血虚则发渴。有瘀血则发渴。水虚亦发渴。
血虚发渴者。血为阴。气为阳。血少则气多。阳亢无阴汁以濡之。故欲饮水也。法宜补血。血足则气不热矣。
圣愈汤。加天冬花粉治之。或当归补血汤。加花粉苎麻根玉竹麦冬。
瘀血发渴者。以津液之生。其根出于肾水。水与血。交会转运。皆在胞中。胞中有瘀血。则气为血阻。不得上
升。水津因不能随气上布。但去下焦之瘀。则水津上布。而渴自止。小柴胡。加丹皮桃仁治之。血府逐瘀汤
亦治之。挟热蓄血者。桃仁承气汤治之。夹寒瘀滞者。温经汤治之。
水虚发渴者。以肺胃之水津不足。是以引水自救。水津虽由水谷所化。而其气实发源于肾中。肾中天癸
之水。至于胞中。循气冲。随呼吸。而上于肺部。肺金司之。布达其气。是以水津四布。口舌胃咽。皆有津液。而
不渴也。若肾中之水不足。则不能升达上焦。是以渴欲引水。宜启下焦之阴。以滋津液。地黄汤加人参麦
冬诃子。或左归饮加儿茶人参玉竹。三才汤加知母治之。夫水津虽生于肾。而实布于肺。又有肾中之水
津本足。而肺金郁滞。不能散布。以致水结为痰。咽干口渴。宜小柴胡汤。通上焦之滞。使肺气通调。则水津
四布矣。又曰。津液虽生于肾。布于肺。而实赖胃中水谷以滋其化源。胃中燥结。则津不生。三一承气汤治
之。胃中蕴热。则津不生。玉泉散治之。胃经肌热。则津液被灼。人参白虎汤治之。胃中虚热。则津不生。麦冬
养荣汤治之。
上分三条。皆失血多有之证。与杂病消渴水停不化。津气不升者不同。参看可也。水停不化。当用五苓真武等汤。
Blood deficiency leads to thirst. Blood stasis also leads to thirst. Deficiency of body fluids (Water) likewise leads to thirst.
Regarding thirst caused by blood deficiency: Blood belongs to Yin, and Qi belongs to Yang. When blood is scant, Qi becomes relatively excessive. Hyperactive Yang without sufficient Yin fluids to moisten it causes the desire to drink water. The treatment principle should be to tonify blood; when blood is sufficient, Qi will no longer be hyperactive and hot. Use Shengyu Decoction (Shengyu Tang), adding Tian Dong (Asparagi Radix) and Hua Fen (Trichosanthis Radix). Alternatively, use Danggui Buxue Tang (Angelica Sinensis Decoction for Tonifying Blood), adding Hua Fen (Trichosanthis Radix), Zhu Ma Gen (Ramie Root), Yu Zhu (Polygonati Odorati Rhizoma), and Mai Dong (Ophiopogonis Radix).
Regarding thirst caused by blood stasis: The generation of body fluids has its root in Kidney Water. Water and Blood intersect and transport within the Bao Gong (Uterus/Pelvic Cavity). If there is blood stasis in the Bao Gong, Qi is obstructed by the blood and cannot ascend. Consequently, body fluids cannot distribute upward with the Qi. By removing the stasis from the Lower Jiao, body fluids can ascend and distribute, and the thirst will cease. Use Xiao Chai Hu Tang (Minor Bupleurum Decoction), adding Dan Pi (Moutan Cortex) and Tao Ren (Persicae Semen). Xuefu Zhuyu Decoction (Xuefu Zhuyu Tang) is also effective. For retained blood complicated by heat, use Taoren Chengqi Tang (Peach Kernel Decoction to Order the Qi). For stasis complicated by cold, use Wenjing Tang (Decoction to Warm the Channels).
Regarding thirst caused by fluid deficiency: This occurs because the body fluids of the Lung and Stomach are insufficient, prompting the body to seek water for self-rescue. Although body fluids are transformed from food and drink, their Qi source actually originates from the Kidneys. The Tian Gui (Essence/Water of the Kidneys) reaches the Bao Gong, follows the Chong Mai (Penetrating Vessel), and ascends to the Lungs along with respiration. The Metal of the Lung governs this, distributing its Qi, thereby allowing body fluids to distribute throughout the body. Thus, the mouth, tongue, stomach, and pharynx have fluids, and there is no thirst. If the water in the Kidneys is insufficient, it cannot ascend to reach the Upper Jiao, resulting in thirst and a desire to drink. Treatment should stimulate the Yin of the Lower Jiao to nourish body fluids. Use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill), adding Ren Shen (Ginseng Radix), Mai Dong (Ophiopogonis Radix), and He Zi (Terminalia Chebula Fruit). Alternatively, use Zuogui Yin (Left Restoring Drink), adding Er Cha (Catechu), Ren Shen (Ginseng Radix), and Yu Zhu (Polygonati Odorati Rhizoma). Sancai Tang (Three Talents Decoction) added with Zhi Mu (Anemarrhenae Rhizoma) is also used. Although body fluids are generated in the Kidneys, they are distributed in the Lungs. There are cases where Kidney fluids are sufficient, but Lung Metal is stagnant and unable to distribute them, causing water to congeal into Phlegm, leading to dry throat and thirst. In such cases, use Xiao Chai Hu Tang to unblock stagnation in the Upper Jiao, allowing Lung Qi to flow freely so that body fluids distribute widely. It is also said: Although body fluids are generated in the Kidneys and distributed in the Lungs, they rely on the food and drink in the Stomach to nourish their source. If the Stomach is dry and constipated, fluids are not generated; treat with Sanyi Chengqi Tang (Three-One Decoction to Order the Qi). If the Stomach harbors latent heat, fluids are not generated; treat with Yuquan San (Jade Spring Powder). If there is muscular heat in the Stomach Meridian, fluids are scorched; treat with Renshen Baihu Tang (Ginseng White Tiger Decoction). If there is deficient heat in the Stomach, fluids are not generated; treat with Maidong Yangrong Tang (Ophiopogon Decoction to Nourish the Spirit).
The above are divided into three categories, which are common syndromes in patients who have lost blood. They differ from miscellaneous diseases such as Xiao Ke (Wasting-Thirst), retention of water failing to transform, and failure of fluids and Qi to ascend. These can be referred to. For retention of water failing to transform, formulas such as Wuling San (Five-Ingredient Powder with Poria) and Zhenwu Tang (True Warrior Decoction) should be used.