URINARY TRACT INFECTION (CYSTITIS, BLADDER INFECTION, URETHRITIS, KIDNEY INFECTION, LIN SYNDROME)

GENERAL

Clinical Manifestations	A Urinary Tract Infection or UTI refers to an infection affecting any component of the urinary system, i.e. the Kidneys, ureters, Bladder or urethra. UTIs tend to be more common in women than men, with almost all females suffering from them at least once during the course of their lifetime. In uncomplicated cases, UTIs can be treated easily using antibiotics. In complicated cases, especially if the Kidneys are affected, longer courses or medication may be required, depending upon the nature of complication. The following is a list of symptoms commonly associated with a Urinary Tract Infection. Anyone having these should get themselves checked for the same. The most commonly experienced symptom across individuals with UTIs is a burning sensation during urination. The passage through which urine passes to be expelled from the body becomes tender due to the infection; when urine goes through it, the person experiences a painful sensation that mostly doesn’t last post urination. Since in a lot of cases UTIs are not present with signs, if a burning pain is felt during urination, the infection may be strong, and thus seeking treatment at the earliest is recommended. Lin syndrome refers to a condition characterized by frequent, incontinent urinary discharge with pain, spasm of the lower abdomen, and umbilical pain. According to the different etiology and pathogenesis in the clinic, it is divided into five types altogether. They include Heat Lin, Stone Lin, Blood Lin, Qi Lin and Turbid Lin syndromes. Lin Syndrome is mainly seen in some urinary system diseases with abnormal stimulation or infections of the urethra, such as pyelonephritis, cystitis, renal tuberculosis, stones in the urinary bladder, and chylous urine.
Treatment Principle
Herb Formulas
Points	KI-3, LIV-8, LU-7, SP-9 REN-3, SP-6, SP-9, ST-36, UB-20 REN-4, SP-6, SP-9 REN-3 through to REN-4, SP-6, ST-30 SP-6, SP-8, UB-23, UB-28 KI-7, KI-9, ST-29, UB-23, UB-58 For yellow urine: REN-2 For red urine: UB-32 For red, rough urination: REN-3 For diffuse burning: KI-7 For not urine: REN-4, ST-36 For urinary dysfunction: LIV-3 Ear: Kidney, Bladder, Urethra, Subcortex, Sympathetic, Shenmen

SHAO YANG WITH CONGESTED FLUIDS

Clinical Manifestations	Alternating chills and fever (chills predominate) or Chills without fever Sensation of irritability in the chest Sweating from the head Fatigue Gastrointestinal weakness Heavy head Neuralgia Epigastric distension Lower abdominal pain Tension around pubic bone Periumbilical pain Urinary difficulty T: Moist C: White and slippery P: Superficial and wiry
Treatment Principle	Disperse Clumping Harmonize the Shao Yang Warm the Interior Dispel Cold
Herb Formulas	Chai Hu Gui Zhi Gan Jiang Tang
Points	GB-41, SJ-5, moxa or moxa needle REN-4, REN-6, REN-8, REN-12, SJ-6, ST-25, ST-36

SHAO YIN HEAT

Clinical Manifestations	Dry throat and/or mouth Chronic sore throat (not acute) Restlessness Malar flush Insomnia Disturbed speech Low grade fever, worse in afternoon Yellow urine Irritability with a sensation of Heat in the chest Palpitations with anxiety Sores in the mouth or on the tongue More Heat than in Yin Deficiency (chronic low grade fever) Pain in the Bladder T: Red, deep red C: None P: Deep, thready and rapid
Treatment Principle	Nourish Yin Reduce Heat
Herb Formulas	Huang Lian E Jiao Tang Zhu Ling Tang
Points	DU-14, HT-5, HT-7, KI-3, KI-6, KI-7, LIV-3, SP-6, UB-10, UB-15, UB-23

WEI STAGE: SUMMERHEAT WITH DAMPNESS

Clinical Manifestations	Fever and chills, fever more pronounced or Tidal fever Abdominal distention Thirst Sweat Stifling sensation in the chest Restlessness Gastric disturbances: Heaviness Nausea Severe diarrhea Scanty urine T: Red tip and edges C: Greasy white or yellow P: Rapid and soft
Treatment Principle	Disperse Wind Clear Heat Resolve Damp
Herb Formulas	Liu Yi San Gui Ling Gan Lu Yin Huang Qin Hua Shi Tang
Points	Bleed UB-40, needle DU-14, DU-23, DU-24, GB-20, LI-4, LI-11, REN-9, SJ-5, SP-6, SP-9, ST-8, ST-28, Taiyang, UB-12, UB-20

