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Part Eleven:QI, BLOOD AND BODY FLUID OF MUTUAL CAUSALITY

第十一部分:气、血、津液的相互关系

http://www.100md.com   2006-2-7
     Despite their differences in nature, form and function, qi, blood and body fluid have something in common with each other. They are the basic materials that constitute the human body and maintain life activities; they all derive from cereal essence; they, physiologically, depend on each other for existence and restrain and utilize each other; they, pathologically, act upon each other and have causality between them.

    尽管气、血、津液的性状及其功能各不相同,但它们却有许多共同之处。三者均为构成人体和维持人体生命活动的基本物质。它们均来自水谷精气。在生理上,它们相互依存、相互制约、相互为用;在病理上,它们相互影响,互为因果。

    Qi and blood are closely related. Qi is the "commander" of blood, and blood is the "mother" of qi. As the commander of blood, for one thing, qi is the motive power for blood formation, or rather, it produces blood. Blood is formed from mutritive qi and body fluid, both of which come from food and water. All these cannot be separated from the functions of qi. Blood circulation depends on the propelling function of heart-qi. For another, qi controls blood and keep it flowiing in the blood vessels without extravasation. This function of qi is performed by spleen-qi. When qi is deficient, it fails to control blood, thus leading to hemorrhage. Blood is referred to as the mother of qi because, on the one hand, blood is a carrier of qi; and on the other, blood provides adequate nutrients for qi. Therefore, it is impossible for qi to exist without its"mother", blood.

    气血紧密相关。气为血之帅,血为气之母。气为血帅,一方面因为气是血液形成的原动力;另一方面是由于气可生血。血由营气和津液形成,后两者都源于水谷。而以上这些都离不开气的作用。血液循行依赖气的推动功能,另一方面,气摄血,维持血行于脉中不致外溢。气的此项功能由脾气来执行。气虚不能摄血可导致出血。所谓“血为气之母”,是因为,一则,血以载气;二则,血为气提供充足的营养。因此,如无气之母-血,则气也不可能存在。

    The relationship between qi and body fluid is rather similar to that between qi and blood. This is shown in the following four aspects. First, qi produces body fluid. The formation, distribution and excretion of body fluid depend upon all the movements of qi and its warming, promoting and controlling functions. The existence of qi in the body not only depends upon blood, but on body fluid which is formed from food essence by the functions of the stomach and spleen. So, whether body fluid is adequate or inadequate depends upon the conditions of spleen-qi and stomach-qi. Second, qi promotes the transportation of body fluid. The movements of qi are the motivity for the transportation, and distribution of body fluid, and the excretion of sweat and urine. Therefore, In case of deficiency of qi or dysfunction of qi, disturbance of body fluid in transportation, distribution and excretion will occur. Thereby leading to the stagnation of body fluid. Third, qi controls body fluid. Qi may control the excretion of body fluid and maintain the balance of the metabolism of body fluid, In case qi fails to control the excretion of body fluid some of body fluid will run off. Fourth, body fluid is a carrier of qi.(Qi resides in body fluid, Body fluid serves as a carrier of qi) That is, body fluid carries qi. Qi cannot exist without body fluid. This is the reason why the loss of body fluid often damages qi. If qi fails to attach to body fluid, qi-deficiency and even qi prostration will ensue. So the medical book Prescriptions of the Golden Cabinet says:"No one has perfect qi after hidrosis, vomiting etc." Examples in point are:hidrosis, polyuria, enormous vomiting and diarrhea cause great loss of body fluid, which, in turn, gives rise to qi colapse.

    气和津液的关系与气和血的关系非常相似。这可以从以下四方面表明。第一,气生津。津液的形成、分布和排泄依赖气的运动和温煦、推动和固摄功能。人体气的存在不仅依赖血,也依赖脾运化的水谷精微所形成的津液。因此,津液的充足与否依赖脾胃之气的状态。第二,气推动津液的运行。气的运动是津液运行分布和汗尿液排泄的原动力。因此,气虚或气的功能失常,就会发生津液运行、分布和排泄的紊乱,使津液停滞。第三,气固摄津液。气可以控制津液的排泄,维持体液代谢平衡。如气无法控制津液的排泄,便会导致津液的横溢。第四,津液是气的载体。这就是津能载气。如果没有津液,气就无法存在。这就是为什么伤津就会耗气。如气无法依托于津液,则气虚甚则气陷就会随之发生。这就是《千金翼方》所说的:“汗吐之后无完气。”过汗、大汗、大泻使津液丢失从而导致气脱就是一个例子。

    Blood and body fluid are liquids and, what's more, they both perform the nourishing and moistening functions. Body fluid will become and important component of blood when infiltrating into the blood vessels. As blood and body fluid originate from the essence of food and water, they are known as "body fluid and blood are derived from a common source." Recurrent or severe bleeding may do damage to body fluid, resulting in thirst, scanty urine and dry skin. And severe consumption or loss of body fluid will affect the source of blood, leading to the exhaustion of both blood and body fluid. For this reason, it is not advisable to use diaphoretics for haemorrhagic patients, and the methods of breaking blood or pricking blood should be avoided in treating patients with the inadequate of body fluid and hidrosis. Miraculous Pivot states:" The patients lost bolld should avoid perspiring; while the patients lost perspiration should avoid Losing blood." And "the first contraindication refers to emaciated patients; the second to patients lost blood; the third to patients after severe perspirationl;the fourth to patients after severe diarrheal and the fifth to patients of postpartum hemorrhage. Purgation is contraindicated in all these cases."

    血和津液都是液体,而且它们都有滋养功能。津液进入脉中就会成为血液的重要组成部分。因为血和津液都源于水谷津液,因此被称为“津血同源”。周期或严重出血会损伤津液导致口渴、尿少和皮肤干燥。严重的津液耗损和丢失会影响血源,导致津液和血液的枯竭。因此,对于出血的患者不宜用汗法,破血或活血法不宜用于津液不足或汗证的患者。《灵枢》指出:“夺血者无汗,夺汗者无血。”并说:“形肉已夺,是一夺也;大夺血之后,是二夺也;大出汗之后,是三夺也;大泄之后,是四夺也;新产及大血之后,是五夺也。此皆不可泻。”

    To sum up, the close and complicated relationships between the three are often shown in physiology and pathology, and are of great importance in TDS.

    总之,三者的关系是紧密复杂的,这常在生理和病理上体现,对于辨证论治非常重要。

 
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