Discussing Yin and Yang, the Five Elements, and the various diseases of the world. Listen as Wendon explains the “Huangdi Neijing”.
Hello everyone!
Today, we will talk about what Yin deficiency is. Yin deficiency is a unique professional term in Traditional Chinese Medicine (TCM), which Western medicine does not understand. Those familiar with TCM are well aware of the term Yin deficiency, but it remains a vague concept for many. We all know that deficiency means insufficiency, but what does Yin refer to?
In TCM, Yin refers to the body fluids. What do we mean by body fluids? For example, the saliva secreted in the mouth, the pulmonary fluid in the lungs, and the pericardial fluid between the heart and the pericardium, etc. Body fluids exist in all the organs and systems of the body. The body fluids secreted can separate the organs to prevent adhesion, nourish the organs, and maintain normal body temperature.
Additionally, the fluids produced by the five organs also play a role in lowering body temperature and reflecting physiological functions. The “Suwen: Xuanming Wuqipian” states: “The five organs produce fluids: the heart produces sweat, the lungs produce mucus, the liver produces tears, the spleen produces saliva, and the kidneys produce spittle.” These are the five fluids. Therefore, the five fluids produced by the five organs are: sweat, mucus, tears, saliva, and spittle. Now, let’s introduce the relationship between the five organs and the five fluids, as well as the situation of Yin deficiency in the five organs.
The “Huangdi Neijing” states: “The heart governs the blood vessels, and sweat is the fluid of the heart.” If a person sweats excessively, it will lead to a deficiency of heart Yin. At this point, let’s explain how sweat is produced. The “Huangdi Neijing” says: “Yang added to Yin is called sweat.” How should we understand this? For example, a pot of water placed on the ground will not produce water vapor, but if placed on a stove, it will produce water vapor after a while. The sweat in our body is equivalent to water vapor. In other words, the Yang energy of the body vaporizes the Yin fluids, resulting in sweat.
Under normal circumstances, sweating requires physical activity. If a person sweats while sitting without any exercise, aside from high environmental temperatures, it is pathological. This pathology indicates that the Yang energy in the body is continuously vaporizing the Yin fluids, causing excessive sweating. In TCM, this can be explained in two ways: one is that the body is affected by wind evil, leading to open pores, which is a manifestation of Qi deficiency that requires closing the pores. The other is a manifestation of excessive Yang, meaning that the Yang energy in the body is too strong, continuously evaporating the internal moisture. This requires clearing internal heat to treat the sweating.
In general, normal sweating in the body requires appropriate exercise. We all know that moderate exercise can cause an increase in heart rate and blood flow. The acceleration of blood flow raises body temperature. In this case, our central nervous system has a way to control body temperature by opening the sweat valves, which are the pores, to lower body temperature through sweating.
So, where is our sweat stored?
In TCM, the body’s sweat is stored in the lymphatic system, which is referred to as the Sanjiao (Three Burners) in TCM. The “Huangdi Neijing” states: “The Sanjiao is the official of drainage, from which the waterway emerges.” The term drainage means to clear the waterways. The lymphatic system is spread throughout the body, serving both immune and fluid transport functions. Additionally, it helps maintain normal body temperature.
Once there is a lack of water in the lymphatic system, it cannot maintain normal body temperature, which in TCM is considered a sign of Yin deficiency. Generally, patients with Yin deficiency experience a higher body temperature; many Yin deficiency patients feel hot, but their measured body temperature is still normal. This is an early reaction of Yin deficiency. Once it progresses to a severe stage, the patient may develop a low-grade fever that persists.
So, under what circumstances does one exhibit symptoms of heart Yin deficiency?
For example, heatstroke in summer, excessive exercise leading to profuse sweating, or warm diseases causing excessive sweating can all trigger heart Yin deficiency. Additionally, excessive sweating during special seasons can also lead to heart Yin deficiency. This season is winter. We all know that winter is the time for storage. What is being stored? It is primarily the essence and Qi of the body. Qi is formless and must exist in the form of essence. Therefore, excessive sweating in winter can also lead to the loss of essence, which can cause heart Yin deficiency.
