The imbalance between body fluids (津液, jīnyè) and Qi-Blood (气血, qìxuè) is commonly seen in clinical practice, primarily manifesting as water retention with Qi obstruction, Qi loss following fluid loss, fluid depletion leading to blood dryness, and fluid deficiency with blood stasis.
1. Water Retention with Qi Obstruction: This condition occurs when body fluids accumulate in the body, leading to pathological changes that obstruct the flow of Qi. The generation, distribution, and excretion of body fluids depend on the ascending and descending movements of the organ Qi. When Qi flows, fluids also flow. If the transformation of body fluids is abnormal, it can lead to the accumulation of dampness and phlegm, which obstructs the movement of Qi. For instance, if phlegm obstructs the lungs, it can cause lung Qi stagnation, resulting in symptoms such as chest fullness, cough, and difficulty breathing when lying down. If fluids obstruct the heart, they can hinder heart Qi, leading to suppressed heart Yang, which may present as palpitations and chest pain. When fluids stagnate in the middle burner, they can obstruct the Qi movement of the spleen and stomach, causing symptoms like dizziness, fatigue, abdominal distension, poor appetite, nausea, and vomiting. If fluids accumulate in the limbs, they can obstruct the circulation of Qi and blood in the meridians, leading to symptoms such as edema, heaviness, or pain in the limbs.
2. Qi Loss Following Fluid Loss: This condition occurs when a significant loss of body fluids leads to the loss of Qi that relies on these fluids, resulting in a pathological change characterized by the simultaneous loss of both Yang Qi and Yin fluids. Qi loss following fluid loss is often caused by excessive sweating, severe vomiting, or diarrhea, which depletes body fluids.
3. Fluid Depletion and Blood Dryness: This refers to a state where body fluids are deficient or even exhausted, leading to internal heat and dryness of the blood, or the generation of wind due to blood dryness. Body fluids are an essential component of blood, and both fluids and blood originate from the refined essence of food and water. Conditions such as high fever damaging body fluids or burns can lead to significant fluid depletion, or Yin deficiency with heat can cause hidden consumption of body fluids, resulting in fluid depletion and blood dryness. Symptoms may include irritability, dryness of the nasal and pharyngeal mucosa, thirst, muscle wasting, scanty urination, a red tongue with little moisture, and a thin, rapid pulse.
4. Fluid Deficiency with Blood Stasis: This condition refers to the loss of body fluids leading to poor circulation of blood. Adequate body fluids are crucial for maintaining the fullness of blood vessels and smooth blood flow. If significant body fluids are consumed due to high fever, burns, vomiting, or excessive sweating, both body fluids and blood can become deficient, leading to stagnation and poor circulation of blood. Clinically, this may present with a purplish tongue or the appearance of petechiae on the skin, in addition to the original symptoms of fluid deficiency.