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“If there is deficiency, supplement it.” When Yang is deficient, it must be supplemented.
Although the term Yang deficiency is used, all five organs have Yang, so the treatment varies. Different individual conditions require targeted approaches to supplement Yang to achieve ideal therapeutic effects. The degree of Yang deficiency can vary, and the treatment methods differ accordingly. However, clinically, methods to supplement Yang can generally be divided into warming Yang and reviving Yang.
Warming Yang is primarily applied in cases of mild Yang deficiency. However, since the functions of the five organs differ, the methods for warming and supplementing the Yang of each organ also vary.
The lung is a delicate organ, intolerant to cold and heat; it can become ill from both. Individuals with Yang deficiency often develop internal cold due to Yin, leading to frequent colds. Nowadays, treatments for colds often involve antibiotics and saline drips without differentiating between cold and heat.
For colds and coughs caused by warm diseases, antibiotics may be effective, but for coughs caused by cold, using antibiotics will only worsen the condition. Therefore, for those who frequently catch colds, it is necessary to check for the presence of Yang deficiency. “Cold in form, cold drinks harm the lungs” refers to individuals with Yang deficiency who often feel cold. Additionally, consuming cold foods will further damage Yang Qi.
Once Yang Qi is damaged, phlegm and dampness can develop, affecting the lung’s ability to disperse and regulate. If the lung cannot disperse and regulate, it will lead to internal phlegm and dampness obstructing the lung, preventing the exterior from being governed, resulting in frequent colds. Since the lung governs Qi throughout the body, treatment should focus on supplementing Qi, warming Yang, and strengthening the spleen to transform dampness simultaneously. The lung is the vessel of phlegm, while the spleen is the source of phlegm.
If the spleen is deficient, it cannot transform dampness, so when treating lung Yang deficiency, it is essential to strengthen the spleen and transform dampness as a fundamental approach. At the same time, use herbs that warm and disperse the lung to promote its dispersing function.
I often use a self-formulated prescription with satisfactory results: Huang Qi (Astragalus) 20g, Cang Zhu (Atractylodes) 20g, Fu Ling (Poria) 30g, Sheng Jiang (Fresh Ginger) 30g, Ban Xia (Pinellia) 15g, Chen Pi (Dried Tangerine Peel) 15g, Su Ye (Perilla Leaf) 20g, Ma Huang (Ephedra) 5g, Xing Ren (Apricot Kernel) 5g, and Dang Gui (Angelica) 10g.
If phlegm and dampness transform into heat, add Gua Lou Pi (Trichosanthes Peel), Huang Qin (Scutellaria), and Sang Bai Pi (Mulberry Root Bark); if Yang deficiency has persisted for a long time, add Fu Zi (Aconite) to invigorate the fire of the Ming Men (Gate of Life) and increase the dosage of Huang Qi. While some use Xi Xin (Asarum) for lung cold conditions, I believe Sheng Jiang is better for lung cold. Sheng Jiang has strong dispersing properties and is effective in eliminating fluids, making it more suitable for lung cold conditions.
The heart governs blood vessels, and heart blood is Yin in nature; it cannot move far without the push and warmth of Yang Qi. When heart Yang is insufficient, symptoms such as heart pain, shortness of breath, palpitations, numbness and coldness in the limbs, and purplish spots on the tongue surface may appear. To determine if there is heart Yang deficiency, one cannot rely solely on a single symptom; a cluster of symptoms must be assessed. However, within this cluster, one symptom will often be particularly severe, indicating the core pathogenesis of the disease.
In cases of Yang deficiency, if shortness of breath is prominent, it indicates that the patient primarily suffers from both Qi and Yang deficiency, necessitating simultaneous supplementation of Qi and warming Yang. A one-sided approach to warming Yang often fails to achieve ideal therapeutic effects; palpitations can have many causes and are a common symptom associated with heart conditions.
In clinical practice, even when Yang deficiency symptoms are present, careful differentiation is required for palpitations. Deficiencies in Qi, blood, Yin, and Yang can all lead to palpitations, and water Qi can also affect the heart. Clinically, it is often observed that Yang deficiency coexists with deficiencies in Qi, Yin, and blood. In recent years, I have collaborated with Director Wang Baoshui of the Respiratory Department at Wenrong Hospital, frequently consulting on chronic lung diseases.
