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Insufficiency of both heart yīn and heart yáng. The chief signs are heart palpitation and fearful throbbing, oppression in the chest and shortness of breath exacerbated by exertion, physical cold and cold limbs, heart vexation, and heat in the hearts of the palms and soles. Other signs include emaciation, scantness of breath and laziness to speak, fatigue and lack of strength, dizziness, spontaneous or night sweating, and sweating at the slightest exertion. In some cases, there may be postmeridian tidal heat, reddening of the cheeks, sleeplessness, or forgetfulness. The tongue is pale and peeled. The pulse is skipping or intermittent, or faint, fine, and rapid.

Analysis: A chief sign of all heart patterns is heart palpitation. Heart yáng vacuity is a development of heart qì vacuity. When heart qì is insufficient, there is shortness of breath exacerbated by exertion, and fatigue and lack of strength. When yáng is vacuous, the body is deprived of warmth and the fleshy exterior becomes insecure and unsound, hence the physical cold and cold limbs and spontaneous sweating. When yīn is vacuous, vacuity heat arises internally, hence the heat in the hearts of the palms and soles, tidal heat, night sweating, and reddening of the cheeks. When vacuity fire harasses the heart and disquiets the heart spirit, there is heart vexation and sleeplessness. Insufficiency of heart yīn deprives the brain of nourishment, hence the dizziness and forgetfulness. When heart yīn and yáng are both debilitated and fail to warm and nourish, there is fatigue and lack of strength, scantness of breath and laziness to speak, and emaciation. The tongue and pulses also reflect both the heart yīn and heart yáng vacuity.

Medicinal therapy: Enrich yīn and warm yáng; nourish the heart and quiet the spirit. Use Honey-Fried Licorice Decoction (炙甘草汤 zhì gān cǎo tāng).

Acumoxatherapy: Base treatment mainly on back transport points, HT, PC, and CV. Select BL-15 (Heart Transport, 心俞 xīn shù), CV-14 (Great Tower Gate, 巨阙 jù què), CV-4 (Pass Head, 关元 guān yuán), CV-6 (Sea of Qì, 气海 qì hǎi), BL-20 (Spleen Transport, 脾俞 pí shù), PC-6 (Inner Pass, 内关 nèi guān), HT-7 (Spirit Gate, 神门 shén mén), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo); needle with supplementation and large amounts of moxa.

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