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Chapter Two The Theory of Yin and Yang

At first , the theory of yin and yang was found in the classic book " Zhou Yi " ( Canon of Changes ) . It was a spontaneous and naive dialectic philosophy in ancient China . Through development , the theory of yin and yang gradually became the general program elucidating the structure of the entire cosmos.

In Sinomedicine , the theory of yin and yang is used to explain physiological functions and pathological changes of the human body , and direct clinical diagnosis and treatment . Therefore , the theory of yin and yang is an important component in Sinomedicine .

1.Basic Concepts of Yin and Yang

Through observation of natural phenomena , the ancients recognized that every thing had two mutually opposed aspects , opposing each other and connecting each other . The ancients used yin and yang to generalize these two aspects , taking the interaction , movement , production and change of yin and yang as the program explaining changes of all things .

Yin and yang are the basic law of nature , the program of all things , the basis of changes and the origin of the processes in which things go through the beginning to the ending . Therefore , all things consist of yin and yang which are two opposed aspects , and the generation , development and change of all things are the results of mutual movement of the opposed yin and yang aspects. Generally speaking , movableness , hotness, upperness , outside , brightness , hyperfunction, excitation , sturdiness ... are yang ; while quietness , coldness , lowerness , inside , dimness , decline , inhibition , weakness ... are yin .

Yin and yang properties of things are relative . On one side , yin can transform into yang and yang can transform into yin under certain conditions . On the other side , yin and yang can be subdivided into yin and yang . That is to say , there are yin and yang within yin , and there are yin and yang within yang . All things can be classified into yin-category and yang-category , any thing can be divided into yin-aspect and yang-aspect as well , and yin-aspect or yang-aspect can still be subdivided infinitely into yin and yang .

The law of movement of yin and yang shows in the following four aspects :

(1).Interdependence between yin and yang

Both yin and yang presuppose the existence of its opposed aspect . If any aspect separates from the other opposed aspect , it can not exist alone .

(2).Growth and decline of yin and yang

Both yin and yang are not in the state of standstill and changelessness , while they are in movement and change of mutual growth and decline , i. e. " decline of yang and growth of yin " or " decline of yin and growth of yang ".

(3).Coordination of yin and yang

In normal state , growth and decline of yin and yang are coordinative , forming relation of synchronously mutual replenishment . If growth and decline of yin and yang are not coordinative , diseases will occur .

(4).Transformation between yin and yang

Under certain conditions,yin-aspect and yang-aspect of one thing can transform into its opposed aspect , i. e. yin can transform into yang , and yang can transform into yin as well.

2.Uses of the Concepts of Yin and Yang

In Sinomedicine , the concepts of yin and yang are used in anatomy , physiology, pathology , diagnostics , therapeutics and others .

[1].In Anatomy and Physiology Yin and yang can be used to generalize the structures and functions of the human body . For the whole body of human being , the upper part is yang , while the lower part is yin ; the surface of body is yang , while the inside of body is yin ; the dorsum is yang , while the abdomen is yin ; the lateral part is yang , while the medial part is yin . For classification of the zang-organs and fu-organs , the five zang-organs ---- the liver , heart , spleen , lung and kidney are yin , while the six fu-organs ---- the gallbladder , stomach , large intestine,small intestine,urinary bladder and triple warmer are yang . Among the five zang-organs,for those belong to the dorsum, the heart is a part of yang within yang , and the lung is a part of yin within yang ; for those belong to the abdomen , the liver is a part of yang within yin , the kidney is a part of yin within yin , and the spleen is a part of extreme yin within yin.

The normal life activities of the human body are the results that yin and yang keeps coordinative relation of unity of opposites , and they are the processes of coordination and unity of assimilation in which " yin gives shape to things" and dissimilation in which " yang forms vital energy".

[2].In Pathology Diseases are caused by abnormality of coordination of yin and yang in the body . Although pathological changes are very complicated , they can be generalized by using the concepts of yin and yang . Generally speaking , the diseases which show chronic , cold , asthenic and hypofunctional pathological changes belong to yin syndromes ; the diseases which show acute , hot , sthenic and hyperfunctional pathological changes belong to yang syndromes.

