KD patterns Flashcards
all KD patterns (8)
Empty Patterns
- Kidney Qi Deficiency
- Kidney Qi Failing to Secure
- Kidney Failing to Grasp Qi
- Kidney Yang Deficiency
- Kidney Deficiency with Water Effusion
- Kidney Yin Deficiency
- Kidney Essence Deficiency
Full Patterns
8. Damp-Heat in Kidney
KD functions
sealing and hibernating
govern ming men fire
- Stores Essence/Jing
- Governs Reproduction
- Governs growth and development
- Generates Marrow, fills the brain and engenders blood
- Transforms Essence to Kidney Yin and Kidney Yang, governs and regulates yin and yang of the entire body
- Governs Water Metabolism
- Controls the Reception of Qi
EWMRQI:
essence, water metabolism, reception of qi
KD relationships
Spirit Wisdom 智 zhì
Internal-external connection Urinary Bladder
Open orifice Ears, genitalia, anus
Dominates Bones, teeth
External manifestation Head hair
Fluid Spittle
Fire Ming Men Fire 命門之火 mìng mén zhī huǒ
Emotion Fear, fright
Season Winter
Five Phase Water
Six Climate Factor Cold
Organ clock 5pm-7pm
(LI is 5am-7pm so LI can treat KD)
KD channel six channel pair and interior exterior pair
In the Six-Channel pairing
Kidney Foot Shao Yin
Heart Hand Shao Yin
Interior-Exterior relationship with the Urinary Bladder meridian
Common etiological factors of the Kidney
mainly caused by internal factors such as:
1. Weak constitution: prenatal deficiency - including congenital insufficiency, premature and congenital disorders; postnatal deficiency, including malnutrition and chronic illness
2. Improper diet, malnutrition
3. Sexual and physical overstrain
4. Aging
Pathological changes and major manifestations of the Kidney
often due to Kidney Essence deficiency, Kidney failing to receive Qi, or Kidney failing at Qi transformation to promote water metabolism:
1. Soreness and weakness of the lower back and knees, dizziness, poor memory
2. Growth, development, and reproductive ability disorder (Impotence, infertility)
3. Water metabolism disorder: edema, diarrhea, leukorrhea, difficult urination or frequent urination (SI also)
4. Respiratory disorder: panting or asthma, dypsnea (LU)
5. Symptoms related to the brain, marrow, bone, hair, ear, or bowel movement and urination
Kidney Qi Deficiency Pattern
腎氣虛証
shèn qì xū zhèng
Definition: hypofunction of the Kidney.
Clinical Manifestations: Soreness and weakness of the lower back and knees, dizziness, fatigue, hearing loss, tinnitus, frequent or difficult urination, loose stools, panting, dyspnea.
Tongue: Pale and flabby
Pulse: deep, weak
Key points: Soreness and weakness of the lower back and knees, deep and weak pulse, plus Qi deficiency signs and symptoms
This pattern often develops as a normal part of the process of aging
● Congenital deficiency
● Chronic illness
● Overstrain
Treatment Principle: Tonify Kidney Qi
Acupuncture: BL-23, BL-52, Ren-4, Du-4, KD-3
Method: Tonification, moxibustion is applicable
Herbal Formula: 金匱腎氣丸 jīn guì shèn qì wán Kidney Qi Pill from the Golden Cabinet
Kidney Qi Failing to Secure Pattern
腎氣不固証
shèn qì bù gù zhèng
Definition: Kidney failing to perform its securing or controlling functions.
