284 ENERGETICS IN ACUPUNCTURE

Generally, we tend to feel more thirsty when we are active or warm or when it
is dry outside. When we are cold or when the weather is humid, we tend to be less
thirsty. It is also quite normal to have a dry throat if one talks a lot and loudly (like
a teacher), or at night if one tends to breathe through the mouth during sleep.
In all other situations, excessive thirst means:
n There is need for fluid –Yin deficiency. This could be a Kidney Yin deficiency.
n Or it could be a dry-heat symptom in the respiratory system.
n It could also be dryness in Stomach with cold or heat.

When thirst is a symptom of the Stomach, also ask the patient about their pref-
erence for hot or cold drinks. A cold Stomach (Yin dominant state) asks for boiling
hot drinks, while a hot Stomach (Yang dominant state) prefers cold drinks. A hyper­
sensitive Stomach (Yin deficiency with Yang excess) is sensitive to all and can only
tolerate moderate temperatures and no fizzy drinks; and a Yang deficient Stomach
is not sensitive and likes only extreme temperatures, and fizzy or burning drinks.
Hunger and thirst are governed by the same factors – and therefore should be
present or absent simultaneously. But if a patient confuses hunger with appetite, in
which case they may say that they forget to drink but are very hungry; or that they
are often thirsty but not hungry. If this happens, then we should consider thirst as
the symptom that is more important for diagnosis (and ignore the hunger).

11.1.2 Spleen absorbs and distributes nutrients

The Spleen absorbs what the Stomach digests, and sends the nutrients downwards
to the Kidneys. The Kidney makes bone marrow, which makes Blood – and sends
the Blood up to Lung in the upper warmer. The Lung introduces oxygen into the
making of Blood, and finally Heart synthesizes red Blood – combining all these
nutritional factors. The red Blood – once synthesized – will be circulated centrally
by the Heart Qi to all the organs and tissues, and peripherally by the Spleen Qi.
(See Blood metabolism, p. 30).
Absorption of nutrition is a function of the Spleen. If the Spleen function is
deficient, there is malabsorption – diabetes mellitus (where glucose absorption
is affected), malabsorption diarrhoea after meals, or vomiting after meals are all
be examples of this. A patient with Spleen Qi deficiency has difficulty absorbing
nutrients from the food he or she consumes, and could therefore be malnour-
ished. This is called Spleen Blood deficiency – meaning there is less stored nutri-
tion in the Blood due to Spleen malfunction or because the patient eats poorly. It is
important to tonify their Spleen Qi and advise them to eat foods that are easy to
digest and absorb in their condition.
In diabetes mellitus, both types 1 and 2, the patients should be advised to avoid
refined carbohydrates and sugars, and eat wholemeal (unrefined) products. In
cases of malabsorption diarrhoea, heavy and fatty foods should be avoided; all
food must be cooked, and eaten warm and in small portions but more frequently.
Spleen circulates Blood in the periphery, and is responsible for the capillary cir-
culation of Blood. It is possible to be warm in the body, and have cold extremities
when the Spleen Yang is deficient. Because the Blood does not reach the hands and
feet (it has to be all extremities – hands, feet, nose and ears – not just one of them),
there could be numbness or even poor healing of wounds. Reynaud’s syndrome
and polyneuritis (common in diabetic or alcoholic patients) are some examples.
Also, since the capillary circulation is affected, and Blood and fluid stagnate here,
the capillaries could be injured easily – thus causing bruising or slow bleeding
symptoms such as easy bruising, spotting at the end of or between cycles of men-
struation, bleeding gums or microscopic bleeding in urine or stools.