太阳热结，小便不利，仲景用五苓散，家秘用羌独木通汤。阳明热结，小便不利，仲景用猪
苓汤、木通汤、六一散。另有风湿相搏，身肿身痛，小便不利，用通苓散、羌活胜湿汤。有
肠胃热结，大便闭涩，小便不利，用八正散。有心热遗于小肠而不利者，导赤各半汤。有上
焦肺热而不利者，清肺饮。有水饮停结而不利者，用平胃四苓散合二陈汤。有误汗太过，津
液外亡而不利者，用生脉益气汤。有误下太过，中气损伤，津液内耗而不利者，用生脉建中
汤。若论运气便闭，《内经》有阳明司天之政，天气急，地气明，民病癃闭，此言燥热加临
也，宜用白虎汤、清燥汤。又云少阴司天之政，地气肃，天气明，其病淋，此言君火行令
也，宜用泻心汤、导赤各半汤。又云太阴在泉，湿淫所胜，病小腹肿，不得小便，此言土败
浸淫也，宜用平胃五苓散。又云水不及曰涸流，其病癃闭，此言火炎燥土，金不生水也，宜
用清肺饮、凉膈散。又云厥阴司天，风淫所胜，民病溏泄，土受木克，不能分利小便，水谷
偏渗大肠，先用羌防胜湿汤散风祛湿，随用五苓散、猪苓汤分利阴阳。另有食滞中焦，小便
赤涩黄浊，此即中气不清，溲便变色，宜用辛温化滞保和散，加砂仁、豆蔻，合苍术平胃
散。若妄用寒凉，则食滞凝结。另有三阴里寒，而小便不通，此是阴症寒闭也。真阳不足
者，金匮肾气丸；中气虚寒，气化不及州都者，补中气汤。外有水肿而小便不利，呃逆而小
便不利，女科胎前而不利，跌扑伤损而不利，另具本门杂症中。
太阳病，发汗后，大汗出，胃中干，烦躁不得眠，欲饮水者，少少与饮之，令胃气和则愈。
若脉浮小便不利，微热消渴者，与五苓散主之。
发汗后，又大汗出，则表邪已解，胃中干欲饮水，故以水治其干渴，可以令愈。若脉尚见
浮，则表邪未散，又小便不利，微热消渴，此太阳热结膀胱。
太阳病身黄，脉沉结，小腹硬，小便不利者，为无血也。
此辨小腹硬是水是血。同一身黄，脉沉结，小腹硬，而以小便利为蓄血，以小便不利为溺结。
大下之后，复发汗，小便不利者，亡津液故也，勿治之，得小便，必自愈。
此言汗下太过，津液外亡下竭，勿用劫利膀胱，则病必自愈。
伤寒五六日，已发汗而复下之，胸胁满微结，小便不利，渴而不呕，但头汗出，往来寒热，
心烦者，此为未解也，柴胡桂枝干姜汤主之。
小便不利，里热者多，然尚见少阳太阳表证，故立散表法门。
阳明病，发热汗出者，此为越热不能发黄也。但头汗出，身无汗，剂颈而还，小便不利，渴
引水浆者，此为瘀热在里，身必黄，茵陈汤主之。伤寒七八日，身黄如橘子色，小便不利，腹
微满者，茵陈蒿汤。
此条详注发黄。言表汗未透，热瘀于内，故发黄。而小便不利，腹微满，用茵陈汤去湿热
则黄退便利，腹满亦减。
病患小便不利，大便乍难乍易，时有微热，喘冒不能卧者，有燥粪也，宜大承气汤。
此症有结粪微热，加以小便不利，故下大便，则小便利。详注不得卧。
五苓散
泽泻 猪苓 茯苓 白术 桂枝
阳明小便不利，用猪苓汤。太阳之邪热，内结膀胱，而小便不利，用此方。但白术凝滞，
桂枝辛热，必得里无郁热者，可用。
羌活木通汤 见发热。
桂枝五苓散，外解太阳表邪，内利膀胱小便，但南方热令不用，家秘化立。羌活解太阳之
表，木通利膀胱之里。
猪苓汤
猪苓 白茯苓 泽泻 滑石 阿胶 木通
阳明热结，小便不利，不用五苓而用此方，家秘以黄芩易阿胶最效。
六一木通汤 即木通汤调下六一散。
前条以羌活木通汤，双解太阳；此条又以滑石、木通，分利阳明。
通苓汤
木通 猪苓 茯苓 车前子 淡竹叶 甘草 麦门冬
此方通利小便，家秘加川连，清心胃之热；加桔梗、黄芩、石膏清肺胃之热；加生地、黄
柏、知母，清肾火以滋真阴；气化不及，加人参以助肺气。
羌活胜湿汤
羌活 防风 苍术 黄柏 泽泻 茯苓 广皮 甘草
此方散表胜湿，兼用泽泻、黄柏清利下焦，极得表里分消之妙。
八正散
车前子 瞿麦 蓄 滑石 山栀 甘草稍 木通 大黄
前后热结，二便不利者，用此方。家秘加通草、枳壳，其力更专。
导赤各半汤 见发热。
导赤散，治血热小便不利者。今合泻心汤则气血兼清，且木通、川连同用，引心火下通小
便；生地、川连同用，凉心血而心火自清。人但知川连凉心火，而不知心主血，同生地其功乃全。
清肺饮
桔梗 黄芩 山栀 连翘 花粉 玄参 薄荷 甘草
利小便莫如清肺，此方不用利小便药，然深得利小便法。
平胃四苓汤 即平胃散合四苓散。
利小便忌燥药，今因中焦水饮痞塞混浊，故用辛散，亦利水一法也。
生脉补中汤 即生脉散合补中益气汤。
膀胱者，州都之官，津液藏焉，气化则能出矣。此方以生脉润津液，补中助气化。家秘加
车前子，其效更速。
生脉建中汤
人参 麦门冬 五味子 白芍药 桂枝 甘草
上方以生脉散与补中汤同用，此方又与建中汤同用，一以益气，一以滋血，开二大法门。
白虎汤 见口渴。
阳明燥热，则肺受火制。此方清上焦燥火，则小便自利。
清燥汤
桑叶 石膏 甘草 人参 阿胶 杏仁 麻仁 麦冬 枇杷叶
此方详注喘逆门。石膏与杏仁同用，清肺火，佐以阿胶、麦门冬润肺燥；火伤气旺；益以
人参、甘草；肺燥大肠亦燥，佐以麻仁，则下焦火泄，小便自利。
金匮肾气丸
生地 牡丹皮 泽泻 猪茯苓 山茱萸 山药 车前子 附子 肉桂
手少阴心主火旺而小便不利，用导赤各半汤；足少阴肾经火旺而小便不利，用知柏六味
丸；足少阴肾经火衰，而小便不利，用此方以补水中之火。一方治热极小便不利；一方治