QI STAGE: OBSTRUCTION OF THE CHEST BY HEAT

Clinical Manifestations	High fever or Fever Aversion to Heat Irritability Restlessness (neither activity nor resting brings relief) Heat sensation in the chest Thirst Has urge to vomit but cannot May have dark yellow urine T: Red C: Yellow P: Rapid or Forceful and rapid
Treatment Principle	Clear Heat Remove Obstructions
Herb Formulas	Zhi Zi Chi Tang
Points	DU-14, HT-7, LI-11, PC-6, ST-44

QI STAGE HEAT WITH FOOD STAGNATION

Clinical Manifestations	Distention of the abdomen Distention of the epigastrium Fever Fullness of the abdomen Fullness of the epigastrium Indigestion Insomnia Irritability Resurgence of Heat signs Thirst T: Red C: Greasy-dirty-yellow P: Floating, slippery and rapid especially on the right position or Floating, full and rapid
Treatment Principle	Clear Heat Disperse Stagnation
Herb Formulas	Zhi Shi Zhi Zi Chi Tang
Points

LARGE INTESTINE HEAT

Clinical Manifestations	Dry stools Knotted constipation Mouth parched Sensation of burning heat, swelling and pain of anus Urine short and dark T: Pink C: Yellow and dry P: Slippery and rapid
Treatment Principle	Clear Heat Purge constipation
Herb Formulas	Ma Zi Ren Wan
Points	LI-4, LI-11, SJ-6, ST-25, ST-37, ST-44, UB-25

DAMP-HEAT IN THE LARGE INTESTINE

Clinical Manifestations	Diarrhea with tenesmus which intensifies after defecation Frequent stools which are small in quantity Stools are yellow or brown, thin, watery, with foul smell or sticky and pasty like jam or sticky fluid or containing pus and Blood Burning hot sensation in anus Abdominal pain Urine short and red Sustained fever despite profuse perspiration or Raging fever in the afternoon Severe cases: High fever and coma Mouth dry but no desire to drink Body heavy Limbs tired Fullness in chest Lump in epigastrium Anorexia Vomiting T: Red C: Yellow and greasy P: Slippery and rapid
Treatment Principle	Clear Heat Transform Dampness Stop dysentery
Herb Formulas	Shao Yao Tang Bai Tou Weng Tang
Points	LI-4, LI-11, SP-9, ST-25, ST-37, ST-44, UB-25

DAMP-HEAT INJURES THE SPLEEN

Clinical Manifestations	Anorexia Abdominal distention and discomfort Suffocating sensation in the chest Epigastric mass Maybe abdominal pain on palpation Yang jaundice (sclera and skin are bright yellow) Dislike of oily foods Nausea Vomiting Lassitude Scanty, dark urine Maybe thirst or thirst with no desire to drink Diarrhea with foul smell or Constipation Fever Sweet sticky taste or bitter taste in mouth T: Pink C: Thick, yellow and greasy (maybe sticky) P: Soft and rapid
Treatment Principle	Clear Heat Benefit Dampness
Herb Formulas	Yin Chen Wu Ling San
Points	LI-11, REN-12, SP-9, ST-36, ST-44, UB-20 For Damp-Heat Diarrhea: LI-4, SP-9, ST-25, ST-36, ST-44, UB-25 For Damp-Heat Dysentery: LI-4, LI-11, SP-9, ST-25, ST-37, ST-44

SPLEEN DEFICIENCY EDEMA

Clinical Manifestations	Edema in limbs, especially lower limbs Maybe anasarca Maybe abdominal distention Loose stools Physical and mental fatigue T: Pale C: White and moist P: Soft and even
Treatment Principle	Warm Yang Strengthen the Spleen Benefit Qi Move water
Herb Formulas	Si Ling San Wu Ling San
Points	REN-6, REN-9, SP-6, SP-9, ST-28, ST-36, UB-20, UB-22, UB-23

SPLEEN DEFICIENCY WITH DAMP HEAT

Clinical Manifestations	Long-term, unremitting fishy-smelling, viscous vaginal discharge that is yellow white in color A pale yellow complexion Dizziness A sensation of heaviness in the head Anorexia Occasional loose stools Delayed menstruation with pale Blood A weak lower back and knees T: Pale C: Thin and white P: Soft and slippery and may be deep
Treatment Principle	Clear Heat Dry Dampness Strengthen the Spleen
Herb Formulas	Yi Huang Tang
Points

