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1. What is Yang?
The “Neijing” states: “Yang receives qi from heaven to warm the skin and flesh.” Gu Songyuan says: “The warmth of the whole body is Yang qi.” Zhang Cugong says: “The return of Yang refers to the restoration of body temperature.” According to the above, Yang refers to body temperature. However, Elder Li believes that Yang refers to the overall heat of the body, not just the temperature measured by a thermometer.
2. What is Yang Deficiency?
Elder Li believes that Yang deficiency means insufficient heat in the body.
3. Causes of Yang Deficiency
(1) Insufficient constitution.
(2) Excessive consumption of cold foods (the main 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 main 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 is 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) Excessive Yin obstructing Yang (internally and externally).
(12) Bladder Yang deficiency.
(13) Yang collapse.
This article is from “Li Hanqing, One Hundred Renowned TCM Doctors”
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 (such as in Yang syndrome).
Sideburns: Sweating from the temples to the crown.
Face: Pale complexion, face white as if scraped, face red (like painted), feeling heat in the face.
Eyes: Protruding eyes, dark eyes, fatigue, lack of luster in the eyes.
Ears: Tinnitus followed by deafness.
Nose: Nosebleeds.
Mouth: No thirst, foaming at the mouth, 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, neck is thick.
Chest and sides: Chest and side pain, fullness.
Abdomen: Abdominal pain, bloating, pain around the navel, lower abdominal pain like an egg rolling, hernia pain, intestinal colic, intestinal paralysis, abdominal pain with rumbling, abdominal muscle spasms.
Back: Coldness in the back.
Lumbar region: Soreness and discomfort in the lower back.
Genitals: Coldness in the genital area, sperm leakage, impotence, nocturnal emissions, cold uterus, scrotal edema.
Urination and defecation: Clear urine, frequent urination, long clear urine, 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, fear of cold, cyanosis, spontaneous sweating, excessive sweating, prone to colds, excessive cold, pockmarks sinking.
Mental state: Silence, lack of spirit, fatigue, and timidity.
Sensation: Excessive cold, feeling heat in the face.
Sleep: Curling up, irritability and insomnia during the day, calm at night.
Preferences: Likes warmth, fears cold, dislikes cold foods, prefers sunlight, fire, and hot food.
Pulse: Deep, thin, slow pulse, weak, floating, large without root, deep and thin pulse on the right wrist.
Breathing: Wheezing, cold breath, cough.
Skin: Muscles feel like millet, edema, body heat, feeling cold between muscles and bones when pressed.
Muscles: Muscle (eye rim).
Tendons and bones: Tendons feel tight.
Blood: Vomiting 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 foods, but not eating (some may eat, but the tongue must not be dry).
Clothing: Even in hot months, cannot part with warm clothing (some even wear cotton clothing).
Sexual activity: Reduced libido, groaning after sexual activity.
Note: The above symptoms indicate Yang deficiency (Yang deficiency leads to cold), and there may also be Yang deficiency fire not returning to the source, true cold false heat, internal cold external heat, leading to symptoms like vomiting, nosebleeds, and red face. Therefore, one cannot determine Yang deficiency based solely on one point; the main symptoms must be considered (Yang deficiency symptoms must also consider whether there is a false heat appearance).
(2) Main symptoms of Yang deficiency
Insufficient body temperature, fear of cold (including fear of wind and cold foods), cold hands and feet, clear urination, loose stools, moist tongue, deep, slow, thin, weak pulse, impotence, premature ejaculation, soreness and weakness 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 light in the eyes.
3. Tinnitus followed by deafness: Kidney deficiency cannot close and store, Yin qi fills the Yang orifices, and the pulse must be weak; it is advisable to use Gui Fu Di Huang Wan with magnetite, Acorus, and Cistanche.
