热淋者,三焦有热气,传于肾与膀胱,而热气流入于胞,而成淋也。
血淋者,是热之甚盛者,则尿血,谓之血淋。心主血,血之行身,通遍经络,循环腑
脏。其热甚者,血即散失其常经,溢渗入胞,而成血淋矣。
寒淋者,其病状先寒战、然后尿是也。小儿取冷过度,下焦受之,冷气入胞,与正气交
争,寒气胜则战寒而成淋,正气胜则战寒解,故得小便也。
小便数者,膀胱与肾俱有客热乘之故也。肾与膀胱为表里,俱主水,肾气下通于阴。此
二经既受客热,则水行涩,故小便不快而起数也。
遗尿者,此由膀胱有冷,不能约于水故也。足太阳为膀胱之经,足少阴为肾之经,此二
经为表里。肾主水,肾气下通于阴。小便者,水液之余也。膀胱为津液之腑,既冷,气衰弱
,不能约水,故遗尿也。
三虫者,长虫、赤虫、蛲虫也,为三虫,犹是九虫之数也。长虫,蛔虫也,长一尺,动
则吐清水而心痛,贯心即死。赤虫,状如生肉,动则肠鸣。蛲虫至细微,形如菜虫也,居胴
肠间,多则为痔,剧则为癞,因人疮处,以生诸痈、疽、癣、 、 、疥、龋虫,无所
此既九虫之内三者,而今则别立名,当以其三种偏发动成病,故谓之三虫也。
蛔虫者,九虫内之一虫也。长一尺,亦有长五六寸者。或因腑脏虚弱而动,或因食甘肥
而动。其动则腹中痛,发作肿聚,行来上下,痛有休止,亦攻心痛。口喜吐涎及清水,贯
伤心者则死。
诊其脉,腹中痛,其脉法当沉弱而弦,今反脉洪而大,则是蛔虫也。
热淋,是由于三焦有热气,传至肾与膀胱,热气流入胞宫(此处指下焦泌尿生殖区域),从而形成淋证。
血淋,是热邪极盛的表现,导致尿血,称为血淋。心主血脉,血液在体内运行,通达全身经络,循环于脏腑之间。当热邪极盛时,血液就会散失其正常的运行轨道,溢出并渗入胞宫,从而形成血淋。
寒淋,其病症表现为先出现寒战,然后才排尿。小儿因过度贪凉,导致下焦受寒,寒气侵入胞宫,与人体正气相互交争。若寒气占优势,则发生寒战并形成淋证;若正气占优势,则寒战解除,小便得以通畅排出。
小便频数,是因为膀胱和肾脏都受到外来热邪的侵袭所致。肾与膀胱互为表里,共同主管水液代谢,肾气向下通达于前阴。这两条经脉既受了外来热邪的影响,则水液运行变得涩滞不畅,所以小便不通畅且次数频繁。
遗尿,这是由于膀胱有寒,不能约束水液所致。足太阳经是膀胱的经脉,足少阴经是肾的经脉,这两条经脉互为表里。肾主水,肾气向下通达于前阴。小便,是水液代谢后的剩余部分。膀胱是津液汇聚之腑,既然有了寒邪,气机衰弱,不能约束水液,所以发生遗尿。
三虫,指的是长虫、赤虫、蛲虫,它们属于“九虫”的数量范畴。长虫,即蛔虫,长约一尺,活动时呕吐清水并伴有心痛,若贯穿心脏则致死。赤虫,形状像生肉,活动时肠鸣。蛲虫极其细微,形状像菜虫,居住在胴肠(肠道)之间,数量多时会引发痔疮,严重时会导致癞病,或者通过人体的疮口处,滋生各种痈、疽、癣、疥、龋齿虫等,无所不有。这三者本是九虫中的三种,现在单独设立名称,是因为这三种虫容易偏激发动而致病,所以称为三虫。
蛔虫,是九虫中的一种。长约一尺,也有长五六寸的。有时因为脏腑虚弱而活动,有时因为食用甘甜肥腻食物而活动。它活动时腹部疼痛,发作时肿块聚结,上下移动,疼痛有间歇性,也会攻冲心痛。口中喜欢吐出涎水和清水,若贯穿心脏则致死。
诊察其脉象,腹中疼痛,按照脉法应当表现为沉弱而弦的脉象,现在反而出现洪大脉象,这就是蛔虫病的表现。
Heat strangury (Re Lin) arises from heat qi in the Sanjiao (Triple Burner), which transmits to the Kidney and Bladder, and flows into the Bao (uterus/bladder area), resulting in strangury.
Blood strangury (Xue Lin) is caused by excessive heat, leading to blood in the urine, hence called Blood Strangury. The Heart governs the blood; blood circulates throughout the body, penetrating the meridians and cycling through the Zang-Fu organs. When heat is extreme, blood loses its normal course, overflows, and infiltrates the Bao, resulting in Blood Strangury.
Cold strangury (Han Lin) presents initially with chills followed by urination. In children, excessive exposure to cold causes the Lower Jiao to be affected; cold qi enters the Bao and contends with healthy Qi. If cold qi prevails, chills occur and strangury forms; if healthy Qi prevails, the chills resolve, allowing normal urination.
Frequent urination occurs because both the Bladder and Kidney are invaded by exogenous heat. The Kidney and Bladder are exterior-interior pairs, jointly governing water metabolism, with Kidney Qi extending downward to the external genitalia. Once these two meridians are affected by exogenous heat, water flow becomes obstructed and sluggish, causing difficult and frequent urination.
Enuresis (involuntary urination) results from cold in the Bladder, which fails to constrain water. The Foot-Taiyang Meridian belongs to the Bladder, and the Foot-Shaoyin Meridian belongs to the Kidney; these two are exterior-interior pairs. The Kidney governs water, with Kidney Qi extending downward to the external genitalia. Urine is the residue of fluid metabolism. The Bladder is the Fu-organ of fluids; when afflicted by cold, its Qi becomes weak and unable to constrain water, leading to enuresis.
The Three Worms refer to Changchong (Long Worm), Chichong (Red Worm), and Nuochong (Pinworm). They constitute part of the "Nine Worms." Changchong is the Ascaris (roundworm), about one chi long; when active, it causes vomiting of clear fluid and heart pain, and if it penetrates the heart, death ensues. Chichong resembles raw meat; when active, it causes borborygmus (intestinal rumbling). Nuochong is extremely minute, resembling a vegetable worm, residing in the intestines; an abundance leads to hemorrhoids, while severe cases cause leprosy-like conditions. It may also enter wounds, generating various sores, abscesses, tinea, scabies, and dental caries worms. These three were originally among the Nine Worms but are now named separately because they tend to act independently to cause disease, thus termed the Three Worms.
Ascaris (Hui Chong) is one of the Nine Worms. It is about one chi long, sometimes five or six cun. It may become active due to weakness of the Zang-Fu organs or after consuming sweet and fatty foods. When active, it causes abdominal pain, with palpable masses that move up and down, pain that comes and goes, and attacks on the heart region. The patient often spits saliva and clear fluid. If it penetrates the heart, death ensues.
Upon pulse diagnosis for abdominal pain, the pulse should typically be deep, weak, and wiry. However, if the pulse is instead surging and large, this indicates Ascaris infestation.