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In various diseases, turbid fluids all belong to heat syndromes. (See full text in Diagnosis chapter.) Yellow urine indicates heat in the lower abdomen. (See full text in Edema chapter.) For yellow urine, no herb is more effective than Huangbai (Phellodendri Cortex) and Zhi Mu (Anemarrhenae Rhizoma).

If the pulse at the Chi position is choppy (Se), with cold feet and calves, and red urine, Fuzi Sini Tang (Aconite Decoction to Restore the Prostrate Yin) should be taken, and Taichong (LR3, Great Surge) on the Foot Taiyin channel should be tonified via acupuncture.

There are four organ-related causes for yellow urine:
First, it belongs to Liver Heat. The classics state: "In Liver Heat disease, the urine turns yellow first."
Second, it belongs to Stomach Excess Heat. The classics state: "When Qi of the Foot Yangming Stomach channel is abundant, the anterior part of the body becomes hot; if there is excess in the stomach, digestion accelerates with frequent hunger, and urine becomes yellow."
Third, it belongs to Lung Deficiency. The classics state: "When Qi of the Hand Taiyin Lung channel is deficient, shoulder and back pain with coldness occur, shortness of breath makes breathing difficult, and urine color changes."
Fourth, it belongs to Kidney Deficiency. The classics state: "The Winter pulse is the Kidney pulse. If the Winter pulse is insufficient (deficient), it causes obstruction of clear orifices, spinal pain, and changes in urination."

Regarding Six Qi transformation (Yunqi), there are two causes for yellow urine:
First, related to Wind. The classics state: "When Jueyin wind prevails, Qi stagnates in the hypochondrium, transforms into heat, and urine becomes yellow and red."
Second, related to Heat. The classics state: "When Shaoyin governs the year, excessive heat causes disease manifesting as changed urine color." It also states: "When Shaoyang prevails, urine is red and prone to fright." It further states: "When Yangming governs, dryness descends, sudden heat arrives, resembling summer heat where Yang Qi is stagnant and erupts, causing urine changes." This sudden heat refers to the Shaoyin heat from Earth Qi.

Where pathogenic factors reside, there is always a deficiency. Deficiency of Middle Qi causes changes in urination and defecation; one should tonify the point below the outer ankle and retain the needle. (See full text in Acupuncture for Deficiency and Excess chapter.)

[From *Jia Yi Jing*] Heat in the Small Intestine causes red-yellow urine; Zhongwan (CV12, Middle Elixir) treats it. Yellow urine is treated by Xialian (ST34, Lower Limb Abyss). Red-yellow urine is treated by Wangu (GB12, Complete Bone). Yellow urine accompanied by borborygmus (intestinal rumbling) chasing each other is treated by Shanglian (ST33, Upper Limb Abyss).

[Li Dongyuan] Urinary incontinence is due to deficiency of Lung Metal. One should rest quietly to nourish Qi and avoid overexertion. Tonify with herbs like Huangqi (Astragali Radix) and Renshen (Ginseng Radix et Rhizoma). If ineffective, suspect heat and add Huangbai (Phellodendri Cortex) and Shengdihuang (Rehmanniae Radix). (*Jia Yi Jing* states: "Lung pulse deficiency leads to shortness of breath and sudden uncontrollable incontinence.")

Lower Deficiency refers to deficiency of the Bladder and Lower Jiao. The classics state: "Unceasing urine flow indicates the Bladder's failure to store." Zhang Zhongjing stated: "When Lower Jiao fails, urinary incontinence occurs because Qi cannot control itself spontaneously; no specific treatment is needed, and it will heal after time." He also said: "When Lower Jiao Qi does not return, urinary incontinence results. The world commonly uses Sangpiaoxiao (Mantis Egg Case) and Jineijin (Chicken Gizzard Membrane) for this."

[Zhu Danxi] To treat incontinence: Stir-fry Sangpiaoxiao (Mantis Egg Case) with wine, grind into powder, and take 2 qian with ginger decoction for excellent effect.

[Hua Bolin] Jineijin Powder treats bedwetting.
Take one Ji Nei Jin (Chicken Gizzard Membrane), wash clean with the intestine, burn to ash. Use female chicken for male patients, male chicken for female patients. Grind the yellow skin inside the gizzard into powder. Take 2 qian per dose, mixed with wine for best results.
Another prescription: Fill a sheep stomach with water, tie both ends with thread, boil until cooked. Take the water inside once to cure.

[From *Shan*] For adults with unconscious incontinence: Grind Qiangweigen (Rose Root) finely and take with wine.

[Zhu Danxi] Lurong Wan (Deer Antler Pill) treats chronic deficiency-cold, spontaneous turbid urine, and slippery/frequent incontinence.
Ingredients: Lurong (Cervi Cornu Pantotrichum), Jiaohong (Zanthoxyli Pericarpium), Guizhi (Cinnamomi Ramulus), Fuzi (Aconiti Lateralis Radix Praeparata), Muli (Ostreae Concha), Shihu (Dendrobii Caulis), Buguzhi (Psoraleae Fructus), Roucongrong (Cynomorphi Herba), Jineijin (Gigastri Mesogastri Endothelium), Chenxiang (Aquilariae Lignum Resinatum) (each 1 liang); Sangpiaoxiao (Mantis Egg Case) (3 fen).
Grind all into powder, mix with wine paste to make pills the size of tung seeds. Take 30 pills before meals with wine. (Danxi adopted this formula because Chenxiang resolves various obstructions.)
Also stated: Roast Lu Jiaoxie (Cervi Cornu Degelatinatum) until yellow, grind into powder, and take 2 qian with warm wine for good effect. Materia Medica states: Deer antlers expel evil qi and bad blood from the yin regions. Lurong Wan (see Deficiency section).