Many chronic lung diseases are not solely lung issues; heart conditions are also prevalent. It is more common to see not just isolated heart Yang deficiency but rather a combination of deficiencies in Qi, blood, Yin, and Yang. “Yin generates Yang”; Yin and Yang are interdependent. Prolonged Yang damage can deplete Yin. Therefore, ancient sages proposed that for treating heart diseases, “to damage the heart, adjust its Ying and Wei.” Ying refers to the Yin aspect, while Wei refers to the Yang aspect. A one-sided approach to nourishing Yin without Yang will lead to an inability to transform Yin, thus failing to nourish the Yin aspect. For patients with predominant heart Yang deficiency, it is essential to also consider the Yin and blood aspects.
I use: Sheng Huang Qi (Astragalus) 30g, Dang Gui (Angelica) 15g (for loose stools, use Ji Xue Teng (Spatholobus) 30g), Bai Shao (White Peony) 15g, Gui Zhi (Cinnamon Twig) 15g, Gou Qi Zi (Goji Berries) 30g, Pao Fu Zi (Processed Aconite) 10g, Fu Ling (Poria) 20g, Chen Pi (Dried Tangerine Peel) 10g as a foundational formula for treatment, which has shown good results. When Yang deficiency symptoms appear, and the pulse is wiry and rapid, with significant palpitations, this indicates water Qi affecting the heart, necessitating the use of draining herbs on the basis of supplementing Qi and warming Yang; only by removing water can the heart be calmed. In cases of acute and severe conditions, one must not be misled by the wiry and rapid pulse; one must prioritize symptoms over pulse diagnosis.
I use: Sheng Huang Qi (Astragalus) 50g, Ji Xue Teng (Spatholobus) 30g, Bai Zhu (White Atractylodes) 30g, Gui Zhi (Cinnamon Twig) 20g, Ze Xie (Alisma) 30g, Pao Fu Zi (Processed Aconite) 20g, Fu Ling (Poria) 100g, Chen Pi (Dried Tangerine Peel) 15g as a foundational formula for treatment, which has shown significant effects; generally, one dose can reverse the condition. Once the condition improves, the treatment direction can be adjusted.
Since the heart governs blood vessels, the herbs used to warm heart Yang should primarily include Gui Zhi (Cinnamon Twig), which has strong dispersing properties and effectively warms while also promoting Yang. If Yang deficiency is severe, Gui Zhi should be combined with Fu Zi (Aconite) to enhance the effect. However, for patients with heart Yang deficiency, it is necessary to also consider the Yin and blood aspects; a one-sided approach to warming Yang and dispersing will deplete Yin and blood. Without blood to circulate, the heart will also be harmed.
Spleen Yang deficiency, from a clinical symptom perspective, is discussed in the “Shang Han Lun” (Treatise on Cold Damage), which states, “For treating Tai Yin disease, if there is diarrhea without thirst, with cold predominating and vomiting, abdominal pain with loose stools, the pulse is deep and weak or cold and tight.” “Or if there is chest fullness and vomiting, and cold-induced diarrhea.”
Diarrhea from eating cold foods can worsen abdominal pain (pressing the area may provide relief), and abdominal distension and digestive issues are often observed. The degree of spleen Yang deficiency can vary; mild cases generally indicate simple spleen and stomach cold deficiency, as mentioned in the “Shang Han Lun,” which suggests using Li Zhong Tang (Regulating the Middle Decoction) (composed of Ren Shen (Ginseng), Bai Zhu (White Atractylodes), Zhi Gan Cao (Honey-fried Licorice), and Gan Jiang (Dried Ginger)).
In cases of severe Yang deficiency, add Fu Zi to the basis of Li Zhong Tang. This is a treatment direction, merely indicating that spleen Yang derives from kidney Yang. In clinical treatment, simply using Li Zhong Tang and Fu Zi Li Zhong Tang for spleen Yang deficiency often yields unsatisfactory results. The spleen governs transformation; it must have normal transformation functions, which require sufficient Yang Qi; if Yang is deficient, Qi and blood will not flow smoothly.
