Yin-Yang Thinking: Identifying Yang Deficiency and Yin Deficiency (Including 17 Points of Yin-Yang Differentiation)

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Identifying All Yang Deficiency Syndromes

For those with Yang deficiency, Yin energy must naturally be abundant (the term Yin energy refers to the abundance of water, which is blood. When blood is abundant, Qi is weak, which is the cause of Yang deficiency). Although there may be manifestations of all fire symptoms externally (this fire is called “deficiency fire,” which is different from “excess fire.” Excess fire is caused by external pathogens entering the Yang channels, resulting from depression. Deficiency fire occurs when Yin energy rises excessively; Yin refers to water, and Qi refers to the innate Yang of water, hence it is called deficiency fire. Water Qi flows downward smoothly and rises against the flow, which is due to the weakness of the ruling fire, unable to control and absorb, leading to excessive upward movement and illness), it is similar to excess fire, and both should be differentiated using this method, ensuring no mistakes are made.

In cases of Yang deficiency, the person will have a pale blue-white complexion, lackluster lips, sleepy eyes, a low voice, shortness of breath, little energy to speak, a heavy body, fear of cold, expectoration of clear water, lack of appetite, a tongue that is blue and slippery, or black and moist with a pale yellow and smooth color, abundant saliva, and no desire for water; if they drink, they prefer hot soup. Their urination is frequent, pulse is floating and weak, fine and without strength, spontaneous sweating, cold limbs, blue nails, abdominal pain with a contracted feeling, and various symptoms are all true manifestations of Yang deficiency. When using medicine, one should support Yang and suppress Yin (supporting Yang includes the upper, middle, and lower aspects, such as Gui Zhi (Cinnamon Twig), Ren Shen (Ginseng), and Huang Qi (Astragalus) for supporting upper Yang; Jiang (Ginger), Cao Guo (Tsaoko Cardamom), and Xi Sha (West Sand) for supporting middle Yang; Tian Xiong (Heavenly Warrior), Fu Zi (Aconite), and Liu Huang (Sulfur) for supporting lower Yang). However, there are also cases that resemble excess fire, which should also be noted. Yang deficiency symptoms may include a face that is red like vermilion resembling excess fire (indicating that the original Yang has overflowed, and one can rely on the above symptoms), a pulse that is extremely large and strong like a stone (indicating that the original Yang has violently escaped, and one can rely on the above symptoms), and a body that is very hot (this has three aspects: one is that the original Yang has overflowed, and the body must not be painful or thirsty, with no external pathogens to rely on; one is that postpartum blood has suddenly become deficient, and Yang has no attachment; one is that vomiting blood injures Yin, and the original Qi has no support, causing the Qi mechanism to rise outward, and the original Qi also escapes outward). There may also be bleeding from the gaps between the teeth (indicating that Yang Qi is deficient and cannot control blood, leading to excessive blood), and symptoms of shortness of breath, cough, and phlegm (the lungs are the organ of clear deficiency, and cannot tolerate even a trace of Yin energy; now the heart and lung Yang is insufficient, hence cannot control the excessive upward movement of Yin energy. Yin energy refers to kidney water and kidney fire, indicating internal injury). There may also be difficulties in urination and defecation (indicating that Yang is insufficient to transform Yin, and one can rely on the above symptoms). This section briefly outlines a few points; further exploration of Yang deficiency through questions and answers will clarify more.

【Explanation】Zheng states at the beginning of this book: “In medicine, it is not difficult to use medicine, but it is difficult to recognize symptoms; it is also not difficult to recognize symptoms, but it is difficult to recognize Yin and Yang.” He also says: “Chen Xiuyuan’s medical books, thirteen in total, draw from the ancient to the present, discussing deeply and annotating lightly, gaining much from Zhang Zhongjing’s subtlety, and also clarifying it. Among them, the division of Yin and Yang is based on actual evidence, and the lively mechanism of using medicine is sometimes briefly mentioned but not detailed.” Therefore, he wrote the two works “Medical Theory True Transmission” and “Medical Method Round Communication.” In discussing the actual evidence of Yang deficiency and Yin deficiency, and the lively and flexible use of formulas and methods, he elaborates on dozens of points to clarify Zhang Zhongjing’s painstaking efforts in establishing laws and prescriptions, which is sufficient to supplement the shortcomings of Mr. Xiuyuan. Thus, his method of identifying all Yin deficiency and Yang deficiency syndromes is a culmination of the achievements of predecessors, combined with his own clinical experience over decades, making it quite comprehensive and applicable. The Yang deficiency conditions mentioned in this section have been verified by the author over many years of clinical practice, and I am confident in their authenticity. For any of these conditions, using supportive Yang and suppressive Yin medicines with adjustments and combinations will yield effective results. Any fire symptoms without these conditions are all excess fire. However, there are also Yang deficiency symptoms that resemble excess fire, such as the red face like vermilion mentioned by Zheng; although all fire signs are present externally, they should not be mistakenly identified as excess fire, and careful differentiation is necessary. As long as there are Yang deficiency symptoms to rely on, one should still use supportive Yang and suppressive Yin medicines for treatment.

