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Traditional Chinese Medicine (TCM) and YNSA Theory

Mechanisms of action. Several theories are discussed on how acupuncture works along with theories that are specific to scalp acupuncture. One such theory regarding the mechanical separation of the subcutaneous scalp tissues, resulting in the separation of microcalcifications, resulting in a change of electrical resistance is discussed.

Conclusions. From traditional Chinese medicine of acupuncture and moxibustion to YNSA, the highly skilled acupuncturist is touching qi, affecting the patient’s electromagnetic field through the needle thereby influencing, promoting harmony and health.

The Eastern physician approaches the patient from a global, contextual, organic perspective using both Quantum and Newtonian thought. This physician views patients from a perspective of looking for harmony within their environment and noting their presenting disharmony or symptom. The Eastern physician does this by looking at patients’ biographical, psychological, emotional, and biological states in addition to their the symptoms. The Eastern physician identifies health first and then interweaves a description of characteristics and current symptomology to identify “dysharmonies,” deviation(s) from perfect health. This poetic, yet workable, description of the patient engenders a prescription or a formula for therapeutic action based on the central Chinese concepts of systematic correspondences.2

The difference can be described as the following—The West asks the question, What X is causing Y disease? The East asks, What is the relationship between X and Y? The West looks for the silver bullet to save a life, stop a symptom, or kill a germ. The East looks for dysharmony and tries to reconfigure the physiology and psychology to restore harmony, which is a definition of health.³ Another way to sum it up is: The Western physician’s thought process is linear, uniformly measured, and materialistic. The Eastern physician’s thought process is quantum mechanical, individually assessed, and vitalistic.

Chinese Principles and Terms

YNSA is a microsystem of acupuncture that uses a simple, yet complex, system of diagnostic and treatment protocols. Knowledge of OM or Traditional Chinese Medicine (TCM) acupuncture theory and practice is very helpful but not required to practice YNSA. For those readers without any TCM knowledge, the following Chinese principles and terms are given.

In the 16th century, the Jesuits returned to Europe from China with a new medical treatment in Latin called acus punctura or acupuncture, but until recently in North America acupuncture was not widely accepted because it clashed with the accepted paradigms of Western medicine.4 China, the prevailing philosophical constructs in which acupuncture and TCM were developed was based on holistic patterns, a causal relationship, nonlinear logic, and nonreductionistic phenomenology. By contrast, Western medicine is based on reductionistic scientific theories and causality. Chinese Taoism had a disdain for explanatory theories and chose instead to merely observe phenomena to maintain harmony with nature.⁵

The Chinese physician/philosophers before 200BCE had been involved in defining humanity’s place on the earth and under heaven. The Chinese philosophers saw humans as a connection between the terrestrial (earthly) and the ethereal (heavenly). Because they saw humans as the center of the universe (their world), humans were viewed as the connection between heaven and earth, with both forces having an influence upon human existence. This influence could be either beneficial or detrimental to health. The philosophers devised the following principles:

Qi

Qi (pronounced chee) is the vital energy and is symbolized by two parts of the ideogram: qi, for air and for breathing, and mi, for grain as the origin of nutrition.⁶ Qi signifies movement, something on the order of energy, the energy of life. Qi has two unique aspects. First, and most importantly, it is thought of as matter without form. Second, it is a term for the functional active state of the body. In The Yellow Emperor’s Classic of Internal Medicine (Huang Di Nei Jing) first published in 100BCE there are many keys to OM thought. In it the Su Wen, known as Simple Questions, chapter 25, states, “a human being results from the qi of heaven and earth … the union of heaven and earth is called human being.” In the classic of difficulties, it says, “qi is the root of a human being.” There are two particular aspects of qi that are relevant to medicine: (1) qi is an energy that manifests simultaneously on the physical and spiritual level and (2) qi is in a constant state of flux; when qi condenses, energy transforms and accumulates into physical shape.

When acupuncture physicians attempt to make a diagnosis, they are evaluating the presence and character of qi in all its many states. When acupuncture is used, qi is said to be obtained with the needle and then manipulated. The act of grabbing the qi and obtaining it with a needle is called de qi.

