Pulse: In cases of urinary retention, the pulse is floating, wiry, and choppy; a knotted pulse indicates hematuria; a rapid pulse indicates yellow-red urine; difficulty in urination is termed "long" (strangury/retention), and excess patterns are commonly seen at the left chi position.

Urinary retention is mostly caused by heat accumulation.

Zhuling Tang (Polyporus Decoction) treats urinary retention due to heat accumulation.
Ingredients: Tongcao (Tetrapanacis Medulla), Polyporus (Polypori Umbellati Sclerotium), Alisma Rhizoma (Alismatis Rhizoma), Talcum (Talcum), Aurantium Fructus (Aurantii Fructus, stir-fried), Phellodendri Cortex (Phellodendri Chinensis Cortex, wine-soaked), Achyranthis Bidentatae Radix (Achyranthis Bidentatae Radix, remove rhizome), Ophiopogonis Radix (Ophiopogonis Radix, remove heart), Dianthi Herba (Dianthi Herba), Plantaginis Semen (Plantaginis Semen) (all equal parts), Glycyrrhizae Radix et Rhizoma (Glycyrrhizae Radix et Rhizoma, tip used, reduced by half), Artemisiae Scopariae Herba (Artemisiae Scopariae Herba, ten leaves).
Crush the above ingredients for one dose. Boil with a bundle of Juncus effusus (Junci Medulla) in water, take on an empty stomach.

In cases where there is no thirst but urinary retention exists, the heat is accumulated in the blood aspect of the lower jiao.

Tongguan Wan (Passage-Opening Pill) treats urinary retention without thirst, where heat is in the blood aspect of the lower jiao, and also effectively treats strangury and retention.
Ingredients: Phellodendri Cortex (Phellodendri Chinensis Cortex, washed with wine and dried), Anemarrhenae Rhizoma (Anemarrhenae Rhizoma, washed with wine and dried, 1 liang), Cinnamomi Cortex (Cinnamomi Cortex, 1 qian).
Grind all into fine powder, mix with cooked water to form pills the size of sophora seeds. Take 100 pills per dose, swallow with plain warm water on an empty stomach. After taking the medicine, stomp the feet twice to facilitate the downward movement of the medicinal effect. If urination becomes smooth and there is a stabbing pain in the urethra like a knife cut, it indicates that pathogenic turbid matter is being expelled.

If there is thirst accompanied by urinary retention, the heat is in the qi aspect of the upper jiao.

Qingfei Yinzi (Lung-Clearing Decoction) treats thirst with difficult urination, which is due to heat pathogen in the lung portion of the upper jiao. The lung belongs to metal, and metal generates water. If there is heat in the lung, it cannot generate kidney water, thus cutting off the water source. Treatment should employ bland-draining agents to clear lung qi, drain fire pathogen, and nourish the upper source of water.
Ingredients: Red Poria (Poria cum Radio, peel removed, 1.5 qian), Polyporus (Polypori Umbellati Sclerotium, 2 qian), Alisma Rhizoma (Alismatis Rhizoma, 1 qian), Tetrapanacis Medulla (Tetrapanacis Medulla, 2 qian), Junci Medulla (Junci Medulla, 1 qian), Plantaginis Semen (Plantaginis Semen, stir-fried, separately ground, 1 qian), Succinum (Succinum, separately ground, 0.5 qian), Artemisiae Scopariae Herba (Artemisiae Scopariae Herba, 0.7 qian), Akebiae Caulis (Akebiae Caulis, 0.7 qian), Dianthi Herba (Dianthi Herba, 0.7 qian).
Crush the above ingredients for one dose. Boil in water, take slightly warm on an empty stomach.

Urinary retention due to deficiency-cold is caused by cold accumulation.

Jiawei Wuling San (Modified Five-Ling Powder) treats urinary retention due to deficiency-cold.
Ingredients: Polyporus (Polypori Umbellati Sclerotium), Alisma Rhizoma (Alismatis Rhizoma), Atractylodis Macrocephalae Rhizoma (Atractylodis Macrocephalae Rhizoma, remove rhizome), Red Poria (Poria cum Radio, peel removed), Cinnamomi Cortex (Cinnamomi Cortex), Angelicae Sinensis Radix (Angelicae Sinensis Radix), Aurantium Fructus (Aurantii Fructus), Achyranthis Bidentatae Radix (Achyranthis Bidentatae Radix, remove rhizome), Akebiae Caulis (Akebiae Caulis) (all equal parts), Glycyrrhizae Radix et Rhizoma (Glycyrrhizae Radix et Rhizoma, slightly reduced).
Crush the above ingredients for one dose. Boil with a bundle of Juncus effusus (Junci Medulla) in water, take on an empty stomach.

Urinary retention due to deficiency-heat is caused by heat accumulation.

