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[Danxi] Incontinence or retention of urine during pregnancy is caused by heat in the Small Intestine transmitting to the Uterus (Bao), leading to obstruction. If accompanied by Qi stagnation in the Heart and Lungs, it results in panting and urgency. Chen Wuyue stated: During pregnancy, the fullness of the fetus pressing on the Uterus often leads to difficult urination. If there is deficiency of Qi in the Heart and Kidneys, causing turbid and clear energies to interfere with each other, various types of Lin syndrome (dysuria) occur. If the ligaments of the bladder are twisted, resulting in urinary retention, it is named "Zhuan Bao" (Displaced Bladder). If the fullness of the fetus causes urine leakage, it is named "Yi Niao" (Enuresis).

[Danxi] Women suffering from Zhuan Bao generally have weak constitutions, are prone to worry and depression, have irritable temperaments, or consume rich-flavored foods. Ancient prescriptions mostly used slippery and draining herbs, but rarely achieved efficacy. I reasoned that the Uterus is compressed by the fetus and shifted to one side, causing the bladder ligaments to twist and obstruct flow. If the fetus were lifted and suspended centrally, the ligaments would relax, and the water pathway would function naturally. However, the reason for the fetus descending must be identified. One day, a favored concubine of the Wu family suffered from this condition. Her pulse was slightly choppy in both hands, wiry upon heavy pressure, and slightly harmonious in the left hand. I said: This resulted from worry and distress. A choppy pulse indicates blood deficiency and excess Qi; a wiry pulse indicates fluid retention. Blood deficiency makes the Uterus weak and unable to lift itself; excess Qi with fluid retention causes unclear middle Jiao and narrowing, so the Uterus avoids discomfort and descends, hence the tendency to drop. Therefore, I prescribed Siwu Tang (Four Substances Decoction) added with Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), Banxia (Pinellia Tuber), Chenpi (Tangerine Peel), Sheng Gancao (Raw Licorice Root), and Shengjiang (Fresh Ginger). She took it on an empty stomach, and I induced vomiting by probing her throat. After her breath stabilized, she took another dose. The next day, the same procedure was repeated. After eight doses, she recovered. This method proved effective, though I feared it might be accidental. Later, several others used it with evident success, though the exact mechanism remains unknown. Zhang Zhongjing stated: Women originally possessing abundant flesh and a raised head/full body, now becoming emaciated with a hollow abdomen, suffer from twisted bladder ligaments leading to displaced bladder. The precise meaning is unclear to me; surely someone knows it. A forty-one-year-old woman, nine months pregnant, suffered from Zhuan Bao with no urination for three days. Her lower abdomen was urgent, feet swollen, and she could barely survive, coming for emergency help. Upon examination, her form was emaciated; her right pulse was choppy and the left slightly harmonious. This indicated injury to Qi after overeating, weakness of the fetal ligaments preventing self-lifting, causing descent and compression of the bladder to one side. The urgent Qi was blocked, preventing urine exit. Zhuan Bao generally presents thus. I formulated a prescription to nourish Blood and Qi. Once Blood and Qi are rectified, the fetal ligaments lift naturally, preventing descent, ensuring safety. I prepared Ren Shen (Ginseng Root), Dang Gui (Angelica Sinensis Root, head and tail), Baishao (White Peony Root), Baizhu (Atractylodes Rhizome), Chenpi (Tangerine Peel with pith), Zhi Gancao (Honey-fried Licorice Root), Banxia (Pinellia Tuber), and Shengjiang (Fresh Ginger), decocted into a strong liquid for four doses, allowing her to swallow despite crying. At dawn the next day, another four doses were given. The dregs were decocted as one dose, taken all at once, and vomiting was induced. Urine flowed immediately, appearing black. Subsequently, Dafupi (Areca Peel), Zhike (Bitter Orange Fruit), Qingcong Ye (Green Onion Leaf), and Suoren (Amomum Fruit) were added to the formula for twenty doses to prevent deficiency before and after delivery. She delivered safely and remained healthy postpartum. Another woman, seven to eight months pregnant, suffered from urinary retention unresponsive to many doctors, worsening with urgency and distension. Her pulse was fine and weak. I surmised Blood and Qi deficiency, or that fluid carrying the fetus made it heavy, pressing on the bladder outlet. If tonifying herbs were used to lift the fetus, it would descend naturally. Until the drug effect arrived, distension worsened. I instructed an old woman to apply sesame oil to her hands, insert them into the birth canal, and lift the fetus. Urine gushed out, and distension resolved instantly. Meanwhile, Ren Shen (Ginseng Root), Huangqi (Astragalus Root), and Shengma (Cimicifuga Rhizome) were decocted in large doses. If slight urgency occurred, manual lifting was repeated. After three days, the fetus gradually rose, and urination normalized.

