Introduction Yang deficiency refers to the decline of Yang Qi in the body, leading to reduced function, weakened metabolism, and low reactivity, which manifests as insufficient Yang heat. Yang Qi plays a crucial role in warming the limbs and internal organs; thus, Yang deficiency can result in diminished bodily functions and symptoms of coldness. Common types include Stomach Yang deficiency, Spleen Yang deficiency, and Kidney Yang deficiency. The main symptoms of Yang deficiency include aversion to cold, cold limbs, pale complexion, loose stools, clear and frequent urination, and a weak, deep pulse.1. What is Yang?The “Huangdi Neijing” states: “Yang receives Qi from heaven to warm the skin and flesh.” Gu Songyuan explains: “The warmth of the entire body is Yang Qi.” Zhang Cugong states: “The concept of returning Yang refers to restoring body temperature.” Based on these interpretations, Yang refers to body temperature. However, Li Lao believes that Yang refers to the overall heat energy of the body, not merely the temperature measured by a thermometer.2. What is Yang Deficiency?Li Lao believes that Yang deficiency indicates insufficient heat energy in the body.3. Causes of Yang Deficiency(1) Insufficient constitution.(2) Excessive consumption of cold foods (the primary cause of Spleen and Stomach Yang deficiency).(3) Excessive sweating (the main cause of Wei Yang deficiency).(4) Improper use of cold medicines.(5) Excessive sexual activity (the primary cause of Kidney Yang deficiency).(6) Yin deficiency: Yin and Yang are interdependent; prolonged Yin deficiency will inevitably lead to Yang deficiency.(7) Qi deficiency (Yang deficiency must be supplemented with Qi).(8) Cold climate: wearing thin clothing (e.g., freezing to death indicates the death of Yang).4. Types of Yang Deficiency(1) Kidney Yang deficiency.(2) Spleen Yang deficiency.(3) Heart Yang deficiency.(4) Lung Yang deficiency.(5) Stomach Yang deficiency.(6) Wei Yang deficiency.(7) Liver Yang deficiency.(8) Exterior Yang deficiency.(9) Interior Yang deficiency.(10) True Yang deficiency collapse.(11) Excess Yin obstructing Yang (above and outside).(12) Bladder Yang deficiency.(13) Yang collapse.5. Symptoms of Yang Deficiency
(1) General symptoms of Yang deficiency
Head: ① Headache (such as Yang deficiency headache), the top of the head feels icy. ② Red complexion (as in Yang syndrome).Sideburns: Sweating from the temples to the crown.Face: Cyanotic complexion, pale as if scraped, red face (as if painted), feeling hot on the face.Eyes: Protruding eyes, dark eyes, fatigue, dull vision, light in the eyes.Ears: Tinnitus followed by deafness.Nose: Nosebleeds.Mouth: No thirst, foamy saliva, nausea, vomiting, although thirsty, unwilling to drink, excessive clear phlegm, vomiting blood, vomiting.Tongue: Swollen tongue, tongue coating must be slippery.Teeth: Loose teeth.Throat: Swollen, painful throat.Neck: Neck feels icy, thick neck.Chest and sides: Chest and side pain, fullness.Abdomen: Abdominal pain, bloating, pain around the navel, lower abdominal pain like an egg moving up and down, hernia pain, intestinal colic, intestinal paralysis, abdominal pain with rumbling, abdominal muscle spasms.Back: Coldness in the back.Waist: Soreness and discomfort in the lower back.Genitals: Coldness in the genital area, slippery white discharge, impotence, nocturnal emissions, cold uterus, scrotal edema.Urination and defecation: Clear urination, incontinence, clear and frequent urination, urinary retention (bladder paralysis), loose stools, diarrhea, constipation, alternating diarrhea and constipation.Limbs: Cold hands and feet, foot edema, soreness and discomfort in the lower back and knees.Whole body: Cold body, aversion to cold, cyanosis all over, spontaneous sweating, excessive sweating, prone to colds, excessive coldness, pockmarks sinking.Mental state: Silence, insufficient spirit, fatigue, lack of energy.Sensation: Excessive coldness, feeling hot on the face.Sleep: Curling up, irritability and insomnia during the day, quiet at night.Preferences: Preferring warmth and fearing coolness, aversion to cold, preferring to wear clothes, preferring sunlight, preferring fire, preferring hot food.Pulse: Deep, thin, slow pulse, weak, floating, large without