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Golden Chamber 2

Golden Chamber 2. Chapter 14 On Pulse Syndrome Complex and Treatment of Edema. Concept: edema caused by qi failing to transform. Classification: Feng Shui (Wind-edema), Pi Shui(skin-edema), Zheng Shui (Zheng-edema), Shi Shui (Stone-edema), Huang Han (Yellow-sweat) 【1】

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Golden Chamber 2

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  1. Golden Chamber 2

  2. Chapter 14 On Pulse Syndrome Complex and Treatment of Edema

  3. Concept: edema caused by qi failing to transform. • Classification: • Feng Shui (Wind-edema), Pi Shui(skin-edema), Zheng Shui (Zheng-edema), Shi Shui (Stone-edema), Huang Han (Yellow-sweat) 【1】 • Five Zang Shui ( five Zang edema) 【13】 【14】 【15】 【16】 【17】

  4. Five Zang Edema • 【13】 Heart edema • 【14】 Liver edema • 【15】 Lu edema • 【16】 SP edema • 【17】 K edema

  5. Feng Shui (Wind-edema) • Location: LU • Exterior syndrome: aversion to wind, joints pain • Edema: face swollen first or severer • Degree: acute onset, fast development • Pathogenesis: Wind from exterior, water from interior.  Wind water conflict and flood in skin • “The exterior of the exterior”

  6. Pi Shui(skin-edema) • Zangfu: LU, SP • Not related to an exterior syndrome • Swelling all over body, especially extremities • Degree: slow onset • Pathogenesis: SP LU qi deficency, fail to transport and regulate water passage, water flood in superficial body • “Interior of the exterior” type water retention.

  7. Zheng Shui (Zheng-edema) • Ki, SP, LU • Fullness in abdomen with wheezing • Pathogenesis: SP K yang deficiency qi transforming dysfunction flow upward to disturb LU

  8. Shi Shui (Stone-edema) • Zangfu: Liv, K • Fullness in abdomen without wheezing • K yand deficiency, Liv qi stagnation  water isolated in lower jiao

  9. Huang Han (Yellow-sweat) • Zang fu: SP LU • Edema in four extremities and face, yellow sweating, deep slow pulse, no aversion to wind • Pathogenesis: water dampness obstructed in Ying and Wei (from Golden Chamber description).

  10. Causes and pathogenesis • 【2】 Wind and Water Co-attack • Wind attack Lu • Acute stage with excess wind urticaria • Chronic stage rotten blood and flesh impetigo • Excess water  edema in exterior

  11. 【12】 SP deficiency fail to “Trans” • After disease with diarrhea or dysentery • Thirst SP ST qi and fluid damaged • Difficult urination SP qi deficiency fail to transport fluid

  12. 【9】 LU fail to regulate water passage, K deficiency leads to flooding • Cun Kou pulse wiry and tight • LU qi deficiency with cold  fail to regulate water passage  the fluid from diet can not be transported by qi movement and stay in intestines  edema • Shaoyin pulse tight cold, pain, and deep interior, water • K yang deficiency with interior cold Bladder Qi transform disability difficult urine edema

  13. 【20】 Blood level syndrome and Water level syndrome interaction • Edema after menstruation absence Blood level blood stasis blocks in water passage • Edema before menstruation absence Water level water pathogen obstructed blood flow

  14. 【30】Qi Level syndrome • Upper Middle Jiao yang qi deficiency, qi and blood deficiency, with cold • Cun Kou pulse: slow and chopy • Fu Yang pulse: feeble and slow • Cold limbs, chills yang qi obstruction • Fullness in abdomen • Bone pain  blood bostruction

  15. Treatment principles • Promote urination 【18】 For edema/water retention below waist • Promote diaphoresis 【18】For edema/water retention above the waist • Purge downward 【11】For edema below the waist but only in emergency situations (big belly, dysuria, deep unpalpable pulse).

  16. Differentiation and Treatment • Feng Shui • Wind edema with heat • Edema all over body • Floating pulse • Thirst • Absent of high fever?? • Yue Bi Tang越婢汤 【23】 • 麻黄ma huang (Herba Ephedrae) • 石膏 shi gao （Gypsum Fibrosum） • 甘草gan cao (Radix Glycyrrhizae Uralensis) • 生姜sheng jiang (Rhizoma Zingiberis Officinalis Recens) • 大枣da zao (Fructus Zizyphi Jujubae)

