“It stings when I pass water and I go every half hour.”
It stings and I go all the time
A three-day urinary picture in someone who has been here before and feels it differently this time.
- Patient
- Woman, 33
- Occupation
- Sales rep; long hours driving between calls
- Medication
- None. Taking cranberry since Monday on her own.
- Allergies
- Allergic to penicillin
- History
- Two bladder infections in three years, both resolved.
- Habits
- Drinks little water while driving so she does not have to stop.
1 · The consultation
You have 18 minutes. Each question or examination costs 2. Choose carefully what to ask.
Questions
Examination
2 · The tongue
3 · The pulse
Describe the pulse on each axis.
4 · The pattern
5 · Differential diagnosis
You're torn between two patterns. Which is it?
Which finding decides it?
6 · Case twist
Patient update“«Oh, and since last night I have had chills and it hurts back here, in my side. I took my temperature earlier: 38.4.»”
Mark the warning signs present:
What do you do?
7 · The treatment
Principle
Strategy
Points (choose 3)
Case solved
Reasoned solution
Pattern: Damp-Heat in the Bladder. Supporting signs: Burning and urgency on urination, Cloudy, dark, strong-smelling urine, Heaviness low in the belly, Yellow greasy coating at the root, Rapid, slippery pulse.
The deciding clue: Cloudy, dark urine: Concentrated, with sediment and a strong smell. In Yin deficiency the urine is clear..
Safety: Fever with chills and renal-angle pain is no longer a lower urinary infection: it is an upper one and needs medical assessment today.
Treatment: Clear Damp-Heat, Promote urination; Drain and cool. Points: BL28, CV3, SP9.
More patients are waiting in the app, with voice, a real timer and a history of your decisions.
See the solution without playing
Pattern: Damp-Heat in the Bladder. Supporting signs: Burning and urgency on urination, Cloudy, dark, strong-smelling urine, Heaviness low in the belly, Yellow greasy coating at the root, Rapid, slippery pulse.
The deciding clue: Cloudy, dark urine: Concentrated, with sediment and a strong smell. In Yin deficiency the urine is clear..
Safety: Fever with chills and renal-angle pain is no longer a lower urinary infection: it is an upper one and needs medical assessment today.
Treatment: Clear Damp-Heat, Promote urination; Drain and cool. Points: BL28, CV3, SP9.
Teaching case. Fictional patient for study purposes. If you have real symptoms, consult a healthcare professional.
