〔大〕妇人脬转之病者，由脬为热所迫，或忍小便，俱令水气迫于脬，屈辟不得充张，
外水应入不得入，内溲应出不得出，内外壅滞，胀满不通，故为脬转。其状少腹急痛，
不得小便，甚者至死，不可治也。
〔薛〕前证不问男女孕妇，转脬小便不利，命在反掌，非八味丸不能救，余参前后
论主治。一妇人小便淋沥，小腹胀闷，胸满喘急，诸药不应，余视为转脬之证，用八
味丸料煎服，小便即利而痊。一妇人因郁怒，小便滴沥，渐至小腹肿胀，痰咳喘促，余
用八味丸料煎服，小便即利而痊。
〔大〕滑石散 （《千金》）治妇人丈夫脬转，小便数日不通。
滑石（一两） 凝水石（二两） 葵子（一合）
上为末，以水一斗，煮取五升，时时服，一升即利。
又方
乱发（烧灰存性） 葵子 车前子（各等分）
上为细末，每服二钱，茶汤调下。
叶散 治妇人脬转，小便不通。亦可治男子。
裹茶 叶（烧灰存性，一两） 滑石（研细，半两）
上研停，沸汤调二钱服。
石韦汤 治证同前。
石韦（去毛） 车前子（各等分）
上为粗末，每服五钱，水二盏，煎至一盏，去滓服。
治妇人忍小便，不得根据时而起，致令脬转，经四五日，困笃欲死。
滑石（二两） 乱发灰（一两）
上研停，取桃白皮一斤熟捣，以水三盏，绞取汁，无时，温半盏调一钱服。
又方 以滑石末葱汤调下二钱服。
《千金翼》方 治妇人不得小便。
杏仁（七粒，去皮尖）
上一味，麸炒黄，细末，水调服立通。
又方 以紫草为末，井华水调服三指撮立通。又云∶紫菀皆可用。
若卒暴不通，小腹膨急，气上冲心，闷绝欲死，此由异气传并膀胱，或从忧惊，气
无所伸，郁闭而不流，气冲脬系不正。诊其脉，右手涩小，左手急大，宜葱白汤。
葱白汤方
橘皮（三两） 葵子（一两） 葱白（一茎）
上 咀，以水五升，煮取二升，分三服。（出《指迷方》）
《补遗》∶紫金皮为末，葱汤调下二钱。葵子汤亦可。
又方 胞转小便不通，炒盐半斤，囊之，乘热熨小腹。
〔薛〕滋肾生肝饮
山药 山茱萸（肉，各一钱） 熟地黄（自制，二钱） 泽泻 茯苓 牡丹皮（各七分）
五味子（杵炒，五分） 柴胡（三分） 白术 当归 甘草（各三分）
上水煎服。
八味丸 治脬转小便不通，殊有神效，但世所不用，以致误人多矣。（方见杂病虚劳。）
一方 皂角为末，吹鼻内取嚏。
【大论】妇人患脬转（膀胱扭转或受压导致排尿障碍）的病，是因为膀胱被热邪所迫，或者强行憋住小便，都会导致水气压迫膀胱，使膀胱屈曲收缩而不能充盈扩张。此时，外面的水液应入而不能入，里面的尿液应出而不能出，内外壅滞，胀满不通，所以称为脬转。其症状表现为小腹部急痛，不能小便，严重的甚至会导致死亡，无法救治。
【薛己按语】上述病症，不论男女或孕妇，出现脬转、小便不利的情况，性命危在旦夕，非用八味丸（即金匮肾气丸，温补肾阳之剂）不能挽救，其余请参考前后的论述来确定主治方法。有一位妇人小便淋沥不尽，小腹胀闷，胸部胀满且呼吸急促，服用各种药物无效，我视其为转脬的证候，使用八味丸的药料煎服，小便随即通畅而痊愈。另一位妇人因愤怒郁结，小便滴沥不畅，逐渐发展到小腹部肿胀，伴有痰多咳嗽和喘息急促，我使用八味丸的药料煎服，小便随即通畅而痊愈。
【大论】滑石散（出自《千金方》），治疗妇人和男子脬转，小便数日不通。
滑石（一两） 凝水石（二两） 葵子（冬葵子，一合）
以上药物研为末，用水一斗，煮取五升药液，不时少量服用，服下一升后小便即可通利。
又一方：
乱发（烧成灰但保留药性） 葵子 车前子（各等分）
以上药物研为细末，每次服用二钱，用茶汤调服。
叶散，治疗妇人脬转，小便不通。也可以治疗男子。
裹茶 茶叶（烧成灰但保留药性，一两） 滑石（研细，半两）
以上药物研磨均匀，用沸水调服二钱。
石韦汤，治疗的证候同前。
石韦（去毛） 车前子（各等分）
以上药物研为粗末，每次服用五钱，用水两盏，煎至一盏，去渣服用。
治疗妇人强忍小便，不能按时排尿，导致脬转，经过四五日，病情危重欲死。
滑石（二两） 乱发灰（一两）
以上药物研磨均匀，取桃白皮一斤煮熟捣烂，用水三盏，绞取汁液，随时取半盏温服，调入一钱药末。
又一方：用滑石末，用葱汤调下二钱服用。
《千金翼方》，治疗妇人不能小便。
杏仁（七粒，去皮尖）
以上一味药，用麦麸炒黄，研为细末，用水调服，立即通畅。
又一方：用紫草研为末，用清晨第一次打的井水调服三指撮的量，立即通畅。又说：紫菀也可以用来治疗。
如果突然完全不通，小腹部膨隆急迫，气向上冲撞心脏，胸闷窒息欲死，这是由于异气传并膀胱，或者因为忧惊，气机无处伸展，郁闭而不流动，气冲撞膀胱系膜使其位置不正。诊察其脉象，右手脉涩小，左手脉急大，适宜用葱白汤。
葱白汤方：
橘皮（三两） 葵子（一两） 葱白（一茎）
以上药物切碎，用水五升，煮取二升，分三次服用。（出自《指迷方》）
又一方：胞转导致小便不通，炒盐半斤，装入袋中，趁热熨烫小腹部。
【薛己】滋肾生肝饮：
山药 山茱萸（肉，各一钱） 熟地黄（自制，二钱） 泽泻 茯苓 牡丹皮（各七分）
五味子（杵炒，五分） 柴胡（三分） 白术 当归 甘草（各三分）
以上药物用水煎服。
八味丸，治疗脬转小便不通，特别有神效，只是世间不再使用，以致误人很多。（方剂见杂病虚劳篇。）
一方：皂角研为末，吹入鼻内引起打喷嚏。
