Excess & Deficiency

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Victoria,

How does an excess lead to a deficiency?

For example, from overexercise one can deplete energy. Is it that one can burn

up their Yang until it is depleted?

Let's say one sits around too much, and is always calm and cool, can this lead

to a deficiency of Yin? Are they using up their Yin? If one doesn't activate

their Yang, does Yin eventually go deficient?

One reason why I ask is that I'm having a Yin deficiency now. I was wondering

if I exercised a lot and consistently if this would burn up the excess Yang and

bring balance back between the Yin and Yang. Does this make sense?

Ed

 

Judy Fitzgerald wrote:

 

> Excess problems are caused by there being too much of something -

> temperatures are too hot and trigger heat stroke, too much Yang causing the

> body to be too Hot, too much Dampness in the body, Phlegm, Stagnation, Blood

> Stasis, too many spicy foods, infection, etc.

>

> Deficiency problems are caused by there not being enough of something. Too

> little Yang to warm the body properly (Deficiency Cold). Too little Yin to

> cool the body properly (Yin Deficiency). Too little proper Blood (Blood

> Deficiency). Too little Fluids (Fluid Deficiency). Etc.

>

> Victoria

>

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[Guest guest]

>How does an excess lead to a deficiency?

>For example, from overexercise one can deplete energy.

 

I'm glad you brought this up because the idea that a condition can change

into its opposite is one of the key concepts of TCM (and Taoist philosophy).

TCM recognizes that imbalances are not static, that clinical pictures can

change, and that treatment needs to be altered to reflect changing

conditions.

 

In some complex cases where problems have gone untreated for sometime, it's

necessary to know if a change into an opposite has occured because this will

mean a different treatment.

 

Here is a good example of a problem that has gone on untreated for sometime,

and things have changed into their opposites. A person starts out with a

Root of Spleen Qi Deficiency. One of the jobs of the Spleen is to transport

and transform fluids in the body and make sure all tissues receive the

proper amount of fluid. Because Spleen Qi is Deficient, it can't move and

transport fluids. Over time the Excess of Dampness accumulation occurs.

 

But because none of this is being treated and it continues, over time the

Dampness congeals into Phlegm (a more serious Excess than Dampness). The

nature of Phlegm is to block, so over time Phlegm can block, creating

Dryness or Fluid Deficiency in parts of the body. Deficiency becomes Excess

becomes Deficiency, and Dampness gives rise to Dryness.

 

Knowing that this has occured can be crucial to proper and effective

treatment. Let's say that by the time this person finally consults a TCM

healer (or other herbalist), the Dryness problems are the most obvious of

the person's problems. They really stand out above all other problems - at

least with a surface examination. So what happens if the healer just treats

the Dryness by just using Yin tonics and/or astringent herbs? These are

going to increase the Dampness problems which in turn will increase the

Phlegm problems which in turn will aggravate the Dryness still more.

Sometimes Dryness will be due to other factors, and just Yin tonics and/or

astringent herbs will be the appropriate treatment. But in complex cases

like this, the Spleen Deficiency is going to have to be recognized as the

Root, and the Spleen Deficiency treated while at the same time the healer

treats the Dampness, Dryness, and Phlegm.

 

Treating complex cases is challenging, but it can be done. There is a

posting in the archieves where I forwarded in the link to the article

" Scatology Redux " by Bob Flaws. In it Flaws talks about Li Dong-yuan's Pi

Wei Lun (Treatise on the Spleen and Stomach) and how many of his formulas

are complex for complex problems. They are warm and cool or cold,

" supplement and (sic) drain, support and atack at the same time. "

 

I encourage other readers to offer examples of when something can change

into its opposite because this is going to help people new to TCM to learn.

One of the best known examples is Wind Cold turning into Fire as in the

common cold becoming pneumonia. The Wind Cold invades the body, the Wind and

Cold closes down the sweating mechanism, and the Wind Cold becomes trapped

in the body. Under certain conditions, when there is a blockage, Heat can be

the result. If the Heat is not released, over time it will transform into

destructive Fire.

 

More later.

 

Victoria

 

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>How does an excess lead to a deficiency?

>For example, from overexercise one can deplete energy.

