The concept of 'consumptive disease' in Donguibogam shares very similar points with the 'chronic stress response' and 'hypothalamic-pituitary-adrenal axis dysfunction' discussed in modern medicine. When our body undergoes stress, it activates this hypothalamic-pituitary-adrenal axis running from the hypothalamus to the pituitary gland and adrenal gland, secreting a stress hormone called 'cortisol.' This cortisol plays an important role in raising energy and regulating inflammation during crisis situations.
The problem is that modern individuals are constantly exposed to chronic stress. Work stress, interpersonal relationships, sleep deprivation, irregular meals, and various other factors excessively stimulate our body's hypothalamic-pituitary-adrenal axis. At first, the adrenal gland diligently pumps out cortisol to respond to stress, but as this situation becomes prolonged, the function of the adrenal gland begins to lose balance, much like an engine worn out from overwork. Although commonly called 'adrenal fatigue,' strictly speaking, it is not that the adrenal gland itself becomes fatigued, but that an abnormality arises in the regulatory function of the hypothalamic-pituitary-adrenal axis, disrupting the balance of hormone secretion.
This hypothalamic-pituitary-adrenal axis dysregulation manifests through various symptoms. First, morning fatigue and lethargy are typical symptoms. A healthy person has their highest cortisol levels in the morning to start the day vigorously, but when the hypothalamic-pituitary-adrenal axis is dysregulated, cortisol levels are high at night, preventing sleep, and paradoxically drop in the morning, making it difficult to wake up. A state of being dazed and lacking motivation continues.
Second, vulnerability to stress also increases. Easily feeling overwhelmed by minor stresses that used to be handled well, along with anxiety, irritability, and depressive feelings setting in easily, is deeply related to the imbalance of neurotransmitters, including cortisol.
Third, cravings for sweet and salty food are related to 'aldosterone,' another hormone produced by the adrenal gland. Aldosterone regulates blood pressure and electrolyte balance, but when adrenal function weakens, the secretion of this hormone is also affected, making the body prone to salt loss. At this time, our body instinctively craves salt. In addition, unstable blood glucose control drives the pursuit of simple carbohydrates such as sugar for rapid energy replenishment.
Fourth, orthostatic hypotension is a symptom where blood pressure fails to rise sufficiently when suddenly standing up from lying down in the morning, causing vision to spin or a feeling of dizziness. This is also one of the common symptoms that can appear as blood pressure regulation deteriorates due to HPA axis dysfunction. It can be seen as a phenomenon closely connected with our body's autonomic nervous system.
Ultimately, 'consumptive disease due to depletion of vital qi' described in Donguibogam can be viewed in modern medicine as 'functional dysregulation of the endocrine system, particularly the hypothalamic-pituitary-adrenal axis, caused by chronic stress.' This can be considered a serious condition that may lead to systemic energy depletion, decreased immunity, and emotional instability.
