The syndrome of water-dampness flooding refers to the general term for various symptoms caused by the disturbance of qi transformation leading to water-dampness retention and flooding in the skin, resulting in swelling of the head, face, limbs, chest, abdomen, waist, back, and the whole body. This syndrome is mostly caused by external pathogens obstructing yang qi, or insufficient yang qi, leading to the inability of qi to move water, resulting in retention and stagnation. The main clinical manifestations of this syndrome include: puffiness of the eyelid, as if just waking up, or swelling of the limbs, initially swelling that rebounds upon pressing, then swelling that leaves an indentation upon pressing, and even the appearance of pleural effusion and ascites; difficulty in urination, heavy body, chest tightness, white and greasy tongue coating, and slippery or deep and slow pulse.

This syndrome is commonly seen in conditions related to "edema."

The syndrome of water-dampness flooding should be differentiated from the "syndrome/pattern of internal retention of water-fluid," "syndrome/pattern of dampness impacting the spleen and stomach," "syndrome/pattern of water binding with heat," "syndrome of water and blood stasis binding together," and "syndrome of water stagnation with yellow sweat," among others.

bubble_chart Differentiation and Treatment

Due to the differences in the disease cause, mechanism of disease, and location of disease that lead to water-dampness flooding, the clinical manifestations also vary.

1. For example, in the pathological changes of "edema," if the syndrome is caused by water-dampness soaking, it is often due to wading in water or exposure to rain, leading to internal invasion of water-dampness, or improper diet, resulting in the spleen being overwhelmed by dampness, yang qi being suppressed and unable to expand, causing the spleen to fail in controlling water and leading to water-dampness retention. Symptoms include swelling of the limbs, heavy body, chest tightness, poor appetite, nausea, white and greasy tongue coating, and a deep, soft pulse. The treatment should focus on invigorating the spleen and resolving dampness, promoting yang and facilitating water discharge. The prescription can be adjusted from Five Ingredients with Poria Powder (from the "Treatise on Cold Damage Diseases") combined with Five-Peel Decoction (from Sanyin Fang).
2. If the syndrome is caused by insufficient spleen yang, it is often due to a constitutionally weak spleen, further damaged by dietary overstrain, leading to insufficient spleen yang, deficiency of middle qi, and failure of qi to promote water transformation, causing the spleen to fail in dispersing essence and leading to water-dampness retention. Symptoms include generalized edema, more pronounced swelling below the waist, pitting edema, shallow yellow complexion, mental fatigue and lack of strength, anorexia and loose stools, chest tightness, abdominal distension and fullness, difficulty in urination, white and greasy tongue coating, pale and swollen tongue texture, and a thin, soft pulse. The treatment should focus on invigorating spleen yang and warming to transform water-dampness. The prescription can be adjusted from White Atractylodes Powder (from Taiping Huimin Heji Jufang) or Spleen-Strengthening Decoction (from Jisheng Fang).
3. If the syndrome is caused by insufficient kidney yang, it is often due to excessive sexual activity, leading to kidney qi deficiency. Since the kidney governs water, kidney deficiency leads to uncontrolled water movement and dysfunction of the bladder's opening and closing, resulting in water retention. Symptoms include pale complexion, generalized edema, more pronounced swelling below the waist, pitting edema, cold limbs, palpitations, shortness of breath upon exertion, lumbago, pale and swollen tongue texture, white and greasy tongue coating, and a deep, slow pulse. The treatment should focus on warming the kidney and promoting water discharge. The prescription can be adjusted from True Warrior Decoction (from the "Treatise on Cold Damage Diseases").

Treatment of influenza, enterovirus, and various viral colds, Chinese medicine is more refined, non-toxic, and effective than Western medicine

Water is yin, and dampness is also a yin pathogen. When water and dampness combine and linger, yin mist spreads, and yang qi is suppressed. Therefore, the characteristic of this syndrome is yin exuberance and yang deficiency. Clinically, it can be seen that individuals with a constitutionally yang deficiency are prone to yang deficiency and water-dampness flooding. As for patients with spleen-kidney yang deficiency caused by external dampness triggering internal dampness, improper diet, excessive consumption of raw and cold foods, or excessive sexual activity depleting primordial yang, this syndrome often occurs. It must be noted that salty and cold foods enter the kidney, and excessive consumption of salty and cold foods damages kidney qi, disturbs qi transformation, and affects the bladder's opening and closing, becoming an important factor in the recurrent episodes of this syndrome.

