〔大〕妊娠小便淋者，乃肾与膀胱虚热不能制水。然妊妇胞系于肾，肾间虚热而成
斯证，甚者心烦闷乱，名曰子淋也。
〔薛〕前证若颈项筋挛，语涩痰甚，用羚羊角散。（身体痛。）若小便涩少淋沥，用安荣
散。若肝经湿热，用龙胆泻肝汤。（前阴诸疾。）若肝经虚热，用加味逍遥散。腿足转筋而小便
不利，急用八味丸，缓则不救。若服燥剂而小便频数或不利，用生地黄、茯苓、牛膝、黄
柏、知母、芎、归、甘草。若频数而色黄，用四物加黄柏、知母、五味、麦门、玄参。若
肺气虚而短少，用补中益气加山药、麦门。若阴挺痿痹而频数，用地黄丸。若热结膀胱而
不利，用五淋散。（淋。）若脾肺燥不能化生，宜黄芩清肺饮。（淋。）若膀胱阴虚，阳无所生，用
滋肾丸。（淋）。若膀胱阳虚，阴无所化，用肾气丸。一妇人每怒发热胁胀，小便淋涩，如遇经
行，旬余未已。受胎三月，因怒前证复作。朝用加味逍遥散，夕用安胎饮各二剂而安。五
月又怒，复下血如经行，四日未止，仍用前药而愈。一妊娠饮食后因恼怒，寒热呕吐，
头痛恶寒，胸腹胀痛，大便不实，其面青色，小便频数，时或有血，服安胎止血之剂益甚。
余曰∶寒热呕吐而腹胀，此肝木克脾土而元气伤也。大便不实而面青，此饮食伤脾，兼
肝侮土也。小便频数而有血，此肝热传胞而兼挺痿也。用六君子加枳壳、紫苏、山栀二
剂，脾胃顿醒。又用加味逍遥散加紫苏、枳壳二剂，小便顿清。后节饮食调理而安。
地肤大黄汤 （《外台》）疗妊娠子淋宜下。
川大黄 地肤草（各三两） 知母 黄芩 猪苓 赤芍药 通草 川升麻 枳实
甘草（各二两）
上 咀，每服四钱，水一盏，煎七分，去滓温服。
疗妊娠患淋，小便涩不利，小腹水道热痛。
冬葵子（一升） 芍药（二两） 黄芩 赤茯苓 车前子（各三两）
上 咀，以水七升，煎至二升，温分三服。
疗妊娠数月，小便淋沥、疼痛，心烦闷乱，不思饮食。
瞿麦穗 赤茯苓 桑白皮 木通 葵子（各一两） 黄芩 芍药 枳壳 车前子（各半两）
上为粗末，每服四钱，水一盏，煎至六分，温服。
安荣散 治妊娠小便涩少，遂成淋沥。
麦门冬（去心） 通草 滑石 人参 细辛（各二钱） 当归（去芦，酒浸） 灯草 甘草（各半钱）
上为细末，每服二钱，不拘时，麦门煎汤调服。
大腹皮散 治妊娠大小便赤涩。
大腹皮 枳壳（去白，麸炒） 甘草（炙，各一钱） 赤茯苓（去皮，三钱）
上为细末，每服二钱，不拘时，浓煎葱白汤调下。
《经心录》疗妊娠患子淋，小便数，出少或热疼痛，及子烦。
地肤子（三两）
上细切，水四升，煮取二升半，去滓分三服，日三服。
《补遗》治胎前诸般淋沥，小便不通。
槟榔 赤芍药（各等分）
上锉，每服五钱，水煎温服，甚效。
猪苓散 疗妊娠子淋，小便涩痛。（方见前大小便不通。）
【大】妊娠期间出现小便淋沥不畅的症状，是由于肾与膀胱的虚热无法制约水液所致。然而孕妇的胞宫系于肾脏，肾间产生虚热而引发此证，严重时会出现心烦意乱、胸闷不安，这种病症被称为“子淋”。
【薛】上述症状如果伴有颈项部筋脉拘挛、言语涩滞且痰多，可使用羚羊角散。（针对身体疼痛。）若表现为小便涩滞量少、淋沥不尽，使用安荣散。若是肝经湿热所致，使用龙胆泻肝汤。（针对前阴各类疾病。）若是肝经虚热所致，使用加味逍遥散。若出现腿足转筋且小便不利，需紧急服用八味丸，若拖延则难以救治。若因服用燥热药物导致小便频数或排尿不畅，使用生地黄、茯苓、牛膝、黄柏、知母、川芎、当归、甘草。若小便频数且颜色发黄，使用四物汤加入黄柏、知母、五味子、麦门冬、玄参。若因肺气虚弱导致尿量短少，使用补中益气汤加入山药、麦门冬。若出现阴部下垂、痿痹且尿频，使用地黄丸。若因热邪结聚膀胱导致排尿不利，使用五淋散。（针对淋证。）若因脾肺干燥无法化生津液，适宜使用黄芩清肺饮。（针对淋证。）若膀胱阴虚，阳气无所生化，使用滋肾丸。（针对淋证。）若膀胱阳虚，阴液无法气化，使用肾气丸。有一位妇人每次发怒后便发热、胁肋胀满，小便淋沥涩痛，恰逢月经来潮，持续十余天未停。怀孕三个月时，因愤怒导致前述症状复发。早晨服用加味逍遥散，晚上服用安胎饮，各两剂后病情安定。到了五月再次发怒，又出现阴道出血如月经般，持续四天未止，仍然使用前面的药物而痊愈。还有一位孕妇在饮食后因恼怒，出现寒热交替、呕吐、头痛、恶寒、胸腹胀痛、大便不成形，面色发青，小便频数，偶尔带血，服用安胎止血的药物后病情反而加重。我说：寒热呕吐且腹胀，这是肝木克制脾土导致元气受损。大便不成形且面色发青，这是饮食损伤脾脏，兼有肝气侮犯脾土。小便频数且带血，这是肝热传变至胞宫并兼有阴挺痿痹。使用六君子汤加入枳壳、紫苏、山栀，两剂后脾胃功能顿时恢复清醒。又使用加味逍遥散加入紫苏、枳壳，两剂后小便顿时清澈。后来通过节制饮食进行调理而平安无事。
地肤大黄汤（出自《外台秘要》）治疗妊娠子淋，适宜采用攻下法。
川大黄、地肤草（各三两）、知母、黄芩、猪苓、赤芍药、通草、川升麻、枳实、甘草（各二两）。
以上药材切碎，每次服用四钱，加水一盏，煎煮至七分，去渣温服。
治疗妊娠患淋证，小便涩滞不利，小腹及尿道热痛。
冬葵子（一升）、芍药（二两）、黄芩、赤茯苓、车前子（各三两）。
以上药材切碎，用水七升，煎煮至二升，分三次温服。
治疗妊娠数月，小便淋沥、疼痛，心烦闷乱，不思饮食。
瞿麦穗、赤茯苓、桑白皮、木通、葵子（各一两）、黄芩、芍药、枳壳、车前子（各半两）。
以上药材制成粗末，每次服用四钱，加水一盏，煎煮至六分，温服。
安荣散 治疗妊娠小便涩滞量少，遂成淋沥不尽。
麦门冬（去心）、通草、滑石、人参、细辛（各二钱）、当归（去芦头，酒浸）、灯草、甘草（各半钱）。
以上药材研为细末，每次服用二钱，不限时间，用麦门冬煎汤调服。
大腹皮散 治疗妊娠大小便赤涩。
大腹皮、枳壳（去白瓤，麸炒）、甘草（炙，各一钱）、赤茯苓（去皮，三钱）。
以上药材研为细末，每次服用二钱，不限时间，用浓煎的葱白汤送服。
《经心录》治疗妊娠患子淋，小便频数，排出量少或有热痛感，以及子烦。
地肤子（三两）。
