小便不通。由膀胱与肾俱有热也。肾主水。膀胱为津液之府。此二经为表里。而水行于
小肠。
入胞者为小便。若肾与膀胱即热。热入于胞。热气大盛。故结涩。令小便不通。小腹胀满。
气急甚者。水气上逆。令心急腹满。乃至于死。诊其脉紧而滑直者。不得下小便也。
一论膀胱有热。小便闭而不通也。
导水散
当归（二钱） 瞿麦（三钱） 车前子（二钱） 滑石（三钱） 赤茯苓（三钱） 泽泻（二钱）
猪苓
（二钱） 木通（二钱） 石莲子（去壳一钱） 山栀子（三钱） 黄连（六分） 黄柏（一钱五分酒
炒） 知母（一钱五分） 甘草（八分）
上锉。灯心煎。空心。温服。
一小便不通。百法不能奏效。服此无不愈。
禹功散
陈皮 半夏（姜制） 赤茯苓 猪苓 泽泻 白术（炒） 木通（各一钱） 条芩（八分）
升麻（三分） 甘草（三分） 山栀子（炒一钱）
上锉一剂。水二钟。煎至一钟。不拘时服。少时。以鸡翎探吐之。得解而止。妙在吐。
譬如滴水之器。闭其上窍则不沥。拔之则水通流泄矣。
一论溺溲不通。非细故也。期朝不通。便令人呕。名曰关格。又曰不通而死矣。一见呕
吐。便不可救。经曰。出入废则神机化灭。升降息则血气孤危。此之谓也。
一论小便闭塞。用凉药过多而不通者。是元气虚而不能输化也。以补中益气汤主之。
一论小便淋沥不通。以六味丸倍茯苓、泽泻。
一论小便不通。先将麝香半分。填患人脐中。上用葱白。田螺。各捣烂成饼。封于脐上
用
布带缚住。良久下宜用皂荚烧烟。熏入阴中。其水窦自通。妇人亦用皂荚熏洗便处。即通。
一论小便不通。膀胱发热者。朴硝为细末。每服二钱。大茴香煎汤调下。
一论小便不通。腹胀。土蒺藜炒黄为末。黄酒调下。
一论小便不通。用猪胆汁投热酒中。服之立通。
又方。用蚯蚓研。以冷水滤浓汁。服半碗立通。大解热极。不知人事欲死者。用之。
一论小便不通。脐下满闷者。
海金沙（一两） 腊茶（五钱）
上为末。每服三钱。生姜、甘草梢煎汤调下。
一论小便不通。两尺脉俱沉微乃阴虚故也。曾服通滑寒凉之药所致。用大附子一枚。
重
一两者。炮去皮脐。盐水浸。泽泻一两。二味锉作四剂服。水二盏。灯心七根煎。食远服。
一论小便不通。体肿喘嗽。用补中益气汤。金匮肾气丸兼服。
一论小便不通。服凉药过多。胀满几死。以附子理中汤加琥珀末。一服立通。
一妇人病饮食如故。烦热不得卧。而反倚息。以脬系了戾不得溺。故致此病。名曰转脬
但利小便则愈。八味丸主之。（方见补益）
一治男子消渴。小便反多。妇人转脬。小便不通。宜服八味丸。又治妇人阴冷。
立斋云。
治老人阴痿思色。精不出。内败。小便道涩痛如淋。八味丸加车前子、牛膝。若老人精已
竭
而复耗之。大便小便牵痛。愈痛愈欲便。愈便则愈痛。此药最效。八味丸主之。（方见补益
）
一治小便不通。用蝼蛄一个。焙熟嚼吃。黄酒送下。立通。
一治小便不通。并伤寒杂症。而不可以药通利者。用此药立通。以皮硝煎化。用青皮蘸
水搭脐上。并小便处。热则易之。
一治小便不通。已经七八日。遍身手足肿满。诸医罔效。余以紫苏煎汤。入大脚盆内。
令病患坐上熏蒸。冷则添热滚汤。外用炒盐熨脐上遍身肿处。良久便通。肿消而愈。
一治小便不通。小腹胀满。不急治。即杀人。连根葱白一斤。捣烂炒热。以布裹。分作
二包。更替熨脐下。即通。加麝香尤妙。
一治小便不通。诸药无效。或转胞至死。此法用之。小便自出。猪尿胞一个。倾出尿。
用鹅
毛管去头尾。插入窍孔内。线扎定。以口吹气。令满胞。用线管下再扎住。管口放在小便头
上向窍孔。解下线。手搓。其气透里。自然小便即出。甚效。
Urinary retention. It is caused by heat in both the Bladder and Kidney. The Kidney governs water metabolism, and the Bladder is the mansion of body fluids (Jin Ye). These two meridians are exteriorly-interiorly related, while water flows through the Small Intestine. What enters the "Pao" (here referring to the Bladder) becomes urine. If there is heat in the Kidney and Bladder, heat enters the Pao. When heat qi is excessive, it causes coagulation and astringency, leading to urinary retention, abdominal distension below the umbilicus. In severe cases of Qi urgency, water qi rebels upward, causing palpitations in the heart region and abdominal fullness, potentially leading to death. Palpation reveals a tight, slippery, and straight pulse, indicating inability to pass urine.