 

One of the mechanisms of overexercising depleting Qi is excessive sweating

depleting the Qi. Also, excessive activity (and worrying) can damage the

Spleen. The Spleen plays a key role in the accumulation of Qi. The Spleen

extracts Qi from food rotting in the Stomach and transports it to the Lungs

where it mixes with the Qi the Lungs extracted from the air, and Original Qi

to become the Upright Qi.

 

>One reason why I ask is that I'm having a Yin deficiency now. I was

>wondering

>if I exercised a lot and consistently if this would burn up the excess Yang

>and

>bring balance back between the Yin and Yang. Does this make sense?

 

The first step is to figure out why a person is Yin Deficient. There are

many possibilities, and treatment will vary according to what the cause is.

 

Some people are born with a tendency to Yin Deficiency (or Yang Deficiency).

In these cases the person will need to go a little heavier than other

people with eating foods and teas with Yin (or Yang) tonic properties his or

her entire life in order to obtain the extra Yin the individual needs.

 

Another consideration is if the Yin Deficiency is due to Yin being Deficient

or is it due to an Excess of Yang? I wish I could graph this out in email

but I can't. So imagine a straight line. When both Yin and Yang are

adequate, they will both meet this straight line. Now imagine that Yang

reaches it (the person has enough Yang), but the Yin line does not. This is

a person who is Yin Deficient because there is not enough Yin. This person

is going to need a Yin tonic (and maybe some other herbs depending on the

cause of the Yin Deficiency).

 

Now imagine that the Yin lines reaches the straight line (Yin is adequate),

but the Yang line goes beyond it (Excessive Yang). Yin is not really

Deficient in these cases though the person will have many of the symptoms of

Yin Deficiency. The problem is that there is too much Yang, and this is

creating an apparent Deficiency of Yin when Yin is not really Deficient.

There's too much Yang. In these cases you want to take away the cause of

the Excess Yang. Sometimes it will be diet. The person is eating too many

Yang foods. Change the diet. Sometimes it will be herbal. This happens when

a person takes too many Yang tonic herbs. It's happens in China when older

men take too many Yang tonic herbs in order to try to recapture youthful

vigor (including libido). It also happens in this country. Look for more of

it to happen as part of the buying public rushes to buy herbal equivatlents

of Viagra, not realizing that these herbs are inappropriate for treating

normal declines in libido. They're only to be used for Yang Deficiency when

the person clearly is Yang Deficient.

 

Something like this also happened to me, but for different reasons from the

ones listed above. I was severely Kidney Yang Deficient. In my case I

probably have a tendency to Yang Deficiency that I was born with. I can

remember hating the winter and having trouble getting warm as a kid. Plus, I

had chronic mononucleosis. Any chronic, long-term illness or TCM imbalance

can lead to Yang Deficiency. A double whammy in my case. Unlike the other

Organs, when the Kidneys are Yang Deficient, they almost always are Yin

Deficient. The reverse is also true. When a person is Kidney Yin

Deficient, the person almost always is also Kidney Yang Deficient. One of

these will always predominate. In my case, the Kidney Yang Deficincy was so

great it entirely masked the symptoms of Kidney Yin Deficiency. It wasn't

until I finally increased my Deficient Kidney Yang to a certain level that

the symptoms of the Kidney Yin Deficiency began to appear. I'm still Kidney

Yang Deficient (Kidney Yang Deficiency takes a long time to correct), but I

have improved to the point where now the Kidney Yin Deficiency is starting

to become noticeable (and a problem). In cases like mine, the solution to

the Kidney Yin Deficiency problems is not to stop the Kidney Yang tonics,

but to take more Kidney Yin tonics along with the Kidney Yang tonics. I

need both Yin and Yang tonics, but more Yang tonic than Yin. BTW, it's

common practice for at least one Yin tonic herbs to be included in formulas

for Kidney Yang Deficiency, and for at least one Yang tonic herb to be

included in formulas for Kidney Yin Deficiency because you can just about

bet that when one Deficiency is present in the Kidneys, the other also is to

a lesser degree.

 

The Organs most likely to suffer from Yin Deficiency are the Kidneys, Lungs,

Heart, Liver, and Stomach. The etiology and treatment of the Yin Deficiency

can vary according to which Organ is effective.

 

The most common etiologies for Heart Yin Deficieny are long-term worry and

always being on the go (this is a case where excessive exercise instead of

using up Yang would trigger Yin Deficiency) and an attack of Exterior Heat.