水虚小便不利；一方治火虚小便不利。外感小便不利，不应列入火衰方法，此因外感互发内伤也。
大陷胸汤 见结胸。
陷胸汤丸，原非利小便方法。今因结胸症，见小便不利，治结胸，即是利小便。
茵陈蒿汤 见发黄。
先小便不利而身黄，利小便则黄退。身黄而小便不利，清湿热，则身黄退，而小便自利。
柴胡桂枝干姜汤 见寒热。
因表邪而小便不利，先散表邪。今以少阳症兼见太阳，故用此方。
真武汤 见腹痛。
【背景信息】
书名：伤寒大白 作者：高世栻 朝代：清 章节：小便不利 类别：伤寒
太阳经受邪热结聚，导致小便不通畅，张仲景使用五苓散（Wuling San, Five-Ling Decoction），家传秘方使用羌独木通汤（Qiangdu Mutong Tang）。阳明经受邪热结聚，导致小便不通畅，张仲景使用猪苓汤（Zhuling Tang）、木通汤（Mutong Tang）、六一散（Liuyi San）。另有风湿二气相互搏结，身体肿胀疼痛，小便不通畅，使用通苓汤（Tongling Tang）、羌活胜湿汤（Qianghuo Shengshi Tang）。有肠胃热结，大便闭塞涩滞，小便不通畅，使用八正散（Bazheng San）。有心经热邪遗留给小肠而导致小便不通畅的，使用导赤各半汤（Daochi Banban Tang）。有上焦肺热而导致小便不通畅的，使用清肺饮（Qingfei Yin）。有水饮停聚结滞而导致小便不通畅的，使用平胃四苓散（Pingwei Siling San）合二陈汤（Erchen Tang）。有误用发汗法太过，津液向外亡失而导致小便不通畅的，使用生脉益气汤（Shengmai Yiqi Tang）。有误用攻下法太过，中气受损，津液在内耗损而导致小便不通畅的，使用生脉建中汤（Shengmai Jianzhong Tang）。如果论述运气学说中的便闭，《内经》提到阳明司天之政，天气急迫，地气明朗，百姓患癃闭（long bi, difficulty in urination）病，这是说燥热加临所致，适宜使用白虎汤（Baihu Tang）、清燥汤（Qingzao Tang）。又说少阴司天之政，地气肃杀，天气明朗，其病为淋证（lin zheng, strangury），这是说君火行令所致，适宜使用泻心汤（Xiexin Tang）、导赤各半汤。又说太阴在泉，湿气淫盛，病见小腹肿胀，不能小便，这是说土气败坏浸淫所致，适宜使用平胃五苓散（Pingwei Wuling San）。又说水运不及称为涸流，其病为癃闭，这是说火炎上灼干燥土气，金不生水所致，适宜使用清肺饮、凉膈散（Liangge San）。又说厥阴司天，风气淫盛，百姓患溏泄（tang xie, loose stools），土受木克制，不能分别利导小便，水谷偏渗于大肠，先用羌防胜湿汤（Qiangfang Shengshi Tang）疏散风祛除湿邪，随后使用五苓散、猪苓汤分别利导阴阳。另有食积停滞在中焦，小便赤色涩痛黄浊，这就是中气不清，尿液颜色改变，适宜使用辛温化滞保和散（Xinwen Huazhi Baohe San），加砂仁（Amomum fruit）、豆蔻（Cardamom seed），合苍术平胃散（Cangzhu Pingwei San）。如果妄用寒凉药，则食积凝结。另有三阴经里寒，而小便不通，这是阴症寒闭也。真阳不足者，使用金匮肾气丸（Jinkui Shenqi Wan）；中气虚寒，气化功能达不到州都（膀胱的别称）者，使用补中气汤（Buzhongqi Tang）。此外有水肿而小便不通畅，呃逆而小便不通畅，妇科胎前而小便不通畅，跌扑损伤而小便不通畅，另在本门杂症中详细记载。
太阳病，发汗后，大汗出，胃中干燥，烦躁不得安眠，想喝水的，少量多次给予饮水，令胃气调和则痊愈。如果脉浮，小便不通畅，微热消渴（xiao ke, thirst with excessive drinking and urination）的，与五苓散主治。
发汗后，又大汗出，则表邪已解，胃中干燥想喝水，所以以水治疗其干渴，可以令病愈。如果脉尚且见浮，则表邪未散，又小便不通畅，微热消渴，这是太阳经热结于膀胱。
这是辨别小腹硬是水结还是血结。同样是身黄，脉沉结，小腹硬，而以小便通利为蓄血（xu xue, blood accumulation），以小便不通畅为溺结（niao jie, urine accumulation）。
大下之后，复发汗，小便不通畅的，是亡失津液缘故，不要治疗它，得到小便通利，必定自愈。
这是说汗下太过，津液外亡下竭，不要用劫夺利水膀胱的药，则病必定自愈。
伤寒五六日，已发汗而复下之，胸胁满闷微结，小便不通畅，口渴但不呕吐，只有头部出汗，往来寒热（wang lai han re, alternating chills and fever），心烦的，此为病未解除，柴胡桂枝干姜汤（Chaihu Guizhi Ganjiang Tang）主治。
小便不通畅，里热者多，然而尚且见少阳太阳表证，所以设立疏散表邪的法门。
阳明病，发热汗出的，这是热越出而不能发黄也。只有头部出汗，身上无汗，齐颈而还，小便不通畅，渴引水浆的，这是瘀热在里，身体必定发黄，茵陈汤（Yinchen Tang）主治。伤寒七八日，身黄如橘子色，小便不通畅，腹微满的，茵陈蒿汤（Yinchen Hao Tang）。
