Urinary infection is the common name of pyelonephritis, cystitis and urethritis. The urinary infection is caused by bacteria, and it is common among females (especially among pregnant women). The main clinical symptoms are fever, lumbago, frequent micturition, urgent urination, urodynia, etc. According to the symptoms, urinary infection falls into two kinds: acute and chronic cases. Most of the acute infections may be cured, but a small number of the cases will become protracted and recurrent, which eventually develop into chronic state due to various causes. In the final state of the decease it can lead to a renal insufficiency. In Traditional Chinese Medicine (TCM) urinary infections are included in two categories: "strangury" and "lumbago." In the chronic urinary infections there are more complex pathogenesis and different clinical manifestations. The one with remarkable symptoms due to deficiency such as edema, acratia and emaciation should be included in the syndromes of "edema" and "consumptive disease" of TCM.

Etiology and Pathogenesis

Because of eating too much food, which is pungent and sweet in flavour, and hot and fatty in nature; or because of excessive drinking [NOTE: this means usually alcoholic beverages; this can be stated also; or because of excessive drinking of water], damp-heat is led to flow downward into the urinary bladder.  Because of the low orifices are unclean, dirty and turbid pathogens seize the opportunity to invade the urinary bladder; a damp-heat is formed; and because of damp-heat is accumulated in the lower-warmer, the qi of the urinary bladder fails to perform its function normally. In this case there will be urgent urination, frequent micturition and urodynia. If the disease is protracted, both the spleen and kidney will become weakened, and in turn, syndromes due to both deficiency and excess will be brought about.

Type and Treatment

1. Type of Damp-Heat in the Urinary Bladder (usually seen in acute urinary infection)

Symptoms: Fever, aversion to cold, frequent micturition , urgent urination, urodynia, distending pain in the low abdomen, lumbago, yellow greasy tongue coating, and slippery rapid pulse.

Therapeutic Method: Clearing away heat, removing toxic material and inducing diuresis to treat strangury.

Prescription: Shiwei Tonglin Fang (Pyrrosia Leaf Recipe for Treating Strangury).

Ingredients:

Shiwei Folium Pyrrosiae

Bianxu Herbal polygoni Avicularis

Qumai Herba Dian Thi

Dahuang Radix et Rhizoma Rhei

Danzhuye Herba Lophatheri

Baimaogen Rhizoma Imperatae

Cheqianzi Semen Plantaginis (decocted after being wrapped in a piece of cloth)

Huashi Talcum

Kuncao Herba Leonuri

Gancao Radix Glycyrrhizae

Administration: Decocted in water for oral use, 1 dose daily.

Modification: In case of more severe chills and fever, bitter taste, nausea and vomiting, the drugs added are Chaihu Radix Bupleuri, Banxia Rhizoma Pinelliae and Huangqin Radix Scutellariae.

If the number of pus cells fails to be reduced and the tongue coating is yellow and greasy, the herbs added are Pugongying Herbal Taraxaci, Tufuling Rhizoma Smilacis Glabrae.

In case of hematuria, the herbs added are Xiaoji Herbal Cirii, Shendi Radix Rehmanniae and Oujie Nodus Nelumbinis Rhizoma.

Simple Prescription 1

Pugongying Herba Taraxaci

Decocted in water for oral use.

Simple Prescription 2

Xianshuweigen Radix Pyrrosiae

Cleaned, pounded and then decocted in water to get thick decoction for oral use.

Proven Prescription 1

Ingredients:

Diding Herba Violae

Cheqianzi Semen Plantaginis

Administration: Decocted in water for oral use.

Proven Prescription 2

Ingredients

Shuanghua Flos Lonicerae

Maogen Rhizoma Imperatae

Kuncao Herba Lonicerae

Cheqiancao Herb Plantaginis

Zhuye Herba Lophatheri

Administration: Decocted in water for oral use.

2. Type of Retention of Damp-heat due to Insufficiency of the Kidney-Yin (usually seen in chronic urinary infection).

Symptoms: Dizziness, tinnitus, soreness and weakness of the loins and knees, dry throat and lips, low fever, mild or severe frequent and urgent urination and urodynia, reddish tongue with thin coating, and taut thready rapid pulse.

Therapeutic Method: Nourishing Yin, invigorating the kidney, clearing away heat and descending fire.

Prescription: Modified Zhi Bai Dihuang. Tang (Decoction of Anemarrhena, Phellodendron and Rehmannia).

Ingredients:

Shengdi Radix Rehmanniae

Shanyao Rhizoma Dioscroeae

Shanyurou Fructus Corni

Danpi Cortex Moutan

Fuling Poria

Zexie Rhizoma Alismatis

Zhimu Rhizoma Anemarrhenae

Huangbai Cortex Phellodendri

Shiwei Herba Pyrrosiae

Danzhuye Herba Lophatheri

Administration: Decocted in water for oral use, 1 dose daily.

3. Type of Deficiency of Both the Spleen and Kidneys, and Weakened Body Resistance and Retention of Pathogens (usually seen in chronic pyelonephritis)

Symptoms: Edema of the face and feet, listlessness, acratia, soreness and weakness of the loins and knees, dizziness, tinnitus, anorexia, distension of the abdomen, loose stools, frequent and dribbling urination, pale tongue with thin white coating, and deep thready weak pulse.

Therapeutic Method: Strengthening the spleen, invigorating the kidney, clearing way heat and inducing diuresis.

Prescription: Wubi Shanyao Wan (Incomparable Pill of Chinese Yam).

Ingredients:

Shanyao Rhizoma Dioscoreae

Fuling Poria

Zexie Rhizoma Alismatis

Shudi Radix Rehmanniae Preparata

Shanyurou Fructus Corni

Bajitian Radix Morindae Officinalis

Tusizi Semen Cuscutae

Duzhong Cortex Eucommiae

Niuxi Radix Achyarn this Bidentatae

Wuweizi Fructus Schisandrae

Roucongrong Herba Cistanches

Chishizhi Halloysitum Rubrum

Administration: decocted in water for oral use, 1 dose daily.