Maciocia says that the first etiology of Heart Yin Deficiency is the most

common in Western countries where people are always on the go. The second

most common etiology - Exterior Heat consuming Body Fluids usually only

happens in very hot countries (or areas of a country which is very hot like

the American deep South or southwest). (Foundations, P. 207) Maciocia says

the principle of treatment in Heart Yin Deficiency is to " tonify and nourish

Heat Yin, noursih Kidney-Yin if necessary, pacify the Mind " (Spirit which

resides in the Heart). (p. 207)

 

Some cases of Heart Yin Deficiency arise from the Heart, and treatment is

directed mainly towards tonifying Heart Yin. But there's also a combined

Heart and Kidney Yin Deficiency problem called Kidney and Heart Not

Harmonized. In this case the Heart is Yin Deficient because the Kidneys are

Yin Deficient. In this case you can give a person Heart Yin tonics forever,

and the problem is not going to be corrected because the Kidney Yin

Deficiency is the Root. You have to treat the Kidney Yin Deficiency in

addition to treating the Heart Yin Deficiency.

 

The most common etiology of Stomach Yin Deficiency is irregular diet,

especially eating late at night. The principle of treatment is to nourish

Stomach Yin and nourish fluids. The most significant sign of Stomach Yin

Deficiency is a tongue without coating ( " peeled " ) or a tongue that has a

coating but it is without root (you can scrape it off easily). (Foundations,

p. 269) Stomach Yin Deficiency can really burn up Fluids and trigger

widespread Yin Deficiency and Fluid Deficiency problems.

 

Lung Yin Deficiency can arise from long-term, untreated Lung Qi Deficiency.

In these cases the Lung Qi Deficiency also is going to need to be treated.

Stomach Yin and Kidney Yin Deficiency can also trigger Lung Yin Deficiency,

in which case the Stoamch Yin and Kidney Yin Deficiency are going to have to

be treated. Irregular diet and eating late at night can damage Stomach Yin;

long-term overwork can damage Kidney Yin. Excessive Exterior Dryness - like

living in a desert can damage Lung Yin. (So much for automatically

recommending the desert for all asthmatics. Works will well for some Roots

that can manifest as asthma, but not for asthma which is a manifestation of

Lung Yin Deficiency and Dryness.) (Foundations, p. 234)

 

Liver and Kidney Yin frequently occur together. Kidney and Lung Yin

Deficiency also can occur.

 

Fluid Deficiency is a mild form of Yin Deficiency, but Fluid Deficiency is

not quite the same as Yin Deficiency. However, Fluid Deficiency can trigger

Yin Deficiency, and Yin Deficiency can trigger Fluid Deficiency. In these

cases excessive exercising through increasing sweating will make Yin

Deficiency worse. Treatment for cases where Fluid Deficiency is triggering

Yin Deficiency must also include drinking more liquids. (Note: Do not tank

up on water without at least a little food in your stomach. In susceptible

people, excessive fluid intake can dilute electrolytes in the blood and

trigger epileptic seizures.)

 

Any Excessive Heat can damage Fluids and trigger Yin Deficiency. This is

another reason to be cautious about using excessive exercise to try to treat

Yin Deficiency. The Heat generated in the body could further damage Fluids.

Latent Heat can damage Fluids and deplete Yin. Latent Heat is Heat that

is in the body because of a past infection that never was resolved entirely.

The Heat is still trapped in the body.

 

I realize all this sounds very complex to some of the readers who are new to

TCM, but in time it will become a lot easier to deal with what can seem like

a bewildering array of possible Roots of just one condition. The man idea

to get at this point is that in order to treat sucessfully one first has to

identify the Root.

 

Victoria

 

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>From all your writings, the subtleties of diagnosing the root cause is

>tricky.

 

A person can have more than one TCM syndrome, and there can be more than one

Root when a person suffers a single TCM syndrome or muliple syndromes. For

example a person who has Hot Phlegm (or Cold Phlegm) Blocking the Lungs.

There almost always are two Roots in these cases. One is why the person is

too Hot (or Cold), and the other is the Spleen Deficiency which allows the

Phlegm to form in the first place.

 

>I suppose that only experience can guide one to know.

 

Familiarity and experience. The more one learns about TCM, the more things

fall into place.