[Da] The disease of "Pao Zhuan" (bladder torsion or compression leading to urinary retention) in women occurs when the bladder is forced by heat pathogens, or when urination is forcibly suppressed. Both conditions cause water qi (fluid metabolism energy) to press upon the bladder, causing it to curl and shrink, preventing it from filling and expanding. Consequently, external fluids cannot enter, and internal urine cannot exit. This results in internal and external stagnation, distension, and obstruction, hence termed "Pao Zhuan." Its manifestations include acute pain in the lower abdomen and inability to urinate; in severe cases, it may lead to death and be incurable.
[Xue Ji's Commentary] Regarding the above syndrome, regardless of whether the patient is male, female, or pregnant, if "Pao Zhuan" occurs with difficulty in urination, life is in imminent danger. Only Ba Wei Wan (Eight-Ingredient Pill with Rehmannia, a formula for warming and tonifying Kidney Yang) can save them. For other treatments, refer to the preceding and following discussions on management. One woman suffered from dribbling urination, lower abdominal distension and stuffiness, chest fullness, and rapid breathing. Various medicines failed to work. I diagnosed this as "Zhuan Pao" (transferred bladder issue) and administered Ba Wei Wan decoction; her urination immediately became free, and she recovered. Another woman, due to anger and depression, experienced dripping urination that gradually progressed to lower abdominal swelling, accompanied by phlegm, cough, and panting. I administered Ba Wei Wan decoction; her urination immediately became free, and she recovered.
[Da] Hua Shi San (Talcum Powder Decoction, from *Qian Jin Fang*) treats "Pao Zhuan" in women and men, where urination has been obstructed for several days.
Hua Shi (Talcum, 1 liang) Ning Shui Shi (Calcitum, 2 liang) Kui Zi (Malva Seeds, 1 he).
Grind the above into powder. Boil in 10 dou of water until 5 sheng remain. Take small amounts frequently. After consuming one sheng, urination will flow freely.
Another prescription:
Luan Fa (Human Hair Ash, burnt to retain efficacy) Kui Zi (Malva Seeds) Che Qian Zi (Plantago Seeds) (equal parts).
