（见大小腑门本证。）
痛者为血淋。不痛者为尿血。血淋别见后大小腑门。淋闭证。尿血。先与生料五苓散。
和四
物汤。若服药不效。其人素病于色者。此属虚证。宜五苓散和胶艾汤。吞鹿茸丸。或附子八
味丸。或辰砂妙香散。加五苓散。吞二项丸子。若小便自清。后有数点血者。五苓散加赤芍
药一钱。亦有如砂石。色红。却无石淋之痛亦属虚证。宜五苓散和胶艾汤。或五苓散和辰砂
妙香散。吞鹿茸丸。八味丸。玉茎肿痛。其证不一。有通身水气。 茎俱肿者。此当求之诸
气门、水肿气证。以治水之法。肾风痒。抓搔过伤以致肿疼此当求之疮毒门 风证。 风愈
则肿自消。有妒精蚀疮。用干疮之药太紧。毒瓦斯未散。蕴结成肿。有服金石秘涩之剂。精气
壅遏。不能宣扬。或试紧炉之方。取一时之快。不知热毒反着自身。俱能为肿。有血气凝滞
阴间窍道闭塞。致使茎肿。近俗戏名吹大。或缘忍溺而得。下三证。并宜灯心汤。调五
苓散。服饵以涤其内。荆芥甘草木通。煎汤淋洗。以宣其外。
淋痛。五淋者。血石气膏劳是也。血淋。溺中有血。石淋。溺中有砂石之状。其溺于盆
也有
声。此即是精气结成砂石以溺俱出气淋。气郁所致。小腹有若膀胱气之状。膏淋。溺与精混
或沉在漩。下如糊状。或浮在漩。上如脂膏状。劳淋病在多色。下元虚惫。清浊不分。肾
气不行。郁结而为淋。或劳心过度。火不得其养。小肠为心之腑。脏病而腑与俱病。或心肾
不交。肾之不温。津道闭塞。或出汗大过。或失血太多。津道欲枯竭。皆成劳淋五者得名。
而不及热与冷。何哉。盖五者。皆有冷有热。血有热血。有瘀血。气有热气。有冷气。劳有
虚冷。有虚热。若与汤药过差。精不由其道妄行。不禁与溺俱出。此乃热剂之伤。未可概以
为冷也。
治淋之法。除的然虚冷之外。其余诸证。若用本题药不效。便宜施以调气之剂。盖津道
之逆
顺皆一气之通塞为之也。如木香流气饮。却为的当。其中自有木通麦门冬腹皮辈。比如不效
但宜投以益血之方盖小便者。血之余也。血苟充满。则滋腴下润。自然流通。如火府丹
自
却为的当。其中有地黄辈。然此非特言血淋气淋。一应淋。皆可用。独不可用之虚冷耳。淋
病。小便之色。多是见赤。未可便以赤为热。气道蕴结。故如此尔。
便血不止者。用松杨柿一个。烧存性。研末。米饮调下即愈。
（参见大小腑门本证。）
疼痛的是血淋。不疼痛的是尿血。血淋另见后文大小腑门。对于淋闭证、尿血，先用生料五苓散，配合四物汤服用。如果服药无效，且患者平素因房事过度而致病，这属于虚证。适宜用五苓散配合胶艾汤，吞服鹿茸丸；或者附子八味丸；或者辰砂妙香散，配合五苓散，同时吞服上述两种丸药。如果小便原本清澈，随后出现几点血迹，在五苓散中加入一钱赤芍药。也有排出物像砂石一样，颜色发红，却没有石淋的疼痛，这也属于虚证。适宜用五苓散配合胶艾汤，或者五苓散配合辰砂妙香散，吞服鹿茸丸、八味丸。
阴茎肿痛，其病症不一。有的全身水肿，阴茎也肿胀，这种情况应当从诸气门、水肿气证方面寻求病因，采用治疗水气的方法。肾风瘙痒，抓挠过度导致肿痛，这种情况应当从疮毒门的风证方面寻求病因，风邪治愈则肿胀自然消退。有妒精蚀疮，使用治疗干疮的药物过于猛烈，毒气未散，蕴结形成肿胀；有服用金石类秘涩的药物，精气壅滞，不能宣发；或者尝试紧炉之方，追求一时的快感，不知道热毒反而侵袭自身，这些都能导致肿胀。有气血凝滞于阴部窍道闭塞，致使阴茎肿胀，近俗戏称为“吹大”，或者是由于忍尿所致。以下三种证候，都适宜用灯心草汤调服五苓散，内服以涤荡体内病邪，用荆芥、甘草、木通煎汤淋洗，以宣通外部经络。
淋痛：五淋，是指血淋、石淋、气淋、膏淋、劳淋。血淋，是小便中有血；石淋，是小便中有砂石样的东西，排尿到盆中时有声音，这是精气结成砂石随尿一起排出；气淋，是由气郁所致，小腹有类似膀胱气胀的感觉；膏淋，是尿液与精液混合，有的沉在漩涡下如糊状，有的浮在漩涡上如脂膏状；劳淋，多见于色欲过度之人，下元虚惫，清浊不分，肾气不行，郁结而成淋；或者思虑过度，火不得滋养，小肠为心之腑，脏病则腑也随之生病；或者心肾不交，肾阳不温，津道闭塞；或者出汗过多，或者失血太多，津道将要枯竭，这些都形成劳淋。这五种淋病得名，而没有包括热淋和冷淋，为什么呢？因为以上五种，都有冷证和热证之分。血淋有热血和瘀血，气淋有热气气和冷气，劳淋有虚冷和虚热。如果用药过差，精气不由其道妄行，不禁与尿一起排出，这是热剂造成的伤害，不可一概认为是冷证。
