Thirst, Sweat, & Urine: What is Normal?
In contrast to the requisite ruling out of red flags by most nurses in conventional medical settings, the reason Chinese Medical practitioners ask about almost every system in your body is because we are diagnosing based on complete patterns—not just symptoms.
For example, if someone comes in for acid reflux, we cannot know their prescriptions until we know how often they urinate or poop, what each one is like, whether they experience headaches or dizziness, which part of the head they get their headaches in, how is their appetite, how thirsty they are during the day versus in the evening, etc. etc. This is because we are one of the only true forms of holistic medicine.
So, what is normal?
A normal amount of urination is approximately 6 times a day (yes, this includes waking at night). Much less than that and you are likely either retaining, or not drinking enough water in the first place. More than 6 indicates either a weakness in the urogenital microbiome, or excessive inflammation in the urogenital microbiome, which over time can lead to local weakness by putting strain on it. The remainder of the intake questions will determine which of the two is the case.
People should sweat, but not excessively so. Chinese Medicine is critical of HIIT or marathon training, hot yoga, and sauna therapy in most cases. While these might all feel great in the short-term and/or be proven to offer certain isolated benefits in the short-term, we believe they ultimately deplete the body’s healthy metabolic fluids. On the other hand, never sweating (exercising) at all is obviously just as harmful.
While some people barely break a sweat even when they exercise, others are drenched by the time they finish their morning commute, especially triggered by certain climates or seasons. The former can either indicate body fluid depletion or a malfunction of the immunological “qi.” The latter can either indicate inflammation, fluid retention, or also a malfunction of the immunological “qi.” This is where diagnoses and prescriptions get tricky.
Many western doctors have now begun to recognize the health benefits of the Chinese herb, astragalus, which on one hand is great. On the other hand, their recognition by way of empirical studies poses the challenge of having no comprehension of Chinese Medicine. If you give astragalus to the former example of a “cold-body person” with a simple immunological malfunction they will feel amazing and sing your praises. If you give it to someone with both immunological malfunction AND fluid deficiency it will do almost nothing. Worse, if you give it to a “hot-body person” with inflammation and fluid retention they will feel much worse.
Finally, it is normal to be thirsty, for 6-9 cups of water per day. A lack of thirst tells us there is fluid retention in the microbiome, signaling to the brain that it’s got plenty of liquid down here—no need to hydrate! This is dangerous, and better to fake it ‘til you make it in acquiring thirst. On the other pole are those who are ravenously or insatiably thirsty, which informs us of inflammatory heat in either their respiratory microbiome, gastrointestinal microbiome, or both, drying out their fluids. As always, the most complicated patterns are those who are generally unthirsty followed by sudden bouts of desperate thirst. This is a combination pattern that requires more thought, trial, and error.
I hope this was interesting and informative. One of western medicine’s shortcomings is its reliance on tests and labs to determine whether we are healthy or normal. While these are undeniably valuable, they tell only part of the story, which is why so many diseases get caught too late. Chinese Medicine is more brilliant in its neurotic recognition of pathologies in any abnormality, any imbalance, as something to rectify before it spirals into disease.
Refuting the “Man Cold” Cliche
Well, if Covid and seasonal allergies had a lovechild its name would apparently be the upper respiratory pathogens of Winter, 2023. I experienced both personally and professionally, not only the severity of these viruses’ symptoms, but maybe even more troubling was how stubborn they were to resolve. Coughs that would linger for weeks on end, allergies turned to sinus infections, and one friend had the shingles virus transform into a vicious cough, which in my humble opinion occurred because he didn’t properly treat the former with Chinese Medicine.
I am grateful we seem to be passing simultaneously, likely not coincidentally, out of this post-pandemic ripple effect along with the cold weather. Besides dilating the blood vessels of our respiratory microbiomes, thereby giving pathogens wider exit pathways, the warm air should eventually aid in transforming latent mucus and boosting our metabolic energies enough to in turn boost our immunological energies, or “wei qi.”
I plead ignorance, in the past few years more than ever, to most current events, trends on social media, philosophical platitudes, and pop culture; and I often question whether that makes me an “ignorant person”—especially since we will all eventually die still relatively ignorant about most things and peoples. Besides my family, I devote most of my time and mental energy to Chinese Medicine. Whatever is left over at the end of each day are mere scraps, an hour or two at most, and I choose to shut my mind off with friends and/or sports. Maybe in another chapter of my life I’ll read more articles and keep up with external themes and events.
