Edema

SYMPTOMS AND SIGNS: Edema ls Water retention in certain parts of the body, such as edema of the skin, or face, eyelids, four limbs, abdomen and back of body, or edema of the whole body. lri Western medicine, edema is mostly seen in acute and chronic nephritis, and infantile malnutrition.

ETIOLOGY AND PATHOLOGY: The normal movement and distribution of water metabolism or body fluids are closely related to the dispersing function of lung, transformation and transportation functions of spleen, and the primary generating power of kidney Qi function. The water passages are usually called San Jiao (triple burner, ortri pie warmer) through the functions of lung, spleen and kidney. So any pathogenic factors which can cause the dysfunction of those three organs are going to cause edema, such as the attacking of lung by the exogenous wind factor, or the obstruction or deficiency of spleen by living in a damp area for long time, or excessive food, drinks and alcohol or kidney Qi deficiency due to giving birth or excessive sexual activities. 

DIFFERENTIATIONS: 

1. EDEMA OF YANG TYPE:

(1). Edema by Exogenous Wind: 

Indications: Sudden onset of edema from eyelids, then spread to four limbs and other parts of the body, sore and heavy limbs, dysuria, Usually accompanied with aversion to cold, or wind, fever; or cough, asthma, shortness of breath, white and thin coating, floating and rolling pulse; or sore and painful throat, red tongue, floating, rolling and rapid pulse. Deep pulse can be seen if the edema spreads to other parts of the body in a very quick manner. 

Treatment & Formulas: Dispel wind and clear the heat, open the lung Qi thereby eliminating excessive water.

Products:

    • Yue Pi Jfa Zhu Tang (Atractylodes Combination, Item No. 2205): This is the best formula for edema of exogenous wind type. It is also applied for acute nephritis, rheumatoid arthritis, eczema, acute conjunctivitis, Reiter's syndrome, and etc. 

(2). Edema of Water and Damp-retention: 

Indications: Edema of the whole body, hard to recover to normal when pressing the skin, dysuria, or oliguria, heaviness and fatigue, poor appetite, vomiting, white greasy coating, deep and slow pulse. This type usually has a long and chronic edema. 

Treatment & Formulas: Tonify the spleen and eliminate the dampness or water retention, promote the Yang so as to help the water metabolism. 

Products:

    • Wu Ling San (Hoelen Five Herb Formula, Item No. 2043): This is a famous formula for chronic edema from Dr. Zhong Jing Zhang's book San Han Lun (The Treatise on Febrile Diseases) 210 A.D. ltis often applied for nephritis, renal necrosis, chronic nephritic edema, cardiac edema, etc.
    • Wu Pi Yin (Hoelen and Areca Combination, Item No. 2042): This is a strong formula for diuresis. It can be combined with Wu Ling San (Item No. 2043) to treat overall edema, and usually has a
      very effective and quicker result by using these two formulas.  

(3). Edema of Damp-heat Type: 

Indications: Overall edema, bright and moist skin, fullness of chest and abdomen, restlessness, thirsty, scanty urine, constipation, yellow greasy tongue coating, deep and rapid pulse. 

Treatment & Formulas: Eliminate the damp-heat and promote the diuresis. 

Products

    • Yin Chen Hao Tang (Capillaris Combination, Item No. 2142): This is a strong formula for damp-heat symptoms
    • Wei Ling Tang (Magnolia and Hoelen Combination, Item No. 2135): This formula is for damp-retention symptoms. 
    • Jiu Wei Bin Lang Jia Wu Fu Tang (Areca Seed Combination, Item No. 2013): This is a good formula for edema, beriberi, hyperpnea due to the turbid damp factor. 
    • The above three formulas may be combined together, or make two of them combined; or use singly according to the symptoms and signs. 

2. EDEMA OF YING TYPE:

(1 ). Edema due to Spleen Yang Deficiency: 

Indications: Edema below waist, hard to recover to normal when pressing skin, full and dull sensation of abdomen, poor appetite, loose stool, dull and yellowish face, fatigue, scanty urine, pale tongue, white and greasy coating, deep and slow pulse. 

Treatment & Formulas: Tonify the spleen and promote water metabolism. 

Products:

    • Fang Ji Huang Qi Tang (Stephania and Astragalus Combination, Item No. 2102): It tonifies the spleen and has a diuretic function at the same time. It is used in nephrosis, sephrities, hydrocele, eczema, obesity, rheumatism due to the deficiency of spleen. 
    • Yin Chen Wu Ling San (Capillaris and Hoelen Five Formula, Item No. 2143): This is a formula for damp retention symptoms due to spleen Yang deficiency. It use for nephritis, renal necrosis, liver disease or jaundice, dysuria, etc. 
    • Gui Pi Tang (Ginseng and Longan Combination, Item No. 2261): It treats edema due to the spleen Qi deficiency by promoting the function of spleen and stomach. 
    • Shen Ling Bai Zhu San (Ginseng and Atractylodes Formula, Item No. 2173): This is a very good formula for any damp symptoms due to the spleen Qi deficiency. So it is often used for edema, chronic gastroenteritis, diarrhea, indigestion, anorexia, infantile diarrhea, and etc. 

(2). Edema due to the Kidney Yang Deficiency: 

Indications: Edema of face and lower part of the body, especially below the waist, skin does not recover quickly after pressing, palpitation, shortness of breath, cold, heavy and sore sensation at I um bar regions, scanty urine, cold four limbs, cold looking, fatigue, grey, dull or pale face, pale and enlarged tongue, white coating, thready deep or slow deep pulse. 

Treatment & Formulas: Tonify the kidney Yang and promote water metabolism.

Products:

    • Zhen Wu Tang (Vitality Combination, Item No. 2170): This is a typical formula for edema of kidney Yang deficiency type. It is often applied to endocrine disorders, vertigo, palpitation, chronic diarrhea, gastrointestinal weakness, peritonitis, appendicitis, chronic nephritis, etc.; which are all due to the kidney Yang deficiency type. 
    • Ji Sheng Shen Qi Wan (Achyranthes and Plantago Formula, Item No. 2263): It is often used for chronic nephritis, lumbago, edema due to kidney Yang deficiency. It tonifies the kidney Yang, and also has a diuretic function at the same time. 

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