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Module 5   Lesson 2   Yin Yang and Qi Ji

Yin-Yang disharmony and the Qi mechanism

Why does an acupuncturist not always cool when it is hot, and what happens when the Qi goes the wrong way?

Two maps of the same disease: Yin-Yang tells you how much, the Qi mechanism tells you which way. After this lesson you can follow how the four imbalances turn into one another, apply the classical rule for cooling that does not work, name the five disorders of the Qi mechanism for each organ, and read emotions and climate as directions. Module 1, lesson 2 and module 2, lesson 12 are the foundation.

How much: Yin and Yang Which way: the Qi Excess of Yang Full-Heat Yin deficiency Empty-Heat Excess of Yin Full-Cold Yang deficiency Empty-Cold consumes the Yin Yang breaks loose injures the Yang lets Yin accumulate top: warm bottom: cold red fill Full, blue fill Empty; red border Heat, blue border Cold Qi ascending Liver, Spleen, Kidney-Water fault: sinks, or rises too far descending Lungs, Stomach, Heart-Fire fault: rebellion, goes up entering Kidneys receive fault: breath stays up exiting Lungs, pores fault: shut or too open not moving: stagnation
Schematic, an arrangement of our own after ch. 28 (transformation and interaction, p. 420) and ch. 29 (ascending and descending p. 426, entering and exiting p. 432). The organs for each direction are textbook knowledge.

Know by heart

  • Four imbalances, four transitions. Excess of Yang (Full-Heat) consumes the Yin; Excess of Yin (Full-Cold) injures the Yang; Yang deficiency lets Yin accumulate as Cold and water; Yin deficiency lets the Yang loose, and it rises. mnemonic: too much of one eats the other; too little of one sets the other free.
  • Su Wen 74: cooling that does not work. If you cool and it stays hot, look for it in the Yin; if you warm and it stays cold, look for it in the Yang. Wang Bing: strengthen the source of Water, strengthen the source of Fire. mnemonic: still hot after cooling? Then it is Empty-Heat.
  • Su Wen 5: the extreme turns over. Extreme Yang becomes Yin, extreme Yin becomes Yang: cold hands with a high fever (false Cold). Look at the core, not at the edges.
  • Five disorders of the Qi mechanism. Stagnation (stuck), rebellion (what should descend goes up), sinking (what should rise drops), closure (slams shut), collapse (leaks away). mnemonic: stuck, up, down, shut, gone; the last two are emergencies.
  • The four axes. Liver up, Lungs down; Spleen sends the clear up, Stomach sends the turbid down; Heart-Fire down, Kidney-Water up; Lungs make Qi descend, Kidneys receive it. Every pattern with rebellion or sinking is one of these axes reversed.
  • Su Wen 39: nine movements. Anger makes Qi rise, joy slows it, sadness dissolves it, fear makes it descend, shock scrambles it, pensiveness knots it; Cold contracts it, Heat lets it escape, overwork consumes it. mnemonic: six emotions, two climates, one lifestyle.
  • In and out. Too shut: Wind-Cold, no sweating; too open: spontaneous sweating, Wei-Qi deficiency; jammed in the hinge: alternating chills and warmth (Shao Yang). mnemonic: door shut, door open, door jammed.

The rest of this lesson is reference.

Yin-Yang disharmony and the Qi mechanism: Why does an acupuncturist not always cool when it is hot, and what happens when the Qi goes the wrong way?
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Three practice questions from this lesson

Case. Man, 40, had a high fever for two weeks; now a dry mouth, thirst, warm at night. Tongue red with a thin, peeled yellow coating; pulse rapid and thinner than last week. What has happened?
  1. Full-Cold has injured the Yang
  2. Full-Heat has consumed the Yin
  3. Pure Empty-Heat: only nourish Yin

Answer: Full-Heat has consumed the Yin. The yellow coating says there is still Heat, the peeled coating and the thinner pulse that the Yin has been eaten into. Two bars out of place: two principles, clear and nourish. Pure Empty-Heat has no yellow coating after weeks of fever; Full-Cold gives no red tongue with thirst.

Case. Woman, 49, drank cooling tea for weeks against hot flushes. The hot flushes remain, she develops a cold stomach and loose stools. Tongue red without coating. What does Su Wen 74 say?
  1. The extreme turns over: Heat becomes Cold
  2. Cool harder, the Heat has not gone yet
  3. If it stays hot after cooling, look in the Yin

Answer: If it stays hot after cooling, look in the Yin. Su Wen 74: if you cool and it stays hot, look for it in the Yin. Empty-Heat: there was no Heat to take away, so cooling harder only harms the Spleen. Nourishing Yin is the principle; the Spleen now needs care as well. That the extreme turns over is Su Wen 5.

Case. Man, 72, feels the cold, swollen ankles, passes clear urine often at night. Tongue pale, wet, swollen with a white coating; pulse deep and slow. Heart, kidneys and medication have been checked. Which mixed form?
  1. Yin deficiency with rising Yang
  2. Yang deficiency letting Yin accumulate
  3. Full-Heat with Yin deficiency

Answer: Yang deficiency letting Yin accumulate. Too little fire (cold, pale urine, deep slow pulse), and what is not transformed accumulates (oedema, wet tongue). Warm and drain water.

The rest of this lesson

In the course you get the step-by-step explanation, 16 case-based practice questions, 17 spaced-repetition flashcards, the pitfalls and the bridge to physiology with evidence grades. This lesson belongs to module 5: Patterns.

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