these symptoms were always immediately aggravated from overwork. Her urinary symptoms
started 2 months after a hysterectomy operation which had been done due to very heavy
bleeding. Her tongue was Pale and her pulse very Weak and Fine, especially so on both Rear
positions.

Diagnosis This is a condition of Fatigue Painful-Urination Syndrome against a
background of Kidney-Yang deficiency. As for a previous patient
whose case history was presented in the section on Qi Painful-Urination
Syndrome, the urinary symptoms started after a hysterectomy: this was
due to the transferral of a condition of stagnation from the uterus to the
nearest organ, i.e. the bladder. The heavy menstrual bleeding which
prompted her to have the hysterectomy itself, was obviously due to the
deficiency and sinking of Spleen- and Kidney-Qi, the same causes of
the subsequent Painful-Urination Syndrome.

Treatment principle The principle of treatment adopted was to tonify Spleen-Qi and
Kidney-Yang. This patient was treated only with acupuncture.

Acupuncture The points used (with reinforcing method) were the following:

LU-7 lieque on the right and KI-6 Zhaohai on the left to open the

Directing vessel, tonify the Kidneys and move Qi in the lower abdomen.

Ren-4 Guanyuan with direct moxa cones to tonify and warm

Kidney-Yang.

Du-20 Baihui to raise Qi: this point combines well with Ren-4

Guanyuan.

KI-3 Taixi with moxa on needle to tonify and warm Kidney-Yang.

BL-20 Pishu and BL-23 Shenshu to tonify Spleen- and Kidney-Yang.

This patient was treated for over 9 months as her energy was very low

and this produced an improvement of about 70% in her symptoms.

Appendix: Urinary Calculi

The "Classic of the Secret Transmission" (c. AD 200) by Hua Tuo mentions urinary stones in
chapter 44:

A dull abdominal pain, difficulty and pain on micturition and emaciation indicate

urinary stones ... Stones are caused by Qi deficiency and Heat ... [their

formation] is similar to the evaporation of sea water by fire to produce