Student asks: Why is the sensation of thirst in ying fen disease not as severe as in wei fen disease? Why does the feeling of thirst decrease even when bodily fluids are more severely damaged? Teacher Miao answers: Ying refers to nutrients, and its main function is to transport vital substances such as qi, blood, and bodily fluids throughout the body. The issue of thirst in ying fen disease relates to the entire circulatory process after water intake into the stomach. This includes growth, storage, transformation, absorption, utilization, and excretion. Which organ systems are involved? What role do they play at different stages? These concepts have been discussed in the overall perspective of the platform course, using that knowledge to explain all principles regarding water, bodily fluids (the water of Zheng Qi), water pathogens, dampness, and phlegm (the water of pathogenic Qi). This time, let’s change our perspective and understand the water in the human body from the supply and demand angle: Insufficient supply leads to dehydration, whether one feels thirsty or not When we talk about the Taiyin Spleen, it does not refer solely to the Taiyin or the Spleen as a single entity, but rather to the function of Taiyin acting throughout the body. Every corner of the body, including moisture and bodily fluids, naturally has the function of Taiyin. Areas that are not reached or lack moisture will become dry. Some areas will express thirst, such as the lungs, stomach, and spleen, directly manifesting the symptom of thirst. However, if other areas lack bodily fluids, they may not necessarily feel thirsty. For example, if water does not reach the skin, one will not feel thirsty but may experience dryness. This is from the perspective of ying (nutrient transport of bodily fluids), considering the issue from the supply angle. Insufficient demand from organ systems can mask signs of dehydration However, there is another angle to consider, which is the function of the Taiyin Spleen in transformation. This is closely related to the function of ying. If a certain area, department, or organ system has issues, whether it is a deficiency or excess condition, it may not require as many raw materials due to reduced activity, leading to a decreased demand for bodily fluids. For the Spleen, when it is deficient, symptoms such as fatigue and reluctance to speak may arise, and the speed of blood circulation slows down, resulting in less consumption. With reduced consumption, the demand for water decreases, hence one does not feel thirsty. This lack of thirst is pathological lack of thirst, as it is due to not having a normal workload. This is a relative concept; try to think from this relative perspective. Although one may not feel thirsty, if asked to walk 5000 meters or briskly walk 2000 steps, they will immediately experience dry mouth, dizziness, and overall fatigue. This is because their physical capacity has not been utilized according to a normal workload, leading to a false appearance of not lacking water, while in reality, there is an overall deficiency. Using an economic concept, this is a problem of supply and demand. Situations of fluid deficiency without thirst (false appearance of not lacking water): If there is a supply issue, meaning bodily fluids cannot reach the organ systems that need water, one will definitely feel thirsty. However, if the units consuming bodily fluids are sluggish, they will not feel thirsty. What types of conditions are most likely to present without thirst? 1. Cold conditions 2. Excess conditions 3. Cold excess conditions 4. Damp-heat (not primarily heat excess). If damp-heat is mixed with heat excess, one will feel thirsty. But if dampness is predominant, and the heat is stagnant and not excessive, this type of damp-heat will not cause thirst. 5. Organ systems outside the lungs, spleen, and stomach lacking bodily fluids will also not present as thirst. Of course, from a holistic perspective, when one part is excessively deficient in bodily fluids, other parts cannot have an abundance of fluids either. Whether it is a deficiency or excess condition, they will transform into each other over time. 6. Pure heat, when the heat is not strong, may also not cause thirst. Situations of fluid deficiency that definitely cause thirst: 1. When the heat is very strong. 2. When damp-heat is mixed, with heat being predominant. 3. When cold or dampness obstructs bodily fluids, preventing fluids from reaching their intended locations, especially when they cannot reach the lungs and stomach. This type of thirst, caused by cold, dampness, phlegm, or sudden external pathogens obstructing the flow of bodily fluids, is characterized by: not feeling thirsty before the illness, but only recently developing this sensation. I have treated a case of this type of thirst, which was quite difficult to manage; it improved but could not stabilize. 4. When kidney water is damaged. Yangming heat syndrome and heart fire transferring to stomach fire thirst is intense thirst, with a strong desire to drink large amounts of water. In contrast, thirst due to kidney water damage is characterized by a constant desire to drink water, with daily intake several times that of a normal person. It is not the intense thirst type, but rather a persistent mild thirst, leading to frequent small sips of water, which indicates kidney water damage. 5. Another type of thirst lies between illness and non-illness, belonging to a state of constitutional imbalance. For example, individuals with congenital loose skin and pores tend to sweat easily, thus feeling thirsty often. This condition can also be considered an illness, but it is quite difficult to treat. Water and other pathogenic factorsWater-heat or water-dampness interaction——To add a point, “pathogenic heat steams the yin of ying upwards to the mouth, hence thirst is not as severe as thirst from heavy heat in the qi level” is defined in our expression system as a disease of water-heat or water-dampness interaction. Because of heat, the speed of bodily fluid movement increases, leading to accumulation in certain areas, which can transform into water, dampness, or phlegm, combined with heat. If it affects the lungs, it becomes lung water-dampness, or water-heat, or damp-heat accumulation. Water-heat mutual transformation into phlegm——If it becomes more severe, water stagnation transforms into water pathogens, while the heat is strong, it will dry up the water pathogens, transforming them into phlegm, forming phlegm-heat or heat-phlegm. As the heat gradually subsides, the water will also slowly transform, and the illness will resolve. Wind-water mutual transformation——If this energy combines with the power of dispersion, the steaming speed will be faster and more intense than pure heat. This energy could be wind, which assists fire and can also assist water, leading to diseases like wind-fire or wind-water. Wind-dampness mutual transformation,combined withcold or heat——When dampness combines with wind, it leads to wind-dampness issues. Therefore, wind-dampness often combines with heat or cold, or a mixture of cold and heat. For instance, in cases of cold-dampness obstruction, whether early, late, mild, or severe, localized heat may develop. Dampness, heat, and wind combined prevent yang energy from returning to warm, leading to insufficient yang energy. Of course, this transformation requires time; it takes a long time for such extreme opposite transformations to occur. Thus, the repeated emphasis is on this knowledge; there are no more theoretical concepts. Utilizing this knowledge can capture all physiological and pathological rules and provide treatment plans.
Teacher Miao discusses the “External Classic Micro Words” Kidney Water Chapter
Thanks to the overall perspective TCM Q&A group’sM&M students for reviewing and correcting.