Formulas · Text · Donguibogam 東醫寶鑑

Urine

Sobyeon

한글 소변 · Pinyin Xiao Bian

Where urine comes from and why it stops — the bladder with an upper mouth and no lower one, the eight stranguries, the twisted bladder of pregnancy, and the turbid urine that is essence leaking away

小便

The longest chapter in the Inner Landscape, and the most practical. It opens on a real argument: Dongwon asks whether urine is simply the water strained off in the gut, or something the spleen and lung have transformed and sent down — and answers that it is both, since water is the child of qi and qi the mother of water. From there the chapter divides what can go wrong. Urine that comes with difficulty; urine that stops altogether, sorted by one question — is the patient thirsty, which puts the heat in the lung, or not, which puts it in the kidney. The twisted bladder, which the chapter blames on holding urine too long, riding after a heavy meal, or a pregnancy pressing the bladder flat, and for which Danxi has the midwife lift the womb with an oiled hand. Block and repulsion, where nothing goes down and nothing stays down. Incontinence, from the infant who wets the bed to the woman whose bladder was torn in labour. Then the eight stranguries one at a time — taxation, blood, heat, qi, stone, gao, sand and cold — and the turbid urine that Danxi reads as essence leaking away. It ends on two sections that read like marginalia and are among the best things in the book: why the old pass more water than the young, and why wine leaves the body before the food eaten with it.

1.1 Where the Urine Comes From 小便原委

1.1.1

Source원문

靈樞曰, 水穀者, 常幷居胃中, 成糟粕而俱下于大腸, 而成下焦, 渗而俱下, 濟泌別汁, 循下焦而渗入膀胱焉.

Translation영역

The Lingshu says: water and grain always dwell together in the stomach, become dregs and go down together into the large intestine, forming the lower burner; seeping and going down together, the juice is strained and parted, and following the lower burner it seeps into the bladder.

Yeongchu 靈樞

1.1.2

Source원문

內經註曰, 水液自廻腸泌別汁, 渗入膀胱之中, 胞氣化之而爲尿, 以泄出也.

Translation영역

The commentary on the Neijing says: the fluid is parted off from the juice at the returning gut and seeps into the bladder; the qi of the 胞 transforms it into urine, and it is discharged.

Naegyeong-ju 內經註

1.1.3

Source원문

難經註曰, 水穀自小腸盛受於闌門以分別也, 其水則渗灌入於膀胱上口而爲溲便. 詳此三說, 則小便卽泌別之水液渗入膀胱以出者也. 內經曰, 飮入於胃, 遊溢精氣, 上輸於脾, 脾氣散精, 上歸於肺, 通調水道, 下輸膀胱, 則小便又似水飮精微之氣上升, 脾肺運化而後成者也. 夫溲尿者水也, 水之下流, 其性則然也. 飮入於胃, 其精氣雖上升, 其本體固不能上升, 則豈可謂小便獨爲氣化所成哉. 內經曰, 膀胱者津液藏焉, 氣化則能出矣. 且水者氣之子, 氣者水之母, 氣行則水行, 氣滯則水滯. 或者謂小便純由泌別, 不由運化, 盖不明此理故也. 《東垣》

Translation영역

The commentary on the Nanjing says: water and grain are received from the small intestine at the gate of the rail and there divided; the water seeps and pours into the bladder's upper mouth and becomes urine. Considering these three accounts, urine is the fluid parted off and seeped into the bladder to be discharged. But the Neijing says: drink enters the stomach, the essential qi roams and overflows, is carried up to the spleen, and the spleen's qi scatters the essence upward to the lung, which regulates the waterways and sends them down to the bladder — by which urine seems rather to be formed when the fine qi of drink rises and the spleen and lung transform it. Now urine is water, and it is water's nature to flow downward; and though the essential qi of what is drunk rises, its substance certainly cannot rise. How then can one say urine is made by transformation alone? The Neijing says: in the bladder the fluids are stored, and when the qi transforms them they can be discharged. Moreover water is the child of qi and qi the mother of water: where the qi moves the water moves, and where the qi stagnates the water stagnates. Those who say urine comes purely from straining and not from transformation are simply not clear on this principle.

Clinical note임상 주석

Dongwon arguing with himself in public, and it is the best piece of reasoning in the chapter. Two accounts of urine — mechanical straining and qi transformation — and he refuses to choose: the water goes down by its own nature and the qi is what moves it. 水者氣之子, 氣者水之母 is the sentence the rest of the chapter runs on, and every retention formula that adds a warm medicinal to a cold one is applying it.

Dongwon 東垣

1.2 The 胞 Is the Vessel of Urine 脬爲尿器

1.2.1

Source원문

膀胱雖曰津液之府, 至於受盛津液, 則又有脬而居膀胱之中焉. 故內經曰, 脬移熱於膀胱. 靈樞曰, 膀胱之脬薄以濡. 類纂曰, 膀胱者, 脬之室也. 夫脬之居於膀胱也, 有上口而無下口. 津液旣盛於脬, 無由自出, 必因乎氣化而後能漸漬浸潤於脬外, 積於脬下之空處, 遂爲尿以出於前陰也. 若曰脬下無空處, 則人尿急時至厠, 安能卽出乎. 夫惟積滿脬下之空處而不可再容, 故急. 急則至厠卽出矣. 《東垣》

Translation영역

Though the bladder is called the bowel of fluids, as for actually receiving and holding them there is further a 胞 that sits within the bladder. So the Neijing says: the 胞 moves heat to the bladder; the Lingshu says: the bladder's 胞 is thin and soft; the Yuchan says: the bladder is the 胞's chamber. Now the 胞, sitting within the bladder, has an upper mouth and no lower one. The fluids being full in the 胞, they have no way out of themselves; only by transformation of qi can they gradually soak and seep outside the 胞, gathering in the empty space below it, and so become urine and issue from the front yin. If it were said that there is no empty space below the 胞, then when a person's need is urgent and they reach the privy, how could it come out at once? It is only because the empty space below the 胞 is filled and can hold no more that the need is urgent; and being urgent, it issues as soon as the privy is reached.

Clinical note임상 주석

The Bladder chapter's 11.1 and 11.3 argued out at length. Dongwon's proof is ordinary experience: if the urine had to be transformed at the moment of voiding it could not come out the instant one reached the privy, so there must be a reservoir already filled. He is reasoning his way toward a bladder from the inside of a patient's day.

Dongwon 東垣

1.3 Telling the Colour of the Urine 辨尿色

1.3.1

Source원문

水液渾濁, 皆屬於熱.

Translation영역

Fluid that is turbid all belongs to heat.

Naegyeong 內經

1.3.2

Source원문

小便黃者, 小腹中有熱也.

Translation영역

Where the urine is yellow, there is heat in the lower abdomen.

Naegyeong 內經

1.3.3

Source원문

肝熱病者, 小便先黃.

Translation영역

In liver heat disease the urine turns yellow first.

Naegyeong 內經

1.3.4

Source원문

足陽明之脈病, 氣盛則尿色黃. 《內經》

Translation영역

In disease of the foot yang brightness channel, where the qi is exuberant the urine is yellow.

Naegyeong 內經

1.3.5

Source원문

疸證, 小便如黃栢汁. 《仲景》

Translation영역

In jaundice the urine is like phellodendron dye.

Clinical note임상 주석

黃栢汁 — the yellow-brown of phellodendron steeped in water, which is the colour of bilirubin in urine. The Jaundice chapter uses it as the diagnostic sign, and it is exact.

Junggyeong 仲景

1.3.6

Source원문

小便有五色, 惟赤白色者多. 赤色多因酒得之, 白色乃下元虛冷. 《資生》

Translation영역

Urine has five colours, but red and white are the commonest. Red mostly comes of wine; white is vacuity cold of the origin below.

Jasaenggyeong 資生經

1.3.7

Source원문

下焦無血, 小便澁數而黃. 《正傳》

Translation영역

Where the lower burner has no blood, the urine is rough, frequent and yellow.

Jeongjeon 正傳

1.3.8

Source원문

小便不禁, 赤者有熱, 白者氣虛. 《丹心》

Translation영역

In incontinence, red urine means heat and white means qi vacuity.

Dansim 丹心

1.4 The Pulse 脉法

1.4.1

Source원문

少陰脈數, 婦人則陰中生瘡, 男子則氣淋.

Translation영역

Where the lesser yin pulse is rapid, in a woman there are sores within the genitals and in a man qi strangury.

Junggyeong 仲景

1.4.2

Source원문

腎脈滑實, 爲癃㿉. 《仲景》

Translation영역

Where the kidney pulse is slippery and replete, there is retention and bulging.

Junggyeong 仲景

1.4.3

Source원문

遺精白濁, 當驗於尺. 結ㆍ芤ㆍ動ㆍ緊, 二證之的. 《脈訣》

Translation영역

For seminal emission and white turbidity, look to the cubit. Bound, hollow, stirred and tight are the marks of these two patterns.

Maekgyeol 脉訣

1.4.4

Source원문

便血則芤, 數則赤黃. 實脈癃閉, 熱在膀胱. 《脈訣》

Translation영역

Blood in the urine gives a hollow pulse; rapid means red and yellow urine. A replete pulse with retention means heat in the bladder.

Maekgyeol 脉訣

1.4.5

Source원문

兩尺脈洪數, 必便濁遺精. 《正傳》

Translation영역

Where both cubit pulses are surging and rapid, there will surely be turbid urine and seminal emission.

Jeongjeon 正傳

1.4.6

Source원문

淋脈盛大而實者生, 虛細而澁者死. 《脈經》

Translation영역

In strangury, a pulse exuberant, large and replete means life; empty, fine and rough means death.

Maekgyeong 脉經

1.4.7

Source원문

癃病脈細不治. 《綱目》

Translation영역

In retention, a fine pulse is not to be treated.

Gangmok 綱目

1.4.8

Source원문

淋病之脈, 細數何妨. 少陰微者, 氣閉膀胱. 女人見之, 陰中生瘡. 大實易愈, 虛澁則亡. 《醫鑑》

Translation영역

In strangury, what harm in a fine and rapid pulse? A faint lesser yin means the qi is shut in the bladder; seen in a woman, there are sores within the genitals. Large and replete heals easily; empty and rough is death.

Clinical note임상 주석

The rule the section keeps repeating: in a disease of blockage, a strong pulse is good news and a weak one is not. There is something to push against.

Uigam 醫鑑

1.5 The Outer Sign of Difficult Urination 小便難外候

1.5.1

Source원문

候其鼻頭色黃者, 小便必難. 《仲景》

Translation영역

Where the tip of the nose is yellow, urination will surely be difficult.

Junggyeong 仲景

1.5.2

Source원문

候其鼻準色黃者, 知其小便難也. 《正傳》

Translation영역

Where the bridge of the nose is yellow, one knows that urination is difficult.

Clinical note임상 주석

A yellow nose for a blocked bladder — the Large Intestine chapter's 10.4.1 read the same nose for the bowel. Where the yellow is jaundice, the association with dark scanty urine is real.

Jeongjeon 正傳

1.6 Urination That Does Not Pass Freely 小便不利

1.6.1

Source원문

陰虛則小便難. 《仲景》

Translation영역

Where the yin is vacuous, urination is difficult.

Junggyeong 仲景

1.6.2

Source원문

小便澁者, 血因火爍, 下焦無血, 氣不得降而渗泄之令不行也. 宜補陰降火, 四物湯方見血門加知母ㆍ黃栢. 《丹心》

Translation영역

Where the urine is rough, the blood has been scorched by fire; the lower burner has no blood, the qi cannot descend, and the order to seep and discharge is not carried out. Supplement the yin and downbear the fire: Four Substances Decoction formula in the Blood chapter with anemarrhena and phellodendron added.

Dansim 丹心

1.6.3

Source원문

下焦無血, 小便澁數而黃, 四物湯加知母ㆍ黃栢ㆍ牛膝ㆍ甘草梢. 《丹心》

Translation영역

Where the lower burner has no blood and the urine is rough, frequent and yellow, Four Substances Decoction with anemarrhena, phellodendron, achyranthes and licorice root tips added.

Dansim 丹心

1.6.4

Source원문

小便難者, 出不快也. 經曰, 陽入陰分則膀胱熱而小便難. 惟陰分虛而陽熱乘之. 若小便黃赤, 則萬全木通散利之. 《入門》

Translation영역

Difficult urination means it does not come out easily. The classic says: where yang enters the yin division, the bladder is hot and urination difficult — it is only that the yin division is vacuous and yang heat takes advantage of it. Where the urine is yellow-red, Ten Thousand Times Safe Akebia Powder frees it.

