45 :Hepatophilic virus disease – TCM classification as “Wetness-heat vaporization form” Common symptoms (10):Wetness-heat of lower-jiao (III)

Cold stranguria: It is formed by cold weakness of lower-jiao, so that gasification does not occur, leading to dysfunction of the opening and closing ability of urinary bladder and finally to stasis of urine.  At first, the urine is cold and goes faster, then frequent urination appears.  Later, there is unsmooth micturition and the urine becomes clear and white.  Nocturnal urination occurs and continues for long period; in severe cases, there is persistent swelling of the urethral orifice and it may relapse frequently.

Summer stranguria: This is due to ingestion of excessive cold drinks in the summer.  The fluid may be retained in the upper portion of the body or expelled exteriorly to become sweat.  If there is obstruction of the small intestines, the fluid cannot flow down. This in turn, causes scanty reddish urine, dysuria and dribbling urination and then becomes stranguria.

Senile stranguria: Besides dribbling urination, due to unstability of energy in old people, a history of gonorrhea may evoke the illness.  The patient may also have bloody urine and obstructive pain and distention of lower abdomen due to ill effect on the digestive tract.

Pregnant stranguria (child stranguria): When there is obstruction of fetal qi and heat occurs in the bladder, urination becomes dribbling and unsmooth; this is child stranguria (子淋).

Postpartum stranguria: In the postpartum period, the woman retains heat and her liver is in a state of hyperfunction.  The uterus retains heat after delivery or if there is deficiency of qi combined with heat retention, the heat may drive blood to the uterus, and in this place the blood may turn to the bladder and pass out by the urinary tract.  The urinary passage may present some obstruction because of the combined effect of heat and turbidity and hence urine cannot come out smoothly and the illness is formed.  It is characterized by dribbling and painful urination, the urine being yellowish, whitish or reddish and it may intermingle with blood threads.

Lai (code number 2410) female, age 44 years.  Her first visit was on March, 2001 with the complaint of finding positive type B hepatitis antibodies in blood examination.  She had occult hematuria for 10 years.  Presently, she felt fatigue, vertigo and left leg numbness for more than two months.

Physical examination: tongue pale and enlarged, hepatomegaly of 3 cm, mild edema of lower extremities.  The tentative diagnosis was chronic hepatitis, deficiency of blood and energy, wetness-heat vaporization complicated with hematostranguria.

After 3 parcels of TCM drugs, she had increase of flatus but parasthenia of hands decreased; the liver returned to normal.  After another 3 parcels, urination was smooth, parasthenia of hands disappeared but she still felt tired.  Sleeping was good and she lost 2 lbs of body weight.  During the course of TCM treatment, she experienced chilliness, fever, coughing and hoarseness of voice for 2 days.

When the therapy was going on, she had her menstrual period, the amount of blood decreased and there were no clots and no pain.  In the post menstrual period, she felt tired, sleepy and had mild symptoms of common cold.  She had plenty of sputum, but the lung was normal. She took totally 6 weeks of TCM drugs, after which clinical cure was attained and the TCM therapy was discontinued.  Urine examination was done and it showed normal results.

Ho (code number 1568) male, age 45 years.  He first visited our clinic on August 1985 with the complaint of a history of hepatomegaly and peptic ulcer and had received treatment for a long time in this clinic because of repeated gastric bleeding leading to malnutrition, emaciation, weakness and anemia.  In April, 1987 on account of taking unripe bivalve seafood, he had acute type A hepatitis with jaundice and abnormal liver function, and was cured by TCM therapy.  From June, 1990 to February 1993, he had relapses of hepatomegaly four times (liver dullness margin increased to 1.5 cm to 4.5 cm).  During this time, after a hot steam bath, he had an infection of gonorrhea and had chilliness, fever, frequency of urination, dysuria and purulent discharge from the urethral orifice.  He had received modern medical specific remedy and then visited our clinic for further treatment.  He was found to have a hepatomegaly of 4.5 cm.  Clinical cure was obtained after TCM treatment and therapy was stopped for further observation.