Oedema During Periods

CHAPTER 21 Oedema During Periods



AETIOLOGY 405

PATHOLOGY 405

IDENTIFICATION OF PATTERNS AND TREATMENT 405
Spleen- and Kidney-Yang deficiency 405

Stagnation of Qi 408

Ancient acupuncture prescriptions for oedema at period time 409

PROGNOSIS AND PREVENTION 410

Oedema at period time can affect the face, hands, lower legs and abdomen. It usually occurs before the period.



Aetiology




Excessive physical work


Excessive physical work weakens the Spleen; if it goes on for many years it may also affect the Kidneys. Deficient Spleen- and Kidney-Yang fails to transform, transport and excrete fluids which accumulate in the space between the skin and muscles and lead to oedema, usually affecting the ankles and occurring before or during the period. This is called ‘real oedema’, i.e. the visible swelling is caused by actual retention of fluids under the skin: if the skin is pressed with the thumb, it leaves a dip. If the oedematous area is needled with fairly thick needles, a clear fluid can be seen trickling out when the needles are withdrawn.



Emotional stress


Prolonged emotional stress due to anger, worry, guilt, frustration and resentment may lead to stagnation of Liver-Qi; stagnant Liver-Qi does not flow freely and fails to promote the transformation of fluids all over the body. This may lead to accumulation of Qi in the space between the skin and muscles. This is called ‘not real oedema’ because it is caused by stagnation of Qi rather than actual fluids. When the skin is pressed with the thumb, it does not leave a dip. This type of oedema is more likely to affect the face, hands and breast and occurs before the period.



Pathology


The main pathological factors causing oedema at period time are:


• Spleen- and Kidney-Yang deficiency

• stagnation of Qi.

The oedema from Spleen- and Kidney-Yang deficiency tends to be permanent and becomes worse during the period, while that from stagnation of Qi may appear only before the period.



Identification of patterns and treatment



Spleen- and Kidney-Yang deficiency



Clinical manifestations


Oedema before or during the period, backache, tiredness, loose stools, chilliness, heavy period. Tongue: Pale and Swollen. Pulse: Deep and Weak.



Treatment principle


Tonify the Kidneys, strengthen the Spleen, warm Yang, transform fluids.



Acupuncture


BL-20 Pishu, BL-23 Shenshu, Ren-12 Zhongwan, ST-36 Zusanli, KI-7 Fuliu, Ren-9 Shuifen, ST-28 Shuidao, SP-9 Yinlingquan, BL-22 Sanjiaoshu, Ren-5 Shimen, LU-7 Lieque, L.I.-6 Pianli The first five points with reinforcing method, the others with reducing or even method. Moxa is applicable.




Explanation


– BL-20, BL-23, Ren-12, ST-36 and KI-7 tonify the Spleen and Kidneys. Moxa can be used to warm the Yang. KI-7, in particular, also resolves oedema.

– Ren-9, ST-28, SP-9, BL-22 and Ren-5 promote the transformation, transportation and excretion of fluids to resolve oedema. Ren-5 is the Front-Collecting (Mu) point of the Triple Burner and specifically of the Lower Burner. In order to understand the function of this point, one must recall the role of the Triple Burner in relation to Original Qi (Yuan Qi). The Original Qi arises from between the Kidneys and spreads to the five Yin and six Yang organs via the intermediary of the Triple Burner. This point is the Front-Collecting point of the Triple Burner and rouses the Original Qi to circulate to all the organs and channels. In particular, this point stimulates the Triple Burner (and specifically the Lower Burner) to transform and excrete fluids, and ensures that the Water passages of the Lower Burner are open. Its use is therefore indicated for oedema of any part of the body.

– LU-7 and L.I.-6 can be used if the oedema is concentrated in the hands.


Herbal treatment



a Prescription



– LING GUI ZHU GAN TANG Variation

– Poria-Ramulus Cinnamomi-Atractylodes-Glycyrrhiza Decoction Variation


Explanation

A very old prescription from the Discussion of Cold-induced Diseases by Zhang Zhong Jing is composed of the first four herbs listed above. It tonifies the Spleen and promotes the transformation of fluids.


– Bu Gu Zhi and Ba Ji Tian are added to tonify Kidney-Yang.

– Chuan Xiong is added because of the interrelationship between fluids and Blood. Invigorating Blood helps to move fluids.


b Prescription



– QUAN SHENG BAI ZHU SAN Variation

– Whole Generating Atractylodes Powder Variation


Explanation

The first five herbs constitute the formula Quan Sheng Bai Zhu San which tonifies Spleen-Qi and promotes the transformation of fluids.


– Gui Zhi is added to warm Yang and transform fluids.

Compared with the previous formula, this prescription tonifies only the Spleen and not the Kidneys.



c Prescription



– JI SHENG SHEN QI WAN

– Kidney-Qi Pill from Formulae to Aid the Living


Explanation

The first eight herbs constitute the well-known Jin Gui Shen Qi Wan Golden Chest Kidney-Qi Pill which warms and tonifies Kidney-Yang.


– Niu Xi performs two functions. First of all, it invigorates Blood and, by doing that, it helps to transform fluids because of the interrelationship between fluids and Blood. Second, it directs the herbs to the lower part of the body and therefore helps to relieve oedema of the ankles.

– Che Qian Zi drains Dampness and helps to resolve oedema.

Please note that the dosages given in Appendix 1 are those of the original prescription and, generally speaking, they should be reduced substantially. Compared with the previous two formulae, this prescription mostly tonifies Kidney-Yang (rather than Spleen-Yang) and it is more warming than the others.

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Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Oedema During Periods

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