Grind into fine powder. Take 2 qian per dose, mixed with tea water.
Ye San (Leaf Powder) treats "Pao Zhuan" in women with urinary obstruction. It can also treat men.
Guo Cha Ye (Tea Leaves, burnt to retain efficacy, 1 liang) Hua Shi (Talcum, ground fine, 0.5 liang).
Grind uniformly. Mix 2 qian with boiling water and take.
Shi Wei Tang (Pyrosula Decoction) treats the same syndrome as above.
Shi Wei (Drynaria Folium, hairs removed) Che Qian Zi (Plantago Seeds) (equal parts).
Grind into coarse powder. Take 5 qian per dose. Boil in 2 zhan of water until 1 zhan remains. Strain and take.
For women who forcibly suppress urination, failing to void at regular intervals, leading to "Pao Zhuan," persisting for four to five days, becoming critically ill and near death:
Hua Shi (Talcum, 2 liang) Luan Fa Hui (Human Hair Ash, 1 liang).
Grind uniformly. Take 1 jin of Tao Bai Pi (Pericarpium Persicae Mume, inner bark of peach tree), cook thoroughly, and pound. Add 3 zhan of water, squeeze out the juice. At any time, take half a zhan warm, mixed with 1 qian of powder.
Another method: Take 2 qian of Hua Shi powder, mixed with Cong Bai (Scallion White) water.
*Qian Jin Yi Fang*, treats women unable to urinate.
Xing Ren (Apricot Kernel, 7 grains, skin and tip removed).
Take this single herb, stir-fry with bran until yellow, grind into fine powder. Mix with water and take; urination will immediately flow.
Another method: Grind Zi Cao (Arnebia Root) into powder. Take three finger-pinches mixed with Jing Hua Shui (first-drawn well water at dawn); urination will immediately flow. It is also said that Zi Wan (Aster Root) can be used.
If sudden complete obstruction occurs, with lower abdominal distension and urgency, Qi rushing upward to the heart, causing suffocation and near-death sensation, this is due to abnormal Qi transmitting to the Bladder, or resulting from worry and fright, where Qi has no outlet, becomes depressed and closed, failing to flow, and rushes against the Bladder ligaments, causing misalignment. Pulse diagnosis reveals a choppy and small pulse on the right hand, and an urgent and large pulse on the left hand. Cong Bai Tang (Scallion White Decoction) is suitable.
Cong Bai Tang Formula:
Ju Pi (Citrus Reticulatae Pericarpium, 3 liang) Kui Zi (Malva Seeds, 1 liang) Cong Bai (Scallion White, 1 stalk).
Cut into pieces. Boil in 5 sheng of water until 2 sheng remain. Divide into three doses. (From *Zhi Mi Fang*).
*Bu Yi*: Grind Zi Jin Pi (Bark of Ziziphus Jujuba) into powder. Take 2 qian mixed with Cong Bai water. Kui Zi Tang (Malva Seed Decoction) is also acceptable.
Another method: For "Bao Zhuan" (uterine/bladder torsion) causing urinary obstruction, stir-fry 0.5 jin of salt, place in a bag, and apply hot compress to the lower abdomen.
[Xue Ji] Zi Shen Sheng Gan Yin (Nourish Kidney and Generate Liver Decoction):
Shan Yao (Dioscoreae Rhizoma, 1 qian) Shan Zhu Yu (Corni Fructus, flesh only, 1 qian) Shu Di Huang (Rehmanniae Radix Praeparata, self-made, 2 qian) Ze Xie (Alismatis Rhizoma) Fu Ling (Poria) Mu Dan Pi (Moutan Cortex) (each 0.7 fen) Wu Wei Zi (Schisandrae Fructus, pounded and stir-fried, 0.5 fen) Chai Hu (Bupleuri Radix, 0.3 fen) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Dang Gui (Angelicae Sinensis Radix) Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 0.3 fen).
Decoct in water and take.
Ba Wei Wan (Eight-Ingredient Pill with Rehmannia) treats "Pao Zhuan" with urinary obstruction, showing miraculous efficacy. However, it is rarely used in modern times, leading to many errors. (Formula see Miscellaneous Diseases: Deficiency and Emaciation.)
Another method: Grind Zhao Jiao (Gleditsiae Sinensis Fructus) into powder. Blow into the nose to induce sneezing.