小便不通,由膀胱与肾俱有热故也。肾主水,膀胱为津液之腑,此二经为表里;而水行
于小肠,入胞者为小便。肾与膀胱既热,热入于胞,热气大盛,故结涩,令小便不通,小腹
胀满气急。甚者,水气上逆,令心急腹满,乃至于死。
诊其脉,紧而滑直者,不得小便也。
小便难者,此是肾与膀胱热故也。此二经为表里,俱主水,水行于小肠,入胞为小便。
热气在于脏腑,水气则涩,其热势微,故但小便难也。
诊其尺脉浮,小便难。尺脉濡,小便难。尺脉缓,小便难有余沥也。
遗尿者,此由膀胱虚冷,不能约于水故也。膀胱为足太阳,肾为足少阴,二经为表里。
肾主水,肾气下通于阴。小便者,水液之余也。膀胱为津液之腑,腑既虚冷,阳气衰弱,不
能约于水,故令遗尿也。
诊其脉来过寸口,入鱼际,遗尿。肝脉微滑,遗尿。左手关上脉沉为阴,阴绝者,无肝
脉也,苦遗尿。其汤熨针石,别有正方,补养宣导,今附于后。
《养生方·导引法》云∶蹲踞高一尺许,以两手从外屈膝内入,至足趺上,急手握足五
指,极力一通,令内曲入,利腰髋,治遗尿。
夫人有于眠睡不觉尿出者,是其禀质阴气偏盛,阳气偏虚者,则膀胱肾气俱冷,不能温
制于水,则小便多,或不禁而遗尿。
膀胱,足太阳也,为肾之腑。肾为足少阴,为脏,与膀胱合,俱主水。凡人之阴阳,日
入而阳气尽则阴受气,至夜半阴阳大会,气交则卧睡。小便者,水液之余也,从膀胱入于胞
为小便,夜卧则阳气衰伏,不能制于阴,所以阴气独发,水下不禁,故于眠睡而不觉尿出也
小便不通,是由于膀胱和肾脏都有热邪所致。肾主司水液代谢,膀胱是贮存津液的腑,这两条经脉互为表里;而水液运行于小肠,进入胞宫(此处指下焦泌尿部位)的成为小便。肾与膀胱既有热邪,热邪侵入胞中,热气亢盛,导致水道结滞涩痛,致使小便不通,小腹胀满且气促。严重的情况下,水气上逆,引起心下急迫、腹部胀满,甚至导致死亡。
诊察其脉象,若脉紧而滑直,则是小便不通的症状。
小便困难,这是由于肾与膀胱有热邪所致。这两条经脉互为表里,都主管水液,水液运行于小肠,进入胞中成为小便。热邪存在于脏腑之中,水液运行则变得涩滞,如果热势轻微,所以仅仅表现为小便困难。
诊察尺部脉象浮起,是小便困难;尺部脉象濡软,是小便困难;尺部脉象缓弱,是小便困难且有余沥不尽。
遗尿,是由于膀胱虚寒,不能约束水液所致。膀胱属于足太阳经,肾属于足少阴经,这两条经脉互为表里。肾主司水液,肾气向下通达于前阴。小便,是水液代谢后的残余部分。膀胱是贮存津液的腑,腑气既已虚寒,阳气衰弱,不能约束水液,所以导致遗尿。
诊察脉象,脉搏超过寸口,直达鱼际部位,会出现遗尿。肝脉微滑,会出现遗尿。左手关部脉沉伏为阴脉,阴脉断绝者,即没有肝脉搏动,会苦于遗尿。至于汤药熏熨、针刺砭石等治疗方法,另有专门的正方,补养宣导之法,现在附在后面。
《养生方·导引法》说:蹲踞高度约一尺左右,用双手从外侧弯曲膝盖向内收,直到脚背上方,用力握住脚趾,极力伸展一次,使体内气机内曲深入,有利于腰髋关节,治疗遗尿。
有的人在睡眠中不知不觉尿出,这是因为其体质阴气偏盛,阳气偏虚,导致膀胱和肾气俱冷,不能温煦制约水液,所以小便多,或者不能控制而遗尿。
膀胱,属于足太阳经,是肾的腑。肾属于足少阴经,是脏,与膀胱相合,都主管水液。大凡人的阴阳变化,日落时阳气耗尽则阴气受气,到半夜阴阳之气大会,气机交合则入睡。小便,是水液代谢后的残余部分,从膀胱进入胞中成为小便,夜间卧睡时阳气衰伏,不能制约阴气,所以阴气独发,水液下行无法禁止,因此在睡眠中不知不觉地尿出。
Urinary retention is caused by heat in both the Bladder and Kidney. The Kidney governs water metabolism, and the Bladder is the fu-organ that stores body fluids; these two meridians are exterior-interiorly related. Water flows through the Small Intestine, and what enters the "bao" (uterus/lower jiao urinary area) becomes urine. When heat exists in the Kidney and Bladder, heat penetrates the bao, causing excessive heat qi, which leads to obstruction and astringency, resulting in urinary retention, abdominal distension, and shortness of breath. In severe cases, water qi rebels upward, causing urgency in the heart region and abdominal fullness, potentially leading to death.
