淋证2(泌尿系感染)
吕某，女，28岁，1989年9月5日初诊。自3日起，因服冷饮之后，自觉恶寒发热，排尿不适，尿频，尿急，继而发冷寒战恶风，尿道灼热刺痛，去医院就诊，查体温39.6℃，WBC2300／mm 3，尿检：白细胞30～50个／高倍视野，红细胞?10～20个／高倍视野，脓球少量，诊断为急性泌尿系感染，用抗菌素与解热止痛药后，大汗出，热退，寒战止，从第二天开始又复作，特来求赵老医治。刻下，发热恶风，尿频，尿急，尿通灼热刺痛，尿急不尽，小腹拘急，腰部发凉且痛，舌质红苔薄白，脉滑细且数，体温38.6℃，尿检查：白细胞满视野，红细胞20～30，脓球大量。证属湿热蕴郁，下注膀胱。治拟清热化湿、凉血通淋。药用剂防败毒散加减，处方：荆芥6克，防风6克，前胡6克，独活6克，生地榆10克，滑石10克，瞿麦10克，木通2克，炒山栀6克，炒槐花10克，大腹皮10克，焦三仙各10克，茅芦根各20克。服药3剂发热见轻，又服4剂，热退，尿路刺激症消失，大便偏干，小便色赤，体温正常，尿常规检查：血球3～5个／高倍视野，红血球O～2个／高倍视野，湿邪渐化，余热未愈，仍以前法进退，药用：荆芥炭10克，防风6克，白芷6克克，独活6克，生地榆10克，炒槐花10克，茅芦根各10克，桑棱10克，柴胡6克，黄芩6克，焦三仙各10克，小蓟10克。
又服上方14剂，尿检正常，无其他不适。
[按]：淋证临床较为常见，其主要表现为小便频数，滴沥刺痛，或痛引腹腹，或伴有血尿，或伴有尿浊，甚至排出砂石等。其中包括一部分现医学的尿路感染，尿路结石以及急慢性肾盂肾兜等病。此患者素体湿热较盛，又进饮玲，寒湿外袭，内外湿热相合，传入膀胱，气化失司，水道不利，发为淋症。赵师认为患者虽恶寒较重，甚则寒战，但并非冷淋。冷淋多为肾气不足或命门虚寒。此病案有恶寒战傈，乃寒湿外袭，气机阻滞，阳气不得外达而致。因此治疗必先化湿邪为主，兼以清热方法邀里赵师重用风药，老师认为风能胜湿，风能开郁，风能调畅气机。另外必注意饮食宜忌，饮食宜清淡，生冷辛辣油腻当禁之。
遗尿1
阎某，男，11岁。于1992年1月26日初诊。患儿自幼至今，每夜尿床1～2次，形体瘦弱，心烦急躁，夜寐梦多，时有梦语啮齿，乏力，食欲不振，精神不集中，经常腹痛，大便干结小便黄，气味臭秽。舌红苔黄，脉弦数。
辨证：肝胆郁热，阳明积滞。
治法：清泻肝胆郁热，消导胃肠积滞。
方药：蝉表6克，片姜黄6克，白僵蚕10克，大黄2克，柴胡6克，黄芩6克，川楝子6克，7剂
二诊
服药大便溏泄4～5次，三剂后正常，遗尿未作，除心烦急躁外，余症皆减。脉弦滑，舌红。原方去柴胡、黄芩、川楝子，加焦三仙各10克，水红花子10克，7剂
三诊
近一周来仅尿床一次，舌红苔白，脉弦细。继用前法。
药用；钩藤10克，蝉表6克，僵蚕10克，枳壳6克，郁金10克，复盆子10克，7剂
四诊
遗尿未作，饮食增，夜寐安，精神爽，二便正常。黄连2克，蝉衣6克，僵蚕10克，复盆子10克，钩藤10克，川楝子6克，生牡蛎20克，7剂，巩固疗效。
[按]：小儿遗尿，既往多认为由先天肾气不足，下元虚冷，膀胱失约所致。此患儿经常腹痛，食欲不振，舌红苔黄，大便干结，此为胃肠积滞，郁而化热；心烦急躁，夜寐梦多，甚则梦语啮齿，舌红，脉弦数，乃湿热蕴郁肝胆，内扰心神}湿热下移，蕴结于膀胱，热迫膀胱失约则睡中遗尿。《医学心悟·遗尿》云；“火性急速，逼迫而遗。”热灼津液，则尿臊色黄。老师用升降散升清降浊，调畅气机，荡涤胃肠之积滞；再以柴胡，黄芩，川楝子清泻肝胆之郁热，使之郁散湿去热清，故能奏效。
遗尿(肾盂积水)
孙某某，女，12岁初诊
自幼遗尿，迄今未愈。每夜必于睡眠中遗尿1～2次，全不自觉。近作B超，示双侧肾盂轻度积水。大便干结，小便不畅。舌红苔黄且腻，脉象弦精且数。湿热蕴郁下焦，先用清化湿热方法。
荆芥6克，防风6克，白芷6克，独活6克，生地榆10克，炒槐花10克，丹参10克，茜草10克，大黄2克，蝉表6克，雷丸6克，滑石10克，七付
二诊
药后大便畅行。小溲色黄不畅。入夜仍遣尿1次。舌红苔黄，脉象滑数。此肺气不宣，三焦不利。必开通肺气，以利三焦。
苏叶10克，杏仁10克，枇杷叶10克，前胡6克，荆芥6克，防风8克，白芷6克，独活6克，大黄2克，使君子10克，雷丸6克。七付
三诊
小溲较前畅利，夜间遗尿减轻。大便偏干，脉仍精数，舌红苔黄。仍用宣肺化湿方法。
荆芥6克，防风6克，苏叶10克，白芷6克，杏仁10克，前胡6克，焦兰仙各10克，水红花子10克，使君子10克，雷丸6克，茅芦根各10克，大黄3克，七付
四诊
夜间遗尿显著减轻，已能于睡中自醒如厕小便，一周来仅遗尿1次。夜梦已减，时觉心烦，舌红苔黄，脉象弦滑，仍用前法进退。
蝉衣6克，僵蚕10克，片姜黄6克，大黄1克，苏叶子各10克，前胡6克，浙贝母10克，使君子10克，雷丸6克，川楝子10克，七付
五诊
上药续服一周，夜间未再发生遗尿，白天小溲畅通，大便如常，食眠均佳。经肾脏B超复查，报告双是肾盂未发现积水。病已向愈，遂停药观察，并嘱其少食肥甘，以防复发。
[按]外儿遗尿并非皆是肾虚。若湿热蕴郁，肺气不利，气化失司，也可导致遗尿，本案即是一例。肺为水之上源，通调水道。小便通利正常与否，与肺气关系甚大。本案患者白天小便不畅，夜间小便自遗，全是肺气失于宣化，湿热童结不行，三焦水道不利所致。其肾盂积水也说明了水湿蓄积不行。初诊用风药胜湿，活血化瘀通络，并琬利三焦之品，因缺少宣肺之品，故疗效并不甚理想。二诊以后，从宣肺入手，仍用风药胜湿与疏利三焦水道，收到了明显的效果。
