Written By Jun Heo(許浚, 1539~1615), Translated by Namil Kim, Wung Seok Cha et al., Published by Ministry of Health & Welfare (Korea)Buy vitamins and supplements.
11 Urinary Incontinence 小便不禁소변을 참지 못하는 것
① Enuresis means unawareness of urination.
② Enuresis happens owing to the bladder unable to fasten itself.
③ Spring water cannot stop to flow due to the bladder unable to save it.
④ As deficiencies of the kidney and bladder lead to that of qi inside, white urine comes out itself at the placenta. It may be much more as yin excesses in the night.
⑤ Related to internal damage by blood retention or consumptive disease, enuresis happens but one does not recognize this.
⑥ If unable to control the cold lower energizer by warming water-fluid, one cannot hold one’s urine.
⑦ As lung qi is deficient, the urine may have changed color and leak freely.
⑧ As the Inner Classic (內經) says, “The origin of Water is in the kidneys and the end in the lungs,” so, make sure the Water of heaven is penetrating from up to down.
⑨ The Inner Classic says, “There would be enuresis by lower deficiency.” It means deficiencies of the bladder and lower energizer. Zhang Zhongjing says, “There would be enuresis or loosened bowels by lower deficiency unable to control itself due to a qi deficiency.” Also, enuresis happens as the lower energizer cannot return to original yang. It is in such case that others use Mantidis Oőtheca (桑螵蛸) and Galli Stomachicum Corium (雞䀝胵).
⑩ Enuresis and urinary incontinence come from a lung qi deficiency. Lie down calmly to foster qi, never labor and tonify with Ginseng Radix (人參) and Astragali Radix (黃芪). Still it is possible to have a little improvement by heat, so use Phellodendri Cortex (黃柏) and Rehmanniae Radix Crudus (生地黃).
⑪ On urinary incontinence, red urine means heat, while white means deficiency.
⑫ Urine coming out freely or incontinence is because of incapacity and palsy through the prolapse of genitalia. Extract Alismatis Rhizoma (澤瀉) from a Six Ingredients Rehmannia Pill (六味地黃丸) [the prescription is mentioned in the chapter on Deficiency Vexation] and add Alpiniae Oxyphyllae Fructus (益智仁).
⑬ Urinary incontinence belongs to heat or deficiency. Add a Resolve Toxicity Decoction to Five Ingrediens Powder with Poria [all prescriptions are mentioned in the chapter on Cold Damage] on heat, and add Four Substances Decoction [the prescription is mentioned in the chapter on Blood] to Five Ingredients Powder with Poria with Corni Fructus (山茱萸) and Schisandrae Fructus (五味子).
⑭ For urinary incontinence by internal damage due to lower deficiency, mainly tonify the yin blood of the bladder, and purge Fire. So use a Modified Eight Ingredients Pill or add Anemarrhenae Rhizoma (知母), Phellodendri Cortex (黃柏), and Schisandrae Fructus (五味子) to a Six Ingredients Formula with Rehmannia or Tonify Yin Pill [the prescription is mentioned in the chapter on Fire] would be the best.
⑮ For urinary incontinence by deficiency and coldness getting severe in the night, use a Restrict Stream Formula and Secret Formula Elixir. Use a Five Seeds Formula, Household Allium Formula, and Ginseng and Astragalus Decoction for the old or the weak. Use a Tonify Bladder Drink and Pig Bladder Decoction for enuresis in women after childbirth. For child enuresis, use Galli Intestinum Powder and Chicken Intestines and Spleen Powder. Use a Great Cuscutae Seed Formula, Deer Antler Velvet and Frankincense Formula and Instant Relief Pill in general.
⑯ There is enuresis in both Cold Damage and summerheat stroke. [The contents are mentioned in the respective chapters].