Upon pulse diagnosis, if the pulse is tight, slippery, and straight, it indicates urinary retention.
Difficulty in urination is also caused by heat in the Kidney and Bladder. These two meridians are exterior-interiorly related and both govern water. Water flows through the Small Intestine and enters the bao to become urine. When heat resides in the zang-fu organs, the flow of water becomes astringent. If the heat pathogen is mild, only difficulty in urination occurs.
If the chi position pulse is floating, it indicates difficulty in urination. If the chi position pulse is soft (ru), it indicates difficulty in urination. If the chi position pulse is slow/relaxed (huan), it indicates difficulty in urination with residual dribbling.
Enuresis (involuntary urination) is caused by deficiency-cold in the Bladder, which fails to constrain water. The Bladder belongs to the Foot-Taiyang meridian, and the Kidney belongs to the Foot-Shaoyin meridian; these two meridians are exterior-interiorly related. The Kidney governs water, and Kidney qi descends to the external genitalia. Urine is the residue of fluid metabolism. The Bladder is the fu-organ for storing fluids; when the fu-organ is deficient and cold, and yang qi is weak, it cannot constrain water, thus causing enuresis.
Pulse diagnosis: If the pulse exceeds the cunkou position and reaches the yuchi area, enuresis may occur. If the Liver pulse is slightly slippery (hua), enuresis may occur. If the pulse at the left guan position is deep (chen) indicating yin, and the yin pulse is absent (indicating no Liver pulse sensation), the patient suffers from enuresis. Regarding treatments such as herbal decoctions, moxibustion/warming, acupuncture, and stone therapy, there are separate specific formulas. Tonifying, nourishing, and guiding exercises are attached below.
The *Yangsheng Fang · Daoyin Fa* states: Squat at a height of about one chi. Use both hands to bend the knees inward from the outside until reaching the dorsum of the foot. Firmly grasp the five toes with your hands, exert maximum force to stretch once, allowing internal qi to curve inward. This benefits the waist and hips and treats enuresis.
Some individuals urinate involuntarily during sleep without awareness. This is due to a constitution where yin qi is excessive and yang qi is deficient, leading to coldness in both the Bladder and Kidney qi, which fails to warm and control water. Consequently, there is polyuria or inability to control urination, resulting in enuresis.
The Bladder is the Foot-Taiyang meridian and is the fu-organ of the Kidney. The Kidney is the Foot-Shaoyin meridian and is a zang organ, harmonizing with the Bladder, both governing water. Generally, regarding human yin and yang: when the sun sets, yang qi is exhausted, and yin qi receives influence; at midnight, yin and yang qi meet and intersect, leading to sleep. Urine is the residue of fluid metabolism, flowing from the Bladder into the bao to become urine. During night sleep, yang qi declines and hides, failing to control yin. Thus, yin qi acts alone, and downward-flowing water is not restrained, causing involuntary urination during sleep.