人有小便不通，点滴不能出，急闷欲死，心烦意躁，口渴索饮，饮而愈急，
人以为小肠之热极也，谁知是心火之亢极乎。夫心与小肠为表里，小肠热极而癃闭，乃热在
心而癃闭也。盖小肠之能开阖者，全责于心肾之气相通也。今心火亢热，则清气不交于小肠，
惟烈火之相迫，小肠有阳无阴，何能传化乎。小肠既不能传化，膀胱何肯代小肠以传化耶。
况心肾之气，既不入于小肠，亦何能入于膀胱，以传化夫水哉。治法泻心中之火，兼利其膀
胱，则心肾气通，小便亦通矣。方用凉心利水汤∶
麦冬（一两） 茯神（五钱） 莲子心（一钱） 车前子（三钱）水煎服。二剂水出
如注，四剂全愈。
此方补心之药，即凉心之药也。在心既无太亢之虞，在小肠又宁有大干之患。况又有滑
利澹渗之味以通其水，则心气自交于肾，肾气自交于膀胱，气化易于出水，岂尚有不通之苦哉。
人有小肠不通，眼睛突出，面红耳热，口渴引饮，烦躁不宁，人以为上焦之火盛也，谁
知是膀胱之火旺乎。夫膀胱与肾为表里，膀胱必肾气相通，而后能化水，是膀胱之火，即肾中
命门之火也。膀胱无火不能化水，何火盛反闭结乎？不知膀胱
得正火，则水易分消，得邪火而水难通利。盖膀胱乃太阳之经也，太阳最易入邪，一入邪而
寒变为热。热结于膀胱，乃邪将散之时也。邪既将散，宜火随溺而泄矣，何反成闭结之症？盖
因邪将出境，惟恐截杀去路，故作威示强，屯住于膀胱耳。治法不必泄肾火，但利膀胱，则
邪去如扫。方用导水散∶
王不留行（五钱） 泽泻（三钱） 白术（三钱）水煎服。一剂通达如故，不必二剂。
此方逐水至神，因王不留行性速善走，故用之以祛除耳。闭原在膀胱，利膀胱而闭自开，
何用张皇轻投迅利之剂耶。
人有小便闭结，点滴不通，小腹作胀，然而不痛，上焦无烦躁之形，胸中无闷乱之状，
口不渴，舌不干，人以为膀胱之水闭也，谁知是命门之火塞乎。夫膀胱者决渎之官，肾中气化
而能出，此气即命门之火也。命门火旺，而膀胱之水通；命门火衰，而膀胱之水闭矣。或曰∶
小水之勤者，由于命门之火衰也。火衰正宜小便大利，何反至于闭塞也？不知命门之火，
必得肾水以相养，肾水衰而火乃旺，火旺者，水无力以制之也。无水之火，火虽旺而实衰；无
火之水，水欲通而反塞。命门火衰而小水勤，衰之极者，勤之极；勤之极者，闭之极也。人
见其闭，错疑是膀胱之火，
反用寒剂，愈损其命门之火，膀胱之气益微，何能化水改投利水之药，转利转虚矣。治法必
须助命门之火然徒助命门之火，恐有阳旺阴消之虑，必须于水中补火，则火生于水之中，水
即通于火之内耳。方用八味地黄汤∶
熟地（一两） 山茱萸（五钱） 丹皮（三钱） 山药（五钱） 泽泻（三钱） 伏苓（
五钱） 肉桂（三钱） 附子（一钱）水煎服。一服即如注。
八味汤乃水中补火之圣药也。水中补火，而火无大炎之惧；火中通水，而水无竭泽之虞。
即久闭而至于胞转，以此方投之，无不奏功于眉睫，况区区闭结哉。
此症用行水汤亦甚效。
熟地（二两） 巴戟天 茯神 芡实（各一两） 肉桂（二钱）水煎服。
人有小便不通，目睛突出，腹胀如鼓，膝以上坚硬，皮肤欲裂，饮食不下，独口不渴，
服甘淡渗泄之药皆无功效。人以为阳盛之极也，谁知是阴亏之至乎。夫阴阳不可离也。淡甘
渗泄之药，皆阳药也。病是无阴，而用阳药宜乎，阴得阳而生矣。然而无阴者，无阴中之
至阴也。阴中之至阴，必得阳中之至阳而后化。小便之不通，膀胱之病也。膀胱为津液之
府，必气化乃能出。是气也，即阳中至阳之气也。原藏
于至阴之中，至阳无至阴之气，则孤阳无阴，何以化水哉。治法补其至阴，而阳自化也。
方用纯阴化阳汤∶
熟地（一两） 玄参（三两） 肉桂（二分） 车前子（三钱）水煎服。一剂小便如
涌泉，再剂而闭如失。
此方又胜于滋肾丸，以滋肾丸用黄柏、知母苦寒之味以化水，不若此方用微寒之药以
化水也。论者谓病势危急，不宜用补以通肾，且熟地湿滞，不增其闭涩之苦哉。讵知肾有
补无泻，用知母、黄柏反泻其肾，不虚其虚乎。何若用熟地纯阴之品，得玄参濡润之助。既
能生阴又能降火，攻补兼施，至阳得之，如鱼得水，化其亢炎而变为清凉，安得不崩决而
出哉。或谓既用熟地、玄参以生阴，则至阳可化，何必又用肉桂、车前子多事。然而药是纯
阴，必得至阳之品以引入于至阳，而又有导水之味，同群共济，所以既能入于阳中，又能出
于阳外也。矧肉桂止用其气以入阳，而不用其味以助阳，实有妙用耳。
此症用加生化肾汤亦神。
熟地（四两） 生地（二两） 肉桂（三分）水煎服。
人有小便不出，中满作胀，口中甚渴，投以利水之药不应，人以为膀胱之火旺也，谁
