论曰膀胱者州都之官，津液藏焉，气化则能出矣，其气有余则实，实则热气留之。故壅
阏而不通，其内证胞闭不得小便，烦满而躁，其外证体热，腰中痛，头眩是也，内经曰，膀
胱不利为癃者以此。
治膀胱实热，小便癃闭，舌燥引饮，烦闷。石膏汤方
石膏（碎） 山栀子（去皮） 赤茯苓（去黑皮） 甘草（炙锉） 木通（锉各一两）
上五味，粗捣筛，每服三钱匕，水一盏，煎至七分，去滓温服。
治膀胱实热，小便不通。壅闷烦躁。瞿麦饮方
瞿麦穗 黄芩（去黑心） 甘草（生锉） 木通（锉各一两） 葵根（洗锉） 车前子
（各半两）
上六味，粗捣筛，每服四钱匕，水一盏半，煎至一盏，去滓温服。
顺膀胱，利小便，解烦热。车前子散方
车前子 海金沙 井泉石 滑石碎各一两 葶苈（纸上炒一分）
上五味，捣罗为散，每服二钱匕，蜜熟水调下，未利再服。
治胞囊实热，溲便癃闭，日夜不通。槟榔饮方
槟榔（生锉） 羚羊角（镑） 大黄（锉各半两） 甘草（炙锉） 赤茯苓（去黑皮） 防
己（锉各一两）
上六味，粗捣筛，每服五钱匕，水一盏半，煎至一盏，去滓温服。
治膀胱实热，小便不通。腰腹重痛，烦躁。猪苓散方
木猪苓（去黑皮） 防己（锉） 栀子仁（各一两） 滑石（碎） 车前子 槟榔（生
锉） 大黄
上七味，捣罗为散，每服二钱匕，温熟水调下，水煎至七分，温服亦得。
治膀胱热结不通。芒硝散方
芒硝（别研半两） 赤茯苓（去黑皮为末一两）
上二味，捣研和匀，每服二钱匕，蜜熟水调下，心热烦躁者，以冷蜜水下。
治膀胱热小便不通，舌干咽肿。升麻饮方
升麻 大青（各三两） 射干 玄参 黄柏（去粗皮） 蔷薇根白皮（各四两）
上六味， 咀如麻豆大，每服五钱匕，水一盏半，煎至一盏，临熟入蜜一匙，打匀去滓
服。
治膀胱实热，小便不通，烦闷不解。栀子仁汤方
栀子仁（二两） 石膏（四两） 赤茯苓（去黑皮） 知母（焙各二两） 生地黄 淡
竹叶（各
上以水煎四钱，去滓，入芒硝五分，沸服，日二。
论述说：膀胱是州都之官，津液在其中贮藏，经过气化作用才能排出。如果其气有余则形成实证，实证时热气就会滞留其中。因此会出现壅塞阻滞而不通畅的情况，其内部表现为小便闭塞不通、烦闷躁扰；其外部表现为身体发热、腰部疼痛、头晕目眩。《内经》说：“膀胱不利为癃”，指的就是这种情况。
治疗膀胱实热证，症状为小便癃闭不通、舌干口渴引饮、烦闷不安的石膏汤方：
石膏（捣碎）一两，山栀子（去皮）一两，赤茯苓（去掉黑皮）一两，甘草（炙后锉碎）一两，木通（锉碎）一两。
以上五味药，粗捣筛过，每次服用三钱匕，加水一盏，煎煮至七分满，去渣后温服。
治疗膀胱实热证，症状为小便不通、壅闷烦躁的瞿麦饮方：
瞿麦穗一两，黄芩（去掉黑心）一两，甘草（生用锉碎）一两，木通（锉碎）一两，葵根（洗净锉碎）一两，车前子半两。
以上六味药，粗捣筛过，每次服用四钱匕，加水一盏半，煎煮至一盏满，去渣后温服。
具有疏通膀胱、利小便、解烦热功效的车前子散方：
车前子一两，海金沙一两，井泉石一两，滑石（捣碎）一两，葶苈子（在纸上炒制）一分。
以上五味药，捣碎过罗成为散剂，每次服用二钱匕，用蜂蜜和熟水调服，若小便未通利可再服。
治疗胞囊实热证，症状为小便癃闭不通，日夜均无法排尿的槟榔饮方：
槟榔（生用锉碎）半两，羚羊角（镑片）半两，大黄（锉碎）半两，甘草（炙后锉碎）一两，赤茯苓（去掉黑皮）一两，防己（锉碎）一两。
以上六味药，粗捣筛过，每次服用五钱匕，加水一盏半，煎煮至一盏满，去渣后温服。
治疗膀胱实热证，症状为小便不通、腰腹部沉重疼痛、烦躁的猪苓散方：
木猪苓（去掉黑皮）一两，防己（锉碎）一两，栀子仁一两，滑石（捣碎）一两，车前子一两，槟榔（生用锉碎）一两，大黄一两。
以上七味药，捣碎过罗成为散剂，每次服用二钱匕，用温热的熟水调服，也可以用水煎煮至七分满，温服亦可。
治疗膀胱热结导致的不通，芒硝散方：
芒硝（单独研细）半两，赤茯苓（去掉黑皮并研成末）一两。
以上两味药，捣研混合均匀，每次服用二钱匕，用蜂蜜和熟水调服，若是心中烦热烦躁者，用冷蜜水送服。
治疗膀胱热盛导致的小便不通、舌干咽肿的升麻饮方：
升麻三两，大青三两，射干四两，玄参四两，黄柏（去掉粗皮）四两，蔷薇根白皮四两。
以上六味药，切碎如麻豆大小，每次服用五钱匕，加水一盏半，煎煮至一盏满，临出锅时加入一匙蜂蜜，搅匀去渣后服用。
治疗膀胱实热证，症状为小便不通、烦闷不解的栀子仁汤方：
栀子仁二两，石膏四两，赤茯苓（去掉黑皮）二两，知母（焙干）二两，生地黄二两，淡竹叶二两。
以上药物加水煎煮四钱药量，去渣后，加入芒硝五分，煮沸后服用，每日两次。