Zheng states: Tian Xiong, Fu Zi, and Liu Huang support lower Yang, which has its characteristics. Li Shizhen’s “Compendium of Materia Medica” states that Wu (Aconite), Fu (Aconite), and Tian Xiong are all medicines that supplement the Yang of the lower jiao (lower burner) due to their similar nature but different names, all possessing pungent, hot properties and being toxic, requiring preparation before use. They are indeed essential medicines for treating lower jiao Yang deficiency. Liu Huang is also extremely hot and pure Yang, capable of supplementing the true fire of the Mingmen (Gate of Life) when it is insufficient. Long Huitang’s “Chun Zi Yi” also states: “Liu Huang is originally the essence of fire, capable of clearing all damp heat.” However, due to its sour and toxic nature, it is generally used sparingly for internal use; only Zhang Yan Chun is adept at using it, and his work “Medical Records of the East and West” states: “Over more than ten years, I have cured countless cases of chronic cold and stubborn cold diseases with raw Liu Huang. Liu Huang is originally non-toxic; its toxicity is its heat, so taking a small amount will not feel hot, and it does not harm the person at all, so it can be taken without preparation and can even be taken regularly. Moreover, throughout history, those who have discussed Liu Huang have all stated that its efficacy surpasses Gui (Cinnamon) and Fu (Aconite). However, using it raw is a foolish view, and it is based on my gradual experimentation, knowing its efficacy is indeed remarkable and stable, thus I dare to use it for treatment. Now, in the city, hundreds of people take raw Liu Huang daily, and none do not increase their appetite and strengthen their bodies; all are foolishly guided by this.” I also often use Liu Huang to treat patients; for any symptoms of diminished Mingmen fire and chronic cold, it is particularly effective, but I do not use it raw; it must be prepared and then used in decoctions or pills. The method is to hollow out a radish, place Liu Huang inside, seal it, and boil it for two hours to remove its odor; or it can be boiled with tofu for two hours as well. A patient, Liu ××, could not eat, and even water was vomited. Upon examination, it was diagnosed as cardia cancer, requiring surgical removal. I diagnosed it as a case of obstruction disease with obvious Yang deficiency symptoms and diminished Mingmen fire, so I used a modified Fu Zi Li Zhong Decoction, adding 20 to 30 grams of Liu Huang, and after three months of treatment, he was completely cured, and it has been five years without recurrence, which proves the efficacy of Liu Huang and its potential for broader application.

As for Zheng’s mention of bleeding from the gaps between the teeth, it is due to Yang deficiency being unable to control blood, leading to excessive blood. I often base my treatment on the principle that “teeth belong to the kidneys,” using Si Ni Decoction with added Gui (Cinnamon) to treat such symptoms, achieving significant results.

For those with shortness of breath, cough, and phlegm, Zheng indicates that it is due to insufficient heart and lung Yang, hence unable to control the excessive upward movement of kidney water and kidney fire, which is indeed a statement based on experience. For treating such conditions, as long as the expectorated phlegm is white, foamy, or salivary, slightly salty, with shortness of breath and chills, I prescribe Fu Zi Li Zhong Decoction with added Sha Ren (Cardamom), and it always yields immediate effects.

As for constipation, resembling sheep droppings, it is generally thought to be due to excess fire. Zheng points out that it is due to Yang not transforming Yin, which is also Yin binding. I follow his idea and use Fu Zi Li Zhong Decoction combined with Ban Liu Wan (Half-Sulfur Pill) with added Rou Cong Rong (Cistanches), Ma Ren (Hemp Seed), and Xing Ren (Apricot Kernel) for effective results. Liu Huang is extremely hot and can supplement the true fire of the Mingmen, promoting Yang Qi to unblock the large intestine, and is also assisted by Ban Xia (Pinellia) to descend turbidity. Therefore, Ban Liu Wan has long been a good agent for treating Yin binding.