治疗淋病的方法，除了确凿无疑的虚冷证之外，其余各种证候，如果使用针对本题的药物无效，就适宜施用调理气机的方剂。因为津道的逆顺都是由气的通塞决定的。如木香流气饮，就非常恰当。其中自有木通、麦门冬、腹皮等药物。比如如果不效，只适宜投用补血方剂。盖小便，是血的余沥。血液如果充满，就会滋润下行，自然流通。如火府丹，就非常恰当。其中有地黄等药物。然而这不仅仅指血淋、气淋，所有的淋病都可以使用，唯独虚冷证不可用。淋病，小便的颜色，多是呈现红色，不可一见红色就认为是热证，这是因为气道蕴结的缘故。
便血不止者，用一个松杨柿，烧至存性，研成粉末，用米饮调服即可痊愈。
(See the main syndrome in the section on Major and Minor Orifices.)
Those with pain are classified as bloody strangury (Xuelin). Those without pain are classified as hematuria (Niaoxue). Bloody strangury is discussed separately later under the section on Major and Minor Orifices. For strangury obstruction syndromes and hematuria, initially administer Shengliao Wuling San (Raw Material Five-Ingredient Powder with Poria) combined with Siwu Tang (Four-Substance Decoction). If there is no effect after taking the medicine, and the patient has a history of excessive sexual activity, this belongs to deficiency syndromes. It is appropriate to use Wuling San (Five-Ingredient Powder with Poria) combined with Jiao'ai Tang (Colla Corii Asini and Moutan Decoction), swallowing Lurong Wan (Deer Antler Pill); or Fuzi Bawei Wan (Aconite Eight-Ingredient Pill); or Chensha Miaoxiang San (Cinnabar Wonderful Fragrance Powder) combined with Wuling San (Five-Ingredient Powder with Poria), while swallowing the aforementioned two types of pills. If the urine was originally clear but later shows a few drops of blood, add one qian of Chishao Yao (Red Peony Root) to Wuling San (Five-Ingredient Powder with Poria). There are also cases where the discharge resembles gravel, is red in color, yet lacks the pain characteristic of stone strangury; this also belongs to deficiency syndromes. It is appropriate to use Wuling San (Five-Ingredient Powder with Poria) combined with Jiao'ai Tang (Colla Corii Asini and Moutan Decoction), or Wuling San (Five-Ingredient Powder with Poria) combined with Chensha Miaoxiang San (Cinnabar Wonderful Fragrance Powder), swallowing Lurong Wan (Deer Antler Pill) and Bawei Wan (Eight-Ingredient Pill).