The dysfunction of the lungs, spleen, and kidneys, disturbance of qi transformation in the triple energizer, and dysfunction of the bladder's opening and closing are the main mechanisms of disease in this syndrome, indicating that the smooth movement of qi in the body prevents water-dampness retention. Since there are many disease causes that lead to disorder of qi movement, this syndrome can present with different accompanying symptoms of pathogenic factors. For example, if accompanied by qi stagnation, it is often due to emotional fluctuations, depression, and stagnation of qi movement. Qi stagnation leads to water stagnation, and failure of qi to move water results in symptoms such as difficult urination, dribbling, and urinary retention. The treatment method involves regulating qi movement and moving qi to transform water. Another example is if accompanied by blood stasis, it is often due to disturbance of qi transformation, leading to poor blood circulation. Jingui Yaolue·"Water Qi Abnormal Pulse Syndrome and Treatment" states: "If blood does not flow smoothly, it turns into water," which can manifest as liver-spleen blood stasis in "tympanites" or liver blood disorder in women leading to amenorrhea. The treatment should focus on moving qi to transform water and invigorating blood and resolving stasis. Edema due to yang deficiency is the main mechanism of disease in this syndrome, and warming and promoting water discharge are common treatment methods. However, warm and hot herbs can easily dry up fluids, and excessive diuresis or aggressive purging can lead to fluid depletion. During the progression of the disease, yang qi deficiency can evolve into "deficiency of both qi and yin," presenting with generalized edema, difficulty in urination, dry mouth and sore throat, irritability, red tongue texture, greasy tongue coating, and a thin, slippery, and rapid pulse. Therefore, the principle of "stopping when the majority is reduced" should be strictly adhered to, and aggressive purging formulas must be used cautiously. If the syndrome persists for a long time, in the late stage [third stage], it can manifest as generalized swelling, listlessness, dizziness, tinnitus, sore and weak lower back and knees, cold limbs, scant and peeled tongue coating, and a deep, thin, and weak pulse, indicating "deficiency of both yin and yang." Ultimately, it can lead to the critical condition of water turbidity interacting, pathogenic excess and healthy qi deficiency, and separation of yin and yang.

1. Syndrome/pattern of internal retention of water-fluid and water-dampness flooding syndrome: Both are pathological changes caused by insufficient yang qi and abnormal distribution of body fluids, and both present symptoms such as chest tightness, heavy body, and a white greasy tongue coating. However, the syndrome/pattern of internal retention of water-fluid mainly refers to the retention of water in the chest, abdomen, gastrointestinal tract, and limbs, which is different from water-dampness flooding syndrome, where water-dampness can flood throughout the body. Clinically, the former may present with splashing sounds in the stomach, gurgling sounds in the intestines, pain upon coughing or spitting, and a palm-sized area of discomfort on the back. The latter mainly manifests as edema and dysuria. Although edema may sometimes be seen in the syndrome/pattern of internal retention of water-fluid, such as in "subcutaneous fluid retention" where the limbs are heavy and swollen, the edema is generally mild and distinct from the significant swelling in water-dampness flooding syndrome. The treatment for the syndrome/pattern of internal retention of water-fluid focuses on transforming and transporting water, while water-dampness flooding syndrome is treated by warming yang and excreting water. These two should be differentiated accordingly.
2. Syndrome/pattern of dampness impacting the spleen and stomach and water-dampness flooding syndrome: Both may present symptoms of spleen yang deficiency and dampness obstruction, such as chest tightness, heavy body, and scanty urine. However, the syndrome/pattern of dampness impacting the spleen and stomach primarily affects the middle energizer, manifesting as dampness obstruction due to dysfunction of the spleen and stomach in transformation and transportation. Symptoms include mental fatigue, limb heaviness, chest and abdominal distension and fullness, heavy body, poor appetite, or low-grade fever, sticky mouth, scanty urine, greasy tongue coating, and a soggy pulse. When occurring in summer, it is also called "summer non-acclimatization." The key points for differentiation from water-dampness flooding syndrome are:
   1. The syndrome/pattern of dampness impacting the spleen and stomach is localized and may have seasonal characteristics, whereas water-dampness flooding syndrome refers to systemic water-dampness pathology.
   2. The former primarily presents with chest and abdominal distension and fullness, poor appetite, heavy body, and limb heaviness, and its treatment focuses on resolving dampness in the middle energizer. The latter mainly presents with swelling of the face and limbs and dysuria, and its treatment focuses on warming yang and excreting water.
   3. Summerheat dampness affecting the spleen and stomach may sometimes cause facial puffiness or a sensation of limb swelling, which is due to the seasonal characteristics of summerheat dampness and the tendency of summerheat to consume qi, leading to qi deficiency and swelling. However, the edema is mild and secondary. These two should be differentiated accordingly.
3. Syndrome/pattern of water binding with heat and water-dampness flooding syndrome: The syndrome/pattern of water binding with heat is also known as "thoracic accumulation syndrome." It is caused by the incorrect use of purgatives in an exterior syndrome, leading to inward invasion of external pathogens, which transform into heat and bind with water in the chest and hypochondrium. Symptoms include chest and hypochondriac pain, severe pain and hardness from the epigastrium to the lower abdomen, slight sweating on the head, dysphoria, shortness of breath, restlessness, stifling sensation, dry mouth and tongue, and dry stools. The differentiation from water-dampness flooding syndrome is:
   1. Although both involve water, the former refers to the binding of water and heat in external-contraction febrile diseases, with the pathological location in the chest, hypochondrium, epigastrium, and abdomen. The latter refers to systemic water-dampness flooding in internal damage Zabing, with the pathological location being systemic.
   2. The former primarily presents with chest and hypochondriac pain, tenderness, and slight sweating on the head, while the latter primarily presents with swelling. Therefore, the two are not difficult to differentiate.
4. Syndrome/pattern of water and blood stasis binding and water-dampness flooding syndrome: The syndrome/pattern of water and blood stasis binding refers to the symptoms and signs of "liver and spleen blood stasis" in "tympanites." Due to stagnation of liver and spleen qi, over time, the collaterals become obstructed, blood circulation is impaired, spleen deficiency leads to internal accumulation of water-dampness, and liver blood stasis leads to water stagnation. Symptoms include a distended abdomen like a jar, hypochondriac and abdominal distension and pain, visible veins, pleural effusion, ascites, dark complexion, thirst without desire to drink, dysuria, purple tongue with ecchymosis, and a fine slippery or deep soggy pulse. The key points for differentiation from water-dampness flooding syndrome are:
   1. Although both involve internal accumulation of water-dampness and flooding in the chest and abdomen, presenting with pleural effusion, ascites, and dysuria, the former mainly involves water accumulation in the abdomen, while the latter involves systemic water accumulation.
   2. The pathological zang-fu organs in the syndrome/pattern of water and blood stasis binding are mainly the liver, spleen, and kidneys, whereas in water-dampness flooding syndrome, the dysfunction involves the lungs, spleen, and kidneys.
   3. The syndrome/pattern of water and blood stasis binding not only presents with symptoms of internal water-dampness accumulation such as pleural effusion and ascites but also has obvious manifestations of static blood stasis, such as visible veins on the abdomen, vascular nevi on the face, neck, chest, and back, appearing as blood streaks, red marks on the palms, gingival hemorrhage, and a tongue with ecchymosis or cyanosis. Therefore, these should be differentiated accordingly.
5. Water stagnation yellow sweat syndrome and water-dampness flooding syndrome: Water stagnation yellow sweat syndrome, also known as "yellow sweat," occurs when dampness pathogens soak the skin and hair, and the dampness pathogens are suppressed and transform into heat, forcing sweat to emerge. Symptoms include body heat, chest fullness, swelling of the limbs and face, heavy pain in the body, coldness in the two [unclear], yellow-colored sweat, and a deep, slow pulse. The distinction from water-dampness flooding syndrome is:
   1. Although both can manifest as dampness-heat obstructing the flow of qi movement, leading to swelling in the limbs and face, the former is due to dampness-heat obstruction, while the latter is due to yang qi stagnation.
   2. The pathological location of the former is in the skin and flesh, while the latter is in the lungs, spleen, and kidneys.
   3. The main characteristic of water stagnation with yellow sweat syndrome is sweating that stains clothes like cypress juice, whereas the main feature of water-dampness flooding syndrome is edema and difficulty in urination. Therefore, these should be used for differentiation.

