Some diuretic cautions

[Guest guest]

Hi Victoria, What do you know about Interstitial Cystitis? (cold or dampheat TCM types)

It's slow going with acupuncture alone, it looks like herbs are certainly indicated this time. _Skip

ps im reading the Chinese Traditional Medicine archives to review for the nat'l boards. Good writing !

[Guest guest]

Fluid Physiology and Pathology in Traditional by Steven

Clavey contains an essay " On Promoting of Urination' by Du Yi Sui Bi

('Random Notes while Reading Medicine' 1898) which contains some cautions

about diuretic herbs and their improper use.

 

Du Yi Sui Bi points out that excessive urination (from whatever cause, Yang

Deficiency or wrong use of herbs) will, like excessive bowel movements and

excessive sweating, damage Qi. It depletes it. Du Yi Sui Bi said that

excessive urination can damage Qi even worse than diarrhea, and that

inappropriately using herbs like Zhu Ling (Sclerotium Polypori Umbellati),

Fu Ling (Sclerotium Poriae Cocos), Ze Xie (Rhizoma Alismatis

Plantago-aquaticae), and Mu Tong (Caulis Mutong) " to force urination with

patients whose urination, even with these herbs, refuses to pass, will be

even more injurious to the yang than it is to the yin. " (p. 144)

 

Urination - like purging the bowels - is sometimes used to get rid of Heat

and pathogens. Just like sweating sometimes is induced to get rid of an

Exterior Pernicious Evil that is trying to invade. There are correct times

to induce urination, to purge, and to induce sweating, and there are

situations in which these are inappropriate and will make the person sicker.

 

One of the times when it's not correct to use diuretic herbs to promote

urination is when an Exterior pathogen is attacking. Think about this for a

minute. One way to combat an Exterior pathogen which is trying to invade is

to promote sweating. The pores open, and the sweat and Defensive Qi come

out and circulate. If the person's Fluids are being drained by promoting

urinalysis, the Fluid isn't available for sweating out the Evil. If they

promote urinalysis " with an exogenous pathogen present, then the pathogenic

qi sinks into the interior; with internal injury, then the True Yang drains

away below; there is also the saying that (inappropriate diuresis) will

destroy the Heart. Promotion of urination causes the qi on the surface to

suddenly sink and the rising qi to be concealed: because of this, the

manifestations of the illness will temporarily recede: (these doctors) point

to this as an improvement in the condition, thus misleading the patient, and

then immediately deny any jurther responsibility, dumping the disaster onto

the next doctor. " (p. 146)

 

Note the reference to inappropriate diuresis destroying the Heart, and think

about the way anorexics and bulimics and others use diuretics to lose

weight. What all too often happens in many of these cases is the person

ends up dying from heart failure.

 

Also consider in cases where obesity does exist, the underlying Root

frequently is Qi Deficiency with Qi Stagnation and Phlegm. Often, Interior

Wind will be present. One of the things which can give rise to Interior

Wind is Blood Deficiency, and Blood Deficiency can result from Fluid

Deficiency.

 

But getting back to Qi Deficiency as a Root of obesity. Anything which

damages Qi - be it inappropritely sweating from an herb like Ma Huang, using

purgatives like Da Huang (Rhizoma Rhei - rhubarb rhizome), or various

chemical or herbal diuretics - is going to make the Root of the obesity that

much worse in the long-run and make it that much harder to lose real weight.

The inappropriate use of these substances also are going to wreck havoc

with the overall health over the long-run.

 

Di Yi Sui Bi recommended " either nourishing yin or regulating qi movement "

be " used before diuretic herbs are tried. " (p. 146) He also cautioned that

" even when diuretic herbs do not cause a perceptible increase in urination,

the yuan qi - which is insubstantial - can still be lost. " (p. 146) Yuan Qi

is Original Qi. In the days to come we'll be getting into Original Qi in

more detail and will examine the role it plays in Jin-Ye (Fluids)

physiology. For now I'll just say that it makes no sense to deplete

something which is needed in order for Fluids to be generated and

distributed and disgarded properly.

 

Du Yi Sui Bi also cautions that if one wouldn't use diuresis in causes of

Yin Deficiency, definitely don't use it in cases of Yang Deficiency because

the damage to Yang can be even greater than the damage to Yin. (p. 145, p.

144) I have to question why anyone would ever use diuresis with a Kidney

Yang Deficient person considering how people who are Kidney Yang Deficient

tend to go to the bathroom too much and too often. Even when pockets of

edema are present in a Kidney Yang Deficient person, it's better to to

concentrate on improving the Spleen (if the Spleen also is Deficient) so

that the Spleen and Qi are strong enough to move and transform Fluids.

There are also cases where Kidney Essence, the Kidneys, and Orignial Qi

problems are going to have to be addressed in order to resolve the edema

(and other) problems.

 

Steven Clavey in a footnote to the chapter on edema points out that even

though requent urination usually characterizes Kidney Yang Deficiency, there

are times when Kidney Yang Deficiency will manifest as scant urine. This

usually is one of those

its-been-going-on-for-some-time-and-some-other-things-may-also-be-present

situations. The etiology Clavey gives is " when Kidney yang deficiency leads

to frequent urination, the Kidney-Urinary Bladder functions both of

transforming fluids, and of storing ('gu' to consolidate) fluids are

impaired. In the present situation, Kidney consolidation is normal but

Urinary Bladder is unable to transform, and then expel, fluids, which

accumulate internally. " (pp. 146-147) In these situations you're see signs

and symptoms of Yang Deficiency, lower body edema, but scant urine.

 

" It is in the lower Jiao, " (the lower Warmer, part of the Triple Warmer)

" however, that the most immediate and striking effects of yang qi deficiency

will be found: Urinary Bladder qi transformation is directly supported by

Kidney yang, which enables it to separate clear fluids from murky fluids,

recovering the former to be recycled back into the body and expelling the

latter through the urine. Weakness of Kidney yang quickly becomes apparent

as scanty urine, gradually followed by lower body edema. " (p. 125) What

actually happens in a person who is severely Kidney Yang Deficient and has

been that way for some time is that the person will alternate between the

more usual copious and frequent clear urine and times of scant urine (which

usually is clear). Needless to say, by the time a person reaches this

state, there usually are a host of other problems too. Like Damp Heat

building up in the Bladder and bladder infections.

 

Victoria

 

 

 

 

_______________

Get your FREE download of MSN Explorer at http://explorer.msn.com/intl.asp

[Guest guest]

Hi all A friend is looking for info on the herb

clemattidis

aramani

does any one have an idea?

 

thanks

Adam