辽宁石××，年三十二岁，于仲冬得小便不通证。
病因 晚饭之后，食梨一颗，至夜站岗又受寒过甚，遂致小便不通。
证候 病初得时，先入西医院治疗。西医治以引溺管小便通出，
有顷小便复存蓄若干，西医又纳以橡皮引溺管，使久在其中有尿即通出。乃初虽稍利，继则小便
仍不出，遂求为延医。其脉弦细沉微，不足四至，自言下焦疼甚且凉甚，知其小便
因受寒而凝滞也，斯当以温热之药通之。
处方 野党参（五钱） 椒目（五钱炒捣） 怀牛膝（五钱） 乌附子（三钱）
广肉桂（三钱） 当归（三钱） 干姜（二钱） 小茴香（二钱）
生明没药（二钱） 威灵仙（二钱） 甘草（二钱）
共煎一大盅，温服。
方解 方中之义，人参、灵仙并用，可治气虚小便不通。椒目与桂、附、干姜并用，可治因寒
小便不通。又佐以当归、牛膝、茴香、没药、甘草诸药，或润而滑之，或引而下之，或
辛香以透窍，或温通以开瘀，或和中以止疼，众药相济为功，自当随手奏效也。
效果 将药煎服一剂，小便通下，服至三剂，腹疼觉凉全愈，脉
已复常。俾停服汤药，日用生硫黄钱许研细，分作两次服，以善其后。
帮助 诸家本草，皆谓硫黄之性能使大便润小便长，用于此证，
其暖而能通之性适与此证相宜也。
Liaoning resident Shi XX, aged thirty-two, contracted a syndrome of urinary retention in the middle of winter.
Etiology After dinner, he ate one pear. Later that night, while standing guard, he was severely exposed to cold, which subsequently led to urinary retention.
Clinical Manifestations At the onset of the illness, he first sought treatment at a Western hospital. The Western physicians employed a catheter to drain urine. After a short while, a certain amount of urine accumulated again in the bladder, so the physicians inserted a rubber catheter and left it in place for an extended period to ensure immediate drainage whenever urine was produced. Although there was slight relief initially, urination eventually ceased completely. He then requested my medical consultation. His pulse was wiry, fine, deep, and faint (Xian Xi Chen Wei), with fewer than four beats per respiration. He reported severe pain and intense cold sensation in the lower jiao. This indicated that his urinary retention was caused by cold-induced stagnation; therefore, warm-natured herbs should be used to promote urination.
Prescription Wild Codonopsis Root (Dangshen) - 5 qian; Zanthoxylum Seed (Jiaomu) - 5 qian (stir-fried and crushed); Huai Achyranthes Root (Huainiuxi) - 5 qian; Prepared Aconite Root (Wufuzi) - 3 qian; Guang Cassia Bark (Guangrougui) - 3 qian; Angelica Sinensis Root (Danggui) - 3 qian; Dried Ginger (Ganjiang) - 2 qian; Small Fennel Fruit (Xiaohuixiang) - 2 qian; Raw Myrrh (Shengming Moyao) - 2 qian; Clematis Root (Weilingxian) - 2 qian; Licorice Root (Gancao) - 2 qian.
Decoct together in a large cup of water and take warm.
Formula Analysis The rationale of this formula is as follows: The combination of Ginseng Radix et Rhizoma (Renshen) and Clematis Root (Weilingxian) can treat urinary retention due to Qi deficiency. The combination of Zanthoxylum Seed (Jiaomu) with Cassia Bark (Rougui), Aconite Root (Fuzi), and Dried Ginger (Ganjiang) can treat urinary retention due to cold. Additionally, herbs such as Angelica Sinensis Root (Danggui), Achyranthes Root (Niuxi), Fennel Fruit (Huixiang), Myrrh (Moyao), and Licorice Root (Gancao) are added as adjuvants. Some provide moistening and lubricating effects, some guide the action downward, some use acrid-aromatic properties to penetrate orifices, some use warming and unblocking actions to resolve stasis, and some harmonize the middle jiao to relieve pain. Through the synergistic effect of these herbs, efficacy is expected to be achieved promptly.
Outcome After taking one dose, urination became patent. After three doses, abdominal pain and the sensation of cold in the abdomen were completely resolved, and the pulse returned to normal. It was advised to stop taking the decoction. Instead, approximately one qian of raw Sulfur (Liuhuang) should be ground into fine powder daily and taken in two divided doses to consolidate the recovery.
Commentary Various materia medica texts state that Sulfur (Liuhuang) has the property of moistening the bowels and promoting urination. Its warming and unblocking nature is particularly suitable for this syndrome.