Therefore, for treating spleen Yang deficiency, I often use: Huang Qi (Astragalus) 30g, Cang Zhu (Atractylodes) 30g, Fu Ling (Poria) 30g, Gan Cao (Licorice) 15g, Gan Jiang (Dried Ginger) 20g, Dang Gui (Angelica) 10g, Chen Pi (Dried Tangerine Peel) 10g as a foundational formula. Spleen Yang deficiency leads to poor transformation and elevation, often accompanied by phlegm and dampness. Internal obstruction from phlegm and dampness not only hinders the spleen’s transformation function but also obstructs its elevating function. The role of Ren Shen (Ginseng) is to generate fluids, which is unfavorable for those with internal phlegm and dampness obstruction; Huang Qi (Astragalus) supplements spleen Qi and promotes blood circulation and elevation of Yang; Cang Zhu (Atractylodes) and Bai Zhu (White Atractylodes) have different functions, with Bai Zhu focusing on strengthening and Cang Zhu on promoting; thus, for patients with spleen Yang deficiency, Cang Zhu is more suitable; adding Fu Ling (Poria) to eliminate dampness aids in elevation; adding Dang Gui (Angelica) and Chen Pi (Dried Tangerine Peel) harmonizes Qi and blood.
From a clinical perspective, this foundational formula has shown significantly better results than Li Zhong Tang.
Sweetness enters the spleen; for patients with spleen Yang deficiency, sweet and warm herbs should be combined. Through the gentle nature of sweet herbs, warming Yang herbs can be contained in the middle burner. The most commonly used are Gan Cao (Licorice) and Gan Jiang (Dried Ginger). However, since the spleen governs transformation, for patients with spleen Yang deficiency, while warming and supplementing Yang Qi, it is also necessary to promote spleen function.
Liver Yang deficiency is often overlooked; many believe the liver only has Yin deficiency and not Yang deficiency. In fact, liver Yang deficiency is quite common clinically. Common symptoms of Yin pain are actually liver cold symptoms. The liver is the starting point for Yang Qi in the body, and the liver channel descends to the Yin organs. When liver Yang is deficient, Yang Qi cannot rise, leading to Yin pain. Treatment involves warming the liver and regulating Qi, which is well known among those studying TCM. However, many only consider the spleen for elevation; the spleen’s elevating function requires normal liver Yang. If liver Qi is stagnant and liver wind cannot rise, the spleen cannot elevate either. Li Dongyuan created “Bu Zhong Yi Qi Tang” (Tonifying the Middle and Benefiting Qi Decoction) to elevate Yang, which includes Chai Hu (Bupleurum) and Sheng Ma (Cimicifuga) as wind herbs, utilizing the upward nature of wind herbs to promote Qi movement and achieve the purpose of elevating Yang.
Thus, whenever there is a lack of spleen transformation and elevation, one must consider liver Yang issues. Sufficient liver Yang is necessary to achieve the goal of “wood dispersing earth”; insufficient liver Yang means wood cannot disperse earth. The liver’s desire is to disperse; warming Yang involves not only internal Gui Zhi (Cinnamon Twig) and Wu Zhu Yu (Evodia) but also any warm and dispersing herbs, such as Chen Pi (Dried Tangerine Peel).
Kidney Yang is the root of all Yang Qi in the body, so warming and supplementing kidney Yang is also a core issue in warming Yang. Regardless of which organ has Yang deficiency, if it is somewhat severe, it must be accompanied by warming and supplementing kidney Yang. Clinically, conditions such as chronic bronchial asthma and heart-lung diseases often primarily involve kidney Yang deficiency. However, the kidney stores essence, so for patients with kidney Yang deficiency, when selecting warming Yang herbs, it is best to choose those that also have kidney tonifying and essence-filling properties, such as Ba Ji Tian (Morinda Root), Rou Cong Rong (Cistanches), Sang Piao Xiao (Mantis Egg Case), Tu Si Zi (Cuscuta), Fu Pen Zi (Raspberry), and Ling Xian Pi (Lonicera).
