经曰∶血泄淋闭，皆属于热。盖诸淋始作，当以同类析之。小便浊，痛不甚。白曰白浊，赤
曰赤浊。不痛自出，或胀痒者为滑精。不痛下血为溺血，不痛胀涩为癃闭。惟小腹胀急，痛引脐
下，小便频少，解时滴沥涩痛，叫喊难忍为淋。有五证∶血、石、膏、劳、肉是也。血淋火动则
发，所下皆血；石淋如小砂石，涩痛难出；膏淋邪热煎稠，状如脂膏；劳淋作劳则甚，痛引气冲
；肉淋成条窒塞，甚至人呼多方得出，随腹大痛，死证不治。又气淋者，小便涩数，常有余沥。
膀胱经客热，皆由斫丧致伤肾水。七情饮食，助其火邪，水道不下输，而施其清化之令也。脉盛
实大生，虚细涩死。戒发汗。
主方 （诸淋） 黄柏 （酒炒） 知母（酒炒） 滑石（水飞，调服） 木通 栀子
蓄 生地黄 当归 赤茯苓 枳壳 麦门冬 牛膝（各一钱） 甘草（五分） 加灯心煎。
血淋加炒蒲黄、茅根汁。石淋，石苇。膏淋加川萆 、石莲子。劳淋加人参。肉淋，连翘、
秋葵子。气淋加青皮。热淋，黄连、酒煮大黄。尿淋，车前草捣绞汁。死血淋，桃仁、牡丹皮、
玄胡索、琥珀（另研，调服）。老人虚淋加人参、黄 、升麻（少许），去知、柏、 、滑。久
虚，补中益气汤、六味地黄丸。
五淋散 诸淋初感皆效，日久宜滋阴补肾。忌泻肾与膀胱药。
赤茯苓 赤芍药 栀子（各一钱） 木通 泽泻 生地 车前子 黄芩（条） 当归（各八
分） 滑石（水飞。减半） 甘草梢（五分） 水煎成调滑石服。
八正散 治心经蕴热，脏腑秘结，小便赤涩，淋沥不通。
大黄 瞿麦 木通 滑石 蓄 栀子（炒） 车前子 甘草梢（各等分）
上加灯心二十枝，水煎，空心服。
海金砂散 五淋，一服效。
当归（酒洗） 大黄（酒浸） 川牛膝（酒洗） 木香（另研） 海金砂（研） 雄黄（等分
）
上为末，入香、沙、雄，每服钱半，临睡好酒调下。
清心莲子饮 上盛下虚，心火炎上，口苦咽干渴，小便浊或淋。
石莲子 人参 黄 麦冬 赤苓（各一钱） 车前子 黄芩 地骨皮 甘草（各五分）
水煎，空心服。
二陈汤加香附、木通。探吐，痰出上窍通，下窍利；初疏通，久升提。
简便方 血淋，车前草捣汁饮。石淋，用汁调软石膏（ 、研，一钱）服。
石淋∶土牛膝煎服，入乳香、麝香（各少许）妙。秋葵子研末，米汤下。
又 黑豆百粒，甘草二寸，水煎，调滑石末，服。或黄鱼脑骨（ ，研）汤下。
血淋∶竹茹五钱，水煎服。或苦杖根，研服。尿血，升麻煎服。
诸淋∶三叶酸浆草捣绞汁，荡热，空心服，加蜜少许。便闭加砂糖少许，妙。
诸淋痛∶六一散（暑门）、海金砂（研） 各二钱，灯心、木通、麦冬。煎汤，入蜜少许，
调服。
又 大萝卜切一指浓五片，蜜二两，浸拌铁铲上，慢火炙蜜尽，细嚼，盐汤下。
痛甚，牛膝煎浓汁饮（酒煎亦可）。或萱草根捣汁服；或茅根煎服。
又 赤芍药（一两）、槟榔（一枚，面包，煨）为末，水调空心服。或船底青苔一团，煎服。
《内经》说：血泄、淋证、小便闭塞，都归属于热证。大凡各种淋证刚开始发作时，应当根据症状的相似之处来辨析。小便浑浊，疼痛不严重的，白色称为白浊，红色称为赤浊。不痛而精液自行流出，或者伴有胀感、痒感的，称为滑精。不痛而下血的，称为溺血；不痛但感到胀满涩滞的，称为癃闭（排尿困难）。只有小腹胀急，疼痛牵引至脐下，小便频数且量少，排尿时滴沥不尽、涩痛难忍、甚至叫喊痛苦的，才称为淋证。淋证有五种类型：血淋、石淋、膏淋、劳淋、肉淋。血淋因火邪妄动而发作，排出物全是血液；石淋排出物像细小的砂石，涩痛难以排出；膏淋因邪热煎熬尿液变得浓稠，状如脂膏；劳淋在劳累后加重，疼痛牵引至气冲穴部位；肉淋形成条状物堵塞尿道，甚至人呼喊多次才能排出，随后腹部剧烈疼痛，属于死证，无法治愈。另外，气淋表现为小便涩滞频数，常有剩余尿意。膀胱经中有客热，多由过度房事损伤肾水所致。七情内伤和饮食不当，助长火邪，导致水道不能正常向下输布，从而破坏了清化功能。脉象盛大实大的可生，脉象虚细涩滞的预后不良。严禁使用发汗法治疗。
主方（适用于各类淋证）：黄柏（酒炒）、知母（酒炒）、滑石（水飞后调服）、木通、栀子、蓄草、生地黄、当归、赤茯苓、枳壳、麦门冬、牛膝（各一钱）、甘草（五分），加灯心草煎煮。血淋加炒蒲黄、茅根汁。石淋加石苇。膏淋加川萆薢、石莲子。劳淋加人参。肉淋加连翘、秋葵子。气淋加青皮。热淋加黄连、酒煮大黄。尿淋用车前草捣绞取汁。死血淋（瘀血阻滞）加桃仁、牡丹皮、玄胡索、琥珀（另研细末，调服）。老人虚性淋证加人参、黄芪、升麻（少许），去掉知母、黄柏、蓄草、滑石。久病体虚者，用补中益气汤、六味地黄丸。
五淋散：各种淋证初起服用皆有效，日久则宜滋阴补肾。忌用泻肾及膀胱的药物。
配方：赤茯苓、赤芍药、栀子（各一钱）、木通、泽泻、生地、车前子、黄芩（条）、当归（各八分）、滑石（水飞，减半用量）、甘草梢（五分），水煎成后调入滑石粉服用。
八正散：治疗心经蕴热，脏腑秘结，小便赤红涩痛，淋漓不通。
配方：大黄、瞿麦、木通、滑石、蓄草、栀子（炒）、车前子、甘草梢（各等分）。
上方加灯心草二十枝，水煎，空腹服用。
海金砂散：治疗五淋，服用一次即见效。
配方：当归（酒洗）、大黄（酒浸）、川牛膝（酒洗）、木香（另研）、海金砂（研）、雄黄（等分）。
上方研为末，加入木香、海金砂、雄黄粉末，每次服用钱半，临睡前用好酒调服。
清心莲子饮：治疗上盛下虚，心火炎上，口苦咽干渴，小便浑浊或淋证。
配方：石莲子、人参、黄芪、麦冬、赤茯苓（各一钱）、车前子、黄芩、地骨皮、甘草（各五分）。
水煎，空腹服用。
二陈汤加香附、木通。采用探吐法，痰出上窍则通畅，下窍亦利；初期疏通，后期升提。
简便方：血淋，用车前草捣汁饮用。石淋，用汁调服软石膏（煅烧，研细，一钱）。