遗尿3(尿失禁)
张某，女，45岁，1989年12月11日初诊。患小便失禁已8年左右，时轻时重，到处求医，服中西药不计其数，痛苦难忍。经友介绍求诊于赵老，症见，体质瘦弱。心烦急躁，头晕目眩，夜寐梦多，腰痛乏力，阵阵汗出，小便失禁，大便正常，舌红瘦且干，两脉弦细滑数。
辨证：肝经郁热，肾阴不足。
立法：清泻肝经郁热，滋补下元不足，以疏调肝肾。
方药：荆芥6克，防风6克，柴胡6克，川楝子6克，木瓜10克，升麻6克，茯苓10克，白芍10克，阿腔珠10克，生牡蛎30克。
二诊
12月18日，服上药7剂小便失禁有减，心烦急躁、夜寐梦多好转。热郁渐清，改用填补方法。
处方：仙茅10克，仙灵脾10克，柴胡6克，沙参10克，熟地10克，玉竹10克，补骨脂10克，独活6克，桑寄生10克，珍珠母20克。
三诊：12月25日。
服上方7剂，小便失禁大减，腰痛见轻，头晕未作。仍以前法进退。
处方：仙茅10克，仙灵脾10克，熟地10克，补骨脂10克，桑寄生10克，杜仲10克，川断10克，白芍10克，珍珠母20克，五味子10克，金樱子10克。
四诊：1990年元月3日
服上方7剂，小便失禁未作，余症均除，精神较佳，面带喜色，再以上方加升麻10克，海螵蛸10克。服药10剂，以巩固疗效。三个月后随访。病愈未再反复，体质转健，饮食倍增，体重增加5公斤。
[按]：小便失禁是指在神志完全清醒状态下，膀胱不能维持其控制排尿的功能，造成尿液不自主的流出的病症。在临床上以老年人，妇女以及大病之后为多见。一般认为小便失禁多属肾气虚衰，气化无权，膀胱失约而致小便自行排出。此患者素体阴虚，阴虚生内热，虚热内扰，膀胱失约而为小便失禁。乙癸同源，肾阴不足，水不涵术，久病不愈，阴损及阳，下元亏虚，固摄无权，则小便自遗。加之病已延久，情志抑郁，肝失疏泄，肝火偏盛，表现出肾虚肝旺之征。因此赵师在治疗上先以清肝热，后议补下元，取效甚佳。使患病8年之苦，仅服30剂药而愈，经随访未复发
尿血1(膀胱癌)
秦某，男，60岁，于1989年10月13日初诊。患者自8月初外出旅游，中途出现发热，并伴有尿频，尿痛，尿赤，以“泌尿系感染”治疗10余天，尿频，尿痛症减轻，仍血尿时作，低热不退，又改换抗生素、中药等治疗月余疗效不明显，尿化验检查：尿蛋白++，红血球大量，潜血++，后经膀胱镜检查确诊为膀胱癌，医院建议手术治疗。患者本人与家属决定先请赵老医治，刻诊见：身热恶寒，头目不清，急躁，眠不实，胸脘不舒，小便短赤，舌黄苔厚腻，有瘀斑，脉濡滑且数。证属暑湿郁热蕴郁于内，拟先用宣郁化湿方法。药用，藿香10克(后下)，佩兰10克(后下)，杏仁10克(后下)，枇杷叶10克，荆芥炭10克，茅芦根10克，柴胡6克，炒山栀6克，菖蒲6克，郁金6克，香附10
克，焦麦芽10克。服药10剂，身热恶寒消失，余症减轻，尿蛋白(一)，红细胞5～10个／高倍视野，尿潜血+，舌红苔厚，脉滑数，湿郁渐化，气机渐疏，郁热未解，用凉血化瘀清热方法。
药用：荆芥炭10克，柴胡6克，黄芩6克，生地榆10克，茜草10克，炒山栀6克，丹参10克，蝉衣6克，僵蚕10克，片姜黄6克，半枝莲10克，白花蛇舌草10克，大黄1克，茅芦根各10克，服药20余剂，血尿未作，尿检(一)。膀胱镜检查；膀胱粘膜白斑，未见其他异常。舌红苔白且千，脉弦滑，接之略数，血分郁热，改用清热凉血、甘寒育阴方法。方药：柴胡6克，黄芩6克，川樟子6克，赤芍10克，生地榆10克，丹参10克，茜草10克，炒槐花10克，沙参10克，麦冬10克，焦三仙各10克，茅芦根各10克，白花蛇舌草10克，半枝莲10克。以此方加减服药2月余，又去复查，原病灶区白斑均消失，未见其他异常。仍以前法进退，饮食当慎，防其复发。药用：凤尾草10克，生地榆10克，丹参10克，茜草10克，蝉衣6克，僵蚕10克，片姜黄6克，半枝莲10克，白花蛇舌草10克，焦三仙各10克，茅芦根各10克，大黄1克，每周2～3剂，续续服用。
[按]：此病案系膀胱癌，是经权威西医医院做膀胱镜检查，并取活组织切片病理实验而确诊，而未作手术及化疗治疗，单纯用中药治愈的。患者平素嗜酒吸烟，外出旅游正值暑期，湿气盛，气温高，易贪凉，以致暑湿温热之邪相合而受之，与翥体湿热之邪相为交织互结，病势缠绵，表里同病。赵师在治疗上，先以宜郁化湿，后用凉血清热，再以甘寒育阴，分层次，有步骤进行治疗，但无论在哪一阶段都没有抛开疏调气机之法。因此赵师常说；“治病之要，贵在疏调。”此患者与医生积极配合再未近烟酒，每日早晚锻炼，服药未断，现已6年，身体颇健，未见复发。
淋证2（泌尿系感染）
吕某，女，28岁，1989年9月5日初诊。自3日起，因饮用冷饮后，自觉恶寒发热，排尿不适，尿频，尿急，继而出现发冷、寒战、恶风，尿道灼热刺痛，去医院就诊，查体温39.6℃，白细胞2300／mm³，尿检：白细胞30～50个／高倍视野，红细胞10～20个／高倍视野，脓球少量，诊断为急性泌尿系感染，用抗菌素与解热止痛药后，大汗出，热退，寒战止，从第二天开始又复发，特来求赵绍琴老中医医治。刻下，发热恶风，尿频，尿急，尿通时灼热刺痛，尿急不尽，小腹拘急，腰部发凉且痛，舌质红苔薄白，脉滑细且数，体温38.6℃，尿检查：白细胞满视野，红细胞20～30，脓球大量。证属湿热蕴郁，下注膀胱。治拟清热化湿、凉血通淋。药用荆防败毒散加减，处方：荆芥6克，防风6克，前胡6克，独活6克，生地榆10克，滑石10克，瞿麦10克，木通2克，炒山栀6克，炒槐花10克，大腹皮10克，焦三仙各10克，茅根芦根各20克。服药3剂发热见轻，又服4剂，热退，尿路刺激症消失，大便偏干，小便色赤，体温正常，尿常规检查：血球3～5个／高倍视野，红血球0～2个／高倍视野，湿邪渐化，余热未愈，仍以前法进退，药用：荆芥炭10克，防风6克，白芷6克，独活6克，生地榆10克，炒槐花10克，茅根芦根各10克，桑椹10克，柴胡6克，黄芩6克，焦三仙各10克，小蓟10克。
