Traditional Chinese Internal Medicine Kidney Disorders

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Internal Medicine – Kidney Disorders

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Click below for information…

Diabetes

Enuresis

Impotence

Lin Syndrome (Urinary Tract Infection)

Retention Of Urine

Seminal Emission

 

Important: as with all items posted on TCM Health-info, it is very strongly recommended that you seek proper advise from your healthcare professional before administering any form of treatment to yourself.  This website is for informational purposes and does not replace the proper diagnosis of your physician. 

 

Overview Of Kidney Function:

The kidneys are referred to as the root of Qi.  This is because the kidneys store both the post-haven Qi and pre-haven Qi.  Pre-haven Qi is derived from our parents and given to us prior to our birth.  Post-haven Qi is received through the food we eat and the air we breath.  We can easily produce more post-haven Qi but it is extremely difficult to manipulate and strengthen our pre-haven Qi.  Kidney Yin energy is responsible for our birth, growth and reproduction while our kidney Yang energy is responsible for all of our physiological processes.  The kidneys produce marrow which fills the brain, spinal cord and controls our bones.  The kidneys also govern water by transforming and transporting different types of fluids which are found in our bodies.  The kidneys also control the bodies two lower orifices. Therefore if the kidneys are weak the possible symptoms would be frequent urination or incontinence, nocturnal emissions, diarrhea and possible prolapsed anus. The kidneys Qi is a burning energy or a fire found in the lower gates of vitality.  It is commonly called the minister fire (the heart fire is called the king fire) and it’s heat is the source of fire for all the internal organs.  This heat helps separate different fluids in the body and it also warms the stomach and spleen to aid in their digestion functions.  The warmth also keeps the bodies essence warm aiding in all sexual functions keeping fertility healthy and menstruation regular.  When the kidneys are deficient they represent disorders such as diabetes, enuresis, retention of urine, impotence, seminal emission and urinary tract infections.

 

Click here for more TCM Kidney Foundations:  Functions of the TCM Kidneys

 

 

Diabetes – Wasting Thirst Disorder – Xiao Ke

Top of the Document

3 more – 1 less (eat, drink, urinate more – lose weight/emaciation less).   Person can eat & drink a lot but not quench thirst or gain weight.  No matter how much is the patient drinks the same amount of urine is passed.  The main pathogenesis is Yin ↓ w/ dry Heat.  This syndrome is closely related to Diabetes type 1 (early onset insulin dependant).

 

Pathogenesis:

            Dry Lung                              

            Stomach Yin Deficiency        

            Kidney Yin Deficiency          

            Kidney Yin/Yang Deficiency

 

 

Lung Dryness (Upper Jiao)

Very thirsty, drink lots of fluids but still has dry mouth & tongue, frequent large amount of urine, irritable

            T – red, thin dry coat                                        P – thin, rapid

Treatment:        clear upper jiao heat and purge fire to promote production of body fluids

Formula            Xiao Ke fang

 

Stomach Yin Deficiency (Middle Jiao)

Hungry, will not stay full after meals, need to eat or get dizzy, extreme emaciation, constipation with dry stools

            T – red, scanty dry coat                                    P – thin, rapid

Treatment:        Clear Stomach fire and nourish middle jiao yin

Formula            Yu Nu Jian + Da Huang / Mang Xiao (constipation)

 

Kidney Yin Deficiency (Lower Jiao)

Frequent cloudy/thick urination, urine is oily or greasy, thirsty, night sweats, dizzy, tinnitus, seminal emission, insomnia

                        T – red, thin coat                                              P – thin, rapid

            Treatment:        Nourish Kidney yin and clear deficient heat.

            Formula            Liu Wei Di Huang Wan

 

Kidney Yin & Yang Deficiency (Lower Jiao)

Frequent cloudy oily urination, trouble holding urine, 5-centre heat sensation, thirsty, coldness, aversion to cold, weak lower back and knees, impotence, amenorrhea, night sweat, spontaneous sweat, dry/dull complexion

                        T – scanty coat                                                 P – thin, deep weak

            Treatment:        Tonify Kidney yin and yang

            Formula            Jing Gui Shen Qi Wan + Er Xian Tang

 

 

 

Enuresis – Yi Niao

Top of the Document

Yi Niao is the inability to control the urge to urinate especially while in bed.  Mainly caused by Kidney & Bladder disorders usually caused by Deficiency Cold. Yi Niao is common in babies, geriatrics or during post delivery in men.  Yi Niao is commonly called incontinence if urination occurs while patient is awake.

