Healing is restoring the balance between Yin and Yang
In 1962 Binrong Ma was a whiz kid mathematician who had graduated at the top of his class from the prestigious Fu Dan University in China. In 1965, as the Red Terror overtook China, Professor Ma was sent to the countryside and assigned the job of raising pigs. In 1975 Ma was allowed to return to the Capital University of Medical Science, where he was assigned to study Chinese medicine. Three years later, an epidemic of hepatitis B swept across China. Hepatitis B is a chronic systemic illness, caused by a viral infection, that results in extensive inflammation and necrosis (death) of liver cells. It is profoundly debilitating and in some cases evolves to cirrhosis (scarring of the liver) and liver failure. Hepatitis B, which is transmitted by exposure to blood or by intimate contact, was spreading across China like a firestorm. Hospitals in the larger cities, such as Beijing and Shanghai, were full of sick people.
Because Western medicine had not yet developed a vaccination against hepatitis B, the epidemic could not be effectively halted by Western medicine. Chinese medicine was known to be effective in the treatment of hepatitis B, but treating so many ill people with Chinese herbs was impossible because Chinese medicine is not designed to be standardized like Western medicine. Western medicine begins by diagnosing an illness; once the diagnosis is clear the basic treatment is almost always the same for everyone. Chinese medicine, on the other hand, recognizes different patterns of imbalances or subtypes within the same diagnosis. The treatment is individualized according to the person's subtypes and other aspects of the individual's uniqueness. The efficacy of treatment depends upon how specifically the treatment plan can be tailored to address each patient's individuality. To prescribe herbal medicine during a hepatitis epidemic would require thousands of practitioners to observe and probe people for information, organize signs and symptoms into patterns of imbalances and formulate individualized herbal prescriptions. There were not enough experienced herbalists to go around. Even if doctors worked day and night, the epidemic would move faster than they could diagnose and prescribe.
Professor Ma was called upon to join an elite task force that included Dr. Yubo Guan, a doctor of Chinese medicine who was a specialist in treating liver disease. The team was sequestered and instructed to develop a traditional Chinese medicine (TCM) artificial intelligence system in hepatitis B, which would use a computer program to simulate Dr. Guan's diagnostic and liver/hepatitis treatment expertise. Using the old TQ16 computer that did computation and calculation by punching holes in an infinitely long paper belt, after weeks of working, often at night, the team successfully developed a single program. This program diagnosed thousands of sick people on an individual basis and was able to generate over a hundred thousand different herbal formulations, quickly arresting the epidemic.
Herding Chinese medical diagnostic principles into a computer program was like chasing mercury. To understand the complexity of the variables within the hepatitis B diagnosis and the treatment methods offered by Chinese medicine, a deeper understanding of the basic concepts of Chinese medicine is useful, beginning with the Vital Substance Qi.
In a cosmic sense, Qi is viewed as the basic substance (mass or matter), as well as the Energy necessary to create the physical world, which includes all living things. As explained by Western science, throughout the universe mass can be converted to energy, and energy can be converted into mass—for example, the food we eat is converted to energy, and burning wood creates the energy of heat. From a Chinese medicine perspective, Qi is the singular common bond that exists and connects all living things, thereby being able to pass back and forth and interact. In fact, Qi is not only the common bond between all living things but also the commonality shared by all existence. Qi cannot be created or destroyed, it can only be transformed from one form to another.
Qi supports and sustains your body's life functions such as breathing, me tabolism, thoughts and feelings, but it is also the life function itself.
Qi is dynamic in nature, in that it is constantly moving (circulating) and changing (transforming).
Qi is always striving to attain balance and harmony.
Qi involves the constant movement of Yin and Yang, two mutually dependent opposites.
The creation of Qi
Qi is derived from three sources:
Qi is genetically inherited. Your genetically inherited Qi is made up primarily of Kidney Energy and determines your constitutional uniqueness and strength. (The Five Energetic Systems, comprising of Heart, Lung, Spleen, Liver and Kidney Energies, are explained on pages 25–27.) Note: When names of organs are capitalized, they denote the Chinese medicine Energetic system. Organs in lowercase denote organs in the Western sense.