SPLEEN AND KIDNEY YANG DEFICIENCY (MILD)

Clinical Manifestations	Continuous cramping pain in the abdomen Pain is not severe Pain is relieved by pressure Edema of the feet Urinary difficulty Slight edema (primarily of the lower limbs) Symptoms generally occur during pregnancy Pale face Fatigue Heaviness of head Lassitude Lower abdominal pain Dizziness Tinnitus Lumbago Edema Abdominal pain with edema during pregnancy due to Blood Deficiency and abnormal water circulation Oliguria Palpitations Cold feet Extreme coldness of the hands and feet Vertigo Weakness and numbness of lower back and legs during pregnancy or postpartum Mal position of the fetus Dysmenorrhea Irregular menstruation Right upper quadrant pain Hepatomegaly Anemia Lack of energy Sore back Thirst with no desire to drink T: Pale or pink maybe petechiae on margin C: Thin or Greasy white P: Deep and weak or Soft, floating, small and slow or Wiry and small or Wiry and rough
Treatment Principle	Warm and Reinforce the Spleen and Kidneys
Herb Formulas	Dang Gui Shao Yao San
Points	Moxa or moxa needle REN-4, REN-12, SP-6, SP-9, ST-36, UB-20, UB-23

FOOD STAGNATION IN THE STOMACH TRANSFORMING INTO DMP-HEAT WITH INTESTINAL OBSTRUCTION

Clinical Manifestations	Abdominal pain (worse with pressure) Abdominal and epigastric distention Dysentery Scanty dark urine Constipation T: Red C: Yellow and greasy or slippery P: Deep and forceful
Treatment Principle	Reduces and guides out Stagnation and Accumulation Clears Heat Dispels Dampness
Herb Formulas	Zhi Shi Dao Zhi Wan
Points

HEART FIRE TRANSFERRING TO THE SMALL INTESTINE

Clinical Manifestations	Stabbing pain in the Bladder Ulceration, erosion, and pain of mouth and tongue Thirst with a desire for cold drinks Irritability Irascibility Feeling of Heat and disturbance in the Heart Insomnia Flushed face Bitter taste in the mouth T: Red tip with ulcers especially on the tip P: Excess and rapid
Treatment Principle	Clear Heat Purge Fire Calm the Shen
Herb Formulas	Dao Chi (Re) San San Huang Xie Xin Tang Liang Ge San Cheng Shi Fen Xing Yin Chinese Patent Medicines: Dao Chi Pian Te Xian Pai Shi Wan Long Dan Xie Gan Wan Qian Lie Xian Wan Chuan Xin Lian Kang Yan Pian
Points	HT-7, HT-8, PC-7, PC-8, UB-15 HT-8, KI-6, PC-6, REN-3, SP-6, SP-9, ST-28, Yintang

HEART FIRE WITH KIDNEY YIN DEFICIENCY AND DAMP-HEAT POURING DOWNWARD

Clinical Manifestations	Restlessness Irritability Thirst Nocturnal emission Insomnia Dream disturbed sleep Lack of spirit Fatigue Low back pain Tinnitus Dysuria Depression Turbid urine Abnormal uterine bleeding Polyuria Enuresis Seminal emission Leukorrhea Blood tinged leukorrhea Anorexia Dry mouth Dry Tongue Five Sole Heat Fever Physical and mental overexertion T: Red C: Little or None P: Deep and rapid
Treatment Principle	Clear Heart Fire Disperse Damp-Heat Benefit Qi and Yin Promote urination
Herb Formulas	Qing Xin Lian Zi Yin
Points

HEART AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Insomnia with much dreaming Spermatorrhea with erotic dreams Premature ejaculation Irritability Easily startled Palpitations Poor memory Dizziness Tinnitus Low back soreness Legs weak Tidal fever Night sweats Dry mouth Red cheeks Urine short and red T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Reduce Fire Make Heart and Kidney communicate
Herb Formulas	Sang Piao Xiao San With Fire Rising: Dao Chi San
Points	HT-7, KI-3, PC-6, PC-7, UB-15, UB-23

SMALL INTESTINE EXCESS HEAT

Clinical Manifestations	Irritability Ulceration and erosion of the mouth and tongue Sore throat Dry mouth Thirst Desire for cold drinks Maybe deafness Urination short, dark, difficult and painful or Hematuria or Pain in the urethra Fullness and distention of lower abdomen T: Red C: Yellow P: Slippery and rapid
Treatment Principle	Clear Excess Heat Promote diuresis
Herb Formulas	Dao Chi (Re) San
Points	HT-8, LIV-2, REN-3, SP-6, SP-10, UB-27 PC-7, REN-4

