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If a pregnant woman suffers from meridian and vessel injury due to overexertion, heat enters the blood. When blood is affected by heat, it seeps into the Paofang (bladder), causing hematuria. Fetal leakage refers to bleeding from the vagina, whereas hematuria refers to bleeding from the urethra. For hematuria during pregnancy caused by heat in the Chongbao (uterus/bladder area), Siwu Tang (Four Substances Decoction) with Gardeniae Fructus (Shanzhi) and Ash of Hair (Fahui) is commonly used, or alternatively, Eupolyphaga Secretio (Ejiao), Rehmanniae Radix Praeparata (Shudi), Ophiopogonis Radix (Maidong), and Schisandrae Fructus (Wuweizi).

When a pregnant woman experiences scanty, difficult, and dribbling urination, it is called Zilin (pregnancy dysuria). This occurs because Qi and Blood gather to nourish the fetal origin but fail to adequately moisten and permeate the water passages, leading to stagnant heat in the Bladder. Treatment should involve Danggui (Angelicae Sinensis Radix) and Baishao (Paeoniae Radix Alba) to harmonize the blood; Renshen (Ginseng Radix) to tonify Qi; Maidong (Ophiopogonis Radix) to clear Lung heat to nourish the source of Kidney Water; and Huashi (Talcum) to promote urination and clear stagnation. This formula is named Anrong San. Ancient formulas contain Huashi, which has a heavy and sedative nature, raising concerns about inducing abortion; however, it is excellent if used near term. If used before the seventh or eighth month, Huashi should be removed, and Shihu (Dendrobii Caulis) and Shanzhi (Gardeniae Fructus) added for greater safety. If the condition persists for a long time leading to fatigue and a weak pulse on the right side, this indicates Qi deficiency with sinking, accompanied by a sensation of bearing down. Due to weak Qi and empty intestines causing poor circulation, only large doses of Renshen (Ginseng Radix) can move the Qi, after which urination will naturally become easy.

The syndrome of Baozhuan (displaced bladder/uterus) presents with urgent pain below the umbilicus and inability to urinate. This is caused by holding urine forcibly, running rapidly, holding urine after a full meal, or engaging in intercourse while holding urine. These actions cause water-Qi to rebel upward, forcing the Bao (bladder/uterus) to twist and preventing it from expanding. This is not a disease of the Small Intestine or Bladder itself, nor can it be resolved merely by using diuretic drugs. The method is to lower the rebellious Qi, after which the patient will recover. If the Bao descends excessively and necroses, the fetus will die. This condition often affects those with weak constitutions, those who are prone to worry and depression, those with irritable temperaments, and those who consume rich flavors. Ancient formulas using slippery/diuretic drugs have rarely been effective. It is reasoned that the Bao twists because it is compressed by the fetus; if the fetus is lifted, the Bao's ligaments will relax, and the water passage will open. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is appropriate. After taking the medicine, inducing vomiting can lift the Qi, allowing urination to resume spontaneously. Immediately after urination resumes, large doses of Renshen (Ginseng Radix) and other tonics should be used to prevent miscarriage.

Danxi stated: A woman nine months pregnant suffered from Baozhuan, unable to urinate, with severe lower abdominal urgency and leg swelling so bad she could not walk. Her pulse was choppy on the right and slightly harmonious on the left. This was due to qi injury from overeating, with weak uterine ligaments unable to support the fetus, causing it to drop and press against the bladder, blocking the Qi flow and preventing urination. The prescription used Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Zhigancao (Prepared Licorice Root), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Banxia (Pinelliae Tuber), and Shengjiang (Zingiberis Rhizoma Recens) to nourish blood and tonify Qi. Once Qi and Blood were robust, the uterine ligaments would lift the fetus. She drank it all at once, and induced vomiting. After four doses, dark water flowed out upon urination. She recovered after subsequent regulation and tonification. In another case of a woman in her seventh or eighth month of pregnancy unable to urinate, the pulse was fine and weak, indicating deficient and timid Middle Qi unable to lift the fetus. The fetus pressed on the lower opening of the bladder, preventing voiding. Buzhong Tang (Middle-Tonifying Decoction) with lifting herbs was used. Due to insufficient medicinal power, distension and pain were unbearable. An elderly woman applied sesame oil to her hand and manually lifted the fetus through the birth canal. Urine gushed out, and the distension and urgency instantly resolved. Large doses of Renshen (Ginseng Radix) were then administered. By the third day, the fetus had risen, and urination returned to normal. *Zhengzhi Zhunsheng* states: The concept of Baozhuan refers to the Bao being forced to the side. Here, "Bao" refers to the Bladder. However, Zilin resembles Baozhuan. Zilin is characterized by frequent, painful, dribbling urination, caused by deficiency-heat in the Bladder and Small Intestine. Deficiency fails to control water, and heat fails to promote free flow. Thus, if there is frequency with little output and no pain, it is Baozhuan, which may have slight pain but differs fundamentally from Zilin. The *Classic* states: "Qi of the Zi Bao." It also says: "Heat transfers from the Bao to the Bladder." And: "Chong Mai and Ren Mai both originate from the Bao." In these instances, "Bao" is pronounced "Bao" and refers to the Uterus. The *Lingshu* states: "The Bao of the Bladder is thin and soft," pronounced "Pao," referring to the organ responsible for storing urine (the urinary bladder). There are three types of "Bao," yet they share the same character. Why do later generations misunderstand? Some separate the Bladder from the Urinary Bladder (Paofang). Others, citing *Leizuan*, say "The Bladder is the chamber of the Bao," mistakenly equating the Zi Bao (Uterus) with the Bladder. This is a significant error. The Bladder is the Paofang, and the Paofang is the Bladder. Is there another object inside the Bladder? Those who equate Zi Bao and Bladder should consider: in Baozhuan, the uterus presses down on the bladder, causing urinary retention. Here, the Bao (uterus) is above, and the Bladder is below. Their locations are distinct, clearly proving they are not the same object.