Course: Foundations of Traditional Chinese Medicine II
Class #: 4
Date:
May 9, 2007
Body Fluids
Body Fluid is a fluid-like vital substance which contains jin and ye. (More on jin and ye later). The
source of fluids in the body are the Spleen, Stomach, Small Intestine and Large Intestine.
Here’s another Dr. Wu diagram to illustrate:
Generation and transformation of body fluids
Generation and transformation of body fluids occurs in 4 organs: Spleen, Stomach, Small Intestine, and
Large Intestine .
Transportation of body fluids
Three organs are responsible for transportation of body fluids: Lung (upper jiao), Spleen (middle jiao)
and Kidney (lower jiao). Of the three, Spleen is the most important for transportation and works as a
pivot. Why? Two reasons:
 Spleen Qi generates Lung Qi.
Spleen is the Mother of Lung in Five Element Theory. Earth generates Metal. All Lung functions
rely on the Spleen.
 Spleen controls the Kidney
This is another five element relationship: earth controls water.
Discharge and excretion of body fluids
Two organs are responsible: Lung and Kidney. You could make an argument for including the yang
organs of the Bladder and Large Intestine, but Kidney controls the opening and closing of both the
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urethra and the anal opening regardless. And besides they’re paired with those yin organs anyhow).
The Lung controls sweating and opens the sweating pores to release body fluids. The Lung also breathes
out vapor. Kidney controls urination. Of the two organs, Kidney is the more important one in this
function as it is able to discharge about three times more waste from the body than the Lung does.
Relationship of the Body Fluids with the Internal Organs
Refer back the latest Dr. Wu diagram on the previous page.
 Spleen
This is the most important organ for both transformation and transportation of the body fluids.
It does not, however, involve the excretion of fluids. Spleen is in the central or middle jiao and
therefore has no connection to the orifices or sweating pores.
 Lungs
Lungs transport, excrete and regulate water passages via the San Jiao channel. Lung is the
upper source/container/reservoir of water in the body. Lung controls the distribution of body
fluids depending on the temperature, etc. It does not, however, involve the generation of water or
body fluids.
Note: In The Golden Chamber Zhang Zhongjing said that edema above the waist is largely a
dysfunction of the Lung. To resolve upper body edema, promote sweating with herbs such as ma
huang. Edema below the waist is largely a dysfunction of the Kidney. Resolve edema in the
lower body by promoting urination with herbs having a diuretic function.
 Kidneys
Kidney’s role in water metabolism involves the following functions:
a. Transportation of body fluids
Kidney yang steams fluids up to the Lung which disperses them like a fine mist through
the body.
b. Excretion
Kidney controls the opening and closing of the Bladder to release fluid waste.
c. Transformation
Kidney qi and yang support, facilitate and transform body fluids indirectly through
supporting the Spleen, Large Intestine, Small Intestine and Stomach.
Kidneys are the lower source and container (lower jiao) of fluids in the body.
So Spleen, Lung, and Kidney are the 3 most directly involved organs in body fluid metabolism because
they directly influence water metabolism. With that said, here is a brief discussion of the yang organs’
role in body fluids.
 Bladder or Urinary Bladder
The urine bladder holds body fluids (which are referred to in TCM as body fluid while retained
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in the bladder), and excretes urine. Note that the Kidney still controls the opening and closing of
the Bladder orifice.
 Stomach
The Stomach transforms and generates water.
 San Jiao
San Jiao’s role is transportation. It is the yang water passage organ throughout the trunk. It does
not directly excrete or transform.
Relationship of Qi and Body Fluid
This is the same as the blood and qi relationship
Qi to Body Fluid
a. Qi generates/produces body fluids, unless there is insufficient intake to do so.
b. Qi moves/transports body fluids, but not if there is retention or stagnation of fluids.
c. Qi holds body fluids, but not if there is leakage like spontaneous sweating, frequent
urination or incontinence.
Body Fluid to Qi
Body fluid carries the qi throughout the whole body. Dehydration is the loss not only of fluids
but also of qi which is why fatigue accompanies dehydration. The best herb for this is American
ginseng (xi yang shen) to nourish the fluids and tonify the qi. Tonify qi to help generate fluids.
Relationship of Blood and Body Fluid
 Blood and body fluid derive from the same source: Stomach and Spleen
Since the source of body fluid is the Spleen/Stomach, if there is enough blood there is also
enough body fluid.
 Blood and body fluid are mutually supported
Body fluid flows outside of the vessels. Fluids inside the blood vessels are referred to as blood.