LIVER QI STAGNATION TURNING TO HEAT WITH UNDERLYING QI AND BLOOD DEFICIENCY

Clinical Manifestations	Irritability Short temper Restlessness Fever or tidal fever Red eyes Dry mouth and throat Palpitations Lower abdominal pain Difficult urination Painful urination Increased menstrual flow Uterine bleeding Early menstruation Aching in limbs Dizziness Mental instability Red face Thirst Turbid urine Alternating chills and fever Red cheeks Wheezing Nervousness Headache Red eyes Dry mouth Anorexia Infertility Abdominal pain Spontaneous sweating or night sweats with fever Anxiety Dry eyes Hypochondriac pain Somnolence Insomnia Aching shoulders Five Sole Heat Earache Premenstrual tension Hot flashes Fatigue Lassitude Depression Restlessness Constipation with flushing up Pale complexion Bitter taste in mouth Vertigo Abdominal distention near the umbilicus Epistaxis Irregular menstruation Heaviness in the lower abdomen T:Red or Red edges C: Thin and yellow P: Thready, rapid and wiry or Wiry and tight and rapid
Treatment Principle	Pacify the Liver Spread Liver Qi Strengthens the Spleen Nourish the Blood and Yin Regulate menstruation Sedate the Heart Clear Heat
Herb Formulas	Jia Wei Xiao Yao San
Points

LIVER FIRE

Clinical Manifestations	Severe, splitting headaches with dizziness Sudden tinnitus or Sudden deafness Flushed face Red, swollen, painful eyes Irascibility with violent angry outbursts Dry mouth Bitter taste in mouth Thirst Vomiting sour or bitter liquid Insomnia Restlessness Constipation or dry stools Maybe rib pain In severe cases: Mania Hemoptysis Hematemesis Epistaxis Liver Fire Attacks the Lungs: Hemoptysis Rib pain which is severe when coughing Liver Fire Attacks the Stomach: Hematemesis T: Red tip and edges C: Thick, yellow, dry and rough P: Wiry, Excess and rapid
Treatment Principle	Clear the Liver Purge Fire
Herb Formulas	Long Dan Xie Gan Tang Dang Gui Long Hui Wan Chinese Patent Medicines: Te Xian Pai Shi Wan Long Dan Xie Gan Wan Qian Lie Xian Wan Chuan Xin Lian Kang Yan Pian
Points	GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19 LIV-2, LIV-3, LIV-5, REN-3, SJ-6, UB-28

DAMP-HEAT IN THE LIVER AND GALLBLADDER

Clinical Manifestations	Yang jaundice (sclera and skin bright yellow) Pain and fullness in ribs on both sides Maybe pain in the right hypochondrium Bitter taste in mouth Nausea Vomiting sour and bitter fluids Anorexia Maybe alternating chills and fever Concentrated, dark urine Abdominal distention Women: Yellow vaginal discharge with foul smell Pruritis vulvae Men: Pain, swelling and burning sensations of testicles T: Pink C: Yellow and greasy or sticky P: Wiry and rapid or Slippery and rapid
Treatment Principle	Clear Dampness Purge Heat from Liver and Gall Bladder
Herb Formulas	Long Dan Xie Gan Tang
Points	Dannangxue, DU-9, GB-24, GB-34, LIV-14, SI-4, SP-9, UB-18, UB-19, UB-48

LIVER AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Numbness of limbs Flaccid paralysis (Wei syndrome), weakness Tinnitus Deafness Forgetfulness Low back and knees sore and painful Throat dry and painful Five sole Heat Low-grade fever Night sweats Irritability Insomnia Stools difficult to pass Constipation Men: Spermatorrhea Women: Irregular menses or Scanty menses or Amenorrhea Vaginal discharge T: Red C: None P: Thready and rapid
Treatment Principle	Nourish and Reinforce the Liver and Kidneys
Herb Formulas	Qi Ju Di Huang Wan Yi Guan Jian Da Bu Yin Wan Liu Wei Di Huang Wan With Fire Flaring: Zhi Bai Di Huang Wan
Points	KI-3, LIV-3, SP-6, UB-18, UB-23

KIDNEY YANG DEFICIENCY (CHRONIC)

