Patient Background
In the spring of engxu year, I traveled to the capital for the imperial examination. A fellow candidate, Mr. Zhang, developed urinary retention in early June after prolonged rainy weather and excessive tea consumption. Within days, his limbs swelled severely, progressing to breathlessness and inability to lie flat.
Misguided Treatment
A merchant from his hometown (with basic medical knowledge) diagnosed it as “yang-deficiency edema”:
“Young men who overindulge in wine and pleasure deplete their vital energy. You must take Kidney Qi Pills from Jin Gui Yao Lue.”
Mr. Zhang followed this advice, but within days (<40g of medication):
Swelling worsened
Breathing became labored
He required assistance to turn in bed
Correct Diagnosis
When I examined him:
All six pulse points were imperceptible
Eyes remained unnaturally wide open
My analysis:
“This is edema, but not from yang deficiency. Damp-heat pathogens are trapping fluids under the skin instead of excreting them through urine. Using tonics on a congested body is like plugging a drain!”
Treatment Protocol
Emergency Relief
Prescribed Water Expediting Pill (Morning Glory Seed, Rhubarb, Kan Sui, Da Ji, Yuan Hua, Green Citrus Peel, Citrus Red, Areca Nut)
Dose: 4 qian (~12g)
Result: Profuse urination within hours, 48-hour resolution of edema
Recovery Phase
Followed with Digestion-Regulating Pill (Aged Citrus Peel, Pinellia, Roasted Bitter Orange, Atractylodes)
Dose: 0.5 jin (~300g)
Outcome: Full recovery
Key Concepts for International Readers
Yang deficiency: Traditional term for functional energy depletion
Qian/Jin: Historical weight units (1 qian≈3g, 1 jin≈600g)
Damp-heat: TCM pathology describing inflammatory fluid retention
Herbal components like Yuan Hua (Genkwa Flower) and Da Ji (Euphorbia pekinensis) are still used in modern TCM formulations
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