Heart yáng vacuity

Also devitalized heart yáng (心阳不振 xīn yáng bú zhèn).

A disease pattern chiefly characterized by heart palpitation or fearful throbbing; stifling oppression in the heart and chest; vacuity cold signs.

Description: Heart palpitation or fearful throbbing; stifling oppression and pain in the heart and chest; shortness of breath; spontaneous sweating; fear of cold and cold limbs; lassitude of spirit and lack of strength; bright-white facial complexion or green-blue or purple face and lips; glossy white tongue fur; a pulse that is weak and bound or intermittent.

Pathogenesis: Heart yáng vacuity arises as a further development of heart qì vacuity when devitalized heart yáng leads to stagnation of the heart vessels.

Analysis of signs

• Inhibition of yáng qì in the heart and the chest: Heart palpitation or fearful throbbing, stifling oppression and possibly pain in the chest, and panting.
• Vacuity cold: Fear of cold and cold limbs.
• Yáng qì failing to move the blood: Bright-white or dull green-blue facial complexion with dull purple lips.
• Tongue: Pale and enlarged with glossy white fur.
• Pulse: Weak and bound or intermittent.

Diseases: Heart palpitation; fearful throbbing; vacuity taxation; chest impediment.

Treatment

Medicinal therapy: Warm and supplement heart yáng. Use Origin-Preserving Decoction (保元汤 bǎo yuán tāng) or Cinnamon Twig, Licorice, Dragon Bone, and Oyster Shell Decoction (桂枝甘草龙骨牡蛎汤 guì zhī gān cǎo lóng gǔ mǔ lì tāng).

Acumoxatherapy: Base treatment mainly on back transport points, HT, and CV. Select BL-15 (Heart Transport, 心俞 xīn shù), CV-14 (Great Tower Gate, 巨阙 jù què), CV-17 (Chest Center, 膻中 shān zhōng), CV-4 (Pass Head, 关元 guān yuán), CV-6 (Sea of Qì, 气海 qì hǎi), GV-4 (Life Gate, 命门 mìng mén), PC-6 (Inner Pass, 内关 nèi guān), and HT-7 (Spirit Gate, 神门 shén mén), needle with supplementation and moxa. For blood stasis signs, add BL-17 (Diaphragm Transport, 膈俞 gé shù), SP-10 (Sea of Blood, 血海 xuè hǎi), LR-3 (Supreme Surge, 太冲 tài chōng), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo); needle with even supplementation and drainage.

Comparison: Heart qì vacuity: Heart yáng vacuity is similar to heart qì vacuity. Both share heart palpitation or fearful throbbing, oppression in the chest and shortness of breath exacerbated by exertion, and lassitude of spirit and lack of strength. Either may be associated with heart pain. Heart yáng vacuity is associated with cold signs such as fear of cold and cold limbs, which are not observed in heart qì vacuity. Furthermore, because heart yáng vacuity is more severe than heart qì vacuity, the propelling action of qì is weaker, and blood stasis signs are more pronounced. Thus, the heart palpitation, fearful throbbing, oppression in the chest, shortness of breath, and heart pain are more marked. The dark stagnant complexion and pale green-blue tongue are not observed in qì vacuity.

Fulminant desertion of heart yáng: Heart yáng qì vacuity must also be distinguished from fulminant desertion of heart yáng. Heart yáng qì vacuity is a chronic condition of heart palpitation or fearful throbbing, oppression in the chest, shortness of breath, aversion to cold, and cold limbs. Fulminant desertion of heart yáng is a critical development of heart yáng vacuity, characterized by a somber-white complexion, dripping cold sweat, reversal cold of the limbs, a faint pulse on the verge of expiration, and, in severe cases, coma.

Dual vacuity of heart yīn and yáng shares the cold signs of heart yáng vacuity and is further marked by yīn vacuity signs such as emaciation, heart vexation, tidal heat, night sweating, dry throat lacking liquid, heat effusion and spontaneous sweating at the slightest exertion, peeling tongue fur, and faint fine rapid pulse.

Combined pattern: Heart-kidney yáng vacuity, characterized by heart palpitation or fearful throbbing, puffy swelling and scant urine, with vacuity cold signs. In many cases, heart yáng vacuity is attributable to kidney yáng vacuity (disease of the kidney affecting the heart).

Comparison: Heart yáng vacuity differs from heart qì vacuity by the greater severity of signs and the presence of cold signs.

Further developments

• Vacuity desertion of heart yáng: Heart palpitation, stifling oppression in the heart and chest, cold sweating, reversal cold of the limbs, and a faint pulse.
• Heart vessel obstruction: Heart palpitation, stifling oppression in the heart and chest, and blood stasis signs.