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CHYLURIA (CLOUDY URINATION)

GENERAL

Clinical Manifestations	Chyluria, also called chylous urine, is a medical condition involving the presence of chyle in the urine stream, which results in urine appearing milky white.
Treatment Principle
Herb Formulas
Points

DAMP-HEAT IN THE LOWER JIAO

Clinical Manifestations	Urinary frequency Urinary urgency Painful, burning urination or Continuous dripping of urine or Sudden interruption to the urinary stream Turbid urine or Pus and blood in the urine or Sand and stones in the urine Lower abdominal distention In Damp-Heat Pouring Downward there may also be: Fever Thirst Dry mouth Low back pain In Damp-Heat Crystallizes in Urinary Bladder there may also be: Colicky pain in the low back, possibly radiating to the groin T: Red C: Yellow P: Slippery and rapid
Treatment Principle	Clear Heat Eliminate Dampness by diuresis
Herb Formulas	Ba Zheng San Xiao Ji Yin Zi Zhi Zhuo Gu Ben Wan Wu Lin San Jia Wei Er Miao Wan Cheng Shi Fen Xing Yin Bei Xie Shen Shi Tang
Points	KI-7, LIV-2, REN-3, SP-6, SP-9, UB-23, UB-28, UB-39 REN-3, SP-6, SP-9, UB-23, UB-28 HT-8, REN-3, SP-6, SP-10, UB-17, UB-28 To disperse Heat: LI-4, LI-11 To eliminate Dampness: REN-9, SP-6, SP-9 For retention of urine: 1. REN-3, SP-6, SP-9, UB-28 2. REN-3, SP-6, SP-9, UB-39

CENTRAL QI SINKING

Clinical Manifestations	Prolapse of one or more organs Sallow complexion Anorexia Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Shortness of breath T: Pale and flabby - may have teethmarks C: White P: Even or Soft and thready
Treatment Principle	Strengthen the Spleen Benefit Qi Reinforce the Center Invigorate Yang
Herb Formulas	Bu Zhong Yi Qi Tang
Points	DU-4, DU-20, KI-3, LIV-13, LU-7, REN-6, SP-6, UB-20, UB-23

HEART FIRE TRANSFERRING TO THE SMALL INTESTINE

Clinical Manifestations	Stabbing pain in the Bladder Ulceration, erosion, and pain of mouth and tongue Thirst with a desire for cold drinks Irritability Irascibility Feeling of Heat and disturbance in the Heart Insomnia Flushed face Bitter taste in the mouth T: Red tip with ulcers especially on the tip P: Excess and rapid
Treatment Principle	Clear Heat Purge Fire Calm the Shen
Herb Formulas	Cheng Shi Fen Xing Yin
Points	HT-7, HT-8, PC-7, PC-8, UB-15 HT-8, KI-6, PC-6, REN-3, SP-6, SP-9, ST-28, Yintang

SPLEEN AND KIDNEY QI DEFICIENCY

Clinical Manifestations	Milky, turbid spermatorrhea Listlessness Fatigue A shiny, white complexion Anorexia or Increased food intake Restlessness Vaginal discharge Diarrhea Dryness of the external ears Dizziness Enuresis Copious urination Thirst Premature ejaculation Lumbago T: Pale C: White P: Deep and frail
Treatment Principle	Tonify the Kidneys Stabilize Jing Stop leakage Strengthen the Spleen Drain Dampness
Herb Formulas	Fu Tu Dan
Points

HEART FIRE WITH KIDNEY YIN DEFICIENCY AND DAMP-HEAT POURING DOWNWARD

Clinical Manifestations	Restlessness Irritability Thirst Nocturnal emission Insomnia Dream disturbed sleep Lack of spirit Fatigue Low back pain Tinnitus Dysuria Depression Turbid urine Abnormal uterine bleeding Polyuria Enuresis Seminal emission Leukorrhea Blood tinged leukorrhea Anorexia Dry mouth Dry Tongue Five Sole Heat Fever Physical and mental overexertion T: Red C: Little or None P: Deep and rapid
Treatment Principle	Clear Heart Fire Disperse Damp-Heat Benefit Qi and Yin Promote urination
Herb Formulas	Qing Xin Lian Zi Yin
Points

HEART AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Frequent urination Cloudy urine that resembles rice-water Seminal emissions Enuresis Disorientation Constipation Forgetfulness Fatigue Anorexia T: Pale or Light pink C: Thin and white P: Thin, slow and frail or Deep and weak
Treatment Principle	Regulate and tonify the Heart and Kidneys Stabilize Jing Stop seminal emissions
Herb Formulas	Sang Piao Xiao San
Points

JUE YIN STAGE: COLD AND HEAT

Clinical Manifestations	Delirium Heat in upper body Cold in lower body Sensation of Qi rushing to the chest Vomits worms Persistent thirst Feverishness Anorexia (hungry but can't eat) Chronic diarrhea Cold extremities Maybe edema Vertex headache Vomits food Cardiac Heat with pain T: Red or pink or pale and flabby C: Thick and greasy or thin P: Deep, thready and weak or wiry
Treatment Principle	Clear worms Clear Heat (Do not purge, create diaphoresis, or create emesis) Revive Yang
Herb Formulas	Wu Mei Wan
Points	Moxa needle REN-4, REN-6, REN- 8, ST-25, ST-36, needle DU-14, LI-4, LI-11, LIV-3, REN-17

