I would like to welcome you to my website! The following are lecture notes from a recent talk I gave on 07-23-05 at the TriHealth (Cincinnati
Good Samaritan and Bethesda Hospitals) Integrative Health and Medicine Center, located at I-71 and Pfeiffer Road. What is your first impression when you hear the terms yin and yang? Are they jargons used
in Asian study or Oriental philosophy? Do they refer to female and male or woman and man? Are we talking about Feng Shui here? Whatever comes to your mind at this moment is probably correct. Yin
and Yang refer to a wide variety of objects, concepts or phenomena of opposite characteristics. Yin and yang constitute two major pillars in traditional Chinese medicine. One very important treatment
principle is the yin/yang differentiation. I will illustrate that in this article.
Why do I want to talk about yin and yang? Western medicine has never touched on this. Yet, every day in my office, I see
patients with a wide variety of disorders and symptoms secondary to yin and yang imbalance. Not infrequently, just by balancing the yin/yang energy, they improve very quickly. Once in a while, someone
presents with extreme yin/yang imbalance and deficiency and he or she may have puzzling presentations to physicians trained in Western medicine only. That being said, yin and yang medicine may be very useful to
compliment conventional Western treatment.
I frequently get asked the question, "If I would like to read more about traditional Chinese medicine, which book would you recommend?" Unfortunately, there are
quite a few textbooks written for medical professionals or traditional Chinese medical practitioners, but very few are written on a level intended for general readers. Hopefully one day, I will write a book on
this subject "Embracing Yin and Yang," to help introduce Traditional Chinese Medicine (TCM) to the general public.
As I mentioned earlier, yin and yang refer to a wide range of things. Yang is symbolic of
heaven, sun, fire, male or man, left hardness, anything that is moving, day brightness, spring or summer, exterior, heat excess, top convex, and last (if not least), it refers to Qi energy which is activity produced by
the energy in the human body.
To the contrary, yin is symbolic of the earth, moon, water, female or woman, right, being sedentary, night, darkness, autumn or winter, interior, cold, deficit, bottom, concave and
in the human body it also refers to blood, body fluid (such as secretion) or simply put, it refers to substance including muscle or body mass.
The yang energy makes one feel warm and do like things. The yin
energy makes one feel cold and makes one feel like he or she would like to rest. I have been searching for years for the equivalent of yin and yang in Western medicine, and the closest that I've come up with is
the sympathetic and parasympathetic nervous system. Just like the yin and yang, which are present in every organ, energy pathway or meridian according to traditional Chinese medicine, the sympathetic and
parasympathetic nervous system are present in every part of the body.
Through the secretion of adrenaline, the sympathetic nervous system prepares us for a "fight or flight." Just to give a couple of
simple examples, when the sympathetic nervous system is called to work, our heart rate speeds up, our blood sugar rises and the blood flow to the body is increased. The parasympathetic nervous system, on the other
hand, is for nurturing the body, preserving the energy, etc. It contributes to digesting food, moving our bowels, emptying our bladder and when the parasympathetic nervous system is called to work, it slows down
the heart rate and conserves the body energy. I should note here, that I am only making an analogy between yin/yang and sympathetic/parasympathetic nervous system. To me, they are not exactly
the same things.
Next, I would like to talk about the relationships between yin and yang, just like the sympathetic and parasympathetic nervous system. The yin and yang restrain and balance each other and an
imbalance may give rise to illnesses, depending on which organ or energy meridian is predominantly affected. What is unique in the traditional Chinese philosophy and medicine, is that the yang energy dominates
during the day (yang phase of a day), and the yin energy prevails at night (the yin phase of a day).
The yin and yang energy also exists in a constantly changing and evolving relationship. For instance, at 12
p.m. or high noon, yang energy reaches its peak and yin energy begins to rise. The yin energy reaches its peak at midnight, and at that time, the yin energy begins to rise.
It certainly makes sense that the yin
energy should prevail at night, because yin energy refers to inactivity, and in order for us to have a good night's sleep, we should have abundant yin energy. Interestingly, clinically, people with yin
energy deficiency frequently have insomnia characterized by waking up early, for instance at 3 a.m. or 4 a.m. and have difficulty falling asleep again (just to give you a simple example of how the yin/yang imbalance
affects the human body).
Traditional Chinese medicine is not just
about yin and yang. As a matter of fact, we talk about eight principles: Yin and yang, deficiency and excess, cold versus heat and interior versus exterior. Any clinical problems may be dissected according to those eight principles, or four pairs of opposing concepts or phenomena.
At this point, I would like to introduce concept and two principles, i.e., deficiency and excess. By combining yin and yang with deficiency and excess, we now have four different patters, namely, yang energy
excess, yang energy deficiency, yin energy excess and yin energy deficiency. Needless to say, if I bring in cold/heat and interior/exterior, it will become even more complicated.
To help you relate to these
energy imbalance patterns, I will use examples to help illustrate them. For instance, a patient hospitalized in the intensive care unit because of pneumonia or meningitis, probably has the so called yang energy
deficiency according to traditional Chinese medicine. The clinical manifestations include high fever, rapid heart beat, perhaps altered sensorium/delirium, etc. Another person may complain of chronic
fatigue, feeling cold, having difficulty losing weight and/or feeling depressed, and this person may also have a yang energy deficiency.
