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I have heard that in spring and summer, the Qi of the human body circulates externally on the surface. Therefore, there is profuse sweating and scanty urine. In autumn and winter, the Qi of the human body retracts internally. Therefore, there is little sweating and abundant urine. However, some individuals drink the same amount of water at the same time, yet those who are vigorous produce less urine, while the elderly produce more urine. Why is this? It is because the vigorous resemble the Qi of spring and summer, with more ascending and less descending; whereas the elderly resemble the Qi of autumn and winter, with more descending and less ascending. This is the source of their difference. By understanding these differences to diagnose pathological changes, one can thereby determine the disease state through diagnosing these variations.

What are the methods for diagnosing urine? Urinary retention (Bi Long) indicates a Excess syndrome of the San Jiao (Triple Burner); urinary incontinence indicates a Deficiency syndrome of the San Jiao (Triple Burner). Continuous dribbling of urine indicates that the Bladder fails to store. If storage control is maintained, life is preserved; if lost, death ensues. Obstruction of urination indicates dysfunction of the Bladder Qi transformation. Head sweating indicates a fatal prognosis; absence of head sweating indicates a favorable prognosis. In external contraction diseases, clear urine indicates that the pathogen is not in the interior but remains in the Exterior. Turbid urine in external contraction diseases indicates that the pathogen is in the interior, not in the Exterior. Turbid fluids all belong to Heat syndromes; clear and cold fluids all belong to Cold syndromes. Changes in urine characteristics indicate insufficiency of Middle Qi; frequent urination indicates excess of Fu-organ Qi. Yellow urine indicates Heat in the lower abdomen; white urine indicates Cold in the lower abdomen. Turbid, red, and short urine indicates Excess-Heat in the Lower Jiao; clear, white, and long urine indicates Deficiency-Cold in the Lower Jiao. Urine resembling the juice of Phellodendron bark indicates mild Jaundice; urine resembling soap pod juice indicates severe Jaundice. Urine resembling rice-washing water indicates food stagnation; urine resembling fat or paste indicates Kidney Xiao (Kidney Wasting-Thirst); bloody urine indicates Blood Lin (Painful Urination Syndrome); pasty urine indicates Gao Lin (Chyluria); sandy/stony urine indicates Shi Lin (Stony Urination Syndrome); post-void dribbling indicates Qi Lin (Qi Urination Syndrome). Patients suffering from Lin syndromes experience frequent urgency to urinate, painful and obstructive dribbling, feeling the need to void but unable to do so, and inability to stop the flow. Bai Yin (White Impurity) arises from endless rumination, unfulfilled desires, mental lust directed outward, and excessive sexual intercourse. These are all methods for diagnosing urine.

From this perspective, incontinence and retention are signs of Deficiency and Excess; clarity and turbidity are signs of Exterior and Interior; redness and whiteness are signs of Heat and Cold; shortness and length are signs of Pathogenic factors and Healthy Qi. Cross-analyzing retention/retention, clarity/turbidity, redness/whiteness, and shortness/length allows one to understand the variations in Deficiency/Excess, Exterior/Interior, Heat/Cold, and Pathogen/Healthy Qi. Conversely, cross-analyzing Deficiency/Excess, Exterior/Interior, Heat/Cold, and Pathogen/Healthy Qi allows one to understand the manifestations of retention/retention, clarity/turbidity, redness/whiteness, and shortness/length. Other conditions such as Lin syndromes, turbid urine, Xiao (Wasting-Thirst), and Dan (Jaundice) are also deduced by applying these principles.