〔大〕妊娠小便不通，为小肠有热，传于胞而不通耳。若兼心肺气滞，则致喘急。陈
无择云∶妊娠胎满逼胞，多致小便不利。若心肾气虚，清浊相干，则为诸淋。若胞系了
泪，小便不通，名曰转胞。若胎满尿出，名曰遗尿。
〔丹〕转胞病胎妇禀受弱者，忧闷多者，性躁急者，食味浓者，大率有之。古方皆用
滑利疏导药，鲜有应效。因思胞为胎所压，展在一边，胞系了戾不通耳。胎若举起，悬在
中央，胞系得疏，水道自行。然胎之坠下，必有其由。一日吴宅宠人患此，脉之两手似涩，
重取则弦，左手稍和。予曰∶此得之忧患，涩为血少气多，弦为有饮，血少则胞弱而不能
自举，气多有饮，中焦不清而隘，则胞知所避而就下，故喜坠。遂以四物汤加参、术、半
夏、陈皮、生甘草、生姜空心饮，随以指探喉中，吐出药汁，候少顷气定，又与一帖，次
日亦然，如是八帖而安。此法果为的确，恐偶中耳。后有数人历历有效，未知果何如耶？
仲景云∶妇人本肌盛头举身满，今反羸瘦举中空减，胞系了戾，亦致胞转。其义未详，必
有能知之者。一妇人四十一岁，妊孕九个月，转胞小便不出，三日矣。下急脚肿，不
堪存活，来告急。予往视之，见其形瘁，脉之右涩而左稍和，此饱食而气伤，胎系弱，不
能自举而下坠，压着膀胱，偏在一边，气急为其所闭，所以水窍不能出也。转胞之病，大
率如此。予遂制一方补血养气，血气既正，胎系自举，则不下坠，方有安之理。遂作人参、
当归身尾、白芍药、白术、带白陈皮、炙甘草、半夏、生姜，煎浓汤与四帖，任其叫啖。
至次早，又与四帖，药渣作一帖，煎令顿饮之，探喉令吐出此药汤，小便立通，皆黑水。
后就此方加大腹皮、枳壳、青葱叶、缩砂仁二十帖与之，以防产前后之虚，果得就蓐平
安，产后亦健。一妇人妊娠七八个月，患小便不通，百医不能利，转加急胀，诊其脉
细弱。予意其血气虚弱，不然水载其胎，故胎重坠，下压住膀胱下口，因此溺不得出。若
服补药升扶胎起，则自下。药力未至，愈加急满。遂令一老妇用香油涂手，自产门入托
起其胎，溺出如注，胀急顿解。一面却以人参、黄 、升麻、大剂煮服，或少有急满，仍
用手托放取溺，如此三日后，胎渐起，小便如故。
〔薛〕前证亦有脾肺气虚，不能下输膀胱者；亦有气热郁结膀胱，津液不利者；亦
有金为火烁，脾土湿热，甚而不利者；更当详审施治。司徒李杏冈仲子室，孕五月，小
便不利，诸药不应。余曰∶非八味丸不能救。不信，别用分利之药，肚腹肿胀，以致不起。
儒者王文远室，患此小腹肿胀几至于殆，用八味丸一服，小便滴沥，再以前丸之料，加
车前子一剂即利，肚腹顿宛而安。
〔仲〕问曰∶妇人病饮食如故，烦热不得卧而反倚息者，何也？师曰∶此名转胞，不
得溺也。以胞系了戾，故致此病。但利小便则愈，宜肾气丸主之。（即八味丸。方见杂病虚劳。
每以酒下十五丸至二十丸，日再服。）
〔产〕疗小便不通及胞转。
桑螵蛸捣末，米饮服方寸匕，日三。
〔仲〕妊娠有水气，重身，小便不利，洒淅恶寒，起即头眩，葵子茯苓散 主之。
葵子（一斤） 茯苓（三两）
上二味杵为散，饮服方寸匕，日三服，小便利则愈。
妊娠小便难，饮食如故，归母苦参丸主之。
当归 贝母 苦参（各四两）
上为末，炼蜜丸如小豆大。饮服三丸，加至十丸。（男子加滑石半两。）
〔大〕治妊娠卒不得小便。
杏仁一味去皮尖，捣丸如绿豆大，灯心汤吞七丸，立利。
〔丹〕朱宅妇人三十余岁，怀胎四个月，大小便闭，因与通利，冬葵子等药已通，但
气未顺。此由性急，血耗气乱，须和其气，滋其血乃安。
陈皮 青皮 芍药（一钱） 人参 归身尾 川芎 地黄 白术（半两） 茯苓 木通 甘
草（二分）
独圣散 治妊娠小便不通。
上用蔓荆子为末，每服二钱，食前浓煎葱白汤调下。
【朱丹溪】妊娠期间小便不通，是因为小肠有热邪，热气传入胞宫导致水道不通。如果同时伴有心肺气机阻滞，就会引发气喘急促。陈无择说：妊娠时胎体增大压迫膀胱，多会导致小便不利。如果是心肾气虚，清浊之气相互干扰，就会形成各种淋证。如果是胞系扭曲，小便完全不通，这种病名叫“转胞”。如果胎体增大但尿液自行流出，这种病名叫“遗尿”。
【朱丹溪】患转胞病的孕妇，大多体质虚弱、忧郁闷躁、性情急躁或饮食口味浓重的人容易得此病。古方多用滑利疏导的药物，很少见效。我思考认为，这是因为胞胎压迫膀胱，使膀胱偏向一侧，导致胞系扭曲堵塞。如果能把胎儿托起，悬在中央，胞系得以舒展，水道自然通畅。然而胎儿下坠必有其原因。有一天，吴家的宠妾患此病，诊脉两手脉象似涩，重按则弦，左手稍和缓。我说：这是因忧患所致，涩脉表示血少气多，弦脉表示体内有水饮。血少则胞宫虚弱不能自举，气多且有水饮，中焦不清而狭窄，所以胞宫知道避开狭窄处而下坠，因此喜欢下坠。于是用四物汤加入人参、白术、半夏、陈皮、生甘草、生姜，空腹服用，随即用手指探喉催吐，待气息稍定后，再服一剂，第二天也这样做，如此共服八剂而痊愈。这个方法确实确切，恐怕是偶然中的。后来又有几个人使用此法都有效，不知究竟是何道理？张仲景说：妇人原本肌肉丰盛头部抬起身体满实，现在反而消瘦腹部中空减损，胞系扭曲，也会导致胞转。其中的含义我不详细知晓，必定有能懂的人。有一位四十一岁的妇人，怀孕九个月，转胞小便不出，已经三天了。小腹急迫脚肿，痛苦不堪无法生存，来告急。我去诊治，见她形体憔悴，诊脉右脉涩而左脉稍和，这是饱食后损伤了气，胎系虚弱，不能自举而下坠，压迫着膀胱，偏在一边，气机急迫被其闭塞，所以尿道口不能排尿。转胞这个病，大抵都是这样。于是我制定一方补血养气，血气既正，胎系自然举起，就不下坠，方子才有安胎的道理。于是用人参、当归身尾、白芍药、白术、带白陈皮、炙甘草、半夏、生姜，煎浓汤给患者连服四帖，任由她叫喊吞咽。到第二天早上，又给四帖，药渣再煎成一帖，煎好后一次性喝下，并探喉令其吐出这药汤，小便立刻通畅，排出的都是黑水。后来在这个方子基础上加大腹皮、枳壳、青葱叶、缩砂仁二十帖给她服用，以防产前产后之虚，果然平安临产，产后也很健康。还有一位妇人怀孕七八个月，患小便不通，众多医生治疗无效，反而更加急胀，诊其脉细弱。我推测她是血气虚弱，或者是水湿承载胎儿，导致胎重下坠，压住膀胱下口，因此尿液不得排出。如果服用补药升提胎儿，则自然下降。药力未到，会更加急满。于是让一位老妇用香油涂手，从产门进入托起胎儿，尿液如注而出，胀急顿时缓解。一面却用人参、黄芪、升麻，大剂量煮服，如果稍有急满，仍用手托放取尿，如此三天后，胎儿渐渐升起，小便恢复正常。
【薛己】前面的病症也有脾肺气虚，不能将津液下输膀胱的；也有气热郁结膀胱，津液不利的；也有金（肺）被火（心）灼烧，脾土湿热，甚至不利的；更应当详细审察施治。司徒李杏冈的二儿媳，怀孕五个月，小便不利，各种药物无效。我说：非八味丸不能救。她不信任，另外用分利小便的药物，导致肚腹肿胀，最终不治身亡。儒者王文远的妻子，患此病小腹肿胀几乎致死，服用八味丸一剂，小便滴沥而出，再用前丸的药料，加入车前子一剂即通利，肚腹顿时舒缓而安。
