【歌】忍尿持重入房中，了戾膀胱溺不通，莫把药汤增水泛，沉香琥珀有神功。
【论】仲景曰∶妇人病饮食如故，烦热不得卧，而反倚息者，此转脬不得溺也。以脬系了戾，故致此病，宜
利小便则愈，肾气丸主之。夫脬受水液，气不转行，则小肠满胀，或忍小便，饱食用力，或忍便行房，或忍便疾行，
或忍便持重，今脬系了戾，屈抑而不得舒张，故小便不下。其症∶脐下急痛，烦闷汗出，气逆奔迫，内外壅塞，胀
满不通，此脬系转戾不通，非汤药所能治，法当行其气，气化则能出矣。沉香琥珀丸主之，外用小麦杆煎汤熏
洗。《甲乙经》曰∶脬转不得溺，关元主之。
【脉】右手涩小左手急大者，葱白葵子桔皮汤。
【方】
沉香琥珀丸
沉香 牙皂 琥珀
等分为末，饭丸，益元散为衣，温酒服二钱。
强忍小便气逆不通困笃欲死方
滑石（二两） 发（一两，烧）
桃根白皮煎汤，调服一钱。
【歌】厥阴肝脉入阴中，抵器连阴及子宫，作痒生疮因湿热，肿而坚痛受寒风，脾虚下陷宜升举，郁结攻冲
可宣通，更有阴吹人不识，发膏煎子出张公。
【论】立斋曰∶阴病乃七情郁火伤损肝脾，湿热下注。其外证有生疮者，有阴中舒出如蛇，俗呼阴挺。有翻
突如饼，俗呼阴菌。有如鸡冠，俗呼阴痔。亦有生虫肿痛，湿痒溃烂出水，胀闷脱坠者，其内症口干内热，体倦，
经候不调，饮食无味，日晡潮热，胸膈不利，小腹痞胀，小便淋漓。治法∶肿痛者，四物汤加龙胆草、柴胡、山栀、
丹皮。湿痒者，归脾加山栀、柴胡、丹皮。淋漓者，龙胆泻肝汤加白术、丹皮。溃腐者，加味逍遥散。胀闷脱坠者，
补中益气汤加山栀、丹皮，佐以外治法。脉数则阴中生疮，弦则阴中掣痛。又曰∶紧则腹痛，数则生疮。少阴滑数，
阴中生疮。脉至如琴弦，苦小腹痛，月水不利，孔窍生疮。
阴疮
如何阴户忽生疮，相火淫精湿热伤，外洗野狼牙敷杏麝，内煎龙胆泻肝汤。
阴肿
寒伤形而热伤气，气伤痛兮形伤肿，只因风冷入肝经，所以疾病生阴孔。
阴痛
从来诸痛皆为实，惟有阴疼湿热看，龙胆逍遥俱可服，要知此病属于肝。
阴痒
阴痒三虫蚀不安，脾虚湿热渍于肝，槐枝枸杞根汤洗，龙胆
逍遥硫鲤丸。
阴挺
阴挺元虚湿热侵，如蛇突出痛淋漓，补中龙胆兼熏洗，古法三茱一捻金。
阴痔
湿热停留又着风，如茄如菌结阴中，归脾益气逍遥散，醋淬乌头可外攻。
阴冷
劳伤子脏阴中冷，以是三阴元气虚，内服天冬钟乳酒，外施牛胆食茱萸。
阴吹
胃实肠虚气下行，阴吹喧搏只闻声，猪膏乱发同煎服，肠胃和平自不鸣。
交接出血
少女频交阴户伤，血流肝肾火猖狂，发灰锅黑敷俱好，洗用黄连甘草汤。
尿血
小便行时浑血来，厥阴风热浸徘徊，备金生地逍遥散，牛膝车前及发灰。
遗尿
膀胱不禁苦遗尿，睡里流来不自知，萆 鸡肝同益智，白薇白芍亦相宜。
针灸
阴中诸病，照海穴在足内踝下，归来在天枢下七寸。
【方】
【歌诀】
憋尿、负重或行房事，导致膀胱气机逆乱，小便不通。不要盲目使用利尿药物增加水分代谢，沉香和琥珀具有显著疗效。
【论述】
张仲景说：妇女患病饮食正常，但感到烦热无法平卧，反而需要倚靠呼吸，这是转脬（膀胱扭转）导致的小便不通。因为膀胱系带扭曲，所以引发此病，应当通利小便即可痊愈，用肾气丸主治。膀胱接受水液，若气机不运转流通，则小肠充满胀满；或者憋住小便，饱食后用力，或者憋着大便行房事，或者憋着大便快跑，或者憋着大便提重物，如今膀胱系带扭曲，屈曲受压而不能舒展，所以小便排不出。其症状：脐下急痛，烦闷出汗，气逆奔迫，内外壅塞，胀满不通，这是膀胱系带扭转不通，不是汤药所能治疗的，治法应当行气，气机通畅则小便自出。用沉香琥珀丸主治，外用小麦秆煎汤熏洗。《甲乙经》说：转脬小便不通，关元穴为主治穴位。
