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[Symptoms of Urinary Difficulty Due to Yin-Cold] Pain and discomfort in the bone joints, inability to flex or extend, sweating with shortness of breath, aversion to wind with slight edema; this is due to the binding of cold-dampness, resulting in urinary difficulty. In Shaoyin disease, abdominal pain occurs after four or five days; the patient may have cough, heaviness and pain in the limbs, or spontaneous diarrhea; this indicates internal binding of cold-dampness leading to urinary difficulty.

[Causes of Urinary Difficulty Due to Yin-Cold] Wind-cold-damp pathogens bind in the meridians and collaterals. Yin-cold governs closure, and dampness governs obstruction, often causing body pain and urinary difficulty. Additionally, when cold-dampness injures the Shaoyin channel, upward rushing of yin-cold causes coughing; downward binding of yin-cold at the Guanyuan (CV-4) point causes urinary difficulty.

[Pulse Signs of Urinary Difficulty Due to Yin-Cold] The pulse must be soggy and slow (Ru-Huan), or even soggy and delayed (Ru-Chi) in severe cases. A soggy and delayed pulse on the right position indicates Taiyin cold-dampness. A soggy and delayed pulse on the left position indicates Shaoyin cold-dampness.

[Treatment for Urinary Difficulty Due to Yin-Cold] For Taiyin cold-dampness, use Gancao Fuzi Tang (Licorice and Prepared Aconite Decoction) or Zhufu Tang (Atractylodes and Aconite Decoction). For Shaoyin water qi pathology, use Zhenwu Tang (True Warrior Decoction). For Shaoyin yin-cold pathology, [text implies warming formulas].

Gancao Fuzi Tang (Licorice and Prepared Aconite Decoction)
Sheng Gancao (Raw Licorice Root)
Shu Fuzi (Prepared Aconite Lateral Root)

Zhufu Tang (Atractylodes and Aconite Decoction)
Baizhu (Atractylodes Macrocephala Rhizome)
Shu Fuzi (Prepared Aconite Lateral Root)

Zhenwu Tang (True Warrior Decoction)
Baifuling (Poria Cocos Sclerotium)
Baishao Yao (White Peony Root)
Shengjiang (Fresh Ginger Rhizome)
Baizhu (Atractylodes Macrocephala Rhizome)
Shu Fuzi (Prepared Aconite Lateral Root)

Sini Tang (Recovery Decoction)
Ganjiang (Dried Ginger Rhizome)
Shu Fuzi (Prepared Aconite Lateral Root)
Zhi Gancao (Honey-fried Licorice Root)

[Symptoms of Urinary Difficulty Due to Heat Binding] Wheezing, cough, facial swelling, rebellious qi with chest fullness; this is urinary difficulty due to heat in the Lung and Intestines. Mental restlessness, fever, irritability, red urine, and constipation; this is urinary difficulty due to heat in the Heart and Small Intestine. Lower back pain, bone-steaming tidal fever, hot sensation in the soles of both feet; this is urinary difficulty due to heat in the Kidney and Bladder.

[Causes of Urinary Difficulty Due to Heat Binding] The Lung governs the unblocking and regulation of water passages, while the Intestines govern the transmission and transformation of food and fluids. If the Upper Jiao loses its clear descending function, it cannot transport fluids down to the Bladder, resulting in urinary difficulty. The Heart and Small Intestine are interior-exteriorly related; if Heart heat transfers to the Small Intestine, urinary difficulty ensues. The Kidney and Bladder govern the lower part of the body and control urination; heat in these two channels leads to lower Jiao heat binding, causing urinary difficulty.

[Pulse Signs of Urinary Difficulty Due to Heat Binding] A surging and rapid pulse at the Right Cun position indicates heat in the Lung channel. A rapid pulse extending from Cun to Chi indicates heat in the Large Intestine. A rapid pulse extending from Cun to Guan indicates heat in both the Lung and Stomach. A fine and rapid pulse at the Left Cun position indicates fire in the Heart channel. A large and rapid pulse at the Left Cun position indicates heat in the Small Intestine. A fine and rapid pulse at the Left Chi position is a diagnosis of Kidney fire. A large and rapid pulse at the Left Chi position indicates binding heat in the Bladder.

[Treatment for Urinary Difficulty Due to Heat Binding] For heat in the Lung channel, use Qingfei Yin (Lung-Clearing Drink) or Huangqin Xiebai San (Scutellaria and White Peony Powder). For heat in the Large Intestine, use Huanglian Zhike Tang (Coptis and Aurantium Decoction). For heat in the Stomach [text incomplete], and binding heat in the Bladder, use Cheqian Mutong Tang (Plantago and Akebia Decoction).

Qingfei Yin (Lung-Clearing Drink)
Jiegeng (Platycodon Root)
Huangqin (Scutellaria Root)
Shanzhi (Gardenia Fruit)
Lianqiao (Forsythia Fruit)
Tianhuafen (Trichosanthes Root)
Xuanshen (Scrophularia Root)
Bohe (Mentha Haplocalyx)
Gancao (Licorice Root)

Huangqin Xiebai San (Scutellaria and White Peony Powder)
Huangqin (Scutellaria Root)
Sangbaipi (Morus Bark)
Digupi (Lycium Bark)
Gancao (Licorice Root)

Huanglian Zhike Tang (Coptis and Aurantium Decoction) See section on Damp-Heat Dysentery.

Qingwei Tang (Stomach-Clearing Decoction) See section on Abdominal Pain.

Xiexin Tang (Drain the Heart Decoction)
Chuan Huanglian (Coptis Rhizome) (3 qian)
Gancao (Licorice Root) (2 qian)

Daochi Banban Tang (Half-and-Half Guide-Out Redness Decoction) See previous text.

Zhibai Dihuang Wan (Anemarrhena, Phellodendron, and Rehmannia Pill) Also known as Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), added with Zhimu (Anemarrhena Rhizome) and Huangbai (Phellodendron Bark).

Cheqian Mutong Tang (Plantago and Akebia Decoction)
Cheqianzi (Plantago Seed) (3 qian)
Mutong (Akebia Caulis) (2 qian)