 

>In your graph, when Yang is above Yin, how do you know when it is Yang

>excess or

>Yin deficient? Experience is the key, huh?

 

I'll do a separate post on Yin and Yang Deficiency and their symptoms and

signs.

 

One of the ways you know if it's true Yin Deficiency or an Excess of Yang is

through careful questioning of the person. For example, if questioning

reveals that the person has been on Yang tonics, suspect Yang Excess

creating a false Yin Deficiency. TCM questionnaires and examinations are

very lengthy. The herbalist I saw schedules an hour and a half for the

initial evaluation. Mine took an hour and forty-five minutes, but I had a

lot of problems. He did a tongue diagnosis, a pulse diagnosis, took my blood

pressure, took a medical history, and gave me a very lengthy TCM

quesitonnaire. Often, the questions will be grouped according to meridians

on these questionnaires. I answered " yes " to just about every question

under the Kidney section, including the ones about a history of ear and

hearing problems. (The ears are a part of the Kidney system, and problems

with hearing or the ears frequently will indicate Kidney imbalances. There

are some ear/hearing problems that can also indicate Liver problems, but you

go by the overall picture.)

 

>Can you describe what Yin deficient means? How can one look at a meridian

>and

>say, " oh, that meridian is Yin deficient. " ?

>And the same for Yang deficiency in a meridian?

 

From the time a client first walks in the door, the TCM healer is observing

and analyzing. For example, if the person has very quick movements and

speech, this points to a Heat problem. Very forceful movements and speech

point to Excess. If the person's movements and speech are slow, this points

to the possibility of Cold. Withdrawn behavior and quiet, non-forceful

speech point to Deficiency. Yellowish tones in the complexion point to

Dampness, red tones to Heat, and white or pale to Cold or Blood Deficiency

or Qi Deficiency. In cases of Blood Deficiency, the complexion will be dull

pale; in cases of Qi Deficiency the paleness often will have a bright sheen.

Sometimes there will be a smell about the person which is part of the

clinical picture. These are just a few of the things the healer is

observing and noting as the person walks in.

 

A tongue diagnosis is performed. The Cliff Notes version of tongue

diagnosis is that the normal color of the tongue tissue is pink or pale red.

Red usually indicates Heat; paleness can be Cold or Blood Deficiency or Qi

Deficiency; purple points to Qi Stagnation or Blood Stasis (if discoloration

is great). Reddish purple is Stagnation with Heat; bluish purple is

Stagnation with Cold. If the tongue is thicker than normal or swollen, this

can indicate Yang Deficiency, Dampness problems, and/or Spleen and/or Kidney

Deficiency. In Blood Deficiency, the pale tongue often will be thinner than

normal or even whithered-appearing.

 

The tongue coating is also considered. A normal tongue coating is thin

white with root (it can't be scraped off easily). A white tongue coating is

either normal or Cold, and a yellow coating points to Heat. You also note

things like fissures in the tongue. For example, two transverse fissures

near the tip often are an indication of a Lung problem, in particular an

infection that wasn't entirely resolved.

 

Areas of the tongue point to various systems. For example, if the tip of

the tongue is redder than the rest of the tongue, this points to Heat in the

Heart and/or Lungs. The sides can indicate Gallbladder or Liver, the center

can indicate the Stomach and Spleen, and the back of the tongue can reveal

problems with the Kidneys, Bladder, and Intestines.

 

A pulse diagnosis is performed. A minimum of 12 pulses are checked. A

slower than normal pulse points to Cold (as does slower than normal body

movements and speech). Or, if questioning reveals that the person is a

well-conditioned athelete, a slower than normal pulse is normal and not

necessarily a sign of Cold.

 

A rapid pulse points to Heat (as do rapid movements and speech). A pulse

which can be felt strongest with the least pressure on the wrist is called a

" floating pulse, " and floating pulses often mean an Exterior problem. (It

can mean some other things, but you go by the total picture.) A " sinking "

pulse is one that be felt the strongest with the most pressure on the wrist,

and it indicates Interior problems.

 

These are just a few of the main points of pulse diagnosis.

