钟大延治一贵家孕妇，小便秘，肿痛，面赤发喘，众医莫效。大延诊之曰∶是可弗药，乃胎压膀胱耳。令
其周身运转而瘳。（《宁波府志》。）
孙卓，浮梁人，素精歧黄。正德间，邑令以宸濠之变，先舆送其夫人避中山，病前秘五日，腹大如鼓，仰
面张目，息已微。急召孙，孙曰∶此盛暑急驱，饮水过度，羞溺而转脬也。法以猪尿脬吹气贯满，令女婢投入
冲之，而溺淋淋下遂起。（《江西通志》。）
孙文垣治一富家妇，大小便秘者三日。市师以巴豆丸二帖，大便泻而小便愈秘，胀闷脐突二寸余，前阴胀
裂，不可坐卧，啼泣呻吟，欲求自尽。孙曰∶此转脬病也。 树东行根皮一寸，滑石三钱，元胡索、桃仁、当
归、瞿麦各一钱，临服入韭菜汁半杯。服后食顷，小便稍行，玉户痛甚，非极用力努之则不能出。改用升麻、
桔梗、枳壳、元胡索，煎成调元明粉二钱，乃提清降浊之意。服后大小便俱行，始不胀急。次日报云∶每便时
腹先痛，有淡血水，小便短。再以丹参、丹皮、当归、白芍、甘草、青皮、香附、元胡、茯苓、山栀、山楂，
两帖而安。
孙君又有四卷七十七页一案，亦转脬病，治法大抵如前。惟多令患者横卧，界有力妇人，以患者两腿膝弯
架肩上，将下体虚空提起，摇摆数回，则尿脬倒上，徐徐放下。患者去衣不及，小便箭射而出，热如汤，黑如
墨，顷刻盈盆。（按∶转脬病，古人但令患者横卧榻上，高其下体，良久其尿自通，殊不费力。）
黄履素曰∶予窗友贺立庵方伯，常言其伯父贺岳精于医，曾治一孕妇将坐草，患小便不通，百药不效，愈
饮愈饱，束手待毙。贺君诊之曰∶此乃脾气虚弱，不能胜胞，故胞下压塞膀胱，以致水道不通，大健其脾则胞
举，而小便自通。以白术二两土炒，加炒砂仁数钱，别加一二辅佐之药，服一剂小便立通。其神如此，予常记
此言于怀中。王寅岁内人有妊，临月竟同此病，医疗无效，危甚。余以此法告医者，喜医虚心，如法治之立效，
遂举长子寅锡。余若不闻此言，母子均殆矣。（雄按；今夏钱希敏室人患此甚危，速余视之，脉甚滑数，睛赤口
干，与车前子、滑石、血余、栝蒌、知母、栀子、牛膝、紫草、沙苑，大剂投之。溺仍不行，竟产一男，既而
胞下，溲满其中。盖儿已出胞，频饮汤水，尽贮于中心。余虽初不料其如此，然设非开泄导下，则胎不即下。
而再加健脾燥补之药，则吉凶不可知矣，临证不亦难乎？）
李时珍尝治数人，小便不通，及转脬危急者，令将葱管吹盐入茎内，极有捷效。又小儿不尿，乃胎热也，
用大葱白切四片，乳汁半盏，同煎片时，分作四服即通。不小便者，服之即通。不饮乳者，服之即饮乳。若脐
四旁有青黑色皮口撮者，不可救也。（《本草纲目》。）
薛立斋治司徒李杏冈仲子室，孕五月，小便不利，诸药不应。薛曰∶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，患小便不通，小腹肿胀，几至于殆。用八味丸一服，小便滴沥。再以前药一料加车前子，
一剂即利，肚腹顿宽而安。
陆养愚治方思桂女，年十四，患大小便不通，已三日。村医与丸药数十粒，如芝麻大，服之大便立通而泻，
小便仍秘。又二日胀闷，脐下突出，胀时抽痛，不能坐卧，啼泣呻吟，欲求自尽。脉之沉数，而两尺尤甚，曰∶
此转脬病也。时尚炎热，以六一散，井水调服之，小便稍行，行时阴中极痛，后仍点滴不畅，大便努责而无积，
腹痛时作，痛则如刀刺。再诊，脉仍沉数，乃用升麻三分，柴、葛、甘、桔各一钱，以提清降浊。服后二便俱
行，小便纯血，大便亦带血水，其家犹危之。曰∶今无恙矣。向者丸药必巴豆也，病本热郁，而以极热之药攻
之，向之刺痛，今之溺血，皆巴毒使然也。以犀角地黄汤加黄连、山栀而愈。
万密斋治一娠妇，小便淋沥不通。医作转胞，治之不愈。乃用槟榔、赤芍二味研末，顺取长流水，煎汤调
服效。此方治男妇一切血淋，及淋涩水道疼痛，用之无不神效。
马元仪治沈氏外家，妊娠八月，下利二十余日，利后患小便淋闭，渴而引饮，饮毕方去滴许，涩痛异常，已
三昼夜。诊得肺脉独大，余脉虚涩，曰∶下利经久，脾阴必耗，燥火自强。今见肺脉独大，是火据肺位，金被
火制，气化不及州都，便溺何由而出？经曰病在下者治上，令上窍越，则下窍自行矣。且妊妇之体脉见虚涩，
气血不能养胎可知。若再行趋下，不惟病不除，且有胎动之患。因与紫菀五钱，专理肺气下及膀胱；干葛一钱，
升发胃气，敷布津液；火郁则气燥，以杏仁、苏子润之；燥胜则风生，以薄荷清之，加枳壳、桔梗开提三焦之
气。一剂小便如泉，再剂利下亦止。
吴桥治赵氏妇，故孱弱，有身七月，病不得大小溲。医者递以四苓利之，卒不利，久则小腹前后胀急痛楚，
躁乱昏愦，殆将不胜。桥诊之，则以补中益气汤加黄连为剂，一服小溲稍行。明日为汤液五斗，呼 壶者口授
