Hi Sharon,
I am curious about your observation of SI deficient scenarios that "water that should be in the blood is leaking out the bladder" manifesting in frequent urination and night urination. In my practice, relative Kidney excess commonly manifests with frequent urination and nocturia and supplementing SI helps. In these cases the urinary issues have always manifested with incomplete urination causing the frequency.
I understand that blood stasis can cause fluids to leave the vessels. Clinically that has mostly shown up as edema. That SI deficiency can manifest with fluids leaking out of the bladder is a novel idea and not something I've encountered. In your experience, is what you are terming leakage excessive unobstructed urination? Can it occur with urgency or incontinence?
Is this Small Intestine deficiency, rather than strong Kidney excess, show up in particular scenarios, such as post trauma, where supplementing SI can be helpful to move blood even when Kidney excess signs are not strong? I do keep an open mind about what might be preventing the resolution of blood stasis, besides overconsolidation coming from the Kidneys.
Thanks in advance.
Hi Kristin, I find it exciting that you have noticed the water imbalance with small intestine deficiency too. In Chinese, 不李 Bu Li, is often translated as "inhibited urination." However, more accurately, 不利 means "unbeneficial urination." Various physicians have written about this. Professor Feng Shilun comes to mind. Many consider "unbeneficial urination" to be a better translation of the term because it can include frequent urination, profuse urination, urgent urination, inhibited/incomplete urination, or incontinence. It is a general term to indicate that urination is not working in a beneficial way. A beneficial way is that the fluids are appropriately steamed, absorbed, and discharged. This is all to say that with SI deficiency, I see the results of water not being properly steamed and absorbed as both leaking out too much or pooling up. Pooling up can mean inhibited urination or edema, both of which can come with frequent urination. Leaking out can mean frequent copious urination or incontinence.
I've found that frequent urination is more common than we think, and finding it might relate to our questions. I often ask if the person feels like they drink and that water goes right through them. I ask if they feel they need to limit what they drink to control how often they have to pee.
Does that make sense?
That does makes sense. I'll be on the lookout for this presentation. I tend not to grill patients on urination unless they feel it is a problem for them or there is something I don't understand about their fluid metabolism because, in general, it doesn't provide information that will make or break my Saam diagnosis.
In my clinic, cases of urinary frequency/incontinence with free flowing urine have responded well to treatments that astringe, hold and contain.
Thanks again. Your presentation has given me lots to chew on!
