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Kidney failing to absorb qì
肾不纳气 〔腎不納氣〕shèn bù nà qì
Also:
- Lung-kidney qì vacuity (肺肾气虚 fèi shèn qì xū). This name is preferred by some because it is invariably a combined pattern.
- Vacuous kidney failing to absorb qì (肾虚不纳气 shèn xū bù nà qì).
A disease pattern chiefly characterized by panting with exhalation greater than inhalation, exacerbated by exertion; limp aching lumbus and knees; signs of insufficiency of yáng qì.
Description: Incessant panting with exhalation more pronounced than inhalation and with discontinuity between breaths, exacerbated by physical exertion; spontaneous sweating; lassitude of spirit; a low timid voice; limp aching lumbus and knees; in some cases, involuntary loss of urine on coughing; pale, sometimes purplish tongue with white fur; a pulse that is sunken and weak. When panting is severe, there may be cold dripping sweating, cold limbs and a green-blue face, and a pulse that is floating, large, and without root (not detectable at the deep level). Detriment to yáng affecting yīn may cause the pattern to take on yīn vacuity signs, such as hasty breathing with short breaths, reddening of the cheeks, heart vexation, vexing heat in the five hearts, dry pharynx and mouth, a tongue that is red with little or no fur, and a pulse that is fine and rapid.
Diseases: Panting; wheezing.
Biomedical correspondence: chronic cardiopulumonary failure.
See supplementing the kidney to promote qì absorption for treatment.
Pathogenesis: Insufficiency of kidney qì impairing qì absorption. The lung is the governor of qì and controls breathing, while the kidney is the root of qì and governs absorption of qì. Lung-kidney qì vacuity is a condition in which the lung’s function of depurative downbearing and the kidney’s function of absorbing qì are compromised. This results from any of the following factors:
- damage to lung qì by enduring cough and panting that eventually affects the kidney;
- taxation damage or weak health in advancing years causing depletion of kidney qì;
- constitutional insufficiency of original qì.
Analysis of signs
- Insufficiency of depurative downbearing and qì absorption: Cough and panting marked by exhalation more pronounced than inhalation. The lung’s depurative downbearing action and the kidney’s qì absorption function are jointly responsible for drawing air into the lungs. Whey they are impaired, the patient has difficulty drawing in air, but less difficulty expelling it. This pathomechanism is often described as
(气不归元 qì bù guī yuán).qì failing to home to its origin - Kidney vacuity: Limp aching lumbus and knees; tinnitus.
- Qì vacuity: Low timid voice; spontaneous sweating; lassitude of spirit and lack of strength; in some cases, involuntary loss of urine on coughing.
- Tongue: Pale with white fur.
- Pulse: Weak.
- Yáng vacuity on the verge of desertion: When kidney yáng weakens to the point of deserting, panting becomes more severe and is accompanied by dripping cold sweat, cold limbs, and green-blue face, and a pulse that is floating, large, and without root.
- Detriment to yáng affecting yīn may cause the pattern to take on yīn vacuity signs, such as hasty breathing with short breaths, reddening of the cheeks, heart vexation, vexing heat in the five hearts, dry pharynx and mouth, a tongue that is red with little or no fur, and a pulse that is fine and rapid. Note that yīn vacuity signs are inner-body signs, while most of the yáng vacuity signs are outer-body signs.
Treatment
Medicinal therapy: Supplement the kidney and promote qì absorption using Ginseng and Walnut Decoction (人参胡桃汤 rén shēn hú táo tāng).
Acumoxatherapy: Supplement and moxa