（并见产后腹痛门）
遗尿者，溺出不自知觉也。闭癃者，溺闭不通而淋沥滴点也。惟肝与督脉、三焦、膀胱主之。
肝脉督脉主之者，经云∶肝足厥阴之脉，过阴器。所生病者，遗溺闭癃。又云∶督脉者，女子入系廷孔，
其孔溺孔之端也。其男子循茎下至篡，与女子等。其生病癃痔遗溺。故遗溺闭癃，皆取厥阴俞穴及督脉俞穴也。
三焦主之者，经云∶三焦下脉，在于足太阳之前，少阳之后，出于 中外廉，名曰委阳，足太阳络也。三
焦者，足太阳少阳之所将，太阳之别也，上踝五寸，别入贯 肠，出于委阳，并太阳之正，入络膀胱，约下焦，
实则闭癃，虚则遗溺。遗溺则补之，闭癃则泻之是也。
膀胱主之者，经云∶膀胱不利为癃，不约为遗溺是也。然遗溺闭癃，不取膀胱 穴者，盖膀胱但藏溺，其
出溺皆从三焦及肝督脉也。
闭癃，合而言之，一病也。分而言之，有暴久之殊。盖闭者暴病，为溺闭，点滴不出，俗名小便不通是也。
癃者久病，为溺癃，淋沥点滴而出，一日数十次或百次，名淋病是也。今分其病立为二门。
〔垣〕小便不利，在气在血之异。夫小便者，足太阳膀胱所主，长生于申，申者西方金也。金能生水，金
者肺也，肺中伏热，水不能生，是绝小便之源也。人法象天地，膀胱之源，自头项下至于足，故曰阳中之阴。
如渴而小便不通者，肺不能降是也。治法皆用清燥金之正化，气味薄之药，茯苓、猪苓、泽泻、琥珀、灯心、
通草、车前子、瞿麦、 蓄之类，皆为淡渗之药，能泻肺火而清肺金，滋水之化源也。若不渴，热在下焦，是
绝其流而溺不泄也、须用气味俱浓、阴中之阴药治之。二者之病，一居上焦，在气分而必渴。一居下焦，在血
分而不渴。血中有湿，故不渴也。二者之殊，至易分别耳。
清肺散 治渴而小便闭，或黄或涩，邪热在气分也。
茯苓（二钱） 猪苓（三钱） 泽泻（三钱） 琥珀（五分） 灯心（二分） 木通（七分） 通草（二分）
车前子（一钱，炒） 瞿麦（五分） 蓄（七分） 桂（五分）
上为末，每服五钱，水煎热服。五苓散、八正散，亦宜用之。
〔仲〕猪苓汤 治脉浮发热，渴而小便不利。（方见伤寒。）
五苓散治烦渴饮水过多，或多水入即吐，心中淡淡，小便不利。（方见伤寒。）
茯苓戎盐汤方
茯苓（半斤） 白术（二两） 戎盐（弹丸大，一枚）
上三味，为末，白汤调下。
〔《百》〕小便不通。车前子草一斤，水三升，煎取一升半，分作三服。
〔垣〕滋肾丸 治下焦阴虚，脚膝软无力，阴汗阴痿，足热不能履地，不渴而小便闭者，邪热在血分也。
黄柏（二两，酒洗，焙） 知母（二两，酒洗，焙） 肉桂（二钱）
《内经》云∶热者寒之。又云∶肾恶燥，急食辛以润之。以黄柏之苦寒泻热，补水润燥，故以为君。以知母
苦寒泻肾火，故以为佐。肉桂辛热，寒因热用也。
上为细末，熟水为丸，如鸡豆大。每服百丸，加至二百丸，煎百沸汤下，空心服。
昔长安有大贾王善夫，病小便不通，渐成中满，腹大坚硬如石，壅塞之极，腿脚肿胀，破裂出黄水，双睛
凸出，昼夜不得眠，饮食不下，苦痛不可名状。求予治之，因问受病之始，知病不渴，近苦呕哕。众医皆用治
中满利小便渗淡之药，急难措手，乃辞归。从夜至旦，耿耿不寝，穷究其理，忽记《素问》有云，无阳则阴无以
生，无阴则阳无以化。又云，膀胱州都之官，津液藏焉，气化则能出矣。此病小便癃闭，是无阴而阳气不化者
也。凡利小便之药，皆淡味渗泄为阳，止是气药阳中之阴，非北方寒水，阴中之阴所化者，此乃奉养太过，膏
粱积热，损北方之阴，肾水不足，故膀胱肾之室，久而干涸，小便不化，火又逆上而为呕哕，非膈上所生也，
独为关，非格病也。洁古老人曰∶热在下焦，填塞不便，是治关格之法。今病者内关外格之病悉具，死在旦夕，
但治下焦可愈。随处以禀北方寒水所化，大苦寒气味俱阴者，黄柏、知母，桂为引用，丸如桐子大，沸汤下二
百丸。服药少时，须臾前阴如刀刺火烧之痛，溺出如瀑泉涌出，卧具皆湿，床下成流，顾盼之间，肿胀消散。
予惊喜曰∶大哉圣人之言，岂可不遍览而执一者也。其证小便闭塞而不渴，时见躁者是也。凡诸病居下焦皆不渴
也。二者之病，在气在血，最易分别。
〔洁〕黄连丸 治因服热药过，小便不利，诸药莫能效者。或脐下痛，不可忍者。
黄连（炒） 黄柏（炒） 甘草（各等分）
上 咀，水煎温服，食前。如更不通，加知母，此药助气，使气得化则通矣。
〔罗〕白花散 治小便不通，膀胱有热。用朴硝不以多少为细末，每服二钱，煎茴香汤调下，食前。《简要》先用茴香酒调。
〔垣〕导气除燥汤 治小便不通，乃血湿致气不通而窍涩之症。
知母（三分，酒洗） 黄柏（四钱） 滑石（二钱，炒黄） 泽泻（三分） 茯苓（二钱，去皮）
上和匀，每服半两，水煎稍热空心服，如急闭小便，不拘时候。
〔《斗》〕小便不通。用蚯蚓杵，以冷水摅过，浓服半碗，立通。大解热疾，不知人事欲死者，服之效。
〔仲〕小便不利者，有水气，其人苦渴，栝蒌瞿麦丸主之。
栝蒌根（二两） 茯苓 薯蓣（各三两） 附子（一枚，炮） 瞿麦（一两）
上五味末，炼蜜丸如桐子大。服三丸，日三服。不知，增至七八丸，以小便利，腹中温谓之知。
小便不通腹下痛，状如覆碗，痛闷难忍者，乃肠胃干涸，膻中气不下。故经所谓膀胱者，州都之官，津液
藏焉，气化则能出矣。故膻中者，臣使之官。三焦相火，肾为气海也。王注曰∶膀胱津液之府，胞内居之。少
腹处间毛内藏胞器，若得气海之气施化，则溲便注下，气海之气不及，则隐秘不通，故不得便利也。先用木香、
沉香各三钱，酒调下，或八正散。甚则宜上涌之，令气通达，便自通利，经所谓病在下，上取之。王注曰∶热
攻于上，不利于下，气盛于上，则温辛散之，苦以利之。（一方煎陈皮、茯苓汤，调木香、沉香末服之，空心下。）
〔丹〕小便不通，属气虚，血虚，有实热，痰气闭塞，皆宜吐之，以提其气，气升则水自降，盖气承载其
水者也。气虚用参、术、升麻等，先服后吐，或就参、 药中调理吐之。血虚用四物汤，先服后吐，或就芎归
汤探吐之。痰多二陈汤，先服后探吐之。痰气闭塞，二陈汤加香附、木通探吐之。实热当利之，或用八正散，
盖大便动则小便自通矣。
