Greater yīn (tài yīn) disease

Greater yīn (tài yīn) disease is characterized by abdominal fullness with periodic pain, vomiting, diarrhea, nonmovement of ingested food, absence of thirst, and a weak, moderate pulse. The pathomechanism of greater yīn (tài yīn) disease is failure of movement and transformation of the food, resulting from devitalization of spleen yáng, and manifesting as vomiting and diarrhea. The abdominal distension is explained by spleen vacuity qì stagnation, whereas the abdominal pain results from vacuity cold. Although it rarely occurs naturally in the progression of externally contracted febrile diseases, it may arise when incorrect treatment of yáng diseases, such as inappropriate precipitation in greater yáng (tài yáng) and lesser yáng (shào yáng) disease, or excessive use of cold and cool freeing precipitants in yáng brightness (yáng míng) disease, damages spleen yáng. It may also occur when, owing to a regular spleen qì vacuity, cold evil enters the greater yīn (tài yīn) directly. This is known as a direct strike on greater yīn (tài yīn). Like the yáng brightness (yáng míng) bowel pattern, greater yīn (tài yīn) disease is a digestive tract disease, but presents as vacuity rather than as repletion. It is characterized by vomiting, diarrhea, absence of thirst, vacuity fullness and pain, and a weak, moderate pulse, whereas yáng brightness (yáng míng) bowel patterns are identified by the presence of constipation, thirst, great repletion and fullness, and a sunken replete pulse. It is said that Greater yīn (tài yīn) disease is associated with vacuity, and yáng brightness (yáng míng) disease is associated with repletion.

Medicinal therapy: Since greater yīn (tài yīn) disease is attributable to damage to spleen yáng by cold, it is treated by warming the center and dispersing cold, and by restoring the correct and fortifying the spleen. The principal formula is Center-Rectifying Pill (理中丸 lǐ zhōng wán). Where interior cold is pronounced, Aconite Center-Rectifying Decoction (附子理中汤 fù zǐ lǐ zhōng tāng) is used, which is the same formula with the addition of aconite (Aconiti Radix Lateralis Praeparata, 附子 fù zǐ).