Dr. Hope Farner, ND
Like the predominant weather patterns here in the Arizona desert, the most common underlying symptom pattern I see in my patients is dry heat. Chinese medicine uses the term Yin Deficiency to categorize this condition, which is commonly associated with fatigue and some form of inflammation. In this article I hope to show the ramifications of general Yin vacuity and the rationale for adding an appropriate Yin Tonic to your chronic disease protocols.
Clinical Dehydration. While dryness from a Western point of view is dehydration or water deficiency, the Eastern idea of body fluids or “Xue” encompasses a much broader clinical scope. Most patients tend to self-medicate themselves with filtered water in an effort to prevent dehydration. However the bottled-water fad has lead consumers into varying states of mineral deficiency. Just last month a case of “Too Much Water” was reported in a popular Tucson newspaper. The article described an 80-year-old female and a marathon runner, both suffering from “water-intoxication,” a mineral-deficient state clinically known as hyponatremia. While acute fluid loss due to excess physical demand is hard to miss, the subtle presentation of chronic Yin Deficiency can easily go undiagnosed. Both suffer from Yin deficiency. Excess yang activity depleted the body fluid of the marathon runner, while a state of chronic depletion slowly drained the fluids from the 80-year-old woman. Both lost minerals as well as water. Both suffer from a fluid deficiency, a Xue and Yin vacuity. Unless you provide emergency medical services, you are more likely to see conditions of chronic fluid depletion, with accompanying symptoms of Emptiness rather than symptoms of Excess.
- Empty symptoms – weak voice, dull lingering pain, very pale face, slight sweating, and listlessness, with a quiet disposition.
- Full symptoms – strong loud voice, excruciating pain and a very red face with profuse sweating, restlessness and a tendency toward outbursts of temper.
Yin Deficiency
Yin aspects of the body encompass more than just body fluids, they include cellular secretions, and intracellular fluids such as seen in the matrix of tissues that form the solid substances of the body – bone, muscle, and other tissues.
- Cellular secretions: hormones, neurotransmitters, digestive enzymes (parietal & chief cells of the stomach; pancreatic cells-endocrine & exocrine secretions), bile secretions of the liver cells, sweat, tears, mucous secretions of goblet cells found in the large intestine, and synovial fluids.
From this perspective, it is easy to see how a general Yin deficiency can feed many clinical conditions, particularly osteoporosis and muscle wasting diseases, post-menopausal hormone deficiencies, depression, GERD, diabetes mellitus, poor fat digestion, constipation and osteoarthritis.
Diagnosis
The most common Yin Deficient pattern I see in my practice is Spleen Qi Deficiency coupled with Kidney Yin and Yang Deficiency and Liver Qi stagnation or Liver-Blood Deficiency. The Spleen and Kidney (adrenals) are primarily Yin organs, so deficiency in these can seriously deplete the patient’s body fluids. Vacuity in both Kidney Yin and Yang represent the general deficiency most patients present with. Care must be taken to properly diagnose which is most deficient, Yin or Yang, as improper treatment can worsen the patient’s condition.
Spleen Qi Deficiency. Fatigue is the hallmark sign of Spleen Qi Xu. Body fluids or ‘Xue” generated by the Chinese Spleen are compromised as well, engendering a plethora of associated symptoms. Spleen Qi Deficiency symptoms are complicated by Kidney Qi vacuity.
Kidney (adrenal) Deficiency. Over-working and undernourishment depletes the Chinese Kidneys, which represent the adrenal glands in Western Medicine. General Kidney Qi/Adrenal deficiency promotes an enduring disease pattern that is resistant to cure. Kidney Yang deficiency is responsible for the joint pain with stiffness of the sinews that inhibits the patient’s proper range of motion. Kidney Yin vacuity produces the symptoms of dryness, redness and swelling. The most common complaints are dry eyes and throat with intermittent complaints of dizziness, vertigo, insomnia and night sweats. Many patients report constipation, dry skin, poor digestion and varying degrees of mental fog as well. Acute hypertension and tinnitus develops as the Yin becomes more deficient.
Liver Qi Stagnation & Blood Stasis. Enduring body pain with age spots, cherry hemangiomas and spider nevi reflect Liver Qi stagnation, along with a purple tongue and a tendency to anger. Liver-Blood stasis can develop quickly in stagnant Qi conditions causing blurred vision, numbness, amenorrhea or scanty periods, anxiety, depression, fatigue, and lassitude.
Therapy
Individual Spleen Qi and Kidney Yin remedies are warming and should be used with care as they could feed the False Heat of Yin vacuity, further depleting the body fluids. The safest therapeutic route is to a) nourish the Yin with Bu Yin Tang (Supplemental Yin Decoction) and mineral-rich “Water” foods, b) supplement the Liver and Kidneys (adrenals) and c) promote the free flow of blood and lymph.