[3].In Diagnostics The basic cause of genesis and development of a disease is abnormality of the coordination of yin and yang . Therefore , to diagnose correctly , yin and yang should be distinguished first , so that the nature of a disease can be grasped . For inspection , bright and lustrous color in the skin belongs to yang , while dark and gloomy color belongs to yin ; for auscultation and olfaction , a loud and clear voice belongs to yang ,while a low voice belongs to yin ; for palpation and pulse-feeling , such pulse conditions as floating pulse, rapid pulse and large pulse belong to yang , while sunken pulse , slow pulse and small pulse belong to yin .

[4].In Therapeutics Diseases result from abnormality of coordination of yin and yang . Therefore , the general principle of treating diseases is returning coordination of yin and yang to normal , i. e. invigorating its insufficiency or attenuating its excess according to excess or insufficiency of yin and yang to correct the phenomenon of excess tendency or insufficiency tendency of yin and yang , and to return yin and yang to normal coordinating relation.

3.Substance of Yin and Yang

In recent years , the medical world have extensively explored the substance of yin and yang and made much headway . We will analyse the structures and functions of human body at the levels of whole body , cell and molecule according to the principle of classification of yin and yang in Sinomedicine on the basis of these achievements . We will discuss the laws of changes of yin and yang , and the characteristics and interrelations of them as well .

[1]. Yin and Yang in the Human Body

(1). Yin and Yang for the Structures and Functions at the Level of Whole Body

A. Yin and Yang for Regions

Upperness and lowerness : Upperness is yang , while lowerness is yin . The upper region of human body belongs to yang , while the lower region belongs to yin . To pump the blood to the organs in the upper region , the heart consumes much energy in surmounting gravity to do work , therefore , the upper region of body belongs to yang . To pump the blood to the organs in the lower region , the heart consumes less energy because of taking advantage of gravity , therefore , the lower region of body belongs to yin . The dorsomedial nucleus of the hypothalamus is the thirst center , and it is near the upper region , belonging to yang . The ventromedial nucleus of the hypothalamus is the thirst inhibiting center , and it is near the lower region , belonging to yin .

Left and right: The left is yang , while the right is yin . The left cerebral hemisphere is in charge of linguistic thinking , and it controls the activities on the right side of human body , belonging to yin ; the right cerebral hemisphere is in charge of space distinguishing , and it controls the activities on the left side of human body , belonging to yang . In the male , the activities of the right cerebral hemisphere occupy a dominant position , and his ability of space distinguishing is stronger , it belonging to yang ; in the female , the activities of the left cerebral hemisphere occupy a dominant position , and her ability of linguistic thinking is stronger , it belonging to yin .

The sex difference of two cerebral hemispheres results from the influence of sex hormones secreted by the fetus in the period of embryonic development . " Sphygmology in Poems " point out : " When short and quick pulse appears on the left cunkou ( the left radial artery ) of a gravida , she is being pregnant with a boy fetus , however , when this pulse condition appears on the right cunkou of a gravida , she is being pregnant with a girl fetus . " According to report,in judgment of sex of a fetus on the basis of pulse conditions , the conforming rate of pulse-feeling by the doctors of Sinomedicine is 51.4 % , and the conforming rate of measurement with sphygmograph is 77.7 % . The short and quick pulse appearing on the left cunkou of a gravida who is being pregnant with a boy fetus might result from the increasing of bloodflow on the left side of the mother's body , which is the result that the mother's right cerebral hemisphere is affected by androgen secreted by the fetus . The short and quick pulse appearing on the right cunkou of a gravida who is being pregnant with a girl fetus might result from the increasing of bloodflow on the right side of the mother's body , which is the result that the mother's left cerebral hemisphere is affected by estrogen secreted by the fetus .

