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1. What is Yin Deficiency
The term “Yin” is not an empty concept, but refers to the totality of various body fluids. The Daoist scriptures state: “Tears, saliva, essence, fluids, sweat, blood, and other liquids are all classified as Yin.” Yin represents the moisture within the body’s tissues. “Deficiency” indicates insufficiency. The body’s moisture is generally fixed, constituting about two-thirds of body weight. This moisture is continuously consumed and replenished through diet, which is a normal phenomenon. However, if consumption exceeds replenishment, and this continues over time, physiological functions will be affected when moisture is depleted by about 10%. This leads to noticeable changes, which can be perceived either subjectively or objectively, resulting in what is commonly referred to as Yin Deficiency syndrome. Thus, insufficient lung fluids indicate Lung Yin Deficiency, insufficient kidney essence indicates Kidney Yin Deficiency, insufficient heart fluids indicate Heart Yin Deficiency, insufficient liver fluids indicate Liver Yin Deficiency, and insufficient spleen fluids indicate Spleen Yin Deficiency. Generally, Yin Deficiency is primarily focused on the lungs, spleen, and kidneys, while Heart and Liver Yin Deficiencies are categorized under Blood Deficiency due to their emphasis on blood.
2. Causes of Yin Deficiency include the following: 1. Congenital insufficiency: This is the root cause of all deficiency syndromes, especially Yin Deficiency. 2. Chronic illness: Prolonged illnesses (such as febrile diseases, persistent cough, chronic diarrhea, dysentery, malaria, etc.) can lead to Yin Deficiency. 3. Excessive sweating: Overuse of diaphoretic or purgative herbs can also lead to Yin Deficiency, particularly affecting the heart, spleen, and kidneys. 4. Improper sexual activity: This is a major cause of Kidney Yin Deficiency. 5. Excessive consumption of tobacco, alcohol, spicy, and hot foods: This is a primary cause of Lung Yin Deficiency, as excessive heat leads to Yin Deficiency. 6. Overthinking: This is a major cause of Heart Yin Deficiency. 7. Long-term emotional distress: This can lead to Liver Yin Deficiency. 8. Excessive fatigue: This is a primary cause of Spleen Yin Deficiency. Overall, excessive indulgence in alcohol and sexual activities is the most common cause of Yin Deficiency. This is due to the fact that fewer people practice moderation while many indulge excessively. Furthermore, a single factor alone will not quickly lead to Yin Deficiency; it often requires a combination of excessive sexual activity or congenital insufficiency to manifest. Even if it does occur, it is usually easier to treat as it does not damage the fundamental essence. 3. Changes caused by Yin Deficiency can be summarized as follows: 1. Yin Deficiency leads to heat. This explains the phenomena of body heat, bone steaming, five hearts heat, and all heat syndromes caused by Yin Deficiency. 2. Yin Deficiency leads to Blood Deficiency, as body fluids are a major component of blood. 3. Yin Deficiency leads to Blood dryness. The first two points explain the dryness syndromes associated with menstrual irregularities and all forms of blood insufficiency. 4. Yin Deficiency leads to fluid insufficiency. 5. Yin Deficiency leads to insufficient body fluids. These two points explain the symptoms of dry mouth, thirst, dry nose, and dry throat due to insufficient moisture. 6. Yin Deficiency leads to essence deficiency, which explains symptoms such as low essence, sparse essence, and unstable essence. 7. Yin Deficiency leads to excessive heat. 8. Yin Deficiency leads to active heat. 9. Yin Deficiency leads to excessive fire. 10. Yin Deficiency leads to Yang excess. 11. Yin Deficiency leads to excessive fire. The above five points explain all fire phenomena caused by Yin Deficiency, such as bitter mouth desiring coolness, dry tongue, and dry throat. 12. Excessive fire from Yin Deficiency can consume body fluids and lead to phlegm. 13. Active fire from Yin Deficiency can cause water to transform into phlegm. The above two points explain the phlegm syndromes caused by Yin Deficiency. 14. Excessive fire from Yin Deficiency can force blood out of various orifices, explaining various bleeding syndromes. 15. Yin Deficiency leads to deficient fire rising. 16. Yin Deficiency leads to deficient Yang rising. 17. Yin Deficiency leads to deficient Yang reversing. The above three points explain all phenomena of upper body heat, such as facial redness, red lips, flushed cheeks, dry cough, and vomiting. 18. Yin Deficiency leads to empty bone marrow, with fire penetrating the bones, explaining the symptoms of bone steaming and cold skin. 19. Yin Deficiency leads to Yang having no support. 20. Yin Deficiency leads to Yang collapse. The above two points explain the symptoms of sudden dizziness, loss of voice, and absence of heat in the body.
