Two Prescriptions of Nephritis Decoction
Lin Zheng Yi An Yi Fang (Clinical Case Records and Medical Formulas) contains two Nephritis Decoction formulas, Nephritis Decoction No. 1 and Nephritis Decoction No. 2.
The composition of Nephritis Decoction No. 1 is as follows: Dongguazi (Winter Melon Seed) 30 g, Dongguapi (Winter Melon Peel) 30 g, Cheqianzi (Plantain Seed) 30 g (in a cloth bag), Fulingpi (Poria Peel) 30 g, Chixiaodou (Rice Bean) 30 g, Yiyiren (Coix Seed) 30 g, Baimaogen (Cogongrass Rhizome) 60 g, Zexie (Water Plantain Rhizome) 12 g, Sugeng (Perilla Stem) 6 g, Jiegeng (Platycodon Root) 6 g, Chenpi (Tangerine Peel) 6 g, Hanliancao (Eclipta Herb) 9 g, Chantui (Cicada Slough) 6 g.
Administration: decoct in water, one dose daily, taken warm twice, morning and evening. This formula promotes urination and reduces swelling. It chiefly treats acute nephritis with generalized edema, aching pain in the lower back, scanty yellow urine, a thin white tongue coating, and a floating rapid pulse.
The composition of Nephritis Decoction No. 2 is as follows: Bajitian (Morinda Root) 9 g, Xianlingpi (Epimedium) 9 g, Buguzhi (Psoralea Fruit) 9 g, Zhi Fuzi (Processed Aconite) 5 g, Sheng Huangqi (Raw Astragalus) 15 g, Dangshen (Codonopsis) 9 g, Fuling (Poria) 12 g, Yiyiren (Coix Seed) 12 g, Zhuling (Polyporus) 12 g, Shiwei (Pyrrosia Leaf) 15 g, Baimaogen (Cogongrass Rhizome) 30 g, Hanliancao (Eclipta Herb) 9 g.
Administration is also by water decoction, twice daily. This formula warms the kidney and fortifies the spleen, and promotes urination and reduces swelling. It chiefly treats chronic nephritis with spleen-kidney yang deficiency, generalized edema, sore and weak lower back and knees, scanty urine, aversion to cold with cold limbs, a pale, enlarged, tender tongue with teeth marks, and a deep, fine, weak pulse.
Both formulas promote urination and reduce swelling, but their indications differ slightly. Patients suited to the first formula do not have kidney yang deficiency or aversion to cold with cold limbs, so all the herbs used in it are common diuretics and anti-edema herbs. Among them, Sugeng, Jiegeng, and Chenpi also regulate qi. Patients suited to the second formula have kidney yang deficiency with aversion to cold and cold limbs, so while promoting urination and reducing swelling, it must also warm and tonify kidney yang. Bajitian, Xianlingpi, Buguzhi, and Zhi Fuzi in the formula are kidney-yang-warming tonics. This is the biggest difference in the two formulas' composition logic.
When TCM treats edematous diseases, it decides the medication approach according to the patient's clinical symptoms. These two formulas can actually also be used to treat pleural effusion (pleural fluid), ascites (abdominal fluid), and pelvic effusion. TCM can treat these diseases and nephritis with "different diseases treated by the same method"—that is, different diseases receiving the same treatment—because their treatment principle is the same: promoting urination and reducing swelling.