娠妇劳伤经络，热乘于血，血得热则渗入于脬，故令尿血。胎漏自人门下血，尿血自尿门下血。妊娠尿
血属胞热者，多四物加山栀、发灰，或阿胶、熟地、麦冬、五味子之类。
孕妇小便涩少淋漓，名曰子淋。由气血聚养胎元，不及敷荣渗道，遂使膀胱郁热，宜归、芍调血；
人参补气；麦冬清肺以滋肾水之源；滑石通导利小便以清郁滞，名安荣散。古方内有滑石，
石乃镇重之剂，恐致堕胎，若临月极妙。如在七八月前，宜去此味，加石斛、山栀尤稳。若日久倦怠，右
脉微弱者，此气虚下陷，
而时坠下，然气弱肠虚而难流通，惟大服人参运之，其便自易。
胞转证候脐下急痛，小便不通。凡强忍小便，或风急疾走，或饱食忍尿，或忍尿入房，使水气上逆，
气逼于胞，故屈戾不得舒张所致，非小肠、膀胱受病而用药所能利也。法当落其气则愈，若
胞落即殂。凡病患禀受弱者，忧闷多郁、性躁急者，食味浓者，多有之。古方用滑利药鲜效。因思胞水自转，
为胎所压，胎若举起，胞系自疏，水道自通矣，宜补中益气汤。服后探吐，以提其气自
通。通后即用参、 大补，恐胎堕也。
丹溪曰∶有妇妊孕九月转胞，小便不出，下急脚肿不堪步，诊脉右涩左稍和，此饱食气伤，胎系弱不能自举，下坠
着膀胱，偏在一边，气急为其所闭，故水窍不能出，方用参、术、陈皮、炙草、归、芍、半夏、生姜，补血养气，气血
既旺，胎系自举，顿饮之，探喉令吐，如是四服，小便通下皆黑水，复重调补而愈。又妊娠七八月，小便不通，诊之脉
细弱，此由中气虚怯，不能举胎，胎压其膀胱下口，因不得溺，用补中汤，加升举之药。因药力未至，胀痛难忍，遂令
老妇用香油涂手，自产户托起其胎，溺出如注，胀急顿解，随以大剂参 补之。 至三日后，胎渐起，小便如故。《证治》
曰∶转胞之说，胞为所逼而侧，名胞者，即膀胱也。然子淋与转胞相类，但小便频数，点滴而痛地得，为子淋，膀胱小
肠虚热也。虚则不能制水，热则不能通利，故淋若频数，出少不痛者，为转胞，间有微痛，终与子淋不同。
《经》曰∶妇子胞气。又曰∶胞移热于膀胱。又曰∶冲脉任脉皆起于胞中。凡此胞字皆音包，以子宫为言也。《灵枢》
曰∶膀胱之胞薄以懦，音抛，以当溲脬而为言也。胞物有三，而字则相同，奈何后人不解其意，或忍膀胱与尿胞为二物，
又因《类纂》曰∶膀胱者，胞之室，反以子胞与膀胱为一物，其误甚矣。夫膀胱即脬，脬即膀胱也。为得复有一物，居
膀胱之内，者乎？其以子胞与膀胱为一物者，试不思转胞下压膀胱，以致小便不通者，则胞在上，更膀胱在下，则其部
位各别，而非一物更明矣。
孕妇因劳累损伤经络，热邪侵袭血液，血受热则渗入膀胱（储存尿液的器官），从而导致尿血。胎漏是指从阴道出血，而尿血是从尿道出血。妊娠期间尿血若属于胞宫有热的情况，多使用四物汤加入山栀、发灰，或者阿胶、熟地、麦冬、五味子等药物。
孕妇小便涩滞量少、淋漓不尽，称为子淋。这是由于气血聚集以滋养胎元，未能充分濡润和渗灌水道，致使膀胱郁积热邪。治疗宜用当归、白芍调和血液；人参补益元气；麦冬清肺以滋补肾水之源；滑石通利小便以清除郁滞，此方名为安荣散。古方中含有滑石，滑石性质沉重镇坠，担心会导致堕胎，若在临产月使用则非常适宜。若在怀孕七八个月时，应当去掉滑石，加入石斛、山栀更为稳妥。如果病程日久出现倦怠，右脉微弱，这是气虚下陷，导致小便时有坠胀感，然而气弱肠虚导致气机难以流通，只有大量服用人参来运化推动，小便自然通畅。
胞转病的证候表现为脐下急痛，小便不通。凡是强忍小便，或疾速奔跑，或饱食后忍尿，或忍尿行房事，导致水气上逆，气逼迫于膀胱，使其屈曲扭转不能舒展所致，并非小肠、膀胱本身受病，也不是单纯用药利尿所能治愈的。治疗方法应当降其逆气则痊愈，如果膀胱下垂严重则胎儿死亡。凡体质虚弱、忧闷多郁、性情急躁、饮食口味浓重的人，多有此病。古方使用滑利药物治疗鲜有疗效。我思考认为，膀胱下垂是因为被胎儿压迫，如果将胎儿托起，膀胱系带自然松弛，水道自然通畅，适宜使用补中益气汤。服药后通过探吐的方法，以提升气机，使小便自通。小便通畅后立即使用人参等大补药物，恐怕会导致堕胎。
朱丹溪说：有一位怀孕九个月的妇女患胞转病，小便不出，下腹部急迫、脚肿得无法行走，诊脉右手涩左手稍和缓，这是饱食伤气，胎系虚弱不能自行举托，下坠压迫膀胱，偏在一边，气机急迫被闭塞，所以尿道口不能排尿，方药用人参、白术、陈皮、炙甘草、当归、白芍、半夏、生姜，补血养气，气血旺盛后，胎系自然举托，一次性饮服，探喉催吐，如此服用四次，小便通下都是黑水，随后重新调理补益而痊愈。又有一例怀孕七八个月的妇女，小便不通，诊脉细弱，这是由中气虚怯，不能举托胎儿，胎儿压迫膀胱下口，因而无法排尿，使用补中益气汤，加入升提举托的药物。因为药力未到，胀痛难忍，于是让老妇人用香油涂手，从产户托起胎儿，尿液流出如注，胀痛顿时解除，随即用大剂量人参补益。到第三日，胎儿逐渐升起，小便恢复正常。《证治准绳》说：所谓转胞，是膀胱受到逼迫而侧倾，所谓的“胞”，即指膀胱。然而子淋与转胞症状相似，只是小便频数，点滴而出且疼痛的，称为子淋，这是膀胱和小肠虚热所致。虚则不能制约水液，热则不能通利，所以淋证若频数、排出少且不痛的，为转胞，间或有轻微疼痛，终究与子淋不同。《内经》说：女子胞的气。又说：胞移热于膀胱。又说：冲脉任脉都起于胞中。凡是这些“胞”字都读作“包”，指的是子宫。《灵枢》说：膀胱之胞薄而软弱，读作“抛”，指的是作为贮存尿液的脬（膀胱）。膀胱相关的物体有三种，但字形相同，为什么后人不懂其意，有的将膀胱与尿胞分为两物，又因《类纂》说：膀胱者，胞之室，反而将子胞与膀胱视为一物，错误很大了。夫膀胱就是脬，脬就是膀胱。难道里面还有一物吗？那些将子胞与膀胱视为一物的人，试不想想转胞是下压膀胱以致小便不通，那么胞在上，膀胱在下，部位各自不同，这就更明显不是一物了。