此条详细注解发黄。说表汗未透，热瘀于内，故发黄。而小便不通畅，腹微满，用茵陈汤去除湿热则黄退便利，腹满亦减。
病患小便不通畅，大便乍难乍易，时有微热，喘冒不能卧的，有燥粪也，宜大承气汤（Da Chengqi Tang）。
此症有结粪微热，加以小便不通畅，所以下大便，则小便利。详细注解不得卧。
五苓散
泽泻（Alismatis Rhizoma） 猪苓（Polypori Parietis Sclerotium） 茯苓（Poria） 白术（Atractylodis Macrocephalae Rhizoma） 桂枝（Cinnamomi Ramulus）
阳明经小便不通畅，用猪苓汤。太阳经的邪热，内结膀胱，而小便不通畅，用此方。但白术凝滞，桂枝辛热，必须得里没有郁热的，可用。
桂枝五苓散，外解太阳经表邪，内利膀胱小便，但南方热令不用，家秘化立。羌活（Notopterygii Radix et Rhizoma）解太阳之表，木通（Akebiae Caulis）利膀胱之里。
猪苓汤
猪苓 白茯苓 泽泻 滑石（Talcum） 阿胶（Asini Corii Colla） 木通
阳明经热结，小便不通畅，不用五苓散而用此方，家秘以黄芩（Scutellariae Radix）易阿胶最效。
通苓汤
木通 猪苓 茯苓 车前子（Plantaginis Semen） 淡竹叶（Lophatheri Herba） 甘草（Glycyrrhizae Radix et Rhizoma） 麦门冬（Ophiopogonis Tuber）
此方通利小便，家秘加川连（Coptidis Rhizoma），清心胃之热；加桔梗（Platycodonis Radix）、黄芩、石膏（Gypsum Fibrosum）清肺胃之热；加生地（Rehmanniae Radix）、黄柏（Phellodendri Cortex）、知母（Anemarrhenae Rhizoma），清肾火以滋真阴；气化不及，加人参（Ginseng Radix et Rhizoma）以助肺气。
羌活胜湿汤
羌活 防风（Saposhnikoviae Radix） 苍术（Atractylodis Rhizoma） 黄柏 泽泻 茯苓 广皮（Citri Reticulatae Pericarpium） 甘草
八正散
车前子 瞿麦（Dianthi Herba） 蓄（Polygoni Avicularis Herba） 滑石 山栀（Gardeniae Fructus） 甘草稍 木通 大黄（Rhei Radix et Rhizoma）
前后热结，二便不利者，用此方。家秘加通草（Tetrapanacis Medulla）、枳壳（Aurantii Fructus），其力更专。
导赤散（Daochi San）治血热小便不通畅的。今合泻心汤则气血兼清，且木通、川连同用，引心火下通小便；生地、川连同用，凉心血而心火自清。人但知川连凉心火，而不知心主血，同生地其功乃全。
清肺饮
桔梗 黄芩 山栀 连翘（Forsythiae Fructus） 花粉（Trichosanthis Radix） 玄参（Scrophulariae Radix） 薄荷（Menthae Haplocalycis Herba） 甘草
平胃四苓汤 即平胃散（Pingwei San）合四苓散（Siling San）。
利小便忌燥药，今因中焦水饮痞塞混浊，故用辛散，亦利水一法也。
生脉补中汤 即生脉散（Shengmai San）合补中益气汤（Buzhong Yiqi Tang）。
膀胱者，州都之官，津液藏焉，气化则能出矣。此方以生脉润津液，补中助气化。家秘加车前子，其效更速。
生脉建中汤
人参 麦门冬 五味子（Schisandrae Chinensis Fructus） 白芍药（Paeoniae Radix Alba） 桂枝 甘草
上方以生脉散与补中汤同用，此方又与建中汤（Jianzhong Tang）同用，一以益气，一以滋血，开二大法门。
清燥汤
桑叶（Mori Folium） 石膏 甘草 人参 阿胶 杏仁（Armeniacae Semen Amarum） 麻仁（Canavaliae Semen） 麦冬 枇杷叶（Eriobotryae Folium）
此方详注喘逆门。石膏与杏仁同用，清肺火，佐以阿胶、麦门冬润肺燥；火伤气旺；益以人参、甘草；肺燥大肠亦燥，佐以麻仁，则下焦火泄，小便自利。
金匮肾气丸
生地 牡丹皮（Moutan Cortex） 泽泻 猪茯苓 山茱us（Corni Fructus） 山药（Dioscoreae Rhizoma） 车前子 附子（Aconiti Lateralis Radix Praeparata） 肉桂（Cinnamomi Cortex）
手少阴心主火旺而小便不通畅，用导赤各半汤；足少阴肾经火旺而小便不通畅，用知柏六味丸（Zhibai Liuwei Wan）；足少阴肾经火衰，而小便不通畅，用此方以补水中之火。一方治热极小便不通畅；一方治水虚小便不通畅；一方治火虚小便不通畅。外感小便不通畅，不应列入火衰方法，此因外感互发内伤也。
