Dribbling urinary block

Also urinary block; urinary stoppage. Dribbling urination or, in severe cases, almost complete blockage of urine flow. Distinction is made between a number of vacuity and repletion patterns. Vacuity patterns include insufficiency of center qì and insufficiency of kidney qì. Repletion patterns include lower burner damp-heat, lung qì congestion, depressed liver qì, and urinary tract stasis blockage.

Biomedical correspondence: Ischuria due to spasm of the vesical sphincter, urinary calculus, urethrostenosis, tumor of the urethra, urethral injury, hyperplasia of the prostate in old age, myelitis, or toxemia.

Patterns

Insufficiency of center qì (中气不足 zhōng qì bù zú) is characterized by difficult voiding, fatigue, shortness of breath, reduced food intake, distension and oppression in the stomach duct and abdomen, sagging distension in the smaller abdomen, sloppy stool, pale tongue with thin fur, and a sunken weak pulse.

Medicinal therapy: Supplement the center and boost qì; free urination. Use variations of Center-Supplementing Qì-Boosting Decoction (补中益气汤 bǔ zhōng yì qì tāng).

Insufficiency of kidney qì (肾气不足 shèn qì bù zú) is characterized by forceless voiding, frequent urge to urinate, aching lumbus and knees, lack of warmth in the extremities, pale tongue with dental impressions, thin white tongue fur, and a fine sunken pulse that is weak at the cubit position.

Medicinal therapy: Warm kidney yáng and boost qì; supplement the kidney and disinhibit urine. Use variations of Life Saver Kidney Qì Pill (济生肾气丸 jì shēng shèn qì wán).

Lower burner damp-heat (下焦湿热 xià jiāo shī rè) is characterized by urinary block with painful urination, frequent urination, and urinary urgency, bitter taste in the mouth, thirst without desire to drink, inhibited stool, red tongue with slimy yellow fur, and a sunken rapid or soggy rapid pulse.

Medicinal therapy: Clear and disinhibit damp-heat; free urination. Use formulas such as Eight Corrections Powder (八正散 bā zhèng sǎn).

Lung qì congestion (肺气壅滞 fèi qì yōng zhì) is marked by oppression in the chest, cough and inhibited rapid breathing, constipation, red tongue or pale tongue, with white or thin yellow tongue fur, and sunken weak pulse.

Medicinal therapy: Treat by taking the lid off, i.e., by inducing sneezing or by mechanical emesis to open lung qì. For enduring conditions in which heat has developed, Lung-Clearing Drink (清肺饮子 qīng fèi yǐn zi) can be used with the judicious addition of urine-freeing medicinals.

Depressed liver qì (肝气郁结 gān qì yù) is characterized by dribbling urinary block or ungratifying urination, affect-mind binding depression, tendency to vexation and irascibility, constrained feeling in the rib-sides, unquiet sleep, profuse dreaming, bitter taste in the mouth and acid swallowing, red tongue with thin yellow fur, and a stringlike pulse.

Medicinal therapy: Treat by Aquilaria Powder (沉香散 chén xiāng sǎn), combined with Bupleurum Liver-Coursing Powder (柴胡疏肝散 chái hú shū gān sǎn) if necessary.

Urinary tract stasis blockage (尿道瘀阻 niào dào yū zǔ) is characterized by intermittent inability to void urine, lesser abdominal distension, dark purple tongue with stasis speckles, white or slightly yellow tongue fur, and a rough pulse.

Medicinal therapy: Move stasis and disperse binds; disinhibit the waterways. Use Substitute Dead-On Pill (代抵当丸 dài dǐ dàng wán).

Acumoxatherapy: For repletion patterns, base treatment mainly on the alarm and back transporting points of BL and SP. Select CV-3 (Central Pole, 中极 zhōng jí), BL-28 (Bladder Transport, 膀胱俞 páng guāng shù), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), SP-9 (Yīn Mound Spring, 阴陵泉 yīn líng quán), and LU-5 (Cubit Marsh, 尺泽 chǐ zé); needle with drainage. For vacuity patterns, base treatment mainly on KI, SP, and back transporting points. Select BL-23 (Kidney Transport, 肾俞 shèn shù), BL-20 (Spleen Transport, 脾俞 pí shù), BL-22 (Triple Burner Transport, 三焦俞 sān jiāo shù), CV-4 (Pass Head, 关元 guān yuán), KI-10 (Yīn Valley, 阴谷 yīn gǔ), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo); needle with supplementation and add moxa. Compare inhibited urination; shifted bladder; block and repulsion; urine.

Etymology

Chin 癃 is composed of 疒, the illness signifier, with 隆 lóng, high, prominent, thriving, or intense. The character composition may originally have reflected the fullness in the abdomen associated with urinary stoppage. However, in The Inner Classic (内经 nèi jīng), 癃 was used interchangeably with 淋 lín, dribble. In the Hàn Dynasty, the given name 隆 of the Emperor Hàn Shàng Dì 汉殇帝, invoked the taboo against profane use the emperor’s name, and thereafter 癃 was replaced with 淋, until the Míng Dynasty when the two characters came to be used in distinct senses. Still to this day, 癃 is commonly explained as dribbling or trickling and as denoting a mild form of urine retention, whereas 闭 bì is explained as denoting severe or complete blockage.