I Can Talk to the Internal Organs-Chapter 47 - 42: Spleen and Kidney Yang Deficiency
"Why does what you said sound so strange?" Lu Jiu was both amused and helpless.
Qiao Ling smirked, "Just joking. Hey, Dr. Lu, this is my friend, Xue Yiyi. She’s been feeling a bit unwell lately, can you take a look at her?"
Lu Jiu smiled, "Sure, give me your hand."
Compared to Qiao Ling, Xue Yiyi was a bit more reserved.
When she reached out her hand, she didn’t even have the courage to look directly at Lu Jiu.
Lu Jiu gently placed his fingers on her chubby little hand and asked, "Where are you feeling unwell? Let’s hear it."
Xue Yiyi was quite robust, but her voice was soft and cute, and especially quiet, "It’s just that my stomach feels bloated and uncomfortable. Every time I eat at night, it bloats, and it’s still bloated the next morning."
Oh?
Abdominal bloating?
This symptom is also known as drum distention in traditional Chinese medicine.
It is mentioned in the "Inner Canon of the Yellow Emperor," under the Chapter on Abdominal Disorders.
"When the abdomen feels full and one cannot eat both breakfast and dinner, what is the illness? Qi Bo replied, it’s called drum distention."
Later, Zhang Zhongjing also discussed in the "Essential Prescriptions of the Golden Cabinet" in the Chapter on water diseases, that abdominal distention similar to drum distention is related to liver water, spleen water, and hydronephrosis among the Five Viscera water retention.
Generally, patients with water disease feel heavy and sluggish, short of breath, unable to sleep well, and restless, with swelling below.
Liver water patients, however, mostly have bulging abdomens, can’t freely turn their bodies, with pain below the ribs and in the abdomen, as the liver controls regulation and dispersion, causing fluid to rise and fall, often leading to a dry mouth with scant remaining saliva, and urination that sometimes is difficult and sometimes smooth.
Fei Jin patients don’t just have abdominal swelling but experience edema all over the body, with difficult urination and often water-mixed stools resembling duck droppings.
Spleen water patients also have very bloated abdomens, but feel extreme heaviness in the limbs, have dry mouths without saliva, insufficient breath, and difficult urination.
Hydronephrosis patients not only have a bloated abdomen but also noticeable swelling around the navel, accompanied by lower back pain, difficult urination, a moist groin like a sweaty bull’s nose, cold feet, but contrary to some renal patients with facial swelling, they appear thin-faced.
Of course, some people with water retention diseases may not only have one type.
"How’s your appetite lately?" Lu Jiu asked.
"Not much of an appetite, feel full after eating a little." Xue Yiyi replied.
"How about sleep? Any restlessness as soon as you lie in bed?" Lu Jiu asked.
"No." Xue Yiyi shook her head.
"Are you afraid of the cold?" Lu Jiu asked.
"A bit, my feet are cold." Xue Yiyi said.
"How’s your urination?" Lu Jiu asked.
Xue Yiyi blushed, "It’s okay."
Okay? So, not quite normal then.
"And your bowel movements, are they dry, loose, or mixed?" Lu Jiu asked.
"Dry..." Xue Yiyi was embarrassed by the detailed questions and blushed even more.
Lu Jiu was accustomed to it and didn’t feel anything was amiss, "Open your mouth, let me see your tongue coating."
"Ah~~" Xue Yiyi opened her mouth.
The tongue was slightly swollen, with a purplish hue, and a pale white coating.
Along with Xue Yiyi’s deep, fine, and weak pulse, Lu Jiu judged it to be spleen and kidney Yang deficiency causing spleen and kidney water retention.
The pathological nature of drum distention is essentially a case of root deficiency with superficial excess. Initially, the liver and spleen are first damaged, leading to disrupted liver regulation and weak spleen transport. As they affect each other, it results in qi stagnation with blocked dampness, mixing of clarity and turbidity, indicating an excess state.
Gradually, the internal accumulation of damp-turbidity in the middle Jiao obstructs the qi mechanism, which can either transform into heat through constraint or cause water-dampness entrapment in the spleen due to cold-damp transformation over time, leading to complicated stagnation of qi and blood, and further aggravation of water retention.
