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STRANGURY (STRANGURIA)

GENERAL

Clinical Manifestations	Difficulty in micturition in which the urine is passed only drop by drop with pain and tenesmus.
Treatment Principle
Herb Formulas	For dribbling urination that starts and stops: Wu Bi Shan Yao Wan
Points	REN-3, SP-6, SP-9, UB-28

SPLEEN QI DEFICIENCY WITH DAMPNESS

Clinical Manifestations	Dribbling urination which occurs due to overwork and fatigue Sallow complexion Anorexia Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Shortness of breath Edema in limbs, especially lower limbs Maybe anasarca Maybe abdominal distention Physical and mental fatigue T: Pale and flabby - may have teethmarks C: White and moist P: Soft and even
Treatment Principle	Warm Yang Strengthen the Spleen Benefit Qi Move water
Herb Formulas	Shen Ling Bai Zhu San
Points	REN-6, REN-9, SP-6, SP-9, ST-28, ST-36, UB-20, UB-22, UB-23

CENTRAL QI SINKING

Clinical Manifestations	Dribbling urination which occurs due to overwork and fatigue Prolapse of one or more organs A sallow or bright white complexion Lassitude Anorexia Four limbs feel tired and heavy Abdominal and epigastric distention after eating Lower abdominal sagging and distention Maybe acid regurgitation or vomiting Loose stools Shortness of breath T: Pale and flabby - may have teethmarks C: White P: Even or Soft and thready or Thready and weak
Treatment Principle	Strengthen the Spleen Benefit Qi Reinforce the Center Invigorate Yang
Herb Formulas	Bu Zhong Yi Qi Tang modified
Points	DU-20, REN-4, REN-6, ST-36 With cold limbs and diarrhea: + moxa REN-8 With gastric prolapse: + SP-16 through to REN-8 With rectal prolapse: + DU-1 With uterine prolapse: + KI-11, Zigong

SPLEEN AND STOMACH DEFICIENCY COLD

Clinical Manifestations	Dribbling urination which occurs due to overwork and fatigue Mild constant epigastric pain; relieved by warmth and pressure Anorexia Abdominal pain and fullness after meals Nausea Vomiting Loose, unformed stools Excessive salivation Cold limbs Lassitude Weakness Sallow or pale, dull complexion Maybe edema Maybe scanty urination Maybe clear, watery, copious vaginal discharge T: Pale C: White and greasy P: Deep, thready and forceless
Treatment Principle	Strengthen the Spleen Warm Yang Warm the Center Dispel Cold
Herb Formulas	Fu Zi Li Zhong Wan modified
Points	Moxa or moxa needle LIV-13, REN-12, SP-3, SP-6, ST-36, UB-20, UB-21

HEART FIRE TRANSFERRING TO THE SMALL INTESTINE

Clinical Manifestations	Stabbing pain in the Bladder Ulceration, erosion, and pain of mouth and tongue Thirst with a desire for cold drinks Irritability Irascibility Feeling of Heat and disturbance in the Heart Insomnia Flushed face Bitter taste in the mouth T: Red tip with ulcers especially on the tip P: Excess and rapid
Treatment Principle	Clear Heat Purge Fire Calm the Shen
Herb Formulas	Dao Chi (Re) San
Points	HT-7, HT-8, PC-7, PC-8, UB-15

LIVER QI STAGNATION WITH PHLEGM NODULATION

Clinical Manifestations	Urinary strangury and obstruction which is worse with emotional upset or stress Lower abdominal distention Irritability A quick temper Insomnia Maybe flatulence T: Normal or Slightly dark C: White and slimy P: wiry and slippery
Treatment Principle	Dredge the Liver Regulate Qi Transform Phlegm Scatter nodulation
Herb Formulas	Shu Gan San Jie Fang
Points

LIVER QI STAGNATION WITH YANG DEFICIENCY

Clinical Manifestations	Dribbling, clear urination Lower abdominal distention and fullness Fullness and oppression in the umbilical area T: Pale and slightly enlarged C: Thin and white P: Deep and wiry
Treatment Principle	Regulate Qi Warm and tonify Yang
Herb Formulas	Chen Xiang San modified
Points	DU-4, LIV-3, UB-23, UB-28 With rib and flank pain: + LIV-14 With lower abdominal distention and pain: + LIV-9 With lower abdominal stabbing pain: + SP-6, SP-10 With Qi Deficiency: + REN-6