又服上方14剂，尿检正常，无其他不适。
[按]：淋证临床较为常见，其主要表现为小便频数，滴沥刺痛，或痛引小腹，或伴有血尿，或伴有尿浊，甚至排出砂石等。其中包括一部分现代医学的尿路感染，尿路结石以及急慢性肾盂肾炎等病。此患者素体湿热较盛，又进饮冷，寒湿外袭，内外湿热相合，传入膀胱，气化失司，水道不利，发为淋症。赵师认为患者虽恶寒较重，甚则寒战，但并非冷淋。冷淋多为肾气不足或命门虚寒。此病案有恶寒战栗，乃寒湿外袭，气机阻滞，阳气不得外达而致。因此治疗必先化湿邪为主，兼以清热方法。赵师重用风药，老师认为风能胜湿，风能开郁，风能调畅气机。另外必注意饮食宜忌，饮食宜清淡，生冷辛辣油腻当禁之。
遗尿1
阎某，男，11岁。于1992年1月26日初诊。患儿自幼至今，每夜尿床1～2次，形体瘦弱，心烦急躁，夜寐梦多，时有梦语啮齿，乏力，食欲不振，精神不集中，经常腹痛，大便干结小便黄，气味臭秽。舌红苔黄，脉弦数。
辨证：肝胆郁热，阳明积滞。
治法：清泻肝胆郁热，消导胃肠积滞。
方药：蝉蜕6克，片姜黄6克，白僵蚕10克，大黄2克，柴胡6克，黄芩6克，川楝子6克，7剂
二诊
服药大便溏泄4～5次，三剂后正常，遗尿未作，除心烦急躁外，余症皆减。脉弦滑，舌红。原方去柴胡、黄芩、川楝子，加焦三仙各10克，水红花子10克，7剂
三诊
近一周来仅尿床一次，舌红苔白，脉弦细。继用前法。
药用：钩藤10克，蝉蜕6克，僵蚕10克，枳壳6克，郁金10克，覆盆子10克，7剂
四诊
遗尿未作，饮食增，夜寐安，精神爽，二便正常。黄连2克，蝉衣6克，僵蚕10克，覆盆子10克，钩藤10克，川楝子6克，生牡蛎20克，7剂，巩固疗效。
[按]：小儿遗尿，既往多认为由先天肾气不足，下元虚冷，膀胱失约所致。此患儿经常腹痛，食欲不振，舌红苔黄，大便干结，此为胃肠积滞，郁而化热；心烦急躁，夜寐梦多，甚则梦语啮齿，舌红，脉弦数，乃湿热蕴郁肝胆，内扰心神；湿热下移，蕴结于膀胱，热迫膀胱失约则睡中遗尿。《医学心悟·遗尿》云：“火性急速，逼迫而遗。”热灼津液，则尿臊色黄。老师用升降散升清降浊，调畅气机，荡涤胃肠之积滞；再以柴胡，黄芩，川楝子清泻肝胆之郁热，使之郁散湿去热清，故能奏效。
遗尿（肾盂积水）
孙某某，女，12岁初诊
自幼遗尿，迄今未愈。每夜必于睡眠中遗尿1～2次，全不自觉。近作B超，示双侧肾盂轻度积水。大便干结，小便不畅。舌红苔黄且腻，脉象弦紧且数。湿热蕴郁下焦，先用清化湿热方法。
荆芥6克，防风6克，白芷6克，独活6克，生地榆10克，炒槐花10克，丹参10克，茜草10克，大黄2克，蝉蜕6克，雷丸6克，滑石10克，七付
二诊
药后大便畅行。小溲色黄不畅。入夜仍遗尿1次。舌红苔黄，脉象滑数。此肺气不宣，三焦不利。必开通肺气，以利三焦。
苏叶10克，杏仁10克，枇杷叶10克，前胡6克，荆芥6克，防风8克，白芷6克，独活6克，大黄2克，使君子10克，雷丸6克。七付
三诊
小溲较前畅利，夜间遗尿减轻。大便偏干，脉仍紧数，舌红苔黄。仍用宣肺化湿方法。
荆芥6克，防风6克，苏叶10克，白芷6克，杏仁10克，前胡6克，焦兰仙各10克，水红花子10克，使君子10克，雷丸6克，茅根芦根各10克，大黄3克，七付
四诊
夜间遗尿显著减轻，已能于睡中自醒如厕小便，一周来仅遗尿1次。夜梦已减，时觉心烦，舌红苔黄，脉象弦滑，仍用前法进退。
蝉衣6克，僵蚕10克，片姜黄6克，大黄1克，苏叶各10克，前胡6克，浙贝母10克，使君子10克，雷丸6克，川楝子10克，七付
五诊
上药续服一周，夜间未再发生遗尿，白天小溲畅通，大便如常，食眠均佳。经肾脏B超复查，报告双肾盂未发现积水。病已向愈，遂停药观察，并嘱其少食肥甘，以防复发。
[按]：小儿遗尿并非皆是肾虚。若湿热蕴郁，肺气不利，气化失司，也可导致遗尿，本案即是一例。肺为水之上源，通调水道。小便通利正常与否，与肺气关系甚大。本案患者白天小便不畅，夜间小便自遗，全是肺气失于宣化，湿热壅结不行，三焦水道不利所致。其肾盂积水也说明了水湿蓄积不行。初诊用风药胜湿，活血化瘀通络，并疏利三焦之品，因缺少宣肺之品，故疗效并不甚理想。二诊以后，从宣肺入手，仍用风药胜湿与疏利三焦水道，收到了明显的效果。
遗尿3（尿失禁）
张某，女，45岁，1989年12月11日初诊。患小便失禁已8年左右，时轻时重，到处求医，服中西药不计其数，痛苦难忍。经友介绍求诊于赵老，症见，体质瘦弱。心烦急躁，头晕目眩，夜寐梦多，腰痛乏力，阵阵汗出，小便失禁，大便正常，舌红瘦且干，两脉弦细滑数。
辨证：肝经郁热，肾阴不足。
立法：清泻肝经郁热，滋补下元不足，以疏调肝肾。
方药：荆芥6克，防风6克，柴胡6克，川楝子6克，木瓜10克，升麻6克，茯苓10克，白芍10克，阿胶珠10克，生牡蛎30克。
二诊
12月18日，服上药7剂小便失禁有减，心烦急躁、夜寐梦多好转。热郁渐清，改用填补方法。