之。扶病者坐临盘，递引汤沃病者腹。沃已，口授产妪举手捧其胎，大小溲即行，病愈矣。病得之食砒而吐未
尽，其遗毒触胎。病者故内虚，胎气下堕而压脬矣。或曰∶胎压脬而不得小溲，诚是也，大溲何为？桥曰∶
小溲塞则鼓膀胱，是将壅大肠，其气亦为不利故尔。闻者曰∶善。（《太函集》。）
钟大延治疗一位贵族家的孕妇，患者小便不通，伴有肿痛，面色发红且气喘，其他医生治疗均无效。钟大延诊察后说：“这不需要用药，是胎儿压迫膀胱所致。”让他全身活动运动，病就好了。（出自《宁波府志》。）
孙卓，浮梁人，向来精通中医医术。正德年间，县令因为宸濠之乱，先用轿子送他的夫人去中山避难，夫人患病前阴闭塞五天，腹部胀大如鼓，仰面瞪眼，气息微弱。急忙召请孙卓，孙卓说：“这是在盛暑中急行赶路，饮水过多，又因羞耻憋尿导致转脬（小便不通）。”治疗方法是用猪膀胱吹气使其充满，让女婢将其投入水中冲撞患者，于是小便淋漓而下，病情随即好转。（出自《江西通志》。）
孙文垣治疗一位富家妇女，大小便不通已有三天。市井医生给她服用了两帖巴豆丸，大便虽然泻下，但小便更加不通，腹胀闷塞，肚脐突出二寸多，前阴肿胀破裂，无法坐卧，哭泣呻吟，想要自杀。孙文垣说：“这是转脬病。”用树东行根皮一寸，滑石三钱，元胡索、桃仁、当归、瞿麦各一钱，服药时加入韭菜汁半杯。服用后过了一顿饭的时间，小便稍微通畅，但尿道疼痛剧烈，不用极大力气努挣则尿液不能排出。改用升麻、桔梗、枳壳、元胡索，煎好药后调入元明粉二钱，这是提升清气、降泄浊气的意思。服用后大小便都通了，腹胀急感才消除。第二天报告说：每次排尿时腹部先痛，有淡血水流出，小便短少。再用丹参、丹皮、当归、白芍、甘草、青皮、香附、元胡、茯苓、山栀、山楂，两帖后病情安定。
孙君还有另一卷第七十七页的一个医案，也是转脬病，治疗方法大体与上述相同。只是多让患者横卧，由有力气的妇人将患者的两腿膝盖弯架在肩上，将下身虚空提起，摇摆几次，使膀胱倒置，然后慢慢放下。患者来不及穿衣，小便像箭一样射出，热得像开水，黑得像墨汁，顷刻间就盈满盆子。（按语：转脬病，古人只让患者横卧在床上，抬高下半身，很久之后尿液自然通畅，并不费力。）
黄履素说：“我的朋友贺立庵方伯，常说他伯父贺岳精通医术，曾治疗一位即将分娩的孕妇，患小便不通，百药无效，越喝汤药越饱胀，束手待毙。贺岳诊断后说：“这是脾气虚弱，不能承载子宫，所以子宫下垂压迫堵塞膀胱，导致水道不通，大补脾气则子宫举起，小便自然通畅。”用土炒白术二两，加炒砂仁数钱，另外加一二种辅助药物，服用一剂小便立即通畅。其神奇如此，我常记在心里。王寅年岁末，我的妻子怀孕，临产时竟得了同样的病，医疗无效，情况危急。我把这个方法告诉医生，那位医生虚心接受，照此法治疗立即见效，于是生下了长子寅锡。我如果不听到这句话，母子都会危险。（按语：今年夏天钱希敏的妻子患此病非常危急，急忙让我诊治，脉象很滑数，眼睛红口干，给予车前子、滑石、血余炭、栝蒌、知母、栀子、牛膝、紫草、沙苑子，大剂量投药。小便仍然不行，最终生下一个男孩，随后胎盘脱落，尿液充满其中。原来孩子已经出胞，频繁饮用汤水，都储存在中心。我虽然起初没料到会这样，但如果不是开泄导下的方法，胎就不会立即下来。如果再加健脾燥湿补益的药物，吉凶就不可知道了，临床诊疗不也是很难吗？）
李时珍曾经治疗几个人，小便不通及转脬危急的情况，让他们将葱管吹盐进入尿道内，极有快速疗效。又有小儿不排尿，这是胎热所致，用大葱白切四片，乳汁半盏，一起煎煮片刻，分四次服用即通。不小便的，服用后即通。不喝奶的，服用后即喝奶。如果脐部四周有青黑色皮肤、口唇撮缩的，不可救药。（出自《本草纲目》。）
薛立斋治疗司徒李杏冈的二儿媳，怀孕五个月，小便不利，各种药物无效。薛立斋说：“非八味丸不能救。”家属不信，另用分利小便的药物，导致肚腹肿胀以致死亡。
儒生王文远的妻子，患小便不通，小腹肿胀，几乎危及生命。用八味丸一服，小便滴沥而出。再用前方一料加车前子，一剂即通利，肚腹顿时宽舒而安。
陆养愚治疗方思桂的女儿，十四岁，患大小便不通，已三天。村医给服了数十粒芝麻大的丸药，服用后大便立即通利并腹泻，小便仍然秘结。又过了两天腹胀闷，脐下突出，胀时抽痛，不能坐卧，哭泣呻吟，想要自杀。诊脉沉数，两尺脉尤其明显，说：“这是转脬病。”当时天气炎热，用六一散，井水调服，小便稍通，排尿时阴中极痛，后来仍点滴不畅，大便努责但没有积滞，腹痛时作，痛时如刀刺。再诊，脉仍沉数，于是用升麻三分，柴胡、葛根、甘草、桔梗各一钱，以提清降浊。服用后大小便都通，小便纯血，大便也带血水，家属依然担心。陆养愚说：“现在没事了。之前的丸药一定是巴豆，病本是热郁，却用极热的药攻伐，之前的刺痛，现在的溺血，都是巴豆毒性所致。”用犀角地黄汤加黄连、山栀而痊愈。