Front and rear : The posterior or dorsal region is yang ; while the anterior or ventral region is yin . Stimulation on the intermedial portion or posterior portion of the cingulate gyrus will result in acceleration of respiratory movement , these portions belonging to yang . Stimulation on the anterior portion of the cingulate gyrus will result in inhibition of respiratory movement , this portion belonging to yin . The posterior portion of the hypothalamus is the sympathetic nerve center , belonging to yang ; and the anterior portion of the hypothalamus is the parasympathetic nerve center , belonging to yin . The sympathetic trunk is located in the posterior wall of the thoracic cavity , abdominal cavity and pelvic cavity , belonging to yang ; while the vague nerve is located in the front of the sympathetic trunk , belonging to yin . The various yang channels and extensors are arranged on the dorsal face of the trunk , and the sweat glands and hairs on this face which are controlled by the sympathetic nerves are more developed , the dorsal face of the trunk belonging to yang . The various yin channels and flexors are arranged on the ventral face of the trunk , and the sweat glands and hairs on this face which are controlled by the sympathetic nerves are less developed , the ventral face of the trunk belonging to yin .

Inside and outside : The outside is yang ; while the inside is yin .The lateral portion of the hypothalamus is the " feeding center ", belonging to yang ; while the ventromedial nucleus of the hypothalamus is the " satiety center ", belonging to yin . When the dorsal portion of the hypothalamus is stimulated, the blood vessel of the leptomeninx will contract , this portion belonging to yang . When the central portion of the hypothalamus is stimulated , the blood vessel of the leptomeninx will dilate , this portion belonging to yin . The parasympathetic nucleus at the superior colliculus level of the midbrain is located in the deep of the brain stem , belonging to yin . The pressor area in the lateral reticular formation of the medulla oblongata which can promote the rising of blood pressure belongs to yang . The depressor area in the medial reticular formation of the medulla oblongata which can promote the falling of blood pressure belongs to yin . The lateral nucleus in intermediate zone of the lateral horn of the 1st thoracic segment to the 3rd lumbar segment of the spinal cord is a sympathetic nerve center , belonging to yang . The medial nucleus in the intermediate zone of the lateral horn of the 2nd to 4th sacral segment of the spinal cord is a parasympathetic nerve center , belonging to yin . In the spinal cord,the nerve cells which control the extensors of the extremities arrange along the edge of the anterior horn , belonging to yang ; while the nerve cells which control the flexors of the extremities arrange in the deep , belonging to yin .

Medialness and lateralness: On the lateral face of the extremities and trunk , three yang channels of hand and three yang channels of foot , as well as the extensors and abductors are arranged , and the sweat glands and hairs which are controlled by the sympathetic nerves are more developed , so the lateral faces of the extremities and trunk belong to yang . On the medial faces of the extremities and trunk , three yin channels of hand and three yin channels of foot , as well as the flexors and adductors are arranged , and the sweat glands and hairs which are controlled by the sympathetic nerves are less developed , so the medial faces of the extremities and trunk belong to yin .

In a word , the structures of human body conform the law that the upperness , left , rear and outside or lateralness belong to yang , while the lowerness , right , front and inside or medialness belong to yin .

B. Yin and Yang for Organs

The zang -organs are yin , while the fu -organs are yang . The heart , lung , liver , spleen and kidney belong to yin . Generally speaking , excitation of the sympathetic system can strengthen the functions of these organs , while excitation of the parasympathetic system can weaken the functions of these organs . The gallbladder , stomach , large intestine , small intestine and urinary bladder belong to yang . Generally speaking , excitation of the sympathetic system can weaken the functions of these organs , while excitation of the parasympathetic system can strengthen the functions of these organs. Among the five zang -organs , the heart ( the heart , thyroid gland , parathyroid glands and brain ) and the lung ( the trachea , the bronchi and the lungs ) are located over the diaphragm , being yang zang -organs ; the liver , spleen ( the spleen , pancreas and duodenum ) and kidney ( the adrenal glands , kidneys and sex glands) are located below the diaphragm , being yin zang -organs. Among the yang zang -organs , the arteries which supply the heart ( the heart , the thyroid gland , the parathyroid glands and the brain ) branch firstly from the aorta , and the superiority of blood supply for the heart is the strongest , therefore , the heart is a part of yang within yang ; the nutrient blood vessels of the lung ( the trachea , the bronchi and the lungs ) branch later from the aorta , and the superiority of blood supply for the lung is weaker , therefore , the lung is a part yin within yang . Among the yin zang -organs , the liver keeps close to the diaphragm , its position is the highest , and metabolic rate and temperature in it are the highest as well , therefore , it is a part of yang within yin . When comparing the kidney ( the adrenal glands , kidney and sex glands ) with the spleen ( the spleen , the pancreas and duodenum ) , it can be found that the arterial bloodflow of the former is larger , and it can secrete several kinds of yang -natured hormones ; while the arterial bloodflow of the latter is smaller , and it can secrete only one kind of yang -natured hormone . Therefore , the kidney is a part of yin within yin , and the spleen is a part of extreme yin within yin . For the reproductive organs , the testicles of the male are located in the out of the abdominal cavity , and the penis protrudes , therefore , they belong to yang ; the ovaries of the female are located in the abdominal cavity , and the vagina sinks inward , therefore , they belong to yin .

