Library

31. Yin syndrome is characterized by heavy body, shortness of breath, cold limbs, dull eyes with lack of spirit, non-red complexion, absence of fever desire to lie down, cold extremities (Jue), vomiting or dysentery, clear urine, and cyanotic nails.
[Note] The term "Yin syndrome" refers to a pathogenic pattern of Yin-cold. Regardless of whether it involves the Three Yin meridians or the Three Yang meridians, any presentation of these symptoms indicates deficiency of Yin-cold (deficiency of Yang Qi). Yin governs stillness, hence the heavy body; Yin governs sleep, hence the dull gaze and desire to lie down. Deficiency and cold of Yang Qi result in shortness of breath and cold air exhaled from the mouth and nose. Excess Yin evil on the exterior leads to a lack of ruddy color in the face, cold extremities, and cyanotic nails. Yin evil entering the interior causes vomiting and diarrhea with undigested food (Qing Gu) and clear white urine. All the above belong to Cold syndromes of the Three Yin meridians. Clinicians should select appropriate formulas such as Fuzi Tang (Aconite Decoction), Sini Tang (Recover the Reversed Decoction), Lizhong Tang (Regulate the Middle Decoction), or Wuzhuyu Tang (Evodia Decoction) based on the specific condition. For details, refer to the chapter on the Three Yin meridians.

32. Yang-excess repelling Yin syndrome presents with cold extremities, aversion to heat, irritability, thirst, difficulty in defecation, deep and slippery pulse, red nails, and red urine. If sweating, purging, and clearing methods are applied appropriately, Yin fluids will naturally be preserved.
[Note] The Classic states: "When Yang Qi is excessively abundant, Yin Qi cannot circulate harmoniously." The inability to circulate harmoniously means they cannot interpenetrate. Since they cannot interpenetrate, Yin is repelled to the exterior, hence the term "Yang-excess repelling Yin." Although the external manifestations include cold body and extremities, resembling a Yin-cold pattern, internally there is a cluster of Yang-excess heat signs: irritability, thirst, difficulty in defecation, red urine, aversion to heat and reluctance to wear clothes, red nails, and a deep, slippery pulse. If the methods of sweating, purging, and clearing are applied correctly, Yang can be diminished, and Yin can be fully restored. For exterior excess with no sweat, use Sanhuang Shigao Tang (Three-Yellow Gypsum Decoction); for interior excess with constipation, use the Three Chengqi Decoctions; for intense heat without exterior or interior excess signs, Jiedu Baizhu Tang (Detoxifying White Tiger Decoction) is indicated.
[Collected Notes] Liu Wusu stated: When internal heat is severely accumulated, the pulse should be rapid and frequent. However, due to extreme heat accumulation causing obstruction in the pulse vessels, the pulse may instead appear deep, fine, and nearly absent. Laypeople, failing to understand the principles of nature, often mistakenly diagnose this as transmission to extreme cold or Yin-toxin syndrome. In cases where Yang-heat suddenly becomes severe at onset, presenting with these symptoms; or in cases of simultaneous contraction of exterior and interior with severe heat, one should generally use Jiedu Plus Dachengqi Tang (Detoxifying plus Great Order the Qi Decoction) to purge. If heat subsides slightly but recovery is incomplete, Huanglian Jiedu Tang (Coptis Detoxification Decoction) should be used for regulation. If slight heat remains, Liangge San (Cool the Diaphragm Powder) is suitable. In cases where failure to purge led to extreme heat, resulting in cold body, faint pulse, coma, and impending death, immediate purging would cause the residual Yin to abruptly perish, leading to death because Yang had already exhausted. Not purging also leads to death; in such cases, Liangge San or Huanglian Jiedu Tang should be used to nourish Yin and retreat Yang. As the accumulated heat gradually dissipates, the chest and heart will warm again, and the pulse will gradually return.