〔丹〕治一男子，小便不通，用吐法，一吐便如注。论见治虚实法，病在下取之上条。
〔仲〕小便不利，蒲灰散、滑石白鱼散、茯苓戎盐汤主之。（蒲灰、发灰，本草消污血。滑石，丹溪云逐污血。）
蒲灰散方
蒲灰（七分，恐即蒲黄粉） 滑石（三分）
上二味杵为散，饮服五分方寸匕，日三服。
滑石白鱼散方
滑石（二分） 乱发（二分，烧） 白鱼（二分，衣鱼也）
上三味杵为散，饮服五分匕，日三服。
〔无〕发灰散 治脐下急满，小便不通。用发灰研细，每用二钱，米醋二合调服。一法与葵子等分为末，饮服
二钱讫，即炒黑豆叶盖其上，即通。（丹溪云∶发鬓，补阴之功甚捷。）
〔《本》〕桃仁煎 治妇人积血，顷在毗陵，有一贵宦妻外家，小便不通，脐腹胀痛不可忍。众医皆作淋治，如
八正散之类数种，皆治不通，病愈甚。予诊之曰∶此血瘕也，非瞑眩药不可去。予用此药，初服至日午，大
痛不可忍，卧少顷，下血块如拳者数枚，小便如黑豆汁一二升，痛止得愈。此药猛烈大峻，气虚血弱者，宜斟酌之。
桃仁 大黄 朴硝（各一两） 虻虫（半两，炒黑）
上四味为末，以醇醋二升半，银石器内，慢火煎取一升五合，下大黄、桃仁、虻虫等，不住手搅，良久出
之，丸如梧子大。前一日，不晚食，五更初，温酒吞下五丸，日午取下如赤豆汁，或如鸡肝虾蟆衣状。未下
再作，如见鲜血即止。续以调血气药补之。此方出《千金》。（此方不可妄用。）
上四方，治污血小便不利。前三方轻剂可用，后一方峻剂，须认得分晓用之。
〔丹〕吕仲年六十六岁，病伤寒得汗，热退后，脉尚洪，此洪脉作虚脉论，与人参、黄 、白术、炙甘草、
当归、芍药、陈皮，数日其脉仍大，未收敛，又小便不通，小腹下妨闷，颇为所苦，但仰卧则点滴而出。予曰∶
补药服之未至，前药倍加黄 、人参，大剂与服，两日小便方利。
小腹痛胀如覆碗为实。其法有二∶气壅塞于下者，用吐法以提之，血污于下者，用桃仁之类以破之。（二方并
见血气条。）
〔世〕治小便 。用大田螺生去壳，捣细，封脐上即通。治伤寒后，小便不通，用生姜八九块，杵碎，水
十余碗，麻布五六尺同煎数沸，用桶盛，至候通手，以布频熨小腹良久，恰用红豆末一匕，江茶二匕，井花水
调服，神效，小便如注。
〔《本》〕治小便难，小腹胀满。不急治，杀人。用葱白一斤，细锉，炒令热，以帕子裹，分作两处，更
替熨脐下，即通。
〔《玄》〕阴阳关格，前后不通，利大便，小水自行。中有转胞之证，诸药不效，无救，则胀满闷乱而死。
予曾以甘遂末，水调敷脐下，内以甘草节汤饮之，药汁至脐，二药相反，而胞自转矣，小水来如涌泉，此救急
之良法也。
〔《圣》〕治小便难，腹满闷，不急疗之，杀人。用秦艽一两去苗，以水一大盏，煎取七分，去渣，每于
食前，作两服瘥。
〔世〕治小便不通，用大杏仁二十一枚，研，水调分作二服效。（杏仁、紫菀利小水解肺郁，郁解则气
自降而小便去矣。）
〔《千》〕治妇人卒不得小便。用紫菀末，以井花水，服三撮便通。小便血，五撮立止。
〔《外》〕若小便不通，数病而微肿，方取陈笔头一枚，烧为灰，和水服之。（此方未详。）
经云∶肾合膀胱，膀胱者，津液之府也。小肠属肾，肾上连肺，故将两脏。三焦者，中渎之府也，水液出
焉，是属膀胱，乃肾之府也。又云∶膀胱者，州都之官，津液藏焉，气化则能出矣。由是言之，膀胱藏水，三
焦出水。治小便不利，故刺灸法，但取三焦穴，不取膀胱也。小肠属肾肺，故东垣用清肺饮子、滋肾丸，利小
便是也。
运气 小便不利有三∶
其一属湿邪攻三焦。经云∶太阴在泉，湿淫所胜，病小腹痛肿，不得小便。又云∶水不及曰涸流，涸流之
纪，上宫与正宫同，其病癃闭是也。
其二属风邪攻脾。经云∶厥阴司天，风淫所胜，病溏瘕泄水闭是也。
其三属燥热。经云∶阳明司天之政，天气急，地气明，民病癃闭。初之气，其病小便黄赤，甚则淋。又云∶
少阴司天之政，地气肃，天气明，二之气，其病淋是也。
《内经》刺灸小便不利法有五∶
其一取肝。经云∶肝足厥阴之脉，所生病者癃闭。又云∶小腹满，身寒热，小便不利，取足厥阴。又云∶
癃取阴跷及三毛，上及血络出血是也。
其二取三焦。经云∶三焦病者，腹气满，小腹丸坚，不得小便，窘急，溢则水流即为胀候，在足太阳之外
大络，大络在足太阳少阳之间，亦见于脉，取委阳。又云∶小腹痛肿，不得小便，邪在三焦，约取之太阳大络，
（大络，委阳。）视其络脉，与厥阴小络结而血者（当有取之二字。）是也。
其三取肾络。经云∶足少阴之别，名曰大钟，当踝后绕跟，别走太阳。其病实则癃闭，取之所别也。
其四取脾。经云∶足太阴之脉所生，病者溏瘕泄水闭，视虚实寒热陷下，而施补泻疾留灸也。
其五杂取。经云∶内闭不得溲，刺足少阴太阳与 骨上，以长针，气逆则取其太阴、阳明、厥阴，甚则取
少阴、阳明，动者之经也。
〔《经》〕治小便淋沥，或有血。以赤根楼葱，近根截一寸许，安脐中，上以艾灸七壮。
〔罗〕治小便淋涩不通。用盐不以多少，炒热填满病患脐中，却用艾如箸头大，灸七壮，其小便自出。
〔《摘》〕（内阴谷出《密语》）关元（八分，令病患觉淋沥三五次为度，便揉小腹，却取下穴。）三阴
交（三分即透。）阴谷
〔《撮》〕小便闭数不通∶阴谷（一寸五分，灸。）阴陵泉（泻之。）
〔《标》〕又法 偏历
〔《集》〕小便闭不通∶阴陵泉 阴谷 三阴交 气海 关元（灸三十壮，刺二寸五分。）不已，取下穴∶太溪 阴交
〔东〕热淋，小便黄，腹满∶阴陵泉 关元（各二寸。） 气冲（二七壮。）
石淋不得小便∶关元（三七壮。） 气门 大敦（各二七壮。）
血淋∶气海 丹田（各刺灸三七壮。）
小便热痛，目赤尿如血∶列缺（沿皮一寸。） 大陵 承浆（各五分。）又法∶曲骨（灸二七壮。）
阴阳二陵泉（各二寸五分。）
〔《甲》〕少腹中满，热闭不得溺，足五里取之。溺难，痛，白浊，卒疝，少腹肿，咳逆呕吐，卒阴跳腰
痛不可以俯仰，面黑，热，腹中 满，身热厥痛，行间主之。
（相关内容见产后腹痛门）
遗尿，是指小便排出时自己不能感知。闭癃，是指小便闭塞不通，只能淋沥点滴而出。这主要与肝、督脉、三焦和膀胱有关。