TURBID (MILKY) (LAO) LIN

Clinical Manifestations	Frequent, urgent, painful urination Turbid milky urine that soon sediments with catkin substance at the bottom (chyluria) A fatty, oily substance at the surface of the urine container with coagulation Bloody difficult urinary discharge with feverish pain Soreness in the lumbar region and knees Dizziness Lassitude Suprapubic distention and discomfort fullness in the chest and abdmen Poor appetite Bitter taste in the mouth Thirst with no desire to drink A tendancy toward constipation or Alternating constipation and diarrhea T: Red tongue proper C: Slightly white and greasy P: Soft and rapid or Rapid and thready
Treatment Principle	Warm the Kidneys Drain Dampness Separate the turbid from the clear
Herb Formulas	Bei Xie Fen Qing Yin Qing Xin Lian Zi Yin Ba Zheng San Sang Piao Xiao San Cheng Shi Bei Xie Fen Qing Yin Chinese Patent Medicines: Te Xiao Pai Shi Wan Long Dan Xie Gan Wan Qian Lie Xian Wan Chuan Xin Lian Kang Yan Pian
Points	DU-20, KI-3, LIV-2, REN-3, REN-6, SP-9, UB-23, UB-28 KI-3, KI-6, LIV-2, REN-3, SP-9, UB-23, UB-28 REN-4, REN-6, SP-6, SP-9, UB-22, UB-27, UB-28 GB-41, KI-7, LIV-5, REN-3, SJ-5, SP-4, SP-6, SP-9, UB-22, UB-28 Ear: Urinary Bladder, Kidney, Sympathetic, Occiput, Adrenal, Endocrine

KIDNEY YIN DEFICIENCY WITH FIRE FLARING

Clinical Manifestations	Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of the low back Spermatorrhea or Premature ejaculation Aching in the bones Aching in the leg and heel Dry mouth Thirst Night sweats Five Sole Heat Malar flush Low grade fever in the afternoon Dry throat, maybe recurrent sore throat Dry stools and/or Constipation Urine short and red Heightened libido If Heart Fire also Flares: Insomnia Frequent dreams Palpitations If Liver Yang also Rises: Dizziness Blurred vision T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Zhi Bai Di Huang Wan Chinese Paent Medicines: Zhi Bai Ba Wei Wan For bleeding: + Yun Nan Bai Yao
Points	KI-2, KI-6, REN-4, ST-28, UB-23 KI-1, KI-2, KI-3, KI-6, KI-9, KI-10, REN-4, SP-6, UB-23 If Heart Fire also Flares: HT-7, PC-7, UB-15 If Liver Yang also Rises: LIV-3, UB-18

KIDNEY YANG DEFICIENCY

Clinical Manifestations	Chronic, or recurrent cloudy or opaque urination that is frequent and copious Lumbago: low back feels cold, weak and aching Feeling chilled Aversion to Cold Cold limbs General debility Waxy, pale complexion with dark rings under the eyes Oliguria with edema Edema below the waist and in the ankles Cold extremities Maybe nocturia Lassitude Listlessness Lethargy Withdrawn, subdued behavior Knees feel cold and aching Dizziness Tinnitus Difficult urination Impotence Spermatorrhea Premature ejaculation Low libido Female infertility ("uterus cold and infertile") Maybe anorexia Maybe loose stools Maybe chronic diarrhea or "cock crow" diarrhea T: Pale and swollen C: Thin and white P: Deep and thready - maybe slow
Treatment Principle	Warm and Reinforce Kidney Yang
Herb Formulas	Jin Gui Shen Qi Wan Lu Rong Bu Se Wan For frequent urination: Sang Piao Xiao San modified With turbid urine: Bei Xie Fen Qing Yin With less or no Cold and evidence of Heart involvement (frequent and cloudy urination, forgetfulness and disorientation: Sang Piao Xiao San Chinese Patent medicines: Jin Gui Shen Qi Wan Ren Shen Lu Rong Wan Ge Jie Bu Shen Wan Jin Suo Gu Jing Wan * The last formula is usually taken with one of the first three.
Points	DU-26, KI-7, REN-3, SP-6, moxa or moxa needle DU-4, REN-6, REN-9, UB-23, UB-53 DU-26, KI-3, KI-11, SI-3, SP-6, moxa or moxa needle DU-4, REN-4, UB-23 Moxa or moxa needle DU-4, KI-3, REN-4, UB-23 For chronic diarrhea, rectal prolapse and Vanquished Yang: + moxa DU-20, REN-8 For Kidney Yang Deficiency impotence: moxa or moxa needle DU-4, DU-20, KI-3, REN-4, UB-23 For Kidney Yang Deficiency (Cock Crow) Diarrhea: moxa or moxa needle DU-20, KI-3, REN-4, UB-23