知是肺气之干燥乎。夫膀胱者，州都之官，津液藏焉，气化则能出矣。上焦之气不化，由于
肺气之热也。肺热则金燥而不能生水，投以利水之药，益耗其肺气，故愈行水而愈不得水
也。治法当益其肺气，助其秋令，水自生焉。方用生脉散治之。
人参（一两） 麦冬（二两） 北五味子（一钱） 黄芩（一钱）水煎服。二剂而水通矣。
生脉散补肺气以生金，即补肺气以生水是矣。何加入黄芩以清肺，不虑伐金以伤肺乎。
不知天令至秋而白露降，是天得寒以生水也。人身肺金之热，不用清寒之品，何以益肺以生
水乎。此黄芩之必宜加入于生脉散中，以助肺金清肃之令也。
此症用麦冬茯苓汤∶
麦冬（三两） 茯苓（五钱）水煎服。
人有饮食失节，伤其胃气，遂至小便不通，人以为肺气之虚也，谁知是胃气下陷于下焦，
不能升举之故乎。夫膀胱必得气化而始出，气升者，即气化之验也。气之升降，全视乎气之
盛衰，气盛则清气升，而浊气降；气衰则清气不升，而浊气不降矣。若胃者多气之府也，群
气皆统之，胃气之盛衰，尤为众气之盛衰也。所以胃
气一虚，各经众气多不能举。故脾胃虚而九窍皆为之不通，岂独前阴之闭水哉。治法必须提其
至阳之气，而提气必从胃始也。方用补中益气汤∶
人参（二钱） 黄 （三钱） 白术（三钱） 当归（二钱） 甘草（一钱） 陈皮（二
分） 柴胡（一钱） 升麻（五分）
水煎服。一剂而小便通矣，再剂全愈。
此方用参、 甘温之味，补其胃气；以升麻、柴胡从化原之下而升提之，则清升浊降，
而肺气不虚，自能行其清肃之令，何至有闭结之患哉。
有一位患者小便完全不通，点滴无法排出，急迫憋闷几乎要死去，心烦意乱，口渴想喝水，但喝下去后症状反而更加急迫。人们认为这是小肠热到了极点，却不知这是心火亢盛到了极点。因为心与小肠互为表里，小肠热极导致癃闭（排尿困难或闭塞），实际上是心热导致的癃闭。大概小肠能够开阖，全赖于心肾之气相通。现在心火亢盛炽热，清气就不能交合于小肠，只有烈火相互逼迫，小肠有阳无阴，怎么能传导化气呢？小肠既然不能传导化气，膀胱怎么会代替小肠来传导化气呢？况且心肾之气既然不能进入小肠，又怎么能进入膀胱来传导化水液呢？治疗方法是泻心中之火，同时利导膀胱，那么心肾之气就能通畅，小便也就通了。方剂用凉心利水汤：麦冬（一两）、茯神（五钱）、莲子心（一钱）、车前子（三钱），用水煎服。两剂药后，尿液像水流一样涌出，四剂药后完全痊愈。
这个方子补心的药物，也就是凉心的药物。在心既没有过于亢盛的忧虑，在小肠又怎么会有大的干扰祸患呢？况且又有滑利淡渗的味道来通利水道，那么心气自然交合于肾，肾气自然交合于膀胱，气化容易使水液排出，哪里还会有不通畅的痛苦呢？
有一位患者小肠不通，眼睛突出，面色红赤，耳朵发热，口渴引饮，烦躁不安，人们认为这是上焦火盛，却不知这是膀胱火旺。因为膀胱与肾互为表里，膀胱必须与肾气相通，然后才能化水，所以膀胱的火，就是肾中命门之火。膀胱没有火就不能化水，为什么火盛反而闭结呢？不知道膀胱得到正火，则水液容易分消；得到邪火，则水液难以通利。大概膀胱是太阳经，太阳经最容易受邪气侵袭，一旦受邪，寒就会变成热。热结在膀胱，是邪气将要消散的时候。邪气既然将要消散，应该随着尿液一起泄出，为什么反而形成闭结的症状？这是因为邪气即将离开身体，唯恐被截断去路，所以故作威风示强，屯驻在膀胱罢了。治疗方法不必泄肾火，只要利导膀胱，那么邪气去除就像扫除一样快。方剂用导水散：王不留行（五钱）、泽泻（三钱）、白术（三钱），用水煎服。一剂药后通达如常，不需要第二剂。
这个方子逐水非常神奇，因为王不留行性速善走，所以用它来祛除邪气。闭结的根源在膀胱，利导膀胱而闭结自然打开，何必惊慌失措地轻率投用迅利猛烈的药剂呢？
有一位患者小便闭结，点滴不通，小腹胀痛，但是不疼痛，上焦没有烦躁的表现，胸中没有闷乱的感觉，口不渴，舌不干，人们认为是膀胱的水液闭阻，却不知这是命门之火塞滞所致。膀胱是决渎之官（主管水道流通的器官），肾中气化才能排出，这气就是命门之火。命门火旺，膀胱之水就通畅；命门火衰，膀胱之水就闭结。有人问：小便频数，是由于命门之火衰微。火衰正应该让小便大利，为什么反而至于闭塞呢？不知道命门之火，必须得到肾水的滋养，肾水衰微而火才显得旺盛，火旺是因为水无力制约它。没有水火的火，虽然旺但实际上是衰微；没有火的水，水想要通畅反而被塞住。命门火衰而小便频数，衰微到极点，就是频数到极点；频数到极点，就是闭结到极点。人们看到其闭结，错误地怀疑是膀胱之火，反而使用寒凉药剂，更加损伤命门之火，膀胱之气更加微弱，怎么能化水呢？改投利水药物，越利水越虚损。治疗方法必须助长命门之火，然而如果徒然助长命门之火，恐怕有阳气旺盛阴液消减的顾虑，必须在水中进行补火，那么火就生于水中，水就在火之内通畅了。方剂用八味地黄汤：熟地黄（一两）、山茱萸（五钱）、牡丹皮（三钱）、山药（五钱）、泽泻（三钱）、茯苓（五钱）、肉桂（三钱）、附子（一钱），用水煎服。服用一剂后立即像水流一样涌出。