Immun 入門

1.6.5

Source원문

小便數而不利者有三. 若大便泄瀉而津液澁少者, 一也, 宜利而已. 若熱搏下焦, 津液不能行者, 二也, 必渗瀉乃愈. 若脾胃氣澁, 不能通調水道, 下輸膀胱而化者, 三也, 可順氣令施化而出, 宜茯苓琥珀散. 《綱目》

Translation영역

Frequent but unfree urination has three causes. Where the stool is loose and the fluids are scant — that is the first, and freeing alone suffices. Where heat strikes the lower burner and the fluids cannot move — that is the second, and only seeping and draining heals it. Where the spleen and stomach qi is rough and cannot regulate the waterways to send them down to the bladder for transformation — that is the third, and the qi may be made to flow so that transformation issues; Poria and Amber Powder is appropriate.

Clinical note임상 주석

Three causes for one symptom and a different treatment for each — loose stool, heat, and a stalled spleen. The third is 1.1.3's transformation failing, and the Gangmok treats it by moving qi rather than water.

Gangmok 綱目

1.6.6

Source원문

上盛下虛, 小便赤澁, 或欲成淋, 宜淸心蓮子飮方見消渴ㆍ導赤散方見五藏. 《得效》

Translation영역

Where there is exuberance above and vacuity below, with red rough urine that threatens to become strangury, Clear the Heart Lotus Seed Drink formula in the Wasting Thirst chapter and Guide Out the Red Powder formula in the Five Viscera chapter are appropriate.

Deukhyo 得效

1.6.7

Source원문

腎虛小便數而瀝, 如欲渗之快, 宜平補元. 《直指》

Translation영역

Where the kidney is vacuous and the urine frequent and dribbling, as if about to seep away at any moment, Level Supplementation Pill is appropriate.

Jikji 直指

1.6.8

Source원문

一方, 梔子ㆍ大黃ㆍ連翹ㆍ甘草各等分, 爲末, 每二錢, 空心以茅根煎湯調下.

Translation영역

Another formula: gardenia, rhubarb, forsythia and licorice in equal parts, powdered; take 2 don at a time on an empty stomach stirred into a decoction of imperata root.

Donguibogam · Sobyeon

1.7 Urine That Will Not Pass 小便不通

1.7.1

Source원문

胞移熱於膀胱, 則癃, 尿血. 《內經》

Translation영역

Where the 胞 moves heat to the bladder, there is retention and blood in the urine.

Naegyeong 內經

1.7.2

Source원문

膀胱不利爲癃. 《內經》八正散加木香主之. 《丹心》

Translation영역

Where the bladder does not pass freely there is retention. Eight Corrections Powder with costus added governs it.

Naegyeong 內經 · Dansim 丹心

1.7.3

Source원문

足厥陰之脈過陰器, 所生病遺尿閉癃. 督脈者, 女子入繫廷孔, 其孔溺孔之端也, 其生病癃痔遺尿. 足三焦者, 太陽之別也, 入絡膀胱, 約下焦, 實則癃閉, 虛則遺尿. 《綱目》

Translation영역

The foot reverting yin channel passes the genitals, and the diseases it engenders are enuresis and retention. The governing vessel, in a woman, enters and ties to the court orifice, which is the end of the urinary orifice, and the diseases it engenders are retention, piles and enuresis. The foot three burners is the greater yang's divergence; it enters and networks the bladder and binds the lower burner — where it is replete there is retention, where vacuous, enuresis.

Gangmok 綱目

1.7.4

Source원문

閉癃合而言之一病也, 分而言之有暴久之殊. 盖閉者暴病, 爲尿點滴不出, 俗呼小便不通是也. 癃者久病, 爲尿澁淋瀝點滴而出, 一日數十次或百次, 名爲淋病是也. 《綱目》熱在下焦, 塡塞不便, 其證小便閉塞而不渴, 時見躁者是也. 《元素》

Translation영역

Blockage and retention, spoken of together, are one disease; spoken of apart, they differ as sudden and long-standing. Blockage is the sudden disease, where not a drop of urine comes out — what is commonly called urine not passing. Retention is the long-standing disease, where the urine is rough and dribbles out drop by drop, tens or a hundred times a day, and is named strangury. Where heat is in the lower burner, filling and blocking so that nothing passes, the pattern is urine shut off without thirst, with restlessness seen at times.

Clinical note임상 주석

The distinction the whole chapter is built on. 閉 is acute retention — nothing at all — and 癃 is chronic dribbling, which is what the strangury sections treat. A modern clinic would separate them the same way and for the same reason.

Gangmok 綱目 · Wonso 元素

1.7.5

Source원문

小便不通有氣血之異. 如渴而小便不通者, 熱在上焦氣分, 宜淸肺散. 如不渴而小便不通者, 熱在下焦血分, 宜滋腎丸. 《東垣》

Translation영역

Urine not passing differs as qi and as blood. Where there is thirst and the urine does not pass, the heat is in the upper burner, at the qi level: Clear the Lung Powder is appropriate. Where there is no thirst and the urine does not pass, the heat is in the lower burner, at the blood level: Enrich the Kidney Pill is appropriate.

Clinical note임상 주석

One question — is the patient thirsty? — sorting retention into two diseases with two formulas. Dongwon's cleanest piece of triage, and the whole of 1.7 hangs on it.

Dongwon 東垣

1.7.6

Source원문

小便不通, 臍下狀如覆椀, 痛悶難堪. 治法有二. 如氣不能化而不通, 則陳皮ㆍ茯苓湯調木香ㆍ沈香末二錢, 空心服, 兼用吐法以提之. 如血汚於下而不通, 則用桃仁承氣湯之類方見寒門以破之. 《綱目》

Translation영역

Where the urine will not pass and below the navel there is a shape like an upturned bowl, with pain and oppression hard to bear, there are two methods of treatment. Where the qi cannot transform and so nothing passes, take a decoction of tangerine peel and poria with 2 don of powdered costus and aloeswood stirred in, on an empty stomach, and use the ejection method as well to lift the qi. Where blood is fouling below and so nothing passes, use Peach Kernel Order the Qi Decoction and its kind formula in the Cold Damage chapter to break it.

Clinical note임상 주석

臍下狀如覆椀 — below the navel a shape like an upturned bowl. A distended bladder palpable above the pubis, described exactly. It is the sign that tells acute retention from anything else, and any clinician would recognize it.

Gangmok 綱目

1.7.7

Source원문

夫熱則不通, 冷則不禁. 其熱盛者, 小便閉而絶無. 其熱微者, 小便難而僅有. 《直指》

Translation영역

Heat makes it not pass and cold makes it not be held. Where the heat is exuberant the urine is shut off and there is none at all; where the heat is slight, urination is difficult and there is barely any.

Jikji 直指

1.7.8

Source원문

小便不通, 乃血澁致氣不通而竅澁, 宜導氣除燥湯. 《東垣》

Translation영역

Urine not passing is the blood grown rough so that the qi does not move and the orifice is rough; Guide the Qi and Remove Dryness Decoction is appropriate.

Dongwon 東垣

1.7.9

Source원문

小便不通, 宜五苓散方見傷寒ㆍ導赤元ㆍ地膚子湯ㆍ宣氣散ㆍ通關丸ㆍ猪苓湯ㆍ加味五苓散ㆍ透泉散.

Translation영역

For urine that will not pass: Five Poria Powder formula in the Cold Damage chapter, Guide Out the Red Pill, Kochia Seed Decoction, Diffuse the Qi Powder, Open the Gate Pill, Polyporus Decoction, Supplemented Five Poria Powder and Penetrate the Spring Powder.

Donguibogam · Sobyeon

1.7.10

Source원문

老人氣虛, 小便不通, 四物湯加黃芪ㆍ人參, 呑下滋腎丸. 《正傳》

Translation영역

For an old person with qi vacuity whose urine will not pass, Four Substances Decoction with astragalus and ginseng added, used to swallow Enrich the Kidney Pill.

Jeongjeon 正傳

1.7.11

Source원문

老人虛人小便不通, 琥珀末, 以人參ㆍ赤茯苓煎湯調, 空心服. 《丹心》

Translation영역

For the old and the vacuous whose urine will not pass: powdered amber, stirred into a decoction of ginseng and red poria and taken on an empty stomach.

Dansim 丹心

1.7.12

Source원문

一人病小便不通, 諸藥無效. 丹溪曰, 此積痰病也. 積痰在肺, 肺爲上焦而膀胱爲下焦, 上焦閉則下焦塞, 比如滴水之器, 必上竅通而後下竅之水出焉. 乃以二陳湯先飮, 大吐之, 病如失. 《丹溪》

Translation영역

A man could not pass urine and no medicine worked. Danxi said: this is a disease of accumulated phlegm. The accumulated phlegm is in the lung; the lung is the upper burner and the bladder the lower, and when the upper is shut the lower is blocked — as with a dripping vessel, the upper hole must be open before the water runs from the lower. So he gave Two Matured Ingredients Decoction first and made him vomit greatly, and the disease vanished.

Clinical note임상 주석

滴水之器 — a dripping vessel, which will not pour until its upper hole is unstopped. The image that made the ejection method respectable for retention, and it is a fair piece of physics. 提壺揭蓋, lifting the lid off the pot, is the later name for it.

Danggye 丹溪

1.7.13

Source원문

痰多阻滯, 水道不通, 二陳湯加香附子ㆍ木香ㆍ木通煎之, 先服一盞, 以餘渣探喉中吐之, 以提其氣. 氣升則水自降.

Translation영역

Where much phlegm obstructs and the waterways do not pass, decoct Two Matured Ingredients Decoction with cyperus, costus and akebia added; drink a jan first, then with the remaining dregs probe the throat to induce vomiting, so as to lift the qi. When the qi rises the water descends of itself.

Donguibogam · Sobyeon

1.7.14

Source원문

實熱不通, 砂糖水調黑牽牛末一二錢服, 探吐之. 《入門》

Translation영역

Where repletion heat blocks it, take 1 or 2 don of powdered black morning-glory seed stirred into sugar water and probe the throat to vomit.

Immun 入門

1.7.15

Source원문

水道不行, 其本在腎, 合用牽牛ㆍ澤瀉. 其末在肺, 合用葶藶ㆍ桑白皮. 更以木通ㆍ滑石佐之, 又能透達. 雖然大便小便脈絡相貫, 人有多日小便不通, 但用神保元方見氣門微大瀉數行, 小便自通. 《直指》

Translation영역

Where the waterways do not move, the root is in the kidney and morning-glory seed and alisma should be used; the branch is in the lung and lepidium and mulberry root bark should be used, with akebia and talc as assistants, which can also penetrate through. Yet stool and urine are connected by their vessels: where a person has not passed urine for many days, simply use Spirit Protecting Pill formula in the Qi chapter to purge somewhat and let the bowel move a few times, and the urine passes of itself.

Clinical note임상 주석

The rule Dojeok-won is built on: open the bowel and the bladder follows. It is sound — a loaded rectum does obstruct the bladder neck — and it gave the tradition a way through when nothing else worked.

Jikji 直指

1.7.16

Source원문

實熱尿閉, 宜用導水丸ㆍ三花神祐丸幷見下門.

Translation영역

For repletion heat with urine shut off, Guide the Water Pill and Three Flowers Divine Protection Pill both in the Purgation chapter should be used.

Donguibogam · Sobyeon

1.8 The Pattern of the Twisted Bladder 轉脬證

1.8.1

Source원문

轉脬證候, 臍下急痛, 小便不通. 凡强忍小便, 或尿急疾走, 或飽食忍尿, 或飽食走馬, 或忍尿入房, 使水氣上逆, 氣迫於脬, 故屈戾而不得舒張也. 脬落卽死. 《直指》

Translation영역

In the pattern of the twisted bladder there is urgent pain below the navel and the urine will not pass. It comes of forcibly holding the urine, or running hard when the need is urgent, or holding the urine after a full meal, or riding a horse after a full meal, or going in to a woman while holding the urine — so that the water qi counterflows upward and the qi presses on the bladder, which is therefore bent awry and cannot stretch out. If the bladder drops, death.

Clinical note임상 주석

Five ways to twist a bladder, and four of them are holding urine while the body is jolted. Acute retention does follow a held bladder and a hard ride, and the Jikji's list is a list of real precipitants.

Jikji 直指

1.8.2

Source원문

轉脬證候, 孕婦多有之. 患在忍縮小便, 或醉飽入房, 使小腸之氣逆而不通, 大腸之氣與之俱滯, 外水不得入膀胱, 內水不得出膀胱, 淋瀝急數, 每欲尿時痛不可言. 大便亦裏急頻倂, 似痢非痢, 必以手按臍下, 庶可立出小便. 甚者因此腹脹浮腫. 治法用凉藥疎利小腸中熱, 仍與通泄大腸, 俟其腹中攪痛, 大便大下, 則尿脬隨卽歸正, 小便自然順流. 《直指》

Translation영역

The twisted bladder is commonest in pregnant women. The trouble lies in holding and contracting the urine, or going in to a woman drunk and full, so that the small intestine's qi counterflows and does not pass and the large intestine's qi stagnates with it; outside water cannot enter the bladder and inside water cannot leave it. There is dribbling, urgency and frequency, and at every attempt to urinate the pain is beyond words. The stool too is urgent within and repeatedly attempted, like dysentery and not dysentery; one must press below the navel with the hand for the urine to come out at all. At worst the abdomen distends and swells. The method of treatment is to use cooling medicines to free the heat in the small intestine and then to open and drain the large intestine; wait for a griping pain in the belly and a great movement of the bowel, and the bladder returns to true of itself and the urine flows freely.

