INTRODUCTION TO BODY FLUIDS

I. Body Fluids Physiology reflects the dynamic interplay between JIN YE and YUAN QI


A. Jin Ye ( The pure or normal Physiological Fluids)

1) JIN FLUIDS

a) follow the circulation of Qi and Blood, and assist their smooth flow, spreading through the surface of the body, moistening muscles, flesh and orifices. Thin, clear and watery; flow easily.



2) YE FLUIDS



a) A thick, paste-like substance which can seep into the spaces of the bones, and nourish and strengthen the bones and marrow. Thick and viscous, move slowly, function as a lubricant and supplement to Jing Essence LING SHU, ch. 81

Ying (Nutritive) Qi comes out of the Middle Jiao and secretes Jin and Ye fluids like a life-giving fog
From above it pours into the confluences of the tissues, the seeps into the delicate collaterals (SUN MAI), where, if the Jin and Ye are harmonious, through the Qi transformation of the Lungs and Heart they can become RED BLOOD. If this blood remains harmonious, it will first fill the delicate collaterals, then pour into the collaterals proper ( LUO MAI).

When these are full, the blood will pour into the major channels (JING MAI), Both Yin and Yang, ensuring abundance of the protective nourishing Qi and Blood, flowing through the body with the rhythmic impetus of the Lung's breath, Zhang Jing-Yue, 1624:



Jin is the clear portion of Yin and Ye is the murking portion of Jin

Jin is classed as Yang because it travels to the surface and becomes sweat, and Ye is classed as Yin because it pours into the bones and supplements the brain and marrow.

B. Fluid Physiology

A. Spleen: The Separation of the CLEAR (QING) from the MURKY (ZHUO)

- The Fire of Ming Men provides heat for Spleen transformation: The Spleen absorbs

Food and Drink Essences, and sends them upward; - All of the Zang organs (KIDNEY, LUNG, SPLEEN) involved in BF passageways promote this active transformation and transportation

B. The San Jiao is the path for fluid metabolism

- All fluids, both rarified and heavy, move through the energy of the San Jiao.

The Ming Men presides over the Ministerial Fire, and is Director of the separation of the

Yuan Qi in the Kidneys

- The Energy of the San Jiao is the active circulation of the Kidney Yang manifest

as YUAN QI.

In this manner Source Qi is differentiated into "the Three QI".

ZONG QI

GU QI

YUAN QI of lower Jiao

LING SHU, CH. 36:



Of that Qi emerging from the SAN JIAO:

- that which warms the muscles and the flesh and fills out the skin

is called the JIN-FLUIDS.
- that which flows without moving is called the YE-FLUID

C. Other Zang Fu of Fluids Metabolism



Spleen: RULES THE ACSCENT OF THE CLEAR
- Prime Mover and Transformer of the Middle; Root of Post Heaven

- Works with Kidney and Lung to transform and distribute pure fluids

Transforms the Ying and Wei

Lung:
- Transforms Fluids into a fine mist to warm and nourish the surface;
- Promotes the initial descent of the turbid from the top down, promotes movement of "Stomach House" and descent of the murky.
- Wei Qi regulates the pores, travels with fluids
- Works with heart to separate Blood from Fluids and to circulate all Qi and fluids.


Kidney:

- Root of all BF metabolism; power Source for SAN JIAO, Source of all the body's Yang and Yin.
- Rules over the final transformation and storage of Essences; drains the waste from the lower orifices.



STOMACH: RULES THE DESCENT OF THE MURKY

Gateway to the Inner Duct of the San Jiao;

Receives the fullness of foods and fluids and separates the turbid from the murky

Stomach, Large Intestine and Small Intestine

all work in harmony to purify the body by moving waste material and ensuring the

complete transformation of any waste materials still within.



Small Intestine:

-Steams fluids and absorbs essences

-connects energetically to Heart Fire

Large Intestine:

-Final Essences are extracted from mostly solid wastes to support the SOURCE QI And reinforce the JING



Bladder:

- Stores waste fluids for final steaming from Kidney Yang; and ultimate excretion of waste

D. Relationship of JIN YE to other Vital Substances

1. Qi: depends upon QI to transform and transport it

2. Blood: derived from a part of Fluid essences in Upper Jiao

3. Breast Fluids: transformed from the Qi and Blood of the CHONG AND REN

4. Jing Essence

Fluid transformation is directly dependent upon QI transformation, but also promotes Yuan Qi production in the lower Jiao

Ye Fluids/ Jing Essences very close in nature

5. Shen

Integrity of the Blood is dependent on BF physiology SHEN depends upon rarefied Qi

