Section A | The Differences

Richard A. Feely, DO

Section B | Yin and Yang

Yin and Yang is one of the central concepts of not only Chinese medicine but also Chinese culture. Yin and Yang says that everything can be seen as belonging to one of two categories. Anything which shares the qualities in the first column is considered Yang. Anything which shares the qualities of the second column is considered Yin.

Yang is hot, dry, and active like fire; yin is cold, moist, and passive like water. Symptoms of too much yang and not enough Yin are: feeling hot, restlessness, dry skin, scanty urination, constipation, and fast pulse. Symptoms of too much Yin and not enough Yang are: feeling cold, not thirsty, low energy, edema, frequent urination, looses stools, and slow pulse.

The goal of acupuncture and Chinese herbal treatments is to bring a relative balance between Yin and Yang of the body. Where there is not enough Yin or Yang, those acupuncture points and herbal formulas that tonify Yin or Yang are chosen; where there is too much, points and formulas that reduce excess Yin or Yang are administered. When Yin and Yang are brought into relative balance, not only is there an improvement in the symptoms picture, but there is also an increase in well-being and vitality.
Section C | 5 Climates
In Chinese medicine, nature and the body are part of one expression. What is seen in nature is also seen in the body. In nature, extremes of wind, dampness, dryness, heat, and cold can create damage. These external climates found in nature can enter the body and produce body symptoms. These climates are called External Wind, External Dampness, External Dryness, External Heat, and External Cold. For example, living in damp environments can over time produce the type of arthritis which worsens with damp and rainy weather. Being exposed to prolonged External Heat can produce a heat stroke. External Wind and Cold can generate cold and flu symptoms. Excess External Dryness can produce a dry hacking cough.

In addition, the body is seen as having internally generated climates which in excess can cause disease. These are called Internal Wind, Internal Dampness, Internal Dryness, Internal Heat, and Internal Cold.

Internal Wind
In nature Wind comes and goes quickly and can shake things. In the body symptoms of Internal Wind show the same quality. There can be dizziness, high blood pressure with dizziness, migraine, stumbling or uncoordinated gait, poor limb coordination, spasm or paralysis.

Internal Dampness
In nature excess dampness can create swamps. In the body excess Internal Dampness shows as edema, head feeling full, puffiness of the face, and diarrhea. When Dampness congeals it becomes Phlegm with symptoms of heaviness, excess saliva, gall or kidney stones.

Internal Dryness
In nature excess dryness withers vegetations. In the body excess Internal Dyrness shows as dry skin and mucous membranes, chapping or cracking, scanty menstrual flow, reduced urination, dry cough, sore and dry throat.

Internal Heat
In nature excess heat can scorch the earth. In the body excess Internal Heat shows as inflammations, fever, red face, ulcerations, constipation, decreased urination, and pain which improves with cold.

Internal Cold
In nature excess cold can freeze a stream. In the body excess Internal Cold shows as poor circulation, slow metabolism, cold hands and feet, pain which improves with heat.

Chinese herbs are classified in terms of their effect on the 5 climates. For example, a patient who catches a cold after being exposed to a windy and cold climate would receive herbs and points which have an effect on External Wind and External Cold. Similarly, a patient showing symptoms of Internal Wind with dizziness, high blood pressure, and stumbling would receive herbs and points which calm the Internal Wind.
Section D | 5 Constituents
Traditional Chinese Medicine has 5 body constituents. These are Qi, Moisture, Blood, Essence, and Shen.

Qi
Qi (pronounced chee) is the bio-electromagnetic energy of the body. Qi is present in all body cells and also flows in larger concentrations within specific pathways called channels or meridians. Its primary function is initiating and maintaining transformations. For example, this includes the transformation of food to flesh and blood. Emotional responses, including decision making, are the result of Qi. There are different types of Qi. The essence of food and air becomes the pure or Righteous or Zheng Qi. Defensive or Wei Qi helps the body resist external disease producing influences.

Symptoms of weak Qi include weakness or fatigue with minimal exertion, weak muscles, perspires easily at rest or with slight exertion, easily catches colds and flus, weak voice, pale complexion. The flow of Qi can become interrupted or flow the wrong way and become Stagnant Qi with symptoms of gas pains, belching,, regurgitation, and pain that improves with movement.

Moisture
This refers to the liquid aspects of the body such as joint fluids, disgestive secretions, urine, sweat, saliva, sexual secretions, etc. Moisture is a substance as well as the process of generating, storing, and distributing of fluids.

Symptoms of excess Moisture include nausea with excess saliva or fluid in stomach, loose stools, urinary frequency or urgency, swelling or puffiness of face, hands, or ankles, premenstrual bloating with a feeling of heaviness or water retention, symptoms worse in humid or cold weather

Blood
Blood is a substance as well as the process of generating, storing, and distributing nutrients in the body. Blood and Qi are mutually dependent. Without Qi, Blood cannot move and wihtout Blood, Qi cannot be nourished.

