Heart Water: Trouble lying down; swollen genitals

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" 'Xin shui' (Heart water) results from insufficiency of Heart yang, so that

cold constricts flud movement, causing it to gather and disturb the Heart,

leading to symptoms of swelling and sensations of heaviness; shortness of

breath as water accumulates in the chest; inability to lie down because

pathogenic water will rise and further limit the breathing; irritability and

restlessness as the predominant yin prevents the free flow of yang, which,

becoming pent-up, intensifies into pathogenic heat which dusturbs the shen;

and swelling of the genitals due to Heart Yang failing to warm the Kidneys,

and thus yang is unable to transform the water that sinks into the lower

Jiao. " (Fluid Physiology and Pathology in Traditional ,

Steven Clavey, p. 149.)

 

This passage on Heart water is not as specific as the information on the

other Zang Organs. This is due in part to the possible etiologies of Heart

Yang Deficiency. Part of the etiologies for Heart Yang Deficiency are the

same as those for Heart Qi Deficiency: 1.) Loss of Blood, and 2.) emotional

factors (specifically sadness). (Maciocia, Foundations of ,

pp. 202-203.) But, Heart Yang Deficiency also can be caused by chronic

Kidney Yang Deficiency as the Kidneys supply the Yang for the rest of the

body. In these cases the clinical picture is more apt to be that of Kidney

water (thin face, heavy lower body with edema greater below the waist than

above, continuous sweating in groin area, etc.) with some additions that are

specific to the Heart. The part about breathing becoming more difficult when

one lies down is not specific to Heart Yang Deficiency as Kidneys Refusing

to Receive Qi (a subtype of Kidney Yang Deficiency which involves lack of

coordination between the Lungs and Kidneys) also can have the symptom of

breathing being more difficult when the person is lying down than when

sitting up. There also is a pattern called Kidney Yang Deficient, Water

Overflowing in which the Heart and/or the Lungs are affected and in which

breathing will be harder when the person is lying down. A reminder that the

Lungs can fill with Fluid even though there is no apparent upper body edema.

 

The symptoms which are Heart-specific are those involving disturbances to

Shen (Spirit). (Shen resides in the Heart.) But, disturbances to Shen are

not specific to Heart Yang Deficiency. Heart Blood Deficiency will result in

Shen disturbances. So will Heart Yin Deficiency. In addition there is a

pattern called Kidney and Heart Not Harmonized which can result in

disturbances to Shen. (There are others as well, but I don't want to get

into Phlegm disorders at present.) Kidney and Heart Not Harmonized " is

basically characterized by Kidney-Yin deficiency failing to nourish

Heart-Yin which also becomes deficient. This leads to the flaring up of

Heart Empty-Fire. In 5-Element terms, it corresponds to Water not flowing

upwards to nourish and cool Fire (represented by the Heart). Water and Fire

must assist each other; the Fire of the Heart must descend to warm the

Kidneys, and the Water of the Kidneys must ascend to cool the Heart. "

(Maciocia, Foundations, p. 260.)

 

In cases of Yang Deficiency (aka Deficiency Cold, aka Empty Cold), the

predominate symptoms will be those of Cold - pale and shiny complexion, pale

tongue, frequent and clear and profuse urination, aversion to drinking cold

drinks, etc. In cases of Yin Deficiency (aka Deficiency Heat, aka Empty

Heat), the predominate symptoms will be those of Heat - spotty reddish tones

to the complexion (in particular a " malar flush " across the cheeks), red

tongue, infrequent and scant and dark urination, desire for lots of cold

drinks, and feelings of heat greater in the afternoon than at other times).

But what about those cases where some Heat symptoms are mixed in with those

of Cold?

 

This is more than just the fact that if the Kidneys are Yang Deficient, they

almost are certain to also be Yin Deficient though the Yang Deficiency

symptoms will predominate. (And vice versa.) One of the hardest TCM

concepts for many students to grasp is that if any imbalance is extreme and

goes on long enough, it can turn into or give rise to its opposite. This

definitely happens with Heart water.

 

Note the passage " irritability and restlessness as the predominant yin

prevents the free flow of yang, which, becoming pent-up, intensifies into

pathogenic heat which dusturbs the shen " . (Clavey, p. 149.)

 

This is a situation in which it will be very likely that there are mixed

symptoms and signs of Cold and Heat. The Cold symptoms will predominte, but

the pulse may be rapid (possible sign of Heat - the pulse changes far more

rapidly than the tongue color does) and the tip of the tongue may be red

even though the rest of the tongue is pale.

 

In these cases it is very important to recognize that that the Root of the

Heat in the Heart is Yang Deficiency. Just treating Heat in the Heart is

not going to help the person, and will make the person worse because using

just herbs that cool is making the person even colder and even more Yin than

s/he already is. Cold can slow down Qi circulation, resulting in Qi

Stagnation. If Qi is blocked bad enough and long enough, Cold " changes " into

Heat through being pent-up. Sort of like a pressure cooker. (Not exactly,

but it's like that direct relationship between pressure and temperature in

gas laws in chemisty. If one raises the pressure on the gas, the temperature

of the gas rises. If Qi pressure builds up because of Stagnation and

Blockage - and Cold is one of the things which can cause this - then Heat

results.)

 

If just the Heat problems are addressed without addressing the underlying

Yang Deficiency (which is causing the Cold), the Heat symptoms not only will

continue, they will become worse because the Root of the problem is Cold.

(This does not mean that Heat-clearing herbs and acupoints are never used in

these types of situations, just that the underlying Yang Deficiency problems

ALSO have to be addressed if the problem is to be cleared up. The Yang

Deficiency is the Root of the problem; the localized Heat symptoms due to Qi

blockage due to Cold are results/ manifestations/ symptoms.)

 

The " sensations of heaviness " is sensations in the chest.

 

Victoria

 

 

 

 

 

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