root, deep and thin on the right wrist.Breathing: Wheezing, cold breath, cough.Skin: Muscles feel bumpy, edema, body heat, feeling cold when pressing between muscles and bones.Muscles: Muscle (eye twitching).Tendons and bones: Tendons twitch.Blood: Coughing blood, nosebleeds must have black spots.Digestive system: Slightly cold food leads to diarrhea.Diet: Reduced appetite, no thirst, or thirsty but unwilling to drink, although craving cold food, but not eating (some may eat but the tongue must not be dry).Clothing: Even in hot months, not parting with warm clothing (some may wear cotton clothing).Sexual activity: Reduced libido, groaning after sexual activity.Note:All the above symptoms indicate Yang deficiency (Yang deficiency leads to cold), and there may also be Yang deficiency with false heat, true cold with false heat, internal cold with external heat, leading to symptoms such as vomiting, nosebleeds, and red face. Therefore, one cannot solely rely on one point to determine Yang deficiency; the main symptoms must be considered (Yang deficiency symptoms must also consider whether there is a false heat appearance).
(2) Main symptoms of Yang deficiencyInsufficient body temperature, aversion to cold (including fear of wind and cold and dislike of cold foods), cold hands and feet, clear urination, loose stools, moist tongue, deep, slow, thin, weak pulse, impotence, premature ejaculation, soreness in the lower back and knees.1. Headache: Often occurs in the morning, accompanied by other Yang deficiency symptoms, prefers warmth around the head, and pain occurs when exposed to cold.2. Light in the eyes: A sign of true Yang exposure. Whether awake or asleep, one sees a bright appearance in the eyes.3. Tinnitus followed by deafness: Kidney deficiency cannot store, Yin Qi obstructs Yang orifices, the pulse must be weak, suitable for Gui Fu Di Huang Wan with magnetite, Acorus, and Cistanche.4. Nausea and vomiting: Due to Kidney Yang deficiency, Yin fire surging upwards, suitable for Zheng Yuan Dan.5. Foamy saliva: If it is Yin deficiency, the mouth must be thirsty.6. Loose teeth: This is due to Kidney Yang deficiency, with deficiency fire rising (if taking cold medicine, it will worsen).7. Diarrhea: Often occurs at dawn, or clear stools, or loose stools like duck droppings.8. Constipation: If there is cold accumulation. If there is Kidney Yang deficiency with intestinal accumulation.9. Cold hands and feet: Sometimes cold, sometimes warm is not Yang deficiency; careful differentiation is needed.10. Cough: Yang deficiency cough is very rare. (Chronic cold cough is always Yang deficiency.)11. Wheezing: Yang deficiency wheezing is rare. Yang deficiency wheezing is often a critical condition because it is a main symptom of true Yang collapse.12. Alternating diarrhea and constipation: This is part of the three consumptions.6. Diagnosis
1. It is essential to understand the main symptoms and general symptoms of Yang deficiency.
2. Yang deficiency must be compared and measured against Yin deficiency symptoms.3. Yang deficiency must be compared and measured against Qi deficiency symptoms. In many cases, Yang deficiency and Qi deficiency are related, but they are actually different, so differentiation is necessary.7. MechanismYang deficiency leads to Qi deficiency, Yang deficiency leads to blood deficiency, which cannot transform essence into Qi and blood. (The relationship between Yang and Qi, Qi belongs to Yang, and if Qi is abundant, it transforms into fire.)Yang deficiency leads to Yin deficiency: Yang generates Yin.Yang deficiency leads to external cold: such as frequent fear of cold, easy to catch cold pathogens (insufficient resistance).Yang deficiency leads to turbid Yin rising: turbid Yin spreads, making it easy to develop cough and phlegm obstruction in the chest.Yang deficiency with water rising leads to phlegm: Kidney Yang deficiency easily forms phlegm and fluid.Yang deficiency prefers Yang assistance: such as light in the morning and heavy in the evening.Yang deficiency leads to Yin escaping: resulting in significant vomiting and bleeding.Yang deficiency leads to the inability to self-regulate Yuan Qi: Yang collapse often leads to wheezing.Spleen Yang deficiency leads to dampness not transforming.