Symptoms of deficient Blood include pale face without brightness, lusterless skin, hair, and nails, dizziness, seeing floaters, palpitation, pale tongue, absent, scanty, intermittent, or irregular menstruation

Essence
The foundational energy out of which everything else arises including Qi, Blood, and Moisture. Essence includes the egg, sperm, and genetic material. Important for growth, development, sexual potency, and fertility. Essence is nourished by the quallity of daily food and air. The quality and quantity of Essence determines longevity.

Symptoms of deficient Essence include weakness and debility, inability to conceive, premature menopause, aging such as thinning or falling hair, wrinkled skin, diminished potency and fertility, weakening of bones.

Shen
Shen means spirit. It embodies consciousness, emotions, and thoughts. It denotes the higher faculties of mind, both intellectual and intuitive.

Symptoms of disturbed Shen include insomnia or restless sleep, disturbing dreams, anxiety, and fright , jitteriness and dizziness, confusion associated with inability to concentrate, poor memory.

Chinese herbs and acupuncture points are classified in terms of how they have an influence on the 5 body constituents. Herbs and acupucnture points target themselves to Qi, Blood, Moisture, Essence, and Shen. For example, a patient with weak Qi showing symptoms of tiring easily and weakness would receive those herbs and be treated with those acupuncture points which Tonify Qi. If there area also symptoms of disturbed Shen with symptoms of disturbing dreams and insomnia, the patient would, in addition to herbs/points to strengthen Qi, also receive points to calm the Shen.
Section E | 5 Organs
In Western anatomy and physiology body organs are seen in terms of structure and function. For example, the heart has 4 ventricles and its function is to circulate blood. In Chinese medicine body organs are seen as a network of relationships.

Heart
Moves Blood; controls intuition and clear perception; houses the Shen or Spirit; has a relationship to the tongue, blood vessels, and external ear; controls the emotion of joy and shock; is associated with bitter taste, and is adversely affected by heat. Coupled with the Small Intestine. Belongs to the Fire Element.

Symptoms of Heart dysfunction are anxiety or nervousness, disturbed sleep, nervousness, awakening in the night or morning with throbbing and anxiety, perspires easily when embarrasssed or startle, palpitations, tachycardia, or erratic rhythms of the heart, chest pain brought on by anxiety or excitement.

Lung
Governs respiration; controls movement of Qi; has a relationship to skin, hair and lymph; protects from external climates; controls the emotion of sadness; is associated with the spicy taste, and is adversely affected by dryness. Coupled with the Large Intestine. Belongs to the Metal Element.

Symptoms of Lung dysfunction are shallow breathing , perspiration with slight physical effort , sensitivity to drafts or chill, shortness of breath, wheezing, coughing,, dryness nose and throat, respiratory allergies, enlarged lymph nodes associated with allergic reactions.

Spleen
Digests food and produces Qi; distributes Moisture, maintains muscles and flesh; has a relationship with the lips and mouth and gums; associated with thinking; controls the emotion of worry; is associated with the sweet taste, and is adversely affeced by dampness. Coupled with the Stomach. Belongs to the Earth Element.

Symptoms of Spleen dysfunction are weakness and fatigue accompanied by indigestion, belching, bad breath, flatulence, excessive cravings for sweet ands tarchy foods, slow digestion of food, abdominal bloating and flatulence, difficulty losing weight, constipation or diarrhea, puffiness, heavy sensations in limbs.

Liver
Stores the Blood; is associated with tendons, eyes and nails; ensures the smooth flow of Qi; controls the emotion of anger; is associated with the sour taste; is adversely affected by wind. Coupled with Gall Bladder. Belongs to the Wood Element.

Symptoms of Liver dysfunction are migraine, stiff neck, symptoms worsen from anger, frustration, or pressure , premenstrual tension, irregular or painful menstruation, intermittent pains in the ears, throat, chest, ribs, liver, gallbladder, and external genitalia , cramps in the side, irregular bowel movement, easy to anger, depression with anger.

Kidney
Stores the Essence; controls growth, development, fertillity, and libido; is associated with bone, marrow, brain, inner ear as well as anus and urethra; controls the emotion of fear; is associated with the salty taste, and is adversely affected by cold. Coupled with the Bladder. Belongs to the Water Element.

Symptoms of Kidney dysfunction are back pain, knee pain, low libido, premature ejaculation , diminished hearing or vision, apathy during cold weather, loss of stamina and endurance, difficulty awakening in the morning, difficulty conceiving, miscarriage or premature labor , retarded growth, premature menopause, dark circles around the eyes.

