URINARY INCONTINENCE

GENERAL

Clinical Manifestations	Urinary incontinence, the loss of bladder control, is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when coughing or sneezing to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. Though it occurs more often as people get older, urinary incontinence isn't an inevitable consequence of aging. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence. Many people experience occasional, minor leaks of urine. Others may lose small to moderate amounts of urine more frequently. Types of urinary incontinence include: Stress incontinence. Urine leaks when pressure is exerted on the bladder by coughing, sneezing, laughing, exercising or lifting something heavy. Urge incontinence. There a sudden, intense urge to urinate followed by an involuntary loss of urine. There may be a need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection, or a more-severe condition such as a neurological disorder or diabetes. Overflow incontinence. Frequent or constant dribbling of urine due to a bladder that doesn't empty completely. Functional incontinence. A physical or mental impairment prevents making it to the toilet in time. Mixed incontinence. More than one type of urinary incontinence.
Treatment Principle
Herb Formulas	Post-stroke: Bu Yang Huan Wu Tang Postpartum or post-surgical: Bu Zhong Yi Qi Tang
Points	DU-4, LU-7, LU-9, REN-1, SJ-4, SP-9, ST-36, UB-27, UB-28, UB-67 Alternate between: 1. REN-3, UB-32, UB-39 2. SP-6, UB-23, UB-33 DU-2, DU-4, REN-6 UB-25, UB-32 UB-33, UB-39, UB-52 REN-3, SP-6, UB-25 REN-24 Moxa or moxa needle: 1. DU-28, LIV-3, LIV-4, REN-3, UB-22, UB-27, UB-67 2. LIV-1, LIV-2, REN-4, REN-6, SP-9 3. GB-34 Electro-acupuncture: SP-6 to UB-28, or UB-38 to UB-28 Ear: Bladder, Urethra, Sympathetic, External Genitalia, Kidney, Spleen, Sanjiao For urinary incontinence of unknown origin: GB-34, SP-9 For stress incontinence: DU-4, DU-20, REN-4, UB-33

DEFICIENCY COLD LUNG ATROPHY

Clinical Manifestations	Cold extremities No thirst Dry throat Excessive salivation with spitting up of clear Fluids No coughing Spontaneous sweating A bland taste in the mouth Cold breath Frequent, clear urination Irritability Dizziness Frequent urination Urinary incontinence Cold limbs A pale complexion Abdominal pain which is alleviated by warmth and pressure and aggravated by Cold T: Pale and moist C: None P: Frail or Deep and slow or Wiry and tight
Treatment Principle	Warm the Lungs Strengthen the Stomach
Herb Formulas	Gan Cao Gan Jiang Tang
Points

LUNG AND SPLEEN QI DEFICIENCY

Clinical Manifestations	Frequent, copious, clear urine or Incontinence or enuresis Worse with exertion and fatigue or when sneezing or coughing Protracted, incessant cough or Cough Panting Expectoration of copious, clear, watery or white Phlegm Short, weak, breathing Soft, low voice or Reluctance to speak Asthma Pale complexion and lips Mild edema of the eyelids or fingers which is worse in the morning Facial edema Dizziness Chest oppression Four limbs tired Anorexia General lassitude Cold body Fatigue Lassitude Weakness Poor appetite Distention and pain of the epigastrium and abdomen on food intake Loose stools Severe cases: Frightens easily T: Pale C: White P: Weak or Thready and weak
Treatment Principle	Reinforce the Spleen Benefit the Lungs Aid ascent of Yang Tonify Qi Warm and transform Phlegm-Dampness Secure the Bladder
Herb Formulas	Bu Zhong Yi Qi Tang modified Bu Fei Tang + Bu Zhong Yi Qi Tang modified For a sudden in crease in output due to a Wind-Cold invasion: Shen Su Yin Chinese patent medicines: Bu Zhong Yi Qi Wan Jin Suo Gu Jing Wan
Points	LU-7, REN-6, SP-6, ST-36 For chest oppression: + REN-17 For weak limbs and lack of strength: + moxa UB-43 For abdominal distention: + SP-4 For spontaneous perspiration: + UB-13 DU-20, LU-7, REN-4, REN-6, REN-12, SP-6, ST-36, UB-20, UB-24 LU-9, REN-17, SP-3, ST-36, UB-13, UB-20, UB-43 REN-6, SP-6, ST-36, UB-13, UB-20 For a sagging sensation in the lower abdomen: + Tituo For spontaneous perspiration: + moxa HT-6

