Foundations: Yin and yang

Nothing is yin or yang on its own

陰陽 yīn yáng

Yin and yang only exist against something else. The chest is yin to the back and yang to the abdomen. Asking «is this yin?» without saying compared to what has no answer.

Cold, still, interior

yin pole

Heat, movement, exterior

yang pole

Common mistake: Treating yin and yang as two boxes to sort things into.

Someone gets hot flushes only before dawn. What does the timing suggest?

1. Yang excess, because there is heat
2. Yin deficiency, because heat appears when yin should dominate
3. Internal cold, because it is night

Four relationships, not one

Yin and yang do not merely oppose. They depend on each other, consume each other and, at the extreme, turn into each other. Each relationship explains a different clinical picture, and mixing them up means treating backwards.

They oppose

heat and cold exclude each other

They depend

without yin there is no yang to hold

They consume

if one rises the other falls

They transform

the extreme becomes its opposite

Common mistake: Stopping at opposition and failing to recognise a heat that is really a lack of coolness.

Sort each trait toward the pole it belongs to.

• Skin hot to the touchYin sideYang side
• Slow, sparse speechYin sideYang side
• Restless, cannot sit stillYin sideYang side
• Prefers to lie downYin sideYang side
• Copious, clear urineYin sideYang side
• Scanty, dark urineYin sideYang side

A long-standing yin deficiency ends up producing cold and exhaustion too. Which relationship explains it?

1. Opposition: cold has defeated heat
2. Mutual consumption: yang has risen too far
3. Interdependence: without enough yin, yang stops being generated

Match each area with the pole it belongs to.

Order the day by yang, from lowest to highest and back.

1. Midnight: yang at its lowest↑↓
2. Dawn: yang begins to grow↑↓
3. Noon: yang at its peak↑↓
4. Dusk: yang withdraws↑↓
5. Early night: yin dominates↑↓

Heat in palms and soles, dry mouth at night and a red tongue with no coating. Real heat or deficiency heat?

1. Real heat: drain it with strong cold
2. Deficiency heat: nourish the yin
3. Neither: it is cold in disguise

Two people feel cold. One has for years and improves when wrapped up; the other started yesterday with fever and chills. What separates them?

1. The first has yang deficiency; the second, external cold attacking
2. Both have yang deficiency, only the duration differs
3. Both have external cold, only the intensity differs

Both are deficiencies. Sort each sign into yin deficiency and yang deficiency.

• Night sweatsYin deficiencyYang deficiency
• Spontaneous daytime sweatingYin deficiencyYang deficiency
• Thirst, sipping small amountsYin deficiencyYang deficiency
• No thirst, prefers hot drinksYin deficiencyYang deficiency
• Red cheeks in the late afternoonYin deficiencyYang deficiency
• Pale, dull complexionYin deficiencyYang deficiency

Cold lower back, clear urine at night and weak knees. Build the diagnosis.

After a very high fever the patient turns icy, pale, with a barely perceptible pulse. What happened?

1. A new external cold has been added
2. Yang at its extreme has transformed into yin
3. The fever was never real heat

Treatment comes from the diagnosis, not the symptom

Facing heat there are two opposite treatments, and choosing wrong makes things worse. If yang is in excess you remove it; if yin is short you add it. The symptom — heat — is the same in both.

Yang in excess

drain the heat

Yin insufficient

nourish and moisten

Yin in excess

disperse the cold

Yang insufficient

warm and tonify

Common mistake: Cooling every heat. When heat comes from a deficiency, cooling removes base from what is already short.

Match each imbalance with what has to be done.

Stiff neck, aversion to cold and a superficial pulse, two days in. Where is the problem?

1. At the surface: the factor has not gone in yet
2. In the interior: it already affects the organs
3. It cannot be located without lab work