Vacuity and repletion

Vacuity: emptiness or weakness. Repletion: fullness or strength. Vacuity is weakness of right qì, that is, the forces that maintain the health of the body and fight disease, whereas repletion is strength of evil qì or accumulation of physiological products within the body such as phlegm-rheum, water-damp, static blood, and stagnant qì. Vacuity patterns may be due to such causes as a weak constitution, damage to right qì either through enduring illness, loss of blood, seminal loss, and great sweating, or by invasion of an external evil (yáng evils readily damaging yīn humor and yīn evils readily damaging yáng qì). These causes are succinctly summed up in the phrase, Where essential qì is despoliated, there is vacuity.

Distinction is made between general insufficiencies of qì, blood, yīn, and yáng. Since these frequently affect specific organs, further distinction is made between such forms as heart yīn vacuity, liver blood vacuity, kidney yáng vacuity, and lung qì vacuity. Qì and yáng vacuity are both forms of yáng qì insufficiency, hence their clinical manifestations are similar. Signs include bright or somber-white complexion, lassitude of spirit, lack of strength, spontaneous sweating, and low voice. Yáng vacuity is characterized by pronounced cold signs. Blood vacuity denotes depletion of the blood and often occurs in conjunction with qì vacuity (dual vacuity of qì and blood) or with yīn vacuity (dual vacuity of yīn and blood). Yīn vacuity refers to insufficiency of the yīn humor and is invariably characterized by signs of heat and dryness. See exterior vacuity; interior vacuity; vacuity heat; vacuity cold. Repletion may be due to such factors as an invading evil, phlegm-rheum, water-damp, static blood, worm accumulations, and food accumulations. For this reason, it is said, Where evil qì is exuberant, there is repletion.

Repletion patterns vary according to the nature of the evil and the organ affected. A common feature of repletion patterns is that they are associated with exuberant evil qì. Thus, when a heat evil is exuberant, a repletion heat pattern emerges; the presence of an exuberant cold evil gives rise to a repletion cold pattern; and exuberant phlegm gives rise to phlegm and drool congesting the upper body. It should be emphasized that repletion reflects not only the exuberance of an evil but also the strength of the body’s reaction to it. This explains why rapid surging pulses, slippery stringlike pulses, and large replete pulses, which are all forceful at the deep level, are associated with repletion patterns.

See exterior repletion; interior repletion; repletion heat; repletion cold. For terms describing pathomechanisms that manifest in vacuity and repletion patterns, see exuberance and debilitation.

Etymology

Chin 虚 xū, empty, lacking, weak (originally written as 虍 hū, the conspicuous markings of a tiger’s skin with 丘 qiū, hill, the two elements together signifying a conspicuous hill); 实 shí, full, solid, substantial, real, sincere, fruit, seed (originally , a building, full of 贯, valuables). Vacuity and repletion are closely related to the terms insufficiency and superabundance respectively. In general, the latter are quantitative terms applied to specific entities within the body (blood, qì, yīn, yáng), whereas the former are comparatively qualitative terms that describe the same states in terms of their relationship to the whole body.