Jikji 直指

1.8.3

Source원문

胎婦轉脬之病, 稟受弱者, 憂悶多者, 性急躁者, 食味厚者, 大率有之. 古方用滑利疎導藥, 鮮有應效. 因思脬爲胎所壓, 展在一邊, 脬系了戾不通爾. 胎若擧起懸在中央, 脬系得舒, 水道自行. 一婦患此, 診之兩手似澁, 重取則弦. 此得之憂患. 澁爲血少氣多, 弦爲有飮. 遂以四物湯加參ㆍ朮ㆍ半夏ㆍ陳皮ㆍ甘草ㆍ生薑, 空心煎服, 隨以指探喉中, 吐出藥汁. 候少頃又與一貼, 次早亦然. 如是與八貼而安. 此法恐偶中, 後歷用數人皆驗. 《丹溪》

Translation영역

The twisted bladder in pregnancy is found mostly in those weak from birth, those much given to worry and oppression, those hasty and irritable in nature, and those who eat rich flavours. The old formulas use slippery, freeing and guiding medicines, and these seldom answer. Reflecting on it: the bladder is pressed by the fetus and spread to one side, and the bladder's cord is twisted awry and does not pass. If the fetus is lifted up and hung in the centre, the bladder's cord can stretch and the waterway runs of itself. A woman suffered this; on examination both hands seemed rough, and pressed hard they were stringlike. This she had got from worry: rough means little blood and much qi, stringlike means there is rheum. So I gave Four Substances Decoction with ginseng, atractylodes, pinellia, tangerine peel, licorice and fresh ginger added, decocted and taken on an empty stomach, and immediately probed her throat with a finger so that she vomited the medicine up. After a little while another packet, and the same again next morning. Eight packets in this way and she was well. I feared this method had succeeded by chance, but I have since used it on several people and it has answered every time.

Clinical note임상 주석

Danxi reasoning out the mechanism — a gravid uterus pressing the bladder flat and kinking its outlet — and then treating it by making the patient vomit, to lift the whole mass. He says outright that he suspected luck and tested it again. The anatomical insight is correct: retention in late pregnancy is caused by exactly this.

Danggye 丹溪

1.8.4

Source원문

轉脬, 宜二石散加木通ㆍ車前子等分煎服, 仍施陰陽熨法. 《入門》

Translation영역

For the twisted bladder, Two Stones Powder with akebia and plantain seed in equal parts added, decocted and taken; and apply the yin-and-yang ironing method.

Immun 入門

1.8.5

Source원문

轉脬, 用蒲黃散ㆍ滑石散ㆍ葱白湯.

Translation영역

For the twisted bladder, use Cattail Pollen Powder, Talc Powder and Scallion White Decoction.

Donguibogam · Sobyeon

1.8.6

Source원문

老人脬轉困篤欲死, 六味地黃丸倍澤瀉服之, 效方見虛勞.

Translation영역

For an old person whose twisted bladder has brought them to the point of death, Six Flavours Rehmannia Pill with the alisma doubled is effective formula in the Vacuity Taxation chapter.

Donguibogam · Sobyeon

1.8.7

Source원문

孕婦脬轉, 宜參朮飮.

Translation영역

For a pregnant woman's twisted bladder, Ginseng and Atractylodes Drink is appropriate.

Donguibogam · Sobyeon

1.8.8

Source원문

一方, 葵子ㆍ梔子(炒)ㆍ滑石各五錢, 木通三錢. 右剉, 作一貼, 水煎空心服. 外以葵子ㆍ梔子ㆍ滑石爲細末, 入田螺肉搗膏, 或生葱汁調, 貼臍中, 立通. 《正傳》

Translation영역

Another formula: mallow seed, gardenia (stir-fried) and talc 5 don each, akebia 3 don. Cut up, make one packet, decoct in water and take on an empty stomach. Outwardly, powder mallow seed, gardenia and talc finely, pound with the flesh of a pond snail into a paste, or mix with fresh scallion juice, and stick it on the navel — it opens at once.

Jeongjeon 正傳

1.8.9

Source원문

一孕婦九月轉脬, 尿閉脚腫, 形瘦, 脈左稍和而右澁. 此必飽食氣傷, 胎系弱不能自擧而下壓膀胱, 故閉而不通. 以人參ㆍ白朮ㆍ當歸ㆍ芍藥ㆍ陳皮ㆍ半夏ㆍ甘草煎服四貼, 次早煎査頓服, 探吐, 小便大通, 皆黑水. 《丹溪》

Translation영역

A woman nine months pregnant had a twisted bladder, urine shut off and legs swollen, her body thin, her left pulse fairly harmonious and her right rough. This must be qi damaged by eating to fullness, with the fetus's cord weak so that it could not lift itself and pressed down on the bladder, shutting it. Four packets of ginseng, white atractylodes, angelica, peony, tangerine peel, pinellia and licorice were decocted and taken; next morning the dregs were decocted and taken at a draught and vomiting induced, and the urine passed greatly — all of it black water.

Danggye 丹溪

1.8.10

Source원문

一孕婦轉脬, 脈細氣弱, 胎壓膀胱下口. 用補藥恐加急滿, 令産婆以香油抹手, 入産門托起其胎, 尿出如注. 《丹溪》

Translation영역

A pregnant woman had a twisted bladder, her pulse fine and her qi weak, the fetus pressing on the bladder's lower mouth. Fearing that supplementing medicines would add to the urgency and fullness, he had the midwife oil her hand with sesame oil, enter the birth passage and lift the fetus up — and the urine came out in a stream.

Clinical note임상 주석

Manual reduction of a retroverted gravid uterus. It is still the treatment, and it still works the same way and as fast. Danxi's reason for choosing it over medicine — that a supplementing formula would make a full bladder fuller — is sound clinical judgement.

Danggye 丹溪

1.8.11

Source원문

又法, 將孕婦倒竪起, 胎自墜轉, 其尿注出, 勝於手托. 《丹溪》

Translation영역

Another method: stand the pregnant woman upside down, and the fetus falls back of itself and turns, and the urine pours out — better than lifting with the hand.

Clinical note임상 주석

Inverting the patient so gravity frees the uterus off the bladder neck. The knee-chest position does the same thing and is still described in obstetric texts for the same indication.

Danggye 丹溪

1.9 The Pattern of Block and Repulsion 關格證

1.9.1

Source원문

邪在六腑則陽脈不和, 陽脈不和則氣留之, 氣留之則陽脈盛矣. 邪在五藏則陰脈不和, 陰脈不和則血留之, 血留之則陰脈盛矣. 陰氣太盛則陽氣不得相營, 故曰格. 陽氣太盛則陰氣不得相營, 故曰關. 陰陽俱盛, 不得相營, 故曰關格. 關格者, 不得盡其命而死矣. 《靈樞》

Translation영역

Where evil is in the six bowels the yang vessels are not harmonious; not harmonious, the qi lodges in them; lodging, the yang vessels are exuberant. Where evil is in the five viscera the yin vessels are not harmonious; not harmonious, the blood lodges in them; lodging, the yin vessels are exuberant. Where the yin qi is too exuberant the yang qi cannot circulate with it — this is called repulsion. Where the yang qi is too exuberant the yin qi cannot circulate with it — this is called block. Where yin and yang are both exuberant and cannot circulate with each other, it is called block and repulsion; and one with block and repulsion cannot live out their allotted life.

Yeongchu 靈樞

1.9.2

Source원문

關則不得小便, 格則吐逆. 關者, 甚熱之氣. 格者, 甚寒之氣. 無出曰關, 無入曰格. 寒在胸中, 遏絶不入. 熱在下焦, 塡塞不便. 《潔古》

Translation영역

Block means the urine does not come; repulsion means retching and vomiting. Block is the qi of extreme heat, repulsion the qi of extreme cold. Nothing going out is block, nothing going in is repulsion. Cold in the chest bars and cuts off what would enter; heat in the lower burner fills and blocks so that nothing passes.

Gyeolgo 潔古

1.9.3

Source원문

陰陽易位, 病名關格. 寒在胸中, 水漿不下, 故曰格. 熱在丹田, 小便不通, 故曰關. 《雲岐》

Translation영역

Where yin and yang change places, the disease is named block and repulsion. Cold in the chest, so that water and gruel will not go down, is repulsion; heat in the cinnabar field, so that the urine will not pass, is block.

Ungi 雲岐

1.9.4

Source원문

關者不得小便, 格者吐逆, 上下俱病也. 《綱目》

Translation영역

Block is the urine not coming, repulsion is retching and vomiting: above and below are both diseased.

Gangmok 綱目

1.9.5

Source원문

內經曰, 人迎脈大於氣口四倍, 名曰格. 氣口脈大於人迎四倍, 名曰關.

Translation영역

The Neijing says: where the Inyeong pulse is four times the size of the Gigu, it is called repulsion; where the Gigu is four times the Inyeong, it is called block.

Naegyeong 內經

1.9.6

Source원문

兩寸俱盛曰關格. 其證嘔逆而小便不通者是也. 《正傳》

Translation영역

Where both inch pulses are exuberant, it is block and repulsion; the pattern is retching with the urine not passing.

Jeongjeon 正傳

1.9.7

Source원문

此證多死, 寒在上熱在下故也. 《丹心》

Translation영역

This pattern is mostly fatal, because the cold is above and the heat below.

Dansim 丹心

1.9.8

Source원문

大小便不通, 亦謂之陰陽關格, 乃三焦約之病也. 凡大小便不通, 內經謂之三焦約. 約者, 不行也. 長流水煎八正散服之. 《類聚》

Translation영역

Where neither stool nor urine passes, this too is called yin-yang block and repulsion, and is the disease of the three burners constricted. Whenever neither stool nor urine passes, the Neijing calls it the three burners constricted; constricted means not moving. Decoct Eight Corrections Powder in long-flowing water and take it.

Yuchwi 類聚

1.9.9

Source원문

關格者, 謂膈中覺有所碍, 欲升不升, 欲降不降, 欲食不食. 此謂氣之橫格也. 《醫鑑》

Translation영역

Block and repulsion means feeling something obstructing in the diaphragm: wanting to rise and not rising, wanting to descend and not descending, wanting to eat and not eating. This is called the qi barring across.

Uigam 醫鑑

1.9.10

Source원문

關格, 宜芒硝湯ㆍ大承氣湯方見寒門. 中虛者, 補中益氣湯加檳榔以升降之. 痰格者, 枳縮二陳湯.

Translation영역

For block and repulsion, Mirabilite Decoction and Major Order the Qi Decoction formula in the Cold Damage chapter are appropriate. Where the centre is vacuous, Supplement the Centre and Boost the Qi Decoction with areca added, to raise and lower it. Where phlegm is the barrier, Bitter Orange and Amomum Two Matured Ingredients Decoction.

Donguibogam · Sobyeon

1.9.11

Source원문

陰陽關格, 前後不通, 大便快利則小水自行. 《鉤玄》

Translation영역

In yin-yang block and repulsion, where neither front nor back passes, once the stool moves freely the urine runs of itself.

Guhyeon 鉤玄

1.9.12

Source원문

關格死在朝夕, 但治下焦可愈, 宜大承氣湯方見寒門. 《入門》

Translation영역

In block and repulsion death is a matter of morning or evening, but treating the lower burner can heal it; Major Order the Qi Decoction is appropriate.

Immun 入門

1.9.13

Source원문

一婦人忽吐逆, 大小便不通, 煩亂, 四肢漸冷, 無脈. 與大承氣湯一劑, 至夜半漸得大便通, 脈漸和, 翌日乃安. 此關格之病極爲難治, 垂死而活, 只此一人耳. 《孫兆》

Translation영역

A woman suddenly began retching, neither stool nor urine passed, she was vexed and disordered, her four limbs grew cold by degrees and there was no pulse. One dose of Major Order the Qi Decoction was given; by midnight the stool gradually passed, the pulse gradually harmonized, and the next day she was well. Block and repulsion is extremely hard to treat; of those at the point of death, this is the only one I have brought back.

Clinical note임상 주석

垂死而活, 只此一人耳 — of those at the point of death, this one only. Sun Zhao recording a single success and admitting it was a single success. The honesty is what makes the case worth keeping.

Sonjo 孫兆

1.9.14

Source원문

關格忌用淡渗利小便之藥. 《入門》

Translation영역

In block and repulsion, bland seeping medicines that free the urine are to be avoided.

