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It is common for the bladder to be damaged due to the carelessness of midwives, leading to a condition of dribbling urine (incomplete emptying of the bladder), which becomes a disability. One day, a middle-aged woman surnamed Xu suffered from this. I reasoned that if external muscle injuries can be repaired and healed, the bladder, although located within the abdomen, might also be treatable. Upon examining her pulse, it was found to be extremely deficient. I said, "The cause of difficult labor is mostly Qi deficiency; after difficult labor, both Blood and Qi are even more deficient. Let us try a vigorous tonification." The prescription used Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) as Sovereign herbs, Xiong Gui (Ligusticum Chuanxiong Rhizome and Angelicae Sinensis Radix) as Minister herbs, Tao Ren (Persicae Semen), Chen Pi (Citri Reticulatae Pericarpium), Huang Qi (Astragali Radix), and Fu Ling (Poria) as Assistant herbs. It was decocted with broth made from pig or sheep bladders and administered when the patient was extremely hungry. Each dose was one liang. After one month, she recovered. This was because the sudden growth of Qi and Blood allowed the bladder to heal itself. If treatment were delayed slightly, success would be difficult to achieve.

Zhuan Bao disease (obstruction of urination during pregnancy with urgency and pain in the umbilical region) occurs frequently in pregnant women who have weak constitutions, those who are prone to worry and depression, those with irritable temperaments, and those who consume rich-flavored foods. Ancient prescriptions all used slippery and draining medications, but few were effective. I reasoned that the bladder is displaced by the fetus to one side, causing the bladder ligaments to twist and obstruct flow. If the fetus could be lifted and suspended centrally, the bladder ligaments would relax, and urinary flow would resume naturally. However, there must be a reason for the fetus descending. One day, a favored concubine in the Wu household suffered from this. Her pulses on both hands seemed choppy (Se); upon heavy pressure, they were wiry (Xian), though the left hand was slightly harmonious. I said, "This resulted from worry and distress. A choppy pulse indicates deficient Blood and excess Qi; a wiry pulse indicates fluid retention. Deficient Blood makes the bladder weak and unable to lift itself; excess Qi with fluid retention causes turbidity in the Middle Jiao and overflow, forcing the bladder downward." Therefore, Si Wu Tang (Four Substances Decoction) was modified with Ren Shen, Bai Zhu, Ban Xia (Pinelliae Tuber), Chen Pi, Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma), and Sheng Jiang (Zingiberis Rhizoma Recens). It was taken on an empty stomach, followed immediately by inducing vomiting by probing the throat to expel the medicinal juice. After a short while, once the Qi settled, another dose was given. The next morning, the same procedure was repeated. After eight doses in this manner, she recovered. This method may not be definitive, perhaps merely a lucky hit! Later, it was successfully applied to several other cases. I wonder what the truth is? Zhang Zhongjing stated: "Women who are originally obese feel fullness when the abdomen is lifted; those who are emaciated feel emptiness when lifted. Twisting of the bladder ligaments also leads to Zhuan Bao." The meaning here is unclear; there must be someone who knows it.