This causes persistent deficiency in the liver and spleen, eventually affecting the kidneys, where defunct kidney Fire fails to warm and assist the spleen Yang in transforming water-dampness. When the open and close mechanisms are disrupted and qi transformation impaired, it results in excessive water and Yang deficiency. If Yang damages Yin or damp-heat accumulates internally, it further worsens the condition with combined liver-kidney Yin deficiency, and with kidney Yin damage, the Yang cannot transform, leading to stagnant water. Thus, in the advanced stages, the disease mostly presents as a deficiency.
Although Lu Jiu had identified Xue Yiyi’s symptoms, he felt it wasn’t over.
Since edema caused by spleen and kidney Yang deficiency is often accompanied by excessive cold-dampness in the lower Jiao, a lack of Yang Qi means insufficient transformation of water-dampness, which logically implies significant menstrual issues for Xue Yiyi.
"Has your menstrual pain been worse lately?" Lu Jiu asked.
Xue Yiyi stared at Lu Jiu in surprise. She hadn’t mentioned menstruation, how did he know?
Oh, right, Qiao Ling mentioned that this doctor seems to know everything from just feeling the pulse.
"Yes." Xue Yiyi replied.
That should be about it.
Let’s hear what the Five Viscera say.
Lu Jiu intentionally blocked out the Five Viscera’s voices.
Lately, whenever he feels the pulse, the voices of the Five Viscera echo in his mind, significantly reducing his diagnostic time and difficulty.
After all, when he asks the Five Viscera anything, they seem to tell him everything.
These internal spies, once they know I’m a doctor coming to their rescue, volunteer information, down to details as trivial as what color underwear their host wore yesterday.
It’s hard for Lu Jiu to not know such details!
This method indeed can be magical at crucial moments.
For instance, with critically ill patients who have given up hope, if he’s able to detail their daily activities and thoughts without asking, it greatly helps in rekindling their will to fight the illness.
Some people’s life or death hinge on a thought. A healthy individual might succumb within half a month due to a terminal illness report, while a terminally ill person might miraculously recover due to an overwhelming will to live.
Many suggest that traditional Chinese medicine acts as a psychological placebo; if it cures, then what harm is there?
However, constantly relying on information from the Five Viscera may lead Lu Jiu to overly depend on external methods, losing his inherent abilities.
Even if he received rewards from a system, Lu Jiu believes this isn’t right.
If it can appear suddenly, why can’t it disappear suddenly?
Lu Jiu doesn’t feel that this so-called Great Doctor System will always be around.
So, after a few days, Lu Jiu decisively chose to rely on himself, only seeking the Five Viscera for confirmation after finishing his diagnosis, to check if there were any overlooked details.
"Ah, so tired, feel like I have no energy," Hydronephrosis said.
"Same here, it’s okay now, but more tired by night," Spleen Earth said.
"You both might as well lie down, whining every day, it’s annoying," Liver Wood said.
"See, I told you, once you two speak, Liver Wood gets angry," Fei Jin said.
"It’s okay for them to whine but not for me to get angry?" Liver Wood said.
"I didn’t say that," Fei Jin said.
"But that’s what you mean!" Liver Wood said.
"Alright, alright, stop whining, don’t argue," Spleen Earth said.
"All day long, just bickering, can’t you work? Her meridians are blocked, don’t you know how to clear them? I’m talking to you, Fei Jin; without enough qi, how can I push the blood? And you, Liver Wood, there’s so little blood on her back, how can I direct them to clear the congestion?" Heart Fire said.
"..."
Oh?
Meridian blockage?
The back?
Lu Jiu’s attention returned, focusing his gaze on Xue Yiyi’s back.
Right!
From when she walked in, Lu Jiu noticed that aside from her short, stubby hands, Xue Yiyi was well-proportioned, but her thick back gave her a rather broad appearance.
Initially, Lu Jiu hadn’t looked closely. Now, with the reminder from the Five Viscera, he immediately realized Xue Yiyi’s Bladder Meridian was blocked.
The Bladder Meridian is a natural barrier against external wind and cold, while also being the body’s largest detoxification pathway.
People who sit for long periods, suffer from stiff backs and shoulders, causing meridian blockages over time, severely impacting metabolism, leading to excess fat accumulation on the back.
Moreover, excessive cold intake can chill the back, and when the Bladder Meridian isn’t open, internal toxins can’t be excreted timely, slowing fat metabolism, hence thick necks and back fat often worsen.
"Do you often sit for long periods and enjoy cold foods?"
