膀胱主分津液。热蓄于内，津液不下行，故不利也。有邪气结于下焦，聚而不散，
则小腹硬满而痛，小便所以不利也。凡不利者宜导而渗泄之。若引饮过多，下焦蓄热，
或中湿发黄，水饮停留，皆先利小便。有汗下后亡津液，胃中干竭，则有利小便之戒。
有小便不利而头出汗者，乃为阴脱关革之疾也。
【和解】伤寒五六日，已汗复下，小便不利、心烦，桂枝汤、小柴胡汤。
【分利】太阳汗后脉浮，小便不利，微热而渴，五苓散。渴甚者，猪苓汤。
【清利】伤寒七八日，身黄如橘，小便不利，腹微满者；头汗出小便不利，渴饮水
浆，瘀热在内必发黄，并用茵陈蒿汤。
【攻下】小便不利，大便乍难乍易，微热，胃中有燥粪也，大承气汤，选用。有潮
热兼大便泄，小便不利，
柴苓汤。
【温】风湿自汗，身重不利者，阴气也，甘草附子汤。
【熨法】小便不通，其因有二。热郁不通，用田螺捣朴硝，少加麝香如泥，贴脐
上自通。寒凝小水不利者，用炒盐熨脐下当通。然则寒热不可不详审也。
【灸】阴寒甚而小便不通，阴囊缩入，腹痛欲死，灸石门穴，仍服四逆汤。
伤寒小便自利，正因不当利而反自利也。如太阳阳明自汗者，不应利小便而反自
利者，寒为膀胱不禁，热为蓄血使然。是亦伤寒之一证也。津液竭则病危矣夫，安得
不有治乎？
【和】太阳病小便自利，以饮水多，心下悸，桂枝茯苓甘草汤。
【血】太阳身黄，小盒饭不利，今反自利，其人如狂，为下焦蓄血，抵当汤。伤寒有
热，小腹满，应小便不利，今反自利，为有血也，抵当丸。尿血，玄胡散。大便闭，小便自
利，知其热在内，微用承气汤下之。
【温】大便自通，小便清利，知其内虚寒也，四逆汤，真武汤去茯苓用。
【蜜导】阳明自汗，应小便不利，而反利，津液内竭也。粪虽硬不可攻，宜蜜导猪胆
汁法。
膀胱负责分别清浊、排泄津液。若热邪蓄积于体内，导致津液不能向下输布运行，就会出现小便不利的症状。如果有邪气结聚在下焦，聚集不散，就会导致小腹部坚硬胀满且疼痛，这就是小便不利的原因。凡是出现小便不利的情况，适宜采用通导和渗湿泄热的方法治疗。如果因饮水过多，导致下焦蓄积热邪，或者因中湿而发黄，水饮停留体内，都应当先通过利小便来治疗。如果在发汗或攻下之后，津液耗伤，胃中干燥枯竭，则有关于禁止使用利小便方法的告诫。如果有小便不利但头部出汗的情况，这是阴气脱失、关格病发作的危重证候。
【和解法】伤寒病经过五六天，已经发汗又误用攻下法，出现小便不利、心烦的症状，可用桂枝汤或小柴胡汤治疗。
【分利法】太阳病发汗后，脉象仍浮，小便不利，伴有轻微发热和口渴，用五苓散治疗。如果口渴严重的，用猪苓汤治疗。
【清利法】伤寒七八天，身体发黄像橘子皮颜色一样，小便不利，腹部轻微胀满；或者只有头部出汗、小便不利，口渴想喝水浆，这是因为瘀热在体内必然导致发黄，均使用茵陈蒿汤治疗。
【攻下法】小便不利，大便时而困难时而容易，伴有轻微发热，说明胃中有燥屎内结，可选用大承气汤。如果有潮热兼有大便泄泻、小便不利的情况，用柴苓汤治疗。
【温法】风湿病导致自汗，身体沉重且活动不利的，属于阴寒之气所致，用甘草附子汤治疗。
【熨法】小便不通的原因有两种。如果是热郁导致的不通，将田螺捣碎加入朴硝，再加少量麝香调成泥状，贴敷在脐上，小便自然通畅。如果是寒凝导致的小便不利，用炒热的盐熨烫脐下部位，通常可以通畅。然而，寒证和热证不可不仔细审察辨别。
【灸法】阴寒极盛导致小便不通，阴囊收缩入腹，腹痛剧烈欲死，可灸石门穴，同时服用四逆汤。
伤寒病中出现小便自利（正常排尿），正是因为本不应利小便反而出现了自利的情况。例如太阳病或阳明病出现自汗时，本不应利小便却反而小便自利的，若是寒证则是膀胱固摄失职，若是热证则是蓄血所致。这也是伤寒病的一种证候。津液枯竭则病情危重，怎么可以不进行治疗呢？
【和解法】太阳病出现小便自利，因为饮水过多导致心下悸动，用桂枝茯苓甘草汤治疗。
【血证法】太阳病身体发黄，原本应该小便不利，现在反而小便自利，病人出现如狂的症状，这是下焦蓄血，用抵当汤治疗。伤寒有热，小腹胀满，按理说应该小便不利，现在反而小便自利，说明有瘀血存在，用抵当丸治疗。尿血的，用玄胡散治疗。大便闭塞，小便自利，知道热邪在内部，轻微使用承气汤攻下。
【温法】大便自行通畅，小便清澈通利，知道是内部虚寒，用四逆汤，或者真武汤去掉茯苓后使用。
【蜜导法】阳明病自汗，按理说应该小便不利，反而小便通利，这是津液在内枯竭的表现。粪便虽然干硬但不能攻下，适宜使用蜜导或猪胆汁灌肠的方法。
The Bladder is responsible for separating clear turbid fluids and excreting body fluids. If heat accumulates internally, preventing the downward distribution of fluids, symptoms of difficult urination (Difful urination) occur. If pathogenic factors knot in the Lower Jiao (Lower Burner), gathering without dispersing, it leads to hardness, fullness, and pain in the lower abdomen, which is the cause of difficult urination. For cases of difficult urination, it is appropriate to use methods that guide and promote diuresis (Promoting urination). However, if excessive drinking leads to heat accumulation in the Lower Jiao, or if dampness causes jaundice with water retention, diuresis should be employed first. Conversely, after sweating or purging therapies, if body fluids are depleted and the Stomach becomes dry and exhausted, there are warnings against using diuretic methods. If difficult urination is accompanied by sweating only on the head, this indicates a critical condition of Yin collapse and Guan-Ge disease (Obstruction and Reversal syndrome).