陷胸汤丸，原非利小便方法。今因结胸症（jiexiong syndrome, chest binding syndrome），见小便不通畅，治结胸，即是利小便。
先小便不通畅而身黄，利小便则黄退。身黄而小便不通畅，清湿热，则身黄退，而小便自利。
柴胡桂枝干姜汤 见寒热。
[Background Information]
Book: Shanghan Da Bai (Great Clarification of Cold Damage)
Author: Gao Shishi
Dynasty: Qing
Chapter: Difficulty in Urination (Xiaobian Buli)
Category: Cold Damage (Shanghan)
When the Taiyang channel is affected by heat accumulation causing difficulty in urination, Zhang Zhongjing uses Wuling San (Five-Ling Decoction), while our family secret formula uses Qiangdu Mutong Tang. When the Yangming channel is affected by heat accumulation causing difficulty in urination, Zhang Zhongjing uses Zhuling Tang, Mutong Tang, and Liuyi San. Additionally, when wind-dampness pathogens interact, causing body swelling and pain along with difficulty in urination, Tongling Tang or Qianghuo Shengshi Tang are used. In cases of heat accumulation in the intestines and stomach leading to constipation and difficulty in urination, Bazheng San is employed. If heart heat transfers to the small intestine causing difficulty in urination, Daochi Banban Tang is prescribed. For upper jiao lung heat causing difficulty in urination, Qingfei Yin is used. When fluid retention causes difficulty in urination, Pingwei Siling San combined with Erchen Tang is applied. If excessive sweating leads to the loss of body fluids and subsequent difficulty in urination, Shengmai Yiqi Tang is used. If excessive purging damages middle qi and depletes internal fluids resulting in difficulty in urination, Shengmai Jianzhong Tang is indicated. Regarding constipation discussed in the context of Six Qi theory, the *Neijing* states that during the governance of Yangming, the heavenly qi is urgent and earthly qi is bright, causing the people to suffer from long bi (difficulty in urination); this indicates dry-heat imposition, suitable for Baihu Tang and Qingzao Tang. It also states that during the governance of Shaoyin, the earthly qi is solemn and heavenly qi is bright, causing strangury; this indicates the action of Minister Fire, suitable for Xiexin Tang and Daochi Banban Tang. Furthermore, during Taicyin's position in the lower heaven, excessive dampness