Spillage rheum

One of the four rheums. Water in the limbs, characterized by heavy painful and sometimes swollen limbs and sometimes accompanied by panting and cough; so called because rheum spills outward to the body surface. It arises when voracious drinking (drinking of large quantities of fluid at one time) or contraction of external evils causes lung qì to become depressed and blocked, impairing both diffusion and depurative downbearing, in particular the ability to regulate the waterways. As a result, ingested fluid does not flow down to the bladder, but is forced outward to the four limbs, where it stagnates in the fleshy exterior. Owing to nondiffusion of lung qì, the interstices are tightly closed, preventing sweating and the discharge of the rheum through it.

Biomedical correspondence: nephritic edema; cardiogenic edema.

Medicinal therapy: Warm the lung and effuse sweat with Major Black Dragon Decoction (大青龙汤 dà qīng lóng tāng) or Minor Black Dragon Decoction (小青龙汤 xiǎo qīng lóng tāng). The major formula promotes sweating, disperses water, and clears heat; it is suitable for spillage rheum with exuberant evil in the exterior due to external contraction of wind-cold, with depressed heat in the interior. It is therefore appropriate when there is an exterior pattern of heat effusion and aversion to cold, generalized pain, absence of sweating, and a tight pulse, combined with an interior pattern of panting with vexation and agitation. The minor formula moves water, warms the lungand downbears qì; it is suitable for spillage rheum due to external contraction of wind-cold, with cold rheum in the interior. It is appropriate when there is an external pattern of aversion to cold with heat effusion and an internal pattern of glomus in the chest, dry retching, cough, and panting.

Acumoxatherapy: Base treatment mainly on CV, ST, SP, LU, and LI. Select CV-12 (Center Stomach Duct, 中脘 zhōng wǎn), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), ST-40 (Bountiful Bulge, 丰隆 fēng lóng), SP-9 (Yīn Mound Spring, 阴陵泉 yīn líng quán), BL-20 (Spleen Transport, 脾俞 pí shù), BL-13 (Lung Transport, 肺俞 fèi shù), LI-4 (Union Valley, 合谷 hé gǔ), and KI-7 (Recover Flow, 复溜 fù liū); needle with drainage and add moxa. For panting and cough, add Panting Stabilizer (定喘 dìng chuǎn), and LU-9 (Great Abyss, 太渊 tài yuān).

See phlegm-rheum.