【因】 湿能自汗，热能自汗。虚则盗汗。痰亦自汗、头汗。
【证】 阴阳俱虚，身体枯燥，头汗，亡津液也。热入血室，头汗。
伤湿额上汗，因下之，微喘者死。胃热上熏，头汗。发黄头汗，小便不利而渴。此瘀热
在里也。心下懊 ，头汗。
（附小便不禁 肾脏风）
【脉】 细而数。脉盛大而实者生；虚小而涩者死。尺中盛大，此阴血不足，阳
乘之，为关。
【因】 膀胱有热则淋。然赤涩、淋涩，如脂膏、如砂石，皆内热也。如水煎盐
而成也。气不利则不通。《经》曰，小便为气所化，气不化则脐腹满不利，闷而为淋。
【治法】 淋者，解热利小便；闭者，行气则水自下。有气虚则气不行，血虚则
气不升
，痰多气塞则气不运。治法，气虚补气，血虚补血，痰多导痰。先服本药，后皆用吐之以提
其气，气升则水自下，加以五苓散。有人患淋，乃血滞，故四物汤内加杜牛膝而愈。死血亦
淋也。
李论∶皆邪在肺而无资其化源，邪热在肾而闭其下焦，可除其热、泻其塞当已。
治热在上焦，以栀子、黄芩主之；热在中焦，加以连、芍；热在下焦，加之以柏。
资肾丸 治小便闭，不渴，热在下焦血分也。
知母（酒制） 黄柏（各二两，酒炒） 肉桂（一钱）
清肺饮子 治渴，小便不利，热在上焦气分。
茯苓（二钱） 猪苓（三钱） 泽泻（五钱） 琥珀（五分） 灯心（一钱） 木通（七钱） 通草（
二钱） 车前子（一钱） 扁豆（七钱） 瞿麦（半钱）
导气除湿汤 治小便闭，乃血涩致气不通；或淋者，即有死血。
知母（三钱，酒浸） 黄柏（四钱，酒制） 滑石（二钱，炒黄） 泽泻 茯苓（各三钱）
空心服。
牛漆膏 治前方证，大妙。
肾疸汤 治目黄渐至身，小便赤涩。
升麻（半两） 羌活 防风 本 独活 柴胡（各半钱） 白术 苍术（一钱） 猪苓（四
钱） 茯苓（二钱） 黄柏（二钱） 泽泻（三钱） 白芍（五分） 神曲（六钱，炒） 人参（三钱）
甘草（三钱）
作二服。
秘方 淋热则利之，山栀之类；气虚补之，参、术加木通、山栀之类。
小便不通。气虚，参术升麻汤，后吐之。血虚，四物汤，后吐之。痰气闭塞，二陈汤，
加木通、香附，后吐之。
又方 治淋。
麦门冬 葱头（带根） 人参 三臼根 黑豆
浓煎，饮之。
淋方
五淋散 牛膝根 葵子 滑石 瞿麦
冷加附；热加芩；血加栀子；膏加秋石，加石苇；气，小腹满闭，加沉香、木香。
发灰散 治饮食、忍小便、走马房劳，皆致转胞，脐下急满不通。醋服一合，或
加葵子、甘遂，加大蒜捣饼，安脐心，令实，着艾灸三十壮，治小便不通。
小便不禁（膀胱不约为遗尿）
因 归之肾冷，用韭子丸（六两，炒），佐以鹿茸、肉苁蓉、牛膝、巴戟、菟丝、
石斛、杜仲、肉桂、当归、地黄等药。
阿胶散 治湿。
阿胶（二两，炒） 牡蛎（ ） 鹿茸（酥炙，四两）
煎散，任下。
茯苓丸 治心肾虚，淋沥。
赤白茯苓（各二两） 地黄汁
好酒熬膏，丸，盐酒下。
【证】 大小便闭者，外有骨热不同。关格者，外有肝实热、心实热。便利不禁
者，外有风湿、肝痹不同。肾脏风乃湿。
【治】 阴茎痒痛不忍，苦参、大黄、荆芥、皂角洗熏。
阴胞痒，虫蚀方 狗脊（不用金毛者）、黄连、黄柏、黄丹、水银粉、光粉、赤石脂，为
末敷好。
又方 大甘草汤浸海螵蛸末，敷。
【病因】 湿气能导致自汗，热邪也能导致自汗。虚证则表现为盗汗（夜间睡眠中出汗）。痰湿也能引起自汗、头汗（仅头部出汗）。
【证候】 阴阳两虚，身体干枯粗糙，出现头汗，这是津液亡失的表现。热邪侵入血室（指女子胞宫或肝经血分），会出现头汗。
伤于湿邪且额头出汗，如果误用攻下法，出现轻微气喘的，预后不良（主死）。胃中热邪上熏，会导致头汗。发黄且伴有头汗，小便不利且口渴，这是瘀热在里的表现。心中烦闷懊恼（心中郁热不适），会出现头汗。
【脉象】 脉细而数。脉象盛大而实的，预后良好（主生）；脉象虚小且涩的，预后不良（主死）。尺脉盛大，这是阴血不足，阳气乘虚侵袭，导致关格之病。