causes abdominal swelling and inability to urinate; this indicates the failure of Earth element, suitable for Pingwei Wuling San. It is said that insufficient Water qi is called "dried stream," causing difficulty in urination; this indicates fire blazing and drying Earth, with Metal failing to generate Water, suitable for Qingfei Yin and Liangge San. During Jueyin's governance, excessive Wind causes loose stools; Wood overacts on Earth, impairing its ability to separate clear turbid fluids, causing water and grain to leak into the large intestine. Initially, Qiangfang Shengshi Tang is used to disperse wind and remove dampness, followed by Wuling San and Zhuling Tang to separate and promote yin and yang. Additionally, food stagnation in the middle jiao causing dark, astringent, yellow, and turbid urine indicates unclear middle qi and changed urine color; Xinwen Huazhi Baohe San added with Amomum fruit and Cardamom seed, combined with Cangzhu Pingwei San, is suitable. Misuse of cold-natured herbs will cause food stagnation to congeal. In cases of interior cold in the Three Yin channels causing urinary obstruction, this is Yin syndrome cold closure. For deficiency of True Yang, Jin Kui Shenqi Wan is used; for deficiency-cold of middle qi where qi transformation fails to reach the Zhou Du (bladder), Buzhongqi Tang is used. Externally, edema with difficulty in urination, hiccups with difficulty in urination, prenatal conditions with difficulty in urination, and trauma with difficulty in urination are detailed separately in the miscellaneous diseases section.
In Taiyang disease, after sweating, profuse sweating occurs, causing dryness in the stomach, restlessness, insomnia, and desire for water. Give water sparingly; when stomach qi harmonizes, the patient recovers. If the pulse is floating, there is difficulty in urination, slight fever, and thirst with excessive drinking, treat with Wuling San.
After sweating, followed by profuse sweating, the exterior pathogen is resolved, but stomach dryness causes thirst. Water can resolve this dryness and cure the condition. However, if the pulse remains floating, the exterior pathogen has not dispersed, and accompanied by difficulty in urination, slight fever, and thirst, this indicates Taiyang heat accumulation in the Bladder.