Identifying All Yin Deficiency Syndromes

For those with Yin deficiency, Yang Qi must naturally be abundant (the term Yang Qi refers to the abundance of fire. When fire is abundant, water is depleted, which is the cause of Yin deficiency). Although there may be manifestations of all Yin signs externally, resembling Yang deficiency symptoms, they should be differentiated using this method, ensuring no mistakes are made. In cases of Yin deficiency, the person will have a red complexion, energetic spirit, wide-open eyes, insomnia, a loud voice, foul breath, light body, aversion to heat, difficulties in urination, thirst for cold drinks, a tongue with a dry yellow or black-yellow coating, and no saliva, with prickly sensations in the mouth, irritability, or tidal fever with night sweats, dry cough without phlegm, and continuous thirst. The six pulses are long, large, and strong, and various symptoms are all true manifestations of Yin deficiency. When using medicine, one should tonify Yin to break Yang (tonifying Yin includes all six Yin aspects, referring to the discussion on the rise and fall of Qi and blood, where excess Qi indicates a segment of fire, and the methods of preserving Yin, rescuing Yin, transforming Yin, and nurturing Yin are all included; careful consideration will reveal the path of Yin deficiency). However, there are also cases resembling Yang deficiency, with several indicators. In Yin deficiency symptoms, there may be a pulse that is hidden and not felt, or fine like a thread, while if Yang deficiency is extreme (extreme heat leads to a hidden pulse, and there must be the above symptoms to rely on), there may be cold limbs like ice, while if Yang is completely absent (evil heat is hidden internally, and Yang Qi does not reach the four extremities, there must be the above symptoms to rely on), there may be sudden vomiting and diarrhea, profuse sweating like Yang escape (this heat is hidden internally, forcing out vomiting and diarrhea, and there must be the above symptoms to rely on), and a desire to speak but unable to, while if Qi is lost (heat phlegm rises and obstructs, there must be the above symptoms to rely on). This section only briefly outlines a few points; further exploration of Yin deficiency through questions and answers will clarify more.

According to Yin deficiency symptoms, they are all due to excess fire (fire is Qi), and excess fire injures blood; this is an unchanging principle throughout the ages. Later scholars specifically discuss fire, while the true nature of Yin deficiency symptoms is completely obscured. Zhang Zhongjing’s methods of preserving Yin, transforming Yin, nurturing Yin, and rescuing Yin have all been abandoned, and no one recognizes them now, hence this special evidence.

【Explanation】For those with Yin deficiency, due to excess Qi, fire is abundant, hence water is often depleted and blood is weak, and the symptoms presented are often opposite to those of Yang deficiency. In cases of Yang deficiency, due to insufficient Qi, blood cannot be controlled, leading to slow blood flow and low body temperature. In cases of Yin deficiency, water is depleted and fire is abundant, hence body temperature is often high with various fever phenomena. In clinical practice, whenever Yin deficiency symptoms are presented, one should use medicines to tonify Yin and suppress Yang. Although there may be external Yin signs, resembling Yang deficiency, as Zheng mentioned in several situations, as long as there are various symptoms of Yin deficiency, one should still treat according to Yin deficiency.

Appendix: 17 Points of Yin-Yang Differentiation

(1) Yin Syndrome

Any syndrome that conforms to the general attributes of “Yin” is called a Yin syndrome. For example, interior syndromes, cold syndromes, and deficiency syndromes generally fall under the category of Yin syndromes.

【Clinical Manifestations】Generally, interior deficiency cold syndromes all belong to Yin syndromes. Patients may face the wall quietly, close their eyes and dislike brightness (i.e., prefer darkness and drowsiness, not wanting to see people), curl up, feel heavy, have a pale or dull complexion or cyanosis, fatigue and weakness, shallow breathing, speak little, have a low and timid voice, be mentally sluggish, have a confused or faint consciousness, grasp at empty air, feel around for clothes and beds, or prefer warmth, have a bland taste and no thirst, feel cold, have cold hands and feet, dry skin, clear and long urination, loose stools, a pulse that is deep and slow or weak or thin and rough, a pale and plump tongue, and a white and slippery coating. Any disease affecting the blood or organs also falls within the scope of Yin syndromes.

【Syndrome Analysis】Mental sluggishness, fatigue, and low voice are manifestations of deficiency syndromes. Cold limbs and cold body, clear and long urination, and loose stools are manifestations of interior cold. A pale and plump tongue, deep and slow pulse, weak and thin or rough pulse are all signs of deficiency cold.

(2) Yang Syndrome

Any syndrome that conforms to the general attributes of “Yang” is called a Yang syndrome. For example, exterior syndromes, heat syndromes, and excess syndromes generally fall under the category of Yang syndromes.

【Clinical Manifestations】Generally, exterior heat excess syndromes all belong to Yang syndromes. Yang syndrome patients may lie facing outward, open their eyes and enjoy seeing people (with some exceptions for those who are shy of light), stretch their bodies, feel light, have a red complexion, flushed face, a radiant appearance, bright eyes, feel cold and hot, have hot skin, dry mouth and throat, thirst for cold drinks, feel restless and unable to sleep, be mentally agitated, speak loudly or incoherently, have coarse or rough voices, breathe deeply and loudly, have shortness of breath with phlegm, have a clear and loud voice, feel hot and have warm hands and feet, have moist skin, experience constipation with foul odor, and have painful and short urination, with a pulse that is floating, rapid, or strong and forceful, or slippery and solid, with a red tongue and a yellow thick and dry or black coating. Any disease affecting the Qi aspect (or Wei aspect) or affecting the bowels also falls under the category of Yang syndromes.