Clinical Manifestations	Lumbago: low back feels cold, weak and aching Feeling chilled Aversion to Cold Cold limbs General debility Pale face Urinary frequency with abundant, clear urine or Oliguria with edema Maybe nocturia Lassitude Withdrawn, subdued behavior Knees feel cold and aching Dizziness Tinnitus Impotence Spermatorrhea Premature ejaculation Low libido Female infertility ("uterus cold and infertile") Maybe anorexia Maybe loose stools Maybe chronic diarrhea or "cock crow" diarrhea T: Pale and swollen C: Thin and white P: Deep and thready - maybe slow
Treatment Principle	Warm and Reinforce Kidney Yang
Herb Formulas	Jin Gui Shen Qi Wan (Ba Wei Di Huang Wan)
Points	Moxa or moxa needle DU-4, KI-3, REN-4, UB-23 For chronic diarrhea, rectal prolapse and Vanquished Yang: + moxa DU-20, REN-8 For Kidney Yang Deficiency impotence: moxa or moxa needle DU-4, DU-20, KI-3, REN-4, UB-23 For Kidney Yang Deficiency (Cock Crow) Diarrhea: moxa or moxa needle DU-20, KI-3, REN-4, UB-23

KIDNEY YIN DEFICIENCY

Clinical Manifestations	Chronic urinary tract infection Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of low back Spermatorrhea or premature ejaculation Aching in bones Aching in leg and heel T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Reinforce the Kidneys
Herb Formulas	Liu Wei Di Huang Wan Mai Wei Di Huang Wan Ba Xian Chang Shou Wan With Damp-Heat in the Large Intestine: Zhi Bai Di Huang Wan
Points	KI-1, KI-3, KI-6, REN-4, SP-6, UB-23 GB-20, KI-1, KI-2, KI-3, KI-6, LI-11, LIV-3, REN-4, SP-6, ST-36, UB-23

KIDNEY YIN DEFICIENCY WITH FIRE FLARING

Clinical Manifestations	Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of the low back Spermatorrhea or Premature ejaculation Aching in the bones Aching in the leg and heel Dry mouth Thirst Night sweats Five Sole Heat Malar flush Low grade fever in the afternoon Dry throat, maybe recurrent sore throat Dry stools and/or Constipation Urine short and red Heightened libido If Heart Fire also Flares: Insomnia Frequent dreams Palpitations If Liver Yang also Rises: Dizziness Blurred vision T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Zhi Bai Di Huang Wan Chinese Patent Medicines: Zhi Bai Ba Wei Wan For bleeding: + Yun Nan Bai Yao
Points	KI-1, KI-2, KI-3, KI-6, KI-9, KI-10, REN-4, SP-6, UB-23 If Heart Fire also Flares: HT-7, PC-7, UB-15 If Liver Yang also Rises: LIV-3, UB-18

KIDNEY YIN AND YANG DEFICIENCY

Clinical Manifestations	Amenorrhea Irregular menstruation Hot flashes Dizziness Tinnitus Night sweats Perspiration Nervousness Muscular flaccidity Fatigue Mood swings Cold feet Lassitude Frequent, clear urine Irritability Headache Palpitations Insomnia T: Pale C: Thin and white P: Thready and rapid
Treatment Principle	Replenish Kidney Yin and Yang Tonify Kidney Jing Purge Deficiency Fire Regulate the Chong and Ren
Herb Formulas	Er Xian Tang
Points

KIDNEY JING DEFICIENCY

Clinical Manifestations	Dizziness Tinnitus Low back and knees weak and aching In adults: Hair loss Graying or whitening of the hair Weak sexual function Atrophy and weakness of the feet with difficulty walking Poor memory Senility (premature or mature) Brittle bones Gradual deterioration of the hearing In children: Retardation in mental and/or physical development Failure to thrive Late or incomplete closing of the fontanel Poor bone development Brittle bones
Treatment Principle	Reinforce the Kidneys Benefit Jing
Herb Formulas	Da Bu Yuan Jian
Points	DU-4, HT-7, KI-3, REN-4, UB-11, UB-15, UB-23