Because blood contains body fluid:
 if blood is deficient, body fluids from soft tissues can go into the vessels to supplement
the blood.
 if the body fluids are deficient, blood will compensate.
Important Clinical Principles to know regarding body fluids
 Blood deficiency
If you have a patient who is blood deficient, it is contraindicated to promote sweating! Doing so
would further deplete the blood since blood will attempt to compensate the lost fluids and will be
further taxed.
 Body fluid deficiency
If a patient has body fluid deficiency be careful not to promote circulation of the body fluids
which will cause more deficiency.
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Disclaimer: This is not an official AOMA document, is intended for reference only and is not a replacement for your own class notes. This document is
available for your use As Is and may contain errors and omissions. Cat Calhoun retains full copyright ownership, rights and protection in all material
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(There is no Body Fluid to Essence relationship to discuss.)
Difference between Jin and Ye
Jin
Light, watery, clear type of Body
Fluid
Example: tears, saliva
Superficial, runs with the Wei Qi
Quicker, more generalized
Easily nourished
More Yang
Ye
Heavy, sticky, turbid part of
Body Fluid
Example: CSF, synovial fluid
Localized, runs deeper, moves
with the Ying Qi
Slower, more static/localized
Hard to nourish
More Yin
Function of Body Fluids
 Moisten - both the jin and ye do this, but jin more.
 Nourish – more of a ye function. It is heavy, sticky like ying qi.
 Body fluids are part of the blood.
Pathologies of Body Fluids
There are two patterns (deficiency and retention) and four syndromes (Body Fluid Deficiency, Damp
Retention, Phlegm Retention, and Water Retention).
Body Fluid Deficiency
The organs which can be affected by a body fluid deficiency are the Lung, Stomach and Large
Intestine (not to the Liver, Heart or Spleen). The treatment is dietary supplements and herbs
which work better than acupuncture for this problem.
General Symptoms:
 Dryness of mouth, skin, hair, lips and stool. And probably scanty urine.
 Tongue: small/thin body, normal color. Rough and dry coat of normal color.
 Pulse: thin and thready
Lung
General symptoms +
 Dry cough with no or
little mucus that is
hard to expel.
 Dry nose with itching
Stomach
General symptoms +
 Burning pain in epigastric
region
 Thirst with desire to drink
 Wretching
 Tongue: dry with cracks,
mirror coat, no coat.
Large Intestine
General symptoms +
 Constipation and/or dry
stool
 Scanty urine
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Disclaimer: This is not an official AOMA document, is intended for reference only and is not a replacement for your own class notes. This document is
available for your use As Is and may contain errors and omissions. Cat Calhoun retains full copyright ownership, rights and protection in all material
contained herein. You may use this document for your own purposes and distribute it to other people provided you 1) do not charge for it and 2) attribute it
as having been generated by Cat Calhoun and disclose that it available free of charge on CatsTCMNotes.com. © 2010 Catherine (Cat) Calhoun
Retention of Body Fluids
Damp retention is a result of Spleen dysfunction. When the Spleen cannot transport the water
properly there will be dampness. Damp retention is the most basic of Body Fluid retentions.
Dampness + Heat = Phlegm Retention
Damp + Cold = Water Retention
Damp is ‘cooked’ by heat into phlegm.
You do something similar in cooking
when you make a reduction by
simmering away liquids to make a thick
sauce.
The problem here is insufficient warmth to
keep the dampness from congealing. If
you’ve ever made ice cream or frozen yogurt
you have used this principle to change liquids
to solids by applying cold.
Smoking adds fire directly to the lung,
causing mucus (which is usually worse
in the mornings). Spicy, fried and grilled
food causes more fire in the body.
Frying and grilling cooking methods
add more fire quality to food. The food
retains this property whether it is
physically hot when you eat it or not.
Diary consumption causes more cold and
damp in the body. So do other foods with
cold properties such as certain kinds of
seafood, seaweeds, watermelon and tofu.
Retention of water tends to go downward in
the body.
Phlegm in the lung tends to go upward,
as it is the lung’s job to expel extra
phlegm.
“Spleen is the source of phlegm while Lungs store the phlegm.”
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Disclaimer: This is not an official AOMA document, is intended for reference only and is not a replacement for your own class notes. This document is
available for your use As Is and may contain errors and omissions. Cat Calhoun retains full copyright ownership, rights and protection in all material
contained herein. You may use this document for your own purposes and distribute it to other people provided you 1) do not charge for it and 2) attribute it
as having been generated by Cat Calhoun and disclose that it available free of charge on CatsTCMNotes.com. © 2010 Catherine (Cat) Calhoun