Classica Sinica Medica

小便不利

xiǎo biàn bù lì

Difficult urination · xiao bian bu li

Also rendered: Difficult urination (This site) · Urine not free (Literal) · Oliguria (Clinical)

Pathology

Reviewed · 2026-10-31

At a glance

Pinyin
xiǎo biàn bù lì
Simplified
小便不利
Literal
小 biàn is the small passage — 小便, urine; 不 is not; 利 lì is free, unobstructed, the same graph used of a smooth stool and a favourable outcome. The phrase therefore does not mean pain on passing water but a failure of free passage: scanty, hesitant, or held back. What causes it is what the chapter then has to decide.
Shuowen
**《說文》：「便，安也。」** 借爲溲便之便；「利，銛也」，引申爲通利。**六至十篇十九見**，分佈第六篇七、第七篇四、第八篇八。**其因不一，最須分辨**：一爲**蓄水**，脉浮發熱、渴欲飲水，五苓散；二爲**濕熱發黄**，但頭汗出、渴引水漿，茵蔯蒿湯；三爲**亡津液**，汗下之後而小便不利，勿治之；四爲**蓄血**，少腹鞕滿而小便自利，反不言不利；五爲**氣化不行**，柴胡桂枝乾薑湯證之胸脅滿微結。**同一名而五證**，故不可見不利即利之。

In brief

Failure of the urine to pass freely — scanty, hesitant, or suppressed. In these chapters it is never a diagnosis in itself but a question: which of several mechanisms is at work? Where the pulse floats, there is fever, thirst and a stalled water metabolism, the cause is water retained and the answer is the five-ingredient powder. Where there is sweat only on the head, thirst for great draughts and a threatened jaundice, damp heat is steaming and the answer is capillaris. Where sweating, purging or diuresis has gone before, the fluids are simply gone and the rule is to do nothing. In blood accumulation the urine is freely passed, and that very freedom is the sign. The phrase thus carries no treatment of its own; it marks a place where several patterns look alike.

Senses in the classical corpus

1
蓄水 若脉浮，小便不利，微熱消渴者
發汗後大汗出、胃中乾而渴，脉浮而小便不利、微熱消渴，是水停不化，與五苓散
After sweating, a great sweat, a dry stomach and thirst; the pulse floats, urine will not pass, there is slight fever and unquenchable thirst: water is stalled and not transformed. Five-ingredient powder with poria.
若脉浮，小便不利，微熱消渴者，與五苓散主之。 — 辨太陽病脉證并治中第六
2
亡津液 小便不利者，亡津液故也
大下復汗而小便不利，非水停，乃津液亡；勿以利小便爲治，得小便利則自愈
Purged and then sweated, with urine not passing: this is not stalled water but fluid gone. Do not treat by promoting urine; when it flows, the patient recovers.
大下之後，復發汗，小便不利者，亡津液故也，勿治之，得小便利，必自愈。 — 辨太陽病脉證并治中第六
3
蓄血之對照 小便不利者，爲無血也
身黄脉沉結、少腹鞕而小便不利，是無血；若小便自利而其人如狂，則爲血證，主抵當湯
Yellow body, deep knotted pulse, hard lower abdomen and urine not passing means there is no blood; if the urine passes freely and the patient is as if mad, it is a blood pattern, and the resisting pill governs.
太陽病，身黄，脉沉結，少腹鞕，小便不利者，爲無血也。 — 辨太陽病脉證并治中第六
4
濕熱發黄 小便不利，渴引水漿者
陽明發熱汗出而身無汗、但頭汗出、劑頸而還、小便不利、渴引水漿，是瘀熱在裏，身必發黄
Yang brightness with fever and sweat, yet the body does not sweat — only the head, and it stops at the neck — urine will not pass and the patient drinks great draughts: stagnant heat is within, and the body will turn yellow.
但頭汗出，身無汗，劑頸而還，小便不利，渴引水漿者，此爲瘀熱在裏，身必發黄，茵蔯湯主之。 — 辨陽明病脉證并治第八

Occurrences in the classics

Passages where the term does real work, with the original, pinyin and English on the same line.