【Syndrome Analysis】Yang syndrome is a summary of exterior syndromes, heat syndromes, and excess syndromes. The simultaneous presence of cold and heat indicates the characteristics of exterior syndromes. A red complexion, mental agitation, hot skin, dry mouth, and thirst for cold drinks are manifestations of heat syndromes. A coarse voice, deep breathing, shortness of breath with phlegm, and constipation are also manifestations of excess syndromes. A red tongue, yellow or black coating, and a floating, rapid, or strong pulse are all signs of excess heat.

(3) Differentiation between Yin and Yang Syndromes

[Reprinted] TCM Differentiation: Yin-Yang Differentiation

Yin and Yang are relative; when Yang is strong, Yin is weak, and when Yin is strong, Yang is weak. For example, if the pulse is large and strong, the tongue is red with a dry coating, and there are accompanying symptoms of thirst and fever, it indicates that Yang is strong and Yin is weak. If the pulse is deep and slow, the tongue is white with a moist coating, and there are accompanying symptoms of abdominal pain and diarrhea, it indicates that Yin is strong and Yang is weak. In addition, the complex changes of Yin and Yang are specifically manifested in the six categories of cold, heat, deficiency, and excess. Yin deficiency syndrome is also called deficiency heat syndrome, while Yang deficiency syndrome is also called deficiency cold syndrome. The kidneys are the foundation of Yin and Yang in the human body; when Yin and Yang are deficient for a long time, or due to prolonged illness, it can damage kidney Yin or kidney Yang, leading to true Yin deficiency or true Yang deficiency syndromes, which are true Yin deficiency and true Yang deficiency.

The “Medical Mirror of Gu Songyuan” discusses the differentiation of Yin and Yang diseases, mentioning the division of day and night severity, which can also serve as a reference. For example, it states: “Yang diseases are heavier during the day and lighter at night, as Yang Qi and pathogenic Qi are both strong; Yin diseases are lighter during the day and heavier at night, as Yin Qi and pathogenic Qi are both strong. If it is Yang deficiency disease, it is lighter during the day; if it is Yin deficiency disease, it is lighter at night, with Yin and Yang each returning to their respective states. This also indicates their changes; do not be rigid. This is for the practitioners to determine the timing of treatment based on the symptoms; if it is not yet manifested, one should follow and guard against it (treating Yin and Yang according to the situation). If it is at the time of onset, one should avoid its sharp edge; if it has already occurred, one should strike at its sluggish return. Whether during the day or night, if it occurs intermittently, it is purely a deficiency syndrome, and one should not be bound by the timing of day and night; one should take tonics broadly to nourish the right Qi.”

(4) True Yin Deficiency (Kidney Yin Deficiency)

True Yin deficiency refers to the deficiency of true Yin in the kidneys, such as the common clinical manifestations of deficiency heat caused by pulmonary tuberculosis or other chronic consumptive diseases.

【Clinical Manifestations】Deficiency heat may manifest as a pale face with red cheeks, lips like painted red, five hearts feeling hot, dizziness, tinnitus, dry mouth and throat, hot palms and feet, dizziness and blurred vision, tinnitus, weak lower back and knees, bone steaming with night sweats, nightmares, nocturnal emissions, constipation, short and scanty urination, and a pulse that is thin, rapid, and weak, with a red tongue that is dry and has little coating.

【Syndrome Analysis】With prolonged illness, Yin essence is damaged, affecting true Yin, leading to Yang not being controlled, resulting in deficiency heat, hence the pale face with red cheeks, red lips, dry mouth, five hearts feeling hot, night sweats, constipation, scanty urination, red and dry tongue, and thin, rapid, and weak pulse. At the same time, since the disease has affected kidney Yin, symptoms of kidney dysfunction may also appear. For example, the kidney generates marrow and governs bones, leading to symptoms such as dizziness, blurred vision, and weak lower back and legs. The kidney governs reproduction, and deficiency heat disturbs the essence chamber, leading to nocturnal emissions.

(5) True Yang Deficiency (Kidney Yang Deficiency)

True Yang deficiency refers to the insufficiency of true Yang in the kidneys, leading to Yang not supporting Yin, commonly seen in various diseases with declining body functions and reduced basal metabolism, especially in the elderly and weak individuals.

【Clinical Manifestations】Pale complexion, cold limbs, fatigue and desire to lie down, cough with shortness of breath and swelling, pale lips and tongue, bland taste with excessive saliva, shortness of breath and swelling, spontaneous sweating, dizziness, lack of appetite, abdominal distension, and edema of the lower limbs, with loose stools or morning diarrhea, undigested food, Yang atrophy, nocturnal emissions, premature ejaculation, cold essence leading to infertility, or cold uterus leading to infertility, with a pale, moist, or plump tongue, white slippery coating, and a deep, slow pulse or weak pulse at the right wrist.

