Lung-kidney yīn vacuity

A disease pattern chiefly characterized by dry cough with scant phlegm; hoarse voice; seminal emission; menstrual irregularities; vacuity heat signs.

Description: Cough with scant phlegm possibly streaked with blood; in some cases, hoarse voice; limp aching lumbus and knees; emaciation; dry mouth and pharynx; steaming bone tidal heat; night sweating; reddening of the cheeks; seminal emission; scant menstruation or in severe cases flooding and spotting; red tongue with little fur; a pulse that is fine and rapid.

Diseases: Cough; panting, loss of voice; vacuity taxation; dispersion-thirst.

Pathogenesis: Insufficiency of yīn qì in both the lung and kidney giving rise to internal heat.

Kidney yīn is the root of the yīn qì of the whole body. It nurtures the yīn of the other viscera and is also dependent upon nourishment from them. The lung has a special mutually beneficial relationship with the kidney, which is often described as metal and water engendering each other. Lung-kidney yīn vacuity usually arises in one of two ways:

• Lung disease affecting the kidney: Enduring cough damaging lung yīn and creating lung disease that then affects the kidney.
• Kidney disease affecting the lung: Enduring illness or vacuity taxation causing damage to kidney yīn and creating kidney disease that then affects the lung.

Analysis of signs

• Insufficiency of lung yīn affecting depurative downbearing in the lung: Dry cough with scant sticky phlegm or no phlegm; hoarse voice.
• Vacuity heat damaging the network vessels in the lung: Expectorated phlegm flecked with blood.
• Insufficiency of kidney yīn: Limp aching lumbus and knees; emaciation.
• Lack of fullness in the thoroughfare (chōng) and controlling (rèn) vessels: Scant menstruation or amenorrhea.
• Vacuity heat: Tidal heat effusion and vexing heat in the five hearts; night sweating.
• Severe vacuity heat: When vacuity heat is severe, it can harass the essence chamber, causing seminal emission. In women, it can lead to frenetic movement of hot blood that manifests in flooding and spotting.
• Tongue: Red with little or no fur.
• Pulse: Fine and rapid, reflecting yīn vacuity and vacuity heat respectively.

Treatment

Medicinal therapy: Enrich and nourish the lung and kidney. Use Lily Bulb Metal-Securing Decoction (百合固金汤 bǎi hé gù jīn tāng).

Acumoxatherapy: For lung-kidney yīn vacuity, base treatment mainly on back transport points, LU, and KI. Select BL-13 (Lung Transport, 肺俞 fèi shù), BL-23 (Kidney Transport, 肾俞 shèn shù), BL-43 (Gāo-Huāng Transport, 膏肓俞 gāo huāng shù), LU-5 (Cubit Marsh, 尺泽 chǐ zé), KI-3 (Great Ravine, 太溪 tài xī), and KI-6 (Shining Sea, 照海 zhào hǎi); needle with supplementation. See lung yīn vacuity; kidney yīn vacuity; kidney vacuity; dual vacuity of the lung and kidney.