Urinary Syndrome Flashcards by Michelle Olsen-Petty

a condition of urinary dysfunction characterized by frequency, scanty or excessive urine, dribbling, pain, urgency and difficulty.
Pain is not always present.
SP, KID, LU, BL, LV, TW, SI

Lin Syndrome

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:TCM: Painful Urination

Common, acute, intense burning pain upon urination. Heat thought to be present in all acute cases of urinary syndrome, Damp Heat or Fire

Heat

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TCM: Painful Urination

: urinary calculi or gravel, intense pain radiating, obstructed urination depending upon location of stones

Stone or sand

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TCM: Painful Urination

: Deficiency of Spleen, follows chronic Heat types poorly treated by antibiotics or very cold herbs. Dragging discomfort relieved by pressure, or a feeling of burning that is improves with warmth and pressure. Excess is Qi stagnation exacerbated by mental/emotional

Qi:

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TCM: Painful Urination

urination with bleeding

Blood:

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TCM: Painful Urination

cloudy or milky urine

Cloudy:

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TCM: Painful Urination

chronic, recurrent, initiated or aggravated by sex, overexertion, when fatigued. Incomplete or dribbling urination, lumbar pain and weakness, mild pain often worse after urination.

Exhaustion

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URINARY SYNDROME pathology

Common factor; internal or external; settles into lower Jiao, obstructing passages; causing pain; clouding urine. With Heat, burning urination

Dampness and Damp Heat

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URINARY SYNDROME pathology

LIV channel; TW keeping passages open and free;
Pain before urination; dysfunction; hypogastric distention

Qi Stagnation

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URINARY SYNDROME pathology

Qi sinking; LU Qi def. not communicating with KID/BL

Qi Deficiency

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URINARY SYNDROME pathology

Yang: dribbling, frequency, damp. Yin: scanty, chronic

Kidney Deficiency

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External Dampness
Diet
Excessive sexual activity
Old age, chronic illness
Emotional stress
Excessive lifting or standing

URINARY SYNDROME etiology

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COLOR of Urine:

Dark, concentrated

Heat, damp heat or Yin def.

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COLOR of Urine:

Pale:

KD Yang def., SP Qi def., or Qi stagnation

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COLOR of Urine:

Cloudy and murky:

Damp or Damp Heat

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COLOR of Urine:

Pale pink to bright red or purple:

Bleeding due to Fire, Damp Heat, Blood stasis, KD yin def. or stones

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PAIN

Burning:

Heat or Damp Heat (severe ‘like passing glass’) or Yin def. (mild)

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PAIN

Stabbing, localized; w or w/o blood flecks:

Blood stagnation or urinary stones

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PAIN

Mild or dragging, empty discomfort after urinating

Qi deficiency

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FREQUENCY

Frequent, urgent, concentrated

Heat or Damp Heat

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FREQUENCY

Frequent, pale:

KD Yang or Qi def.

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FREQUENCY

Frequent, pale, broken stream:

KD Yang def,

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TIMING of PAIN (test question)

During urination

Excess condition

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TIMING of PAIN (test question)

Before urination:

Qi Stagnation (excess condition)

TIMING of PAIN (test question) After Urination:

Deficient condition

Frequent, scanty and difficult urination, burning pain on urination, dark urine with a strong smell, hypogastric pain, bitter taste, nausea, pain on the sacrum, constipation, thirst. Most common clinically, damp or fire. T: yellow sticky coat on root, red spots P: Slippery on left rear and slightly rapid

HEAT URINARY SYNDROME LIVER FIRE: irritability, h/a, dizziness, tinnitus; T: red; P: Wiry rapid HEART FIRE: insomnia, tongue ulcers, mental restlessness; T: red, redder tip P: overflowing

TX: Clear Heat, drain Damp, open waterways Liver Fire: soothe Liver, drain Fire Heart Fire: drain Heart Fire, calm Mind EPI: release exterior, expel wind, open waterways Points: CV 3, BL 28, BL 22, ST 28, SP 9, BL 66, BL 63, LI 11 LIV 2, SP 6 HT 8, SI 2 LI 4, LU 7, TW 5 Maclean: Damp: CV 3, LIV 5, 2; HT 8, SP 9, 6; BL 28, if ‘shao yang’ condition add TW 5/GB 39. HT Fire: CV 3, ST 28, SP 6, HT 8, SP 9, PC 8, KD 6, PC 6, Yin Tang. LIV Fire: BL 28, CV 3, TW 6, LIV 5,3,2.

