〔大〕妇人淋沥，由肾虚而膀胱热也。盖膀胱与肾为表里，主于水，行于脬者为小
便也。若肾虚则小便频数，膀胱热则小便淋沥，甚则不通，腹胀喘急，当速治之。
〔薛〕前证若膀胱热结，用五淋散。若脾肺虚热，用补中益气（杂病劳倦。）加山药、五
味、麦门。若脾经郁热，用加味归脾汤。（即归脾加丹皮、山栀。）若肺经郁火，用黄芩清肺饮。
若肝经湿热，用龙胆泻肝汤。（杂病淋。）血虚用加味逍遥散。（结核。）阴虚用六味丸（杂病虚劳。）加
柴胡、山栀。大抵不渴而不利者，热在下焦血分也，用滋肾丸。渴而不利者，热在气分
也，用清肺饮。尺脉数而无力者，阴火盛而阳不能化也，用六味丸、滋肾丸为主。尺脉
浮而无力者，阳气虚而阴不能生也，用加减八味丸、（杂病消瘅。）滋肾丸为主。一妇人素
有前患，内热体倦。余以为肝火血少，脾气虚弱，用八珍、逍遥二散，兼服月余而小便
利，又用八珍汤而血气复。一妇人患前证，面青胁胀，诸药不应。余以为肝经气滞而血
伤，用山栀、川芎煎服而愈。 一妇人小便不利，小腹并水道秘闷，或时腹胁胀痛，余
以为肝火，用加味逍遥散加龙胆草，四剂稍愈，乃去胆草佐以八珍散加炒黑山栀兼服而
瘥。
石韦散 治妇人小便卒然淋沥。
石韦 黄芩 瞿麦穗 榆白皮 木通 葵子（各一钱半） 甘草（半钱）
上作一服，水二盅，煎至一盅，食前服。
木通散 治妇人五淋。
木通 榆白皮 瞿麦穗 大麻仁 滑石（各一两） 葵子 贝齿 白茅根（各二两） 甘草（半
两）
上为粗末，每服五钱，水煎空心温服。
桃胶散 治妇人气淋、劳淋。
桃胶 榆白皮（各一两） 车前子 冬瓜子 鲤鱼齿 葵子 瞿麦 木通（各半两） 枳壳（二钱半）
上 咀，每服四钱重，水一盏，煎至七分，去滓温服。
金沙散 治妇人诸淋。
上海金沙草阴干为末，煎生甘草汤调服二钱。
又方 真琥珀（研末，不以多少，） 研木香白汤调下。（此二方出陈总领方。）
鸡苏散 治妇人血淋。
鸡苏叶 木通（各二两） 生干地黄 滑石（各三两） 刺苏根（一两）
上为粗末，每服半两，水盏半， 竹叶三七片，煎至七分，去滓食前温服。
治妇人血淋及尿血涩痛方。
生干地黄（三两） 郁金 蒲黄（各二两）
上为细末，每服二钱，车前子叶煎汤调下，以利为度。
亦有血瘕似淋，小便不通，脐腹胀满，宜桃仁煎。（方见前积聚 瘕门血瘕条。）
后有用乱发方治脬转不得小便，亦可治血淋、尿血。
火府丹 治心经热，小便涩，及治五淋。（加甘草，为 咀煎，名导赤散。出《本事方》。）
生地黄（二两） 木通 黄芩（各一两）
上为细末，炼蜜丸如梧桐子大。每服三十丸，木通煎汤下。兼治淋沥，脐下满痛。
许学士云∶壬戌年一卒渴病，一日饮水一斗，不食者三月，心中烦闷，时已十月。予谓曾
经三伏热，与此药数服。越二日来谢云∶当日三服渴止，又三服饮食如故。此本治淋，用
以治渴，可谓通变也。
治妇人诸般淋。
苦杖根俗呼为杜牛膝，多取洗净锉碎，取一合，用水五盏，煎至一盏，去滓，用麝香、
乳香少许调下。
鄞县武尉耿梦得，其内人患沙石淋者十三年，每漩痛楚不可忍，溺器中小便沙石剥
剥有声，百方不效。偶得此方服之，一夕而愈。目所视也。
《局方》五苓散、八正散、清心莲子饮皆可用。
滋肾丸 治热在血分，不渴而小便不利；或肾虚足热腿膝无力，不能履地；又下焦阴
虚，小便不利，肚腹肿胀，或皮肤胀裂，眼睛突出。此神剂也。
知母 黄柏（各酒炒，二两） 肉桂（去粗皮，二钱）
上各另为末，水丸如桐子大。每服二百丸，空心百滚汤下。
黄芩清肺饮 治肺热小便不利，宜用此药清之。
黄芩（炒） 山栀（炒，各一钱）
上水煎服。不利加盐豉二十粒。
五淋散 治膀胱有热，水道不通，淋沥不出，或尿如豆汁，或成砂石，或如膏汁，或
热怫便血。
赤茯苓（一钱半） 赤芍药 山栀（各一钱） 当归 甘草（各一钱二分）
上入灯心，水煎服。
【大论】妇女出现小便淋沥不尽的症状，是由于肾虚兼有膀胱热所致。因为膀胱与肾互为表里关系，共同主管水液代谢，尿液在胞中形成后排出即为小便。如果肾气虚弱，就会导致小便次数频繁；如果膀胱有热，就会导致小便淋沥不畅，严重时甚至完全不通，伴随腹部胀满、气喘急促，此时应当迅速进行治疗。
【薛己按语】上述病症若属于膀胱热结，使用五淋散治疗。若属于脾肺虚热，使用补中益气汤（参见杂病劳倦章节），并加入山药、五味子、麦门冬。若属于脾经郁热，使用加味归脾汤（即在归脾汤基础上加入牡丹皮、山栀）。若属于肺经郁火，使用黄芩清肺饮。若属于肝经湿热，使用龙胆泻肝汤（参见杂病淋证章节）。若属于血虚，使用加味逍遥散（参见结核章节）。若属于阴虚，使用六味丸（参见杂病虚劳章节），并加入柴胡、山栀。大体而言，口不渴而小便不利者，是热邪在下焦血分，使用滋肾丸。口渴而小便不利者，是热邪在气分，使用清肺饮。尺脉数而无力者，是阴火旺盛而阳气不能化生，以六味丸、滋肾丸为主治。尺脉浮而无力者，是阳气虚弱而阴液不能滋生，以加减八味丸（参见杂病消瘅章节）、滋肾丸为主治。