处方：仙茅10克，仙灵脾10克，柴胡6克，沙参10克，熟地10克，玉竹10克，补骨脂10克，独活6克，桑寄生10克，珍珠母20克。
三诊：12月25日。
服上方7剂，小便失禁大减，腰痛见轻，头晕未作。仍以前法进退。
处方：仙茅10克，仙灵脾10克，熟地10克，补骨脂10克，桑寄生10克，杜仲10克，川断10克，白芍10克，珍珠母20克，五味子10克，金樱子10克。
四诊：1990年元月3日
服上方7剂，小便失禁未作，余症均除，精神较佳，面带喜色，再以上方加升麻10克，海螵蛸10克。服药10剂，以巩固疗效。三个月后随访。病愈未再反复，体质转健，饮食倍增，体重增加5公斤。
[按]：小便失禁是指在神志完全清醒状态下，膀胱不能维持其控制排尿的功能，造成尿液不自主的流出的病症。在临床上以老年人，妇女以及大病之后为多见。一般认为小便失禁多属肾气虚衰，气化无权，膀胱失约而致小便自行排出。此患者素体阴虚，阴虚生内热，虚热内扰，膀胱失约而为小便失禁。乙癸同源，肾阴不足，水不涵木，久病不愈，阴损及阳，下元亏虚，固摄无权，则小便自遗。加之病已延久，情志抑郁，肝失疏泄，肝火偏盛，表现出肾虚肝旺之征。因此赵师在治疗上先以清肝热，后议补下元，取效甚佳。使患病8年之苦，仅服30剂药而愈，经随访未复发
尿血1（膀胱癌）
秦某，男，60岁，于1989年10月13日初诊。患者自8月初外出旅游，中途出现发热，并伴有尿频，尿痛，尿赤，以“泌尿系感染”治疗10余天，尿频，尿痛症减轻，仍血尿时作，低热不退，又改换抗生素、中药等治疗月余疗效不明显，尿化验检查：尿蛋白++，红血球大量，潜血++，后经膀胱镜检查确诊为膀胱癌，医院建议手术治疗。患者本人与家属决定先请赵老医治，刻诊见：身热恶寒，头目不清，急躁，眠不实，胸脘不舒，小便短赤，舌黄苔厚腻，有瘀斑，脉濡滑且数。证属暑湿郁热蕴郁于内，拟先用宣郁化湿方法。药用，藿香10克(后下)，佩兰10克(后下)，杏仁10克(后下)，枇杷叶10克，荆芥炭10克，茅根芦根10克，柴胡6克，炒山栀6克，菖蒲6克，郁金6克，香附10克，焦麦芽10克。服药10剂，身热恶寒消失，余症减轻，尿蛋白(-)，红细胞5～10个／高倍视野，尿潜血+，舌红苔厚，脉滑数，湿郁渐化，气机渐疏，郁热未解，用凉血化瘀清热方法。
药用：荆芥炭10克，柴胡6克，黄芩6克，生地榆10克，茜草10克，炒山栀6克，丹参10克，蝉衣6克，僵蚕10克，片姜黄6克，半枝莲10克，白花蛇舌草10克，大黄1克，茅根芦根各10克，服药20余剂，血尿未作，尿检(-)。膀胱镜检查：膀胱粘膜白斑，未见其他异常。舌红苔白且干，脉弦滑，接之略数，血分郁热，改用清热凉血、甘寒育阴方法。方药：柴胡6克，黄芩6克，川楝子6克，赤芍10克，生地榆10克，丹参10克，茜草10克，炒槐花10克，沙参10克，麦冬10克，焦三仙各10克，茅根芦根各10克，白花蛇舌草10克，半枝莲10克。以此方加减服药2月余，又去复查，原病灶区白斑均消失，未见其他异常。仍以前法进退，饮食当慎，防其复发。药用：凤尾草10克，生地榆10克，丹参10克，茜草10克，蝉衣6克，僵蚕10克，片姜黄6克，半枝莲10克，白花蛇舌草10克，焦三仙各10克，茅根芦根各10克，大黄1克，每周2～3剂，续续服用。
[按]：此病案系膀胱癌，是经权威西医医院做膀胱镜检查，并取活组织切片病理实验而确诊，而未作手术及化疗治疗，单纯用中药治愈的。患者平素嗜酒吸烟，外出旅游正值暑期，湿气盛，气温高，易贪凉，以致暑湿温热之邪相合而受之，与体内湿热之邪相为交织互结，病势缠绵，表里同病。赵师在治疗上，先以宣郁化湿，后用凉血清热，再以甘寒育阴，分层次，有步骤进行治疗，但无论在哪一阶段都没有抛开疏调气机之法。因此赵师常说：“治病之要，贵在疏调。”此患者与医生积极配合再未近烟酒，每日早晚锻炼，服药未断，现已6年，身体颇健，未见复发。
Lin Syndrome 2 (Urinary Tract Infection)
Patient Lv, female, 28 years old, first consultation on September 5, 1989. Since the 3rd, after consuming cold drinks, she felt aversion to cold and fever, discomfort during urination, frequent urination, and urgency of urination. This was followed by chills, rigors, and aversion to wind. She visited a hospital where her temperature was 39.6°C, WBC count was 2300/mm³, and urine examination showed: white blood cells 30-50/high power field (HPF), red blood cells 10-20/HPF, and a small amount of pus cells. Diagnosed with acute urinary tract infection, she was treated with antibiotics and antipyretic analgesics. After profuse sweating, the