Depressive heat and vacuous (def) heat

The answer has to do with life-gate/ministerial fire. This is the source for both depressive heat and vacuity heat. In both cases (yu re and xu re), we are talking about the manifestations of life-gate/ministerial fire. Because of the very close relationship between the life-gate/ministerial fire and the liver, depressive heat is sometimes even called ministerial fire. However, it is this same life-gate/ministerial fire that is the source of kidney yang, and it is the flaring of kidney yang due to lack of control by kidney yin which results in vacuity heat. Depressive heat is, by definition, a species of replete heat (shi re), and, in Chinese medicine, a single entity cannot be both vacuous (xu) and replete (shi) at the same time. While depressive heat may damage yin and lead to vacuity heat, when this balance is tipped, the heat goes from replete to vacuity. Thus, one cannot have depressive heat and vacuity heat (meaning kidney vacuity/vacuity heat) at the same time.

That being said, you can have depressive heat damaging stomach yin leading to a fluid dryness of the stomach. In that case, you have depressive liver heat and stomach yin vacuity. However, the heat is not vacuity heat, it is depressive heat. We don't call stomach yin vacuity vacuity heat. Once again (for the umteenth time), this goes back to how Chinese use their own language when working within Chinese medicine. This problem concerning depressive and vacuity heat is another example of confusion based on not understanding this medicine in its original source language. Fuzzy language leads to fuzzy thinking.

Bob Flaws
Blue Poppy