有一位妇人素来患有上述病症，伴有内热、身体疲倦。我认为这是肝火旺盛、血少、脾气虚弱所致，使用八珍汤和逍遥散两种方剂交替服用，持续一个多月后小便通利，随后又用八珍汤调理使气血恢复。另一位妇人患上述病症，面色青暗、胁肋胀满，服用其他药物无效。我认为这是肝经气滞导致血伤，使用山栀、川芎煎服而痊愈。还有一位妇人小便不利，小腹部及尿道闭塞闷痛，有时腹胁胀痛，我认为这是肝火所致，使用加味逍遥散加入龙胆草，服用四剂后稍有好转，于是去掉龙胆草，配合八珍散加入炒黑山栀同时服用而康复。
石韦散：治疗妇女突然发生的小便淋沥。
药材：石韦、黄芩、瞿麦穗、榆白皮、木通、葵子（各一钱半），甘草（半钱）。
制法用法：以上药材为一服量，加水二盅，煎至一盅，饭前服用。
木通散：治疗妇女五种淋证。
药材：木通、榆白皮、瞿麦穗、大麻仁、滑石（各一两），葵子、贝齿、白茅根（各二两），甘草（半两）。
制法用法：以上药材捣成粗末，每次服用五钱，加水煎煮，空腹温服。
桃胶散：治疗妇女气淋、劳淋。
药材：桃胶、榆白皮（各一两），车前子、冬瓜子、鲤鱼齿、葵子、瞿麦、木通（各半两），枳壳（二钱半）。
制法用法：以上药材切碎，每次服用四钱重，加水一盏，煎至七分，去渣温服。
金沙散：治疗妇女各种淋证。
制法用法：取上海金沙草阴干研为细末，用生甘草汤调服二钱。
另一方法：真琥珀（研为细末，用量不限），研木香，用白开水调下。（这两个方子出自陈总领方。）
鸡苏散：治疗妇女血淋。
药材：鸡苏叶、木通（各二两），生干地黄、滑石（各三两），刺苏根（一两）。
制法用法：以上药材捣成粗末，每次服用半两，加水一盏半，竹叶三十七片，煎至七分，去渣饭前温服。
治疗妇女血淋及尿血涩痛的方子。
药材：生干地黄（三两），郁金、蒲黄（各二两）。
制法用法：以上药材研为细末，每次服用二钱，用车前子叶煎汤调下，以小便通畅为度。
也有血瘕类似淋证，导致小便不通，脐腹部胀满，适宜使用桃仁煎（方见前文积聚 瘕门血瘕条）。
后来有用乱发治疗的方子治疗胞转导致的小便不通，也可以治疗血淋、尿血。
火府丹：治疗心经热盛，小便涩痛，以及治疗五种淋证。（加入甘草，切碎煎煮，名为导赤散。出自《本事方》。）
药材：生地黄（二两），木通、黄芩（各一两）。
制法用法：以上药材研为细末，用炼蜜制成梧桐子大小的丸药。每次服用三十丸，用木通煎汤送下。兼治淋沥不尽，脐下满痛。
许学士说：壬戌年有一位卒官患口渴病，一天喝水一斗，三个月没吃东西，心中烦闷，当时已是十月。我认为是曾经历三伏天的暑热，给予此药服用数次。过了两天来道谢说：当天服用三次后口渴停止，又服用三次后饮食恢复正常。这本来是治疗淋证的药，用来治疗口渴，可以说是灵活变通了。
治疗妇女各种淋证。
苦杖根俗称为杜牛膝，多取洗净锉碎，取一合，用水五盏，煎至一盏，去渣，用麝香、乳香少许调下。
鄞县武尉耿梦得的妻子患沙石淋长达十三年，每次排尿痛苦难忍，溺器中小便沙石发出剥剥的声音，尝试百种方法无效。偶然得到此方服用，一夜之间痊愈。这是亲眼所见的事实。
滋肾丸：治疗热在血分，口不渴而小便不利；或肾虚足热腿膝无力，不能站立行走；又如下焦阴虚，小便不利，肚腹肿胀，或皮肤胀裂，眼睛突出。这是神效之剂。
药材：知母、黄柏（各酒炒，二两），肉桂（去粗皮，二钱）。
制法用法：以上药材分别研为细末，用水泛丸如桐子大小。每次服用二百丸，空腹时用滚开的水送下。
黄芩清肺饮：治疗肺热导致的小便不利，宜用此药清热。
药材：黄芩（炒）、山栀（炒，各一钱）。
制法用法：加水煎服。若不利，加入盐豉二十粒。
五淋散：治疗膀胱有热，水道不通，淋沥不出，或尿如豆汁，或结成砂石，或如膏汁，或热盛迫血妄行导致便血。
药材：赤茯苓（一钱半），赤芍药、山栀（各一钱），当归、甘草（各一钱二分）。
制法用法：加入灯心草，加水煎服。
[Da Lun] Women experiencing dribbling dysuria (Lin Li) are caused by Kidney deficiency combined with Bladder heat. Since the Bladder and Kidney have an interior-exterior relationship and jointly govern water metabolism, urine formed in the bladder is excreted as small urine. If Kidney Qi is deficient, it leads to frequent urination; if there is heat in the Bladder, it causes dribbling dysuria, which may progress to complete retention accompanied by abdominal distension, asthma, and urgency. In such cases, prompt treatment is required.
