（因汗而小便不利者津液亡于外也因下而小便不利者津液耗于内也痞症或发
黄及热病而小便不利者皆热郁所致也）
伤寒表不解。心下有水气。干呕。发热而咳。小便不利。少腹满。或喘。（小青龙汤去
麻黄加茯苓）太阳病。大汗后。胃干。烦躁不眠。欲饮。小便不利。（脉浮者五苓散不
浮者猪苓汤）太阳病。饮水多。心下悸。小便少。（茯苓甘草汤）太阳发汗。遂漏不止。则恶风
。小便难。四肢难屈伸。（桂枝加附子汤）身黄。小腹硬。脉沉结。（茵陈汤）表未解。反下之
。不结胸。但头汗出。小便不利。必发黄。（茵陈汤或栀子柏皮汤）小便不利。大便乍难乍易
。微热。喘冒不能卧。有燥屎也。（大承气汤）少阳往来寒热。胸胁满。不欲食。心烦喜呕。
或心下悸。小便不利。（小柴胡汤）八九日下之。胸满烦惊。小便不利。谵语。身重。（柴胡
加龙骨牡蛎汤）少阴小便不利。大便自利。腹痛。四肢沉重。有水气也。（真武汤）厥阴小便
不利。关节疼痛。汗出恶风。身肿者。属风湿。（甘草附子汤）厥阴少阴寒闭。或灸气海。或
行葱熨法
按仲景大法。在太阳症。脉浮用五苓散。不浮用猪苓汤。二方皆以猪苓茯苓泽泻为主。
但五苓散。加白术与桂辛甘为阳也。猪苓汤。加阿胶滑石甘寒为阴也。阳明热黄。与栀子柏皮汤
。胁痛身黄。与小柴胡汤。少阴有水。则行真武。厥阴寒秘。则行四逆。其汗多亡阳者。以
桂枝加附子汤。后世以渴者与八正散。不渴者与知柏地黄。补仲景之未备也。大都汗多者。
津液外泄。小便因难。不可利之。恐重亡其津液。待汗止小便自行也。又有热甚而小便仍利
者。勿妄利之。恐引热入于膀胱。往往变为蓄血也。
（因为发汗而导致小便不利的，是津液在外耗亡；因为攻下而导致小便不利的，是津液在内消耗；痞证或出现发黄以及热病导致的小便不利，都是由于热邪郁结所致。）
伤寒表证未解，心下有停饮水气。表现为干呕、发热且咳嗽、小便不利、少腹部胀满，或者气喘。（用小青龙汤，去掉麻黄，加入茯苓）太阳病，大汗之后，胃中干燥，烦躁不能入睡，想喝水，小便不利。（脉象浮的，用五苓散；脉不浮的，用猪苓汤）太阳病，饮水过多，心下悸动，小便量少。（用茯苓甘草汤）太阳病发汗后，汗出淋漓不止，因而怕风，小便困难，四肢难以屈伸。（用桂枝加附子汤）身体发黄，小腹硬满，脉象沉而结。（用茵陈汤）表证未解，反而误用攻下法，没有形成结胸证，只是头部出汗，小便不利，必然会出现发黄。（用茵陈汤或栀子柏皮汤）小便不利，大便时而难解时而通畅，轻微发热，气喘头晕不能躺卧，这是有燥屎内结。（用大承气汤）少阳病往来寒热，胸胁部胀满，不想吃东西，心烦喜呕，或者心下悸动，小便不利。（用小柴胡汤）患病八九日误用攻下法，出现胸满、烦乱惊悸、小便不利、说胡话、身体沉重。（用柴胡加龙骨牡蛎汤）少阴病小便不利，大便自利，腹痛，四肢沉重，这是有水气停留。（用真武汤）厥阴病小便不利，关节疼痛，出汗怕风，身体浮肿，属于风湿证。（用甘草附子汤）厥阴和少阴因寒邪闭塞导致的小便不利，可以艾灸气海穴，或者施行葱熨法。
遵循张仲景的大法：在太阳病证中，脉象浮的用五苓散，脉不浮的用猪苓汤。这两方都以猪苓、茯苓、泽泻为主药。但五苓散加了白术和桂枝，辛甘化阳；猪苓汤加了阿胶和滑石，甘寒滋阴。阳明经热盛发黄，用栀子柏皮汤；胁痛身黄，用小柴胡汤；少阴病有水气，则用真武汤；厥阴病寒凝便秘，则用四逆汤。那些汗多导致亡阳的，用桂枝加附子汤。后世医家对于口渴的小便不利者用八正散，不口渴的用知柏地黄丸，以补充张仲景理论的不足。大致来说，汗多的患者，津液外泄，小便因此困难，不可使用利尿药，恐怕会进一步耗伤津液，应等待汗止住，小便自然会通利。又有热邪极盛但小便仍然通利的，不要妄用利尿药，恐怕会将热邪引入膀胱，往往转变为蓄血证。
(When urinary difficulty arises due to sweating, it is because body fluids are exhausted externally; when it arises due to purgation, it is because body fluids are consumed internally. In cases of Pi syndrome (a sensation of fullness and obstruction in the epigastrium), jaundice, or febrile diseases, urinary difficulty is caused by heat stagnation.)