In Chinese medicine, there are several types of qi. One is source qi. It is the basal energy of the body formed from the essence of the kidneys, the nutrients absorbed from food, and the energy absorbed by the lungs from the air. Source qi is manifested in various ways. First, there is organ qi, which is the physiological activity and functions of each organ. Second, is the channel or channel qi, which is the transportive and moving function of the channels. Third, is nourishing qi, which is the qi that moves with the blood. Its functions are transforming blood, creating blood, and helping the blood nourish the tissues of the body. Fourth, is protective qi, which is the qi that travels outside the channels. Protective qi warms the organs and travels subcutaneously between the skin and the muscle to regulate the opening and closing of pores. The fifth and final qi is the ancestral qi, the qi that collects in the chest. The center point is Ren-17 (chan zhong).

“Qi may be understood as a matterless forcefield on which matter is constructed, organized, expressed, directed, and affected. Qi creates and ’moves’ or directs matter; acupuncture stimulates or otherwise manipulates that qi or matterless forcefield.”⁷

The energy of life, qi, is the fundamental concept of Chinese thought. This electromagnetic force has a pervasive and diffusive influence on the physiology and function of each person. There are various types of qi; however, there is ultimately only one qi, merely manifesting itself in different forms in various parts of the body and at various stages of development. The ancient text of the Ling Shu describes true qi: True Qi is a combination of what is received from the heavens and the Qi of water and food. It permeates the whole body. Qi changes its form according to its location and function. Zhangshi Leijing further tells us that: True Qi is the original Qi. Qi from heaven is received through the nose and controlled by the windpipe; Qi from food and water enters the stomach and is controlled by the gullet. That which nourishes the unborn is the Qi of the former heaven (pre-natal); that which fills the (new)born is called the qi of the latter heaven (post-natal). Original Qi is in the lower burner, which is below the navel and above the pubic synthesis. Original Qi nourishes the kidneys.8

Figure 2–1 Development of qi and blood.

A more complete description of how qi is transformed is as follows. Original Qi is nothing but essence in the formof qi rather than fluid and it relies on nourishment from the postheaven essence. Its functions are a dynamic motive force that arouses and moves the functional activity of all organs. Original Qi is the basis for kidney qi. Original Qi occupies the acupuncture source points and dwells between the two kidneys below the umbilicus and posterior to the gate of vitality Du-4 (ming men). It acts as an agent of change in the transformation of Gathering Qi into True Qi. It also facilitates the transformation

of Food Qi into blood. Food Qi comes from the middle burner (stomach, spleen, and small intestine) and it rises to the chest where it combines with the air from the lungs and forms the Gathering Qi, also called Essential Qi. True Qi is the last stage of transformational Qi where Gathering Qi is transformed under the catalytic action of Original Qi. True Qi is the final stage of the process of refinement and transformation where qi circulates in the channels and nourishes the organs.

True Qi becomes one of two different forms— Nutritive Qi and Defensive Qi. Nutritive Qi is closely related to the blood and flows in the blood vessels, following the course of the channels. Defensive Qi is in a yang relationship to Nutritive Qi. It is on the exterior and protects the body from attack by external pathogenic physical factors such as wind, cold, heat, and damp. Defensive Qi has its root in the lower burner, the kidneys, and is nourished by the middle burner, stomach, and spleen. It spreads outwards in the upper burner, the lungs. Defensive Qi circulates 50 times in a 24-hour cycle, see Figure 2–1.

The basic functions of qi are transforming, transporting, holding, raising, protecting, and warming. The spleen transforms food into food qi, kidney qi transforms the fluids, the bladder qi transforms urine, and the heart qi transforms food qi into the blood. Principle transportation duties of qi occur with the spleen qi transporting the food qi, and the lung qi transporting the fluids to the skin.

The direction of movement of qi is as follows: the kidney qi transports the qi upward, the liver qi transports the qi in all directions, and the lung qi transports qi downward. The function of controlling fluids and the blood in the blood vessels is done by the spleen qi. The kidney qi and bladder qi hold the urine. The lung qi holds the sweat. The spleen qi and the kidney qi rise upward while the lung qi protects the body from external pathogens. Both the spleen yang and kidney yang functions are to warm the body.9

The Su Wen further describes qi on earth as follows: That which was from the beginning in heaven is Qi; on earth it becomes visible as form; Qi and form interact, give birth to the myriad things. The qi flows through these vessels called channels. Yijiang Jingyi tells us that “the channels are the paths of the transforming action of Qi in the solid and hollow organs.”¹⁰ Qi is a yang characteristic that is the basis of all bodily energy.

