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Liver Yin Deficiency & patterns derived from patterns

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In the post of Kidney Jing Deficiency, I made the statement that the Kidney Jing

Deficiency pattern is derived from the Kidney Qi Deficiency pattern which in

turn is derived from the Qi Deficiency pattern. The Kidney Jing Deficiency has

all the symptoms of Kidney Qi Deficiency plus some like serious development

problems, premature aging, brittle bones, etc.


I want to go more into how patterns can be derived from patterns, but I want to

do it with Liver Yin Deficiency. I also want to offer a review for long-term

readers and reintroduce some info for new readers.


In Wicke's first text book, he goes from the general to the specific in

diagnosis. The first thing the reader learns is Diagnosis by the Eight Principal

Patterns. These are Exterior & Interior, Excess & Deficiency, Hot & Cold, and

Yang & Yin. He gives the general symptoms of say Interior Deficiency Cold (Yang

Deficiency). The remarks for this condition apply to all Interior Deficiency

Cold (Yang Deficiency) conditions. Then a few chapters later he goes into how

Spleen Yang Deficiency, Kidney Yang Deficiency, etc. will differ from each

other. He goes from the general to the specific.


I want to demonstrate this with Liver Yin Deficiency. I also want to offer a

review for long-term readers about how to differenciate TCM syndromes.


First, let's start with the general symptoms of Interior Heat. By now some of

you will start to remember the very general symptoms of Internal Heat,

regardless if the cause is Excess Heat or Deficiency Heat.


All Internal Heat conditions will have the symptoms of the person feels too hot

and will be bothered by hot. The person will tend to be thirsty and want cold

drinks. The urine will tend to be dark-colored and scanty. If there is pain or

discomfort, cold will relieve it, hot will make it worse. Body movements and

speech will tend to be rapid. The tongue will be red, and the pulse will be



These remarks apply to all Internal Heat conditions regardless of rather or not

they are Excess conditions or Deficiency conditions. So how do you tell if the

condition is Excess or Deficiency?


First, let's review what an Excess and a Deficiency condition are. In Excess

conditions there is a problem because of too much of something. In the case of

Excess Heat, there is too much infection, too much spicy food, too much Phlegm

(any Phlegm is too much), etc. In Deficiency conditions there is too little of

something. In this case, too little Yin. Yin cools and calms the body. In Yin

Deficiency (Interior Deficiency Heat) conditions, there is not enough Yin to

cool the body adequately, and Heat arises because of the Deficiency of Yin.


What are the symptoms that will tell you rather the Heat is Excess or

Deficiency? In an Excess condition the breathing will tend to be heavy and

rasping if the breathing is being affected. In Deficiency, the breathing will be

shallow with perception of shortness of breath if there are breathing problems.


There are some other things as well. Remember how cold will relieve pain and

discomfort in any Heat condition? Well, pressure will aggravate pain and

discomfort when the root is Excess; it will relieve pain coming from a

Deficiency condition.


In both Excess and Deficiency Heat, the movements and speech will tend to be

rapid. But, in Excess Heat the movements and speech will tend to be both rapid

and forceful. In Deficiency Heat the movements and speech will tend to be rapid

but weak.


Looking at the tongue coating is one of the best ways to distinguish Excess from

Deficiency. In Excess conditions, the tongue coating with be thick. In

Deficiency conditions the tongue coating will tend to be thinner than normal or

absent altogether.


I want all of you to get a mirror and look at your tongue. Notice if the coating

is thick, thin, or absent. Now, ask some family members and friends to show you

their tongues. If you see some thick coatings, chances are the person *may* have

an Excess condition. If the tongue coating is very thin or absent, changes are

the person *may* have a Deficiency condition. I say *may* because at this point

most of you don't know that much about tongue diagnosis, don't know what a

normal tongue coating looks like, and could be mistaken about what is abnormal

and what is normal. But this is a good way to start learning tongue diagnosis as

long as you don't take your findings too seriously at this state. (See the

Giovanni Maciocia website for some pictures of tongues and explanations.)


