Spleen yáng vacuity

Also:

• Devitalized spleen yáng (脾阳不振 pí yáng bù zhèn)
• Spleen vacuity cold (脾虚寒 pí xū hán)

A disease pattern chiefly characterized by continual cold pain in the stomach duct and abdomen that likes warmth; fear of cold and cold limbs; spleen qì vacuity signs; vacuity cold signs.

Description: Reduced eating; abdominal distension and continual abdominal pain that likes warmth and pressure; fear of cold and lack of warmth in the extremities; lusterless white complexion, sometimes with puffy swelling; bland taste in the mouth; sloppy stool, in severe cases, with grain failing to transform; pale enlarged tongue (possibly bearing dental impressions) with a glossy white tongue fur; a pulse that is sunken, slow, and forceless. In some cases, there may be puffy swelling of the limbs, short voidings of scant urine, or copious thin clear vaginal discharge.

Diseases: Diarrhea; abdominal pain; water swelling; drum distension.

Pathogenesis: Spleen yáng vacuity is a development of spleen qì vacuity in which insufficiency of the yáng qì of the spleen that manifests in impaired movement and transformation and inability to warm the body. It results from:

• enduring spleen qì vacuity;
• excessive consumption of raw and cold food or excessive use of cold and cool medicinals;
• kidney yáng vacuity depriving the spleen of warmth.

Analysis of signs

• Spleen qì vacuity: Reduced eating; abdominal distension; and sloppy stool, in severe cases, with grain failing to transform (undigested food in the stool).
• Cold signs: Continuous cold abdominal pain that likes warmth and pressure; fear of cold and cold limbs; and absence of thirst.
• Water-damp: When water-damp gathers in the skin, there is puffy swelling. When it pours downward, copious vaginal discharge is observed.
• Tongue: Pale and enlarged with glossy fur.
• Pulse: Sunken, slow, and forceless.

Treatment

Medicinal therapy: Warm yáng and fortify the spleen. Use spleen-fortifying medicinals such as white atractylodes (Atractylodis Macrocephalae Rhizoma, 白朮 bái zhú), dioscorea (Dioscoreae Rhizoma, 山药 shān yào), and lablab (Lablab Semen Album, 扁豆 biǎn dòu), combined with yáng-warming medicinals blast-fried ginger (Zingiberis Rhizoma Praeparatum, 炮姜 páo jiāng), cinnamon bark (Cinnamomi Cortex, 肉桂 ròu guì), and aconite (Aconiti Radix Lateralis Praeparata, 附子 fù zǐ). Formulas for treating spleen yáng vacuity include Center-Rectifying Pill (理中丸 lǐ zhōng wán), Aconite Center-Rectifying Decoction (附子理中汤 fù zǐ lǐ zhōng tāng) and variations.

Acumoxatherapy: Base treatment mainly on CV, SP, and ST. Select BL-20 (Spleen Transport, 脾俞 pí shù), CV-12 (Center Stomach Duct, 中脘 zhōng wǎn), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), SP-4 (Yellow Emperor, 公孙 gōng sūn), CV-4 (Pass Head, 关元 guān yuán), CV-6 (Sea of Qì, 气海 qì hǎi), and GV-4 (Life Gate, 命门 mìng mén); needle with supplementation and large amounts of moxa.

Further developments: Easily gives rise to cold-damp encumbering the spleen.

Combined pattern: Spleen-kidney yáng vacuity, characterized by cold pain in the lumbus and abdomen, enduring diarrhea or dysentery, and puffy swelling, with vacuity cold signs. This pattern is often attributable to kidney disease affecting the spleen.