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Treatment for deficiency and damage in the Yang aspect, where Qi is weak and unable to circulate freely, resulting in difficult urination.
Ye Taishen (Wild Ginseng) (4 qian) Weilingxian (Clematis Root) (1.5 qian) Cun Maidong (Ophiopogon Tuber with heart) (6 qian) Difuzi (Kochia Fruit) (1 qian).

Treatment for deficiency and damage in the Yin aspect, where Blood is deficient and unable to moisten, resulting in difficult urination.
Huai Shudi (Prepared Rehmannia Root) (1 liang) Sheng Guiban (Tortoise Shell) (5 qian, crushed) Sheng Hangshao (White Peony Root) (5 qian) Difuzi (Kochia Fruit) (1 qian).

For cases where both Yin and Yang aspects are deficient, use both formulas alternately, as described in the following case record. Urination will naturally become free.

An elderly woman, over sixty years old, suffered from edema. Medical treatment was ineffective. At that time, there was a physician famous specifically for treating edema, whose prescription was kept secret. After taking his medicine, the patient passed several buckets of water through stool, and all swelling disappeared. The doctor advised avoiding salty food for one hundred days, promising a permanent cure. However, within a few days, the swelling returned, reverting to its previous state. This happened after three courses of this medication, leaving the patient increasingly weak and exhausted. Before taking this medicine, she already had difficulty urinating; after taking it, urination ceased completely, which is why the swelling subsided only to return immediately. Other physicians consulted stated that patients who relapsed after taking such medicines were absolutely untreatable. Later, I examined her and found her pulse rapid and powerless. I said: A rapid pulse indicates Yin deficiency, while a powerless pulse indicates Yang deficiency. The Bladder (Zang-Fu organ responsible for storing and excreting urine) has an outlet but no inlet. Water and fluids must circulate with Qi and Blood to reach the Bladder and be excreted as urine. This corresponds to what the *Neijing* states: "The Officer of the State Capital stores body fluids; when Qi transformation occurs, they can be excreted." In this case, the deficiency of both Yin and Yang damaged Qi transformation, preventing the transportation and transformation of water and fluids to the Bladder, hence the complete absence of urination. One formula uses Ren Shen (Ginseng Root) as the sovereign drug, assisted by Maidong (Ophiopogon Tuber) to counteract the heat of Ren Shen, and Weilingxian (Clematis Root) to move the stagnation caused by Ren Shen, with a small amount of Difuzi (Kochia Fruit) as a guiding drug; it is named Xuan Yang Tang (Yang-Revealing Decoction). The other formula uses Shu Di Huang (Prepared Rehmannia Root) as the sovereign drug, assisted by Guiban (Tortoise Shell) to enhance the moistening property of Shu Di Huang, and Shaoyao (Peony Root) to move the stagnation of Shu Di Huang (Shaoyao is good at promoting urination, thus resolving the cloying nature of Shu Di Huang), also with a small amount of Difuzi (Kochia Fruit) as a guiding drug; it is named Ji Yin Tang (Yin-Nourishing Decoction). These two formulas are taken alternately, starting with Ji Yin Tang, to utilize the principle of generating Yuan Qi from the depth of Yin. After three doses, urination became slightly freer. Then Xuan Yang Tang was taken for another three doses, resulting in significantly freer urination. Subsequently, Ji Yin Tang was taken again, causing urination to flow like a spring, and the swelling completely disappeared.

A woman, around thirty years old, suffered from severe edema due to Yin deficiency causing difficult urination, accompanied by constipation for ten days. An old physician prescribed Ba Zheng San (Eight-Herb Powder for Rectification) without effect. My friend Gao XX prescribed a formula using 6 liang of raw Bai Shao (White Peony Root), decocted into two large bowls of liquid, into which 2 liang of E Jiao (Donkey-hide Gelatin) was melted, instructing the patient to drink as much as possible. The old physician was greatly skeptical, but Gao XX strongly advocated for its use. After completing one dose, both bowel movements and urination cleared, and the swelling vanished instantly. Later, the old physician met me face-to-face, recounted this event, and asked how these medicines could treat this disease. I replied: This must be due to Yin deficiency failing to transform Yang, leading to obstruction of both bowels and bladder. Bai Shao (White Peony Root) is excellent at promoting urination, and E Jiao (Donkey-hide Gelatin) lubricates the bowels. Used together, they greatly tonify True Yin, enriching the Yin aspect to transform the excess Yang in the Lower Jiao, thereby allowing both bowels and bladder to function freely.

Zi XX treated a case of edema. The patient was sixty years old, suffering from obstructed urination and defecation, chest fullness, and occasional irritability. Knowing that the patient had Yin deficiency with accumulated internal heat, combined with stagnant Qi, Zi XX administered 3 liang of raw Bai Shao (White Peony Root), along with 3 qian each of Ju Hong (Tangerine Peel) and Chai Hu (Bupleurum Root). After one dose, urination and defecation resumed. The patient recovered after continuing with medications that nourished Yin, regulated Qi, and mildly promoted urination.

A woman, around forty years old, suffered from edema unresponsive to various medicines. Accidentally eating mung bean porridge made her abdomen feel relaxed and comfortable, so she continued to eat it several times. Her urination became very free, and she recovered.
Someone told me this story and asked for the reason behind the recovery. I answered: Mung beans belong to the same category as Adzuki beans, so they can promote water metabolism and urination. Moreover, their nature is slightly cool, effectively nourishing Yin and clearing heat. For any case of difficult urination caused by Yin deficiency with heat, taking them is effective.