The Causes of Edema (浮腫之因) -(edema 1)
The Causes of Edema (浮腫之因)
1. 腫者, 鍾也. 寒熱氣所鍾聚也. 《醫鑑》
Swelling (腫) means gathering,
in other words, cold and heat qi gathers together.
2
諸濕腫滿, 皆屬脾土. 《內經》
All dampness with swelling and fullness is ascribed to spleen-earth
(脾土).
3
三陰結, 謂之水. 註曰, 三陰結, 謂脾肺之脈, 俱寒結也. 脾肺寒結, 則氣化爲水. 《內經》
The triple yin bind (三陰結) is
called water. In Annotation, it says, "The triple yin bind (三陰結) refers to cold bind in the spleen and lung channels.” When cold binds
in the spleen and lung, qi transforms into water.
4
下焦溢爲水. 註曰, 下焦爲分注之所, 氣窒不瀉, 則爲溢水. 《內經》
When it overflows from the lower burner, it becomes water.
In Annotation (註), it says, "The lower burner is
where water derives from, but if qi is blocked and fails to free, this causes
water to overflow.
5
問曰, 少陰何主腎, 腎何以主水. 對曰, 腎者, 至陰也. 至陰者, 盛水也. 肺者, 太陰也. 少陰者, 冬脈也. 故其本在腎, 其末在肺, 皆積水也. 問曰, 腎何以能聚水而生病. 對曰, 腎者, 胃之關也. 關閉不利, 故聚水而從其類也. 上下溢於皮膚, 故爲胕腫, 胕腫者, 聚水而生病也. 《內經》
Huangdi (黃帝) asked, "How can
lesser yin govern the kidney and how can the kidney control water?", Qibo
(岐伯) answered, "The kidney is consummate yin, and consummate
yin contains exuberant water. The lung is greater yin and lesser yin is related
with the winter vessel (冬脈), therefore the root is in
the kidney and the branch is in the lung". Huangdi (黃帝) asked, "How can the kidney gather water and bring about
disease? ", Qibo (岐伯) answered, "The kidney
is kind of the gateway of the stomach. If the gateway is blocked, water gets to
gather and follow similar things從其類. So it overflows upward and downward to the skin, this results in pitting
edema (胕腫), which occurs when water gathers.
6
胕腫, 謂皮肉俱腫, 按之陷下, 泥而不起也. 《內經》
Pitting edema (胕腫) refers
to swelling both in the skin and flesh, which gives in when pressure is applied, but
generally fails to come back.
7
陰陽氣道不通, 四海閉塞, 三焦不瀉, 津液不化, 水穀幷行腸胃之中, 別于迴腸, 留于下焦, 不得滲膀胱, 則下焦脹, 水溢則爲水脹. 《靈樞》
The way of yin-yang qi is obstructed and thus the four
seas are blocked and the triple burner fail to let the water out and therefore
fluid and humor get to fail to transform into. Generally, water and food derive
out to the ileum (迴腸) in the middle of descending to the
stomach and intestines, but if fail to do, staying in the lower burner without
percolating into the bladder, there will be distention in the lower burner and
overflow water brings about water distention (水脹).
9
腎熱傳於膀胱, 熱盛逆於脾胃, 脾虛而不能制腎水. 脾主四肢, 故流走而身面皆腫也. 若加喘者, 重也, 何以然. 腎水勝而克退脾土, 反勝心火, 心又勝肺, 肺爲心剋故喘也. 《錢乙》
When kidney heat shifts to the bladder, exuberant heat counterflows
to the spleen and stomach, and then the spleen becomes weak and cannot control
kidney water. The spleen controls the limbs that is why water wanders and the
body and face swell. In addition to this, if there is panting, this is severe
case. Why? If the prevalent kidney water restrains spleen earth, heart fire
becomes exuberant. Heart fire overcoms the lung. as like this, the lung restrained
by heart fire arises panting, therefore this is severe case.
10
久喘, 久瘧, 久痢, 羸悴之餘, 皆患此病. 《入門》
Experiencing of debilitation from enduring pating,
malaria, or dysentery causes this.