bubble_chart Concept

Emaciation refers to the condition of having thin muscles, being underweight, or even being as thin as a stick.

The Neijing contains records of "wind consumption," "flesh disintegration," and "loss of flesh." In other medical texts, it is also referred to as "loss of form," "disintegration of flesh," "severe loss of flesh," and "extreme thinness."

Under normal physiological conditions, there is a significant variation in body weight among individuals. If a person is relatively thin but has a full spirit, a bright and moist complexion, normal tongue and pulse, and no physical discomfort, this is not considered a pathological condition and does not fall under this category.

bubble_chart Pattern Analysis

1. Spleen-Stomach Qi Deficiency︰Emaciation, poor appetite, abdominal distension and fullness after eating, loose and thin stool, fatigue and lack of strength, shortage of qi and reluctance to speak, shallow yellow complexion, pale tongue with white coating, weak pulse. Spleen-stomach qi deficiency. Emaciation is caused by postnatal malnutrition or excessive contemplation injuring the spleen and stomach, hence initially manifesting as poor appetite, abdominal distension and fullness after eating, loose and thin stool, and other symptoms of dysfunction of the spleen in transportation. Subsequently, systemic malnutrition symptoms such as emaciation, shallow yellow complexion, fatigue and lack of strength, shortage of qi and reluctance to speak appear. Treatment should focus on tonifying the spleen and replenishing qi, and the prescription selected is Four Gentlemen Decoction with modifications.
2. Deficiency of Both Qi and Blood︰The body is emaciated, with a shallow yellow and lusterless complexion, fatigue and lack of strength, shortage of qi and reluctance to speak, dizziness and dizzy vision, palpitation and insomnia, a pale tongue with thin coating, and a thin and weak pulse. The emaciation due to qi and blood deficiency results from overstrain and internal damage, or post-illness maladjustment, leading to insufficient generation and transformation of qi and blood. The deficiency of qi and blood fails to nourish the whole body, hence the manifestations such as a yellow and emaciated face, fatigue and lack of strength, shortage of qi and reluctance to speak, dizziness and dizzy vision, palpitation and insomnia, all of which are signs of dual deficiency of qi and blood. The treatment should focus on tonifying qi and nourishing blood, and the formula of choice is the Eight Precious Ingredients Decoction with modifications.
3. Lung Yin Deficiency︰Emaciation, dry cough with scanty sputum, blood-streaked sputum, or hemoptysis, dry mouth and throat, tidal fever and night sweats, flushed cheeks in the afternoon, vexing heat in the chest, palms, and soles, red tongue with scant moisture, and thready rapid pulse. This syndrome arises from chronic cough disease damaging the lungs, or dryness-heat invading the lungs, leading to injury of lung fluids and deficiency of lung yin. Insufficient lung yin disrupts the descending and purifying functions, injures the lung collaterals, and thus results in dry cough with scanty sputum, blood-streaked sputum, or hemoptysis. Deficiency of yin fluids and stirring of fire due to yin deficiency manifest as emaciation, tidal fever, night sweats, vexing heat in the chest, palms, and soles, and flushed cheeks in the afternoon. The treatment should focus on enriching yin and clearing the lung, with the prescription Lily Bulb Metal-Securing Decoction as the basis for modification.
4. Stomach Heat︰Emaciation, thirst with a preference for cold drinks, polyphagia with frequent hunger, irritability, fetid mouth odor, scanty dark urine, dry stool, yellow and dry tongue coating, wiry and rapid pulse with strong force. Stomach heat exuberance leads to emaciation due to excessive consumption of pungent-heat or sweet-fatty foods, or pathogenic heat entering the interior, scorching fluids and damaging body fluids. Intense heat results in rapid digestion and frequent hunger, while heat scorching fluids causes thirst with a preference for cold drinks, irritability, fetid mouth odor, and dryness accumulation in stool. Treatment should focus on clearing stomach fire, and the formula selection is Jade Lady Decoction with modifications.
5. Up-flaming of Liver Fire︰Emaciation, dysphoria and restlessness, irritability, dizziness and dizzy vision, hypochondriac region burning pain, bitter taste in mouth and red eyes, scanty dark urine, dry stool and constipation, red tongue with yellow coating, wiry and rapid pulse. Excessive liver fire leading to emaciation is caused by constitutional yang deficiency, or depression and anger transforming qi stagnation into fire, resulting in the gradual consumption of nutrient yin. Excessive liver fire impairs its free-flowing function, hence symptoms such as dizziness and dizzy vision, dysphoria and irritability, hypochondriac region burning pain, etc. The treatment should focus on clearing the liver and draining fire, and the formula selection is Gentian Liver-Draining Decoction combined with All-Along Decoction with modifications.
6. Worm Accumulation︰Emaciated body, complexion shallow yellow, epigastric upset, umbilical and abdominal pain occurring intermittently, poor appetite, or pica, loose and thin stools, pale tongue with white coating, weak and feeble pulse. This condition is caused by unclean diet, parasitic accumulation in the abdomen, stomach disharmony, and spleen transportation dysfunction. Spleen transportation dysfunction leads to emaciation, yellow complexion, poor appetite, and loose thin stools; parasitic accumulation in the abdomen and stomach disharmony result in umbilical and abdominal pain occurring intermittently and pica. This syndrome is characterized by umbilical and abdominal pain occurring intermittently and pica. Treatment should focus on quieting ascaris and expelling parasites, using Parasite-Exterminating Pill with modifications.

Emaciation, although a sign of physical malnutrition, should not be uniformly regarded as a deficiency pattern. Treatment should involve pattern identification to determine the cause of the disease, distinguishing between deficiency and excess. Deficiency should be treated with tonification to nourish the source of qi and blood generation and transformation. In cases of excess, eliminating pathogenic factors to stabilize the body will naturally restore physical fullness.

bubble_chart Documentation

1. Nanjing．The Fourteenth Difficulty Diagnosis: "What is the disease of the damaged pulse?... The second damage is to the muscles, the muscles become emaciated, and the food does not nourish the muscles..."
2. Jingyue Quanshu．Deficiency Damage: "Thought originates from the heart, as the classic says, if the heart is anxious and overthinking, it will harm the spirit, and if the spirit is harmed, it will lead to fear and self-loss, the flesh will be broken and the muscles will be shed, dry hair and lusterless skin, death in winter, this is the result of heart injury."