What symptoms do patients with heart Yin deficiency exhibit?
Patients with heart Yin deficiency may experience: palpitations, anxiety, insomnia, fatigue, nocturnal emissions, forgetfulness, heat in the palms and soles, mouth and tongue sores, a red tongue with little coating, and a thin, rapid pulse. Additionally, heart Yin deficiency can lead to neuroses, anemia, hyperthyroidism, tuberculosis, and other syndromes and diseases.
If heart Yin is deficient and cannot balance Yang energy, it will lead to Yin deficiency with excessive Yang, resulting in symptoms of internal heat or even excessive fire due to Yin deficiency. The main symptoms of excessive fire due to Yin deficiency include five hearts feeling hot, tidal fever, night sweats, thirst with dry throat, flushed face, red tongue, and thin, rapid pulse. More severe heart Yin deficiency can lead to an inability to control Yang, resulting in excessive heart Yang, which affects the spirit, manifesting as heat in the heart, restlessness, or insomnia. Therefore, many insomnia patients exhibit this symptom. In TCM, this presentation can generally be diagnosed as heart Yin deficiency leading to excessive heart Yang.
At this point, some friends may ask, what should we take for treatment? I must clarify that if this condition is confirmed, it is not difficult to treat under the care of a TCM practitioner. Generally, in the early stages, taking a little Zhu Sha An Shen Wan to clear heart fire, and later using Tian Wang Bu Xin Dan to nourish Yin and blood can effectively treat it. However, many patients have mixed conditions of cold and heat, deficiency and excess, and it is rare for patients to have only this one condition. Therefore, I advise those without diagnostic ability not to self-medicate. Although Chinese medicine has fewer side effects, using the wrong medicine can still lead to complications. This point is often reiterated, so I won’t elaborate further.
Next, let’s talk about mucus, which refers to nasal mucus. Mucus is the body fluid in the respiratory tract, serving to lubricate the respiratory tract and resist harmful pathogens invading the trachea and lungs. Mucus is produced by the lungs, hence the “Huangdi Neijing” states: “Mucus is the fluid of the lungs.” Once a person exhibits symptoms of lung Yin deficiency, they may experience: dry cough without phlegm, or scanty and sticky phlegm, dry mouth and throat, emaciation, afternoon tidal fever, five hearts feeling hot, night sweats, flushed cheeks, and in severe cases, blood-streaked phlegm, hoarseness, red tongue with little moisture, and thin, rapid pulse.
The causes of lung Yin deficiency are generally due to damage from warm-dry evil. TCM believes that dryness is the main Qi of autumn. We all know that every year, late summer is the season of heat and humidity, characterized by hot, humid, and sticky weather. This is the characteristic of damp evil. However, once autumn arrives, we immediately feel the refreshing air, and the moisture in the air is quickly drawn away, leading to cool weather and fresh air, eliminating the sticky feeling on our bodies.
But after this comfort, we may not realize that a type of evil is quietly arriving with the autumn wind. How can we detect this evil? We can observe nature. After the autumn equinox, we notice that the originally lush green leaves begin to turn yellow, as the moisture in the leaves is gradually drawn away, leading to the withering of the leaves. This is the effect of autumn dryness, which has the effect of drawing moisture from plants. We all know that once the moisture is drawn from plants, they will wither, hence the scene of falling leaves. This is the gathering effect of autumn, which TCM refers to as the evil of dryness.
Autumn dryness is most likely to harm the lungs. The “Huangdi Neijing” states: “The lungs are the upper source of water,” and also says that the lungs are delicate organs that do not tolerate cold or heat. Autumn is the season when the lungs are most affected, making them susceptible to the invasion of dry evil. The characteristic of dry evil is that it consumes the body fluids, leading to a deficiency of body fluids, manifesting as various dry and parched symptoms and signs, such as dryness of the mouth and nose. Phlegm becomes sticky and difficult to cough up, which affects the lung’s ability to disperse and descend, resulting in dry cough with little phlegm, or sticky phlegm that is hard to expel, or even blood-streaked phlegm, and symptoms like wheezing and chest pain. In such cases, TCM will use formulas like Sang Ju Yin, Sang Xing Tang, or Xing Su San for dialectical treatment based on the condition.