肝经和督脉主管此病，经文说：足厥阴肝经，经过生殖器部位。它所主的疾病中，包括遗尿和闭癃。又说：督脉，女子进入系连廷孔，这个孔就是溺孔的末端。男子则沿着阴茎下行至会阴，与女子相同。它发生的疾病有癃闭、痔疮和遗尿。所以治疗遗尿和闭癃，都选取厥阴俞穴及督脉俞穴。
三焦主管此病，经文说：三焦的下行经脉，位于足太阳膀胱经之前，足少阳胆经之后，出于外踝上五寸的中廉穴，名叫委阳，这是足太阳膀胱经的络穴。三焦，是足太阳和足少阳所统领的，是足太阳的别络，上行至外踝上五寸处，别行进入贯穿大肠，出于委阳，并入足太阳正脉，入络于膀胱，约束下焦。实证表现为闭癃，虚证表现为遗尿。遗尿应当用补法，闭癃应当用泻法，说的就是这个道理。
膀胱主管此病，经文说：膀胱气机不利则发生癃闭，约束无力则发生遗尿。然而治疗遗尿和闭癃，不选取膀胱本经穴位的原因，是因为膀胱只是贮藏尿液，而排尿的过程都由三焦以及肝、督脉来主导。
闭癃，合起来说是一种病；分开来说，有发病急缓的区别。所谓“闭”，是急性病，表现为小便完全闭塞，点滴不出，俗称小便不通。所谓“癃”，是慢性病，表现为小便淋沥点滴而出，一天几十次或上百次，称为淋病。现在将这两种病分开设立为两个门类。
〔李杲〕小便不利，有在气分和血分的区别。小便，由足太阳膀胱所主，生于申时，申属西方金。金能生水，金对应肺脏。肺中有伏热，水液无法生成，这就断绝了小便的来源。人效法天地，膀胱之源，从头项下至于足，所以称为阳中之阴。如果口渴且小便不通，是肺气不能下降所致。治疗方法都应使用清燥金之正化的药物，气味轻薄的药，如茯苓、猪苓、泽泻、琥珀、灯心草、通草、车前子、瞿麦、萹蓄之类，这些都是淡渗利湿的药，能泻肺火而清肺金，滋补水液的化源。如果不口渴，说明热在下焦，这是断绝了水流而尿液不泄，必须使用气味浓厚、属于阴中之阴的药物来治疗。这两种病，一种在上焦，在气分且必然口渴；一种在下焦，在血分且不口渴。血中有湿，所以不口渴。这两种病的区别，非常容易分辨。
清肺散：治疗口渴且小便闭塞，尿色黄或涩滞，邪热在气分。
茯苓（二钱） 猪苓（三钱） 泽泻（三钱） 琥珀（五分） 灯心草（二分） 木通（七分） 通草（二分） 车前子（一钱，炒） 瞿麦（五分） 萹蓄（七分） 桂枝（五分）
以上研为末，每次服用五钱，用水煎煮后热服。五苓散、八正散，也适宜使用。
〔张仲景〕猪苓汤：治疗脉浮发热，口渴且小便不利。（方剂见《伤寒论》。）
五苓散：治疗烦渴饮水过多，或多喝水后立即呕吐，心中悸动不安，小便不利。（方剂见《伤寒论》。）
茯苓戎盐汤方
茯苓（半斤） 白术（二两） 戎盐（弹丸大小，一枚）
以上三味，研为末，用开水调服。
〔《备急千金要方》〕小便不通。用车前子草一斤，水三升，煎取一升半，分三次服用。
〔李杲〕滋肾丸：治疗下焦阴虚，脚膝软弱无力，阴汗阳痿，足心发热不能踩地，不口渴但小便闭塞者，这是邪热在血分。
黄柏（二两，酒洗，焙干） 知母（二两，酒洗，焙干） 肉桂（二钱）
《内经》说：热者寒之。又说：肾恶燥，急食辛以润之。用黄柏的苦寒来泻热，补水润燥，所以作为君药。用知母的苦寒来泻肾火，所以作为佐药。肉桂辛热，是寒药因热用（反佐）。
以上研为细末，用热水泛丸，如鸡豆大。每次服用一百丸，加至二百丸，用滚开水送下，空腹服用。
以前长安有个大商人王善夫，患小便不通，逐渐发展成中满，腹部胀大坚硬如石，壅塞到了极点，腿脚肿胀，破裂流出黄水，双眼凸出，昼夜不能睡觉，饮食不下，痛苦不可名状。求我治疗，我问起发病的起因，知道病人不口渴，最近苦于呕吐呃逆。众医生都用治疗中满、利小便、淡渗利尿的药，我急忙难以着手，于是辞别回家。从夜晚到早晨，耿耿不眠，穷究其理，忽然想起《素问》中说：无阳则阴无以生，无阴则阳无以化。又说：膀胱是州都之官，津液藏焉，气化则能出矣。这个病人的小便癃闭，是无阴而阳气不能气化。凡是利小便的药，都是淡味渗泄属阳，只是气药中的阳中之阴，并非北方寒水，阴中之阴所化生的。这是因为奉养太过，膏粱厚味积热，损伤了北方的阴，肾水不足，所以膀胱和肾的宫室，久而久之干涸，小便不能气化，火又逆上导致呕吐呃逆，这不是膈上所生的病，仅仅是关证，不是格证。洁古老人说：热在下焦，填塞不便，这是治疗关格的方法。现在病人内关外格的病症都具备，死在旦夕之间，但只要治疗下焦就可以痊愈。随处选用禀受北方寒水所化、大苦大寒气味俱阴的黄柏、知母，以肉桂为引经药，丸如梧桐子大，沸水送下二百丸。服药不久，须臾间前阴像刀刺火烧一样疼痛，尿液像瀑布泉涌一样流出，卧具都湿了，床下成流，转眼之间，肿胀消散。我又惊又喜地说：圣人的话多么伟大啊，怎么能不遍览群书而固执一端呢？这种证候是小便闭塞而不口渴，时常出现烦躁。凡诸病居在下焦的都不口渴。这两种病，在气在血，最容易分辨。
〔张元素〕黄连丸：治疗因服用热药过量，导致小便不利，各种药无效。或者脐下疼痛，不可忍受。
黄连（炒） 黄柏（炒） 甘草（各等分）
以上切碎，水煎温服，饭前服用。如果仍然不通，加知母，此药助气，使气得气化则通。
〔罗天益〕白花散：治疗小便不通，膀胱有热。用朴硝不限多少研为细末，每次服用二钱，用茴香汤调下，饭前服用。《简要济众方》先用茴香酒调服。
〔李杲〕导气除燥汤：治疗小便不通，这是血湿导致气不通而窍道涩滞的症状。
知母（三分，酒洗） 黄柏（四钱） 滑石（二钱，炒黄） 泽泻（三分） 茯苓（二钱，去皮）
以上混合均匀，每次服用半两，用水煎煮稍热后空腹服用，如果是紧急的小便闭塞，不拘泥于时间。
〔《斗门方》〕小便不通。用蚯蚓捣烂，用冷水冲洗干净，浓服半碗，立刻通畅。治疗大便热疾，神志不清欲死者，服用有效。
〔张仲景〕小便不利，有水气，其人苦于口渴，栝蒌瞿麦丸主治。
栝蒌根（二两） 茯苓 薯蓣（各三两） 附子（一枚，炮制） 瞿麦（一两）
以上五味研末，炼蜜丸如梧桐子大。每次服三丸，每日三次。不见效，增至七八丸，以小便利，腹中温暖称为见效。
