10. Syndrome of Kidney-Yin deficiency
Manifestations
Main symptoms
Dizziness, tinnitus, dry throat, premature gray hair, poor concentration, forgetfulness, weakness of the back and knees, irregular menstruation or hypomenorrhea.
Secondary symptoms
Aching of knees and heels, warm palms and soles, bone steaming, emaciation, night sweats, constipation, insomnia, menorrhagia, polymenorrhea, spermatorrhea.
Tongue
Red without coating.
Pulse
Thready, or thready and wiry, or thready and rapid, but weak in the third position.
Associated disorders in western medicine
Diabetes, Parkinson’s disease, arthritis, insomnia, hyperthyroidism, menopause syndrome, menorrhagia, polymenorrhea, infertility and habitual abortion.
Analysis of the syndrome
The Kidney-Yin is the principal Yin of the body. As it is derived from the pro-heaven-Qi, which determines the constitution and vitality of each individual, the Kidney-Yin determines the conditions, the functions and storage of the Yin of all the other Zang and Fu organs. The Kidney-Yin declines with age, but it may decline quicker than normal in some conditions such as poor constitution, chronic disease, prolonged stress, intensive study and hard work, overconsuming spicy food or taking certain medications. An overactive sexual life and having many pregnancies and labors may also consume the Kidney-Yin.
Unlike the Yin of the other organs, Kidney-Yin is divided into two parts: the thick part, the essence, which is called Jing in Chinese; the thin part, the fluid, which is called Yie.
• When the Kidney-Yin is not able to support and nourish the brain, which is considered as the sea of the marrow generated by the Kidney-essence, one may suffer from dizziness, tinnitus, poor concentration and forgetfulness.
• If the Kidney-Yin is not able to nourish the bones, one may feel weak and ache, particularly in the back, the heels and the knees.
• Yin deficiency may directly cause dryness and blood deficiency, constipation may exist and menstruation may become irregular or with little menstrual flow.
• Yin deficiency often causes empty-fire. In a severe condition, the fire may ascend and overstimulate the body fluids, essence and blood, resulting in bone steaming, hot flushes, warm palms and soles, insomnia, menorrhagia, polymenorrhea or spermatorrhea. The empty-heat may quickly consume the essence of the body and lead to loss of weight and emaciation.
• Since the Kidney and the Liver are both located in the Lower-Jiao, and the Kidney-essence and Liver-blood can change into each other, Yin deficiency of the Kidney is often accompanied by Liver-Yin deficiency, and causes corresponding symptoms.
• Kidney-Yin deficiency is often shown in a red tongue without coating and a thready and weak pulse in the third position.
Treatment principle: Nourish the Kidney-Yin and reduce the empty-fire
Herb selection principles and formula composition strategies
• First, herbs that are sweet and neutral, sweet and slightly warm, or sweet and cold, enter the Kidney and Liver meridians, and are able to tonify the Kidney-essence, the Liver-blood and the body fluids are selected.
• Along with these, it is equally important to select sweet and slightly warm herbs that can strengthen the Kidney-Yang in a small amount in the formula in order to promote Yin generation, because the Yin and Yang of the Kidney are derived from one origin and they promote each other’s development.
• Herbs that can enter the Kidney meridian, strengthen the bones and benefit the back and legs are often used.
• Herbs that reduce the empty-fire from the Kidney and descend the Liver-Yang are often used if the balance between Yin and Yang in the Lower-Jiao is severely disturbed.
• Herbs that tonify the blood can be selected as they may generate the essence and benefit the Kidney-Yin.
• Herbs that regulate the Liver-Qi are often selected as Liver-Yin deficiency commonly coexists with Kidney-Yin deficiency and frequently causes Liver-Qi stagnation.
• Herbs that regulate the Spleen-Qi and promote digestion are often used because most of the herbs that nourish the Yin and tonify the essence and blood are cloying in nature and place an extra burden on the Spleen.
Structure of the formula and selection of herbs
Chief: Nourishes the Kidney-Yin
Shu Di Huang ( Rehmanniae radix praeparata), He Shou Wu ( Polygoni multiflori radix) and Gou Qi Zi ( Lycii fructus)
These three herbs all enter the Kidney meridian. The first two are sweet and slightly warm in nature and the third is neutral. They are able to tonify the Kidney-essence and nourish the blood. They treat weakness and stiffness of the back and knees, blurred vision, poor memory, disorders of menstruation, infertility, menopause syndrome and sexual disorders caused by deficiency of Kidney-essence and blood.
Shu Di Huang is the most important herb for tonifying the blood as well as tonifying the Kidney-essence. Its function is the strongest and quickest among the herbs that tonify the Kidney-essence. Compared with He Shou Wu, Shu Di Huang has a stronger function of tonifying the essence and blood, but as it is more cloying in nature than He Shou Wu, it easily causes distension of the abdomen and reduces appetite. It is often used with Sha Ren ( Amomi xanthioidis fructus) to reduce this side effect.
He Shou Wu and Gou Qi Zi are weaker in their tonifying actions than Shu Di Huang, but they are not as cloying. They can be used for a longer period of time without bringing any extra burden to the digestion. They are commonly selected in a formula to treat chronic and moderate cases of Yin deficiency.
Nu Zhen Zi ( Ligustri lucidi fructus), Sheng Di Huang ( Rehmanniae radix) and Zhi Mu ( Anemarrhenae rhizoma)
Nu Zhen Zi is sweet and cold, and enters the Liver and Kidney meridians. It can nourish the Yin, particularly the fluid part, without any cloying effect. It is suitable for treating dizziness, tinnitus, blurred vision, weakness of the back and knees, and premature gray hair due to the Liver-Yin and Kidney-Yin deficiency. Since it is not cloying in nature, has a gentle and steady action, it can be used for a long period of time for chronic diseases. Moreover, it is also suitable in conditions where blood is deficient and there is slight heat in the blood.
Sheng Di Huang is sweet and cold, and enters the Heart, Liver and Kidney meridians. It nourishes the Yin, particularly the fluid part of these organs. It can also reduce heat and cool the blood. It is particularly suitable for conditions where the heat has injured the fluid, and not only the Kidney-Yin, but also the Heart-Yin and Liver-Yin are weakened. This manifests as restlessness, palpitations, irritability and insomnia. Sheng Di Huang is also frequently used in bleeding conditions, such as in prolonged menstrual periods or heavy menstruation.
Zhi Mu is bitter and cold, but is moist in nature. This herb principally enters the Kidney and Lung meridians and is often used to moisten dryness due to Yin consumption by heat. The symptoms are night sweats, hot flushes, constipation and dry throat and mouth.
Deputy: Strengthen the Kidney-Yang in order to generate Yin, strengthen the back and benefit to the bones
Tu Si Zi ( Cuscutae semen)
Tu Si Zi
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