- Restrict Stream Formula 縮泉元 축천원: Used for frequent urination, about a hundred times a day, due to urinary a bladder qi deficiency. Grind Linderae Radix (烏藥) and Alpiniae Oxyphyllae Fructus (益智仁) all the same amounts into powder, make into paste with starch cooked by steeping Dioscoreae Rhizoma (山藥) with wine and make it into pills as big as a seed of the royal foxglove tree. Take 70 pills with boiled salted water before going to bed.
- Secret Formula Elixir 秘元丹 비원단: Used for urgent urinary incontinence by consumptive disease. [The prescription is mentioned in the chapter on Essence].
- Five Seeds Formula 五子元 오자원: Used for urinary incontinence, dizziness, and weakness of legs in the night. It occurs mostly in the old or the weak. One suddenly dies by a great loss of essence humor. Cuscutae Semen (兎絲子) (processed with wine), Allii Tuberosi Semen (韭子) (a little stir-baked), Alpiniae Oxyphyllae Fructus (益智仁), Foeniculi Fructus (茴香) (stir-baked), and Cnidii Fructus (蛇床子) (stir-baked), all the same amount. Grind into powder, make into paste with starch cooked with wine, and form these to pills as big as a seed of the royal foxglove tree. Take 50 to 70 pills with a rice gruel cooked with waxy rice.
- Household Allium Formula 家韭子元 가구자원: Used for enuresis and urinary incontinence due to a cold urinary bladder by kidney yang failure. Allii Tuberosi Semen (家韭子) (a little stir-baked) 6 nyang, Cervi Parvum Cornu (鹿茸) (removed of the hair by fuming) 4 nyang, Cistanchis Herba (肉蓗蓉) (soaked in wine), Achyranthis Radix (牛膝) (soaked in wine), Rehmanniae Radix Preparata (熟地黃), Angelica Gigantis Radix (當歸) (washed in water) 2 nyang each, Cuscutae Semen (兎絲子) (processed with wine), Morindae Radix (巴戟) 1.5 nyang each, Eucommiae Cortex (杜冲) (stir-baked), Dendrobii Herba (石斛) (washed in water), Zingiberis Rhizoma (乾薑) (rolled in a damp paper and baked), and Cassiae Cortex Interior (桂心) 1 nyang each. Grind, make into paste with starch cooked with wine, and make it into pills as big as a seed of the royal foxglove tree. Take 100 pills with warm wine or boiled salted water on an empty stomach.
- Ginseng and Astragalus Decoction 參芪湯 삼기탕: Used for enuresis by qi deficiency. Ginseng Radix (人參) Astragali Radix (黃芪) (soaked in honey and roasted) Poria Sclerotium (白茯苓) Angelica Gigantis Radix (當歸) Rehmanniae Radix Preparata (熟地黃) Atractylodis Rhizoma Alba (白朮) Citrus Unshius Pericarpium (陳皮) 1 don each, Alpiniae Oxyphyllae Fructus (益智仁) (ground) 8 pun, Cimicifugae Rhizoma (升麻) Cinnamomi Cortex Spissus (肉桂) five pun each, Glycyrrhizae Radix (甘草) 3 pun. Chop these into 1 package, steep 3 pieces of Zingiberis Rhizoma (生薑), and 2 pieces of Zizyphi Fructus (大棗) with water, and take it on an empty stomach. For the old, add Aconiti Lateralis Radix Preparata (附子) (rolled in a damp paper and baked).
- Tonify Bladder Drink 補脬飮 보포음: Used for urinary incontinence, dampness by leaking urine or difficulty in urination by damage of the urinary bladder in women due to childbirth. Golden-yellow raw silk 1 ja (chopped and ground), white Moutan Cortex (牧丹皮) powder 2 don [use one with compound petal as others are not efficacious], and Bletillae Rhizoma (白芨) powder 1 don. Put it in 1 bowl of water and steep until the golden-yellow raw silk looks like taffy. Take it on an empty stomach. When taking this, do not make a noise. If there is noise, there would be no effect.
