Lesser yīn (shào yīn) disease

Disease of the foot lesser yīn (shào yīn) kidney channel and the hand lesser yīn (shào yīn) heart channel. Lesser yīn (shào yīn) disease arises when the heart and kidney are vacuous, and there is a marked drop in resistance to disease. It takes two different forms, vacuity cold and vacuity heat.

Patterns

Vacuity cold (虚寒 vacuity cold): Cold evil damages yáng qì, and the main form is a vacuity cold pattern that manifests as aversion to cold, curled-up lying posture, hypersomnia, reversal cold of the limbs, and faint fine pulse. Clear-grain diarrhea may occur in some cases. Generally, there is no heat effusion, and, in severe cases, the limbs may suffer a drop in temperature, indicated yáng collapse vacuity desertion. In On Cold Damage (伤寒论 shāng hán lùn), the section on lesser yīn (shào yīn) disease is headed with the statement, The patient has a faint fine pulse, and desires only to sleep. A faint fine pulse indicates vacuity of qì and blood, and desire only for sleep indicates debilitation of the spirit. These are both signs of general vacuity. Wherever a faint fine pulse occurs, whether in disease of recent onset or enduring disease, thought should be given to the possibility of lesser yīn (shào yīn) disease. Absence of heat effusion, aversion to cold, curled-up lying posture, and reversal cold of the limbs occurring with such a pulse indicate the presence of exuberant internal cold and the inability of debilitated yáng to warm and nourish the skin and muscle and fully permeate the limbs, thereby confirming the presence of lesser yīn (shào yīn) disease. Clear-grain diarrhea is explained by kidney vacuity affecting the spleen (spleen-kidney yáng vacuity), causing failure to move and transform food. Great sweating, reversal cold in the limbs, and a faint pulse verging on expiration indicate fulminant desertion of yáng qì.

Medicinal therapy: This type of lesser yīn (shào yīn) disease pattern is treated by the method of returning yáng and stemming counterflow, and the main formula is Counterflow Cold Decoction (四逆汤 sì nì tāng), which can be varied to suit different patterns. Where vacuity is predominant, ginseng (Ginseng Radix, 人参 rén shēn) may be added; where cold is predominant, dried ginger (Zingiberis Rhizoma, 干姜 gān jiāng) can be increased in quantity. Where exuberant yīn repels yáng, pig’s bile may be added. Patterns that include signs of water qì may be treated with True Warrior Decoction (真武汤 zhēn wǔ tāng), a standard variant of Counterflow Cold Decoction.

Vacuity heat (虚热 xū rè): Rarely, a transmuted lesser yīn (shào yīn) pattern of vacuity heat may be observed. Insufficiency of kidney yīn and heart fire flaming upward causes signs such as heart vexation, insomnia, and dry pharynx and mouth. On Cold Damage (伤寒论 shāng hán lùn) provides little detail concerning this second pattern, although clinical observation shows that a red or crimson tongue, and a rapid pulse that is either fine or vacuous are determining signs.

Medicinal therapy: This form of lesser yīn (shào yīn) disease is treated by enriching yīn and clearing heat, the main formula being Coptis and Ass Hide Glue Decoction (黄连阿胶汤 huáng lián ē jiāo tāng).