Diseases 7, urinary

Strangury (淋 lìn): A disease characterized by dribbling urination (frequent, short, rough voidings) with scorching or stinging pain in the urethra and tension in the smaller abdomen (the lower abdomen). In some cases, there is pain stretching into the lumbus or abdomen. Note that the Chinese term 淋 lìn literally means to drizzle, drip, or dribble, while the English term strangury comes from Greek stranx, drop squeezed out + ouron, urine.

Distinction is made between heat strangury, stone strangury, qì strangury, blood strangury, and unctuous strangury (traditionally called the five stranguries). In most cases, these are caused by damp-heat. Damp-heat is not present in qì strangury, which is strangury caused by qì vacuity or qì stagnation. It is present in blood strangury due to blood heat, but not in blood strangury due to blood vacuity, blood stasis, or blood cold. Here, the focus is on strangury caused by damp-heat. While damp-heat patterns are treated by water-disinhibiting dampness-percolating medicinals, other categories of medicinals are used for other patterns.

Heat strangury (热淋 rè lìn), also called damp-heat strangury (湿热淋 shī rè lìn) arises from damp-heat pouring downward, with heat more pronounced than dampness. It gives rise to scorching pain on urination, short voidings of reddish urine, and sometimes presents with aversion to cold and heat effusion, and a bitter taste in the mouth.

Stone strangury (石淋 shí lìn) arises when damp-heat pours downward and scorches the urine to produce stones. It manifests in difficult urination and the passing of stones, sometimes with complete stoppage of urine and intense pain. Sand strangury is the same condition, but the stones are smaller, like grains of sand.

Blood strangury (血淋 xuè lìn) arises when damp-heat pours downward into the bladder, scorching the network vessels of the bladder and causing frenetic movement of blood. It manifests in dribbling urination with deep-red urine that in some cases contains blood clots.

Unctuous strangury (膏淋 gāo lìn) arises when damp-heat pours downward to cause inhibited qì transformation. The urine becomes murky like the water that rice has been washed in. When the urine is left to stand, a light sediment forms at the bottom. See also white turbidity.

Qì strangury (气淋 qì lìn) is strangury caused by either qì stagnation (depressed liver qì) or qì vacuity (spleen vacuity qì fall), and hence marked by distinct accompanying signs.

Dribbling urinary block (癃闭 lóng bì): The reduction of urine to a mere dribble or no urine at all. It corresponds to anuria in biomedicine. In kidney disease, these conditions are usually attributable to insufficiency of kidney yáng and impairment of the opening and closing of the bladder. It may also be attributable to bladder damp-heat.

White turbidity (白浊 bǎi zhuó): A condition in which the urine is white and murky like water in which rice has a been washed. The term white turbidity usually refers to white murky urine unassociated with inhibited urination or pain on urination and is attributable to kidney vacuity or spleen vacuity qì fall. By contrast, unctuous strangury usually refers to conditions caused by damp-heat and associated with painful inhibited urination. However, in practice, the use of the terms is not so clear-cut.