典藏书目

*Baojian* (Mirror of Treasures) states in the *Bi Lun* (Treatise on Bi Syndrome): "Bao Bi (Bladder Bi syndrome) presents with pain inside the lower abdomen at the Bladder region upon palpation, feeling as if scalded by hot water, with difficult and scanty urination, and upper symptoms manifesting as clear nasal discharge. This is because the Bladder is the 'Official of the Reservoir' (the gathering place for fluids), where Jin Ye (body fluids) are stored; only through Qi transformation can they be excreted. Now, when Wind-Cold-Damp pathogens invade the Bao (uterus/bladder area), Qi cannot transform and excrete, resulting in abdominal fullness and obstruction of the water pathways. The manifestations include internal pain in the lower abdomen/Bladder region upon pressure, a sensation of being scalded by hot water, and urinary difficulty. This occurs because the straight branch of the Foot-Taiyang Bladder Meridian ascends to intersect at the forehead, enters and connects with the Brain, and its Qi descends to irrigate the nasal orifices, thus producing clear discharge."

From this, it is known that Lin Syndrome (Dysuria/Pollakiuria) has distinctions between Cold and Heat patterns; treatment should differentiate based on pulse conditions.

Chen Wuyue stated: "Lin was anciently called 'Long'. The names differ. 'Long' implies fatigue and weakness, while 'Lin' implies dripping drops. Ancient formulas attribute Small Intestine and Bladder dysfunction to Stagnation of Heart and Kidney Qi. There are also Cold Lin, Damp Lin, and Heat Lin, which belong to external causes. Since Heart-Kidney Qi stagnation and emotions like fright, thought, fear, and worry are mentioned, these are internal causes. Moreover, dietary extremes, sexual excess, labor, and holding urine often cause this disease; are these not non-internal/non-external causes? Generally, there are five types: Cold, Heat, Paste (Gao), Blood, and Stone. Although different, all are rooted in Qi dynamics."

Yan Shi stated: "The Five Lins are Qi, Stone, Blood, Paste, and Labor. Qi Lin manifests as difficult urination with residual dribbling; Stone Lin involves pain in the urethra and inability to void suddenly; Paste Lin presents with urine resembling paste; Labor Lin flares up after fatigue, with pain radiating to the Qichong point; Blood Lin occurs upon exposure to heat, potentially leading to hematuria. Observing a yellowish hue on the tip of the nose indicates difficult urination. Generally, this condition arises from failure of Heart-Kidney interaction, accumulation of heat toxins, post-coital activity after drinking, consumption of hot-drying substances, or emotional stagnation. Long Bi (Retention) and Lin are essentially the same category of disease."

Commentary: The names for the Five Lins vary, so both accounts are preserved. However, Stone Lin is colloquially known as Sand-Stone Lin. Hezi stated: "People often contract this from taking metallic/mineral hot-drying agents. It is common among farmers; does this mean those who ingest minerals are prone to it?" Generally, this results from Heat accumulation in the Bladder, similar to limescale accumulating in a pot boiled over fire for too long. The pathology of Stone Lin aligns with this reasoning, which is highly accurate. *Neijing* states: "Heat in the lower abdomen with white fluid discharge," which is also very similar.