【张仲景】问：妇人患病饮食正常，烦热不能卧躺反而倚靠呼吸，这是什么病？老师说：这叫转胞，不能排尿。因为胞系扭曲，所以导致此病。只要通利小便就能痊愈，宜用肾气丸主治。（即八味丸。方剂见杂病虚劳篇。每次用酒送服十五丸至二十丸，每天两次。）
【产科专论】治疗小便不通及胞转。
桑螵蛸研成末，米汤送服方寸匕，每天三次。
【张仲景】妊娠有水气，身重，小便不利，洒淅恶寒，起身即头晕目眩，用葵子茯苓散主治。
冬葵子（一斤） 茯苓（三两）
以上两味捣碎为散，用米汤送服方寸匕，每天三次，小便利则愈。
妊娠小便难，饮食正常，用归母苦参丸主治。
当归 贝母 苦参（各四两）
以上三味研末，炼蜜制成如小豆大的丸药。每次用水送服三丸，加量至十丸。（男子服用加滑石半两。）
【朱丹溪】治疗妊娠突然小便不通。
杏仁一味，去皮尖，捣丸如绿豆大，灯心草汤吞服七丸，立即通利。
【朱丹溪】朱家妇人三十多岁，怀胎四个月，大小便闭结，给予通利药物，冬葵子等药已通，但气机未顺。这是由于性情急躁，血耗气乱，必须调和其气，滋养其血才能安宁。
陈皮 青皮 芍药（一钱） 人参 当归身尾 川芎 地黄 白术（半两） 茯苓 木通 甘草（二分）
[Danxi] Incontinence or retention of urine during pregnancy is caused by heat in the Small Intestine transmitting to the uterus (Baogong), leading to obstruction. If accompanied by Qi stagnation in the Heart and Lungs, it may result in panting and urgency. Chen Wuyue stated: During pregnancy, the fullness of the fetus pressing on the bladder often leads to difficult urination. If there is deficiency of Qi in the Heart and Kidneys, with turbid and clear energies interfering with each other, various types of Lin syndrome (dysuria) occur. If the vesical ligaments are twisted causing complete urinary retention, this condition is named "Zhuanbao" (Bladder Displacement). If the fetus is full but urine leaks out involuntarily, it is named "Yiniao" (Urinary Incontinence).
[Danxi] Women suffering from Zhuanbao generally have weak constitutions, are prone to melancholy and irritability, have hot tempers, or consume rich-flavored foods. Ancient formulas mostly used slippery and draining herbs, rarely achieving efficacy. I reasoned that the fetus presses against the bladder, displacing it to one side, causing the vesical ligaments to twist and obstruct flow. If the fetus could be lifted and suspended centrally, the ligaments would relax, and the water pathway would open naturally. However, fetal descent must have a cause. One day, a favored concubine of the Wu family suffered from this. Her pulse was slightly choppy in both hands, wiry upon heavy pressure, and slightly harmonious on the left. I said: This resulted from worry and distress. A choppy pulse indicates blood deficiency and excess Qi; a wiry pulse indicates fluid retention. Blood deficiency makes the uterus weak and unable to lift itself; excess Qi with fluid retention causes unclear middle Jiao and narrowing, so the uterus avoids the narrowness and descends, hence the tendency to drop. I prescribed Siwu Tang (Four Substances Decoction) added with Renshen (Ginseng), Baizhu (Atractylodes Macrocephala Rhizome), Banxia (Pinellia Tuber), Chenpi (Tangerine Peel), Sheng Gancao (Raw Licorice Root), and Shengjiang (Fresh Ginger), taken on an empty stomach. Immediately after, I induced vomiting by stimulating the throat. After