Commentary states: The Bladder is the official of the "Zhou Du" (State Capital), where body fluids are stored; it can discharge them only after Qi transformation. If its Qi is in excess, it forms a Excess syndrome, during which pathogenic Heat lingers. Consequently, there is obstruction and blockage leading to non-patency. Internally, this manifests as closure of the bladder sac with inability to urinate, irritability, fullness, and restlessness. Externally, it presents as fever, pain in the waist, and dizziness. The *Nei Jing* (Inner Canon) states, "Impaired function of the Bladder leads to strangury," referring to this condition.
**Shigao Tang (Gypsum Decoction)** for treating Bladder Excess-Heat with strangury, dry tongue with thirst, and irritability.
Ingredients: Shigao (Gypsum Fibrosum, crushed) 1 liang, Zhizi (Gardeniae Fructus, peeled) 1 liang, Chifuling (Poria cum Radix Pini, black skin removed) 1 liang, Gancao (Licorizae Radix et Rhizoma, roasted and chopped) 1 liang, Mutong (Akebiae Caulis, chopped) 1 liang.
Preparation: Coarsely crush and sieve the above five herbs. For each dose, take 3 qianbi (approx. 9g), add one zhan (approx. 200ml) of water, decoct until reduced to seven-tenths, remove the dregs, and take warm.
**Qumai Yin (Dianthus Decoction)** for treating Bladder Excess-Heat with urinary retention, oppression, stuffiness, and restlessness.
Ingredients: Qumaishui (Dianthi Herba) 1 liang, Huangqin (Scutellariae Radix, black heart removed) 1 liang, Gancao (Licorizae Radix et Rhizoma, raw and chopped) 1 liang, Mutong (Akebiae Caulis, chopped) 1 liang, Kuigen (Malvae Root, washed and chopped) 1 liang, Cheqianzi (Plantaginis Semen) 0.5 liang.
Preparation: Coarsely crush and sieve the above six herbs. For each dose, take 4 qianbi, add one and a half zhan of water, decoct until reduced to one zhan, remove the dregs, and take warm.