TCM can effectively treat dry eye syndrome, floaters, retinopathy, and various chronic eye diseases

bubble_chart Documentation

1. Suwen-Yinyang Bie Lun：「Three yin constipation is called water.」
2. Lingshu-Shuizhang：「When water begins to rise, there is puffiness of the eyelid, like the appearance of someone who has just woken up, the neck pulse moves, there is occasional coughing, coldness between the inner thighs, swelling of the lower legs, and the abdomen becomes large, indicating that the water has already formed.」
3. Jingui Yaolue Xindian‧Water Qi Abnormal Pulse Syndrome and Treatment》：「Wind edema, water is agitated by wind, and thus water disease is caused by wind. Wind damages the skin and hair, and dampness flows into the joints, hence the pulse is floating with aversion to wind and joint pain. Skin edema, water moves within the skin, internally combining with lung qi, hence the pulse is also floating, without wind, so there is no aversion to wind. The abdomen is like a drum, which meansNeijing𪔣𪔣 not firm. Because the disease is in the skin, and the intestines are deficient, there is external swelling but no internal fullness or panting. Water in the skin should be resolved through sweating, hence it is said: sweating should be induced. Typical edema, the water of the kidneys is self-sufficient. Stony edema, water that accumulates and does not move. Typical edema takes advantage of yang deficiency and invades the upper energizer, hence the pulse is deep and slow with panting. Stony edema is due to the excess of yin and is congealed in the lower abdomen, hence the pulse is deep with abdominal distension and fullness but no panting. Yellow sweat, sweat stains clothes like cypress juice, caused by dampness-heat combined disease, with dampness residing outside heat, its excess in the upper part and yang not moving, then there is body heat, chest fullness, swelling of the limbs and head, and over time it invades internally and the nourishment does not pass, then it rebels in the flesh and becomes abscesses and pus.」
4. Yizong Jinjian‧Jingui Yaolue Annotation：「All those with water, refer to all water diseases. To treat all water diseases, one should know the methods of dispersing and eliminating from the exterior and interior, upper and lower. Swelling above the waist indicates water is external, sweating should be induced to cure, such as in the cases of Yuebi and Qinglong decoctions; swelling below the waist indicates water is internal, promoting urination should be induced to cure, such as in the cases of Wuling and Polyporus decoctions.」