万密斋治疗一位孕妇，小便淋沥不通。医生当作转胞治疗，未愈。于是用槟榔、赤芍两味研成末，顺流长流水煎汤调服，见效。此方治疗男女一切血淋，以及淋涩水道疼痛，使用无不神效。
马元仪治疗沈氏的外家亲属，妊娠八月，腹泻二十多天，腹泻后患小便淋闭，口渴想喝水，喝完才吐出一滴少许，涩痛异常，已持续三昼夜。诊得肺脉独大，其余脉虚涩，说：“腹泻经久，脾阴必耗损，燥火自强。现在见肺脉独大，是火占据肺位，金被火克制，气化不及膀胱，小便如何能排出？经书说病在下者治上，令上窍开通，则下窍自行矣。况且孕妇的脉象见虚涩，可知气血不能养胎。如果再行趋下之法，不仅病除不了，还有胎动的祸患。”于是给予紫菀五钱，专门调理肺气下及膀胱；干葛一钱，升发胃气，敷布津液；火郁则气燥，用杏仁、苏子润之；燥胜则风生，用薄荷清之，加枳壳、桔梗开提三焦之气。一剂小便如泉涌，再剂腹泻也停止。
吴桥治疗赵氏妇人，原本体弱，怀孕七月，患不能大小便。医生依次用四苓散利小便，始终不利，久了则小腹前后胀急痛楚，烦躁昏愦，几乎不能承受。吴桥诊察后，用补中益气汤加黄连为剂，一服小便稍通。第二天准备五斗汤液，叫来壶者口授喂药。扶病人坐在盆上，轮流用汤水浇淋病人的腹部。浇完后，口授接生婆举手捧托其胎，大小便即通，病好了。这病是因为吃砒霜呕吐未尽，残留毒素触动胎气。病人本来内虚，胎气下堕压迫膀胱。有人说：“胎压膀胱导致不得小便，确实是这样，那为什么连大便也不通？”吴桥说：“小便堵塞则鼓胀膀胱，这将壅塞大肠，大肠的气机也不利，所以如此。”听的人说：“好。”（出自《太函集》。）
Zhong Dayan treated a pregnant woman from a noble family. The patient suffered from urinary retention accompanied by swelling and pain, flushed face, and panting. Other physicians failed to achieve any effect. After diagnosis, Zhong Dayan said, "Medication is not necessary; this is caused by the fetus pressing on the bladder." He instructed her to move her whole body, and she recovered. (From *Gazetteer of Ningbo Prefecture*.)
Sun Zhuo, a native of Fuliang, was well-versed in traditional Chinese medicine. During the Zhengde reign, due to the rebellion of Chen Hao, the county magistrate first sent his wife away in a sedan chair to Zhongshan. She fell ill with urinary retention for five days, her abdomen distended like a drum, eyes staring upward, and breath faint. Sun Zhuo was urgently summoned. He said, "This resulted from rushing in the intense heat, drinking excessive water, and holding urine due to shame, leading to *Zhuan Pao* (urinary retention)." The treatment method involved inflating a pig's bladder with air until full, then having a female servant throw it against the patient. Urine then flowed freely, and she recovered. (From *Gazetteer of Jiangxi*.)