Immun 入門

1.9.15

Source원문

一小兒小溲不通, 號跳旋轉, 下則成砂石, 大便秘, 肛門脫出一二寸. 戴人曰, 此下焦塞也. 不吐不下則下焦何以開. 不令飮水則小溲何以利. 以調胃承氣湯一兩加牽牛子頭末三錢, 河水煎服, 又用瓜蒂末糊丸芥子許六十丸呑下. 上吐下瀉一時齊出, 有膿有血. 涌泄旣定, 令飮新水二三十次, 每次飮一盞, 其病如失. 《子和》

Translation영역

A child could not pass urine, crying and leaping and turning about; what came down was sand and gravel, the stool was bound, and the anus prolapsed an inch or two. Zhang Zihe said: this is the lower burner blocked. Without vomiting and purging, how is the lower burner to be opened? Without letting him drink water, how is the urine to be freed? He gave a nyang of Regulate the Stomach and Order the Qi Decoction with 3 don of the first sifting of morning-glory seed added, decocted in river water; and pills of powdered melon pedicel the size of mustard seeds, sixty of them, to swallow. Vomiting above and purging below came at once together, with pus and blood. When the welling and draining had settled, he had the child drink fresh water twenty or thirty times, a jan at a time — and the disease vanished.

Jahwa 子和

1.10 Washing and Ironing Methods 洗熨法

1.10.1

Source원문

治脬轉小便不通. 生薑ㆍ葱白ㆍ紫蘇葉各一握, 煎湯, 密室內熏洗小腹ㆍ外腎ㆍ肛門等處, 再溫再洗, 拭乾, 於綿被仰坐垂脚, 自舒其氣. 次用赤茯苓ㆍ赤芍藥ㆍ白芍藥各五錢, 蜀葵子二錢半. 右剉一兩, 煎水調蘇合香元方見氣門三丸, 幷靑鹽末半錢, 空心溫服, 卽效. 《得效》

Translation영역

To treat the twisted bladder with urine not passing: fresh ginger, scallion white and perilla leaf a handful each, decocted; in a closed room steam and wash the lower abdomen, the genitals and the anus, warm it again and wash again, wipe dry, and sit back on a padded quilt with the legs hanging down, letting the qi stretch out of itself. Then red poria, red peony and white peony 5 don each and hollyhock seed 2 don 5 pun; cut 1 nyang, decoct in water and stir in three pills of Storax Pill formula in the Qi chapter with half a don of powdered blue salt, and take warm on an empty stomach — effective at once.

Deukhyo 得效

1.10.2

Source원문

小便難, 小腹脹, 不急治殺人. 葱白三斤, 細剉炒熱, 以帕子包, 分兩裹更替熨臍下, 卽通. 《得效》

Translation영역

Where urination is difficult and the lower abdomen distended, failing to treat it quickly kills. Scallion white 3 geun, finely cut and fried hot, wrapped in a cloth and divided into two bundles used in turn to iron below the navel — and it passes.

Deukhyo 得效

1.10.3

Source원문

又炒鹽半斤囊盛, 熨臍下, 亦通. 《得效》

Translation영역

Or half a geun of fried salt in a bag, ironed below the navel, also opens it.

Deukhyo 得效

1.10.4

Source원문

産後小便不通, 腹脹如鼓, 悶亂不省. 此由産時尿脬運動不順. 用鹽塡臍中, 葱白十餘根細切厚鋪鹽上, 用大艾炷灸之, 覺熱氣直入於腹內卽通, 神驗. 《得效》

Translation영역

After childbirth the urine will not pass, the belly is distended like a drum, and the woman is oppressed, disordered and unaware. This comes of the bladder having moved out of true during delivery. Pack salt into the navel, cut ten or more scallion whites fine and lay them thickly on the salt, and burn a large moxa cone on it; when the heat is felt going straight into the belly it passes — proven divinely.

Clinical note임상 주석

Moxa on salt and scallion at the navel for postpartum retention — the Body chapter's navel methods put to an emergency. The heat felt travelling inward is what the practitioner waits for, and postpartum retention is common enough that the technique got a great deal of use.

Deukhyo 得效

1.11 Covering the Navel 掩臍法

1.11.1

Source원문

小便閉, 大田螺生搗細, 封臍上, 卽通. 《綱目》

Translation영역

Where the urine is shut off, pound a large live pond snail fine and seal it on the navel — it passes at once.

Gangmok 綱目

1.11.2

Source원문

治小便不通. 麝香ㆍ半夏末塡臍中, 上用葱白ㆍ田螺二味搗成餠, 封臍上, 用布線縛定. 下用皂角烟入陰中, 自通. 女人用皂角煎湯洗陰戶內. 《回春》

Translation영역

To treat urine that will not pass: pack powdered musk and pinellia into the navel, pound scallion white and pond snail into a cake and seal it over, and bind it fast with cloth and thread. Below, let the smoke of gleditsia enter the genitals, and it passes of itself; for a woman, wash within the vulva with a gleditsia decoction.

Hoechun 回春

1.11.3

Source원문

治小便不通通臍法. 以白磁甁滿盛水, 以有字紙七重密封甁口, 於患人臍內用鹽一捻塡之, 倒置甁口覆在臍上, 偃臥. 如覺冷, 小便卽通. 《類聚》

Translation영역

The navel-opening method for urine that will not pass: fill a white porcelain bottle with water, seal its mouth tightly with seven layers of written paper, pack a pinch of salt into the patient's navel, invert the bottle so its mouth covers the navel, and have them lie on their back. When the cold is felt, the urine passes.

Clinical note임상 주석

A cold, wet weight on the belly. The chapter offers heat at 1.10 and cold here for the same complaint, which suggests the active thing is the stimulus rather than the temperature — and a cold shock to the lower abdomen does provoke voiding.

Yuchwi 類聚

1.11.4

Source원문

治小便癃閉不通, 宜貼臍膏方見大便ㆍ通關散.

Translation영역

To treat retention with the urine not passing, Navel Plaster formula in the Stool chapter and Open the Gate Powder are appropriate.

Donguibogam · Sobyeon

1.12 Hard to Treat and Untreatable Signs 難治不治證

1.12.1

Source원문

嘔噦而小便不通者難治. 中滿鼓脹病小便不通者亦難治. 《回春》

Translation영역

Retching with the urine not passing is hard to treat; drum distension with fullness of the centre and the urine not passing is likewise hard to treat.

Hoechun 回春

1.12.2

Source원문

老人氣虛一作短, 小便不通, 爲下焦血氣乾者死. 《正傳》

Translation영역

In an old person with qi vacuity one version says shortness of qi whose urine does not pass, where the blood and qi of the lower burner have dried, death.

Jeongjeon 正傳

1.12.3

Source원문

關格不通, 不得尿, 頭無汗者可治, 有汗者死. 《仲景》

Translation영역

In block and repulsion with nothing passing and no urine, where there is no sweat on the head it can be treated; where there is sweat, death.

Junggyeong 仲景

1.12.4

Source원문

頭汗, 內外關格, 小便不通, 此爲陽脫, 不治. 《得效》

Translation영역

Sweat on the head with block and repulsion within and without, and the urine not passing — this is the yang deserting, and it is not to be treated.

Deukhyo 得效

1.12.5

Source원문

凡關格見頭汗者死. 《入門》

Translation영역

In block and repulsion, whoever shows sweat on the head dies.

Clinical note임상 주석

Head sweat in a patient who cannot pass urine or keep food down. The Fluids chapter's 5.7 made head sweat a yang sign; here it marks the end, and in uraemia a clammy forehead with vomiting and anuria is exactly the terminal picture.

Immun 入門

1.12.6

Source원문

傷寒熱病及風溫, 狂言直視遺尿者死. 《入門》

Translation영역

In cold damage, heat disease and wind warmth, where there is wild speech, a fixed stare and wetting, death.

Immun 入門

1.13 Urine That Cannot Be Held 小便不禁

1.13.1

Source원문

遺尿者, 尿出不自知覺也. 《綱目》

Translation영역

Enuresis is urine coming out without one's knowing it.

Gangmok 綱目

1.13.2

Source원문

膀胱不約爲遺尿. 《內經》

Translation영역

Where the bladder does not bind, there is enuresis.

Naegyeong 內經

1.13.3

Source원문

水泉不止者, 是膀胱不藏也. 註曰, 水泉者, 前陰之流注也. 《內經》

Translation영역

Where the water spring does not stop, the bladder is not storing. The commentary says: the water spring is what flows from the front yin.

Naegyeong 內經

1.13.4

Source원문

腎與膀胱俱虛, 內氣不充, 故脬中自滑, 所出多而色白焉. 是以遇夜而陰盛愈多. 《直指》

Translation영역

Where kidney and bladder are both vacuous and the inner qi does not fill them, the bladder is slippery of itself, so that much comes out and it is white in colour; and so at night, when the yin is exuberant, there is more of it.

Jikji 直指

1.13.5

Source원문

下焦蓄血與虛勞內損, 則便尿自遺而不知. 《直指》

Translation영역

Where blood is amassed in the lower burner, or in vacuity taxation with internal detriment, the urine passes of itself without one's knowing.

Jikji 直指

1.13.6

Source원문

下焦虛寒, 不能溫制水液, 則便尿欲出而不禁. 《直指》

Translation영역

Where the lower burner is vacuous and cold and cannot warm and control the fluids, the urine wants to come out and cannot be held.

Jikji 直指

1.13.7

Source원문

肺氣虛則尿色變, 卒遺失無度. 《甲乙》

Translation영역

Where the lung qi is vacuous the colour of the urine changes, and it is suddenly lost without measure.

Gabeulgyeong 甲乙經

1.13.8

Source원문

內經曰, 水之本在腎, 其末在肺, 則知天一之水自上而下相爲貫通也. 《直指》

Translation영역

The Neijing says: water's root is in the kidney and its branch in the lung — whence one knows that the water of heaven's one runs through from above to below as one.

Jikji 直指

1.13.9

Source원문

經曰, 下虛則遺尿. 下虛謂膀胱下焦虛也. 仲景曰, 下焦竭則遺尿失便, 其氣虛不能自禁制也. 又云, 下焦不歸則遺溲. 世用桑螵蛸ㆍ鷄肫真之類是也. 《綱目》

Translation영역

The classic says: where below is vacuous there is enuresis — below meaning the bladder and lower burner. Zhongjing says: where the lower burner is exhausted there is enuresis and loss of stool, the qi being too vacuous to restrain itself. It also says: where the lower burner does not return, there is wetting. What the world uses is mantis egg-case, chicken gizzard lining and their kind.

Gangmok 綱目

1.13.10

Source원문

小便遺失者, 肺氣虛也. 宜安臥養氣, 禁勞役, 以參芪補之. 不愈則當責有熱, 用黃栢ㆍ生地黃. 《綱目》

Translation영역

Loss of urine is lung qi vacuity. Lie quietly and nourish the qi, avoid labour, and supplement with ginseng and astragalus. If it does not heal, look for heat and use phellodendron and fresh rehmannia.

Gangmok 綱目

1.13.11

Source원문

小便不禁, 色赤爲熱, 色白爲虛. 《入門》

Translation영역

In incontinence, red urine means heat and white means vacuity.

Immun 入門

1.13.12

Source원문

小便無度, 或淋瀝不禁, 乃陰挺痿痺也. 六味地黃丸方見虛勞去澤瀉, 加益智仁. 《回春》

Translation영역

Urine without measure, or dribbling that cannot be held, is the yin stalk wilted and numb. Six Flavours Rehmannia Pill formula in the Vacuity Taxation chapter with the alisma removed and alpinia added.

Hoechun 回春

1.13.13

Source원문

小便不禁, 屬熱屬虛. 熱者, 五苓散合解毒湯方見火門. 寒虛者, 五苓散合四物湯方見血門加山茱萸ㆍ五味子. 《丹心》

Translation영역

Incontinence belongs to heat or to vacuity. For heat, Five Poria Powder combined with Resolve Toxin Decoction formula in the Fire chapter; for cold vacuity, Five Poria Powder combined with Four Substances Decoction formula in the Blood chapter with cornus and schisandra added.

Dansim 丹心

1.13.14

Source원문

下虛內損而不禁, 宜補膀胱陰血, 瀉火邪爲主. 加減八味丸ㆍ六味地黃元加知母ㆍ黃栢ㆍ五味子, 補陰丸最妙方見火門.

Translation영역

Where there is vacuity below with internal detriment and the urine is not held, supplement the bladder's yin blood and drain the fire evil as the main thing. Modified Eight Ingredients Pill, and Six Flavours Rehmannia Pill with anemarrhena, phellodendron and schisandra added; Supplement the Yin Pill formula in the Fire chapter is best of all.