HEAT URINARY SYNDROME cont….

Stones or sand in the urine, difficulty urination which may stop suddenly, hypogastric pain, sacral pain, blood in urine T: Red, thick sticky coat on root P: Wiry on left rear, rapid

STONE URINARY SYNDROME TX: Clear Heat, drain Damp, open waterways, expel stones BL 22, ST 28, SP 9, CV 6, CV 3, BL 28, BL 63, BL 39, KD 2

STONE URINARY SYNDROME Maclean BL 23 - to SP 9 +, EA, on same side Aux.: BL 28, KD 6, ST 25, GB 25

Kidney Stones:

STONE URINARY SYNDROME Maclean UPPER: BL 23 - to BL 28 +, EA, on same side Aux: CV 6, BL 22 LOWER: BL 23 – TO ST 28 +, EA, on same side Aux: CV 3, BL 32

Ureter Stones:

STONE URINARY SYNDROME Maclean CV 4 or 3 – to ST 28 + or SP 6 +, EA Aux: KD 8, SP 14, PC 6; Ear: KD, BL, Shen Men, subcortex. Strong manual or electro-stimulation

Bladder or Urethra stones:

difficult painful urination, hypogastric pain and distention, irritability. P: Wiry, deep

QI URINARY SYNDROME Full: TX: move Qi, open waterways

difficult urination, weak stream, slight hypogastric distention, tiredness. P:weak T: pale

QI URINARY SYNDROME Empty: TX: tonify, raise Qi, open waterways CV 3, CV 5, BL 28, LIV 3, LIV 5, LIV 8,BL 64, SP 6, ST 36, CV 6, GV 20, LU 7, KID 6, SI 3, BL 62 Maclean: PC 6, BL 18, BL 22, LV 5,3; BL 28, CV 5, ST 30

difficult urination, burning pain on urination, blood in urine (small clots), fullness an pain in hypogastrium, mental restlessness T: Red P: Rapid, full in middle

BLOOD URINARY SYNDROME Blood Heat TX: Clear Heat, cool Blood, stop bleeding

pale blood in urine, slight discomfort on urination, not much pain, sore back, depression, heat in evening. T: red, no coat. P: rapid , floating empty

BLOOD URINARY SYNDROME Empty Heat: TX: Clear Empty heat, cool Blood, nourish Yin, stop bleeding, open waterways LIV 3, KD 2, CV 3, BL 28, BL 63, SP 10, BL 17, SP 6, CV 4, KD 6. Maclean: CV 3, SP 6, 10; BL 17, 28; HT 8,

May follow acute trauma to the groin, lower back or pelvis. Sharp stabbing pain, rough pain during urination, w/o burning; purple urine or with purple clots; fixed stabbing pain in lower jiao; palpable masses; spider naevi on trunk or around inner ankle and knee; dark ashen complexion, dark or purplish lips, dark rings under eyes. T: purple or with brown/purple spots P: Thready and choppy

BLOOD STASIS TX: Invigorate Blood, eliminate stasis, Warm Yang, break through painful obstruction BL 28, CV 3, SP 10, SP 1, ST 29, CV 4, SP 6, BL 17

: turbid, cloudy urine; possible blood or sediment, difficult urination. Urine is either scanty and cloudy like rice water or cloudy and yellow. T: sticky coat P: full slippery

STICKY URINARY SYNDROME DAMP: TX: drain Damp, clear Heat, separate clear/turbid Maclean: BL 28, 22; CV 3, SP 9, 6; ST 28, GB 34, ST 40, KD 7

cloudy or turbid urine, slight difficulty in urination, tiredness, dizziness, lower backache. T: pale, sticky coat P: soggy

STICKY URINARY SYNDROME Qi DEF.: TX: tonify Qi, Kidneys, separate clear/turbid, drain dampness, open waterways Giovanni: CV 3, BL 22, BL 28, BL 23, KD 7, CV 6, CV 9, ST 28, SP 9, SP 6 Maclean: BL 28, CV 3, CV 4, SP 9, KD 3, DV 6, GV 20, ST 40, Si Feng

Difficult urination coming in bouts, no burning, frequency, dribbling after micturition, dragging feeling in hypogastrium, exhaustion, sore back, depression, feeling cold Chronic condition with Kidney Yang deficiency T: Pale P: Weak

FATIGUE URINARY SYNDROME TX: Tonify, raise Qi, tonify KD, open waterways BL 23, CV 4, BL 28, GV 20, ST 36, SP 6, SP 9, CV 6, KD 3, GV 4 Maclean: Yang: GV 4, BL 23, 28; KD 3,6,7; CV 4, SP 6, LU 7.

