One of the most fundamental goals for health and longevity in TCM is nurturing and banking the Yin aspect of the body. Most of the characteristics of contemporary fast-paced life directly drain and deplete this important substance: chronic stress, poor sleep, chronic worry, use of stimulants, and poor nutrition. While acupuncture can play a supportive role managing these various challenges, the primary therapeutic modality for nourishing and supporting Yin is TCM “internal medicine” and its herbal formulas.
The most classic TCM herbal formula for nourishing Yin is “Liu Wei Di Huang Wan”, an elegantly simple six-ingredient formula. Liu Wei Di Huang Wan consists of three nourishing herbs—Shu Di Huang, Shan Zhu Yu, Shan Yao, and three draining herbs—Fu Ling, Mu Dan Pi, Ze Xie. Working in concert, these 6 medicinals enrich the Yin and nourish the Kidneys. The classic formula Liu Wei Di Huang Wan targets a wide spectrum of clinical presentations rooted in the lack of Yin and is particularly applicable for Yin deficiency symptoms such as chronic insomnia, chronic lower back / knee pain, vertigo, tinnitus, diminished sight / hearing, chronic sore throat / dry mouth, and chronic fatigue. The patient typically presents with a red tongue with little coating, often with cracks. Pulse is typically rapid and thin.
The classic formula Liu Wei Di Huang Wan also serves as an elemental blueprint for two important formulas which evolve from this classic formula: Zuo Gui Yin and Zuo Gui Wan. These two formulas also deeply nourish Yin but have subtle differences. Zuo Gui Yin consists of four herbs from Liu Wei Di Huang Wan: Shu Di Huang, Shan Yao, Shan Zhu Yu, and Fu Ling. The addition of Gou Qi Zi and Zhi Gan Cao round out Zuo Gui Yin. This Yin nourishing formula is more targeted toward issues of excess Yin Deficiency without extreme heat signs. Tongue characteristics are usually a pale / red tongue with a peeled shiny coat while pulse is typically rapid and thin. I use Zuo Gui Yin for patients presenting with these signs along with extreme fatigue, chronic lower back pain, low libido, and for athletes suffering from overtraining syndromes especially Female Athlete Triad.
The formula You Gui Wan consists of three herbs from Liu Wei Di Huang Wan: Shu Di Huang, Shan Yao, and Shan Zhu Yu. Upon this foundation, the herbs Gou Qi Zi, Tu Si Zi, and Chuan Niu Xi are added, along with the medicinals Lu Jiao Jiao and Gui Jia / