东垣滋肾丸治下焦阴虚脚膝无力阴汗阴痿足热不履地不渴而小便闭
黄柏(酒洗焙) 知母(酒洗焙各一两) 肉桂(二钱)
上为末水丸如桐子大每服百丸加至二百丸煎百沸汤送下
白花散治小便不通膀胱蕴热
朴硝
上为末每二钱煎茴香汤调下食前服
按以上并血分药也
清肺散治渴而小便 或黄或涩
五苓散加琥珀(半钱) 灯芯(一分) 木通(七分) 通草(一分) 车前子(炒一分) 瞿麦
(半钱) 蓄(七分)
上为细末每五钱水煎食前服作汤亦可
红秫散治小便不通止喘
红秫黍根(一两) 蓄(一两半) 灯草(一百根三寸长)
上 咀每五钱长流水煎服
按以上并气分药也
黄芩清肺饮治肺燥而小便不通
黄芩(一钱) 栀子(三个打破)
上 咀长流水煎服不利加盐豉二十粒
滋阴化气汤治因服热药过多小便不利诸药不效或脐下 痛难忍
黄连 黄柏(各炒) 甘草(炙等分)
上 咀每五钱水煎食前服如不通加知母
按此二方助阴药也
千金方茯苓丸治胞痹小便内痛
赤茯苓 防风 细辛 白术 附子(炮) 泽泻 官桂(各半两) 天花粉 紫菀 牛膝(
酒浸) 黄 芍药 甘草(炙各三分) 生地黄 山茱萸 山药 独活 半夏(各一分)
上末蜜丸梧子大每十丸温酒送下食前服
巴戟丸治胞痹脐腹痛小便不利
巴戟(去心一两半) 桑螵蛸(麸炒黑) 远志(去心) 山芋 生地黄 附子(炮) 续断
肉苁
蓉(酒浸各一两) 杜仲(炒) 石斛 鹿茸(酥炙) 龙骨 五味子 菟丝子(酒浸) 山茱萸
桂(各二分)
上十六味细末蜜丸梧子大每三十丸空心酒下
肾沥汤治胞痹小腹急小便不利
麦门冬 木通 桔梗 桑白皮 杜仲(炒) 犀角屑 五加皮(各一两) 赤芍(五钱)
上 咀每五钱水煎加羊肾一个竹沥少许
宣明肾者汤治胞痹证小腹膀胱按之内痛若沃以汤涩于小便上为清涕不止者
赤茯苓 白术(各四两) 甘草(炙三两) 干姜(炮二两)
上为末每五钱水煎温服日三
按此四方当分寒热之异选使然肠痹亦有腹痛飧泄小便秘涩者宣明论有证治例详见本论又
可见小便不利非止胞痹为患也
李东垣的滋肾丸用于治疗下焦阴虚导致的脚膝无力、阴部出汗、阳痿、足底发热至无法着地、口不渴但小便闭塞。
药材：黄柏（酒洗后焙干）、知母（酒洗后焙干，各一两）、肉桂（二钱）。
将上述药材研为细末，用水泛丸，如梧桐子大小。每次服用一百丸，可加至二百丸，用煮沸百次的白开水送服。
白花散用于治疗小便不通，因膀胱蕴积热邪所致。
药材：朴硝。
将上述药材研为细末，每次取二钱，用茴香汤煎煮调服，饭前服用。
按语：以上方剂均属于调理血分的药物。
清肺散用于治疗口渴且小便异常，或色黄或涩滞不畅。
药材：五苓散加入琥珀（半钱）、灯芯草（一分）、木通（七分）、通草（一分）、车前子（炒制，一分）、瞿麦（半钱）、萹蓄（七分）。
将上述药材研为细末，每次取五钱，加水煎煮，饭前服用；也可改为汤剂煎服。
红秫散用于治疗小便不通兼有喘息。
药材：红秫黍根（一两）、萹蓄（一两半）、灯心草（一百根，每根三寸长）。
将上述药材切碎，每次取五钱，用长流水煎煮后服用。
按语：以上方剂均属于调理气分的药物。
黄芩清肺饮用于治疗肺燥导致的小便不通。
药材：黄芩（一钱）、栀子（三个，打破）。
将上述药材切碎，用长流水煎煮服用。若服药后小便仍不利，加盐豉二十粒。
滋阴化气汤用于治疗因服用过多热性药物导致的小便不利，且其他药物治疗无效，或脐下疼痛难忍的情况。
药材：黄连、黄柏（各炒制）、甘草（炙制，等分）。
将上述药材切碎，每次取五钱，加水煎煮，饭前服用。若小便仍不通，加知母。
按语：这两个方剂属于辅助滋阴的药物。
《千金方》中的茯苓丸用于治疗胞痹，表现为小便时内部疼痛。
药材：赤茯苓、防风、细辛、白术、附子（炮制）、泽泻、官桂（各半两）、天花粉、紫菀、牛膝（酒浸）、黄芪、芍药、甘草（炙制，各三分）、生地黄、山茱萸、山药、独活、半夏（各一分）。
将上述药材研为细末，用蜂蜜制成梧桐子大小的丸剂。每次服用十丸，用温酒送服，饭前服用。
巴戟丸用于治疗胞痹引起的脐腹疼痛和小便不利。
药材：巴戟天（去心，一两半）、桑螵蛸（麸炒至黑）、远志（去心）、山芋、生地黄、附子（炮制）、续断、肉苁蓉（酒浸，各一两）、杜仲（炒制）、石斛、鹿茸（酥炙）、龙骨、五味子、菟丝子（酒浸）、山茱萸、桂枝（各二分）。
将上述十六味药材研为细末，用蜂蜜制成梧桐子大小的丸剂。每次服用三十丸，空腹时用酒送服。
肾沥汤用于治疗胞痹，表现为小腹拘急、小便不利。
药材：麦门冬、木通、桔梗、桑白皮、杜仲（炒制）、犀角屑、五加皮（各一两）、赤芍（五钱）。
将上述药材切碎，每次取五钱，加水煎煮，加入一个羊肾和少许竹沥汁。
《宣明论》中的肾者汤用于治疗胞痹证，表现为小腹及膀胱部位按压时内部疼痛，感觉像被热水浇淋一样，小便涩滞，同时伴有鼻涕不止的症状。
药材：赤茯苓、白术（各四两）、甘草（炙制，三两）、干姜（炮制，二两）。
将上述药材研为细末，每次取五钱，加水煎煮，温服，每日三次。
按语：以上四个方剂应当根据寒热的不同进行选择使用。此外，肠痹也有腹痛、完谷不化的泄泻以及小便便秘涩滞的表现，《宣明论》中有相关的证治条例，详见本论。这也可见小便不利并非仅由胞痹引起。
Li Dongyuan's Zishen Wan (Nourishing Kidney Pill) is used to treat weakness of the lower limbs and knees, sweating in the genital area, impotence, heat sensation in the feet preventing them from touching the ground, absence of thirst, but with urinary retention, caused by Yin deficiency in the Lower Jiao (Lower Burner).
Herbs: Huangbai (Phellodendri Cortex, processed with wine and dried), Zhimu (Anemarrhenae Rhizoma, processed with wine and dried, each 1 liang), Rougui (Cinnamomi Cortex, 2 qian).
Grind the above herbs into fine powder, make pills with water, sized like tung tree seeds. Take 100 pills per dose, increasing up to 200 pills, taken down with boiled water.
Baihua San (White Flower Powder) is used to treat urinary obstruction due to heat accumulation in the Bladder.
Herb: Puxiao (Mirabilitum).
Grind the above herb into fine powder. Take 2 qian per dose, mixed with Fennel Decoction, taken before meals.
Note: The above formulas belong to drugs regulating the Blood aspect.
Qingfei San (Clear Lung Powder) is used to treat thirst accompanied by abnormal urination, where urine is either yellow or difficult to pass.
Formula: Wuling San (Five-Ingredient Powder with Poria) added with Hupo (Succinum, half qian), Dengxincao (Junci Medulla, 1 fen), Mutong (Akebiae Caulis, 7 fen), Tongcao (Tetrapanacis Medulla, 1 fen), Cheqianzi (Plantaginis Seed, stir-fried, 1 fen), Qumai (Dianthi Herba, half qian), Pianchu (Polygoni Avicularis Herba, 7 fen).
Grind the above herbs into fine powder. Take 5 qian per dose, decoct with water, take before meals; can also be prepared as a decoction.
Hongshu San (Red Sorghum Powder) is used to treat urinary obstruction accompanied by asthma/wheezing.
Herbs: Hongshushugen (Root of Red Sorghum, 1 liang), Pianchu (Polygoni Avicularis Herba, 1.5 liang), Dengcao (Junci Strobilus, 100 stalks, 3 cun long each).
Cut the above herbs roughly. Take 5 qian per dose, decoct with flowing water, and take.
Note: The above formulas belong to drugs regulating the Qi aspect.
Huangqin Qingfei Yin (Scutellaria Clearing Lung Decoction) is used to treat urinary obstruction due to Lung dryness.
Herbs: Huangqin (Scutellariae Radix, 1 qian), Zhizi (Gardeniae Fructus, 3 pieces, broken).
Cut the above herbs roughly, decoct with flowing water, and take. If urination remains difficult, add Yanchi (Salted Soybean Ferment, 20 grains).
Ziyin Huaqi Tang (Nourishing Yin and Transforming Qi Decoction) is used to treat difficult urination caused by excessive intake of hot-natured medicines, where other treatments are ineffective, or unbearable pain below the umbilicus.
Herbs: Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex, both stir-fried), Gancao (Licorice Root, honey-fried, equal parts).
Cut the above herbs roughly. Take 5 qian per dose, decoct with water, take before meals. If urination does not improve, add Zhimu (Anemarrhenae Rhizoma).
Note: These two formulas assist in nourishing Yin.
Fuling Wan (Poria Pill) from *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) is used to treat Bao Bi (Bladder Obstruction) characterized by internal pain during urination.
Herbs: Chifuling (Polyporus with Red Host, 0.5 liang), Fangfeng (Saposhnikoviae Radix, 0.5 liang), Xixin (Asari Radix et Rhizoma, 0.5 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 0.5 liang), Fuzi (Aconiti Lateralis Radix Praeparata, processed, 0.5 liang), Zexie (Alismatis Rhizoma, 0.5 liang), Guangui (Cinnamomi Ramulus, 0.5 liang), Tianhuafen (Trichosanthis Radix, 0.5 liang), Ziwan (Asternis Radix, 0.5 liang), Niuxi (Achyranthis Bidentatae Radix, wine-soaked, 0.5 liang), Huangqi (Astragali Radix, 0.5 liang), Shaoyao (Paeoniae Radix, 0.5 liang), Gancao (Licorice Root, honey-fried, 3 fen), Shengdihuang (Rehmanniae Radix, 0.5 liang), Shanzhuyu (Corni Fructus, 0.5 liang), Shanyao (Dioscoreae Rhizoma, 0.5 liang), Duhuo (Angelicae Pubescentis Radix, 0.5 liang), Banxia (Pinelliae Rhizoma, 1 fen).
Grind the above herbs into powder, make pills with honey, sized like tung tree seeds. Take 10 pills per dose, taken down with warm wine, before meals.
Ba Ji Wan (Morinda Pill) is used to treat Bao Bi (Bladder Obstruction) causing abdominal pain around the navel and difficult urination.
Herbs: Bajitian (Morindae Officinalis Radix, heart removed, 1.5 liang), Sangpiaoxiao (Mantis Ootheca, stir-fried with bran until black), Yuanzhi (Polygalae Radix, heart removed), Shanyu (Dioscoreae Rhizoma), Shengdihuang (Rehmanniae Radix), Fuzi (Aconiti Lateralis Radix Praeparata, processed), Xuduan (Drynariae Rhizoma), Rongrong (Cistanches Herba, wine-soaked, each 1 liang), Duzhong (Eucommiae Cortex, stir-fried), Shihu (Dendrobii Caulis), Lurong (Cervi Cornu Degelatinatum, roasted with butter), Longgu (Fossilia Ossis Mastodi et Scapulae), Wuweizi (Schisandrae Fructus), Tusizi (Cuscutae Semen, wine-soaked), Shanzhuyu (Corni Fructus), Guizhi (Cinnamomi Ramulus, each 2 fen).
Grind the above sixteen herbs into fine powder, make pills with honey, sized like tung tree seeds. Take 30 pills per dose, taken on an empty stomach with wine.
Shenli Tang (Kidney Drip Decoction) is used to treat Bao Bi (Bladder Obstruction) presenting with urgency in the lower abdomen and difficult urination.
Herbs: Maimendong (Ophiopogonis Radix, 1 liang), Mutong (Akebiae Caulis, 1 liang), Jiegeng (Platycodonis Radix, 1 liang), Sangbaipi (Mori Cortex, 1 liang), Duzhong (Eucommiae Cortex, stir-fried, 1 liang), Xijiaoxie (Rhinocerotis Cornu, sliced, 1 liang), Wujiaopi (Acanthopanacis Cortex, 1 liang), Chishao (Paeoniae Radix Rubra, 5 qian).
Cut the above herbs roughly. Take 5 qian per dose, decoct with water, add one sheep kidney and a small amount of Zhuli (Bamboo Sap).
Shenzhe Tang (Kidney Master Decoction) from *Xuanming Lun* (Treatise on Clarifying the Mystery) is used to treat Bao Bi (Bladder Obstruction) syndrome, characterized by internal pain upon pressing the lower abdomen and bladder, feeling as if scalded by hot water, difficulty in urination, and continuous clear nasal discharge.
Herbs: Chifuling (Polyporus with Red Host, 4 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 4 liang), Gancao (Licorice Root, honey-fried, 3 liang), Ganjiang (Zingiberis Rhizoma, processed, 2 liang).
Grind the above herbs into powder. Take 5 qian per dose, decoct with water, take warm, three times daily.
Note: The above four formulas should be selected based on the differentiation of cold and heat patterns. Additionally, Chang Bi (Intestinal Obstruction) may also present with abdominal pain, diarrhea with undigested food, and difficult/obstructed urination. *Xuanming Lun* has detailed examples of symptoms and treatments for these conditions, which can be found in this chapter. This also illustrates that difficult urination is not solely caused by Bao Bi (Bladder Obstruction).