丁 血淋溺痛，左寸脉洪数，此心移热于小肠，搏于血脉，入于胞中，与溲俱下。因瘀热迫注溺窍，并
茎中亦痛也。当先清利火腑，用导赤散加赤苓、丹皮、麦冬、归尾、灯心、木通。一剂淋痛减，后用生地、
茯苓、归身、丹参、远志、丹皮、侧柏叶、鲜藕。数服寻愈。
周 游幕县署。淋症失调，晡后寒热如疟。医误以为阴虚，杂进补涩，病益剧。又进散剂，疑不敢服。
涕泣求诊，脉虚软而浮。用补中汤数服，寒热止，淋亦渐瘳，后用六味丸加减而愈。
王二 给役书馆，夜私出。初便浊，秘不言。后乃不便自遗，瘦怯不任起立，常如欲溺状，或前欲溺
而后亦不禁。此浊久气虚下陷也。或以泻热之剂与服，病益剧。予用升举法，佐以利湿。升麻、茯苓、猪苓、
白术、半夏、炙草、莲须、莲子。仿治浊固本丸意，滑泄自止。
贡 淋症愈而忽发，色苍形瘦，食减便溏，咽干膝痛，脉沉濡，左寸稍大。是心热移于小肠，而与湿相
搏。参萆 厘清饮。赤苓、生薏米（各三钱）、生白术、泽泻（各八分）、石斛、麦冬（各二钱）、防己、
甘草（各一钱）、萆 、通草（各钱半）、滑石（飞三分）。数服淋愈，但脉来沉小，食少足酸。乃脾阳肾
阴素亏，宜兼调为治。熟地、杞子、益智仁（煨）、茯神、甘草（炙）、薏米、山药、莲子（俱炒）、归身。
同研末，加粳米屑调服，日二次，食进而足亦健步。
岳 劳淋是膀胱气分病。近日大便秘结，食顷必胀，足胫冷
诊脉弦而迟。乃阴结胃气，不主下行，而膀胱之转输不利，乃为淋也。治宜温通，勿进止涩。川附、生术、
缩砂壳，陈皮白、韭子、蒌仁、苏子（俱炒研）、茯苓、海金沙。四服逆气平，胀秘良已，脉亦和。去川附、
蒌仁，加牛膝（蒸）、莲子服愈。
江 溺前涩痛，茎端宿有瘀腐。向服瞿麦汤痛减，导火下行故也。然脉来洪实搏指，不特膀胱瘀热未尽，
抑且心肾根源未清，故痛减淋不减也。宜收心节欲，勿扰肾脏，戒酒薄味，静养可安。茯苓、生地、石斛、萆 、
莲须、甘草梢、灯心、泽泻。数服而效。
王 便浊而数，且痛，午后寒热不时，头眩神倦，脉弱，自秋延春，兼溺血点。乃劳力伤阴，阴火迫注膀
胱。先用分利法，导赤散加赤苓、莲须、归尾、赤芍、丹皮、栀子、灯草。二服眩痛止，去木通、竹叶，改熟
地、归身，又加萆 ，三服诸症俱瘳。又令服六味丸愈。
族某 劳淋，初用厘清饮，涩痛已减。后服单方，通利太过，反致溺后精沥，腰足酸软，畏冷，左脉虚涩
少神，肾气不摄，乃成虚滑，摄固为宜。沙苑子、菟丝子、杞子、莲子、破故纸、熟地（砂仁末炒）、杜仲。
数服而效，后加鹿胶、潞参、归身、茯苓、山药、乃固。
眭 劳力伤阴，脉右弦左大，腹痛溺涩出粉，此为沙淋。海金沙（六分）、杜牛膝（一钱）、当归尾（八分）、
薏仁（三钱）、灯心（八分）、赤苓（二钱）、小茴香（盐水炒八分）。数服涩痛止，去前三味，加杞子、沙
苑子、益智子（俱炒）、钗斛、怀牛膝（酒蒸），数服甚适。此温通之剂，能节劳则淋可不发。
族某 膏淋溺面浮油，有时便中推出髓条，此积劳损伤肾阴所致。宿恙经年，近又兼病阴疟，真元日惫，
饮食无味，益肾必先补脾。潞参、茯神、山药、生白术、薏仁、杜仲、芡实、莲子（俱炒）、何首乌、沙苑子，
十数服全愈。
陈 色苍体长，木火之质，阴分易亏。五旬外纳宠，急图嗣续月前因浊成淋，溺数而欠，着枕仍然遗泄，
延至血水滴沥而痛，
是为血淋。精室既伤，心火犹炽，诊两尺左弦右数，宜腰膝痿软，足心如烙也。夫不痛为溺血，痛为血淋。虽
肾虚挟火，然导赤厘清，如方凿圆枘，五苓八正，亦抱薪救焚。急用生料六味作汤，可济燃眉。熟地（六钱）、生
