Urinary calculus is a common disease in the urinary system, 
				including calculus of the kidneys, urethral calculus, vesical 
				calculus and urethral calculus. This disease incidence appears 
				obviously in certain areas. The disease belongs to the 
				categories of "sha lin" (strangury form urolithiasis), "shi 
				lin"  (strangury caused by urinary calculus) and  "xue lin" 
				(strangury complicated by hematuria) in TCM. 
				  
				
 
				 
                                                                       
                                                                       
	
                                                                       
                                                                       
				Main 
				Points of Diagnosis 
  
				
				
				
				1.Symptoms  
   
				
				
				
				1) Calculus of the Kidneys: There is a dull pain in the lower 
				loins of the affected side, when the stones in the kidney 
				radiates along the ureter to the lower abdomen and the perineal 
				region which is associated with different degrees of hematuria. 
				If the case turns into a complicated infection, the patient may 
				have fever and pus cells in the urine.  
   
				
				
				
				2) Ureteral Calculus: In the lumbar region there is an acute 
				pain which is often associated with hematuria. When the stones 
				happen to be in the upper 1/3 part of the ureter, the pain will 
				be in the costovertebral angle region and radiate to the part 
				above iliac crest and external side of the abdomen. When the 
				stones descend, the region of pain will also come down with the 
				pain radiating to the thigh, testicle or vulva region.  
   
				
				
				
				3) Vesical Calculus: There is a pain in urination and the pain 
				is often severest at the end of urination. This pain mainly 
				occurs in the lower abdomen and may radiate to the perineum and 
				balanus. Other symptoms are often difficulty of interruption in 
				micturation and hematuria at the end of urination, urgent and 
				frequent micturation.  
   
				
				
				
				4) Urethral Calculus: Pain in urination, thready urination, 
				dribbling urination , or even retention of urine may appear.  
   
				
				
				
				2. Signs: The patients who have kidney calculus will have a 
				percussion pain or a tenderness on the kidney area of the 
				affected side. When there is an obstruction caused by kidney 
				calculus and urethral calculus, sometimes, a swollen kidney will 
				be felt. In vesical calculus and posterior urethral calculus, 
				stones can be felt in rectal examination. In the case of 
				anterior urethral calculus, a hard lump with tenderness may be 
				felt in the local region.  
   
				
				
				
				3. Laboratory Examination: Through urine test the number of red 
				blood cells is often found increased. When the function of 
				kidney is suspected of being impaired, urea nitrogen and 
				creatinine tests will be necessary.  
   
				
				
				
				4. X-ray Examination: The urogram will show the majority of the 
				stones. Use excretion urography or retrograde urography to help 
				you find out the positions of the stones and the functions of 
				both kidneys.  
   
				
 
				
                                                                       
                                                                       
	
                                                                       
                                                                       
				
				
				5. Cystoscopy: "B" type ultrasonograpny and 
				isotope renogram will be helpful for clinical diagnosis.
				
				Differentiation and Treatment of Common Syndromes 
				
				
				
				The following therapies are good for those cases 
				in which the transverse diameter of the stones in the kidney and 
				ureter is less than 1 cm; the transverse diameter of the stones 
				the urinary bladder is less than 2 cm and there is no serious 
				obstruction and infection, and the function of kidney is in a 
				good condition.  
   
				
				
				
				1. Internal Treatment  
   
				
				
				
				1) Qi-Stagnation Type  
   
				
				
				
				Main Symptoms and Signs: In the waist and the lower abdomen 
				there is distending pain, full ache or even paroxysmal colicky 
				pain accompanied with nausea, vomiting and hematuria, tongue 
				with white and greasy fur and tight and taut pulse.  
   
				
				
				
				Therapeutic Principle: Promoting the circulation of qi, inducing 
				diuresis, relieving strangury and removing the stones.  
   
				
				
				
				Recipe: Modified Pyrrosia Decoction  
   
				
				
				
				lysimachia  
   
				
				
				
				pyrrosia leaf  
   
				
				
				
				plantago seed  
   
				(piece 
				of cloth before it is decocted with other herbs  
 				)  
				
				
				cluster mallow fruit  
   
				
				
				
				oriental water plantain rhizome  
   
				
				
				
				citron fruit  
   
				
				
				
				vaccaria seed  
   
				
				
				
				radish seed  
   
				
				
				
				rhubarb  
   
				
				
				
				all the above herbs are to be decocted in water for oral 
				administration.  
   
