Supplementing agents

Also vacuity-supplementing agents. Supplementing medicinals are agents that treat vacuity patterns. Vacuity patterns are attributable to insufficiency of bodily substances (qì, blood, fluids) and result in functional problems. Since the insufficiency can affect specific bowels and viscera, the clinical manifestations are extremely broad.

Subcategories

Supplementing medicinals are divided into four categories:

• Qì-supplementing agents, which treat qì vacuity patterns, characterized by lack of strength, laziness to speak, and spontaneous sweating.
• Yáng-supplementing agents, which treat yáng vacuity patterns, characterized by bright white facial complexion, shortage of qì, laziness to speak, fear of cold and cold limbs, listlessness of essence-spirit, bland taste in the mouth, absence of thirst or liking for hot drinks, long voidings of clear urine (or inhibited urination with puffy swelling), and sloppy stool or diarrhea.
• Blood-supplementing agents, which treat blood vacuity patterns, characterized by lusterless or withered-yellow complexion, pale tongue, and a fine pulse.
• Yīn-supplementing agents, which treat yīn vacuity patterns, characterized by vexing heat in the five hearts, emaciation, red cheeks, dry throat and mouth, night sweating, tidal heat effusion, red tongue with litte fur, and a pulse that is vacuous, fine, and rapid.

Supplementing medicinals are mostly sweet in nature. Those that supplement qì, yáng, and blood are warm in nature. Yīn-supplementing agents are often cool or cold. The channel entry of supplementing medicinals is varied.

Properties

Nature: Medicinals that supplement qì, yáng, and the blood are often warm in nature. Yīn-supplementing agents are often cool or cold.

Flavor: Supplementing medicinals are generally sweet in flavor.

Channel entry: Supplementing medicinals enter different channels, but a distinct pattern is observable:

Qì-supplementing agents mostly supplement the lung or spleen; hence, they enter the spleen and lung channels.

Yáng-supplementing agents mainly supplement kidney yáng; hence, they enter the kidney channel.

Blood-supplementing agents mostly treat liver and heart blood vacuity; hence, they enter the liver and heart channels.

Yīn-supplementing agents can be divided into two groups: those that supplement lung and stomach yīn, which enter the lung and stomach channels; and those that supplement liver and kidney yīn, which enter the liver and kidney channels. A certain overlap exists between these two groups.

Bearing: Varying.

Actions And Indications

Supplementing qì includes supplementing spleen qì, supplementing lung qì, supplementing heart qì, supplementing kidney qì, and supplementing original qì.

Supplementing yáng includes supplementing kidney yáng, supplementing spleen yáng, and supplementing heart yáng.

Supplementing the blood includes supplementing heart blood and supplementing liver blood.

Supplementing yīn includes supplementing lung yīn, supplementing stomach yīn, supplementing liver yīn, supplementing kidney yīn, supplementing heart yīn, and supplementing spleen yīn.

Qì Vacuity

Pathomechanism: Qì vacuity arises due to conditions including insufficiency of earlier heaven, later heaven loss of nourishment, disorders of the lung and spleen, general weakening of the constitution in advancing years, and taxation fatigue.

Signs: General insufficiency of qì manifests in lack of strength and laziness to speak. If defense qì becomes insecure, there may be spontaneous sweating. When yáng qì fails to bear upward normally, there may be dizziness. Signs vary depending on the bowels and viscera affected.

Lung qì vacuity: shortness of breath (in severe cases also panting), a low faint voice, forceless cough, and tendency to sweat easily.

Heart qì vacuity: heart palpitation or fearful throbbing, oppression in the chest, and shortness of breath, all of which are exacerbated by physical exertion. In addition, the pulse is vacuous.

Spleen-stomach qì vacuity: appetite and indigestion, vacuity distension in the stomach duct and abdomen, sloppy stool, physical fatigue and lassitude of spirit, withered-yellow or bright white complexion, emaciation, and generalized vacuity puffiness. In addition there may be signs of center qì fall (prolapse of the rectum or uterus) or of the spleen failing to control the blood (bloody stool or flooding and spotting).

Kidney qì vacuity: frequent urination, dribbling after voiding, profuse urination at night, enuresis (bed-wetting) or incontinence. In men, there may be premature ejaculation, seminal emission (loss of semen during sleep, usually without dreaming), or seminal efflux (loss of semen in the daytime). In women, there may be clear thin vaginal discharge. If the kidney’s function of absorbing qì is disturbed, there can be shortness of breath and vacuity panting characterized by more exhaling than inhaling, and severe panting with sweating on exertion.

Severe vacuity of original qì with impending desertion: Short rapid breathing and a faint pulse on the verge of expiration.

Treatment: Supplement qì.

Yáng Vacuity

Pathomechanism: Contraction of external cold in externally contracted disease or cold arising within due to damage to yáng qì in or enduring miscellaneous disease.