Chinese herbs and acupuncture points are chosen for their effect on the 5 Organs. A patient with slow digestion, abdominal bloating, craving for sweets, and diarrhea would be given herbs and acupuncture points which have an effect on the Spleen whereas a patient with premenstrual syndrome and irritability would be given herbs and points which have an effect on the Liver.
Section F | 5 Elements
The 5 Elements express how nature and the human body are one expression. The 5 elements are Water, Wood, Fire, Earth and Metal. These elements are found in nature, have a correspondence to body organs and to Qi, Moisture, Blood, Essence, and Shen.

Fire
In the body Fire corresponds to the Heart which stores the Shen and moves the Blood. In nature Fire corresponds to late Summer.

Metal
In the body Metal corresponds to the Lungs which circulate the Qi. In nature Metal corresponds to Autumn.

Earth
In the body Earth corresponds to the Spleen which distributes Moisture. In nature Earth corrresponds to Summer.

Wood
In the body Wood corresponds to the Liver which stores the Blood and insures smooth movement of Qi. In nature Wood corresponds to Spring.

Water
In the body Water corresponds to the Kidneys which stores the Essence. In nature Water corresponds to Winter.

The Generating Cycle
In the Generating Cycle each element produces its neighboring element. Fire produces Earth which produces Metal which produces Water which produces Wood which produces Fire.

In nature Fire replenishes the Earth. In the body the Heart supports the Spleen by providing the Fire necessary for digesting food.

In nature Earth generates Metal (minerals). In the body the Spleen supports the Lungs by giving it the food Qi which combines with the Qi from the air resulting in Zheng Qi which circulates in the meridians.

In nature Metal invigorates Water. In the body the Lungs supports the Kidney by sending Moisture which the Kidney collects and stores.

In nature Water nourishes Wood. In the body the Essence stored in the Kidney helps to generate the Blood which is stored in the Liver.

In nature Wood feeds Fire. In the body the Liver Blood feeds the Heart which contains the Shen.
The Controlling Cycle

In the Controlling Cycle each element restrains another element. Fire controls Metal which controls Wood which controls Earth which controls Water which controls Fire.
In nature Fire melts Metal. In the body the Blood of the Heart helps to control the Qi of the Lung.

In nature Metal cuts Wood. In the body the Qi of the Lungs helps the Liver to gather Blood.

In nature Wood breaks up the Earth. In the body the Qi of the Liver helps to control the digestive functions of the Spleen.

In nature Earth dams Water. In the body the Spleen Qi controls the Kidney’s ability to concentrate Moisture.

In nature Water puts out Fire. In the body the Essence of the Kidney keeps in check the Yang Fire of the Heart.

Chinese Herbs are classified in terms of their elements. For example, a patient with weak Lungs showing symptoms of shortness of breath, cough, sweating easily, dry skin, a craving for spicy foods would choose herbs to help strengthen the Lungs by using the 5 elements. An herbalist might choose herbs which have a correspondence with the Earth element thereby nourishing the Lungs. Earth generates Metal. In addition the herbalist would include herbs which have a direct correspondence to Metal.

In acupuncture points are also classified in terms of what Element they belong to. The acupuncturist would choose Earth Element points or points on the Spleen Meridian to nourish the Lungs or the Metal Element by using the Generating Cycle. In addition, the acupuncturist would also choose Metal Element points or points on the Lung Meridian to directly stimulate the Metal Element.

Section H | Example

A doctor of Chinese medicine takes into consideration the totality of the patient, including life style, diet, environment, emotions, body functioning and then weaves a pattern from all the information. The doctor would then come to a diagnosis based on a combination of what is predominant in terms of the 5 Constituents, Yin and Yang, 5 Elements, 5 Climates, and 5 Organs.

For example, a patient tires easily, has digestive problems, edema, diarrhea, premenstrual tension with depression, digestive symptoms worse with damp weather and with anger. The doctor would perform the following diagnosis:

5 Constituents

Weak Qi with symptoms of fatigue. Stagnant Qi with symptoms of PMS and digestion.

5 Body Organs

Dysfunctional Spleen with digestive problems, edema, diarrhea, symptoms worse with dampness. The Spleen controls digestion and distribution of Moisture.

Dysfunctional Liver with premenstrual tension, depression, symptoms worse with anger. The Liver insures the smooth flow of Qi and Blood. In premenstrual syndrome Blood and Qi flow are irregular. Liver controls anger.

5 Elements

Wood (Liver) overcontrolling Earth (Spleen).

The treatment would involve Chinese herbs and acupuncture points that would benefit the Qi, the Spleen and Liver, and harmonize Wood and Earth.
Page modified on 5/15/2011