11. Syndrome of Kidney-Yang deficiency
Manifestations
Main symptoms
Low vitality, cold limbs and a cold sensation of the back, edema, poor concentration, forgetfulness, irregular menstruation and dysmenorrhea.
Secondary symptoms
Infertility, impotence, spermatorrhea, retention of urine, urinary incontinence, low sexual drive, diarrhea.
Tongue
Pale, dull in color with a white coating.
Pulse
Deep, slow and weak.
Associated disorders in western medicine
Heart or kidney failure, arthritis, dementia, chronic diseases of the digestive system, anemia, hypotension, hypothyroidism, hypoadrenalism, chronic nephritis, infertility, menopause syndrome, impotence.
Analysis of the syndrome
The Kidney-Yang, derived from the pro-heaven Qi, is the root of the Yang in the body as it warms the body, stimulates the Qi movement and water metabolism, promotes the process of Qi and blood generation, promotes all the functions of the Zang and Fu organs and determines the vitality of each individual. Although the Kidney-Yang declines with age, it can be injured in conditions of chronic or severe disease, poor constitution and improper care. In addition, since the Yin and Yang of the Kidney are derived from one root, severe deficiency of Kidney-Yin may cause Kidney-Yang deficiency as well.
• When the Kidney-Yang is weak and is not able to support the other organs, patients may have low vitality, feel sleepy, reluctant to move and tired, and suffer from poor concentration and forgetfulness. Dementia and degeneration may occur earlier than at the average age.
• If the Kidney-Yang is not able to spread the warmth in the body and support the bones, patients may have a cold feeling in the limbs, and even feel cold, weakness and aching of the body, particularly of the back.
• The Kidney-Yang is an important organ for promoting water metabolism. If the Kidney-Yang is too weak to steam the water, to separate the turbid from the clean, edema and retention of urine may appear.
• If the Kidney-Yang fails to warm the Spleen-Yang, diarrhea and cramping of the abdomen may occur.
• Irregular menstruation and dysmenorrhea may appear if the Kidney-Yang is too weak to warm the Lower-Jiao, to stimulate the blood and to maintain the proper function of the Chong and Ren meridians.
• The Kidney-Yang directly influences sexual activity and fertility. If the Yang is deficient, infertility, impotence, spermatorrhea and low sexual drive may present.
• Kidney-Yang deficiency is often shown in a pale and dull color of the tongue with a white, moist coating and a slow, deep and weak pulse, particularly in the third position.
(See Figure 5.5 on page 190 .)
Treatment principle: Tonify the Kidney-Yang and warm the interior
Herb selection principles and formula composition strategies
• First, herbs that are sweet and warm, enter the Kidney meridian, are able to tonify the Kidney-essence and Kidney-Yang are selected.
• Along with these, herbs that are pungent and warm, and can stimulate and spread the Yang, are often used in a small dosage. They can promote the function of herbs that tonify the Yang, spread the warmth in the body and accelerate the water metabolism.
• Herbs that tonify the Kidney-Yin are often selected as the Yin and Yang of the Kidney derive from one origin and they promote each other’s development.
• Herbs that enter the Kidney, strengthen the bones, expel wind, cold and dampness and benefit the back and legs are also often used.
• Herbs that regulate Qi and promote water metabolism are used to reduce the cloying nature of the tonifying herbs, to aid digestion and to make the whole formula more active and effective.
CAUTIONS
1. Protect the Yin:
Herbs that are too hot and too pungent and can stimulate the Yang should not be used as they may injure the Yin, which is the root of the Yang, and they may scatter the Yang quickly and eventually weaken the process of Yang generation.
2. Protect the Spleen:
Herbs that are too heavy and cloying should be used with caution as they can place an extra burden on the Spleen.
Structure of the formula and selection of herbs
Chief: Tonify the Kidney-Yang
Rou Gui ( Cinnamomi cassiae cortex)
Rou Gui is sweet and hot, and enters the Kidney and Liver meridians. It is able to tonify the Kidney-Yang, strengthen the fire of the vital gate, warm the Lower-Jiao and scatter cold there. It is the first choice for treating Kidney-Yang deficiency with many symptoms such as low vitality, tiredness, depression, cold limbs, diarrhea, edema, a weak and cold back, infertility and sexual disorders. Although it is sweet, it is quite hot, and the tonifying function is weaker than the Yang stimulating function, all of which may lead to the side effects of injury to the Kidney-Yin and scattering of the Kidney-Yang. Thus the dosage of Rou Gui should be low in the normal range.
Bu Gu Zhi ( Psoraleae fructus)
Bu Gu Zhi
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