八味汤是在水中补火的圣药。在水中补火，就没有大火燃烧的恐惧；在火中通利水液，就没有水枯竭的忧虑。即使是久闭导致胞转（膀胱扭转或功能丧失），以此方投用，无不立刻见效，何况是普通的闭结呢？
此症使用行水汤也非常有效。熟地黄（二两）、巴戟天、茯神、芡实（各一两）、肉桂（二钱），用水煎服。
有一位患者小便不通，眼睛突出，腹部胀大如鼓，膝盖以上坚硬，皮肤紧绷欲裂，饮食不下，唯独口不渴，服用甘淡渗泄的药物都没有功效。人们认为是阳盛到了极点，却不知这是阴亏到了极点。阴阳是不可分离的。甘淡渗泄的药物，都是阳药。病是无阴，而用阳药，按理说阴得阳而生。然而无阴者，是无阴中的至阴。阴中之至阴，必须得到阳中的至阳才能化生。小便不通，是膀胱的病。膀胱是津液之府，必须气化才能排出。这气，就是阳中的至阳之气。原本藏于至阴之中，至阳如果没有至阴之气，就是孤阳无阴，怎么能化水呢？治疗方法是补其至阴，而阳自然能化生。方剂用纯阴化阳汤：熟地黄（一两）、玄参（三两）、肉桂（二分）、车前子（三钱），用水煎服。一剂药后小便像涌泉一样流出，再剂药后闭结消失。
这个方子又胜于滋肾丸，因为滋肾丸用黄柏、知母苦寒的味道来化水，不如这个方子用微寒的药物来化水。论者说病势危急，不宜用补法来通肾，而且熟地黄湿滞，不是增加其闭涩的痛苦吗？哪里知道肾有补无泻，用知母、黄柏反而是泻其肾，使其更虚吗？何如用熟地黄纯阴之品，得到玄参濡润的帮助。既能生阴又能降火，攻补兼施，至阳得到它，如鱼得水，化其亢炎而变为清凉，怎么能不崩决而出呢？有人说既然用熟地黄、玄参以生阴，那么至阳可以化生，何必又用肉桂、车前子多此一举。然而药是纯阴，必须得到至阳之品以引入于至阳，而且又有导水的味道，同群共济，所以既能入于阳中，又能出于阳外。况且肉桂只取其气以入阳，而不取其味以助阳，实在有妙用。
此症使用加生化肾汤也很神奇。熟地黄（四两）、生地黄（二两）、肉桂（三分），用水煎服。
有一位患者小便不出，中焦满闷作胀，口中很渴，投用利水药物不应验，人们认为是膀胱之火旺，却不知是肺气干燥。膀胱是州都之官（首都般的器官，指膀胱汇聚津液），津液藏在那里，气化才能排出。上焦之气不化，是由于肺热的缘故。肺热则金燥而不能生水，投用利水药物，更加耗损肺气，所以越行水越得不到水。治疗方法应当益补肺气，助其秋令，水自然生成。方剂用生脉散治疗：人参（一两）、麦冬（二两）、北五味子（一钱）、黄芩（一钱），用水煎服。两剂药后水液通畅了。
生脉散补肺气以生金，也就是补肺气以生水。为什么加入黄芩以清肺，不担心伐金伤肺吗？不知道天时到秋天白露下降，是天得到寒冷以生水。人身肺金的热，不用清寒之品，怎么能益肺以生水呢？这就是黄芩必须加入生脉散中，以助肺金清肃命令的原因。
有一位患者饮食失节，伤了胃气，以至于小便不通，人们认为是肺气虚，却不知是胃气下陷于下焦，不能升举的缘故。膀胱必须得到气化才开始排出，气升，就是气化的验证。气的升降，全看气的盛衰，气盛则清气升，浊气降；气衰则清气不升，浊气不降。若胃是多气的府库，众气都统摄它，胃气的盛衰，尤为众气盛衰的关键。所以胃气一虚，各经众气大多不能举升。因此脾胃虚而九窍都不通，难道只是前阴闭水吗？治疗方法必须提举至阳之气，而提气必须从胃开始。方剂用补中益气汤：人参（二钱）、黄芪（三钱）、白术（三钱）、当归（二钱）、甘草（一钱）、陈皮（二分）、柴胡（一钱）、升麻（五分），用水煎服。一剂药后小便通利，再剂药后完全痊愈。
这个方子用人参、黄芪甘温的味道，补其胃气；用升麻、柴胡从原气之下而升提之，那么清升浊降，肺气不虚，自然能行其清肃的命令，哪里有闭结的祸患呢？