For individuals with kidney Yang deficiency, a one-sided approach to warming Yang is also inappropriate; the Yin aspect must also be considered. Kidney Yin and Yang are the roots of Yin and Yang in the human body; balance is essential for health. Although Yang deficiency symptoms are present, merely warming and supplementing kidney Yang often yields no effect. The “Cui’s Kidney Qi Pill” in the “Jin Gui Yao Lue” (Essentials of the Golden Chamber) is used for warming and supplementing kidney Yang, and from the overall formula perspective, it also contains a significantly larger quantity of Yin-nourishing herbs than warming Yang herbs to achieve the effect of “seeking Yang within Yin.”
Many patients often report feeling cold, frequent nighttime urination, lack of energy upon movement, and frequent colds, which are clear signs of kidney Yang deficiency. However, when they take warming kidney Yang herbs, they often experience heat symptoms such as facial acne and oral ulcers. Conversely, consuming cold foods leads to diarrhea and increased sensitivity to cold. This situation is quite common, and the fundamental reason is the imbalance of Yin and Yang Qi in the kidneys.
For example, patients with menopausal syndrome may experience alternating cold and heat, sweating upon heating, palpitations, insomnia, irritability, poor appetite, and bad temper. This is also clearly caused by the imbalance of Yin and Yang Qi in the kidneys. Some may use Xiao Chai Hu Tang (Minor Bupleurum Decoction) for treatment, but for those with kidney deficiency, using wind herbs indiscriminately will only disturb the fundamental Yuan Qi in the kidneys.
Some may apply “Gui Zhi Jia Long Gu Mu Li Tang” (Cinnamon Twig Decoction with Dragon Bone and Oyster Shell), but this does not address the root problem. For menopausal syndrome patients with symptoms of tidal heat, sweating, palpitations, and insomnia, I have formulated a prescription: Dang Shen (Codonopsis) 30g, Cang Zhu (Atractylodes) 20g, Chen Pi (Dried Tangerine Peel) 20g, Ban Xia (Pinellia) 20g, Fu Ling (Poria) 30g, Dang Gui (Angelica) 15g, Bai Shao (White Peony) 15g, Gou Qi Zi (Goji Berries) 30g, Tu Si Zi (Cuscuta) 50g, Shan Yao (Chinese Yam) 30g, Ba Ji Tian (Morinda Root) 30g, Sang Piao Xiao (Mantis Egg Case) 30g, Huai Niu Xi (Achyranthes) 30g, Dan Pi (Moutan Root) 15g, and Yu Jin (Curcuma) 20g.
If insomnia is severe, add Bai He (Lily); for back pain, add Chuan Duan (Dipsacus) and Gou Ji (Cibotium). This combines clearing the upper, warming the lower, and promoting the transformation of the middle burner to allow Yang Qi to return to the kidneys. I have used this approach to treat menopausal syndrome with satisfactory results.
When discussing reviving Yang, it refers to a severe deficiency of Yang Qi, requiring the use of strong warming and hot herbs to invigorate the body’s Yang Qi.
The “Si Ni Tang” (Four Reversal Decoction) and similar formulas in the “Shang Han Lun” have been used continuously to this day. However, there are two amusing phenomena in the current TCM community: one is that graduates from universities tend to use cool herbs in large hospitals, fearing Fu Zi (Aconite) like a tiger; the other is that some folk doctors with only a superficial understanding of TCM tend to use excessively warm or cool herbs, either too cold or too hot.
Upon encountering inflammation, they immediately prescribe a large quantity of heat-clearing herbs; when Yang deficiency is present, they recklessly use large doses of Xi Xin (Asarum) and Fu Zi (Aconite). The dosages of Xi Xin and Fu Zi can reach dozens or even hundreds of grams. This past January, a patient from Benxi, Liaoning, mentioned that she had seen a folk TCM doctor in Shandong who prescribed 400 grams of Fu Zi in one dose, nearly causing her to suffer from poisoning.
Why is there such reckless use of Xi Xin and Fu Zi? The main reason is that these doctors lack a solid foundation in TCM knowledge and do not understand the properties of the herbs. In clinical treatment, only two types of people can use large doses of herbs: those who are proficient and those who are ignorant. The proficient ones understand and are confident, so they use heavy doses for treatment. The ignorant ones do not know the harm of the herbs; ignorance is not bliss.
