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The *Yuan Bing Shi* states: Enuresis with incontinence is caused by cold. The *Nei Jing* (Inner Canon) says: Incontinence of urine results from the failure of the Bladder to maintain control. Renzhai said: Urine is the surplus of body fluids. The Kidney governs water metabolism, and the Bladder is the fu-organ of body fluids. When both the Kidney and the Bladder are deficient, and cold pathogenic factors take advantage of this deficiency, they cannot restrain the water, leading to uncontrolled outflow; this is called enuresis. When urination occurs involuntarily during sleep, it is called bedwetting. All these conditions are caused by deficiency of the Kidney and Bladder combined with cold. The primary treatment should be Jichang San (Chicken Intestine Powder), yet herbs such as Yizhi Ren (Alpinia Oxyphylla Fruit) and Poguzhi (Psoralea Fructus) should not be omitted.

There are also cases where heat pathogens lodge in the Kidney region and the Bladder, causing fire pathogens to move recklessly, disturbing the water so that it cannot remain tranquil. Consequently, control is lost, and urination becomes frequent. Treatment should focus on tonifying the Yin and blood of the Bladder and purging the fire pathogens, assisted by astringent agents such as Muli (Oyster Shell), Shanzhuyu (Cornus Officinalis Fruit), and Wuweizi (Schisandra Chinensis Fruit). Since the root of the disease belongs to heat, purging fire is appropriate. Because water is insufficient, fire moves, leading to increased urination; as urination increases, water becomes more deficient, so tonifying blood and purging fire is indicated. Tonifying blood treats the root; astringing and consolidating treat the branch.

[Attached Formulas]
Jichang San (Chicken Intestine Powder): Guizhi (Cinnamon Twig, 1.5 qian), Longgu (Dragon Bone, 2.5 qian), Muli (Oyster Shell, calcined to ash), Fuling (Poria), Sangpiaoxiao (Mantis Egg Case, stir-fried, each 5 qian), one Chicken Intestine (burned until carbonized but retaining efficacy; use female intestine for males, male for females). Grind all into an extremely fine powder. Additionally, take one Chicken Gizzard Skin and one Chicken Intestine, burn until carbonized, and grind into an extremely fine powder. Each time, take 1 qian of the previous medicine, dissolve it with warm wine, and administer before meals.

Another Prescription: One Chicken Gizzard Skin, one Chicken Intestine (burned), one Pig Bladder (roasted until scorched; use female bladder for males, male for females). Grind into powder and take with wine.

Summary: Wood originates from damp-heat and stagnant blood; hand numbness originally belongs to Qi deficiency. Sudden numbness of ten fingers indicates damp-phlegm and stagnant blood due to Stomach deficiency.
Pulse Method: A floating and soggy pulse indicates Qi deficiency. If felt at the cun position (front of the guan), numbness is in the upper body; if felt at the chi position (back of the guan), numbness is in the lower body. A floating and moderate pulse indicates dampness, manifesting as paralysis; a tight and floating pulse indicates cold, manifesting as painful bi-syndrome; a choppy and hollow pulse indicates stagnant blood, manifesting as anesthesia (numbness without pain or itch sensation).
The *Nei Jing* says: The combination of wind, cold, and damp pathogens forms bi-syndrome. Therefore, when wind prevails, it is moving bi-syndrome; when cold prevails, it is painful bi-syndrome; when damp prevails, it is fixed bi-syndrome. (Self-commentary: Although the *Nei Jing* commentary notes they combine to form bi, their origins differ. Wind affects yang, thus forming moving bi; cold affects yin, thus forming painful bi; damp affects skin, flesh, and sinews, thus forming fixed bi that does not depart.) Hejian said: Pathogens lingering and not departing cause numbness and spasms in the four limbs.
Qibo said: Pain is due to excessive cold; having cold causes pain. Conditions that are neither painful nor insensible occur because the disease has progressed deeply over a long period, causing the circulation of Ying and Wei to become sluggish, and meridians to be occasionally empty, hence no pain; the skin lacks nourishment, hence insensibility. What is called insensibility involves either the whole body or the four limbs feeling a buzzing sensation, with numbness and loss of pain/itch sensation, resembling the feeling after a rope binding is first untied; ancient formulas call this paralysis (ma bi).
Danxi said: Numbness (ma) is due to Qi deficiency; anesthesia (mu) is due to damp-phlegm and stagnant blood. Thus, ma and mu are distinguished within the category of insensibility. However, there are cases of dual Qi and Blood deficiency presenting only with numbness without anesthesia, and cases of deficiency compounded by dampness. When numbness and anesthesia occur together, it may be due to deficiency allowing wind, cold, and damp pathogens to invade. When general body twitching pain accompanies numbness, ancient formulas call this generalized bi-syndrome (Zhou Bi); the treatment method should prioritize sweating followed by tonification. However, treatment should be applied by analogy, not rigidly adhering to a single view.

If numbness occurs in all ten fingers, it indicates damp-phlegm and stagnant blood in the Stomach. Erchen Tang (Two-Cured Decoction) should be used with Cangzhu (Atractylodes Rhizome), Taoren (Peach Seed), Honghua (Carthamus Flower), and a small amount of Fuzi (Aconite Lateral Root) to promote meridian circulation. Alternatively, Siwu Tang (Four Substance Decoction) with Cangzhu, Baizhu (Atractylodes Macrocephala Rhizome), Chenpi (Tangerine Peel), Fuling, Qianghuo (Notopterygium Rhizome), Honghua, and Sumu (Sappan Wood) is suitable.

If numbness occurs in both hands and feet, including fingertips, it indicates phlegm stagnation in the meridians. Erchen Tang with Zhuli (Bamboo Sap), Jiangzhi (Ginger Juice), and Baijiezi (White Mustard Seed) should be used to dispel phlegm-fire and scatter wind.

For "ma" (numbness), Buyi Zhongyi Tang (Tonify the Middle and Augment the Qi Decoction) with Danggui (Angelica Sinensis Root), Muxiang (Vladimiria Root), Xiangfu (Cyperus Rhizome), Qingpi (Green Tangerine Peel), and Chuanxiong (Ligusticum Rhizome), plus a small amount of Guizhi to promote meridian circulation, is indicated.

For "mu" (anesthesia), Siwu Tang (Four Substance Decoction) and Erchen Tang (Two-Cured Decoction) with Taoren, Honghua, Zhuli, Jiangzhi, and Baijiezi are both suitable. These help promote meridian circulation to the hypochondrium, reaching the location of the phlegm.

[Attached Formulas]
Erchen Tang (Two-Cured Decoction): See section on various vomiting syndromes.
Siwu Tang (Four Substance Decoction): See section on dysentery syndromes.
Buyi Zhongyi Tang (Tonify the Middle and Augment the Qi Decoction): See section on rectal prolapse syndromes.