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Source: Yungu Mountain House
In China, the term “Kidney Deficiency” is well-known, yet most people cannot distinguish between Kidney Yang Deficiency and Kidney Yin Deficiency. This article discusses the specific types of kidney deficiency and provides the simplest TCM formula for adjustment, which is practical and worth praising!
1Identifying Kidney Yang Deficiency and Supplementing True Yang is Not Complicated
Individuals with Kidney Yang Deficiency often exhibit soreness or pain in the lower back and knees, feeling cold, and having cold extremities, especially in the lower limbs. Their complexion may appear pale and lack luster (referred to in TCM as “pale complexion”) or dark and dull (referred to as “dark complexion”). They may feel fatigued, lethargic, and experience dizziness.
They may have clear and prolonged urination, increased nighttime urination, weak urination, residual urine after urination, or experience edema in the lower body; or they may have abdominal distension and diarrhea, with loose stools containing undigested food. Some may experience diarrhea at dawn (known in TCM as “five dawn diarrhea”).
Men may experience reduced libido, impotence, premature ejaculation, or nocturnal emissions; women may have cold wombs leading to infertility, with a clear and copious vaginal discharge. The tongue is pale and swollen, with a white or slippery coating, and the pulse is deep, slow, and weak, particularly at the wrist.
Although the symptoms of Kidney Yang Deficiency can be complex, they share a common characteristic of coldness, so we can refer to individuals with Kidney Yang Deficiency as the “cold group.” Just remember that if there are signs of coldness along with kidney deficiency, it indicates Kidney Yang Deficiency.
Yang Qi is the body’s fire energy, maintaining body temperature and resisting external cold. The kidneys are the foundation of congenital essence, and Kidney Yang is the root of the body’s Yang Qi, also known as “Yuan Yang,” “True Yang,” or “Mingmen Fire.”
Kidney Yang Deficiency means insufficient fire energy in the body, which naturally leads to a fear of cold. People often say, “A strong young man can sleep on a cold bed, relying on his strong fire energy,” meaning that a robust young man has strong resistance to cold, which actually indicates vigorous Kidney Yang.
To change the weak constitution of Kidney Yang Deficiency, one must use warming methods to treat it. The treatment for kidney deficiency is to supplement, and for Yang deficiency, one must use warming supplements. Warming supplements refer to the warming and hot nature of the herbs used to replenish the body’s Yang Qi, essentially replenishing the body’s fire energy.
In traditional Chinese medicine, there are many herbs that warm and supplement Kidney Yang, with the most famous being Fu Zi (Aconite) and Rou Gui (Cinnamon). Friends with weak Kidney Yang should seek treatment from a doctor for safety.
For those with milder and simpler symptoms of Kidney Yang Deficiency, they can use warming Kidney Yang TCM formulas for adjustment. There are many such formulas, and below we introduce a well-known and historically safe TCM formula—Gui Ling Ji.
Emperor Jiajing of the Ming Dynasty was frail and sickly, bedridden at the age of 29 and unable to have children. Imagine, with the emperor bedridden, no one could govern the country, and there was no heir, causing great anxiety among officials. They announced to the world, seeking a miraculous doctor to cure the emperor’s illness.
During the Ming Dynasty, two famous alchemists—Shao Yuanjie and Tao Zhongwen—based on the records of the “Lao Jun Yi Shou San” from the Song Dynasty Daoist Zhang Junfang, combined their clinical experience and selected twenty-eight herbs according to the arrangement of the twenty-eight constellations to create a medicine, which they refined for forty-nine days and presented to Emperor Jiajing.
Emperor Jiajing took this medicine and gradually recovered, becoming strong by the age of 50, and fathered eight sons and five daughters. The emperor was delighted and named this medicine Gui Ling Ji, designating it as the exclusive medicine for the royal family.
It is said that one of the longevity experiences introduced by the famous longevity emperor Qianlong was to regularly take Gui Ling Ji. Below is a brief introduction to Gui Ling Ji.
2Gui Ling Ji
【Composition】
Ren Shen (Ginseng), Lu Rong (Deer Antler Velvet), Hai Ma (Seahorse), Gou Qi Zi (Goji Berries), Ding Xiang (Clove), Chuan Shan Jia (Pangolin), Que Nao (Bird’s Nest), Niu Xi (Achyranthes), Shu Di Huang (Rehmannia), Sheng Di Huang (Raw Rehmannia), Bu Guo Zhi (Psoralea), Tu Si Zi (Cuscuta), Du Zhong (Eucommia), Shi Yan (Stone Fish), Rou Cong Rong (Cistanche), Gan Cao (Licorice), Tian Dong (Asparagus), Yin Yang Huo (Epimedium), Suo Yang (Cynomorium), Di Gu Pi (Lycium), Qing Ting (Dragonfly), Tian Xiong (Tian Xiong), Zhu Sha (Cinnabar), Ji Xing Zi (Jing Zhi), Jiang Zhi (Ginger Juice), Da Qing Yan (Big Blue Salt), Sha Ren (Amomum), etc.