Signs: The generalized signs of yáng vacuity are bright white facial complexion, shortage of qì, laziness to speak, fear of cold and cold limbs, listlessness of essence-spirit, bland taste in the mouth, absence of thirst or liking for hot drinks, long voidings of clear urine, and sloppy stool and diarrhea. In some cases there is puffy swelling or inhibited urination. The tongue is pale and enlarged with a white moist fur. The pulse is sunken, slow, and forceless or weak.

Because kidney yīn and kidney yáng are the root of the yīn and yáng of the entire body, yáng vacuity essentially means kidney yáng vacuity. Hence numerous vacuity signs are associated with the kidney:

Sinew and bones: Lack of strength in the sinew and bones, feeble gait, and cold painful limp aching lumbus and knees.

Reproductive function problems: poor libido, impotence, male sterility, female infertility. Insecurity of the essence gate giving rise to seminal emission, seminal efflux, and premature ejaculation.

Urination and water swelling: Kidney yáng vacuity can manifest in frequent urination, increased urination at night, enuresis, and incontinence. It can also cause water swelling and inhibited urination.

Spleen: Kidney yáng vacuity can deprive the spleen of warmth, causing the spleen to lose its movement and transformation function and to giving rise to sloppy stool or fifth-watch diarrhea (early morning diarrhea).

Thoroughfare and controlling vessels: Kidney yáng vacuity can manifest in insecurity of the thoroughfare (chōng) and controlling (rèn) vessels with incessant flooding and spotting, and clear thin vaginal discharge.

Qì absorption. Kidney yáng vacuity can also entail the kidney failing to absorb qì, giving rise to feeble respiration, exhaling more than inhaling, shortness of breath, and panting.

Kidney essence: Kidney yáng vacuity can also give rise to insufficiency of kidney essence. In children this can manifest in slowness to walk, slowness to teethe, delayed closure of fontanels, and other manifestations of a slow development. In adults, it can manifest in maldevelopment of the genitals or in signs of premature aging such as early graying, dizziness, flowery vision, tinnitus, deafness, limp wilting sinews and bones, and feeble gait.

Treatment: Supplement yáng (kidney yáng).

Blood vacuity

Pathomechanism: blood vacuity is most commonly caused by excessive bleeding or insufficient production of blood due to poor digestive function.

Signs: blood vacuity is insufficiency of the blood or failure of the blood to adequately perform its nourishing functions. It manifests as a lusterless or withered-yellow complexion, pale tongue, and a fine pulse.

Heart: When the heart is deprived of the nourishment of blood, heart blood vacuity develops. There are heart palpitation or fearful throbbing, and signs of disquieted heart spirit such as heart vexation, insomnia, and forgetfulness.

Liver: When the liver is deprived of the nourishment of blood, liver blood vacuity develops, the signs are as follows:

Head: In liver blood vacuity, blood fails to reach the head, so the signs are dizziness and tinnitus.

Eyes: When the eyes are deprived of nourishment, the signs are dry eyes, loss of visual acuity, or night blindness.

Sinews: When the sinews are deprived of nourishment, the signs are tingling and numbness, hypertonicity of the sinews, and tremor.

Nails: Because the liver has its bloom in the nails, liver blood vacuity can manifest in pale dry brittle nails.

Women: Insufficiency of liver blood in women that prevents the thoroughfare (chōng) and controlling vessels (rèn) from remaining full causes delayed menstruation with pale scant menstrual discharge, or in severe cases amenorrhea.

Treatment: Supplement the blood (heart blood and liver blood).

Yīn Vacuity

Pathomechanism: Damage to yīn in advanced-stage warm-heat disease or enduring miscellaneous disease, due excessive thought and preoccupation, or due to sexual intemperance. These factors may act separately or jointly. When yīn is damaged, yáng is left unrestrained, hence vacuity heat arises internally.

Signs: Emaciation, dry mouth and throat, dry skin, constipation due to intestinal dryness, postmeridian tidal heat effusion (fever occurring in the afternoon or evening), vexing heat in the five hearts, tidal reddening of the cheeks, night sweating, and dizzy head and vision. The tongue is red or crimson with little or no fur, and the pulse is fine and rapid.

Lung yīn vacuity: When yīn vacuity affects the lung, there is dry cough with little phlegm, expectoration of blood, or hoarse voice.

Stomach yīn vacuity: When yīn vacuity affects the stomach, there is dull pain in the stomach duct, hunger with no desire to eat, glomus in the stomach duct, bloating after eating, vomiting, or hiccup.

Spleen yīn vacuity: Yīn vacuity can affect the spleen, giving rise to spleen yīn vacuity, which in fact is dual vacuity of spleen qì and spleen yīn. In such cases there is reduced eating, distension after eating, constipation, dry lips, and dry tongue with scant fur.

