Water accumulation syndrome

Ban Xia and Sheng Jiang are both pungent and warm, and enter the Stomach meridian. They can soothe the Stomach-Qi and eliminate the accumulation of water and phlegm in the Stomach. They relieve nausea and vomiting and improve appetite. All these symptoms are often seen in the syndrome of internal cold in the Middle-Jiao. 

This syndrome is caused by accumulation of water in the chest and abdomen. As the accumulation obstructs the Qi in the San Jiao water passage, patients suffer from edema and difficult urination. 

Spironolactone is an antagonist to aldosterone —the latter when elaborated in the body in excessive amounts gives rise to a syndrome called aldosteronism. Spironolactone, a synthetically produced steroid does not have a natural counterpart in the body, is diuretic when mercurial or thiazide diuretics are ineffective it prevents sodium retention and potassium excretion— effects opposite to aldosterone. Hence spironolactone is used in aldosteronism, against edema, in the treatment of congestive heart failure and in other conditions in which an accumulation of water, and water-retaining salt, is to be corrected. 

Water-soluble vitamins removed by hemodialysis (HD) contribute to malnutrition and vitamin deficiency syndromes. Patients receiving HD often require replacement of water-soluble vitamins to prevent adverse effects. The vitamins that may require replacement are ascorbic acid, thiamine, biotin, folic acid, riboflavin, and pyridoxine. Patients receiving HD should receive a multivitamin B complex with vitamin C supplement, but should not take supplements that include fat-soluble vitamins, such as vitamins A, E, or K, which can accumulate in patients with renal failure. 

The drugs for treating hypertension can quickly descend the Qi and Yang of Liver, but they may suppress the Liver-Qi. They may also slow down water metabolism and blood circulation. Therefore the syndrome can change into one of Liver-Qi stagnation with Kidney-Yin and Liver-Yin deficiency, or Liver-Qi stagnation with dampness accumulation in the Middle-Jiao. 

This chapter introduces the principles, methods and strategies for the composition of formulas that stimulate the intestines, promote bowel movement in order to purge accumulation, eliminate toxic substances, drain fire and cold of the body and drive out congested water. They are used to treat excess conditions and interior syndromes. These methods and strategies relieve the symptoms rather than treat the cause. However, they can stop further pathological changes caused by the accumulations. 

The Spleen is regarded as a Yin organ and it is easily injured by exterior damp-heat or cold. If the Spleen fails to transport water and food that has accumulated in the Middle-Jiao, this will eventually generate heat in a Yang constitution. Persistent accumulation of damp-heat in the Middle-Jiao may develop damp-heat in the Large Intestine. Both syndromes have a lingering process of pathological development. 

Damp-cold accumulation often coexists in Yang deficiency syndrome. Because cold obstructs the meridians, this leads to obstruction of Qi movement and water circulation, and cold-dampness is thus formed. Moreover, when the Yang is too weak to steam the fluid into Qi and Yin, the water metabolism becomes very slow and the water may accumulate in certain places in the body. In this condition, herbs that are warm in nature and have the function of transforming dampness should be used as assistants in formulas. 

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