CASE STUDY
This is a case of a 54-year-old woman. Her main complaint was edema throughout the whole body. It developed in her lower limbs when she caught a chill after bathing. Another cause was the great demand of household duties that led her to over work herself. Gradually the water swelling became worse. When she came to see me, she had been suffering from this for more than nine months.
The patient’s whole body had superficial edema that pitted when pressed. Her hands tingled, she felt flustered, thirsty and liked to
drink. Her abdomen was swollen and her appetite very strong. Her urination was copious and clear, bowel movements normal, pulse wiry, big and rapid. Her tongue was glossy red with cracks like porcelain. Her complexion was withered yellow and lacked lustre.
Diagnosis and treatment method: In order to treat the root fluid insufficiency of the Spleen and Stomach, the method had to be to boost the Stomach and generate fluids.
- Shi Hu 12g (Dendrobii Herba)
- Sha Shen 12g (Glehniae Adenophorae Radix)
- Tian Hua Fen 12g (Trichosanthis Radix)
- Bai Shao 12g (Paeoniae Radix alba)\
- Shan Yao 24g (Dioscoreae Rhizoma)
- Huang Qi Pi 10g (Astragali Cortex)
- Bai Zhu 10g (Atractylodis macrocephalae)
- Sheng Yi Ren 15g (Coicis Semen)
- Chi Xiao Dou 30g (Phaseoli Semen)
After three packets of these herbs, the swelling gradually decreased. After six packets the tongue became paler and a coat began to develop.
Discussion: This case of water swelling for more than nine months is a mix of excess and deficiency. From the complex symptoms Dr Qin grasped the main pathological condition and firmly established the disease mechanism. He first thought over Spleen vacuity as the root of why this patient could not transform dampness. The Nei Jing says: “All damp swelling accumulating belongs to the Spleen.” But, aside from the yellow complexion, arm tingling and flustered heart being (possible) manifestations of the Spleen being weak and unable to transform, there was also thirst with the ability to drink, a very strong appetite and profuse clear urine. These later symptoms did not conform to a disease mechanism of damp blockage. With the tongue and pulse, these symptoms show Spleen and Stomach extreme fluid depletion.
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