Prescriptions for Promoting Diuresis and Eliminating Dampness
Wuling San
(Powder of Five Drugs Containing Poria )
Source: Shanghan Lun (Treatise on Exogenous Febrile Diseases).
Ingredients:
No. 1 Zhuling (Polyporus) 9 g;
No. 2 Zexie (Rhizoma Alismatis) 15 g;
No. 3 Baizhu (Rhizoma Atractylodis) 9 g;
No. 4 Fuling (Poria) 9 g;
No. 5 Guizhi ( Ramulus Cinnamomi) 6 g.
Administrations: Grind the above drugs into fine powder; take orally 6 g each time and 3 times daily with warm boiled water. Or prepare them into decoction, with dosages in proportion to the original recipe.
Actions: Inducing diuresis, eliminating dampness, warming yang and promoting qi function.
Clinical Application: This recipe is indicated for syndrome of fluid retention in the interior, marked by edema, diarrhea, dYsuria, pale tongue with glossy whitish fur, soft pulse. It is applicable to edema from nephritis and cirrhosis, acute enteritis, uroschesis, hydrocephalus and others, which pertain to fluid-retention and dampness in the interiror. In case of excessive retention of fluid, Wupi San [ Chenpi ( Pericarpium Citri Reticulatae ), Fulingpi ( Cortex Sclerotii Poriae ), Shengjiangpi ( Exocarpium Zingiberis Recentis ), Sangbaipi ( Cortex Mori Radicis) and Dafupi ( Pericarpium Arecae )] may be used simultaneously to enhance the effect of inducing diuresis and relieving swelling.
Elucidation : The syndrome is caused by dysfunction of the spleen in transportation and transformation, leading to retention of fluid in the interiror and dysfunction of qi transformation of the bladder. It should be treated by inducing diuresis and warming yang to promote qi function. With a large dosage, No. 2 is effective in inducing diuresis and used as monarch drug. No. 4 and No. 1 are sweet and mild in nature and function as minister drugs, which can promote diuresis and enhance the effect of the monarch drug in relieving swelling. No. 3 in combination with No. 4 futher strengthens the function of reinforcing the spleen and inducing diuresis, while No. 5 promotes the function of the bladder in excretion of urine. No. 3 and No. 5 together play the role of adjuvant drugs. Originally this recipe was used for treating retention of fluid manifesting dysfunction of the bladder in excretion of urine and bradyuria, which are caused by the unrelieved exogenous pathogenic factors retaining in taiyang meridian. Thus it can be inferred that No. 5 also bears the effect of relieving exterior syndrome and eliminating pathogenic factors. This recipe is mainly to invigorate the spleen and induce diuresis and, thus, fit for retention of fluid due to dysfunction of the spleen.
Cautions: Warm in nature as this recipe is, it should not be used for the case of heat transformed from water-dampness.
Zhuling Tang
(Umbellate Pore Decoction)
Source: Shanghan Lun ( Treatise on Exogenous Febrile Diseases).
Ingredients :
No. 1 Zhuling (Polyporus) 9 g;
No. 2 Zexie (Rhizoma Alismatis) 9 g;
No. 3 Fuling (Poria) 9 g
No. 4 Ejiao ( Colla Corri Asini) (melted) 9 g;
No. 5 Huashi (Talcum) 9 g.
Administration: Decoct the above drugs in water for oral application.
Actions: Promoting diuresis, eliminating dampness, clearing away heat and nourishing yin.
Clinical Application: This recipe is indicated for yin impairment by retention of water and heat, marked by dysuria, fever, thirst with desire for drinking, or vexation, insomnia, or concomitant with vomiting and diarrhea, or stranguria with blood in urine, reddened tongue with whitish or yellowish fur, thready and rapid pulse. It is applicable to such cases associated with dysuria as infection of the urinary system, nephritis and others, which pertain to retention of water and heat concomitant with yin deficiency. If concomitant with frequency and urgency of urination with pain, add Zhizi (Fructus Gardeniae ) and Cheqianzi (Semen Plantaginis ) to clear away heat and induce diuresis for treating stranguria. In case of stranguria with blood in urine or hematuria, add Baimaogen ( Rhizoma Imperatae ) and Xiaoji( Herba Cephalanoploris ) to remove heat from blood and stop bleeding.
Elucidation: This syndrome is caused by fluid-retention and heat retaining in the lower energizer, leading to yin impairment and dysfunction of qi transformation of the bladder. It should be treated by inducing diuresis, clearing away heat and nourishing yin. No. 1 and No. 3 function as monarch drugs, which can induce diuresis and invigorate the spleen. No. 2 is used as minister drug, which further enhances the effect of inducing diuresis in combination with the monarch drugs. No. 5 and No. 4 act as adjuvant drugs, the former capable of clearing away
heat, promoting diuresis and treating stranguria and the latter nourishing yin and blood and arresting bleeding. All ingredients as a whole bring about the result of promoting diuresis without impairing yin and nourishing yin without retaining pathogenic factors so that dampness and heat are eliminated, yin fluid restored and all the symptoms relieved.
Both this recipe and Wuling San possess diuretic function and are used for the treatment of dysuria. The latter is specially fit for dysuria due to dysfunction of the spleen in transportation, retention of dampness and dysfunction of qi transformation of the bladder. That is why Zexie ( Rhizoma Alismatis ), Zhuling ( Polyporus ) and Fuling (Poria) are used in compatibility with Guizhi (Ramulus Cinnamomi ) to activate yang and with Baizhu (Rhizoma Atractylodis Macrocephalae) to promote the spleen in transportation. It is formed with the effects of warming yang, promoting qi transformation and the excretion of urine. The former, however, is suitable for dysuria as the result of retention of fluid and heat concomitant with yin impairment and includes a compatibility of Zexie ( Rhizoma Alismatis ), Zhuling ( Polyporus ) and Fuling (Poria) with Huashi (Talcum) to clear away heat and treat stranguria and with Ejiao ( Colla Corri Asini) to nourish yin and moisten dryness, which bears the function of clearing away heat, nourishing yin and inducing diuresis.