LUNG AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Urinary incontinence Unproductive cough or Scanty, sticky phlegm or Sometimes blood-streaked sputum Dry mouth Dry throat Low back and knees sore and weak "Steaming Bone" tidal fever Night sweats Malar flush Maybe hoarse voice Maybe pain in shin, foot, and heel Sterility Spermatorrhea T: Red and dry C: None P: Thready and rapid
Treatment Principle	Nourish Yin Moisten the Lungs Reinforce the Kidneys
Herb Formulas	Ba Xian Chang Shou Wan
Points	HT-6, KI-3, KI-6, LU-6, LU-9, UB-13, UB-23

LUNG AND KIDNEY QI DEFICIENCY

Clinical Manifestations	Shortness of breath (difficult to inhale) Dyspnea exacerbated by exertion Asthma (inhalation difficult) Soft, weak voice Spontaneous perspiration Aversion to Wind Emaciated body Exhausted Shen Dispirited Limbs cold Face blue-green-colored Maybe superficial edema of limbs and body Maybe dysuria Maybe stress incontinence on coughing T: Pale, moist and swollen C: White P: Deep and thready or Weak
Treatment Principle	Nourish the Lungs Soothe asthma Reinforce the Kidneys to Grasp Qi
Herb Formulas	Hei Xi Dan Sheng Mai San + Ji Sheng Shen Qi Wan Ren Shen Ge Jie San
Points	DU-4, KI 3, LU 9, REN-4, REN-6, REN-17, REN-22, ST-36, UB-13, UB-23

CENTRAL QI SINKING

Clinical Manifestations	Prolapse of one or more organs 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 T: Pale and flabby - may have teethmarks C: White P: Even or Soft and thready
Treatment Principle	Strengthen the Spleen Benefit Qi Reinforce the Center Invigorate Yang
Herb Formulas	Bu Zhong Yi Qi Tang
Points	DU-20, other points are selected according to the type of prolapse

SPLEEN AND LUNG QI DEFICIENCY

Clinical Manifestations	Frequent, copious, clear urine or Incontinence or enuresis Worse with exertion and fatigue or when sneezing or coughing Protracted, incessant cough or Cough Expectoration of copious, clear, watery or white Phlegm Short, weak, breathing Soft, low voice or Reluctance to speak Asthma Pale complexion and lips Mild edema of the eyelids or fingers which is worse in the morning Facial edema Dizziness Chest oppression Four limbs tired Anorexia General lassitude Cold body Fatigue Lassitude Distention and pain of the epigastrium and abdomen Loose stools Severe cases: Frightens easily T: Pale C: White P: Weak or Thready and weak
Treatment Principle	Reinforce the Spleen Benefit the Lungs Aid ascent of Yang Warm and transform Phlegm-Dampness
Herb Formulas	Bu Zhong Yi Qi Tang modified Bu Fei Tang + Bu Zhong Yi Qi Tang modified For a sudden in crease in output due to a Wind-Cold invasion: Shen Su Yin Chinese patent medicines: Bu Zhong Yi Qi Wan Jin Suo Gu Jing Wan
Points	LU-7, REN-6, SP-6, ST-36 For chest oppression: + REN-17 For weak limbs and lack of strength: + moxa UB-43 For abdominal distention: + SP-4 For spontaneous perspiration: + UB-13 DU-20, LU-7, REN-4, REN-6, REN-12, SP-6, ST-36, UB-20, UB-24 LU-9, REN-17, SP-3, ST-36, UB-13, UB-20, UB-43

