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Supplementing formulas

补益剂 〔補益劑〕bǔ yì jì

Medicinal formulas that treat vacuity. They supplement qì, blood, yīn, and yáng. They correspond to supplementation among the eight methods make use of supplementing agents.

Vacuity patterns include qì, blood, yīn, and yáng vacuity, which always involve the five viscera. These may be due to earlier-heaven (congenital) factors or to later-heaven (acquired factors), the latter including poor diet, taxation fatigue, affect-mind disturbances, and improper care after illness.

Qì, blood, yīn, and yáng are all interrelated. Qì and blood are mutually dependent in that blood is the mother of qì, and qì is the commander of the blood. Blood is produced by the action of qì, so the treatment of blood vacuity involves the use of qì-boosting medicinals. Conversely, qì cannot be exuberant or move freely without adequate supplies of blood. Therefore, qì-supplementing formulas often include blood-supplementing agents in the role of assistant. Dual vacuity of qì and blood naturally requires dual supplementation of qì and blood.

Yīn and yáng are similarly independent; they are rooted in each other. Formulas used to treat vacuity of either of these invariably include assistant agents that supplement its opposite. This is called seeking the yīn in yáng, and seeking the yáng in yīn. Yáng supplementing agents are warm and dry and hence can damage liquid, which can be prevented by the inclusion of enriching and moist yīn-supplementing medicinals in formulas. Yīn-supplementing medicinals can cause congealing and stagnation, which can be prevented by including yáng-supplementing medicinals in formulas. Dual vacuity of yīn and yáng naturally requires dual supplementation of yīn and yáng.

Five-phase interaction cycles should also be considered. One principle is In vacuity, supplement the mother. For example, lung qì vacuity can be treated by supplementing the spleen (banking up earth to engender metal). Spleen yáng vacuity can be treated by supplementing the life gate, embodying the principle of supplementing fire to engender earth. Liver yáng vacuity can be enhanced by supplementing the kidney, which is the principle of enriching water to moisten wood.

In supplementing yīn and yáng, the importance of the spleen and kidney is paramount. The spleen is the root of later heaven and the source of production of qì and blood. The kidney is the root of earlier heaven, the house of true yīn and true yáng. So supplementing the spleen and supplementing the kidney play key roles in the treatment of vacuity patterns in general.

Cautions

First, it is important to distinguish true vacuity from false vacuity. A patient apparently suffering from repletion who also displays signs of vacuity may have true vacuity and false repletion. Treatment of this condition as a repletion pattern makes the vacuity even worse (traditionally called evacuating vacuity). Similarly, apparent vacuity with repletion signs may actually be true repletion and false vacuity, which, if treated as vacuity, would only serve to worsen the repletion (replenishing repletion).

Second, if supplementing medicinals fail to produce the desired effect, this may be because of spleen-stomach weakness. In such cases, treatment should first be to adjust spleen-stomach function, with formulas that fortify the spleen, harmonize the stomach, rectify qì, or abduct food stagnation to enable the supplementing agents to be absorbed.

Subcategories

Qì-Supplementing Formulas

Qì-supplementing formulas treat qì vacuity, which manifests in fatigue and lack of strength, scantness of breath (slight breathlessness), hasty breathing on exertion, laziness to speak, faint low voice, pale white or withered yellow complexion, reduced eating, sloppy stool, pale tongue with white fur, and a pulse that is vacuous and weak. In some cases, there may be vacuity heat and spontaneous sweating or failure qì’s retentive function causing prolapse of the anus or prolapse of the uterus.

Main agents

Often used in tandem with these are qì-rectifying, dampness-percolating, yáng-upbearing, blood-supplementing, yīn-nourishing, and wind-coursing medicinals.

Representative formulas

Blood-Supplementing Formulas

Blood supplementing formulas treat blood vacuity, which is intimately related to the heart, liver, and spleen. Signs include withered-yellow facial complexion, dizzy head and vision, pale lips and nails, heart palpitation, insomnia, a pale tongue, and a fine pulse. In women, there may menstrual irregularities with pale menstrual discharge or even amenorrhea.

Main agents

Combined with these according to need are qì-supplementing, qì-rectifying, and stasis-dispelling agents.

Representative formulas

Dual Qì-Blood Dual Supplementation Formulas

These formulas treat dual vacuity of qì and blood, manifesting in lusterless facial complexion, dizzy head and vision, heart palpitation fearful throbbing, reduced eat, fatigue, shortness of breath, laziness to speak, a pale tongue and a pulse that is vacuous and forceless.

Main agentsFormulas use qì-supplementing medicinals such as the following:

  • Ginseng (Ginseng Radix, 人参 rén shēn)
  • Codonopsis (Codonopsis Radix, 党参 dǎng shēn)
  • Astragalus (Astragali Radix, 黄芪 huáng qí)
  • White atractylodes (Atractylodis Macrocephalae Rhizoma, 白朮 bái zhú)

    • These are combined with blood-supplementing agents such as

    Representative formula: Eight-Gem Decoction (八珍汤 bā zhēn tāng).

    Yīn-Supplementing Formulas

    Yīn-supplementing formulas treat yīn vacuity. Yīn vacuity is closely associated with the five viscera, especially the kidney, but also the heart, liver, spleen, and lung. Yīn vacuity signs include emaciation, dizzy head, tinnitus, tidal heat and tidal reddening of the cheeks, vexing heat in the five hearts, night sweating, insomnia, aching lumbus, seminal emission, cough with expectoration of blood, a red tongue with scant fur, and a pulse that is find and rapid.

    Main agents

    Because yīn vacuity can easily cause fire transformation, heat-clearing agents can be used with the above. Yáng-supplementing and qì-rectifying medicinals can be added according to need.

    Representative formulas

    Yáng-Supplementing Formulas

    Yáng-supplementing formulas treat yáng vacuity, which is closely related to the bowels and viscera, notably the heart, kidney, and spleen. Heart yáng vacuity and spleen yáng vacuity tend to be treated with interior-warming formulas. Here the discussion focuses on kidney yáng vacuity, which manifests in somber white facial complexion, cold limbs, aching pain in the lumbus and knees, weak legs, inhibited urination, or frequent urination and dribble after voiding, lesser-abdominal tension, impotence and premature ejaculation in men, uterine cold and infertility in women, a pale tongue with white fur, and a pulse that is sunken and fine, especially at the cubit position.

    Main agents

    These are often combined with urine-disinhibiting and yīn-supplementing agents.

    Representative formulas

    Dual Yīn-Yáng Dual Supplementing Formulas

    These formulas treat dual vacuity of yīn and yang, which is marked by dizzy head and vision, limp aching lumbus and knees, impotence, seminal emission, fear of cold and cold limbs, spontaneous and night sweating, postmeridian tidal heat. Treatment involves a combination of yīn-supplementing agents and yáng-supplementing agents.

    Main agents

    These are combined with yīn-supplementing agents such as:

  • Aconite (Aconiti Radix Lateralis Praeparata, 附子 fù zǐ)
  • Cinnamon bark (Cinnamomi Cortex, 肉桂 ròu guì)
  • Morinda (Morindae Officinalis Radix, 巴戟天 bā jǐ tiān)
  • Cistanche (Cistanches Herba, 肉苁蓉 ròu cōng róng)
  • Epimedium (Epimedii Herba, 淫羊藿 yín yáng huò)
  • Deerhorn glue (Cervi Cornus Gelatinum, 鹿角胶 lù jiǎo jiāo)
  • Curculigo (Curculiginis Rhizoma, 仙茅 xiān máo)

    • Representative formulas

    See supplementation and supplementing medicinals.

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