4. Symptoms of Yin Deficiency (1) Symptoms in various body parts: Head: dizziness, headache. Face: flushed cheeks. Eyes: blurred vision, red eyes. Ears: tinnitus, hearing loss (Yin Deficiency fire rising can lead to hearing loss). Nose: dry nose, nasal congestion, hot breath, nosebleeds. Mouth: dry mouth, thirst, vomiting blood, spitting blood, vomiting. Tongue: dry tongue, tongue pain, tongue bleeding. Teeth: loose teeth, bleeding gums. Throat: dry throat, loss of voice, throat ulcers. Chest and abdomen: fullness in the chest, internal heat sensation, abdominal fullness (Zhong Chun states: Spleen deficiency leads to fullness, known as static night syndrome, which is also Spleen Yin Deficiency). Lower back: back pain. Genital area: blood in urine, painful or obstructed urination, nocturnal emissions in men, irregular menstruation, blood depletion leading to amenorrhea, and hidden pain during intercourse in women. Rear genital area: constipation, blood in stool, diarrhea. Limbs: leg and calf soreness, dry heat in the soles of the feet, heel pain, heat in palms and soles, nails dry and discolored. Hair: hair loss, hair disorder. Skin: night sweats, dry and rough skin. Muscles and bones: bone steaming at night, widespread muscle and joint pain, or pain like fractures. Diet: lack of taste, increased hunger. Breathing: shortness of breath, chest tightness, wheezing, phlegm cough, dry cough, coughing blood. Sleep: insomnia.
Without proper standards, it is easy to misdiagnose Yin Deficiency as Yang Deficiency, Qi Deficiency, Blood Deficiency, or Deficient Fire, as different syndromes may present similar symptoms. We must carefully analyze the specific circumstances, progression, and accompanying symptoms to accurately differentiate. (2) Main symptoms of Yin Deficiency: 1. Afternoon body heat. 2. Five hearts heat. 3. Weak and thin pulse. 4. General symptoms include static night syndrome or mild in the morning and severe in the evening. 5. Subjective feeling of heat, preference for cool foods, but eating does not resolve the issue. (3) Accompanying symptoms of Yin Deficiency: 1. Lung Yin Deficiency: (1) Persistent cough not resolving. (2) Producing turbid phlegm or dry cough with little phlegm, or blood-streaked phlegm. (3) Nasal heat or nosebleeds. (4) Chest fullness, inability to sleep on one side, shortness of breath, or hoarseness. 2. Spleen Yin Deficiency: (1) Reduced appetite. (2) Fatigue in limbs. (3) Muscle wasting. (4) Diarrhea. 3. Kidney Yin Deficiency: (1) Soreness in lower back and legs. (2) Nocturnal emissions. (3) Dry heat in the soles of the feet. (4) Heel pain. (5) Painful or obstructed urination. (6) Tinnitus or hearing loss. (7) Loose teeth. (8) Bone steaming and internal heat. Note: The three types of Yin Deficiency are not completely fixed or distinctly separated; there are often overlaps. However, we can determine the focus of treatment based on the severity of symptoms in each area. 5. Diagnosis of Yin Deficiency: The diagnostic methods for this condition, like others, involve the four examinations: observation, listening, inquiry, and palpation, along with various experiential methods. 1. Recognizing from main symptoms: This is the primary diagnostic method for all diseases, as every disease has its fixed main symptoms. 2. Comparing similar symptoms: After identifying the main symptoms, to avoid errors, we need to compare symptoms that are similar to the main symptoms. For example, the main symptom of Yin Deficiency is afternoon body heat, but we cannot immediately assume it is Yin Deficiency without comparing it to the “afternoon body heat” of warm diseases, checking for any changes in climate or external pathogens. This comparison can help reduce errors. From a treatment perspective, ancient texts state: “If it is not cool, it is because there is no water.” Also, “If internal heat does not resolve, and repeated cooling does not reduce the fire, it indicates Yin insufficiency.” Additionally, “If the exterior pathogen does not resolve, and repeated dispersing does not lead to sweating, it indicates that Yin Qi cannot reach.” Furthermore, “In cases of deficiency labor, if one cannot take ginseng and astragalus, it indicates that blood dryness and Yin Deficiency are present.” According to the ratio of diseases, Gu’s theory states: “Yin Deficiency accounts for 80-90%, while Yang Deficiency accounts for 10-20%.” This method is only applicable when distinguishing between Yang and Yin Deficiency, serving as a helpful guide when other methods are unclear, rather than a universal application. 6. Treatment methods for Yin Deficiency: The treatment methods for Yin Deficiency mainly consist of three parts: (1) Treatment for Lung Yin Deficiency: 1. Clear the lungs and moisten dryness (Clear Metal and Moisten the Lungs): This is the primary method for treating Lung Yin Deficiency, such as using Qing Jin Tang, Ba Xian Yu Ye, etc. When used for a long time, care must be taken not to be overly simplistic to avoid causing diarrhea or reduced appetite. 2. Clear the lungs and nourish the kidneys: This method treats Lung Deficiency with concurrent Kidney Yin Deficiency, using formulas that combine the two (such as Gu Ben Wan), or using lung-clearing herbs (like Qing Jin Tang) in the morning and kidney-nourishing herbs (like Liu Wei Di Huang Wan) in the evening, with a focus on the lungs. When Lung Yin Deficiency is severe, regardless of whether Kidney Yin Deficiency symptoms are present, it is essential to nourish Kidney Yin, as the kidneys are the root of congenital essence, while also being cautious not to harm the spleen. 3. Clear the lungs and tonify the spleen: This method treats Lung Yin Deficiency with concurrent Spleen Yin Deficiency, such as using Jia Wei Qing Ning Gao. Treating both meridians can be challenging, as the lungs prefer moisture while the spleen prefers dryness; tonifying the spleen can hinder lung function, and tonifying the lungs can hinder spleen function. If lung-moistening herbs are used excessively, appetite may decrease, or diarrhea may worsen; if spleen-tonifying herbs are overused, dry cough symptoms may worsen. Therefore, when treating Lung Yin Deficiency, regardless of whether there are signs of spleen deficiency, it is crucial to prevent the onset of spleen deficiency.
