DONGUIBOGAM; Internal Bodily Elements 10. Fluids and Humors 津液 진액

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△ 『Dongui Bogam-Internal Bodily Elements(동의보감-내경편』 Cover Page.

Written By Jun Heo(許浚, 1539~1615), Translated by Namil Kim, Wung Seok Cha et al., Published by Ministry of Health & Welfare (Korea)


01 Fluids and Humors Inside the Body 身中津液 몸속의 진액

① Divine Pivot (靈樞) says, “When interstices open, sweat comes out to moisten the skin. This is called Jin (津, fluid). Jintal (津脫, fluid collapse) is heavy sweat due to the open interstices.

② When grain comes in, qi gets filled up to wet bones, move joints, spread moisture, tonify the brain’s marrow, and wet the skin. That is called Aek (液, humor). Aektal (液脫, humor collapse) is to have joints move unsmoothly, have bad color on the face, have decreased marrow in the brain, have the shins chilled, and have frequent ringing in the ears.”

③ As water and grain enter the mouth and are delivered to the intestines and stomach, fluid and humor are classified into five types. If thin clothes are worn on a cold day, it becomes urine and the steam of breath. If thick clothes are worn on a hot day, it becomes sweat. If sorrow causes qi to congest, it becomes tears. If the stomach droops due to heat in the middle energizer, it becomes spittle. If pathogenic qi reverses upward, qi cannot circulate, which will cause water distention.

④ Sweat coming out to moisten the skin a little when the interstices open is called Jin (津, fluid). The motionless and remaining Jin permeating the orifices is called Aek (液, humor).

⑤ The large intestine governs fluid and the small intestine governs humor. The large and small intestines receive nutrient qi of the stomach, send fluid and humor to the upper energizer, wet the skin and hair and complete the interstices. Without adequate drinking and eating, the large and small intestines may have nothing to receive due to the deficiency of the stomach qi, so fluid and humor dry up.

02 The Kidneys Govern the Five Humors 腎主液 신은 오액을 주관한다

① The Classic of Difficult Issues (難經) says, “The kidneys govern the five humors and distribute them to the five viscera. The humors become tears in the liver, sweat in the heart, drool in the spleen, snivel in the lungs, and spittle in the kidneys.”

② Divine Pivot (靈樞) says, “The five viscera transform humor. They become sweat in the heart, snivel in the lungs, tears in the liver, drool in the spleen, and spittle in the kidneys. These are called the five humors.”

03 Diagnosis by Pulse Taking 脈法 맥법

① The Inner Classic (內經) says, “When Chi (尺) is rough and the pulse is slippery, one sweats heavily.” The Annotation say, “It means the Chi (尺) region is rough and the Chi (尺) pulse is slippery.” This is a case of dried blood and depleted fluid due to spontaneous sweating.

② Sweating occurs when the pulse is large, vacuous, floating, or soggy.

③ Rhymes for the Pulse (脈訣) says, “The pulse upon sweating is floating, vacuous, rough, or soggy. If the pulse is soft, dissipated, surging, or large, thirst will induce heavy drinking of water.”

④ The pulse upon sweating is large, vacuous, rough, or soggy. Spontaneous sweating can be detected on the Cun (寸) pulse, while night sweating can be detected on the Chi (尺) pulse.

⑤ Rhymes for the Pulse (脈訣) says, “In the case of a healthy man, there is much night sweating when the pulse is vacuous, weak, faint, or fine.”

⑥ A faint wrist pulse and tight Chi (尺) pulse is due to heavy sweating, which is caused by deficiency damage. Yin is always there but yang is cut off and will not appear.

⑦ In the case of Cold Damage, if the pulse is floating and slow, the face is reddish and there is a fever and shivering, induce sweating to cure. The slow pulse means no yang qi. Without sweating, the body will become itchy.

04 The Causes for Sweating Is Dampness-heat 汗因濕熱 땀이 나는 원인은 습열이다

① The Inner Classic (內經) says, “It becomes sweat in the heart.” Also, “When yang enters the eum aspect, one sweats.” The Annotation says, “While yang qi rises up, yin guards firmly. Thus, fumigation causes sweating.” Again, “The sweat of yang is the same as raining in the heaven and earth.”