[Xueji] The aforementioned conditions also include Spleen and Lung Qi deficiency failing to transport fluids to the Bladder; Qi-heat stagnation in the Bladder obstructing fluid metabolism; Metal (Lung) scorched by Fire (Heart), causing Damp-Heat in Spleen Earth, even leading to obstruction. These must be carefully differentiated for treatment. The wife of Li Xingang, Second Son of the Grand Commandant, was five months pregnant with urinary difficulty, unresponsive to various medicines. I said: Only Bawei Wan (Eight-Ingredient Pill) can save her. Disbelieving, she used diuretic drugs instead, resulting in abdominal swelling and death. Wang Wenyuan, a scholar, had a wife suffering from severe lower abdominal swelling nearly fatal. One dose of Bawei Wan (Eight-Ingredient Pill) produced dripping urine; a second dose using the same ingredients plus Cheqianzi (Plantago Seed) promoted free urination, resolving abdominal tension instantly.

[Zhang Zhongjing] Question: A woman suffers from normal appetite, irritability, heat, inability to lie down, and orthopnea. What is this? Master said: This is named Zhuan Bao (Displaced Bladder), characterized by inability to urinate. It is caused by twisted bladder ligaments. Promoting urination will cure it. Use Shenqi Wan (Kidney Qi Pill) as the primary treatment. (This is Bawei Wan / Eight-Ingredient Pill. See Miscellaneous Diseases - Deficiency and Emaciation. Take fifteen to twenty pills with wine, twice daily.)

[Obstetrics] Treatment for urinary retention and bladder displacement.
Sangpiaoxiao (Mantis Egg Case) ground into powder, taken with rice drink, one cun bi (measure) per dose, three times daily.

[Zhang Zhongjing] Pregnancy with water qi, heaviness of the body, urinary difficulty, aversion to cold with shivering, and dizziness upon rising. Treat with Kuizi Fuling San (Abelmoschus Seed and Poria Powder).
Kuizi (Hibiscus Seed) (one jin) Fuling (Poria) (three liang)
Crush these two ingredients into a powder. Take one cun bi with water, three times daily. Cure when urination becomes smooth.

Pregnancy with difficult urination, normal diet. Treat with Guimu Kushen Wan (Angelica and Sophora Pill).
Danggui (Angelica Sinensis Root) Beimu (Fritillaria Bulb) Kushen (Sophora Root) (each four liang)
Grind into powder, mix with refined honey to make pills the size of small beans. Take three pills with water, increasing to ten pills. (For men, add Huashi (Talc) half liang.)

[Zhu Danxi] Treatment for sudden urinary retention in pregnancy.
Xingren (Apricot Seed), peeled and de-seeded, ground into pills the size of mung beans. Swallow seven pills with Dengxin Tang (Juncus Decoction). Urination will resume immediately.

[Zhu Danxi] A woman of Zhu's household, over thirty years old, four months pregnant, suffered from constipation of both stool and urine. Given promoting drugs, Kuizi (Hibiscus Seed) etc., stool and urine passed, but Qi was not smooth. This was due to impatience, consuming Blood and disordering Qi. Qi must be harmonized, and Blood nourished for peace.
Chenpi (Tangerine Peel) Qingpi (Green Tangerine Peel) Shaoyao (Peony Root) (one qian) Renshen (Ginseng Root) Danggui (Angelica Sinensis Root, head and tail) Chuanxiong (Ligusticum Rhizome) Dihuang (Rehmannia Root) Baizhu (Atractylodes Rhizome) (half liang) Fuling (Poria) Mutong (Akebia Stem) Gancao (Licorice Root) (two fen)

Dusheng San (Single Holy Powder) treats urinary retention in pregnancy.
Use Manjingzi (Vitex Fruit) ground into powder. Take two qian, mixed with strong decoction of Congbai (Scallion White) before meals.