Yin deficiency

Elder bark is contraindicated during pregnancy and for people with a yin-deficient condition (lacking moisture). For others it should only be used with great caution. 

Before receiving drug treatment, patients with hypertension often have a syndrome of Liver-Yang ascending with Kidney-Yin and Liver-Yin deficiency. 

The drugs for treating hypertension can quickly descend the Qi and Yang of Liver, but they may suppress the Liver-Qi. They may also slow down water metabolism and blood circulation. Therefore the syndrome can change into one of Liver-Qi stagnation with Kidney-Yin and Liver-Yin deficiency, or Liver-Qi stagnation with dampness accumulation in the Middle-Jiao. 

St John s wort and Ginseng are also frequently suggested for treating mild depression. According to syndrome differentiation in TCM, they are only suitable for treating patients who suffer from depression due to deficiency of Qi and Yang. If the patients have a Yin deficiency, internal heat or constrained heat due to stress and anxiety, these herbs may lead to restlessness and insomnia, and may make the condition worse. In this case, a Chinese herbal formula based on syndrome differentiation is more effective than that of using only these herbs. 

This formula is effective in inducing sweating and expelling wind-cold-dampness. It is a commonly used formula for treating an excess condition. Because there are many pungent and drying herbs in the formula, it should be used with caution or modified for treating patients with Yin deficiency. 

In this formula, two groups of herbs are selected to treat two aspects of the syndrome - Yin deficiency and constipation. Furthermore, the side effects of the purgative herbs have to be considered as the Yin and fluid in the intestines may be further injured and constipation can get worse. 

A deep red tongue without coating and a thready and rapid pulse are typical signs of Yin deficiency with heat. 

A lingering low-grade fever indicates Qi and Yin deficiency. The Qi is too weak to pit its efforts against the pathogenic heat, causing the heat to smolder in the body. 

Heat due to Yin deficiency in the internal disorders is termed empty-heat external pathogenic heat at the Yin level is termed deficient heat. 

Gui Ban is salty, sweet and cold, and enters the Kidney and Heart meridians. It nourishes the Yin and strengthens the Kidney, tonifies the blood and calms the mind. It is used when the Yin, essence and blood in the Lower-Jiao are severely injured. It can also reduce the heat and treat bone steaming due to Yin deficiency in warm-febrile disease. Its function of tonifying the Yin is stronger than its function of reducing deficient heat. 

This formula is able to reduce deficient heat and is used at the late stage of warm-febrile diseases when there is chronic low-grade fever, bone steaming, irritability and lethargy due to Yin deficiency of the Kidney and Liver with deficient heat. 

These two herbs are able to regulate the Qi and descend the Qi in the intestines. They reduce the distension of the abdomen and treat constipation, the symptoms that often accompany the condition of Qi and Yin deficiency of the Large Intestine due to heat consumption. 

Yin deficiency with excess fire and empty-fire may cause night sweats, bone steaming, low-grade fever, restlessness, anxiety, irritability, insomnia, bleeding gums and spermatorrhea. 

These three herbs are bitter, cold and sweet, and all enter the Kidney meridian. They serve as deputies to nourish the Yin and clear the heat of the Kidney. They can be used separately or together, depending on the degree of Yin deficiency. 

This formula nourishes the Yin and reduces heat of the Kidney, and is used particularly to stop sweating caused by Yin deficiency with severe empty-heat. The severe empty-heat manifests as night sweats, a red face, dry lips, irritability, constipation, dark and scanty urine, a red tongue with a yellow coating and a rapid pulse. 

In many conditions, when the Qi is obstructed, cold sensation can also appear. When the Yin is too weak to nourish the tendons and muscles, cramp of limbs may also appear. Many patients with blood deficiency also have Yin deficiency with heat in the blood they are often afraid of cold since the Qi is not strong. A clear and correct differentiation of the syndrome is therefore required at the outset. 

