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