realizing it. This usually happens to children in nocturnal enuresis.

Incontinence means inability to control the voiding of urine. The urine is passed involuntarily;
the person involved knows he or she is doing it, but cannot hold it back. This happens to old
people or to those suffering from certain neurological diseases such as multiple sclerosis.

In less severe cases, there may only be urgency of urination (i.e. the person has to go quickly
once the urge comes or will be incontinent) or difficulty in holding urine. In yet other cases, a
person may be only slightly incontinent and pass urine only on coughing or jumping. All these
less severe conditions share the same aetiology, pathology and treatment as true enuresis and
incontinence.

Aetiology and Pathology

Weak Constitution

Weak constitution is a cause of nocturnal enuresis in children. Constitutionally-deficient Kidneys
are unable to control fluids and fail to provide Qi to the Bladder: this results in nocturnal
enuresis.

Shock

Prenatal or perinatal shock in children can be a cause of nocturnal enuresis. This can be observed
in a bluish colour on the child's chin.

Old Age

The natural decline of Qi occurring with ageing may cause incontinence in old people. This is
due to a decline not only of Kidney-Qi, but also of Lung- and Spleen-Qi.

Excessive Sexual Activity

Excessive sexual activity weakens Kidney-Yang and may lead to inability of the Kidneys to
control fluids and therefore to slight incontinence.

Chronic Cough

The persistent strain caused by a chronic cough may lead to incontinence in a mechanical way
from the strain on the bladder and, in an energetic way, from deficient Lung-Qi not controlling