Blood

In Chinese medicine, blood, or xue, is composed of two ideograms; chu for a drop, and min for a vessel.¹¹ Xue or blood is more than just the red blood cells and liquid that circulate throughout the body; it is also regarded as a force in OM and has a level of activity in the body that is involved in the sensitivity of the sense organs. Traditionally, it is said that blood is manufactured in the middle burner using qi derived from food digested by the spleen, gu qi, or food qi, and from the air in the lungs, zong qi, or air qi. Blood is a yin substance.

Essence

Essence, called jing, is a yin characteristic that is the basis for all growth, development, and sexuality. Jing is composed of two ideograms: mi for grain and quing for fresh or young. The young grain symbolizes the essence of life.¹¹ The traditional Chinese medical books describe jing in three different contexts with slightly different meanings. Preheaven essence or jing is the blending of the sexual energies of male and female to conceive a human being. Postheaven essence or jing is refined and extracted from food and fluids by the stomach and spleen after birth. Kidney essence or jing derives from both pre- and postheaven essence and determines growth, reproductive development, sexual maturation, conception, and pregnancy.

The difference between essence and qi within the human body is that qi is formed after birth and essence or jing is derived from the parents. Qi is energy-like. Essence is fluid-like. Qi is every-where and essence resides mostly in the kidneys. Qi can easily be replenished on a dayto-day basis. Essence is replenished only with great difficulty, if at all. Qi flows in short cycles—some yearly, some monthly, and some daily—while a few are even shorter, whereas essence flows in 6-year cycles for women and 8-year cycles for men. Qi moves and changes quickly from moment to moment, whereas essence changes slowly and gradually over decades. Congenital essence or jing can never be replaced. Essence or jing may also be used narrowly to mean semen.

Spirit

Shen means spirit, psychic energy, reasoning ability, and consciousness. The original means of shen in ancient China, in the cultural context of ancestor worship, was communication between humans and gods by way of spirits. The shen consists of two ideograms: shi, which means to make known and shen, which means to report. The commentator of the Huai Tzu says, “Jing is the qi of the person” and “shen is the protective nature of the person.”¹² The Su Wen says, “if the shen is damaged or leaves, we cannot cure the disease.”¹² The Ling Shu describes the continuum of jing and shen thus, “when the two shen meet, form is created. Before the form is created, this is Jing. When the two Jing meet, shen is formed.” The I Ching describes jing and shen as “Jing creates the form” when “Yin–Yang cannot be measured, it is called Shen.” Finally, the Ling Shu and the Su Wen tells us where the jing and the shen are stored. “Jing is stored in the kidneys” and “Shen is stored in the heart.”¹² Spirit, or shen, is a yang characteristic that is the force behind one’s mental state and actions.13 Beji yang spirit is received from heaven and is manifested in consciousness and thought.

Fluid

Fluids of the body include sweat, urine, tears, saliva, and other secretions. They are either thin, jin, or thick, ye (yang or yin, respectively). The thin fluid moistens the muscles, skin, flesh, and membranes. The thick fluid moistens the inner organs and brain. Fluids are a yin characteristic.

Yin/Yang

The Chinese believed that the beginning of the world was a formless, indivisible whole. For life to develop, the unity had to become a duality, and from this idea came the concept of complementary opposites, which they called yin and yang. This duality is pervasive in Chinese life, art, literature, philosophy, and medicine.

Yang

This yin and yang concept is at the cornerstone of Chinese and Oriental thought. Yang consists of two ideograms: fu is for hill and yang is for brightness, expansiveness. Yang is the sunny side of the hill.

Yin

Yin consists of two ideograms: jin is for now or present and yun is for clouds. Yin is the shady side of the hill.¹⁴

The Taiji or great polarity is a symbol of yin and yang as seen in Figure 2–2. Yin and yang are emblems of the fundamental duality within Chinese medicine and describe the universe. The color black in the Taiji signifies yin and white signifies yang. These two colors coil around, fade into, and penetrate each other. Both yin and yang are necessary for the whole to exist. This yin– yang concept is projected to all levels of the universe and a system of correspondences. Yin and yang are complementary. They are not contradictory. Nor is one good and the other bad. It is the harmony between them that is sought and the avoidance of imbalance that provides health and life. To be able to distinguish between the yin and yang quality of a person’s constitution or illness is an important step in the process of synthesizing the necessity for proper treatment using traditional Chinese medicine and YNSA.

Figure 2–2 The Yin/yang symbol Taijitu (literally “diagram of the supreme ultimate”).

The yin and yang correspondences are seen in medical conditions. Table 2–1 lists correspondences for the cosmos.