Shengma Shengyang Tang (not explicitly named in text, referred to as Shen Gui Shengma Tang) treats urinary retention in deficient persons.
Ingredients: Ginseng Radix (Ginseng Radix, remove rhizome), Angelicae Sinensis Radix (Angelicae Sinensis Radix), Rehmanniae Radix Recens (Rehmanniae Radix Recens), Red Poria (Poria cum Radio, peel removed), Polyporus (Polypori Umbellati Sclerotium), Alisma Rhizoma (Alismatis Rhizoma), Gardeniae Fructus (Gardeniae Fructus), Aurantium Fructus (Aurantii Fructus, remove pith), Achyranthis Bidentatae Radix (Achyranthis Bidentatae Radix, remove rhizome, wine-washed), Phellodendri Cortex (Phellodendri Chinensis Cortex, wine-stir-fried), Anemarrhenae Rhizoma (Anemarrhenae Rhizoma, wine-stir-fried) (all equal parts), Cimicifugae Rhizoma (Cimicifugae Rhizoma, small amount), Glycyrrhizae Radix et Rhizoma (Glycyrrhizae Radix et Rhizoma, reduced by half).
Crush the above ingredients for one dose. Boil with a bundle of Juncus effusus (Junci Medulla) in water, take on an empty stomach.

In elderly people, urinary retention is mostly due to shortness of qi and blood deficiency. Use Siwu Tang (Four-Substance Decoction) plus Huangqin (Scutellariae Radix) decocted as soup, to swallow Tongguan Wan (Passage-Opening Pill), taken on an empty stomach.

Urinary retention accompanied by cough and asthma is due to phlegm-qiu obstruction.

Erchen Tang (Two-Aged Decoction) treats urinary retention due to phlegm-qiu blockage.
Ingredients: Citri Reticulatae Pericarpium (Citri Reticulatae Pericarpium), Pinelliae Rhizoma (Pinelliae Rhizoma, stir-fried with ginger juice), Poria (Poria), Aurantium Fructus (Aurantii Fructus, bran-stir-fried), Achyranthis Bidentatae Radix (Achyranthis Bidentatae Radix, remove rhizome), Polyporus (Polypori Umbellati Sclerotium), Akebiae Caulis (Akebiae Caulis), Gardeniae Fructus (Gardeniae Fructus), Ophiopogonis Radix (Ophiopogonis Radix, remove heart), Plantaginis Semen (Plantaginis Semen), Phellodendri Cortex (Phellodendri Chinensis Cortex, wine-stir-fried) (all equal parts), Glycyrrhizae Radix et Rhizoma (Glycyrrhizae Radix et Rhizoma, reduced by half).
Crush the above ingredients for one dose. Boil with a bundle of Juncus effusus (Junci Medulla) in water, take on an empty stomach.

For those with deficient yuan qi unable to transform and transport, Buchong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is suitable (formula see Tonification section). For urinary retention due to yin deficiency, this is due to excessive fire; Ziyin Jianghuo Tang (Nourish Yin and Descend Fire Decoction) treats urinary retention in frail persons with yin deficiency and hyperactive fire (formula see Deficiency Labor section); Liuwei Wan (Six-Ingredient Pill) is particularly effective, based on the original formula adding Polyporus, Alisma Rhizoma, Akebiae Caulis, and Achyranthis Bidentatae Radix. Generally speaking, when urinary retention does not respond to diuretic herbs, it is because accumulated phlegm is in the lung. The lung is the upper jiao, and the bladder is the lower jiao; if the upper jiao is closed, the lower jiao is blocked, similar to a dripping vessel where water flows out from the lower spout only if the upper opening is open. If urinary retention occurs during diarrhea or dysentery, it is due to excessive fluid loss and insufficient intake; after diarrhea stops, urination will naturally resume. If urinary retention occurs with vomiting or hiccups, it is difficult to treat. If urinary retention occurs with abdominal fullness and distension (鼓胀), it is also difficult to treat.

To treat elderly patients with deficiency-cold in the lower origin, resulting in "zhuanbao" (bladder displacement/retention) preventing urination, with abdominal distension, urgency, pain, and critical condition lasting four to five days, use Liuwei Wan (Six-Ingredient Pill) with doubled Alisma Rhizoma dosage, which is effective (formula see Tonification section).

Supplementary Secret Prescriptions
Treating urinary retention: Fill the umbilicus with powder of Moschus (Moschus) and Pinelliae Rhizoma (Pinelliae Rhizoma). Cover the umbilicus with a paste made from Scallion White (Allii Fistulosi Bulbus) and Snail (Cochleae Concha), and bind tightly with cloth. Below, use smoke from Sophora Flower (Sophorae Flos) introduced into the vagina for natural passage; for women, wash the vaginal interior with decoction of Sophora Flower.

Daochi Tang (Directing Red Decoction) treats urine resembling rice-water color, cured within two doses.
Ingredients: Akebiae Caulis (Akebiae Caulis), Talcum (Talcum), Glycyrrhizae Radix et Rhizoma (Glycyrrhizae Radix et Rhizoma, tip), Phellodendri Cortex (Phellodendri Chinensis Cortex), Poria (Poria), Rehmanniae Radix Recens (Rehmanniae Radix Recens), Aurantium Fructus (Aurantii Fructus), Atractylodis Macrocephalae Rhizoma (Atractylodis Macrocephalae Rhizoma), Gardeniae Fructus (Gardeniae Fructus).
Boil in water, take on an empty stomach.

Treating sensation of urinary dragging/heaviness: Take 3 liang of high-quality Hemp Stem (Cannabis Sativae Caulis), tear it up, roast it over fire, cover with a new basin to collect the ash produced. Mix with yellow wine and take orally. Cover with blankets to induce sweating, then recover.

Treating urinary retention: Mix 1 he of Natrii Sulfas (Natrii Sulfas) with one green onion including roots, pound into a mixture. Spread on green cloth like a plaster, apply hot tile to iron/warm it, and urine will flow out.