Also known as ‘Kidney Qi not firm’, ‘Kidney Essence failing to secure’ and ‘Jing Gate failing to secure’ 精關不固 jīng guān bù gù (insecurity of the essence gate)
● Jing Gate Failing to Secure refers specifically to the inability to withhold semen
Clinical Manifestations: Sore, weak lower back region and knees, lassitude, listlessness, tinnitus (also LV), hearing loss, frequent copious urination, scanty or difficult urination, incontinence of urine, enuresis; spermatorrhea, premature ejaculation; continuous menstrual spotting, clear copious vaginal discharge, habitual miscarriage
Tongue: Pale
Pulse: Weak
Key points: Frequent urination, dribbling after urination, incontinence, enuresis, spermatorrhea, premature ejaculation, clear copious vaginal discharge, habitual miscarriage, plus Kidney Qi deficiency signs and symptoms
Treatment Principle: Tonify Kidney Qi, stabilize the essence and stop leakage
Acupuncture: BL-23, BL-52, CV-4, KI-3, GV-20, ST-36
Herbal formula: 桑螵蛸散sāng piāo xiāo sǎn Mantis Egg-Case Powder
Comparison: Kidney Qi Failing to Secure vs. Spleen Qi Sinking
Kidney Qi Failing to Secure
- Deficient Kidney qi fails to control and secure the essence gate and yin orifices
Spleen Qi Sinking
- Deficient Spleen qi fails to secure and hold
Common
Urine or fecal incontinence, chronic loose stools, listlessness, lassitude, pale complexion, low voice, pale tongue, weak pulse
Different
Kidney Qi Failing to Secure
- Urine, essence, Conception and Girdle vessels not secured, causing leakage: frequent urination, menorrheagia, spermatorrhea, leukorrhea, miscarriage
- Soreness and weakness of the lower back and knees, tinnitus, dizziness, copious or difficult urination, infertility or sterility
Spleen Qi Sinking
- Internal organ prolapse: gastroptosis, renal ptosis, hepatoptosis, uterine prolapse, rectal prolapse
- Poor appetite, bloating and distention, or obesity
Tongue & Pulse
- Pale tongue; weak pulse
Kidneys Failing to Grasp Qi Pattern
腎不納氣証
shèn bù nà qì zhèng
Definition: respiratory issues, caused by Kidney Qi deficiency, which then fails to receive or ‘grasp’ the qi. aka “Kidneys failing to absorb Qi,” or “Kidney Qi Failing to Grasp the Qi”
Clinical Manifestations: Chronic wheezing, rapid and weak breathing, cough, panting, difficult inhalation, shortness of breath, worse with exertion, feeble voice, spontaneous
sweating, fatigue and soreness and weakness of the lower back and knees. In severe cases: dyspnea, profuse cold sweating, cold limb, dark complexion.
Tongue: n.a.
Pulse: Big pulse without root.
Key points: Chronic wheezing, dyspnea, cough, panting, difficult inhalation, worse with exertion, plus Kidney qi deficiency signs and symptoms.
Etiology
● Chronic cough or asthma
● Impaired Lung qi weakening the Kidney
● Physical overstrain
● Congenital weakness with primary qi deficiency
● Kidney qi deficiency due to aging
Pathology
The Kidneys receive clear qi inhaled by the Lung and also regulates respiration to ensure deep breathing
● This maintains the normal gas exchange between the inside and outside of the body
● When Kidney qi is deficient, it is unable to grasp the qi, or maintain normal inspiration, causing: shortness of breath, panting and difficult inhalation
● Since physical exertion consumes qi, all of these symptoms become worse with exertion
Deficient qi fails at its functions to push, promote and secure, resulting in the following:
● Feeble voice, spontaneous sweating, fatigue
● Deep and weak pulse
○ Deep pulse 沉脈 chén mài, “Submerged” - interior pattern
○ Weak pulse 弱脉 ruò mài, “Frail” - qi and blood xu
However, severe Yang qi deficiency can lead to yang qi collapse, resulting in :
● Dyspnea, profuse and cold sweating, cold limbs, pale and dim complexion
● Big pulse without root
○ Large pulse 大脈 dà mài, “Big” - wide and forceful (heat), wide and forceless (deficiency)
Treatment Principle: tonify the Kidneys to grasp the Qi
Acupuncture: CV-16, CV-17, BL-13, BL-23, BL-43, BL-52, GV-12, LU-7, KI-3, KI-6, KI-7
Method: Reinforcing. Moxibustion is applicable.
Formulas to treat Kidneys: 補肺湯bǔ fèi tāng Tonify the Lungs Decoction
Comparison:
Lung Qi Deficiency
vs.
