bubble_chart Concept

Yin deficiency pattern refers to the general term for clinical manifestations of yin deficiency with insufficient body fluids, where yin fails to control yang, due to insufficient essence and blood or depletion of body fluids. It is often caused by congenital deficiency, prolonged illness, overexertion, or Rebing anus fluid depletion. The yin deficiency pattern discussed in this section refers to the overall yin deficiency with insufficient body fluids in the body, which is both related to and distinct from the yin pattern of each zang-fu organ. The yin deficiency pattern of each zang-fu organ is introduced in relevant entries and will not be repeated here.

The main clinical manifestations of yin deficiency pattern include: emaciation, dry mouth and throat, vertigo, insomnia, tidal fever, night sweats, vexing heat in the chest, palms, and soles, flushed cheeks in the afternoon, scanty dark yellow urine, dry stools, red tongue with little coating, and a thin rapid pulse.

Yin deficiency pattern is commonly seen in diseases such as "deficiency fatigue," "consumptive disease," "consumptive thirst," and "vertigo."

This syndrome should be clinically differentiated from "blood deficiency pattern," "fluid deficiency pattern," and "dampness stagnation with latent heat syndrome."

bubble_chart Differentiation and Treatment

The yin deficiency pattern can be seen in various diseases. Due to differences in disease causes and locations, the clinical manifestations also vary.

• For example, those who exhibit yin deficiency pattern due to deficiency fatigue often suffer from congenital insufficiency, excessive sexual activity, and depletion of yin essence, zang-fu organ deficiency. Symptoms include dizziness, flushed cheeks, sore throat, insomnia, night sweats, vexing heat in the chest, palms, and soles, sore lower back, seminal emission, a red tongue with peeling coating, and a thin, rapid pulse. These are all signs of yin deficiency with effulgent fire. Treatment should focus on strengthening water to control yangming, using the Six-Ingredient Rehmannia Pill (Xiao'er Yaozheng Zhijue).
• If pulmonary tuberculosis presents with this syndrome, it is often due to the invasion of tuberculosis pathogens, lung damage, and long-term lung yin deficiency. Yin deficiency leads to internal heat, resulting in steaming bone fever, flushed cheeks, cough, hemoptysis, chest and rib pain, night sweats, vexing insomnia, a deep red tongue, and a thin, rapid pulse. Treatment should focus on enriching yin and clearing the lung, using the Large Gentian and Turtle Shell Powder (Weisheng Baojian) with modifications.
• If consumptive thirst presents with yin deficiency pattern, it is often due to inherent yin deficiency, excessive fatigue, emotional imbalance, or rich and greasy food leading to heat damaging yin. Symptoms include extreme thirst, excessive eating with weight loss, sweet-tasting urine, a red tongue, and a thin, rapid pulse. Treatment should focus on nourishing yin fluids, using the Six-Ingredient Rehmannia Pill with modifications.
• If vertigo presents with yin deficiency pattern, it is often due to yin deficiency causing internal stirring of liver wind. Symptoms include vertigo, tinnitus, limb tremors, muscular twitching, vexing heat in the chest, palms, and soles, nausea, vomiting, a red tongue, and a thin, rapid pulse. Treatment should focus on nourishing yin and extinguishing wind, using the Major Wind-Stabilizing Pearl (Wenbing Tiaobian) with modifications.

The yin deficiency pattern is commonly seen in chronic diseases, where prolonged illness easily damages yin fluids. Those who habitually consume fried and grilled foods are also prone to accumulating heat and stirring fire, damaging yin and presenting with yin deficiency pattern. Wu Ju-tong said, "Wherever heat passes, yin is inevitably damaged." Therefore, in the late stage of warm febrile disease [third stage], there is often a tendency for yin damage, frequently presenting with yin deficiency pattern.

In the evolution of the mechanism of disease, the yin deficiency pattern often manifests in three scenarios:

• First, yin deficiency with insufficient fluids leads to yang qi losing its restraint, resulting in yang hyperactivity transforming into wind, presenting as the pattern of yin deficiency and wind stirring. Clinical manifestations include headache, vertigo, limb numbness and tremors, wriggling of limbs, and speech difficulties.
• Second, prolonged yin deficiency pattern leads to yin deficiency affecting yang, presenting as the pattern of both yin and yang deficiency. Clinical manifestations include both yin deficiency symptoms such as tidal fever, night sweats, and vexing heat in the chest, palms, and soles, and yang deficiency symptoms such as fatigue, lack of strength, fear of cold, and cold limbs.
• Third, in the late stage of warm disease [third stage] or certain internal damage Zabing, yin fluid deficiency also damages original qi, presenting as the pattern of qi and yin deficiency. Symptoms include fatigue, lack of strength, shortness of breath, reluctance to speak, dry mouth and throat, low-grade or tidal fever, vexing heat in the chest, palms, and soles, spontaneous sweating, night sweats, and a weak, rapid pulse.