A patient presents with complete inability to urinate, unable to pass even a drop, suffering from urgent distension as if about to die, mental restlessness, thirst desiring drink, yet drinking exacerbates the urgency. People assume this is extreme heat in the Small Intestine (Small Intestine), but little do they know it is hyperactivity of Heart Fire (Heart Fire). The Heart and Small Intestine are exterior-interiorly related; when the Small Intestine suffers from extreme heat leading to retention of urine (Ling Bi), it is actually heat in the Heart causing the retention. The opening and closing of the Small Intestine rely entirely on the communication between Qi of the Heart and Kidney. Now, with hyperactive and scorching Heart Fire, clear Qi cannot interact with the Small Intestine; only fierce fire presses upon it. The Small Intestine has Yang without Yin, how can it transmit and transform? Since the Small Intestine cannot transmit and transform, how could the Bladder (Bladder) substitute for it? Moreover, since Qi of the Heart and Kidney does not enter the Small Intestine, how can it enter the Bladder to transform water? The treatment method is to drain Heart Fire while promoting diuresis in the Bladder, so that Qi of the Heart and Kidney becomes unobstructed, and urination resumes. Use Liang Xin Li Shui Tang (Cool the Heart and Promote Water Decoction): Radix Ophiopogonis (Mai Dong, 1 liang), Poria Cocos (Fu Shen, 5 qian), Lotus Plumule (Lian Zi Xin, 1 qian), Semen Plantaginis (Che Qian Zi, 3 qian). Decoct in water and take orally. After two doses, urine flows like a stream; after four doses, full recovery occurs.
This formula uses herbs that tonify the Heart, which are also cooling herbs. With the Heart no longer at risk of excessive hyperactivity, how could the Small Intestine suffer major interference? Furthermore, with slippery and leaching flavors to unblock the water pathways, Heart Qi naturally interacts with Kidney Qi, and Kidney Qi naturally interacts with Bladder Qi. Qi transformation easily expels water; where would there be the distress of obstruction?