fever subsided, and rigors stopped. However, symptoms recurred from the next day. She specifically sought treatment from Master Zhao Shaoqin. Current symptoms include fever, aversion to wind, frequent urination, urgency of urination, burning and stabbing pain during urination, incomplete emptying of the bladder, tightness and spasm in the lower abdomen, coldness and pain in the lower back. The tongue is red with a thin white coating, and the pulse is slippery, fine, and rapid. Temperature is 38.6°C. Urine examination shows: white blood cells filling the field, red blood cells 20-30, and a large amount of pus cells. The syndrome is attributed to damp-heat accumulating and stagnating, sinking into the Bladder. The treatment principle is to clear heat, transform dampness, cool the blood, and promote free flow of urine. The prescription is based on Jingfang Baidu San (Astragalus and Saposhnikovia Decoction modified): Jingjie (Schizonepetae Spica) 6g, Fangfeng (Saposhnikoviae Radix) 6g, Qianhu (Peucedani Radix) 6g, Duhuo (Angelicae Pubescentis Radix) 6g, Shengdiyue (Sanguisorbae Radix) 10g, Huashi (Talcum) 10g, Qumai (Dianthi Herba) 10g, Mutong (Akebiae Caulis) 2g, Chao Zhizi (Gardeniae Fructus, stir-fried) 6g, Chao Huaihua (Sophorae Flos, stir-fried) 10g, Dafupi (Arecae Pericarpium) 10g, Jiao Sanxian (Scorodocarpus, Hawthorn, and Malt, charred) 10g each, Maogen (Imperatae Rhizoma) and Lugen (Phragmitis Rhizoma) 20g each. After taking 3 doses, the fever lightened. After another 4 doses, the fever subsided, and urinary irritation symptoms disappeared. Stool became slightly dry, urine turned red, and body temperature normalized. Routine urine examination showed: blood cells 3-5/HPF, red blood cells 0-2/HPF. Dampness is gradually resolving, but residual heat remains. The previous method is continued with adjustments. Prescription: Jingjie Tan (Schizonepetae Spica, charred) 10g, Fangfeng 6g, Baizhi (Angelicae Dahuricae Radix) 6g, Duhuo 6g, Shengdiye 10g, Chao Huaihua 10g, Maogen and Lugen 10g each, Sangshen (Mori Fructus) 10g, Chaihu (Bupleuri Radix) 6g, Huangqin (Scutellariae Radix) 6g, Jiao Sanxian 10g each, Xiaoji (Cirsii Herba) 10g.
After taking the above prescription for 14 doses, urine examination returned to normal, with no other discomfort.