 

Western Medicine

Neurological dysfunction, urinary tract disorders, brain disorders, (meningitis, stroke, tumour) prostate disorders, kidney dysfunction.

 

All 5 Zang organs can cause Yi Niao

Lung Qi Def.  -lung regulates water passages- def qi allows lung to loose it’s governing function there fore impairing the Bladders function.

SP. Qi Def.     -spleen transports/transforms fluids which controls fluid movement –spleen qi sinking allows the spleen to loose control of these fluids.

Weak Kid.      -kidney controls the gates – when kidney is weak it looses control of the gate allowing urine to leak out. 

Kid. Yang def. –kidney looses transforming fluids function, it is unable to help bladder retail fluids

Liver Qi stag. & Damp Heat – liver will loose it’s soothing & regulating function – this causes the muscles to become flaccid allowing leakage.

Liver Yin Def.  –liver impairs DU meridian function

Heart Qi Def. -heart connects to S.I. & KD– when heart Qi is deficient it impacts the S.I. function so it will not absorb all the water and the KD will

                         not be able to balance the water.

 

Causes:

            Deficiency cold

            Accumulation of damp heat

            Accumulation of blood stasis in lower Jiao (trauma ie. Post pregnancy)

 

Differentiation / Treatment

 

Kidney Yang Qi Def. (def. cold in lower Jiao)

Large amount of clear urine, general kd def. cold sympt. Cold, tired, knee & lower back weakness/ache

            T-pale                                                              P-deep thin

Treatment:        warm kidney, induce astringent, consolidate kidney Qi

Formula            Tu Si Zi Wan

 

Lung & Spleen Qi Def.

Prolapse feeling in Lower abdomen, urine leaks out when coughing/talking, frequent urgent urination, grey pale complexion, short of breath, over-worked / over-worry / over-thinking (sad/worried/tired)

      T-pale                                                              P-weak

Treatment:           nourish spleen/lung Qi to control urine

Formula    Bu Zhong Yi Qi Tang + astringent herbs Long Go, Mu Li

 

Heart & Kidney Qi Def.

Dreaming with enuresis, canker sores, poor sleep, irritable, general yin def. symptoms.

      T-red tip/strawberry’s                                       P-thin/rapid/deep(kd)

Treatment:           nourish & harmonize Heart and Kidney

Formula    Sang Piao Xiao San + Jiao Tai Wan

 

Accumulation of Damp Heat in Lower Jiao

            Smelly, yellow, frequent, hot urine, (NO PAIN)

                        T-red/yellow/ greasy coat                                 P-thin/slippery/rapid

            Treatment:     induce diuresis to clear heat

            Formula          Ba Zheng San

 

Blood Stasis

Usually has traumatic injury, possible fever (infection=dark urine), masses in abdomen, more incontinence than enuresis.

      T-red/purple                                                     P-uneven/rapid

Treatment:            remove blood stasis from lower jiao, clear heat

Formula    Shao Fu Zhu Yu Tang+clear heat herbs Zhi Zi, Huang Lian, Huang Bai

 

Du Meridian Def. / Kidney Essence Def.

Dizziness, blurred vision, reproductive disorders (impotence/infertility), general kidney essence def. symptoms.

      T-thin, weak                                                     P-wiry

Treatment:           nourish Kidney & DU essence

Formula    Shen Shi Tu Si Zi Wan

 

 

 

 

Impotence – Yang Wei

Top of the Document

Impotence (inability to achieve full erection) & premature ejaculation during ages of regular sexual practices (16-64 +/-).  This is usually due to KI   but can also be caused by external factors.  Chronic illness, stress, & depression seem to be very common in these individuals.