【病因】 膀胱有热则导致淋证（小便频数短涩、滴沥刺痛）。然而，小便赤涩、淋涩，排出如脂膏、如砂石，都是内热的表现，就像用水煎盐一样。气机不利则水道不通。《内经》说，小便由气化所生成，气不化则脐腹部胀满不利，憋闷而成淋证。
【治法】 淋证，要清热利小便；闭证（小便点滴不出），行气则水液自然下行。如果有气虚，则气不行；血虚，则气不升；痰多气塞，则气不运。治疗方法是：气虚补气，血虚补血，痰多导痰。先服用本方药，之后都用吐法以提举其气，气升则水液自然下行，并配合使用五苓散。有人患淋证，乃是血滞所致，所以在四物汤中加入杜牛膝而痊愈。死血（瘀血）也会导致淋证。
李氏论述：都是邪气在肺而没有资助其化源（津液化生之源），邪热在肾而闭塞了下焦，可以清除其热、泻除其壅塞，应当痊愈。
治疗热在上焦，以栀子、黄芩为主药；热在中焦，加上黄连、白芍；热在下焦，加上黄柏。
资肾丸：治疗小便闭，口不渴，病因为热在下焦血分。
知母（酒制） 黄柏（各二两，酒炒） 肉桂（一钱）
清肺饮子：治疗口渴，小便不利，病因为热在上焦气分。
茯苓（二钱） 猪苓（三钱） 泽泻（五钱） 琥珀（五分） 灯心草（一钱） 木通（七钱） 通草（二钱） 车前子（一钱） 扁豆（七钱） 瞿麦（半钱）
导气除湿汤：治疗小便闭，乃因血涩导致气不通；或者淋证，即有死血（瘀血）。
知母（三钱，酒浸） 黄柏（四钱，酒制） 滑石（二钱，炒黄） 泽泻 茯苓（各三钱）
空腹服用。
牛漆膏：治疗上述前方证候，效果极佳。
肾疸汤：治疗目黄逐渐蔓延至全身，小便赤涩。
升麻（半两） 羌活 防风 藁本 独活 柴胡（各半钱） 白术 苍术（一钱） 猪苓（四钱） 茯苓（二钱） 黄柏（二钱） 泽泻（三钱） 白芍（五分） 神曲（六钱，炒） 人参（三钱） 甘草（三钱）
分为两次服用。
秘方：淋证属热则利之，如山栀之类；气虚则补之，用人参、白术加木通、山栀之类。
小便不通。气虚，用人参、白术、升麻汤，之后用吐法。血虚，用四物汤，之后用吐法。痰气闭塞，用二陈汤，加木通、香附，之后用吐法。
又一方：治疗淋证。
麦门冬 葱头（带根） 人参 三臼根 黑豆
浓煎，饮用。
淋方
五淋散：牛膝根 葵子 滑石 瞿麦
寒证加附子；热证加黄芩；血证加栀子；膏淋加秋石，加石苇；气淋，小腹满闭，加沉香、木香。
发灰散：治疗饮食不当、忍尿、纵欲房劳，都导致转胞（膀胱扭转或功能失调），脐下急迫胀满不通。醋服一合，或者加葵子、甘遂，加大蒜捣成饼，敷于脐心，令其实紧，施艾灸三十壮，治疗小便不通。
小便不禁（膀胱不固约导致遗尿）
病因：归属于肾冷，用韭子丸（六两，炒），佐以鹿茸、肉苁蓉、牛膝、巴戟天、菟丝子、石斛、杜仲、肉桂、当归、地黄等药。
阿胶散：治疗湿证。
阿胶（二两，炒） 牡蛎 鹿茸（酥炙，四两）
煎散剂，任其服用。
茯苓丸：治疗心肾虚，淋沥不尽。
赤茯苓 白茯苓（各二两） 地黄汁
用好酒熬成膏，制成丸剂，盐酒送服。
【证候】 大小便闭结者，外感骨热不同。关格（小便不通与呕吐并见）者，外感肝实热、心实热不同。大小便失禁者，外感风湿、肝痹不同。肾脏风属于湿邪。
[Pathogenesis] Dampness can cause spontaneous sweating, and heat can also cause spontaneous sweating. Deficiency syndromes manifest as night sweats (sweating during sleep). Phlegm-dampness can also induce spontaneous sweating and head sweat (sweating only on the head).