LIVER AND KIDNEY DEFICIENCY

Clinical Manifestations	Blurred vision Dizziness Tinnitus Profuse dreaming Low back and knee pain and weakness Impotence Seminal emissions Dribbling urination T: Pale C: White P: Thready and weak
Treatment Principle	Enrich and supplement the Liver and Kidneys Tonify Jing Brighten the eyes
Herb Formulas	Bu Shen Ci Shi Wan Jia Wei
Points

KIDNEY JING DEFICIENCY

Clinical Manifestations	Uterine prolapse Soreness and weakness in the lower back Severe lower abdominal distention Urinary frequency which is worse at night Tinnitus Nocturnal emission Profuse pink menstrual discharge Nocturia Hearing loss Dizziness Forgetfulness Weakness of the lower limbs Lack of spirit T: Pale-red C: Normal P: Deep and frail or Deep and slow
Treatment Principle	Tonify Yin and Blood Benefit Yang and Qi Strengthen Kidney Jing Invigorate the Spleen
Herb Formulas	Da Bu Yin Wan With Liver Blood Deficiency: Zhu Jing Wan
Points

KIDNEY DEFICIENCY WITH COLD IN THE URINARY BLADDER

Clinical Manifestations	Dribbling urination Enuresis Frequent, long clear urination Fatigue Lassitude Upper and lower back pain and aching Cold limbs T: Pale C: White P: Deep and thready
Treatment Principle	Warm the Kidneys Secure the Bladder
Herb Formulas	Jin Gui Shen Qi Wan modified For scanty urination and edema in the lower limbs: Ji Sheng Shen Qi Wan
Points	Moxa or moxa needle REN-4, REN-6, UB-28, UB-34 With an aversion to Cold: + moxa DU-4 With loose stools: + ST-36 With clear, thin vaginal discharge: + GB-26 With impotence: + REN-2 With dizziness: + moxa DU-20

URINARY BLADDER DAMP-HEAT

Clinical Manifestations	Urinary frequency Urinary urgency Painful urination or Continuous dripping of urine or Sudden interruption to the urinary stream Turbid urine or Pus and blood in the urine or Sand and stones in the urine In Damp-Heat Pouring Downward there may also be: Fever Thirst Dry mouth Low back pain In Damp-Heat Crystallizes in Urinary Bladder there may also be: Colicky pain in the low back, possibly radiating to the groin T: Red C: Yellow P: Slippery and rapid
Treatment Principle	Clear Heat Eliminate Dampness by diuresis
Herb Formulas	Ba Zheng San With Blood Stagnation: Interstitial Cystitis #1
Points	KI-7, LIV-2, REN-3, SP-6, SP-9, UB-23, UB-28, UB-39 REN-3, SP-6, SP-9, ST-28, UB-28 For lower abdominal distention and oppression: + UB-27 For a fever: + bleed UB-40 For low back pain: + UB-26 For retention of urine: 1. REN-3, SP-6, SP-9, UB-28 2. REN-3, SP-6, SP-9, UB-39

HEAT (RE) LIN

Clinical Manifestations	Rapid onset of urinary dripping Frequent, urgent, painful urination Dark yellow urine with feverish and painful sensations Hasty urinary discharge Pain involving the umbilicus Fever with aversion to Cold A bitter taste in the mouth T: Red C: Yellow and greasy P: Rapid and soft
Treatment Principle	Clear Heat Purge Fire Promote urination Unblock painful urinary dysfunction
Herb Formulas	Ba Zheng San
Points	KI-3, LI-4, LIV-2, REN-3, SJ-5, SP-9, UB-28 Ear: Urinary Bladder, Kidney, Sympathetic, Occiput, Adrenal, Endocrine

STONE (SHI) LIN

Clinical Manifestations	Frequent, urgent, painful urination Difficult urination with occasional sandy substance in the urine Dysuria with pain involving the lower abdomen difficult to tolerate or On and off urinary discharge with stabbing lumbar pain that involves both the lower abdomen and external genitalia Occasional bloody urine T: Red C: Thin and white or Thin and yellow P: Wiry or Wiry and rapid
Treatment Principle	Clear Heat Purge Fire Promote urination Unblock painful urinary dysfunction
Herb Formulas	Shi Wei San Ba Zheng San With Kidney Deficiency: Liu Wei Di Huang Wan modified For sand strangury with severe, cutting distention and pain stretching to the low back, urethra or perineum which is worse during urination, sand in the urine and maybe hematuria: Shi Wei San modified
Points	KI-2, KI-3, LIV-2, REN-3, SP-9, UB-28, UB-39 KI-1, LIV-1, REN-4, UB-23, UB-28, UB-40 KI-6, REN-3, SP-6, SP-9, UB-28, UB-39 Ear: Urinary Bladder, Kidney, Sympathetic, Occiput, Adrenal, Endocrine

