bubble_chart Concept

Fatigue refers to the clinical symptoms of mental weariness and physical lethargy.

This condition has numerous names in medical texts, Suwen . Pingren Qixiang Lun calls it "Jie Yi", Lingshu . Hai Lun calls it "Dai Duo", Lingshu . Hanrebing refers to it as "Ti Duo".

Fatigue is an extremely common symptom in clinical practice, and almost all acute and chronic sexually transmitted diseases can present with varying degrees of fatigue. The scope of this discussion is limited to cases where fatigue is the primary symptom.

bubble_chart Pattern Analysis

1. Summerheat Damaging Qi︰Lassitude of limbs, lack of strength, mental fatigue, shortage of qi, reluctance to speak, feverish body with sweating, restlessness and thirst, poor appetite, loose stool, greasy facial complexion and turbid tongue coating, weak and rapid pulse. This syndrome occurs during the scorching summer heat. Summerheat is a yang pathogen, characterized by dispersion and prone to consuming qi and body fluids, hence manifesting as lassitude of limbs, mental fatigue, shortage of qi, reluctance to speak, feverish body with sweating, restlessness and thirst, weak and rapid pulse, etc. Moreover, summerheat often combines with dampness, leading to greasy facial complexion, turbid tongue coating, and loose stool. The treatment should focus on clearing summerheat and replenishing qi, enriching yin and producing fluid. The recommended formula is Summerheat-Clearing Qi-Replenishing Decoction with modifications.
2. Spleen Deficiency with Dampness Retention︰Lethargy and reluctance to speak, heavy body, bitter taste in mouth, dry tongue, large loose stools, aversion to cold, fullness and oppression in the chest and epigastrium, reduced appetite, scanty urine, thick and greasy tongue coating, soggy pulse. Caused by overstrain, improper diet, and other factors leading to spleen deficiency and impaired transportation, resulting in water-dampness retention. Dampness is heavy and turbid in nature; excessive dampness prevents the clear yang from ascending, hence causing limb fatigue and lack of strength. Clinically, it is accompanied by symptoms of spleen deficiency and impaired transportation such as fullness and oppression in the chest and epigastrium, reduced appetite, and loose stools. Treatment should focus on invigorating the spleen and resolving dampness, ascending lucidity and descending turbidity. The recommended formula is Yang-Raising Stomach-Replenishing Decoction combined with Stomach-Calming Powder with modifications.
3. Deficiency of Both Qi and Blood︰Mental fatigue and limb fatigue, shortage of qi leading to reluctance to speak, low and timid voice, vertigo and insomnia, spontaneous sweating and palpitation, numbness in hands and feet, pale complexion without luster, pale lips, tongue, and nails, deep and thin weak pulse. This syndrome is often caused by congenital deficiency, improper recovery after illness, or prolonged illness without proper treatment. Insufficiency of qi and blood leads to malnourishment of the body, resulting in manifestations such as shortage of qi and reluctance to speak, mental fatigue and limb fatigue, vertigo and insomnia, palpitation and spontaneous sweating. Treatment should focus on replenishing both qi and blood, and the Ten Major Tonics Decoction can be modified for use.

The differentiation of the above three syndromes: Summer heat injuring qi and causing fatigue occurs in the summer, presenting both manifestations of summer heat and symptoms of qi deficiency; spleen deficiency with dampness retention fatigue often occurs in the summer and autumn seasons, showing signs of dampness obstruction as well as symptoms of spleen deficiency. The first two syndromes are both a combination of deficiency and excess. Fatigue due to dual deficiency of qi and blood is purely a deficiency pattern, primarily characterized by qi deficiency and blood deficiency. Clinically, these three are relatively easy to differentiate based on their manifestations.

bubble_chart Documentation

1. Lingshu-Hai Lun: "Insufficiency of the sea of marrow leads to brain dizziness, tinnitus, soreness of the shins, dizziness, and blurred vision, resulting in lethargy and a desire to lie down."
2. Chinese Medicine Clinical Essentials: "Dampness can stagnate qi, and summerheat can damage qi. In summer, when summerheat and dampness obstruct internally, there is often no major illness, but extreme fatigue, commonly known as 'summer non-acclimatization.' For mild cases, use Patchouli and Fortune Eupatorium to brew and drink. For severe cases, use Summerheat-Clearing Qi-Replenishing Decoction with modifications."