**Cheqianzi San (Plantago Powder)** to smooth the Bladder, promote urination, and relieve irritability and heat.
Ingredients: Cheqianzi (Plantaginis Semen) 1 liang, Haijinsha (Lygodii Spora) 1 liang, Jingquanshi (Well Spring Stone) 1 liang, Huashi (Talcum, crushed) 1 liang, Tingli (Semen Lepidii seu Descurainiae, stir-fried on paper) 1 fen.
Preparation: Crush and sieve the above five herbs into a powder. For each dose, take 2 qianbi, mix with honey and boiled water to swallow. If urination is not yet patent, administer another dose.
**Binglang Yin (Areca Seed Decoction)** for treating Excess-Heat in the bladder sac with strangury and urinary retention, day and night without relief.
Ingredients: Binglang (Arecae Semen, raw and chopped) 0.5 liang, Lingyangjiao (Saigae Tataricae Cornu, shaved) 0.5 liang, Dahuang (Rhei Radix et Rhizoma, chopped) 0.5 liang, Gancao (Licorizae Radix et Rhizoma, roasted and chopped) 1 liang, Chifuling (Poria cum Radix Pini, black skin removed) 1 liang, Fangji (Stephaniae Tetrandrae Radix, chopped) 1 liang.
Preparation: Coarsely crush and sieve the above six herbs. For each dose, take 5 qianbi, add one and a half zhan of water, decoct until reduced to one zhan, remove the dregs, and take warm.
**Zhuling San (Polyporus Powder)** for treating Bladder Excess-Heat with urinary retention, heavy and painful waist and abdomen, and restlessness.
Ingredients: Muzhuling (Polyporus, black skin removed) 1 liang, Fangji (Stephaniae Tetrandrae Radix, chopped) 1 liang, Zhiziren (Gardeniae Fructus) 1 liang, Huashi (Talcum, crushed) 1 liang, Cheqianzi (Plantaginis Semen) 1 liang, Binglang (Arecae Semen, raw and chopped) 1 liang, Dahuang (Rhei Radix et Rhizoma) 1 liang.
Preparation: Crush and sieve the above seven herbs into a powder. For each dose, take 2 qianbi, mix with warm boiled water to swallow. Alternatively, decoct with water until reduced to seven-tenths and take warm.
**Mangxiao San (Mirabilite Powder)** for treating Bladder Heat accumulation causing non-patency.
Ingredients: Mangxiao (Natrii Sulfas, separately ground) 0.5 liang, Chifuling (Poria cum Radix Pini, black skin removed and ground into powder) 1 liang.
Preparation: Crush, grind, and mix evenly. For each dose, take 2 qianbi, mix with honey and boiled water to swallow. For those with Heart Heat and restlessness, use cold honey water for administration.
**Shengma Yin (Cimicifugae Decoction)** for treating Bladder Heat with urinary retention, dry tongue, and swollen throat.
Ingredients: Shengma (Cimicifugae Rhizoma) 3 liang, Daqing (Indigo Naturalis) 3 liang, Shegan (Belamcandae Rhizoma) 4 liang, Xuanshen (Scrophulariae Radix) 4 liang, Huangbai (Phellodendri Cortex, rough skin removed) 4 liang, Qiangweigen Baipi (Rosae Multiflorae Radix Cortex) 4 liang.
Preparation: Cut the above six herbs into pieces the size of hemp seeds. For each dose, take 5 qianbi, add one and a half zhan of water, decoct until reduced to one zhan. Just before completion, add one spoonful of honey, mix well, remove dregs, and take.
**Zhiziren Tang (Gardenia Kernel Decoction)** for treating Bladder Excess-Heat with urinary retention and unresolved irritability.
Ingredients: Zhiziren (Gardeniae Fructus) 2 liang, Shigao (Gypsum Fibrosum) 4 liang, Chifuling (Poria cum Radix Pini, black skin removed) 2 liang, Zhimu (Anemarrhenae Rhizoma, baked) 2 liang, Shengdihuang (Rehmanniae Radix) 2 liang, Danzhuye (Lophatheri Herba) 2 liang.
Preparation: Decoct the above herbs in water using 4 qianbi of the mixture per dose. Remove dregs, add Mangxiao (Natrii Sulfas) 5 fen, boil, and take. Administer twice daily.