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Treats the accumulation of excess heat in the lower jiao, swelling of the bladder, obstruction of the urethra, and urinary retention with only a few drops.
Hua Shi (Talcum, 1 liang) Sheng Hang Shao (Raw Paeoniae Radix Alba, 1 liang) Zhi Mu (Anemarrhenae Rhizoma, 8 qian) Huang Bo (Phellodendri Cortex, 8 qian)

A patient, over sixty years old, had hematuria for several days, followed by sudden urinary retention, with no urine output at all for two days. The patient was unable to bear it and rubbed/squeezed the area with his hands, expelling a small amount of bloody water, which provided slight relief. After repeated squeezing, the pain became unbearable. In panic and helplessness, he asked me to find a doctor for him. His pulse was deep and forceful. It was mid-summer, and although he was covered with thick quilts, he still felt cold. I determined that excess heat was stagnating in the lower jiao, causing the urethra to swell and become obstructed due to heat. I prescribed this decoction. After one dose, urination slightly improved. Then, Mu Tong (Akebiae Caulis) and Hai Jin Sha (Lygodii Spora), each 2 qian, were added. After two doses, he was completely cured.

To treat urinary retention with only a few drops. Occasionally, due to vomiting or hiccups, or when lying on the side and stretching, a small amount of urine can pass; this is called "Zhuan Bao" (Cystoptosis/Bladder Displacement). Using lifting herbs to raise the bladder and restore its normal position, once the ligamentous attachments are untwisted, urination will naturally resume.
Sheng Huang Qi (Astragali Radix, 5 qian) Dang Gui (Angelicae Sinensis Radix, 4 qian) Sheng Ma (Cimicifugae Rhizoma, 2 qian) Chai Hu (Bupleuri Radix, 2 qian)

A woman suffered from difficult urination after childbirth and sent someone to ask for a prescription. She was advised to use Sheng Hua Tang (Decoction for Generating Blood) with added Bai Shao (Paeoniae Radix Alba), but it was ineffective. She returned asking for another prescription. She stated that she sometimes experienced nausea and vomiting, during which a small amount of urine could pass. I suddenly realized: this must be caused by excessive effort or pushing during delivery, leading to torsion of the bladder's ligamentous attachments, thus causing urinary retention. Nausea and vomiting cause the qi mechanism to rebel upwards, creating a tendency for the bladder ligaments to be lifted and twisted, allowing a small amount of urine to pass. Therefore, I prescribed this decoction, and she was cured after one dose.

When the qi transformation of the San Jiao (Triple Burner) fails to ascend, it cannot descend. Difficult urination often results from qi sinking and stagnating in the lower jiao, blocking the mechanism of ascending and descending circulation. Therefore, using all kinds of diuretic herbs is ineffective, while using lifting herbs often yields miraculous effects. Thus, my proposed decoction not only treats Zhuan Bao but also treats Long Bi (Urinary Retention).

Ancient formulas exist that use a heavy dose of Huang Qi alone to treat difficult urination accumulating into edema (see Lu Dingpu's *Leng Lu Yi Hua*).
Edema syndromes can be either deficiency or excess. Excess patterns seem unsuitable for Huang Qi. However, true excess patterns are rare, while deficiency patterns are common. Once the pattern is identified as deficiency, one must carefully distinguish between Yin deficiency, Yang deficiency, or combined Yin-Yang deficiency. Yang deficiency involves depletion of the Qi aspect and can be treated with single or heavy doses of Huang Qi. Yin deficiency involves exhaustion of the Blood aspect; it is appropriate to heavily use Yin-nourishing herbs, taking advantage of the principle that "Yang generates Yin," assisted by Huang Qi. For combined Yin-Yang deficiency, Huang Qi and Yin-nourishing herbs can be used in equal parts. Physicians who do not investigate the etiology and vehemently condemn its use are certainly reckless. Those who continuously use strong damp-draining agents are even more reckless. Generally, when the disease progresses to edema, even if the etiology is excess, the Qi and Blood have already been depleted by this stage. Potent and harsh drugs may be used once or twice. If unavoidable usage extends to several times, they should be assisted by Qi- and Blood-tonifying herbs. Moreover, these cases originally belong to deficiency patterns curable by heavy doses of Huang Qi. Today's physicians, regarding this condition, even if they do not use strong damp-draining agents, often excessively use diuretics. They fail to realize that for Yin deficiency, excessive use of diuretics damages Yin; for Yang deficiency, excessive use of diuretics also damages Yang. Diuretic herbs are not unusable, but it is crucial to deeply investigate the etiology and provide fundamental treatment; diuretic herbs serve merely as guides.

[Attached Formulas] Ge Zhichuan's *Zhou Hou Fang* treats urinary retention using two large earthworms (Lou Gu). Remove the posterior half, soak in one sheng of water, and drink. Urination clears shortly after.
Also, *Shou Yu Fang* uses the posterior half of the earthworm, dried and powdered, taken with liquid (half qian). Urination clears immediately; raw powder is also acceptable.
Also, *Tang Shi Jing Yan Fang* uses the posterior half of the earthworm mixed with Moschus (She Xiang), pounded, applied into the umbilicus and bound securely. Urination clears immediately.
Note: Tu Gou refers to Lou Gu (Earthworm/Antlion larva). *Ri Hua Zhu Jia Ben Cao* states it treats edema and facial swelling. Li Shizhen states it unblocks both large and small intestines/bladder and treats Stone Lin (Calculus). It is indeed an essential herb for promoting urination. For any case of urinary retention, regardless of cold, heat, deficiency, or excess, it can be added to prescriptions as a guide. Even taken alone, it is very effective. However, observing ancient formulas, only the posterior half is used. This is because the anterior half has stronger breaking/purging power, while the posterior half has stronger diuretic power. If treating blockage of both stool and urine, the whole insect should be used.
Folk tradition: A method to treat urinary retention by smelling a herbal powder. Use Ming Xiong Huang (Realgar, 1 qian), Chan Su (Toad Venom, 5 fen, dried until brittle), and She Xiang (Moschus, 6 li). Grind finely together. Inhale through the nose; urination clears immediately.