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Lungbi (Oliguria/Anuria) refers to the condition where urination is scanty or completely obstructed, which in severe cases leads to distension and edema, even causing panting, chest fullness, and a sensation of impending death. Wulin (Five Types of Strangury) refers to painful, difficult, and dribbling urination, characterized by the urge to void but inability to do so, or the inability to stop the flow. It is divided into five types: Shilin (Gravel Strangury), Gaolin (Gelatinous Strangury), Qilin (Qi Strangury), Xuelin (Blood Strangury), and Laolin (Labor Strangury).

It is common knowledge that Lungbi is treated with diuretic herbs. However, if increased diuresis worsens the obstruction, leading to severe distension and suffocation, one must treat the root cause. The *Classic of Medicine* states: "The Bladder is the official of the Zhou Du (State Capital), storing body fluids; it can discharge them only through Qi transformation." Since urine cannot be discharged drop by drop, the pathology lies in impaired Qi transformation. Guizhi (Cinnamon Twig) has a direct path to the Taiyang meridian and promotes Qi transformation; thus, it is indispensable for this condition. If Yin deficiency fails to transform fluids, and heat forces the Bladder, presenting with lower abdominal distension and pain, and a vigorous Chi pulse, Zishen Wan (Kidney-Nourishing Pill) should be used as the main formula. If Yang deficiency fails to transform fluids, and cold congeals in the Bladder, presenting with no lower abdominal pain and a weak Chi pulse, Jiajian Shenqi Wan (Modified Kidney Qi Pill) should be used as the main formula. Nevertheless, fearing that these may not yield immediate results, there are ingenious methods to apply. Consider a vessel for dripping water: if its top is sealed and it is inverted, drops will not fall. Removing the blockage at the top allows water to flow freely; thus, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used to lift the Qi. Even after consuming this decoction, inducing vomiting by stimulating the throat can lead to urination within moments. Furthermore, there is a method of opening external acupoints to open internal orifices. Mahuang (Ephedra Herb) has potent action and can unblock Yang Qi below the extreme Yin. The Lung governs the skin and hair; when paired with Xingren (Apricot Seed) to descend Qi, Lung Qi descends to the Zhou Du (Bladder), following the principle that "draining water must start from high places." Adding these two herbs to Bazheng San (Eight-Ingredient Powder for Rectification) yields immediate results. In summer, if Mahuang is contraindicated due to fear of Yang collapse and profuse sweating, equal parts of Suye (Perilla Leaf), Fangfeng (Saposhnikovia Root), and Xingren (Apricot Seed) can be decocted in water, taken warm, and covered to induce slight sweating, after which urination will proceed smoothly. (This is a verified case by Zhang Yinan treating edema.) For those with deficiency, taking Ren Shen (Ginseng Root) and Mahuang (Ephedra Herb) each in 1 liang, decocted and taken, yields miraculous effects. (This is a verified case by Lu Jingong.) If excessive sweating precludes further diaphoresis, Ziwan (Aster Root) and Sangbaipi (Mulberry Bark) each in 3 qian, along with Maidong (Ophiopogon Tuber) in 5 qian, added to diuretic or lifting formulas, are also effective. (This is a verified case by Li Shicai.) All these are methods of treating lower diseases by addressing upper causes. (For treating edema, one may follow this method to address the branch symptoms, while simultaneously using Liujunzi Tang (Six-Gentlemen Decoction) minus Gancao (Licorice Root), plus Cangzhu (Atractylodes Rhizome), Houpo (Magnolia Bark), Paojiang (Prepared Ginger), and Fuzi (Aconite Root) to support Spleen Qi and restore Yuan Qi.)

Strangury encompasses five types, with numerous formulas for treatment, but all essentially relate to accumulated heat. Generally, Jingyue's Dali Qingyin (Great Purifying Infusion) is used as the main formula.

For Gravel Strangury, where urine passes like sand and stones, combine Yiyuan San (Benefit Origin Powder) with Hupo (Amber), or use the head of a Sciaena fish containing 5-6 small stones, ground into powder and taken with water.

For Gelatinous Strangury, where urine passes like gelatin, add Biba (Dioscorea Hypoglauca Rhizome) and Haigefen (Clam Shell Powder) each in 2 qian, and Shichangpu (Acorus Rhizome) in 8 fen.

For Qi Strangury, caused by Qi stagnation and obstruction, presenting with discomfort, fullness, distension, and pain below the umbilicus, add Jingjie (Schizonepeta Spike) in 2 qian, Xiangfu (Cyperus Rhizome) and Sheng Maiya (Unroasted Barley Sprout) each in 1 qian. If ineffective, add Shengma (Cimicifuga Rhizome), or employ emetic therapy.

For Blood Strangury, caused by blood stasis accumulating in the urethra, presenting with cutting pain that is unbearable, add Niuxi (Achyranthes Root), Shengdi (Rehmannia Root), Danggui (Angelica Sinensis Root), and Taoren (Peach Kernel) each in 3 qian, and Honghua (Carthamus Flower) and Chuanxiong (Ligusticum Rhizome) each in 1 qian. If ineffective, separately use Niuxi Gao (Achyranthes Paste).

For Labor Strangury, acquired through overexertion, where Qi transformation fails to reach the Zhou Du (Bladder), combine the base formula with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and decoct together.

The above five types of strangury are all caused by accumulated heat. There is another type called Lenglin (Cold Strangury). Symptoms include cold limbs and nose/mouth, and a preference for hot drinks; Jiawei Shenqi Tang (Modified Kidney Qi Decoction) is used as the main formula. Additionally, some cases arise from excessive consumption of mineral-based heating drugs, leading to degenerated essence causing strangury. Similarly, in elderly men with impotence who desire sexual activity to release essence, if the essence does not exit but rots internally, it causes pulling pain in both bowel movements and urination resembling strangury. The more painful, the more frequent the urge to defecate; the more one defecates, the more painful it becomes. Use the previous infusion (Dali Qingyin) plus Biba (Dioscorea Hypoglauca Rhizome), Tusizi (Cuscuta Seed), Shichangpu (Acorus Rhizome), and Yuanzhi (Polygala Root) to guide the pathology, followed by Liuwei Wan (Six-Ingredient Pill with Rehmannia).