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Xue Lizhai stated: For pregnancy accompanied by scanty, dribbling, and difficult urination, Anrong San (Safety and Prosperity Powder) should be used. If the condition is due to damp-heat in the Liver channel, Longdan Xiegan Tang (Gentian Liver-Draining Decoction) is indicated. If it is due to deficient-heat in the Liver channel, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) is indicated. If frequent urination or difficulty in urination occurs after taking drying agents, Shengdi Huang (Rehmanniae Radix), Fuling (Poria), Niuxi (Achyranthis Bidentatae Radix), Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), and Gancao (Glycyrrhizae Radix et Rhizoma) should be used. If urination is frequent with yellow urine, Siwu Tang (Four Substances Decoction) added with Zhimu, Huangbai, Wuweizi (Schisandrae Chinensis Fructus), Maidong (Ophiopogonis Radix), and Yuan Shen (Scrophulariae Radix) is indicated. If shortness of urine is caused by deficiency of Lung Qi, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Shanyao (Dioscoreae Rhizoma) and Maidong is indicated. If difficulty in urination is caused by heat accumulation in the Bladder, Wulin San (Five Types of Strangury Powder) is indicated. If dryness of the Spleen and Lung prevents the transformation and generation of fluids, Huangqin Qingfei Yin (Scutellaria Lung-Clearing Infusion) is suitable. If Bladder Yin is deficient and Yang cannot be generated, Zishen Wan (Kidney-Nourishing Pill) is indicated. If Bladder Yang is deficient and Yin cannot be transformed, Shenqi Wan (Kidney-Energy Pill) is indicated.

Shen Zhai commented: The above four points describe the syndrome of strangury with difficult urination during pregnancy. There are five types of strangury; Zhu Danxi primarily attributed them to heat. Regarding strangury in pregnancy, *Chanbao* (Precious Prescriptions for Obstetrics) and *Liangfang* (Good Prescriptions) attributed it to deficient-heat and stagnant-heat located in the Bladder. Xue Lizhai further traced the origin, distinguishing between damp-heat and deficient-heat in the Liver channel. This is because the Bladder is the organ that stores urine, while the orifice through which urine exits belongs to the distribution area of the Foot-Jueyin (Liver) channel. Therefore, to clear heat from the Bladder, one must simultaneously soothe the Qi of the Jueyin channel.

The *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion) states: In cases of Baozhuan (retention of urine due to bladder torsion/compression) where urination is impossible, with fullness in the lower abdomen, Guanyuan (CV 4) is the primary point. It also states: For difficult urination, water swelling, scanty urine output, and Baozhuan, Qugu (CV 3) is the primary point.

The *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) states: When a woman suffers from illness, eats normally, feels vexed and hot, cannot lie down, but instead leans forward to breathe (dyspnea), what is this disease? The Master said: This is named Baozhuan (bladder retention), characterized by the inability to urinate. This occurs because the Baoxi (membranes connecting the uterus/bladder) are twisted and disordered. The condition will resolve once urination is promoted; Shenqi Wan (Kidney-Energy Pill) is indicated as the principal treatment.

The *Shengji Zonglu* (Comprehensive Mirror of Holy Relief) states: When the Bao (uterus/bladder region) receives fluid but Qi fails to circulate, the Small Intestine becomes distended. This may result from exertion after a full meal or from sexual intercourse, causing the Bao to twist and deviate, preventing the passage of urine, thus leading to Baozhuan. The symptoms include obstruction of the urinary pathway, urgent pain in the lower abdomen, vexation, sweating, rebellious Qi rushing upward, and even death. This is called Baozhuan and requires rapid treatment.