- Pig Bladder Decoction 猪脬湯 저포탕: ① Used for urinary incontinence by damage to the urinary bladder in women due to childbirth. Ginseng Radix (人參), Atractylodis Rhizoma Alba (白朮) 2 don, Persicae Semen (桃仁), Citrus Unshius Pericarpium (陳皮), Astragali Radix (黃芪), Poria Sclerotium (白茯苓), Cnidii Rhizoma (川芎), and Angelica Gigantis Radix (當歸) 1 don each. Chop into 1 package, steep with a bladder of a pig or sheep, and take it on an empty stomach. ② One woman had difficulty in urination from damage to the urinary bladder from the midwife’s carelessness during a hard labor. Muscles torn outward could also be treated, so I thought it might be cured though the urinary bladder is inside the abdomen. As the pulse was much vacuous, I had to use a strongly tonifying medicine. Hence, I boiled a bladder of a pig or a sheep, steeped it, and made her take it for 1 month whenever she was very hungry. Then she became well. As blood qi grew fast, the urinary bladder became complete itself. Had it been delayed just a little more, it would have been impossible to succeed.
- Galli Intestinum Powder 雞腸散 계장산: Used for enuresis or urinary incontinence in a child that is mostly due to a cold urinary bladder or deficiency of the inborn yang qi. Galli Intestinum (雞腸) (burnt), Ostreae Concha (牡蠣粉), Poria Sclerotium (白茯苓), Mantidis Oőtheca (桑螵蛸) (steamed) 5 don each, Cinnamomi Cortex Spissus (肉桂) (spicy) and Fossilia Ossis Mastodii (龍骨) 2.5 don each. Chop, steep each 2 don with 3 pieces of Zingiberis Rhizoma (生薑) and 2 pieces of Zizyphi Fructus (大棗), and take it on an empty stomach. Or grind and mix 1 don with a rice gruel.
- Chicken Intestines and Spleen Powder 雞肶胵散 계비치산: Used for enuresis in a child. 1 Galli Stomachicum Corium (雞䀝胵), 1 Galli Intestinum (雞腸) (burnt until the nature of the medicinals remains), and a bladder of a pig (baked until burnt). Grind, mix each 1 one with wine, and take it.
- Great Cuscutae Seed Formula 大兎絲子元 대토사자원: Used for urinary incontinence by the deficient and cold urinary bladder qi. Cuscutae Semen (兎絲子) (processed with wine), Cistanchis Herba (肉蓗蓉) (soaked in wine) 2 nyang each, Ostreae Testa (牡蠣) (heated), Schisandrae Fructus (五味子), Aconiti Lateralis Radix Preparata (附子) (rolled in a damp paper and baked), Cervi Parvum Cornu (鹿茸) (soaked in wine and baked) 1 nyang each, Mantidis Oőtheca (桑螵蛸) (soaked in wine and baked), Galli Stomachicum Corium (雞䀝胵) (baked) 5 don each. Grind, make into paste with starch cooked with wine, and make these into pills as big as a seed of the royal foxglove tree. Take 70 pills with warm wine or boiled salted water on an empty stomach.
- Cervus and Olibanum Formula 茸香元 용향원: Used for enuresis or urinary incontinence by consumption and polyuria due to weakness and coldness. Galli Stomachichum Corium (雞內金) (baked) 7.5 don, Cervi Parvum Cornu (鹿茸) (pasted with condensed milk and baked), Cistanchis Herba (肉蓗蓉) (soaked in wine), and Angelica Gigantis Radix (當歸) (washed with wine) 5 don each, Fossilia Ossis Mastodii (龍骨) (heated), Ostreae Concha (牡蠣粉), Morindae Radix (巴戟), Halloysitum Rubrum (赤石脂), Limonitum (禹餘粮) (heated, soaked in vinegar and ground), Zingiberis Rhizoma (乾薑) (stripped the bark and dried), Alpiniae Oxyphyllae Fructus (益智仁), and Olibanum (乳香) 2.5 don each. Grind, make into paste with waxy rice starch and make these into pills as big as a seed of the royal foxglove tree. Take 70 pills with boiled salted water on an empty stomach.