[Xue Ji's Commentary] For the above conditions, if they belong to Bladder heat accumulation, use Wulin San (Five Lin Decoction). If they belong to Spleen and Lung deficiency heat, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (see Miscellaneous Diseases: Fatigue and Overwork chapter), adding Dioscoreae Rhizoma (Shanyao), Schisandrae Fructus (Wuweizi), and Ophiopogonis Radix (Maimendong). If they belong to Spleen meridian stagnant heat, use Jiawei Guipi Tang (Modified Return the Spleen Decoction) (i.e., Guipi Tang plus Moutan Cortex (Danpi) and Gardeniae Fructus (Zhizi)). If they belong to Lung meridian stagnant fire, use Huangqin Qingfei Yin (Scutellaria Lung-Clearing Drink). If they belong to Liver meridian damp-heat, use Longdan Xiegan Tang (Gentian Draining the Liver Decoction) (see Miscellaneous Diseases: Lin Syndrome chapter). If they belong to Blood deficiency, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) (see Tuberculosis chapter). If they belong to Yin deficiency, use Liuwei Wan (Six-Ingredient Pill) (see Miscellaneous Diseases: Deficiency Consumption chapter), adding Bupleuri Radix (Chaihu) and Gardeniae Fructus (Zhizi). Generally speaking, if there is no thirst but difficulty in urination, the heat is in the Blood aspect of the Lower Jiao, treat with Zishen Wan (Kidney-Nourishing Pill). If there is thirst but difficulty in urination, the heat is in the Qi aspect, treat with Qingfei Yin (Lung-Clearing Drink). If the Chi pulse is rapid but forceless, it indicates excessive Yin fire with Yang unable to transform, primarily treating with Liuwei Wan and Zishen Wan. If the Chi pulse is floating but forceless, it indicates Yang Qi deficiency with Yin unable to generate, primarily treating with Jiajian Bawei Wan (Modified Eight-Ingredient Pill) (see Miscellaneous Diseases: Xiao-Dan chapter) and Zishen Wan.
