窃闻春夏气行于外。故汗多而溺少。秋冬气收于内。故汗少而溺多。然有饮水同。饮之时又同。而壮者溺
少。老者溺多。何也。盖壮者如春夏之气。升多而降少。老者如秋冬之气。降多而升少。此其所以异也。知其
异。以诊其变。则诊其变。可知其病焉。诊法维何。闭癃者。三焦实。遗溺者。三焦虚。水泉不止者。胱膀不藏也。
得守则生。失守则死。小便不通者。膀胱不利也。头有汗则死。头无汗则生。外感小便清者。知不在里。仍在
表也。外感小便浊者。知其在里。不在表也。水液混浊。皆属于热。澄彻清冷。皆属于寒。溲便变者。中气不足。
小便数者。腑气有余。小便黄者。小腹中有热。小便白者。小腹中有寒。浊赤而短者。下焦实热。清白而长者。
下焦虚寒。溺如黄柏汁者。黄胆犹轻。溺如皂角汁者。黄胆已重。尿变米泔者食滞。溺如脂膏者肾消。溺如
血者血淋。溺如膏者膏淋。溺如沙石者石淋。溺有余沥者。气淋。病淋者。频欲小便。痛涩滴沥。欲去不去。欲
止不止也。白淫者。思想无穷。所愿不得。意淫于外。入房太甚也。是皆诊溺之法也。由是观之。遗闭者。虚实
之征也。清浊者。表里之征也。赤白者。寒热之征也。短长者。邪正之征也。遗闭清浊赤白短长交推。则虚实
表里寒热邪正之变可知。虚实表里寒热邪正交推。则遗闭清浊赤白短长之变可知。他如淋浊消疸诸
证。亦举此而措之耳。
我听说春夏季节，人体之气运行于体表外部。因此汗出多而小便少。秋冬季节，人体之气收敛于体内内部。因此汗出少而小便多。然而，有的人饮水相同，饮水的时间也相同，但身体强壮的人小便少，年老体弱的人小便多，这是为什么呢？大概是因为身体强壮的人如同春夏之气，升发多而肃降少；年老体弱的人如同秋冬之气，肃降多而升发少。这就是他们之间的差异所在。了解这种差异，从而诊断病情的变化，那么通过诊断其变化，就可以知道疾病的情况了。
诊察小便的方法是怎样的呢？小便闭塞不通（闭癃）的，是三焦实证；遗尿失禁的，是三焦虚证。尿液淋漓不尽的，是膀胱不能固藏。若能保持膀胱的固摄功能则生，失去固摄功能则死。小便不通畅的，是膀胱气化不利。头部有汗出的则预后不良（主死），头部无汗出的则预后良好（主生）。外感病中，小便清亮的，可知病邪不在里，仍在表；外感病中，小便浑浊的，可知病邪在里，不在表。水液混浊不清，都归属于热证；清澈寒冷，都归属于寒证。小便性状改变的，是中气不足；小便频数的，是腑气有余。小便黄色的，是小腹中有热；小便白色的，是小腹中有寒。小便浑浊色赤且量少短的，是下焦实热；小便清白且量多长的，是下焦虚寒。小便颜色像黄柏汁一样的，黄疸较轻；小便颜色像皂角汁一样的，黄疸已重。尿液变成米泔水样的，是食积停滞；小便像脂膏一样的，是肾消病；小便带血的，是血淋；小便如膏脂状的，是膏淋；小便中有沙石排出的，是石淋；小便后有余沥不尽的，是气淋。患淋证的病人，频繁想小便，排尿疼痛涩滞、点滴难出，想解解不出，想停停不住。白淫症，是由于思虑无穷，愿望不得实现，意念淫乱于外，加之房事过度所致。这些都是诊察小便的方法。
由此看来，遗尿与闭癃，是虚实变化的征象；小便清与浊，是表里变化的征象；小便赤与白，是寒热变化的征象；小便短与长，是邪正盛衰变化的征象。将遗闭、清浊、赤白、短长相互推究，就可以知道虚实、表里、寒热、邪正的病情变化；反之，将虚实、表里、寒热、邪正相互推究，也可以知道遗闭、清浊、赤白、短长的表现变化。其他如淋证、浊证、消渴、黄疸等各种证候，也是依据这些原则来类推应用的。
I have heard that in spring and summer, the Qi of the human body circulates externally on the surface. Therefore, there is profuse sweating and scanty urine. In autumn and winter, the Qi of the human body retracts internally. Therefore, there is little sweating and abundant urine. However, some individuals drink the same amount of water at the same time, yet those who are vigorous produce less urine, while the elderly produce more urine. Why is this? It is because the vigorous resemble the Qi of spring and summer, with more ascending and less descending; whereas the elderly resemble the Qi of autumn and winter, with more descending and less ascending. This is the source of their difference. By understanding these differences to diagnose pathological changes, one can thereby determine the disease state through diagnosing these variations.
