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[Da Lun] The disease of "Pao Zhuan" (bladder torsion or compression leading to urinary retention) in women is caused by the bladder being forced by heat pathogens, or by holding urine forcibly. Both conditions cause water qi to press upon the bladder, making it curl and close, preventing it from filling and expanding normally. Consequently, external fluids that should enter cannot enter, and internal urine that should exit cannot exit. This results in internal and external stagnation, distension, fullness, and blockage, hence the term "Pao Zhuan." Its manifestations include acute pain in the lower abdomen and inability to urinate; in severe cases, it can lead to death and is difficult to treat.

[Xue Ji's Commentary] Regarding the above symptoms, regardless of whether the patient is male, female, or pregnant, if Pao Zhuan occurs with difficulty in urination, life is in imminent danger. Only Ba Wei Wan (Eight-Ingredient Pill with Rehmannia, a formula for warming and tonifying Kidney Yang) can save them. For other details, please refer to the preceding and following discussions on treatment principles. One woman suffered from dribbling urine, lower abdominal distension and stuffiness, chest fullness, and rapid breathing. Various medicines failed to work. I diagnosed this as Pao Zhuan and prescribed Ba Wei Wan decoction. Her urination immediately became free, and she recovered. Another woman, due to depression and anger, experienced dripping urine that gradually progressed to lower abdominal swelling, accompanied by phlegm, cough, and shortness of breath. I prescribed Ba Wei Wan decoction. Her urination immediately became free, and she recovered.

[Da Lun] Hua Shi San (Talcum Powder Decoction, from *Qian Jin Fang*) treats Pao Zhuan in women and men, where urination has been blocked for several days.
Hua Shi (Talcum, 1 liang) Ning Shui Shi (Alumen, 2 liang) Kui Zi (Malva Seeds, 1 he).
Grind the above into powder. Boil in 10 dou of water until 5 sheng remain. Take frequently. After consuming 1 sheng, urination will become free.

Another prescription:
Luan Fa (Burnt Human Hair Ash, retaining its nature) Kui Zi (Malva Seeds) Che Qian Zi (Plantago Seeds) in equal parts.
Grind into fine powder. Take 2 qian each time, mixed with tea water.

Ye San (Leaf Powder) treats Pao Zhuan in women with urinary obstruction. It can also treat men.
Guo Cha Ye (Tea Leaves wrapped in leaves, burnt ash retaining nature, 1 liang) Hua Shi (Talcum, ground fine, 0.5 liang).
Grind together uniformly. Mix 2 qian with boiling water and take.

Shi Wei Tang (Pyrrosia Leaf Decoction) treats the same condition as above.
Shi Wei (Pyrrosiae Folium, de-haired) Che Qian Zi (Plantaginis Semen) in equal parts.
Grind into coarse powder. Take 5 qian each time. Boil in 2 zhan of water until 1 zhan remains. Strain and take.

For women who hold their urine and do not void at appropriate times, causing Pao Zhuan, lasting four or five days, becoming critically ill and near death:
Hua Shi (Talcum, 2 liang) Luan Fa Hui (Ash of Burnt Human Hair, 1 liang).
Grind uniformly. Take 1 jin of Tao Bai Pi (Pericarpium Persicae Albugo), cook until soft, and pound well. Add 3 zhan of water, squeeze out the juice. At any time, take half a zhan warm, mixed with 1 qian of the powder.

Another prescription: Take 2 qian of Hua Shi powder, mixed with Cong Bai Tang (Scallion White Decoction).

*Qian Jin Yi Fang* treats women unable to urinate.
Xing Ren (Apricot Kernel, 7 grains, skin and tip removed).
Take this single ingredient, stir-fry with bran until yellow, grind into fine powder. Mix with water and take; urination will immediately flow freely.

Another prescription: Grind Zi Cao (Arnebiae Radix seu Lithospermi Radix) into powder. Mix with Jing Hua Shui (well water drawn at dawn) three finger-pinches amount and take; urination will immediately flow freely. It is also said that Zi Wan (Asteris Radix) can be used.

If sudden total obstruction occurs, with lower abdominal distension and urgency, Qi rushing up to the heart, causing suffocation and near-death sensation, this is due to abnormal Qi transmitting to the Bladder, or resulting from worry and fright, where Qi has no outlet, becomes depressed and closed, failing to flow, and strikes the ligaments of the bladder causing misalignment. Pulse diagnosis reveals a choppy and small pulse on the right hand, and a rapid and large pulse on the left hand. Use Cong Bai Tang (Scallion White Decoction).

Cong Bai Tang Formula:
Ju Pi (Citri Reticulatae Pericarpium, 3 liang) Kui Zi (Malvae Semen, 1 liang) Cong Bai (Allii Fistulosi Bulbus, 1 stalk).
Cut into pieces. Boil in 5 sheng of water until 2 sheng remain. Divide into three doses. (From *Zhi Mi Fang*)

*Bu Yi*: Grind Zi Jin Pi (Cortex Eucommiae treated with iron sulfate, often referred to as processed bark) into powder. Take 2 qian mixed with Cong Tang (Scallion Decoction). Kui Zi Tang (Malva Seed Decoction) is also acceptable.

Another prescription: For Bao Zhuan (Pao Zhuan) with urinary obstruction, stir-fry 0.5 jin of salt, place in a bag, and apply hot compress to the lower abdomen while hot.

[Xue Ji] Zi Shen Sheng Gan Yin (Nourish Kidney and Generate Liver Decoction):
Shan Yao (Dioscoreae Rhizoma) Shan Zhu Yu (Corni Fructus, flesh only, 1 qian each) Shu Di Huang (Prepared Rehmanniae Radix, homemade, 2 qian) Ze Xie (Alismatis Rhizoma) Fu Ling (Poria) Mu Dan Pi (Moutan Cortex, 0.7 qian each) Wu Wei Zi (Schisandrae Fructus, pounded and stir-fried, 0.5 qian) Chai Hu (Bupleuri Radix, 0.3 qian) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Dang Gui (Angelicae Sinensis Radix) Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.3 qian each).
Decoct in water and take.

Ba Wei Wan (Eight-Ingredient Pill with Rehmannia) treats Pao Zhuan with urinary obstruction, showing miraculous efficacy. However, it is rarely used in modern practice, leading to many errors. (See Formula in Miscellaneous Diseases - Deficiency and Emaciation.)

Another prescription: Grind Zao Jiao (Gleditsiae Sinensis Spina) into powder. Blow into the nose to induce sneezing.