地（三钱）、怀山药（炒二钱半）、茯苓（三钱）、丹皮、泽泻（各一钱）、生莲子（不去心，一两）、莲
子须、麦冬（各二钱）、五味子（五分）。数服痛止淋减，汤丸兼进而安。
丁：血淋，排尿疼痛。左寸脉象洪大而数，这是心火移热于小肠，搏结于血脉，进入膀胱，随小便一同排出。因瘀热逼迫注入尿道口，并导致阴茎内部也疼痛。应当先清利火腑，使用导赤散加入赤茯苓、牡丹皮、麦冬、当归尾、灯心草、木通。服用一剂后，淋痛减轻，之后用生地黄、茯苓、当归身、丹参、远志、牡丹皮、侧柏叶、鲜藕。服用数剂后痊愈。
周：在县衙担任幕僚。淋证调理不当，傍晚后出现寒热往来如疟疾状。医生误认为是阴虚，杂进补益固涩药物，病情更加严重。又给予散剂，怀疑不敢服用。哭泣着求诊，脉象虚软而浮。使用补中汤服用数剂，寒热停止，淋证也逐渐好转，之后用六味丸加减治疗而痊愈。
王二：在书馆做差役，夜间私自外出。起初小便浑浊，秘密不说。后来不仅不能正常排尿，反而自行遗尿，身体消瘦怯弱，无法支撑站立，经常像要小便的样子，或者前阴想排尿，后阴也不受控制。这是浊邪日久导致气虚下陷。有人给他服用泻热的药剂，病情更加严重。我采用升举法，佐以利湿。用药：升麻、茯苓、猪苓、白术、半夏、炙甘草、莲须、莲子。仿照治浊固本丸的意旨，滑泄自然停止。
贡：淋证痊愈后忽然复发，面色苍老形体消瘦，食欲减退大便溏薄，咽干膝痛，脉象沉濡，左寸稍大。这是心热移于小肠，与湿邪相搏结。使用参萆薢厘清饮。用药：赤茯苓、生薏米（各三钱）、生白术、泽泻（各八分）、石斛、麦冬（各二钱）、防己、甘草（各一钱）、萆薢、通草（各钱半）、滑石（飞研三分）。服用数剂后淋证痊愈，但脉来沉小，食少足酸。这是脾阳肾阴素来亏虚，应当兼调治疗。用药：熟地黄、枸杞子、益智仁（煨制）、茯神、甘草（炙制）、薏米、山药、莲子（均炒制）、当归身。同研为末，加粳米粉调服，每日二次，进食增加且脚力也健步如常。
岳：劳淋是膀胱气分的病证。近日大便秘结，吃一点东西就胀满，小腿发冷。诊脉弦而迟。这是阴结胃气，不主下行，而膀胱的转输功能不利，从而形成淋证。治疗宜温通，不要进用止涩药物。用药：川附子、生白术、缩砂壳、陈皮白、韭子、瓜蒌仁、苏子（均炒研）、茯苓、海金沙。服用四剂后逆气平复，胀满便秘良好缓解，脉象也调和。去掉川附子、瓜蒌仁，加入牛膝（蒸制）、莲子服用而愈。
江：排尿前涩痛，阴茎端部宿有瘀腐。先前服用瞿麦汤疼痛减轻，是因为引导火邪下行所致。然而脉象洪实搏指，不仅膀胱瘀热未尽，而且心肾根源未清，所以疼痛减轻但淋证不减。应当收摄心神节制欲望，不要扰动肾脏，戒酒清淡饮食，静养可安。用药：茯苓、生地黄、石斛、萆薢、莲须、甘草梢、灯心草、泽泻。服用数剂见效。
王：小便浑浊且频数，并且疼痛，午后寒热不时发作，头晕神倦，脉弱，从秋季延续到春季，兼见尿中带血点。这是劳力伤阴，阴火逼迫注入膀胱。先用分利法，导赤散加入赤茯苓、莲须、当归尾、赤芍、牡丹皮、栀子、灯心草。服用两剂后眩晕疼痛停止，去掉木通、竹叶，改用熟地黄、当归身，又加入萆薢，服用三剂诸症全部痊愈。又令其服用六味丸而愈。
族中某人：患劳淋，初用厘清饮，涩痛已减轻。后服用单方，通利太过，反而导致排尿后精液沥出，腰足酸软，畏冷，左脉虚涩少神，肾气不摄，形成虚滑，适宜摄固。用药：沙苑子、菟丝子、枸杞子、莲子、破故纸、熟地黄（砂仁末炒制）、杜仲。服用数剂见效，后加入鹿角胶、党参、当归身、茯苓、山药，乃巩固疗效。