 

Western Medicine:

            Three Causes: Psychological (function impotence)

                                    Faulty Genitals (anatomic impotence)

                                    Neuromuscular dysfunction (atonic impotence)

 

Pathogenesis:

            Ming Men Fire(Qi & essence) Deficiency         

            Heart and Spleen Deficiency                            

            Kidney Qi Deficiency due to shock                  

            Damp Heat in L. Jiao                                       

 

 

Ming Men Fire Deficiency

Infertility, thin clear looking sperm, Kidney Yang deficient symptoms, lower back weakness, coldness, fatigue

                        T – pale, puffy                                                  P – deep, weak

            Treatment:        Warm ming men fire to tonify Kidney essence

            Formula            You Gui Wan

 

Heart & Spleen Deficiency

            Insomnia, palpitations, poor appetite, fatigue, soft stools

                        T – Pale                                                           P – thin

            Treatment:        Nourish Heart and Spleen

            Formula            Gui Pi Tang + Qi Fu Yin

 

Kidney Qi Deficiency Due To Shock

Long term fears, sudden shock, timid person, insomnia with excess dreams, palpitations

            T – red, greasy coat                                                      P – thin, wiry

Treatment:        Nourish Kidney and calm spirit

Formula            Da Yu Tang + Kidney tonics

 

Damp Heat In Lower Jiao

Skin disorders around genitals (wet/soft types), dark scanty yellow hot urine, possible odor, possible constipation

            T – red, greasy yellow coat                               P – slippery, rapid

Treatment:        induce diuresis to clear heat and transform dampness

Formula            Long Dan Xie Gan Tang

 

 

 

 

Lin Syndrome – Urinary Tract Infection

Top of the Document

Frequent, Urgent, Painful, dripping, dark urination caused by damp heat in the Bladder.  Urine may contain stones, blood or a milky/greasy substance.

 

Western Medicine:

            Chyluria, Prostatitis, T.B. of Kidney, Cancer

 

May be caused by :

            Shi Lin  - stone (heat coagulates urine into stones)

            Re Lin   - heat  (toxic damp heat attacks bladder – burning pain)

Xue Lin  - blood  (heat pushes blood out of damaged vessels)

            Gao Lin   - Chyluria  (heat injures meridians impairing transform/transport)

            Lao Lin  -  kidney def. (kd can’t help bladder transform urine or control gate)

Qi Lin   -liver qi/blood stagnation fire travels down liver meridian impairing bladder)

 

 

Differentiate between?

                        Long Bi – retention of urine – not urgent, no pain, no blood

                        Blood Urine – blood in the urine – not urgent, no pain, mainly blood

                        Jing Zuo – pee with spermies during urination, usually after ejaculation.

 

 

Re Lin (excess)

            Mainly caused by damp heat

Frequent dribbling, urgent burning urination with bitter taste, fever, aversion to cold and other general damp heat accumulation symptoms.

            Tongue – red, yellow coat         Pulse – soft, slippery, rapid

Treatment:     induce dieresis to clear damp heat

Formula:         Ba Zheng San

 

Re Lin (deficient kidney Yin)

            Deficient kidney fire

All symptoms above but less severe – mild/dull pain, lower back/knee pain & weakness, chronic

            Tongue – red, scanty coat                                 Pulse – thin, rapid

Treatment:     nourish kidney, clear heat

Formula          Zhi Bai Di Huang Wan

 

Xue Lin (excess)

Frequent dribbling, urgent burning urination with bitter taste, fever, aversion to cold and redness in urine (blood in urine)

            Tongue – red, yellow coat                                 Pulse – rapid

Treatment:      clear heat, induce dieresis, cool blood to stop bleeding

Formula          Xiao Ji Yin Zi

 

Xue Lin (deficient kidney yin)

Frequent dribbling, urgent urination with mild/ dull pain, lower back/knee pain & weakness, chronic with slight red or pink colour

            Tongue – red, scanty coat                                 Pulse – thin, rapid

Treatment:      Nourish kidney, clear heat, stop bleeding

Formula          Zhi Bai Di Huang Wan + Gui Ban + E Jiao +Han Lian Cao

 

Qi Lin (excess – Liver Qi Stagnation)

Frequent dribbling, urgent, painful urination with pain in the lower abdomen, distended pain, aggravated by stress / emotion, unfinished feeling after urination

            Tongue – red or normal                                    Pulse – Wiry, deep

Treatment:     regulate Qi & Blood, induce dieresis

Formula          Chen Xiang San

 

Qi Lin (deficient spleen Qi sinking)

Frequent, dribbling, urgent urination, agg-when tired, pulling feeling in lower abdomen, amel-pressure, general Qi deficient symptoms.

