C. Yang Deficiency, also known as “Kidney Yang Deficiency”
This pattern usually includes the above symptoms of Yin Deficiency with some added symptoms unique to “Kidney Yang Deficiency”. For simplification we will call this pattern Yang Deficiency. If Kidney Yang is deficient for a long period of time, it can lead to Kidney Yin Deficiency, in which case one may see many of the symptoms under Yang Deficiency, and only several of the above Yin Deficiency symptoms, commonly night sweats or lower back pain. Likewise, if Yin deficiency is lasting a long time it can lead to Yang Deficiency, in which case most of the symptoms would be under the pattern of Yin Deficiency, with only a few under Yang Deficiency. Yin and Yang Deficiency can show as having symptoms of both patterns. It can be predominantly one pattern or the other, but includes both. For instance you could have night sweats, lower back pain, urination at night (Yin Deficiency) and cold limbs with severe fatigue (Yang Deficiency). This is very common. Most likely one pattern will predominate, and the tongue and pulse usually show the dominant pattern.
Kidney Yang Deficiency is mainly a constitutional problem these days, meaning it is mostly part of your genetic makeup inherited from your parents. It is often present in the elderly, or again, from chronic disease or sexual overindulgence. The decline of Yin and Yang is a normal part of aging, but symptoms can be treated at any stage, thus preventing further decline leading to illness. Many of these symptoms overlap with the pattern of Qi Deficiency, since the pattern of Yang Deficiency usually evolves from the pattern of Qi Deficiency.
A pure Yang Deficiency pattern is rare these days. It was more prevalent when people had real deficiencies, like lack of food or firewood/fuel to warm them. Also the problems of cold climate are not as common today as we live in heated houses with unlimited sources of heat. If you didn’t have food or fuel, or exposed yourself to extreme conditions like mountaineering in cold conditions, you could present with pure Yang Deficiency. Most commonly today we see a combination of Yin and Yang Deficiency.
1) The headache can present as any of the patterns already listed, and also have some of the symptoms below.
2) Frequent or pale urination, low output of urine (oliguria)
3) An aversion to cold, feeling cold, cold limbs (not just the hand or foot, but the forearm and/or calve as well), difficulty warming up the body
4) Lassitude or lack of energy or vitality, severe fatigue, exhaustion, especially in the morning.
5) Loose stools, or diarrhea, especially early in the morning.
6) Constipation can also manifest in this pattern, although more rare, and especially if there is difficulty in going to the toilet, and exhaustion and sweating after going. The stools are usually NOT dry.
7) Lower back/ knee weakness and/or feeling of cold or coolness of the skin
8) Edema, swelling, or water retention in the body, usually more pronounced in the lower limbs.
9) Upper body distress or a feeling of heat and restlessness, especially in the head
10) A lack of will power, or spirit of initiative.
11) The headache is aggravated or caused by eating lots of cold (both energetically, like cucumber or oyster, and physically like ice cream) and/or raw foods or drinking cold drinks over a prolonged period of time, being exposed to cold weather or living in a cold climate, or by exhausting the mental or physical energy. It may be alleviated by warm or hot foods (both energetically, like spicy, or physically hot, like soup), being in a warm environment, or application of heat to the body, and by rest or recovery from exhaustion.
12) For males: impotence, or spermatorrhea (excessive or involuntary ejaculation), for both male and female, a generally low or no sex drive.
13) For females: infertility and cold in the uterus, clear vaginal discharge, no ovulation, little or scanty menses, or amenorrhea (no menses), usually manifesting as severe hormonal imbalances, many women are already on HRT (hormone replacement therapy); often a luteal phase defect; ovulation occurs but there is little rise in basal body temperature (less than 2/10 of a degree).
14) Low basal body temperature would be a hallmark symptom of Yang Deficiency for male or female.
15) Diseases or weakness of the bone or marrow, like cancer of the marrow, including leukemia, myeloma, and pancytopenia; especially conditions where the western treatment involves a bone marrow transplant.
16) Very weak teeth, especially from birth or a young age.
17) Developmental or growth problems, especially in childhood, and those involving growth hormones or the immune system, like cretinism or congenital hypothyroidism, PIDD (primary immune deficiency disease), or SCID (severe combined immunodeficiency) or the bubble boy syndrome. Also neuro-developmental conditions like autism, cerebral palsy, and Down’s syndrome are worth mentioning here. These conditions usually have a Yin Deficiency component as well, but are often a combination of Yin and Yang Deficiency acquired from the parents.
18) The classic tongue is pale and swollen, with a white coating, so a generally pale color of the body is the key symptom.
19) The classic pulse is deep and threadlike, so one has to press deeply to feel it, and it feels weak, like a thread pushing up on the finger. In severe conditions the pulse can be downright feeble or hard to find.
Most of you will have found the patterns causing your headaches from above. The diagnosis will be either one of the excess patterns of Liver Yang Rising or Liver Fire, and caused from one of the three deficiency patterns of Blood, Yin, or Yin and Yang (for example, the patterns of Liver Yang Rising from Blood Deficiency is the most common). Or you could fall under only the deficiency patterns, without symptoms from the excess patterns above, but this is less common (an example would be headache from Blood Deficiency).
You may also have symptoms falling under multiple pattern categories. For instance it is common to see “Liver Yang Rising” from “Yin Deficiency”, AND “Liver Qi Stagnation”. You must remember that is important to figure out which patterns are predominant and which patterns are minor. Maybe 1 or 2 or even 3 symptoms in a category shows a mild involvement of a pattern, while 4 or more symptoms shows a stronger or predominant pattern. Maybe a key or hallmark symptom of a pattern shows a strong involvement of that pattern, its not just about the numbers. Be sure to read through all the patterns presented in this series.