The pulse will tend to be rapid in all cases of Internal Heat. But, in the

Excess Heat conditions it will be both rapid and strong. You can feel that

sucker very clearly no matter how much or how little pressure you put on the

wrist. In cases of Deficiency Heat, the pulse will be rapid but weak. You will

have trouble feeling the pulse.


Another distinguishing characteristics between Excess and Deficiency is that all

Deficiency states (Yang, Yin, Qi, Blood) have fatigue as a symptom. A

distiguishing characteristic between Interior Excess Heat and Interior

Deficiency Heat is that even though dark-colored, scanty urine is a symptom of

both, in Excess Heat the urine will tend to smell stronger than in the case of

Deficiency Heat. The same remarks apply to bowel movements. In Excess Heat

conditions, the bowel movment will tend to stink a lot more than in Deficiency

Heat conditions.


Now that we've looked at differentiating Interior Excess Heat from Interior

Deficiency Heat, let's finetune this to looking specifically at Interior

Deficiency Heat in the Liver (Liver Yin Deficiency).


You're going to find most of the general symptoms of Internal Heat, most of the

general symptoms of Internal Deficiency Heat, but you're also going to find some

symptoms that tend to occur most often when the Interior Deficiency Heat is in

the Liver. Remember how the eyes and vision are considered part of the Liver

system? Well, when it comes to Interior Deficiency Heat in the Liver (Liver Yin

Deficieny), in addition to all the general symptoms of Internal Deficiency Heat

there may also be vison problems. Things like blurred vision and the eyes being

dry. (Yin cools and moistures. There's not enough Yin in the Liver, the eyes

don't get moistened and are dry.) In Liver Yin Deficiency there also tends to be

dizziness and light-headed sensations. Remember how the emotion of anger is most

associated with the Liver and Gallbladder. Well, in cases of Liver Yin

Deficiency, you may see irritability. Crabbiness. You may also see depression as

some cases of depression are due to unacknowledged anger.


What are some of the differences between Liver Yin Deficiency (Interior

Deficiency Heat) and Yin Deficiency in some of the other systems. In Kidney Yin

Deficiency the fatigue is much more pronounced than when Yin Deficiency affects

other systems. All Deficiency states have fatigue as a symptom (Qi, Blood, Yang,

or Yin). But in cases of Yin Deficiency, the fatigue may be masked by

nervousness (Yin calms). The exception to this is when it's Kidney Yin

Deficiency. In cases of Kidney Yin Deficiency the fatigue is not masked and is

very apparent.


Also, in cases of Kidney Yin Deficiency, there will be pain in the lower back.

In all cases of Kidney imbalances there will tend to be pain and discomfort and

even weakness in the lower back. This is one clue that the Kidney system

possibly is involved.


In Deficiency of Stomach Yin, the accent is on stomach problems. In addition to

the general symptoms of Interior Deficiency Heat, you amy see dry vomiting or

belching, and dry mouth and lips. The pain will tend to be in the epigastric

area (upper middle part of the abdomen, there area where the stomach is). You

can see something odd when it comes to thrist. Even though the person is thirsty

a lot and desires cold drinks (typical of any Interior Heat condtion), the

person may not wish to swallow.


Stomach Yin Deficiency also is the Deficiency condition where you're the most

likely to see no tongue coating or tongue coating absent in patches. In

Deficiency conditions in general, the tongue coating tends to be thinner than

normal, but there usually is a coating. When it comes to Yin Deficiency, its

more likely to be absent. This is especially true when it's Stomach Yin



When it comes to Yin Deficiency and the Lung, you guessed it. The accent will be

on breathing problems, irritating, non-productive coughs, scratchy throat,

really thick mucus (Phlegm) when any occasionally is coughed up, etc. In

addition to the usual Heat symptom of is thirsty a lot and desires cold drinks,

the throat may be dry. Night sweats may be really pronounced with this Yin







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