Qi is acquired internally through your body's functional activities, such as converting nutrients from food sources via digestion. This source of Qi is made up primarily of Spleen Energy.
Qi is acquired from the air (oxygen) via Lung Energy.
Once integrated within your body through the actions of these three sources, Qi is then distributed throughout your body and to all other Energetic systems in order to sustain their functions and activities.
The basic movement of Qi
Ascending. Qi distributes and spreads nutrients and oxygen throughout your body as it ascends.
Descending. Qi passes down metabolic waste and toxins for elimination, and can also deliver nutrients as it descends.
Inward/Outward. Qi supports and strengthens your body through inward movement. Qi disperses nutrients and expels toxins through outward movement.
Circulating. Qi circulates. In other words, Energy or the Life Force circulates within your body.
Powers the circulation of Energy. Qi is the source of the dynamics within your body.
Regulates the Energy movement. Qi acts as the traffic controller, directing the various Energy systems throughout your body.
Nourishes your body. Qi delivers nutrients throughout your body.
Detoxifies your body. Qi removes toxins and metabolic wastes from your body.
Protects your body. Qi guards against the invasion of External Causes and protects against Internal Causes. (External Causes and Internal Causes are explained on pages 33 and 36.)
Maintains all organs, blood and bodily fluids within the physical systems to which they belong. Qi maintains blood within the circulatory system to prevent hemorrhaging and keeps your internal organs suspended appropriately to prevent them from sagging—for example, a prolapsed uterus.
Energizes your body. Qi keeps your body Energized by maintaining the back-and-forth transformations of Qi and the metabolism of your body.
Classification of Qi
Primordial (Yuan Qi). The most fundamental and important Qi. It is primarily genetically inherited. It can be strengthened or depleted throughout the course of life. It provides the most important part of vitality. It nourishes and supports all the other specific Energetic systems. It dictates growth, development and aging.
Ancestral (Zong Qi). Originates from within the region of your chest (lungs and heart), and is closely connected to the air you breathe. Its main function is to support breathing and blood circulation.
Protective (Wei Qi). The Qi created from nutrients by Spleen Energy, supported and enhanced by Kidney Energy, and distributed by Lung Energy. It is active and circulates primarily along the exterior of your body to protect against the invasion of External Causes.
Nutritive (Ying Qi). This is the Qi most intimately associated with the Vital Substance of Blood. It circulates along blood vessels. Its primary function is to deliver nutrients to and throughout the body.
Meridian (Jin Qi). This is the Qi that circulates within the Meridians. It R connects all of the Energetic systems and parts of your body into an inte grated whole. It nourishes, regulates and detoxifies. This is the Qi that acupuncture primarily works through.
Organ (Zang Fu Qi). This Qi belongs to and carries the functions of each individual major and minor Energetic system. In a Western sense, this Qi empowers the physiologic functions of each organ.
Blood (Xue): The primary function of Blood is to nourish. The concept of Blood within Chinese medicine is similar to that of blood as defined by Western medicine. The only significant difference is that Blood has an intimate connection with Qi. In Western medicine blood circulation is considered mechanical in nature. In Chinese medicine Blood circulation is powered and carried by the movement of Qi. In Chinese medicine, like Western medicine, Blood is the substance that circulates throughout the blood vessels.
Blood is created primarily from nutrients extracted from the food you eat and is converted by Spleen Energy, transported to Lung Energy and combined with your Primordial Qi, which is then powered into the circulatory system. During this circulation all five major Energetic systems—Heart, Lung, Spleen, Liver and Kidney—are involved in maintaining Blood's movement and distribution.
Fluid (Jin Ye): Fluid within Chinese medicine encompasses all of your bodily fluids (except blood), including secretions such as gastric juices, tears, saliva and perspiration. As in Western medicine, Chinese medicine recognizes that Fluid contains many other substances that are important to your body. Thereby, it also has nourishing properties. The Fluid of your body is continuously interconnected with Blood.
