（因汗而小便不利者津液亡于外也因下而小便不利者津液耗于内也痞症或发
黄及热病而小便不利者皆热郁所致也）
伤寒表不解。心下有水气。干呕。发热而咳。小便不利。少腹满。或喘。（小青龙汤去
麻黄加茯苓）太阳病。大汗后。胃干。烦躁不眠。欲饮。小便不利。（脉浮者五苓散不
浮者猪苓汤）太阳病。饮水多。心下悸。小便少。（茯苓甘草汤）太阳发汗。遂漏不止。则恶风
。小便难。四肢难屈伸。（桂枝加附子汤）身黄。小腹硬。脉沉结。（茵陈汤）表未解。反下之
。不结胸。但头汗出。小便不利。必发黄。（茵陈汤或栀子柏皮汤）小便不利。大便乍难乍易
。微热。喘冒不能卧。有燥屎也。（大承气汤）少阳往来寒热。胸胁满。不欲食。心烦喜呕。
或心下悸。小便不利。（小柴胡汤）八九日下之。胸满烦惊。小便不利。谵语。身重。（柴胡
加龙骨牡蛎汤）少阴小便不利。大便自利。腹痛。四肢沉重。有水气也。（真武汤）厥阴小便
不利。关节疼痛。汗出恶风。身肿者。属风湿。（甘草附子汤）厥阴少阴寒闭。或灸气海。或
行葱熨法
按仲景大法。在太阳症。脉浮用五苓散。不浮用猪苓汤。二方皆以猪苓茯苓泽泻为主。
但五苓散。加白术与桂辛甘为阳也。猪苓汤。加阿胶滑石甘寒为阴也。阳明热黄。与栀子柏皮汤
。胁痛身黄。与小柴胡汤。少阴有水。则行真武。厥阴寒秘。则行四逆。其汗多亡阳者。以
桂枝加附子汤。后世以渴者与八正散。不渴者与知柏地黄。补仲景之未备也。大都汗多者。
津液外泄。小便因难。不可利之。恐重亡其津液。待汗止小便自行也。又有热甚而小便仍利
者。勿妄利之。恐引热入于膀胱。往往变为蓄血也。
(When urinary difficulty arises due to sweating, it is because body fluids are exhausted externally; when it arises due to purgation, it is because body fluids are consumed internally. In cases of Pi syndrome (a sensation of fullness and obstruction in the epigastrium), jaundice, or febrile diseases, urinary difficulty is caused by heat stagnation.)
In Shaoyang disease, the exterior pattern remains unresolved, with fluid retention in the stomach region. Symptoms include dry retching, fever with cough, urinary difficulty, fullness in the lower abdomen, or wheezing. (Use Xiao Qing Long Tang [Minor Blue Dragon Decoction], removing Ephedrae Herba [Mahuang, 麻黄] and adding Poria [Fuling, 茯苓].) In Taiyang disease, after excessive sweating, the Stomach becomes dry, causing irritability and insomnia, thirst, and urinary difficulty. (If the pulse is floating, use Wu Ling San [Five-Ingredient Powder with Poria]; if not floating, use Zhu Ling Tang [Poria Decoction].) In Taiyang disease, excessive water intake leads to palpitations in the heart region and scanty urination. (Use Fu Ling Gan Cao Tang [Poria and Licorice Decoction].) After sweating in Taiyang disease, if sweating continues incessantly, leading to aversion to wind, difficult urination, and limbs that are difficult to flex and extend, (use Gui Zhi Jia Fu Zi Tang [Cinnamon Twig Decoction with Added Aconite Root].) If the body turns yellow, the lower abdomen is hard, and the pulse is deep and knotted, (use Yin Chen Tang [Artemisia Capillaris Decoction].) If the exterior pattern is unresolved and purgation is mistakenly applied, resulting in no Jie Xiong syndrome (chest binding), but only sweating on the head, urinary difficulty, and inevitable jaundice, (use Yin Chen Tang or Zhi Zi Bai Pi Tang [Gardenia and Phellodendron Bark Decoction].) With urinary difficulty, bowel movements alternating between difficulty and ease, slight fever, wheezing, dizziness, and inability to lie down, this indicates the presence of dry feces. (Use Da Cheng Qi Tang [Major Order the Qi Decoction].) In Shao Yang disease, with alternating chills and fever, fullness in the chest and hypochondrium, loss of appetite, irritability and frequent vomiting, or palpitations in the heart region, and urinary difficulty, (use Xiao Chai Hu Tang [Minor Bupleurum Decoction].) After nine or eight days, if purgation is mistakenly applied, leading to chest fullness, irritability, fright, urinary difficulty, delirium, and heaviness of the body, (use Chai Hu Jia Long Gu Mu Li Tang [Bupleurum Decoction with Added Dragon Bone and Oyster Shell].) In Shao Yin disease, with urinary difficulty, spontaneous diarrhea, abdominal pain, and heavy limbs, this indicates water qi retention. (Use Zhen Wu Tang [True Warrior Decoction].) In Jue Yin disease, with urinary difficulty, joint pain, sweating with aversion to wind, and bodily swelling, this belongs to Wind-Dampness. (Use Gan Cao Fu Zi Tang [Licorice and Aconite Root Decoction].) For urinary difficulty due to cold closure in Jue Yin and Shao Yin, one may moxa Qi Hai (CV6) or apply the scallion-warming method.)
Following Zhang Zhongjing's general principles: in Taiyang patterns, a floating pulse indicates the use of Wu Ling San, while a non-floating pulse indicates Zhu Ling Tang. Both formulas primarily utilize Poria [Zhu Ling, 猪苓], Poria [Fu Ling, 茯苓], and Alisma Rhizome [Ze Xie, 泽泻]. However, Wu Ling San adds Atractylodes Macrocephala Rhizome [Bai Zhu, 白术] and Cinnamon Twig [Gui Zhi, 桂枝], using acrid-sweet properties to transform Yang; Zhu Ling Tang adds Donkey-Hide Gelatin [E Jiao, 阿胶] and Talcum [Hua Shi, 滑石], using sweet-cold properties to nourish Yin. For Yangming heat-induced jaundice, use Zhi Zi Bai Pi Tang; for hypochondriac pain and jaundice, use Xiao Chai Hu Tang; for Shao Yin water retention, use Zhen Wu Tang; for Jue Yin cold constipation, use Si Ni Tang [Frigid Extremities Decoction]. For those with excessive sweating leading to Yang collapse, use Gui Zhi Jia Fu Zi Tang. Later generations used Ba Zheng San [Eight-Herb Powder for Rectification] for thirst-associated urinary difficulty, and Zhi Bai Di Huang Wan [Anemarrhena, Phellodendron, and Rehmannia Pill] for non-thirst cases, supplementing Zhang Zhongjing's incompleteness. Generally, in cases of excessive sweating, body fluids leak outward, making urination difficult; diuretics should not be used, as they risk further exhausting body fluids. One should wait for sweating to cease, and urination will naturally resume. In cases where heat is severe but urination remains unobstructed, do not recklessly use diuretics, lest heat be drawn into the Bladder, often transforming into Blood Accumulation syndrome.)