It’s All About Balance

While Chinese medicine can seem endlessly complicated, and the human body a maddening chaos of possibilities, I am constantly reminded to return to the basics.

Our dual nature is at the very foundation of Chinese medicine — we rely on the opposing forces of yin and yang. I have lately been thinking about patients in these very simple terms. Even though I have already been in practice for three years, it helps to review what yin and yang actually are.

The nature of Yin is:

  • Dark
  • Heavy
  • Still
  • Moist
  • Cool
  • Contracting
  • Inward and downward

Yang is the direct opposite:

  • Bright
  • Light
  • Moving
  • Dry
  • Warm
  • Expanding
  • Outward and upward

The symbol of yin and yang (taijitu) illustrates this not just in the idea of opposites. If you look at a properly drawn taijitu, you’ll notice that the white (yang) aspect is rising and growing upward, while the black (yin) aspect is settling and collecting downward. If you look at the little dots at either end, you’ll see that at its peak, one transforms into or begets the other. As a side note, you’ll notice that the movement is circular and clockwise, which seems to be the way that healthy qi moves.

Yin and Yang Deficiency

When I look at someone through the lens of yin versus yang, I am looking for the deficiency. Theoretically nobody has too much yin or yang. The issue is one of deficiency, if yin or yang has been depleted. And then ultimately, it’s about the relative balance. A deficiency in one means the other becomes overactive creating the impression of an excess. To make things even more interesting, a deficiency in one will eventually impair the other, leaving both aspects empty. This does not feel good.

Let’s look at each one separately:

A yin deficient type of person will have a hard time with stillness and coolness. This means they will be restless, hot, and tend towards anxiety or frustration. They will also seem to be lacking with the down-and-in motion within their body. Headaches, dizziness, and other inappropriate upward-rising dynamics may appear. As yin is considered the female aspect, this type of deficiency tends to show up for women, but men have yin deficiency too. And yin is typically used up by pushing through life without the proper amount of rest / turning off / tuning out.

A yang deficient type of person is going to be missing the proper amount of warmth and movement, and may seem sluggish. The body functions themselves may be slow. This person is missing the outward and upward expansion of yang, so everything seems to be under-active. Usually libido will be low, as yang is the fire that drives sexuality. Yang is considered the male aspect, but both sexes can experience yang deficiency. A good balance of yang is especially important for fertility.

Yin and Yang on the Pulse

I have lately felt like I could make a lot of sense out of my patients just by clarifying yin and yang status overall, and then within each element. This is a fundamental concept I learned in school, but like most things gathered from books and study notes, it’s different to viscerally understand what it means and why it matters.

I have started to notice that I can tune into the yin and yang aspects of each element through the pulse. So for example if I’m looking at the Wood element, I might “listen” for information about the state of the Liver (yin aspect, deep level) as distinct from the Gallbladder (yang aspect, surface level).

Then, I can check the overall balance of yang versus yin on the pulse. If the pulse in general seems outward, expanding, energetic, with little root or foundation underneath, this is a person whose yang is relatively in excess, and yin is deficient. In contrast, a person who is overall imbalanced in an inward, contracted, heavy way, their pulse will feel like that. It will seem to be missing the spark of life and vitality that should be dancing at the surface.

Yin versus Yang Nature

Of course, in Chinese medicine, even the simple ideas become complicated. Thus it is with yin and yang. Once I started thinking about people through this lens, it seemed that the entire system really functions on the dynamic between yin and yang — and the rest is just details. In the Dao De Ching, first there was the one, the unity of the universe, and then there was two, the polar forces of yin and yang. And then, three is the interplay between these forces to create the ten thousand things.

Yet this does not mean that all things must at all times contain an equal balance of yin and yang. The body has aspects that are more yin, and aspects that are more yang at all levels. The same is true of a community of people. Some must by nature be overall more yin and others more yang. Some of the elements are more yang. Wood is a very yang element, and a Wood type is a go-getter in some form or is learning to manifest this aspect of themselves. A Metal person is relatively more yin, and can seem to others as somewhat cool in personality. Fire people are hot-natured and get other people moving or laughing very easily.

So while I may be thinking about a relative balance of yin and yang within a person, I am not going for absolute balance in each person. There is not a neutral single way to be. I’m looking for the balance for that person in particular. Is their body functioning with yin and yang in the proper amounts? Are they in harmony with their natural environment, wherever they live, and considering the time of day and time of year? Are they a healthy representation of themselves?