her Qi settled, she took another dose, repeating this daily for eight doses until cured. This method proved effective, though perhaps by chance. Later, several others were successfully treated with this method, though the exact reason remains unclear. Zhang Zhongjing stated: Women originally with abundant flesh and upright posture now become emaciated with a hollow abdomen; twisting of the vesical ligaments also causes bladder displacement. The precise meaning is unknown to me, but surely someone knows it. A forty-one-year-old woman, nine months pregnant, suffered from Zhuanbao with urinary retention for three days. Her lower abdomen was urgent, legs swollen, unbearable suffering, seeking emergency help. Upon examination, her form was haggard; right pulse was choppy, left slightly harmonious. This indicated damage to Qi from overeating, weakness of the fetal ligaments preventing self-elevation, leading to descent and compression of the bladder on one side, blocking Qi and thus the urethra. Zhuanbao is generally like this. I formulated a prescription to tonify Blood and Qi. Once Blood and Qi are rectified, the ligaments lift naturally, preventing descent, ensuring safety. I prepared Ren Shen (Ginseng), Dang Gui (Angelica Sinensis Root) body and tail, Bai Shao (White Peony Root), Bai Zhu (Atractylodes Macrocephala Rhizome), Chenpi (Tangerine Peel with white pith), Zhi Gancao (Honey-fried Licorice Root), Banxia (Pinellia Tuber), and Sheng Jiang (Fresh Ginger), decocted into a strong liquid, administered four doses, allowing her to swallow despite crying. Next morning, another four doses were given. The dregs were decocted again as one dose, drunk entirely, then inducing vomiting. Urine flowed immediately, dark in color. Later, adding Dafupi (Areca Peel), Zhike (Bitter Orange Fruit), Qingcong Ye (Green Onion Leaf), and Suosharen (Amomum Fruit) to this formula for twenty doses prevented pre- and post-partum deficiency. She delivered safely and remained healthy postpartum. Another woman, seven to eight months pregnant, suffered urinary retention unresponsive to many doctors, worsening distension. Her pulse was fine and weak. I surmised Blood and Qi deficiency, or water carrying the fetus making it heavy, pressing on the bladder outlet. Tonifying herbs to lift the fetus should work, but until the medicine acts, distension worsens. I instructed an old woman to apply sesame oil to her hands, insert them into the vagina to lift the fetus. Urine gushed out, distension resolved instantly. Simultaneously, large doses of Ren Shen (Ginseng), Huangqi (Astragalus Root), and Shengma (Cimicifuga Rhizome) were decocted and consumed. If distension recurred, manual lifting was repeated. After three days, the fetus rose, and urination normalized.