Next, let’s discuss tears. The “Huangdi Neijing” states that the liver opens to the eyes, hence tears are the fluid of the liver. Human tears also serve to protect the eyes. If a person experiences dry eyes, it is likely due to liver Yin deficiency. Liver Yin deficiency is also known as insufficient liver Yin.
So, what causes liver Yin deficiency?
There are many causes of liver Yin deficiency, such as emotional distress leading to Qi stagnation transforming into fire, or damage to liver Yin after the late stage of warm diseases, or insufficient kidney Yin leading to insufficient nourishment of the liver, resulting in a deficiency of liver Yin fluids and internal heat disturbing the body.
What does it mean that water does not nourish wood?
In the theory of the Five Elements, the kidney belongs to water, and the liver belongs to wood, and water can generate wood. So, what does water rely on to generate wood? Water itself is the only thing that can generate wood. Therefore, the kidney itself is Yin, and this Yin refers to water.Thus, a person with liver Yin deficiency needs to supplement from kidney Yin.
There is a saying in TCM: “Yi and Gui share the same source,” where Yi refers to the liver and Gui refers to the kidney. The meaning of sharing the same source is that the liver and kidney originate from the same source.What does it mean to share the same source? It means they come from the same origin, indicating that liver Yin and kidney Yin are interconnected.
So, what symptoms do patients with liver Yin deficiency exhibit?
The symptoms of liver Yin deficiency mainly include: dizziness, tinnitus, dry eyes, decreased vision, facial flushing or redness, dry mouth and throat, five hearts feeling hot, tidal fever, night sweats, or subtle burning pain in the hypochondrium, or twitching of the hands and feet, etc. Additionally, once the liver’s function is impaired, it can lead to conflicts with the spleen and stomach, which we commonly refer to as liver-stomach disharmony. Furthermore, liver Yin deficiency can lead to liver Yang hyperactivity, causing hypertension.
The “Huangdi Neijing” states: “The liver governs the smooth flow of Qi,” and besides governing the relaxation of tendons and the excretion of the spleen and stomach, the liver also governs the emotional release. A person with liver Qi stagnation may experience not only physical symptoms of liver-stomach disharmony and pain in the flanks but also be prone to anger. If liver Qi is not released for a long time, it can lead to symptoms of depression. We have discussed the issue of liver Qi stagnation in related courses, so I won’t repeat it here.
Now, back to liver Yin deficiency. I recommend a patent medicine, Qi Ju Di Huang Wan, which is used to nourish liver and kidney Yin deficiency. However, the effect of pills is limited and slow. TCM believes that pills are for slow conditions, meaning they are for diseases that require gradual nurturing.
Next, let’s discuss spittle and saliva. Spittle and saliva are both secretions from the mouth, but there are certain differences. TCM believes that saliva is transformed from spleen essence, originating from the cheeks, i.e., the sides of the teeth, and is relatively thin and can flow from the corners of the mouth; while spittle is produced from kidney essence, originating from under the tongue, is thicker, and is often spat out. Therefore, in clinical treatment, excessive saliva from the corners of the mouth is treated from the spleen, while frequent spitting of spittle is treated from the kidney.
For example, facial paralysis leading to drooling is treated from the spleen. However, if a person frequently spits out spittle, this condition needs to be treated from the kidney.
So, what are the manifestations of spleen Yin deficiency?
