The Clinical Symptoms Of Edema And The Distribution Of Yin And Yang Syndromes

BackgroundEdema can be caused by external pathogens, poor diet, or exhaustion interfering with the normal functions oforgans which help regulates the fluid balance of the body. These organs include:the lungs'functions of governing the waterways, the spleens' role in transporting fluids and nutrients, the kidneys'role in governing the waters, and the bladder's role in qi transformation. Acombination of these mechanisms contribute to fluid retention in the body, especially in the head, eyelids, limbs, abdomen, back, or even the whole body. Since the Song dynasty, edema was further classified as Yang-edema or Yin-edema, a type of classification that is still being used by modern Chinese physicians. Yang-edema usually includes exterior syndrome, excessive syndrome and heat syndrome, while Yin-edema usually includes interior syndrome, deficient syndrome and cold syndrome. My tutor has accumulated years of experience in the treatment of renal edema. In his experience, Yin-edema can show Yang symptoms, while Yang-edema can also exhibit Yin symptoms. In clinical practice, it is rare that patients with Yin-edema present solely Yin symptoms, and the reverse is true. According to TCM theories, though Yin and Yang are rooted in each other, the two controls and oppose each other too.As such, clinical manifestations of diseases are always complicated and do not adhere to the textbook definition of a classical syndrome type.PurposeTo conduct a preliminary study of the clinical symptoms of edema, and the distribution of Yin-edema and Yang-edema-MethodsClinical symptoms of100edema patients were recorded and classified as Yin or Yang symptoms based on TCM theory. Finally, statistical means were used to analyze these symptoms and to find out the distribution of Yin-edema and Yang-edema.Results1.The recorded symptoms are classified as causal factors, edema symptoms, systemic symptoms, appearance of the tongue and the five different types of pulse. There are a total of141kinds of symptoms, with a sum of frequency of1168, amongst which there are52Yang symptoms and89Yin symptoms.2.There are a total of8causal factors of edema, with a frequency of17.The most frequent causal factor is flu (a frequency of5)and exhaustion (a frequency of5). Erysipelas is also a cause of edema.3.Excluding tongue and pulse, there are119systemic symptoms. The ten most frequently seen symptoms are:weakness of the legs and lumbar, fatigue, aversion to cold, dry mouth, deep-colored urine, flushed face, craving for hot food, bitter taste in mouth and insomnia.4.There are15kinds of tongue appearances, with a total frequency of248. Tongue body and tongue coating are both recorded.In all the recorded tongue body, dusky red tongue and red tongue are seen most frequently,36.80%and33.60%respectively. Pale red tongue and cracked tongue are also seen frequently. In the recorded tongue coating, thin white coat is the most prominent,42.48%,followed by dry coat, thin yellow coat, yellow greasy coat and white greasy coat etc.5.There are8kinds of pulse, with a total frequency of184. Of which, wiry pulse is the most frequent (a frequency of55), followed by deep pulse (a frequency of50).In descending order of frequency, thread pulses, weak pulses, rapid pulses, rough pulses, floating pulses are seen too.Floating pulse only appeared once in a patient with edema triggered by flu.6.Statistical analysis indicates that there are a total of646Yin symptoms and522Yang symptoms.The average percentage of Yin symptoms and Yang symptoms are54.77%and45.23%respectively. In Yin-edema patients, the percentage of Yang symptoms is44.12%while that of Yin symptoms is55.88%. In Yang-edema patients, the percentage of Yang symptoms is48.35%while that of Yin symptoms is51.65%. There are only2Yang-edema patients who exhibited only Yang symptoms.All Yin-edema patients exhibited both Yin and Yang symptomsConclusion1.Clinical symptoms of edema are variable and complicated.The common symptoms include:weakness of the legs and lumbar,fatigue, aversion to cold,dry mouth, deep-colored urine, flushed face, craving for hot food,bitter taste in mouth and insomnia.2.Edema usually exhibits both Yin and Yang symptoms. Pure Yang-edema or Yin-edema is rarely seen...