Ryan_Gallagher: March 11, 2020, 6:49pm
I realized I was getting sloppy diagnosing “internal dryness,” so I made a list of markers I can use. Here’s what I’ve
been using:
thinness
tense/hard rectus abdominis
tense/hard or withered tissues throughout the body
dry/cracked tongue
dry/hard stool
dry cough
possibly thirst and/or dry mouth/throat (although this could also be external dryness)
possibly nasal dryness (although this could also be external dryness)
possibly hunger (although, as I understand it, this could also be an expression of abundant Spleen, especially if
it’s a craving for sweets)
possibly watery diarrhea in very dry, skinny patients
possibly vaginal dryness (although this could also be external dryness)
possibly hot flashes
possibly urinary issues
possibly pain (if there’s dryness + stagnation)
possibly thin or rough/choppy or tense/tight/wiry pulses
possibly vexation
Correct me if I’m wrong, but in the case of internal dryness, our primary options are to supplement SP, LU, or BL.
Secondary might include SI (especially if dryness is leading to stagnation, or vice versa) and possibly LR (although
you’d certainly need to have other SJ-excess findings).
Am I missing any good indicators of internal dryness?
KristinWisgirda: March 11, 2020, 7:50pm
Hi Ryan,
Great idea to brainstorm on internal dryness! I’m sure it will help you see it better in clinic.
A couple of refinements:
The liver quality is only very, very slightly moistening. Toby conjures the Hoh rainforest when he talks of the
Liver, so it is easy to think wet, but really it is dense and dark. SJ is only very, very slightly drying, in contrast.
With the tongue, dryness isn’t an indicator of internal dryness. It just shows dryness in the mouth- which could be
external. I treated a tightly wound patient with Liver+ and her dry mouth filled with fluid when she was on the
table. So for her the local dryness was more a function of tension and not part of a dry exterior/interior.15/01/2024, 16:51Diagnosing internal dryness? – Qiological Community
https://forum.qiological.com/t/diagnosing-internal-dryness/947/print2/2
A deeply fissured tongue indicates dryness that will benefit from Taiyang water. This is the way Toby taught it- not
saying interior or exterior. My experience is that patients with this type of tongue also benefit from Sp+.
Both SI and Kidney are a mix of fire and water and so could be considered when there is dryness.
Toby first thinks of the vagina as external but holds that it could possibly be internal.
Just a reminder that pulse doesn’t have clinical weight unless it is rapid.
I wouldn’t include hunger because it could be so many things. A patient just reported that St+ really reduced her
excessive appetite. Her bloating was creating disordered eating.
While the dividing line of exterior/interior is oh so blurry- the nose is often considered more exterior.
Many of your “possibles” could be so many other things. I wouldn’t include them on my list but if you can separate
them as secondary outcomes to a dry interior and it helps you to have them there, so be it.
My preference is to pare things down to the essential to reduce clutter.
There is more of a discussion here: Degrees of heat and moisture