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.
07 Dysuria 小便不通 소변이 나오지 않는 것
① As heat moves from the placenta to bladder, difficulty in urination or hematuria appears.
② Difficulty in urination and anuria means a blocked bladder. Add Aucklandiae Radix (木香) to Eight Ingredient Rectify Powder (八正散).
③ The liver meridian passes the external genitals. The diseases from that place would be enuresis, difficulty in urination, and hematuria. For a woman, the governor vessel enters into the external genitals and the orifice exists at the end of the urethra. If this area catches a disease, there will be difficulty in urination, hemorrhoids, and enuresis. The foot triple energizer is branched from the bladder meridian. It enters the bladder in the continuum and moves around the lower energizer. Therefore, uroschesis and ischuria are caused by the excess foot triple energizer, while enuresis is caused by a deficient one.
④ Difficulty in urination and anuria may be the same thing, but there is the difference of acute and chronic disease. Blockage of urination is involves acute dribbling of urination. Outside the medical field, it is called dysuria. Difficult urination is a chronic disease involving the dribbling of urination so one urinates ten to a hundred times a day. This is called strangury disease.
⑤ One cannot urinate when heat obstructs the lower energizer. Symptoms include blockage of urination, lack of thirst, and agitation.
⑥ There is a difference between qi and blood when considering dysuria. Dysuria with thirst means heat in the qi aspect of the upper energizer, so use Clear Lungs Powder. Dysuria with no thirst means heat in the blood aspect of the lower energizer, so use a Nourish Kidneys Pill.
⑦ In the case of dysuria, the part below the umbilicus looks like a turned-over bowl and it is hard for one to endure the pain and oppression. There are two treatments. For dysuria by malfunction of qi transformation, use a Tangerine Peel and Poria Decoction with the powder of Aucklandiae Radix (木香) and Aquillariae Lignum (沈香) 2 dons each, take it on an empty stomach, and make qi come up by vomiting. For dysuria caused by static blood in the lower energizer, use a Peach Pit Order Qi Decoction [the prescription is mentioned in the chapter on Cold Damage] to break the static blood.
⑧ Heat causes dysuria while cold causes urinary incontinence. If the heat is severe, there will be anuria; if the heat is mild, there will be dysuria.
⑨ Dysuria means rough blood and qi not being able to flow well, blocking the orifices. Use a Guide Qi to Eliminate Dryness Decoction.
⑩ Use Five Ingredients Powder with Poria [the prescription is mentioned in the chapter on Cold Damage], Guide Out Red Formula, Broom Cypress Decoction, Qi Diffusion Powder, Unblock Barriers Pill, Polyporus Decoction, Augmented Five Ingredients Poria Powder, or Penetrate Wellspring Powder for dysuria.
- Eight Ingredient Rectify Powder 八正散 팔정산: Used for difficult urination and anuria caused by heat accumulating in the bladder. Rhei Radix et Rhizoma (大黃), Akebiae Caulis (木通), Dianthi Herba (瞿麥), Polygoni Avicularis Herba (萹蓄), Talcum (滑石), Gardeniae Fructus (梔子), Plantaginis Semen (車前子), and Glycyrrhizae Radix (甘草) 1 don each. Chop these into 1 package, add Junci Medulla (燈心) 1 don, steep it with water, and take it on an empty stomach.
- Clear Lungs Powder 淸肺散 청폐산: Used for blockage of urination with thirst. Polyporus (猪苓), Tetrapanacis Medulla (通草) 1.5 don each, Poria Sclerotium Rubra (赤茯苓), Alismatis Rhizoma (澤瀉), Junci Medulla (燈心), Plantaginis Semen (車前子) 1 don each, Polygoni Avicularis Herba (萹蓄), Akebiae Caulis (木通), Dianthi Herba (瞿麥) 7 pun each, and Succinum (琥珀) 5 pun. Chop these into 1 package, steep it with water, and take it on an empty stomach.