What are the methods for diagnosing urine? Urinary retention (Bi Long) indicates a Excess syndrome of the San Jiao (Triple Burner); urinary incontinence indicates a Deficiency syndrome of the San Jiao (Triple Burner). Continuous dribbling of urine indicates that the Bladder fails to store. If storage control is maintained, life is preserved; if lost, death ensues. Obstruction of urination indicates dysfunction of the Bladder Qi transformation. Head sweating indicates a fatal prognosis; absence of head sweating indicates a favorable prognosis. In external contraction diseases, clear urine indicates that the pathogen is not in the interior but remains in the Exterior. Turbid urine in external contraction diseases indicates that the pathogen is in the interior, not in the Exterior. Turbid fluids all belong to Heat syndromes; clear and cold fluids all belong to Cold syndromes. Changes in urine characteristics indicate insufficiency of Middle Qi; frequent urination indicates excess of Fu-organ Qi. Yellow urine indicates Heat in the lower abdomen; white urine indicates Cold in the lower abdomen. Turbid, red, and short urine indicates Excess-Heat in the Lower Jiao; clear, white, and long urine indicates Deficiency-Cold in the Lower Jiao. Urine resembling the juice of Phellodendron bark indicates mild Jaundice; urine resembling soap pod juice indicates severe Jaundice. Urine resembling rice-washing water indicates food stagnation; urine resembling fat or paste indicates Kidney Xiao (Kidney Wasting-Thirst); bloody urine indicates Blood Lin (Painful Urination Syndrome); pasty urine indicates Gao Lin (Chyluria); sandy/stony urine indicates Shi Lin (Stony Urination Syndrome); post-void dribbling indicates Qi Lin (Qi Urination Syndrome). Patients suffering from Lin syndromes experience frequent urgency to urinate, painful and obstructive dribbling, feeling the need to void but unable to do so, and inability to stop the flow. Bai Yin (White Impurity) arises from endless rumination, unfulfilled desires, mental lust directed outward, and excessive sexual intercourse. These are all methods for diagnosing urine.
From this perspective, incontinence and retention are signs of Deficiency and Excess; clarity and turbidity are signs of Exterior and Interior; redness and whiteness are signs of Heat and Cold; shortness and length are signs of Pathogenic factors and Healthy Qi. Cross-analyzing retention/retention, clarity/turbidity, redness/whiteness, and shortness/length allows one to understand the variations in Deficiency/Excess, Exterior/Interior, Heat/Cold, and Pathogen/Healthy Qi. Conversely, cross-analyzing Deficiency/Excess, Exterior/Interior, Heat/Cold, and Pathogen/Healthy Qi allows one to understand the manifestations of retention/retention, clarity/turbidity, redness/whiteness, and shortness/length. Other conditions such as Lin syndromes, turbid urine, Xiao (Wasting-Thirst), and Dan (Jaundice) are also deduced by applying these principles.