Kidney Failing to Grasp Qi
Lung Qi Deficiency
- Lung qi deficiency fails to descend, leads to short exhalation
Kidney Failing to Grasp Qi
- Kidney Qi deficiency fails to grasp qi, leading to difficult inhalation
Common
- Panting, wheezing, dyspnea, shortness of breath, feeble sound, fatigue, pale complexion
Different
Lung qi xu
- Harder to exhale than inhale
- Spontaneous sweating, catches cold frequently, cough
KD failing to grasp Qi
- Harder to inhale than exhale
- Soreness and weakness of the lower back and knees
Tongue & Pulse
Pale and tender tongue, deep and weak pulse
Treatment strategy
Tonify the lung, augment the qi, nourish yin
Tonify the Kidney to grasp the qi
Herbal Formulas: Sheng Mai San, Bu Fei Tang Jing Gui Shen Qi Wan, Shen Ge San Symptoms
Key Points:
1) Abnormal breathing pattern: harder to exhale vs. harder to inhale
2) Lung symptoms such as spontaneous sweating and cough vs. Kidney symptoms such as weakness in the lumbar area or knee pain
Kidney Yang Deficiency Pattern
腎陽虛証
shèn yáng xū zhèng
Definition: deficient Kidney yang, which fails to warm the body and limbs, lack the motivating force to move and transform qi, and manifests as a hypofunctioning of the body.
Clinical Manifestations: Soreness and weakness of the lower back and knees with a cold sensation, intolerance of cold, cold limbs, early morning diarrhea, loose stools with undigested food, edema, frequent and copious urination, frequent nocturnal urination, difficult urination;
impotence, spermatorrhea, premature ejaculation, menstruation disorder and infertility.
Tongue: Pale flabby
Pulse: Deep weak
Key points: Disorder of sexual and reporductive function, general hypoactivity of physical function,
plus deficiency cold signs and symptoms.
Kidney Yang Deficiency is derived from the following:
● Chronic illness
● Sexual overstrain
● Excessive physical work
● Diet: excessive consumption of cold and raw foods may weaken Spleen and Kidney Yang
Kidney yang deficiency pattern manifests as:
1. Failure to warm: intolerance of cold, cold limbs, cold sensation in the lower back
and knees, pale or dark complexion, dizziness and vertigo, apathy
2. Decline of 命門 Mìng mén fire: reduced reproductive function. Impotence,
premature ejaculation, spermatorrhea (nocturnal or daytime emission)
oligospermia (low sperm count), azoospermia (undetectable sperm count) or even
aspermia (complete lack of sperm). Infertility, dysmenorrhea (menstrual cramping),
amenorrhea (loss of period), low libido.
3. Fire is unable to warm earth, leading to Spleen dysfunction: early morning diarrhea,
chronic loose stools, and watery stools with undigested food.
4. Qi transformation 氣化 qì huà failure: Manifests in a
water metabolism disorder, resulting in clear, copious
and frequent urination, frequent nocturnal urination or
difficult or no urination. Pitting edema may also
appear, which is worse in the lower body, accompanied
by scanty urine. If dampness attacks other organs,
there may be abdominal distention and bloating,
palpitations or panting
5. Pale tongue with a white coating
6. Deep and thin pulse, especially weak in the proximal
position
Treatment Principle: Tonify and warm Kidney Yang
Acupuncture: BL-23, CV-4, GV-4, KI-3, ST-36
Method: Reinforcing, Moxa should be used (Maciocia)
Comparison: Kidney Qi Failing to Secure vs. Kidney Yang Deficiency
Pathogenesis
Common
Both develop from Kidney Qi deficiency
Different
KD yang xu
- Kidney Yang fails to warm and transform qi, leading to coldness
KD qi fail to secure
- Deficient Kidney Qi fails to control and secure essence gate and yin orifices, leading to leakage
Sx
Common
Pale face, sore and weak lower back and knees, tinnitus, dizziness, copious urination, difficult urination, infertility or sterility
Different
- Yang xu: COLD: Yang deficiency with cold: intolerance of cold, cold limbs, edema below the waist, loose stools
- KD fail to secure: more LEAKAGE: Urine, essence, Conception and Girdle vessels, not secured, causing leakage: frequent urination, menorrhagia, spermatorrhea, leukorrhea, miscarriage, no obvious cold signs
Tongue & Pulse
- KD yang xu: Pale flabby tongue with white coating, deep, feeble, weak or slow pulse
- KD fail to secure: Pale tongue; weak pulse
Treatment strategy
Tonify and warm Kidney yang
Stabilize and tonify the Kidney, stop leakage
Herbal Formulas: Jin Gui Shen Qi Wan, You Gui Yin Jin Suo Gu Jin Wan, Sang Piao Xiao San, Suo Quan Wan
Key Points:
1) Coldness vs. intolerance to cold
2) Leakage: frequent urination, menorrhagia, smperatorrhea, leukorrhea, miscarriage
Kidney Yang Deficiency with Water Effusion
腎虛水泛 shèn xū shuǐ fàn
Definition: deficient Kidney yang, which fails to perform its qi transformation 氣化 qìhuà function, leading to a disorder of water metabolism with water retention
Clinical Manifestations: General pitting edema with greater severity in the lower extremities, abdominal distention, scanty urine, shortness of breath, cough and panting with sputum gurgling in the throat, palpitations, panting aggravated by exertion, intolerance of cold, cold extremities.
