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Urination that is not smooth and unobstructed is caused by heat in the Kidney (Shen) and Bladder (Pangguang). These two meridians are exteriorly-interiorly related and both govern water metabolism. Water flows through the Small Intestine (Xiaochang), enters the bladder to become urine. If heat pathogens reside within these zang-fu organs, the flow of water becomes astringent and sluggish, thus causing urination to be unsmooth and obstructed.

The Spleen (Pi) and Stomach (Wei) are harmonized; the Stomach is the sea of food and fluids. The essence from food and fluids transforms into blood and qi to circulate through the meridians; its dregs and liquid waste are transported to the Large Intestine (Dachang) and Small Intestine. If the Triple Burner (Sanjiao) is peaceful, the five zang organs will be regulated, and there will be no bias towards deficiency/excess or cold/heat. However, if the qi of the Spleen and Stomach is weak, the Large and Small Intestines tend toward deficiency, and the Lower Jiao tends toward cold, failing to control the transformation of food and fluids, this causes frequent urination and defecation.

Various types of strangury (Lin Zheng) in children are caused by heat in the Kidney and Bladder. The Bladder and Kidney are exteriorly-interiorly related and both govern water. Water enters the Small Intestine, descends to the bladder, passes through the yin region, and becomes urine. Kidney qi connects downward to the yin region, which is the pathway for fluid waste; the Bladder is the mansion of body fluids. When the Bladder has heat, body fluids overflow internally and flow into the channels, causing the water pathways to be obstructed. Water neither ascends nor descends, stagnating and accumulating in the bladder. Kidney qi fails to connect to the yin region; kidney heat causes qi to become astringent, thus leading to unsmooth water pathways, dribbling urination, hence termed "strangury" (Lin). Its presentation includes: small amount of urine with frequent voiding, tension and urgency in the lower abdomen, pain radiating to the umbilicus. There are also stone strangury (Shi Lin), qi strangury (Qi Lin), heat strangury (Re Lin), blood strangury (Xue Lin), and cold strangury (Han Lin). The morphological signs and syndromes of various stranguries are explained individually in subsequent chapters; here, one formula is used to treat all stranguries, hence termed "various stranguries" (Zhu Lin).

Stone strangury (Shi Lin) refers to strangury accompanied by the passage of stones. The Kidney governs water; when water coagulates, it transforms into stones, so stones and sand lodge in the Kidney. When the Kidney is invaded by heat, heat generates strangury. Its presentation includes: pain in the urethra during urination, inability to pass urine suddenly, pain often radiating to the lower abdomen. Urgency within the Bladder, with stones and sand passing through the urinary tract. In severe cases, the water pathway is blocked causing pain, leading to suffocation or fainting.

Qi strangury (Qi Lin) is caused by Kidney deficiency, where the Bladder receives heat qi from the Lung. Qi accumulates in the Bladder, causing distension. The Lung governs qi; when qi is invaded by heat, it flows into the Bladder. The Bladder and Kidney are exteriorly-interiorly related; bladderness heat causes qi to stagnate and fail to disperse, resulting in fullness in the lower abdomen and failure of water to circulate smoothly, thus causing astringent strangury. Its presentation includes: fullness of the Bladder and lower abdomen, astringent urination, and constant post-void dribbling. It is also called "qi retention" (Qi Long). Palpation revealing a rapid pulse at the Shaoyin position indicates that a male patient suffers from qi strangury.