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Obstruction and blockage of urination and defecation are generally attributed to Fire. However, Fire is distinguished into Yin Fire and Yang Fire. Obstructions caused by Yang Fire are easily recognized by people, whereas those caused by Yin Fire are difficult to identify.

First, regarding the obstruction of defecation: If cold pathogens and Fire force their way into the Large Intestine, burning up its fluids and causing dryness leading to intestinal knotting and pain that cannot be touched by hand, it is necessary to use purgative agents for vigorous evacuation. Otherwise, the pathogen remaining in the abdomen will inevitably transform into symptoms of delirium and madness. Such diseases are caused by Yang Fire.

If Kidney Water is deficient and fails to moisten the Large Intestine, resulting in feces as hard as sheep dung, cases where there has been no bowel movement for a month often occur. Although there may be a sense of urgency, it is not the unbearable type of pain; after two or three days, the condition remains similar to before. This symptom is common in the elderly and is caused by Yin Fire. The so-called Yin Fire refers to Ministerial Fire, which is Deficient Fire. Excess Kidney Fire is actually due to insufficiency of Kidney Water. If one were to use purgatives in such cases, it would further deplete the already deficient Yin, bringing death closer.

I have now established two formulas: one for treating Yang Fire and one for treating Yin Fire.
The formula for treating Yang Fire is named *Li Huo Xia Dao Tang* (Fire-Draining Downward-Guiding Decoction). Although this formula contains Da Huang (Rhubarb Rhizome) for moving Fire and Huo Ma Ren (Hemp Seed) for moistening, it takes Dang Gui (Angelica Sinensis Root) as the sovereign herb. Thus, tonification outweighs purgation. This follows the momentum of the disease to guide it out, ultimately avoiding the loss of Yin through excessive purging.

The formula for treating Yin Fire is named *Sheng Yang Xia Yin Tang* (Ascending Yang and Descending Yin Decoction). The brilliance of this formula lies in using Shu Di Huang (Prepared Rehmannia Root), a purely Yin herb, as the sovereign agent, assisted by the moistening properties of Di Yu (Sanguisorba Root), Rong Rong (Cistanche Stem), and Huo Ma Ren (Hemp Seed). Particularly ingenious is the use of Sheng Ma (Cimicifuga Rhizome) to ascend clear Qi, thereby naturally causing turbid matter to descend. Why add Da Huang unnecessarily?

Regarding the obstruction of urination: The free flow of urine depends on the Qi transformation of the Bladder. If the Bladder is affected by Fire pathogen, urine will pass drop by drop or not at all. Symptoms include rapid breathing, red face, nausea with sour regurgitation, abdominal distension with sensation of intestinal rupture, red eyes, restlessness, and mania. This is a Yang syndrome.

Conversely, if urine is urgent but not completely obstructed, breathing is normal, face is not red, eyes are not painful, abdominal distension is relieved by pressure, stomach comfort is present but appetite is poor, this is a Yin syndrome. If one fails to distinguish between Yin and Yang and lightly uses opening and unblocking agents, it leads to a half-dead, half-alive state.

Why is Yang syndrome easy to treat while Yin syndrome is difficult? It is because Yin syndromes are not sufficiently analyzed and clarified. Generally, the free flow of urine originates from the Qi transformation of the Bladder. The Bladder fears Fire yet also relies on Fire (Yang Qi). Excessive Fire hinders Bladder Qi transformation; absence of Fire prevents Bladder Qi transformation. When Bladder Yin is deficient, the water passages become like frozen pools, unable to conduct Yin-cold water. Thus, urination becomes obstructed.

I have also established two formulas: one for Yang syndrome and one for Yin syndrome.
The formula for Yang syndrome is named *Qing Shui Zhi Shen Tang* (Clearing Water Reaching Divine Effect Decoction). One dose can facilitate Che Qian Zi (Plantago Seed) to promote diuresis without depleting Qi, Liu Ji Nu (Artemisia Annua Herb) to remove water without damaging Yin, Sheng Ma (Cimicifuga Rhizome) to ascend and thereby achieve the appropriate effect of descending, and Bai Guo (Ginkgo Seed) to enter the Ren and Du meridians to drain water Qi directly into the Bladder. This has truly miraculous effects.

The formula for Yin syndrome is named *Yi Huo Ji Shui Tang* (Benefiting Fire to Aid Water Decoction). The brilliance of this formula lies in purely tonifying Yin without directly promoting diuresis. Using only Rou Gui (Cinnamon Bark) to transform Yang allows nature to melt snow like spring water, thawing ice and clearing all channels. If one merely removes water-draining herbs, the Bladder becomes colder, forming an impregnable fortress.

**Li Huo Xia Dao Tang**
Da Huang (3 qian), Dang Gui (1 liang), Hong Hua (2 qian), Chi Shao Yao (3 qian), Nong Po (2 qian), Zhi Shi (1 qian), Chai Hu (8 fen), Huo Ma Zi (3 qian). Decoct in water and take orally.

**Sheng Yang Xia Yin Tang**
Shu Di (1 liang), Dang Gui (5 qian), Di Yu (1 qian), Huo Ma Zi (1 qian), Sheng Ma (1 qian), Sheng Di (5 qian), Mai Dong (5 qian), Rou Cong Rong (5 qian, washed to remove salt). Decoct in water, add half a bowl of human milk when ready, and take orally.

**Qing Shui Zhi Shen Tang**
Yi Yi Ren (5 qian), Bai Guo (10 pieces), Sheng Ma (5 fen), Che Qian Zi (1 liang), Ze Xie (3 qian), Liu Ji Nu (5 qian). Decoct in water and take orally.

**Yi Huo Ji Shui Tang**
Shu Di (1 liang), Shan Yao (5 qian), Fu Ling (5 qian), Shan Zhu Yu (5 qian), Niu Xi (3 qian), Rou Gui (2 qian), Mai Dong (5 qian), Che Qian Zi (3 qian), Yi Yi Ren (5 qian). Decoct in water and take orally.