In Taiyang disease, with jaundice, deep and knotted pulse, hardness in the lower abdomen, and difficulty in urination, this indicates absence of blood stasis.
This distinguishes between water accumulation and blood stasis in the lower abdomen. With identical symptoms of jaundice, deep knotted pulse, and lower abdominal hardness, patent urination indicates blood stasis (Xu Xue), while difficult urination indicates urine accumulation (Niao Jie).
After severe purging followed by sweating, if difficulty in urination occurs, it is due to the loss of body fluids. Do not treat it directly; once urination resumes, the disease will heal spontaneously.
This explains that excessive sweating and purging lead to external loss and internal depletion of fluids. Avoid using harsh diuretics that deplete bladder fluids; the disease will heal itself.
In cold damage after five or six days, having been sweated and then purged, presenting with fullness and slight knotting in the chest and hypochondrium, difficulty in urination, thirst without vomiting, only head sweating, alternating chills and fever, and irritability, the disease is unresolved. Treat with Chaihu Guizhi Ganjiang Tang.
Difficulty in urination is often due to interior heat, but since Shaoyang and Taiyang exterior signs remain, the method of dispersing the exterior is established.
In Yangming disease, fever and sweating indicate that heat escapes outward, preventing jaundice. Only head sweating, no body sweat up to the neck, difficulty in urination, and thirst for liquids indicate stagnant heat in the interior, leading to jaundice. Treat with Yinchen Tang. After seven or eight days of cold damage, if the body is yellow like an orange peel, with difficulty in urination and slight abdominal fullness, use Yinchen Hao Tang.
This section details jaundice. It states that if exterior sweat does not penetrate, heat stagnates internally, causing jaundice. With difficulty in urination and slight abdominal fullness, Yinchen Tang removes damp-heat, resolving jaundice, improving urination, and reducing abdominal fullness.