[Syndrome Manifestations] When both Yin and Yang are deficient, the body becomes dry and rough, accompanied by head sweat; this indicates the loss of body fluids. When heat enters the Blood Chamber (referring to the uterus or the blood aspect of the Liver meridian), head sweat occurs.
If injured by dampness with sweating on the forehead, and purgation is mistakenly applied, resulting in slight panting, the prognosis is poor (fatal). Heat steaming upward from the Stomach causes head sweat. Jaundice accompanied by head sweat, with difficulty in urination and thirst, indicates stasis-heat residing internally. Mental restlessness and oppression (internal heat discomfort) lead to head sweat.
(Attached: Incontinence of urine, Kidney Wind)
[Pulse Diagnosis] The pulse is fine and rapid. A pulse that is large and excess indicates a favorable prognosis (survival); a pulse that is deficient, small, and choppy indicates an unfavorable prognosis (death). A large pulse at the Chi position indicates insufficient Yin-blood, with Yang invading due to deficiency, leading to Guan-Ge syndrome (obstruction).
[Pathogenesis] Heat in the Bladder leads to Lin syndrome (dysuria characterized by frequent, short, scanty, and painful urination). However, red and astringent urine, or Lin syndrome with discharge resembling fat paste or gravel, all indicate internal heat, similar to boiling salt in water. If Qi mechanism is obstructed, the water passages become blocked. The *Classic* states that urine is transformed by Qi; if Qi fails to transform, there is fullness and obstruction in the umbilical and abdominal regions, leading to stifling and the formation of Lin syndrome.
[Therapeutic Methods] For Lin syndrome, clear heat and promote diuresis; for Bi syndrome (complete urinary retention), promote Qi movement so that water flows down naturally. If there is Qi deficiency, Qi does not move; if there is Blood deficiency, Qi does not ascend; if there is excessive phlegm causing Qi blockage, Qi does not circulate. The treatment methods are: tonify Qi for Qi deficiency, nourish Blood for Blood deficiency, and guide out phlegm for excessive phlegm. First administer the base formula, then use emesis to raise the Qi; once Qi ascends, water flows down naturally, combined with the use of Wuling San. A patient suffering from Lin syndrome was cured by adding Du Niuxi (Achyranthes Bidentata Root) to Siwu Tang, indicating that stagnant blood caused the condition. Dead blood (blood stasis) can also cause Lin syndrome.
Li's discussion: These conditions involve pathogenic factors in the Lung without supporting its source of transformation (the origin of fluid metabolism), and pathogenic heat in the Kidney blocking the Lower Jiao. Clearing the heat and draining the obstruction should lead to recovery.
For heat in the Upper Jiao, use Gardenia (Zhi Zi) and Scutellaria (Huang Qin) as main herbs; for heat in the Middle Jiao, add Coptis (Lian) and White Peony (Shao); for heat in the Lower Jiao, add Phellodendron (Bo).
Zishen Wan (Kidney-Nourishing Pill): Treats urinary retention without thirst, caused by heat in the Blood aspect of the Lower Jiao.
Anemarrhena Rhizome (processed with wine) Phellodendron Bark (each 2 liang, stir-fried with wine) Cinnamon Twig (1 qian)
Qingfei Yinzi (Lung-Clearing Decoction): Treats thirst and difficulty in urination, caused by heat in the Qi aspect of the Upper Jiao.
Poria (2 qian) Polyporus (3 qian) Alisma (5 qian) Amber (0.5 fen) Centipede Grass (1 qian) Akebia Stem (7 qian) Trogopterorus (2 qian) Plantago Seed (1 qian) Faba Bean (7 qian) Dianthus Flower (0.5 qian)
Daoqi Chushi Tang (Qi-Guiding and Dampness-Expelling Decoction): Treats urinary retention caused by blood stagnation leading to Qi obstruction; or Lin syndrome, which involves dead blood (blood stasis).
