CHAPTER OUTLINE
This chapter introduces the principles, methods and strategies of the composition of formulas that have the function of tonifying and nourishing the body. They are used to treat different kinds of deficiency syndromes.
The main substances of the body are the Qi and essence that further generate blood, body fluids, Yin and Yang. In pathological conditions, the deficiency often shows four aspects, namely deficiency of the Qi, deficiency of the blood, deficiency of the Yin and deficiency of the Yang. The deficiency can be found in specific organs, such as Kidney-Yin deficiency, Spleen-Qi deficiency or Heart-blood deficiency. A deficiency syndrome also exists in patients with a weak constitution or those in the recovery period of disease, in elderly people or in children. In those situations, it is difficult to determine which organ is weak and which part should be tonified, as the general condition of the patient is weak.
The formulas that tonify are arranged following these four aspects for the convenience of syndrome differentiation and treatment. The compositions of formulas are followed by different syndromes in each category and are discussed in detail. In practice, especially when treating chronic deficiency syndromes, an integrated treatment to tonify more substances and organs is required. A formula should be composed with thoughtfulness, yet following the principles and strategies demonstrated separately in this chapter.
CAUTIONS
1. Use in deficiency conditions only:
Formulas that tonify are, in general, applied for treating deficiency syndrome. They should not be used in conditions where substantial excess pathological products are present, such as phlegm, food and water accumulation, and stagnation of Qi and blood. This is because many tonifying herbs in the formulas have a rich and cloying nature and may retain material pathological products in the body. For the same reason, they are not suitable for conditions where exogenous pathogenic factors exist. However, in many cases, the deficiency syndromes coexist with excess pathological factors, or the internal disorders coexist with external factors. Quite often the factor of deficiency plays a causative role in the whole pathological process, thus the formulas that tonify can be used with herbs that eliminate the excess and exogenous pathogenic factors.
2. Protect the function of the Spleen and promote Qi movement in the Middle-Jiao:
Compared with formulas in the other chapters, formulas that tonify contain many tonifying herbs. These herbs have a sweet and cloying nature and are not easily digested, especially in patients with deficiency of the Spleen and Stomach, in elderly people and in children. The herbs that stimulate Qi and the herbs that promote digestion are almost always recommended in composing these formulas.
3. Plan an appropriate treatment course and diet:
An appropriate treatment course with an appropriate diet should also be taken in consideration in practice. Treatment of chronic deficiency syndromes should take place in stages. Generally speaking, it is better to start tonifying treatment in the winter rather than in the summer because winter is the time of storing and the digestive capability is stronger than in the summer. Another time to start treatment is following the changes of the Yin and Yang in nature. In cases of Yin deficiency, treatment should cover the spring and summer; in cases of Yang deficiency, treatment should start in the autumn and end after winter. At the same time, diets that can tonify and protect the Spleen and Stomach are also recommended to patients.
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13. Syndrome of Heart-Yang deficiency
Manifestations
Main symptoms
1. Palpitations, shortness of breath, which is often worse in winter and on exertion, pale complexion, cold extremities, stuffiness in the chest.
2. Chest Bi syndrome: Severe chest pain, breathlessness, cold sweats, extremely cold limbs and very deep and weak pulse.
3. Heart-Yang collapse: Loss of consciousness, cold sweats, extremely cold limbs and a very deep and weak pulse.
Secondary symptoms
Edema, shortness of breath, dizziness, nausea, vomiting or coughing out clear, thin, cold fluid, small amount of urine.
Tongue
Pale, dull color with teeth marks, and a white and moist coating.
Pulse
Deep, weak and irregular, or deep, slow and wiry.
Associated disorders in western medicine
1. Rheumatic heart disease, pulmonary heart disease, pulmonary emphysema, anemia, nephritis, drugs that inhibit heartbeat and reduce blood pressure, poor nutrition or having a low calorie diet.
2. Chest Bi syndrome: Acute myocardial infarction, angina pectoris.
3. Heart-Yang collapse: Acute myocardial infarction, heavy bleeding, dropping of blood pressure in shock and before death in terminal disease.
Analysis of the syndrome
The Heart is a fire organ. The Heart-Yang is very important in promoting the blood circulation and spreading the warmth in the body. The Heart-Yang can be injured directly by Yang and blood obstruction, such as in chest Bi syndrome or in an accident where there is heavy bleeding. This syndrome also arises in chronic conditions, e.g. chronic Kidney-Yang deficiency and Spleen-Yang deficiency.
• When the Heart-Yang is deficient, it fails to spread the warmth in the body, promote the Qi movement in the chest or circulate the blood, and therefore cold extremities, stuffiness in the chest and severe chest pain, cold limbs and a very deep and weak pulse present.
Two common syndromes that are referred to as the cold water affects the Heart and the cold water attacks the Lung mainly cause the secondary symptoms. These may occur if there is Heart-Yang and Kidney-Yang deficiency, or Heart-Yang and Spleen-Yang deficiency.
• When the Heart-Yang is too weak in the Upper-Jiao, the cold water may move upward from the Lower- or Middle-Jiao and attack the Heart and the Lung; thus shortness of breath, dizziness, vomiting or coughing out of clear, thin, cold fluid, and edema appear.
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