URNARY BLADDER DAMP-HEAT

Clinical Manifestations	Urinary frequency Urinary urgency Painful, burning urination or Continuous dripping of urine or Sudden interruption to the urinary stream Turbid urine or Pus and blood in the urine or Sand and stones in the urine Lower abdominal distention In Damp-Heat Pouring Downward there may also be: Fever Thirst Dry mouth Low back pain In Damp-Heat Crystallizes in Urinary Bladder there may also be: Colicky pain in the low back, possibly radiating to the groin T: Red C: Yellow P: Slippery and rapid
Treatment Principle	Clear Heat Eliminate Dampness by diuresis
Herb Formulas	Ba Zheng San Xiao Ji Yin Zi Zhi Zhuo Gu Ben Wan Wu Lin San Jia Wei Er Miao Wan Bi Yu San With an External Wind Invasion: Dang Gui Nian Tong Tang
Points	KI-7, LIV-2, REN-3, SP-6, SP-9, UB-23, UB-28, UB-39 REN-3, SP-6, SP-9, UB-23, UB-28 HT-8, REN-3, SP-6, SP-10, UB-17, UB-28 To disperse Heat: LI-4, LI-11 To eliminate Dampness: REN-9, SP-6, SP-9 For retention of urine: 1. REN-3, SP-6, SP-9, UB-28 2. REN-3, SP-6, SP-9, UB-39

DAMP-HEAT WITH KIDNEY YIN DEFICIENCY

Clinical Manifestations	Urinary frequency Urinary urgency Painful, burning urination or Continuous dripping of urine or Sudden interruption to the urinary stream Turbid urine or Pus and blood in the urine or Sand and stones in the urine Lower abdominal distention Dizziness Tinnitus Tidal fever Five sole Heat Lower back pain In Damp-Heat Pouring Downward there may also be: Fever Thirst Dry mouth In Damp-Heat Crystallizes in Urinary Bladder there may also be: Colicky pain in the low back, possibly radiating to the groin T: Deep red C: Yellow and sticky P: Thready and rapid
Treatment Principle	Clear Heat Eliminate Dampness by diuresis Nourish Kidney Yin
Herb Formulas	Zhi Bai Di Huang Wan Zhu Ling Tang
Points	To adjust the UB: REN-3, UB-28 To eliminate Dampness: REN-9, SP-6, SP-9 To nourish kidney Yin: KI-3, SP-6, UB-23

DAMP-HEAT WITH SPLEEN AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	Urinary frequency Urinary urgency Painful, burning urination or Continuous dripping of urine or Sudden interruption to the urinary stream Turbid urine or Pus and blood in the urine or Sand and stones in the urine Lower abdominal distention Lower back pain Lassitude Anorexia Shortness of breath In Damp-Heat Pouring Downward there may also be: Fever Thirst Dry mouth In Damp-Heat Crystallizes in Urinary Bladder there may also be: Colicky pain in the low back, possibly radiating to the groin T: Pale C: Sticky and white P: Deep and deficient
Treatment Principle	Clear Heat Eliminate Dampness by diuresis Tonify Spleen and Kidney Yang
Herb Formulas	Liu Jun Zi Tang modified Tu Si Zi Wan
Points	To adjust the UB: REN-3, UB-28 To eliminate Dampness: REN-9, SP-6, SP-9 To tonify Spleen Yang: LIV-13, UB-20 To tonify Kidney Yang: DU-4, UB-23

HEAT AND BLOOD STAGNATION

Clinical Manifestations	Frequent, urgent, painful urination Lower abdominal distention and pain (usually on right) Pain increases on pressure with rebound tenderness Guarding of the abdominal musculature Groin pain resembling urinary dysfunction without urinary difficulty Groin pain relieved by flexing hip and knee Groin pain intensified by extending hip Perspiration Irregular or intermittent fever followed by chills and perspiration May be mass in lower right quadrant of abdomen Aversion to Cold Hard lumps T: Pink C: Thin, white or yellow and greasy P: Slippery and rapid or Tight or Wiry and tight or Tight and rapid
Treatment Principle	Drains Heat Breaks up Blood Stasis Invigorates the Blood Disperses nodules Reduces swelling
Herb Formulas	Da Huang Mu Dan Tang
Points

HEAT (RE) LIN

Clinical Manifestations	Rapid onset of urinary dripping Frequent, urgent, painful urination Dark yellow urine with feverish and painful sensations Hasty urinary discharge Pain involving the umbilicus Fever with aversion to Cold A bitter taste in the mouth T: Red C: Yellow and greasy P: Rapid and soft
Treatment Principle	Clear Heat Purge Fire Promote urination Unblock painful urinary dysfunction
Herb Formulas	Ba Zheng San
Points	KI-3, LI-4, LIV-2, REN-3, SJ-5, SP-9, UB-28 Ear: Urinary Bladder, Kidney, Sympathetic, Occiput, Adrenal, Endocrine