[Commentary]: Lin Syndrome is clinically common. Its main manifestations include frequent urination, dripping and stabbing pain, or pain radiating to the lower abdomen, accompanied by hematuria, cloudy urine, or even passage of sand-like stones. It includes some modern medical conditions such as urinary tract infections, urinary calculi, and acute and chronic pyelonephritis. This patient had a constitution prone to abundant damp-heat. Consuming cold drinks invited cold-dampness from outside. External cold-dampness combined with internal damp-heat, transmitted to the Bladder, causing dysfunction of Qi transformation and obstruction of the water passages, resulting in Lin Syndrome. Master Zhao believed that although the patient had severe aversion to cold, even rigors, it was not Cold Lin. Cold Lin is mostly due to deficiency of Kidney Qi or deficiency-cold of the Gate of Vitality. The aversion to cold and rigors in this case were caused by external invasion of cold-dampness, stagnation of Qi mechanism, and failure of Yang Qi to reach the exterior. Therefore, treatment must prioritize transforming dampness, supplemented by clearing heat. Master Zhao heavily used Wind herbs, believing that Wind can overcome dampness, open stagnation, and regulate Qi mechanism. Additionally, dietary precautions are necessary: diet should be bland, and raw, cold, spicy, and greasy foods should be avoided.
Enuresis 1
Patient Yan, male, 11 years old. First consultation on January 26, 1992. Since childhood, the child wets the bed 1-2 times every night. He is emaciated, irritable, has many dreams during sleep, occasionally talks and grinds teeth in his sleep, feels fatigued, has poor appetite, lacks concentration, often experiences abdominal pain, dry stool, yellow urine with a foul odor. The tongue is red with a yellow coating, and the pulse is wiry and rapid.
Syndrome Differentiation: Liver and Gallbladder Qi stagnation transforming into heat, Yangming accumulation and stagnation.
Treatment Method: Clear and drain Liver and Gallbladder stagnant heat, digest and guide out gastrointestinal accumulation.
Prescription: Chan Tui (Cicadae Periostracum) 6g, Pian Jianghuang (Curcumae Longae Rhizoma) 6g, Bai Jiangcan (Bombyx Batryticatus) 10g, Dahuang (Rhei Radix et Rhizoma) 2g, Chaihu 6g, Huangqin 6g, Chuan Lianzi (Toosendan Fructus) 6g, 7 doses.
Second Consultation
After taking the medicine, loose stools occurred 4-5 times; after 3 doses, bowel movements normalized, enuresis ceased, and except for irritability, all other symptoms decreased. The pulse is wiry and slippery, tongue is red. Remove Chaihu, Huangqin, and Chuan Lianzi from the original prescription, add Jiao Sanxian 10g each, Shuihong Huazi (Alternantherae Philoxeroides Herba) 10g, 7 doses.
Third Consultation
Only wet the bed once in the past week. Tongue is red with a white coating, pulse is wiry and fine. Continue the previous method.
Medication: Gouteng (Uncariae Ramulus cum Uncis) 10g, Chan Tui 6g, Jiangcan (Bombyx Batryticatus) 10g, Zhiqiao (Aurantii Fructus) 6g, Yujin (Curcumae Radix) 10g, Fupenzi (Rubiae Fructus) 10g, 7 doses.
Fourth Consultation
Enuresis did not occur. Appetite increased, sleep improved, spirit refreshed, bowel and bladder functions normal. Huanglian (Coptidis Rhizoma) 2g, Chan Yi (Cicadae Periostracum) 6g, Jiangcan 10g, Fupensi 10g, Gouteng 10g, Chuan Lianzi 6g, Sheng Muli (Ostreae Concha) 20g, 7 doses, to consolidate therapeutic effect.
[Commentary]: Pediatric enuresis was previously mostly considered to be caused by congenital deficiency of Kidney Qi, deficiency-cold of the lower origin, and loss of control by the Bladder. This child frequently has abdominal pain, poor appetite, red tongue with yellow coating, and dry stool. This indicates gastrointestinal accumulation stagnating and transforming into heat. Irritability, many dreams, talking and grinding teeth in sleep, red tongue, and wiry-rapid pulse indicate damp-heat accumulating in the Liver and Gallbladder, disturbing the Heart Spirit internally. Damp-heat moves downward, accumulates in the Bladder, and heat forces the Bladder to lose control, causing enuresis during sleep. "Medical Enlightenment · Enuresis" states: "Fire nature is swift and urgent, forcing leakage." Heat scorching body fluids results in pungent-smelling yellow urine. The teacher used Shengjiang San (Ascending and Descending Powder) to ascend clear Yang and descend turbid Yin, regulate Qi mechanism, and cleanse gastrointestinal accumulation. Then, using Chaihu, Huangqin, and Chuan Lianzi to clear and drain Liver and Gallbladder stagnant heat, dispersing stagnation, removing dampness, and clearing heat, thus achieving efficacy.
Enuresis (Hydronephrosis)
Patient Sun XX, female, 12 years old, first consultation.
Enuresis since childhood, unresolved until now. Must wet the bed 1-2 times every night during sleep, completely unaware. Recent ultrasound showed mild bilateral hydronephrosis. Dry stool, difficult urination. Red tongue with yellow and greasy coating, wiry-tight and rapid pulse. Damp-heat accumulating in the Lower Jiao. First use methods to clear and transform damp-heat.
Jingjie 6g, Fangfeng 6g, Baizhi 6g, Duhuo 6g, Shengdiye 10g, Chao Huaihua 10g, Danshen (Salviae Miltiorrhizae Radix et Rhizoma) 10g, Qiancao (Rubiae Radix) 10g, Dahuang 2g, Chan Tui 6g, Leiwan (Oxyriae Herba) 6g, Huashi 10g, 7 doses.
Second Consultation
After medication, bowel movements flowed freely. Urine was yellow and difficult to pass. Still wetting bed once at night. Red tongue with yellow coating, slippery-rapid pulse. This is Lung Qi not diffusing, Triple Burner not benefiting. Must open Lung Qi to benefit the Triple Burner.