小便不通，小腹疼痛，形状像倒扣的碗，痛闷难忍，这是肠胃干涸，膻中气不下行。所以经文说膀胱是州都之官，津液藏焉，气化则能出矣。所以膻中是臣使之官。三焦相火，肾为气海。王冰注曰：膀胱是津液之府，胞居于其中。少腹处在阴毛内藏有胞器，如果得到气海的气施化，则溲便注下，气海的气不及，则隐秘不通，所以不能便利。先用木香、沉香各三钱，酒调下，或者用八正散。严重的应该用涌吐法，令气通达，便自然通利，经文所说病在下，上取之。王冰注曰：热攻于上，不利于下，气盛于上，则用温辛散之，苦以利之。（一方煎陈皮、茯苓汤，调木香、沉香末服，空腹下。）
〔朱震亨〕小便不通，属于气虚、血虚、有实热、痰气闭塞，都适宜用吐法，以提举其气，气升则水自降，因为气承载水。气虚用人参、白术、升麻等，先服药后催吐，或者就在人参、白术药中调理催吐。血虚用四物汤，先服药后催吐，或者就在芎归汤中探吐。痰多用二陈汤，先服药后探吐。痰气闭塞，二陈汤加香附、木通探吐。实热应当利小便，或者用八正散，因为大便动则小便自通。
〔朱震亨〕治疗一个男子，小便不通，用吐法，一吐后小便如注。论述见治虚实法，病在下取之上条。
〔张仲景〕小便不利，蒲灰散、滑石白鱼散、茯苓戎盐汤主治。（蒲灰、发灰，本草记载能消污血。滑石，丹溪说能逐污血。）
蒲灰散方
蒲灰（七分，恐怕就是蒲黄粉） 滑石（三分）
以上两味杵为散，饮服五分方寸匕，每日三次。
滑石白鱼散方
滑石（二分） 乱发（二分，烧炭） 白鱼（二分，衣鱼也）
以上三味杵为散，饮服五分匕，每日三次。
〔无考〕发灰散：治疗脐下急满，小便不通。用发灰研细，每次用二钱，米醋二合调服。另一法与葵子等分为末，饮服二钱后，立即炒黑豆叶盖在上面，即通。（丹溪说：头发鬓发，补阴之功甚捷。）
〔《本草》〕桃仁煎：治疗妇人积血。过去在毗陵，有一位贵宦的妻子，小便不通，脐腹胀痛不可忍受。众医生都当作淋病治疗，如八正散之类数种，都治不好，病更重。我诊察后说：这是血瘕，非瞑眩药不能去除。我用此药，初服到中午，大痛不可忍，躺了一会儿，排出拳头大的血块数个，小便像黑豆汁一二升，痛止得愈。此药猛烈峻烈，气虚血弱者，宜斟酌使用。
桃仁 大黄 朴硝（各一两） 虻虫（半两，炒黑）
以上四味为末，用醇醋二升半，在银石器内，慢火煎取一升五合，下大黄、桃仁、虻虫等，不停地搅动，很久后取出，丸如梧子大。前一天晚上不吃晚饭，五更初，温酒吞下五丸，日午排出像赤豆汁，或者像鸡肝虾蟆衣状。未排出再作，如见鲜血即停止。随后用调血气药补之。此方出自《千金方》。（此方不可妄用。）
以上四方，治疗污血导致的小便不利。前三方是轻剂可用，后一方是峻剂，必须辨认清楚再用。
〔朱震亨〕吕仲年六十六岁，患伤寒得汗，热退后，脉仍洪大，此洪脉当作虚脉论，给予人参、黄芪、白术、炙甘草、当归、芍药、陈皮，数日后脉仍大，未收敛，又出现小便不通，小腹下妨闷，颇为所苦，但仰卧则点滴而出。我说：补药服用未到量，将前药倍加黄芪、人参，大剂与服，两天后小便才通利。
小腹痛胀如覆碗为实证。其法有二：气壅塞于下者，用吐法以提举；血污于下者，用桃仁之类以破血。（二方并见血气条。）
〔世传〕治疗小便不通。用大田螺生去壳，捣细，封在脐上即通。治疗伤寒后，小便不通，用生姜八九块，捣碎，水十余碗，麻布五六尺同煎数沸，用桶盛，等到温度适宜，用布频繁熨烫小腹良久，恰好用红豆末一匕，江茶二匕，井花水调服，神效，小便如注。
〔《本草》〕治疗小便难，小腹胀满。不急治，杀人。用葱白一斤，细切，炒令热，用帕子包裹，分作两处，交替熨烫脐下，即通。
〔《玄珠》〕阴阳关格，前后不通，利大便，小水自行。其中有转胞之证，诸药不效，无救，则胀满闷乱而死。我曾以甘遂末，水调敷脐下，内服甘草节汤，药汁至脐，二药相反，而胞自转矣，小水来如涌泉，这是救急的良法。
〔《圣济总录》〕治疗小便难，腹满闷，不急疗之，杀人。用秦艽一两去苗，以水一大盏，煎取七分，去渣，每于食前，作两服瘥。
〔世传〕治疗小便不通，用大杏仁二十一枚，研，水调分作二服效。（杏仁、紫菀利小水解肺郁，郁解则气自降而小便去矣。）
〔《千金方》〕治疗妇人卒不得小便。用紫菀末，以井花水，服三撮便通。小便血，五撮立止。
〔《外台秘要》〕若小便不通，数病而微肿，方取陈笔头一枚，烧为灰，和水服之。（此方未详。）
经文说：肾合膀胱，膀胱是津液之府。小肠属肾，肾上连肺，所以将两脏联系起来。三焦是中渎之府，水液出焉，这属于膀胱，乃是肾之府。又说：膀胱是州都之官，津液藏焉，气化则能出矣。由此而言，膀胱藏水，三焦出水。治疗小便不利，所以刺灸法，只取三焦穴，不取膀胱穴。小肠属肾肺，所以东垣用清肺饮子、滋肾丸，利小便也是这个道理。
运气学说中，小便不利有三种：
其一属湿邪攻三焦。经文说：太阴在泉，湿淫所胜，病小腹痛肿，不得小便。又说：水不及曰涸流，涸流之纪，上宫与正宫同，其病癃闭是也。
其二属风邪攻脾。经文说：厥阴司天，风淫所胜，病溏瘕泄水闭是也。
其三属燥热。经文说：阳明司天之政，天气急，地气明，民病癃闭。初之气，其病小便黄赤，甚则淋。又说：少阴司天之政，地气肃，天气明，二之气，其病淋是也。
《内经》刺灸小便不利法有五：
其一取肝。经文说：肝足厥阴之脉，所生病者癃闭。又说：小腹满，身寒热，小便不利，取足厥阴。又说：癃取阴跷及三毛，上及血络出血是也。
其二取三焦。经文说：三焦病者，腹气满，小腹丸坚，不得小便，窘急，溢则水流即为胀候，在足太阳之外大络，大络在足太阳少阳之间，亦见于脉，取委阳。又说：小腹痛肿，不得小便，邪在三焦，约取之太阳大络，（大络，委阳。）视其络脉，与厥阴小络结而血者（当有取之二字。）是也。
其三取肾络。经文说：足少阴之别，名曰大钟，当踝后绕跟，别走太阳。其病实则癃闭，取之所别也。
其四取脾。经文说：足太阴之脉所生，病者溏瘕泄水闭，视虚实寒热陷下，而施补泻疾留灸也。
其五杂取。经文说：内闭不得溲，刺足少阴太阳与髀骨上，以长针，气逆则取其太阴、阳明、厥阴，甚则取少阴、阳明，动者之经也。
〔《经》〕治疗小便淋沥，或有血。以赤根楼葱，近根截一寸许，安脐中，上以艾灸七壮。
