〔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，是因为膀胱受到热邪逼迫，或者强行憋住小便，都会导致水气压迫膀胱，使膀胱屈曲闭塞，不能正常充盈扩张。此时，外部的尿液应入而不能入，内部的尿液应出而不能出，造成内外壅滞胀满不通，所以称为脬转。其症状表现为小腹部急痛，无法排尿，严重的甚至会导致死亡，难以治愈。
【薛己按语】上述病症，无论男女孕妇，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及主治方法。有一位妇人小便淋漓不尽，小腹胀闷，胸部满闷气喘急促，服用多种药物无效，我诊视认为是脬转之证，使用八味丸的药料煎服，小便随即通畅而痊愈。另一位妇人因郁怒，小便滴沥不畅，逐渐发展到小腹部肿胀，伴有痰多咳嗽、气喘急促，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，时时服用，喝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 叶（烧成灰但保留药性，一两） 滑石（研细，半两）
以上研磨均匀，用沸水调服二钱。
石韦汤，治疗的证候同上。
石韦（去毛） 车前子（各等分）
以上研为粗末，每次服用五钱，用水两盏，煎至一盏，去渣服用。
治疗妇人忍尿（憋尿），不能按时起解，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，调入一钱药粉服用。
又一方：用滑石末，葱汤调下二钱服用。
《千金翼方》，治疗妇人不得小便。
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，井华水（清晨第一次打的井水）调服三指撮的量，立即通畅。又说：紫菀也可以使用。
如果突然完全不通，小腹部膨隆急迫，气上冲心脏，胸闷窒息欲死，这是由于异气传并膀胱，或者因为忧惊，气机无处舒展，郁闭而不流动，气冲撞膀胱系带使其不正。诊察其脉象，右手脉涩小，左手脉急大，宜用葱白汤。
葱白汤方：
橘皮（三两） 葵子（一两） 葱白（一茎）
以上切碎，用水五升，煮取二升，分三次服用。（出自《指迷方》）
又一方：胞转（即脬转）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）
以上用水煎服。
八味丸，治疗脬转小便不通，非常有神效，只是世间很少使用，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 Lun] The disease of "Pao Zhuan" (bladder torsion or compression leading to urinary retention) in women is caused by the bladder being forced by heat pathogens, or by holding urine forcibly. Both conditions cause water qi to press upon the bladder, making it curl and close, preventing it from filling and expanding normally. Consequently, external fluids that should enter cannot enter, and internal urine that should exit cannot exit. This results in internal and external stagnation, distension, fullness, and blockage, hence the term "Pao Zhuan." Its manifestations include acute pain in the lower abdomen and inability to urinate; in severe cases, it can lead to death and is difficult to treat.
[Xue Ji's Commentary] Regarding the above symptoms, 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 details, please refer to the preceding and following discussions on treatment principles. One woman suffered from dribbling urine, lower abdominal distension and stuffiness, chest fullness, and rapid breathing. Various medicines failed to work. I diagnosed this as Pao Zhuan and prescribed Ba Wei Wan decoction. Her urination immediately became free, and she recovered. Another woman, due to depression and anger, experienced dripping urine that gradually progressed to lower abdominal swelling, accompanied by phlegm, cough, and shortness of breath. I prescribed Ba Wei Wan decoction. Her urination immediately became free, and she recovered.
[Da Lun] Hua Shi San (Talcum Powder Decoction, from *Qian Jin Fang*) treats Pao Zhuan in women and men, where urination has been blocked for several days.
Hua Shi (Talcum, 1 liang) Ning Shui Shi (Alumen, 2 liang) Kui Zi (Malva Seeds, 1 he).
Grind the above into powder. Boil in 10 dou of water until 5 sheng remain. Take frequently. After consuming 1 sheng, urination will become free.
Another prescription:
Luan Fa (Burnt Human Hair Ash, retaining its nature) Kui Zi (Malva Seeds) Che Qian Zi (Plantago Seeds) in equal parts.
Grind into fine powder. Take 2 qian each time, 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 wrapped in leaves, burnt ash retaining nature, 1 liang) Hua Shi (Talcum, ground fine, 0.5 liang).
Grind together uniformly. Mix 2 qian with boiling water and take.
Shi Wei Tang (Pyrrosia Leaf Decoction) treats the same condition as above.
Shi Wei (Pyrrosiae Folium, de-haired) Che Qian Zi (Plantaginis Semen) in equal parts.
Grind into coarse powder. Take 5 qian each time. Boil in 2 zhan of water until 1 zhan remains. Strain and take.
For women who hold their urine and do not void at appropriate times, causing Pao Zhuan, lasting four or five days, becoming critically ill and near death:
Hua Shi (Talcum, 2 liang) Luan Fa Hui (Ash of Burnt Human Hair, 1 liang).
Grind uniformly. Take 1 jin of Tao Bai Pi (Pericarpium Persicae Albugo), cook until soft, and pound well. Add 3 zhan of water, squeeze out the juice. At any time, take half a zhan warm, mixed with 1 qian of the powder.
Another prescription: Take 2 qian of Hua Shi powder, mixed with Cong Bai Tang (Scallion White Decoction).
*Qian Jin Yi Fang* treats women unable to urinate.
Xing Ren (Apricot Kernel, 7 grains, skin and tip removed).
Take this single ingredient, stir-fry with bran until yellow, grind into fine powder. Mix with water and take; urination will immediately flow freely.
Another prescription: Grind Zi Cao (Arnebiae Radix seu Lithospermi Radix) into powder. Mix with Jing Hua Shui (well water drawn at dawn) three finger-pinches amount and take; urination will immediately flow freely. It is also said that Zi Wan (Asteris Radix) can be used.
If sudden total obstruction occurs, with lower abdominal distension and urgency, Qi rushing up 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 strikes the ligaments of the bladder causing misalignment. Pulse diagnosis reveals a choppy and small pulse on the right hand, and a rapid and large pulse on the left hand. Use Cong Bai Tang (Scallion White Decoction).
Cong Bai Tang Formula:
Ju Pi (Citri Reticulatae Pericarpium, 3 liang) Kui Zi (Malvae Semen, 1 liang) Cong Bai (Allii Fistulosi Bulbus, 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 (Cortex Eucommiae treated with iron sulfate, often referred to as processed bark) into powder. Take 2 qian mixed with Cong Tang (Scallion Decoction). Kui Zi Tang (Malva Seed Decoction) is also acceptable.
Another prescription: For Bao Zhuan (Pao Zhuan) with urinary obstruction, stir-fry 0.5 jin of salt, place in a bag, and apply hot compress to the lower abdomen while hot.
[Xue Ji] Zi Shen Sheng Gan Yin (Nourish Kidney and Generate Liver Decoction):
Shan Yao (Dioscoreae Rhizoma) Shan Zhu Yu (Corni Fructus, flesh only, 1 qian each) Shu Di Huang (Prepared Rehmanniae Radix, homemade, 2 qian) Ze Xie (Alismatis Rhizoma) Fu Ling (Poria) Mu Dan Pi (Moutan Cortex, 0.7 qian each) Wu Wei Zi (Schisandrae Fructus, pounded and stir-fried, 0.5 qian) Chai Hu (Bupleuri Radix, 0.3 qian) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Dang Gui (Angelicae Sinensis Radix) Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.3 qian each).
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 practice, leading to many errors. (See Formula in Miscellaneous Diseases - Deficiency and Emaciation.)
Another prescription: Grind Zao Jiao (Gleditsiae Sinensis Spina) into powder. Blow into the nose to induce sneezing.