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If a pregnant woman suffers from meridian and vessel injury due to overexertion, heat invades the blood. Blood enters the *Paoguan* (Bladder) when heated, causing hematuria. *Tainlou* (Fetal leakage) refers to bleeding from the vagina, whereas hematuria refers to bleeding from the urethra. For hematuria during pregnancy caused by heat in the uterus (*Zigong*), *Siwu Tang* (Four Substances Decoction) is often used with added Gardenia (*Shanzhi*) and burnt hair (*Fahui*), or ingredients such as Ejiao (Donkey-hide gelatin), Shudi (Prepared Rehmannia Root), Maidong (Ophiopogon Tuber), and Wuweizi (Schisandra Fruit).

When a pregnant woman experiences scanty, difficult, and dribbling urination, it is called *Zilin* (Pregnancy Dysuria). This occurs because Qi and Blood gather to nourish the fetus and fail to adequately moisten and irrigate the water passages, leading to stagnant heat in the Bladder. Treatment should use Danggui (Angelica Sinensis) and Baishao (White Peony Root) to harmonize the blood; Renshen (Ginseng) to tonify Qi; Maidong (Ophiopogon Tuber) to clear the Lungs and nourish the source of Kidney Water; and Huashi (Talcum) to promote urination and clear stagnation. This formula is named *Anrong San*. Ancient formulas contain Huashi, which has a heavy and sedative nature, raising concerns about inducing abortion; however, it is excellent if used near term. If used at seven or eight months of pregnancy, Huashi should be removed, and Shihu (Dendrobium Stem) and Shanzhi (Gardenia) added for greater safety. If the condition persists for a long time accompanied by fatigue and a weak pulse on the right side, this indicates Qi deficiency with sinking, causing a sensation of heaviness or prolapse during urination. Due to weak Qi and empty intestines hindering smooth flow, large doses of Renshen (Ginseng) are required to move the Qi, after which urination will naturally become easy.

The syndrome of *Baozhuan* (Displacement of the Uterus/Bladder) presents with urgent pain below the umbilicus and inability to urinate. It is caused by holding urine forcibly, running rapidly, holding urine after a full meal, or having intercourse while holding urine. These actions cause water Qi to reverse upward, pressing against the bladder, causing it to twist and preventing expansion. This is not a disease of the Small Intestine or Bladder itself, nor can it be cured merely by using diuretic herbs. The method is to lower the rebellious Qi to achieve cure; if the bladder descends severely, the fetus may die. This condition is common in individuals with weak constitutions, those prone to worry and depression, those with irritable temperaments, and those who consume rich-flavored foods. Ancient formulas using slippery/diuretic herbs have rarely been effective. I reason that the bladder displaces because it is compressed by the fetus. If the fetus is lifted, the bladder's ligaments will relax, and the water passage will open. Therefore, *Buzhong Yiqi Tang* (Tonify the Middle and Augment the Qi Decoction) is appropriate. After administration, inducing vomiting helps lift the Qi, allowing urination to resume naturally. Immediately after urination resumes, strong tonics like Renshen (Ginseng) should be avoided to prevent abortion.

Danxi stated: A woman nine months pregnant suffered from *Baozhuan*, unable to urinate, with severe lower abdominal urgency and leg swelling making walking impossible. Her pulse was choppy on the right and slightly harmonious on the left. This was caused by overeating injuring Qi, resulting in a weak uterine ligament unable to support the fetus, which descended and pressed against the bladder, obstructing Qi and blocking the urinary outlet. The prescription used Renshen (Ginseng), Baizhu (Atractylodes Macrocephala), Chenpi (Tangerine Peel), Zhi Gancao (Honey-fried Licorice), Danggui (Angelica Sinensis), Baishao (White Peony Root), Banxia (Pinellia Tuber), and Shengjiang (Fresh Ginger) to nourish Blood and Qi. Once Qi and Blood were robust, the uterine ligaments naturally supported the fetus. After drinking the decoction once, inducing vomiting was performed. After four doses, dark water flowed out upon urination. She recovered after subsequent regulation and tonification. Another case involved a woman at seven or eight months of pregnancy with urinary retention and a fine, weak pulse, indicating deficient and timid Middle Qi unable to lift the fetus. The fetus pressed on the lower opening of the bladder, preventing voiding. *Buzhong Tang* (Tonify the Middle Decoction) was used with herbs to lift and raise. Due to insufficient medicinal effect, she endured unbearable distension and pain. An elderly woman then applied sesame oil to her hands and manually lifted the fetus through the vaginal opening. Urine gushed out, and the distension and urgency instantly resolved. She was subsequently treated with a large dose of Renshen (Ginseng) for tonification. By the third day, the fetus had risen, and urination returned to normal. *Zhengzhi Zhunsheng* states: The concept of *Baozhuan* refers to the bladder being forced into a lateral position; here, "Bao" refers to the bladder. However, *Zilin* and *Baozhuan* are similar. *Zilin* is characterized by frequent urination, dribbling, and pain, caused by deficiency-heat in the Bladder and Small Intestine. Deficiency prevents controlling water, and heat prevents free flow. In contrast, *Baozhuan* involves frequency but little output without pain (or with slight pain), distinguishing it from *Zilin*. The *Classic of Difficult Issues* says: "The Qi of the Woman's Bao." It also says: "Heat transfers from the Bao to the Bladder." And: "The Chong and Ren meridians both originate from the Bao." In all these instances, "Bao" is pronounced "Bao" and refers to the uterus. The *Ling Shu* states: "The Bao of the Bladder is thin and flaccid," pronounced "Pao," referring to the organ storing urine (the bladder). There are three entities referred to as "Bao," yet the character is identical. Why do later generations misunderstand? Some separate the Bladder from the Urinary Sac. Others, citing *Leizuan*, say "The Bladder is the chamber of the Bao," mistakenly equating the fetal Bao (uterus) with the bladder. This is a significant error. The Bladder is the Pao, and the Pao is the Bladder. Is there another entity residing within the Bladder? Those who equate the fetal Bao with the Bladder should consider: in *Baozhuan*, the upper structure presses down on the Bladder, causing urinary retention. Thus, the Bao is above, and the Bladder is below; their locations are distinct, clearly proving they are not the same entity.