Fu Zi and Xi Xin are used for emergency situations, requiring large doses to revive Yang; they should not be recklessly administered at the first sign of Yang deficiency, as this shows a disregard for human life. Fu Zi can invigorate Yuan Yang, and large doses are only for urgent use. If a patient is merely Yang deficient and not at the point of Yang Qi collapse, there is no need to use heavy doses of Fu Zi.
For example, chronic pelvic inflammatory disease, chronic bronchitis, and menopausal syndrome are merely Yang deficient; warming Yang must also pay attention to dosage. Xi Xin primarily serves to penetrate the cold of Shao Yin; it is not necessary to use dozens or hundreds of grams of Xi Xin for Yang deficient patients. Therefore, for patients with only Yang deficiency, treatment should also focus on harmonizing the spleen and kidneys. Strengthening the spleen and stomach to promote transformation, with slight warming, is sufficient; there is no need for heavy doses of Fu Zi or Xi Xin.
Moreover, Yang deficiency does not develop overnight; it is a process that takes a long time, so warming and supplementing Yang Qi cannot be achieved in a day or two. It is impossible to consume the amount of Fu Zi meant for a year within two days. For chronic disease treatment, patience is required; haste makes waste. Otherwise, it will only lead to a shift from one extreme to another.
Common accompanying symptoms in Yang deficient patients include: 1) Yang deficiency leading to insufficient blood circulation; 2) Yang deficiency causing poor Qi transformation leading to dampness obstruction; 3) Dampness and blood stasis mutually obstructing over time, leading to hidden heat. A one-sided approach to warming Yang without addressing accompanying symptoms will not cure the disease. For example, when observing a wiry pulse, purplish spots on the tongue, and skin issues, treatment should focus on warming Yang and promoting blood circulation, using both warming Yang herbs and blood-activating herbs.
When Yang deficient patients present with a pale, swollen tongue with excessive moisture and a wiry, slippery pulse, treatment should focus on warming Yang and promoting fluid metabolism. If there is hidden heat, then warming Yang and dispersing heat should be applied.
However, in clinical practice, conditions do not present in such a mechanical manner. The aforementioned three accompanying symptoms often appear simultaneously and influence each other. Therefore, clinical treatment requires careful differentiation. For instance, if dampness is severe and one only warms Yang without addressing dampness, it may lead to a damp-heat syndrome.
These considerations must be noted in clinical treatment; one cannot simply administer warming herbs at the first sign of Yang deficiency. The treatment principle is to “first address the urgent symptoms while considering the others.” For example, in a Yang deficient patient with water Qi affecting the heart, in the initial days, it is necessary to primarily address the water dampness while warming Yang as a secondary treatment. Once heart function stabilizes, gradually reduce the dampness herbs and increase the warming Yang herbs.
Last winter, I consulted on a patient with chronic obstructive pulmonary disease (COPD) exacerbation at Wenrong Hospital. The patient presented with a cough, excessive phlegm, and severe shortness of breath, unable to lie down. The tongue was pale and swollen with teeth marks. The pulse was deep, wiry, and rapid. The previous TCM prescription was “Ma Xing Shi Gan Tang” (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction) with additional Bai Bu (Stemona) and Qian Hu (Peucedanum) for treatment. I asked Director Wang why this TCM doctor prescribed such a formula; he said the previous TCM doctor believed the patient’s rapid pulse indicated wind-cold transforming into heat.
In fact, this situation was due to long-term lung disease leading to chronic heart failure. This rapid pulse was not due to heat but rather a manifestation of heart failure, requiring warming Yang and promoting fluid metabolism, especially the fluid-promoting herbs must be decisive; a one-sided approach to warming Yang cannot save heart failure.
I prescribed: Fu Ling (Poria) 100g, Sang Bai Pi (Mulberry Root Bark) 30g, Ting Li Zi (Descurainia) 20g, Ma Huang (Ephedra) 10g, Pao Fu Zi (Processed Aconite) 20g, Ji Xue Teng (Spatholobus) 50g. After one dose, the patient’s chest tightness and shortness of breath began to improve within two hours.