The creation of Fluid is initially accomplished through the function of Spleen Energy. Spleen Energy extracts and absorbs Fluid from the ingestion of water and foods. These absorbed Fluids are transported to Lung Energy, which distributes them throughout your body. During this process Kidney Energy is involved in Fluid regulation and distribution. The Small Intestine Energetic system and the Large Intestine Energetic system (explained on page 27) are also involved. The Small Intestine separates the pure Fluid from Impurities, and the Large Intestine reabsorbs some Fluid.
A disharmony of Fluids produces visible or invisible Phlegm and Damp ness.
Essence (Jing): Essence is an entirely inherited, specific part of Kidney Energy that governs reproduction and development. Although it is inherited, your Jing can be strengthened or depleted during the course of life. It is confined within the Kidney Energy system.
Shen: In a broad sense, Shen is spirit without a religious affiliation. For example, an individual who has the presence of good health, balance and harmony as well as the radiance of health is said to “have the Shen.” A Chinese medical doctor is trained to observe the patient's Shen. If someone is gravely ill but still has Shen, it means he or she will survive.
In a specific sense, Shen is all of the mental and psychological functions and activities of an individual. In the Chinese culture, if your Shen is blurred, it means that you are not alert. Generally, the more Shen one has, the more balanced one's body will be. Shen is closely associated with Heart and Kidney Energies. In order for Shen to be created and sustained there needs to be a balance of the Vital Substances Qi, Blood, Fluid and Essence as well as a balance of Kidney and Heart Energies.
In Chinese medicine, optimal health is achieved through a state of balance and harmony that involves body, mind and environment.
Harmony is determined by the balance between Yin and Yang. Yin and Yang are the most basic concepts used by Chinese philosophy to characterize the world and life. To ancient Chinese sages, Yin and Yang were the essence of existence and changes. Everything embodies Yin and Yang, and the interactions and movement between Yin and Yang provide a dynamic source for the occurrence, development and shifting of all things. Yin and Yang are a pair of mutually dependent opposites.
Originally, Yang, meaning “the sunny side of the mountain,” represented the positive or active aspects. Yin, meaning “the shady side of the mountain,” represented the negative or passive aspects. Yang is heat, light, day, summer, vigor, masculinity, upwardness, exterior and function. Yin is cold, dark, night, winter, stillness, femininity, downwardness, interior and substance. A common conceptualization of Yin and Yang in Chinese medicine is water (Yin) and fire (Yang).
Yin/Yang polarity (direct opposites) is omnipresent. This polarity exists in all things or phenomena.
Yin and Yang are opposite yet interdependent. Yin and Yang define each other and are relative to one another. Up would have no meaning without down; cold is definable only in relation to heat. The Equator is hot in relation to the North Pole, yet it is cold in relation to the surface of the sun. This relativity also determines that there are no absolutes—everything is relative. There is no distinct or separate black and white, yes and no, normal and abnormal, or sick and healthy.
Within Yin there is Yang, and within Yang there is Yin. For instance, male is Yang and female is Yin. A woman's body's functional activity is Yang and her substance, the physical structure, is Yin. Within her body, the exterior is Yang and interior is Yin. Internally, her Energetic systems can be again divided into Yin and Yang Energetic systems depending on their structure and functions.
The Five Energetic Systems are Yin. Liver, Heart, Spleen, Lung and Kidney are mostly solid organs that store Vital Substances, which are Qi, Blood, Fluid, Essence and Shen. The minor Energetic systems are Yang: Gall Bladder, Small and Large Intestines, Stomach and Urinary Bladder are mostly hollow and responsible for transporting and eliminating impurities from the Vital Substances. Each Yin organ, in turn, has its own aspect of Yin and Yang. (The Energetic systems are further explained on pages 25–30.)
