Urosehesis-hepatogenic frostatic hypertrophy and
inflammation causing “retention of urine”
“Hepatophilic virus” infection can induce wetness-heat of lower-jiao leading to the above mentioned “stranguria” and “turbid urine”. If it is neglected for a long time not treated by hepatic drugs to eliminate wetness-heat, the patient is liable to get weakness of liver and kidney and deficiency of qi, with the result of causing disorder of water elevation and descent and dysfunction of kidney and urinary bladder gasification. Prolonged stranguria and turbid urine would hurt the kidney and promote heat retention in the bladder, so that urination becomes dribbling and its flow unsmooth. If the course is prolonged and the foundation not treated, there will be urinary obstruction caused by stranguria and turbid urine. If the retention of urine in the bladder continues, the lower abdomen will show acute pain and this extreme suffering is “uroschesis”.
“Uroschesis” and “stranguria” both belong to difficulty in urination. But the latter is characterized by painful and dribbling micturition, the amount of urine being normal. Uroschesis means scantiness of urine, which is excreted in a dribbling manner or altogether no urine is excreted and this is its chief characteristic. Therefore, uroschesis is more serious than stranguria and its prognosis is poorer; it is a common disease in elderly people.
If there is exhaustion of fluid caused by weakness of kidney, the bladder may be attacked by evil so that heat is retained and accumulated to become an excess condition which is called “dysfunction of the urinary bladder”. The symptoms may be tenderness of the region over the bladder and lower abdomen; if the patient takes soup, the urine amount is scanty and enuresis may occur.
The book “Huang Di Nei Jing” (Canon of Medicine) (黃帝內經) stated: The disease “uroschesis” is caused by attack of evil to the kidney. The book “Ling Shu (靈樞) – Bun Shu (本輸)” also stated that uroschesis derived from disease of the liver. Li ZhongZi (李中梓) of the Ming dynasty (明朝) considered that uroschesis can be caused by lung dryness, inability of rising of splenic energy, dryness-heat of kidney and disharmony of the bladder. He also demonstrated that uroschesis was closely related to the function of the liver channel, due channel and the threejiao. In fact, these are the pathologic manifestations in different stages during the development of chronic hepatitis. Therefore, the complications of chronic hepatitis like prostatic diseases (including prostatitis, prostatic hypertrophy, decrease tension of urinary bladder, sphincter spasm of urinary bladder, urinary tract inflammation, urinary stones, neurotic anuria, factors causing dribbling urination and retention of urine) all belong to the category of lower-jiao wetness-heat.
Uroschesis has two meanings: hypouria and anuria.
Hypouria means scanty urine; the disease has mild onset and symptoms, the urine dribbling out, the number of micturition countless and there is pain in the shaft of penis. Anuria means blockage of urinary flow. The patient has the desire to urinate but no urine is excreted; therefore, there is pain in the lower abdomen and also distention of the bladder and this condition is usually called “retention of urine”.
In the acknowledgement that uroschesis is usually the result of lower-jiao wetness-heat, the only preventive method is early effective, systemic treatment of “chronic hepatitis”. If clinical cure is attained, uroschesis can be prevented, or, at least, the chance of forming uroschesis is lessened.
Introduction of cases
| Case 6
Young (code No.2112) male, age 33 years. His chief complaint was that one year ago, blood examination showed positive type B hepatitis surface antigen and antibodies and hepatitis B core antibodies. Three months ago, he felt painful urination, unsmooth urinary flow and excretion of a yellowish mucous discharge. These symptoms disappeared after modern medical treatment. But presently there were repeated episodes of painful and unsmooth urination. Blood examination revealed a high uric acid level 474 (90-420). In the past, he had repeated manifestations of acne, gastrointestinal discomfort, abdominal pain, diarrhea and flatulence. When he came to the clinic, he was suffering from wetness-heat abdominal pain, diarrhea, loose and wetness-heat stools, dysuria, frequent urination, fatigue and acne. Physical examination: facial color yellowish, anomaly of hypochondria with bulging of right side and depression of the left, liver mild percussion tenderness, hepatomegaly of 3 cm. The diagnosis was hepatophilic virus disease, wetness-heat vaporization form, showing wetness-heat of stomache, intestines and lower-jiao (uroschesis). Treatment : after 3 parcels of TCM drugs, the liver returned to normal but still showed percussion tenderness. Diarrhea stopped and flatulence decreased; the urine flow was smooth and its color was yellowish. After 2 weeks of TCM treatment, he felt some abdominal distention and abundance of flatus. There were five episodes of diarrhea, the stools loose, darkish in color and there was vague abdominal pain. Urination was smooth, not frequent and without pain. No discharge was seen coming out from urethral orifice. The skin of the abdominal wall was dry and veins were prominent at the hypochondria. The liver was normal. After 23 parcels of TCM drugs, flatus was still abundant and stink smelling. Urination was smooth and without discharge. He felt some discomfort in the recent two episodes of ejaculation. These symptoms disappeared during the TCM therapy and he took the entire course of systemic treatment. He obtained clinical cure and stopped the medication for further observation.
|
By WONG Kwok Hung
published on 14th August 2001
(translated by Professor ZHENG Hua En in 2003)