and Qi deficiency.

By rolling the finger proximally on the left Rear position, one can feel the prostate position. If
this feels Full and Slippery it may indicate prostatic hypertrophy. This is often the cause of
Painful-Urination Syndrome, especially Qi Painful-Urination Syndrome or Fatigue
Painful-Urination Syndrome.

Differentiation and Treatment

I shall discuss six types of Painful-Urination Syndrome:

Heat

Stone

Qi

Blood

Sticky

Fatigue.

All types are manifested with difficulty and pain on urination (which may radiate to the
hypogastrium), dribbling of urine, sacral ache and frequency of micturition.

As always in Chinese medicine, it is essential to distinguish between Full and Empty conditions.
Generally speaking, the beginning stages of Painful-Urination Syndrome are characterized by
Fullness, e.g. Dampness, Heat, stones and Qi stagnation. The chronic stage is characterized by
Emptiness, e.g. Qi deficiency, Spleen-Qi sinking, Lung-Qi deficiency and Kidney deficiency.

Three of the six types of Painful-Urination Syndrome are always Full or always Empty in
character.

These are:

Heat Painful-Urination Syndrome - Full type

Stone Painful-Urination Syndrome - Full type

Fatigue Painful-Urination Syndrome - Empty type.

Each of the other three categories of Painful-Urination Syndrome can be either of the Full or
Empty type. These may be summarized in tabular form (Table 20.1Table 20.1).

In the beginning stages when Fullness is evident the main principle of treatment is to clear Heat,
resolve Dampness, drain Water and open the Water passages. In the late stages when Deficiency