Yin

Yang

Yin and yang are relative terms. It is important to understand that what is yin in relation to one thing may be yang in relation to another.¹³ Yin and yang must succeed one another so that in a yin condition the corresponding yang state can be foretold and vice versa. The qualities of yin and yang are relative and not absolute.

The Su Wen best describes yin and yang the way we use it in YNSA: “There is yin within YIN and yang within YANG. From dawn till noon, the yang of heaven is within the YANG; from noon till dusk the yin of heaven is within the YANG; from dusk till midnight the yin of heaven is within the YIN; from midnight till dawn the yang of heaven is within the YIN.”15 We describe all Basic and Ypsilon points in yin or yang terms and then further divide YIN into yin or yang and YANG is also divided into yin or yang.

Yin and yang are two phases of a cyclical movement, alternating between day and night. The sun is in the heaven, therefore the heaven is yang and the earth is yin. The ancient Chinese farmers thought heaven was a round vault and the earthwas flat, therefore yang is round and yin is square. Because the sun rises in the east and sets in the west, the east is yang and the west is yin. The directions are further divided by Chinese tradition.

In Chinese imperial ceremonies it is quoted, “the emperor face south towards the subjects who face north.”¹⁶ The emperor thus opened himself up to see the influence of heaven yang and south. South is, therefore, like heaven at the top, yang. North is, therefore, like earth at the bottom, yin. By facing south, the emperor identifies his left with the east and his right with the west. Thus, left corresponds to yang and right to yin.

In the Su Wen, it says, “east represents yang, west represents yin, in the west and in the north there is a deficiency of heaven hence the left ear and eyes hear and see better than the right, in the east and south there is deficiency of earth hence the right hand and foot are stronger than the left.” The second chapter of Su Wen says: “Heaven is the accumulation of yang and earth is the accumulation of yin.” Thus, in the purest and more rarified form, yang is totally immaterial and corresponds to pure energy and yin in its coarsest and densest form is totally material and corresponds to matter. Again in chapter 2 of Su Wen, “yin is quiet and yang is active. Yang gives life and yin makes it grow. Yang is transformed into qi and yin is transformed into material life.”

There are four main aspects of yin and yang in their relationship. First, yin and yang are opposite stages of each other’s cycle. However, the opposition is relative and not absolute in so far as nothing is totally yin or totally yang. The second aspect is the interdependence of yin and yang. Although they are opposites, one cannot exist without the other. Everything contains opposite forces that are mutually exclusive but, at the same time, are dependent upon each other. The third aspect in the yin/yang relationship is that they are in a constant state of dynamic balance, which is maintained by a continuous adjustment of the relative values of yin and yang. The fourth aspect of their relationship is that yin and yang are not static. They actually transform into each other. Yin can change into yang and yang can change into yin.

Yin/Yang Relationship

According to Chinese philosophy, the transformation of life is accomplished in the Five Phases or Five Elements (Fig. 2–3) also known as wu xing. Wu is the ideogram for five and xing means to go, the journey, and the change. Its ideogram is composed of chi, which means small step and chu, which means to go to.¹⁴

The late professor J.R. Worsley, in Classical Five Element Acupuncture: The Five Elements and the Officials states, “Every living thing and every person on the planet is a unique embodiment and combination of the five elements.”¹⁷ “The five elements express and embody the aspects of this change and movement within the qi energy. Each element describes a particular phase of its movement, the particular qualities that belong to that part of its changing pattern. Together the elements help us to understand the process of dynamic harmony and balance in the whole system of energy. Through this they give us the insight, which allows us to promote by our system of medicine. When we look at the individual elements, therefore, we always have to keep in our minds that we are looking at parts of a much larger picture. As practitioners of acupuncture who treat the whole person, this must be one of most important guiding principles.”17

The Five Phase system of acupuncture is based on the ancient Chinese medical and premedical texts including Huang Di Nei Jing, Su Wen, Ling Shu, Nan Jing, and Zhen Jiu Jia Yi Jing. There is a strong resemblance between the phase name in the Chinese translations of fire, earth, metal, water, and wood and the four phases of the Greco-European thought of fire, earth, water, and air. This Five Phase approach is a very complete system of correspondences, providing excellent reasoning and methodology for a complete diagnosis and treatment.

