【伤寒小便不利之症】太阳病，发汗后，若脉浮，小便不利，微热消渴，此热结膀胱
也。太阳误下，若不结胸，但头汗，身发黄，小便不利，又阳明病，但头汗，身无汗，渴饮身
黄，腹微满，小便不利，此湿热所致也。若大下后，复发汗，小便不利，此汗亡津液也。若
大便乍难乍易，时有微热，小便不利，此里热之症也。夏秋之交，身热便闭，此三时热病也
【伤寒小便不利之因】太阳病，卫中阳邪不得外解，内结膀胱之本，则自汗发热消渴，
而
邪下伏，身发黄而小便不利。阳明病，本多汗，今反无汗，则热不外解，内伏消渴，而小便
不利。又阳明病，里有热结，肠有燥屎，则小便不利。三时温热之令，热邪不从外解，内伏
小肠膀胱，则亦小便不利。
【伤寒小便不利之脉】身热脉浮，热结膀胱，动数变迟，太阳误下、右脉洪数。阳明湿
热，六脉虚微，内亡津液。六脉沉数，里热便结。
【伤寒小便不利之治】热结膀胱者，仲景用五苓散，今推展羌活木通汤，阳明湿热，茵
陈汤、平胃四苓散、猪苓汤。脉虚亡津液，生脉散合当归补血汤。里热便结，二便俱闭者，八
正散。若温热病，小便不利，宜用清利之剂，如猪苓汤、导赤各半汤治之。
五苓散
茯苓 猪苓 泽泻 白术 肉桂
羌活木通汤
羌活（三钱） 木通（三钱）
茵陈汤
茵陈 大黄 栀子
四苓散 即五苓散去肉桂。
猪苓汤
猪苓 茯苓 泽泻 滑石 阿胶
生脉散
人参 拣冬 北五味
当归补血汤
当归（三钱） 黄 （三钱）
八正散
车前子 木通 瞿麦 蓄 滑石 甘草梢 大黄 山栀
导赤各半汤 见前。
【伤寒小便不利之症】太阳病（太阳经受邪所致的病证），发汗后，如果脉象浮，小便不通畅，伴有轻微发热和口渴多饮，这是热邪结聚在膀胱。太阳病误用攻下法，如果没有形成结胸证，仅头部出汗，身体发黄，小便不通畅；或者是阳明病，仅头部出汗，身体无汗，口渴想喝水，身体发黄，腹部轻微胀满，小便不通畅，这是由湿热引起的。如果在严重泻下之后，又再次发汗，导致小便不通畅，这是因为发汗过度耗伤了津液。如果大便时而困难时而容易，偶尔有轻微发热，小便不通畅，这是里热的症状。夏秋交替之际，身体发热且二便闭塞，这是三时（春、夏、秋）的热病。
【伤寒小便不利之因】太阳病，卫分中的阳邪不能从体表解除，内结于膀胱的根本，就会导致自汗、发热、口渴，而邪气潜伏在下部，身体发黄且小便不通畅。阳明病，本应多汗，现在反而无汗，则热邪不能向外解除，内伏导致口渴，进而小便不通畅。另外，阳明病体内有热邪结聚，肠道中有干燥的粪便，也会导致小便不通畅。三时温热的气候时节，热邪不从体表解除，内伏于小肠和膀胱，也会造成小便不通畅。
【伤寒小便不利之脉】身体发热，脉象浮，是热结膀胱的表现；脉象由动数变为迟缓，多见于太阳病误用攻下法；右脉洪大且数，也是太阳误下的表现。阳明湿热证，六脉虚微，提示体内津液亡失；六脉沉而数，提示里热且大便结滞。
【伤寒小便不利之治】对于热结膀胱者，张仲景使用五苓散，此处推演使用羌活木通汤；对于阳明湿热，使用茵陈汤、平胃四苓散、猪苓汤。脉象虚弱且津液亡失者，使用生脉散合当归补血汤。里热且大便结滞，大小便均闭塞者，使用八正散。如果是温热病导致的小便不通畅，适宜使用清利湿热的方剂，如猪苓汤、导赤各半汤来治疗。
导赤各半汤 见前文。
[Symptoms of Impaired Urination in Cold Damage] In Taiyang disease (disease pattern caused by pathogenic invasion of the Taiyang channel), after sweating therapy, if the pulse is floating, urination is impaired, accompanied by slight fever and polydipsia (excessive thirst and drinking), this indicates heat binding in the Bladder. If Taiyang disease is incorrectly treated with purgation, and no Jie Xiong syndrome (chest binding) forms, but there is only head sweating, jaundice of the body, and impaired urination; or in Yangming disease, there is only head sweating, no body sweating, thirst with desire to drink, jaundice, slight abdominal fullness, and impaired urination, this is caused by Damp-Heat. If severe purgation is followed by repeated sweating, leading to impaired urination, this is due to the loss of Body Fluids (Jin Ye) from excessive sweating. If stool is occasionally difficult and occasionally easy, with occasional slight fever and impaired urination, this is a symptom of Interior Heat. At the transition between summer and autumn, body fever combined with constipation and urinary retention, this is a Heat Disease of the Three Seasons (Spring, Summer, Autumn).