Another patient presents with Small Intestine obstruction, protruding eyes, red face, hot ears, thirst with desire to drink, and irritability. People attribute this to excess fire in the Upper Jiao (Upper Jiao), but little do they know it is exuberant fire in the Bladder. The Bladder and Kidney are exterior-interiorly related; the Bladder must communicate with Kidney Qi to transform water. Thus, Bladder fire is the Fire of Ming Men (Gate of Life) within the Kidney. Without fire, the Bladder cannot transform water; why does excess fire cause blockage? It is unknown that when the Bladder receives proper fire, water disperses easily; when it receives pathogenic fire, water flow is difficult. The Bladder belongs to the Taiyang (Greater Yang) channel, which is most susceptible to pathogens. Once invaded by pathogens, cold transforms into heat. Heat accumulation in the Bladder indicates pathogens are about to dissipate. If pathogens are dissipating, fire should exit with urine; why does it form a blockage symptom? Because as pathogens prepare to leave, fearing their route will be cut off, they pretend to be strong and lodge in the Bladder. The treatment need not drain Kidney fire; simply promote diuresis in the Bladder, and pathogens will be removed as easily as sweeping. Use Dao Shui San (Guide Water Powder): Herba Centellae Asiaticae (Wang Bu Liu Xing, 5 qian), Rhizoma Alismatis (Ze Xie, 3 qian), Rhizoma Atractylodis Macrocephalae (Bai Zhu, 3 qian). Decoct in water and take orally. After one dose, normal passage is restored; a second dose is unnecessary.
This formula is miraculous in driving out water because Wang Bu Liu Xing acts swiftly and travels well, thus used to expel pathogens. The root of blockage lies in the Bladder; promoting diuresis in the Bladder opens the blockage naturally. Why panic and rashly administer rapid and potent agents?