石淋：土牛膝煎服，加入乳香、麝香（各少许）效果奇妙。秋葵子研末，米汤送服。
又方：黑豆一百粒，甘草二寸，水煎，调服滑石末。或用黄鱼脑骨（煅烧，研细）汤送服。
血淋：竹茹五钱，水煎服。或用苦杖根，研末服用。尿血，用升麻煎服。
诸淋：三叶酸浆草捣绞取汁，清热，空腹服用，加少许蜂蜜。若伴随便闭，加少许砂糖，效果妙。
诸淋疼痛：六一散（见暑门章节）、海金砂（研）各二钱，灯心草、木通、麦冬。煎汤，入少许蜂蜜，调服。
又方：大萝卜切一指厚五片，蜂蜜二两，浸泡并拌在铁铲上，慢火炙烤至蜜尽，细细咀嚼，盐汤送下。
疼痛严重者，饮牛膝煎制的浓汁（也可用酒煎）。或用萱草根捣汁服用；或用茅根煎服。
又方：赤芍药（一两）、槟榔（一枚，用面包裹，煨熟）研为末，水调空腹服用。或用船底青苔一团，煎服。
The *Neijing* states: Hematuria, strangury (Lin syndrome), and urinary retention all belong to Heat. Generally, when various types of Strangury first manifest, they should be differentiated based on similar symptoms. Cloudy urine with slight pain is called White Turbidity if white, or Red Turbidity if red. Painless spontaneous discharge, or accompanied by distension and itching, is called Slippery Essence (Seminal Leakage). Painless hematuria is called Urinary Bleeding; painless distension and astringency is called Long Bi (Urinary Difficulty/Retention). Only when there is lower abdominal fullness and urgency, pain radiating to the umbilicus and below, frequent but scanty urination, dripping and astringent painful urination, and unbearable crying out, is it defined as Strangury. There are five types of Strangury: Blood Strangury, Stone Strangury, Paste Strangury, Labor Strangury, and Flesh Strangury. Blood Strangury arises from Fire agitation, with excreted material being entirely blood; Stone Strangury involves passing small gravel-like stones, difficult to pass due to astringency and pain; Paste Strangury results from pathogenic heat scorching the urine into a thick consistency resembling fat/paste; Labor Strangury worsens with exertion, with pain radiating to the Qichong point; Flesh Strangury involves blockage by strip-like matter, sometimes requiring multiple cries to pass, followed by severe abdominal pain, which is a fatal condition and incurable. Additionally, Qi Strangury presents with astringent and frequent urination, often with a sensation of incomplete emptying. Guest-Heat in the Bladder Meridian is caused by excessive sexual activity injuring Kidney Water. Seven Emotions and dietary irregularities assist the Fire Pathogen, preventing the water passages from descending normally, thereby disrupting the clear transformation function. A pulse that is large, full, and solid indicates survival; a pulse that is deficient, fine, and choppy indicates death. Sweating therapy is contraindicated.