Sun Wen Yuan treated a wealthy woman who had been unable to urinate or defecate for three days. A quack doctor administered two doses of *Radix Crotonis Tiglii* pills. Although she had a bowel movement, her urinary retention worsened. Her abdomen became bloated and stifling, with the umbilicus protruding over two inches. The external genitalia swelled and cracked, making sitting or lying down impossible. She cried, groaned, and wished to end her life. Sun Wen Yuan diagnosed, "This is *Zhuan Pao* disease." He prescribed one cun of root bark from the east side of a tree, three qian of *Talcum* (Hua Shi), and one qian each of *Rhizoma Corydalis Yanhu Suo* (Yan Hu Suo), *Peach Kernel* (Tao Ren), *Angelica Sinensis* (Dang Gui), and *Herba Diantherae* (Qu Mai). Half a cup of chive juice was added just before administration. After about the time it takes to eat a meal, urination slightly resumed, but urethral pain was severe, requiring extreme straining to pass urine. The prescription was changed to *Cimicifugae Rhizoma* (Sheng Ma), *Platycodon Root* (Jie Geng), *Aurantii Fructus Immaturus* (Zhi Ke), and *Rhizoma Corydalis Yanhu Suo*, decocted and mixed with two qian of *Mirabilite* (Yuan Ming Fen). This aimed to raise clear qi and descend turbid qi. After administration, both urination and defecation resumed, and abdominal distension subsided. The next day, it was reported that abdominal pain preceded urination, with pale bloody fluid discharge and scanty urine. A new prescription of *Salvia Miltiorrhiza* (Dan Shen), *Moutan Bark* (Dan Pi), *Angelica Sinensis*, *White Peony Root* (Bai Shao), *Licorice Root* (Gan Cao), *Green Tangerina Peel* (Qing Pi), *Cyperi Rhizoma* (Xiang Fu), *Rhizoma Corydalis Yanhu Suo*, *Poria* (Fu Ling), *Gardenia Fruit* (Shan Zhi), and *Hawthorn Fruit* (Shan Zha) was given for two doses, after which the condition stabilized.
