Tuesday, February 21, 2012

Symptomatic Diagnosis: Elimination

Tenesmus (sense of incomplete bowel movement)
Constipation
Incontinence of feces
Incontinence of urine
Cloudy urination
Frequent urination
Oliguria, or difficult urination
Seminal fluid in urine

 Tenesmus

  • Accumulation of damp, heat, and toxic heat

    Clinical manifestations
    • Tenesmus, diarrhea, abdominal pain, blood and mucus in stool.
    • Pus and burning sensation in anus, possible fever
    • Yellow scanty urine
    • T: Red with yellow coat
    • P: Slippery and rapid
    Formula
    • Dang Gui Shao Yao Tang (Angelica and Peony Decoction)

Constipation

  • Yang Ming Heat (Yang Ming Organ=L.I.)

    Clinical manifestations
    • Fever, constipation, abdominal discomfort,
    • dislikes palpation
    • feels mass in abdomen
    • P: Deep, strong and slow due to stagnation
    Treatment Principle
    • Purge heat and stagnation
    Formula
    • Da Cheng Qi Tang (Major Order the Qi Decoction)
  • Qi Stagnation

    Clinical manifestations
    • Constipation
    • depression, easily angered, chest congestion discomfort in hypochondria,
    • distention and discomfort in breast, water retention (due to digestive problems,
      secondary to the stagnation)
    Formula
    • Chai Hu Shu Gan Tang (Bupleurum and Cyperus Combination) + lubricative herbs such as Tao Ren (Sm. Persicae) or Huo Ma Ren (Fr. Cannabis).
  • Qi deficiency

    Clinical manifestations
    • Constipation, sometimes loose
    • extreme fatigue especially after a bowel movement
    • Weak voice
    • possible rectal prolapse
    • T: Pale with white coat
    • P: Weak
    Formula
    • Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction)
  • Blood and yin deficiency

    Clinical manifestations
    • Chronic, old age patients
    • Constipation, emaciation, dry skin
    • palpitations, pale complexion
    • T: Pale, or Red or Narrow
    • P: Thready and rapid
    Herbs:
    • Dang Gui (Rx. Angelicae Sinensis), Sheng Di Huang (Rx. Rehmanniae), Rou Cong Rong (Hb. Cistanches)
    Formula
    • Wu Ren Wan (Five Seed Pills)

Incontinence of Feces (all serious conditions)

  • Accumulation of heat and toxins.

    Clinical manifestations
    • Blood level heat and toxin
    • High fever, delirium
    • Semi consciousness, coma, XS diarrhea with pus and blood
    • T: Red with yellow coat
    • P: Rapid
    Treatment Principle
    • Clear blood level heat
    Formula
    • Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction)
  • Spleen, Kidney yang deficiency

    Clinical manifestations
    • Chronic Diarrhea/dysentery
    • Diarrhea with mucus, incontinence of feces
    • Fatigue, cold, low back pain,
    • T: Pale
    • P: Deep, thready, weak
    Formula
    • Zhen Ren Yang Zang Tang (Immortal’s Decoction to Nourish the Organs)
  • Spleen Qi Sinking (Extreme weak condition)

    Clinical manifestations
    • Incontinence of feces, rectal prolapse, tired disoriented
    • T: Pale
    • P: Feeble
    Formula
    • Shen Fu Tang (Ginseng and Prepared Aconite Decoction)

Incontinence of urine

  • Kidney Qi Deficiency

    Common among the elderly and those recovering for serious illness.
    Clinical Manifestations
    • Frequent urination and incontinence, mostly in the evening.
    • Kidney qi and/or yang deficiency symptoms
    • T: Pale
    • P: Deep, weak especially in the kidney positions.
  • Lung and Spleen qi deficiency

    The problem begins with Spleen qi sinking and is worsened by the spasmodic action of the abdomen with coughing.

Cloudy Urination

  • Accumulation of damp Heat (excess turbid damp, acute)

    Clinical Manifestations
    • Cloudy urine with white or yellow urine.
    • Frequent, burning, urgent, painful urination
    • fever, thirst
    • T: Red with yellow coat
    • P: Wiry and thready
    Formula
    • Ba Zheng San (Eight Herb Powder for Rectification) + Shi Chang Pu (Rz. Acori Tatarinowii)
    • Bei Xie Fen Qing Yin (Dioscorea Hypoglauca Decoction to Separate the Clear)
  • Kidney yin or yang deficiency (deficiency syndrome in which the essence leaks out with the urine)