Mild low back ache, frequent urination that feels hot, occasional irritation or discomfort, heat in 5 palms. T: red, little or no coat. P: thready, rapid

Exhaustion Painful Urination Syndrome…Maclean Kidney Yin Deficiency BL 23, 28; CV 2, KD 3, 2, 6.

Lower abdominal discomfort, better with warmth, low back ache, weakness, clear urine, pale complexion, edema of lower extremities T: pale, thin coat P: deep, thready

Exhaustion Painful Urination Syndrome…Maclean Kidney Qi Deficiency GV 4, BL 23, 28; KD 3, 6, 7; CV 4, SP 6, LU 7

Same as KD Qi def. with added Cold signs, lower abdm. better with warmth, cold extremities, intolerance to cold. T: pale, swollen, toothmarks. P: slow

Exhaustion Painful Urination Syndrome…Maclean Kidney Yang Deficiency GV 4, BL 23, 28; KD 3,6,7; CV 4, SP 6, LU 7

‘A dull abdominal pain, difficulty and pain on micturition and emaciation indicate urinary stones…caused by Qi deficiency and Heat…formation is similar to the evaporation of sea water by fire to produce salt.’ Classic of the Central Organ Urinary stones or sand derive from Dampness, precipitated into solid stones by Heat. Calcium (cheese and milk) Uric acid (liver, kidney, fish roe, sardines) Oxalate (spinach, rhubarb) Phosphates ( in foodstuffs)

URINARY CALCULI

``` Etiology Excessive sexual activity Diet Lack of exercise Loss of fluids ```

URINARY CALCULI

Pathology Pain, lateral abdominal region, groin or urethra depending upon location of stone

URINARY CALCULI | Acute stage

Pathology Damp Heat, KD Yin Deficiency and KD Yang deficiency

URINARY CALCULI | Chronic stage

Pain, lateral abdominal region, groin of urethra depending upon location of stone. Pain is colicky in nature, very intense, coming in waves; restless, sweats, may appear as if in shock; burning pain upon micturition, frequency, urgency, blood in urine, dark urine T: thick yellow coat with red spots on root P: Rapid, wiry on left rear

Acute Stage TX: Expel stones, stop Pain BL 23, ST 25, CV 6, SP 9, LIV 3, KD 3. Local points

burning urination, difficulty, dark urine, T: yellow sticky coat P: Slippery

Chronic Stage | Damp Heat: BL 22, ST 28, SP 9, ST 36

repeated attacks, dull ache in back , dark urine, prickly pain in urethra, insomnia, dry mouth, night sweats T: red, no coat P: Floating empty

Chronic Stage | Kidney Yin deficiency: BL 23, 25; SP 6, LIV 3, KD 6

repeated attacks, sore back, chilliness, depression, exhaustion T: pale P: Weak, deep

Chronic Stage | Kidney Yang deficiency

EA; LIV 5, 2; HT 8, TW 5, GB 39

Maclean Tx for Stones… | Damp Heat

EA; SP 10, ST 29, BL 32

Maclean Tx for Stones | Blood Stagnation

EA; ST 36, CV 4

Maclean Tx for Stones… | Kidney Qi deficiency

EA; KD 6, KD 3. Gentle EA stimulation for deficient

Maclean Tx for Stones… | Kidney Qi deficiency

EA: BL 23 to SP 9, same side of body | Aux. pts.: BL 28, KD 6, ST 25, GB 25

…Kidney Stones

EA: BL 23 to KD 6, same side of body | Aux. pts.: CV 6, BL 22

Upper Ureter Stones

EA: BL 23 to ST 28, same side of body | Aux. pts.: CV 3, BL 32

Lower Ureter Stones

EA: CV 4 or CV 3 to ST 28, same side of body | Aux. pts.: KD 8, SP 14, PC 6; EAR: KD, BL, Shen Men, Subcortex with strong manual stimulation of EA.

Bladder or Urethra Stones