Connection of SHEN to San Jiao; Heart Connects to L.I.; influences Heat, prevents toxic fire
E. FLUIDS OF THE ZANG FU

1. SWEAT - is the Fluid of the Heart;


- fluids that were once Jin become sweat when "steamed" by Yang heat of the Wei Qi



2. TEARS- Fluid of the Liver
- Yang activation of eye fluids is role of Liver


3. (WATERY) SALIVA (XIAN)-Fluid of The Spleen

-Spleen governs the mouth and tongue


4. MUCOID SALIVA (TUO)- Fluid of the Kidney;

-underside of tongue, digestive enzymes, Stomach fluids, jing essences


5. NASAL MUCUS- Lung

-congestion of fluids in URT due to failure of Lung to  descend and disperse fluids.



II. DAMPNESS: PRINCIPLES AND TREATMENT

A. Chief symptoms



- general heaviness, lack of thirst, feelings of fullness and distention,



1. Differentiation according to three Jiaos





Upper Jiao- heavy head, dizziness, stuffiness of chest

and epigastrium





Middle Jiao- Loss of taste and appetite, lack of thirst

abdominal distention and fullness, fullness and stagnation

after eating, nausea, weak-heavy limbs, loose stool and

diarrhea, thick white greasy tongue coating

Lower Jiao- Dampness "pouring down"; edema of feet,

murky, difficult urination, leukorrhea, loose stool





B. Nature



1. Damp is heavy and turbid:



Sinking, heavy, sore sensations



2. Damp Illness tends to be chronic



-Spleen weakness is always root of Dampness



- failure of TRANSFORMATION

transformation implies not only changing but

raising



- dampness obstructs spleen function further,

damaging the energy from which it springs



3. Yin Pathogen



Harms Yang and blocks the flow of Qi



4. Causes wide range of problems



Integrity of Body Fluids protects the Tissues and

the Qi

5. Tends to combine with other pathogens



Wind damp

Damp Heat

Cold Damp



6. Seasonal Pathogen



reflects changes in the weather, and

the transformation of the seasons





C. Treatment Principles



a. Transform the Pathogen



1. Expel with sweet-bland diuretic



- FU LING (PORIA COCOS)

Enters: SPLEEN/STOMACH, HEART,LUNG, KID

Harmonizes Center; Calms the Spirit



- ZHU LING (Polyporous)

More diuretic, less tonifying than Fu Ling



- ZE XIE ( Alisma)

Drains damp heat; Yin deficient Heat





2. Eradicate Damp Heat with cooling diuresis





- MU TONG ( Caulis Akebia)

- Enters Heart, Lung, Small Intestine

Drains Heart and Lung Fire

Promotes BF flow ( Milk, Blood)



- QU MAI (DIANTHUS)

"Slippery, descending nature"

Enters HEART/S.I.: moves blood, cools heat

Damp Heat LIN, and obstructed toxic Heat



- YIN CHEN HAO ( Artemesia Capillaris)

Fragrant, only slightly cold

SP/ST LIV/GB: JAUNDICE







3. Transformation of thick and turbid

with fragrant aromatics





-HOU PO ( CX MAGNOLIA)

Parches the Spleen Qi and

moves the Qi

Promote Descent of Lung Qi by

removing fullness



- SHA REN (AMOMI)

Warm and strongly fragrant:

Parches the Spleen and moves the middle Qi



-HUO XIANG (AGASTACHE/POGOSTEMON)

Lung, Spleen/Stomach

promotes perspiration, relieves summerheat

transform middle jiao, move Qi, piercing fragrance


4. Parch the Spleen with warm-bitter

substances to restore T and T



Pungent warm:


CANG ZHU ( Rhiz Atractylodes)

strengthens spleen, expels wind damp



BAN XIA ( PINELLIA)

strong descending nature

Moves Qi downward: breaks up phlegm

stops NAUSEA

for thin, clear phlegm damp



Bitter Cold :



HUANG QIN (SCUTELLARIA)

- LUNG AND LARGE INTESTINE

Clears Fire and Toxic Heat and damp

HUANG LIAN (COPTIS)

HEART AND MIDDLE JIAO

Clears Damp Heat, obstructed fire



HUANG BAI (PHELLODENDRON)

drain kidney fire, eliminate

lower jiao damp heat

Yin deficiency with Fire flaring





5. Expel Wind-Damp in the surface Tissues

with Wind-dispersing herbs, promote

Spleen transportation of fluids



DU HUO (Rx. Duhuo)

Kidney, Bladder channels

Stops pain of wind-cold-damp in lower body



QIN JIAO ( GENTIANA MACROPHYLLA)