Donguibogam · Sobyeon

1.13.15

Source원문

虛冷不禁, 遇夜愈多, 宜縮泉元ㆍ秘元丹. 老人虛人, 宜五子元ㆍ家韭子元ㆍ參芪湯. 産後遺尿, 宜補脬飮ㆍ猪脬湯. 小兒遺尿, 宜鷄腸散ㆍ鷄肫真散. 通用大兎絲子元ㆍ茸香元ㆍ旣濟丸.

Translation영역

For vacuity cold with the urine not held, worse at night: Contract the Spring Pill and Secret Origin Elixir. For the old and the vacuous: Five Seeds Pill, Garden Leek Seed Pill and Ginseng and Astragalus Decoction. For enuresis after childbirth: Mend the Bladder Drink and Pig's Bladder Decoction. For a child's enuresis: Chicken Intestine Powder and Chicken Gizzard Lining Powder. For general use: Major Cuscuta Pill, Antler Velvet and Frankincense Pill and Already Crossed Pill.

Donguibogam · Sobyeon

1.13.16

Source원문

傷寒遺尿ㆍ中暑遺尿幷見各門.

Translation영역

Enuresis in cold damage and in summerheat stroke each in its own chapter.

Donguibogam · Sobyeon

1.14 The Patterns of Strangury 諸淋證

1.14.1

Source원문

淋之爲病, 小便如粟狀, 小腹弦急, 痛引臍中. 《仲景》

Translation영역

In strangury the urine is like grains of millet, the lower abdomen is taut and urgent, and the pain draws into the navel.

Junggyeong 仲景

1.14.2

Source원문

諸淋所發, 皆腎虛而膀胱有熱也. 心腎氣鬱, 蓄在下焦, 故膀胱裏急, 膏血砂石從小便道出焉. 於是有欲出不出, 淋瀝不斷之狀. 甚者窒塞其間, 則令人悶絶矣. 《直指》

Translation영역

All the stranguries arise from kidney vacuity with heat in the bladder. The heart and kidney qi is depressed and gathers in the lower burner, so the bladder is urgent within, and grease, blood, sand or stone come out by the urinary passage. Hence the state of wanting to come out and not coming out, dribbling without cease; and at worst it stops up the passage and makes a person faint away.

Jikji 直指

1.14.3

Source원문

大凡小腸有氣則小便脹, 小腸有血則小便澁, 小腸有熱則小便痛. 痛者爲血淋, 不痛者爲尿血. 敗精結者爲砂, 精結散者爲膏, 金石結者爲石. 《直指》

Translation영역

In general, where the small intestine has qi the urine distends; where it has blood the urine is rough; where it has heat the urine pains. With pain it is blood strangury; without pain it is blood in the urine. Spoiled essence binding makes sand; essence binding and scattering makes grease; metal and stone binding makes stone.

Clinical note임상 주석

痛者爲血淋, 不痛者爲尿血 — painful is blood strangury, painless is blood in the urine. The Blood chapter has the painless kind; this chapter has the painful. Painless haematuria is still the sign that sends a patient for imaging rather than antibiotics, and the tradition separated the two on the same observation.

Jikji 直指

1.14.4

Source원문

最不可用補藥. 氣得補而愈脹, 血得補而愈澁, 熱得補而愈盛, 水道不行, 加之穀道閉遏, 未見其能生者也. 《直指》

Translation영역

Supplementing medicines are above all not to be used. Qi supplemented distends the more, blood supplemented grows rougher, heat supplemented grows more exuberant; the waterway does not move and the grain passage is barred as well — I have not seen such a one live.

Jikji 直指

1.14.5

Source원문

淋者, 小便淋瀝澁痛, 欲去不去, 去而又來, 曰淋. 《醫鑑》

Translation영역

Strangury is urine that dribbles, is rough and painful, wants to go and will not go, goes and comes again — this is called strangury.

Uigam 醫鑑

1.14.6

Source원문

淋皆屬熱, 間有冷者, 由心腎氣鬱, 小腸膀胱不利, 或忿怒房勞忍尿, 酒肉濕熱下流, 干於肝經挺孔鬱結. 初則熱淋血淋, 久則火爍爲砂石淋, 如湯罐煎久而生鹻. 《入門》

Translation영역

The stranguries all belong to heat, with a cold one now and then. They come of the heart and kidney qi being depressed and the small intestine and bladder not passing freely, or of rage, sexual taxation and holding the urine, or of the damp heat of wine and meat flowing down to offend the liver channel and bind at the urinary orifice. At first it is heat strangury and blood strangury; after long it is scorched by fire into sand and stone strangury — as a kettle long boiled grows a scale.

Clinical note임상 주석

如湯罐煎久而生鹻 — like the limescale that forms in a kettle boiled long enough. The tradition's model for how a stone forms in the bladder, and as an image of solutes precipitating out of a concentrated fluid it is essentially right.

Immun 入門

1.14.7

Source원문

腎虛極而淋者, 當補腎精而利小便, 不可獨用利水藥. 《正傳》

Translation영역

Where the strangury comes of extreme kidney vacuity, supplement the kidney essence and free the urine; water-freeing medicines must not be used alone.

Jeongjeon 正傳

1.14.8

Source원문

五淋者, 膀胱蓄熱也. 《回春》

Translation영역

The five stranguries are heat amassed in the bladder.

Hoechun 回春

1.14.9

Source원문

淋而小腹脹滿甚者, 宜瀉腎湯. 《入門》

Translation영역

Where in strangury the lower abdomen is severely distended and full, Drain the Kidney Decoction is appropriate.

Immun 入門

1.14.10

Source원문

諸淋皆屬于熱, 雖有冷淋, 盖千百之一也. 《綱目》

Translation영역

The stranguries all belong to heat; though there is a cold strangury, it is one in a thousand.

Gangmok 綱目

1.14.11

Source원문

淋雖有五, 皆屬於熱. 取滋腎丸百丸, 以四物湯加甘草梢ㆍ虎杖根ㆍ木通ㆍ桃仁ㆍ滑石ㆍ木香煎湯呑下, 兼灸三陰交穴名. 累試累效. 《丹心》

Translation영역

Though the stranguries are five, all belong to heat. Take a hundred pills of Enrich the Kidney Pill and swallow them with a decoction of Four Substances Decoction with licorice root tips, knotweed root, akebia, peach kernel, talc and costus added, and moxa Samumgyo a point name as well. Tried again and again, effective again and again.

Dansim 丹心

1.14.12

Source원문

淋病不可發汗, 發汗則便血. 《仲景》

Translation영역

In strangury one must not induce sweating; inducing sweating brings blood in the urine.

Clinical note임상 주석

The Fluids chapter's 5.16.1 rule — do not sweat one who has lost fluid — applied here. Zhongjing's prohibition is one of the few in the Cold Damage treatise about the urinary tract, and the chapter quotes it as a closing warning.

Junggyeong 仲景

1.15 Strangury Has Five Kinds 淋病有五

1.15.1

Source원문

一曰勞淋, 二曰血淋, 三曰熱淋, 四曰氣淋, 五曰石淋. 《本草》

Translation영역

The first is taxation strangury, the second blood strangury, the third heat strangury, the fourth qi strangury, the fifth stone strangury.

Boncho 本草

1.16 Taxation Strangury 勞淋

1.16.1

Source원문

苦倦虛損, 小便不出, 小腹急痛. 《本草》

Translation영역

Weariness with vacuity detriment, the urine not coming out, and urgent pain in the lower abdomen.

Boncho 本草

1.16.2

Source원문

勞淋者, 遇房勞卽發, 痛引氣衝穴名, 痛墜及尻. 《正傳》

Translation영역

Taxation strangury breaks out on sexual taxation, the pain drawing to Gichung a point name and bearing down to the buttocks.

Jeongjeon 正傳

1.16.3

Source원문

勞傷虛損則發, 宜四物湯方見血門加知母ㆍ黃栢ㆍ滑石ㆍ琥珀. 《入門》

Translation영역

It breaks out on taxation damage with vacuity detriment; Four Substances Decoction formula in the Blood chapter with anemarrhena, phellodendron, talc and amber added is appropriate.

Immun 入門

1.16.4

Source원문

酒慾過傷, 膀胱之氣虛損滯而成淋, 宜補中益氣湯方見內傷升補眞氣. 《醫鑑》

Translation영역

Where wine and desire have damaged too far and the bladder's qi is vacuous, detrimented and stagnant so that strangury forms, Supplement the Centre and Boost the Qi Decoction formula in the Internal Damage chapter should lift and supplement the true qi.

Uigam 醫鑑

1.16.5

Source원문

縱慾强留不泄, 淫精渗下而作淋, 宜益元固眞湯. 《醫鑑》

Translation영역

Where indulgence with the emission forcibly held back lets the lewd essence seep downward and make strangury, Boost the Origin and Secure the True Decoction is appropriate.

Uigam 醫鑑

1.17 Blood Strangury 血淋

1.17.1

Source원문

小便不出, 時下血, 疼痛滿急. 《本草》

Translation영역

The urine will not come out, blood comes down at times, and there is aching pain with fullness and urgency.

Boncho 本草

1.17.2

Source원문

遇熱則發, 甚則尿血, 熱結莖痛, 宜四物湯加知母ㆍ黃栢ㆍ澤瀉ㆍ赤茯苓. 《入門》

Translation영역

It breaks out with heat, and at worst there is blood in the urine, with heat binding and pain in the penis; Four Substances Decoction with anemarrhena, phellodendron, alisma and red poria added is appropriate.

Immun 入門

1.17.3

Source원문

色鮮者, 心與小腸虛熱, 導赤散方見五藏去甘草加黃芩. 色如黑豆汁者, 腎與膀胱火也, 宜五淋散方見下.

Translation영역

Where the colour is bright, it is vacuity heat of the heart and small intestine: Guide Out the Red Powder formula in the Five Viscera chapter with the licorice removed and scutellaria added. Where the colour is like black bean liquor, it is fire of the kidney and bladder: Five Stranguries Powder is appropriate.

Clinical note임상 주석

Bright blood from the heart and small intestine, dark from the kidney and bladder — the tradition locating the bleeding by the colour, which is what a urologist does too: bright red is lower tract, dark and smoky is upper.

Donguibogam · Sobyeon

1.17.4

Source원문

血淋, 宜增味導赤散ㆍ金黃湯ㆍ小薊飮子.

Translation영역

For blood strangury, Augmented Guide Out the Red Powder, Golden Yellow Decoction and Small Thistle Drink are appropriate.

Donguibogam · Sobyeon

1.17.5

Source원문

死血作淋, 牛膝膏最妙方見下.

Translation영역

Where dead blood makes the strangury, Achyranthes Paste is best formula below.

Donguibogam · Sobyeon

1.18 Heat Strangury 熱淋

1.18.1

Source원문

小便熱赤色, 淋瀝不快, 臍下急痛. 《本草》

Translation영역

The urine is hot and red, dribbles without ease, and there is urgent pain below the navel.

Boncho 本草

1.18.2

Source원문

暴淋痛甚, 尿赤淋瀝, 宜八正散方見上ㆍ導赤元方見上.

Translation영역

For sudden strangury with severe pain and red dribbling urine, Eight Corrections Powder and Guide Out the Red Pill are appropriate.

Donguibogam · Sobyeon

1.18.3

Source원문

滋腎丸方見上百丸, 以加梔子導赤散煎水呑下, 空心.

Translation영역

A hundred pills of Enrich the Kidney Pill, swallowed on an empty stomach with a decoction of Guide Out the Red Powder with gardenia added.

Donguibogam · Sobyeon

1.18.4

Source원문

益元散方見暑門二錢, 加木香ㆍ檳榔ㆍ茴香各一錢, 爲末, 空心白湯點服. 《入門》

Translation영역

Boost the Origin Powder formula in the Summerheat chapter 2 don, with costus, areca and fennel 1 don each added; powder them and take stirred into plain hot water on an empty stomach.

Immun 入門

1.19 Qi Strangury 氣淋

1.19.1

Source원문

小便澁滯, 常有餘瀝不盡, 小腹脹滿. 宜沈香散ㆍ通秘散, 或益元散加木香ㆍ檳榔ㆍ茴香爲末, 如上法點服. 《入門》

Translation영역

The urine is rough and stagnant, there is always a dribble left over that will not finish, and the lower abdomen is distended and full. Aloeswood Powder and Free the Blockage Powder are appropriate, or Boost the Origin Powder with costus, areca and fennel added, powdered and taken as above.

Clinical note임상 주석

常有餘瀝不盡 — always a dribble left that will not finish. Terminal dribbling, and the commonest complaint of an enlarged prostate. The chapter has it under qi rather than heat, and treats it by moving qi.

Immun 入門

1.19.2

Source원문

氣虛而淋, 八物湯方見虛勞加黃芪ㆍ虎杖根ㆍ黃芩ㆍ牛膝煎服. 《丹心》

Translation영역

Where the strangury comes of qi vacuity, Eight Substances Decoction formula in the Vacuity Taxation chapter with astragalus, knotweed root, scutellaria and achyranthes added, decocted and taken.