8. Various Deficiency Syndromes1. Exterior Yang deficiency (Wei Yang deficiency): Main symptoms: spontaneous sweating and aversion to cold (spontaneous sweating indicates Yang deficiency, feeling cold after sweating). Common formulas: Huang Qi Liu Yi San or Yu Ping Feng San with Fu Zi (Qi deficiency with Ren Shen), Shao Yao Gan Cao Fu Zi Tang (both Yin and Yang deficiency after sweating).2. Heart Yang deficiency: Deficiency of fire in the Heart. Causes: Water and phlegm obstructing fire, excessive sweating, liver not generating wood, and deficiency of the child cannot nourish the mother. Main symptoms: feeling cold in the heart, palpitations, weak pulse, sweating after exertion, palpitations that feel like they need to be pressed. Common formulas: Zhen Wu Tang, Ling Gui Zhu Gan Tang, Gui Zhi Gan Cao Tang.3. Kidney Yang deficiency: Deficiency of fire in the Mingmen. Causes: congenital insufficiency, excessive sexual desire, excessive sweating, prolonged illness. The first two are the main causes. Main symptoms: soreness and weakness in the lower back and knees, cold in the genital area, slippery discharge, incontinence, edema, no tongue coating, slow pulse or floating large without root. Common formulas: Gui Fu Shen Qi Wan, Er Jiao Long Gu Tang.4. Lung Yang deficiency: Causes: prolonged external wind-cold not resolving, insufficient constitution, excessive cold food. Main symptoms: cough, shortness of breath, clear and thin phlegm, worsens with slight cold or cold food, but must be prolonged (light in spring and summer, heavy in autumn and winter), or has main symptoms of Yang deficiency (cannot be confused with cough due to cold). Common formulas: Bao Yuan Tang, Liu Jun Zi Tang with Gan Jiang, and for those with Kidney Yang deficiency, Zhen Wu, Shen Qi, etc.5. Liver Yang deficiency: Insufficient Liver fire. Caused by insufficient Mingmen fire and insufficient Heart fire. Main symptoms: cold hernia, internal cold, mental fatigue, nocturnal emissions. Common formulas: Gui Gan Long Mu Tang, Dang Gui Si Ni Jia Wu Yu Sheng Jiang Tang.6. Spleen Yang deficiency: Excessive consumption of cold foods, excessive use of cold medicines for heat diseases. Main symptoms: inability to transform food and water, loose stools, phlegm and fluid accumulation, cold diarrhea. Common formulas: Liu Jun Zi Tang with Xiang Sha, Xiao Jian Zhong Tang, Li Zhong Tang, Bu Zhong Yi Qi Tang.
9. Main Formulas and Usage for Yang Deficiency1. Shen Fu Tang: 1 liang of Ren Shen (Ginseng), 5 qian of Pao Fu Zi (Aconite), ginger, and jujube. Treats Kidney Yang deficiency with spontaneous sweating, wheezing, and cold limbs. (From “Xiao Zhu Fu Ren Liang Fang”)2. Si Ni Jia Ren Shen Tang: 2 liang of roasted Gan Cao (Licorice), 2.5 qian of Gan Jiang (Dried Ginger), 1 piece of Fu Zi (Aconite), 1 liang of Ren Shen (Ginseng). Treats Kidney Yang deficiency with spontaneous sweating, wheezing, cold limbs, and clear diarrhea, with a weak pulse.3. Si Ni Tang: 2 liang of roasted Gan Cao (Licorice), 2.5 qian of Gan Jiang (Dried Ginger), 1 piece of Fu Zi (Aconite). Treats clear diarrhea, cold limbs, and weak pulse.4. Zhen Wu Tang: 3 liang each of Ren Shen (Ginseng), Gan Jiang (Dried Ginger), and roasted Gan Cao (Licorice), 1 liang of Bai Zhu (Atractylodes), and 1 piece of Fu Zi (Aconite). Must include