Mr. Sun had another case record in Volume 4, page 77, also involving *Zhuan Pao*. The treatment was largely similar, except the patient was instructed to lie horizontally while a strong woman supported her legs bent at the knees on her shoulders, lifting the lower body into the air and shaking it several times to invert the bladder, then slowly lowering it. Before the patient could dress, urine shot out like an arrow, hot as boiling water and black as ink, filling a basin instantly. (Note: For *Zhuan Pao*, ancients simply had patients lie horizontally with their lower body elevated for a long time until urine passed naturally, without much effort.)
Huang Lvsu stated: "My friend, Fangbo He Li'an, often spoke of his uncle, He Yue, who was skilled in medicine. He once treated a pregnant woman near delivery who suffered from urinary retention. All medicines failed; the more she drank, the fuller she felt, leaving them helpless awaiting death. He Yue diagnosed, 'This is spleen qi deficiency failing to support the uterus, causing uterine prolapse compressing the bladder and blocking the water passages. Greatly tonifying the spleen will lift the uterus, and urination will resume.' He used two liang of earth-fried *Atractylodes Macrocephala Rhizome* (Bai Zhu), plus a few qian of fried *Amomum Villosum Fruit* (Sha Ren), along with one or two auxiliary herbs. One dose resulted in immediate urination. Its efficacy was miraculous, and I often kept this in mind. In the winter of the Year of Wang Yin, my wife, pregnant and nearing term, suffered the same illness. Medical treatments were ineffective, and the situation was critical. I informed the attending physician of this method. The physician accepted it humbly and applied it, resulting in immediate efficacy, and our eldest son, Yin Xi, was born. Had I not heard these words, both mother and child would have perished. (Note: This summer, the wife of Qian Ximin suffered severely from this illness. I was summoned urgently. Her pulse was slippery and rapid, eyes red, and mouth dry. I administered a large dose of *Plantago Seed* (Che Qian Zi), *Talcum*, *Scorched Human Hair* (Xue Yu Tan), *Trichosanthes Fruit* (Gua Lou), *Anemarrhena Rhizome* (Zhi Mu), *Gardenia Fruit*, *Achyranthes Root* (Niu Xi), *Arnebia Root* (Zi Cao), and *Astragalus Complanatus Seed* (Sha Yuan Zi). Urine still did not pass, and she eventually delivered a male infant. Subsequently, the placenta detached, and urine filled the cavity. It seems the child had already exited the womb, and frequent drinking of fluids accumulated in the center. Although I did not initially anticipate this, if I had not used draining and guiding methods, the fetus would not have been expelled quickly. If I had additionally used spleen-tonifying and drying/astringent herbs, the outcome would have been unpredictable. Is clinical practice not difficult?)
Li Shizhen once treated several cases of urinary retention and critical *Zhuan Pao*. He instructed blowing salt into the urethra through a scallion tube, achieving very rapid effects. For infants not urinating due to fetal heat, he sliced four pieces of large white scallion stalks, boiled them with half a cup of milk for a short while, divided into four doses, which restored urination. Those with urinary retention urinated immediately upon ingestion. Infants refusing breast milk began nursing after ingestion. However, if there were dark blue-black skin around the navel and puckering of the lips, the condition was incurable. (From *Compendium of Materia Medica*.)
Xue Lizhai treated the second daughter-in-law of Situ Li Xingang, who was five months pregnant and suffering from difficult urination. Various medicines failed. Xue Lizhai stated, "Only *Eight-Ingredient Pill with Rehmannia* (Ba Wei Wan) can save her." The family did not believe him and used diuretic drugs instead, leading to abdominal swelling and death.
The wife of scholar Wang Wenyuan suffered from urinary retention and abdominal distension, nearly dying. One dose of *Eight-Ingredient Pill with Rehmannia* resulted in dripping urination. A subsequent dose of the same formula added with *Plantago Seed* brought free urination, and the abdomen relaxed and comfort returned.
