 Yin and Yang is one of the most fundamental concepts in Traditional Chinese Medicine, as it is the foundation of diagnosis and treatment.  The earliest.

 Yin and Yang is one of the most fundamental concepts in Traditional Chinese Medicine, as it is the foundation of diagnosis and treatment.  The earliest reference to Yin and Yang is in the I Ching (Book of Changes) in approximately 700 BC.  In this work, all phenomena are said to be reduced to Yin-Yang.

 The theory of Yin-yang is introduced into medical field as a methodology and forms a doctrine of medicine.  It classifies the things that have the characters of moving, exciting and warming into yang and the things that have the characters of moistening and restraining into yin.

The Yin and Yang Philosophy Masculine/ManFeminine/Woman Active Passive Night/Dar k Day/Brigh t Moving, Ascending, Progressing, Hyperactive Stillness, Descending, Degeneration, Hypoactive Fire/Hot Water/Cold Yin Yang

 Yin and yang are the summarization of the attributes of two opposite aspects of correlative things or phenomena in nature.  The original meanings of yin and yang mainly referring to facing towards the sun belongs to yang and facing away from the sun belongs to yin.  Then the meaning extended to mean warmth and cold of the weather; upper and lower, up and down, upper and lower, right and left, inner and outer in orientation, activeness and stillness in moving state.

 Through long term of observation of living practice, the ancient people gradually found there generally exist two opposite aspects of yin-yang in things.  They further recognized the mutual action of the two promotes the formation, development and change of things.  Consequently yin and yang are used to explain all kinds of phenomenon in nature, and lay the foundation for development of yin-yang theory.

 Substances (static things) are seen as more yin while functions (activities) are more yang.  Organs, blood, and body fluids tend to be yin, while the functions – transporting and transforming things, as with breathing and digestion – are seen as more yang.  The exterior (outside) of the body is regarded as more yang, while the interior (inside) is more yang.

 The exterior (outside) of the body is regarded as more yang, while the interior (inside ) is more yin.  The head (upward like fire) is yang.  The feet (downward like water) are yin.  Acupuncture meridians on the outer sides of the arms, legs, and black are yang, while those on the inner sides of the arms and legs, and across the abdomen, are yin.

 The various organs of the body are classified as solid (Zang 脏 ), which are more yin, or hollow (Fu 腑 ), which are more yang in character – but they still contain both aspects.  The Heart ( a Zang organ) is predominantly yin, but it is in the upper half of the body, so it is rather more yang in character than the Liver ( also Zang and yin), which is in the lower abdomen.

 In a healthy body, the relationship between yin and yang is constantly changing: we exercise and become more yang, or rest indoors and become more yin.  These two energy forces also adapt and blend to our changing needs in what the Chinese refer to as “mutual restraint” – each controlling the other.

 In disease and illness, this mutual restraint collapses and yin or yang get out of hand:  Overactive yin damaging yang;  Overactive yang damaging yin;  Excess yang resulting from a deficiency of yin;  Excess yin resulting from a deficiency of yang.

 A disease characterized by fever and inflammation, might be seen in terms of excessive yang. But the yang excess could be due to overactive yang, or to excess yang because yin is weak.  Treatment aimed at reducing or controlling yang might be appropriate if it is overactive, but if the problem is really yin deficiency.  But if the problem is really yin deficiency, then restraining yang may simply serve to weaken the patient by reducing damaged energy levels still further.

 The opposition of yin and yang means there exist contrary attributes of two opposite aspects in all kings of things and phenomena in nature, such as heaven and earth, day and night, cold and heat, active and static, internal and external, ascending and descending, entering and exiting, etc.

 Interdependence of yin and yang indicates that yin or yang must take existence of its counterpart as the prerequisite for the existence of its own, and no one can exist solitarily without its counterpart.  For example, heat belongs to yang and cold to yin, without heat there would be no cold.

 Nothing is totally Yin or totally Yang.  Just as a state of total Yin is reached, Yang begins to grow. Yin contains seed of Yang and vise versa. They constantly transform into each other.  For Example: no energy without matter, no day without night. The classics state: "Yin creates Yang and Yang activates Yin".

 Restriction of yin and yang indicates that two opposite side of yin and yang present with relationship of mutual restriction and control.  For example, in spring, summer, autumn, winter, there are warm, hot, cool, and cold changes in climate.  The warmth-hotness in spring and summer are due to rising yang qi restricts the cold- cool qi of autumn and winter.  That is the consequence that yang qi and yin qi restrict ether in nature.

