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Throughout history, TCM has treated Yang deficiency and Yin deficiency primarily through tonification methods. Huang Yuan Yu stated: “The Four Symbols represent the rise and fall of Yin and Yang, and Yin and Yang are the fluctuations of the central Qi. When discussed separately, they are called the Four Symbols; when combined, they are simply Yin and Yang. When discussed separately, they are called Yin and Yang; when combined, they are merely the transformations of the central Qi.“
Let’s see how Huang Yuan Yu utilized the theory of rise and fall to treat Yin deficiency and Yang deficiency:
Huang Yuan Yu created the formula for treating Yin deficiency: Di Po Tang (Earth Spirit Decoction)
Ingredients: Ban Xia (Pinellia) 9g, Bei Wu Wei (Schisandra) 3g [ground], Mai Dong (Ophiopogon) 9g [remove heart], Shao Yao (Peony) 9g, Yuan Shen (Scrophularia) 9g, Mu Li (Oyster Shell) 9g [calcined, ground], Gan Cao (Licorice) 6g [honey-fried]
Huang Yuan Yu stated: “Water is Yin, and Yin is generated in the lungs and stomach. If the stomach is rebellious and the lung metal does not consolidate, the monarch and minister rise and leak, then the heart fluid is lost, and there is no source for Yin to be generated. Ban Xia and Wu Wei descend and control the rebellious stomach and lung; Mai Dong and Shao Yao clear the fire of the monarch and minister; Yuan Shen clears metal and benefits water; Mu Li calms the spirit and stores essence“. Gan Cao nourishes the earth and raises the spleen Yang to assist in controlling the rebellious stomach.
Huang Yuan Yu also advised: “If heat injures lung Qi and cannot transform water, then use Ren Shen (Ginseng) and Huang Qi (Astragalus) to benefit Qi and generate water, thus nourishing the essence of Yin. This is the method of nourishing Yin“. Both Ren Shen and Huang Qi are used to raise spleen Yang.
Everyone can compare this with Liu Huang Di Huang Tang (Six-Ingredient Rehmannia Decoction) to see the differences.
Liu Wei Di Huang Tang consists of Sheng Di (Rehmannia), Shan Yao (Chinese Yam), Shan Zhu Yu (Cornus), Fu Ling (Poria), Ze Xie (Alisma), and Dan Pi (Moutan). Clinically, Yin deficiency has never shown symptoms of spleen dampness; using Fu Ling and Ze Xie to drain dampness is inappropriate. Dan Pi is good for clearing ministerial fire but cannot clear monarch fire. A large dose of Sheng Di can hinder the spleen and stomach. Clinically, the efficacy of Huang’s Di Po Tang is better than that of Liu Wei.
Huang Yuan Yu also created a formula for tonifying Yang: Tian Hun Tang (Heavenly Soul Decoction)
Ingredients: Fu Ling (Poria) 9g, Gan Cao (Licorice) 6g, Gan Jiang (Dried Ginger) 9g, Fu Zi (Aconite) 9g, Gui Zhi (Cinnamon Twig) 9g, Ren Shen (Ginseng) 9g. This formula is essentially Huang Ya Tang (Huang’s Sprout Decoction) with Gui Zhi and Fu Zi added.
Huang Yuan Yu stated: “Fire is Yang, and Yang rises in the liver and spleen. If the spleen is trapped and the liver wood does not generate, the warming Qi declines, then Yang has no source for transformation. The root of the spleen’s entrapment is due to earth dampness, and the dampness arises from water cold. Gan Cao and Fu Ling nourish the earth and drain dampness; Gan Jiang and Fu Zi warm the spleen and warm the kidneys; Ren Shen and Gui Zhi reach the wood and support Yang.“
“If liver blood is weak and cannot generate fire, then use Gui (Angelica), Di (Rehmannia), and Shou Wu (Fo-Ti) to nourish the source of Yang spirit. When fire is cleared, the spirit is released; blood is the mother of the spirit.“
Huang Yuan Yu warned us: “Pure Yang is immortal, pure Yin is ghostly. When Yang is abundant, it is strong; when Yin is abundant, it is sick. The incidence of illness due to Yin deficiency is one in a thousand, while that due to Yang deficiency is universal. The medical practices of later generations have gone astray, opening the door to nourishing Yin, often using Yin tonics for those with Yang deficiency, causing calamity throughout history, which is truly lamentable.“
Huang Yuan Yu cautioned that clinically, “the incidence of illness due to Yin deficiency is one in a thousand”. Is the rampant use of Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) for nourishing Yin worth reflecting upon? “Using Yin tonics for those with Yang deficiency, causing calamity throughout history, is truly lamentable!” Is this not worth lamenting?