SPLEEN AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	Stress incontinence Frequent nocturia Body cold Limbs icy Complexion white and shiny Fatigue Lassitude Weakness Dizziness upon standing Cold hands and feet Low back, knees and abdomen feel cold and painful Lower abdomen feels cold and painful Loose stools containing undigested food “Cock-crow” diarrhea (occurs at about 5 am) Maybe chronic hemorrhoids Edema of face and limbs Dysuria Vaginal discharge Decreased sexual desire Severe: Abdominal ascites T: Pale, moist and swollen C: Thin and white or White and greasy P: Deep, thready, weak and maybe slow
Treatment Principle	Warm and Reinforce the Spleen and Kidneys
Herb Formulas	Bu Zhong Yi Qi Tang modified Huang Qi Jian Zhong Tang
Points	DU-20, KI-3, REN-4, ST-36 With more pronounced Yang Deficiency: + DU-4 With Yin Deficiency: + KI-7 With marked Qi Deficiency: + SP-6 With low back pain: + KI-7, SP-4 With lack of communication between the Heart and Kidney: + HT-7, UB-52 With Liver Qi Stagnation: + LIV-4 With nocturia: + UB-52 With Damp-Heat: - REN-4, + REN-2 With dysuria or painful urination: + UB-54 Moxa or moxa needle REN-4, REN-12, SP-6, SP-9, ST-36, UB-20, UB-23 REN-4, REN-6, REN-12, ST-36, Weishangxue

PHLEGM OBSTRUCTS THE HEART ORIFICE: EXHAUSTION SYNDROME

Clinical Manifestations	Sudden collapse with loss of consciousness Mouth open and hands relaxed Eyes closed Limbs cold Snoring Perspiration ("flows like oil") Incontinence of urine and feces T: Not described P: Minute and thready - about to collapse or Superficial and big but with no root (with a red face)
Treatment Principle	Support Zheng Qi Consolidate Exhaustion Strengthen Qi Return Yang
Herb Formulas	Shen Fu Tang Di Huang Yin Zi
Points	Moxa REN-4, REN-6, REN-8, ST-36

HEART AND KIDNEY DEFICIENCY

Clinical Manifestations	Urinary incontinence Frequent urination Cloudy urine that resembles rice-water Seminal emissions Enuresis Dribbling urination Maybe turbid urine Insomnia Disorientation Palpitations Poor appetite Constipation Forgetfulness Fatigue Emaciation Pale facial complexion Shortness of breath T: Pale or Light pink C: Thin and white P: Thin, slow and frail or Deep and weak or Weak and thready
Treatment Principle	Regulate and tonifies the Heart and Kidneys Stabilize Jing Stop seminal emissions Stop incontinence
Herb Formulas	Sang Piao Xiao San
Points	HT-7, KI-3, REN-4, UB-15, UB-23

LIVER QI STAGNATION (STRESS INCONTINENCE)

Clinical Manifestations	Urinary frequency or incontinence that is initiated by stress or emotional upset Urination feels incomplete or hesitant Fullness in the lower abdomen Tightness or fullness in the chest Difficulty getting a satisfying breath Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Hypochondriac discomfort or tightness Dizziness Occasional fatigue, better with exercise Abdominal distention Melancholy Depression Irritability Inappropriate anger Irregular menses Dysmenorrhea Menstrual lower abdominal distention and pain Breast distention and pain before and during menses Premenstrual syndrome Flatulence Alternating diarrhea and constipation T: Pink or Dark and slightly enlarged C: Thin and white or White and slimy P: Wiry
Treatment Principle	Soothe the Liver Clear Stagnation Resolve Dampness Disinhibit urination
Herb Formulas	Chai Hu Shu Gan Tang modified Xiao Yao San modified Acute: Chen Xiang San Chinese Patent Medicines: Chen Xiang Hua Qi Wan Shu Gan Wan Ma Xing Shun Qi Wan Xiao Yao Wan Long Dan Xie Gan Wan
Points	GB-34, LIV-3, REN-3, UB-28 For concomitant Blood Stasis signs and symptoms: + LI-4, SP-6 For Liver Qi Stagnation transforming into Liver Fire: + LIV-2 For painful menstruation: + LIV-4 For frequent sighing: + LIV-14 For chest oppression: + REN-17 LIV-3, LIV-5, LIV-8, PC-6, REN-5, UB-18, UB-22, UB-28

LIVER QI STAGNATION INVADES THE SPLEEN

Clinical Manifestations	Urine leaks when pressure is exerted on the bladder by coughing, sneezing, laughing, exercising or lifting something heavy Abdominal distention and pain Gas Borborygmus Diarrhea Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Women: Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: White and greasy P: Slippery and wiry
Treatment Principle	Soothe the Liver Invigorate the Spleen
Herb Formulas	Si Ni San
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37