One woman had a history of these symptoms, with internal heat and physical fatigue. I considered this due to Liver fire, blood deficiency, and Spleen Qi weakness. She alternated taking Bazhen Tang (Eight-Treasure Decoction) and Xiaoyao San (Free and Easy Wanderer Powder) for over a month, after which urination became smooth. Subsequently, she took Bazhen Tang again to restore Qi and Blood. Another woman suffered from these symptoms, presenting with a bluish complexion and hypochondriac distension, unresponsive to other medications. I diagnosed it as Liver meridian Qi stagnation injuring Blood, and cured her with decoctions of Gardeniae Fructus (Zhizi) and Ligustici Chuanxiong Rhizoma (Chuanxiong). Another woman had difficulty urinating, with blockage and stifling pain in the lower abdomen and urinary tract, sometimes accompanied by abdominal and hypochondriac distending pain. I attributed this to Liver fire and prescribed Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) added with Gentiana Scabra Radix (Longdancao). After four doses, she improved slightly. Then, Gentiana was removed, and she concurrently took Bazhen San (Eight-Treasure Powder) added with stir-fried black Gardeniae Fructus (Zhizi), leading to recovery.
Shiwei San (Pyrrosiae Folium Decoction): Treats sudden dribbling dysuria in women.
Ingredients: Pyrrosiae Folium (Shiwei), Scutellariae Radix (Huangqin), Agrostidis Spica (Qumai Sui), Ulci Albi Cortex (Yubai Pi), Akebiae Caulis (Mutong), Abelmoschi Semen (Kuizi) (each 1.5 qian), Licorice Root (Gancao) (0.5 qian).
Preparation and Administration: These ingredients constitute one dose. Add two cups of water, decoct to one cup, and take before meals.
Mutong San (Akebiae Caulis Decoction): Treats the Five Lin syndromes in women.
Ingredients: Akebiae Caulis (Mutong), Ulci Albi Cortex (Yubai Pi), Agrostidis Spica (Qumai Sui), Cannabis Fructus (Dama Ren), Talcum (Huashi) (each 1 liang), Abelmoschi Semen (Kuizi), Concha Arcae (Beichi), Imperatae Rhizoma (Baimaogen) (each 2 liang), Licorice Root (Gancao) (0.5 liang).
Preparation and Administration: Coarsely powder the ingredients. Take 5 qian per dose, decoct in water, and take warm on an empty stomach.
Taojiao San (Prunus Persica Gum Decoction): Treats Qi Lin and Lao Lin in women.
Ingredients: Prunus Persica Gum (Taojiao), Ulci Albi Cortex (Yubai Pi) (each 1 liang), Plantaginis Semen (Cheqianzi), Benincasae Semen (Dongguazi), Cyprini Carassii Dens (Liyuchi), Abelmoschi Semen (Kuizi), Agrostis Herb (Qumai), Akebiae Caulis (Mutong) (each 0.5 liang), Aurantii Fructus (Zhiqiao) (2.5 qian).
Preparation and Administration: Cut the ingredients into small pieces. Take 4 qian weight per dose, add one cup of water, decoct to 0.7 cup, remove dregs, and take warm.
Jinsha San (Gold Sand Powder): Treats various Lin syndromes in women.
Preparation and Administration: Dry Shanghai Jinsha Cao (likely referring to a specific herb or mineral, contextually often associated with clearing heat/dampness, here treated as a raw material) in the shade and powder it. Mix 2 qian with Sheng Gancao Tang (Raw Licorice Decoction) and take.
Another Method: Real Amber (powdered, quantity as needed) mixed with Costi Radix (Muxiang) powder, taken with plain boiled water. (These two formulas are from Chen Zongling's Formulas.)
Jisu San (Elsholtzia Decoction): Treats Blood Lin in women.
Ingredients: Elsholtziae Herba (Jisu Ye), Akebiae Caulis (Mutong) (each 2 liang), Rehmanniae Radix Preparata (Sheng Gan Dihuang), Talcum (Huashi) (each 3 liang), Cissampeli Radix (Cisu Gen) (1 liang).
Preparation and Administration: Coarsely powder the ingredients. Take 0.5 liang per dose, add 1.5 cups of water and 37 leaves of Bambusa Leaves (Zhuye), decoct to 0.7 cup, remove dregs, and take warm before meals.
Formula for treating Blood Lin and painful hematuria in women.