Dansim 丹心

1.20 Stone Strangury 石淋

1.20.1

Source원문

莖中痛, 尿不能出, 內引小腹膨脹急痛, 尿下砂石, 令人悶絶. 《本草》

Translation영역

Pain within the penis, the urine unable to come out, drawing within to the lower abdomen with swelling distension and urgent pain, sand and stone passed in the urine, making a person faint away.

Boncho 本草

1.20.2

Source원문

莖中痛, 努力出砂石. 《正傳》

Translation영역

Pain within the penis, and with straining sand and stone come out.

Jeongjeon 正傳

1.20.3

Source원문

沙淋凝脂而易散, 石淋結塊而難消. 攻療石淋, 以枳殼散卽六一枳殼散煎水呑來復丹方見氣門爲妙. 久服則關絡開通瘥爾. 大便通泄, 石塊自小便出. 《直指》

Translation영역

Sand strangury congeals like grease and scatters easily; stone strangury binds into a lump and is hard to disperse. To attack stone strangury, decoct Bitter Orange Powder that is, the Six-to-One Bitter Orange Powder and swallow Return of Yang Elixir formula in the Qi chapter with it — excellent. Taken long, the passes and network vessels open through and it mends; when the bowel moves and drains, the stone comes out with the urine.

Jikji 直指

1.20.4

Source원문

益元散偏主石淋. 《丹心》

Translation영역

Boost the Origin Powder is especially the governing medicine for stone strangury.

Dansim 丹心

1.20.5

Source원문

石淋, 宜石燕丸ㆍ滑石散ㆍ硼砂散.

Translation영역

For stone strangury, Stone Swallow Pill, Talc Powder and Borax Powder are appropriate.

Donguibogam · Sobyeon

1.21 Strangury Has Eight Kinds 淋病有八

1.21.1

Source원문

五淋之外, 又有膏淋ㆍ沙淋ㆍ冷淋, 合爲八也.

Translation영역

Besides the five stranguries there are also gao strangury, sand strangury and cold strangury, making eight in all.

Donguibogam · Sobyeon

1.22 Gao Strangury 膏淋

1.22.1

Source원문

尿出如膏, 莖中澁痛. 《入門》

Translation영역

The urine comes out like grease, with roughness and pain within the penis.

Immun 入門

1.22.2

Source원문

尿濁如膏, 浮凝如脂. 《正傳》

Translation영역

The urine is turbid like grease and floats and congeals like fat.

Jeongjeon 正傳

1.22.3

Source원문

膏淋, 宜鹿角霜丸ㆍ秋石元ㆍ海金沙散ㆍ香兒散.

Translation영역

For gao strangury, Deer Antler Frost Pill, Autumn Mineral Pill, Lygodium Spore Powder and Musk and Catechu Powder are appropriate.

Donguibogam · Sobyeon

1.22.4

Source원문

一少年患膏淋三年, 藥餌鍼灸無少減. 戴人見之曰, 惑蠱之疾也, 亦曰白淫, 實由小腹熱, 非虛也. 以藥涌痰三升, 又瀉積穢數行, 尋覺病去矣. 《子和》

Translation영역

A young man suffered gao strangury for three years, and medicines, needles and moxa did not lessen it in the least. Zhang Zihe saw him and said: this is the disease of delusion and gu, also called white lewdness; it truly comes of heat in the lower abdomen and is not vacuity. With medicine he made him bring up three seung of phlegm, and drained accumulated filth several times — and presently the disease was felt to be gone.

Clinical note임상 주석

Three years of treatment as a vacuity, and Zhang Zihe reverses the diagnosis and attacks instead. 實由小腹熱, 非虛也 — it is truly heat, not vacuity — is the kind of correction his case records exist to make.

Jahwa 子和

1.23 Sand Strangury 沙淋

1.23.1

Source원문

陰莖中有砂石, 澁痛, 尿不得卒出, 砂出痛止. 《正傳》

Translation영역

There is sand and gravel within the penis, rough and painful; the urine cannot come out at once, and when the sand comes out the pain stops.

Jeongjeon 正傳

1.23.2

Source원문

小便出細砂, 沈在缸底. 膀胱陰火煎熬津液, 凝結, 輕則爲砂, 重則爲石.

Translation영역

Fine sand comes out with the urine and settles at the bottom of the pot. The bladder's yin fire boils and dries the fluids, which congeal and bind: lightly it is sand, heavily it is stone.

Donguibogam · Sobyeon

1.23.3

Source원문

沙淋, 宜二神散ㆍ魚石散ㆍ苦杖散ㆍ琥珀散.

Translation영역

For sand strangury, Two Spirits Powder, Fish Stone Powder, Bitter Staff Powder and Amber Powder are appropriate.

Donguibogam · Sobyeon

1.24 Cold Strangury 冷淋

1.24.1

Source원문

必先寒慄, 小便澁數, 竅中腫痛. 《入門》

Translation영역

There is always shivering first, with rough frequent urination and swelling and pain within the orifice.

Immun 入門

1.24.2

Source원문

亦有挾冷而淋者, 其證先寒戰而得溲便. 盖冷氣與正氣交爭, 冷氣勝則寒戰成淋, 正氣勝則寒戰解而得便尿也. 《直指》

Translation영역

There are also stranguries with cold attached, whose sign is shivering before the urine comes. Cold qi and right qi are contending: where the cold prevails the shivering makes strangury, and where the right qi prevails the shivering resolves and the urine comes.

Clinical note임상 주석

Rigors before voiding. The Jikji reads it as a contest between the cold and the body's own qi, and the observation itself — shaking chills with painful urination — is acute pyelonephritis.

Jikji 直指

1.24.3

Source원문

冷淋, 宜八味丸方見虛勞ㆍ生附湯ㆍ木香湯.

Translation영역

For cold strangury, Eight Ingredients Pill formula in the Vacuity Taxation chapter, Raw Aconite Decoction and Costus Decoction are appropriate.

Donguibogam · Sobyeon

1.25 The General Treatment of the Stranguries 諸淋通治

1.25.1

Source원문

淋證所感不一. 或因房勞, 或因忿怒, 或因醇酒, 或因厚味. 盖房勞者陰虛火動也, 忿怒者氣動生火也, 醇酒厚味者釀成濕熱也. 積熱旣久, 熱結下焦, 所以淋瀝作痛. 初則熱淋血淋, 久則煎熬水液, 稠濁如膏如砂如石也. 夫散熱利小便, 只能治熱淋血淋而已. 其膏淋沙淋石淋, 必須開鬱行氣ㆍ破血滋陰方可也. 古方用鬱金ㆍ琥珀開鬱也, 靑皮ㆍ木香行氣也, 蒲黃ㆍ牛膝破血也, 黃栢ㆍ生地黃滋陰也. 東垣治小腹痛用靑皮ㆍ黃栢. 夫靑皮疎肝, 黃栢滋腎, 盖小腹乃肝腎之部位也. 《丹心》

Translation영역

What brings on strangury is not one thing: sexual taxation, or rage, or strong wine, or rich flavours. Sexual taxation is yin vacuity with fire stirring; rage is qi stirring and engendering fire; strong wine and rich flavours ferment into damp heat. Heat accumulating long binds in the lower burner, and hence the dribbling and the pain. At first it is heat strangury and blood strangury; after long it boils and dries the fluid, thick and turbid like grease, like sand, like stone. Now scattering heat and freeing the urine can treat heat strangury and blood strangury only; for gao, sand and stone strangury one must open depression and move qi, break blood and enrich yin. The old formulas use curcuma and amber to open depression, green tangerine peel and costus to move qi, cattail pollen and achyranthes to break blood, phellodendron and fresh rehmannia to enrich yin. Dongwon treats lower-abdominal pain with green tangerine peel and phellodendron — green peel courses the liver and phellodendron enriches the kidney, the lower abdomen being the territory of liver and kidney.

Clinical note임상 주석

The chapter's summary, and the most useful page in it. Danxi says plainly that draining alone handles only the two mild stranguries, and names the four further methods with the medicinals that carry each. Every formula in 1.25 can be read off this paragraph.

Dansim 丹心

1.25.2

Source원문

諸淋通用瀉腎湯ㆍ鬱金黃連丸ㆍ三因琥珀散ㆍ石韋散ㆍ五淋散ㆍ通草湯ㆍ琥珀散方見上ㆍ二神散方見上ㆍ必效散ㆍ海金沙散ㆍ澹寮方五淋散ㆍ婦人白茅湯ㆍ一方.

Translation영역

For the stranguries in general: Drain the Kidney Decoction, Curcuma and Coptis Pill, Three Causes Amber Powder, Pyrrosia Powder, Five Stranguries Powder, Tetrapanax Decoction, Amber Powder, Two Spirits Powder, Certain Effect Powder, Lygodium Spore Powder, Damryo's Five Stranguries Powder, Imperata Root Decoction for women, and another formula.

Donguibogam · Sobyeon

1.25.3

Source원문

一年少自初生七箇月患淋病, 五日七日必一發. 其發也大痛, 惕地嘷天, 水道方行, 狀如漆如粟者約一盞然後定. 診其脈, 輕則澁, 重則弦. 視其形瘦而稍長, 其色靑而蒼. 意其父必因多服下部藥, 遺熱在胎, 留於子之命門而然. 遂以紫雪和黃栢細末, 丸梧子大, 望十分乾而與二百丸作一服, 經二時又與三百丸作一服, 率以熱湯下, 以食物壓之. 又經半日痛大作, 連腰腹, 水道乃行, 下如漆如粟者一大椀許, 其病減十分之八. 後以陳皮一兩, 桔梗ㆍ木通各半兩作一貼與之, 又下漆粟者一合許, 遂安. 《丹溪》

Translation영역

A young man had suffered strangury from seven months after birth, breaking out without fail every five or seven days. At its breaking out the pain was great — he beat the ground and howled at heaven — and only when the waterway ran and about a jan of something like lacquer and like millet had come down did it settle. His pulse was rough on light pressure and stringlike on heavy; his body was thin and somewhat long, his colour green and dark. I supposed his father must have taken many medicines for the lower body, leaving heat in the womb that lodged in the child's gate of life. So I mixed Purple Snow with finely powdered phellodendron, made pills the size of a firmiana seed, waited until they were thoroughly dry, and gave two hundred as one dose; two hours later, three hundred as another — both swallowed with hot water and pressed down with food. Another half-day and the pain came on greatly, reaching the lumbus and abdomen; the waterway ran and about a large bowlful of the lacquer-and-millet matter came down, and the disease was eight-tenths reduced. Afterwards tangerine peel 1 nyang with platycodon and akebia half a nyang each, made one packet, was given, and about a hop more of the lacquer and millet came down, and he was well.

Clinical note임상 주석

A child sick from seven months old, and Danxi traces it to the father's medicines reaching the fetus. The aetiology is his own invention; the case is not. A congenital urinary malformation passing gritty debris for years would look exactly like this, and the description of the attacks — every five or seven days, screaming, then relief when the material passes — is a patient rather than a doctrine.

Danggye 丹溪

1.26 Red and White Turbidity 赤白濁

1.26.1

Source원문

小便出赤濁或白濁. 其狀, 面如油光彩不定, 脚澄下凝如膏糊, 或如米泔, 或如粉糊, 或如赤膿, 皆是濕熱內傷也. 猶如天氣熱則水渾濁, 渾濁之病濕熱明矣. 《回春》

Translation영역

The urine comes out red and turbid or white and turbid. Its look: the surface like oil, the sheen shifting; the settling below congealed like grease and paste, or like rice-washing water, or like flour paste, or like red pus. All of these are internal damage from damp heat. It is as when the weather is hot and water grows turbid; that turbidity is a disease of damp heat is plain.

Clinical note임상 주석

面如油光彩不定 — an oily film on the surface with a shifting sheen. Chyluria, described by looking at the pot. The whole section is a study of what settles at the bottom and what floats.

Hoechun 回春

1.26.2

Source원문

先賢有言, 夏則土燥而水濁, 冬則土堅而水淸. 此其理也. 水火旣濟則土自堅, 其流淸矣. 小便白濁, 皆脾有虛熱而腎不足, 土邪干水也. 《得效》

Translation영역

The worthies of old said: in summer the earth is dry and the water turbid; in winter the earth is firm and the water clear. Such is the principle. When water and fire are in their places, the earth is firm of itself and the stream runs clear. White turbid urine is always vacuity heat in the spleen with the kidney insufficient — earth's evil offending water.

Deukhyo 得效

1.26.3

Source원문

內經曰, 水液渾濁, 皆屬於熱.

Translation영역

The Neijing says: fluid that is turbid all belongs to heat.