[Xueji] The aforementioned conditions can also stem from Spleen and Lung Qi deficiency failing to transport fluids to the Bladder; or Qi-heat stagnating in the Bladder obstructing fluids; or Metal (Lung) scorched by Fire (Heart), with Spleen Earth damp-heat, even leading to obstruction. Careful differentiation is required. The second wife of Situ Li Xingang, five months pregnant, had difficult urination unresponsive to various drugs. I said: Only Bawei Wan (Eight-Ingredient Pill) could save her. She did not believe, using diuretic herbs instead, resulting in abdominal swelling and death. The wife of scholar Wang Wenyuan suffered severe lower abdominal swelling nearly fatal. One dose of Bawei Wan (Eight-Ingredient Pill) produced dripping urine; a subsequent dose with Cheqianzi (Plantago Seed) brought relief, and the abdomen became comfortable.
[Zhang Zhongjing] Question: A woman suffers normal appetite, restlessness, heat, inability to lie down, preferring to lean forward to breathe. What is this? Master said: This is called Zhuanbao (Bladder Displacement), inability to urinate. Due to twisted vesical ligaments, this disease occurs. Promoting urination will cure it. Use Shenqi Wan (Kidney Qi Pill) as the main treatment. (This is Bawei Wan / Eight-Ingredient Pill. See Miscellaneous Diseases - Deficiency Consumption. Take fifteen to twenty pills with wine, twice daily.)
[Obstetrics Section] Treatment for urinary retention and bladder displacement.
Sangpiaoxiao (Mantis Egg Case) ground to powder, taken with rice water, one cun bi (measure) per dose, three times daily.
[Zhang Zhongjing] Pregnancy with water qi, heaviness, urinary difficulty, chills, and dizziness upon rising. Treat with Kuizi Fuling San (Abelmoschus Seeds and Poria Powder).
Kuizi (Abelmoschi Semen, 1 jin) Fuling (Poria, 3 liang)
Crush these two ingredients into powder. Take one cun bi with water, three times daily. Cured when urination flows freely.
Pregnancy with difficult urination, normal diet. Treat with Guimu Kushen Wan (Danggui, Fritillaria, and Sophora Pill).
Danggui (Angelica Sinensis Root) Beimu (Fritillaria Bulb) Kushen (Sophora Root) (each 4 liang)
Grind into powder, mix with honey to make pills the size of small beans. Take three pills with water, increasing to ten pills. (For men, add Han Shi [Talcum] half liang.)
[Zhu Danxi] Treatment for sudden urinary retention in pregnancy.
Xingren (Apricot Seed), peeled and de-seeded, made into pills the size of mung beans. Swallow seven pills with Dengxin Tang (Juncus Decoction). Urination flows immediately.
[Zhu Danxi] Mrs. Zhu, over thirty years old, four months pregnant, suffered constipation of both stool and urine. Given promoting herbs, Kuizi (Abelmoschus Seeds) etc. cleared the bowels, but Qi was not smooth. This was due to impatience, consuming Blood and disturbing Qi. Must harmonize Qi and nourish Blood for peace.
Chenpi (Tangerine Peel) Qingpi (Green Tangerine Peel) Shaoyao (Peony Root) (1 qian) Renshen (Ginseng) Danggui Shentail (Angelica Root Body and Tail) Chuanxiong (Ligusticum Rhizome) Dihuang (Rehmannia Root) Baizhu (Atractylodes Macrocephala Rhizome) (0.5 liang) Fuling (Poria) Mutong (Akebia Stem) Gancao (Licorice Root) (2 fen)
Dusheng San (Single Holy Powder) for treating urinary retention in pregnancy.
Use Manjingzi (Vitex Fruit) ground to powder. Take 2 qian per dose, mixed with strong decoction of Congbai (Green Onion White) before meals.