Display
4 passages
辨太陽病脉證并治中第六·辨太陽病脉證并治中第六 Read in context →
太陽病，發汗後，大汗出，胃中乾，煩燥不得眠，欲得飲水者，少少與飲之，令胃氣和則愈。若脉浮，小便不利，微熱消渴者，與五苓散主之。 太阳病，发汗后，大汗出，胃中干，烦燥不得眠，欲得饮水者，少少与饮之，令胃气和则愈。若脉浮，小便不利，微热消渴者，与五苓散主之。
tài yáng bìng fā hàn hòu dà hàn chū wèi zhōng gān fán zào bù dé mián yù dé yǐn shuǐ zhě shào shào yǔ yǐn zhī lìng wèi qì hé zé yù ruò mài fú xiǎo biàn bù lì wēi rè xiāo kě zhě yǔ wǔ líng sǎn zhǔ zhī
In taiyang disease, after sweating with profuse sweat, the stomach is dry, and there is restlessness with sleeplessness and a wish to drink. Give a little water to drink, and when the stomach qi is harmonised the illness resolves. If the pulse is floating, urination is difficult, and there is slight fever with wasting thirst, give Five-Ingredient Poria Powder.
脉浮、發熱、渴而小便不利，是蓄水；與亡津液之不利，恰在渴與不渴、汗與不汗分。
辨太陽病脉證并治中第六·辨太陽病脉證并治中第六 Read in context →
太陽病，身黄，脉沉結，少腹鞕，小便不利者，爲無血也。小便自利，其人如狂者，血證諦也。抵當湯主之。 太阳病，身黄，脉沉结，少腹硬，小便不利者，为无血也。小便自利，其人如狂者，血证谛也。抵当汤主之。
tài yáng bìng shēn huáng mài chén jié shào fù yìng xiǎo biàn bù lì zhě wéi wú xuè yě xiǎo biàn zì lì qí rén rú kuáng zhě xuè zhèng dì yě dǐ dāng tāng zhǔ zhī
In taiyang disease with yellowing of the body, a deep, bound pulse, hardness of the lower abdomen and difficult urination, there is no blood. Where urination is free and the patient is as if mad, the blood syndrome is certain. Resisting Decoction governs it.
以小便之利不利辨血之有無，是蓄血證的肯綮。
辨陽明病脉證并治第八·辨陽明病脉證并治第八 Read in context →
陽明病，發熱汗出，此爲熱越，不能發黄也。但頭汗出，身無汗，劑頸而還，小便不利，渴引水漿者，此爲瘀熱在裏，身必發黄，茵蔯湯主之。 阳明病，发热汗出，此为热越，不能发黄也。但头汗出，身无汗，剂颈而还，小便不利，渴引水浆者，此为瘀热在里，身必发黄，茵𫈟汤主之。
yáng míng bìng fā rè hàn chū cǐ wéi rè yuè bù néng fā huáng yě dàn tóu hàn chū shēn wú hàn jì jǐng ér huán xiǎo biàn bù lì kě yǐn shuǐ jiāng zhě cǐ wéi yū rè zài lǐ shēn bì fā huáng yīn chén tāng zhǔ zhī
In yangming disease with fever and sweat, the heat is escaping and cannot make yellow. If sweat appears on the head alone, the body is dry, and it stops at the neck, with difficult urine and thirst drawing on water and broth, this is stagnant heat within; the body will surely turn yellow, and Yinchen Decoction governs it.
但頭汗出、劑頸而還、小便不利、渴引水漿，四證合而瘀熱發黄之形具。
傷寒論·辨少陰病脉證并治第十一 Read in context →
少陰病，二三日不已，至四五日，腹痛，小便不利，四肢沉重疼痛，自下利者，此爲有水氣。其人或欬，或小便利，或下利，或嘔者，真武湯主之。 少阴病，二三日不已，至四五日，腹痛，小便不利，四肢沉重疼痛，自下利者，此为有水汽。其人或咳，或小便利，或下利，或呕者，真武汤主之。
shào yīn bìng èr sān rì bù yǐ zhì sì wǔ rì fù tòng xiǎo biàn bù lì sì zhī chén zhòng téng tòng zì xià lì zhě cǐ wéi yǒu shuǐ qì qí rén huò kài huò xiǎo biàn lì huò xià lì huò ǒu zhě zhēn wǔ tāng zhǔ zhī
In shaoyin disease that does not resolve in two or three days, by the fourth or fifth day there is abdominal pain, difficult urination, heaviness and pain of the limbs, and spontaneous diarrhoea: this is water qi. Whether the patient coughs, or urine flows freely, or there is diarrhoea, or vomiting, True Warrior Decoction governs.
「腹痛，小便不利，四肢沉重疼痛，自下利者，此爲有水氣」——少陰腎陽不化，水停不行，故小便不利；水寒浸漬，故腹痛、四肢沉重、自下利。真武湯温腎利水，與五苓之蓄水不同。

Compounds built on this term

小便不利
xiǎo biàn bù lì
difficult urination
辨太陽病脉證并治中第六
小便自利
xiǎo biàn zì lì
free passage of urine
辨太陽病脉證并治中第六
五苓散
wǔ líng sǎn
five-ingredient powder
辨太陽病脉證并治中第六
蓄水
xù shuǐ
retained water
辨太陽病脉證并治中第六

How it has been translated

Every rendering below is a decision about which reader is being addressed. There is no neutral option.

This sitedifficult urinationkeeps 不利 as failure of free passage
Literalurine not beneficialexact, and misleading in English
Clinicalscanty urineplain, but includes cases that are not scanty

Entry status

Review pending — who reviews this?

2026-10-31

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