【Syndrome Analysis】With prolonged illness, Yang Qi is damaged, affecting true Yang, leading to Yin cold internally, resulting in Yang deficiency symptoms, hence the pale complexion, cold body, pale lips and tongue, bland taste with excessive saliva, spontaneous sweating, lack of appetite, pale and plump tongue, white slippery coating, and deep, slow, or weak pulse. At the same time, since the disease has affected kidney Yang, symptoms of kidney dysfunction may also appear. For example, the kidney governs the intake of Qi and water, leading to shortness of breath and swelling, and the kidney governs reproductive functions, leading to Yang atrophy, premature ejaculation, infertility, and kidney deficiency leading to morning diarrhea.

(6) Loss of Yin

Loss of Yin refers to the syndrome of Yin fluids being severely depleted due to excessive loss of body fluids. Loss of Yin is a deficiency heat syndrome.

【Clinical Manifestations】Profuse sweating, shortness of breath, aversion to heat, warm hands and feet, restlessness or confusion, dry mouth and throat, dry lips and tongue, wrinkled skin, sunken eye sockets, cracked lips and tongue, scanty urination or urinary retention, thirst for cold drinks, red and dry tongue, and thin, rapid, and weak pulse. Profuse sweating is often a characteristic of loss of Yin, with the sweat being warm, salty, and thin (loss of Yin due to vomiting or diarrhea may sometimes occur without profuse sweating).

【Syndrome Analysis】Yin fluids are exhausted, losing their moistening function, hence dry mouth and throat, dry lips and tongue, and wrinkled skin. The source of fluids is exhausted, hence very little urination. Yin deficiency leads to internal heat, hence body heat and warm limbs. If deficiency heat rises, it leads to restlessness. A red and dry tongue, and thin, rapid, and weak pulse indicate the signs of dry fluids and deficiency heat. Profuse sweating often occurs in patients with pre-existing heat diseases, where heat evils force fluids to leak out. It can also occur in cases of improper treatment, where excessive sweating is induced. At this time, profuse sweating is both a cause and a symptom of loss of Yin.

(7) Loss of Yang

Loss of Yang refers to a cold deficiency syndrome where Yang deficiency leads to a decrease in bodily functions.

【Clinical Manifestations】Profuse sweating, pale complexion, mental sluggishness, cold limbs, aversion to cold, curled up posture, thirst for hot drinks, bland taste, weak breath, pale and moist tongue, and a pulse that is weak or floating and large.

【Syndrome Analysis】Loss of Yang occurs in various conditions leading to Yang Qi weakness and potential loss. Yang deficiency cannot control fluids, hence the pores open and sweat profusely, with cold sweat and bland taste being essential symptoms of loss of Yang. Yang deficiency leads to cold, hence body coldness, aversion to cold, and cold limbs.

(8) Differentiation between Loss of Yin and Loss of Yang

Loss of Yin and Loss of Yang are dangerous syndromes of disease; a slight misdiagnosis or delayed treatment can lead to immediate death.

Loss of Yin and Loss of Yang refer to the rapid loss of the material basis of life activities and the decline of activity capacity.

Both Loss of Yin and Loss of Yang are caused by high fever, profuse sweating, severe vomiting and diarrhea, excessive blood loss, severe dehydration, collapse, shock, or improper treatment.

Loss of Yin and Loss of Yang are two different types of syndromes; the fundamental cause of Loss of Yin is the massive loss of body fluids, leading to Loss of Yin. The main cause of Loss of Yang is the escape of Yang Qi. Since Qi can escape with fluids and blood, Loss of Yang is also often seen after excessive sweating, vomiting, diarrhea, or severe bleeding. Additionally, many diseases can present Loss of Yang in critical stages.

Yin and Yang are opposites that are interdependent; when Yin is exhausted, Yang Qi has no support and disperses, and when Yang is lost, Yin fluids have no transformation and are depleted. Therefore, Loss of Yin can quickly lead to Loss of Yang, and Loss of Yang often follows Loss of Yin. The two are only different in priority and sequence, with no clear boundary. In clinical practice, it is important to differentiate the priority of Loss of Yin and Loss of Yang for timely treatment.