[Liu Wansu] When extreme heat lodges in the Kidney region and the Jueyin meridians of the hands and feet, the Ting Kong (urethral meatus) becomes extremely congested, preventing the free flow of Qi and Blood. This leads to flaccidity and numbness, rendering the Shen (Spirit/Mind) useless. Consequently, fluids seep into the Bladder, causing immediate urinary incontinence that cannot be controlled. The classics say: "The eyes see when nourished by blood; ears hear when nourished by blood; fingers grasp when nourished by blood; palms hold when nourished by blood; feet walk when nourished by blood; Zang organs produce fluids when nourished by blood; Fu organs generate Qi when nourished by blood. Wherever Blood flows, Qi follows. When Qi and Blood move forward, the Shen within remains clear and harmonious, enabling responsive function. Thus, the classics say: 'Qi and Blood are the Spirit of humans; they must be carefully nurtured.' Therefore, regular movement promotes smooth Qi and Blood flow, enabling function. Obstruction leads to weak Qi and Blood flow and blocked pathways, resulting in weakness. If pathological heat is extreme, congestion occurs, blocking Qi and Blood, rendering Shen useless and unresponsive. Depending on the severity of congestion, functional loss varies. Thus, eye congestion prevents vision; ear congestion prevents hearing; nose congestion prevents smelling; tongue congestion prevents tasting. Flaccidity and bone bi syndrome, and inability to excrete, are all caused by congestion."

[Zhu Danxi] *Qianjin Yi Fang* Baiwei San (Baiwei Powder) treats involuntary urination.
Ingredients: Baiwei (Cynanchi Atrati Radix - noted in Materia Medica as having great cold property), Baishao Yao (Paeoniae Radix Alba) (equal parts).
Grind into powder, mix with warm wine, take one cun bi (square inch measure) per dose, three times daily before meals.
I once treated a man with unconscious incontinence; his pulse was large and vigorous. I used Huangbai (Phellodendri Cortex), Zhi Mu (Anemarrhenae Rhizoma), and Duniu Xi (Achyranthis Bidentatae Radix) as sovereign herbs, Qingpi (Citri Reticulatae Pericarpium Viride) and Gancao (Glycyrrhizae Radix et Rhizoma) as minister herbs, and Muxiang (Aucklandiae Radix) as assistant herb, with a small amount of Guizhi (Cinnamomi Ramulus) as counter-agent. After several doses, there was a significant effect. This method aligns with Liu Wansu's concept that extreme heat causes congestion in the Ting Kong, rendering Shen useless and unable to control retention.

[Worldly/Popular] Shenxiong Dao Shui Wan (Shenxiong Water-Guiding Pill) treats enuresis with excess heat. Take 100 pills on an empty stomach with plain boiled water. If diarrhea occurs after one dose, stop subsequent doses. (The previous method refers to Liu Wansu's concept of Ting Kong congestion preventing control; this method refers to "profluvial Qi causing incontinence, Bi syndrome gathering in the Kidney," where Bi means blockage of Qi and Blood flow.)

[Hua Bolin] Fuling Wan (Poria Pill) treats dual deficiency of Heart and Kidney, unsettled Shen, dribbling incontinence, and seminal emission with white turbidity.
Ingredients: Chi Fuling (Poria with Red Hosta Wood), Bai Fuling (White Poria).
Grind into powder, wash with fresh well water, clarify to remove new foam, drain dry. Take fresh Dihuang juice (Rehmanniae Radix) and good wine, boil in a silver or ceramic vessel until thickened into a paste. Mix with the powder to form pills the size of tung seeds. Chew and swallow with hot wine on an empty stomach.

[Worldly/Popular] Coix Seed (Yiyiren), stir-fried with salt and decocted, is effective. (See Pediatric section.)

[From *Ben Cao*] Yan Ru Cao (Swallow Nest Grass) treats sleepwalking incontinence. Burn until black, grind, and take one cun bi with water. It also treats hiccups. This is the grass found in swallow nests.

Bladder Cough manifests as coughing with urinary incontinence. (See full text in Cough chapter.)

Acupuncture methods for incontinence include four approaches: First, select Liver channel points; second, Du Meridian points; third, Sanjiao channel points (see Incontinence and Dysuria chapter); fourth, Lung channel points. The classics state: "The collateral of the Hand Taiyin Lung channel is named Lieque (LU7). Its pathology includes yawning due to deficiency and frequent/incontinent urination. Treat at the point one cun from the wrist, which connects to the Yangming channel."

[Zhang Yuansu] Enuresis and incontinence: Yinlingquan (SP9) and Yanglingquan (GB34) (depth 2.5 cun). Dazhun (LR1) (7 moxa cones). Another prescription: Qugu (CV2), Yin-Lingquan, and Yang-Lingquan (each 2.5 cun depth).

[From *Jia Yi Jing*] Incontinence is treated by Guanmen (ST22) and Shenmen (HT7), Weizhong (BL40). Qi stagnation with yellow urine, abdominal fullness, and deficiency leading to incontinence is treated by Shimen (CV5).

A slightly slippery Liver pulse indicates incontinence. (See full text in Treatment Methods chapter.)