Liver yīn vacuity: dizziness and tinnitus, dry eyes, numbness of the limbs, hypertonicity of the sinews, and lusterless nails.

Kidney yīn vacuity: Because kidney yīn and kidney yáng are the root of the yīn and yáng of the whole body, yīn vacuity always involves the kidney. Kidney yīn vacuity is characterized by dizzy head and vision, tinnitus, deafness, loosening of the teeth, limp aching lumbus and knees, and seminal emission.

Heart yīn vacuity: When yīn vacuity affects the heart, there are signs such as heart palpitation or fearful throbbing, insomnia, and profuse dreaming.

Treatment: Supplement yīn (lung, spleen liver, kidney, heart yīn).

Combinations

Because qì, blood, yīn, and yáng are all related, the medicinals of the four subcategories are frequently combined.

Combining qì-supplementing and yáng-supplementing medicinals: Qì vacuity often develops into yáng vacuity, and yáng vacuity inherently entails qì vacuity. So qì supplementing medicinals are often combined with yáng-supplementing medicinals.

Combining qì-supplementing and blood-supplementing medicinals. Blood is a tangible substance that is born of intangible qì. When qì is vacuous and has no strength to perform its engendering transformation function, blood vacuity may result. Blood is the mother of qì; hence, when blood is vacuous, qì is deprived of support, resulting in qì vacuity. For this reason, qì-supplementing medicinals and blood-supplementing medicinals are often used together.

Combining qì-supplementing and yīn-nourishing medicinals: Qì engenders liquid, and liquid carries qì (enables it to move smoothly). Qì vacuity can affect the production of fluids, giving rise to insufficiency of fluid. When fluids are severely depleted, this can give way to qì deserting with liquid. Febrile disease not only easily damages yīn, vigorous fire (pathological fire) can also consume qì, giving rise to dual vacuity of qì and yīn. Hence, qì-supplementing medicinals are often combined with yīn-supplementing agents.

Combining blood-supplementing and yīn-supplementing medicinals: Blood is said to be the juice of the center burner; liquid and blood are of the same source. Fluid is an important part of blood, and blood, like fluids, belongs to yīn. Loss of blood and blood vacuity can cause yīn vacuity. Conversely, severe damage to yīn-liquid can give rise to dryness of both liquid and blood. blood vacuity and yīn vacuity very often occur together, and so blood-supplementing agents are often combined with yīn-supplementing agents.

Combining yīn-supplementing and yáng-supplementing medicinals: Yīn and yáng are rooted in each; they are interdependent. If yīn does not exist, yáng cannot be engendered. When yáng does not exist, yīn has no way to grow. Damage to yīn or yáng very often causes insufficiency of the other. This is called detriment to yīn affecting yáng and detriment to yáng affecting yīn. The result of this process is dual vacuity of yīn and yáng. Hence, it is often necessary to combine yīn-supplementing and yáng-supplementing medicinals.

Note that yáng-supplementing medicinals mostly supplement kidney yáng, which stands in complementary opposition to the true yīn of the kidney, which is kidney essence. The yīn-enriching medicinals that are often combined with yáng-supplementing medicinals are ones that supplement kidney essence, not the ordinary clearing and supplementing medicinals that supplement lung, stomach, and heart yīn.

Combining supplementing medicals with agents of other categories. Supplementing medicinals are not only used to treat simple vacuity patterns. Since many illnesses take the form of right vacuity and evil repletion, supplementing medicinals must often be combined with agents that address evil qì. Hence, the use of supplementing medicinals is broad in scope. For example, yáng vacuity easily gives rise to internal cold, and exuberant cold easily damages yáng. Hence, yáng-supplementing medicinals are often combined with interior-warming cold-dispelling medicinals. Yīn vacuity easily gives rise to internal heat. Exuberant heat easily damages yīn. Hence, yīn supplementing medicinals are frequently combined with heat-clearing agents.

Method Of Use And Warnings

Qì-supplementing medicinals: Qì-supplementing medicinals are sweet. They tend to congest the center, hamper qì, and assist dampness. They should be used with care in exuberant dampness with center fullness. If necessary, they can be combined with qì-rectifying and dampness-eliminating medicinals.

Yáng-supplementing medicinals are contraindicated in yīn vacuity with effulgent fire. Yáng-supplementing medicinals are mostly warm. They easily assist fire and damage yīn.

Blood-supplementing medicinals: Many blood-supplementing medicinals are contraindicated in spleen vacuity with reduced eating and sloppy stool. Some are contraindicated in the presence of dampness or phlegm.

Yīn-supplementing medicinals hamper spleen-stomach movement and transformation. Yīn-supplementing agents are generally rich and slimy (cloying). They tend to hamper spleen-stomach movement and transformation. They should be used with care in spleen-stomach vacuity or phlegm-damp causing internal obstruction with abdominal distension and sloppy stool.