 Reciprocity of yin and yang means the interdependent yin and yang often express the relationship of mutual nurturing and promotion.  For example, water can be rising to form cloud and mist as a result of rising earth qi; while the cloud and mist in the sky can fall onto the earh in form of rain by the descending of heaven qi.  “Yin cannot generate without yang and yang cannot develop without yin.” 无阳则阴无以生，无阴则阳无以化

 Wane means decrease and wax means increase.  one wanes while the other waxes. For example, from winter to spring and summer, the weather turns warm gradually and this is called “yin wanes and yang waxes.”  One waxes and the other wanes. For example, the yang qi in spring and summer grows and gets to the prime; thus things on earth also germinate and get to the prime.

 Transformation of yin –yang. This means one side of yin-yang under certain conditions can transform itself into the other, or yin may change into yang and yang into yin.  Generally this occurs during “the extreme phase” in change of things.  For example, yin-cold in winter develops to the extreme, it will gain the condition for transformation, then the yin-cold weather will change into yang-heat weather.

 Balance of yin-yang means that a harmoniously balanced state is maintained by an appropriate change in strength during the motion of yin-yang.  It maintains a dynamic balance through motion of yin-yang kept in a certain range.

 Imbalance of yin-yang means that the change in strength of yin or yang gets too much or too little, beyond the range and leading a state of occurrence of various calamities.  To sum up, yin and yang are the summary of relative attributes of things and phenomenon, so there is a divide infinite.  It is not isolated and still, but mutual relative, affective and casual.

1. To attribute tissue structure 2. To explain physiological function 3. To explain pathological changes 4. To guide clinical diagnosis 5. To guide treatment of disease

 The theory of yin and yang is used extensively in traditional Chinese medicine to explain the histological structure, physiological function, and pathological changes of the human body, and to serve as guide for diagnosis of treatment.

 The Yin-yang Theory holds that the body’s tissues and organs can be signified by yin and yang.  The upper part of the body pertains to yang while the lower part to yin; the body surface belongs to yang while the interior of the body to yin.  The five Zang-viscera pertain to yin because they store essential essence, but do not transport and transform foodstuffs.

 0The six Fu-viscera pertain to yang because they transport and transform foodstuffs.  The heart and lung are located in the upper (thorax), so they pertain to yang; while the liver, spleen and kidney are located in the lower (abdomen), so they pertain to yin.  In brief, among every part of tissue structure of the human body, internal-externally, interior-exteriorly and anterior may all be attributed to yin and yang.

 The Yin-yang Theory holds that human life activity is the outcome of keeping coordination by the two sides of yin-yang.  In terms of nutrients and functional activities, nutrients pertain to yin and the functional activities to yang.  Hence, if the spleen and stomach dysfunction, the nutrients will be difficult to be digested and absorbed.

 Viewing the correlations between qi and blood, qi pertains to yang and blood to yin.  Qi can produce, circulate, and control blood; qi helps blood to produce and circulate.  The relation between the physiological functions of human body and the viscera and tissues is also the relationship that yin and yang are independent upon and serve each other.  If yin and yang cannot maintain relative balance and interaction, they will separate from each other ending the life that depends upon them.

 The imbalance between yin and yang in TCM considered as the basic reason of the occurrence, development and change of disease.  It is a summary for various diseases and pathological mechanisms.  The imbalance between yin and yang mainly expresses the superiority and inferiority of one side, and affection or implication of one side by the other.  This can collectively called “discordance between yin and yang”.

 The vital qi can be divided into yang qi and yin fluid, while the pathogenic qi can also be classified into two kinds of yin and yang.  For example, in the six climatic pathogens, summer heat, dryness and fire (heat) belong to yang, but cold and dampness belong to yin.

 The process of the occurrence, development and change of disease is a process of conflict between the vital and the pathogen with victory or defeat.  The conditions reflected by the interaction and mutual conflict between the vital qi and the pathogenic qi can be briefly explained by superiority or inferiority of yin or yang, namely imbalance on wane-wax of yin and yang:

1. Superiority of yin or yang: this means the pathological changes resulting from that any side of yin and yang is too predominant so as to damage the other side. the changes can be manifested as follows: 1.1 Superiority of yang results in heat 1.2 Superiority of yin results in cold

2. Inferiority of yin or yang: this means the pathological changes resulting from that any side of yin or yang declines below the normal level. The following situations can be occurred: 2.1 Deficiency of yang leads to cold 2.2 Deficiency of yin leads to heat

3. Mutual involvement of yin and yang- yang deficiency affects yin and yin deficiency affects yang.  In the case of dual deficiency of yin and yang due to involvement of yin by yang deficiency, yang deficiency prevails;  And in the case of dual deficiency of yin and yang due to involvement of yang by yin deficiency, yin deficiency prevails.