4. Nausea and vomiting: Due to Kidney Yang deficiency, Yin fire surging upwards; it is advisable to use Zheng Yuan Dan.
5. Foaming at the mouth: If it is Yin deficiency, the mouth must be thirsty.
6. Loose teeth: This is due to Kidney Yang deficiency, with deficiency fire surging upwards (if cold medicine is taken, it will worsen).
7. Diarrhea: Often occurs at dawn, or clear stools, or loose stools like duck droppings.
8. Constipation: There may be cold accumulation. There may be Kidney Yang deficiency with intestinal accumulation.
9. Cold hands and feet: Sometimes cold, sometimes warm is not Yang deficiency; it must be carefully distinguished.
10. Cough: Yang deficiency cough is very rare. (Any chronic deficiency cold cough is Yang deficiency.)
11. Wheezing: Yang deficiency wheezing is rare. Yang deficiency wheezing is often a critical condition because it is the main symptom of true Yang collapse.
12. Alternating diarrhea and urination: This is the lower consumption in 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 areas of TCM, Yang deficiency and Qi deficiency are related; they are actually different, so they must be distinguished.
7. Mechanism
Yang deficiency leads to Qi deficiency, Yang deficiency leads to blood deficiency, which cannot transform essence to generate Qi and blood. (The relationship between Yang and Qi, Qi belongs to Yang; 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 often fearing cold, easily catching cold pathogens (insufficient resistance).
Yang deficiency leads to turbid Yin rising: Turbid Yin spreads, making it easy to develop cough and phlegm fullness in the chest.
Yang deficiency leads to phlegm due to water overflow: Kidney Yang deficiency easily forms phlegm and fluid.
Yang deficiency leads to a preference for Yang assistance: such as light in the morning and heavy in the evening.
Yang deficiency leads to Yin escaping: resulting in significant vomiting and nosebleeds.
Yang deficiency leads to the inability of Yuan Qi to self-regulate: Yang collapse often leads to wheezing.
Spleen Yang deficiency leads to dampness not transforming.
8. Various Symptoms of Yang Deficiency
(1) Exterior Yang deficiency (Wei Yang deficiency): Main symptoms: spontaneous sweating, fear of cold (spontaneous sweating indicates Yang deficiency; feeling cold after sweating). Commonly used 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: Heart fire deficiency. Causes: Water and drink overcoming fire, excessive sweating, liver not generating wood, and the child cannot nourish the mother. Main symptoms: Feeling cold in the heart, palpitations, six pulses weak, sweating after grasping the heart, palpitations wanting to be pressed. Commonly used formulas: Zhen Wu Tang, Ling Gui Zhu Gan Tang, Gui Zhi Gan Cao Tang.
(3) Kidney Yang deficiency: The fire of the Mingmen is deficient. 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, coldness in the genital area, sperm leakage, no children, incontinence, edema, no coating, slow pulse or floating large without root. Commonly used formulas: Gui Fu Shen Qi Wan, Er Jia Long Gu Tang.
(4) Lung Yang deficiency: Causes: External wind-cold not recovering for a long time, insufficient constitution, excessive cold food (excessive cold). Main symptoms: Cough, shortness of breath, expectorating clear phlegm, worsens slightly in cold weather or with cold food, but must be long-term (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). Commonly used formulas: Bao Yuan Tang, Liu Jun Zi Tang with Gan Jiang and Wu Wei, 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, organ cold, mental exhaustion, nocturnal emissions. Commonly used 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: Food and water not transforming, loose stools, phlegm and fluid accumulation, vomiting and coldness. Commonly used 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 Deficiency
1. Shen Fu Tang: Ren Shen one liang, Pao Fu Zi five qian, Sheng Jiang, Da Zao. Treats Kidney Yang deficiency with spontaneous sweating, wheezing, and cold limbs. (From “Annotated Women’s Good Recipes”)
2. Si Ni Jia Ren Shen Tang: Zhi Gan Cao two liang, Gan Jiang two and a half, Fu Zi one piece, Ren Shen one liang. Treats Kidney Yang deficiency with spontaneous sweating, wheezing, and cold limbs, with clear stools, pulse weak and about to collapse.