[Reprinted] TCM Differentiation: Yin-Yang Differentiation

(9) Yang Excess

Yang excess refers to a pathological state where the righteous Qi is strong, and the evil Qi is abundant, leading to functional disorders. Yang excess indicates a pathological state where the righteous Qi has not weakened, Yang Qi is relatively strong, and the functions are hyperactive, resulting in excess heat. The formation of Yang excess is often due to the invasion of heat evils or other evils, leading to Yang transforming into heat; it can also develop from pathological hyperactivity of one’s own functions. Additionally, long-term indulgence in spicy, fatty foods or excessive or improper use of warming and Yang-tonifying substances can also lead to this condition. The main manifestations include strong heat, restlessness, loud voice, red face, thirst, dry stools, short and red urination, a rapid and strong pulse, and a red tongue with a yellow coating.

(10) Yin Excess

Yin excess, habitually referred to as Yin predominance or Yin victory, indicates a pathological state where the righteous Qi has not weakened, and Yin Qi is relatively strong, characterized by functional disorders or insufficient heat, or the accumulation of pathological products such as water, dampness, phlegm, or blood stasis. Functional disorders are real, while Yin predominance leads to cold, and insufficient heat indicates cold; the fundamental nature of this pathological change is Yin excess combined with cold.

The formation of Yin excess is often due to the invasion of cold evils, indulgence in raw and cold foods, or dysfunction or imbalance of internal organs, leading to an excess of Yin Qi that suppresses Yang Qi. The main manifestations include cold limbs, aversion to cold, cold abdominal pain, diarrhea, edema, curled posture, bland taste, and no thirst, clear and thin phlegm, pale tongue with white coating, and a slow pulse.

(11) Yang Deficiency

Yang deficiency refers to the deficiency of Yang Qi in the body, leading to reduced functions and insufficient heat, manifesting as a cold deficiency pathological state. “Yang deficiency leads to external cold” refers to this condition. Yang deficiency often arises from congenital insufficiency, lack of nourishment after birth, overwork, and excessive use of cold and cooling medicines. Clinical manifestations include a pale complexion, cold hands and feet, easy sweating, loose stools, clear urination, pale lips, bland taste, pale tongue, white and moist coating, and weak pulse. Additionally, TCM has a concept of “Yin Repletion.” Repletion refers to cold limbs that are not warm. Internal organs are cold, and Yang Qi cannot reach the extremities, leading to coldness, which is called Yin Repletion. Yin Repletion actually refers to severe Yang deficiency, especially coldness in the hands and feet.

(12) Yin Deficiency

Yin deficiency refers to the deficiency of Yin fluids and their functional decline, leading to an inability of Yin to control Yang, resulting in a pathological state of deficiency heat, i.e., “Yin deficiency leads to internal heat.” Yin deficiency often arises from heat evils injuring Yin, excessive emotional stress leading to heat injuring Yin, prolonged illness depleting Yin fluids, and insufficient nourishment over time. Clinical manifestations include “five hearts feeling hot,” afternoon tidal fever, night sweats, red lips, dry mouth, tender red or crimson tongue, dry without coating, constipation, and yellow and scanty urination, with a thin, rapid pulse.

(13) Yang Excess and Yin Deficiency

In clinical practice, Yang excess, Yin excess, and Yang deficiency, Yin deficiency are often not isolated. Because Yin and Yang exist in a relationship of opposition, interdependence, mutual growth, and transformation, when one side is excessively strong, it inevitably affects the other side to varying degrees, leading to Yang excess harming Yin, and Yin excess harming Yang. The “Suwen: Discussion on Yin and Yang Correspondence” states, “Yin victory leads to Yang disease, Yang victory leads to Yin disease,” referring to this situation. In a state of Yang excess, the intense Yang Qi inevitably causes varying degrees of damage to Yin fluids. When the damage is slight and the symptoms are not obvious, the essence of the disease remains Yang excess; when the damage is severe and the symptoms are obvious, presenting with dry mouth, irritability, red and scanty urination, dry skin, and decreased elasticity, it transforms into Yang excess and Yin deficiency, where the essence of the disease is excess with a mix of deficiency.

(14) Yin Deficiency and Yang Excess

Yin deficiency and Yang excess, although clinically similar, have different pathogenic mechanisms. The former is caused by Yang deficiency leading to Yin excess, while the latter is caused by Yin excess leading to Yang deficiency. Yin deficiency refers to kidney Yin deficiency, while Yin excess refers to internal cold predominance. Because kidney Yang deficiency cannot warm and nourish the organs, it leads to a decline in organ functions, presenting with symptoms of internal cold, such as aversion to cold, cold limbs, diarrhea, edema, and a deep and weak pulse.

(15) Yin Excess and Yang Deficiency

When Yin fluids are excessively strong, they inevitably cause varying degrees of damage to Yang Qi. When Yang damage is slight and the symptoms are not obvious, the essence of the disease remains Yin excess combined with cold; when Yang damage is severe and the symptoms are obvious, it presents with aversion to cold, pale complexion, clear and long urination, and loose stools, indicating Yang Qi deficiency, leading to a lack of warmth and various functional declines, transforming the essence of the disease into Yin excess and Yang deficiency, where the main feature is excess cold combined with Yang damage.