In Shaoyang disease, the exterior pattern remains unresolved, with fluid retention in the stomach region. Symptoms include dry retching, fever with cough, urinary difficulty, fullness in the lower abdomen, or wheezing. (Use Xiao Qing Long Tang [Minor Blue Dragon Decoction], removing Ephedrae Herba [Mahuang, 麻黄] and adding Poria [Fuling, 茯苓].) In Taiyang disease, after excessive sweating, the Stomach becomes dry, causing irritability and insomnia, thirst, and urinary difficulty. (If the pulse is floating, use Wu Ling San [Five-Ingredient Powder with Poria]; if not floating, use Zhu Ling Tang [Poria Decoction].) In Taiyang disease, excessive water intake leads to palpitations in the heart region and scanty urination. (Use Fu Ling Gan Cao Tang [Poria and Licorice Decoction].) After sweating in Taiyang disease, if sweating continues incessantly, leading to aversion to wind, difficult urination, and limbs that are difficult to flex and extend, (use Gui Zhi Jia Fu Zi Tang [Cinnamon Twig Decoction with Added Aconite Root].) If the body turns yellow, the lower abdomen is hard, and the pulse is deep and knotted, (use Yin Chen Tang [Artemisia Capillaris Decoction].) If the exterior pattern is unresolved and purgation is mistakenly applied, resulting in no Jie Xiong syndrome (chest binding), but only sweating on the head, urinary difficulty, and inevitable jaundice, (use Yin Chen Tang or Zhi Zi Bai Pi Tang [Gardenia and Phellodendron Bark Decoction].) With urinary difficulty, bowel movements alternating between difficulty and ease, slight fever, wheezing, dizziness, and inability to lie down, this indicates the presence of dry feces. (Use Da Cheng Qi Tang [Major Order the Qi Decoction].) In Shao Yang disease, with alternating chills and fever, fullness in the chest and hypochondrium, loss of appetite, irritability and frequent vomiting, or palpitations in the heart region, and urinary difficulty, (use Xiao Chai Hu Tang [Minor Bupleurum Decoction].) After nine or eight days, if purgation is mistakenly applied, leading to chest fullness, irritability, fright, urinary difficulty, delirium, and heaviness of the body, (use Chai Hu Jia Long Gu Mu Li Tang [Bupleurum Decoction with Added Dragon Bone and Oyster Shell].) In Shao Yin disease, with urinary difficulty, spontaneous diarrhea, abdominal pain, and heavy limbs, this indicates water qi retention. (Use Zhen Wu Tang [True Warrior Decoction].) In Jue Yin disease, with urinary difficulty, joint pain, sweating with aversion to wind, and bodily swelling, this belongs to Wind-Dampness. (Use Gan Cao Fu Zi Tang [Licorice and Aconite Root Decoction].) For urinary difficulty due to cold closure in Jue Yin and Shao Yin, one may moxa Qi Hai (CV6) or apply the scallion-warming method.)
Following Zhang Zhongjing's general principles: in Taiyang patterns, a floating pulse indicates the use of Wu Ling San, while a non-floating pulse indicates Zhu Ling Tang. Both formulas primarily utilize Poria [Zhu Ling, 猪苓], Poria [Fu Ling, 茯苓], and Alisma Rhizome [Ze Xie, 泽泻]. However, Wu Ling San adds Atractylodes Macrocephala Rhizome [Bai Zhu, 白术] and Cinnamon Twig [Gui Zhi, 桂枝], using acrid-sweet properties to transform Yang; Zhu Ling Tang adds Donkey-Hide Gelatin [E Jiao, 阿胶] and Talcum [Hua Shi, 滑石], using sweet-cold properties to nourish Yin. For Yangming heat-induced jaundice, use Zhi Zi Bai Pi Tang; for hypochondriac pain and jaundice, use Xiao Chai Hu Tang; for Shao Yin water retention, use Zhen Wu Tang; for Jue Yin cold constipation, use Si Ni Tang [Frigid Extremities Decoction]. For those with excessive sweating leading to Yang collapse, use Gui Zhi Jia Fu Zi Tang. Later generations used Ba Zheng San [Eight-Herb Powder for Rectification] for thirst-associated urinary difficulty, and Zhi Bai Di Huang Wan [Anemarrhena, Phellodendron, and Rehmannia Pill] for non-thirst cases, supplementing Zhang Zhongjing's incompleteness. Generally, in cases of excessive sweating, body fluids leak outward, making urination difficult; diuretics should not be used, as they risk further exhausting body fluids. One should wait for sweating to cease, and urination will naturally resume. In cases where heat is severe but urination remains unobstructed, do not recklessly use diuretics, lest heat be drawn into the Bladder, often transforming into Blood Accumulation syndrome.)