[Harmonizing Method] In Shaoyang disease (Taiyang disease in context of Taiyang-Shaoyang transition) lasting five to six days, where sweating has been applied followed by incorrect purging, resulting in difficult urination and irritability, Guizhi Tang (Cinnamon Twig Decoction) or Xiaochaihu Tang (Minor Bupleurum Decoction) may be used.
[Separating and Diuresis Method] After sweating in Taiyang disease, if the pulse remains floating, urination is difficult, accompanied by slight fever and thirst, Wuling San (Five-Ling Powder) is indicated. If thirst is severe, Zhuling Tang (Polyporus Decoction) is used.
[Clearing and Diuresis Method] In Shaoyang disease lasting seven to eight days, if the body is yellow like an orange peel, urination is difficult, and the abdomen is slightly full; or if there is only head sweating, difficult urination, and thirst for drinking fluids, indicating internal stasis-heat causing jaundice, Yinchenshao Tang (Artemisiae Scopariae Decoction) should be used in all these cases.
[Purgative Method] If urination is difficult, bowel movements alternate between difficulty and ease, accompanied by slight fever, it indicates dry feces in the Stomach/Intestines; Dachengqi Tang (Major Order the Qi Decoction) can be selected. If tidal fever is accompanied by diarrhea and difficult urination, Chailing Tang (Bupleurum and Polyporus Decoction) is used.
[Warming Method] In Wind-Dampness disease with spontaneous sweating and heavy body with movement difficulty, attributed to Yin-cold qi, Gancao Fuzi Tang (Licorice and Aconite Decoction) is indicated.
[Moxibustion/Ironing Method] There are two causes for complete urinary retention. If caused by heat stagnation, crush Field Snail (Tianluo) mixed with Mirabilite (Puxiao), add a small amount of Musk (Shexiang), apply as paste to the umbilicus, and urination will naturally resume. If caused by cold coagulation leading to difficult urination, apply hot fried salt to the area below the umbilicus, which usually restores flow. Thus, Cold and Heat patterns must not be examined carelessly.
[Moxibustion Method] In cases of extreme Yin-cold causing urinary retention, retraction of the scrotum, and severe abdominal pain resembling death, moxibustion at Shimen CV5 (Gate of Life) is performed, along with administering Sini Tang (Frigid Extremities Decoction).
In Shaoyang disease, spontaneous normal urination occurs precisely because diuresis was inappropriate but urination occurred spontaneously. For example, in Taiyang or Yangming diseases with spontaneous sweating, if urination is spontaneous when it should not be, it may be due to Cold failing to control the Bladder, or Heat causing Blood Stasis. This is also a syndrome of Shaoyang disease. When body fluids are exhausted, the condition is critical; therefore, treatment is necessary.
[Harmonizing Method] In Taiyang disease with spontaneous urination, caused by excessive water intake leading to palpitations in the epigastrium, Guizhi Fuling Gancao Tang (Cinnamon Twig, Poria, and Licorice Decoction) is used.
[Blood Stasis Method] In Taiyang disease with jaundice, where urination should be difficult but is instead spontaneous, and the patient exhibits manic behavior, this indicates Lower Jiao Blood Stasis; Dandang Tang (Echinops Decoction) is indicated. In Shaoyang disease with heat, lower abdominal fullness, where urination should be difficult but is spontaneous, indicating blood stasis, Dandang Wan (Echinops Pill) is used. For hematuria (blood in urine), Xuanhu San (Corydalis Powder) is used. For constipation with spontaneous urination, knowing the heat is internal, a mild purgation with Chengqi Tang (Order the Qi Decoction) is applied.
[Warming Method] If bowel movements are naturally smooth and urination is clear and free-flowing, it indicates internal deficiency-cold; Sini Tang (Frigid Extremities Decoction) or Zhenwu Tang (True Warrior Decoction) with Poria removed is used.
[Honey Suppository Method] In Yangming disease with spontaneous sweating, where urination should be difficult but is instead free-flowing, it indicates exhaustion of internal body fluids. Although feces are hard, they cannot be purged aggressively; instead, Honey Suppository or Pig Gallbladder Juice method is appropriate.