[Etiology of Impaired Urination in Cold Damage] In Taiyang disease, the Yang pathogen in the Wei level fails to resolve from the exterior and binds internally at the root of the Bladder, resulting in spontaneous sweating, fever, polydipsia, while the pathogen lurks below, causing jaundice and impaired urination. In Yangming disease, which typically involves profuse sweating, the current absence of sweating means heat cannot resolve outward; it lurks internally causing polydipsia and subsequently impaired urination. Furthermore, in Yangming disease, interior heat binding and dry feces in the intestines also lead to impaired urination. During the warm seasons, if the heat pathogen does not resolve from the exterior but lurks internally in the Small Intestine and Bladder, it also causes impaired urination.
[Pulse Diagnosis for Impaired Urination in Cold Damage] Body fever with a floating pulse indicates heat binding in the Bladder; a pulse changing from rapid/agitated to slow often follows incorrect purgation in Taiyang disease; a surging and rapid right pulse also indicates incorrect purgation in Taiyang disease. For Yangming Damp-Heat, the six pulses are deficient and minute, indicating internal loss of Body Fluids; six pulses that are deep and rapid indicate Interior Heat and stool binding.
[Treatment of Impaired Urination in Cold Damage] For heat binding in the Bladder, Zhang Zhongjing uses Wuling San (Five-Ingredient Powder with Poria), here extended to use Qianghuo Mutong Tang (Notopterygium and Akebia Decoction); for Yangming Damp-Heat, use Yinchen Tang (Artemisiae Scopariae Decoction), Pingwei Siling San (Calm the Stomach Four-Ingredient Powder), or Zhuling Tang (Polyporus Decoction). For deficient pulses indicating loss of Body Fluids, use Shengmai San (Generate the Pulse Powder) combined with Danggui Buxue Tang (Angelica Sinensis and Astragalus Decoction). For Interior Heat with stool binding, where both urine and stool are closed, use Bazheng San (Eight-Righteous Powder). For heat diseases causing impaired urination, suitable clearing and draining agents should be used, such as Zhuling Tang (Polyporus Decoction) or Daochi Banhe Tang (Half-Half Decoction for Guiding Out Redness).
Wuling San (Five-Ingredient Powder with Poria)
Poria (Fu Ling), Polyporus (Zhu Ling), Alisma (Ze Xie), Atractodes Macrocephala (Bai Zhu), Cinnamon Twig (Rou Gui)
Qianghuo Mutong Tang (Notopterygium and Akebia Decoction)
Notopterygium Root (Qiang Huo) [3 qian], Akebia Stem (Mu Tong) [3 qian]
Yinchen Tang (Artemisiae Scopariae Decoction)
Artemisia Scoparia (Yin Chen), Rhubarb (Da Huang), Gardenia (Zhi Zi)
Siling San (Four-Ingredient Powder)
Is Wuling San minus Cinnamon Twig.
Zhuling Tang (Polyporus Decoction)
Polyporus (Zhu Ling), Poria (Fu Ling), Alisma (Ze Xie), Talcum (Hua Shi), Donkey-hide Gelatin (E Jiao)
Shengmai San (Generate the Pulse Powder)
Ginseng (Ren Shen), Ophiopogon Tuber (Mai Dong), Schisandra Berry (Bei Wu Wei Zi)
Danggui Buxue Tang (Angelica Sinensis and Astragalus Decoction)
Angelica Sinensis (Dang Gui) [3 qian], Astragalus Root (Huang Qi) [3 qian]
Bazheng San (Eight-Righteous Powder)
Plantago Seed (Che Qian Zi), Akebia Stem (Mu Tong), Dianthus Flower (Qu Mai), Polygonum Aviculare (Bian Xu), Talcum (Hua Shi), Licorice Tip (Gan Cao Shao), Rhubarb (Da Huang), Gardenia (Shan Zhi)
Daochi Banhe Tang (Half-Half Decoction for Guiding Out Redness)
See previous text.