Ascites according to Chinese Medicine

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Ascites factsheet

In Chinese Medicine, ascites can be associated with four so-called "patterns of disharmony". Chinese Medicine sees the body as a system, not a sum of isolated parts. A "pattern" is when the system's harmony is disrupted. It is not equivalent to the Western concept of "disease", as a matter of fact here ascites can be caused by four different patterns.

To understand whether someone's ascites might be caused by a given pattern, one needs to look for signs and symptoms associated with the pattern beyond what one might typically experience from ascites alone. For instance when ascites is caused by the pattern Phlegm, patients also experience symptoms such as chest pressure, nausea, dizziness and feeling of heaviness. Similarly, patients with Phlegm typically exhibit slippery (Hua) or wiry (Xian) pulses as well as a tongue with sticky coating, thick coating.

We've listed below a description of the four patterns associated with ascites so that you can start to get an understanding of the various possibilities according to Chinese Medicine.

Once identified, patterns are often treated using herbal formulas. Drinking herbal infusions is the most common remedy in Chinese Medicine, together with acupuncture. Here we detail below three formulas that can help treat the various patterns associated with ascites, depending on which pattern fits your profile.

The four "patterns of disharmony" associated with ascites

Crow-Dipper Rhizomes (Ban Xia) is the key herb for Er Chen Tang, a formula used for Phlegm

Phlegm

Pulse type(s): Slippery (Hua), Wiry (Xian)

Tongue coating: Sticky coating, Thick coating

Tongue shape: Swollen

Recommended herbal formulas: Er Chen Tang, Liu Jun Zi Tang, Ban Xia Bai Zhu Tian Ma Tang, Wen Dan Tang, Hao Qin Qing Dan Tang, Xing Su San, Wu Ling San

Symptoms: Lumps Nausea Nodules Dizziness Chest pressure Feeling of heaviness Numbness in the limbs

Phlegm has a great importance in Chinese Medicine as it is both a condition in and of itself as well as a cause for other diseases.

The main cause for the formation of Phlegm is Spleen Deficiency since the Spleen rules the transformation and transportation of Body Fluids. If this function is impaired, Body Fluids accumulates and change into Phlegm. 

The Lungs and Kidneys may also be involved since they each play a role in handling body Fluids: the Lungs disperse and descend Body Fluids while the Kidneys transform and excrete them. Again, if they fail to perform those roles, Body Fluids will accumulate and become Phlegm.

That being said, the Spleen malfunction is the fundamental reason behind the formation of Phlegm and, as such, treatments will focus on it first and foremost.

There are two broad types of Phlegm: so-called "Substantial Phlegm" and "Non-Substantial Phlegm". Simply put, Substantial Phlegm can be seen, such as sputum in the Lungs and throat. Non-Substantial Phlegm is more hidden and will manifest itself into, for instance, kidney stones, gallstones or arthritic bone deformities.

Phlegm can further be categorized according to its nature: there is Damp-Phlegm, Phlegm-Heat, Cold-Phlegm, etc. 

Lastly, there is a type of Phlegm called "Phlegm-Fluids". It is very similar to Dampness and is very watery and thin. It can be heard splashing in the body, found usually in the Stomach, Intestines, hypochondrium, limbs or above the diaphragm.

Read more about Phlegm here

The Spleen is a so-called "Zang" Organ. Learn more about the Spleen in Chinese Medicine

Spleen Deficiency with Dampness

Ascites might be due to Spleen Deficiency with Dampness if the condition is paired with typical pattern symptoms such as edema, general sensation of heaviness, diarrhea and urinary difficulty.

Read more about Spleen Deficiency with Dampness here

The Triple Burner is a so-called "Fu" Organ. Learn more about the Triple Burner in Chinese Medicine

Phlegm in the Lower Burner

Ascites might be due to Phlegm in the Lower Burner if the condition is paired with typical pattern symptoms such as throbbing pulsations just below the umbilicus, vomiting frothy saliva, vertigo and shortness of breath.

Read more about Phlegm in the Lower Burner here

Stephania Roots (Fang Ji) is the key herb for Fang Ji Huang Qi Tang, a formula used for Wind-Damp

Wind-Damp

Pulse type(s): Floating (Fu)

Tongue coating: Thick white coating

Tongue color: Pale

Recommended herbal formula: Fang Ji Huang Qi Tang

Symptoms: Edema Sweating Urinary difficulty General sensation of heaviness

Ascites might be due to Wind-Damp if the condition is paired with typical pattern symptoms such as sweating, general sensation of heaviness, edema and urinary difficulty. Similarly, patients with Wind-Damp typically exhibit floating (Fu) pulses as well as a pale tongue with thick white coating.

Read more about Wind-Damp here

The three herbal formulas that might help with ascites

Wu Ling San

Source date: 220 AD

Number of ingredients: 5 herbs

Key actions: Promotes urination,. Warms the Yang. Strengthens the Spleen. Promotes Qi transformation function. Drains Dampness. Clears edema.

Why might Wu Ling San help with ascites?

Because it is a formula often recommended to help with the patterns Phlegm, Spleen Deficiency with Dampness and Phlegm in the Lower Burner which are sometimes associated with ascites. If any of these patterns look like something you might suffer from, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Wu Ling San here

Fang Ji Huang Qi Tang

Source date: 220 AD

Number of ingredients: 6 herbs

Key actions: Diuretic, clears Excess fluid and removes edema. Tonifies the Spleen Qi. Calms External Wind.

Why might Fang Ji Huang Qi Tang help with ascites?

Because it is a formula often recommended to help treat Wind-Damp, a pattern sometimes associated with ascites. If it looks like you might suffer from Wind-Damp, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Fang Ji Huang Qi Tang here

Wei Ling Tang

Source date: 1481 AD

Number of ingredients: 9 herbs

Key actions: Promotes urination. Warms the Yang. Strengthens the Spleen. Drains Dampness. Promotes the movement of Qi. Harmonizes the Stomach.

Why might Wei Ling Tang help with ascites?

Because it is a formula often recommended to help treat , a pattern sometimes associated with ascites. If it looks like you might suffer from , this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Wei Ling Tang here