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24.

Bed-wetting
Bed-wetting refers to the involuntary discharge of urine during sleep at night in children
over three years of age. It is mainly due to the inherent immaturity of the kidneys in
children.
The kidneys control growth and development according to Chinese medicine. For
instance, ones second or permanent teeth and puberty are both signs of the maturation of
the Chinese concept of the kidneys. As in Western medicine, the kidneys are also
responsible
for urination. However, pediatric enuresis, as this condition is technically called,
may also be due to spleen and lung vacuity or damp heat.

Treatment based on pattern discrimination:


1. Kidney vacuity (a.k.a. vacuity cold of the lower origin)
Main symptoms: Nighttime enuresis 1-2 or more times each night, frequent, clear
urination, a pale facial complexion, a tendency to low back or knee soreness or weakness,
possible chilled limbs and a fear of cold, a pale tongue with thin, white fur
Treatment principles: Warm and supplement kidney yang, secure and astringe the
urination

2. Spleen/lung qi vacuity
Main symptoms: Nighttime enuresis, shortness of breath, disinclination to speak,
lassitude of the spirit, lack of strength, a somber white facial complexion, devitalized
appetite, loose stools, spontaneous perspiration, a pale tongue with white fur, a pulse
with diminished force
Treatment principles: Bank the origin and boost the qi, secure and astringe the
urination

3. Liver channel damp heat


Main symptoms: Slippage of a small amount of urine which smells foul and is colored
relatively yellow, emotional tension and agitation, talking in their sleep, bruxism
during sleep, red lips, yellow tongue fur, a rapid, forceful pulse

Treatment principles: Drain the liver and clear heat

Acupuncture & moxibustion


Needle Ye Niao Dian (Nighttime Urination Point) located at the center of the second
transverse
crease on the palmar surface of the little finger. Or one may needle San Yin Jiao (Sp
6) and Guan Yuan (CV 4). If there is concomitant spleen vacuity, add Zu San Li (St 36).

Adjunctive treatments
For vacuity cold of the lower origin make a tea out of cinnamon and licorice and add 2
teaspoons of molasses. For either kidney vacuity or lung-spleen vacuity, do spinal
pinchpull
several times each day to strengthen the bodily constitution. One can also grind a
small amount of Gong Ding Xiang (Flos Caryophylli), Bai Jie Zi (Semen Sinapis), Yi Zhi
Ren (Fructus Alpiniae Oxyphyllae), Wu Yao (Radix Linderae), and Xi Xin (Herba Asari)
into powder. This is then mixed with vinegar and held in place with Shang Shi Zhi Tong
THE DIAGNOSIS & TREATMENT OF COMMONLY ENCOUNTERED PEDIATRIC DISEASES 191

Gao (Injury [due to] Dampness, Stop Pain Plasters) at Zhong Ji (CV 3), Da He (Ki 12),
and San Yin Jiao (Sp 6). These should be changed 1 time each day. And for both the
vacuity and damp heat patterns, a clear, bland diet is very important. For vacuity cold
cases, they should avoid anything which is chilled, cold, or frozen. For lung-spleen vacuity
cases, they should avoid sugar and sweets as well as chilled and raw foods. In the case
of the damp heat in the liver channel, it is also important to help the child develop
stressreducing

and relaxation techniques as well as to identify and correct any causes of emotional
tension and frustration.

Comments
In my clinical practice, the cases of pediatric enuresis I commonly see are due to kidney
vacuity and lung-spleen qi vacuity. Quite frankly, such cases may only present with a
scant few of the symptoms listed above. Happily, when due to kidney vacuity, Jin Suo Gu
Jing Wan (Golden Lock Secure the Essence Pills), which comes as ready-made pills, are
easy for young children to swallow and usually provide cheap, easy, and effective
treatment.
When due to lung-spleen vacuity, I usually prescribe a decoction which is then
administered by an eyedropper.
Some parents both in China and the West try to shame their children into stopping their
bed-wetting, but this is seldom the answer. If the child has weak kidneys, the fear of the
parents anger or disdain will only further damage the kidneys according to Chinese
medicine.
While children with damp heat enuresis in part due to anger and frustration will
obviously only get worse in response to their parents anger and frustration.
Obviously, if a child is having trouble with bed-wetting, they should not be allowed to
drink too much in the evening, and the parents should make sure the child empties their
bladder before bed each evening. In addition, if due to kidney deficiency or lung-spleen
deficiency, the child should not be allowed to become too fatigued before going to bed.
Overfatigue only results in further weakening of the kidneys, spleen, and lungs.