Re-understand Yin and Yang

This forum is for acupuncture professionals. If it is you, we presume that you have already learned the concept of Yin and Yang during your acupuncture school. Here we point out some mistakes during your acupuncture education.

(1). The relationship between the Yin and Yang

According to textbook, the relationship between the Yin and Yang is: Yin promotes the growth of the Yang and Yang also promotes the growth of the Yin. No Yin, there will be no Yang. Also, there is no Yang, there will be no Yin either. When the Yang is growing, the Yin shrinks or goes down or reduces. When the Yin is growing, the Yang also shrinks, reduces, goes down. When the Yin is on its peak, the Yin will turn to the Yang, so when the Yang is over its peak, the Yang will also turn to Yin. This is what you may learn.

However, there is a very important concept that has been missed in the textbook: between the Yin and the Yang, the Yang is the dominated power to trigue and maintain the life and nature. The Yang is the pushing, promoting, starting, activating power, compared with the Yin.

 This concept matches the exact situation in nature, in medical clinic and in human life.

In the nature, the life on the earth depends on the sun shine, which is the Yang energy (we call it Yang Qi). If there is no sun shine, there will be no life on the earth.

In spring, with the more and more Yang Qi in the nature, plants and grass start to grow (The Yin starts to grow). In summer, the sunshine is very much (Yang comes to its peak), so all plants grow to their most in size too (the Yin reaches it peak too). So we say: the growth of Yang brings the growth of the Yin. In fall, the extent of sunshine starts to reduce, so the plants stop to grow and to turn to yellow to fall down of the plants. We say that the Yang Qi has been turned into the seeds of the plants (the form of Yin). Winter is the season in which the Yang Qi is in hidden form in the earth so there is no any growth of plants (the Yin).

In our body, the Yang Qi is the most important thing to maintain the life. Compared with the Yin part of the body, e.g. the muscle, the bone, and the blood, the Yang Qi is very easy to lose and to be exhausted. We have so many ways to exhaust our Yang Qi. You know that every physical and emotional activity of the body needs our Yang Qi (the bio-energy) to fulfill it. No matter we eat, run, breath, laugh, speak, cry, swallow, pass urine, or have bowel movement… or study, consider, image, plan… or love, feel sad, have sex, all need consumption of the body energy, e.g. the Yang Qi. No enough Yang, the body material part (the Yin) is a dead Yin.

As a TCM doctor, you must always keep in mind to protect the Yang Qi in the body. Since there are much more chance in the modern life to exhaust the body Yang Qi, you have to pay much attention to see if a patient is in a Yang deficiency, rather than a Yin deficiency. If you need to use Cold herbs for the initial treatment, you should also use more Warm herbs to maintain the Yang Qi in the body. The Yang herbs mean the herbs that could warm up the body, stimulate the body function. The commonly used herbs in this group is Fuzi, Shengjiang, Ganjiang, Guizhi, Mahuang[1] and others. Do you normally use these herbs in your formula?

If you do not know this, your clinic effect will be most probably a short time improvement of a syndrome. Your patients have to come to you later again and again, though each time you can reduce their symptoms down.[2] The Yang deficiency is so popular that one of famous TCM doctors said he did not even see any patients with a Yin deficiency![3]

(2). Assessment of Yin or Yang is very important in clinic

In the textbook, the assessment of Yin or Yang seems very simple: if the disease is on the surface (Biao Zheng), or if it is with fever (Re Zheng), or if it is in an overwhelming condition (Shi Zheng), it belongs to the Yang. If it is inside of the body (Li Zheng), is with cold (Hang Zheng), or if it is in deficiency condition (Xu Zheng), it belongs to the Yin. The diagnosis of the Yin and the Yang seems indirectly.

Actually, the assessment of Yin and Yang is very important and it is a first-hand need to guide the clinic treatment. We can say that without the assessment of the Yin-Yang condition of a patient, you cannot treat an emergency condition with the traditional Chinese Medicine! Such emergency condition can be a shock due to infectious disease, physical trauma (car accident, earthquake, fall into water, burning…), circulation failure, heavy bleeding, etc. The ability to assess the Yin and Yang condition in clinic can be a very important mark if you are a TCM “master” or only an ordinary TCM “technician”.

Here we take two common clinic conditions to tell the importance of the Yin and Yang assessment.

Case 1. A lady, 30 years of old, has long time of running nose which she said is a chronic sinus infection. She has been taken anti-biotics for years with other medicine from her family doctor. The symptoms subside from time to time. Two days ago she started to feel extremely pain in her throat so that she could not even talk. She felt tired and little fever (38 degree). She visited her family doctor again and found that blood WBC number is more 10,000 /mm. So she was asked to take anti-biotic again. After two days, she still felt pain without any clear improvement. For the two days, she felt tired and always want to have a sleep. She felt little bit thirsty but want to drink warm water as she usually did.

She turned to a TCM doctor. Her tongue looked slight prink but little more red color on the tip. Her pulse felt slight faster though deeper (it is summer time at the time to the doctor). Her TCM doctor believed that she suffered from a Fire syndrome so give her herbs that work to clear the Fire from the body. The result is: her symptom was not at all subside after another two days.

Case 2. A man, 40 years of age, was diagnosed as      . He had extreme fever which measured up to 41 C. His body was very hot but the hands and feet felt cold. He sweated lot. He had dry mouth but only want to drink extreme hot water. His urine is very yellowish and his tongue is extreme red and dry. The TCM doctor also diagnosed his condition is Fire, e.g. a Yang Syndrome, but the use of Cold herbs appeared make things worse.

Both conditions belong to a Yin condition so a hot herbal formula should be used, though it seems they belong to a Yang condition. In case 1, the reasons for the assessment as the Yin condition is: long history of chronic sour throat; long time use of anti-biotics[4]; tired and want to have sleep[5]; want to drink warm water; tongue is pink but not red; pulse is deeper, rather than floating. Due to the wrong diagnosis, Cold herb does not help to release her pain.

In case 2, it seems have much more evidences supporting the diagnosis as a Yang condition, but the fact that the patient wanted to drink extremely hot water, which indicates a true Yin condition. This is a pretty common clinic condition whereas it is also a very difficult to make a correct diagnosis. At this movement, any wrong use of Cold herbs could make things worse even speed up the death. How to assess a true evidence from lots of various false evidence needs long time clinic practice. Without this ability, you cannot handle any emergency condition.

Clinic situation is much complex than summarized in a textbook. Wrong use of an herbal formula may show as nothing good or bad happens; or seems good at this movement, so both patient and the doctor are happy, but for a long run it turns the disease into chronic condition[6]; or in some extreme cases, it speeds up the death. Any medical therapy might be helpful if it is used in a proper way, or it might be harmful, if it is used in a wrong way – no exception.