Water Foods. Paul Pitchford, in his book “Healing with Whole Foods,” describes Yin deficiency as the dominance of “extreme heat for several generations.” He claims that excessive intake of “Fire” foods, stress (excessive noise and competition) and the overuse of synthetic drugs are the primary elements that “burn up” the Yin. Advising the patient on a proper food selection is the first place to start.
Annemarie Colbin uses the Chinese Five-Element approach to meal planning in her book “Food and Healing.” She gives specific foods and recipes to help the patient take control of their own state of health with the simplistic plan of minimizing the “Fire” foods and maximizing the “Water” foods.
“Fire” Foods: STIMULANTS & BITTER FOODS – GRAINS: corn, popcorn, sorghum; SPROUTS: corn, sunflower; SEEDS: apricot, sesame, sunflower; HERB: hops; NUTS: pistachio; BEANS: red lentil; VEGETABLES: asparagus, red bell pepper, Brussels sprout, chicory, chive, dandelion root, dandelion greens, endive, escarole, okra, scallion, tomato; FRUIT: apricot, guava, loquat, persimmon, raspberry, strawberry; SEAFOOD: shrimp; POULTRY: squab; MEAT: beef heart, lamb; MISC: beer, coffee, bitter chocolate, ketchup, liquor, tobacco, and wine.
“Water” Foods: SALTY FOODS – GRAIN: buckwheat; SPROUTS: buckwheat; NUTS: chestnut; BEANS: aduki, black soybean, kidney beans, pinto beans; VEGETABLES: agar-agar, beet & beet greens, burdock, carrageen, kale, kelp, kombu, mushrooms (button, shiitake), nori, wakame, water chestnut; FRUIT: blackberry, blueberry, black raspberry, boysenberry, concord grapes, cranberry, watermelon; DAIRY: caviar, egg yolk; SEAFOOD: abalone, bluefish, catfish, clam, crab, cuttlefish, lobster, mussel, octopus, oyster, sardine, scallop, squid, turtle; POULTRY: duck; MEAT: ham, beef kidney, pork; MISC: Cafix (coffee substitute), decaf coffee, miso, salty pickles, salt, and Bancha Tea.
Supplement the Liver Qi. Liver Qi nourishes the Chinese Spleen, which is responsible for producing all the body fluids. Thus supporting optimum liver function will support the lagging production of body fluids, optimize detoxification and control angry moods associated with Liver Stagnation. American producers of the Xiao Yao Wan or Xiao Yao San formula give immediate symptomatic relief. Western Herbs and nutritional support work well here also.
Supplement the Kidney Qi or Adrenals. Diminishing adrenal function is a multifaceted affair with symptoms that shift dramatically as the patient passes through the various stages of adrenal fatigue. But the underlying constant is Yin and Xue deficiency. Thus all Adrenal Fatigue protocols can be augmented nicely with the Chinese Formula Bu Yin Tang. For other Adrenal Therapeutics, see James L. Wilson’s book Adrenal Fatigue: the 21st Century Stress Syndrome.
Promote circulation. Hydrotherapy is the best therapeutic modality to improve circulation. While any form of hydrotherapy is helpful, constitutional hydrotherapy is the best choice. Mild exercise works well here also, if the patient is careful not to overstress their body. Excess fluid loss through perspiration and increased metabolic demand can exacerbate their Yin deficiency.
Summary
In a world of bottled water and nutrient-poor foods, hidden mineral and fluid deficiencies can be a roadblock to cure for many of our patients. Direct attention to “rooting” the deficiency Yin can improve the efficacy of our best therapeutic protocols.
Dr. Farner is in private practice in Scottsdale and Tucson, AZ. She received her Doctorate of Naturopathic Medicine degree from the Southwest College of Naturopathic Medicine in Tempe, AZ, and Masters Degree in Biological Sciences specializing in neurophysiology, cardiovascular physiology and preventative medicine. Dr. Farner served as Associate Professor at the Southwest College of Naturopathic Medicine and is the author of numerous textbooks including Clinical Neurology: Diagnosis & Naturopathic Therapy, Rheumatology: Diagnosis and Naturopathic Therapy, and Physical Diagnosis.
References and Further Reading:
- Colbin, Annemarie (1986) Food and Healing. Ballantine Books, New York – More on five-element foods.
- Flaws, Bob and Philippe Sionneau (2001) The Treatment of Modern Western Medical Diseases with Chinese Medicine: A Textbook and Clinical Manual. Blue Poppy Press, Boulder, CO.
- Pitchford, Paul (1993) Healing with Whole Foods. North Atlantic Books, Berkeley, CA
- Wilson, James L.( 2002) Adrenal Fatigue: The 21st Century Stress Syndrome. Smart Publications, Petaluma, CA