〔罗天益〕治疗小便淋涩不通。用盐不限多少，炒热填满病患脐中，却用艾如箸头大，灸七壮，其小便自出。
〔《摘元方》〕（内阴谷出《密语》）关元（八分，令病患觉淋沥三五次为度，便揉小腹，却取下穴。）三阴交（三分即透。）阴谷
〔《撮要》〕小便闭数不通∶阴谷（一寸五分，灸。）阴陵泉（泻之。）
〔《标幽赋》〕又法 偏历
〔《针灸集成》〕小便闭不通∶阴陵泉 阴谷 三阴交 气海 关元（灸三十壮，刺二寸五分。）不已，取下穴∶太溪 阴交
〔李杲〕热淋，小便黄，腹满∶阴陵泉 关元（各二寸。） 气冲（二七壮。）
石淋不得小便∶关元（三七壮。） 气门 大敦（各二七壮。）
血淋∶气海 丹田（各刺灸三七壮。）
小便热痛，目赤尿如血∶列缺（沿皮一寸。） 大陵 承浆（各五分。）又法∶曲骨（灸二七壮。）
阴阳二陵泉（各二寸五分。）
〔《甲乙经》〕少腹中满，热闭不得溺，足五里取之。溺难，痛，白浊，卒疝，少腹肿，咳逆呕吐，卒阴跳腰痛不可以俯仰，面黑，热，腹中痞满，身热厥痛，行间主之。
(Related content is found in the section on Postpartum Abdominal Pain)
Enuresis refers to the involuntary passage of urine without conscious perception. Bi-long (urinary retention and dribbling) refers to the obstruction of urination with only scanty, drop-by-drop discharge. This condition is primarily governed by the Liver, Du Mai (Governing Vessel), San Jiao (Triple Burner), and Bladder.
The Liver Meridian and Du Mai govern this disease. The Classics state: "The Foot-Jueyin Liver Meridian passes through the genitalia. Diseases it generates include enuresis and bi-long." It also states: "The Du Mai enters and connects with the Ting Kong in women; this orifice is the end of the urinary meatus. In men, it follows the penis down to the perineum, equal to that of women. Its diseases include long (retention), hemorrhoids, and enuresis." Therefore, for treating enuresis and bi-long, one selects the Shu points of the Jueyin and Du Mai meridians.
The San Jiao governs this disease. The Classics state: "The descending meridian of the San Jiao is located anterior to the Foot-Taiyang and posterior to the Foot-Shaoyang, emerging at Zhonglian outside the ankle, named Weiyang, which is the Luo-connecting point of the Foot-Taiyang. The San Jiao is commanded by the Foot-Taiyang and Foot-Shaoyang; it is the branch of the Foot-Taiyang. Ascending five cun above the ankle, it branches off, penetrates through the intestines, emerges at Weiyang, joins the main channel of the Taiyang, enters and connects with the Bladder, and regulates the Lower Jiao. Excess manifests as bi-long, deficiency manifests as enuresis. Enuresis should be treated with tonification, and bi-long with sedation."
The Bladder governs this disease. The Classics state: "Bladder dysfunction leads to long (obstruction); lack of regulation leads to enuresis." However, when treating enuresis and bi-long, one does not select points from the Bladder meridian itself because the Bladder merely stores urine, while the process of urination is directed by the San Jiao, Liver, and Du Mai.