以上细切，用水四升，煮取二升半，去渣分三次服用，每日三次。
[Da] During pregnancy, if dysuria (dysuria) occurs, it is caused by deficiency-heat in the Kidney and Bladder failing to control water metabolism. However, since the uterus (uterus) of a pregnant woman is connected to the Kidney, deficiency-heat arising from the Kidney induces this syndrome. In severe cases, it manifests as mental restlessness and irritability, a condition named Zi Lin (fetal strangury).
[Xue] If the aforementioned symptoms are accompanied by spasms of the neck tendons, slurred speech, and excessive phlegm, Lingyang Jiao San (Antelope Horn Decoction) should be used. (For body pain.) If there is scanty, difficult, and dribbling urination, Anrong San (Anrong Powder) is indicated. If caused by damp-heat in the Liver channel, Longdan Xiegan Tang (Gentian Liver-Draining Decoction) should be used. (For diseases of the external genitalia.) If caused by deficiency-heat in the Liver channel, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) is appropriate. If leg cramps occur with difficulty in urination, Bawei Wan (Eight-Ingredient Pill) must be administered urgently; otherwise, it may become incurable. If frequent or obstructed urination results from taking drying agents, Sheng Dihuang (Rehmanniae Radix), Fuling (Poria), Niuxi (Achyranthis Bidentatae Radix), Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), and Gancao (Glycyrrhizae Radix et Rhizoma) should be used. If urination is frequent with yellow urine, Siwu Tang (Four Substances Decoction) added with Huangbai, Zhimu, Wuweizi (Schisandrae Chinensis Fructus), Maimendong (Ophiopogonis Radix), and Xuanshen (Scrophulariae Radix) is prescribed. If shortness of urine volume is due to Lung Qi deficiency, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Shanyao (Dioscoreae Rhizoma) and Maimendong is used. If vaginal prolapse, flaccidity, and numbness accompany frequent urination, Dihuang Wan (Rehmannia Pill) is indicated. If heat accumulation in the Bladder causes obstructed urination, Wulin San (Five Stranguries Powder) should be used. (For strangury.) If dryness of the Spleen and Lung prevents fluid transformation, Huangqin Qingfei Yin (Scutellaria Lung-Clearing Drink) is suitable. (For strangury.) If Bladder Yin deficiency leads to insufficient Yang generation, Zishen Wan (Nourish the Kidney Pill) is used. (For strangury.) If Bladder Yang deficiency prevents Yin transformation, Shenqi Wan (Kidney Qi Pill) is indicated.