眭：劳力伤阴，脉右弦左大，腹痛排尿涩滞排出粉末状物，此为沙淋。用药：海金沙（六分）、杜牛膝（一钱）、当归尾（八分）、薏仁（三钱）、灯心草（八分）、赤茯苓（二钱）、小茴香（盐水炒八分）。服用数剂后涩痛停止，去掉前三味药，加入枸杞子、沙苑子、益智子（均炒制）、钗石斛、怀牛膝（酒蒸），服用数剂非常舒适。这是温通的药剂，若能节制劳累则淋证可不发作。
族中某人：膏淋，尿液表面浮油，有时便中推出髓条，这是积劳损伤肾阴所致。宿疾经年，近来又兼患阴疟，真元日益疲惫，饮食无味，益肾必先补脾。用药：党参、茯神、山药、生白术、薏仁、杜仲、芡实、莲子（均炒制）、何首乌、沙苑子，服用十数剂全愈。
陈：面色苍老体型高大，属木火体质，阴分易亏。五十岁外纳妾，急于求嗣续月前因浊成淋，尿频而量少，躺下仍然遗泄，延至血水滴沥而痛，是为血淋。精室既已受伤，心火犹炽，诊两尺脉左弦右数，应该伴有腰膝痿软，足心如烙的感觉。凡是不痛的叫溺血，痛的叫血淋。虽然是肾虚挟火，但是用导赤散、厘清饮，如同方凿圆枘（格格不入），五苓散、八正散，也是抱薪救焚（适得其反）。急用生料六味地黄汤作汤剂，可济燃眉之急。用药：熟地黄（六钱）、生地黄（三钱）、怀山药（炒二钱半）、茯苓（三钱）、牡丹皮、泽泻（各一钱）、生莲子（不去心，一两）、莲子须、麦冬（各二钱）、五味子（五分）。服用数剂后疼痛停止淋证减轻，汤剂丸剂兼进而安。
Ding: Blood lin (hematuria with pain), painful urination. The left cun pulse is surging and rapid, indicating heart heat transferring to the small intestine, clashing with blood vessels, entering the bladder, and exiting together with urine. Due to stasis-heat forcing its way into the urethral orifice, pain also occurs in the penis. One should first clear and drain the fire fu organs, using Dao Chi San (Carpesium Decoction) added with Chi Fu Ling (Red Poria), Mu Dan Pi (Moutan Cortex), Mai Dong (Ophiopogon Tuber), Gui Wei (Angelica Sinensis Tail), Deng Xin Cao (Juncus Effusus), and Mu Tong (Akebia Caulis). After one dose, lin pain decreased. Subsequently, Sheng Di Huang (Rehmannia Root), Fu Ling (Poria), Gui Shen (Angelica Sinensis Body), Dan Shen (Salvia Miltiorrhiza Root), Yuan Zhi (Polygala Root), Mu Dan Pi (Moutan Cortex), Ce Bai Ye (Biota Top Leaf), and Xian Ou (Fresh Lotus Rhizome) were used. After several doses, recovery was achieved.