【Effects】
Strengthens the body and nourishes the brain, solidifies the kidneys and supplements Qi, enhances appetite. Used for memory decline, nocturnal emissions, lower back pain, leg weakness, phlegm cough, five dawn diarrhea, and loss of appetite due to Kidney Qi deficiency.
【Capsules】
Each capsule is 0.3 grams, take 2 capsules once a day, 2 hours before breakfast with light salt water.
Generally, TCM pharmacies have boxed Gui Ling Ji, which can be purchased under the guidance of a doctor. Please use it under the guidance of a doctor or according to the instructions.
3Identifying Kidney Yin Deficiency and Nourishing Yin and Clearing Heat
Individuals with Kidney Yin Deficiency may experience soreness or pain in the lower back or knees, dizziness, tinnitus, insomnia with vivid dreams, and weight loss; they may feel heat in the palms, soles, and chest (known in TCM as “five hearts heat”), experience tidal fever, and sweat during sleep (night sweats), have a flushed face, dry mouth and throat, dry and hard stools, and short yellow urine.
Men may have strong libido (easy erection), nocturnal emissions, and premature ejaculation; women may have scanty menstruation, or even amenorrhea, or prolonged menstrual bleeding (metrorrhagia). The tongue is thin, red, and may have little or no coating, and the pulse is thin and rapid (more than four beats per breath).
Individuals with Kidney Yin Deficiency have many complex symptoms, but the common characteristic is dryness and heat, so we can refer to those with Kidney Yin Deficiency as the “dry heat group.” Just remember that if there are signs of heat along with kidney deficiency, it indicates Kidney Yin Deficiency.
If Yang represents the body’s fire energy, Yin represents the body’s moisture. The kidneys are the foundation of congenital essence, the residence of water and fire, and Kidney Yin and Yang are the roots of Yin and Yang. Yin and Yang are relatively balanced and mutually restraining.
Yin deficiency means a lack of moisture in the body, leading to relative excess of fire, which manifests as heat signs. This is known as Yin deficiency with excess fire, meaning that individuals with Yin deficiency are prone to heat. If you often get angry, have a dry mouth and throat, and your palms and soles feel hot, then you likely have Yin deficiency.
To change the state of Kidney Yin Deficiency, one needs to nourish Kidney Yin, which means increasing the body’s moisture. Since Kidney Yin Deficiency presents heat signs, the herbs used to nourish Kidney Yin are cold in nature. Daoists refer to the method of nourishing Kidney Yin as “Zhi Bu Kidney Yin.”
In TCM, there are many herbs that nourish Kidney Yin, such as Sheng Di Huang (Raw Rehmannia), Xuan Shen (Scrophularia), Nu Zhen Zi (Ligustrum), and Han Lian Cao (Eclipta). There are also many TCM formulas for nourishing Kidney Yin, and it is best to take these under the guidance of a doctor.
For those with mild, typical, and simpler symptoms of Kidney Yin Deficiency, they can take Liu Wei Di Huang Wan (Six Flavor Rehmannia Pill).
Liu Wei Di Huang Wan is a well-known and star-level TCM formula for nourishing the kidneys, originating from the pediatric physician Qian Yi’s “Pediatric Medical Evidence.” It was formulated by Qian Yi based on the Jin Gui Shen Qi Wan by the medical sage Zhang Zhongjing, removing Rou Gui (Cinnamon) and Fu Zi (Aconite), and consists of six herbs: Shu Di Huang (Rehmannia), Shan Yao (Chinese Yam), Shan Zhu Yu (Cornus), Ze Xie (Alisma), Fu Ling (Poria), and Dan Pi (Moutan). The main herb is Di Huang (Rehmannia), hence the name Liu Wei Di Huang Wan.
Although the formula contains only six herbs, the combination is exquisite, characterized by: primarily nourishing the kidneys, supplementing all three Yin, and balancing three supplements with three drains. The formula uses Di Huang to primarily nourish the kidneys; Shan Yao supplements the spleen while also nourishing the kidneys and lungs; Shan Zhu Yu nourishes the liver while primarily nourishing the kidneys, thus supplementing the three Yin of the liver, spleen, and kidneys.
In addition to using Di Huang to nourish Kidney Yin, Ze Xie is used to drain kidney turbidity, as Kidney deficiency can affect the kidney’s water function, leading to damp turbidity; in addition to using Shan Yao to nourish the spleen, Fu Ling is used to drain spleen dampness, as spleen deficiency cannot transform dampness, leading to damp evil; in addition to using Shan Zhu Yu to nourish the liver, Dan Pi is used to drain liver fire, as liver Yin deficiency is prone to excess fire. This is the famous three supplements and three drains.
