Introduction: The author of this article has developed two unique formulas: "Qing Shang Gu Xia Tang" (Clearing the Upper and Consolidating the Lower Decoction) and "Wen Yang Hua Qi Tang" (Warming Yang and Transforming Qi Decoction). Since their creation, clinical validation has shown that these formulas are highly effective in treating bedwetting, urinary incontinence, and enuresis, with no recurrence observed. They can be considered excellent prescriptions.

Enuresis

Song Jianmin

Involuntary urination during sleep is termed enuresis (commonly seen in children). Frequent urination and urinary incontinence are referred to as urinary incontinence (often observed in adults or the elderly). Unconscious and spontaneous urination is called urinary leakage (frequently seen in postpartum women and elderly individuals). Although the symptoms of these three conditions differ, their underlying pathogenesis is fundamentally the same: the bladder fails to restrain urine, leading to loss of bladder control. The *Inner Canon* states, "Failure of the bladder to restrain results in urinary leakage." Most colleagues in treatment often modify formulas such as Suoquan Wan, Buzhong Yiqi Tang, and Shenqi Wan, but the efficacy is suboptimal. One day, while reading the section on urinary leakage in *Wanbing Huichun*, I came across the statement: "Human urination relies on the transmission of qi from the heart and kidneys. The heart and small intestine are exterior-interiorly related, and the kidneys and bladder are exterior-interiorly related. If the qi of the heart and kidneys is deficient, the transmission becomes disordered, leading to this condition." This greatly inspired me. Consequently, I explored a new approach and, based on years of clinical practice, created the formulas "Qing Shang Gu Xia Tang" (Clear the Upper and Secure the Lower Decoction) and "Wen Yang Hua Qi Tang" (Warm Yang and Transform Qi Decoction). According to clinical observations, enuresis is mostly seen in children, as their bladder qi is not yet consolidated, and heart heat is common. Therefore, I used Daochi San (Bamboo Leaf, Licorice, Akebia, and Rehmannia) to clear heart heat, combined with Sichuan Aconite, Fennel, and Cimicifuga to secure the lower origin, hence naming it "Qing Shang Gu Xia Tang." Urinary incontinence, on the other hand, is often caused by insufficient heart yang and impaired qi transformation. Thus, I used Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction) to support heart yang, and Astragalus, Poria, and Ginger to supplement qi and transform turbidity, hence naming it "Wen Yang Hua Qi Tang." This demonstrates that this syndrome varies, with cold, heat, and deficiency mixed with excess. Since creating these formulas, clinical verification has shown repeated efficacy without recurrence, making them excellent prescriptions.

1. Application of Qing Shang Gu Xia Tang

Ingredients: Bamboo Leaf, Licorice, Rehmannia, Cimicifuga, Sichuan Aconite, Fennel.

Usage: Decoct in water for oral administration. Most patients show improvement after 5 doses and recover completely after 10 doses.

Indications: Highly effective for bedwetting in children under 14–15 years old.

Modifications: Add Astragalus (Huangqi) for qi deficiency.

2. Application of the Warming Yang and Transforming Qi Decoction

Medicinal Ingredients: Cinnamon Twig, Poria, Licorice Root, Astragalus, Ginger.

Usage: Decoct in water for oral administration.

Indications: Adults or the elderly experiencing urinary incontinence due to coughing, exertion, or stress.

Modifications: For urinary incontinence accompanied by lower back pain, add Mantis Egg-Case.

3. Empirical Formulas

(1) Effective for women with postpartum urinary incontinence or elderly individuals who frequently experience involuntary urination. Alum 30g, Mantis Egg-case 30g, grind into fine powder, divide into 30 packets. Take 1 packet morning and evening, swallowed with warm water.

(2) Formula for residual urine and incomplete voiding: Euryale Seed 500g, ground into powder. Take 25g three times daily, cooked with rice and consumed.

4. Case Summary

Case 1: Qu, female, 52 years old, farmer, from Zaohang Village, Laiyang City. Initial consultation on May 23, 1997. The patient frequently experiences urinary incontinence and frequent urination due to fatigue. She had previously taken Suoquan Pills and Bawei Dihuang Pills, both without effect. Upon examination, the tongue coating was slightly greasy and white, the body was robust, and the pulse was weak. Diagnosed as qi deficiency failing to restrain and impaired qi transformation. Treatment: Astragalus 30g, Cinnamon Twig 9g, Poria 30g, Licorice 9g, Ginger 3 slices. Decocted in water and taken orally. After 10 consecutive doses, the condition did not recur.

Case 2: Ba, male, 9 years old, student at Laiyang Advanced Studies School. Initial consultation on November 30, 1997. The child had been bedwetting frequently for over three years, with no cure despite prolonged treatment. His grandmother brought him for consultation. Examination revealed a red and glossy tongue and a weak chi pulse. He dreamed of bedwetting every night while sleeping. Diagnosed as heart fire flaring upward and kidney qi failing to consolidate. Treatment with Qing Shang Gu Xia Tang: Rehmannia 20g, Akebia 5g, Bamboo Leaves 6g, Licorice 3g, Fennel 3g, Cimicifuga 4g, Aconite 3g. Decocted in water and taken orally. After the initial 5 doses, improvement was observed. An additional 5 doses were taken, resulting in complete recovery.