- Nourish Kidneys Pill 滋腎丸 자신환: ① Used for blockage of urination with no thirst. Phellodendri Cortex (黃柏), Anemarrhenae Rhizoma (知母) (washed with wine and baked) 1 nyang, and Cinnamomi Cortex Spissus (肉桂) 0.5 don. Grind, make into paste with water, and make it into pills as big as a seed of the royal foxglove tree. Take 100 pills with boiled water on an empty stomach. It is also called Seolsinhwan, the pill discharging the kidneys. ② Someone had suffered from dysuria, abdominal distension, edema of the feet, protrusion of both eyes and insomnia. It was too painful for the person to say a word. Dongyuan said, “The bladder is the house of fluid and humor. When qi transformation is completed, urine may come out. Difficulty in urination and anuria are what happens when there is neither the transformation of yin qi nor of yang qi. This person has eaten too much fat, sweet and greasy food, and accumulated heat. Therefore, the bladder, namely the house of the kidneys, has been dried for a long time, unable to make urine. Now, the person has blockage and repulsion and is soon to die, but can be cured with treatment on the lower energizer.” After taking the medicine, the person urinated easily and recovered.
- Guide Qi to Eliminate Dryness Decoction 導氣除燥湯 도기제조탕: Used for dysuria. Poria Sclerotium Rubra (赤茯苓) 1.5 don, Phellodendri Cortex (黃柏) 1.2 don, Talcum (滑石), Anemarrhenae Rhizoma (知母), and Alismatis Rhizoma (澤瀉) 1 don each. Chop these into 1 package, add Junci Medulla (燈心) 1 don, steep with water, and take it on an empty stomach.
- Guide Out Red Formula 導赤元 도적원: Used for dysuria caused by heat in the bladder. Rhei Radix et Rhizoma (大黃) (stir-baked) 1.5 nyang, Gardeniae Fructus (梔子) 1.2 nyang, Akebiae Caulis (木通), Rehmanniae Radix (生乾地黃) 8 don each, Paeoniae Radix (赤芍藥), Poria Sclerotium Rubra (赤茯苓), and Talcum (滑石) 4 don each. Grind, make into paste with honey and make it into pills as big as a seed of the royal foxglove tree. Take 30 to 50 pills with water steeped with a Guide Out Red Formula (導赤散) [the prescription is mentioned in the chapter on Five Viscera] on an empty stomach. ① Used for dysuria due to heat accumulation in the lower energizer. Kochiae Fructus (地膚子) 1 don, Anemarrhenae Rhizoma (知母), Scutellariae Radix (黃芩), Polyporus (猪苓), Dianthi Herba (瞿麥), Ponciri Fructus Immaturus (枳實), Cimicifugae Rhizoma (升麻), Tetrapanacis Medulla (通草), Malvae Semen (冬葵子), Sargassum (海藻) 7 pun [unit of weight] each. Chop these into 1 package, steep it with water, and take it on an empty stomach. ② When a woman has dysuria with a sunken and fine pulse after sexual intercourse, steep this with a half kidney of a pig and take it.
- Qi Diffusion Powder 宣氣散 선기산: Used for acute pain with difficulty in urination and anuria. Glycyrrhizae Radix (甘草) (small roots) and Akebiae Caulis (木通) 3 don each, Gardeniae Fructus (梔子) 2 don, Malvae Semen (葵子), and Talcum (滑石) 1 don each. Grind these into powder and take it each 2 don with Junci Medulla (燈心)-steeped water.
- Unblock Barriers Pill 通關丸 통관환: Used for dysuria. Phellodendri Cortex (黃柏) and Anemarrhenae Rhizoma (知母) (soaked in wine and stir-baked together), Talcum (滑石) 2 nyang each, Akebiae Caulis (木通) 1 nyang, and Cinnamomi Cortex Spissus (肉桂) 3 don. Grind, make into paste with water, and make it into pills as big as a seed of the royal foxglove tree. Take each 100 pills on an empty stomach.
- Polyporus Decoction 猪苓湯 저령탕: Used for dysuria due to the heat accumulation. Polyporus (豬苓), Akebiae Caulis (木通), Alismatis Rhizoma (澤瀉), Talcum (滑石), Aruantii Fructus Immaturus (枳殼), Phellodendri Cortex (黃柏) (soaked in wine), Achyranthis Radix (牛膝), Liriopis Tuber (麥門冬), Dianthi Herba (瞿麥), Polygoni Avicularis Herba (萹蓄), Plantaginis Semen (車前子) 7 pun each, and Glycyrrhizae Radix (甘草) 3 pun. Chop these into 1 package, add Junci Medulla (燈心) 1 don, steep it with water, and take it on an empty stomach.