Yin and Yang are always striving for balance. Western medicine observes homeostasis as the body's adaptive responses that attempt to return the body from an abnormal state back to the status quo. From a Chinese medicine point of view homeostasis in the human body is maintained by the perpetual dance of Yin and Yang. There is a constant and normal rhythmic or cyclic fluctuation of Yin and Yang. At the same time,Yin and Yang are always trying to engage each other, ensuring that the other does not get too far away. This is why day always follows night, and after winter there will be a summer. It is natural for humans to sleep during the night (forYang to merge intoYin) and become awake during the day (for Yang to emerge from Yin). We also need rest and relaxation (Yin) after a period of exertion and stress (Yang).
Yin and Yang transform into each other. This is true under normal conditions of health and in abnormal conditions of disharmony (illness and death). For example, to sustain any functional activity (Yang) in your body, your body needs to consume certain nutrients (Yin)—thus the process of Yin transforming into Yang. On the other hand, energy (Yang) is spent to assemble the building blocks of your ever-renewing body structure (Yin)—thus the process of Yang transforming into Yin. When the transformation does not proceed properly or proportionally, it will lead to imbalances, which are illnesses or death; for example, dehydration (weakened Yin) due to a high fever (excess Yang), or hypothermia (weakened Yang) resulting from overexposure to cold (excess Yin). With severe exposure to cold, the person may go into shock—Yin and Yang disconnection due to a radical transformation of Yang to Yin. The person may even die—Yang ceases to exist due to complete transformation of Yang to Yin.
The focus of healing is to support the inner propensity of Yin and Yang striving for balance. To assist in your understanding of the many variables of Yin and Yang it is useful to also understand disharmonies, excess imbalance and deficiency imbalance. Once Yin and Yang are defined many other concepts of secondary importance within Chinese medicine can then be determined.
Yin and Yang excess and deficiencies
Physical. Symptoms that are degenerative, recessive, weak and lowering body temperature or causing a cold feeling are considered Yin. Symptoms that are inflammatory, expressive, agitated and elevating body temperature or causing a hot feeling are considered Yang.
Emotional. Depression, sadness, withdrawal and lack of motivation are Yin. Anxiety, anger, aggression and mania are Yang.
Personality traits. Reserved, introverted, calm, steady and reticent are Yin. Ostentatious, extroverted, excitable, volatile and outspoken are Yang.
Constitution. A person whose body tends to run on the Cool side, who likes to dress warmly and prefers warm weather, has more of a Yin constitution. The person whose body tends to run on the Hot side, who likes to dress coolly and prefers cool weather has more of a Yang constitution.
Imbalances between Yin and Yang have eight scenarios
Yin deficiency, also known as deficient Heat imbalance. When Yang is normal but the person can exhibit some Yang symptoms because there is not enough Yin Energy to balance the Yang.
Yang deficiency, also known as deficient Cold imbalance. When Yin is normal yet the person exhibits some Yin symptoms because there is not enough Yang Energy to balance the Yin.
Yin excess, also known as excess Cold imbalance. The person shows pronounced Yin symptoms but without any weakness.
Yang excess, also known as excess Heat imbalance. The person shows pronounced Yang symptoms but without any weakness.
Yin deficiency/Yang excess. The person shows pronounced Heat symptoms along with Yin weakness.
Yang deficiency/Yin excess. The person shows pronounced Cold symptoms along with Yang weakness.
Yin and Yang deficiency. The person can exhibit a general weakness and fluctuate between deficient Heat and Cold symptoms.
Yin and Yang excess. The person can have Heat and Cold symptoms at the same time or alternately without any discernible weakness. This is demonstrated in certain types of common cold or flu as well in malaria, when the person can fluctuate between fever and chills.
Since each Yin organ of the Five Major Energetic Systems has its own Yin and Yang aspects, and can have all the above imbalances, as the illness can in volve any number of them, the possible combination of imbalances among the Five Energetic Systems is 32,768 (85 = 32,768). This is derived from the fact that each of the Five Major Energetic Systems can experience eight different possible imbalances between Yin and Yang. If we take into consideration imbalances of Yang organs of the Six Minor Energetic Systems and the different Pathogens that can interact with the Five Energetic Systems, the possible conditions of imbalances will quickly reach an astronomical number.
In the development of Chinese medicine, once Yin and Yang were in place, the next important concept to be determined and defined was the Five Element Theory.
