The production of Body Fluids
This diagram shows that the production of body fluids originates with the food and drink that is taken in to the Stomach.
The Stomach is referred to as the source of Body Fluids as it starts the process of breaking down the food and drink.
The Spleen has a crucial role in the production of Body Fluids as it regulates the transformation and separation of Body Fluids into pure and impure parts.
The pure parts are sent to the Lungs which then disperse these under the skin to moisten the skin. The Lungs also descend some of the pure fluids to the Kidneys and then on to the Bladder.
The Kidneys are said to steam some of the fluids they receive from the Lungs, sending them back to the Lungs to moisten them.
The impure fluids from the Spleen are sent to the Small Intestine where they are further refined into pure and impure parts. The pure parts from the Small Intestine are sent to the Bladder, whilst the impure part is sent to the Large Intestine.
The Large Intestine re-absorbs some of the fluids, whilst the rest are passed out as part of the stools.
The Bladder further separates the pure fluids it receives from the Small Intestine into pure fluids which are sent back up through the middle and upper Jiaos with the impure fluids being passed out as urine.
The San Jiao, or Three Jiaos, acts as a communication pathway between the Zang-Fu in the upper, middle and lower parts of the body thereby assisting the transformation, transportation and excretion of body fluids at all stage.
Body Fluid pathology in TCM
There are four main pathologies that can develop around Body Fluids:
- Oedema where the body fluids have accumulated in a specific location.
- A deficiency of body fluids.
- Phlegm as a result of Body Fluids accumulating and condensing.
- Damp due to Body Fluids accumulating.
Oedema due to Body Fluid accumulation
Oedema occurs when the transformation and transporting of body fluids has been affected and caused them to start accumulating. This usually indicates that an underlying Spleen imbalance is occurring. In a way it is similar to Damp but has a more visible manifestation.
As the oedema develops and accumulates, it can lead to symptoms of a feeling of stuffiness, heaviness in the body, a lack of appetite and lethargy. In more severe cases it can lead to a discharge.
Oedema can be due to patterns of Excess (Shi), or Deficiency (Xu).
With Excess patterns, these are usually due to:
- An underlying Spleen Qi deficiency so that the Spleen is unable to carry out its function of transforming and transporting Body Fluids.
- An excess of Damp forming foods such as dairy or raw foods that have affected the Spleen leading to ineffective transforming and transporting of Body Fluids.
- An external invasion of Damp that has led onto Bi syndrome which affects the joints.
The location of the oedema can also give an indication of which Zang-Fu may be causing the problem:
- If the oedema is due to an underlying Lung Qi deficiency, this can lead to symptoms occurring in the upper part of the body such as a puffy face.
- If the oedema is due to an underlying Spleen Qi deficiency or Spleen Yang deficiency, this can lead to symptoms occurring in the middle part of the body such as abdominal bloating.
- If the oedema is due to an underlying Kidney Yang deficiency, this can lead to symptoms occurring in the lower part of the body such as the legs and ankles.
Deficiency of Body Fluids
Body Fluids are a Yin substance, so any deficiency of Yin will affect Body Fluids.
With a deficiency of Body Fluids, there can also be signs of Heat, which could be from full Heat or Empty Heat. There may therefore be signs of dry lips, mouth, skin or tongue.
As Jin body fluids thin the Blood to prevent it from stagnating, any loss of Blood will also result in a loss of Body Fluids. An excessive loss of fluids, for example through excessive of chronic sweating, will cause a deficiency of Body Fluids as Jin body fluids are lost through sweating.
Phlegm
Phlegm is a denser substance than Damp and can be divided into visible phlegm and invisible phlegm.
As the name suggests, visible phlegm can be seen, typically in secretions such as from the nose or the mouth through coughing. Visible phlegm is categorised as:
- Phlegm-Cold.
- Phlegm-Damp.
- Phlegm-Heat.
The general way to decide what type of visible phlegm is being dealt with is to through the secretions, the tongue coating and the feel of the pulse.
Phelgm-Cold
With Phlegm-Cold the secretions tend to be watery or runny and either clear or white, such as those seen when someone blows their nose during the first or second day after catching a cold.