Naegyeong 內經

1.26.4

Source원문

便濁之證, 因脾胃之濕熱下流渗入膀胱, 故使溲便或白或赤而渾濁不淸也. 血虛而熱甚者則爲赤濁, 此心與小腸主病, 屬火故也. 氣虛而熱微者則爲白濁, 肺與大腸主病, 屬金故也. 《正傳》

Translation영역

In turbid urine, the damp heat of the spleen and stomach flows down and seeps into the bladder, so that the urine is white or red and turbid rather than clear. Where the blood is vacuous and the heat severe it is red turbidity — the heart and small intestine govern the disease, because they belong to fire. Where the qi is vacuous and the heat slight it is white turbidity — the lung and large intestine govern it, because they belong to metal.

Jeongjeon 正傳

1.26.5

Source원문

赤白濁, 皆因脾胃濕熱, 中焦不淸, 濁氣渗入膀胱爲濁. 《入門》

Translation영역

Red and white turbidity both come of damp heat in the spleen and stomach, the middle burner unclear and the turbid qi seeping into the bladder to make turbidity.

Immun 入門

1.26.6

Source원문

赤者心虛有熱, 由思慮而得之. 白者腎虛有寒, 因嗜慾而致也. 《醫鑑》

Translation영역

Red is heart vacuity with heat, got through thought and worry; white is kidney vacuity with cold, brought on by indulgence of desire.

Uigam 醫鑑

1.26.7

Source원문

小便濁, 主濕熱, 有痰有虛. 赤屬血, 白屬氣, 與痢疾ㆍ帶下同治. 《丹心》

Translation영역

Turbid urine is governed by damp heat, with phlegm and with vacuity. Red belongs to blood and white to qi, and it is treated as dysentery and vaginal discharge are.

Dansim 丹心

1.26.8

Source원문

赤白濁, 肥人多濕痰, 二陳湯加蒼朮ㆍ白朮ㆍ升麻ㆍ柴胡, 或星半蛤粉丸. 瘦人是虛火, 四物湯加知母ㆍ黃栢, 或珍珠粉丸方見精門ㆍ樗栢丸. 《入門》

Translation영역

In red and white turbidity, in the stout it is mostly damp phlegm: Two Matured Ingredients Decoction with both atractylodes, cimicifuga and bupleurum added, or Arisaema, Pinellia and Clam Shell Pill. In the thin it is vacuity fire: Four Substances Decoction with anemarrhena and phellodendron added, or Pearl Powder Pill formula in the Essence chapter and Ailanthus and Phellodendron Pill.

Immun 入門

1.26.9

Source원문

思慮勞心, 宜辰砂妙香散方見神門ㆍ金蓮丸. 房勞傷腎者, 萆薢分淸飮ㆍ小兎絲子元方見虛勞. 脾精不斂成漏濁, 宜蒼朮難名丹ㆍ四炒固眞丹ㆍ蠟苓元. 胃氣下陷, 宜補中益氣湯方見內傷.

Translation영역

For thought and worry taxing the heart: Cinnabar Wondrous Fragrance Powder formula in the Spirit chapter and Golden Lotus Pill. For sexual taxation damaging the kidney: Fish Poison Yam Separate the Clear Drink and Minor Cuscuta Pill formula in the Vacuity Taxation chapter. Where the spleen's essence is not gathered and becomes a leaking turbidity: Atractylodes Nameless Elixir, Four Fryings Secure the True Elixir and Beeswax and Poria Pill. Where the stomach qi has fallen: Supplement the Centre and Boost the Qi Decoction formula in the Internal Damage chapter.

Donguibogam · Sobyeon

1.26.10

Source원문

凡便濁必兼服加減珍珠粉丸. 《入門》

Translation영역

In any turbid urine, Modified Pearl Powder Pill should be taken alongside.

Immun 入門

1.26.11

Source원문

治法宜燥濕降火, 兼升擧之. 二陳湯加二朮ㆍ升麻ㆍ柴胡ㆍ白芍藥. 《丹心》

Translation영역

The method of treatment is to dry damp and downbear fire, with lifting as well: Two Matured Ingredients Decoction with both atractylodes, cimicifuga, bupleurum and white peony added.

Dansim 丹心

1.26.12

Source원문

白濁, 宜四君子湯方見氣門合五苓散方見寒門煎服. 《直指》又秘精元ㆍ固本元ㆍ半苓丸ㆍ導赤湯皆宜.

Translation영역

For white turbidity, Four Gentlemen Decoction formula in the Qi chapter combined with Five Poria Powder formula in the Cold Damage chapter, decocted and taken. Secure the Essence Pill, Secure the Root Pill, Pinellia and Poria Pill and Guide Out the Red Decoction are all appropriate.

Jikji 直指

1.26.13

Source원문

赤濁, 宜加味淸心飮ㆍ淸心蓮子飮方見消渴.

Translation영역

For red turbidity, Supplemented Clear the Heart Drink and Clear the Heart Lotus Seed Drink formula in the Wasting Thirst chapter are appropriate.

Donguibogam · Sobyeon

1.26.14

Source원문

赤白濁通用芡實元方見精門ㆍ妙應丸ㆍ辰砂妙香散方見神門ㆍ水火分淸飮ㆍ桑螵蛸散.

Translation영역

For red and white turbidity in general: Euryale Seed Pill formula in the Essence chapter, Wondrous Response Pill, Cinnabar Wondrous Fragrance Powder formula in the Spirit chapter, Water and Fire Separate the Clear Drink and Mantis Egg-case Powder.

Donguibogam · Sobyeon

1.26.15

Source원문

赤白濁, 小腹疼痛不可忍, 宜作寒治. 東垣酒煮當歸丸最妙方見胞門. 《正傳》

Translation영역

In red and white turbidity with unbearable pain in the lower abdomen, it should be treated as cold; Dongwon's Wine-Boiled Angelica Pill formula in the Uterus chapter is best.

Jeongjeon 正傳

1.26.16

Source원문

小便白如稠米泔, 日數十次, 心神恍惚, 瘦瘁, 此以女勞得之也. 宜桑螵蛸散. 盖桑皮行水, 接螵蛸歸腎經之意也. 《直指》

Translation영역

Urine white like thick rice-washing water, scores of times a day, with the heart-spirit abstracted and the body wasted — this is got from sexual taxation. Mantis Egg-case Powder is appropriate; the mulberry bark moves water and carries the mantis egg-case home to the kidney channel.

Jikji 直指

1.27 Gu Disease and White Lewdness 蠱病白淫

1.27.1

Source원문

內經曰, 脾傳之腎, 病名曰疝瘕, 小腹寃熱而痛, 出白, 一名曰蠱. 註曰, 腎脈貫脊屬腎絡膀胱, 故小腹寃熱而痛, 溲出白液也. 寃熱內結, 消蝕脂肉, 如蠱之蝕, 日內損削, 故云交接漸微也.

Translation영역

The Neijing says: where the spleen passes it to the kidney, the disease is named mounting conglomeration — the lower abdomen with pent-up heat and pain, and white matter coming out; it is also called gu. The commentary says: the kidney channel threads the spine, belongs to the kidney and networks the bladder, so the lower abdomen has pent-up heat and pain and white fluid comes out with the urine. The pent-up heat binds within and eats away the fat and flesh as a gu-worm gnaws, wearing it down by the day — hence it is said that intercourse grows gradually feebler.

Naegyeong 內經

1.27.2

Source원문

夫脾受風邪, 傳於腎經, 邪熱內爍, 故其證小腹寃熱而痛, 溲出白液, 病名曰蠱. 盖邪熱內鬱, 眞精不守故也. 宜肉蓯蓉丸. 《類聚》

Translation영역

The spleen takes in a wind evil and passes it to the kidney channel; the evil heat scorches within, and so the pattern is pent-up heat and pain in the lower abdomen with white fluid coming out in the urine — the disease named gu. The evil heat is depressed within and the true essence is not kept. Cistanche Pill is appropriate.

Yuchwi 類聚

1.27.3

Source원문

內經曰, 思想無窮, 所願不得, 意淫於外, 入房太甚, 宗筋弛縱, 發爲筋痿及爲白淫. 謂白物淋淫如精之狀也. 宜半苓丸方見上.

Translation영역

The Neijing says: where thought and longing are endless and what is wished for is not got, the mind is lewd toward the outside and one goes in to women too much; the ancestral sinew slackens, and it breaks out as sinew wilting and as white lewdness — meaning a white matter oozing out like semen. Pinellia and Poria Pill is appropriate.

Clinical note임상 주석

思想無窮, 所願不得 — endless longing for what cannot be had. The Suwen's aetiology for impotence with a chronic discharge, and it is the frankest psychological statement in the classics.

Naegyeong 內經

1.27.4

Source원문

戴人曰, 遺尿ㆍ閉癃ㆍ陰痿ㆍ脬痺ㆍ精滑ㆍ白淫, 皆男子之疝也. 血枯不月ㆍ腰膝上熱ㆍ足躄ㆍ嗌乾ㆍ癃閉ㆍ小腹有塊或定或移ㆍ前陰突出ㆍ後陰痔核, 皆女子之疝也. 但女子不謂之疝而謂之瘕也. 《子和》

Translation영역

Zhang Zihe says: enuresis, retention, impotence, bladder impediment, slippery essence and white lewdness are all mounting patterns in a man. Blood withered with no menses, heat above the lumbus and knees, lameness, a dry throat, retention, a lump in the lower abdomen that may stay or shift, protrusion of the front yin and haemorrhoidal nodes at the back yin are all mounting patterns in a woman — only that in a woman it is not called mounting but conglomeration.

Jahwa 子和

1.28 The Pattern of Bladder Impediment 脬痺證

1.28.1

Source원문

內經曰, 脬痺者, 小腹膀胱按之內痛, 若沃以湯, 澁于小便, 上爲淸涕.

Translation영역

The Neijing says: in bladder impediment, pressing the lower abdomen over the bladder gives pain within as if scalded with hot water; the urine is rough, and above there is clear mucus.

Clinical note임상 주석

若沃以湯 — as if hot water had been poured in. Suprapubic pain on pressure with a burning quality, and clear nasal discharge with it. The Suwen's name for the syndrome has been applied in modern Chinese practice to interstitial cystitis, and the description fits.

Naegyeong 內經

1.28.2

Source원문

夫膀胱者, 津液之府, 氣化則能出. 今風寒濕邪氣客于脬中, 則氣不能化出, 故脬滿而水道不通也. 足太陽之經, 從巓入絡腦, 腦氣下灌, 出於鼻爲涕也. 《綱目》

Translation영역

The bladder is the bowel of fluids, and only when the qi transforms can it discharge. Now wind, cold and damp evil qi have lodged in the bladder, so the qi cannot transform and discharge, and the bladder is full and the waterway does not pass. The foot greater yang channel goes from the vertex in to network the brain; the brain's qi pours down and issues from the nose as mucus.

Gangmok 綱目

1.28.3

Source원문

脬痺卽寒淋之類也, 屬風寒濕, 宜巴戟丸ㆍ溫腎湯. 《入門》

Translation영역

Bladder impediment is of the kind of cold strangury, belonging to wind, cold and damp; Morinda Pill and Warm the Kidney Decoction are appropriate.

Immun 入門

1.29 Itching and Pain Within the Penis 莖中痒痛

1.29.1

Source원문

童兒精未盛而御女, 老人陰已痿而思色以降其精, 則精不出而內敗, 莖中痛澁而爲淋. 八味丸料加車前子ㆍ牛膝煎服. 《入門》

Translation영역

Where a boy whose essence is not yet abundant goes with a woman, or an old man whose yin has already wilted dwells on lust so as to bring down his essence, the essence does not come out but spoils within, and there is pain and roughness within the penis, making strangury. The ingredients of Eight Ingredients Pill with plantain seed and achyranthes added, decocted and taken.

Immun 入門

1.29.2

Source원문

若精已竭而復耗之, 則大小便道牽疼, 愈疼則愈欲大小便, 愈便則愈疼. 八味丸方見五藏倍附子救之. 凡此當滋化源, 不可誤用知栢淡渗之劑, 旣瀉眞陽, 復損眞陰. 《入門》

Translation영역

Where the essence is already exhausted and is wasted further, the passages of stool and urine drag and ache; the more they ache the more one wants to pass them, and the more one passes them the more they ache. Eight Ingredients Pill formula in the Five Viscera chapter with the aconite doubled rescues it. In all such cases one should enrich the source of transformation, and must not mistakenly use anemarrhena, phellodendron and bland seeping preparations, which drain the true yang and damage the true yin besides.

Clinical note임상 주석

愈疼則愈欲大小便, 愈便則愈疼 — the more it hurts the more one needs to go, and the more one goes the more it hurts. Tenesmus of the bladder and rectum in one sentence, and the warning that follows is against treating it with the cooling drainers the rest of the chapter is full of.

Immun 入門

1.29.3

Source원문

肝經氣滯有熱, 玉莖引脇刺痛, 宜參苓琥珀湯. 《入門》

Translation영역

Where the liver channel's qi is stagnant with heat and the jade stalk draws to the flank with stabbing pain, Ginseng, Poria and Amber Decoction is appropriate.

