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Heat accumulation in the Bladder (Bladder) causes Long Bi (strangury with retention), while cold deficiency causes Yi Niao (enuresis/involuntary urination) and Jin Bu (incontinence). "Bi" refers to complete urinary retention with no drops excreted, accompanied by distension, fullness, and pain in the lower abdomen that is difficult to relieve. "Long" refers to dribbling urination with only drops excreted, accompanied by astringent pain and frequent urgency in the urethra. Urination without awareness is called Yi Niao (enuresis); urination with awareness but inability to control is called Xiao Bian Bu Jin (urinary incontinence). Differentiate among Shi Lin (lithiasis strangury), Xue Lin (hematuric strangury), Gao Lin (chylous strangury), Lao Lin (exhaustion strangury), and Qi Lin (qi strangury).

[Note] Heat accumulation in the Bladder: mild cases are Long, severe cases are Bi. Cold deficiency of the Bladder: mild cases are Yi Niao, severe cases are incontinence. "Bi" means complete urinary obstruction with no drops passing, hence the distension and painful fullness of the lower abdomen. "Long" means dribbling drops out, dozens of times a day, or frequent and uncontrolled discharge, hence the astringent pain in the urethra. Urination without consciousness is termed Yi Niao. Awareness present but inability to retain is termed Xiao Bian Bu Jin.

Vomiting and hiccups combined with urinary obstruction constitute Guan Ge (Guan-Ge syndrome/blockage and reversal). If sweating appears only on the head, life is imperiled. In Shang Han (Cold Damage), delirium and confusion with enuresis indicate death; urinary obstruction with a fine and choppy pulse also indicates death.

[Note] Upper vomiting and hiccups preventing intake, lower urinary obstruction, signifies the blockage and reversal of Yin and Yang Qi. If sweat appears only on the head, it indicates the exhaustion of Yang Qi, hence the peril to life. Delirium and confusion in Shang Han belong to excessive Yang pathogenic factors; enuresis belongs to Yin failing to hold. If urinary obstruction is accompanied by a fine and choppy pulse, it is known that Yin fluids are also exhausted; thus, all these conditions are fatal.

Use the Yin-Yang moxibustion on the navel method with Cong Bai (Scallion White) and She Xiang (Musk); alternating hot and cold moxibustion allows urine to flow spontaneously. To promote upper release, use Mu Tong (Akebia Caulis) and Cong Bai decoction for emesis; to reach the exterior, use Cong Tang (Scallion Decoction) fumigation and sweating to unblock urination.

[Note] Take one jin (approx. 500g) of finely chopped Cong Bai (Scallion White), mix with five fen (approx. 1.875g) of She Xiang (Musk), divide into two bags, and place on the navel. First, apply a charcoal-heated iron to moxa/heat the area; after half an incense stick's time, switch to a bag cooled with cold water and apply with a cold iron. Alternate heating and cooling until urination resumes. If various medicines fail, or if taken medicine is immediately vomited, or if purgatives fail to produce relief, use the method of promoting upper release: decoct Mu Tong (Akebia Caulis) and old Cong Bai (Scallion White) for drinking, induce vomiting after a short while, repeat administration and induction until urination resumes. If various medicines fail or there is no sweating, use the method of reaching the exterior: pour Cong Tang (Scallion Decoction) into a wooden tub, have the patient sit on a stool, submerging up to the navel, wrap a skirt around the waist to cover, and after a short time, sweating will occur and urine will naturally pass. Do not leave the tub when the urge to urinate arises; urinate within the tub, lest leaving causes Qi to contract and urine to flow back.