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Lung yīn vacuity
肺阴虚 〔肺陰虛〕fèi yīn xū
A disease pattern chiefly characterized by dry cough with scant sticky phlegm or no phlegm; yīn vacuity signs (tidal heat, night sweating).
Description: Dry cough with no phlegm or scant sticky phlegm that is difficult to expectorate, in some cases streaked with blood; hoarse voice; dry mouth and pharynx; emaciation; slight heat effusion; postmeridian tidal heat effusion; vexing heat in the five hearts; tidal reddening of the cheeks; night sweating; red tongue with little fur and liquid; a pulse that is fine and rapid.
Diseases: Cough; pulmonary consumption; pulmonary wilting.
Biomedical correspondence: Seen in pulmonary tuberculosis.
Pathogenesis: Depletion of lung yīn giving rise to vacuity fire that impairs depurative downbearing. Any of the following factors may be involved:
- damage to yīn attributable to enduring cough;
- pulmonary consumption (Mycobacterium tuberculosis);
- damage to liquid in the advanced stages of warm-heat disease;
- smoking; alcohol consumption; habitual consumption of hot spicy drying foods.
Analysis of signs
- Cough: Dry cough with no phlegm or scant sticky phlegm that is difficult to expectorate.
- Yīn vacuity: Emaciation; hoarse voice.
- Vacuity heat: Slight heat effusion, postmeridian tidal heat, vexing heat in the five hearts, night sweating, and tidal reddening of the cheeks.
- Yīn vacuity with effulgent fire: Phlegm streaked with blood.
- Tongue: Red or crimson with little liquid, reflecting heat and insufficiency of fluids.
- Pulse: Fine and rapid, reflecting insufficiency of yīn humor and the resulting heat.
Note: When vacuity heat or fire signs are not pronounced, the pattern is sometimes referred to as yīn vacuity and lung dryness.
Treatment
Medicinal therapy: Moisten the lung and relieve cough; enrich yīn and downbear fire. Use
Comparison: Heart yīn vacuity: Lung yīn vacuity and heart yīn vacuity share manifestations of yīn vacuity with effulgent fire such as dry mouth, scant urine, absence of sweating, dry stool, tidal heat, and night sweating. Lung yīn vacuity is marked by cough with scant phlegm that may be flecked with blood, while heart yīn vacuity is characterized by heart palpitation and insomnia. Dryness evil invading the lung: Lung yīn vacuity is like dryness evil invading the lung in that both are characterized by lung dryness signs such as dry cough, dry skin, and dry mouth. However, lung yīn vacuity develops slowly and includes signs of yīn vacuity with effulgent fire, such as tidal heat and night sweating. Dryness evil invading the lung is of rapid onset and is marked by the absence of yīn vacuity with effulgent fire signs.
Acumoxatherapy: Base treatment mainly on back transport points, LU, and KI. Select
Combined pattern:
Clinical sketch: A 37-year-old male, brought into the clinic by his brother, complained of a worsening cough for two years with recent expectoration of blood. Inspection revealed emaciation, reddening of the cheeks, and a red tongue. During inquiry, he stated that he was unemployed, had never been able to get his life together, and lived on social welfare in poor living conditions with inadequate heating in the cold, damp winter climate of his homeland. He confessed that he was given to excesses of alcohol and hashish. He complained of feelings of heat, especially in the latter part of the day. Palpation found a fine rapid pulse and heat in the palms. He was diagnosed as suffering from pulmonary consumption forming a classical pattern of lung yīn vacuity with yīn vacuity with effulgent fire. He was subsequently biomedically diagnosed in the local general hospital as suffering from pulmonary tuberculosis.