If a pregnant woman suffers from meridian and vessel injury due to overexertion, heat invades the blood. Blood enters the *Paoguan* (Bladder) when heated, causing hematuria. *Tainlou* (Fetal leakage) refers to bleeding from the vagina, whereas hematuria refers to bleeding from the urethra. For hematuria during pregnancy caused by heat in the uterus (*Zigong*), *Siwu Tang* (Four Substances Decoction) is often used with added Gardenia (*Shanzhi*) and burnt hair (*Fahui*), or ingredients such as Ejiao (Donkey-hide gelatin), Shudi (Prepared Rehmannia Root), Maidong (Ophiopogon Tuber), and Wuweizi (Schisandra Fruit).
When a pregnant woman experiences scanty, difficult, and dribbling urination, it is called *Zilin* (Pregnancy Dysuria). This occurs because Qi and Blood gather to nourish the fetus and fail to adequately moisten and irrigate the water passages, leading to stagnant heat in the Bladder. Treatment should use Danggui (Angelica Sinensis) and Baishao (White Peony Root) to harmonize the blood; Renshen (Ginseng) to tonify Qi; Maidong (Ophiopogon Tuber) to clear the Lungs and nourish the source of Kidney Water; and Huashi (Talcum) to promote urination and clear stagnation. This formula is named *Anrong San*. Ancient formulas contain Huashi, which has a heavy and sedative nature, raising concerns about inducing abortion; however, it is excellent if used near term. If used at seven or eight months of pregnancy, Huashi should be removed, and Shihu (Dendrobium Stem) and Shanzhi (Gardenia) added for greater safety. If the condition persists for a long time accompanied by fatigue and a weak pulse on the right side, this indicates Qi deficiency with sinking, causing a sensation of heaviness or prolapse during urination. Due to weak Qi and empty intestines hindering smooth flow, large doses of Renshen (Ginseng) are required to move the Qi, after which urination will naturally become easy.