② Divine Pivot (靈樞) says, “The kidney pathogenic qi enters the heart to become sweat.”

③ Sweat is the fluid of the heart. When the heart moves, fear causes one to sweat.

④ The heart is sovereign Fire and the spleen and stomach belong to Earth. It is clear that dampness collides with heat to form sweat. In addition, sweating isn’t possible if Water is not fumigated with Fire, just as in making distilled liquid inside an earthenware steamer.

⑤ The Inner Classic (內經) says, “Sweat comes from the stomach when too much is eaten; from the heart when fear causes leaking essence; from the kidneys when walking a long distance with a heavy load; from the liver when running fast or fearing; from the spleen when moving one’s body and working hard.”

⑥ If defense qi is deficient, one sweats heavily. If nutrient and blood are deficient, one sweats lightly.

⑦ One sweats much in the case of wind diseases, because wind spreads qi. [The details are in the chapter on Wind]. Phlegm syndromes also cause sweating. A Chuanxiong and Pinellia Decoction (芎夏湯) [The prescription is in the Chapter on Phlegm] is good for dizziness and vomiting. The dampness in the stomach turns into sweat and comes out. Mainly use Cool Rib Cage Powder. [The prescription is in the Chapter on Fire].

05 Spontaneous Sweating 自汗 자한

① The spontaneous sweating means sweating profusely at any time. It gets worse when one moves one’s body. It belongs to a yang deficiency and is governed by stomach qi. Tonify yang and control the stomach to cure.
② Divine Pivot (靈樞) says, “Defense qi fill interstices up and governs the opening and shutting.” If defense qi is deficient, so that the interstice loses control of opening and shutting, much sweating will occur.

③ The Inner Classic (內經) says, “Sweating at only one side may become Pyeongo (偏枯, Hemiplegia).”

④ The soft body with much sweating belongs to dampness. The heart governs heat and the spleen governs dampness. The sweating from a collision between dampness and heat is the same as the steam of the earth turning to a cloud, rain, fog, and dew. Use a Regulate Defences Decoction or Jade Windscreen Powder. Use Fresh Licorice and a Prepared Licorice Decoction for heat in the stomach.

⑤ Some spontaneous sweating belongs to a qi deficiency, while others belongs to dampness and phlegm. Add Cinnamomi Ramulus (桂枝) a little to Ginseng Radix (人參) and Astragali Radix (黃芪) for a qi deficiency. Steep some Aconiti Lateralis Radix
Preparata (附子) and urine of a boy under 12 years of age for a deficiency of genuine yang.

⑥ When spontaneous sweating does not stop due to internal damage or a consumptive disease, use a Tonify the Center to Augment the qi Decoction (補中益氣湯) [the prescription is seen in the chapter on Internal Damage] in all cases. Adding some Aconiti Lateralis Radix Preparata (附子), Ephedrae Radix (麻黃根) and Tritici Immatri Semen (浮小麥) may have excellent efficacy. Use Cimicifugae Rhizoma (升麻) and Bupleuri Radix (柴胡) that are soaked in honeyed water and baked in order to decrease the strong nature of lifting up and spreading. It leads the medicine of Ginseng Radix (人參) and Astragali Radix (黃芪) and sends it out to the skin.

⑦ A Cinnamomum Decoction of Zhang Zhongjing may be a great medicine for spontaneous sweating caused by exopathogen wind. An Astragalus Decoction to Build the Center is an excellent medicine when sweating is caused by exopathogenic qi deficiency. A Tonify the Center to Augment the qi Decoction is a superb medicine when it’s caused by internal damage.

⑧ There are nine symptoms of spontaneous sweating that are caused by Cold Damage. [The details are in the chapter on Cold Damage].

⑨ Use an Astragalus Decoction, Astragalus Six to One Decoction [the prescription is in the chapter on Abscess], Ginseng and Angelica for Lower Back Pill, Oyster Shell Powder, Minor Build the Center Decoction [the prescription is in the chapter on Deficiency Vexation], Ginseng and Astragalus Decoction, Double Harmony Decoction [the prescription is in the chapter on Deficiency Vexation], Cinnamomum and Aconite Added Decoction, Atractylodes and Poria Decoction, Calm Fluid Elixir, Ginseng and Aconite Decoction or Astragalus and Aconite Decoction.

