薛立斋曰∶妊娠小便涩少淋沥，用安荣散。若肝经湿热，用龙胆泻肝汤。若肝经虚热，用加味逍遥散。若
服燥剂而小便频数，或不利，用生地、茯苓、牛膝、黄柏、知母、芎、归、甘草。或频数而色黄，用四物加知、
柏、五味、麦冬、元参。若肺气虚而短少，用补中汤加山药、麦冬。若热结膀胱而不利，用五淋散。若脾肺燥不
能生化，宜黄芩清肺饮。若膀胱阴虚，阳无所生，用滋肾丸。若膀胱阳虚，阴无所化，用肾气丸。
慎斋按∶以上四条，序胎前有小便淋涩之证也。淋有五，丹溪一主于热，若妊娠淋病。《产宝》、《良方》
以虚热郁热，属之膀胱。立斋则又推原肝经有湿热、虚热之别。正以膀胱为藏溺之器，而出溺之窍，则为足厥阴
部分。故欲清膀胱之热者，必兼疏厥阴之气也。
《甲乙经》曰∶胞转不得溺，少腹满，关元主之。又曰∶小便难，水胀，溺出少，胞
转，曲骨主之。
《金匮要略》曰∶妇人病，饮食如故，烦热不得卧，而反根据息者何也？师曰∶此名转胞，不得溺也。以胞
系了戾，故致此病。但利小便则愈，宜肾气丸主之。
《圣济总录》曰∶胞受水液，气不转行，则小肠满胀，或饱食用力，或因合阴阳，令胞屈辟，小便不下，
遂致胞转。其候水道不通，小腹急痛，烦闷汗出，气逆奔迫，甚至于死，名曰胞转，宜速治之。
薛立斋说：妊娠期间出现小便涩滞、量少、淋漓不尽的症状，使用安荣散。如果是肝经湿热所致，使用龙胆泻肝汤。如果是肝经虚热所致，使用加味逍遥散。如果服用燥湿药物后导致小便频数，或者排尿不畅，使用生地、茯苓、牛膝、黄柏、知母、川芎、当归、甘草。如果小便频数且颜色发黄，使用四物汤加入知母、黄柏、五味子、麦冬、玄参。如果是肺气虚弱导致尿量短少，使用补中益气汤加入山药、麦冬。如果是热邪结聚膀胱导致排尿不利，使用五淋散。如果是脾肺干燥不能生化津液，适宜使用黄芩清肺饮。如果是膀胱阴虚，阳气无法生成，使用滋肾丸。如果是膀胱阳虚，阴液无法气化，使用肾气丸。
慎斋按语：以上四条内容，叙述了胎前（怀孕期间）有小便淋涩症状的情况。淋证有五种，朱丹溪主张主要病机在于热，对于妊娠淋病，《产宝》、《良方》认为属于虚热和郁热，病位在膀胱。薛立斋则进一步追溯根源，指出肝经有湿热和虚热的区别。这正是因为膀胱是贮存尿液的器官，而排出尿液的窍道，归属于足厥阴肝经的部分。所以想要清除膀胱的热邪，必须兼疏理厥阴肝经的气机。
《甲乙经》说：胞转（膀胱扭转或受压导致排尿困难）导致无法排尿，小腹胀满，由关元穴主治。又说：小便困难，水液停聚肿胀，尿液排出少，胞转，由曲骨穴主治。
《金匮要略》说：妇人患病，饮食如常，烦热无法躺卧，反而倚靠呼吸（喘息），这是什么病？医生说：这名叫转胞，导致无法排尿。因为胞系（连接膀胱的韧带或组织）扭转不顺，所以导致此病。只要通利小便就能痊愈，适宜用肾气丸主治。
《圣济总录》说：胞（此处指膀胱或子宫相关部位）受到水液影响，气机不运转通行，则小肠胀满，或者是由于饱食后用力，或者是因为房事，导致胞屈曲偏斜，小便排不下来，于是导致胞转。其症状表现为水道不通，小腹急痛，烦闷出汗，气逆上冲紧迫，甚至导致死亡，名叫胞转，应当迅速治疗。
Xue Lizhai stated: For pregnancy accompanied by scanty, dribbling, and difficult urination, Anrong San (Safety and Prosperity Powder) should be used. If the condition is due to damp-heat in the Liver channel, Longdan Xiegan Tang (Gentian Liver-Draining Decoction) is indicated. If it is due to deficient-heat in the Liver channel, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) is indicated. If frequent urination or difficulty in urination occurs after taking drying agents, Shengdi Huang (Rehmanniae Radix), Fuling (Poria), Niuxi (Achyranthis Bidentatae Radix), Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), and Gancao (Glycyrrhizae Radix et Rhizoma) should be used. If urination is frequent with yellow urine, Siwu Tang (Four Substances Decoction) added with Zhimu, Huangbai, Wuweizi (Schisandrae Chinensis Fructus), Maidong (Ophiopogonis Radix), and Yuan Shen (Scrophulariae Radix) is indicated. If shortness of urine is caused by deficiency of Lung Qi, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Shanyao (Dioscoreae Rhizoma) and Maidong is indicated. If difficulty in urination is caused by heat accumulation in the Bladder, Wulin San (Five Types of Strangury Powder) is indicated. If dryness of the Spleen and Lung prevents the transformation and generation of fluids, Huangqin Qingfei Yin (Scutellaria Lung-Clearing Infusion) is suitable. If Bladder Yin is deficient and Yang cannot be generated, Zishen Wan (Kidney-Nourishing Pill) is indicated. If Bladder Yang is deficient and Yin cannot be transformed, Shenqi Wan (Kidney-Energy Pill) is indicated.
Shen Zhai commented: The above four points describe the syndrome of strangury with difficult urination during pregnancy. There are five types of strangury; Zhu Danxi primarily attributed them to heat. Regarding strangury in pregnancy, *Chanbao* (Precious Prescriptions for Obstetrics) and *Liangfang* (Good Prescriptions) attributed it to deficient-heat and stagnant-heat located in the Bladder. Xue Lizhai further traced the origin, distinguishing between damp-heat and deficient-heat in the Liver channel. This is because the Bladder is the organ that stores urine, while the orifice through which urine exits belongs to the distribution area of the Foot-Jueyin (Liver) channel. Therefore, to clear heat from the Bladder, one must simultaneously soothe the Qi of the Jueyin channel.
The *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion) states: In cases of Baozhuan (retention of urine due to bladder torsion/compression) where urination is impossible, with fullness in the lower abdomen, Guanyuan (CV 4) is the primary point. It also states: For difficult urination, water swelling, scanty urine output, and Baozhuan, Qugu (CV 3) is the primary point.
The *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) states: When a woman suffers from illness, eats normally, feels vexed and hot, cannot lie down, but instead leans forward to breathe (dyspnea), what is this disease? The Master said: This is named Baozhuan (bladder retention), characterized by the inability to urinate. This occurs because the Baoxi (membranes connecting the uterus/bladder) are twisted and disordered. The condition will resolve once urination is promoted; Shenqi Wan (Kidney-Energy Pill) is indicated as the principal treatment.
The *Shengji Zonglu* (Comprehensive Mirror of Holy Relief) states: When the Bao (uterus/bladder region) receives fluid but Qi fails to circulate, the Small Intestine becomes distended. This may result from exertion after a full meal or from sexual intercourse, causing the Bao to twist and deviate, preventing the passage of urine, thus leading to Baozhuan. The symptoms include obstruction of the urinary pathway, urgent pain in the lower abdomen, vexation, sweating, rebellious Qi rushing upward, and even death. This is called Baozhuan and requires rapid treatment.