Urinary Tract Disorders

Urinary Tract Disorders

Urinary tract disorders refer to frequent and scanty urination, as well as urinary obstruction. There are many books that discuss this condition alone. In blood-related cases, this condition is particularly common because it often occurs concurrently with other symptoms. However, the two urethras are the gateways for information exchange (1); if one is blocked, the upper and middle jiaos cannot communicate, so the "Shanghan Lun" mentions urgent measures to relieve blockages, measures to promote urination, and the idea that having urine is beneficial, while lacking urine is fatal—everyone is concerned about this issue. This is a water-related disease, and water and blood are mutually dependent, as I have repeatedly mentioned. If only blood is affected and water is not, it is easier to cure, because adjusting the water will still leave the blood somewhat hydrated. However, if both blood and water are affected, the upper part will experience wheezing and coughing, the outer part will swell and feel hot, and the lower part will have urinary obstruction—all of which are unavoidable. Water-related diseases cannot hydrate the blood, and blood-related diseases also become harder to cure as a result. I have already discussed blood in urine and swollen cough in detail in previous sections, so you can refer to them.

157

In blood-related cases, urinary tract disorders are often caused by lung weakness. The lungs are responsible for regulating the water channels, and when the lungs are diseased, the body fluids cannot flow, the qi cannot descend, and the regulation of the water channels fails to reach the state level (2), resulting in difficulty urinating. In such cases, Shengdi, Lily, Hua Tianfen, Anemarrhena, Apricot Kernel, Mulberry Bark, Slaked Lime, Jiegeng, Pig Fuling, Ajiao, and Licorice tips are recommended for treatment.

In blood-related cases, when the blood is deficient and the heart heat leaks into the small intestine, unable to separate the clear from the turbid (3), the urine becomes red, short, and obstructed, and Daochi Drink combined with Stir-fried Zhizi, Plantain Seed, Huanglian, Bai Shao, and Lampwick is used for treatment. The spleen's earth fails to transform, which can also obstruct dampness, leading to impaired urination. Wuling San is used to treat this condition. When dampness is accompanied by heat, remove the cinnamon tip and add Yinchenhao, Fangji, Huangbo, and stir-fried Zhizi.

The anterior yin belongs to the liver; when liver fire becomes agitated, there is obstruction in the urethra, sometimes with cutting pain or even hematuria. Longdan Xiegan Tang combined with Rou Congrong, or Dihuang Tang combined with Rou Congrong, Huangbo, and Cheqianzi, are suitable for treatment. If hematuria occurs, add Dihuang, Puhuang.

The kidney is the water organ, while the bladder is the water腑. When there is yin deficiency in the kidney and the water source is depleted, urination becomes impaired. Zhibo Dihuang Tang can be slightly supplemented with Rougui to counteract this. If it is yang deficiency that prevents water transformation, Jinkui Shenqi Wan is used for treatment.

The above treatments are applied according to the affected zang-fu organs, which aligns with the concept of "Sanjiao as the decision-making and drainage function" (4). Chen Xiuyuan used Wulin San to treat all three jiao, but I believe it is more refined to treat the middle and lower jiao separately, while also addressing each zang-fu organ individually.

Turbid urine refers to impure urine—white, yellow, green, or red—which is similar to the muddy floodwaters in summer, caused by damp-heat. For severe dampness, use Weiling Tang with Huangqin, Huanglian, Huangbo, and Baizhu for treatment; for severe heat, use Yinchenhao, Zhizi, Huangbo, Qinpi, Mutong, Cheqianzi, Fangji, and Gancaoshao.

There is also turbid urine caused by stagnant semen, either due to unfulfilled sexual desires or excessive sexual activity leading to semen retention. In such cases, Bixie Fenqing Yin combined with Lu Jiaoxie, Sangpiaoxiao, Baishao, and Rou Congrong is recommended.

Additionally, if the middle qi is weak and the urine changes color upon dripping onto the ground, Liu Junzi Tang and Guipi Tang are appropriate.

[Note]

(1) The gateway of information: the necessary pathway for excretion. Information can refer to increases or decreases in bodily functions.

(2) State capital: refers to the bladder. According to "Suwen·Linglan Midian Lun," "The bladder is the state capital, where fluids are stored."

(3) Separation of clear and turbid substances: refers to the absorption of nutrients from food and the excretion of waste.

(4) Decision-making and drainage: refers to the role of Sanjiao in regulating the flow of water.

[Commentary] Turbid urine is a water-related disease, while blood-related diseases involving turbid urine indicate both blood and water disorders. Blood and water are interdependent, so it is common for them to coexist. For example, lung weakness can lead to improper regulation of water pathways, preventing proper drainage to the state capital. Heart fire can cause heat to spread to the small intestine, hindering the separation of clear and turbid substances. Spleen dampness can result in impaired urination or a combination of dampness and heat. Kidney issues may involve yang deficiency preventing water transformation or yin deficiency failing to nourish the water source. There are also cases of excessive sexual desire leading to turbid semen. Additionally, weakness of the middle qi and instability of the lower jiao can contribute. By diagnosing and treating based on these pathogenic mechanisms, one can address the root cause effectively and ensure the medication targets the correct condition.

158