  • Regulate Defences Decoction 調衛湯 조위탕: Used for spontaneous sweating caused by excess dampness. Ephedrae Radix (麻黃根) and Astragali Radix (黃芪) 1 don each, Osterici Radix (羌活) 7 pun, Glycyrrhizae Radix (甘草) (raw), Angelica Gigantis Radix (當歸) (small roots), Scutellariae Radix (黃芩) raw, and Pinelliae Tuber (半夏) 5 pun each, Liriopis Tuber (麥門冬) and Rehmanniae Radix Crudus (生地黃) 3 pun each, Polyporus (猪苓) 2 pun, Sappan Lignum (蘇木) and Carthami Flos (紅花) 1 pun each, and 7 grains of Schisandrae Fructus (五味子). Chop these into 1 package and steep in water.
  • Jade Windscreen Powder 玉屛風散 옥병풍산: Used for spontaneous sweating caused by an exterior deficiency. Atractylodis Rhizoma Alba (白朮) 2.5 don, and Saposhnikoviae Radix (防風) and Astragali Radix (黃芪) 1.2 don. Chop these into 1 package and steep in water. Saposhnikoviae Radix (防風) and Astragali Radix (黃芪) make exterior qi healthy, and Atractylodis Rhizoma Alba (白朮) dries interior dampness. So it is efficacious.
  • Fresh Licorice and Prepared Licorice Decoction 二甘湯 이감탕: Used for rain-like heavy sweating after eating which is caused by heat in the stomach. Glycyrrhizae Radix (甘草) (raw), Glycyrrhizae Radix (甘草) (baked), Schisandrae Fructus (五味子), and Mume Fructus Praeparatum (烏梅肉) all the same amounts. Chop these into 5 don. Steep it in water with 2 pieces of Zingiberis Rhizoma Crudus (生薑) and 2 pieces of Zizyphi Fructus (大棗).
  • Astragalus Decoction 黃芪湯 황기탕: ① Used for spontaneous or night sweating caused by the deficiency of either yin or yang. Astragali Radix (黃芪) (soaked in honey and baked) 2.2 don, Rehmanniae Radix (生乾地黃), Asparagi Tuber (天門冬), Poria Sclerotium (白茯苓) and Ephedrae Radix (麻黃根) 1.5 don each, Angelica Gigantis Radix (當歸) 1.2 don, Liriopis Tuber (麥門冬) 1 don, and Schisandrae Fructus (五味子), Tritici Immatri Semen (浮小麥) and Glycyrrhizae Radix (甘草) 7 pun each. Chop these into 1 package and steep in water.[B162] ② This medicine is the same as that of Mr. Eom (嚴氏). However, it has no Fossilia Ossis Mastodii (龍骨) and includes Rehmanniae Radix Crudus (生地黃) instead of Rehmanniae Radix Preparata (熟地黃).
  • Ginseng and Angelica for Lower Back Pill 參歸腰子 삼귀요자: Used for spontaneous sweating caused by heart qi consumption. This medicine collects heart humor. Ginseng Radix (人參) and Angelica Gigantis Radix (當歸) (chopped) 5 don each. Slice one heart of a pig, put the heart with the blood inside into 2 bowls of water and boil it until 1.5 bowls of
    water remains. Put in the 2 medicines, boil it together until eighty percent of water remains, get the clear juice, and take it.
  • Oyster Shell Powder 牡蠣散 모려산: ① Used for these symptoms: every deficiency syndrome including spontaneous
    sweating, which gets worse at night and hence leads to weight loss, palpitations, fear, and fright. Ostreae Testa (牡蠣) (heated), Ephedrae Radix (麻黃根), Astragali Radix (黃芪), and Anemarrhenae Rhizoma (知母) 1 nyang each. Grind these into powder, mix each 2 don with water steeped with Tritici Immatri Semen (浮小麥). Slicing, steeping, and taking may also be fine. ② When Danxi treated spontaneous sweating, he chopped the same amounts of Saposhnikoviae Radix (防風), Astragali Radix (黃芪), Atractylodis Rhizoma Alba (白朮), Ostreae Concha (牡蠣粉), and Ephedrae Radix (麻黃根), steeped them in water, and gave it to the patient. This therapy has an excellent effect as well.
