Appendix

The conditions of retention of urine and blood in the urine will be dealt with only in tabular
form.

Retention of Urine

Retention of urine ranges from scanty and difficult urination (without pain) to total absence of
urination. If there is scanty and difficult urination with pain, then it falls under the heading of
Painful-Urination Syndrome.

From a Western medical perspective, urinary retention may be due to episiotomy after childbirth,
bladder stones, prostatic hypertrophy and carcinoma of the prostate. Although acupuncture and
herbal medicine are effective for this condition, in advanced cases when the prostate is grossly
enlarged the possibility of combining Chinese medicine with Western medicine should be
discussed with the patient. In particular, in the case of benign prostatic hypertrophy, Western
medicine can help with a relatively simple procedure consisting of enlarging the urethra with a
catheter.

Retention of Blood

Blood in the urine is characterized by the presence of frank or occult blood in the urine without
pain. If it is accompanied by pain it falls under the category of Painful-Urination Syndrome.

If there are large amounts of blood in the urine, the urine will be smoky-coloured, brightred or
reddish-brown. Haematuria may be caused by nephritis, endocarditis, polyarteritis, systemic
lupus erythematosus (if it affects the kidney), TB of the kidney, polycystic disease, haemorrhagic
disease, tumour of the kidney, infection of the lower urinary tract and carcinoma of the prostate
or bladder. When blood is present in the urine a cause should always be sought and found in
Western medicine. It is therefore essential to get a good Western diagnosis from a specialist.

It is convenient to classify haematuria into pre-renal, renal and post-renal depending on whether
the cause resides in organs above the kidney, in the kidney itself or in organs below the kidney,
i.e. bladder or prostate. Table 21.3Table 21.3 lists the most common of these conditions.

When blood appears only at the beginning of micturition, the source of bleeding is below the
bladder. When blood is uniformly mixed with urine, it may come from anywhere above the
urethra.

The patterns causing retention of urine in Chinese medicine are summarized in Table 21.1Table