Liu Wei Di Huang Tang for edema

  Edema is a disease in which water is retained in the body, causing swelling.  The pathogenesis of edema is mostly attributed to the three organs of the lung, spleen and kidney, mostly due to Qi deficiency and Yang deficiency, but also due to the stagnation of Qi and blood stasis. Therefore, when applying the tonic method, the main focus is on tonifying Qi and Yang, and the application of the method of tonifying Yin is relatively rare. Edema, mainly water-dampness accumulation, and then nourishing Yin to increase fluid, seems inappropriate.  When I was in college, my teacher mentioned that Professor Zhou Fengwu, a famous doctor in Shandong, had applied Liu Wei Di Huang Tang to treat edema, and I was very surprised. After coming to the evidence more, reading more, and gaining a deeper understanding of the dialectical treatment of Chinese medicine, I gradually felt that it was inevitable to treat edema with Liu Wei Di Huang Tang.  In the Qing dynasty, Li Yongcui’s “evidence of treatment Huixing – edema” has a discussion of the pathogenesis of “yin deficiency edema”: “The kidney, the stomach of the off, off the door is unfavorable, gathering water sickness. Therefore, edema belongs to yin deficiency, the lung gold does not descend and swelling, the symptoms of abdominal large umbilical swelling, waist pain, feet hard, small water short, cough with phlegm, can not lie down, red face and thirst, but the diet know taste, stool is dry, this water attached to the dragon up. This is due to the overflow of water from the phase fire.”  The patient’s tongue is mostly red and vivid, and the pulse is thin and stringy, suggesting yin deficiency. The treatment should be to nourish yin and promote water, which can be done by combining pig ling Tang and Liu Wei Di Huang Tang with addition and reduction. The amount and proportion of water-relieving drugs and yin-nourishing drugs should be controlled according to the specific situation of water-dampness accumulation and yin-liquid damage, so that water-relieving drugs do not harm yin and yin-nourishing drugs do not hinder evil. It can also be applied alternately according to the condition to promote water and nourish Yin.  Between attack and supplementation, it depends on one idea. The doctor’s intention is also true!