  17. Differentiation and Treatment • Feng Shui • Wind edema with exterior deficiency • Floating pulse • Heavy sensation in body • Sweating • Aversion to wind • Fang Ji Huang Qi Tang防己黄芪汤【22】 • 防己 fang ji (Radix Stephaniae Tetrandrae) • 甘草gan cao (Radix Glycyrrhizae Uralensis) • 白术bai zhu (Rhizoma Atractylodis Macrocephalae) • 黄芪huang qi (Radix Astragali Membrnacei)

  18. Differentiation and Treatment • Pi Shui • Skin edema with heat • Edema • Deep pulse • Difficult urination • 越婢汤加术汤 Yue Bi Jia Zhu Tang 【5】 • 越婢汤 Yue Bi Tang 【23】 • 麻黄ma huang (Herba Ephedrae) • 石膏 shi gao （Gypsum Fibrosum） • 甘草gan cao (Radix Glycyrrhizae Uralensis) • 生姜sheng jiang (Rhizoma Zingiberis Officinalis Recens) • 大枣da zao (Fructus Zizyphi Jujubae) • 白术bai zhu (Rhizoma Atractylodis Macrocephalae)

  19. Differentiation and Treatment • Pi Shui • Skin edema with excessive exterior • No sweating • 甘草麻黄汤Gan Cao Ma Huang Tang 【25】 • 甘草gan cao (Radix Glycyrrhizae Uralensis) 2 Liang • 麻黄ma huang (Herba Ephedrae) 4 Liang

  20. Differentiation and Treatment • Pi Shui • Skin edema with exterior deficiency • Edema in extetrimities • Trembling limbs • 防己茯苓汤Fang Ji Fu Ling Tang 【24】 • 防己 fang ji (Radix Stephaniae Tetrandrae) • 黄芪huang qi (Radix Astragali Membrnacei • 桂枝gui zhi (Ramulus Cinnamomi Cassiae) • 茯苓fu ling (Poria) • 甘草gan cao (Radix Glycyrrhizae Uralensis)

  21. Zheng Shui (and Feng Shui) 【26】 • Deep pulse with heavy breath is Zheng Shui • Deep pulse • wheezing • Ma Huang Fu Zi Tang麻黄附子汤 • 甘草gan cao (Radix Glycyrrhizae Uralensis) • 麻黄ma huang (Herba Ephedrae) • 附子fu zi (Radix Lateralis Aconiti Carmichaeli Praeparata)

  22. Zheng Shui and Feng Shui 【26】 • Floating pulse with cough is Feng Shui • Xing Zi Tang杏子汤

  23. Yellow Sweating • Wei obstruction with Ying heat, exterior deficiency with damp obstruction • Yellow sweating • Similar to Feng Shui (Wind-edema) • Deep pulse • No aversion to wind • Huang Qi Shao Gui Ku Jiu Tang 黄芪芍桂苦酒汤 【28】 • 黄芪huang qi (Radix Astragali Membrnacei) • 白芍bai shao (Radix Paeoniae Lactiflorae) • 桂枝gui zhi (Ramulus Cinnamomi Cassiae) • 苦酒 ku jiu bitter liquor (vinegar)

  24. Yellow Sweating 【29】 • Qi Deficiency with excessive damp obstructing Yang qi on upper part • Fever with cold lower limbs • Gui Zhi Jia Huang Qi Tang桂枝加黄芪汤 • Gui Zhi Tang (Cinnamon Twig Decoction) 桂枝汤. regulate Ying and Wei • 桂枝gui zhi (Ramulus Cinnamomi Cassiae) • 白芍bai shao (Radix Paeoniae Lactiflorae) • 甘草gan cao (Radix Glycyrrhizae Uralensis) • 生姜sheng jiang (Rhizoma Zingiberis Officinalis Recens) • 大枣da zao (Fructus Zizyphi Jujubae) • 黄芪huang qi (Radix Astragali Membrnacei)

  25. Qi level disease • Yang deficiency with yin coagulation • Hardness in epigastria water retention • Gui Zhi Qu Shao Yao Jia Ma Huang Xi Xin Fu Zi Tang 【31】 • 桂枝gui zhi (Ramulus Cinnamomi Cassiae) • 甘草gan cao (Radix Glycyrrhizae Uralensis) • 生姜sheng jiang (Rhizoma Zingiberis Officinalis Recens) • 大枣da zao (Fructus Zizyphi Jujubae) • 麻黄ma huang (Herba Ephedrae) • 细辛 xi xin (Herba Asari ) • 附子fu zi (Radix Lateralis Aconiti Carmichaeli Praeparata)

  26. Qi level disease • Spleen deficiency with qi obstruction • Zhi Zhu Tang枳术汤 【32】 • 枳实 zhi shi (Fructus Aurantii Immaturus ) • 白术bai zhu (Rhizoma Atractylodis Macrocephalae)

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