乃大便出尿，小便出粪。凡人小肠下口名阑门（七飞门之一）。由此分别清浊，气不循故道
，则失其守也。
主方 泽泻 猪苓 白术 黄连 阿胶 滑石（各一钱） 官桂 木香（磨。各五分）。
加灯心，水煎，化胶服。
简便方 破 头或漆帽烧灰，米汤下。
（附∶大小便闭）
经曰∶胞移热于膀胱，则癃溺血，膀胱不利为癃。又曰∶足三焦者，太阳之别也。并太阳之
脉，入络膀胱约下焦。实则闭癃，虚则遗溺。盖肾主水，膀胱储之，阴阳升降，荣卫流行，则水
窦开合有常。若二经气虚，水不制火，或客热乘之，致君、相不摄，阴阳不调，热闭下焦，故水
道涩。察热微甚，用药寒凉，当寒因热用，必伏其所主，而先其所因。始则大同，终多小异。虚
而热乘，壮水制火，气虚补气，血虚补血。兼湿痰，则渗湿清痰；缘气结，则导气升结。数证先
宜吐法，大吐升提其气，则水自降。
譬如滴水之器，上窍通而下窍之水出矣。又有郁怒日久，木克脾虚，土不制水，渍入肌肤，肿胀
急痛，水道绝矣。渐见毛孔水出者不治。妇人多患，须初觉时，猛宜健脾疏肝。脉多涩数，左尺
脉实，清热调气。
主方 （热结） 黄柏 牛膝 滑石（研） 木通 猪苓 泽泻 麦门冬 车前子 瞿麦
蓄（各八分） 甘草梢（三分） 加灯心二十枝，水煎，空心服。
未通加地肤子、萆 、石莲子、秋葵子、海金砂、枳壳。老人气血虚、不通加四物汤、黄芩，
减利水药。
清肺饮 肺乏生化之源，口渴便闭，热在气分。
猪苓 通草（各二钱） 赤茯苓（钱半） 泽泻（一钱） 灯心（五分） 木通 蓄 瞿
麦（各七分）
水煎成，调入真琥珀末（五分），车前末（一钱），服。
坎离丸 不渴而小便闭，热在血分。
黄柏 知母（俱盐炒。各二两） 肉桂（二钱）
为末，蜜丸桐子大，每百丸，空心淡盐汤下。顿足药行，小便利，茎中痛，以六一散、灯心
汤服，有恶物下。
助元汤 便闭，因气血两虚。
人参 当归 生地 赤苓 猪苓 泽泻 黄柏（盐炒） 知母 牛膝 栀子 枳壳（各八分）
升麻（二分） 甘草（三分）
加灯心二十枝，水煎，空心服。
益阳汤 便闭无热，证属虚寒，甚因凉药过多，加附子。
肉桂 当归 赤苓 白术 枳壳 牛膝 石莲子 泽泻（各八分） 甘草梢（三分）
加姜一片，灯心二十枝，水煎。
五苓散 分理阴阳，清利水道，通小便，止泄泻。
泽泻（二两半） 茯苓 白术 猪苓（各两半） 肉桂（六钱，热甚减去，名四苓散）。
上为细末，每服二钱，空心白汤调下，煎服亦可。
八正散 实热便癃，或大小便闭（方见淋门）。
六味地黄丸 通治前证。虚而热乘，频数遗溺加黄柏、知母盐炒。老人元虚，转胞胀痛，
数日困笃欲绝，倍泽泻煎服，效（方见虚损）。
十全大补汤加黄柏、知母，扶虚（气虚，参、 ；血虚，芎、归，）药中兼探吐。
简便方 便闭。
甘遂末，水调填脐内，用甘草节煎汁饮。
又 秋葵子（研） 赤茯苓（各二钱） 水煎。或牛膝水煎，入麝少许服。
又 陈皮（两半） 秋葵子（五钱） 分三服，葱白三茎，水煎。或年久笔头烧灰，水服。
又 车前草捣汁（一杯），入蜜（一杯），服。或秦艽（一两）煎服。或吞鸡卵黄三个。或乌臼
皮煎服。或雄黄末蜜和，捻条纳溺孔。或杏仁二七，研服。
又 便闭转胞。
无烟梁上挂尘一撮，水调服。
法用猪尿脬底开小孔，将鹅毛管道扎紧，口用小竹筒扎紧，吹满气，将鹅毛管凑入小便之口，
将气挤入，小便即出。或葱（三斤，炒），铺脐腹熨。或炒盐熨。或盐填脐中，艾灸即通。或莴
苣菜捣，贴脐。或蚯蚓泥水调，填脐。
妊妇胞胎压便闭，或因肠曲，服补中益气汤，倍升、柴（方见虚损）。患人仰卧，下体抬高
频摆动，更托胎舒肠，小便自出。
这是指大便从尿道排出，小便从肛门排出的病症。凡人的小肠下口称为阑门（七飞门之一）。由此分别清浊之气，如果气不循行于正常的通道，就会失去其固守的功能。
主方：泽泻、猪苓、白术、黄连、阿胶、滑石（各一钱），官桂、木香（磨汁，各五分）。加灯心草，水煎煮，将阿胶烊化后服用。
简便方：将破旧的帽子或漆帽烧成灰，用米汤送服。
（附：大小便闭塞不通）
《内经》说：“胞移热于膀胱，则癃溺血，膀胱不利为癃。”又说：“足三焦者，太阳之别也。并太阳之脉，入络膀胱约下焦。实则闭癃，虚则遗溺。”大概肾主水液，膀胱储存尿液，阴阳升降，营卫流行，则水窦的开合有常度。如果这两条经脉气虚，水不能制约火，或者客热侵袭，导致君火、相火不能摄持，阴阳不调，热邪闭塞下焦，所以水道涩滞。观察热邪的轻重，用药寒凉，应当“寒因热用”，必须伏其所主，而先治其因。开始治疗大同小异，最终大多略有不同。如果是虚证而热邪乘袭，应当壮水制火；气虚则补气，血虚则补血。兼有湿痰，则渗湿清痰；因为气结，则导气升提结滞。这些证候起初适宜用吐法，大吐可以升提其气，则水液自然下降。