*Faming* (Elucidations): *Nanjing* asks: "What is Guan Ge (Obstruction and Rejection)?" The answer is: "Guan leads to inability to urinate; Ge leads to vomiting. 'Guan' is extreme Heat; 'Ge' is extreme Cold. Guan means no exit, hence Guan; Ge means no entry, hence Ge." Commentary: Cold in the chest obstructs intake; Heat in the lower jiao blocks excretion. *Neijing* states: "If the Renying pulse is four times larger than the Qikou, it is named Ge; if the Qikou pulse is four times larger than the Renying, it is named Guan. Guan prevents urination; Ge causes vomiting." Urination is governed by the Foot-Taiyang Bladder, associated with Shen (Monkey/Metal). Metal generates Water; the organ corresponding to Metal is the Lung. Latent Heat in the Lung prevents water excretion, cutting off the source of urine. The human body assists Heaven and Earth; the source of the Bladder extends from the head/neck to the feet, thus termed Yin within Yang. For instance, thirst with urinary obstruction indicates failure of descent. Therefore, sages established methods using thin, aromatic, drying herbs that correspond to the proper transformation of Dry Metal, such as Fu Ling (Poria), Zhu Ling (Polyporus), Ze Xie (Alisma), Hu Po (Amber), Deng Xin Cao (Juncus Effusus), Tong Cao (Tetrapanax), Che Qian Zi (Plantago Seed), Qu Mai (Dianthus), and Zhu Ru (Bamboo Shavings). These are permeating and bland herbs that drain Lung Fire, clear Lung Metal, and nourish the source of Water generation. If Heat resides in the Lower Jiao, it cuts off the flow, preventing urination; this requires thick-flavored, heavy, Yin-within-Yin herbs. Wang Shanfu of Chang'an suffered from urinary retention progressing to abdominal distension, hard as stone, extreme blockage, swollen legs cracking with yellow fluid, protruding eyes, insomnia, and inability to eat or drink. His relative Zhao Qianfu sought my treatment. I observed him from night till dawn, restless. Recalling *Suwen*: "Without Yin, Yang has nothing to generate; without Yang, Yin has nothing to transform." And: "The Bladder is the Official of the Reservoir... only through Qi transformation can it excrete." This patient's retention is due to lack of Yin, causing Yang to fail to transform. Diuretics are bland and permeating (Yang), merely Qi-moving agents (Yin within Yang), not the cold-water Yin-within-Yin of the North. This resulted from excessive indulgence, rich diet generating heat, damaging Northern Yin, depleting Kidney Water. The Bladder, the chamber of the Kidney, dried out over time. Fire rebelled upward causing vomiting, not a Ge (Rejection) disorder but a Guan (Obstruction) one. Jiegu stated: "Heat in the Lower Jiao blocking excretion" treats Guan Ge. The patient exhibited both internal Guan and external Ge, facing imminent death, but treating the Lower Jiao could cure it. I used bitter-cold herbs derived from Northern Water, Huang Bo (Phellodendron) and Zhi Mu (Anemarrhena), guided by Gui Zhi (Cinnamon Twig), made into pills size of tung seeds, taken with boiling water (200 pills). Shortly after, the patient reported burning/stinging pain in the genitals, followed by a gush of urine wetting the bedding. Swelling vanished instantly. I exclaimed: "Great are the words of the Sages! One must not be dogmatic." This pattern features urinary obstruction without thirst, occasional restlessness. Diseases in the Lower Jiao generally do not cause thirst. The two disorders differ: Upper Jiao/Air level causes thirst; Lower Jiao/Blood level does not, due to dampness in blood. They are easy to distinguish.

Respectfully noted: Some ask why Liver governs urination/Lin, yet treatment focuses on Kidney. Generally, frequent urination stems from Kidney Qi deficiency. Lin has root (Ben) and branch (Biao) aspects: Qi-Heat stagnation causing Bladder fluid overflow and difficulty coordinating is the Root; lower abdominal pain with inability to void, characterized by Excess Qi/Stagnation in Lower Jiao, is the Branch. In severe Shanghan transformations, enuresis and staring indicate early exhaustion of Shaoyin Kidney. Thus, these three meridians affecting the lower body involve more than just the Liver. If Spleen/Lung Qi fails to regulate water passages descending to the Bladder, or Clear Qi fails to descend, Long Bi occurs. Kidney Qi deficiency with turbid Qi failing to ascend, and Deficient Heat harassing Jueyin collaterals, causing genital flaccidity and loss of spirit, leads to frequent, urgent urination. Elderly often suffer this. Extreme Kidney deficiency leads to dryness, blazing fire, dispersion of True Qi, and death. Some ask: Do widows suffering frequency have Kidney deficiency unable to restrain? Yes, but if Metal is scorched by Fire, Earth soaked by Water, and the mutual support of organs fails, with severe Damp-Heat and lax meridians, this disease arises. Ancients used Shen Qi Wan to consolidate essence/Qi, nourish Kidney, drain fire, guide water, benefit joints, and strengthen Spleen Earth. To treat solely as Deficiency-Cold would be an oversimplification.