Library

Pathogenic factors gather in the Lower Jiao (Lower Burner), condensing and failing to disperse. In severe cases, this leads to hardness, fullness, and pain in the lower abdomen, which is the reason for urinary obstruction. Generally, when there is any difficulty in urination, one should employ methods to promote flow, thereby allowing water dampness to be excreted via seepage and drainage. If excessive water intake causes heat accumulation in the Lower Jiao, or if dampness obstructs leading to jaundice, or if fluid retention remains, promoting urination should be the primary treatment principle. However, only after sweating has depleted body fluids and dried up stomach juices, or in Yangming disease with excessive sweating, should the use of diuretics be strictly avoided. If urinary obstruction is accompanied by sweating only on the head, it indicates a critical condition of Yang collapse and Yin-Yang separation (Guan Ge).

If excessive water intake leads to blood-heat accumulation in the Lower Jiao, causing urinary obstruction with a floating pulse, Wuling San (Five-Ling Powder) is used; if the pulse is deep, Zhuling Tang (Polyporus Decoction) is used.

In Taiyang disease, if the body is yellow and the pulse is deep, Zhuling Tang (Polyporus Decoction) is used. In Taiyang disease, if the body is yellow, the pulse is deep and knotted, the lower abdomen is hard, and urination is difficult, it is a syndrome of blood loss; add Yichen (Artemisiae Scopariae Herba) to Wuling San (Five-Ling Powder). If there is vomiting and fever, chest fullness, palpitations in the epigastrium, and urinary difficulty, it is also a syndrome of blood loss; add Yichen (Artemisiae Scopariae Herba) and Fuling (Poria) to Wuling San (Five-Ling Powder).

In Shaoyin disease, with cold extremities or urinary difficulty, Sini San (Frigid Extremities Powder) plus Fuling (Poria) is used.

In Yangming disease, with no sweating, urinary difficulty, and mental restlessness (Ao Nao) in the epigastrium, the body will certainly develop jaundice; add Yichen (Artemisiae Scopariae Herba) to Wuling San (Five-Ling Powder).

The Classic states: Deficiency leads to difficult urination. In Yin deficiency, Yang heat inevitably converges internally. Due to heat affecting the Bladder, urine becomes red, astringent, and non-smooth. It also states: Although there is constipation, if after six or seven days the urine volume is low, it indicates that the stool is only hard at the beginning and loose at the end, not yet definitively formed. If purgatives are applied prematurely, diarrhea will result. One must wait until urine volume increases and the stool is confirmed to be hard before applying purgation. This occurs because water and grain in the Stomach fail to separate properly, so although passage exists, normal defecation cannot occur.

In Yangming Wind Strike, with a floating, wiry, and large pulse, jaundice, dry nose, shortness of breath, abdominal fullness, tidal fever with occasional hiccups, chest and hypochondriac pain, and difficult urination, Xiaochaihu Tang (Minor Bupleurum Decoction) plus Fuling (Poria) is used.

In Taiyang disease, if urination is free, it is due to excessive water intake, which inevitably causes palpitations in the epigastrium; Lingzhi Baizhu Gancao Tang (Poria, Atractylodes, and Licorice Decoction) is used. If urination is scanty, there will likely be tenesmus; Zhuling Tang (Polyporus Decoction) is used.

When urination is frequent or involuntary (Zi Li), it indicates leakage and seepage of body fluids, leading to hard stools. Mild laxatives should be used. In Yangming disease with spontaneous sweating, if sweating is induced again, internal fluids become exhausted. Even if stools are hard, purgation is contraindicated. If defecation is difficult, Honey Suppositories (Mi Dao Jian) should be used for guidance. In Taiyin disease, jaundice is expected; however, if urination is frequent, damp-heat is drained internally, preventing jaundice. Only in blood disorders does one see abdominal urgency and manic behavior. Deficiency of the Kidney and Bladder fails to control fluids, resulting in frequent urination. If Kidney and Bladder deficiency is combined with heat, the water pathways become astringent, causing dysuria, strangury, and frequency. If there is spontaneous sweating with frequent urination, even if exterior symptoms exist, Guizhi Tang (Cinnamon Twig Decoction) is contraindicated, as it would further deplete fluids.

In Taiyang disease, with frequent urition due to excessive water intake causing epigastric palpitations, Lingzhi Guizhi Tang (Poria and Cinnamon Twig Decoction) or Lingzhi Gancao Tang (Poria and Licorice Decoction) is used.

In Taiyang disease with spontaneous sweating, limb stiffness, irritability, slight aversion to cold, and foot cramps, if Guizhi Tang (Cinnamon Twig Decoction) is mistakenly administered, leading to cold extremities, Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) and Gancao Shaoyao Tang (Licorice and Peony Decoction) are given.

With a floating pulse, spontaneous sweating, frequent urination, disharmony of the Stomach, and delirious speech, a small dose of Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction) is given.

In Yangming disease, a floating and choppy pulse indicates strong Stomach Qi (floating) and frequent urination (choppy). The interaction of floating and choppy pulses leads to difficult defecation, known as "Spleen Constriction" (Pi Yue); Maren Tang (Hemp Seed Decoction) is appropriate.

In Shaoyin disease with cold extremities and frequent urination, or white urine, it is a deficiency-cold pattern; Sini Tang (Frigid Extremities Decoction) is used, or Zhenwu Tang (True Warrior Decoction) with Fuling (Poria) removed. If there is both vomiting and diarrhea, with frequent urination, profuse sweating, diarrhea of undigested food, interior cold with exterior heat, and a floating pulse nearly imperceptible, Sini Tang (Frigid Extremities Decoction) is used.