Bi-long, when combined, refers to a single disease; when separated, there is a distinction between acute and chronic onset. "Bi" refers to an acute condition where urine is completely obstructed with no drops coming out, commonly known as urinary retention. "Long" refers to a chronic condition where urine dribbles out drop by drop, occurring dozens or hundreds of times a day, known as strangury (Lin syndrome). Currently, these two conditions are divided into separate categories.
[Li Gao] Urinary difficulty differs based on whether it involves Qi or Blood. Urine is governed by the Foot-Taiyang Bladder, born in Shen (Monkey hour/Metal element). Metal generates Water; Metal corresponds to the Lung. If latent heat exists in the Lung, water cannot be generated, thus cutting off the source of urine. Humans mirror Heaven and Earth; the source of the Bladder extends from the head and neck down to the feet, hence it is called Yin within Yang. If thirst accompanies urinary obstruction, it is due to the Lung's inability to descend. The treatment method uses drugs with thin flavors and mild properties to clear and dry the Metal aspect, such as Poria (Fuling), Polyporus (Zuling), Alisma (Zexie), Amber (Hupo), Juncus (Dengxin), Tongcao, Plantago seed (Cheqianzi), Dianthus (Qumai), and Polygonum aviculare (Bianxu). These are all bland and leaching herbs that drain Lung fire, clear Lung Metal, and nourish the source of Water generation. If there is no thirst, the heat is in the Lower Jiao, blocking the flow so urine does not exit; one must use drugs with strong flavors and properties belonging to Yin within Yin. These two conditions differ in location: one is in the Upper Jiao, in the Qi level, and inevitably involves thirst; the other is in the Lower Jiao, in the Blood level, and involves no thirst. Dampness in the blood causes the lack of thirst. The distinction between these two is very easy to identify.
Qingfei San (Clear the Lung Powder): Treats thirst with urinary obstruction, yellow or涩 (astringent/difficult) urine, indicating pathogenic heat in the Qi level.
Poria (Er qian), Polyporus (San qian), Alisma (San qian), Amber (Wu fen), Juncus (Er fen), Akebia (Qi fen), Tongcao (Er fen), Plantago seed (Yi qian, stir-fried), Dianthus (Wu fen), Polygonum aviculare (Qi fen), Cinnamon Twig (Wu fen).
Grind all into powder. Take Wu qian each time, decoct in water, and take hot. Wuling San (Five-Ingredient Powder with Poria) and Bazheng San (Eight-Herb Powder for Rectifying the Regular) are also suitable.
[Zhang Zhongjing] Zhu Ling Tang (Polyporus Decoction): Treats floating pulse, fever, thirst, and urinary difficulty. (Formula see Shanghan Lun.)
Wuling San (Five-Ingredient Powder with Poria): Treats irritability, excessive thirst and drinking, vomiting immediately after drinking, palpitations in the heart, and urinary difficulty. (Formula see Shanghan Lun.)
Fuling Rongyan Tang Formula
Poria (Ban jin), Atractylodes (Liang liang), Rongyan (One pill-sized piece).
Grind the three ingredients into powder, mix with warm water, and take.
[Beiji Qianjin Yaofang] For urinary obstruction. Use one jin of fresh Plantago herb, decoct in three sheng of water to obtain one and a half sheng, divide into three doses.
[Li Gao] Zishen Wan (Kidney-Nourishing Pill): Treats Yin deficiency in the Lower Jiao, weakness in legs and knees, sweating in the genital area, impotence, heat in the soles preventing walking, no thirst but urinary obstruction, indicating pathogenic heat in the Blood level.
Phellodendron (Liang liang, wine-washed, dried), Anemarrhena (Liang liang, wine-washed, dried), Cinnamon Bark (Er qian).
The Neijing states: "Heat is treated with cold." It also states: "The Kidney dislikes dryness; urgently eat pungent substances to moisten it." Phellodendron's bitter-cold nature drains heat and nourishes water to moisten dryness, serving as the Sovereign drug. Anemarrhena's bitter-cold nature drains Kidney fire, serving as the Assistant. Cinnamon's pungent-hot nature is used counter-intuitively with cold drugs (reverse adjuvant).
Grind into fine powder, make pills with hot water, size of chicken beans. Take Bai wan initially, increase to Er bai wan, swallow with boiling water, on an empty stomach.
Previously, a wealthy merchant in Chang'an named Wang Shanfu suffered from urinary obstruction, gradually developing abdominal fullness, hard and stone-like abdomen, extreme blockage, swollen legs and feet rupturing with yellow fluid, protruding eyes, insomnia day and night, inability to eat, and indescribable pain. I asked about the onset and learned he had no thirst but recent vomiting and hiccups. Other doctors used bland, leaching diuretics for abdominal fullness; I hesitated to act and left. Sleepless from night to dawn, pondering the principle, I suddenly recalled the Suwen: "Without Yang, Yin cannot be born; without Yin, Yang cannot transform." Also: "The Bladder is the Official of the Zhoudu, storing fluids; transformation allows them to exit." This patient's urinary retention was due to Yin deficiency failing to transform Yang. All diuretics are bland and leaching, belonging to Yang, specifically Qi drugs within Yang-Yin, not the transformation of Northern Cold Water (Yin-within-Yin). This was caused by excessive indulgence in rich foods generating heat, damaging Northern Yin, leading to insufficient Kidney Water. Thus, the Bladder and Kidney chambers dried up over time, urine could not transform, and Fire rebelled upward causing vomiting/hiccups, not a Ge (regurgitation) disease but a Guan (closure) disease. Jiegu Laoren said: "Heat in the Lower Jiao causing blockage is the method for treating Guan-Ge." Now the patient has both internal Guan and external Ge, dying soon, but treating the Lower Jiao can cure. Select Phellodendron and Anemarrhena, large bitter-cold and Yin-natured, using Cinnamon as a guide, make pills size of sesame seeds, swallow Er bai wan with boiling water. Shortly after taking, the urethra felt like knife-stabbing and burning, then urine gushed like a waterfall, wetting bedding and flowing under the bed; swelling dissipated instantly. I exclaimed in surprise: "How great are the words of the Sages! How can one not read widely and stick to one view?" This syndrome is urinary closure without thirst, occasionally with restlessness. All diseases in the Lower Jiao involve no thirst. The distinction between Qi and Blood levels is easiest to identify.
[Zhang Yuansu] Huanglian Wan (Coptis Pill): Treats urinary difficulty caused by excessive intake of hot medicines, unresponsive to other drugs. Or unbearable pain below the umbilicus.
Coptis (stir-fried), Phellodendron (stir-fried), Licorice (equal parts).
Cut into pieces, decoct in water, take warm before meals. If still blocked, add Anemarrhena. This drug assists Qi, allowing Qi transformation to achieve patency.
[Luo Tianyi] Baihua San (White Flower Powder): Treats urinary obstruction due to Heat in the Bladder. Use Mirabilite ground to fine powder, take Er qian each time, mixed with Fennel decoction, before meals. Jianyao Jizhong Fang suggests mixing with Fennel wine first.