            Tongue – pale                                                   Pulse – weak

Treatment:     strengthen spleen Qi

Formula          Bu Zhong Yi Qi Tang

 

Shi Lin (excess)

Frequent dribbling, urgent, painful urination with pain and stones, flow suddenly stops in mid stream, over whelming urge to go with severe pain, worse for men, if stones in kidneys severe lower back pain, stones may injure vessels = blood in urine

            Tongue – red yellow coat                                  Pulse – wiry

Treatment:     induce dieresis to eliminate stones

Formula          Ba Zheng San + Shi Wei San (stones)

 

Shi Lin (complicated excess / deficient)

Frequent dribbling, urgent, painful urination, chronic stones, fatigue, dull pain, lower back aching.

            Tongue -                                                          Pulse – weak

Treatment:     strengthen kidney, induce dieresis to eliminate stones

Formula          Zhi Bai Di Huang Wan + Shi Wei San (stones)

 

Gao Lin (excess) Chyluria

Frequent dribbling urgent, painful urination, cloudy urine with floaters at surface, burning pain

            Tongue- red, yellow coat                                  Pulse – rapid

Treatment:     eliminate damp heat, promote separation of waste body fluids

Formula          Bei Xie Fen Qing Yin

 

Gao Lin (deficient kidney Qi)

Chronic frequent, dribbling, urgent, painful urination with cloudy urine, emaciation

            Tongue-                                                           Pulse -

Treatment:     nourish kidney to reinforce gate

Formula          Liu Wei Di Huang Wan + Jin Suo Gu Jing Wan

 

Lao Lin (kidney deficiency)

Chronic frequent, dribbling, urgent, painful urination induced by over strained sexual activity, general kidney deficiency symptoms.

                        Tongue -                                                          Pulse – thin

            Treatment:      nourish deficiency

            Formula          Kid-yin def.       Liu Wei Di Huang Wan

                                    Kid-Qi def.        Tu Si Zi Tang

                                    Kid-Yang def.    Shen Qi Wan

 

Lao Lin (heart deficiency)

Frequent, dribbling, urgent, painful urination accompanied by deficient heart symptoms

Treatment:     nourish deficiency, induce dieresis

Formula          Tu Si Zi Tang  + Qin Xin Lian Zi Yin

 

Lao Lin (spleen)

Frequent, dribbling, urgent, painful urination accompanied by over work, fatigued, general heaviness

            Treatment:     Nourish deficiency

            Formula          Shen Qi Wan

 

 

 

Retention of Urine – Long Bi

Top of the Document

Significant decrease of urine or no passing of urine at all.  Usually caused by lower jiao or bladder disorders relating back to other organs.  (no pain)

 

Western Medicine

Retention of urine, Anuria (unable to urinate), blockages, injury of urinary tract, enlarged prostate, bladder/sphincter spasm, neurological disorders … … …

Aetiology / Pathogenesis

Damp Heat (most common)   – accumulates in mid./lower Jiao, impairing spleen/kidney transformation/transportation functions of urine, damp heat will also block the bladder

Lung Heat      -lung is the upper source of water, lung heat will not allow descending function of water from the lung to the bladder.

Spleen Qi Def. –looses transforming/transporting function, spleen can not separate or descend clear and turbid fluids

Kidney Essence Def.  –causes ming men fire deficiency, yang Qi can’t transform to produce yin (with ought yin there is no yang)

Liver Qi Stag.   –can’t soothe or regulate san Jiao functions the san jiao looses it’s steaming transformation function

Obstruction     - stones, tumour, injury, blood stasis

 

Principle of Treatment:

            Always induce Diuresis

 

Differentiation / Treatment

 

Excess Damp Heat in Bladder

Dark, smelly, burning sensation with fullness in lower abdomen, thirsty with no desire to drink, bitter taste, general feeling of being sticky, possibly constipated

                        T-red, greasy coat                                            P-slippery, rapid

            Treatment:     induce diresis to clear heat

            Formula          Ba Zheng San

 