symptoms of urinary difficulty or edema, palpitations, dizziness, cough, etc.5. Li Zhong Tang: 3 liang each of Ren Shen (Ginseng), Gan Jiang (Dried Ginger), roasted Gan Cao (Licorice), and Bai Zhu (Atractylodes). Treats Spleen and Stomach Yang deficiency, diarrhea, abdominal fullness, and no tenderness.6. Wu Zhu Yu Tang: 1 sheng of Wu Zhu Yu (Evodia), 3 liang of Ren Shen (Ginseng), 6 liang of Gan Jiang (Dried Ginger), and 12 jujubes. Treats cold in the stomach, reduced appetite, nausea, or abdominal pain, and sour regurgitation.7. Liu Wei Hui Yang Yin: 3 qian of Ren Shen (Ginseng) up to 2 liang, 2-3 qian of Pao Fu Zi (Aconite) and Pao Jiang (Dried Ginger), 1 qian of roasted Gan Cao (Licorice), 5 qian to 1 liang of Shu Di Huang (Rehmannia), 3 qian of Dang Gui (Angelica). Decoction for oral administration. Treats symptoms of impending Yang collapse. (From “Jing Yue Quan Shu: New Formulas”)8. Qi Fu Tang: 4 qian of roasted Huang Qi (Astragalus), 4 qian of Pao Fu Zi (Aconite), and 10 slices of ginger. Decoction for oral administration. Treats Wei Yang deficiency with spontaneous sweating. (From “Chi Shui Xuan Zhu”)9. Ji Ji Tang: 1 liang each of Shu Di Huang (Rehmannia) and Shan Yu (Cornelian Cherry), 6 qian each of Sheng Shan Yao (Chinese Yam), Sheng Long Gu (Dragon Bone), and Niu Mu Li (Oyster Shell), 3 qian each of Fu Ling (Poria) and Bai Shao (White Peony), and 1 qian of Fu Zi (Aconite). Treats both Yin and Yang deficiency, wheezing, spontaneous sweating, upward gaze, palpitations, or nocturnal emissions, incontinence, and diarrhea. (From “Yi Xue Zhong Zhong Can Xi Lu”)10. Li Yin Tang: 4 qian of Bai Zhu (Atractylodes), 5 qian of Gan Jiang (Dried Ginger), 3 qian each of Gui Zhi (Cinnamon Twig), roasted Gan Cao (Licorice), Fu Ling (Poria), Bai Shao (White Peony), and 1 qian of Fu Zi (Aconite). Treats Heart and Kidney Yang deficiency, Spleen dampness not rising, and stomach Qi not descending, with phlegm and fluid accumulation.11. Hei Xi Dan: Treats Yang deficiency rising, wheezing, and impending collapse, with lower source cold.12. Fu Zi Tang: 2 pieces of Fu Zi (Aconite), 3 liang of Fu Ling (Poria), 2 liang of Ren Shen (Ginseng), 4 liang of Bai Zhu (Atractylodes), and 3 liang of Bai Shao (White Peony). Treats Yang deficiency with internal cold and excessive cold dampness, with pain in limbs and joints.13. Dun Fu Tang: 4 qian each of Dang Shen (Codonopsis), Shan Yu (Cornelian Cherry), and Bu Guo Zhi (Psoralea), 3 qian each of Wu Fu Zi (Aconite) and walnut kernel, 5 qian of Sheng Shan Yao (Chinese Yam), and 0.5 qian each of Fu Ling (Poria) and fresh chicken inner golden. Treats Spleen and Kidney Yang deficiency, soreness in the lower back and knees, and morning diarrhea. (From “Yi Xue Zhong Zhong Can Xi Lu”)14. Zheng Yuan Dan: Treats decline of Mingmen fire, inability to generate earth, with symptoms of vomiting, cold diarrhea, chest fullness, red face, dizziness, and other symptoms of Yin fire surging upwards.15. Xiao Jian Zhong Tang: 3 qian of Gui Zhi (Cinnamon Twig), 2 qian of roasted Gan Cao (Licorice), 2 jujubes, 6 qian of Bai Shao (White Peony), 3 qian of Gan Jiang (Dried Ginger), and 1 liang of honey. Treats deficiency heat syndrome or deficiency heat due to Yang deficiency.Previous Articles:
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