Abnormal metabolism of Body Fluids
Metabolism of the body fluids is directly related to their formation, distribution, and excretion, and is a complicated physiological process resulting from the cooperative activities of several viscera. Only when the body fluid metabolism is balanced, that is, the amount of water-liquid entering the body is equal to the metabolic water discharged from the body, can normal metabolism be maintained.
The process of formation, distribution, and excretion of the body fluids depend or qi's ascending, descending, exiting, and entering movements, as well as its transformative function. Only when these movements of qi are normal can the body fluids maintain balance. If the transformative function of qi is strong, the formation, distribution, an excretion of body fluids will be normal.
The physiological functions of the lung, spleen, kidney, urinary bladder, triple
jiao, and liver all play an important role in the process of regulating metabolism of the body fluids. The lung's dispersing and depurative descending functions, the spleen transportation, transformation, and distribution functions, and the kidney's evaporatinf and transformative functions play a leading role in the movement of sending up the clear body fluids and sending down the turbid. Abnormality of body fluids metabolism signifie that there is a dysfunction of metabolism in the systemic and local regions, leading to disorder or disturbance of formation, distribution, and excretion of the body fluids.
1. Insufficiency of the Body Fluids
The primary manifestations of this condition denotes a pathological state in which the quantitative decrease of body fluids causes a failure in moistening and nourishing the viscera, external orifices, skin, and hair, creating a series of symptoms of dryness and lae of moisture. The most common cause is dry-heat evil, which scorches the body fluids, may also appear commonly in cases of impairment of body fluids due to profuse sweating loss of blood, severe vomiting, diarrhea,polyuria, or overuse of drying or heat agents.
Generally speaking, the liquid ("fin") refers to fluid that is relatively clear, thin mobile, which is likely to be consumed and supplemented as well; whereas the humou ("ye") denotes thinker and turbid fluid, less mobile, which is neither easily impaired an consumed nor rapidly supplemented whenever consumed. Since insufficient body fluid fail to supplement and nourish the lips, skin and blood vessels, its symptoms are dry withert hair, sunken eyes, sunken finger tips, and a thready pulse. Insufficiency of body fluids leads to a lack of source material for sweat and urine formation, with symptoms such as inability to perspire, unhidrosis, or oliguria. When the large intestine lacks moisture,the body fluids it fails to perform its transporting function, which causes eonstipatlon Heavy consumption of the body fluids is followed by an insufficiency of the body fluid
and blood, which are unable to nourish the tendons, resulting in a syndrome of spasm.
2. Disturbance of Distribution and Excretion of Body Fluids
The distribution and excretion of the body fluids are two key links of body fluias
metabolism, and they are of vital importance to the exiting and entering movements, and the ascending and descending circulation.
Dysfunction of distribution of the body fluids refers to a pathological state in which the body fluids are unable to be transported and distributed normally, Which results in retarded circulation, encumbrance of damp-turbidity, or retention in the local region. This brings about a decrease of transformation of the body fluids, the internal origination of water-dampness, or an accumulation of phlegm-retention. The causative factors of this disorder may be as follows: The lung fails to perform its dispersing and depurative descending; the spleen function of transportation, transformation, and distribution is weakened; failure of the liver in its conducting and dispersing functions leads to the blocking of qi activity, creating retention of water; and the resulting obstruction of the water passage of the triple-jiao causes a disturbance of body fluids circulation.
The disturbance of excretion of the body fluids refers to a pathological state in which hypofunction of the body fluids in transforming into sweat and urine creates retention of water-fluid. The watertransformation of body fluid into sweat depends primarily on the lung's dispersing function, and its transformation into urine mainly relies on the transformative function of kidney-@ Hypofunctioning of the lung and kidney may lead to retention of water-fluid within the body, or edema occurs, when the water-fluid overflows in the flesh and skin. Excessive water may appear when it remains in the space between the viscera and the intestine.
In general, the types of pathological changes of distribution and excretion of the body fluids may be summarized as follows:
? Encumbrance of damp-turbidity
This condition may occur when there is a failure of the spleen in transporting and transforming the body fluids, resulting in retention of water-dampness, which develops into turbid matter. Dampness is characterized by heaviness, turbidity, viscosity, and stagnation, and it is likely to block the activities of qi. Its symptoms may include chest distress, nausea, abdominal fullness and distension, a heavy sensation in the head and body, stickiness in the mouth without thirst, diarrhea, loose stool, yellowish face, and edema.