Main Formula (for various Stranguries): Huangbai (Phellodendri Cortex, wine-fried), Zhi Mu (Anemarrhenae Rhizoma, wine-fried), Huashi (Talcum, water-washed for oral administration), Mutong (Akebiae Caulis), Zhizi (Gardeniae Fructus), Lugucao (Herba Siegesbeckiae), Shengdihuang (Rehmanniae Radix), Danggui (Angelicae Sinensis Radix), Chifuling (Poria cum Ramo et Ligno Rosae), Zhike (Aurantii Fructus), Maimendong (Ophiopogonis Radix), Niuxi (Achyranthis Bidentatae Radix) (each 1 qian), Gancao (Licorice Root, 0.5 qian), add Dengxincao (Junci Medulla) and decoct. For Blood Strangury, add Chao Puhuang (Polygoni Cuspidati Pollen, stir-fried) and Maogen juice (Imperatae Rhizoma juice). For Stone Strangury, add Shiwei (Pyrosiae Folium). For Paste Strangury, add Chuanbixie (Dioscoreae Hypoglaucae Rhizoma) and Shilianzi (Nelumbinis Semen). For Labor Strangury, add Renshen (Ginseng Radix et Rhizoma). For Flesh Strangury, add Lianqiao (Forsythiae Fructus) and Qiukui zi (Abutilonis Semen). For Qi Strangury, add Qingpi (Citri Reticulatae Pericarpium Rubrum). For Heat Strangury, add Huanglian (Coptidis Rhizoma) and Jiu Zhu Dahuang (Rhei Radix et Rhizoma, wine-boiled). For Urine Strangury, use Cheqiancao (Plantaginis Herba) crushed and juiced. For Stasis Blood Strangury, add Taoren (Persicae Semen), Mudanpi (Moutan Cortex), Xiansu (Corydalis Rhizoma), and Hupo (Succinum, separately ground and mixed). For elderly patients with Deficient Strangury, add Renshen, Huangqi (Astragali Radix), and Shengma (Cimicifugae Rhizoma) (a little); remove Zhi Mu, Huangbai, Lugucao, and Huashi. For chronic deficiency, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia).
Wulin San (Five-Strangury Powder): Effective for initial stages of all Stranguries; for long-standing cases, nourish Yin and tonify the Kidney. Avoid herbs that drain the Kidney and Bladder.
Formula: Chifuling (Poria cum Ramo et Ligno Rosae), Chi Shaoyao (Paeoniae Radix Rubra), Zhizi (Gardeniae Fructus) (each 1 qian), Mutong (Akebiae Caulis), Zexie (Alismatis Rhizoma), Shengdi (Rehmanniae Radix), Cheqianzi (Plantaginis Semen), Huangqin (Scutellariae Radix, strip form), Danggui (Angelicae Sinensis Radix) (each 0.8 qian), Huashi (Talcum, water-washed, half dose), Gancao Shao (Licorice Root Tip, 0.5 qian). Decoct in water and take with Huashi powder.