Later, I used: Sheng Huang Qi (Astragalus) 50g, Cang Zhu (Atractylodes) 20g, Sheng Gan Cao (Fresh Licorice) 15g, Chen Pi (Dried Tangerine Peel) 15g, Ban Xia (Pinellia) 20g, Fu Ling (Poria) 50g, Gan Jiang (Dried Ginger) 15g, Ji Xue Teng (Spatholobus) 50g, Sang Bai Pi (Mulberry Root Bark) 20g, Ma Huang (Ephedra) 5g, Tu Si Zi (Cuscuta) 30g, Pao Fu Zi (Processed Aconite) 10g, Shi Chang Pu (Acorus) 10g, Bai Jiang Can (Silkworm) 10g. After a week of treatment, the patient’s condition improved, and they were discharged. Twenty days ago, the patient sought my help after experiencing a cold and receiving intravenous treatment for over ten days without improvement. They reported that after discharge, they used the second prescription to obtain herbs from the pharmacy and continued taking them for over two months. In the past six months, they have not had any exacerbations; previously, climbing two flights of stairs was very exhausting, sometimes requiring rest, but now they can climb four to five flights in one go.
For this patient, although Yang deficiency was the root cause, many accompanying symptoms existed. Therefore, in clinical treatment, it is crucial to differentiate the diagnosis of the disease carefully, focusing on the stage of the condition and emphasizing treatment in that area, rather than using a single prescription continuously.
This patient was fortunate to use the second prescription; had they used the first prescription, taking it for ten to fifteen days would have harmed their health. Due to the urgency of the condition, addressing water Qi is equivalent to preserving Yang. This approach of removing water to preserve Yang is similar to the principle of “Cheng Qi Tang” (Purge the Qi Decoction) in preserving Yin.
Dr. Wu Nanjing
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Behaviors that deplete your Yang Qi must be avoided! (The most effective methods for increasing Yang Qi).
Raising Yang Qi is a good way to change your fate.
Fu Zi Li Zhong Wan, specifically for treating insufficient Yang Qi.
All diseases stem from the depletion of Yuan Yang Qi.
“Huang Di Nei Jing”: Without understanding what “essence and Qi” are, it is difficult to diagnose diseases and prolong life! (Explaining the mysteries of Yin and Yang).
The process of Yang Qi weakening in the body is the process of disease development.
Many young people today are suffering from insufficient Yang Qi | Teacher Nan Huaiqing.
Li Lihong: In the winter months, one must nurture and store; otherwise, Yang Qi will be harmed, leading to various diseases.
Lu Chonghan: The importance of Yang Qi.
Many young people today are suffering from insufficient Yang Qi | Teacher Nan Huaiqing.
Li Lihong: The importance of balance in TCM; why do we always emphasize supporting Yang?
Lu Chonghan: The importance of Yang Qi.
Lu Chonghan: The human body is like a stone mill; Yang Qi is the driving force.
Great doctor Lu Chonghan: Premature aging is due to the depletion of Yang Qi.
Nourishing life is about nourishing Yang Qi.
Li Ke: Where Yang Qi does not reach, there is disease!
“Insufficient Yang Qi, internal Yin evil” is the root of cancer!
Clapping as a health method: clapping vibrates Yang Qi, with astonishing effects.
Old TCM practitioner Li Ke | Understanding depression through Yang Qi.
Western medicines that harm Yang Qi; you must know!
All diseases are related to cold; the fundamental approach of TCM is: support Yang, disperse cold, and eliminate stasis.
Cold easily harms Yang Qi, and dampness also easily harms Yang Qi; what is the difference between the two?
Life is a bundle of Yang Qi; the key to health and disease treatment is to nourish Yang!
Complete Yang is immortal, complete Yin is ghostly; Daoist Yang Qi and health (recommended).
It is better to warm and supplement than to cool and harm – ten major bad habits that consume modern people’s Yang Qi.
Yang Qi is the best medicine for healing; 80% of modern people suffer from insufficient Yang Qi.
In hundreds of cases of cancer, TCM examinations revealed two astonishing commonalities! These Western medicines have been harming Yang Qi!
The secret to restoring Yang Qi in the body.
“Insufficient Yang Qi, internal Yin evil” is the root of cancer.
How to supplement Yang Qi in humans?
TCM believes that without Yang Qi, there is no life (Master Li Ke discusses Yin and Yang).
The secret to restoring Yang Qi in the body.
How to supplement Yang Qi in humans?
Insufficient Yang Qi is due to too many debts.
Accumulating sunlight and driving away Yin Qi.
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