STONE (SHI) LIN

Clinical Manifestations	Frequent, urgent, painful urination Difficult urination with occasional sandy substance in the urine Dysuria with pain involving the lower abdomen difficult to tolerate or On and off urinary discharge with stabbing lumbar pain that involves the lower abdomen, thigh and external genitalia Occasional bloody urine Thirst with no desire to drink alternating constipation and diarrhea T: Red C: Thin and white or Thin and yellow P: Wiry or Wiry and rapid
Treatment Principle	Clear Heat Purge Fire Promote urination Unblock painful urinary dysfunction
Herb Formulas	Shi Wei San Ba Zheng San Niao Lu Pai Shi Tang Er Hao San Jin Tang Chinese Patent Medicines: Te Xian Pai Shi Wan Shi Lin Tong Pian For bleeding: Yun Nan Bai Yao (add to either of the above)
Points	KI-2, KI-3, LIV-2, REN-3, SP-9, UB-28, UB-39 GB-39, HT-8, LIV-2, LIV-5, SJ-5 Ear: Urinary Bladder, Kidney, Sympathetic, Occiput, Adrenal, Endocrine

BLOOD (XUE) LIN

Clinical Manifestations	Frequent, urgent, painful urination Short reddish urine Maybe dark purplish clots Severe burning pain Difficulty in discharging the urine Distending pain in the urethra in severe cases which involves the umbilicus T: Red tip C: Thin and yellow P: Rapid and forceful
Treatment Principle	Clear Heat Purge Fire Promote urination Unblock painful urinary dysfunction Stop bleeding
Herb Formulas	Xiao Ji Yin Z i Dang Gui Liu Huang Wan Zhi Bai Di Huang Wan Ba Zheng San Wu Lin San
Points	KI-3, LIV-2, REN-3, SP-6, SP-9, SP-10, UB-28 KI-1, KI-7, LIV-3, REN-3, SP-10, UB-17, UB-23, UB-27 Ear: Urinary Bladder, Kidney, Sympathetic, Occiput, Adrenal, Endocrine

TURBID (MILKY) (GAO) LIN

Clinical Manifestations	Frequent, urgent, painful urination Turbid milky urine that soon sediments with catkin substance at the bottom (chyluria) A fatty, oily substance at the surface of the urine container with coagulation Bloody difficult urinary discharge with feverish pain Soreness in the lumbar region and knees Dizziness Lassitude Suprapubic distention and discomfort fullness in the chest and abdomen Poor appetite Bitter taste in the mouth Thirst with no desire to drink A tendency toward constipation or Alternating constipation and diarrhea T: Red tongue proper C: Slightly white and greasy P: Soft and rapid or Rapid and thready
Treatment Principle	Warm the Kidneys Drain Dampness Separate the turbid from the clear
Herb Formulas	Bei Xie Fen Qing Yin Qing Xin Lian Zi Yin Liu Wei Di Huang Wan Ba Zheng San Sang Piao Xiao San Cheng Shi Bei Xie Fen Qing Yin Wu Bi Shan Yao Wan Chinese Patent Medicines: Te Xiao Pai Shi Wan Long Dan Xie Gan Wan Qian Lie Xian Wan Chuan Xin Lian Kang Yan Pian
Points	DU-20, KI-3, LIV-2, REN-3, REN-6, SP-9, UB-23, UB-28 KI-3, KI-6, LIV-2, REN-3, SP-9, UB-23, UB-28 REN-4, REN-6, SP-6, SP-9, UB-22, UB-27, UB-28 GB-41, KI-7, LIV-5, REN-3, SJ-5, SP-4, SP-6, SP-9, UB-22, UB-28 Ear: Urinary Bladder, Kidney, Sympathetic, Occiput, Adrenal, Endocrine

BLOOD DEFICIENCY WITH HEAT

Clinical Manifestations	Chronic, continuous uterine bleeding A pale complexion Stabbing pain in the abdomen Alternating chills and fever Irregular menstruation with profuse bleeding Abdominal pain Fever Thirst Itchy skin Heat in the upper body with Cold in the lower body Irritability and restlessness despite fatigue and exhaustion Mood swings A sallow complexion Emaciation T: Dry with a red tip C: Thin white P: Deep and rapid
Treatment Principle	Drain Fire Resolve toxicity Tonify the Blood Stop bleeding Warm the menses Cool the Blood
Herb Formulas	Wen Qing Yin
Points