Another patient presents with urinary retention, unable to pass drops, lower abdominal distension but no pain, no signs of irritability in the Upper Jiao, no feeling of oppression in the chest, no thirst, and a dry tongue. People believe it is water closure in the Bladder, but little do they know it is obstruction of Ming Men Fire. The Bladder is the official of drainage; it empties through Qi transformation of the Kidney, which is Ming Men Fire. When Ming Men Fire is vigorous, Bladder water flows freely; when Ming Men Fire declines, Bladder water becomes obstructed. One might ask: Frequent urination results from declining Ming Men Fire. If fire declines, urine should flow abundantly; why does it become blocked? It is unknown that Ming Men Fire must be nourished by Kidney Water. When Kidney Water declines, fire appears vigorous because water lacks strength to restrain it. Fire without water, though appearing vigorous, is actually deficient; water without fire, though wanting to flow, becomes blocked. Declining Ming Men Fire causes frequent urination; extreme decline leads to extreme frequency; extreme frequency leads to extreme blockage. Seeing the blockage, people mistakenly suspect Bladder fire and use cold medicines, further damaging Ming Men Fire and weakening Bladder Qi, making water transformation impossible. Switching to diuretics only increases deficiency. The treatment must assist Ming Men Fire. However, merely assisting Ming Men Fire risks excessive Yang consuming Yin. One must tonify fire within water, so fire is born in water, and water flows within fire. Use Ba Wei Di Huang Wan (Eight-Ingredient Rehmannia Pill): Prepared Radix Rehmanniae (Shu Di Huang, 1 liang), Fructus Corni (Shan Zhu Yu, 5 qian), Cortex Moutan (Dan Pi, 3 qian), Rhizoma Dioscoreae (Shan Yao, 5 qian), Rhizoma Alismatis (Ze Xie, 3 qian), Poria Cocos (Fu Ling, 5 qian), Cortex Cinnamomi (Rou Gui, 3 qian), Radix Aconiti Lateralis Preparata (Fu Zi, 1 qian). Decoct in water and take orally. After one dose, urine flows like a stream.
Ba Wei Di Huang Wan is the supreme medicine for tonifying fire within water. Tonifying fire within water avoids the fear of excessive burning; facilitating water within fire avoids the fear of water exhaustion. Even in cases of long-term retention leading to bladder torsion, this formula yields immediate results, let alone simple blockages.
Using Xing Shui Tang (Move Water Decoction) for this condition is also very effective: Prepared Radix Rehmanniae (2 liang), Radix Morindae Officinalis (Ba Ji Tian), Poria Cocos (Fu Shen), Semen Euryales (Qian Shi) (each 1 liang), Cortex Cinnamomi (Rou Gui, 2 qian). Decoct in water and take orally.
Another patient presents with urinary obstruction, protruding eyes, abdominal distension like a drum, hardness above the knees, skin tight as if cracking, inability to eat or drink, yet no thirst. Medicines with sweet, bland, and leaching properties have no effect. People assume extreme Yang excess, but little do they know it is extreme Yin deficiency. Yin and Yang cannot be separated. Sweet, bland, and leaching medicines are Yang medicines. In a disease of Yin deficiency, using Yang medicines should theoretically allow Yin to arise from Yang. However, "Yin deficiency" here refers to the ultimate Yin within Yin. The ultimate Yin requires the ultimate Yang within Yang to transform. Urinary obstruction is a Bladder disease. The Bladder is the mansion of fluids, requiring Qi transformation to empty. This Qi is the ultimate Yang within Yang. Originally stored within the ultimate Yin, without the Qi of ultimate Yin, ultimate Yang becomes solitary and Yin-less, unable to transform water. The treatment is to tonify the ultimate Yin, and Yang will naturally transform. Use Chun Yin Hua Yang Tang (Pure Yin Transforms Yang Decoction): Prepared Radix Rehmanniae (1 liang), Radix Scrophulariae (Xuan Shen, 3 liang), Cortex Cinnamomi (Rou Gui, 2 fen), Semen Plantaginis (Che Qian Zi, 3 qian). Decoct in water and take orally. After one dose, urine flows like a spring; after two doses, obstruction disappears.
This formula surpasses Zi Shen Wan (Nourish Kidney Pill) because Zi Shen Wan uses bitter-cold herbs like Cortex Phellodendri (Huang Bo) and Radix Anemarrhenae (Zhi Mu) to transform water, whereas this formula uses slightly cold herbs. Critics argue that in critical conditions, tonification to unblock the Kidney is inappropriate, and that Prepared Radix Rehmanniae is cloying and may worsen obstruction. They fail to realize that the Kidney is only suitable for tonification, not purging; using Zhi Mu and Huang Bo purges the Kidney, increasing deficiency. How does it compare to using Pure Yin Prepared Radix Rehmanniae aided by moistening Radix Scrophulariae? This combination generates Yin and descends fire, combining attack and tonification. Ultimate Yang receiving this is like fish in water, transforming hyperactive heat into coolness, ensuring discharge. Some ask: If Prepared Radix Rehmanniae and Radix Scrophulariae generate Yin, allowing ultimate Yang to transform, why add Cortex Cinnamomi and Semen Plantaginis? The medicine is pure Yin, requiring ultimate Yang agents to guide it into the ultimate Yang, along with water-guiding flavors to work together, entering and exiting Yang. Moreover, Cortex Cinnamomi is used only for its aromatic qi to enter Yang, not its flavor to tonify Yang, demonstrating subtle efficacy.