(2) Treatment for Kidney Yin Deficiency: 1. Nourish Yin and tonify the kidneys (Nourish Water and Control Fire): This is the general method for treating Kidney Yin Deficiency with fire, using formulas like Liu Wei Di Huang Wan, Zuo Gui Yin, etc. Yin Deficiency is always accompanied by fire; as Yin becomes more deficient, fire becomes more intense. However, this fire is different from excess fire and should not be treated with bitter cold herbs, as using bitter cold herbs may not only be ineffective but can also worsen the condition. Therefore, for fire syndromes that do not respond to bitter cold herbs or worsen with their use, this method is most appropriate. 2. Nourish Yin and reduce fire (Nourish Yin and Subdue Yang): This method treats Kidney Yin Deficiency with upward-reversing fire or slight excess fire, using formulas like Zhi Bai Di Huang Wan, Da Bu Yin Wan, or Liu Wei Di Huang Wan with modifications. Since fire is always upward-reversing, it often accompanies excess fire, but in milder cases, the method of nourishing water and controlling fire can be effective, while in more severe cases, this method is necessary. 3. Nourish Yin and clear the lungs: This method treats concurrent Kidney Yin Deficiency and Lung Yin Deficiency, using formulas like Mai Wei Di Huang Wan. Kidney Yin Deficiency easily affects the lungs, leading to cough and other symptoms. 4. Nourish the kidneys and regulate the spleen: This method treats concurrent Kidney Yin Deficiency and Spleen Yin Deficiency. When both meridians are deficient, the treatment should focus on the spleen; otherwise, if the spleen is deficient, it cannot absorb nutrients, and even the best medicines will not be effective. Therefore, when treating Kidney Yin Deficiency, dietary considerations are crucial. (3) Treatment for Spleen Yin Deficiency: The main treatment method should involve neither overly drying nor overly moistening herbs, as the spleen prefers dryness and dislikes moisture, while Yin Deficiency prefers moisture and dislikes dryness. The most effective herbs include Shan Yao, Lian Rou, Bian Dou, and Yi Ren, or combined with Bai He, Dong Hua, Pa Ye, and Mai Dong to treat concurrent Lung Yin Deficiency, such as using Jia Wei Qing Ning Gao. Alternatively, after stopping diarrhea, one can take Liu Wei Di Huang Wan in the morning and evening to treat concurrent Kidney Yin Deficiency. Overall, Yin Deficiency conditions should use sweet and cold herbs, avoiding bitter and cold herbs, as bitter and cold herbs are drying and can harm Yin. Additionally, herbs should be decocted for a longer time, as Yin Deficiency requires heavy and turbid preparations, necessitating prolonged decoction. There is no quick fix for Yin Deficiency, so prolonged use is essential. Ancients often advocated for large doses to nourish Yin, but practical experience shows that smaller doses taken frequently over a longer period are more beneficial. This is because taking nourishing Yin herbs risks harming Spleen Yang, leading to diarrhea and loss of appetite; larger doses are more likely to cause this issue. In treatment, moxibustion should not be used. Zhong Jing stated: “Even a slight fire can cause internal damage, harming bones and muscles, making recovery difficult.” In terms of herbs, Sheng Ma and Zi Su should be avoided. Gu’s theory states: “Misuse of Yin Deficiency leads to upward-reversing Yin fire, increasing cough and phlegm, and causing bleeding.”(The article is sourced from the internet, and copyright belongs to the original author)
The content of this article is for reference only,and should not be used for self-diagnosis or treatment without professional medical advice.