If a patient has difficulty in urination, intermittent difficulty and ease in defecation, occasional slight fever, wheezing, dizziness, and inability to lie down, there is dry feces. Use Da Chengqi Tang.
This syndrome involves hardened feces with slight fever and difficulty in urination. Purging the bowels will restore normal urination. This details the symptom of inability to lie down.
**Wuling San**
Alismatis Rhizoma, Polypori Parietis Sclerotium, Poria, Atractylodis Macrocephalae Rhizoma, Cinnamomi Ramulus.
For Yangming difficulty in urination, use Zhuling Tang. For Taiyang pathogenic heat accumulating internally in the Bladder causing difficulty in urination, this formula is used. However, Atractylodis Macrocephalae Rhizoma is cloying, and Cinnamomi Ramulus is pungent and hot; it is only suitable when there is no interior stagnant heat.
**Qianghuo Mutong Tang** (See Fever).
**Guizhi Wuling San** disperses Taiyang exterior pathogens externally and promotes bladder urination internally. It is not used in the southern hot climate; our family modified it. Notopterygii Radix et Rhizoma resolves the Taiyang exterior, while Akebiae Caulis benefits the bladder interior.
**Zhuling Tang**
Polypori Parietis Sclerotium, Poria, Alismatis Rhizoma, Talcum, Asini Corii Colla, Akebiae Caulis.
For Yangming heat accumulation causing difficulty in urination, instead of Wuling San, this formula is used. Our family secret replaces Asini Corii Colla with Scutellariae Radix for best efficacy.
**Liuyi Mutong Tang** is Mutong Tang taken with Liuyi San.
The previous clause used Qianghuo Mutong Tang to double-resolve Taiyang; this clause uses Talcum and Akebiae Caulis to separately benefit Yangming.
**Tongling Tang**
Akebiae Caulis, Polypori Parietis Sclerotium, Poria, Plantaginis Semen, Lophatheri Herba, Glycyrrhizae Radix et Rhizoma, Ophiopogonis Tuber.
This formula promotes urination. Our family adds Coptidis Rhizoma to clear Heart and Stomach heat; adds Platycodonis Radix, Scutellariae Radix, and Gypsum Fibrosum to clear Lung and Stomach heat; adds Rehmanniae Radix, Phellodendri Cortex, and Anemarrhenae Rhizoma to clear Kidney fire and nourish True Yin; adds Ginseng Radix et Rhizoma if qi transformation is insufficient to assist Lung qi.
**Qianghuo Shengshi Tang**
Notopterygii Radix et Rhizoma, Saposhnikoviae Radix, Atractylodis Rhizoma, Phellodendri Cortex, Alismatis Rhizoma, Poria, Citri Reticulatae Pericarpium, Glycyrrhizae Radix et Rhizoma.
This formula disperses the exterior and overcomes dampness, combining Alismatis Rhizoma and Phellodendri Cortex to clear and drain the Lower Jiao, excellently achieving the separation of exterior and interior.
**Bazheng San**
Plantaginis Semen, Dianthi Herba, Polygoni Avicularis Herba, Talcum, Gardeniae Fructus, Glycyrrhizae Radix et Rhizoma (tip), Akebiae Caulis, Rhei Radix et Rhizoma.
For anterior and posterior heat accumulation causing difficulty in both urination and defecation, use this formula. Our family adds Tetrapanacis Medulla and Aurantii Fructus for more focused power.
**Daochi Banban Tang** (See Fever).
Daochi San treats blood-heat causing difficulty in urination. Combined with Xiexin Tang, it clears both qi and blood. Using Akebiae Caulis and Coptidis Rhizoma together guides Heart fire downward through urination; using Rehmanniae Radix and Coptidis Rhizoma together cools Heart blood, allowing Heart fire to clear naturally. People know Coptidis Rhizoma cools Heart fire, but do not realize the Heart governs Blood; combined with Rehmanniae Radix, its efficacy is complete.