Tongue: Pale flabby tongue body with a thick or greasy white coating
Pulse: Deep, thin and weak
Key points:
Pitting edema worse in the lower extremities, scanty urination, intolerance of cold and cold limbs. In addition to the Kidney, this pattern must involve at least two other organs such as the Heart, Lung or Spleen
Causes:
● Chronic illness
● Aging
● Improper diet
● Improper treatment
● Constitutional weakness leading to Kidney yang deficiency
● In most cases, this pattern develops from a Kidney Yang deficiency pattern
Kidney yang deficiency leads to a failure in qi transformation, resulting in water metabolism disorder and water retention
● Decline of Kidney Yang causes dysfunction of the Urinary Bladder
● Water retention means that less water in general is being sent to the Urinary Bladder, resulting in scanty urination
Treatment Principle: Warm Kidney, promote diuresis to drain water-dampness
Acupuncture: BL-20, BL-23, CV-4, CV-9, KI-7, ST-36
Formulas: 真武湯 zhēn wǔ tāng
True Warrior Decoction
Kidney Yin Deficiency Pattern
腎陰虛証 shèn yīn xū zhèng
Definition: deficiency of Kidney Yin, which fails to nourish the body, producing deficiency fire. aka Kidney water deficiency 肾水虧虛 shèn shuǐ kuī xū and original or true yin deficiency 真陰虧虛 zhēn yīn kuī xū.
Clinical Manifestations: Soreness and weakness of the lower back and knees, dizziness, vertigo, tinnitus,
insomnia, low-grade fever in the afternoon or evening, malar flush, night sweats, hot flashes, five-center heat, steaming bone disorder, dry mouth and throat, poor memory, emaciation; could be premature ejaculation, inhibited ejaculation, excessive sexual desire or nocturnal emission, or scanty menses, amenorrhea, dysmenorrhea, or heavy menses.
Tongue: Red tongue with scanty coating
Pulse: Thin and rapid
Key points: Soreness and weakness of the lower back and knees, dizziness, vertigo, tinnitus, nocturnal emissions or abnormal menses, plus deficiency heat signs and symptoms.
Etiology of Kidney Yin Deficiency Pattern 腎陰虛証 shèn yīn xū zhèng
● Overwork
● Excessive sexual activity
● Loss of body fluids
○ Chronic illness
○ Later stages of febrile disease
● Aging
● Chronic illness
● Overdosage of Chinese herbs
○ Over consumption of herbs used to strengthen Kidney Yang, or herbs taken to strengthen Kidney Yang when in reality Kidney Yin should be strengthened
○ Kidney Yang tonics are too hot and can injure Kidney Yin
● Warm and dry foods, alcohol
● Medications
Treatment Principle: Nourish and tonify Kidney Yin
Acupuncture: BL-23, KI-3, KI-6
Method: reinforcing method, no moxa
Formulas:
六味地黃丸 liù wèi dì huáng wán Six-Ingredient Rehmannia Pill
左歸丸 zuǒ guī wán Restore the Left [Kidney] Pill