Ingredients: Rehmanniae Radix Preparata (Sheng Gan Dihuang) (3 liang), Curcumae Radix (Yujin), Poria Cocos (Puhuang - *Note: Puhuang usually refers to Pollen Typhae, check context, likely Pollen Typhae here*) (each 2 liang).
Preparation and Administration: Powder finely. Take 2 qian per dose, mix with decoction of Plantaginis Leaf (Cheqian Zi Ye), until urination becomes smooth.
There are also cases of Blood Jia (masses) resembling Lin syndrome, causing urinary retention and umbilical/abdominal distension, suitable for Tao Ren Jian (Peach Kernel Decoction) (see previous Accumulation and Mass section, Blood Jia entry).
Later, formulas using human hair were used to treat Pa Zhuan (bladder torsion) causing urinary retention, which can also treat Blood Lin and hematuria.
Huofu Dan (Fire Palace Pill): Treats Heart meridian heat, astringent urination, and the Five Lin syndromes. (Adding Licorice Root, cutting and decocting, it is named Daochi San (Guide Out Redness Powder). From *Ben Shi Fang*.)
Ingredients: Rehmanniae Radix (Sheng Dihuang) (2 liang), Akebiae Caulis (Mutong), Scutellariae Radix (Huangqin) (each 1 liang).
Preparation and Administration: Powder finely, make pills with refined honey the size of Sophora seeds. Take 30 pills per dose, washed down with Mutong decoction. Also treats dribbling dysuria and fullness/pain below the umbilicus.
Scholar Xu said: In the Renxu year, a military officer suffered from polydipsia, drinking one dou of water daily and fasting for three months, feeling vexed internally. It was already October. I reasoned he had been affected by the summer heat during the Sanfu days and administered this medicine several times. Two days later, he thanked me, saying that after three doses the thirst stopped, and after another three doses, his appetite returned to normal. This was originally a formula for Lin syndrome, used here for thirst, demonstrating flexible application.
Treatment for various Lin syndromes in women.
Take Ku Zhang Gen (commonly known as Du Niu Xi/Achyranthes root), wash clean, cut into pieces, take one He (unit of volume), add five cups of water, decoct to one cup, remove dregs, and take with a small amount of Moschus (Shexiang) and Boswelliae Resina (Ruxiang) mixed in.
The wife of Geng Mengde, Military Commander of Yinxian, suffered from Gravel Lin for thirteen years. Each urination was unbearably painful, and gravel could be heard clattering in the urinal. Hundreds of methods failed. She accidentally obtained this formula, took it, and was cured overnight. This is based on personal observation.
Wuling San (Five Ling Powder), Ba Zheng San (Eight Upright Powder), and Qingxin Lianzi Yin (Heart-Clearing Lotus Seed Drink) from *Ju Fang* (Formulary of the Bureau) are all applicable.
Zishen Wan (Kidney-Nourishing Pill): Treats heat in the Blood aspect, non-thirsty but difficult urination; or Kidney deficiency with hot feet and weak legs/knees unable to support the body; or Lower Jiao Yin deficiency with difficult urination, abdominal swelling, skin cracking, or protruding eyes. This is a miraculous agent.
Ingredients: Anemarrhenae Rhizoma (Zhimu), Phellodendri Cortex (Huangbai) (each wine-fried, 2 liang), Cinnamomi Cortex (Rougui) (bark removed, 2 qian).
Preparation and Administration: Powder each separately, make water-honey pills the size of Sophora seeds. Take 200 pills per dose, wash down with boiling water on an empty stomach.
Huangqin Qingfei Yin (Scutellaria Lung-Clearing Drink): Treats difficult urination due to Lung heat; use this medicine to clear the heat.
Ingredients: Scutellariae Radix (Huangqin) (stir-fried), Gardeniae Fructus (Zhizi) (stir-fried) (each 1 qian).
Preparation and Administration: Decoct in water. If urination is not smooth, add 20 grains of Salted Soybean (Yanchi).
Wulin San (Five Lin Decoction): Treats Bladder heat, obstruction of the urinary pathway, dribbling dysuria, urine resembling bean juice, formation of gravel, urine resembling paste, or heat forcing blood to bleed.
Ingredients: Poria Cum Radio (Chifuling) (1.5 qian), Paeoniae Radix Rubra (Chishaoyao), Gardeniae Fructus (Zhizi) (each 1 qian), Angelicae Sinensis Radix (Danggui), Licorice Root (Gancao) (each 1.2 qian).
Preparation and Administration: Add Juncus Effusus (Dengxin), decoct in water, and take.