When Yi Tang and sour-bitter-cold Bai Shao Yao, another deputy herb, are used together, they can generate the Yin of the body and in this way treat the blood and Yin deficiency. As the cold nature of Bai Shao Yao is minimized by the large amount of Yi Tang, Bai Shao Yao will not injure the Yang and Qi. 

The main substances of the body are the Qi and essence that further generate blood, body fluids, Yin and Yang. In pathological conditions, the deficiency often shows four aspects, namely deficiency of the Qi, deficiency of the blood, deficiency of the Yin and deficiency of the Yang. The deficiency can be found in specific organs, such as Kidney-Yin deficiency, Spleen-Qi deficiency or Heart-blood deficiency. A deficiency syndrome also exists in patients with a weak constitution or those in the recovery period of disease, in elderly people or in children. In those situations, it is difficult to determine which organ is weak and which part should be tonified, as the general condition of the patient is weak. 

In cases of Yin deficiency, treatment should cover the spring and summer in cases of Yang deficiency, treatment should start in the autumn and end after winter. At the same time, diets that can tonify and protect the Spleen and Stomach are also recommended to patients. 

The Kidney-Qi is developed from Kidney-essence, and is directly generated by the interaction of Kidney-Yin and Kidney-Yang. The approaches of tonifying Kidney-Qi are via tonifying Kidney-Yin, Kidney-essence and Kidney-Yang. One should consult the formulas in Sections 10 and 11, Syndrome of Kidney-Yin deficiency and Syndrome of Kidney-Yang deficiency respectively, to create an appropriate formula. 

Shan Yao is neutral and sweet, and enters the Spleen meridian. It can either tonify the Spleen-Qi or stabilize the Yin. It is especially selected in the formula as deputy to enhance the ability of the chief to tonify the Qi and treat both Qi and Yin deficiency in the Middle-Jiao. Shan Yao also possesses a slightly astringent property, which is helpful in stopping diarrhea. Furthermore, this herb also enters the Lung and Kidney meridians, and is often applied to tonify and stabilize the Qi and Yin of these organs. The common symptoms are lack of appetite, fatigue, loose stool, shortness of breath, thirst and sweating. 

The stable relationship between the Heart and Kidney is important in maintaining the normal mental state. It is described as the Heart-fire descends to the Lower-Jiao to warm the Kidney-water and the Kidney-water ascends to the Upper-Jiao to calm the Heart-fire. Both herbs are cold in nature and enter the Heart and Kidney meridians. They are able to nourish the Heart-Yin and reduce the excess lire and empty-fire there. They are often chosen in formulas to treat restlessness and palpitation caused by Yin deficiency with heat in the Heart. 

It should be borne in mind that the herbs which stimulate the Yang should be used in small dosage as they can consume the Qi and Yin. In cases of obvious Yin deficiency, where patients have a red tongue without coating and a thready and rapid pulse, warm and pungent herbs should not be used. 

Bai Shao Yao is bitter, sour and slightly cold, and enters the Liver and Spleen meridians. It particularly tonifies the substantial part of the blood and increases the Yin. It is often used in the syndrome of blood and Yin deficiency that manifests as palpitations, restlessness, stiffness and cramping pain of the limbs, dry eyes, blurred vision and scanty menstruation due to deficiency of the blood and Yin of the Heart and Liver. 

If the empty-heat is generated by the Yin deficiency, the heat may consume the Yin and injure the blood vessels, and scanty phlegm and coughing of blood may occur. 

As the cheeks correspond to the Lung, pinkish cheeks often indicate Lung-Yin deficiency. In a severe or chronic case, the empty-heat of the Lung may cause afternoon fever and warm palms and soles. 

Tian Men Dong is sweet, bitter and very cold, and enters the Lung and Kidney meridians. It can strongly nourish the Lung-Yin and the Kidney-Yin and reduce heat. It is particularly used in severe and chronic conditions of Yin deficiency of these organs. Moreover, since it is quite cold and bitter and it can lubricate the intestines and soft stool, it is suitable for use when there is constipation. However, it should be avoided in conditions of weakness of Spleen-Qi and loose stool. 

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