Exterior-Empty

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Pattern factsheet

Chinese name: 表虚

Pinyin name: Biǎo Xū

Associated TCM concepts: Exterior Deficiency / Empty

Diagnosis

Common symptoms: Fatigue Weakness Sweating Headaches Body aches and two other symptoms

Pulse type(s): Slow (Chi), Floating (Fu)

Tongue description: Pale tongue with thin white coating

As explained under Exterior-Full, Exterior pattern should be Full by definition as it is characterized by the invasion of an external Pernicious Influence, which then fight with the Body's Defensive Qi.

However, according to a person’s preexisting condition, one can further differentiate an Exterior pattern between Full and Empty, but only in relative terms. For the Empty type, the symptom of aversion to cold happens more due to Qi and Blood Deficiency, while for the Full type it is more due to external Evil invasion. It occurs more to the elderly or these with weak constitutions. 

The key manifestation difference is that the Empty type evolves slight sweating while the Full type has no sweat,  because the deficient Nutritive Qi fails to hold sweat in place. There are mild or no fever as the Defensive Qi is too weak to react to the Evils' invasion. 

There are two types of Exterior-Empty. One is quite similar to the pattern of Greater Yang Attack of Wind, which is the first stage of the Six Stages theory. The aversion to cold is due to the obstruction of the space between the skin and muscles by Wind: this impairs the circulation of Defensive Qi which cannot fulfill its function of warming the muscles. 

The other type is due to the Lung and Spleen Qi Deficiency, which then fails to supply Defensive Qi to fight the external Evils. 

Diagnosing Exterior-Empty

The Exterior in Chinese Medicine is one of the so-called "Eight Principles". Learn more about Exterior in Chinese Medicine

Pulse type(s): Slow (Chi) or floating (Fu)

Tongue description: Pale tongue with thin white coating

Possible symptoms: Fatigue Weakness Sweating Headaches Body aches Aversion to wind Aversion to cold

Diagnosing a pattern in Chinese Medicine is no easy feat and should be left to professional practitioners.

In particular one has to know how to differentiate between different types of pulses and tongue coatings, shapes and colors. Here patients with Exterior-Empty will tend to exhibit slow (Chi) or floating (Fu) pulses.

Practitioners also learn to read from a long list of seemingly unrelated symptoms. Here patients with Exterior-Empty might experience symptoms like weakness, fatigue, headaches and aversion to wind (full list here above).

Herbal formulas used to treat Exterior-Empty

Gui Zhi Tang

Source date: 220 AD

Number of ingredients: 5 herbs

Key actions: Releases pathogens from the muscle layer. Regulates the Nutritive and Protective Qi.

Formula summary

Gui Zhi Tang is a 5-ingredient Chinese Medicine formula with Cinnamon Twigs (Gui Zhi) as a principal ingredient. Invented in 220 AD, it belongs to the category of formulas that clear Wind-Cold.

Besides Exterior-Empty, Gui Zhi Tang is also used to treat Greater Yang Attack of Wind or Exterior-Cold.

Read more about Gui Zhi Tang

Most important herbs used to treat Exterior-Empty