Zhou: Served as a幕僚 (staff member) in the county office. Lin syndrome was improperly regulated, leading to alternating chills and fever resembling malaria after dusk. The physician mistakenly diagnosed yin deficiency and administered miscellaneous tonifying and astringent medicines, worsening the condition. Powders were then given, but he suspected them and dared not take them. Crying, he sought consultation; the pulse was deficient, soft, and floating. Bu Zhong Tang (Tonify the Middle Decoction) was prescribed for several doses, stopping the chills and fever, and gradually alleviating the lin. Later, Liu Wei Wan (Six-Ingredient Pill with Rehmannia) modified was used for complete recovery.
Wang Er: A servant in the scriptorium who secretly went out at night. Initially, his urine was turbid, which he kept secret. Later, he could not urinate normally and suffered from involuntary leakage. He became emaciated and weak, unable to stand up, often feeling the urge to urinate, or experiencing leakage of both anterior and posterior orifices. This indicates qi deficiency sinking due to prolonged turbidity. Someone gave him heat-draining agents, worsening the illness. I employed a lifting method assisted by dampness-draining herbs: Sheng Ma (Cimicifuga Rhizome), Fu Ling (Poria), Zhu Ling (Polyporus), Bai Zhu (Atractylodes Macrocephala Rhizome), Ban Xia (Pinellia Tuber), Zhi Gan Cao (Prepared Licorice Root), Lian Xu (Lotus Stamen), and Lian Zi (Lotus Seed). Mimicking the intent of Zhi Zhuo Gu Ben Wan (Turbidity-Treating and Root-Securing Pill), the leakage stopped spontaneously.
Gong: Lin syndrome recurred suddenly after recovery. Complexion was sallow, body thin, appetite reduced, stool loose, throat dry, knees painful. Pulse was deep and soggy, with the left cun slightly enlarged. This indicates heart heat transferring to the small intestine, clashing with dampness. Can Bi Xi Li Qing Yin (Ginseng and Dioscorea Hypoglauca Clearing Decoction) was used. Ingredients: Chi Fu Ling (Red Poria), Sheng Yi Mi (Raw Coix Seed) (each 3 qian), Sheng Bai Zhu (Raw Atractylodes Macrocephala Rhizome), Ze Xie (Alisma Rhizome) (each 8 fen), Shi Hu (Dendrobium Stem), Mai Dong (Ophiopogon Tuber) (each 2 qian), Fang Ji (Stephania Tetrandra Root), Gan Cao (Licorice Root) (each 1 qian), Bi Xi (Dioscorea Hypoglauca Rhizome), Tong Cao (Tetrapanax Pith) (each 1.5 qian), Hua Shi (Talcum) (3 fen, flown). After several doses, lin resolved, but the pulse remained deep and small, with poor appetite and sore feet. This indicated inherent deficiency of spleen yang and kidney yin, requiring combined regulation. Ingredients: Shu Di Huang (Prepared Rehmannia Root), Qi Zi (Goji Berry), Yi Zhi Ren (Alpinia Oxyphylla Fruit) (roasted), Fu Shen (Poria with Hostwood), Gan Cao (Licorice Root) (prepared), Yi Mi (Coix Seed), Shan Yao (Dioscorea Rhizome), Lian Zi (Lotus Seed) (all stir-fried), Gui Shen (Angelica Sinensis Body). Ground into powder, mixed with Jing Mi (Rice)屑 (bran/powder) for ingestion, twice daily. Appetite improved, and walking strength returned.
