The diagnosis of fluid pathology is based on the theory of organ representation in Traditional Chinese Medicine (TCM). It involves analyzing and judging the symptoms and signs collected through the four diagnostic methods (inspection, auscultation, inquiry, and palpation) to determine whether there is a deficiency of fluids or an obstruction in their transformation within the current pathological essence of the disease.
Fluid pathology arises from abnormal metabolism of fluids within the body, which may manifest as accumulation without transformation or deficiency and damage. The causes of fluid pathology are varied and can also result from dysfunction of the organs. Insufficient generation of fluids or excessive loss can lead to fluid damage and depletion; if the distribution and excretion are obstructed, it can result in fluid accumulation, presenting as phlegm, fluid retention, or edema. Therefore, fluid pathology can be summarized into two aspects: fluid deficiency and fluid accumulation.
The symptoms of fluid pathology include fluid deficiency syndrome caused by insufficient fluids and phlegm syndrome, fluid retention syndrome, and water retention syndrome caused by fluid accumulation.
Fluid Deficiency Syndrome
Fluid deficiency syndrome refers to the condition where there is a lack of fluids in the body, leading to symptoms due to the failure of organs, tissues, and orifices to be nourished and moistened. The main manifestations include dryness of the mouth, nose, lips, tongue, and skin, as well as dry stools and scanty urination. This syndrome is often caused by dryness and heat damaging the fluids or by excessive sweating, vomiting, diarrhea, or blood loss. Clinical manifestations include dry and shriveled skin, sunken eyes, dryness of the mouth, nose, lips, tongue, throat, and skin, thirst with a desire to drink, dry throat and chapped lips, scanty and yellow urine, constipation, a red tongue with little fluid, and a thin, rapid, and weak pulse.
Main symptoms include severe fluid loss due to excessive sweating, vomiting, diarrhea, high fever, or burns; external dry climate or excessive internal Yang energy leading to fluid depletion; insufficient water intake or weakened organ Qi resulting in inadequate fluid generation, all of which can lead to fluid deficiency syndrome.
When fluids cannot adequately fill the body, symptoms such as dry and emaciated skin and sunken eyeballs appear; insufficient fluids fail to nourish and moisten the organs, tissues, and orifices, leading to dryness in the mouth, nose, lips, tongue, throat, and skin, thirst with a desire to drink, dry throat and chapped lips, scanty and yellow urine, constipation, and other symptoms of dryness and fluid deficiency; insufficient fluids with excessive Yang energy may present as a red tongue and thin, rapid pulse.
Generally, mild fluid damage is referred to as fluid injury or fluid deficiency, primarily manifesting as dryness; more severe fluid damage is termed fluid depletion or fluid loss, clinically presenting as dry and shriveled skin and sunken eyeballs. However, in clinical practice, these two are often referred to collectively without strict differentiation.
Common symptoms of fluid deficiency include lung dryness and fluid injury syndrome, stomach dryness and fluid deficiency syndrome, and intestinal dryness and fluid deficiency syndrome, all of which exhibit dryness symptoms and the characteristic signs of their respective organs. Qi deficiency, blood deficiency, and fluid deficiency can be interrelated, leading to syndromes such as Qi and fluid deficiency syndrome and blood dryness due to fluid depletion.
Symptoms caused by external dry pathogens damaging fluids are termed dry evil syndrome, classified as external dryness; symptoms caused by internal fluid deficiency are termed fluid deficiency syndrome, classified as internal dryness. Key diagnostic points include dryness of the mouth, nose, lips, tongue, throat, and skin, along with dry stools and scanty urination.
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