Western medical science is literal. In other words, doctors read lab reports or use other black-and-white diagnostic methods to determine a diagnosis and treatment plan. Chinese medical concepts cannot be explained in a literal fashion. It is extremely difficult for Westerners to fully understand the symbolism Chinese medicine uses to diagnose and treat illness. Unlike Western medicine, Chinese medicine never evolved a scientific language. In part, the Chinese language does not readily invent new words as does the English language, which adds some two thousand new words each year. Also, Chinese medicine does not place great emphasis on technology. Rather, it developed a philosophical, symbolic and metaphoric emphasis. Today, Chinese medicine continues to use the same ancient language of its origins.
Figure 4 The eight variables of Yin and Yang
The Five Element Theory was first formed in China at about the time of the Zhou dynasty (867 to 255 B.C.). Historically, it arose from observations of the natural world made in early times by people in the course of their lives and pro ductive labor. Wood, fire, earth, metal and water were considered to be five in dispensable materials for the maintenance of life and production, as well as representing five important states that initiated normal changes in the natural world. In other words, all phenomena in the universe correspond in nature to either wood, fire, earth, metal or water, and these elements are in a state of constant motion and change.
The primitive concept of the Five Elements was later developed into a more complex theory, which, together with the theory of Yin/Yang, served as a conceptual tool for understanding and analyzing all phenomena. In traditional Chinese medicine the Five Element Theory served to guide clinical diagnosis and treatment. Modern Chinese medical practitioners are finding the Five Element Theory to be archaic and limiting and are increasingly relying on the Five Energetic Systems instead.
The Five Energetic Systems evolved to some extent from the Five Element Theory. There is good reason to think that the Five Energetic Systems began to gain prominence and the Five Element Theory began to lose its grip on the mainstream of Chinese medicine around 1115 to 1368 B.C. (Jing-Yuan era).
The shift from the Five Element Theory to the Five Energetic Systems was a gradual process. In fact, the Five Element Theory is still in use today in Chinese medicine, but the use has become confined to specific areas of practice, such as certain styles of acupuncture.
The complexities that perplexed the Chinese experts during the hepatitis epidemic of the 1970s included the role of the Zangfu, which is a collective name for the solid Yin organ systems of the Five Major Energetic Systems (Lung, Heart, Spleen, Liver and Kidneys) and the hollow Yang Organ systems of the Six Minor Energetic Systems (Small Intestine, Large Intestine, Gall Bladder, Bladder, Stomach and San Jiao [Triple Warmer]), explained on pages 27–30.
The Yin Organs
The Yin Organs, also known as the Zang or the Five Major Energetic Systems, encompass the Kidney, Heart, Lungs, Spleen and Liver Energies. The notion of balance and wholeness is the heart and soul of Chinese medicine; the Yin/Yang theory provides the bones and skeleton; the Energetic systems are the flesh and blood of Chinese medicine. The Five Major Energetic Systems provide the medium through which the Yin and Yang interactions can flow.
Kidney Energy: Provides the most important part of your vitality by storing and generating Jing (Essence). Kidney Energy is responsible for sexuality and reproduction, structural integrity and functions of the bones. It also serves a major part of cognitive functions such as memory, concentration and the capacity to process information. Kidney Energy regulates bodily fluids. Kidney Energy dictates growth and development. The fluctuations of the life cycle— conception, birth, adolescence, old age and death—are dictated by Kidney Energy. It is also responsible for part of the function of breathing, specifically deep inhalation. The strength of your Kidney Energy is reflected in the state of your hair (lustrous versus dry and brittle). Kidney Energy is particularly connected to the ears, in that many disorders affecting the ears are treated by harmonizing Kidney Energy. Emotional connections are fear/courage. Kidney Energy is associated with the minor Energetic system of the Urinary Bladder. This association determines that the disharmony of each system can affect the other system.
