21.1.
The patterns of blood in the urine are summarized in Table 21.2Table 21.2.
Oedema consists in retention of fluids under the skin which may occur around the eyes, face,
limbs and abdomen. In the "Yellow Emperor's Classic of Internal Medicine" it is called "Water".
This should not be interpreted as Water in a 5-Element sense, but as a pathological overflowing
of body fluids into the space under the skin. Chapter 61 of the "Simple Questions" discusses
oedema and relates it to the Kidneys and the Lungs saying that "... the Kidneys are the root and
the Lungs the end [of this disease]."1(432) In chapter 74 it says: "A feeling of fullness and
swelling from Dampness is due to the Spleen."2(433) Thus, the "Simple Questions" identifies the
Lungs, Spleen and Kidneys as the three organs primarily responsible for oedema. The "General
Treatise on the Aetiology and Symptomatology of Diseases" (AD 610) also relates oedema to the
Spleen and Stomach. It says:
The Kidneys govern Water and Stomach and Spleen govern Earth. Earth overacts
on Water, Stomach and Spleen are exteriorly-interiorly related and the Stomach
is the Sea of Food. When the Stomach is deficient it cannot transform Water [i.e.
fluids], Water overflows out of the channels ... and is retained under the skin
causing oedema.3(434)Dr Zhu Dan Xi in "Essential Methods of Dan Xi" (1481) distinguishes Yang oedema from Yin
oedema:
Yang oedema is characterized by swelling, mental restlessness, dark urine and
constipation. Yin oedema is characterized by swelling without mental restlessness
or dark urine but with loose stools.4(435)The differentiation between Yang oedema and Yin oedema is widely followed today albeit with
a different interpretation.