One discussion states that heat in the Bladder causes urinary obstruction and retention.
Daoshui San (Water-Guiding Powder)
Danggui (Radix Angelicae Sinensis, 2 qian) Qumai (Herba Dianthi, 3 qian) Cheqianzi (Semen Plantaginis, 2 qian) Huashi (Talcum, 3 qian) Chi Fuling (Polyporus with Red Mycelium, 3 qian) Zexie (Rhizoma Alismatis, 2 qian)
Zhuling (Polyporus, 2 qian) Mutong (Caulis Akebiae, 2 qian) Shilianzi (Fructus Nelumbinis, shell removed, 1 qian) Shanzhizi (Fructus Gardeniae, 3 qian) Huanglian (Rhizoma Coptidis, 6 fen) Huangbai (Cortex Phellodendri, 1.5 qian, stir-fried with wine) Zhimu (Rhizoma Anemarrhenae, 1.5 qian) Gancao (Radix Glycyrrhizae, 8 fen)
Crush the herbs. Decoct with Dengxincao (Medulla Junci). Take warm on an empty stomach.
For urinary retention where other methods fail, this formula is invariably effective.
Yugong San (Work-Performing Powder)
Chenpi (Pericarpium Citri Reticulatae) Banxia (Rhizoma Pinelliae, processed with ginger) Chi Fuling Polyporus Zexie Baizhu (Rhizoma Atractylodis Macrocephalae, stir-fried) Mutong (each 1 qian) Tiao Qin (Radix Scutellariae, 8 fen)
Shengma (Rhizoma Cimicifugae, 3 fen) Gancao (Radix Glycyrrhizae, 3 fen) Shanzhizi (Fructus Gardeniae, stir-fried, 1 qian)
Crush one dose. Add two zhong of water, decoct to one zhong. Take at any time. Shortly after, induce vomiting using a chicken feather. Stop when excretion occurs. The efficacy lies in inducing vomiting.
It is like a dripping vessel: if the upper orifice is closed, water does not drip; if opened, water flows freely.
Another discussion states that urinary obstruction is no trivial matter. If it persists for a day, it causes vomiting, named Guan Ge (Obstruction and Repletion). It is also said that obstruction leads to death. Once vomiting appears, it is incurable. The Classics state: "When exit and entry cease, the Spirit Mechanism perishes; when ascent and descent stop, Blood and Qi become isolated and endangered." This refers to such cases.
Another discussion states that urinary blockage due to excessive use of cooling medicines indicates deficiency of Yuan Qi (Original Qi) unable to transport and transform. Treat primarily with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction).
Another discussion states that for dribbling urinary retention, use Liuwei Wan (Six-Ingredient Pill with Rehmannia) doubling the dosage of Fuling (Poria) and Zexie (Alisma).
Another discussion states that for urinary retention, first fill half a qian of Shexiang (Musk) into the patient's umbilicus. Cover with a paste made of Congbai (Bulbus Allii Cepae) and Tianluo (Freshwater Snail), each pounded into a cake. Seal over the umbilicus and bind firmly with a cloth belt. After some time, smoke Yin (Genitalia) with burning Zaojiao (Gleditsia Sinensis Pod). The urinary orifice will naturally open. Women may also use Zaojiao smoke wash on the genital area for immediate relief.
Another discussion states that for urinary retention with heat in the Bladder, take Puxiao (Natrii Sulfas) powder, 2 qian per dose, mixed with Da Huixiang (Foeniculum Vulgare) decoction.
