David, I have several cases I am working on where there is a serious need for herbal diuretics/aquaretics. Both cases have similarities, in that they are both showing signs of stomach/spleen qi deficiency with damp heat. (Swollen, red tongues with central crack) The dampness is primarily showing on the tongue in the lower jiao/kidneys, but they both have swelling in the face, eyelids and upper arms/fingers as well. They have both been prescribed Lasix by different practitioners, but the Lasix isn't doing much for either of them. In fact, they have both reported they think it makes the edema worse! When would it be appropriate to move from mild, potassium sparing diuretics such as dandelion leaf, into herbs such as Bai Zhu, Chen Pi, Fu Ling, and Gan Jiang? Would it ever be appropriate to add in something like Sang Bai Pi for upper body swelling? My thought process in considering a treatment would be something like a blood mover (since blood is closely tied to fluids in TCM), lymphatic support, and eliminatory support via the kidneys. All the while considering the individual and the tastes/energetics of the plants, of course. So much to think about! Am I on the right track? Both of these ladies need major draining and support, as this swelling is severe. They are both being monitored by medical specialists, who seem to be at a loss as to what to do. Jami

If Lasix is not working then I have doubts that a mild aquatic like dandelion will be effective. Bai Zhu is not a diuretic, nor is orange peel. Fu Ling might be of benefit, it is used with Grifola/Zhu Ling and Water Plantain root. Only Ginger skin has diuretic effects, not Ginger root. The first question to ask is why do they have edema ? Cardiac issues ? lung issues ? circulatory issues ? kidney issues ? Sang Bai Pi may be helpful , but not alone, focus on the underlying problem that is causing the fluid build-up.

David, In one case, there is edema due to post mastectomy lymph removal and full hysterectomy. I'm going with circulatory. This person also has EDS. In the second case, it is edema from a kidney issue (glomerulonephritis of an unknown origin). This person, however, has a lifelong standing issue of spleen qi deficiency/anemia, blood stagnation and phlegm (nodules, fibroids, etc). For some reason, I made a note on my materia medica sheet for Bai Zhu that read, "Fluids where they don't belong", and that it can relieve dampness and edema in the lower and middle jiao. Maybe my question should have been: Can treating spleen qi deficiency as part of a larger formula help a person with edema? Thank you, David. Jami

Treating Spleen qi deficiency can sometimes help edema, but in most cases (Kidney issues, post-mastectomy lymphedema, cardiac issues, etc.) it will not work or work well. BTW Bai Zhu is used for dampness, it is drying but not a diuretic. It works best for diarrhea, dampness causing sciatica, excessive sweating and excessive mucus production. For Lymphedema I have used a combination of Cleavers, Sweet Melilot and Horse Chestnut, along with the Vodder technique of lymphatic drainage (done by some massage therapists). TCM formulas often used for facial edema are Wu ling San and Wu Pi Yin.