Chronic Nephritis

"Chronic nephritis" is a Western medical term identifying a disease characterized by
inflammation of the kidney glomeruli. In Chinese medicine, its complex of symptoms and signs
may fall under different categories, such as "Oedema" or "Exhaustion". Its main signs are
oedema of the ankles, albuminuria and hypertension.

Chronic nephritis may develop from acute nephritis. In many cases, however, it develops
insidiously without apparent symptoms. Acute nephritis broadly corresponds to "Yang Water" or
"Yang oedema" in Chinese medicine, whilst chronic nephritis broadly corresponds to "Yin
Water", "True Water" or "Stone Water". As explained above, "Water" here refers not to Water in
a 5-Element sense, but to Water as a pathogenic factor, i.e. the accumulation of body fluids in
oedema.

Cardinal Signs

The three cardinal signs of chronic nephritis are oedema, proteinuria and hypertension.

Oedema

Oedema is due to dysfunction of Lungs, Spleen and Kidneys as explained above under
"Oedema".

Zhang Jing Yue (1563-1640) said: "Oedema is due to the transformation of Essence and Blood
into Water and is mostly deficient in nature."6.(437)

Although chronic nephritis by its very nature is always due to a deficiency of the Lungs, Spleen
and Kidneys, nearly always there is also some Dampness or Damp-Heat. For this reason,
adopting the treatment principle of simply warming and tonifying Spleen and Kidneys may not
be enough. Attention should be paid to draining Dampness as well with such herbs as Huang Bo
Cortex Phellodendri, Hua Shi Talcum or Che Qian Zi Semen Plantaginis. With acupuncture, one
needs to use points such as SP-9 Yinlingquan, SP-6 Sanyinjiao, Ren-9 Shuifen, BL-22
Sanjiaoshu, and ST-28 Shuidao, with even method.

It is possible to differentiate between conditions of Deficient character and conditions of Excess
character according to the severity of the oedema. If oedema is severe, it indicates a
predominance of Dampness, therefore an Excess pattern. This is treated by warming Yang and
resolving Dampness. If oedema is slight or even absent, it denotes a deficiency of Spleen-and
Kidney-Yang, i.e. a Deficient pattern. This is treated by tonifying Spleen and Kidneys.