The earliest reference to Five Phases can be seen in Shu Ching, a book on political philosophy circulated between the 10th and 5th centuries BCE. Similar information can be found in the Li Chi, or the Book of Rights, as early as the 5th century BCE and in the Guan Dzu, a book of philosophy, dating back to the 4th century BCE. The Five Phase concept’s first known application to the body and to medicine was in the Su Wen written ~100BCE. Five Phases also appeared in the Ling Shu and in the most complete and profound way in the Nan Jing. Here, the development of Five Phase theories and correspondences was complete. In the Nan Jing, the development and synthesis of cycles, correspondences, and theories were made realizing the limitations of these ideas. As Kiiko Matsumoto and Stephen Birch point out in their book, Five Elements and Ten Stems, “the Five Element system was not seen as a hard and fast doctrine but rather a problem solving device.”¹⁸

The Five Phases are described as fire, water, wood, metal, and earth. Fire relates directly to heart (HT), small intestine (SI), pericardium (PC), and triple burner (TB). Water relates directly to the kidney (KI) and bladder (BL). Wood relates directly to the liver (LR) and gall bladder (GB). Metal relates directly to the lung (LU) and large intestine (LI). Earth relates directly to spleen (SP) and stomach (ST). In Table 2–2, each phase has yin and yang components, also known as the zang and fu organs.

Fu are yang organs such as gall bladder, small intestine, stomach, large intestine, and bladder. Fu organs are considered hollow organs. The fu ideogram is composed of two parts: rou for flesh and fu for prefecture, or the official residence. Fu organs act as governing authorities, influencing the connecting yin organs. The zang organs are yin organs such as the liver, heart, spleen, lung, and kidney. The zang organs, by tradition, are described as storing the vital energy. Zang organs are considered solid organs.¹² Zang consists of two ideograms: rou, which means flesh, and zang, which is to hide, to pressure, and to store.

Table 2–2 (Zang) Yin–Yang (Fu) organs

Yin (Zang)	Yang (Fu)
HT	SI
KI	BL
PC	TB
LR	GB
LU	LI
SP	ST

Each element or phase is a symbol that represents a category of related functions and qualities, as shown in Table 2–3. Wood is associated with active functions such as growing and increasing. Fire is associated with functions that have reached their maximum state. Metal relates to functions that are declining. Water represents the functions that have reached a maximum state of decline. Earth represents balance and neutrality. Earth acts as a buffer between the other four phases. These five phases act as generic categories for the classification of all phenomena; from colors and sounds to orders, tastes, emotions, animals, destinies, planets, and all things known in the cosmos.

The Shang Shu says, “The five elements are water, fire, wood, metal, and earth. Water moistens downwards, fire flares upwards, wood can be bent and straightened, metal can be molded and hardened, earth permits sowing, growing, and reaping that which soaks and descends, ’water’ is salty. That which blazes upwards ’fire’ is bitter, that which can be bent and straightened ’wood’ is sour, that which can be molded and become hard ’metal’ is pungent, that which permits sowing and reaping ’earth’ is sweet.”

These five phases also represent directions of movement of natural phenomena, see Table 2–4. Wood represents expansive outward movement in all directions, whereas metal represents a contracted inward movement. Fire represents upward movement and water represents downward movement, whereas earth represents neutrality and stability.

Professor J.R. Worsley, the 20th century’s leading Five Phase acupuncturist, in his text, Classical Five-Element Acupuncture: The Five Elements and the Officials, states the key words that would describe each of the five phases.19 The one word that best describes wood is vision. The other words that would describe the patient when taking a history or diagnosing of a wood (causative factor) patient would be; birth, growth, structure, etcetera. Take a close look at Table 2–5, which summarizes these descriptive words nicely.

Five Phase Movement

Looking again at the Five Phase Pentagram (Fig. 2–3), the engendering, restraining, overwhelming, and rebellion cycles of the Five Phases are completely depicted. This first movement is called the engendering sequence or Sheng cycle, where one phase gives rise to the next phase. It is key in propagating life or qi through the channels. So the initial phase is called mother and gives birth or life to the next phase called child. Thus, wood (mother) generates fire (child), fire (mother) generates earth (child), earth (mother) generates metal (child), metal (mother) generates water (child), and water (mother) generates wood (child). So it is said that wood is the child of water and the mother of fire, see Table 2–6.

The restraining cycle, or Ke cycle, is the second movement whereby each phase controls another from being too replete. By controlling its corresponding phase, it promotes balance and harmony. Thus, wood controls the earth, earth controls the water, water controls the fire, fire controls the metal, and metal controls the wood, see Table 2–7. So, wood controls the earth but is also controlled by the metal. This restraining cycle is key in providing balance and harmony within the channels. The Five Phase model provides clinically useful patterns for identification of pathological relationships between the internal organs as well as psychological states.