? Retention of water-fluid
This usually occurs when disturbances of the lung, spleen, and kidney produce a disorder of body fluids metabolism. Water-fluid is unable to be transformed, and it accumulates within the body, creating edema or ascites. If water-fluid overflows in the skin,edema in the head, face, eyelids, limbs, abdomen and back, or even general edema, may appear. If it accumulates in the abdominal cavity, there may be abdominal swelling and distension that indicates ascites.@ Accumulation of phlegm and fluid-retention
Phlegm accumulation or fluid-retention in a particular area of the body is the pathological product by which the disturbance of the visceral function causes a disorder of water metabolism, and further creates a failure of the body fluid in its transformative function.Having been produced, it then becomes the causative factor of many diseases. Accumulation of water leads to fluid-retention, which is agglutinated to the phlegm, resulting in various syndromes of the phlegm or fluid-retention.
Diseases caused by fluid-retention share different names according to their affected regions. For example, fluid-retention in the chest and hypochondrium is called suspended fluid-retention, in the lung it is known as sustained fluid-retention, and in the limbs it is termed over-flowing fluid-retention. The phlegm may be retained in any place along with the ascending and descending movements of qi, involving the various viscera and meridians. The following pathological reflections may be present: The impediment of phlegm in the lung may lead to cough and asthma with profuse sputum the phlegm covering the heart may cause chest distress, palpitations, coma, or depressive and manic psyehosis;retention of the phlegm in the stomach may bring about nausea, vomiting, or discomfort in the epigastrium and abdomen; obstruction of the meridians, or tendons by the phlegm may create scrofula, subcutaneous nodules, numbness of limbs, hemiplegia, or suppurative inflammation of deep tissues; the phlegm-turbidity affecting the head and eyes may cause dizziness, vertigo, blurred vision, or syncope; and an accumulation of the phlegm in the throat may result in an uncomfortable sensation as though "a foreign body" is present in the throat, known as "plum-core feeling in the throat. "
3. Disturbance of Body Fluid and Qi and Blood
1) Retention of Body Fluid and Obstruction of Qi
This refers to a pathological state in which retention of body fluid within the body blocks the functional activities of qi. It often appears when there is a disturbance of body fluid metabolism due to a failure of qi's transformative function, creating an accumulation of water-fluid, and a blockage of the ascending and descending movements of qi. For example, an impediment of fluid-retention in the lung leads to obstruction of lung-qi, which fails to perform its dispersing and depurative descending. The results may be chest fullness, cough, asthmatic or hasty breathing, and a difficulty in lying flat. Fluid-retention affecting the heart obstructs heart-qi, and heart-yang is restrained. The symptoms include palpitation and cardialgia. Accumulation of fluid-retention in the middle-jiao impedes the functional activities of the spleen and stomach, which creates a failure of the
clear qi in ascending, and in the turbid qi's descending function. Dizziness, lassitude, distension and fullness in the epigastrium and abdomen, dyspepsia, nausea, and vomiting may result from this condition. Finally, obstruction of fluid-retention in the limbs impedes the flowing of meridian-qi, qi, and blood, and may be accompanied by heaviness,distension, and pain in the limbs and trunk, as well as signs of edema.
2) Qi Collapse Following Massive Loss of Body Fluids
This refers to a pathological state in which prostration of qi after a great loss of body fluids creates a sudden collapse of both qi and body fluids. It occurs most commonly in cases of great consumption of body fluids due to high fever, profuse sweating, or severe and diarrhea. Since the fluid is the carrier of depletion of body fluids vomiting body qi, produces exhaustion in both qi and yang. This "divorce of yin from yang" may produce symptoms such as profuse sweating, shortness of breath, feeble breathing, cold limbs,a thready and fading pulse, or even death.
3) Exhaustion of Body Fluids and Blood
This refers to a pathological state in which insufficiency or exhaustion of body fluids causes an endogenous deficient heat due to blood-dryness, or a state in which blood-dryness produces endogenous wind. The body fluid is an important component of blood.B100d and body fluid have the same sources from the acquired essence from water and grains. High fever which scorches the body fluid, consumption of body fluid in burn injury, blood loss, depletion of fluid, deficiency of yin with phthisis fever and insidious conof fluid, all these will lead exhaustion of fluid and blood. The morbid mani festations include anxiety, naso-pharyngeal dryness, heat in five centers (palms, soles and.pre-cardia)' thirsty, lean, oliguria, red tongue with scanty saliva, fast thin pulse,
4) Deficiency of Body Fluid and Blood Stasis
This refers to a pathological state in which the deficiency of body fluids produces retarded blood circulation. Sufficient body fluid is an important factor that ensures appropriate blood volume and smooth blood circulation. The pathological changes of this condition result from high fever, burns, vomiting, diarrhea and profuse sweating, all of which consume a large amount of the body fluids, thus causing insufficiency of the body fluids,decrement of blood volume, and retarded blood circulation. The characteristic symptoms edark-purplish tongue, petechiae, ecchymosis, or maculopapule.
