2. Strengthening the Spleen and Promoting Diuresis

2. Strengthening the Spleen and Promoting Diuresis

“The Plain Questions · On the Great Principles of True Truth” states: “All conditions of dampness and edema are related to the spleen.” “The Spiritual Pivot · On the Essence of Spirit” says: “When the spleen qi is deficient, the limbs lose their function, the five zang organs are unsettled, and when it is excessive, there is abdominal distension and difficulty in urination and defecation.” This shows that the “spleen” is also closely related to the onset of chronic nephritis. In fact, when kidney yang is deficient, the vital fire of the Mingmen declines, and over time, the spleen yang loses its ability to warm and thus weakens, further promoting the formation of edema. Clinically, patients with chronic nephritis, in addition to the most common signs of kidney yang deficiency, often also present with loss of appetite, fatigue, and fullness in the epigastrium—symptoms of spleen deficiency. In most cases, these symptoms coexist with those of kidney deficiency; in some cases, they appear alone. Moreover, many diuretic drugs, such as Wuling San and Wupi San, also have the effect of strengthening the spleen, indicating that impaired spleen function is indeed an important cause of nephritic edema. Therefore, strengthening the spleen and promoting diuresis is also one of the fundamental treatments for chronic nephritis. Clinically, Baoyuan Tang combined with Wuling San and Wupi San can be used; more often, however, codonopsis, atractylodes, astragalus, wuling san, and wupi san are added to formulas for warming the kidney yang and tonifying the kidney.