The main manifestations of spleen Yin deficiency include: lack of appetite, food not being digested, discomfort in the stomach, hidden pain, or dry retching, dry mouth and throat, irritability, weight loss, and dry, hard stools. The tongue is red with little moisture, yellow or no coating, and the pulse is thin and rapid. Additionally, spleen Yin deficiency is rarely seen in clinical practice because, generally speaking, the spleen is a damp earth organ, and when it is deficient, dampness tends to prevail, making it rare to see spleen Yin deficiency patients, so I won’t elaborate further.
Liver Yin deficiency refers to insufficient Yin fluids in the liver, also known as kidney water deficiency or true Yin deficiency. So, why do we refer to true Yin deficiency when it comes to the kidneys, while other organs are referred to as Yin deficiency? Is there a specific meaning to true Yin?
Indeed, true Yin does have a specific meaning. In the “Jing Yue Quan Shu: Chuan Zhong Lu: Ming Men Yu Yi,” it states: “The Ming Men is the root of original Qi, the residence of water and fire. The Yin Qi of the five organs cannot nourish without it, and the Yang Qi of the five organs cannot manifest without it.” This means that the root of Yin fluids in the body is in the kidney Yin, and the root of Yang energy in the body is in the kidney Yang. Therefore, the Yin in the kidney is referred to as true Yin, and the Yang in the kidney is referred to as true Yang. The kidney Yin, based on the essence in the kidney, nourishes and moistens all the organs and tissues, working in conjunction with kidney Yang, forming the foundation of life. In the “Huangdi Neijing,” the kidney is also referred to as the source of human life. Therefore, the kidney is the starting point of all Yin and Yang energies in the body, highlighting the importance of kidney function in TCM.
Thus, in ancient times, practitioners avoided sexual relations to protect true Yin and true Yang from being leaked, often humorously referred to as the “lower body defense battle” by modern people. Whether in Buddhism or Taoism, the first step in practice is to ensure that one does not leak the body, meaning that kidney essence is not lost. Only by preventing essence loss can one enter the true practice of refining essence into Qi, refining Qi into spirit, and refining spirit into emptiness.
Therefore, the foundation of all practice is the protection of kidney essence. If a person has abundant kidney essence, they will have a clear mind and vibrant life force, which is a basic condition for longevity. Otherwise, even if one lives long, it will be a life filled with ailments, and such a quality of life is certainly not what we desire.
As modern people, achieving this is quite difficult. For example, a patient asks the doctor how to achieve longevity. The doctor replies: you must not smoke, drink, or indulge in lust. The patient asks, if I do all that, can I live long? The doctor responds: if you do all that, what’s the point of living? Upon reflection, this story is indeed quite thought-provoking.
So, what situations can lead to kidney Yin deficiency?
Kidney Yin deficiency can result from prolonged illness, congenital insufficiency, excessive sexual activity, or overuse of warm-dry medications that harm Yin. For modern people, it is often due to damage from sexual desires, which we need not elaborate on; self-awareness is sufficient, and further discussion is unnecessary.
What symptoms do kidney deficiency patients exhibit?
If kidney Yin is insufficient, the secretion of body fluids decreases, manifesting as internal heat due to Yin deficiency or excessive Yang due to Yin deficiency, leading to symptoms such as lower back and knee soreness, dizziness, tinnitus, insomnia with vivid dreams, five hearts feeling hot, tidal fever, night sweats, premature ejaculation, dry throat and flushed cheeks, red tongue with little moisture and no coating, and thin, rapid pulse.
For kidney Yin deficiency, treatment generally focuses on nourishing Yin, with commonly used patent medicines including Liu Wei Di Huang Wan. If there is excessive fire due to Yin deficiency, it is necessary to nourish Yin and clear heat, typically using Da Bu Yin Wan or Zhi Bai Di Huang Wan. If both Yin and Yang are deficient, Jin Gui Shen Qi Wan is used. These are commonly used TCM remedies for kidney supplementation, and they work quite well. However, using them effectively requires diagnostic ability, so those without such ability should use caution.
Alright, the course ends here, and we have completed the discussion on Yin deficiency in the five organs. Thank you all, and see you next time.
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