit), Congtou (Scallion Bulb), and Wangbuliuxing (Vaccaria Seed) each in several liang, decocted in a basin of soup, allowing the patient to sit and soak therein, fumigating and washing the lower abdomen and genitalia. Over time, internal heat reaches, stagnation opens naturally, and urination resumes. Treatment must carefully examine pulse and symptoms before applying therapy; one must not adhere rigidly to a single approach.
The pulse should be floating and large; fine and small pulses are contraindicated.
Wulin San (Fifty: Universally treats Five Stranguries and Ongbi).
Modification rules. For Qilin, add Jingjie (Schizonepeta Spike), Xiangfu (Cyperus Rhizome), and Sheng Maiya (Raw Barley Sprout). ○ For Xuelin, add Niuxi (Achyranthes Root), Taoren (Peach Kernel), Honghua (Carthamus Flower), and Shengdi (Rehmannia Root), adding a small amount of Shexiang (Musk). ○ For Shilin, administer Liuyi San (Six-One Powder) in three qian with water. ○ For Gaolin, combine with Bixie Fenqing Yin (Dioscorea Hypoglauca Decoction to Separate Clear Turbid). ○ For Laolin, combine with Buzhong Yiqi Tang. ○ If excessive consumption of mineral drugs has occurred, or in elderly men whose Yang Qi is already atrophied, who indulge in sexual thoughts to ejaculate, causing essence to deteriorate internally leading to strangury, add Bixie (Dioscorea Hypoglauca Rhizome), Shichangpu (Acorus Rhizome), and Tusizi (Cuscuta Seed) to guide them out.
Liuyi San (Fifty-Two: Stone Strangury).
Bixie Fenqing Yin (Eighty-Three: Gelatinous Strangury).
Daochi San (Forty-Nine: Red Strangury).
Longdan Xiegan Tang (Ninety-Seven: Suitable for swelling of the penis and severe pain in the urethra).
Buzhong Yiqi Tang (Five: Qi Strangury).
Liuping Wan (Fourteen: Water Deficiency).
Bawei Wan (Fifteen: Cold Strangury).
Jisheng Shenqi Wan (One Hundred and Two: Supporting Yang to transform Yin).
Zishen Wan (Ninety-Four: Nourishing Yin to transform Yang).
Sisheng Wan (One Hundred: Blood Strangury).
Baihe Tang (Ninety-Three: Qi Strangury).