The tongue develop a sticky-white coat where the stickiness indicates the presence of phlegm and white indicates cold.
The pulse becomes wiry or tight due to the cold and also has a slippery quality indicating phlegm.
Phlegm-Damp
With Phlegm-Damp the secretions tend to be stickier than those from Phlegm-Cold and either clear or white.
The tongue develops a thick sticky-white coat where the stickiness indicates the presence of phlegm and white indicates cold. It becomes thick due to the additional Damp that is present.
The pulse may become wiry or tight due to the cold and also has a slippery quality indicating phlegm.
Phlegm-Heat
With Phlegm-Heat the secretions tend to be thick, yellow and difficult to dislodge as the heat has condensed the phlegm.
The tongue develops a sticky, yellow coat and a red body to reflect the phlegm and heat. The pulse becomes faster due to the heat and also has a slippery quality indicating phlegm.
It’s also worth bearing in mind that Phlegm-Cold and Phlegm-Damp can transform into Phlegm-Heat over a period of time.
Invisible Phlegm
Invisible phlegm travels along the channels (generally in an upwards manner) affecting the Heart and the Shen.
This can result in patterns such as Phlegm Misting the Mind where the invisible Phlegm acts as a veil to affect the Shen. If the invisible phlegm is on its own, it can show as depression, dullness or confusion. If the phlegm has combined with fire resulting in phlegm-fire, this can manifest as mental restlessness or inappropriate laughter.
Phlegm can also be retained in the channels and the limbs: in the channels it can create soft lumps such as ganglions, whilst in the limbs it can lead to numbness and heaviness such as in multiple sclerosis. Within the channels travelling to the head, invisible phlegm can cause dizziness and vertigo.
Phlegm can also combine with Internal Wind resulting in Phlegm-Wind.
Damp
There are two main patterns associated with Damp and these are Damp-Cold and Damp-Heat.
Damp-Cold primarily affects the Spleen and the Bladder. Damp-Heat primarily affects the Large Intestine, Bladder, Liver, Gall Bladder and the Spleen.
Damp-Cold
The main symptoms associated with the Damp-Cold are:
- The pulse takes on a slippery quality and becomes slower due to the Cold.
- The tongue develops a sticky white coat as the colour white is associated with Cold.
- There may be a heaviness in the limbs as Damp is a heavy substance and has a tendency to sink.
- There may be swelling (such as oedema) or oozing (such as in weeping eczema).
- If joints are affected by the Damp-Cold, in addition to any swelling they may also feel cold to the touch.
- Any pain may be described as cramping as Cold causes the channels and muscles to become tighter.
Damp-Heat
The main symptoms associated with the Damp-Heat are:
- The pulse takes on a slippery quality and becomes faster due to the Cold.
- The tongue develops a sticky yellow coat as the colour yellow is associated with Heat.
- There may be a heaviness in the limbs as Damp is a heavy substance and has a tendency to sink.
- There may be swelling (such as oedema) or oozing (such as in weeping eczema).
- If joints or the skin are affected by the Damp-Heat, in addition to any swelling or oozing they may also feel warm or hot to the touch.
- Any pain may be described as a burning pain.
Damp and the Zang-Fu
Depending on which Zang-Fu are affected, it will reflect specific signs and symptoms.
For example, if the Spleen is affected, there may be symptoms of oedema, abdominal bloating or loose stools as the Spleen’s function of transforming and transporting body fluids is compromised.
If the Stomach is affected, it may lead to symptoms of nausea and vomiting as the Damp blocks the natural downward flow of Stomach Qi causing it to rebel and rise upwards.
In general, whenever there are signs of Damp, there is usually an underlying Spleen imbalance so it is always worth treating the Spleen to improve the transformation and transporting of Body Fluids.
It is worth bearing in mind that if Damp-Cold has been around for a while, it can transform into Damp-Heat and give rise to a new set of symptoms.
Similarly, Damp-Heat can transform into Damp-Cold as the Heat begins to subside or burn itself out.