Before blowing my own nose about 50 times a day one week back in January, my lungs exacerbated by the need to rid themselves of phlegm, I had never heard of “the man cold.” Apparently, amongst the infinite social media cliches is one that guys are overly dramatic or whiney about their common colds, obviously underscoring “girl power,” which is a great thing, but also the idea that men are weak(er), which might not be great, or accurate.
Recall the first wave of Covid, we were quickly informed that men, along with the elderly and obese, were most susceptible to severe infections. Why? Well, from a Chinese Medical perspective men have more heat and/or yang qi in the body’s upper region. On one hand it is why we are fortunate enough to have generally more energy. It is consistent with our generally superior upper body strength; though it is also why the inflammatory cytokine response is more intense in the context of upper respiratory viruses.
If you require this be translated in conventional medical terms—and most westerners do—as a result of our increased testosterone and androgens, men possess higher numbers of T cells and Natural Killer cells than women, whereas women have greater B cells, neutrophils and phagocytic activity, which makes them more adept at clearing viruses, as well as the toxins from vaccines. Women also have a greater susceptibility to dysregulation of innate lymphoid cells, which makes them generally more prone to autoimmune disease. (source: https://www.nature.com/articles/nri.2016.90.pdf)
Returning to the brilliant simplicity of Chinese Medical jargon: It is the heat from our body’s (masculine) yang qi that provides ample metabolic strength to regulate our lymphoid cells and avoid autoimmune disease. It is that same heat, left uncontrolled, that creates a more inflammatory cytokine storm in the lungs and makes clearing external pathogens more stubborn. It’s not because your husband is being a little bitch.
Spring Season and Moving Day!
Despite the northeast weather forecasts consistently looking more like a frightening EKG than a directly corresponding line with the seasons, Spring is here and we can expect to feel the climactic difference on at least most days relatively soon.
The Spring season corresponds with the wood element, which corresponds with the emotion of anger or frustration, which corresponds with our liver and gallbladder meridians, which might incite symptoms such as temporal headaches, rib-side pain or cramping, dryness in the chest or throat (I lost my voice this past week for the first time in probably a decade!), cold feet in spite of a warm body, the shingles virus, lack of appetite for breakfast, or exaggerated PMS symptoms for women.
The seasonal increase in our liver and gallbladder qi, respectively, makes us more prone to anger and irritability, which can make us more prone to any of these symptoms, which of course creates a vicious cycle—especially for those of us considered “wood element constitutions,” such as myself. “Wood people” tend to be active and potentially temperamental, with a wiry, sinewy build like, well… wood.
Interestingly one of the most common pulse qualities Chinese Medicine recognizes is the “wiry pulse,” because it feels like a taut wife beneath the pads of the finger. When we feel this we often assume that the liver or gallbladder channels are implicated in the etiology of disease.
The best ways to mitigate these “side effects of Spring” are through a healthy amount of exercise—enough to circulate the liver qi without over-sweating and drying out the stomach—and mostly warm foods that are easy to digest. In Classical Medicine liver and gallbladder pathologies are a result of the stomach being completely dried out of healthy fluids, then sending pathogenic heat/inflammation upwards (see aforementioned loss of voice). The one exception to the warm rule these next few months would be in the form of sauerkraut, vinegars, and pickled foods, which along with mildly spicy foods are said to course the liver qi.
As for my own apparent stress variable, (my wife and) I will be moving next week to live in a suburb for the first time in 27 years! Excitement, along with fear and anxiety are likely more prominent within me than anger or frustration, but as a “wood-type person” navigating this seasonal wood transition, it stands to reason that for me such symptoms would arise.
We bought a home in the “coolest,” most culturally diverse suburb still with a good school system that we could find, in South Orange, NJ. One of my favorite mentors’ tai chi school is a 10-minute drive away and we have a 5-minute walk from our house to the NJ Transit stop, which is 40 minutes direct to Penn Station, which is then a 15-minute walk to my office. Not bad! Also, the previous owner happened to be a famous Buddhist monk who founded the Tibet Center on the lower east side. Many cool check-offs on this resume, however I’ve always been a “New York or Nowhere” person, so the great unknown, coupled with all the stressors of renovations and moving with a toddler surely went straight to my throat. Wish us luck!