Penile swelling and pain present various syndromes. In some cases, the whole body is edematous, and the penis is also swollen; in such situations, one should seek the etiology from the sections on Qi Gates and Edema/Qi Syndromes, employing methods for treating water qi. Kidney wind causes itching; excessive scratching leads to swelling and pain; this should be sought from the Wind Syndrome section under Sores and Toxins. Once the wind pathogen is resolved, the swelling will subside naturally. There is "jealousy essence erosion sore" (Du Jing Shi Chuang): using medicines for dry sores too harshly causes toxic vapors not to dissipate, leading to accumulation and swelling. Taking mineral and metallic astringent agents causes essence and qi to stagnate and cannot be disseminated. Or trying tight-furnace prescriptions to gain momentary pleasure, unaware that heat toxins attack the body itself; all these can cause swelling. Stagnation of blood and qi blocking the orifices in the yin region causes penile swelling; colloquially known as "blowing up," or caused by holding urine. The following three categories of syndromes are all suitable for treating with Dengxin Tang (Juncus Decoction) mixed with Wuling San (Five-Ingredient Powder with Poria) to cleanse internally, and washing externally with decoctions of Jingjie (Schizonepeta), Gancao (Licorice), and Mutong (Akebia) to promote circulation externally.
Strangury pain: The five types of strangury are bloody, stone, qi, paste, and exhaustion strangury. Bloody strangury (Xuelin) involves blood in the urine. Stone strangury (Shilin) involves gravel-like substances in the urine; when urinating into a basin, there is a sound, indicating that essence and qi have formed gravel which is expelled with the urine. Qi strangury (Qilin) is caused by qi depression, presenting with a sensation of bladder qi distension in the lower abdomen. Paste strangury (Gaolin) involves urine mixed with semen; it may sink at the bottom of the vortex like paste, or float on top of the vortex like grease. Exhaustion strangury (Laolin) often occurs in those who have indulged excessively in sexual activities, resulting in deficiency and exhaustion of the lower yuan, failure to distinguish between clear and turbid, and dysfunction of kidney qi, leading to stagnation and strangury. Or due to overexertion of the mind, fire fails to receive nourishment; since the Small Intestine is the interior-exterior partner of the Heart, disease in the zang organ affects the fu organ. Or heart-kidney non-interaction, with kidney yang failing to warm, causing blockage of the fluid pathways. Or excessive sweating, or massive blood loss, causing the fluid pathways to approach depletion; all these form exhaustion strangury. These five types derive their names, excluding hot and cold strangury. Why? Because each of the five can present with either cold or heat patterns. Bloody strangury includes hot blood and stasis blood; qi strangury includes hot qi and cold qi; exhaustion strangury includes deficiency-cold and deficiency-heat. If herbal treatment is significantly erroneous, essence and qi may wander off their proper paths and be involuntarily expelled with urine; this is injury caused by hot agents, and one cannot generally assume it to be cold.
The method for treating strangury: Except for definitive deficiency-cold syndromes, for other syndromes, if medications targeting the primary pathology are ineffective, it is appropriate to administer formulas regulating qi. This is because the reversal or smooth flow of fluid pathways depends on the obstruction or patency of qi. For example, Muxiang Liuqi Yin (Costus Flowing Qi Drink) is quite appropriate, containing Mutong (Akebia), Maidong (Ophiopogon), and Fupi (Tangerine Peel), among others. If that is ineffective, it is best to administer blood-nourishing formulas. Urine is the surplus of blood. If blood is abundant, it moistens and descends, flowing naturally. Huofu Dan (Fire Mansion Pill) is quite appropriate, containing Dihuang (Rehmannia), among others. However, this applies not only to bloody and qi strangury, but to all types of strangury, except for deficiency-cold. In strangury diseases, the color of urine is mostly reddish; one must not immediately assume redness indicates heat. It is due to the accumulation and knotting of qi pathways.
For persistent rectal bleeding, take one Songyangshi (Song Yang Persimmon), burn it until carbonized (preserving its nature), grind into powder, and take with rice water to achieve cure.