【脉诊】
右手脉涩小，左手脉急大的，用葱白葵子桔皮汤。
【方剂】
沉香琥珀丸
沉香、牙皂、琥珀，等分为末，用米饭做丸，以益元散为衣，温酒送服二钱。
强忍小便导致气逆不通、病情危重欲死方
滑石（二两）、头发（一两，烧成炭），桃根白皮煎汤，调服一钱。
【歌诀】
厥阴肝经进入阴部，抵达产门连接外阴及子宫，瘙痒生疮因湿热引起，肿胀坚硬疼痛因受寒风，脾虚下陷宜升举，郁结攻冲可宣通，还有阴吹现象不为人知，发膏煎子出自张仲景。
【论述】
薛立斋说：阴部疾病是七情郁火损伤肝脾，湿热下注所致。其外证有长疮的，有阴道内脱出如蛇状，俗称阴挺。有翻突如饼状，俗称阴菌。有如鸡冠状，俗称阴痔。也有生虫肿痛，湿痒溃烂出水，胀闷脱坠者，其内症口干内热，身体疲倦，月经不调，饮食无味，下午潮热，胸膈不利，小腹痞胀，小便淋漓不尽。治法：肿痛者，用四物汤加龙胆草、柴胡、山栀、丹皮。湿痒者，用归脾汤加山栀、柴胡、丹皮。淋漓者，用龙胆泻肝汤加白术、丹皮。溃腐者，用加味逍遥散。胀闷脱坠者，用补中益气汤加山栀、丹皮，配合外治法。脉数则阴中生疮，脉弦则阴中掣痛。又说：脉紧则腹痛，脉数则生疮。少阴脉滑数，阴中生疮。脉至如琴弦，苦于小腹痛，月经不利，孔窍生疮。
阴疮
为何阴户忽然生疮？相火淫溢精血，湿热损伤。外洗野狼牙，敷杏麝，内服龙胆泻肝汤。
阴肿
寒伤形体而热伤气，气伤痛而形伤肿，只因风冷侵入肝经，所以疾病生于阴孔。
阴痛
历来各种疼痛多为实证，唯有阴疼需看湿热，龙胆逍遥散均可服用，要知道此病属于肝。
阴痒
阴痒因三虫侵蚀不安，脾虚湿热浸渍于肝，槐枝枸杞根汤清洗，龙胆逍遥硫鲤丸。
阴挺
阴挺因元气虚弱湿热侵袭，如蛇突出疼痛淋漓，补中益气与龙胆泻肝兼用熏洗，古法三茱一捻金。
阴痔
湿热停留又受风邪，如茄如菌结于阴中，归脾益气逍遥散，醋淬乌头可外攻。
阴冷
劳伤子宫致阴中寒冷，因为三阴元气虚，内服天冬钟乳酒，外施牛胆食茱萸。
阴吹
胃实肠虚气下行，阴吹喧搏只闻声，猪膏乱发同煎服，肠胃和平自不鸣。
交接出血
少女频繁性交致阴户受伤，血流肝肾火猖狂，发灰锅黑敷皆好，洗用黄连甘草汤。
尿血
小便时浑血来，厥阴风热浸徘徊，备金生地逍遥散，牛膝车前及发灰。
遗尿
膀胱不禁苦于遗尿，睡里流来不自知，萆薢鸡肝同益智仁，白薇白芍亦相宜。
【方剂】
[Verse]
Holding urine, bearing heavy loads, or engaging in sexual intercourse can cause the bladder qi to become disordered, resulting in urinary retention. Do not blindly use diuretic drugs to increase water metabolism; Chenxiang (Agarwood) and Hupo (Amber) have significant therapeutic effects.