Using Jia Shen Hua Shen Tang (Add Spirit Transform Kidney Decoction) for this condition is also miraculous: Prepared Radix Rehmanniae (4 liang), Raw Radix Rehmanniae (Sheng Di Huang, 2 liang), Cortex Cinnamomi (Rou Gui, 3 fen). Decoct in water and take orally.
Another patient presents with inability to urinate, middle jiao fullness and distension, severe thirst. Diuretics fail. People attribute this to exuberant Bladder fire, but little do they know it is Dryness of Lung Qi. The Bladder is the capital official, storing fluids, which are expelled through Qi transformation. Failure of Upper Jiao Qi transformation is due to Lung Heat. Lung heat causes Metal dryness, failing to generate Water. Using diuretics consumes Lung Qi further, so the more water is moved, the less water is generated. The treatment should tonify Lung Qi and support Autumn functions, so Water is naturally generated. Use Sheng Mai San (Generate Pulse Powder): Radix Ginseng (Ren Shen, 1 liang), Radix Ophiopogonis (Mai Dong, 2 liang), Fructus Schisandrae (Bei Wu Wei Zi, 1 qian), Radix Scutellariae (Huang Qin, 1 qian). Decoct in water and take orally. After two doses, water flows freely.
Sheng Mai San tonifies Lung Qi to generate Metal, which is equivalent to tonifying Lung Qi to generate Water. Why add Huang Qin to clear Lung heat, risking damage to Metal and Lung? It is known that in autumn, white dew falls; heaven uses cold to generate water. In the human body, Lung Metal heat requires cold-clearing agents to benefit the Lung and generate water. Thus, Huang Qin is necessary in Sheng Mai San to assist the Lung Metal's clearing and descending function.
Using Mai Dong Fu Ling Tang (Ophiopogon and Poria Decoction) for this condition: Radix Ophiopogonis (3 liang), Poria Cocos (5 qian). Decoct in water and take orally.
Another patient presents with urinary obstruction due to irregular diet injuring Stomach Qi. People attribute this to Lung Qi deficiency, but little do they know it is Sinking of Stomach Qi into the Lower Jiao, unable to ascend. The Bladder requires Qi transformation to empty; ascending Qi is the evidence of Qi transformation. The rising and falling of Qi depends on its strength. Strong Qi leads to rising of Clear Qi and falling of Turbid Qi; weak Qi leads to neither rising nor falling. The Stomach is the mansion of abundant Qi, governing all Qi. The strength of Stomach Qi is crucial for the strength of all Qi. Therefore, when Stomach Qi is deficient, Qi of all meridians often fails to rise. Thus, Spleen and Stomach deficiency causes obstruction of all nine orifices, not just anterior water retention. The treatment must lift the Supreme Yang Qi, starting from the Stomach. Use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction): Radix Ginseng (2 qian), Radix Astragali (Huang Qi, 3 qian), Rhizoma Atractylodis Macrocephalae (Bai Zhu, 3 qian), Radix Angelicae Sinensis (Dang Gui, 2 qian), Radix Glycyrrhizae (Gan Cao, 1 qian), Pericarpium Citri Reticulatae (Chen Pi, 2 fen), Radix Bupleuri (Chai Hu, 1 qian), Rhizoma Cimicifugae (Sheng Ma, 5 fen). Decoct in water and take orally. After one dose, urination resumes; after two doses, full recovery occurs.
This formula uses the sweet-warm properties of Ren Shen and Huang Qi to tonify Stomach Qi; Sheng Ma and Chai Hu lift from below the source of Yuan Qi. Thus, Clear rises and Turbid falls, Lung Qi is not deficient, and naturally performs its clearing and descending function, avoiding blockage.