Traditional versus modern Acupuncture

c. Shi (Excessive)and Xu (Deficient)Syndromes

In TAP, the needling technique depends on whether the Syndrome is Shi or Xu type. In Shi type (Excess) the needling method is Xie (reducing type), to dispel the Excess Qi. In Xu type (Deficiency) the needling method is Bu (reinforcing type), to stimulate the Deficient Qi. The TCM rule of needling is Shi needs Xie but Xu needs Bu:

Shi Syndrome needs Xie needling;

Xu Syndrome needs Bu needling.

Palpation pressure on the affected areas helps to distinguish the Shi and Xu Syndromes. In Shi (Excess), with Yang fullness, pressure aggravates discomfort. In Xu (Deficiency), with Yang emptiness, pressure alleviates discomfort.

In Shi Syndromes, body resistance is normal but the body is attacked by an exogenous pathogenic factor. The prognosis is not serious if the attacking factor can be expelled, thereby preventing the disease from reaching the internal organs.

Shi (Excess) Syndromes: Disease recent; elation; robust constitution; restless; spastic; voice sonorous; breathing coarse; chest and abdomen full and distended; abdominal pain, worse on pressure or palpation; constipation; tenesmus; urination painful or difficult; urine scanty and concentrated; pulse of Shi type (coarse, rapid, full); tongue red and coated; skin warm.

Syndromes of Shi (Excess) type are usually (but not always) of the Hot type:

Xu (Deficiency) Syndromes: Disease chronic; listless, depressed; weak; asthenic appearance; apathy; pallor; lies curled-up; voice weak; breathing feeble; palpitation; shortage of breath; tinnitus; vision blurred; insomnia; memory poor; sweating; night sweats; abdominal pain, relieved by pressure or palpation; loose stool; nocturnal spermatorrhoea; enuresis; copious clear urine; pulse of Xu type (fine, weak, irregular); tongue pale, with thin coating; skin cold.

In Xu Syndromes, body resistance is lowered and the disease can reach the internal organs more easily. The prognosis is more serious. Deficiency (Xu) of Yin or Yang can cause Hot or Cold Syndromes of the Xu type respectively. In both cases, resistance is low.

Xu (Deficiency) Syndromes are usually (but not always) of the Cold type:

An example of the Yin Xu Syndrome (Cold Syndrome of the Xu type): Chills; limbs cold; pallor; no thirst; listless; apathy; weak; sweating; stool loose; urine copious and clear; pulse slow and deep; tongue pale with white coating.

But, as in most aspects of Chinese thought, the paradox exists also, the Yang Xu Syndrome (Hot Syndrome of the Xu type): Afternoon fever; malar flush; mouth and throat dry; insomnia; restlessness; feverish feeling in palms and soles; night sweats; constipation; urine concentrated; pulse rapid and thready; tongue red with little coating.