譬如滴水之器，上窍通畅而下窍的水就会流出。又有郁怒日久，肝木克制脾土致脾虚，土不能制水，水渍入肌肤，出现肿胀急痛，水道断绝了。逐渐见到毛孔出水的是不治之症。妇女多患此病，须在初觉时，猛烈健脾疏肝。脉象多涩数，左尺脉实，清热调气。
主方（热结证）：黄柏、牛膝、滑石（研末）、木通、猪苓、泽泻、麦门冬、车前子、瞿麦、蓄（各八分），甘草梢（三分）。加灯心草二十枝，水煎煮，空腹服用。
未通利的，加地肤子、萆薢、石莲子、秋葵子、海金砂、枳壳。老人气血虚弱、不通利的，加四物汤、黄芩，减少利水药。
清肺饮：肺缺乏生化之源，口渴且大便闭塞，热在气分。
猪苓、通草（各二钱），赤茯苓（一钱半），泽泻（一钱），灯心草（五分），木通、蓄、瞿麦（各七分）。
水煎成后，调入真琥珀末（五分），车前子末（一钱），服用。
坎离丸：不渴但小便闭塞，热在血分。
黄柏、知母（均盐炒，各二两），肉桂（二钱）。
研为细末，蜜丸如梧桐子大，每次一百丸，空腹淡盐汤送服。顿足使药力运行，小便通利，若茎中疼痛，以六一散、灯心草汤服用，会有恶物排出。
助元汤：大便闭塞，因气血两虚所致。
人参、当归、生地、赤茯苓、猪苓、泽泻、黄柏（盐炒）、知母、牛膝、栀子、枳壳（各八分），升麻（二分），甘草（三分）。
加灯心草二十枝，水煎煮，空腹服用。
益阳汤：大便闭塞无热，证属虚寒，甚或因凉药过多，加附子。
肉桂、当归、赤茯苓、白术、枳壳、牛膝、石莲子、泽泻（各八分），甘草梢（三分）。
加生姜一片，灯心草二十枝，水煎煮。
五苓散：分理阴阳，清利水道，通小便，止泄泻。
泽泻（二两半），茯苓、白术、猪苓（各一两半），肉桂（六钱，热甚减去，名四苓散）。
以上研为细末，每次服用二钱，空腹白开水调下，煎服也可以。
六味地黄丸：通治前述证候。虚而热乘，频数遗溺加黄柏、知母盐炒。老人元气虚弱，转胞胀痛，数日困笃欲绝，倍用泽泻煎服，有效（方见虚损）。
十全大补汤加黄柏、知母，扶正（气虚，用人参、黄芪；血虚，用川芎、当归），药中兼探吐。
简便方：大便闭塞。
甘遂末，水调匀填敷脐内，用甘草节煎汁饮用。
又方：秋葵子（研末）、赤茯苓（各二钱），水煎煮。或用牛膝水煎，入麝香少许服用。
又方：陈皮（一两半）、秋葵子（五钱），分三次服用，加葱白三茎，水煎煮。或年久笔头烧成灰，水送服。
又方：车前草捣汁（一杯），入蜂蜜（一杯），服用。或用秦艽（一两）煎服。或吞鸡卵黄三个。或乌臼皮煎服。或雄黄末蜜和，捻成条纳入溺孔。或杏仁十四枚，研末服用。
又方：大便闭塞转胞。
无烟梁上挂尘一撮，水调服。
方法：用猪尿脬底开小孔，将鹅毛管道扎紧，口用小竹筒扎紧，吹满气，将鹅毛管凑入小便之口，将气挤入，小便即出。或用葱（三斤，炒），铺于脐腹熨烫。或炒盐熨烫。或盐填脐中，艾灸即通。或莴苣菜捣烂，贴于脐部。或蚯蚓泥水调，填敷脐中。
妊妇胞胎压迫导致大便闭塞，或因肠曲，服用补中益气汤，倍用升麻、柴胡（方见虚损）。患人仰卧，下体抬高频繁摆动，更托胎舒肠，小便自出。
This refers to the condition where feces are discharged from the urethra, and urine is discharged from the anus. The lower opening of the small intestine in humans is called Lanmen (one of the Seven Flying Gates). From here, clear and turbid substances are separated. If Qi does not follow its normal pathway, it loses its controlling function.
Main Formula: Alismatis Rhizoma (Zexie), Polyporus (Zhuling), Atractylodis Macrocephalae Rhizoma (Baizhu), Coptidis Rhizoma (Huanglian), Ecliptae Herba (Ejiao), Talcum (Huashi) (each 1 qian), Cinnamomi Cortex (Guigui), Aucklandiae Radix (Muxiang) (ground into juice, each 0.5 qian). Add Juncus effusus (Dengxincao), decoct with water, dissolve Ejiao, and take orally.
