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According to *Yuan Bing Shi* (Treatise on the Origins of Diseases): Enuresis with incontinence is caused by cold. *Nei Jing* (The Inner Canon) states: Incontinence resulting from lack of restraint is called "yi ni" (involuntary urination). Ren Zhai stated: Urine is the residue of body fluids. The Kidney governs water, and the Bladder is the mansion of body fluids. When both the Kidney and Bladder are deficient, and cold qi takes advantage of this, they cannot restrain the water, causing it to flow out uncontrollably; this is called enuresis. When it occurs spontaneously during sleep, it is called bedwetting. These conditions are all caused by deficiency of both the Kidney and Bladder accompanied by cold. They should be treated with Jichang San (Chicken Intestine Powder). There are also cases where heat pathogens lodge in the Kidney region, interfering with the Foot-Jueyin Liver Meridian, causing extreme stagnation and obstruction in the genital area. Consequently, Qi and Blood cannot circulate freely, leading to flaccidity and numbness where spiritual function is impaired. Thus, fluids seep into the Bladder, resulting in immediate loss of urine that cannot be retained. Xue Shi used Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). For those with deficiency of Spleen and Lung Qi, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was used with added Gubuzhi (Fructus Psoraleae) and Shanzhuyu (Fructus Corni). Zeng Shi argued: This is due to a loss of coordination in transmission between the Heart and Kidney, and the inability of the key gates of the Small Intestine and Bladder to maintain restraint. Cases of enuresis during dreams are all caused by deficiency and cold in the Lower Yuan (Lower Burner), as well as insufficient congenital Yang Qi. Treatment involves Jiuzi Wan (Leek Seed Pill) from *San Yin Fang*, or Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), and Bushen Dihuang Wan (Kidney-Tonifying Rehmannia Pill). However, one must also strengthen Earth (Spleen) to conserve Water, thereby avoiding the hazard of leakage. This aligns with the principle that "tonifying the Kidney is inferior to tonifying the Spleen." Pingwei San (Peace the Stomach Powder) with doubled Yizhiren (Fructus Alpiniae Oxyphyllae), crushed, decocted with fresh ginger, jujube, and roasted salt, should be taken warm on an empty stomach.

Jichang San (Chicken Intestine Powder)
Jichang (Chicken Intestine, one piece; males use hen intestines, females use rooster intestines, calcined to retain its nature) Muli (Ostreae Concha) Fuling (Poria) (peeled) Sangpiaoxiao (Cicada Slough) (fried. Each 5 qian)
Guizhi (Ramulus Cinnamomi) (bark removed) Longgu (Fossilia Ossis Mastodi et Scapulae) (Each 2.5 qian)
Grind the above medicines into an extremely fine powder. Still take one piece of chicken viscera and one piece of chicken intestine, calcine them to retain their nature, and grind into an extremely fine powder. Each time, take 1 qian of the aforementioned powder, dissolve it in warm wine, and take before meals.

[Zhang's] Jichang San Treats conditions where there is heat in the Bladder, excessive intake of cold medicines, inability to control urination, or enuresis.
Jichangcao (Herba Centipedae) Longgu (Fossilia Ossis Mastodi et Scapulae) Maidong (Radix Ophiopogonis) (heart removed, baked) Bai Fuling (Poria) (each half liang) Muli Fen (Concha Ostreae) (7.5 qian)
The above ingredients are pounded into a coarse powder. Take 1 qian per dose, with one small cup of water, add a little fresh ginger and two jujubes, decoct until reduced to 60%, strain, and take warm. Adjust dosage according to the child's age and size.

Note: This formula and the previous one are likely the same formula with errors introduced during transcription. Upon careful examination, using chicken intestines seems more appropriate, whereas Zhang Shi, Lou Shi, and Xue Shi all advocated using Jichangcao. Both versions are preserved here.

Yizhi Wan (Alpinia Pill) Treats deficiency-heat of the Spleen and Kidney, insufficiency of Heart Qi, enuresis, and leukorrhea/turbid urine.
Yizhiren (Fructus Alpiniae Oxyphyllae) Fuling (Poria) Fushen (Poria cum Radix) (Equal parts)
Grind into powder, make pills with refined honey, sized like paulownia seeds. Take 50-60 pills each time, on an empty stomach, washed down with plain boiled water.

Pogu Zhi San (Psoralea Powder) Treats deficiency-cold of the Bladder, nocturnal enuresis, or urinary incontinence. Use Poguzhi (Fructus Psoraleae) ground into powder, take 1 qian per dose, mixed with hot water.
Another prescription: Poguzhi, fried and ground into powder, mixed with Huangbai Tang (Phellodendron Decoction).

*Waitai Mi Yao* (Essential Prescriptions Worth a Thousand Gold for Emergencies) treats children who wet the bed during sleep without awareness. Gui Mo (Cinnamon Bark Powder) and Xiongji Gan (Male Chicken Liver) in equal parts, pounded together, made into pills the size of small beans. Take with warm water, three times a day.

Chu Yushi treated pediatric enuresis. Yiyiren (Semen Coicis) one he, do not remove the heart or shell, crush it, add a small pinch of salt, stir-fry until yellow. Add two zhong of water, decoct until half remains, take on an empty stomach. Repeatedly effective.

San Yin Fang family's Jiuzi Wan (Leek Seed Pill) (Formula see Miscellaneous Diseases: Urinary Incontinence)