All swellings and fullness are related to the spleen

When studying "Treatise on Febrile Diseases", Mr. Liu Duzhou strongly recommended the book "Annotations to Treatise on Febrile Diseases", saying that the book explains classics with classics, and only then did we know the source of "Treatise on Febrile Diseases". By reading the article repeatedly and verifying the Buddhist scriptures cited, I have a basic understanding of the guiding role of "The Yellow Emperor's Classic of Internal Medicine". From then on, the Buddhist scriptures were no longer cracked texts! The following is an overview of the understanding and application of Article 19 of the Pathogenesis of Diseases: “All swellings and fullnesses due to dampness belong to the spleen.”

1. Too much form but not enough energy.

My aunt, who is over 60 years old and in good physical condition, has suffered from facial edema for several months. She did not pay much attention to it and her condition has gradually worsened, so she came to see a doctor. The face is floating, the stomach and wrists are full, there is slight pain under the heart, the spirit is tired and weak, the mind is lazy and unwilling to speak, the tongue is pale with white coating, and the pulse is weak. The Yellow Emperor's Classic of Internal Medicine says that "all swellings and distensions are caused by dampness and are related to the spleen." However, considering that the patient has a weak gastrointestinal tract, this is contrary to the previous advice. Water is a Yin evil that spreads with the vortex of Qi, and when it overflows to the outside, it causes swelling. When water accumulates under the heart, it blocks the Qi wheels, causing the elevators to malfunction, and the clear Qi cannot rise and the depressed Qi cannot decrease, causing fullness and distension. This is exactly what the saying "depressed Qi in the upper part causes swelling" means. The treatment is based on loose soil water treatment, with Fangji Huangqi Decoction combined with Zhike Shaoyaohua Powder: 12g of Fangji, 20g of Huangqin, 12g of Baizhu and Poria, 10g of raw licorice, 30g of Coix seed, 10g of Zhike, 15g of white peony root, 3 slices of ginger, and 3 red dates. Take Fangji Huangqi Decoction to strengthen the spleen and blood, eliminate dampness and reduce swelling, and add coix seed to enhance the effect of strengthening the spleen and stomach and eliminating dampness. Citrus aurantium is bitter and cold in nature, and enters the qi component, having the function of guiding phlegm and turbidity downward. Red peony root enters the blood component, and Ben Jing emphasizes its function of "laxative". The two can be used together to regulate blood and Qi and treat abdominal distension and pain. Used here, it also has the meaning of guiding qi and water. After taking three doses of the medicine, the facial swelling disappeared, the abdominal distension was eliminated, and the appetite increased, so the patient stopped taking the medicine and continued to observe.

2. Strengthen the spleen and stomach and reduce swelling in the limbs.

Mr. Chen said, "When injured by dampness, the lower parts are affected first." At dusk, both lower limbs are swollen, heavy and weak, which is not obvious when getting up in the morning. The appetite is poor, the spirit is tired and weak, the tongue is pale, the tongue coating is white, and the pulse is deep and thin. Considering that the patient has symptoms of spleen and stomach deficiency and coldness, once the stomach and intestines are weak, various symptoms will arise, and I am afraid that anti-osmotic and laxative products will not be able to help. Referring to the theory in the Yellow Emperor's Classic of Internal Medicine that "all swellings and fullness due to dampness are attributed to the spleen", Liujunzi Decoction was selected to strengthen the spleen and harmonize the stomach, so as to make the spleen thick and the river bank firm. Punish the flavors of Codonopsis pilosula, Atractylodes macrocephala, Poria cocos, Pinellia ternata, Coix seed, Cyperus rotundus, Coix seed, and White Cortex. After three doses, the leg swelling subsided, appetite increased, and fatigue was relieved. Therefore, the original method was used to deal with the aftermath.

3. Use secret recipes to broaden their meaning.

My third uncle, a hardworking man, suffered from swelling in his right upper limb and his fist was too loose. He asked me to think of a solution. I was very confused at the time, so I asked him about his diet. He said he had stomach disease, loss of appetite, easy drowsiness, pale tongue with greasy coating, and weak pulse. Take into account: fatigue damages the spleen, digestion and absorption are weak, water stagnation in the body, and the earth cannot control water. With the main focus on strengthening the spleen and stomach, and holding the center to control the four sides, the prescription selected is Pingwei Liujun Decoction with modifications from Mr. Li (teacher Wang Huansheng of the Affiliated Hospital of our hospital): Codonopsis pilosula 20g, Atractylodes macrocephala Poria 20g, Poria 15g, Citron 15g, Ginger and Magnolia bark 10g, Coix seed 30g, White koji 8g, Coix seed 30g, and 15g each of the three immortals. After taking 3 doses of the medicine, the bloating subsided, appetite increased, and other symptoms also decreased. Afterwards, the original prescription will be used for mutual adjustment and follow-up treatment. No limb swelling occurred during follow-up.

Based on this case, I feel deeply that the real Chinese medicine diagnosis and treatment is to apply authentic Chinese medicine logical thinking. Once a theory is put forward, it must have a certain basis. Instead of simple symptomatic treatment, in the end there is no cure.