"Patient wants to urinate, but urine does not flow freely, there is distention and pain; when a patient does not want to urinate, there is some dribbling.”
We could be reading from an urgent care doctor’s intake. In fact, the source of this quote is almost 2,000 years old. It is from Yellow Emperor’s Classic of Internal Medicine. It’s the last stretch of the liquid waste odyssey - bladder to the urethra and, finally, done. But the way can be fraught with dangers. Painful, dripping, and hesitant urination are the most common symptoms.
In Traditional Chinese Medicine (TCM) these are called Lin Syndromes. Most of the Lin syndromes are based on heat with one or two other factors. The factors that can cause urinary dysfunction are heat, damp, stagnation, stones, and fatigue. There are several herbal formulas addressing Lin Syndromes. Getting the right formula based on the symptoms can resolve the condition very effectively.
The following formulas are listed by their Chinese Pin Yin and common name:
Ba Zheng San (Eight-Herb Powder for Rectification)
Ba Zheng San is the classic formula for the common Urinary Tract Infection (UTI). Read the label carefully because Ba Zheng Tang looks similar. Ba Zheng Tang or Eight Treasure Decoction is a tonification formula; Ba Zheng San clears heat and that’s what you want. The eight herbs in Ba Zheng San form a strong heat-clearing, fire draining and urine promoting posse. The usual symptoms of UTI are the indications for its use. Dark, turbid, scanty, difficult and painful urination. The pain during urination and is due to the presence of heat or damp-heat. If there is much dampness involved the patient may feel distention and pain in the lower abdomen. Accompanying heat signs are a dry mouth and throat and a rapid pulse. In severe cases, there will be blood in the urine. Ba Zheng San is not for long-term usage as it's cooling and drying properties can harm the Yin. This formula is used for UTI, Urinary Tract stones, cystitis, urethritis, and prostatitis. (1)(2)
Long Dan Xie Gan Tang (Gentian Decoction To Drain The Liver)
What does the Liver have to with the urinary tract? A burning question indeed. The Liver channel on its way home from the big toe encircles the genitals. When excess heat, damp-heat, or fire are stuck in the Liver channel the signs are distinctive. Difficult, painful and hot urination. Swollen urethra and external genitals or bad-smelling vaginal discharge. Other upshots include headache, red and sore eyes, irritability, and dizziness. When considering Long Dan Xie Gan Tang, the best fit will be for conditions with dark urine, feelings of heat in the urethra, and pain before urination. Pain before urination is from Qi stagnation which is inherent in the Liver channel. Having other Damp-Heat Liver channel symptoms assures the correct choice.
This formula treats acute urinary and genital conditions such as cystitis, vulvitis, and pelvic inflammatory disease. By targeting the Liver channel, it treats viral Hepatitis and acute cholecystitis. Elsewhere it treats Herpes zoster, eczema (3), conjunctivitis, boils, and outer ear infections. Long Dan Xie Gan Tang is like Ba Zheng San in that it is heat and damp clearing. It is different in that it but includes herbs which nourish the Yin and target the Liver channel. Recommended use is 10 days on and 10 days off if conditions do not resolve in the first week of usage. Long Dan Xie Gan Tang is contraindicated in cases of weak digestion. (1)(2)
Dao Chi San (Guide Out The Red Powder)
Indications for this snappy little formula, just four herbs, are similar to those for Ba Zhen Tang or Long Dan Xie Gan Tang. Urine is dark and scanty. The bio-medical diagnosis could be cystitis or urinary tract stone. The distinctive symptoms which indicate Dao Chi San relate to heat in the Heart channel. Irritability with a feeling of heat in the chest. The face is red and there may be mouth sores. Cold beverages are craved. Dao Chi San is also used for night terrors and oral thrush. Compared to Ba Zheng San, this formula has a weaker effect on painful dribbling, but nourishes the Yin and soothes upper body symptoms. (1)(2)
Wu Lin San (Powder For Five Types of Painful Urinary Dribbling)
Due to no fault of its own, Wu Lin San is sometimes mistaken for Wu Ling San. I have seen this in a certain book where they ought to have caught the mistake. Recorded to be for all 5 types of Lin, Wu Lin San is best known for alleviating UTIs with blood or multiple tiny stones. Urination which calls for this formula is rough with stabbing pain and dribbling. The urine is the color of red bean juice or cola. Compared to Ba Zheng San, Wu Lin San specifically cools the blood. Blood when hot becomes reckless and causes bleeding. Wu Lin San is used to treat urethritis, cystitis, and urinary stones. In vitro research shows Wu Lin San inhibits calcium oxalate* formation and aggregation. (4)(1)(2)
(* the most common type of kidney stone material)
Bu Zhong Yi Qi Tang (Tonify The Middle To Augment The Qi Decoction)
Unlike the previous formulas, Bu Zhong Yi Qi Tang does not address a Heat based Lin Syndrome. This formula is for Lin caused by fatigue. The key symptoms are difficult urination with pale urine and a weak stream. The pain appears after urination. These symptoms may be accompanied by organ prolapse or a feeling of pressing down, loose stools, and weak digestion. In TCM terms this formula lifts the Qi and through this action separates the clear from the turbid and relieves painful urination. In both TCM and current medical science, the Kidneys are major players in health. Not only are they connected in an obvious way to urinary health, but also to the whole body well being. TCM herbal literature does not focus on kidneys in relation to Bu Zhong Yi Qi Tang, however, research shows it has a positive effect on compromised kidney cells (5). Bu Zhong Yi Qi Tang can be used to treat fatigue based urinary conditions such as stress incontinence, bladder prolapse, chronic nephritis, cystitis, urethritis. (1)(2)
Health Alert
An untreated or severe UTI can turn into a kidney infection if the bacteria goes up the ureters to the kidneys. This is a serious development and should be attended to by a medical practitioner. A kidney infection is indicated if UTI symptoms are accompanied by the following:
- Pain in the abdomen, lower back, or sides
- Fever, chills, and fatigue
- Nausea and vomiting
Use herbs wisely
Before taking any of these formulas to consult with a knowledgeable practitioner. Chinese herbalism is based on treating the pattern of symptoms, not a western medical diagnosis. If you have questions or special considerations, please work with your practitioner. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease. Serving size is according to instructions on the label or as per your practitioner. Feel better soon.
References 1 The Practice of Chinese Medicine: The Treatment of Diseases with Acupuncture and Chinese Herbs. Giovanni Manioca, Churchill Livingstone, 1994 2 Chinese Herbal Medicine Formulas & Strategies 2nd Edition, Scheid, Bensky, Ellis, Barolet, Eastland Press, 1990 3 GlobinMed.com Long Dan Xie Gan Tang 4 Wu-Ling-San formula inhibits the crystallization of calcium oxalate in vitro. / Chen, Yu Cheng; Ho, Chien Yi; Chen, Lieh Der; Hsu, Sheng Feng; Chen, Wen Chi. In: American Journal of Chinese Medicine, Vol. 35, No. 3, 2007, p. 533-541. 5 Liu XQ, Wu L, Guo XJ. Effect of Bu-Zhong-Yi-Qi-Tang on deficiency of N-glycan/nitric oxide and islet damage induced by streptozotocin in diabetic rats. World J Gastroenterol 2009;15(14): 1730-1737
