6.32 Long Bi

6. 32. 1 How is Long Hi discrfrni muted from stranguria?
Lnng El Srangtiria
Pahn sensaioii with - D urinafion with stab-
No ijrinaHon bing pain
Frcqucnt urination brici and
AiTlotiur of uriuc OLiguna or anria cliff icult with total afliOunt
birig generally normal
Di IIjc1ilt Ilnnatl3Il Ycs Yes


6. 32.2 Try to describe the chief sytnptoms. treatments and recipes of Long Bi caused respectively by accumulation of dampness-heat in the urinary bladder, urethral obstruction and deficiency of the kidney- Yang.

(1) Dampness-heat in the urinary bladder
[Symptoms] Urine retention or ol iguria, scanty dark yellow urination with burning sensation, lower abdominal distention or constipation, bitter taste with sticky mouth, red tongue with yellowish sticky fur, and rapid pulse.
[Treatment] Eliminating dampness and heat and promoting urination.
[Recipe] Ba Zheng San
(2) Urethral obstruction
[Symptoms] Dribbling or thready urine, or retention of urine, lower abdominal di s tent ion and pain, dark purplish tongue or ecchymosis on the tongue, and uneven pulse.
[Treatment] Prornotng urination by removing stasis and obstruction.
[Recipe] Dai Di Ding Wan with rnodificaton.
(3)Declinging of the kidney-Yang
Esyrnptomsj Retention of urine or dribbling and difficult unnat on pale complexion, lassitude, aversion to cold, coldness below the loins, weakness of knees, aie tongue with fur, deep and thready puise.
[Treatment] Warming Yang and supplementing Qi, and invigorating the kidney to promote urination.
[Recipe] Ji Sheng Shen Qi Wan

6. 32.3 Acupuncture Treatment
( I ) Deficient pattern
[Treatment]
Select poinrs mainly from the Shaoyin T¨aiyang, Ren meridians and back Shu points. The reinforcihg method of needling is used or moxibust inn is applicable.
[Prescription]
Shenshu, Sanjiaoshu ,Qihai, Weiyang and Pishu?
(2) Excessive pattern
[Treatment]
Select points mainly from the foot Taiyin, Yaiyang and Ren meridians. The reducing methed of needling is used.
[Prescription]
Sanyinjiao, Yinlingquan, Pangguanshu and Zhongji

6.33 Lumbago

6. 33. 1 How is lumbago due to cold-dampness distinguished from that due to dampness-heat?
(1) Lumbago caused by cold-dampness
[Main points of differentiation] Coldness, heaviness and pains in the loins, aggravated in cloudy and rainy days.
(2)Lumbago caused by dampness-heat
[Main points of differentiation] Lumbago with hot sensation, aggravated by heat.

6. 33.2 What are the etiology and pathogenesis, main points of differentiation, therapeutic methods and recipe of lumbago caused by deficiency of the kidney?
[Etiology and pathogeneses] The loins is the residence of the kidney. Lumbago occurs when there is deficiaxcy of the kidney- Qi resulting in the lack of nutrients in the loins and spinal cord.
[Main points of differentiation] Soreness of the loins and weakness of the knees aggravated by over-work. In case of dominant deficiency of Yang, there are manifestations as chilliness of hands and feet, deep and thready pulse. In case of dominant deficiency of Yin, there appear symptoms of dry throat and insomnia, red tongue with little fur.
[Treatment] In case of deficibney of the kidney-Yang, tonifying the kidney to renforcc Yang; in case oF deficiency of the kidney- Yin, tonifing the kidney to nourish Yin.
[Recipel You Hui Wan for rho case of deficiency of Yang, and Zuo Gui Wan for the case of deficiency of Yin.

6. 33.3 Acupuncture Treatment
[Treatment]
Selcct points on the Foot-Taiyang, Du and Foot.-Shaoyang meridians as main points. Acupuncture and moxibustion are applied at the same rime. The reinforcing and reducing method are used according to the differentiation of excess and deficiency..
[Prescription]
Shenshu, Weizhnng, Jiaji and Ashi
[Modification with various syndromes]
Cold and damp: Yaoyangguan and Gnanvuanshu.
Strain and fatigue: Geshu and Ciliao.
Kidney deficiency: Mingrnen , Zhishi And Taixi,

6.34 Xiao Ke
6.34.1 What is the Xiao Ke?
?Xiao Ne is a disease characterized by excessive intake of water polyphagia, polyuria and emaciation or turbid urine with sweet smell.