Simple Formula: Burn broken hats or lacquered hats to ash, take with rice soup.
(Attachment: Obstruction of both urination and defecation)
The Classic says: "When heat shifts from the bladder to the urinary bladder, there is strangury with blood in urine; if the urinary bladder is obstructed, there is strangury." It also says: "The Foot-Taiyang Sanjiao is a branch of Taiyang. Joining with the Taiyang meridian, it enters and connects to the urinary bladder, regulating the Lower Jiao. When excess, there is obstruction and strangury; when deficiency, there is enuresis." Generally, the Kidney governs water, and the Urinary Bladder stores it. Through the ascending and descending of Yin and Yang, and the circulation of Ying and Wei, the openings and closings of the water passages have regularity. If the Qi of these two meridians is deficient, Water cannot control Fire, or external heat invades, causing the Ministerial Fire and Sovereign Fire to fail in their regulation, leading to disharmony of Yin and Yang. Heat closes the Lower Jiao, so the water pathways become obstructed. Observing the severity of heat, use cold medicines. One should employ "treating cold with cold," subduing the dominant factor and addressing the root cause initially. Treatment starts similarly but often differs slightly at the end. If it is a deficiency syndrome with heat invasion, one should nourish Water to control Fire; for Qi deficiency, tonify Qi; for Blood deficiency, tonify Blood. If accompanied by dampness and phlegm, promote diuresis and clear phlegm; due to Qi stagnation, guide Qi and lift the stagnation. These syndromes are initially suitable for emesis therapy; severe vomiting can lift the Qi, allowing water to descend naturally.