The syndrome of *Baozhuan* (Displacement of the Uterus/Bladder) presents with urgent pain below the umbilicus and inability to urinate. It is caused by holding urine forcibly, running rapidly, holding urine after a full meal, or having intercourse while holding urine. These actions cause water Qi to reverse upward, pressing against the bladder, causing it to twist and preventing expansion. This is not a disease of the Small Intestine or Bladder itself, nor can it be cured merely by using diuretic herbs. The method is to lower the rebellious Qi to achieve cure; if the bladder descends severely, the fetus may die. This condition is common in individuals with weak constitutions, those prone to worry and depression, those with irritable temperaments, and those who consume rich-flavored foods. Ancient formulas using slippery/diuretic herbs have rarely been effective. I reason that the bladder displaces because it is compressed by the fetus. If the fetus is lifted, the bladder's ligaments will relax, and the water passage will open. Therefore, *Buzhong Yiqi Tang* (Tonify the Middle and Augment the Qi Decoction) is appropriate. After administration, inducing vomiting helps lift the Qi, allowing urination to resume naturally. Immediately after urination resumes, strong tonics like Renshen (Ginseng) should be avoided to prevent abortion.
Danxi stated: A woman nine months pregnant suffered from *Baozhuan*, unable to urinate, with severe lower abdominal urgency and leg swelling making walking impossible. Her pulse was choppy on the right and slightly harmonious on the left. This was caused by overeating injuring Qi, resulting in a weak uterine ligament unable to support the fetus, which descended and pressed against the bladder, obstructing Qi and blocking the urinary outlet. The prescription used Renshen (Ginseng), Baizhu (Atractylodes Macrocephala), Chenpi (Tangerine Peel), Zhi Gancao (Honey-fried Licorice), Danggui (Angelica Sinensis), Baishao (White Peony Root), Banxia (Pinellia Tuber), and Shengjiang (Fresh Ginger) to nourish Blood and Qi. Once Qi and Blood were robust, the uterine ligaments naturally supported the fetus. After drinking the decoction once, inducing vomiting was performed. After four doses, dark water flowed out upon urination. She recovered after subsequent regulation and tonification. Another case involved a woman at seven or eight months of pregnancy with urinary retention and a fine, weak pulse, indicating deficient and timid Middle Qi unable to lift the fetus. The fetus pressed on the lower opening of the bladder, preventing voiding. *Buzhong Tang* (Tonify the Middle Decoction) was used with herbs to lift and raise. Due to insufficient medicinal effect, she endured unbearable distension and pain. An elderly woman then applied sesame oil to her hands and manually lifted the fetus through the vaginal opening. Urine gushed out, and the distension and urgency instantly resolved. She was subsequently treated with a large dose of Renshen (Ginseng) for tonification. By the third day, the fetus had risen, and urination returned to normal. *Zhengzhi Zhunsheng* states: The concept of *Baozhuan* refers to the bladder being forced into a lateral position; here, "Bao" refers to the bladder. However, *Zilin* and *Baozhuan* are similar. *Zilin* is characterized by frequent urination, dribbling, and pain, caused by deficiency-heat in the Bladder and Small Intestine. Deficiency prevents controlling water, and heat prevents free flow. In contrast, *Baozhuan* involves frequency but little output without pain (or with slight pain), distinguishing it from *Zilin*. The *Classic of Difficult Issues* says: "The Qi of the Woman's Bao." It also says: "Heat transfers from the Bao to the Bladder." And: "The Chong and Ren meridians both originate from the Bao." In all these instances, "Bao" is pronounced "Bao" and refers to the uterus. The *Ling Shu* states: "The Bao of the Bladder is thin and flaccid," pronounced "Pao," referring to the organ storing urine (the bladder). There are three entities referred to as "Bao," yet the character is identical. Why do later generations misunderstand? Some separate the Bladder from the Urinary Sac. Others, citing *Leizuan*, say "The Bladder is the chamber of the Bao," mistakenly equating the fetal Bao (uterus) with the bladder. This is a significant error. The Bladder is the Pao, and the Pao is the Bladder. Is there another entity residing within the Bladder? Those who equate the fetal Bao with the Bladder should consider: in *Baozhuan*, the upper structure presses down on the Bladder, causing urinary retention. Thus, the Bao is above, and the Bladder is below; their locations are distinct, clearly proving they are not the same entity.