**Qingfei Yin**
Platycodonis Radix, Scutellariae Radix, Gardeniae Fructus, Forsythiae Fructus, Trichosanthis Radix, Scrophulariae Radix, Menthae Haplocalycis Herba, Glycyrrhizae Radix et Rhizoma.
Nothing promotes urination better than clearing the Lung. This formula does not use direct diuretics but deeply understands the method of promoting urination.
**Pingwei Siling Tang** is Pingwei San combined with Siling San.
Diuretics should avoid drying herbs. Here, due to fluid retention blocking the Middle Jiao with turbidity, pungent dispersants are used, which is another method of promoting water metabolism.
**Shengmai Buzhong Tang** is Shengmai San combined with Buzhong Yiqi Tang.
The Bladder is the official of the Zhou Du, storing fluids; qi transformation allows them to exit. This formula uses Shengmai to moisten fluids and tonify the Middle to assist qi transformation. Our family adds Plantaginis Semen for faster effect.
**Shengmai Jianzhong Tang**
Ginseng Radix et Rhizoma, Ophiopogonis Tuber, Schisandrae Chinensis Fructus, Paeoniae Radix Alba, Cinnamomi Ramulus, Glycyrrhizae Radix et Rhizoma.
The above formula combines Shengmai San with Buzhong Tang; this formula combines with Jianzhong Tang. One tonifies qi, the other nourishes blood, opening two major therapeutic gates.
**Baihu Tang** (See Thirst).
Yangming dry-heat restricts the Lung. This formula clears upper jiao dry-fire, allowing urination to flow freely.
**Qingzao Tang**
Mori Folium, Gypsum Fibrosum, Glycyrrhizae Radix et Rhizoma, Ginseng Radix et Rhizoma, Asini Corii Colla, Armeniacae Semen Amarum, Canavaliae Semen, Ophiopogonis Tuber, Eriobotryae Folium.
Detailed in the Wheezing section. Gypsum Fibrosum combined with Armeniacae Semen Amarum clears Lung fire, assisted by Asini Corii Colla and Ophiopogonis Tuber to moisten Lung dryness. Fire injures qi; supplemented by Ginseng Radix et Rhizoma and Glycyrrhizae Radix et Rhizoma. Lung dryness causes Large Intestine dryness; assisted by Canavaliae Semen, Lower Jiao fire drains, and urination flows freely.
**Jinkui Shenqi Wan**
Rehmanniae Radix, Moutan Cortex, Alismatis Rhizoma, Polypori Parietis Sclerotium & Poria, Corni Fructus, Dioscoreae Rhizoma, Plantaginis Semen, Aconiti Lateralis Radix Praeparata, Cinnamomi Cortex.
When Hand-Shaoyin Heart fire is hyperactive causing difficulty in urination, use Daochi Banban Tang; when Foot-Shaoyin Kidney channel fire is hyperactive causing difficulty in urination, use Zhibai Liuwei Wan; when Foot-Shaoyin Kidney channel fire is deficient causing difficulty in urination, use this formula to supplement fire within water. One formula treats extreme heat causing difficulty in urination; one treats water deficiency causing difficulty in urination; one treats fire deficiency causing difficulty in urination. External contraction causing difficulty in urination should not be listed under fire deficiency methods; this arises because external contraction triggers internal injury.
**Da Xianxiong Tang** (See Chest Binding).
Xianxiong Tang and Pills are originally not methods for promoting urination. However, in Chest Binding syndrome presenting with difficulty in urination, treating the Chest Binding is equivalent to promoting urination.
**Yinchen Hao Tang** (See Jaundice).
If difficulty in urination precedes jaundice, promoting urination resolves the jaundice. If jaundice accompanies difficulty in urination, clearing damp-heat resolves jaundice, and urination flows freely.
**Chaihu Guizhi Ganjiang Tang** (See Alternating Chills and Fever).
For difficulty in urination caused by exterior pathogens, first disperse the exterior. Since Shaoyang syndrome presents alongside Taiyang, this formula is used.
**Zhenwu Tang** (See Abdominal Pain).