LIVER AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Urinary incontinence Astringent passage of scanty, dark urination Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Numbness of limbs Flaccid paralysis (Wei syndrome), weakness Tinnitus Deafness Forgetfulness Low back and knees sore and painful Throat dry and painful Five Sole Heat Low-grade fever Tidal malar flush Dull flank pain Night sweats Steaming bones Irritability Insomnia Stools difficult to pass Constipation Men: Spermatorrhea Women: Irregular menses or Scanty menses or Amenorrhea Vaginal discharge T: Red C: None P: Thready and rapid or Thready, wiry and rapid
Treatment Principle	Nourish and Reinforce the Liver and Kidneys
Herb Formulas	Liu Wei Di Huang Wan modified Ba Xian Chang Shou Wan Dang Gui Yu Zhu San Qi Ju Di Huang Wan With Blood Deficiency: Gui Shao Di Huang Tang With Damp-Heat and Blood Stagnation: Zi Shen Tang
Points	KI-3, REN-4, REN-7, SP-6 For dull flank pain: + UB-18, UB-23 For Five-Sole-Heat: + KI-7 For insomnia: + HT-7 For dry, rough-feeling eyes: + UB-18 KI-3, LIV-3, SP-6, UB-18, UB-23

KIDNEY YIN DEFICIENCY

Clinical Manifestations	Frequent, scanty, yellow urine Maybe with a sense of Heat or irritation Later stage: Maybe incontinence Dizziness Vertigo Tinnitus or deafness Poor memory Aching, soreness or weakness of the low back and knees Steaming bones Spermatorrhea or Premature ejaculation Aching in the bones Aching in the leg and heel Dry mouth and throat Thirst Night sweats Five sole Heat Malar flush Facial flushing Red lips Low grade fever in the afternoon Restlessness Dry throat, maybe recurrent sore throat Dry stools and/or Constipation Heightened libido Vexation If Heart Fire also Flares: Insomnia Frequent dreams Palpitations If Liver Yang also Rises: Dizziness Blurred vision T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Kidney Yin Clear Deficiency Heat
Herb Formulas	Zhi Bai Di Huang Wan modified Yu Ye Tang Ba Xian Chang Shou Wan Liu Wei Di HJuang Wan Mai Wei Di Huang Wan Chinese patent medicines: Liu Wei Di Huang Wan Zhi Bai Di Huang Wan Da Bu Yin Wan
Points	KI-3, REN-4, SP-6, UB-28 With insomnia: + HT-7 With palpitations and insomnia: + HT-7, UB-15 With seminal emission : + UB-52 With scanty menstruation or amenorrhea: + SP-10, ST-29 With frequent erections: + REN-1 KI-2, KI-3, KI-6, REN-4, SP-6, UB-23, UB-53 KI-1, KI-2, KI-3, KI-6, KI-9, KI-10, REN-4, SP-6, UB-23 If Heart Fire also Flares: HT-7, PC-7, UB-15 If Liver Yang also Rises: LIV-3, UB-18

KIDNEY YANG DEFICIENCY

Clinical Manifestations	Involuntary urination upon increased intra-abdominal stress Lower and upper back feel cold, weak and aching Feeling chilled Aversion to Cold Cold limbs General debility Pale or bright white face Urinary frequency with abundant, clear urine or Oliguria with edema Nocturia Fatigue Lassitude Withdrawn, subdued behavior Knees feel cold and aching Dizziness Vertigo Tinnitus Weakness Impotence Spermatorrhea Premature ejaculation Low libido Female infertility ("uterus cold and infertile") Maybe leukorrhea or menorrhagia Maybe anorexia Maybe loose stools Maybe chronic diarrhea or "cock crow" diarrhea T: Pale and swollen (may have teethmarks) C: Thin and white P: Deep and thready - maybe slow and forceless
Treatment Principle	Warm and Reinforce Kidney Yang
Herb Formulas	Jin Gui Shen Qi Wan Ba Wei Di Huang Wan You Gui Wan Sang Piao Xiao San Da Tu Si Zi Wan Jia Jian Gui Lu Bu Shen Tang Jie Rong San Ji Sheng Tu Si Zi Wan Jia Jian She Chi Tang Xin Yang San Yang Chuan Yao Yu Lin Zhu Zhuang Yang Chi Wei Wan
Points	Moxa or moxa needle KI-3, REN-3, REN-4, REN-6, SP-6 For premature ejaculation: + KI-11 For seminal emission: + UB-52 For impotence: + moxa or moxa needle DU-4 For menorrhagia: + moxa LIV-1 For loose stools: + SP-4 For profuse, clear thin vaginal discharge: + GB-26 Moxa or moxa needle DU-4, KI-3, REN-4, UB-23 For chronic diarrhea, rectal prolapse and Vanquished Yang: + moxa DU-20, REN-8 For Kidney Yang Deficiency impotence: moxa or moxa needle DU-4, DU-20, KI-3, REN-4, UB-23 For Kidney Yang Deficiency (Cock Crow) Diarrhea: moxa or moxa needle DU-20, KI-3, REN-4, UB-23