Zisu (Perillae Folium) 10g, Xingren (Armeniacae Semen Amarum) 10g, Pipaye (Eriobotryae Folium) 10g, Qianhu 6g, Jingjie 6g, Fangfeng 8g, Baizhi 6g, Duhuo 6g, Dahuang 2g, Shijunzi (Quisqualis Fructus) 10g, Leiwan 6g. 7 doses.
Third Consultation
Urine flow is freer than before, nocturnal enuresis reduced. Stool slightly dry, pulse still tight-rapid, red tongue with yellow coating. Continue method of diffusing Lung and transforming dampness.
Jingjie 6g, Fangfeng 6g, Zisu 10g, Baizhi 6g, Xingren 10g, Qianhu 6g, Jiao Lanxian (Scorodocarpus, Hawthorn, and Malt, charred) 10g each, Shuihong Huazi 10g, Shijunzi 10g, Leiwan 6g, Maogen and Lugen 10g each, Dahuang 3g, 7 doses.
Fourth Consultation
Nocturnal enuresis significantly reduced, able to wake up spontaneously during sleep to urinate, only wetted bed once in the past week. Nightmares decreased, occasional irritability, red tongue with yellow coating, wiry-slippery pulse. Continue previous method with adjustments.
Chan Yi 6g, Jiangcan 10g, Pian Jianghuang 6g, Dahuang 1g, Zi Su Ye (Perillae Folium) 10g each, Qianhu 6g, Zhe Beimu (Fritillariae Thunbergii Bulbus) 10g, Shijunzi 10g, Leiwan 6g, Chuan Lianzi 10g, 7 doses.
Fifth Consultation
Continued taking the above medicine for one week. No nocturnal enuresis occurred, daytime urination was smooth, bowel movements normal, eating and sleeping excellent. Re-examination of renal ultrasound reported no hydronephrosis in either kidney. The disease is healing, so stop medication and observe. Advised to eat less rich and sweet food to prevent recurrence.
[Commentary]: Pediatric enuresis is not always due to Kidney deficiency. If damp-heat accumulates, Lung Qi is obstructed, and Qi transformation fails, it can also cause enuresis, which is the case here. The Lung is the upper source of water, regulating water passages. Whether urination is smooth and normal is closely related to Lung Qi. In this patient, difficulty urinating during the day and spontaneous enuresis at night are entirely due to failure of Lung Qi to diffuse and transform, accumulation of damp-heat, and obstruction of Triple Burner water passages. Hydronephrosis also indicates accumulation and stagnation of water-dampness. In the first consultation, Wind herbs were used to overcome dampness, activate blood and resolve stasis to unblock collaterals, and products to soothe and benefit the Triple Burner. Due to the lack of Lung-diffusing herbs, the efficacy was not ideal. From the second consultation onwards, starting with diffusing Lung Qi, while still using Wind herbs to overcome dampness and soothing/benefiting Triple Burner water passages, obvious effects were achieved.
Enuresis 3 (Urinary Incontinence)
Patient Zhang, female, 45 years old, first consultation on December 11, 1989. Suffering from urinary incontinence for about 8 years, fluctuating in severity, seeking medical help everywhere, taking countless Chinese and Western medicines, unbearable suffering. Introduced by a friend to seek treatment from Master Zhao. Symptoms: emaciated constitution. Irritability, dizziness and vertigo, many dreams during sleep, lower back pain and fatigue, paroxysmal sweating, urinary incontinence, normal bowel movements. Red, thin, and dry tongue, wiry-fine-slippery-rapid pulses in both wrists.
Syndrome Differentiation: Liver Meridian Qi stagnation transforming into heat, Kidney Yin deficiency.
Legislation: Clear and drain Liver Meridian stagnant heat, tonify deficiency of the lower origin, to soothe and regulate Liver and Kidney.
Prescription: Jingjie 6g, Fangfeng 6g, Chaihu 6g, Chuan Lianzi 6g, Mugua (Chaenomelis Fructus) 10g, Shengma (Cimicifugae Rhizoma) 6g, Fuling (Poria) 10g, Baishao (Paeoniae Radix Alba) 10g, Ejiao Zhu (Asini Corii Colla, pearl-coated) 10g, Sheng Muli 30g.
Second Consultation
December 18. After taking 7 doses of the above medicine, urinary incontinence decreased, irritability and many dreams improved. Heat stagnation gradually cleared. Change to tonifying method.
Prescription: Xianmao (Curculiginis Rhizoma) 10g, Xianlingpi (Epimedii Folium) 10g, Chaihu 6g, Shashen (Glehniae Radix) 10g, Shudi (Rehmanniae Radix Preparata) 10g, Yuzhu (Polygonati Odorati Rhizoma) 10g, Buguzhi (Psoraleae Fructus) 10g, Duhuo 6g, Sangjisheng (Taxilli Herba) 10g, Zhenzhumu (Margarita) 20g.
Third Consultation: December 25.
After taking 7 doses of the above prescription, urinary incontinence greatly reduced, lower back pain lightened, dizziness did not occur. Continue previous method with adjustments.
Prescription: Xianmao 10g, Xianlingpi 10g, Shudi 10g, Buguzhi 10g, Sangjisheng 10g, Duzhong (Eucommiae Cortex) 10g, Chuanduan (Dipsaci Radix) 10g, Baishao 10g, Zhenzhumu 20g, Wuweizi (Schisandrae Chinensis Fructus) 10g, Jinyingzi (Chrysanthemi Indici Fructus) 10g.
Fourth Consultation: January 3, 1990.
After taking 7 doses of the above prescription, urinary incontinence did not occur, remaining symptoms eliminated, spirit better, face showing joy. Add Shengma 10g and Haipiaoxiao (Sepiae Endoconcha) 10g to the above prescription. Take 10 doses to consolidate therapeutic effect. Follow-up after three months. Disease cured without recurrence, constitution strengthened, appetite doubled, weight increased by 5 kg.
