"Tongling San" for Treating Frequent Urination
Tongling San comes from Qixiao Liangfang (Effective Formulas Tested over Generations). Its composition is: Yizhiren (Alpiniae Oxyphyllae Fructus, alpinia), Baifuling (white Poria), and Baizhu (Atractylodis Macrocephalae Rhizoma, atractylodes) in equal parts. Grind all the above into a fine powder; take 2 qian (6 g) each time, mixed with plain boiled water or warm wine, at any time.
This formula warms the kidney and nourishes the heart, reduces urination and transforms turbidity. It is indicated for insufficiency of heart qi with frequent urination and red or white cloudy urine (leukorrhagia/non-gonococcal urethritis-like discharge), symptoms often caused by urethritis or prostatitis. Because the formula uses Yizhiren, a Zingiberaceae plant, and TCM theory holds that Yizhiren warms the spleen, stops diarrhea and controls salivation, and warms the kidney, reduces urination and secures essence, this formula is only suitable for the spleen-kidney yang-deficiency type of frequent urination, marked by clear, long urination, cold and painful lower back and knees, and weak feet. Patients with yin deficiency with flourishing fire and scanty, dark yellow urine should use it cautiously.
The Yizhiren in this formula reduces urination, while Fuling and Baizhu strengthen the spleen and promote diuresis (i.e., they are diuretics in TCM). Using a urine-reducing herb together with diuretics reflects TCM's holistic approach: it bilaterally regulates the patient's urination and improves the symptom of frequent urination. This line of reasoning is also seen in formulas like Liuwei Dihuang Wan and Guifu Dihuang Wan: among the Dihuang-series formulas, there are herbs that warm and tonify kidney yang and nourish kidney yin to reduce urination, alongside diuretics such as Fuling and Zexie. Such a composition seems contradictory, but in fact it bilaterally regulates the body's outflow and discharge function.
Frequent urination is mostly a chronic condition requiring long-term treatment. Once the patient improves on this formula, they can grind the herbs into powder, use refined honey as an excipient, and form soybean-sized water-honey pills; take 6 g each time, 2–3 times daily, which is convenient for storage and long-term use.