6.34.2 What are different typ and treatment of Xiao Ke? What are ther main points of differentiation, pathogenesis outline and recipes?
Shang Xiao (Imnpirment of the dje fluid by the lung-heat)
[ Main points of differentiation] Excessive intake of water and iwildipsia and polyuria.
[Pathogenesis] Excessive heat in the lung leading to a consutmipt ton of lung-Yin , which gives rise to a failure of distribution of the body fluid.
[Recipe] Xiao Ke Fang with modification.

Zhong Xiao (excessive blazing heat in the stomach)
[Main points of differentiation] Polyphagia with liability to hunger, emaciated constitution, slippery and full pulse.
[Pathogenesis] Hyperactive digestion and consumption of the body fluid due to excessive blazing heat in the stomach.
[Recipe] Yu Nu Jian with Rhicma Uoptidis and Fructus Grardeniae.
Xia Xiao
(1 )lieficiency of the kidney- Yin
[Main points of differentiation] Frequent mid much discharge of greasy urine, dysphoria with feverish sensation in chest, palms and soles, red tongue with little fur.
[Pathogenesis] Internal blazing of deficiency-fire due to d dificiency and consumption of the kidney- Yin gives rise to the failurc of the kidney in arresting discharge leading to a loss of refined nutritious substances.
[Recipe]? Liu Wei Di Huang Wan

(2)Dcficiency of both Yin and Yang
[Main points of differentiation]Frequent discharge of greasy urine, soreness of bins and chilliness, and deep thready pulse.
[Pathogenesis] Consumption of Qi and Yin, causes the dcificiency and weakness of the renal Qi resulting in the loss of control urination.
[Recipe] jin Gui She Qi Wan
6.35 Spermatorrliea
6. 35. 1 Make brief description of the etiology and pathogenesis of spermatorrhea.
(1) Hyperactive heart-fire and disharmony between the heart and kidney Weary mind or emotional disorder will consume the heart-Yin and induce hyperactive heart-Yang resulting in mental upset and emission with sexual dreams; tile hyperactive heart-Yang will consume the kidney fluid arid cause its falure lo counteract the heart-fire. Hence the essence house is disturbed and emission follows with dreams.
(2) Descent of dampness-heat and disturbance of essence house. Liquor and greasy food will impair the spleen and stomach, and generate dai npn essimcide the body. which accumulates and induces heat. When dampness and heat descend and disturb the essence house, spontaneous emission will occur.
(3) Spermaiorrhea is the result of failure of Qi to arrest spontarictus discharge of sperm resulti rig from overstrai n and impal rrnent of the heart and the spleen. Patients, who have constant overstrain leading to impairment of Qi, suffer from insufficiency of a n middle-jiao and deficiency of the heart- a and the spleen-Qi, and more serious deficiency of Qi whenever they are in the condition of overwork and overanxieiy, as a result there appears sinking of lucid YQ ug causing the fail tire of Qi to control emission
(4) Seminal emission is due to deficeiicy of the kidney resulting in kidney’s failure in arresting spontaneous discharge of sperm because of the early marriage of patienis, or intemperance of sexual life or the bad habit of masturbajion , or congenital insufficiency and remained persistent deficiency after birth. Nocturnal emissiom occurs a result oi deficiency-fire to disturb the kidney when there is excess of the kidne-Yin Yang with cIefciericv of the kidney-Yin , while sperma-torrhea is due to the deficiency of the kidney-Yang ?failing in arresting spontaneous discharge of sperm.

6. 35. 2 What are spermatorrhea. involuntary emission and nocturnal emission?
Sperrnatorrhea refers to emission not as the result of sexual life. Spermatorrhea is usually classified into nocturnal emission and invoiiinIary emission. The former refers to emission at night with sexual dreams, while the latter may occur without dreams. In severe cases, because oF the kidndy’s failure in arresting spontaneous emission, there may appear emission with straining motion or at what one sees, hears or touches.
6. 35. 3 How many types is spermatorrhea chassified into? What are the main points of differentiation, therapeutic methods and recipes of each?
(1) Breakdown of the nonnal physiological coordination between the heart and the kidney due to hyperacdviiy of the heart tire and the kidney fire
[Main points of diflerentiarion] Insomnia and excessive drearning, nocturnal emission, palpitation, dysphoria with feverish sunsation , rapid thready puise.