Ye Tian-Shi on Vacuity Detriment

A Model for a Mode of Inquiry in Chinese Medicine

By: Bob Damone

According to Wiseman and Feng (1998), Vacuity Detriment (xū sǔn虚损) is “any form of severe chronic insufficiency of yīn-yáng, qì-blood, and bowels and viscera arising through internal damage by the seven affects, taxation fatigue, diet, excesses of drink and sex, or enduring illness.” (p.646) I have found this Chinese disease category helpful in evaluating and formulating treatment strategies for patients with enduring diseases such as Chronic Fatigue Syndrome, Depression, and Fibromyalgia.[1] These patients invariably have many concurrent, complicated, and apparently contradictory symptoms, and always present a formidable challenge to the clinician. Vacuity Detriment is a useful conceptual template in such circumstances precisely because it provides the Chinese medical context in which to understand not only the complexities of serious and multiple vacuities but also their complications. As such, it gives clinicians insight into available conceptual models and treatment strategies for deeply vacuous patients. And when treating patients with complex diseases such as Vacuity Detriment, strategy often emerges as the decisive factor for attaining good clinical results.

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Ye Tian-Shi & the Eight Extraordinary Channels

By: Jason Blalack

Ye Tian-Shi was one of the most influential doctors in Chinese medical history in developing clinical applications of the eight extraordinary channel herbal theory. Following is a translated excerpt that summarizes some of the core ideas that he used. Following this piece will be numerous case studies demonstrating these principles in action.

>Ye Tian-Shi’s Pattern Differentiation and Treatment of the Eight Extraordinary Channels

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Understanding Ye Tian Shi’s Cases

Charles Chace recently brought this following passage to my attention. We both found it interesting in helping to understand Ye Tian-Shi’s case studies and putting into context the shorthand style that his cases are presented in. It is an excerpt from Thinking with Cases — Specialist Knowledge and Chinese Cultural History(2007) by Charlotte Furth. A great read.

“… the admirers of Ye Gui (1666-1745) saw to it that after his death some of this legendary doctor’s personal clinical records found their way into best-selling collections. Of these, Medical Cases as a Guide to Clinical Practice (Lin zheng zhinan yi’an), published in 1768, was the most authoritative and enduringly popular (there survive thirty-nine editions printed before tlIe end of the imperial era). A clinically oriented innovator from a hereditary medical family in Suzhou, Ye established a model style of case history that continues to be admired and imitated even today. Stripped of storytelling flourishes or social detail concerning the patients’ identities, Ye’s cases offered a laconic narrative that cut through the presenting symptoms to an underlying diagnostic pattern and concentrated on a customized prescription formula. The “Organizing Principles” (Fanli) that introduced the first edition of the collection help explain its thinking. They warn of the limitations of the nosological categories that constitute the surface organization of the section headings. By the selection and arrangement of cases within each category, the reader is being taught to distinguish between easily recognizable symptoms and syndromes (zheng, clusters of symptoms) and the more subtle “diagnostic patterns” (zhenghou) that identify the disorder at the most fundamental level.

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