    Clinical Manifestations
    • Chronic cloudy urine
    • yin deficiency symptoms,
    • Scanty yellow urine
    • T: Red
    • P: Thready and rapid
    • or yang deficiency symptoms
    • Copious clear urine
    • T: Pale
    • P: Deep and weak
  • Kidneys are unable to govern the essence in the Kidneys

    Treatment principle
    • Tonify kidneys
    • Astringe essence
    Formulas
    • For Kidney yin deficiency
      • Zhi Bai Di Huang Wan (Anemarrhena, Phellodendron, and Rehmannia Pill) + Pi Xia, Fu Pen Zi (Fr. Rubi), Wu Wei Zi (Fr. Schisandrae), Tu Si Zi (Sm. Cuscutae) (all astringents)
    • For Kidney yang deficiency
      • You Gui Yin (Restore the Right (Kidney) Decoction) or Wan (pills)+ Fu Pen Zi (Fr. Rubi), Wu Wei Zi (Fr. Schisandrae), Tu Si Zi (Sm. Cuscutae) (all astringents)

Frequent Urination in Evening

often found in the elderly
  • Kidney qi deficiency

  • Kidney yang deficiency

    Formulas
    • Sang Piao Xiao San (Mantis Egg-Case Powder) + You Gui Yin (Restore the Right (Kidney) Decoction)
    • for prostate problems: Kai Kit Wan (Pre-made formula)

Oliguria, or difficult urination

  • Damp heat

    • Clinical Manifestations
    • Cloudy yellow urine
    • Frequent, burning, urgent, painful urination
    • incontinence
    Formula
    • Ba Zheng San (Eight Herb Powder for Rectification) + Shi Chang Pu (Rz. Acori Tatarinowii)
    • Bei Xie Fen Qing Yin (Dioscorea Hypoglauca Decoction to Separate the Clear)
  • Lung qi Stagnation (Lungs unable to descend the water)

    Clinical Manifestations
    • Cough, dyspnea, chest congestion, constipation
    • T: Red
    • P: Soft and rapid
  • Zhong qi deficiency (Spleen Qi Sinking)

    Clinical Manifestations
    • Urination lacking strength, sluggish stream
    • fatigue, bearing down sense
    • Urine, frequent but small amounts
    • Loose stool
    • T: Pale
    • P: Thready and weak
    Formula
    • Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction)
  • Kidney qi deficiency

    Clinical Manifestations
    • difficult urination, sluggish stream, incontinence.
    • frequent urination
    • Kidney problems in Western medicine.
    Treatment Principle
    • Tonify Kidney
    Formula
    • Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet)
  • Stagnation of Urinary Tract (common after abdominal surgery or trauma)

    • Sluggish, difficult urination
    • Abdominal distention of pain
    • T: Purple, possible with raised purple bumps
    • P: Choppy
  • Clinical Manifestations

Seminal Fluid in Urine

  • Accumulation of Damp Heat

    This section is what the Western world would call a STD, or sexually transmitted disease.
    Clinical Manifestations
    • Frequent, cloudy, sluggish, burning urine
    • White sticky discharge following urination
    • Bitter taste in mouth
    • Thirst, chest congestion, sluggish BM
    • T: Red with Yellow greasy coat
    • P: Soft and rapid (if more damp), or Slippery and rapid (if more heat)
    Treatment Principle
    • Dry damp, clear heat
    Formula
    • Bei Xie Fen Qing Yin (Dioscorea Hypoglauca Decoction to Separate the Clear)
  • Kidney yin deficiency with empty heat

    Clinical Manifestations
    • Frequent, cloudy, burning urine
    • White or red discharge after urination
    • Dizziness, vertigo, insomnia, restlessness
    • Tidal fever, yin deficiency symptoms
    • T: Red with dry coat
    • P: Thready and rapid
    Treatment Principle
    • Tonify yin and jing
    Formula
    • Zhi Bai Di Huang Wan (Anemarrhena, Phellodendron, and Rehmannia Pill) + astringents such as Tu Si Zi (Sm. Cuscutae), Jin Ying Zi (Fr. Rosae Laevigatae), Wu Wei Zi (Fr. Schisandrae).
  • Kidney qi or yang deficiency (very weak people, not an STD)

    Clinical Manifestations
    • Frequent, copious, clear urine
    • seminal fluid discharge following urination
    • Premature ejaculation, impotence, nocturnal emissions.
    • T: Pale
    • P: Deep and weak
    Formula
    • You Gui Yin (Restore the Right (Kidney) Decoction) plus astringents

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