It is like a vessel dripping water: if the upper orifice is open, water flows out from the lower orifice. There is also the case of long-term depression and anger, where Liver Wood overacts on Spleen Earth causing Spleen deficiency. Earth fails to control Water, which infiltrates the muscles and skin, causing swelling and acute pain, and the water pathways are cut off. Gradual appearance of water oozing from pores indicates an untreatable condition. Women suffer from this frequently; early detection requires vigorous strengthening of the Spleen and soothing of the Liver. The pulse is often choppy and rapid, with a full pulse at the left Chi position; treat by clearing heat and regulating Qi.
Main Formula (Heat Accumulation Syndrome): Phellodendri Cortex (Huangbai), Achyranthis Bidentatae Radix (Niuxi), Talcum (Huashi) (ground), Akebiae Caulis (Mutong), Polyporus (Zhuling), Alismatis Rhizoma (Zexie), Ophiopogonis Radix (Maidong), Plantaginis Semen (Cheqianzi), Diantherae Herba (Qumai), Polygoni Avicularis Herba (Jincaihua) (each 0.8 fen), Glycyrrhizae Radix et Rhizoma (Gancao Shao) (0.3 fen). Add twenty stalks of Juncus effusus (Dengxincao), decoct with water, take on an empty stomach.
If not unobstructed, add Kochiae Fructus (Difuzi), Dioscoreae Hypoglaucae Rhizoma (Bixie), Nelumbinis Nuciferae Semen (Shilianzi), Abutilonis Semen (Qiukui Zi), Aurichalcum (Haijinsha), Aurantii Fructus (Zhike). For elderly patients with Qi and Blood deficiency and obstruction, add Siwu Tang (Four Substances Decoction) and Scutellariae Radix (Huangqin), reducing diuretic herbs.
Qingfei Yin (Clear Lung Drink): Lack of source for generation and transformation in the Lung, thirst, and constipation, heat in the Qi level.
Polyporus (Zhuling), Tectona Grandis Caulis (Tongcao) (each 2 qian), Poria (Chifuling) (1.5 qian), Alismatis Rhizoma (Zexie) (1 qian), Juncus effusus (Dengxincao) (0.5 fen), Akebiae Caulis (Mutong), Polygoni Avicularis Herba (Jincaihua), Diantherae Herba (Qumai) (each 0.7 fen).
Decoct with water, mix in true Amber powder (0.5 fen) and Plantaginis Semen powder (Cheqian, 1 qian), and take.
Kanli Wan (Kan-Li Pill): No thirst but urinary obstruction, heat in the Blood level.
Phellodendri Cortex (Huangbai), Anemarrhenae Rhizoma (Zhimu) (both salt-fried, each 2 liang), Cinnamomi Cortex (Rougui) (2 qian).
Grind into fine powder, make honey pills the size of tung tree seeds. Take 100 pills each time, on an empty stomach with light salt water. Stomp feet to move the medicine's action; when urination becomes smooth, if there is pain in the glans penis, take Liuyi San (Six-to-One Powder) and Juncus effusus tea; foul matter will be discharged.
Zhu Yuan Tang (Assist Yuan Decoction): Constipation due to dual deficiency of Qi and Blood.
Ginseng Radix et Rhizoma (Renshen), Angelicae Sinensis Radix (Danggui), Rehmanniae Radix (Shengdi), Poria (Chifuling), Polyporus (Zhuling), Alismatis Rhizoma (Zexie), Phellodendri Cortex (Huangbai) (salt-fried), Anemarrhenae Rhizoma (Zhimu), Achyranthis Bidentatae Radix (Niuxi), Gardeniae Fructus (Zhizi), Aurantii Fructus (Zhike) (each 0.8 fen), Cimicifugae Rhizoma (Shengma) (0.2 fen), Glycyrrhizae Radix et Rhizoma (Gancao) (0.3 fen).
Add twenty stalks of Juncus effusus (Dengxincao), decoct with water, take on an empty stomach.
Yiyang Tang (Benefit Yang Decoction): Constipation without heat, syndrome belongs to deficiency-cold, even due to excessive cooling medicines, add Aconiti Lateralis Radix Praeparata (Fuzi).