 

In addition, specific meridians/ organ systems will have specific

complaints. If a person complains of back pain, especially lower back pain,

this points very strongly to Kidney imbalance. So do knee pain, problems

with the ears and/or hearing, changes in sex drive, teeth problems, and bone

problems. If the person's hair looks like the person is having a bad hair

day, consider the possibility of Kidney imbalance because the health of the

Kidneys often will be reflected in the hair on the head. If this person

looks or acts very afraid (not just the usual anxiety when seeing a healer),

suspect Kidney Deficiency. Fear can damage the Kidneys, and damaged Kidneys

can engender fear.

 

People with Liver imbalances often will be angry, frustrated, and as

ill-tempered as 40 devils. Anger and frustration can damage the Liver (and

Gallbladder), and a damaged Liver (and BG) can endender anger and

frustration. The person may complain of a bitter or sour taste in the mouth

(so a bitter taste can also point to Heart imbalance). Problems with the

eyes and/or vision can indicate imbalances in the Liver. Problems with the

finger nails can indicate imbalances in the Gall Bladder.

 

If the Lungs are imbalanced, the accent will be on breathing. With the

Heart, there can be mental problems. Digestive system problems often point

to the Stomach and/or Spleen. If the person is Qi Deficient, there is an

imbalance in the Lungs and/or Spleen because these two systems play the

biggest role in Qi in the body. The Spleen extracts and transports Qi from

food to the Lungs where it mixes with air Qi extracted by the Lungs from

air. The health of the skin can point to the condition of the Lung system

(though other systems can be involved in skin disorders).

 

 

Suspect and rule in or out Spleen problems if the person is losing muscle

mass. The lack of a sense of taste or a poor sense of taste points to Spleen

Deficiency.

 

Pay attentin to seasons of the year and unusual weather conditions. A

dfferent Pernicious Evil is associated with each season of the year. Wind

is the predominate atmospheric condition in the spring, and the Liver and

Gall Bladder are particularly vulnerable to Wind. You will tend to see more

cases of Liver and Gall Bladder (the Wood element) imbalance any time it is

windy.

 

The Heart and Small Intestine (Fire element) are most vulnerable to Heat.

The Spleen and Stomach are most vulnerable to Dampness though the Stomach

likes some moisture. The Liver is also dislikes Dampness. The Lungs and

Large Intestine are most vulnerable to Dryness. The Kidneys and Bladder are

most vulnerable to Cold (the winter) though the Spleen also tends to be

damaged by Cold.

 

There are some acupoints that can point strongly to problems in a specific

meridian or organ system. Chief among these are the Back Transporting

points. These all lie on the Bladder meridian, and when they are sore to

the touch will indicate possible problems in a specific meridian. For

example, Bladder 23 (just below the waist to either side of the spine) is

the back transporting point for the Kidneys. If this point is sore, it

points to imbalance in the Kidneys. On me, this point often is so sore I

don't have to press it to tell it's sore, it can feel the soreness without

it being pressed. Maciocia says that the back transporting points are very

important not only in diagnosis but in treating chronic conditions and that

one cannot successfully treat a chronic condition without using these points

at some time during treatment. He says Bladder 23 whould be used in any

Deficiency of the Kidneys, but particularly in cases of Kidney Yang

Deficiency.

 

The area between the 4th and 5th foot bones frequently will be sore in cases

of Gallbladder Deficiency. Often, soreness in this area can indicate that

the person has an inflammed gall bladder or maybe even sores. If the person

has had his/her gall bladder removed, this area may still be sore because

even though the person no longer has a gall bladder organ, the person still

has a Gallbladder meridian and organ system.

 

Sometimes a person will point to an area of the body and tell the healer

that s/he has sensations of heat, cold, pain, tingling, numbness, etc. along

this area. These cases can point to specific meridian problems.

 

Go to the archieves and check the posts on the 8 Principal Pattern of

Diagnosis. This is the most basic of the TCM diagnostic techniques. It

involves Exterior/ Interior, Excess/ Deficiency, Hot/ Cold, and Yang/ Yin.

Also check the posts on tongue diagnosis and pulse diagnosis.

 

Victoria

 

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Victoria,

From all your writings, the subtleties of diagnosing the root cause is tricky.

I suppose that only experience can guide one to know.

In your graph, when Yang is above Yin, how do you know when it is Yang excess or

Yin deficient? Experience is the key, huh?

Can you describe what Yin deficient means? How can one look at a meridian and

say, " oh, that meridian is Yin deficient. " ?

And the same for Yang deficiency in a meridian?

 

Ed