				
				
				
				2) Damp-Heat Type  
   
				
				
				
				Main Symptoms and Signs: There is a continuous pain in the waist 
				or the lower abdomen accompanied with fever, frequent 
				micturation, urgent urination, urodynia, cloudy or bloody urine, 
				and pyuria, tongue with yellow and greasy fur and slippery rapid 
				or taut rapid pulse.  
   
				
				
				
				Therapeutic Principle: Clearing away pathogenic heat and 
				dampness, relieving strangury and removing the stones.  
   
				
				
				
				Recipe: Modified Eight Health Restoring Powder  
   
				
				
				
				lysimachia  
   
				
				
				
				prostrate knotweed  
   
				
				
				
				Chinese pink herb  
   
				
				
				
				talc  
   
				
				
				
				phellodendron bark  
   
				
				
				
				capejasmine fruit  
   
				
				
				
				plantago seed  
   
				(piece 
				of cloth before it is decocted in water with other herbs  
 				)  
				
				
				rhubarb  
   
				
				
				
				licorice root tip  
   
				
				
				
				All the above herbs are to be decocted in water for oral 
				administration.  
   
				
				
				
				3) Kidney-deficiency Type  
   
				
				
				
				Main Symptoms and signs: The whole course of the illness lasts 
				for a long period. Its symptoms are weakness and ache of the 
				waist and limbs, fullness of abdomen, unsmoothness and 
				feebleness of urination, pale tongue with thin and whitish fur, 
				and deep and thready pulse.  
   
				
				
				
				Therapeutic Principle: Supplementing qi, reinforcing the kidney, 
				relieving stranguria and removing the stones.  
   
				
				
				
				Recipe: Modified Kidney-Reinforcing Decoction  
   
				
				
				
				prepared rehmannia root  
   
				
				
				
				wolfberry fruit  
   
				
				
				
				dogwood fruit  
   
				
				
				
				achyranthes root  
   
				
				
				
				bighead atractylodes rhizome  
   
				
				
				
				eucommia bark  
   
				
				
				
				cinnamon bark  
   
				
				
				
				pilose asiabell root  
   
				
				
				
				lysimachia  
   
				
				
				
				climbing fern spore  
   
				
				
				
				All the above herbs are to be decocted in water for oral 
				administration.  
   
				
				
				
				For those who are marked by acraturesis, add of 6 grams of 
				ginseng instead of pilose asiabell root 30 grams of congongrass 
				rhizome and 15 grams of milkvetch root, For those who have 
				hematuria, add 20 grams each of Japanese thistle and field 
				thistle and 12 grams of sanguisorba root.  
   
				
				
				
				2. Acupuncture Therapy  
   
				
				
				
				1. Body Acupuncture  
   
				
				
				
				Acupuncture Points: Shenshu (UB 23), Pangguangshu (UB 28), 
				Zusanli (St 36), Guangyuan (Ren 4).  
   
				
				
				
				Adjunct Acupuncture Points: Zhongji (Ren 3), Sanyingjiao(Sp 6), 
				Yinlingquan (Sp 9), Shuidao (St 28).  
   
				
				
				
				Manipulation: Choose 2 or 3 acupoints each time and use strong 
				stimulation. Do this twice a day , retaining the needle for 
				20-30 minutes.  
   
				
				
				
				2) Electrotherapy  
   
				
				
				
				Acupuncture Points: The therapeutic electrode (-)is connected 
				with Shenshu (UB 23) or Pangguangshu (UB 28), while the (+) with 
				Guanyuan (Ren 4) or Shuidao (St 28).  
   
				
				
				
				Manipulation: Select the upper and the lower points of the 
				affected side for needling. The intensity of the needling should 
				be form weak to strong and it must be as strong as the patient 
				could bear. Then, sustain the needling for 20-30 minutes, 1or 2 
				times a day.  
   
				
				
				
				3) Ear Needling  
   
				
				
				
				Auricular Points: In the kidney and ureter's area or the 
				tenderness area.  
   
				
				
				
				Manipulation: Use strong stimulation, retaining the needle for 
				15-40 minutes.  
 				
 
 				 
				
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