DAMP-HEAT

Clinical Manifestations	Heat and pain in the joints and muscles Severe limitation of movement Fever and shaking chills Lusterless yellow complexion Scanty, dark urine Pain worse on cloudy or rainy days Arthralgia involving one or several joints Local redness and Heat of the extremities Swelling with excruciating pain Pain better during the day and worse at night Numbness of the muscles Thirst Dryness of the mouth Irritability Muscular atrophy Restlessness Anorexia Desire for Cold drinks Loose stools Aversion to Heat Fullness of the chest Pain improved with Cold and worse with Heat Muscular swelling Muscle redness General heaviness T:Red, maybe flabby C: Yellow and greasy P: Slippery and rapid
Treatment Principle	Clear Heat Eliminate Dampness Activate the collaterals Stop pain
Herb Formulas	Wu Wei Xiao Du Yin Zhong Man Fen Xiao Wan Due to Spleen Deficiency Edema: Si Ling San
Points

TOXIC HEAT

Clinical Manifestations	Acute red eyes Sore throat Mouth or tongue sores Dark, rough urination Reddish urine Restlessness and Heat in the Heart and diaphragm Constipation Gum bleeding Pimples Burning urination Dizziness T: Red C: Yellow P: Slippery and rapid
Treatment Principle	Clear Heat Resolve toxicity Drain Fire Unblock the bowels Expel Wind
Herb Formulas	Huang Lian Shang Qing Wan
Points

OBSTRUCTION OF THE SAN JIAO BY FIRE TOXINS

Clinical Manifestations	High fever Irritability Fidgeting Dry mouth Dry throat Incoherent speech Insomnia Dark urine Deep-rooted boils Maculae Carbuncles Hematemesis Hemoptysis Palpitations Furuncles Tinnitus Purpura Red face Rashes Deep-rooted boils Red eyes Itchy skin Fidgeting Dry lips Delirium Dysentery with fever Jaundice Epistaxis Hematuria Cloudy mind Diarrhea T: Red C: Yellow P: Rapid and forceful
Treatment Principle	Clear Heat Drain Fire Relieve toxicity from all three Jiaos Relieve inflammation Stop bleeding Purge Damp-Heat Purge the Gallbladder
Herb Formulas	Huang Lian Jie Du Tang
Points

LOWER JIAO BLOOD STAGNATION WITH HEAT

Clinical Manifestations	Acute lower abdominal pain Incontinence of urine Night fevers Delirious speech Irritability Restlessness Thirst May be mania (severe) Dysmenorrhea Amenorrhea Hard stool Dark red complexion Headache Vertigo Tinnitus Insomnia Palpitations Constipation Frequent urination Emotional instability Chills in the waist and feet Afternoon fever Tremors Excruciating abdominal pain with cold Black stool May be chills and fever Hemoptysis Hematuria Red eyes Pain and distention of the head Toothache Irregular menstruation Lochioschesis Severe wheezing Distention of the chest T: Red and dry C: Yellow P: Deep and forceful or Choppy
Treatment Principle	Drain Heat Break up Blood Stasis
Herb Formulas	Tao He Cheng Qi Tang
Points

DAMP-HEAT IN THE LOWER JIAO

Clinical Manifestations	Pain in low back and knees Aches and pains in the bones and sinews Weakness or atrophy of lower extremities Scanty yellow urine Red, hot, swollen and painful feet or knees Edema in lower legs Leukorrhea (thick, yellow, foul-smelling) Sores on lower extremities due to Damp Redness, swelling and pain of the knees with burning sensations Oliguria Eczema T: Normal C: Yellow and greasy P: Soft and and rapid
Treatment Principle	Eliminate Heat and Dampness
Herb Formulas	Er Miao San Fu Ling Pi Tang Zi Shen Tong Guan Wan Si Miao Wan
Points

YI YIN

Clinical Manifestations	Heaviness Swollen extremities Pain in the extremities Sluggish urination Aversion to Cold Fever Anhidrosis Cough Asthma with Phlegm T: Swollen C: Greasy and white P: Tight and wiry
Treatment Principle	Warm Yang Benefit water Dispel exogenous pathogens
Herb Formulas	Wu Ling San
Points	Moxa only PC-6, SJ-6, SP-6, SP-9, ST-40, UB-13, UB-20, UB-23

IMPAIRMENT OF THE LONGITUDINAL LUO OF THE LUNG

Clinical Manifestations	Frequent urination Abundant urination Yawning
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Points	LI-4, LU-7

URINARY TRACT INFECTION (CYSTITIS, BLADDER INFECTION, URETHRITIS, KIDNEY INFECTION, LIN SYNDROME)

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