Body fluids syndrome

There is much concern for the safety of personnel handling articles contaminated with pathogenic viruses such as hepatitis B virus (HB V) and human immunodeficiency vims (HIV) which causes acquired immune deficiency syndrome (AIDS). Some agents have been recommended for disinfection of HBV and HIV depending on the circumstances and level of contamination these are hsted in Table 10.4. Disinfectants must be able to treat rapidly and reliably accidental spills of blood, body fluids or secretions from HIV infected patients. Such spills may contain levels of HIV as high as lO" infectious units/ml. Recent evidence Irom the Medical Devices Agency evaluation of disinfectants against HIV indicated that few chemicals could destroy the vims in a... 

Sepsis The systemic inflammatory response syndrome and documented infection (culture or Gram stain of blood, sputum, urine, or normally sterile body fluid positive for pathogenic microorganisms Severe sepsis Sepsis associated with organ dysfunction, hypoperfusion, or hypotension (systolic blood pressure less than 90 mm Hg). Hypoperfusion and perfusion abnormalities may include, but are not limited to, lactic acidosis, oliguria, or acute alteration in mental status. 

Indications Prostration syndrome due to deficiency of qi deficiency svndrorne of the spleen syndrome of deficiency of the lunq-ai thirst and diabetes due to impairment of body fluid irritability, insomnia, dreaminess, palpitation induced bv frioht. forgetfulness, listlessness, lassitude and others due to deficiency of both the heart and spleen syndromes of deficiency of the blood or both the ai and blood. 

Patients should be warned that rifampicin colors urine, tears and other body fluids reddish-orange. Adverse effects further include rashes and pruritus and gastrointestinal complaints like nausea, anorexia and diarrhoea. With intermittent therapy a probably allergic hypersensitivity reaction can occur which mostly manifests itself as a flu-like syndrome with fever but can also result in nephritis and acute tubular necrosis. Elevation of serum transaminase levels occur frequently but clinical hepatitis is rare. Fatal outcome has been reported however. 

Hypersensitivity reactions, such as pruritus, cutaneous vasculitis, and thrombocytopenia, are seen in some patients, and an immune-mediated systemic flulike syndrome with thrombocytopenia also has been described. Rifampin imparts a harmless red-orange color to urine, feces, saliva, sweat, tears, and contact lenses. Patients should be advised of such discoloration of body fluids. 

The adverse effects that most frequently result in discontinuation of rifabutin include GI intolerance, rash, and neutropenia. Rifabutin levels will be increased with concurrent administration of fluconazole and clarithromycin, resulting in anterior uveitis, polymyalgia syndrome, and a yellowish-tan discoloration of the skin (pseudojaundice). Other adverse reactions are similar to those of rifampin, such as hepatitis, red-orange discoloration of body fluids, and drug interactions due to effects on the hepatic P450 cytochrome enzyme system. 

As soon as a treatment principle is established, the composition plan and treatment strategies can be arranged. For instance, to treat the syndrome of excess heat in the Lung and Stomach, one would first prescribe herbs that have sweet-cold, bitter-cold or salty-cold properties, and which have the functions of clearing heat and reducing fire in the Lung and Stomach. Second, herbs that are sweet and cold and that can nourish body fluids and protect the Yin, which has been severely consumed by the excess heat, should be selected. Herbs that can tonify the Qi should be selected if the Qi is weakened severely by the heat. Herbs that moderate the actions of the harsh herbs in the formula, and reduce their side effects, should also be added. 

This method is used to treat internal heat syndromes. In Chinese herbal medicine, cold ingredients that enter the regions where heat exists are applied. These ingredients have the functions of reducing heat, relieving fire-toxin, cooling the blood and generating body fluids. 

A side effect of Xi Xin occurs when it is applied incorrectly. Because it is very hot and pungent, it can easily injure the Yin, blood, body fluid and Qi. It should not be used, or must be used with caution, in patients who suffer from exterior wind-cold syndrome where internal heat also coexists and the Yin, blood and body fluids are deficient. The dosage of Xi Xin should also be controlled carefully in the range of 1-3 g per day for crude herbs. If the powdered herbal extract is used, the dosage should be reduced to 0.1 -0.5 g per day. Overdose may cause numbness in the throat and tongue, a stifling... 

Bai Shao Yao is often selected in the deficiency condition of an exterior wind-cold syndrome when the Yin, body fluids and blood are weakened through sweating. 

Lu Gen is sweet and cold, and enters the Lung, Stomach and Kidney meridians. It is often used as assistant in a formula to treat a wind-heat syndrome because it not only clears heat but also generates body fluids, which have been injured by heat in a wind-heat syndrome. In addition, it is also used to treat nausea and belching when the heat from the Lung affects the Stomach. 

