Retention of Urine

Introduction

Retention of urine is a disease manifested by difficult urination, distendingpain in the lower abdomen and even blockage of urine. The mild case refers todifficulty in urination and dripping of urine, while the severe case to failurein urination with distension and feeling of urgency.

This disease results from dysfunction of qi in the bladder. As said inInternal Classics : The bladder is in charge of storing liquid. Normalurination suggests the qi is in function. Its dysfunction causes retention ofurine.

Etiology and Pathogenesis

Heat accumulates in the bladder, or heat of the kidney shifts to the bladder. Accumulation of heat in the bladder impedes the qi function and leads to retention of urine.

The kidney and the bladder are exteriorly - interiorly related. The function of the bladder depends upon the warming function of the kidney yang. In case of weakness of the kidney yang and decline of Mingmen fire, the bladder may be too weak to discharge the urine.

Traumatic injury or surgical operation hindering the qi of the meridians or damaging the zang organs, causes retention of urine too.

Accumulation of heat in the bladder:

Main manifestations: Scanty hot urine or retention of urine, distension and fullness of the lower abdomen, thirst but without desire to drink, constipation, red tongue with yellow coating, rapid pulse.

Analysis: In case of accumulation of heat in the bladder, scanty hot urine or retention of urine appears. When water and heat combined together, impair the function of the bladder, distension and fullness of the lower abdomen occur. Since the body fluid fails to be normally distributed, thirst results but there is no desire to drink. Red tongue with yellow coating, rapid pulse, or constipation are due to accumulation of heat in the lower jiao.

Decline of Mingmen fire

Main manifestations: Dribbling urination, attenuating in force of the urine discharge, pallor, listlessness, chilliness below the lumbus, weakness of the loins and knees, pale tongue, deep, thready pulse weak at the chi region.

Analysis : Dribbling urination, attenuating in force of the urine discharge is due to deficiency of the kidney yang which affects the transmitting function. Pallor, listlessness and pale tongue are due to decline of the Mingmen fire and failure of qi in reaching the bladder.

Damage of the qi of the meridian

Main manifestations: Dribbling urination or retention of urine, distension and dull pain in the lower abdomen, purplish spots on the tongue, hesitant, rapid pulse.

Analysis : After a traumatic injury or surgical operation on the lower abdomen, the qi of the Bladder Meridian is damaged and blood stasis occurs, so there appear dribbling urination, retention of urine, distension and pain in the lower abdomen. Purplish spots on the tongue, hesitant, rapid pulse are the signs of blood stasis.

Treatment

Accumulation of heat in the bladder

Method: The metameric shu and mu points are selected as the principal points. Reducing method is applied to remove heat and promote diuresis.

Prescription: [BL28 - RN3 - SP6 - BL39].

Explanation : BL28, the metameric shu point of the bladder, and RN3, the metameric mu point of the bladder, are needled to reduce heat from the bladder and adjust its function. SP6 may dispel heat from the lower jiao. BL39, the lower he-sea point of sanjiao, promotes the circulation of water. These points, used together, reduce heat and promote diuresis.

Decline of the Mingmen Fire:

Method: The points relating to the Kidney Meridian are selected as the principal points. Reinforcing or moxi - bustion is applied to warm the kidney yang.

Prescription: [DU4 - BL23 - DU20 - RN4 - TH4].

Explanation: In case of deficiency of the kidney qi and decline of the Mingmen fire, the kidney qi should be reinforced, DU4 and BL23 are needled to reinforce the kidney yang. Moxibustion to DU20 and RN4 is to invigorate the kidney qi. Urination will be free in smooth qi circulation. Since deficiency of the kidney qi makes sanjiao fail to promote the circulation of water, TH4, the yuan-source point of sanjiao, is needled to strengthen the function of sanjiao and promote circulation of water.

Damage of the qi in the meridian:

Method: The metameric mu point of the bladder is selected as the principal point. Even movement is applied to promote circulation of the qi in the meridian and restore the function of the bladder.

Prescription: [RN3 - SP6 - ST28 - KI5].

Explanation: A traumatic injury or surgical operation can injure the blood vessels and impede the activity of the bladder, thus urodialysis appears. RN3, the metametic mu point of the bladder, is needled to adjust the function of the bladder and promote urination. SP6 may promote the circulation of blood and qi in the meridian. KI5, the xi-cleft point of the Kidney Meridian of Foot - Shaoyin, combined with ST28, may promote urination, and relieve distension and pain.