If a formula contains only tonifying herbs without draining herbs, it is called “stupid tonification,” and the effect may not be good. This is why TCM emphasizes the importance of combinations.
Liu Wei Di Huang Wan is generally taken as small water pills, 6 grams each time, twice a day, or according to the instructions.
4Identifying Qi and Yin Deficiency, Benefiting Qi and Nourishing Yin Simultaneously
Qi and Yin deficiency is characterized by the simultaneous presence of Qi deficiency and Yin deficiency symptoms.
The symptoms of Yin deficiency have been discussed earlier, which include heat signs such as hot palms and soles, heat in the chest, irritability, dry mouth and throat, short yellow urine, and dry stools, along with a thin tongue and little or no coating.
The symptoms of Qi deficiency include fatigue, lack of energy, spontaneous sweating (sweating without activity), weak urination or residual urine after urination, and a pale tongue with a weak pulse.
If the symptoms of Yin deficiency and Qi deficiency coexist, it indicates Qi and Yin deficiency syndrome. Qi and Yin deficiency is a composite syndrome, and there is a growing trend of this condition, with typical manifestations including lower back pain, fatigue, and hot palms and soles.
To change the state of Qi and Yin deficiency, treatment requires both Qi tonification and Yin nourishment. Commonly used formulas include Shen Qi Di Huang Tang (Ginseng and Astragalus Rehmannia Decoction).
Ren Shen (Ginseng), Zhi Huang Qi (Honey-fried Astragalus), Sheng Di Huang (Raw Rehmannia), Shan Yao (Chinese Yam), Shan Zhu Yu (Cornus), Ze Xie (Alisma), Fu Ling (Poria), Dan Pi (Moutan).
Since Qi and Yin deficiency is a composite syndrome, each patient’s presentation may not be identical. Some may have a more balanced presentation of Qi and Yin deficiency, while others may have more pronounced Qi deficiency or Yin deficiency, requiring adjustments to the formula based on each patient’s specific situation.
If Qi and Yin deficiency are relatively balanced, the tonifying and nourishing herbs should also be relatively balanced; if Qi deficiency is more pronounced, the tonifying herbs should be increased, while the nourishing herbs should be reduced; conversely, if Yin deficiency is more pronounced, the nourishing herbs should be increased, while the tonifying herbs should be reduced, mainly adjusting the types or amounts of herbs.
For relatively simple or mild patients, they can take Liu Wei Di Huang Wan, 6 grams each time, twice a day, or according to the instructions. At the same time, they can take Xi Yang Shen (American Ginseng), 6 grams daily, steeped in water or chewed directly.
5Identifying Both Yin and Yang Deficiencies, Nourishing Yin and Strengthening Yang Simultaneously
Yin and Yang deficiency is characterized by the simultaneous presence of symptoms of both Kidney Yin and Kidney Yang deficiencies.
The manifestations of Kidney Yin deficiency include heat signs such as hot palms and soles, while the manifestations of Kidney Yang deficiency include cold signs such as fear of cold and cold extremities.
Since Yin deficiency and Yang deficiency are completely opposite, like water and fire, many believe it is impossible for both to occur in one person. However, many individuals do exhibit both Yin and Yang deficiency symptoms, and those who experience both may find it confusing. If you have symptoms of both Yin and Yang deficiency, you belong to the Yin and Yang deficiency constitution.
The treatment for Yin and Yang deficiency involves simultaneous tonification of both Yin and Yang, meaning that both Yin-nourishing and Yang-supplementing herbs are used together. Yin and Yang deficiency is also a composite syndrome, and some individuals may have a relatively balanced presentation of Yin and Yang deficiency, requiring the herbs in the formula to be relatively equal; if Yang deficiency is more pronounced, the Yang-supplementing herbs should be increased or used in larger amounts; if Yin deficiency is more pronounced, the Yin-nourishing herbs should be increased or used in larger amounts.
For Yin and Yang deficiency, one can use Jin Gui Shen Qi Tang combined with Er Xian Tang.
Rou Gui (Cinnamon), Fu Zi (Aconite), Shu Di Huang (Rehmannia), Shan Yao (Chinese Yam), Shan Zhu Yu (Cornus), Ze Xie (Alisma), Fu Ling (Poria), Dan Pi (Moutan), Xian Mao (Curculigo), Xian Ling Pi (Epimedium).
Jin Gui Shen Qi Tang is also known as Gui Fu Di Huang Tang.
If Yin and Yang deficiency are relatively balanced, one can take Gui Ling Ji in the morning and Liu Wei Di Huang Wan in the evening.
If Yin deficiency is more pronounced, one can use Jin Gui Shen Qi Wan, which is the prepared version of Jin Gui Shen Qi Tang, 6 grams each time, twice a day.
If Yang deficiency is more pronounced, one can use Shen Rong Gu Ben Pian, 5 tablets each time, three times a day.
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