[Li Gao] Daoqi Chuzao Tang (Guiding Qi and Removing Dryness Decoction): Treats urinary obstruction caused by Blood-Dampness blocking Qi and causing orifice涩滞.
Anemarrhena (San fen, wine-washed), Phellodendron (Si qian), Talc (Er qian, stir-fried yellow), Alisma (San fen), Poria (Er qian, peeled).
Mix evenly. Take Ban liang each time, decoct in water, take slightly hot on an empty stomach. For urgent urinary closure, do not restrict timing.
[Doumen Fang] For urinary obstruction. Crush earthworms, wash with cold water, take thick liquid half bowl, immediate relief. Effective for severe heat diseases causing unconsciousness and near-death.
[Zhang Zhongjing] For urinary difficulty with Water-Qi and severe thirst, Gualou Qumai Wan (Trichosanthes Root and Dianthus Pill) is indicated.
Trichosanthes Root (Liang liang), Poria, Dioscorea (each San liang), Prepared Aconite (One piece, processed), Dianthus (Yi liang).
Grind five ingredients into powder, make pills with refined honey, size of sesame seeds. Take San wan, three times daily. If ineffective, increase to Qi-Ba wan. Relief is indicated by free urination and warmth in the abdomen.
For urinary obstruction with lower abdominal pain, shape like an inverted bowl, unbearable pain/stifling sensation, this is dryness of intestines and stomach, with Danzhong Qi failing to descend. Thus, the Classics say the Bladder is the Official of Zhoudu, storing fluids; transformation allows exit. The Danzhong is the Official of the Envoy. San Jiao Xianghuo, Kidney is the Sea of Qi. Wang Bing's commentary: "The Bladder is the mansion of fluids, housing the Bao (uterus/bladder). The lower abdomen contains the Bao organ within the pubic hair. If Qi from the Qi Sea transforms, urine flows; if Qi from the Qi Sea is insufficient, secretion is blocked, hence inability to urinate." First use Musk (Muxiang) and Agarwood (Chenxiang), each San qian, taken with wine, or Bazheng San. Severe cases require emesis to promote Qi circulation, achieving natural patency, as the Classics say: "Disease below, treat above." Wang Bing's commentary: "Heat attacking above hinders below; Qi excess above requires warm-pungent dispersal and bitter draining." (Alternative: Decoct Tangerine Peel and Poria soup, mix with Musk and Agarwood powder, take on empty stomach.)
[Zhu Zhenheng] Urinary obstruction belongs to Qi deficiency, Blood deficiency, Excess Heat, or Phlegm-Qi blockage; all are suitable for emesis to lift Qi. When Qi rises, Water descends, as Qi carries Water. For Qi deficiency, use Ginseng, Atractylodes, Cimicifuga, etc., take medicine then induce vomiting, or adjust within Ginseng/Atractylodes formulas to induce vomiting. For Blood deficiency, use Siwu Tang, take then induce vomiting, or probe vomit within Xionggui Tang. For Phlegm, use Erchen Tang, take then probe vomit. For Phlegm-Qi blockage, use Erchen Tang plus Cyperus and Akebia to probe vomit. For Excess Heat, promote urination, or use Bazheng San; moving stool promotes urination.
[Zhu Zhenheng] Treating a man with urinary obstruction using emesis resulted in immediate profuse urination. Discussion see Treatment of Deficiency/Excess, Disease Below Treating Above section.
[Zhang Zhongjing] For urinary difficulty, Puhui San, Shihui Baiyu San, and Fuling Rongyan Tang are indicated. (Puhui/Fahui eliminate stagnant blood. Talc, according to Danxi, eliminates stagnant blood.)
Puhui San Formula
Puhui (Seven fen, likely Typha pollen powder), Talc (Three fen).
Grind two ingredients into powder, take Wu fen fangcunbi with water, three times daily.
Shihui Baiyu San Formula
Talc (Two fen), Loose Hair (Two fen, burnt), Baiyu (Two fen, silverfish).
Grind three ingredients into powder, take Wu fenbi with water, three times daily.
[Wukao] Fahui San: Treats urgency/fullness below umbilicus, urinary obstruction. Use finely ground hair ash, take Er qian, mixed with Er he rice vinegar. Another method: Mix with Sesame leaf powder equally, take Er qian, then cover with stir-fried black soybean leaves, immediate relief. (Danxi says: Hair/bangs have swift Yin-nourishing effects.)
[Bencao] Taoren Jian (Peach Kernel Decoction): Treats accumulated Blood in women. Previously in Piling, a nobleman's wife had urinary obstruction, unbearable umbilical/abdominal distension/pain. Doctors treated as strangury with Bazheng San etc., ineffective, condition worsened. I diagnosed as Xuejia (Blood mass), requiring Mingxuan (severe reaction) drugs to remove. Using this drug, initial dose caused unbearable pain until noon; after lying briefly, expelled several fist-sized blood clots, urine like black bean juice one-two sheng, pain stopped, cured. This drug is fierce and峻烈; use cautiously in Qi/Blood deficient patients.
Peach Kernel, Rhubarb, Mirabilite (each Yi liang), Blister Beetle (Ban liang, stir-fried black).
Grind four ingredients into powder, slow-fire decoct in Er sheng ban strong vinegar in silver/copper vessel to obtain Yi sheng wu he. Add Rhubarb, Peach Kernel, Blister Beetle, stir constantly, remove after some time, make pills size of wu zi. Fast dinner previous night, at fifth watch swallow Wu wan with warm wine. By noon, discharge like red bean juice or chicken liver/toad skin appearance. If not discharged, repeat. Stop if bright red blood appears. Follow with Blood-Qi regulating tonics. Source: Qianjin Fang. (Do not use recklessly.)
The above four formulas treat urinary difficulty due to stagnant blood. First three are mild agents; the last is a峻 agent, use only after clear differentiation.
[Zhu Zhenheng] Lv Zhongnian, age 66, contracted Shanghan, sweated, fever subsided, but pulse remained flooding. Interpreted flooding pulse as deficiency, given Ginseng, Astragalus, Atractylodes, Roasted Licorice, Angelica, Peony, Tangerine Peel. Days later pulse still large, not converging, developed urinary obstruction, lower abdominal oppression/discomfort, suffering greatly, only dropping urine when supine. I said: Tonification dosage insufficient. Double Astragalus and Ginseng in previous formula, give large dose. Two days later, urination became free.
Lower abdominal pain/distension like inverted bowl indicates Excess. Two methods: Qi stagnation below, use emesis to lift; Stagnant Blood below, use Peach Kernel etc. to break blood. (Two formulas see Blood-Qi section.)
