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Qì vacuity
气虚 〔氣虛〕qì xū
Also original qì vacuity. A disease pattern chiefly characterized by fatigue and lack of strength; shortness of breath and weak breathing; low voice and laziness to speak.
Description: Scantness of breath and laziness to speak; fatigue and lack of strength; dizziness; spontaneous sweating; susceptibility to common cold; exacerbation of signs by exertion and fatigue; pale tender-soft tongue; and a pulse that is fine, weak, and forceless. Many different signs are associated with specific forms.
Pathogenesis: Qì failing to perform its functions (movement, containment, qì transformation, warming, defense, and nourishment). The main signs are fatigue, lack of strength, and reduced visceral function. Qì vacuity is attributable to any of several causes:
- earlier-heaven constitutional insufficiency;
- poor late-heaven nourishment;
- insufficient production of qì developing from functional disorders of the lung, spleen, or kidney;
- taxation damage (including excesses of inactivity as well as excesses of activity) or enduring illness (
prolonged lying damages qì
); - general decline in advancing age, that is, as a result of illnesses, injuries, lack of exercise due to increased immobility, and the natural decline of essential qì.
Types of patient: Qì vacuity is typically seen in patients suffering from chronic illnesses or recovering from illness, in the elderly, and in the undernourished.
Qì vacuity is essentially lung qì and spleen qì vacuity: Qì is responsible for the activity of all the bowels and viscera and other parts of the body. Insufficiency of qì can affect any function of the body. Nevertheless, general qì vacuity essentially means qì of the lung and/or spleen. The lung governs the qì of the whole body. The spleen is the root of later heaven and the source of qì and blood production. Scantness of breath, laziness to speak, and susceptibility to common cold (defense qì which fends off invading evils is closely related to lung qì) are lung signs. Fatigue and lack of strength is a spleen sign.
Kidney essence also plays a role in the production of qì and blood, and qì vacuity patterns notably include insecurity of kidney qì. Qì vacuity patterns also include heart qì vacuity. Nevertheless, qì vacuity is most prominently associated with the lung and the spleen because lung and spleen signs are invariably present.
Qì and yáng: Qì belongs to yáng. Qì vacuity is marked by a breakdown of its functions, which include warming as well as movement, retention, qì transformation, defense, and nourishment. In practice, however, qì vacuity denotes the failure of qì to perform functions other than warming. Yáng vacuity includes qì vacuity and differs only by also being characterized by loss of the warming function. In other words, yáng vacuity patterns always include cold signs, in addition to signs of qì vacuity.
Analysis of signs: Signs vary depending on which bowels and viscera are affected.
- Decline in bowel and visceral functions: Fatigue and lack of strength, scantness of qì or shortness of breath; faint low voice; laziness to speak. These signs are all exacerbated when the patient is tired from overworking.
- Yáng qì failing to bear upward: Dizzy head and vision.
- Insecurity of defense qì: Spontaneous sweating; susceptibility to common cold.
- Lung: Shortness of breath, cough, and a faint low voice.
- Spleen and stomach: Poor appetite, sloppy stool. When the spleen fails to control the blood, there is bleeding.
- Kidney: When the kidney’s retentive function is impaired (insecurity of kidney qì), there may be enuresis (bed-wetting) or urinary incontinence; seminal emission or seminal efflux; vaginal discharge, persistent dribbling menstruation, and a tendency toward miscarriage.
- Facial complexion: White.
- Tongue: Pale with white fur.
- Pulse: Vacuous.
Specific forms: Qì fall (spleen vacuity qì fall); qì desertion; lung qì vacuity; spleen qì vacuity; heart qì vacuity; spleen failing to control the blood; insecurity of kidney qì.
Further developments: Qì produces, propels, and retains both blood and fluids. Qì vacuity can give rise to many disease patterns of the blood and of the fluids. In this connection, spleen qì is of key importance because the spleen, by the power of its qì, produces both qì and blood, controls the blood (prevents it from extravasating), and moves and transforms the fluids. Since qì belongs to yáng, qì vacuity can also develop into yáng vacuity.
- Blood vacuity, developing when in qì vacuity the spleen fails to produce qì and blood.
- Bleeding, which develops when spleen qì vacuity takes the form of spleen failing to control the blood.
- Blood stagnation (mild blood stasis) or blood stasis, arising when qì is vacuous and fails to move the blood.
- Phlegm-rheum or water swelling can arise when the spleen fails to move and transform water-damp.
- Yáng vacuity arising as a development of qì vacuity, such as spleen qì vacuity becoming spleen yáng vacuity.
Treatment
Medicinal therapy: Qì vacuity is treated according to the principle that vacuity is treated by supplementation. Qì-supplementing medicinals include codonopsis (Codonopsis Radix,
Acumoxatherapy: Select
NB: Lung vacuity. Qì vacuity is lung vacuity.
The lung governs qì, and lung qì is engendered by spleen-earth; hence qì vacuity principally denotes spleen-lung qì vacuity.
See
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