Immun 入門

1.29.4

Source원문

病淋而莖中痛不可忍, 六君子湯方見痰飮加知母ㆍ黃栢ㆍ滑石ㆍ石韋ㆍ琥珀煎服. 《丹心》

Translation영역

In strangury with unbearable pain within the penis, Six Gentlemen Decoction formula in the Phlegm chapter with anemarrhena, phellodendron, talc, pyrrosia and amber added, decocted and taken.

Dansim 丹心

1.29.5

Source원문

莖中痛, 出白津, 小便閉, 時作痒, 小柴胡湯加梔子ㆍ澤瀉ㆍ黃連(炒)ㆍ木通ㆍ龍膽草ㆍ赤茯苓煎服, 兼服六味地黃丸方見五藏爲妙. 《回春》

Translation영역

Pain within the penis with a white ooze coming out, the urine shut off and itching at times: Minor Bupleurum Decoction with gardenia, alisma, coptis (stir-fried), akebia, gentian and red poria added, decocted and taken, with Six Flavours Rehmannia Pill formula in the Five Viscera chapter taken alongside — excellent.

Hoechun 回春

1.29.6

Source원문

小便淋澁, 莖中作痛, 屬肝經濕熱, 用龍膽瀉肝湯方見前陰. 《回春》

Translation영역

Dribbling rough urination with pain within the penis belongs to damp heat of the liver channel; use Gentian Drain the Liver Decoction formula in the Genitals chapter.

Hoechun 回春

1.29.7

Source원문

精竭不痛, 莖痒者, 八味丸. 熱盛莖中澁痛, 導赤散方見五藏加梔子ㆍ大黃. 《入門》

Translation영역

Where the essence is exhausted, without pain but with itching of the penis, Eight Ingredients Pill; where the heat is exuberant with roughness and pain within the penis, Guide Out the Red Powder formula in the Five Viscera chapter with gardenia and rhubarb added.

Immun 入門

1.29.8

Source원문

莖中痒出白津, 多因脾土不足, 不能滋生金水, 以致肝經血虛火燥. 宜補中益氣湯與淸心蓮子飮間服. 盖脾胃爲肝腎之源, 心實主之. 《入門》

Translation영역

Itching within the penis with a white ooze is mostly from insufficiency of the spleen's earth, which cannot engender metal and water, so that the liver channel's blood is vacuous and its fire dry. Supplement the Centre and Boost the Qi Decoction and Clear the Heart Lotus Seed Drink should be taken alternately; for the spleen and stomach are the source of liver and kidney, and the heart truly governs them.

Immun 入門

1.29.9

Source원문

陰莖痛, 乃厥陰經氣滯兼熱, 用甘草梢. 盖欲緩其氣耳. 《正傳》

Translation영역

Pain in the penis is qi stagnation of the reverting yin channel with heat; use licorice root tips — the wish being to relax the qi.

Jeongjeon 正傳

1.30 The Crossed Intestines Pattern 交腸證

1.30.1

Source원문

婦人小便中出大便, 名交腸證. 服五苓散效. 如未愈, 舊幞頭燒灰, 酒調服之. 《得效》

Translation영역

Where a woman passes stool with the urine, it is named the crossed intestines pattern. Five Poria Powder is effective; if it does not heal, burn an old head-cloth to ash and take it stirred into wine.

Deukhyo 得效

1.30.2

Source원문

一婦人病愈後, 小便出屎. 此陰陽失於傳送, 名爲大小腸交也. 先服五苓散方見寒門二劑, 又用補中益氣湯而愈. 《回春》

Translation영역

A woman, after recovering from an illness, passed faeces with her urine. This is yin and yang failing in their transmission, and is named the large and small intestines crossing. Two doses of Five Poria Powder formula in the Cold Damage chapter were taken first, then Supplement the Centre and Boost the Qi Decoction, and she was healed.

Clinical note임상 주석

A vesicointestinal fistula — faeces passing into the bladder — which after a severe illness would follow a pelvic abscess eroding between the two. The tradition gave it a name and a clear description; the treatment could not have closed it.

Hoechun 回春

1.30.3

Source원문

一婦人性嗜酒, 常痛飮不醉, 忽糟粕出前竅, 溲尿出後竅, 六脈皆沈澁. 與四物湯加海金沙ㆍ木香ㆍ檳榔ㆍ木通ㆍ桃仁服之而愈. 此人酒多氣升不降, 陽極虛. 又酒濕積久生熱, 煎熬其血, 陰亦太虛. 陰陽俱虛而暫時活者, 以其形實, 酒中穀氣尙在故也. 三月後必死, 果然. 《丹溪》

Translation영역

A woman fond of wine, who always drank hard without getting drunk, suddenly passed dregs from the front orifice and urine from the back, and all six pulses were sunken and rough. Four Substances Decoction with lygodium spore, costus, areca, akebia and peach kernel added was given, and she was healed. In this woman the wine was much, the qi rose and did not descend, and the yang was extremely vacuous; and the wine's damp, accumulating long, engendered heat that boiled her blood, so the yin too was greatly vacuous. That with both yin and yang vacuous she lived a while was because her frame was solid and the grain qi of the wine was still in her. After three months she would surely die — and so it was.

Clinical note임상 주석

Danxi cures the symptom and predicts the death anyway, giving three months. The prognosis is separate from the treatment, and he records both — including that he was right.

Danggye 丹溪

1.31 Why Some Pass More Urine Than Others 小便多寡

1.31.1

Source원문

老人與壯年飮水無異, 多寡壯年小便甚少而老者小便甚多, 何也. 曰, 壯者如春夏之氣, 升者多而降者少. 老者如秋冬之氣, 降者多而升者少. 故不同耳. 《正傳》

Translation영역

The old and the young in their prime drink no differently in quantity, yet the young pass very little urine and the old very much. Why? The answer: the young are like the qi of spring and summer, in which much rises and little descends; the old are like the qi of autumn and winter, in which much descends and little rises. That is all the difference.

Clinical note임상 주석

The observation is correct and familiar to anyone who has grown older — nocturia and increased output with age — and the explanation is the five-phase seasons applied to a lifetime. Whether or not one accepts the mechanism, the tradition noticed the fact and thought it worth a section.

Jeongjeon 正傳

1.32 Passing Water Straight After Drinking 飮後卽小便

1.32.1

Source원문

內經曰, 飮入於胃, 游溢精氣, 上輸於脾, 脾氣散精, 上歸於肺. 病人飮入胃, 遽覺至臍下, 便欲小便, 由精氣不輸於脾, 不歸於肺, 故心火上攻, 便口燥咽乾. 宜補中益氣湯. 《東垣》

Translation영역

The Neijing says: drink enters the stomach, the essential qi roams and overflows, is carried up to the spleen, and the spleen's qi scatters the essence upward to the lung. In a sick person, drink enters the stomach and is at once felt to reach below the navel, and they want to urinate — because the essential qi is not carried to the spleen nor returned to the lung; so the heart fire attacks upward and the mouth is parched and the throat dry. Supplement the Centre and Boost the Qi Decoction is appropriate.

Clinical note임상 주석

Water that seems to go straight through — felt below the navel as soon as it is drunk, with a dry mouth still. Dongwon reads it as the lifting function failing, and treats it by raising rather than draining. It is the Wasting Thirst chapter's picture seen from the bladder's end.

Dongwon 東垣

1.32.2

Source원문

靈樞曰, 人飮酒, 酒入胃, 穀未熟而小便獨先下, 何也. 盖酒者熟穀之液, 其氣悍以淸, 故後穀而入, 先穀而液出焉.

Translation영역

The Lingshu says: when a person drinks wine, the wine enters the stomach and the urine comes down first while the grain is not yet digested — why? Wine is the liquid of ripened grain; its qi is fierce and clear, and so though it enters after the food it leaves as fluid before it.

Clinical note임상 주석

Why one has to leave the table soon after drinking though the meal is still undigested, answered by the nature of wine itself: clear and quick, it passes straight through. The chapter ends on one of the classics' most companionable questions.

Yeongchu 靈樞

1.33 Simple Medicinals 單方

1.33.1

Source원문

凡四十八種. 有透膈散ㆍ牛膝膏.

Translation영역

Forty-eight kinds in all, with Penetrate the Diaphragm Powder and Achyranthes Paste.

Clinical note임상 주석

Forty-eight simples, and the ones that repay reading are the notes on why they work. Talc is Yukil-san by itself: 利小便治淋澁多單使滑石, for freeing the urine and treating rough strangury, talc alone is mostly what is used. Gardenia is defended against its reputation — 梔子實非利小便, 乃淸肺也: gardenia does not really free the urine, it clears the lung, and the lung's qi being clear the bladder can transform and discharge. And of achyranthes, 牛膝治淋聖藥也 — the sage's medicine for strangury — made into a paste with a little musk for strangury caused by dead blood.

Donguibogam · Sobyeon

1.34 Acupuncture and Moxibustion 鍼灸法

1.34.1

Source원문

癃閉, 取陰蹻卽照海穴ㆍ大敦ㆍ委陽ㆍ大鍾ㆍ行間ㆍ委中ㆍ陰陵泉ㆍ石門. 《甲乙》

Translation영역

For retention, take the yin springing that is, the point Johae (照海, KI6), Daedon (大敦, LR1), Wiyang (委陽, BL39), Daejong (大鍾, KI4), Haenggan (行間, LR2), Wijung (委中, BL40), Eumneungcheon (陰陵泉, SP9) and Seongmun (石門, CV5).

Gabeulgyeong 甲乙經

1.34.2

Source원문

小便淋閉, 關元八分ㆍ三陰交三分, 卽透ㆍ陰谷ㆍ陰陵泉ㆍ氣海ㆍ太谿ㆍ陰交. 《綱目》

Translation영역

For dribbling retention of urine: Gwanwon (關元, CV4) 8 pun, Samumgyo (三陰交, SP6) 3 pun, and it passes through at once, Eumgok (陰谷, KI10), Eumneungcheon, Gihae (氣海, CV6), Taegye (太谿, KI3) and Eumgyo (陰交, CV7).

Gangmok 綱目

1.34.3

Source원문

石淋, 取關元ㆍ氣門ㆍ大敦. 《東垣》

Translation영역

For stone strangury, take Gwanwon, Gimun and Daedon.

Dongwon 東垣

1.34.4

Source원문

血淋, 取氣海ㆍ關元. 《東垣》

Translation영역

For blood strangury, take Gihae and Gwanwon.

Dongwon 東垣

1.34.5

Source원문

熱淋, 取陰陵泉ㆍ關元ㆍ氣衝. 《東垣》

Translation영역

For heat strangury, take Eumneungcheon, Gwanwon and Gichung (氣衝, ST30).

Dongwon 東垣

1.34.6

Source원문

小便滑數, 中極(灸)ㆍ腎兪ㆍ陰陵泉ㆍ氣海ㆍ陰谷ㆍ三陰交. 《綱目》

Translation영역

For slippery frequent urination: Junggeuk (中極, CV3, moxaed), Sinsu (腎兪, BL23), Eumneungcheon, Gihae, Eumgok and Samumgyo.

Gangmok 綱目

1.34.7

Source원문

遺尿不禁, 陰陵泉ㆍ陽陵泉ㆍ大敦ㆍ曲骨. 《東垣》

Translation영역

For enuresis that cannot be held: Eumneungcheon, Yangneungcheon (陽陵泉, GB34), Daedon and Gokgol (曲骨, CV2).

Dongwon 東垣

1.34.8

Source원문

莖中痛, 行間(灸三十壯). 又取中極ㆍ太谿ㆍ三陰交ㆍ復溜. 《資生》

Translation영역

For pain within the penis, Haenggan (thirty cones of moxa); also take Junggeuk, Taegye, Samumgyo and Bongnyu (復溜, KI7).

Jasaenggyeong 資生經

1.34.9

Source원문

白濁, 腎兪(灸). 又取章門ㆍ曲泉ㆍ關元ㆍ三陰交. 《綱目》

Translation영역

For white turbidity, moxa Sinsu; also take Jangmun (章門, LR13), Gokcheon (曲泉, LR8), Gwanwon and Samumgyo.

Gangmok 綱目

1.34.10

Source원문

婦人轉脬不得尿, 取曲骨ㆍ關元. 《甲乙》

Translation영역

For a woman with a twisted bladder who cannot pass urine, take Gokgol and Gwanwon.

Gabeulgyeong 甲乙經

1.34.11

Source원문

婦人陰中痛, 取陰陵泉. 《甲乙》

Translation영역

For a woman with pain within the genitals, take Eumneungcheon.

Clinical note임상 주석

Gwanwon and Samumgyo appear in almost every line of this section — the two points the tradition needles for anything below the navel, and the pair that still opens most acupuncture treatments for the bladder.

Gabeulgyeong 甲乙經

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Inner Landscape, Volume 4, Urine chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.