- Instant Relief Pill 旣濟丸 기제환: Used for urinary incontinence by deficient urinary bladder qi and eum Fire. Cuscutae Semen (兎絲子) (processed with wine), Alpiniae Oxyphyllae Fructus (益智仁) (baked), Poria Sclerotium (白茯苓), Allii Tuberosi Semen (韭子) (baked), Cistanchis Herba (肉蓗蓉) (washed with wine), Angelica Gigantis Radix (當歸), Rehmanniae Radix Preparata (熟地黃) 5 don each, Phellodendri Cortex (黃柏) and Anemarrhenae Rhizoma (知母) (soaked in salted water and baked together), Ostreae Concha (牡蠣粉) Corni Fructus (山茱萸) (steamed with wine) 3 don each, and Schisandrae Fructus (五味子) 1 don. Grind, make into paste with flour, and make these into pills as big as a seed of the royal foxglove tree. Take 100 pills with boiled salted water on an empty stomach.
12 Various Strangury Symptoms 諸淋證 여러 가지 임증
① Strangury diseases is when a millet-like object is found in urine and contracture and pain are felt from the lower abdomen to the umbilicus.
② All is due to a kidney deficiency and heat in the bladder. As heart and kidney qi are blocked and accumulated in the lower energizer, the bladder contracts, and urine with oil, blood or stones come out. Difficulty in urination or dribbling of urine occurs. In the more severe cases, blockage causes pain, and tightness leads to fainting.
③ When qi is in the small intestine, urine leads to a swollen abdomen. When blood is in the small intestine, there is difficulty in urination. When heat is in the small intestine, urination is painful. Painful urination is blood strangury, while painfree urination is hematuria. One formed by essence damage is sandy strangury; one formed and spread by essence is unctuous strangury; one formed by iron or stone is stone strangury.
④ In this case, never use tonifying medicine. Tonifying qi makes the abdomen get more swollen, tonifying blood causes more obstruction, and tonifying heat makes it more severe so that not only urine but also defecation may get blocked too. I have never seen such a case to survive.
⑤ Strangury disease involves dribbling, painful, and difficult urination. There is also an urge to urinate even after having just urinated.
⑥ All strangury diseases belong to heat but occasionally cold may be the cause. It is due to the ineffective operation of the small intestine and bladder, caused by the blockages of heart and kidney qi. There could be other causes: dampness-heat flowing downward and invading the liver meridian due to indulgences in one’s sexual life, holding urine, eating wine and meat, or anger. This will eventually block the genitals, which will initially cause heat and blood strangury; Fire will boil them and make them into sandy and stone strangury. It is just like stones appearing when medicine is boiled for a long time in a medical herb extractor.
⑦ Tonify kidney essence and ease urination in the case of strangury disease caused by a kidney deficiency. Never use only diuretics.
⑧ The five strangury diseases come from heat accumulation in the bladder.
⑨ When distention and fullness of the lower abdomen is severe, use a Drain Kidneys Decoction.
⑩ All strangury belongs to heat. Although there is cold strangury, only one in a hunded or thousand cases are caused by cold.
⑪ Despite there being five strangury types, all belong to heat. Prescribe a Nourish Kidneys Pill (100 pills) with water steeped with a Four Substances Decoction in addition to Glycyrrhizae Radix (甘草) (small roots), Polygoni Cuspidati Radix (虎杖根), Akebiae Caulis (木通), Persicae Semen (桃仁), Talcum (滑石), Aucklandiae Radix (木香), and burn moxa on SP6 [name of an acupuncture point]. I tried it many times and it was efficacious.
⑫ Never induce sweating for a strangury disease. Forcing sweating results in bloody stools.