- Augmented Five Ingredients Poria Powder 加味五苓散 가미오령산: Used for dysuria owing to deficiency cold. Add Angelica Gigantis Radix (當歸), Aruantii Fructus Immaturus (枳殼), Achyranthis Radix (牛膝), Akebiae Caulis (木通), and Glycyrrhizae Radix (甘草) (small roots) all same amount to Five Ingredients Powder with Poria (五苓散) (all same amounts of the herbal ingredients). Chop these, add 1 handful of Junci Medulla (燈心), steep, and take it on an empty stomach.
- Penetrate Wellspring Powder 透泉散 투천산: Used for hematuria and dysuria. Talcum (滑石) 1 nyang, Natrii Sulfas (芒硝), Glycyrrhizae Radix (甘草) 5 don each, and Succinum (琥珀) 2.5 don. Grind these into powder, take 2 don each with Junci Medulla (燈心)-steeped water on an empty stomach.
07-1 Difficulty in Urination for the Old and the Weak 老虛人癃閉 노인이나 허약한 사람의 융폐
① Dysuria of a senile person is mostly due to shortness of breath or blood deficiency. Take a Nourish Kidneys Pill with water steeped with a Four Substances Decoction and Astragali Radix (黃芪) on an empty stomach.
② In the case of dysuria of senile persons caused by qi deficiency, take a Nourish Kidneys Pill with water steeped with Astragali Radix (黃芪), Ginseng Radix (人參) and a Four Substances Decoction.
③ In the case of dysuria of the senile or weak persons, take powder of Succinum (琥珀) with steeped Ginseng Radix (人參) and Poria Sclerotium Rubra (赤茯苓) on an empty stomach.
07-2 Vomiting Must be Induced for Difficulty in Urination and Anuria 癃閉宜吐 융폐는 토하게 해야 한다
①Dysuria belongs to qi and blood deficiencies. When there is blockage caused by excess heat or phlegm qi, make qi ascend by inducing regurgitation. Use Ginseng Radix (人參), Atractylodis Rhizoma Alba (白朮), and Cimicifugae Rhizoma (升麻) for a qi deficiency, a Four Substances Decoction for a blood deficiency, and a Syzygii Flos Relieve Stomach Decoction for phlegm. After taking them, massage the throat to induce vomiting. Use Eight Ingredient Rectify Powder to relieve excess heat. [The prescription is mentioned later in the chapter].
② Someone had suffered from dysuria and no medicine worked. Danxi said, “This disease is formed by accumulated phlegm in the lungs. The lungs belong to the upper energizer and the bladder belongs to the lower. As the upper energizer is blocked, so is the lower one. When using a medicine dropper, make sure the upper hole is opened to let water fall down through the lower hole.” After taking a Syzygii Flos Relieve Stomach Decoction and vomiting much, the person could be cured.
③ In case of urine blockage by much phlegm, steep a Syzygii Flos Relieve Stomach Decoction with Cyperi Rhizoma (香附子), Aucklandiae Radix (木香) and Akebiae Caulis (木通), take one glass first, then massage the throat with the residue to vomit and lift qi. As qi ascends, water descends. ④ In the case of dysuria caused by heat access, add Pharbitidis Semen (黑丑) powder 1 to 2 don to sugar water, take it, then massage the throat to induce vomiting.
07-3 For Difficulty in Urination and Anuria Diarrhea Must Be Induced 癃閉宜瀉 융폐는 설사를 시켜야 한다
① The reason why Eight Ingredient Rectify Powder is used for difficulty in urination and anuria caused by excess heat is because if feces move, urine moves as well.
② The basic source of dysuria is in the kidneys, so use Pharbitidis Semen (牽牛子) and Alismatis Rhizoma (澤瀉). While the minor source is in the lungs, add Drabae Semen (葶藶子) to Mori Cortex (桑白皮). In addition, helping this with Akebiae Caulis (木通) and Talcum (滑石) may make urination easy. However, feces and urine are in touch with each other through vessels and collaterals, so use Spiritual Protection Formula [The prescription is mentioned in the chapter on Qi] to induce diarrhea, so as to cure dysuria that has lasted for some days.
③ Use Guide Out Water Pill, Triple Transformation Spiritual Blessing Pill [all mentioned in the chapter on Purgation] for difficulty in urination caused by excess heat.