One patient experienced fever and hypochondriac distension after every episode of anger, along with dribbling and painful urination. Her menstruation had lasted for more than ten days. At three months of pregnancy, anger triggered a recurrence of these symptoms. She took Jiawei Xiaoyao San in the morning and Antai Yin (Fetus-Calming Drink) in the evening, two doses each, which stabilized her condition. In the fifth month, another episode of anger caused vaginal bleeding resembling menstruation, lasting four days. The previous medicines were repeated, leading to recovery.
Another pregnant woman developed alternating chills and fever, vomiting, headache, aversion to cold, chest and abdominal distension and pain, loose stools, and a bluish complexion after becoming angry following a meal. She also had frequent urination with occasional blood. Treatment with fetus-calming and hemostatic agents worsened her condition. I stated: Chills, fever, vomiting, and abdominal distension indicate Liver Wood overacting on Spleen Earth, damaging Yuan Qi (Primary Qi). Loose stools and a bluish complexion suggest dietary injury to the Spleen combined with Liver Qi insulting Earth. Frequent urination with blood indicates Liver Heat transmitting to the Uterus, accompanied by vaginal prolapse and flaccidity. Six Junzi Tang (Six Gentlemen Decoction) added with Zhike (Aurantii Fructus), Zisu (Perillae Folium), and Shanzhi (Gardeniae Fructus) was administered for two doses, restoring Spleen and Stomach function. Subsequently, Jiawei Xiaoyao San added with Zisu and Zhike was given for two doses, clearing the urine. She recovered after regulating her diet.
Difu Dahuang Tang (Kochia and Rhubarb Decoction) [from Waitai Miyao]: Treats fetal strangury requiring purgation.
Chuan Dahuang (Rhei Radix et Rhizoma), Difucao (Kochiae Herba) (each 3 liang), Zhimu, Huangqin (Scutellariae Radix), Zhuling (Polyporus), Chi Shaoyao (Paeoniae Radix Rubra), Tongcao (Tetrapanacis Medulla), Chuan Shengma (Bupleuri Radix), Zhishi (Aurantii Fructus Immaturus), Gancao (2 liang each).
Cut into pieces. Take 4 qian per dose, decoct with one sheng of water until 0.7 sheng remains, strain, and take warm.
Treats strangury during pregnancy with difficult, obstructed urination, and hot, painful sensation in the lower abdomen and urinary tract.
Dongkuizi (Malvae Semen), Shaoyao (Paeoniae Radix) (2 liang), Huangqin, Chi Fuling (Poria cum Risu Rubrum), Cheqianzi (Plantaginis Semen) (each 3 liang).
Cut into pieces. Decoct with 7 sheng of water until 2 sheng remains, divide into three warm doses.
Treats pregnancy at several months with dribbling, painful urination, mental restlessness, and loss of appetite.
Qumai (Dianthi Herba), Chi Fuling, Sangbaipi (Mori Cortex), Mutong (Akebiae Caulis), Kuizi (Malvae Semen) (each 1 liang), Huangqin, Shaoyao, Zhike, Cheqianzi (each 0.5 liang).
Make into coarse powder. Take 4 qian per dose, decoct with one sheng of water until 0.6 sheng remains, take warm.
Anrong San (Anrong Powder): Treats pregnancy with scanty, difficult urination progressing to dribbling.
Maimendong (Ophiopogonis Radix, heart removed), Tongcao, Huashi (Talcum), Renshen (Ginseng Radix), Xixin (Asari Radix et Rhizoma) (each 2 qian), Danggui (Angelicae Sinensis Radix, radix removed, wine-soaked), Dengcao (Junci Medulla), Gancao (each 0.5 qian).
Grind into fine powder. Take 2 qian per dose at any time, mixed with Maimendong decoction.
Dafupi San (Arecae Pericarpium Powder): Treats pregnancy with red, difficult urination and defecation.
Dafupi (Arecae Pericarpium), Zhike (Aurantii Fructus, white pith removed, bran-fried), Gancao (roasted, each 1 qian), Chi Fuling (Poria cum Risu Rubrum, bark removed, 3 qian).
Grind into fine powder. Take 2 qian per dose at any time, taken with strong Scallion White Decoction.
Jingxin Lu treats fetal strangury during pregnancy with frequent urination, scanty output or hot/painful sensation, and Zi Fan (fetal irritability).
Difuzi (Kochiae Fructus) (3 liang).
Finely cut. Decoct with 4 sheng of water until 2.5 sheng remains, strain, divide into three doses, taken three times daily.
Buyi treats various types of dribbling and urinary retention before delivery.
Binglang (Arecae Semen), Chi Shaoyao (Paeoniae Radix Rubra) (equal parts).
Chop. Take 5 qian per dose, decoct in water and take warm. Highly effective.
Zhuling San (Polyporus Powder): Treats fetal strangury with difficult, painful urination. (Formula see under Obstruction of Urine and Feces above.)