Yue: Lao Lin (fatigue-related lin) is a disease of the qi aspect of the bladder. Recently, constipation occurred, bloating after eating, and cold calves. The pulse was wiry and slow. This indicates yin binding of stomach qi, failing to descend, while bladder transportation is impaired, causing lin. Treatment should be warming and unblocking, avoiding astringents. Ingredients: Chuan Fu Zi (Aconitum Carleilii Lateral Root), Sheng Bai Zhu (Raw Atractylodes Macrocephala Rhizome), Suo Sha Ke (Amomum Villosum Shell), Chen Pi Bai (Citrus Reticulata Peel), Jiu Zi (Allium Tuberosum Seed), Lou Ren (Trichosanthes Fruit Kernel), Su Zi (Perilla Fruit) (all stir-fried and ground), Fu Ling (Poria), Hai Jin Sha (Lygodium Spore). After four doses, rebellious qi calmed, bloating and constipation resolved, and pulse harmonized. Chuan Fu Zi and Lou Ren were removed, Niu Xi (Achyranthes Root) (steamed) and Lian Zi (Lotus Seed) added. Recovery followed.
Jiang: Pre-urinary涩痛 (astringent pain), with old stasis and rot at the penile tip. Previously, Qu Mai Tang (Knotweed Decoction) reduced pain by guiding fire downward. However, the pulse was surging and solid against the finger, indicating not only unresolved bladder stasis-heat but also unclear heart-kidney roots, hence pain reduced but lin persisted. Advice: calm the mind, restrain desires, avoid disturbing the kidneys, abstain from alcohol and rich foods, and rest quietly. Ingredients: Fu Ling (Poria), Sheng Di Huang (Raw Rehmannia Root), Shi Hu (Dendrobium Stem), Bi Xi (Dioscorea Hypoglauca Rhizome), Lian Xu (Lotus Stamen), Gan Cao Shao (Licorice Root Tip), Deng Xin Cao (Juncus Effusus), Ze Xie (Alisma Rhizome). Several doses yielded effects.
Wang: Turbid, frequent, and painful urination, intermittent chills and fever in the afternoon, dizziness, mental fatigue, weak pulse. From autumn to spring, accompanied by blood spots in urine. This is labor injuring yin, with yin fire forcing its way into the bladder. First, use separation and drainage: Dao Chi San (Carpesium Decoction) added with Chi Fu Ling (Red Poria), Lian Xu (Lotus Stamen), Gui Wei (Angelica Sinensis Tail), Chi Shao (Red Peony Root), Mu Dan Pi (Moutan Cortex), Zhi Zi (Gardenia Fruit), Deng Cao (Juncus Effusus). Two doses stopped dizziness and pain. Mu Tong (Akebia Caulis) and Zhu Ye (Bamboo Leaf) were removed, replaced by Shu Di Huang (Prepared Rehmannia Root) and Gui Shen (Angelica Sinensis Body), plus Bi Xi (Dioscorea Hypoglauca Rhizome). Three doses cured all symptoms. Finally, Liu Wei Wan (Six-Ingredient Pill with Rehmannia) ensured recovery.
Clansman: Fatigue lin, initially treated with Li Qing Yin (Clearing Decoction), astringent pain reduced. Later, a single prescription caused excessive draining, resulting in post-urinary seminal leakage, sore waist and legs, fear of cold, and a deficient, choppy left pulse lacking spirit. Kidney qi failed to secure, forming deficiency slipperiness, requiring securing and firming. Ingredients: Sha Yuan Zi (Astragalus Complanatus Seed), Tu Si Zi (Cuscuta Seed), Qi Zi (Goji Berry), Lian Zi (Lotus Seed), Po Gu Zhi (Cibotium Barometz), Shu Di Huang (Prepared Rehmannia Root) (stir-fried with Amomum Cardamomum powder), Du Zhong (Eucommia Bark). Several doses effective. Later, Lu Jiao Jiao (Deer Antler Glue), Lu Shen (Codonopsis Pilosula Root), Gui Shen (Angelica Sinensis Body), Fu Ling (Poria), Shan Yao (Dioscorea Rhizome) added for consolidation.
