Exhaustion.5(333)

Dr Zhu indicated the Spleen and Lungs as the two main organs to treat in cases of chronic
tiredness, the Spleen for Yang deficiency and the Lungs for Yin deficiency. Each of these can
eventually lead to Kidney-Yang or Kidney-Yin deficiency and Yang-deficiency can lead to
Yin-deficiency or vice versa. Dr Zhu says:

To treat Deficiency there are two interconnected systems: either the Lungs or the

Spleen. Every [Deficiency] disease boils down to Yang or Yin deficiency. Yang

deficiency can lead to Yin deficiency after a prolonged time ... Yin deficiency can

lead to Yang deficiency after a prolonged time .... In Yang deficiency treat the

Spleen, in Yin deficiency treat the Lungs.6(334)

Aetiology

Weak Constitution

A hereditary weakness of constitution is an obvious and frequent cause of chronic tiredness. A
person's constitution is determined by several factors: the parents' constitution in general, the
parents' health and age at the time of conception, the conditions of pregnancy and childhood
development. Zhu Qi Shi considered the inherited constitution as one of the causes of chronic
tiredness and he said: "Inherited causes of tiredness are due to one of the parents being too old
or to exhaustion or disease at the time of conception. [It can also be due] to the conditions of
pregnancy ..."7(335)

The causes and manifestations of poor hereditary constitution have already been discussed in the
chapter on "Headaches" (Chapter 1). It is important to point out, however, that a weak inherited
constitution can manifest in any of the five main Yin organs, not only the Kidneys. Because the
Kidneys store both the pre-natal and post-natal Essence some people identify an inherited weak
constitution only with a Kidney weakness. This is not so; one can inherit a poor constitution in
any of the five Yin organs. The signs of a poor hereditary constitution for each organ are as
follows:

• Heart: nervousness and disturbed sleep in childhood, a bluish colour on the forehead, and
  a relatively deep midline crack on the tongue reaching the area just behind the tip.


• Lungs: a propensity to catching cold and chest diseases in childhood, a thin chest, a pale
  complexion and weak voice and a pulse in both Front positions which is felt more medial
  and running upwards towards the thumb (see Figure 1.1(336) in Chapter 1).


• Spleen: weak muscles and physical tiredness in childhood, a poor appetite and digestive