Another discussion states that for urinary retention with abdominal distension, take Tu Jili (Fructus Tribuli, stir-fried until yellow) powder, mixed with Huangjiu (Yellow Wine).
Another discussion states that for urinary retention, mix Zhu Danzhi (Bile Porci) into hot wine and drink; passage is immediate.
Another prescription: Grind Diqiu (Lumbricus), filter thick juice with cold water, drink half a bowl for immediate passage. Suitable for cases of extreme internal heat, unconsciousness, and impending death.
Another discussion states that for urinary retention with fullness and stuffiness below the umbilicus:
Haijinsha (Spore Lycopodii) (1 liang) Chacha (Tea Leaves) (5 qian)
Powder these. Take 3 qian per dose, mixed with Jiangsheng (Young Ginger) and Gancaoshao (Tip of Licorice Root) decoction.
Another discussion states that for urinary retention with deep and faint pulses at both Chi positions, this is due to Yin deficiency, caused by prior use of purgative, slippery, and cooling medicines. Use one large Fuzi (Radix Aconiti Lateralis Preparata), weighing 1 liang, prepared, skin and navel removed, soaked in salt water, combined with 1 liang of Zexie. Crush into four doses. Decoct with two zhan of water and seven roots of Dengxincao. Take well after meals.
Another discussion states that for urinary retention with generalized edema and wheezing/cough, combine Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Jin Gui Shenqi Wan (Kidney Qi Pill from the Golden Cabinet).
Another discussion states that for urinary retention caused by excessive cooling medicines, leading to near-fatal distension, use Fuzi Lizhong Tang (Aconite Decoction to Warm the Middle) added with Hupo (Fossilized Wood/Amber) powder. One dose brings immediate relief.
A woman suffered from normal appetite but restlessness, fever, inability to lie flat, and orthopnea. This was due to "Paoxi liaoli" (twisting of the bladder ligaments) preventing urination, causing this condition, named Zhuan Pao (Reversed Bladder). Promoting urination cures it. Treat with Bawei Wan (Eight-Ingredient Pill). (Formula see Tonification section).
Another treatment for men with Xiao Ke (Wasting and Thirsting Syndrome) having excessive urination, or women with Zhuan Pao and urinary retention, is suitable for Bawei Wan (Eight-Ingredient Pill). It also treats female vaginal coldness.
Lizhai stated:
Treating elderly men with impotence and sexual desire without emission, leading to internal decay, and painful, difficult urination resembling strangury, use Bawei Wan (Eight-Ingredient Pill) plus Cheqianzi (Plantago Seed) and Niuxi (Achyranthes Root). If an elderly man whose essence is already exhausted further depletes it, causing pulling pain during defecation and urination—where more pain increases the urge to defecate/urinate, which in turn increases pain—this medicine is most effective. Treat with Bawei Wan (Eight-Ingredient Pill). (Formula see Tonification section).
Another treatment for urinary retention: Roast one Lougu (Mole), chew and swallow with Huangjiu (Yellow Wine) for immediate passage.
Another treatment for urinary retention and external contraction/miscellaneous diseases where medicinal diuretics fail: Melt Pixiao (Natrii Sulfas). Dip Qingpi (Citrus Reticulata Green Peel) in water and apply to the umbilicus and genital area. Replace when it cools.
Another treatment for urinary retention persisting for 7-8 days with generalized swelling of limbs and body, unresponsive to other doctors: I used Zijie (Perilla Leaf) decoction poured into a large basin. Have the patient sit over it to steam. Add boiling water as it cools. Externally, apply fried salt to warm the umbilicus and swollen areas. After a while, urination resumes, swelling subsides, and recovery occurs.
Another treatment for urinary retention with lower abdominal distension. If not treated urgently, it is fatal. Take 1 jin of Congbai (Green Onion White, with roots), pound and stir-fry until hot. Wrap in cloth to make two packs. Alternate applying to the lower abdomen. Immediate relief. Adding Shexiang (Musk) is especially good.
Another treatment for urinary retention unresponsive to all medicines, or Zhuan Pao leading to death: Urine will flow spontaneously. Take one Zhu Niaobao (Pig Bladder), empty the urine. Insert a Goose Feather Tube (without head/tail) into the orifice and tie securely. Blow air into the bladder to inflate it. Tie the tube below. Place the tube opening at the urinary meatus. Untie the thread and massage gently. The air penetrates internally, and urine flows naturally. Highly effective.