Lu Yang Yu treated the daughter of Fang Sigui, aged fourteen, who had not urinated or defecated for three days. A village doctor gave dozens of sesame-sized pills. While bowel movements resumed with diarrhea, urinary retention persisted. Two days later, abdominal distension increased, the area below the umbilicus protruded, cramping pain occurred, making sitting or lying impossible. She cried and wished to die. Her pulse was deep and rapid, especially in the chi positions. Lu said, "This is *Zhuan Pao* disease." Given the hot weather, he administered *Liu Yi San* (Six-to-One Powder) mixed with well water. Urination slightly resumed but was extremely painful in the vagina, followed by only drops. Straining for stool yielded no feces. Abdominal pain came in waves, feeling like knife stabs. Re-examination showed a deep, rapid pulse. He prescribed three fen of *Cimicifugae Rhizoma* and one qian each of *Bupleurum Root* (Chai Hu), *Kudzu Root* (Ge Gen), *Licorice Root*, and *Platycodon Root* to raise clear qi and descend turbid qi. After administration, both urination and defecation resumed. Urine was pure blood, and stool contained bloody fluid. The family remained worried. Lu said, "She is now safe. The previous pills must have contained *Radix Crotonis Tiglii*. The disease was originally heat stagnation, but extreme heat-inducing drugs were used. The previous stabbing pain and current hematuria are due to *Radix Crotonis Tiglii* toxicity." He cured her with *Xi Jiao Di Huang Tang* (Rhinoceros Horn and Rehmannia Decoction) added with *Coptis Rhizome* (Huang Lian) and *Gardenia Fruit*.
Wan Mizhai treated a pregnant woman with dribbling urinary retention. Physicians treated it as *Zhuan Bao* (uterine inversion/compression) without success. He used powdered *Areca Seed* (Bing Lang) and *Red Peony Root* (Chi Shao), decocted in flowing river water, which was effective. This formula treats all types of bloody strangury in men and women, as well as painful, obstructed urinary flow, with miraculous results.
Ma Yuanyi treated a relative of the Shen family, who was eight months pregnant. She had suffered diarrhea for over twenty days. Post-diarrhea, she developed urinary retention and strangury, thirst with desire to drink, yet vomiting small amounts after drinking, with abnormal涩 (astringent/painful) sensation for three days and nights. Her lung pulse was distinctly large, while other pulses were deficient and choppy. He said, "Prolonged diarrhea consumes spleen yin, allowing dryness-fire to flourish. The isolated large lung pulse indicates fire occupying the lung position, controlling metal. Qi transformation fails to reach the bladder (Zhou Du); how can urine be excreted? The Classics state: treat upper disorders for lower diseases. Opening the upper orifices allows the lower orifices to function. Moreover, the deficient and choppy pulse in pregnancy indicates insufficient qi and blood to nourish the fetus. Further downward-draining methods would fail to cure the disease and risk fetal movement." He prescribed five qian of *Aster Root* (Zi Wan) to regulate lung qi descending to the bladder; one qian of *Kudzu Root* (Gan Ge) to raise stomach qi and distribute fluids; *Apricot Seed* (Xing Ren) and *Perilla Fruit* (Su Zi) to moisten dryness caused by fire stagnation; *Mint* (Bo He) to clear wind generated by dryness; and *Aurantii Fructus Immaturus* and *Platycodon Root* to open and lift san jiao qi. One dose resulted in urine flowing like a spring; a second dose stopped the diarrhea.
Wu Qiao treated Mrs. Zhao, who was constitutionally weak and seven months pregnant, suffering from inability to urinate or defecate. Physicians sequentially used *Si Ling San* (Four-Poria Powder) to promote urination, but to no avail. Eventually, severe abdominal distension and pain occurred, with restlessness and confusion, nearly unbearable. Wu Qiao diagnosed and prescribed *Bu Zhong Yi Qi Tang* (Tonify the Middle and Augment the Qi Decoction) added with *Coptis Rhizome*. One dose allowed slight urination. The next day, he prepared five dou of liquid medicine, fed it orally via a flask spout. He had the patient sit over a basin and poured the warm liquid over her abdomen. Then, instructing the midwife to lift and support the uterus manually, both urination and defecation resumed, and she recovered. The illness originated from incomplete expulsion of arsenic poison after vomiting, which irritated the fetus. The patient's internal deficiency caused the fetus to descend and press on the bladder. Someone asked, "If fetal pressure causes urinary retention, why is defecation also blocked?" Wu Qiao replied, "Urinary blockage distends the bladder, which obstructs the large intestine, causing its qi mechanism to become unfavorable as well." The listener agreed. (From *Tai Han Ji*.)