Bazheng San (Eight-Righteousness Powder): Treats latent Heat in the Heart Meridian, internal organ constipation, red and astringent urine, and unblocking dribbling strangury.
Formula: Dahuang (Rhei Radix et Rhizoma), Qumai (Dianthi Herba), Mutong (Akebiae Caulis), Huashi (Talcum), Lugucao (Herba Siegesbeckiae), Zhizi (Gardeniae Fructus, stir-fried), Cheqianzi (Plantaginis Semen), Gancao Shao (Licorice Root Tip) (equal parts).
Add 20 branches of Dengxincao (Junci Medulla), decoct in water, and take on an empty stomach.
Haijinsha San (Sea Gold Sand Powder): Treats Five Stranguries; effective after one dose.
Formula: Danggui (Angelicae Sinensis Radix, wine-rinsed), Dahuang (Rhei Radix et Rhizoma, wine-soaked), Chuan Niuxi (Achyranthis Bidentatae Radix, wine-rinsed), Muxiang (Aucklandiae Radix, separately ground), Haijinsha (Lycopodii Spora, ground), Xionghuang (Realgar) (equal parts).
Grind into powder, mix with Muxiang, Haijinsha, and Xionghuang. Take 1.5 qian per dose, mixed with good wine before sleep.
Qingxin Lianzi Yin (Clear Heart Lotus Seed Decoction): Treats excess above and deficiency below, flaming Heart Fire upward, bitter taste in mouth, dry throat and thirst, turbid urine or strangury.
Formula: Shilianzi (Nelumbinis Semen), Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Maidong (Ophiopogonis Radix), Chifuling (Poria cum Ramo et Ligno Rosae) (each 1 qian), Cheqianzi (Plantaginis Semen), Huangqin (Scutellariae Radix), Digupi (Lycii Cortex), Gancao (Licorice Root) (each 0.5 qian).
Decoct in water and take on an empty stomach.
Erchen Tang (Two-Aged Decoction) plus Xiangfu (Cyperi Rhizoma) and Mutong (Akebiae Caulis). Induce vomiting; when phlegm exits the upper orifices, the lower orifices become unobstructed. Initially promote unblocking, later lift and raise.
Simple Prescriptions:
For Blood Strangury, drink Cheqiancao (Plantaginis Herba) juice.
For Stone Strangury, take Ruanshigao (Gypsum Fibrosum, calcined and ground, 1 qian) mixed with juice.
Stone Strangury: Decoct Tuniu xi (Achyranthis Bidentatae Radix) with Rushxiang (Boswelliae Resin) and Shexiang (Moschus) (a little each) for excellent effect. Or take Qiukui zi (Abutilonis Semen) powder with rice soup.
Another prescription: Boil 100 Black Beans (Phaseoli Vulgaris Semen) and 2 cun of Gancao (Licorice Root) in water, take with Huashi (Talcum) powder. Or take Huangyu naogu (Yellow Fish Brain Bone, calcined and ground) in soup.
Blood Strangury: Decoct 5 qian of Zhuru (Bambusae Caulis in Taenia) in water. Or grind and take Kuzhang gen (unknown root). For Hematuria, decoct Shengma (Cimicifugae Rhizoma) and take.
Various Stranguries: Crush and juice Sansanyesuan Jiangcao (Oxalis Corniculata Herb), clear Heat, take on an empty stomach with a little honey. If accompanied by constipation, add a little brown sugar for excellent effect.
Pain from Various Stranguries: Take Liuyi San (Six-One Powder, see Summer Heat chapter) and Haijinsha (Lycopodii Spora, ground) (2 qian each), with Dengxincao (Junci Medulla), Mutong (Akebiae Caulis), and Maidong (Ophiopogonis Radix). Decoct in water, add a little honey, and take.
Another prescription: Cut 5 slices of Da Luobo (Raphani Radix) one finger-thick, soak and mix with 2 liang of Honey on an iron spatula, roast slowly over low heat until honey is absorbed, chew thoroughly, and swallow with salt water.
For severe pain, drink concentrated juice of Niuxi (Achyranthis Bidentatae Radix) (wine-decocted is also acceptable). Or take Xuancacao (Hemerocallis Radix) juice, or decoct Maogen (Imperatae Rhizoma) and take.
Another prescription: Grind 1 liang of Chi Shaoyao (Paeoniae Radix Rubra) and 1 Binglang (Arecae Semen, wrapped in bread and roasted) into powder, take with water on an empty stomach. Or decoct and take a clump of Chuandi Qingtai (Green Moss from Ship Bottom).