bubble_chart Differentiation of Similar Patterns

1. Blood deficiency pattern and yin deficiency pattern: Blood deficiency pattern falls within the scope of yin deficiency pattern, and both share similarities in disease cause, mechanism of disease, and clinical manifestations. Blood deficiency pattern is caused by spleen-stomach weakness, insufficient generation and transformation, excessive contemplation leading to the depletion of yin-blood, or excessive blood loss. Clinically, it is mainly characterized by a pale or shallow yellow complexion, pale lips and tongue, palpitations, insomnia, dizziness, blurred vision, numbness of limbs, and a thin pulse. Yin deficiency pattern is caused by congenital insufficiency, excessive contemplation leading to the depletion of yin fluids, chronic bleeding, prolonged illness damaging yin, or warm febrile diseases consuming yin fluids. In addition to the symptoms of blood deficiency pattern, yin deficiency pattern also presents with tidal fever, night sweats, vexing heat in the chest, palms, and soles, flushed cheeks in the afternoon, a red tongue, and a thin, rapid pulse, indicating yin deficiency with internal heat. The key point in differentiating blood deficiency pattern from yin deficiency pattern lies in the presence of heat signs due to yin failing to control yang in yin deficiency pattern.
2. Fluid deficiency pattern and yin deficiency pattern: Body fluids belong to yin, and fluid deficiency pattern also falls within the scope of yin deficiency pattern. However, yin deficiency pattern encompasses a broader range, and fluid deficiency pattern can further develop into yin deficiency pattern. Fluid deficiency pattern is caused by profuse sweating, vomiting, diarrhea, and the scorching of fluids by dryness-heat pathogens. Its main manifestations include dry throat, thirst, dry lips and tongue, dry or withered skin, scanty urine, dry stool, and a thin, rapid pulse. Yin deficiency pattern, on the other hand, is characterized by dizziness, blurred vision, palpitations, insomnia, tidal fever, night sweats, and vexing heat in the chest, palms, and soles, indicating yin-blood deficiency and internal heat, which serve as distinguishing points from body fluid deficiency.
3. Dampness stagnation with latent heat syndrome and yin deficiency pattern: The fever manifested in dampness stagnation with latent heat syndrome often "resembles yin deficiency, making the disease difficult to resolve quickly," thus requiring differentiation. Dampness stagnation with latent heat syndrome is caused by dampness-heat in the climate, exposure to rain or water, living in damp environments, or the invasion of dampness pathogens, which are heavy and turbid, obstructing yang qi and preventing heat from dispersing. Clinically, it is characterized by hidden fever, worsening fever in the afternoon, fever persisting despite sweating, fatigue, chest and abdominal distension and fullness, a heavy head as if wrapped, heavy limbs, poor appetite, a thick and greasy tongue coating, and a soggy, rapid pulse. The symptoms of dampness stagnation with latent heat syndrome, such as chest and abdominal distension, anorexia, heavy head, heavy limbs, and greasy tongue coating, are not seen in yin deficiency pattern, while its hidden fever and persistent fever despite sweating differ from the vexing heat in the chest, palms, and soles, and flushed cheeks in the afternoon seen in yin deficiency pattern.

bubble_chart Documentation

1. Suwen-Tiaojing Lun: "Emperor said: What about yin deficiency leading to internal heat? Qibo said: Due to overstrain, the physical energy declines, the grain energy is not abundant, the upper energizer does not function, the lower abdomen is blocked, the stomach qi is hot, the heat energy steams in the chest, hence internal heat."
2. Suwen.Ping Rebing Lun: "Those with yin deficiency, yang will surely gather, hence when qi is short, there is heat and sweating."
3. Lingshu-Benshen Chapter: "The five zang-organs are responsible for storing essence, they must not be harmed, if harmed they lose their hold and yin deficiency occurs, yin deficiency leads to lack of qi, lack of qi leads to death."
4. Yixue Zhengzhuan‧Medical Questions: "It is said that yin deficiency is the true yin deficiency of kidney essence, its illness often involves high fever, blamed on the lack of water, the treatment involves adding Anemarrhena, Phelloendron Bark and other medicines to blood tonics, or Major Yin-Tonifying Pill, enriching yin Major Tonifying Pill and the like."
5. Zhengzhi Huibu‧Vomiting: "Yin deficiency causes vomiting, not only the gastrointestinal system is ill, it is said that without yin there is vomiting."