The third action of movement of the Five Phases is the overwhelming, or Cheng cycle, as depicted in Table 2–8. The overwhelming cycle occurs in the same order as the restraining (Ke) cycle but is much more replete to the detriment of the recipient phase. When wood overacts on earth, earth becomes vacuous and unable to nurture metal. Metal is then unable, through the restraining (Ke) cycle, to control wood. Wood, then, becomes replete also, passing a more excessive overacting force upon the earth phase. In another case, when earth overacts on water, water is unable to nurture wood. Thus, wood is unable to control the earth phase and the cycle exacerbates and continues. When water overacts on fire, fire diminishes and is unable to control metal. Metal increases to foster even more water. When fire overacts on metal, metal is unable to control wood and unable to generate water. Then wood generates more fire, which overacts on metal and starts the cycle again. When metal overacts on wood, wood is unable to control earth and unable to support fire. Earth generates more metal and the cycle repeats.

The fourth movement—the rebellion, or Wu cycle—occurs in the reverse of the restraining (Ke) cycle, see Table 2–9. This back-up of energy is replete (excess) in imposing a deleterious effect upon its recipient phase. When fire dominates and insults the water, water diminishes. When water insults the earth, the earth diminishes. When earth insults the wood, the wood diminishes. When wood insults the metal, the metal diminishes.

The overwhelming (Cheng) and rebellion (Wu) cycles are a reflection of an imbalance or abnormal relationship among the Five Phases. For an illustration of these relationships among each Five Phases, see Figs. 2–3 to 2–9. This abnormal relationship over time produces disease.

Clinical Examples of Five Phase Movements

When the restraining (Ke) cycle gradually becomes replete to the point of being overwhelming (Cheng cycle), the relationship among the phases results in repletions. For example, when the liver (wood) becomes replete and controls or overacts on the stomach and spleen, it is said that the liver qi stagnates and invades the stomach impairing the function of rotting and ripening. The spleen is impaired in its function of transforming and transporting. It prevents the stomach qi from descending causing the symptom—nausea. This prevents the spleen qi from ascending, causing diarrhea. Another example is when the heart (fire) controls or overacts on the lungs. Heart fire can dry up the lung (metal) fluid causing lung yin vacuity (deficient) with signs and symptoms of a dry, nonproductive cough, night sweating, red cheeks, and low-grade fever.

When the spleen (earth) overacts on the kidneys (water), the spleen holds dampness and this can obstruct the function of the kidney transformation and excretion of fluids, which may give rise to water retention, nausea, and possible urinary tract infections. When the lungs (metal) overact on the liver (wood), this is a case of lung vacuity triggering stagnation of the liver qi, which may lead to hay fever, tight cough with difficult expectoration, and/or hyperthyroidism. When the kidneys (water) overact on the heart (fire), the kidney yin is vacuous and empty; heat then forms that can be transmitted to the heart and becomes a factor in panic, depression, and/or essential hypertension.

When the relationships among phases turn to a rebellion (Wu) cycle, pathological conditions will result. When the liver (wood) insults the lungs (metal), the liver qi can stagnate upward and obstruct the chest and breathing. When the heart (fire) insults the kidneys (water), the heart fire can infuse downward into the kidneys and cause kidney yin vacuity and fatigue. When the spleen (earth) insults the liver (wood), the spleen retains dampness, which can impair the free flow of liver qi. When the lungs (metal) insult the heart (fire), the lungs are obstructed by phlegm and can impair the circulation of the heart qi. When the kidneys (water) insult the spleen (earth), the kidneys fail to transform fluids and the spleen and become obstructed by dampness.

When the lung’s ’mother’ depletes itself for the ’child’ kidney, the lung qi is vacuous. The qi in the fluids cannot descend to the kidneys, causing breathlessness. The kidney is unable to receive the qi and dryness of the kidneys ensues. When the kidney ’child’ affects the lung ’mother,’ qi will rebel upward and obstruct the lungs causing breathlessness. When the kidney ’mother’ affects the liver ’child,’ if the kidney yin is vacuous, the liver yin and blood will become vacuous giving rise to tinnitus, dizziness, headaches, and irritability. When the liver ’child’ affects the kidney ’mother,’ if the liver blood is vacuous over a long period of time, it can lead to vacuity of kidney essence causing dizziness, tinnitus, night sweats, and sexual weakness.

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