[Shichuan] Treat urinary obstruction. Use large living snail, remove shell, crush fine, apply to umbilicus, immediate relief. For post-Shanghan urinary obstruction, use 8-9 pieces ginger, crush, decoct in ten-plus bowls water with 5-6 chi hemp cloth for several boils. Hold in bucket, wait until hand-tolerable temperature, frequently apply cloth to lower abdomen for long time. Then take one bi Red Bean powder, two bi Jiang tea, mixed well spring water, miraculous effect, urine flows like injection.
[Bencao] Treat difficult urination, lower abdominal fullness. If not treated urgently, fatal. Use one jin scallion white, finely chop, stir-fry hot, wrap in cloth, divide into two parts, alternate applying to below umbilicus, immediate relief.
[Xuanzhu] Yin-Yang Guan-Ge, front-back obstruction, promoting stool makes urine flow naturally. Among these is Zhongbao (reversed bladder) syndrome, unresponsive to drugs, without rescue, death from distension/oppression. I once used Kansui powder mixed with water applied to below umbilicus, internally drank Licorice Joint soup. Medicine reached umbilicus, two drugs antagonistic, bladder rotated itself, urine flowed like spring, this is a good emergency method.
[Shengji Zonglu] Treat difficult urination, abdominal fullness/oppression, if not treated urgently, fatal. Use Gentiana (Qinjiao) Yi liang remove roots, decoct in Yi da zhen water to obtain Qi fen, remove dregs, take two doses before meals until cured.
[Shichuan] Treat urinary obstruction, use twenty-one large apricot kernels, grind, mix with water, divide into two doses, effective. (Apricot kernel, Aster resolves Lung depression to benefit urination; depression resolved, Qi descends, urine exits.)
[Qianjin Fang] Treat sudden urinary retention in women. Use Aster powder, take San cuo with well water, immediate relief. For bloody urine, take Wu cuo, stops immediately.
[Waitai Miyao] If urinary obstruction, multiple diseases with slight swelling, take one old pen tip, burn to ash, mix with water and take. (This formula details unknown.)
Classics state: Kidney combines with Bladder; Bladder is the mansion of fluids. Small Intestine belongs to Kidney; Kidney connects up to Lung, thus linking two organs. San Jiao is the mansion of channels/ditches, fluids exit here, belonging to Bladder, which is the mansion of Kidney. Also: Bladder is the Official of Zhoudu, storing fluids; transformation allows exit. From this, Bladder stores water, San Jiao outputs water. For treating urinary difficulty, acupuncture/moxibustion only selects San Jiao points, not Bladder points. Small Intestine belongs to Kidney/Lung, hence Dongyuan uses Qingfei Yinzi, Zishen Wan to benefit urination.
Yunqi (Six Qi) theory, urinary difficulty has three types:
First, damp pathogen attacks San Jiao. Classics: "Taiyin ruling underground, dampness excess wins, disease lower abdominal pain/swelling, inability to urinate." Also: "Water deficiency called Heliu; era of Heliu, Upper Gong same as Zheng Gong, disease is long/bi."
Second, wind pathogen attacks Spleen. Classics: "Jueyin ruling heaven, wind excess wins, disease loose stools, masses, diarrhea, water closure."
Third, dryness-heat. Classics: "Yangming ruling heaven's administration, heaven qi urgent, earth qi bright, people disease long/bi. First Qi period, disease urine yellow-red, severe strangury." Also: "Shaoyin ruling heaven's administration, earth qi solemn, heaven qi bright, Second Qi period, disease strangury."
Neijing acupuncture/moxibustion methods for urinary difficulty have five:
First, select Liver. Classics: "Foot-Jueyin Liver Meridian, diseases generated include long/bi." Also: "Lower abdominal fullness, body chills/fever, urinary difficulty, select Foot-Jueyin." Also: "Long select Yinqiao and Sanmao, up to blood collaterals bleed."
Second, select San Jiao. Classics: "San Jiao disease, abdominal Qi fullness, lower abdominal ball-hard, inability to urinate, distress, overflow leads to water flow becoming distension sign, in Foot-Taiyang outer large collateral, large collateral between Foot-Taiyang/Shaoyang, also seen in pulse, select Weiyang." Also: "Lower abdominal pain/swelling, inability to urinate, pathogen in San Jiao, approximately select Foot-Taiyang large collateral, (large collateral, Weiyang), view collateral vessels,結 with Jueyin small collaterals and blood (should have 'select' two characters)."
Third, select Kidney collateral. Classics: "Foot-Shaoyin branch, named Dazhong, behind ankle winding heel, branches to Taiyang. Disease excess is long/bi, select its branch."
Fourth, select Spleen. Classics: "Foot-Taiyin meridian generated, disease loose stools, masses, diarrhea, water closure, view deficiency/excess cold/heat sinking, apply tonification/sedation rapid moxibustion."
Fifth, miscellaneous selection. Classics: "Internal closure unable to urinate, puncture Foot-Shaoyin/Taiyang and thigh bone upper, with long needle, Qi rebellion select Taiyin/Yangming/Jueyin, severe select Shaoyin/Yangming, moving meridian."
[Jing] Treat urinary dribbling, possibly with blood. Use red-root scallion, cut one cun near root, place in umbilicus, moxa seven zhuang on top.
[Luo Tianyi] Treat urinary dribbling/blockage. Use salt unlimited amount, stir-fry hot fill patient's umbilicus, use moxa chopstick-head size, moxa seven zhuang, urine self-exits.
[Zhaiyuan Fang] (Nei Yinggu from Miyu) Guanyuan (Ba fen, let patient feel dribbling 3-5 times as limit, then rub lower abdomen, then remove needling point). Sanyinjiao (San fen penetrate). Yinggu.
[Cuoyao] Frequent urinary closure: Yinggu (Yi cun wu fen, moxa). Yinlingquan (sedate).
Biaofu Youfa Pianli.
[Jijiu] Urinary closure: Yinlingquan, Yinggu, Sanyinjiao, Qihai, Guanyuan (moxa thirty zhuang, needle two cun wu fen). If not better, select lower points: Taixi, Yinjiao.
[Li Gao] Heat strangury, yellow urine, abdominal fullness: Yinlingquan, Guanyuan (each Er cun). Qichong (Er qi zhuang).
Stone strangury unable to urinate: Guanyuan (San qi zhuang). Qimen, Dadun (each Er qi zhuang).
Blood strangury: Qihai, Tiandann (each needle/moxa San qi zhuang).
Hot painful urination, red eyes, urine like blood: Lieque (along skin one cun). Daling, Chengjiang (each Wu fen). Another method: Qugu (moxa Er qi zhuang). Yin-Yang Erlingquan (each Er cun wu fen).
[Jiayi Jing] Lower abdominal fullness, heat closure unable to urinate, select Zuwuli on foot. Difficult urination, pain, white turbidity, sudden hernia, lower abdominal swelling, cough/reverse vomiting, sudden genital jumping/lower back pain unable to bend/extend, dark face, heat, abdominal痞满, body heat/jue pain, Xingjian governs.