The information provided here is not a replacement for a doctor. You shouldn't use it for the purpose of self-diagnosing or self-medicating but rather so you can have a more informed discussion with a professional TCM practitioner.
Preliminary reading: What is a pattern? The Kindey in Chinese Medicine The concept of Qi The concept of Deficiency
Key attributes
Chinese name: 肾所不固 Pinyin name: Shèn Suǒ Bù Gù
Pattern nature: Empty
Pattern hierarchy: Specific pattern under Qi Deficiency
Common combinations: Spleen and Kidney Qi Deficiency
Causes
Precursor patterns: Spleen Yang Deficiency Damp-Cold
Common causes: 1. Excessive sexual activity, 2. Childbirth, 3. Physical over-exertion or over-exercising
Diagnosis
Common symptoms: Fatigue Enuresis Cold limbs Spermatorrhoea Sore lower back and seven other symptoms
Pulse type(s): Deep (Chen), Weak (Ruo)
Tongue description: Slightly Pale tongue
Treatment
Treatment principle: Reinforce and stabilize Kidney Qi, raise Qi, tonify Kidney Yang
Common formulas: You Gui Wan Jin Suo Gu Jing Wan Fu Tu Dan and two other formulas
This pattern is also called ‘Lower Original Qi (元气 Yuan Qi) not Firm’, to show that it is also caused by a shortage of the Original Qi. When Original Qi is weak in the Lower Burner, Qi cannot hold Body Fluids which leads to many 'leaking' symptoms of the sperm, vaginal discharge or urination.
When Kidney Qi and Original Qi are Deficient, the Kidneys cannot provide enough Qi to the Bladder, hence the urine cannot be held and this causes frequent urination, incontinence, enuresis, weak-stream urination and dribbling after urination. When Kidney Qi is weak, it cannot hold the sperm or vaginal secretions in women, which leads to spermatorrhoea, premature ejaculation, chronic vaginal discharge and nocturnal emissions without dreams.
The nocturnal emissions are without dreams because they are caused by a totally Qi Deficient situation, the sperm leaks out because Kidney Qi cannot hold it in. If nocturnal emissions happen at the same time as some vivid sexual dreams, this indicates some Empty Heat within the Kidneys arousing sexual desire.
'Leaking' is one of the two typical characteristics of this pattern. The other one is its 'Cold' symptoms like lower back pain sore and weakness, feeling of cold or cold limbs. It is because Qi is also a type of Yang element.
Precursor patterns: Kidney Qi not Firm can derive from Spleen Yang Deficiency Damp-Cold
Excessive sexual activity: For men, this pattern is frequently caused by excessive sexual activity.
Childbirth: For women, too many children too close together can largely deplete Kidney Qi. It can also happen if childbirth is prolonged and difficult.
Physical over-exertion or over-exercising: Both excessive physical work or over-exercising can largely consume Kidney Yang, which then leads to Kidney Qi not Firm.
Diagnosing a pattern in Chinese Medicine is no easy feat and should be left to professional practitioners. In particular one has to know how to differentiate between different types of pulses and tongue coatings, shapes and colors as well as learn to read from a long list of seemingly unrelated symptoms.
Pulse type(s): Deep (Chen) or weak (Ruo)
Tongue description: Slightly Pale tongue
Main symptoms: Fatigue Enuresis Cold limbs Spermatorrhoea Sore lower back Weak lower back Feeling of cold Abundant urination Weak stream urination Recurrent miscarriage White vaginal discharge Dragging down feeling of abdomen
Diagnosis commentary: Key characteristic symptoms of this pattern are the back pain, chronic vaginal discharge and dribbling after urination.
Reinforce and stabilize Kidney Qi, raise Qi, tonify Kidney Yang
The top herbs in You Gui Wan are Prepared Aconite (Zhi Fu Zi), Cinnamon Bark (Rou Gui) and Deer Antler Glue (Lu Jiao Jiao)
Source date: 1624 AD
Number of ingredients: 10 herbs
Key actions: Warms and tonifies Kidney Yang. Replenishes the Essence. Tonifies the Blood.
You Gui Wan is a 10-ingredient Chinese Medicine formula. Invented in 1624 AD, it belongs to the category of formulas that warm Yang and tonify.
Besides Kidney Qi not Firm, You Gui Wan is also used to treat Yang Deficiency or Empty Yang or Kidneys failing to receive Qi.
The top herbs in Tu Si Zi Wan are Cuscuta Seeds (Tu Si Zi), Pilose Antlers (Lu Rong) and Desert-Living Cistanches (Rou Cong Rong)
Source date: 1253 AD
Number of ingredients: 11 herbs
Key actions: Warms the Kidneys. Prevents abnormal leakage such as urinary incontinence or seminal emissions.
Tu Si Zi Wan is a 11-ingredient Chinese Medicine formula. Invented in 1253 AD, it belongs to the category of formulas that warm Yang and tonify.
Besides Kidney Qi not Firm, Tu Si Zi Wan is also used to treat Kidney Essence Deficiency or Kidney Yang Deficiency.
The top herbs in Fu Tu Dan are Cuscuta Seeds (Tu Si Zi), Schisandra Berries (Wu Wei Zi) and Yam (Shan Yao)
Source date: 1107 AD
Number of ingredients: 5 herbs
Key actions: Stabilizes the Kidney Qi. Strengthens the Spleen. Stops leakage.
Fu Tu Dan is a 5-ingredient Chinese Medicine formula. Invented in 1107 AD, it belongs to the category of formulas that secure Essence and stop enuresis.
Besides Kidney Qi not Firm, Fu Tu Dan is also used to treat Spleen and Kidney Qi Deficiency.
The top herbs in Qing E Wan are Eucommia Bark (Du Zhong), Psoralea Fruits (Bu Gu Zhi) and Walnuts (Hu Tao Ren)
Qing E Wan is a 3-ingredient Chinese Medicine formula. Invented in 1107, it belongs to the category of formulas that warm Yang and tonify.
Besides Kidney Qi not Firm, Qing E Wan is also used to treat Kidney Qi Deficiency.
The top herbs in Jin Suo Gu Jing Wan are Milkvetch Seeds (Sha Yuan Zi), Lotus Seeds (Lian Zi) and Lotus Stamens (Lian Xu)
Source date: 1682 AD
Number of ingredients: 6 herbs
Key actions: Stabilizes the Kidneys. Binds up the semen.
Jin Suo Gu Jing Wan is a 6-ingredient Chinese Medicine formula. Invented in 1682 AD, it belongs to the category of formulas that secure Essence and stop enuresis.
Eat a balanced diet of all cooked foods and those with a warm energy such as whole grains, legumes (especially aduki beans), meat (especially lamb, beef and pork), cooked vegetables and greens. Drink walnut tea or use walnuts in cooking. Asparagus, black cherry juice, raspberries and millet all aid Kidney Qi.
Avoid any intake of cold and raw foods and drinks, frozen yogurt, ice cream, popsicles, iced and refrigerated drinks, juices, sodas, coffee and other caffeinated foods and drinks, sugar, alcohol, soy milk and tofu.
If not treated for a long time, this pattern can give rise to Kidney Yang Deficiency.
Kidney Qi not Firm can be a precursor pattern of Lung and Heart Qi Deficiency.
Liver and Heart Blood Deficiency
Kidney Qi not Firm may sometimes be the precursor of this combination of patterns because the Kidneys are the mother of the Liver and Kidney Essence nourishes Liver Blood.
If left untreated Kidney Qi not Firm can lead to Heart Qi Deficiency