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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:

Analysis of signs

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 Lily Bulb Metal-Securing Decoction (百合固金汤 bǎi hé gù jīn tāng).

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 BL-13 (Lung Transport, 肺俞 fèi shù), BL-43 (Gāo-Huāng Transport, 膏肓俞 gāo huāng shù), LU-5 (Cubit Marsh, 尺泽 chǐ zé), and KI-6 (Shining Sea, 照海 zhào hǎi); needle with supplementation. For lung-kidney yīn vacuity, add BL-23 (Kidney Transport, 肾俞 shèn shù), KI-3 (Great Ravine, 太溪 tài xī), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo).

Combined pattern: Lung-kidney yīn vacuity, characterized by dry cough with scant phlegm, hoarse voice, seminal emission, and menstrual irregularities, and vacuity heat signs. Lung yīn vacuity and kidney yīn vacuity are mutually conducive.

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.

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