Sui: Labor injured yin, right pulse wiry, left pulse large. Abdominal pain, astringent urination with powder discharge, indicating Sha Lin (sand lin). Ingredients: Hai Jin Sha (Lygodium Spore) (6 fen), Du Niu Xi (Cyathula Root) (1 qian), Dang Gui Wei (Angelica Sinensis Tail) (8 fen), Yi Ren (Coix Seed) (3 qian), Deng Xin Cao (Juncus Effusus) (8 fen), Chi Fu Ling (Red Poria) (2 qian), Xiao Hui Xiang (Fennel Fruit) (salt-stir-fried 8 fen). Several doses stopped astringent pain. Removed the first three ingredients, added Qi Zi (Goji Berry), Sha Yuan Zi (Astragalus Complanatus Seed), Yi Zhi Zi (Alpinia Oxyphylla Fruit) (all stir-fried), Cha Hu (Dendrobium Nobile Stem), Huai Niu Xi (Achyranthes Bidentata Root) (wine-steamed). Several doses brought comfort. This is a warming and unblocking formula; if labor is restrained, lin may not recur.
Clansman: Gao Lin (paste lin), urine surface with floating oil, sometimes extruding marrow-like strips during defecation. Caused by accumulated labor injuring kidney yin. Chronic condition for years, recently complicated by yin malaria. True yuan increasingly exhausted, tasteless food. Tonifying kidney must first tonify spleen. Ingredients: Lu Shen (Codonopsis Pilosula Root), Fu Shen (Poria with Hostwood), Shan Yao (Dioscorea Rhizome), Sheng Bai Zhu (Raw Atractylodes Macrocephala Rhizome), Yi Ren (Coix Seed), Du Zhong (Eucommia Bark), Qian Shi (Euryale Seed), Lian Zi (Lotus Seed) (all stir-fried), He Shou Wu (Polygonum Multiflorum Root), Sha Yuan Zi (Astragalus Complanatus Seed). Over ten doses led to full recovery.
Chen: Sallow complexion, tall stature, wood-fire constitution, prone to yin deficiency. Married concubines after fifty, eager for heirs. Previously, turbidity turned to lin, frequent but scant urination, nocturnal emission even when lying down, progressing to dripping bloody pain, defined as blood lin. Essence chamber injured, heart fire blazing. Left chi pulse wiry, right chi pulse rapid. Symptoms likely include weak waist and knees, burning soles. Non-painful urinary blood is "ni xue"; painful is "xue lin". Although kidney deficiency with fire exists, Dao Chi San (Carpesium Decoction) and Li Qing Yin (Clearing Decoction) are like square pegs in round holes; Wu Ling San (Five-Ingredient Powder with Poria) and Ba Zheng San (Eight-Righteous Powder) are like adding fuel to a fire. Urgently use Sheng Liao Liu Wei (Raw Ingredient Six-Ingredient) decoction to relieve urgency. Ingredients: Shu Di Huang (Prepared Rehmannia Root) (6 qian), Sheng Di Huang (Raw Rehmannia Root) (3 qian), Huai Shan Yao (Chinese Yam) (stir-fried 2.5 qian), Fu Ling (Poria) (3 qian), Mu Dan Pi (Moutan Cortex), Ze Xie (Alisma Rhizome) (each 1 qian), Sheng Lian Zi (Raw Lotus Seed) (uncut heart, 1 liang), Lian Zi Xu (Lotus Stamen), Mai Dong (Ophiopogon Tuber) (each 2 qian), Wu Wei Zi (Schisandra Berry) (0.5 fen). Several doses stopped pain and reduced lin. Decoction and pills combined led to peace.