[Discussion]
Zhang Zhongjing stated: When a woman is ill but her diet remains normal, yet she feels irritability and heat, cannot lie flat, and instead has to lean forward to breathe, this is due to "Zhuan Pao" (bladder torsion) causing urinary retention. Because the vesical ligament is twisted, this disease arises. It should be cured by promoting urination, and Shenqi Wan (Kidney Qi Pill) is the primary prescription. The bladder receives fluids; if qi does not circulate freely, the small intestine becomes full and distended. This may result from holding urine, straining after a full meal, having intercourse while holding stool, running fast while holding stool, or bearing heavy loads while holding stool. Now, the vesical ligament is twisted, compressed, and unable to expand, so urine cannot be discharged. Symptoms include acute pain below the umbilicus, irritability with sweating, rebellious qi rushing upward, internal and external blockage, and distension without relief. This is caused by the twisting of the vesical ligament obstructing flow, which cannot be treated merely by decoctions. The treatment method should focus on moving qi; once qi moves, urination will occur naturally. Chenxiang Hupo Wan (Agarwood and Amber Pill) is prescribed, with external fumigation and washing using a decoction of wheat stalks. The *Jia Yi Jing* states: For urinary retention due to bladder torsion, Guanyuan (CV4) is the primary acupoint.
[Pulse Diagnosis]
If the right hand pulse is choppy and small, and the left hand pulse is rapid and large, use Congbai Kuizi Jiepi Tang (Scallion White, Okra Seed, and Tangerine Peel Decoction).
[Formula]
Chenxiang Hupo Wan (Agarwood and Amber Pill)
Chenxiang (Aquilariae Lignum Resinatum), Yazao (Gleditsiae Sinensis Spina), and Hupo (Electri Ambarum Granulum) are ground into powder in equal parts. Form pills with rice paste, coat with Yiyuan San (Benefit Essence Powder), and take 2 qian with warm wine.
Formula for Severe Urinary Retention Due to Forced Holding, Causing Rebellious Qi, Critical Condition, and Near-Death State
Huashi (Talcum), 2 liang; Hair (Fa, 1 liang, burnt to ash). Decoct Taogen Baipi (Prunis Persicae Radix Cortex) in water, mix with the powder, and take 1 qian.
[Verse]
The Jueyin Liver meridian enters the yin region, reaches the uterus, connects to the external genitalia and the uterus. Itching and sores arise from damp-heat; swelling, hardness, and pain result from cold wind invasion. Spleen deficiency with sinking requires lifting; stagnation and attacking rush require dispersing and unblocking. There is also "Yin Chui" (flatulence from the vagina) unknown to many, originating from Zhang Zhongjing's Fa Gao Jian Zi (Hair Grease Decoction).
[Discussion]
Xue Lizhai stated: Yin diseases are caused by emotional depression generating fire that damages the Liver and Spleen, leading to damp-heat pouring downward. External manifestations include sores growing in the vagina, prolapse resembling a snake (commonly called Yin Ting / vaginal prolapse), protrusion like a cake (commonly called Yin Jun), or shape like a chicken comb (commonly called Yin Zhi). There are also cases of parasites causing swelling, pain, itching, ulceration, oozing, distension, and a sensation of falling. Internal symptoms include dry mouth, internal heat, fatigue, irregular menstruation, loss of appetite, afternoon tidal fever, chest and diaphragm discomfort, lower abdominal fullness, and dribbling urination. Treatment methods: For swelling and pain, use Siwu Tang (Four Substances Decoction) added with Longdan Cao (Gentian Root), Chaihu (Bupleurum Root), Shanzhi (Gardeniae Fructus), and Danpi (Moutan Cortex). For itching due to dampness, use Guipi Tang (Restore the Spleen Decoction) added with Shanzhi, Chaihu, and Danpi. For dribbling urination, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction) added with Baizhu (Atractylodis Macrocephalae Rhizoma) and Danpi. For ulceration and putrefaction, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). For distension, oppression, and prolapse, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Shanzhi and Danpi, combined with external treatments. A rapid pulse indicates sores in the vagina; a wiry pulse indicates pulling pain in the vagina. Furthermore, a tight pulse indicates abdominal pain; a rapid pulse indicates sores. A Shaoyin slippery and rapid pulse indicates sores in the vagina. A pulse like a zither string indicates severe lower abdominal pain, irregular menstruation, and sores in the orifices.