Heart Energy: Provides the main dynamic source for blood circulation. Heart Energy is closely associated with Shen. Your Heart Energy is reflected in the state of your complexion (glowing and vibrant versus dull and dry). The Heart is connected with the tongue, in that many disorders of the heart are reflected in the appearance of the tongue and, conversely, some disorders affecting the tongue are treated by harmonizing Heart Energy. Emotional connections are happiness/agony. Heart Energy is associated with the minor Energetic system of the Small Intestine.
Lung Energy: Responsible for breathing. Lung Energy is closely associated with Qi, particularly in that Qi connects our body with the environment. Lung Energy is involved in the distribution of nutrients and Fluid and is also part of the regulating process of blood circulation, which is similar to the ideas of Western medicine. Lung Energy is reflected in the state of your skin (moist and firm versus dry and wrinkled). Lung Energy is particularly connected to the nose, in that the nose is the gateway to the lungs. Many External Causes affect the lungs via the nose, and the majority of disorders and symptoms involving the nose are treated by harmonizing Lung Energy. Emotional connections are sorrow, grieving and chronic worry. Lung Energy is associated with the minor Energetic system of the Large Intestine.
Spleen Energy: Represents a major part of the digestive function; not just for food but also for Fluid assimilation and regulation. It is responsible for providing nourishment for the entire body. It also controls circulation by regulating blood coagulation. Spleen Energy determines the strength of the muscles and functions of the limbs. Spleen Energy is reflected in the state of your lips (moist and plump versus dry and cracked). The Spleen is connected to the mouth, in that many disorders affecting the mouth are treated by harmonizing Spleen Energy. Emotional connections are pensiveness and profound or obsessive thoughts. Spleen Energy is associated with the minor Energetic system of the Stomach.
Liver Energy: The great regulator of our body. It regulates Energy flow and circulation, digestion, emotions, fluid and menses. It stores and releases Blood. Liver Energy is reflected in your fingernails and toenails (smooth and strong versus cracked, ridged and brittle). The Liver is connected to the eyes, in that many disorders affecting the eyes are treated by harmonizing Liver Energy. Liver Energy determines the strength and flexibility of the body's tendons and ligaments. Emotional connections are anger/sadness. Liver Energy is associated with the minor Energetic system of Gall Bladder.
The Yang Organs (Fu)
In addition to the Yin Organs, there are the Yang Organs—called the Fu or the Six Minor Energetic Systems. The Six Minor Energetic Systems actually come closer to relating to the organ of similar name, in terms of their functional similarities, than do the Five Major Energetic Systems.
Small Intestine Energy: Associated with Heart Energy, Small Intestine Energy stores and transports foodstuffs and helps to separate the Purity (nutrients) from the Impurity (digestive waste) within the foodstuffs.
Large Intestine Energy: Associated with the Lung Energy, the main function of Large Intestine Energy is the transportation and elimination of digestive waste.
Gall Bladder Energy: Associated with Liver Energy, Gall Bladder Energy stores and releases bile, and assists in digestion, which is identical to the function as Western medicine conceives of it.
Urinary Bladder Energy: Associated with Kidney Energy, Urinary Bladder Energy stores and eliminates urine, which is identical to the function in West-ern medicine perspective.
Stomach Energy: Associated with Spleen Energy, Stomach Energy stores, transports and assists in the digestion of food. After food has left the stomach, Stomach Energy moves Purities downward through your gastrointestinal tract to the small intestines, and ultimately the large intestine. As Stomach Energy pushes downward the Purities are extracted by Spleen Energy, which moves these Purities upward and distributes them to nourish your body.
San Jiao (Triple Warmer): The Triple Warmer is not an actual organ-based Energetic system, but rather a functionally based activity through which most of the major and minor Energetic systems are integrated. Through its functional activity the metabolism of nutrients and Fluid is accomplished.
Zang means “Organ” (in an Energetic sense), and Xiang means “sign” or “manifestation.” The Zang Xiang system is the functional connection of an Energetic system in its entirety. It is the Energetic web that weaves together a major Energetic system with its associated minor Energetic system. Zang Xiang theory is the study of how the harmony or disharmony of internal Energetic systems reflects or expresses itself outwardly.