This chapter introduces the principles, methods and strategies for the composition of formulas that reduce heat, relieve fire-toxin, cool the blood and generate the body fluids. They are used to treat various internal heat syndromes. 

Tian Hua Fen and Lu Gen are sweet and cold, and enter the Lung and Stomach meridians. They are often used in the syndrome of excess heat in the Lung when the heat has injured the fluid and causes dryness in the Lung. Both herbs can clear heat, generate the body fluids and relieve thirst, dry cough, chest pain and dryness in the mouth. 

Sheng Di Huang and Bai Mao Gen are sweet and cold. They can clear heat and cool the blood, and can be used for bleeding conditions when the heat has injured the blood in the Lung, such as nose bleeds and expectoration of bloody sputum. Moreover, both herbs are able to nourish the Yin and increase body fluids. They are used in the syndrome where the heat has already injured the blood and consumed the Yin and fluid of the Lung. 

The main substances of the body are the Qi and essence that further generate blood, body fluids, Yin and Yang. In pathological conditions, the deficiency often shows four aspects, namely deficiency of the Qi, deficiency of the blood, deficiency of the Yin and deficiency of the Yang. The deficiency can be found in specific organs, such as Kidney-Yin deficiency, Spleen-Qi deficiency or Heart-blood deficiency. A deficiency syndrome also exists in patients with a weak constitution or those in the recovery period of disease, in elderly people or in children. In those situations, it is difficult to determine which organ is weak and which part should be tonified, as the general condition of the patient is weak. 

There are many factors that can cause abnormal discharge of the body fluids and essence besides Qi deficiency. For example, diarrhea can be caused by damp-heat in the intestines excessive urination or spermatorrhea can be the result of damp-heat in the Lower-Jiao shortness of breath can be the consequence of phlegm accumulation excessive sweating is often caused by excess heat or empty-heat in the body. Thus a correct differentiation of the syndrome is required. 

External dryness is one of the six exogenous pathogenic factors it appears in the autumn and directly injures the Lung. In the early autumn, dryness is often combined with heat and it consumes the body fluid and Yin of the Lung - this syndrome is referred to as warm-dryness. In the late autumn, dryness is mainly combined with cold and causes obstruction of spreading of the body fluid of the Lung - this syndrome is referred to as cold-dryness. 

Internal dryness is caused directly by the consumption of body fluids. Some diseases, medicines, herbs or food products can injure the body fluids and cause dryness. Long-term stress and emotional disturbance can also cause consumption of the body fluids. As the Lung, Stomach and Large Intestine are mainly involved, the syndrome of dryness can be respectively divided into dryness in the Upper-, Middle- and Lower-Jiao. 

This formula can nourish the Stomach and generate body fluid. It can also direct rebellious Qi in the Stomach downwards. It treats the syndrome where the Qi and Yin of the Stomach and the Lung are deficient, and the empty-fire of these organs flares up. When the Lung and Stomach lose nourishment from the Yin and fluid, cough, spitting of saliva and... 

This formula can tonify Qi, generate body fluid, moisten dryness and relieve thirst. It treats thirst and wasting syndrome, a syndrome known as diabetes in western medicine. It is caused by Yin deficiency of the Kidney, Stomach and Lung. When dryness occurs in the Stomach, the Qi is too weak to spread the fluid, and excessive thirst appears. Heat consumes the Qi and can directly lead to lassitude and shortness of breath. If the Kidney fails to control the Bladder and is unable to separate clean fluid from turbid, patients may pass large amounts of turbid urine frequently. Yin and Qi deficiency often show in a red tongue with a thin and dry coating, and a weak and thready pulse. 

Jaeken J, Van den Berghe G (1984) An infantile autistic syndrome characterised by the presence of succinylpurines in body fluids. Lancet 2 1058-1061... 

The clinical chemical evaluation of the carcinoid syndrome relies on measurements of serotonin and its metabo-htes in body fluids and tissue. In patients with the typical carcinoid syndrome, 5-HTP is converted to serotonin and stored in tumor secretory granules and in platelets. A small amoxmt of serotonin remains in plasma, but most is converted to 5-HIAA, which is excreted in urine. These patients have increased blood and platelet serotonin levels and increased urinary 5-HIAA. However, some foregut carcinoid tumors lack the aromatic L-amino acid decarboxylase and secrete 5-HTP rather than serotonin into the bloodstream. Patients with these tumors have normal serotonin concentrations in blood and in platelets, but urinary levels are increased because 5-HTP is converted to serotonin in the kidney urinary 5-HIAA levels may be slightly elevated. 

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