4. Transformation of yin-yang: - Yin or yang syndrome, under certain conditions, may transform itself into its opposite direction, or a yang syndrome may transform itself into yin syndrome; - And a yin syndrome may transform itself into yang syndrome.

 No matter how changeable or intricate their clinical manifestations may be, one must first distinguish yin from yang in a correct diagnosis.  The color and luster of the skin can be used to differentiate yin and yang attributes of the conditions. A bright color pertains to yang while a dark and gloomy color to yin.  A case of sonorous voice with a high tone and restlessness pertains to yang, while a low and feeble voice, reticence and rest to yin.

 As for the rate of pulse, rapid pulse belongs to yang slow to yin.  Superficial, surging and large, slippery pulse pertains to yang, while deep, thready, small and choppy pulse belongs to yin.  Distinguishing between yin and yang is the chief work in the four diagnostic process.

1. To determine the therapeutic principle: the therapeutic principle for superiority of yin or yang may be generalized as “reducing the surplus”. 1.1 The therapeutic principle for inferiority of yin or yang may be generalized as “reinforcing the deficient”. 1.2 Purging the heat is used for yang exuberance; 1.3 dispelling the cold is used for yin exuberance.

2. To summarize property of medicinal. The property and acting tendency of a medicinal herb can be summarized by the theory of yin-yang to be the basis of guiding clinic medication. Generally speaking, properties of drugs mainly concern the natures, flavors and acting tendencies:

2.1 The natures: these refer to cold, hot, warm and cool natures of medicinals called the “four natures”. Cool and cold belong to yin while hot and warm pertain to yang. Generally the medicinals that can reduce or eliminate the heat syndromes pertain mostly to cold-cool nature. Conversely the medicinals that can reduce or eliminate cold syndromes pertain to warm- hot nature.

2.2 The Five Flavors: these refer to acrid, sweet, sour bitter and salty. The sour, bitter and salty flavors pertain to yin. Acrid flavor can disperse, sweet flavor can nourish, so the acrid and sweet pertain to yang. There are some medicinals with no distinct flavor, they are known as bland.

 Ascending, descending, floating and sinking.  Herbs with actions of elevating yang, relieving the exterior expelling wind and cold, emesis, and opening orifice are mostly of ascending and outward going properties.  They are characterized by ascending and floating actions so they belong to yang.  While herbs with actions of purgation, clearing away heat, tranquilizing the mind with heavy quality, subduing yang to quench wind, promoting digestion and removing food retention, lowering the rebellious qi, and astringency are mostly of descending and inward going properties; they are characterized by sinking and descending, so they belong to yin.

 By restoring the body’s internal imbalances, it will naturally be healed of diseases, and return to normal health

 In Chinese, “Wu 五 ”refers to five categories of things in the natural world, namely wood, fire, earth, metal and water;  “Xing 行 ” means movement and change.  So “Wu Xing”, or the five elements refer to the movement and change of the five elements of world, namely wood, fire, earth, metal and water.

 The five elements emerged from an observation of the various groups of dynamic processes, functions and characteristics observed in the natural world. The aspects involved in each of the five elements are follows:

 The Five Elements theory posits wood, fire, earth, metal, and water as the basic elements of the material world.  These elements are in constant movement and change.  was an ancient philosophical concept used to explain the composition and phenomena of the physical universe.

 In traditional Chinese medicine, the visceral organs, as well as other organs and tissues, have similar properties to the five elements;  they interact physiologically and pathologically as the five elements do. Through similarity comparison, different phenomena are attributed to the categories of the five elements.

 Based on the characteristics, forms, and functions of different phenomena, the complex links between physiology and pathology as well as the interconnection between the human body and the natural world are explained

 Fire: draught, heat, flaring, ascendance, movement, etc.  Wood: germination, extension, softness, harmony, flexibility, etc.  Metal: strength, firmness, killing, cutting, cleaning up, etc.  Earth: growing, changing, nourishing, producing, etc.  Water: moisture, cold, descending, flowing, etc.