  • Minor Build the Center Decoction 小建中湯 소건중탕: ① Used for spontaneous sweating caused by an exterior deficiency. [The prescription is in the chapter on Deficiency Vexation]. ② An Astragalus Decoction to Build the Center is Astragali Radix (黃芪) added to this prescription. Used for spontaneous sweating caused by consumptive diseases. ③ An Angelica Decoction to Build the Center is Angelica Gigantis Radix (當歸) 1 nyang added to this prescription. Used for spontaneous sweating caused by a blood deficiency. ④ A Cinnamomum and Aconite Decoction is Cinnamomi Ramulus (桂枝) 5 don and a half of Aconiti Lateralis Radix Preparata (附子) (rolled in a damp paper and baked) added to this prescription. Used
    for incessant spontaneous sweating. Steep 7 don each with 7 pieces of Zingiberis Rhizoma Crudus (生薑) and 2 pieces of Zizyphi Fructus (大棗) in water and take it.
  • Ginseng and Astragalus Decoction 參芪湯 삼기탕: Used for spontaneous sweating. Astragali Radix (黃芪) (soaked in honey and baked), Ginseng Radix (人參), Atractylodis Rhizoma Alba (白朮), Poria Sclerotium (白茯苓), Angelica Gigantis Radix (當歸), Rehmanniae Radix Preparata (熟地黃), Paeoniae Radix Alba (白芍藥) (soaked in wine and baked), Zizyphi Semen (酸棗仁) (baked) and Ostreae Concha (牡蠣粉) 1 don each, Citrus Unshius Pericarpium (陳皮) 7 pun, and Glycyrrhizae Radix (甘草) 2 pun. Chop these into 1 package, steep with 2 Zizyphi Fructus (大棗), and 1 handful of Tritici Immatri Semen (浮小麥) and take it.
  • Atractylodes and Poria Decoction 朮苓湯 출령탕: Used for deficiency sweating. Astragali Radix (黃芪), Saposhnikoviae Radix (防風), Poria Sclerotium (白茯苓), Atractylodis Rhizoma Alba (白朮) and Ephedrae Radix (麻黃根) 5 don each, and Glycyrrhizae Radix (甘草) (baked) 2.5 don. Chop these into 7 don, steep it with 100 grains of Tritici Immatri Semen (浮小麥).
  • Calm Fluid Elixir 鎭液丹 진액단: Used for spontaneous sweating. Astragali Radix (黃芪) (soaked in honey and baked) 2.5 nyang, large Aconiti Lateralis Radix Preparata (附子) 2 nyang (buried in a fire covered with ashes with the removed skin and a stalk, soaked in urine of a boy under 12 years of age and baked), Saposhnikoviae Radix (防風) (baked), Atractylodis Rhizoma Alba (白朮) (baked), Paeoniae Radix Alba (白芍藥) (soaked in wine and baked) and Cinnamomi Cortex (中桂) 1 nyang each. Grind these into powder, make into paste with starch cooked with wine, and make pills as big as the seed of the royal foxglove tree. Take 50 pills each time with warm wine on the empty stomach. Putting Zizyphi Semen (酸棗仁) gives more potency.
  • Ginseng and Aconite Decoction 參附湯 삼부탕: Used for spontaneous sweating caused by a yang deficiency. Ginseng Radix (人參) 5 don and Aconiti Lateralis Radix Preparata (附子) (rolled in a damp paper and baked) 1 nyang. Chop these into 3 package, steep in water with 3 pieces of Zingiberis Rhizoma Crudus (生薑), and take it.
  • Astragalus and Aconite Decoction 芪附湯 기부탕: Used for spontaneous sweating caused by a qi deficiency. Astragali Radix (黃芪) (soaked in honey and baked) and Aconiti Lateralis Radix Preparata (附子) (rolled in a damp paper and baked) 2.5 don each. Chop these into 1 package, add 3 pieces of Zingiberis Rhizoma Crudus (生薑), steep in water, and take it.
  • Cinnamomum and Aconite Added Decoction 桂附湯 계부탕: Used for spontaneous sweating that does not stop. Cinnamomi Ramulus (桂枝) and Aconiti Lateralis Radix Preparata (附子) (rolled in a damp paper and baked) 2.5 don each. Chop these and take as forementioned.