Heart qì vacuity

A disease pattern chiefly characterized by heart palpitation; lassitude of spirit; and qì vacuity signs.

Description: Heart palpitation; oppression in the chest; shortness of breath; physical fatigue and lassitude of spirit; spontaneous sweating; exacerbation of signs by fatigue or exertion; pale-white facial complexion; pale tongue; vacuous pulse.

Biomedical correspondence: cardiac failure, angina pectoris, arrhythmia, general asthenia, and neurosis.

Pathogenesis: Insufficiency of heart qì that reduces its driving power. This results from:

• constitutional weakness;
• enduring illness;
• decline of visceral qì in advancing years.

Analysis of signs

• Heart and chest: Heart palpitation due to qì laboring to move the blood; oppression in the chest resulting from reduced movement of qì; shortness of breath due to qì weakening lung function. All these signs are exacerbated by physical exertion or fatigue.
• General qì vacuity: Physical fatigue and lassitude of spirit; spontaneous sweating attributable to impairment of qì’s retentive function.
• Complexion: A pale-white facial complexion results when qì lacks strength to move the blood and enable it to nourish the body.
• Tongue: Tender-soft, reflecting qì vacuity.
• Pulse: Vacuous pulse, reflecting qì vacuity.

Diseases: Heart palpitation; fearful throbbing; vacuity taxation (any extreme vacuity pattern).

Treatment

Medicinal therapy: Heart qì vacuity is treated by supplementing heart qì with medicinals such as mix-fried licorice (mix-fried Glycyrrhizae Radix, 炙甘草 zhì gān cǎo), astragalus (Astragali Radix, 黄芪 huáng qí), codonopsis (Codonopsis Radix, 党参 dǎng shēn), and ginseng (Ginseng Radix, 人参 rén shēn). Appropriate formulas include Honey-Fried Licorice Decoction (炙甘草汤 zhì gān cǎo tāng) and Heart-Nourishing Decoction (养心汤 yǎng xīn tāng).

Acumoxatherapy: Base treatment mainly on HT, back transport points, and CV. Select BL-15 (Heart Transport, 心俞 xīn shù), CV-14 (Great Tower Gate, 巨阙 jù què), HT-7 (Spirit Gate, 神门 shén mén), 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), and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ); needle with supplementation and add moxa.

Combined pattern: Heart-lung qì vacuity, marked by heart palpitation, cough, panting, oppression in the chest, and shortness of breath, with qì vacuity signs. Heart qì and lung qì both rely on the power of ancestral qì to perform their functions; hence they often become insufficient together. Heart qì vacuity may also present with cold-damp, damp turbidity, and static blood complications.

Further developments: Heart qì vacuity can easily develop into heart yáng vacuity, and in extreme cases into fulminant desertion of heart yáng.