BLOOD (XUE) LIN

Clinical Manifestations	Frequent, urgent, painful urination Short reddish urine Maybe dark purplish clots Severe burning pain Difficulty in discharging the urine Distending pain in the urethra in severe cases which involves the umbilicus T: Red tip C: Thin and yellow P: Rapid and forceful
Treatment Principle	Clear Heat Purge Fire Promote urination Unblock painful urinary dysfunction Stop bleeding
Herb Formulas	Dang Gui Liu Huang Wan Zhi Bai Di Huang Wan Ba Zheng San Xiao Ji Yin Z i
Points	KI-3, LIV-2, REN-3, SP-6, SP-9, SP-10, UB-28 KI-1, KI-7, LIV-3, REN-3, SP-10, UB-17, UB-23, UB-27 REN-3, SP-6, SP-9, SP-10, UB-20, UB-28 Ear: Urinary Bladder, Kidney, Sympathetic, Occiput, Adrenal, Endocrine

TURBID (MILKY) (GAO) LIN

Clinical Manifestations	Frequent, urgent, painful urination Turbid milky urine that soon sediments with catkin substance at the bottom (chyluria) A fatty, oily substance at the surface of the urine container with coagulation Bloody difficult urinary discharge with feverish pain Soreness in the lumbar region and knees Dizziness Lassitude T: Red tongue proper C: Slightly white and greasy P: Soft and rapid or Rapid and thready
Treatment Principle	Warm the Kidneys Drain Dampness Separate the turbid from the clear
Herb Formulas	Bei Xie Fen Qing Yin Qing Xin Lian Zi Yin Liu Wei Di Huang Wan Jin Suo Gu Jing Wan Ba Zheng San Gui Pi Tang Huang Qi Jian Zhong Tang Shen Ling Bai Zhu San Ba Zhen Tang Fang Ji Huang Qi Tang
Points	DU-20, KI-3, LIV-2, REN-3, REN-6, SP-9, UB-23, UB-28 KI-6, REN-3, SP-6, SP-9, UB-23, UB-28 Ear: Urinary Bladder, Kidney, Sympathetic, Occiput, Adrenal, Endocrine

FATIGUE (LAO) LIN

Clinical Manifestations	Distending pain in the lower abdomen and pubic region Weakness in discharge of urine Frequent dripping of clear urine Reluctant speech Poor spirit Lumbar soreness T: Pale C: Thin and white P: Weak and thready
Treatment Principle	Promote the circulation of Qi Eliminate Phlegm Dispel Dampness Stop pain
Herb Formulas	Wu Yao Shun Qi San Bu Zhong Yi Qi Tang Bu Zhong Yi Qi Tang + Ba Wei Di Huang Wan With Kidney Deficiency: Zhi Bai Di Huang Wan
Points	KI-3, LIV-2, REN-3, REN-6, SP-9, ST-28, UB-28 DU-20, REN-3, REN-4, SP-6, SP-9, ST-36, UB-28 Ear: Urinary Bladder, Kidney, Sympathetic, Occiput, Adrenal, Endocrine

QI LIN

Clinical Manifestations	Lower abdominal and genital distention and pain after urination Difficult urination Maybe a pale complexion T: Normal C: Thin and white P: Wiry or Thready and weak
Treatment Principle	Regulate Qi
Herb Formulas	Chen Xiang San modified
Points	KI-2, LIV-2, LIV-8, REN-3, SP-9, UB-28 LIV-2, REN-3, SP-6, SP-9, UB-28

DEFICIENCY COLD IN THE LOWER JIAO

Clinical Manifestations	Dull pain in the lower abdomen which comes and goes A cold, icy feeling in the lower abdomen Pain better with warmth and worse with Cold Cold body and limbs Long voidings of clear urination Dribbling urination Lassitude Maybe loose stools Maybe seminal emissions Maybe impotence T: Pale C: White P: Thready and deep
Treatment Principle	Warm and supplement the Lower Jiao
Herb Formulas	You Gui Wan modified
Points	Moxa or moxa needle LIV-13, REN-3, REN-4, UB-20, UB-23 For impotence: + moxa or moxa needle DU-4 For diarrhea with undigested food: + SP-4, ST-25 For clear, thin vaginal discharge: + SP-9