C. Yin and Yang for Muscles

The skeletal muscle of whole body can be divided into two types , one being the flexor and adductor , and the other the extensor and abductor . The flexors and adductors which are arranged on the ventral face of the trunk and the medial faces of the extremities belong to yin ; the extensors and abductors which are arranged on the dorsal face of the trunk and the lateral faces of the extremities belong to yang . Excess and insufficiency of yin and yang embody as the changes of the muscular tonicity . When excess of yin and insufficiency of yang occur , the tonicity of the flexors and adductors increases , while the tonicity of the extensors and abductors decreases . When excess of yang and insufficiency of yin occur , the tonicity of the extensors and abductors increases , while the tonicity of the flexors and adductors decreases .

D. Yin and Yang for Blood

Yin and yang for plasma : Generally speaking , the increasing of serum total protein and albumin , the rising of ratio of albumin to globulin ( A/G ratio ) , and the increasing of fibrinogen are yang ; while the decreasing of serum total protein and albumin , the falling of A/G ratio , and the decreasing of fibrinogen are yin . The increasing of nonprotein nitrogen ( NPN ) is yang , while the decreasing of it is yin . The increasing of carbohydrate and lipid in plasma is yang , while the decreasing of it is yin . Such positive ions as Na+ , K+ , Ca++ , Mg++ in plasma are yin , while such negative ions as Cl- , HCO-3 , HPO-4 ,SO-4 in plasma are yang . The increasing of plasma total osmotic pressure , crystal osmotic pressure and colloid osmotic pressure is yang , while the decreasing of them is yin . The increasing of plasma acidity , or decreasing of its pH is yang ; while the increasing of plasma alkalinity , or the increasing of its pH is yin . When plasma acidity goes beyond certain limit , acidosis will occur . Acidosis belongs to the category of yin exhaustion syndrome . When plasma alkalinity goes beyond certain limit , alkalosis will occur . Alkalosis belongs to the category of yang exhaustion syndrome .

Yin and yang for erythrocyte : The increasing of the number of the erythrocytes is yang , while the decreasing of that is yin . The increasing of ATP produced by the erythrocytes is yang , while the decreasing of that is yin . Under the situation that the number of the erythrocytes is normal , the decreasing of hematocrit and average volume of the erythrocytes is yang , while the increasing of them is yin .

Yin and yang for leukocyte : Generally speaking , the neutrophilic granulocyte and monocyte belong to yang ; the acidophilic granulocyte , basophilic granulocyte , T lymphocyte and B lymphocyte belong to yin .

Yin and yang for thrombocyte : Generally speaking , the increasing of the number of the thrombocytes is yin , while the decreasing of that is yang . cAMP which inhibits aggregation of the thrombocytes is yang ; while cGMP which strengthens aggregation of the thrombocytes is yin .

Yin and yang for coagulative system and fibrinolytic system : The strengthening of activity of coagu-lative system is yin , while the weakening of that is yang . The strengthening of activity of fibrinolytic system is yang , while the weakening of that is yin .

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