This formula can be compared with Gui Fu Di Huang Wan (Cinnamon and Aconite Rehmannia Pill). Gui Fu Di Huang Wan consists of Sheng Di (Rehmannia), Shan Yao (Chinese Yam), Shan Zhu Yu (Cornus), Fu Ling (Poria), Ze Xie (Alisma), Dan Pi (Moutan), Gui Zhi (Cinnamon Twig), and Fu Zi (Aconite). Huang Yuan Yu had a high regard for Gui Fu Di Huang Wan, only slightly critiquing the Sheng Di in the formula.
Huang Yuan Yu believed that replacing Sheng Di with Yuan Shen (Scrophularia) would be more appropriate. Sheng Di “is for those with excessive water and dampness, and should not be taken,” “Xuan Shen clears lung metal and generates kidney water,” “it does not cool the central Qi, making it the best choice.”
Huang Yuan Yu’s insights not only identified the root cause of 80-90% of diseases but also created therapeutic formulas. Huang Yuan Yu’s insights are revolutionary, pointing out that the majority of TCM practitioners only know how to treat 10-20% of diseases, while 80-90% are treated incorrectly.
Famous Qing Dynasty TCM physician Ouyang Zhao Xiong stated in the “Four Sacred Heart Sources Preface”: “Since my youth, I have served my parents in illness and have enjoyed reading medical books. Initially, I studied under Yu Jia Yan and Chang, and then under Chen Xiu Yuan. After ten years, I gained nothing. In the fifth year of Daoguang, Jiangxi Chen Guang Fu presented me with a manuscript of eight medical books by Mr. Yu Qiu Huang. Its source is not entirely from medical families, but since the Tang Dynasty, no one has been able to match it. This lost knowledge of two thousand years has finally been revealed. I have taken the “Four Sacred Heart Sources” and “Su Ling Wei Yun” to print and circulate, and the medical style has greatly changed at that time.”
“My learning is from Zhu, Zhang, Liu, and Li; my formulas are indeed derived from Jing Yue’s “Eight Arrays” and Ye’s “Guidelines”. However, those who do not recover have their fate, not the fault of the physician.“
“Reading this book has made me sweat profusely, and I have felt shame and disgust for the wrongs and rights; is it not shocking!“
From this, we can see the charm of Huang Yuan Yu’s book. After reading Huang Yuan Yu’s book, Ouyang Zhao Xiong felt that after ten years of studying under Yu Chang and Chen Xiu Yuan, he had learned nothing. Who were Yu Chang and Chen Xiu Yuan? They were both masters of cold damage, and countless students learned from them. Only Ouyang Zhao Xiong “felt shame and disgust for the wrongs and rights” after reading this book.
Reflecting on his mistakes! “My formulas are indeed derived from Jing Yue’s “Eight Arrays” and Ye’s “Guidelines”. However, those who do not recover have their fate, not the fault of the physician.”
In treating patients, some are cured, and many are not; I believe that is the fate of the patients, not the responsibility of the physician.
It seems that he was wrong. In the past, he could not distinguish right from wrong, and he reversed the truth.
If our TCM university professors, doctoral advisors, and students of TCM could read Huang Yuan Yu’s book and achieve “sweating profusely” and feel shame, then the TCM field would surely experience a significant transformation.
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