The treatment principles for secondary excess lie in eliminating exogenous pathogens, regulating qi and blood. Often employed are the treatments such as dispelling wind and releasing the lung, clearing away heat and toxic materials, removing dampness and alleviating edema, eliminating water by purgation, activating blood circulation and dissipating the stasis. Treatments to support healthy qi, such as invigorating the spleen, tonifying the kidneys, nourishing yin, warming yang, replenishing qi and nourishing blood are selectively used according to the condition of the deficiency of healthy qi.
Syndrome differentiation and treatment
1. Invasion by Wind and Overflow of Water
Chief Manifestations: Abrupt onset with rapid exacerbation of edema, fever, aversion to cold, soreness of limbs, cough, dyspnea, oliguria, sore throat, red tongue with thin and yellow coating, floating and rapid pulse.
Therapeutic Methods: To disperse wind, relieve superficies syndromes, release the lung and induce diuresis.
2. Accumulation of Damp Heat
Chief Manifestations:
Edema all over the body with strained skin, feeling of stuffiness and oppression in the chest and epigastrium, dyspnea, restless fever, thirst, scanty dark urine and dry stools, red tongue with yellow greasy coating, deep and rapid pulse.
Therapeutic Methods: To clear away heat, remove dampness and promote the flow of qi.
3. Retention of Water and Dampness
Chief Manifestations: Pitted edema all over the body or of the limbs, especially of the lower limbs, oliguria, fatigue and bodily heaviness, feeling of oppression in the chest, impaired appetite, abdominal distention, nausea, white and thin tongue coating, slow and soft-superficial pulse.
Therapeutic Methods: To eliminate dampness, strengthen the spleen, activate yang and induce diuresis.
4. Spleen Deficiency and Dampness Retention
Chief Manifestations: Persistent edema, heaviness of the body and limbs, fatigue and weakness, anorexia, abdominal distention, oliguria, sallow complexion, swollen and pale tongue with white, thin coating, soft-superficial pulse.
Therapeutic Methods: To tonify qi, invigorate the spleen and induce diuresis.
5. Deficiency of Spleen Yang and Kidney Yang
Chief Manifestations: Pale, or sallow or dark complexion, aversion to cold, cold limbs, anorexia, loose stools, soreness of loins and limbs, scanty urine, generalized pitted edema which is more pronounced below the ankle, pale, swollen tongue with thin, white coating or white, greasy and smooth coating, deep and thready
pulse.
Therapeutic Method: To warm and tonify the spleen and kidney.
6. Deficiency of Kidney Yin
Chief Manifestations: Persistent moderate edema, weak and sere loins and knees, feverish sensation in the palms and soles, dry mouth and throat, vertigo and tinnitus, red tougue with little coating, deep, thready or wiry, thready pulse.
Therapeutic Methods: To nourish kidney yin.
7. Obstruction of Blood Stasis
Chief Manifestations: Protracted edema, localized lumbago, dark purple tongue or with petechia, and thready, unsmooth pulse.
Therapeutic Methods: To activate blood circulation and dissipate blood stasis.