Yin Chuang (Vaginal Sores)
Why do sores suddenly appear in the vulva? Excessive ministerial fire damaging essence and damp-heat injury. Wash externally with Ye Langya (Sargentodoxa Radix), apply Apricot and Musk internally, and drink Longdan Xiegan Tang (Gentian Liver-Draining Decoction).
Yin Zhong (Vulvar Swelling)
Cold damages the form, heat damages the qi; qi damage causes pain, form damage causes swelling. Simply because wind-cold enters the Liver meridian, thus disease arises in the yin orifice.
Yin Tong (Vulvar Pain)
Generally, all pains are excess conditions, but for vulvar pain, look to damp-heat. Both Longdan and Xiaoyao formulas can be taken; know that this disease belongs to the Liver.
Yin Yang (Vulvar Itching)
Vulvar itching is due to three parasites causing unrest; spleen deficiency and damp-heat soak into the Liver. Wash with Huai Zhi (Sophorae Tonkinensis Ramulus et Folium) and Gouqigen (Lycii Radicis Cortex) decoction; take Longdan Xiaoyao Liu Li Wan.
Yin Ting (Vaginal Prolapse)
Yin Ting is due to original qi deficiency and damp-heat invasion, protruding like a snake with painful dribbling. Use Buzhong Yiqi and Longdan Xiegan together with fumigation and washing; ancient method uses San Zhu Yi Nian Jin.
Yin Zhi (Vaginal Hemorrhoids/Masses)
Damp-heat lingers and wind strikes, forming masses like eggplants or fungi in the yin. Use Guipi, Yiqi, and Xiaoyao San; vinegar-quenched Wutou (Aconiti Lateralis Radix Praeparata) can be used externally.
Yin Leng (Vulvar Coldness)
Labor injury to the uterus causes coldness in the yin; this is because the yuan qi of the Three Yin meridians is deficient. Internally take Tiandong Zhongru Jiu (Asparagi and Calcitum Wine); externally apply Niudan (Bovis Calculus) and Shizhuyu (Corni Fructus).
Yin Chui (Flatulence from Vagina)
Stomach excess and intestinal emptiness cause qi to descend; Yin Chui makes noise only. Boar fat and hair decocted together taken orally harmonize the stomach and intestines, stopping the sound naturally.
Jiaojie Chuxue (Bleeding During Intercourse)
Young women frequent intercourse injures the vulva; blood flows as Liver and Kidney fire rages. Hair ash and pot black applied topically are good; wash with Huanglian Gancao Tang (Coptis and Licorice Decoction).
Niao Xue (Hematuria)
Cloudy blood comes during urination; Jueyin wind-heat lingers. Beijin Shengdi Xiaoyao San, Niuxi (Achyranthis Bidentatae Radix), Cheqian (Plantaginis Semen), and hair ash.
Yiniao (Enuresis/Urinary Incontinence)
Bladder fails to control, suffering from enuresis; flowing in sleep unknowingly. Bibi (Dioscoreae Hypoglaucae Rhizoma) and Ji Gan (Galli Hepatis et Ventriculi Endothelium Corneum) with Yizhi (Alpiniae Oxyphyllae Fructus); Baiwei (Clerodendri Trichotomi Radix) and Baishao (Paeoniae Radix Alba) are also suitable.
Acupuncture
For various diseases of the yin, Zhaohai (KI6) is located below the medial malleolus; Guilai (ST29) is located seven cun below Tianshu (ST25).
[Formula]