All the above factors may cause dim stomach fire, resulting in failure normal digestion or incomplete digestion, leading to accumulation of the fluid, plus the involvement of abnormal rlung. The result is pervasion,of fluid and, eventually, edema.
Manifestations
At first, the patient reveals a gray edema, i. e. dim complexion, the face and feet are edematous, the buccal mucous membrane and the lips and tongue are lusterless, and the pulse is slender and sunken. Then, the gravitational edema appears, when the regions such as the lower limbs and scrotum, are involved. The last stage of edema follows.
In Tibetan medicine, it is claimed that there are three kinds of water, the external, internal, and the intermediate. External water refers to those edema which are visible to the naked eye, mostly located at skin level; the internal water refers to those located within the body, including the large intestine, bladder, etc.; the intermediate water refers to those between the external and the internal, occurring between the skin and muscles, or the subcutaneous layer. Whatever the type of edema, they are all accompanied by breathlessness and asthma and lassitude. Breathlessness is especially marked after walking.
In recognizing this ailment, Tibetan doctors emphasize two types, namely, cold and heat. For heat type edema, the urine has a dark color, either red or deep yellow, the eyes are also deep-colored; the abdomen is distended and sometimes varicose veins may be seen on the abdominal wall, similar to the tympanitis in TCM, with a tense pulse. For the cold type, grayish green urine, a lack of thirst, borborygmus, sometimes with watery diarrhea, and a pitted edema are common symptoms.
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