Oedema — deficiency type

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Textbook Prescriptions Urogenital

Essentials of Chinese Acupuncture (Beijing, Shanghai and Nanjing Colleges of Traditional Chinese Medicine, 1980) — the standard prescriptions of the Chinese colleges.

Points

BL20 Pishu bilateral

Back-Shu of the Spleen; warms spleen yang to clear damp

Moxibustion.
BL23 Shenshu bilateral

Back-Shu of the Kidney; warms kidney yang to clear fluid

Moxibustion.
CV9 Shuifen midline

Local point above the navel; promotes urination

Moxibustion.
CV6 Qihai midline

Sea of qi; tonifies original qi

Moxibustion.
- Pregnancy: contraindicated
SP6 Sanyinjiao bilateral

Meeting point of the three foot yin; strengthens the spleen to drain damp

Reinforce.
- Pregnancy: contraindicated
ST36 Zusanli bilateral

He-Sea of the Stomach; strengthens spleen and stomach to drain damp

Reinforce.
BL39 Weiyang bilateral

Lower He-Sea of the Triple Burner; clears the water passages

Needling Safety

Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.

Treatment Principle

Warm and tonify the spleen and kidney so that fluid can be moved and excreted.

Indications

Gradual onset, swelling starting on the dorsum of the foot or eyelids and spreading over the bodyChilliness, pallor, backache, general weaknessAbdominal distension, loose stoolsDeep thready pulse

Method

Reinforcing method plus moxibustion; moxa at BL20, BL23, CV9 and CV6, reinforcing at ST36 and SP6.

⚠ Cautions

Oedema can reflect renal, cardiac or hepatic failure, malnutrition or deep-vein thrombosis; these need medical diagnosis. SP6 is contraindicated in pregnancy, and CV6 should not receive strong stimulation or moxibustion in pregnancy. BL20 and BL23 are over the lower thorax and kidneys; needle obliquely and not deep.

About

The colleges' prescription for oedema of the deficiency type, in which weak spleen and kidney yang fail to move water.

Rationale

Moxa at BL20 and BL23 warms the yang of spleen and kidney so that damp and fluid can be cleared, while moxa at CV9 promotes urination and at CV6 tonifies original qi. BL39, the lower He-Sea of the Triple Burner, opens the water passages, and reinforcing ST36 and SP6 strengthens the spleen and stomach to resolve damp.

Clinical Notes

Add by symptom: facial oedema, Renzhong (GV26, catalogued as Shuigou); constipation with abdominal distension, ST40; swelling of the dorsum of the foot, GB41 and SP5. The book links oedema with acute and chronic nephritis and malnutrition.

Sources

Beijing College of Traditional Chinese Medicine, et al. Essentials of Chinese Acupuncture. Beijing: Foreign Languages Press, 1980. Chapter III, Edema, p. 364–365.

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