KIDNEY YANG DEFICIENCY: KIDNEY QI NOT CONSOLIDATED

Clinical Manifestations	Involuntary urination upon increased intra-abdominal stress Nocturia Frequent, clear, abundant urination Dribbling after urination Upper and lower back pain Knees aching and weak Hearing deficit A bright, white facial complexion Fatigue Weakness Cold limbs Dizziness Vertigo Impotence Premature ejaculation Seminal emission Possible white vaginal discharge Possible incessant menstrual leakage T: Pale and swollen with teethmarks C: Thin white P: Deep, forceless and thready
Treatment Principle	Consolidate the Kidneys Conserve Qi
Herb Formulas	Jin Suo Gu Jing Wan Suo Quan Wan Gong Di Wan Jia Jian
Points	REN-3, SP-6, UB-22, UB-23, UB-28, UB-39 REN-3, SP-6, UB-22, UB-23, UB-28 Moxa or moxa needle DU-4, DU-20, KI-3, REN-4, REN-6, SP-6, UB-23 Moxa or moxa needle KI-3, REN-3, REN-4, REN-6, SP-6 For premature ejaculation: + KI-11 For seminal emission: + UB-52 For impotence: + moxa or moxa needle DU-4 For incessant menstrual leakage: + LIV-1 For profuse, clear, thin vaginal discharge: + GB-26

KIDNEY YANG DEFICIENCY: KIDNEY NOT GRASPING QI

Clinical Manifestations	Dyspnea which is worse on exertion Difficult to inhale but not to exhale Shortness of breath, shallow breathing Soft voice Perspiration In chronic cases: Thin physique Mental weariness Urinary incontinence on coughing Cold limbs Facial edema of Deficiency type T: Pale and swollen C: Thin and white P: Superficial and Deficient or Deep and thready
Treatment Principle	Reinforce the Kidneys to Grasp Qi
Herb Formulas	Ren Shen Ge Jie San Hei Xi Dan
Points	DU-4, KI-3, LU-9, REN-6, ST-36, UB-13, UB-23, UB-43 Moxa or Moxa needle DU-4, KI-3, REN-4, REN-6, REN-17, REN-21, REN-22, ST-36, UB-23

KIDNEY QI DEFICIENCY

Clinical Manifestations	Frequent urination Copious amounts of clear urine Incontinence of urine Enuresis Either a tendency towards being too hot of too cold Shortness of breath Asthma Aversion to Cold Cold limbs Weak lower back and knees Lingering tinnitus or deafness Seminal emission Impotence Fatigue Lack of strength Maybe anorexia Maybe loose stools T: Pale C: White P: Deep, weak possibly tight or Thready and weak
Treatment Principle	Tonify and warm Kidney Qi
Herb Formulas	Cong Rong Wan With Jing Deficiency: Tu Si Zi Wan
Points

URINARY BLADDER DAMP-HEAT

Clinical Manifestations	Urinary incontinence Urinary frequency Urinary urgency Painful urination or Continuous dripping of urine or A sagging sensation in the lower abdomen Sudden interruption to the urinary stream Turbid urine or Pus and blood in the urine or Sand and stones in the urine A bitter taste in the mouth 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 or Wiry and rapid
Treatment Principle	Clear Heat Eliminate Dampness by diuresis
Herb Formulas	Ba Zheng San
Points	REN-3, SP-6, SP-9, UB-27, UB-32 For a dry mouth: + UB-22 For stool irregularities: + ST-25 For a poor appetite: + REN-12 KI-7, LIV-2, REN-3, SP-6, SP-9, UB-23, UB-28, UB-39

URINARY BLADDER DEFICIENCY COLD

Clinical Manifestations	Urinary incontinence of unknown origin Face withered and dark P: Deep and thready
Treatment Principle
Herb Formulas
Points	LIV-1, REN-3, REN-4, REN-6, SP-9, UB-23, UB-28

