Water drum

Also water gǔ; water drum distension. A disease pattern characterized by abdominal distension which gurgles when the patient moves. Water drum is usually caused by excessive consumption of liquor that impairs free coursing of the liver, with resultant liver depression damaging the spleen causing impaired movement and transformation that causes water-damp to collect. It is associated with a withered-yellow facial complexion, rib-side pain, red speckles on the body (spider nevi), and sometimes jaundice. In persistent cases, there is scant urine and generalized swelling that pits when pressed.

Medicinal therapy: Boost qì and supplement the blood; nourish yīn and disinhibit urine. Use Spleen-Firming Beverage (实脾饮 shí pí yǐn) plus Chinese angelica (Angelicae Sinensis Radix, 当归 dāng guī) and toosendan (Toosendan Fructus, 川楝子 chuān liàn zǐ).

For pronounced water-rheum, add cinnamon twig (Cinnamomi Ramulus, 桂枝 guì zhī), polyporus (Polyporus, 猪苓 zhū líng), and alisma (Alismatis Rhizoma, 泽泻 zé xiè). Alternatively, use Stomach-Calming Poria Five Decoction (胃苓汤 wèi líng tāng) combined with Bupleurum Liver-Coursing Powder (柴胡疏肝散 chái hú shū gān sǎn).

For persistent cases with generalized water swelling, apply the principle of attack followed by supplementation using water-expelling medicinals such as morning glory (Pharbitidis Semen, 牵牛子 qiān niú zǐ) and kansui (Kansui Radix, 甘遂 gān suì), combined with water-disinhibiting medicinals such as poria (Poria, 茯苓 fú líng), rice bean (Phaseoli Semen, 赤小豆 chì xiǎo dòu), and plantago seed (Plantaginis Semen, 车前子 chē qián zǐ), followed by regulating and supplementing formulas such as Poria Five Powder (五苓散 wǔ líng sǎn) or Four Gentlemen Decoction (四君子汤 sì jūn zǐ tāng).

Acumoxatherapy: Two groups of points may be applied.

1. CV-12 (Center Stomach Duct, 中脘 zhōng wǎn), ST-25 (Celestial Pivot, 天枢 tiān shū), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), BL-20 (Spleen Transport, 脾俞 pí shù), CV-9 (Water Divide, 水分 shuǐ fēn), and ST-44 (Inner Court, 内庭 nèi tíng).
2. SP-15 (Great Horizontal, 大横 dà hèng), CV-6 (Sea of Qì, 气海 qì hǎi), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), BL-20 (Spleen Transport, 脾俞 pí shù), CV-9 (Water Divide, 水分 shuǐ fēn), and ST-44 (Inner Court, 内庭 nèi tíng). Alternate the groups and needle with drainage in treatments every 3–5 days. After needling, moxa CV-12 (Center Stomach Duct, 中脘 zhōng wǎn), CV-4 (Pass Head, 关元 guān yuán), and bilateral SP-15 (Great Horizontal, 大横 dà hèng) for 30–60 minutes.