(16) Both Yin and Yang Deficiency

Both Yin and Yang deficiency result from mutual damage. When either Yin fluids or Yang Qi are deficient to a certain extent, it will affect the other, leading to pathological changes of both Yin and Yang deficiency. Mutual damage occurs on the basis of either Yin deficiency or Yang deficiency, further developing into this condition. Since the kidneys are the “home of water and fire,” housing the original Yin and original Yang, which are the foundation of Yin and Yang for all organs, any deficiency of Yin or Yang in any organ will inevitably affect kidney Yin or kidney Yang; when kidney Yin or kidney Yang is deficient to a certain extent, it will also affect the other, resulting in both Yin and Yang deficiency. Clinically, there are two situations of both Yin and Yang deficiency:

One is the Yin and Yang deficiency primarily characterized by Yang deficiency. This is due to more severe Yang Qi deficiency, affecting Yin fluids, leading to insufficiency. The main characteristics are: simultaneous presence of deficiency cold and deficiency heat, with deficiency cold being predominant and deficiency heat being secondary.

The other is the Yin and Yang deficiency primarily characterized by Yin deficiency. This is due to more severe Yin fluid deficiency, affecting Yang Qi, leading to insufficiency. Its characteristics are: simultaneous presence of deficiency cold and deficiency heat, but with deficiency heat being predominant and deficiency cold being secondary.

(17) Yin and Yang Separation

Yin and Yang separation, also known as Yin exhaustion and Yang escape, refers to a severe stage of disease where Yin and Yang can no longer support each other, leading to disintegration. When clinical manifestations of severe bleeding, profuse vomiting and diarrhea, high fever, and other severe loss of Yin symptoms appear, Yin fluids have already been exhausted, and Yang Qi may escape at any time; internal injuries from miscellaneous diseases, such as heart Yin exhaustion, can also lead to Yang Qi violently escaping. Yin and Yang separation is the most severe imbalance of Yin and Yang and is the final stage, an important mechanism of life-threatening conditions and death. Additionally, it is important to note that in traditional TCM theory, the frequently discussed Yin syndrome and Yang syndrome. In the previous section, we have commented on this: it is actually impossible to use Yin and Yang syndromes to encompass all diseases; the specific meanings of Yin syndrome and Yang syndrome refer to deficiency cold syndrome and excess heat syndrome, respectively. In conjunction with the differentiation of Yin and Yang in terms of disease location, it is more accurate to say that Yin syndrome should refer to Yang deficiency combined with cold, while Yang syndrome should refer to Yang excess combined with heat.

Wonderful Article Review

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Learning to Supplement Yang Qi Can Control Your Lifespan

Song Baishan: Double Huang Lian Damages Yang Qi, Aggravating Cold and Damp Constitution

Finally, Someone Explained “Yang Qi” Clearly; the Function of “Qi Transformation” is the Core of TCM Theory

Falling Asleep is Yang Qi Moving from Surface to Interior, Waking Up is Yang Qi Moving from Interior to Surface

One Breath of Yang Qi, One Breath of Life; One Breath of Cold Qi, One Breath of Disease

Large Doses of Fu Zi Warm Yang, Though It May Achieve Immediate Results, It Will Deplete Yang Qi in the Long Run

Gathering All Fire God School’s Methods Using Fu Zi

Fire God TCM: Eight Articles to Understand the Fire God School

Zheng Qinan’s Regrets and Limitations (Fire God School)

Q&A Record of Li Ke and the Fire God School

The Classic Fire God School Style, Do You Know? Nine Famous TCM Experts’ Principles of Using “Fu Zi”

The Nine Methods of Warming Yang in the Fire God School

The Medical Principles of the Fire God School

“Zhen Wu Decoction” and “Si Ni Decoction” Revealed… (Yang Qi / Supporting Yang)

The Great Role of “Supporting Yang” Medicines Lies in Warming and Unblocking the Twelve Meridians, Not Just Supplementing Kidney Yang

Great Methods of Supporting Yang in Dietary Therapy (Comprehensively Collected)

Li Ke, Old TCM Practitioner: Discussing Treatment Ideas for Cancer (Supporting Yang in Cancer Treatment)

Liu Lihong: TCM Emphasizes Balance; Why Do We Always Emphasize Supporting Yang?

Cai Changfu Discusses Supporting Yang: When Cold, Support Yang; Supporting Yang Will Inevitably Deplete Yin!

All Diseases Are Related to Cold Qi; the Fundamental Approach of TCM is: Supporting Yang, Dispelling Cold, and Removing Stasis

How to Treat “Yin Excess and Yang Deficiency”? The Revival of the Supporting Yang School!