3. Si Ni Tang: Zhi Gan Cao two liang, Gan Jiang two and a half, Fu Zi one piece. Treats clear stools, cold limbs, and weak pulse.
4. Zhen Wu Tang: Ren Shen, Gan Jiang, Zhi Gan Cao each three liang, Bai Zhu one liang, Fu Zi one piece. Must also have difficulty urinating or see edema, palpitations, dizziness, cough, etc.
5. Li Zhong Tang: Ren Shen, Yu Jiang, Zhi Gan Cao, Bai Zhu each three liang. Treats Spleen and Stomach Yang deficiency, clear stools, abdominal fullness, no tenderness.
6. Wu Zhu Yu Tang: Wu Zhu Yu one sheng, Ren Shen three liang, Sheng Jiang six liang, Da Zao twelve pieces. Treats stomach cold, reduced appetite, nausea, or stomach and abdominal pain, sour regurgitation.
7. Liu Wei Hui Yang Yin: Ren Shen three qian to two liang, Pao Fu Zi, Pao Jiang each two to three qian, Zhi Gan Cao one qian, Shu Di five qian to one liang, Dang Gui three qian. Boil in water to take. Treats impending Yang collapse. (From “Jing Yue Quan Shu · New Formulas”)
8. Qi Fu Tang: Zhi Huang Qi four qian, Pao Fu Zi four qian, Sheng Jiang ten slices. Boil in water to take. Treats Wei Yang deficiency with spontaneous sweating. (From “Chi Shui Xuan Zhu”)
9. Ji Ji Tang: Shu Di, Shan Yu each one liang, Sheng Shan Yao, Sheng Long Gu, Niu Mu Li each six qian, Fu Ling, Bai Shao each three qian, Fu Zi one qian. Treats both Yin and Yang deficiency, wheezing, spontaneous sweating, eyes looking upwards, heart palpitations like a hanging flag, or nocturnal emissions, incontinence, diarrhea, etc. (From “Medical Records of Traditional Chinese Medicine”)
10. Li Yin Tang: Bai Zhu four qian, Gan Jiang five qian, Gui Zhi tip, Zhi Gan Cao, Fu Ling, Bai Shao each three qian, Fu Zi one qian. Treats heart and kidney Yang deficiency, Spleen dampness not rising, stomach depression not descending, phlegm evil flooding, etc.
11. Hei Xi Dan: Treats Yang deficiency rising, wheezing, impending collapse, lower source cold, etc.
12. Fu Zi Tang: Fu Zi two pieces, Fu Ling three liang, Ren Shen two liang, Bai Zhu four liang, Shao Yao three liang. Treats Yang deficiency with internal dampness, limb and joint pain, etc.
13. Dun Fu Tang: Dang Shen, Shan Yu, Bu Guo Zhi (pounded in fire) each four qian, Wu Fu Zi, He Tao Ren each three qian, Sheng Shan Yao five qian, Fu Ling, Sheng Ji Nei Jin each one and a half qian. Treats Spleen and Kidney Yang deficiency, soreness and pain in the lower back and knees, and morning diarrhea, etc. (From “Medical Records of Traditional Chinese Medicine”)
14. Zheng Yuan Dan: Treats Mingmen fire decline, unable to generate earth, vomiting, coldness, chest fullness, red face, dizziness, and other symptoms of Yin fire surging upwards.
15. Xiao Jian Zhong Tang: Gui Zhi three qian, Zhi Gan Cao two qian, Da Zao two pieces, Bai Shao six qian, Sheng Jiang three qian, Yi Tang one liang. Treats deficiency labor with urgent symptoms, or deficiency labor with Yang deficiency fever symptoms.
Source: Yipin Ge
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