Dispels wind damp in Liver Channel

Cools Yin deficient Heat



SANG JI SHENG (LORANTHUS)

Tonifies Liver and Kidneys;expels wind damp





6. Strengthen Yang to Transform Damp:

PROMOTE WARMTH AND MOVEMENT

REMOVE ACCUMULATED BODY FLUIDS



GAN JIANG ( ZINGIBERIS SICCATUM)

Warms middle and expels cold; warm St and Spleen





ROU GUI (CORTEX CINNAMOMI)

Warms Kidneys and fortifies Yang

III- DAMP HEAT

A. GENERAL SYMPTOMS:

-low grade or afternoon fever, fullness (oppression), obstruction

chest or abdomen, thirst without desire to drink,

heaviness of head and body, lack of appetite,

scanty, dark, difficult urination, loose, explosive stools,

nausea and vomiting

tongue: Thick, greasy yellow tongue coating

pulse: varies according to pathogen


B. ETIOLOGY

1. Invasion of damp pathogen causes Qi and heat to accumulate and combine with dampness



2. Pathogenic fire can cause damage to fluid metabolism leading to damp-heat accumulation



3. Failure of Yang Qi to transform and raise; heat becomes pent-up and combines with BF

C. PATHOLOGY


1. Enter body usually through the Mouth: connection to Stomach



2. Frequently toxic; the fire of damp heat quickly becomes "toxic" fire



3. Easily damages the Sp/St



4. Easily blocks QI mechanism: Ascent and descent of  QI movement is regulated by San Jiao.

Damp Heat is sticky by nature



5. Upsets Fluid Metabolism:

Upper Jiao: can not open and regulate fluid passageways; unable to send downward.


Middle Jiao: Yang is blocked and spleen's power of digestion is lost.

Lower Jiao: Kidneys lose the strength to vaporize:uncontrolled or frequent urination or fluid

retention and scanty urination, kidneys unable to control opening and closing





D. Treatment Principles



1. Differentiate which pathogen is mild and which is serious, then expel damp and cool heat

a) if damp predominates: disinhibit the heat by transforming the damp


b) if heat predominates: clear heat, promote diuresis

2. Differentiate area:

a) damp heat on surface utilize fragrant to release the surface

b) Damp Heat Blocking Upper Jiao, obstructing Lung
Promote Qi flow to move the damp

Fragrant transformation of source


c) Damp Heat Blocking Middle Jiao

Bitter cold herbs to drain heat and parch damp


d) Damp Heat in Lower Jiao, obstructing Kidney Yang

Drain the turbid damp though the urine

3. Treatment Principles


DAMPNESS:

1. Promote Lung Flow to transform damp

a) Open lungs to assist pathogenic influence to reach the surface

b) Open Lungs to transform damp and allow Heat to escape through the surface

c) Open lungs to promote fluid metabolism


2. Combining pungent and Bitter flavors to warm the Yang and disperse obstruction

3.Use Bland flavors to promote urination and leach out damp

4. Using Fragrance to transform damp

5. Strengthening Spleen to parch damp

6. Opening the flow of Yang Qi to transform damp

a) use spreading, dispersing herbs to promote the flow of Yang

b) Warm pungent and warm bitter to restore San Jiao Qi movement

c) use bland herbs to promote urination


HEAT:

7. Use of Bitter-Cold to clear Heat and dry damp

- use sparingly when damp exceeds heat

-also drain toxicity ( anti-bacterial )



8. Clear Heat and relieve toxicity

-exogenous epidemic toxic dampness

- endogenous damp heat producing fire

9. Cool and move the Blood

- Pathogen moves easily to Ying (Nutritive)

Level

- Leads to Blood stagnation



10. Nourish Yin, Cool Heat, Promote urination

- Fragrant herbs damage Yin by Yang nature

- Bitter herbs are too draining in

some cases of Yin deficiency Damp Heat;

- Use herbs that preserve Yin by lightly

spreading and opening, or mild diuretic:

Fu Ling (Poria), Shan Yao ( Dioscorea)

Lian Qiao (Forsythia), Hua Shi (Talc)


E. Contraindications



1. Pungent Warm diaphoresis:
avoid using strong, warm and pungent herbs

( Ma Huang, Gui Zhi)



2. Bitter Cold purging:



purgatives are not effective in treating damp's "sticky" nature; only manage to further weaken and

bring down Spleen Yang



3. Moist greasy (Yin) tonics



aggravate damp obstruction



4. Sweet, warm, obstructing tonics



-tonifying without dispersing only aggravates

damp accumulation





5. Dietary Contraindications



-Heavy greasy foods produce dampness



-Sweet, cold foods promote dampness



-Spicy foods promote heat