[Famous Doctor] Li Ke: Discussing the Treatment of Disease Before It Occurs and the Use of Supporting Yang

The Theoretical Core of Supporting Yang

Reading Li Ke’s Supporting Yang Thoughts (Wind Heart Disease, Lung Heart Disease, Coronary Heart Disease)

The Root Cure for Tumors: Supporting Yang, Dispelling Cold, and Removing Stasis

The Great Value of Kidney Supplementing and Supporting Yang Methods (Worth Collecting)

How Many Medicines Have We Taken Wrongly Over the Years? (Liu Wei Di Huang Wan, Fu Zi Li Zhong Wan)

Fu Zi, the Transformation from Poison to Good Medicine

How Many Medicines Have We Taken Wrongly Over the Years? (Liu Wei Di Huang Wan, Fu Zi Li Zhong Wan)

Li Hanqing: Six Uses and Eight Precautions of Fu Zi

Da Huang Fu Zi Zhi Bai Gong Guo Lun – Wu Changheng

The Classic Fire God School Style, Do You Know? Nine Famous TCM Experts’ Principles of Using “Fu Zi”

Ma Huang Fu Zi Xi Xin Decoction, It Can Be Used This Way!

Fu Zi Li Zhong Wan for Treating Coronary Heart Disease

National Medicine Master Guo Chengjie’s Experience with Fu Zi, Chuan Wu, and Cao Wu

Fu Zi Li Zhong Wan, Specifically Treating Yang Qi Deficiency

What Medicines Can Replace Fu Zi?

Comparative Analysis of Gui Pi Wan, Bu Zhong Yi Qi Wan, Fu Zi Li Zhong Wan, and Shen Ling Bai Zhu Wan

“Shang Han Lun” “Fu Zi Decoction”

Clinical Applications of Ma Huang Fu Zi Xi Xin Decoction and Wen Dan Decoction (Practical)

Si Ni Decoction for Kidney Cold, Fu Zi Li Zhong Decoction for Spleen Cold, Xiao Qing Long Decoction for Lung Cold…

Improper Use of Fu Zi Can Be Poisonous and Harmful; Proper Use Can Restore Yang and Rescue Reversal, Summary of Elder Pu’s Clinical Experience with Fu Zi!

Zhang Zhongjing’s Preference for Fu Zi; Have You Discovered His Matching Patterns?

Improper Use of Fu Zi Can Be Poisonous and Harmful; Proper Use Can Restore Yang and Rescue Reversal, Summary of Elder Pu’s Clinical Experience with Fu Zi!

97-Year-Old Gynecologist Reveals: Two Foods I Never Eat! (Including Zi Sheng Decoction)

Dr. Ni Boshih Discusses Poisoning from Raw Fu Zi

Effective Prescription for Stubborn Pharyngitis: Ma Huang Fu Zi Xi Xin Decoction

What’s Up with the Blue Veins on a Child’s Nose? (Including Diagnosis and Treatment Methods)

Overview of Fu Zi Usage (Aconite Root)

In Traditional Chinese Medicine, the Tumor-Killing Stars: Fu Zi, Nan Xing, Ban Xia

Many Misconceptions in Later Generations of TCM; Facts and Theories Prove That Ban Xia and Gua Lou Do Not Counteract Fu Zi

Rare Materials, Insights from a Famous Doctor on the Use of “Fu Zi” (Xu Zhongcai)

When Eating, It’s Not Just About the Material; There Are Differences in Spirit, Qi, and Quality of Food!

A Female TCM Practitioner’s Angry Accusation: Why Are Chinese Children So Cold and Yin?

There’s a Type of Exercise That Can Help Everyone Live to 100 Years Old (Recommended by the National Sports Administration)

He Peiren: Blurred Vision? Here’s a Trick to Restore Your Vision

Chen Shiduo Recommends Effective Prescription: Mo Yi Dan (for Treating Pterygium)

Eight Methods for Treating Meniere’s Disease in TCM | Xue Zhicheng

“Big Tendons Soft and Short, Small Tendons Stretched and Long” Explained (Including Views and Cases from Medical Families)

In Winter, To Avoid Brain and Heart Attacks, Stay Away from Three Things, Drink Two Types of Water, and Do One Thing Well!

Does Swimming Hurt Yang Qi and Cause Various Diseases? Listen to What TCM Has to Say

How Many Minutes of “Wall-Pushing Exercises” and “Back-Rolling Exercises” Can Generate Yang Qi and Exercise the Whole Body

The Huangdi Neijing: Why Should We Supplement Yang Qi? How to Supplement? | Zhai Shuangqing

“Pure Men” in Chinese Patent Medicines – Treating Yang Qi Deficiency

Famous TCM Master Wu Fu Zi, The Essence of Treating Diseases is Like This!

Da Huang Fu Zi Zhi Bai Decoction: Cold and Heat Mutual Aid to Open Stagnation