Edema - Shui Zhong

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Contents

Definition

A condition marked by water and body fluid retention which floods the body and resulting in the swelling of the eyelids, face, head, limbs or even all over the body. In some severe cases there can also be hydrothorax and ascites.

Causes

Exogenous Evils

Endogenous Evils

Pathological Mechanisms

  • Three major Zang Fu organs (Lung, Spleen and Kidney) are involved but the kidney is the controlling organ.
  • In Shui Zhong (edema), there are Yang Shui (water) and Yin Shui (water). Yang Shui involves the Lung and Spleen, whilst Yin Shui involves the Spleen and Kidney.
  • Although Shui Zhong is classified into Yang Shui and Yin Shui, impairment of Yang is more prevalent
  • Yang Shui transforming into Yin Shui is often seen due to improper treatments
  • When the Spleen and Kidney are deficient and water not cleared up, it becomes a “root deficiency and branch excess” syndrome.

Patterns

Yang Shui - Feng Shui Flooding

  • Symptoms: Edema: eyelid swelling, followed by swelling all over the body. Developing rapidly. Fever, aversion to wind and cold, achy joints, sore and swelling throat, cough and urination difficulties.
  • Tongue: Thin white coating
  • Pulse: Floating and Slippery or Tight, or Deep, Slippery and Rapid or Deep and Tight
  • Treatment strategy: Expel wind to relieve the exterior and activate the lung to move the water
  • Formula: Yue Bi Tang
  • Acupoints:

Yang Shui - Sore-Toxin Invasion

Yang Shui - Damp Heat Accumulation

  • Symptoms: Edema: spreading whole body, stretched and shiny skin. Vexation, thirsty but not drinking much, stuffy chest and epigastrium, dark and scant urine with difficulties in urination, loose and sticky faeces or constipation.
  • Tongue: Yellow and greasy coating
  • Pulse: Deep and Rapid or Soggy and Rapid
  • Treatment strategy: Clear heat and drain dampness
  • Formula: Shu Zao Yin Zi
  • Acupoints:

Yang Shui - Water and Dampness Flooding

  • Symptoms: Edema: all over the body, compression test shows deep finger indentation. Short and scanty urination, heavy body, lack of shen, stuffy chest nausea and vomit, poor appetite. Slow onset, long history, living in damp place or working in water.
  • Tongue: White and greasy coating
  • Pulse: Moderate
  • Treatment strategy: Dry the dampness and drain the water, regulate qi and invigorate spleen
  • Formula: Combination of Wu Ling San, Wei Ling Tang and Wu Pi Yin
  • Acupoints:

Yin Shui - Spleen Yang Deficiency

  • Symptoms: Edema: swelling more below the waist, compression test shows deep finger indentation. Stuffy epigastrium and poor appetite, distending abdomen and loose faeces, pale complexion, cold limbs, lack of shen, short and scanty urination.
  • Tongue: Pale and swelling tongue with teeth marks, white and slippery or greasy coating
  • Pulse: Deep and Moderate or Weak
  • Treatment strategy: Warm to invigorate spleen yang and drain water
  • Formula: Shi Pi Yin
  • Acupoints:

Yin Shui - Kidney Yang Deficiency

  • Symptoms: Edema: face and body swelling, more below the waist, compression test shows deep finger indentation. Palpitation, short of breath, lower back pains and aches with heavy feeling, pale or even dull grey complexion, very cold limbs, aversion to cold, lack of shen, short and scanty urination or profuse urination.
  • Tongue: Pale and swelling tongue with teeth marks and white coating
  • Pulse: Deep, Slow and Weak
  • Treatment strategy: Warm the kidney to remove cold and activate qi to drain water
  • Formula: Zhen Wu Tang and Ji Sheng Shen Qi Wan
  • Acupoints:

References

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