Cinnamomi Cortex (Rougui), Angelicae Sinensis Radix (Danggui), Poria (Chifuling), Atractylodis Macrocephalae Rhizoma (Baizhu), Aurantii Fructus (Zhike), Achyranthis Bidentatae Radix (Niuxi), Nelumbinis Nuciferae Semen (Shilianzi), Alismatis Rhizoma (Zexie) (each 0.8 fen), Glycyrrhizae Radix et Rhizoma (Gancao Shao) (0.3 fen).
Add one slice of Zingiberis Rhizoma Recens (Shengjiang), twenty stalks of Juncus effusus (Dengxincao), decoct with water.
Wuling San (Five-Ingredient Powder with Cinnamon): Differentiate and regulate Yin and Yang, clear and benefit water pathways, promote urination, stop diarrhea.
Alismatis Rhizoma (Zexie) (2.5 liang), Poria (Fuling), Atractylodis Macrocephalae Rhizoma (Baizhu), Polyporus (Zhuling) (each 1.5 liang), Cinnamomi Cortex (Rougui) (6 qian; remove if heat is severe, named Siling San).
Grind all into fine powder. Take 2 qian each time, mixed with plain warm water on an empty stomach; decoction is also acceptable.
Bazheng San (Eight-Upright Powder): Excess-heat strangury, or obstruction of both urination and defecation (formula see Lin Men).
Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill): Universally treats the aforementioned syndromes. For deficiency with heat invasion and frequent enuresis, add salt-fried Phellodendri Cortex (Huangbai) and Anemarrhenae Rhizoma (Zhimu). For elderly patients with primordial deficiency, turning bladder distension and pain, severe distress after several days nearing death, double the dose of Alismatis Rhizoma (Zexie) and decoct; effective (formula see Xu Sun).
Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) plus Phellodendri Cortex (Huangbai) and Anemarrhenae Rhizoma (Zhimu), supports deficiency (for Qi deficiency, use Ginseng Radix et Rhizoma (Renshen) and Astragali Radix (Huangqi); for Blood deficiency, use Chuanxiong Rhizoma (Chuanxiong) and Angelicae Sinensis Radix (Danggui)). Incorporate emetic therapy within the medication.
Simple Formula: Constipation.
Kansui Radix powder (Gansui), mixed with water, fill into the umbilicus. Drink decoction of Glycyrrhizae Radix et Rhizoma (Gancao Jie).
Another formula: Abutilonis Semen (Qiukui Zi) (ground), Poria (Chifuling) (each 2 qian), decoct with water. Or decoct Achyranthis Bidentatae Radix (Niuxi), add a little Moschus (Shexiang), and take.
Another formula: Citri Reticulatae Pericarpium (Chenpi) (1.5 liang), Abutilonis Semen (Qiukui Zi) (5 qian), divide into three doses. Add three stems of Allium fistulosum (Congbai), decoct with water. Or burn old pen tips to ash, take with water.
Another formula: Plantago asiatica juice (Cheqian Cao) (one cup), mix with honey (one cup), take. Or decoct Gentiana macrophylla (Qinjiao) (1 liang) and take. Or swallow three chicken egg yolks. Or decoct Cornus officinalis bark (Wujiupi) and take. Or mix Realgar powder (Xionghuang) with honey, form into strips, insert into the urethral orifice. Or grind fourteen Almond kernels (Xingren) and take.
Another formula: Constipation with bladder inversion.
One pinch of dust hanging from smokeless beams, mixed with water, take.
Method: Make a small hole in the bottom of a pig bladder. Tie tightly around a goose feather tube. Insert a small bamboo tube into the mouth of the feather tube. Blow air until full. Place the goose feather tube against the urinary orifice and squeeze the air in; urine will flow out. Or stir-fry three jin of Allium fistulosum (Cong), spread on the umbilicus and abdomen, and apply heat compression. Or apply hot salt compression. Or fill the umbilicus with salt, moxa-burn, and it will unblock. Or mash Lactuca sativa (Woshe Cai), apply to the umbilicus. Or mix earthworm mud with water, fill into the umbilicus.
For pregnant women, bladder inversion caused by fetal pressure, or due to intestinal curvature, take Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), doubling the dosage of Cimicifugae Rhizoma (Shengma) and Bupleuri Radix (Chaihu) (formula see Xu Sun). The patient lies supine, elevates the lower body, and swings it frequently. Support the fetus and relax the intestines; urination will occur spontaneously.