53 The Five Elements relates to the Human Body Heart Liver Spleen Kidney Lung

 Water promotes or give rise to Wood, which promotes Fire, which gives rise to Earth, which promotes Metal, which leads back to Water. TCM sees this as a “mother-son” relationship.  The elements also have a controlling function: Water controls Fire, Fire controls Metal, Metal chops Wood, which dominates the Earth beneath its roots, while Earth will soak up rain or divert rivers and to is Water’s controlling elements.

 These cycles of promotion and control are essential to maintain balance and harmony;  If any element becomes too strong and dominates the cycle, imbalance may follow.  The model ensures that this imbalance will eventually return to harmonious normality.

 If Fire’s control over Metal is excessive, then Metal is weakened and becomes incapable of controlling Wood.  Wood then grows too exuberant and starts to over- control Earth  Earth fails to check Water, which is over- strengthened and so exerts increased control on the over-strong Fire, which started the problem.  If one element fails to fulfill its controlling/restraining duties, then the imbalance can become more severe and damaging.

 The Five Elements Theory, taking the knowledge of the five materials as the basis, to extract and deduct the attributes of the five materials so as to explain the motion and changes of inter-promotion and inter- restriction among all things and phenomena in nature.

 “Wood bends and strengthens”, which means the stem and branches can bend, strengthen, grow upward and outward.  It is extended that anything that has the function or property of growing, devleping and flourishing is attributed to wood.

 “Fire burns and flares up”, which means that the fire has the characters of warmth, heat, and ascending.  It is extended anything that has the function or property of warmth, heat, and ascending is attributed to fire.

 “Earth provides for sowing and reaping”, which means that the earth can be used for sowing and reaping.  It is extended that anything that has the function or property of generating, holding and receiving is attributed to earth.

 “Metal works for change”, which means the metal can follow mean’s mind to change its shape.  It is extended that anything that has the function or property of clearing, descending and astringing is attributed to metal.

 “Water moistens and flows downward”, which means that the water has the characters of moistening and downward going.  It is extended that anything that has the function or property of cold and coolness, moistening, downward going to attributed to water.

 Just as the basic five elements interact with each other, so do their various characteristics.  In the basic vision, Water promotes or gives rise to Wood, which promotes Fire, which gives rise to Earth, which promotes Metal, which leads back to Water.  Water, the mother, gives birth to Wood, the son- and so on.

 The elements have a controlling function.  This is again derived from observations:  Water controls Fire, Fire controls Metal, Metal chops Wood, which dominates the Earth beneath its roots, while Earth will soak up rain or divert rivers and so is Water’s controlling element.

 In the reverse direction, these promoting and controlling tendencies act to restrain or weaken the same elements.  These cycles of promotion and control are essential to maintain balance and harmony: if any element becomes too strong and dominates the cycle, imbalance may follow, but the model ensures that this imbalance will eventually return to harmonious normality.

 If Fire’s control over Metal is excessive, for example, then Metal is weakened and becomes incapable of controlling Wood.  Wood then grows too exuberant and starts to over-control Earth.  Earth fails to check Water, which is over- strengthened and so exerts increased control on the over-strong Fire, which started the problem.  Inevitably, if one element fails to fulfill its controlling/restraining duties, then the imbalance can become more severe and damaging.

ElementWoodFireEarthMetalWater DirectionEastSouthCenterWestNorth ColorGreenRedYellowWhiteBlack Season SpringSummerLate Summer (traditionally frp, July 7 for a month) AutumnWinter ClimateWindHotDampnessDrynessCold

ElementWoodFireEarthMetalWater ZangLiverHeartSpleenLungKidney FuGall Bladder Small intestine StomachLarge intestine Bladder Sense organs/ openings Eyes/ SightTongue/ Speech Mouth/ Taste Nose/ Smell Ears/ Hearing EmotionAngerExcess JoyWorryGriefFear

ElementWoodFireEarthMetalWater TasteSourBitterSweetpungent./ Acrid Salty TissuesTendon/ Nails Blood vessels/ Complexion Muscles/ Lips Skin/ Body hair Bone SoundShoutingLaughingSingingWeepingGroaning SmellRancidBurnedFragrantRottenPutried

ElementWoodFireEarthMetalWater Body FluidTearsSweatSalivaMucusUrine MeatChickenMuttonBeefHorsePork CerealWheatGlutinous millet MilletRiceBeans

 Wood is characterized by growing and flourishing, and the liver prefers free flow of qi; so the liver pertains to wood.  Fire is hot and tends to flame up, and heart- yang has a warm action; so the heart pertains to fire.  Earth is characterized by generating myriad of things, and the spleen is the source for production qi and blood; so the spleen pertains to earth.

