Thirst

Thirst

Thirst arises from blood deficiency, blood stasis, and water deficiency.

For thirst caused by blood deficiency, since blood is Yin and Qi is Yang, a lack of blood leads to an excess of Qi. With no Yin fluid to moisten the overheated Yang, one feels compelled to drink. The appropriate treatment is to tonify the blood; once blood levels are adequate, Qi will no longer be overheated. Sheng Yu Tang supplemented with Tian Dong and Hua Fen is effective, or Dang Gui Bu Xue Tang supplemented with Hua Fen, Jie Ma Gen, Yu Zhu, and Mai Dong can also be used.

For thirst caused by blood stasis, the root of fluid production lies in kidney water. Water and blood interact and circulate within the body, and when there is blood stasis in the body, Qi is obstructed by blood and cannot ascend. As a result, water cannot be distributed upward along with Qi. However, if the blood stasis in the lower burner is resolved, water will be able to rise, and thirst will naturally subside. Xiao Chai Hu Tang supplemented with Dan Pi and Tao Ren is effective, as is Xue Fu Zhu Yu Tang. For cases involving heat and blood stasis, Tao Ren Cheng Qi Tang is recommended. For cases involving cold and blood stasis, Wen Jing Tang is advised.

For thirst caused by water deficiency, it stems from insufficient water and fluids in the lungs and stomach, prompting the body to seek hydration on its own. Although water and fluids are derived from food and drink, their Qi actually originates in the kidneys. Kidney water, known as Tian Gui, flows into the body through the meridians, ascending to the lungs via the respiratory system, where it is governed by the Lung Metal element and distributed throughout the body. Thus, when water and fluids are adequately distributed, the mouth, tongue, stomach, and throat all have sufficient moisture, and thirst does not occur. However, if kidney water is insufficient, it cannot reach the upper burner, leading to thirst. To address this, one should activate the lower burner to nourish the body’s fluids. Di Huang Tang supplemented with Ren Shen, Mai Dong, and He Zi, or Zuo Gui Yin supplemented with Er Cha, Ren Shen, and Yu Zhu, or San Cai Tang supplemented with Zhi Mu can be used to achieve this goal. Although water and fluids originate in the kidneys, they are ultimately distributed to the lungs. Even when kidney water is sufficient, if the Lung Metal is blocked and unable to distribute the fluids, water will accumulate as phlegm, causing dry throat and thirst. In such cases, Xiao Chai Hu Tang can be used to clear the blockage in the upper burner, allowing the Lung Qi to flow freely and distribute water and fluids throughout the body. It is also worth noting that although water and fluids are produced in the kidneys, they are ultimately distributed to the lungs, and the kidneys themselves rely on food and drink in the stomach to sustain their production. If the stomach is dry and constricted, fluids will not be produced; San Yi Cheng Qi Tang is recommended in such cases. If the stomach is hot, fluids will not be produced either; Yu Quan San is suggested. If the stomach muscles are overheated, fluids will be scorched; Ren Shen Bai Hu Tang is recommended. If the stomach is slightly warm, Mai Dong Yang Rong Tang is advised.

The three categories mentioned above are all common in blood-related conditions, differing from the symptoms seen in other diseases, such as persistent thirst and inability to metabolize water, leading to stagnation of fluids and Qi. For reference, see the sections on water stagnation and inability to metabolize water.

[Commentary] There are three main causes of thirst in blood-related conditions: blood deficiency, blood stasis, and water deficiency. Blood deficiency means Yin deficiency, which in turn means depleted water resources. Since the body seeks to hydrate itself, thirst arises. Sheng Yu Tang supplemented with Tian Dong and Hua Fen is effective in treating this condition.

When blood stasis occurs, Qi in the body is obstructed by blood, preventing water and fluids from rising. In such cases, Xiao Chai Hu Tang supplemented with Dan Pi and Tao Ren, as well as Tao Ren Cheng Qi Tang, can be used to address the issue.

Water originates in the kidneys and is distributed to the lungs, with the stomach serving as the source of water for the kidneys’ production. Therefore, dysfunction in any of these three systems—kidneys, lungs, and stomach—can lead to water deficiency and subsequent thirst. For issues related to the kidneys, use Di Huang Tang; for problems related to the lungs, use Xiao Chai Hu Tang; and for issues related to the stomach, use San Yi Cheng Qi Tang or Yu Quan San.