Retention of Urine Urinary difficulty

Significant decrease of urine or no passing of urine at all. Usually caused by lower jiao or bladder disorders relating back to other organs. (no pain)

Western Medicine: Retention of urine, Anuria (unable to urinate), blockages, injury of urinary tract, enlarged prostate, bladder/sphincter spasm, neurological disorders … …

Chinese Medicine Basic Pattern: Bladder and San Jiao disorders

Etiology (causes):

1. Damp Heat (most common) – accumulates in mid./lower Jiao, impairing spleen/kidney transformation/transportation functions of urine, damp heat will also block the bladder

2. Lung Heat -lung is the upper source of water, lung heat will not allow descending function of water from the lung to the bladder.

3. Spleen Qi Def. –looses transforming/transporting function, spleen can not separate or descend clear and turbid fluids

4. Kidney Essence Def.–causes ming men fire deficiency, yang Qi can’t transform to produce yin (with ought yin there is no yang)

5. Liver Qi Stag. –can’t soothe or regulate san Jiao functions the san jiao looses it’s steaming transformation function

6. Obstruction - stones, tumour, injury, blood stasis

Chinese Medicine Differentiation and Treatment

Excess Damp Heat in Bladder Dark, smelly, burning sensation with fullness in lower abdomen, thirsty with no desire to drink, bitter taste, general feeling of being sticky, possibly constipated T-red, greasy coat P-slippery, rapid

Principle of Treatment: induce diresis to clear heat

Acupuncture points – Shu, Mu, foot Taiyin, BL 28 and Ren 3, SP 6 and 9 - irritable- PC 6 - loss of consciousness- Du 26, PC 9 (bleed) - toxic Heat- LU 5 and 11 (bleed)

Herbal Medicine Treatment: Ba Zheng San

Excess Heat in Lung Sore and dry throat, respiratory symptoms –dyspnea, dry cough, wheezing retention of urine symptoms T- red, yellow coat P-rapid

Principle of Treatment: clear lung heat, induce diresis

Herbal Medicine Treatment: Qing Fei Yin

Stagnation of Liver Qi Starts with emotional anger, chest/hypochondriac pain or fullness T-red, thin/yellow coat P-wiry

Principle of Treatment: soothe liver Qi stagnation, induce diruesis

Acupuncture points – LR 3 and LI 4 (4 gates), Ren 3 and ST 29 - hypochondriac pain- SJ 6 - bitter taste- PC 7

Herbal Medicine Treatment: Chen Xiang San

Obstruction of Urinary Tract Possible scanty or stream during urination, pain/distension of lower abdomen T-dark purple P-uneven

Principle of Treatment: promote blood circulation, remove obstruction

Herbal Medicine Treatment: Xiao Fu Jue Yu Tang (traditional) Dai Di Dang Wan (more widely used)

Middle Jiao Qi Sinking- Spleen Prolapsed feeling in abdomen, fatigue, short of breath, bloating, other spleen Qi deficiency symptoms, over work, over worry T-pale P-deep thin

Principle of Treatment: strengthen spleen to Ascend clear Qi and Descend turbid

Herbal Medicine Treatment: Bu Zhong Yi Qi Tang + induce diresis Chun Ze Tang

Kidney Yang Deficiency (ming-men fire def.) No force to push urine out, pale, fatigue, lower back and knee weakness or cold T-pale P-deep thin

Principle of Treatment: warm up kidney yang to strengthen kidney Qi

Herbal Medicine Treatment: Shen Qi Wan

Kidney Yin deficiency General yin deficiency symptoms – 5 centre heat sensation, night sweat, zygomatic flush T-red P-thin, rapid

Principle of Treatment: nourish kidney yin and induce diruesis

Acupuncture points – Moxa, Ren 4 and Du 4, BL 23, 28, ST 36

Herbal Medicine Treatment: Liu Wei Di Huang Wan and Zhu Ling Tang

Blood Stasis from surgery or injury, thin stream or no urine, low abdominal pain

Acupuncture points – Ren 6 (Qihai) and SP 10 (Xuehai), BL 28 and Ren 3 - severe pain- ST 25, LR 3

Alternative Treatment Methods

auricular- BL, KI, urinary tract, SJ

electrical- GB 28 or ST 28 transverse subcutaneous to Ren 3, alternate fast and slow frequencies or intermittent

herbal application- mash fresh garlic clove (or Cong Bai) and mix with salt, put on Ren 8 and apply heavy Moxa

massage- gentle warming techniques