URINARY BLADDER DEFICIENCY HEAT

Clinical Manifestations	Urinary incontinence of unknown origin Red urine P: Thready and rapid
Treatment Principle
Herb Formulas
Points	REN-3, REN-4, REN-6, SP-6, SP-9, UB-23, UB-24, UB-28

QI AND YIN DEFICEINCY

Clinical Manifestations	Excessive thirst that is not quenched by substantial intake of fluids Frequent, copious urination or Urinary incontinence Turbid urination Lassitude Shortness of breath Epigastric pain P: Deficient, weak and thready
Treatment Principle	Augment Qi Nourish Yin Generate Fluids Moisten Dryness Alleviate thirst
Herb Formulas	Yu Ye Tang
Points

BLOOD STAGNATION

Clinical Manifestations	Palpable masses that may or may not be painful Lower abdominal pain without palpable masses Lower abdominal distention Lower back pain Lower abdominal distention during menstruation Frequent menstruation (3-5 timer per month) Spotting Dark purple menstrual Blood (usually with clots) Abnormal uterine bleeding with abdominal soreness and pain Aversion to Cold Depression Cold extremities White vaginal discharge T: Pale C: White P: Choppy
Treatment Principle	Invigorate the Blood Promote the movement of Qi Dispel Blood Stasis Warm and regulate menstruation Unblock the collaterals Unblock painful obstruction Alleviate pain
Herb Formulas	Shao Fu Zhu Yu Tang Tao He Cheng Qi Tang
Points

BLOOD STAGNATION DUE TO QI DEFICIENCY

Clinical Manifestations	Urinary incontinence Hemiplegia Paralysis Atrophy of the lower limbs Facial paralysis Slurred speech Drooling Dry stools Frequent urination Deviation of the eyes and mouth Excess salivation Cold extremities Asthenia T: Normal C: White P: Moderate
Treatment Principle	Tonify Qi Invigorate the Blood Unblock the channels Promote movement in the limbs
Herb Formulas	Bu Yang Huan Wu Tang
Points

JING STAGNATION

Clinical Manifestations	Incontinence of urine Dripping urine Stabbing pain in the low back, feet, testes, penis and lower abdomen Occasional swelling of penis and testes aggravated by resting and sleeping and better with movement Maybe impotence Maybe premature ejaculation Maybe erection without stimulation Maybe ejaculation without stimulation Maybe partial erection during copulation Incomplete ejaculation Maybe ejaculation after copulation Premature graying of the hair Itch or pain of hairy areas Tinnitus Stuffy head Chest oppression Retardation of response to stimulation Difficulty concentrating Forgetfulness Insomnia High viscosity sperm with a high number of deformed sperm and abnormal sperm count T: Purple spots C: Normal P: Grating and astringent
Treatment Principle	Invigorate the Blood Free the flow of Jing
Herb Formulas	Huo Xue Tong Jing Tang
Points

TOXIC HEAT WITH PHLEGM

Clinical Manifestations	Acute lower abdominal pain Incontinence of urine Night fevers Delirious speech Irritability Restlessness Thirst May be mania (severe) Dysmenorrhea Amenorrhea Hard stool Dark red complexion Headache Vertigo Tinnitus Insomnia Palpitations Constipation Frequent urination Emotional instability Chills in the waist and feet Tremors Excruciating abdominal pain with cold Black stool May be chills and fever Hemoptysis Hematuria Red eyes Pain and distention of the head Toothache Irregular menstruation Lochioschesis Severe wheezing Distention of the chest T: Red and dry C: Yellow P: Deep and forceful or Choppy
Treatment Principle	Drain Heat Break up Blood Stasis Resolve Phlegm
Herb Formulas	Bo Shi Tang
Points

WEI SYNDROME DUE TO KIDNEY AND LIVER YIN DEFICIENCY

Clinical Manifestations	Weakness and soreness of the lower back and knees Deterioration of the sinews and bones with a general reduction in function Wasting of the muscles of the legs and feet Difficulty walking Dizziness Tinnitus Spontaneous emissions Urinary incontinence T: Red C: Little or None P: Thready and rapid or Thready and weak
Treatment Principle	Enrich Yin Descend Fire Strengthen the sinews and bones
Herb Formulas	Hu Qian Wan Yi Sui Tang
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URINARY INCONTINENCE

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