 Metal has the properties of purifying and astringing, and lung-qi is in charge of purification and descent; so the lung pertains to metal.  Water has the properties of moistening and storage, and the kidney stores essence and governs water metabolism; so the kidney pertains to water.  Through indirect deduction, those things that have relationships with the five Zang, five constituents, five emotions, five orifices are all attributed to the five elements along with the corresponding Zang.

 If a liver disease affects the spleen, this wood subjugates earth;  If a spleen disease involves the liver, this is earth violates wood;  If the liver and the spleen get disordered at the same time, and mutually influence, that is either wood stagnation leads to earth deficiency or earth stagnation leads to wood stagnation;

 A liver disease may also affect the heart, this a child disease involves its mother;  If it affects the lung, this wood violates metal;  If it affects the kidney, this is a child’s disease involves its mother.  Diseases of the other zang can all be explained similarly.

 Abnormal changes in functional activities of the viscera and their relationships can all be reflected in the external appearances.  The five Zang-viscera have a certain relations in the attribution to the five elements to the changes of five colors, five flavors and pulse conditions.  A patient whose complexion is greenish with a preference for sour food and a wiry pulse may be diagnosed as having a liver disease.

 A patient with a reddish complexion, bitter taste in the mouth, and a surging pulse may be diagnosed as having a heart disease.  A patient with spleen deficiency accompanied with a greenish complexion implies that wood (liver) subjugates earth (spleen).  A patient with dark complexion suggests that water (kidney) subjugates fire ( heart).

1. Tonifying the mother: it is a therapeutic principle to treat a deficiency pattern in disorders of mother-child relationship. - For example, if kidney yin gets deficient and fails to nourish the liver-wood, it may lead to deficiency of liver yin with hyperactive liver yang. - Since the kidney is the mother of the liver, kidney –water can promote liver-wood. - The treatment is therefore to nourish kidney yin.

 A deficient lung qi may affect the transformation and transportation of the spleen and leads to weakening the spleen.  As the spleen-earth is the mother of lung- metal, earth can promote metal.  Hence, tonify the mother for a deficiency syndrome.

2.Reducing the child: it is a therapeutic principle to treat an excess pattern. - When the liver fire gets too hyperactive and liver qi over ascending, reducing heart fire will help to reduce liver fire. - It is because the liver-wood is mother and the heart-fire is the child. - So reducing the child for an excess syndrome.

3. Replenishing water to nourish wood: It is also called “replenishing the kidney to nourish the liver.” -it is mainly suitable for deficiency 0f liver yin. -Its clinical manifestations may be dizziness and vertigo, dry eyes, tinitus and flushed face and hot sensation of the heart area, soles and palms, weakness of the waist and knees, spermatorrhea in male, irregular menstration in females.

4. Mutual promotion of water and metal: it meant to nourish the deficient yin of both the lung and kidney. It can also be used when the deficient lung qi fails to nourish the kidney.

5. Reinforcing earth to strengthen metal: it is a method to replenish lung qi by replenishing spleen qi. It is especially appropriate when both the spleen and lung are suffering from qi deficiency.

 6. Supporting fire and strengthening earth: it is a method to support spleen yang by warming and strengthening kidney yang.  It is suitable for a syndrome of both spleen and kidney are suffering from yang deficiency.  Since the introduction of “Life Gate Theory”, the meaning of fire is referring to life gate fire or kidney fire and not heart fire.

7. Checking the strong: this is a therapeutic principle to restrict the hyperactive element in order to help the recovery of the violated element. If the liver qi gets disordered and affect the stomach or spleen, generating disharmony between the liver and stomach. Soothing or pacifying the liver would be able to regulate the stomach disorder.

8. Strengthening the weak: this is a therapeutic principle to support the subjugated element to coordinate of strengths of both elements. - It is suitable for a case in which the power of restriction becomes insufficient, or subjugation due to deficiency. - If the liver is depressed, it would affect the spleen and stomach resulting in the disorder of receiving and transforming functions. - The treatment should be nourishing or harmonizing the liver, strengthening the spleen and normalizing the stomach.