Many want to lose weight and most weight loss programs are successful to begin
with, and the challenge is how to sustain it, as most people gain their weight back within a year. As I see it from the yin/yang standpoint, many people with a weight problem have a yang energy deficiency; as a
result, they have a slower metabolic rate, they do not have the energy to exercise and it is difficult for them to lose weight. A more reasonable and healthier approach is to try to boost their yang energy through
an herbal program and exercise. Of course, what I refer to as an herbal program does not include stimulants such as Ephedra, which was banned by the FDA recently.
People with yin energy deficiency, a
frequent clinical occurrence, would experience dry mouth (dry eyes and dry skin, etc.), restlessness, insomnia characterized by early awakening and difficulty falling asleep again, sometimes night sweats or hot flashes
at night, but not during the day. People with extreme yin energy deficiency may also lose weight (not in a favorable way, as yin deficiency gives you a very uncomfortable feeling). In its extreme form,
people with yin energy deficiency may also have fever, which is more pronounced in the late afternoon, evening or early morning.
So far, the yin and yang seem to be relatively simple, at least to some of you. In
clinical practice, it may be difficult at times. Having said that patients with yang energy excess may have high fever, I have also seen patients with extreme yin energy deficiency present as ongoing significant
temperature elevation.
As a matter of fact, as a medical oncologist, one of my specialties, I treated a patient earlier this year with so called "fever of unknown origin". This is a 41
year old gentleman with extensive lymphoma, undergoing chemotherapy. His body condition deteriorated rapidly during chemotherapy and his complaints included restlessness, dry mouth, insomnia and significant weight
loss. The mentioned symptoms progressed, and he developed a high fever. Needless to say, the first thing that came to my mind was that he had developed some sort of infection. He was hospitalized for
nine days. Extensive workups (including many blood cultures and repeat CAT scans) failed to show any source of infection.
Unfortunately, modern Western treatment had probably made him more
ill, as antibiotics and some of the anti-inflammatory medications cause nausea and stomach pain. I discharged him from the hospital and started him on traditional Chinese herbal remedy to boost and balance his yin energy. His fever subsided within days, and other clinical manifestations also improved very quickly. The point I am trying to make here, is that high fever is not only seen in people with yin energy
excess, it may also be seen in individuals with yang energy deficiency. If an incorrect diagnosis is made, treatment not only is ineffective, it may make things a lot worse.
I will
share with you another case example: A 23 year old female nurse came to me for a severe and disabling migraine headache. She had missed a lot of work in recent months because of her headache. Along
with her headache, she has also experienced dry mouth, irritability, insomnia, night sweats, etc. Her headache is located over the right temporal area, extending to above the right eyebrow and also radiating down
her neck to the right shoulder.
She has tried many Western medications with marginal benefits and significant side effects. With acupuncture and herbal treatment, she improved very
quickly and her yin deficiency symptoms subsided rapidly. Her diagnosis, according to traditional Chinese medicine, is liver yin deficiency leading to uprise of liver yang energy. Stated in a different way, the root of her problem is deficiency of yin energy in the liver channel, and the lack of yin energy is not able to balance or subdue the yang energy. The yang energy rises up, causing her headache and along with that, a feeling of vertigo or dizziness at times.
As you can see, our treatment in traditional Chinese medicine does attempt to get to the root of the problem, i.e., what is the underlying energy imbalance? Let me ask you now, are your yin and yang energies
imbalanced?
One may bring the yin/yang concept into just about every symptom we see clinically. For example, patients with chronic obstructive pulmonary disease or emphysema may be divided into the yin and yang
type. Those who are thin or emaciated are most likely the yin deficiency type. They have lost weight and they complain of an intense thirst sensation and when one checks their tongues, they are usually very
red and without coating (tongue diagnosis is an important part of traditional Chinese medicine in differentiating yin and yang balance).
Another type referred to as the "blue bloater" in Western medicine, are
overweight and they tend to have yang energy deficiency and have dampness or phlegm obstructing their lungs. Likewise, people with diarrhea may be subdivided into yin type of diarrhea and yang type of diarrhea.
People with stomach upset may be further differentiated into yin energy deficiency or yang energy excess, just to give a few examples. All of a sudden, clinical practice becomes a lot more complicated and a lot
more interesting.
Having practiced Western conventional therapy for 20 years as an internist, hematologist and medical oncologist, I feel very strongly that the strength of Western medicine is standardization of care
based on our understanding of basic science, such as virology and microbiology, metabolism, experiments, repeated analysis and results from clinical trials. However, what conventional Western medicine is missing
is the internal variation. In traditional Chinese medicine, no two individuals are treated exactly
the same, as we are all different, and that is the main reason why response to any treatment in Western therapy is not 100%.
It makes a lot of sense to me to integrate the traditional Chinese medicine into
conventional Western therapies, in order to benefit more patients. You are welcome to visit us if you think you have some kind of imbalance and no other physician understands your problem.
