膀胱主分津液。热蓄于内，津液不下行，故不利也。有邪气结于下焦，聚而不散，
则小腹硬满而痛，小便所以不利也。凡不利者宜导而渗泄之。若引饮过多，下焦蓄热，
或中湿发黄，水饮停留，皆先利小便。有汗下后亡津液，胃中干竭，则有利小便之戒。
有小便不利而头出汗者，乃为阴脱关革之疾也。
【和解】伤寒五六日，已汗复下，小便不利、心烦，桂枝汤、小柴胡汤。
【分利】太阳汗后脉浮，小便不利，微热而渴，五苓散。渴甚者，猪苓汤。
【清利】伤寒七八日，身黄如橘，小便不利，腹微满者；头汗出小便不利，渴饮水
浆，瘀热在内必发黄，并用茵陈蒿汤。
【攻下】小便不利，大便乍难乍易，微热，胃中有燥粪也，大承气汤，选用。有潮
热兼大便泄，小便不利，
柴苓汤。
【温】风湿自汗，身重不利者，阴气也，甘草附子汤。
【熨法】小便不通，其因有二。热郁不通，用田螺捣朴硝，少加麝香如泥，贴脐
上自通。寒凝小水不利者，用炒盐熨脐下当通。然则寒热不可不详审也。
【灸】阴寒甚而小便不通，阴囊缩入，腹痛欲死，灸石门穴，仍服四逆汤。
伤寒小便自利，正因不当利而反自利也。如太阳阳明自汗者，不应利小便而反自
利者，寒为膀胱不禁，热为蓄血使然。是亦伤寒之一证也。津液竭则病危矣夫，安得
不有治乎？
【和】太阳病小便自利，以饮水多，心下悸，桂枝茯苓甘草汤。
【血】太阳身黄，小盒饭不利，今反自利，其人如狂，为下焦蓄血，抵当汤。伤寒有
热，小腹满，应小便不利，今反自利，为有血也，抵当丸。尿血，玄胡散。大便闭，小便自
利，知其热在内，微用承气汤下之。
【温】大便自通，小便清利，知其内虚寒也，四逆汤，真武汤去茯苓用。
【蜜导】阳明自汗，应小便不利，而反利，津液内竭也。粪虽硬不可攻，宜蜜导猪胆
汁法。
The Bladder is responsible for separating clear turbid fluids and excreting body fluids. If heat accumulates internally, preventing the downward distribution of fluids, symptoms of difficult urination (Difful urination) occur. If pathogenic factors knot in the Lower Jiao (Lower Burner), gathering without dispersing, it leads to hardness, fullness, and pain in the lower abdomen, which is the cause of difficult urination. For cases of difficult urination, it is appropriate to use methods that guide and promote diuresis (Promoting urination). However, if excessive drinking leads to heat accumulation in the Lower Jiao, or if dampness causes jaundice with water retention, diuresis should be employed first. Conversely, after sweating or purging therapies, if body fluids are depleted and the Stomach becomes dry and exhausted, there are warnings against using diuretic methods. If difficult urination is accompanied by sweating only on the head, this indicates a critical condition of Yin collapse and Guan-Ge disease (Obstruction and Reversal syndrome).
[Harmonizing Method] In Shaoyang disease (Taiyang disease in context of Taiyang-Shaoyang transition) lasting five to six days, where sweating has been applied followed by incorrect purging, resulting in difficult urination and irritability, Guizhi Tang (Cinnamon Twig Decoction) or Xiaochaihu Tang (Minor Bupleurum Decoction) may be used.
[Separating and Diuresis Method] After sweating in Taiyang disease, if the pulse remains floating, urination is difficult, accompanied by slight fever and thirst, Wuling San (Five-Ling Powder) is indicated. If thirst is severe, Zhuling Tang (Polyporus Decoction) is used.
[Clearing and Diuresis Method] In Shaoyang disease lasting seven to eight days, if the body is yellow like an orange peel, urination is difficult, and the abdomen is slightly full; or if there is only head sweating, difficult urination, and thirst for drinking fluids, indicating internal stasis-heat causing jaundice, Yinchenshao Tang (Artemisiae Scopariae Decoction) should be used in all these cases.
[Purgative Method] If urination is difficult, bowel movements alternate between difficulty and ease, accompanied by slight fever, it indicates dry feces in the Stomach/Intestines; Dachengqi Tang (Major Order the Qi Decoction) can be selected. If tidal fever is accompanied by diarrhea and difficult urination, Chailing Tang (Bupleurum and Polyporus Decoction) is used.
[Warming Method] In Wind-Dampness disease with spontaneous sweating and heavy body with movement difficulty, attributed to Yin-cold qi, Gancao Fuzi Tang (Licorice and Aconite Decoction) is indicated.
[Moxibustion/Ironing Method] There are two causes for complete urinary retention. If caused by heat stagnation, crush Field Snail (Tianluo) mixed with Mirabilite (Puxiao), add a small amount of Musk (Shexiang), apply as paste to the umbilicus, and urination will naturally resume. If caused by cold coagulation leading to difficult urination, apply hot fried salt to the area below the umbilicus, which usually restores flow. Thus, Cold and Heat patterns must not be examined carelessly.
[Moxibustion Method] In cases of extreme Yin-cold causing urinary retention, retraction of the scrotum, and severe abdominal pain resembling death, moxibustion at Shimen CV5 (Gate of Life) is performed, along with administering Sini Tang (Frigid Extremities Decoction).
In Shaoyang disease, spontaneous normal urination occurs precisely because diuresis was inappropriate but urination occurred spontaneously. For example, in Taiyang or Yangming diseases with spontaneous sweating, if urination is spontaneous when it should not be, it may be due to Cold failing to control the Bladder, or Heat causing Blood Stasis. This is also a syndrome of Shaoyang disease. When body fluids are exhausted, the condition is critical; therefore, treatment is necessary.
[Harmonizing Method] In Taiyang disease with spontaneous urination, caused by excessive water intake leading to palpitations in the epigastrium, Guizhi Fuling Gancao Tang (Cinnamon Twig, Poria, and Licorice Decoction) is used.
[Blood Stasis Method] In Taiyang disease with jaundice, where urination should be difficult but is instead spontaneous, and the patient exhibits manic behavior, this indicates Lower Jiao Blood Stasis; Dandang Tang (Echinops Decoction) is indicated. In Shaoyang disease with heat, lower abdominal fullness, where urination should be difficult but is spontaneous, indicating blood stasis, Dandang Wan (Echinops Pill) is used. For hematuria (blood in urine), Xuanhu San (Corydalis Powder) is used. For constipation with spontaneous urination, knowing the heat is internal, a mild purgation with Chengqi Tang (Order the Qi Decoction) is applied.
[Warming Method] If bowel movements are naturally smooth and urination is clear and free-flowing, it indicates internal deficiency-cold; Sini Tang (Frigid Extremities Decoction) or Zhenwu Tang (True Warrior Decoction) with Poria removed is used.
[Honey Suppository Method] In Yangming disease with spontaneous sweating, where urination should be difficult but is instead free-flowing, it indicates exhaustion of internal body fluids. Although feces are hard, they cannot be purged aggressively; instead, Honey Suppository or Pig Gallbladder Juice method is appropriate.