Excess Heat in Lung

Sore and dry throat, respiratory symptoms –dyspnea, dry cough, wheezing retention of urine symptoms

            T- red, yellow coat                                           P-rapid

Treatment:     clear lung heat, induce diresis

Formula          Qing Fei Yin

 

Stagnation of Liver Qi

            Starts with emotional anger, chest/hypochondriac pain or fullness

                        T-red, thin/yellow coat                          P-wiry

            Treatment:     soothe liver Qi stagnation, induce diresis

            Formula          Chen Xiang San

 

Obstruction of Urinary Tract

Possible scanty or narrow stream during urination, pain/distension of lower abdomen

            T-dark purple                                                   P-uneven

Treatment:     promote blood circulation, remove obstruction

Formula          Xiao Fu Jue Yu Tang (traditional)

                        Dai Di Dang Wan (more widely used)

 

Middle Jiao Qi Sinking- Spleen

Prolapsed feeling in abdomen, fatigue, short of breath, bloating, other spleen Qi deficiency symptoms, over work, over worry

            T-pale                                                              P-deep thin

Treatment:     strengthen spleen to Ascend clear Qi and Descend turbid

Formula          Bu Zhong Yi Qi Tang + induce diresis Chun Ze Tang

 

Kidney Yang Deficiency (ming-men fire def.)

            No force to push urine out, pale, fatigue, lower back & knee weakness or cold

                        T-pale                                                              P-deep thin

            Treatment:     warm up kidney yang to strengthen kidney Qi

            Formula          Shen Qi Wan

 

Kidney Yin deficiency

General yin deficiency symptoms – 5 centre heat sensation, night sweat, zygomatic flush

            T-red                                                               P-thin, rapid

Treatment:     nourish kidney yin & induce diresis

Formula          Liu Wei Di Huang Wan & Zhu Ling Tang

 

 

 

 

Seminal Emission – Yi Jing

Top of the Document

Seminal emission (Yi Jing) is the passing of seminal fluid during ones sleep or when they are awake without sexual excitement.

 

Pathogenesis:

Heart & Kidney Disharmony -Kidney looses control over lower gate allowing   seminal fluid to leak out.

Kidney Yin Deficiency          

Liver Heat                             

Damp Heat in L.Jiao            

Kidney Qi Deficiency           

Phlegm Fire                           

 

 

Heart & Kidney Disharmony

Seminal emission comes with dreams, insomnia, palpitations, yellow short urine,    KD yin deficient symptoms.

            T - red                                                                         P – rapid

Treatment:        Clear Heart heat (king fire) and nourish Kidney.

Formula            San Cai Feng Shui Dan + clear heat herbs

 

Kidney Yin Deficiency

            Seminal emission without dreams or palpitations, KD yin deficient symptoms.

                        T – red, thin coat                                              P – thin, rapid

            Treatment:        Nourish Kidney yin, clear minister fire

            Formula            Zhi Bai Di Huang Wan

 

Liver Heat

Seminal emission without dreams, prolonged erections during daytime, liver fire symptoms, vexation, bitter taste

            T – red                                                                         P – rapid

Treatment:        Purge liver fire

Formula            Long Dan Xie Gan tang

 

Damp Heat in Lower Jiao

Seminal emissions at night, eruptions around genitalia, possible semen in urine, damp/heat symptoms

            T – red, thick yellow coat                                 P – rapid, slippery

Treatment:        induce dieresis to clear heat and transform dampness

Formula            Bi Xie Fen Qing Yin

 

Kidney Qi Deficiency

Seminal emission when awake, pale puffy complexion, lassitude, KD Qi def. symptoms & possible SP Qi def. symptoms

                        T - pale                                                            P – deep, weak

            Treatment:        Nourish Kidney Qi and consolidate essence

            Formula            Jing Shi Shen Qi Wan + Mi Jing Wan  (+ Gui Pi Tang if SP Def.)

 

Phlegm Fire

Seminal emission, selling in lower jiao, fullness/distention in chest, dark hot scanty difficult urine, cough with phlegm, bitter taste, thirst with no desire to drink.

            T – red, yellow greasy coating                           P – red, slippery

Treatment:        Clear fire and remove phlegm               

Formula            Zhu Ling Wan

 

 

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