[Commentary]: Urinary incontinence refers to the involuntary leakage of urine when consciousness is fully clear, due to the bladder's inability to maintain its function of controlling urination. Clinically, it is more common in the elderly, women, and after severe illness. Generally, urinary incontinence is considered to be caused by deficiency and decline of Kidney Qi, lack of authority in Qi transformation, and loss of control by the Bladder. This patient had a constitution prone to Yin deficiency. Yin deficiency generates internal heat, deficient heat disturbs internally, Bladder loses control, causing urinary incontinence. Liver and Kidney share the same source (Yi Gui Tong Yuan). Deficiency of Kidney Yin means Water does not nourish Wood. Long-term illness not healing leads to Yin damage affecting Yang, deficiency of the lower origin, lack of consolidation authority, resulting in spontaneous enuresis. Additionally, the disease has prolonged, emotional depression causes Liver to fail in soothing and draining, Liver Fire becomes excessive, manifesting signs of Kidney deficiency and Liver excess. Therefore, Master Zhao first cleared Liver heat, then discussed tonifying the lower origin, achieving excellent results. The suffering of 8 years was cured with only 30 doses of medicine, and follow-up showed no recurrence.
Hematuria 1 (Bladder Cancer)
Patient Qin, male, 60 years old, first consultation on October 13, 1989. Since early August, during travel, fever appeared, accompanied by frequent urination, dysuria, and red urine. Treated for "urinary tract infection" for over 10 days. Frequency and pain of urination alleviated, but hematuria still occurred intermittently, low-grade fever persisted. Changed to antibiotics and Chinese medicine for over a month with insignificant efficacy. Urine test: Protein ++, massive red blood cells, occult blood ++. Later diagnosed with bladder cancer via cystoscopy. Hospital suggested surgical treatment. Patient and family decided to seek treatment from Master Zhao first. Current diagnosis: Fever and aversion to cold, unclear head and eyes, irritability, restless sleep, chest and epigastric discomfort, short and red urine, yellow tongue with thick greasy coating, ecchymosis spots, soggy-slippery-rapid pulse. Syndrome belongs to Summer-heat and Dampness with stagnant heat accumulating internally. Plan to first use method to diffuse stagnation and transform dampness. Medication: Huoxiang (Agastaches Herba) 10g (added later), Peilan (Pogostemonis Herba) 10g (added later), Xingren 10g (added later), Pipaye 10g, Jingjie Tan 10g, Maogen and Lugen 10g each, Chaihu 6g, Chao Zhizi 6g, Changpu (Acori Tatarinowii Rhizoma) 6g, Yujin 6g, Xiangfu (Cyperi Rhizoma) 10g, Jiao Maiya (Hordei Fructus Germinatus, charred) 10g. After taking 10 doses, fever and aversion to cold disappeared, remaining symptoms alleviated, urine protein (-), red blood cells 5-10/HPF, urine occult blood +. Red tongue with thick coating, slippery-rapid pulse. Damp stagnation gradually transformed, Qi mechanism gradually unblocked, stagnant heat not resolved. Use method to cool blood, resolve stasis, and clear heat.
Medication: Jingjie Tan 10g, Chaihu 6g, Huangqin 6g, Shengdiye 10g, Qiancao 10g, Chao Zhizi 6g, Danshen 10g, Chan Yi 6g, Jiangcan 10g, Pian Jianghuang 6g, Ban Zhi Lian (Isodontiae Herba) 10g, Bai Hua She She Cao (Hedyotis Diffusa Herba) 10g, Dahuang 1g, Maogen and Lugen 10g each. After taking over 20 doses, hematuria did not occur, urine test (-). Cystoscopy: Bladder mucosal leukoplakia, no other abnormalities seen. Red tongue with white and dry coating, wiry-slippery pulse, slightly rapid upon pressing. Blood level stagnant heat. Change to method of clearing heat, cooling blood, and sweet-cold nourishing Yin. Prescription: Chaihu 6g, Huangqin 6g, Chuan Lianzi 6g, Chi Shao (Paeoniae Radix Rubra) 10g, Shengdiye 10g, Danshen 10g, Qiancao 10g, Chao Huaihua 10g, Shashen 10g, Maidong (Ophiopogonis Radix) 10g, Jiao Sanxian 10g each, Maogen and Lugen 10g each, Bai Hua She She Cao 10g, Ban Zhi Lian 10g. With adjustments to this prescription for over 2 months, re-examination showed disappearance of leukoplakia in the original lesion area, no other abnormalities. Continue previous method with adjustments. Diet should be cautious to prevent recurrence. Medication: Feng Wei Cao (Pteridophyta) 10g, Shengdiye 10g, Danshen 10g, Qiancao 10g, Chan Yi 6g, Jiangcan 10g, Pian Jianghuang 6g, Ban Zhi Lian 10g, Bai Hua She She Cao 10g, Jiao Sanxian 10g each, Maogen and Lugen 10g each, Dahuang 1g. 2-3 doses per week, continuously taken.
[Commentary]: This case is bladder cancer, confirmed by authoritative Western hospitals via cystoscopy and biopsy pathology, cured solely with Chinese medicine without surgery or chemotherapy. The patient usually indulged in alcohol and smoking. Traveling during summer, humidity was high, temperature high, prone to craving coolness, leading to contraction of Summer-heat, Dampness, and Warmth pathogens, intertwining with internal damp-heat pathogens. The disease course was lingering, involving both exterior and interior. Master Zhao's treatment first used diffusing stagnation and transforming dampness, then cooling blood and clearing heat, then sweet-cold nourishing Yin, treating in layers and steps. However, at any stage, the method of soothing and regulating Qi mechanism was never abandoned. Therefore, Master Zhao often said: "The key to treating disease lies in soothing and regulating." This patient cooperated actively with doctors, abstained from tobacco and alcohol, exercised morning and evening, took medicine continuously. Now 6 years have passed, body is quite healthy, no recurrence seen.