Exterior-Empty
The information provided here is not a replacement for a doctor. You shouldn't use it for the purpose of self-diagnosing or self-medicating but rather so you can have a more informed discussion with a professional TCM practitioner.
At a glance
Preliminary reading: What is a pattern? The concept of Exterior The concept of Empty
Key attributes
Chinese name: 表虚 Pinyin name: Biǎo Xū
Pattern nature: Empty
Causes
Common causes: Weak constitution
Diagnosis
Common symptoms: Sweating Body aches Aversion to wind Aversion to cold
Pulse type(s): Slow (Chi), Floating (Fu)
Tongue description: Pale tongue with thin white coating
Treatment
Treatment principle: Warm the Exterior through sweating, tonifies the Lung and Spleen Qi, harmonize the Defensive and Nutritious Qi.
Common formulas: Gui Zhi Tang
Pathology
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.
Causes
Weak constitution: Weak constitution means less strong in Qi and Blood. Then weak Defensive Qi to fight the external Pernicious Influences.
Diagnosing Exterior-Empty
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 as well as learn to read from a long list of seemingly unrelated symptoms.
Pulse type(s): Slow (Chi) or floating (Fu)
Tongue description: Pale tongue with thin white coating
Main symptoms: Sweating Body aches Aversion to wind Aversion to cold
Diagnosis commentary: Key characteristic symptoms of this pattern are the aversion to Cold and Wind, sweating as well as slow and floating Pulse.
Treating Exterior-Empty
Treatment principle
Warm the Exterior through sweating, tonifies the Lung and Spleen Qi, harmonize the Defensive and Nutritious Qi.
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. 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.