Tympanites
General
Description
Tympanites means abdominal distention. Hollow inside and tense
outside,the abdomen is beaten like a drum. Tympanites is clinically
characterized by abdominal distention, sallow skin, blood vessels seen, mass in
the hypo- chondria or abdomen, and thin limbs. In ancient literature, there are
a lot of names for the disease.
According to its etiology, pathology and clinical manifestations, ancient people
divided the disease into tympanites dus to stagnation or qi, tympanites due to
blood stasis, ascites, and tympanites dus to parasitic infestation. The disease
lingers for a long time, and is difficult
to be cured. Hematemesis, hemafecia and coma will appear at its late stage.
The
disease is mainly ascites dus to cirrhosis in western medicine. In addition,
ascites due to tubercular peritonitis or tumor in the abdomen, similar to
symptoms of tympanites, can be diagnosed and treated in reference to this
article.
Etiology
and Pathology
Tympanites
occurs slowly. Although related to improper diet, emotional depression and
schistosomiasis, the disease is directly caused
by dysfunction of the liver, spleen
and kidney and by stagnation of qi, blood and water in the abdomen due to
no treatment or mistreatment of jaundice, hypochondriac pain and
abdominal mass for a long time.
A.
Direct Cause
Lingering
jaundice, hypochondriac pain abdominal mass cause tympanites.
Pathological
changes of jaundice mainly are yang jaundice and yin jaundice. Yang jaundice is
always caused by disorder of qi and by incoordination between the liver and
spleen due to stagnation of damp-heat in the middle jiao. Yin jaundice is caused
by obstruction of cold-dampness, or by stagnation of blood stasis, or by
deficiency of the spleen and blood. Odstruction cold-dampness or stagnation of
blood stasis can cause disorder of qi in the middle jiao and accumulation of
dampness, leadig to impairment of the liver and spleen. Deficiency of the spleen
and blood and failure to transport
and transform nutrients cause stagnation of dampness and disorder of qi, giving
rise to impairment of the liver and spleen. Treated improperly for a long
time,impairment of liver and spleen causes dysfunction of the kidney and
retention of water, leading to stagnation of qi,blood and water.
Pathology
of hypochondriac pain can be summarized as stagnation of blood stasis
,stagnation of the liver-qi, damp-heat in the liver and gallbladder, and
deficiency of the liver-yin. The first three can cause dysfunction of the liver,
disorder of qi, invasion of the spleen by hyperactive liver- qi, failure of the
spleen to transport and transform nutrients, and retention of dampness.
Untreated promptly, the disease will affect the kidney, eventually causing
impairment of the liver, spleen and kidney,and stagnation of qi, blood and
water. Deficiency of the liver-yin can cause malnutrition of
the liver ,incoordination between channels,
disorder of
qi, and incoordination between
the liver and spleen. Lingering deficiency of the liver-yin can also cause
deficiency of the kidney-yin. Yin deficiency of the liver and kidney, if treated
improperly, will eventually lead to impairment of the liver, spleen and kidney,
and stagnation of qi, blood and water.
Main pathological manifestations of abdominal mass are impairment of the
liver and spleen, incoordination between visceral organs, stagnation of qi,
stagnation of blood stasis, stagnation of phlegm-dampness,and indigestion. If
treated improperly for a long time, the disease will c ause dysfunction of the
kidney and retention of water, eventually leading to stagnation of qi, blood and
water.
B.
Predisposing Cause
(A)
Emotional Depression: Anxiety, anger, dysfuncion of the liver and stagnation
of qi cause hypochondriac pain and blood stasis. Stagnation of qi and blood
cause abdominal mass. Lingering hypochondriac pain and abdominal mass cause
tympanites.
(B)Improper
Diet: Over-drinking and over-eating fatty and sweet food cause impairment of the
spleen and stomach, failure to transport and transform nutrients, stagnation of
dampness in the middle jiao, and invasion of the skin by bile to form jaundice.
In addition, accumulation of dampness into phlegm, stagnation of phlegm in qi
system, incoordination between qi and blood, and stagnation of qi ,blood and
phlegm in the abdomen form mass. Lingering jaundice and hypochondriac pain cause
tympanites.
(C)
Schistosomiasis:Obstruction
of channels by schistosome,
incoordina- tion between the liver and spleen and between qi and blood,failure
of the spleen to transport and transform nutrients cause phlegm.Stagnation of
qi,blood stasis ,and accumulation of phlegm form abdominal mass,leading to
tympanites.
If
emotion is not regulated and diet is not restricted or the patient is infected
with schistosome, tympanites will be further aggravated.
In
the process of forming tympanites, qi stagnation, blood stasis,and water
retention are cause and result to one another, forming the main contents of
excessive pathogen. Weakened body resistance is an inevitable trend for the
development of qi stagnation, blood stasis and water retention, mainly involving
the liver, spleen and kidney. Tympanites is a complicated syndrome with
deficiency in origin and excess in superficiality.
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