Anemarrhena Rhizome (3 qian, soaked in wine) Phellodendron Bark (4 qian, processed with wine) Talcum (2 qian, stir-fried until yellow) Alisma Poria (each 3 qian)
Take on an empty stomach.
Niuxi Gao (Achyranthes Ointment): Treats the above-mentioned syndromes; highly effective.
Shendan Tang (Kidney-Jaundice Decoction): Treats yellowing of the eyes spreading to the whole body, with red and astringent urine.
Cimicifuga Rhizome (0.5 liang) Notopterygium Rhizome Saposhnikovia Root Ligusticum Rhizome Angelica Pubescens Radix Bupleurum Root (each 0.5 qian) Atractylodes Macrocephala Rhizome Atractylodes Lancea Rhizome (1 qian) Polyporus (4 qian) Poria (2 qian) Phellodendron Bark (2 qian) Alisma (3 qian) White Peony Root (0.5 fen) Medicated Leaven (6 qian, stir-fried) Ginseng Radix Licorice Root (3 qian)
Divide into two doses.
Secret Formula: For hot Lin syndrome, promote diuresis using Gardenia etc.; for Qi deficiency, tonify using Ginseng and Atractylodes plus Akebia Stem and Gardenia etc.
Urinary Retention. For Qi deficiency, use Ginseng, Atractylodes, and Cimicifuga Decoction, followed by emesis. For Blood deficiency, use Siwu Tang, followed by emesis. For blockage by phlegm-Qi, use Erchen Tang, plus Akebia Stem and Cyperus Rhizome, followed by emesis.
Another Prescription: Treats Lin syndrome.
Ophiopogon Tuber Green Onion Head (with roots) Ginseng Radix Sanguisorba Root Black Soybean
Decoct strongly and drink.
Lin Syndrome Formulas
Wulin San (Five-Lin Powder): Achyranthes Root Sunflower Seeds Talcum Dianthus Flower
Add Aconite for cold patterns; add Scutellaria for heat patterns; add Gardenia for blood patterns; add Autumn Stone and Pyrite for paste-like discharge; for Qi-pattern with lower abdominal fullness and closure, add Agarwood and Costus Root.
Hair Ash Powder: Treats urinary retention (Zhuanbao) caused by improper diet, holding urine, or sexual exhaustion, leading to urgent fullness below the navel and inability to urinate. Take one he with vinegar, or add Sunflower Seeds and Kansui, and apply a garlic paste to the navel center, securing it tightly, and apply moxibustion (30 cones) to treat urinary retention.
Incontinence of Urine (Enuresis due to Bladder failing to secure)
Pathogenesis: Attributed to Cold in the Kidney. Use Jiuzi Wan (Leek Seed Pill, 6 liang, stir-fried), assisted by Deer Antler, Cistanche, Achyranthes, Morinda, Dodder Seed, Dendrobium, Eucommia, Cinnamon Twig, Angelica, and Rehmannia.
Ejiao San (Donkey-Hide Gelatin Powder): Treats dampness.
Donkey-Hide Gelatin (2 liang, stir-fried) Oyster Shell Deer Antler (roasted with butter, 4 liang)
Decoct the powder and take as directed.
Fuling Wan (Poria Pill): Treats Heart and Kidney deficiency with dribbling urination.
Red Poria White Poria (each 2 liang) Rehmannia Juice
Simmer with good wine to make a paste, form pills, and take with salted wine.
[Syndromes] Cases of simultaneous closure of stool and urine differ from external bone heat. Guan-Ge syndrome differs from external Liver Excess-Heat and Heart Excess-Heat. Incontinence of stool and urine differs from external Wind-Dampness and Liver Bi-syndrome. Kidney Wind belongs to Dampness.
[Treatment] For unbearable itching and pain of the penis, wash and fumigate with Sophora Root, Rhubarb, Schizonepeta, and Soap Pod.
Itching of the Vulva/Vagina, Parasitic Erosion Formula: Cibotium Rhizome (without golden hairs), Coptis, Phellodendron, Lead Oxide, Mercury Powder, Calamine, and Red Kaolin, grind into powder and apply.
Another Formula: Soak Sepia Shell powder in Licorice Decoction and apply.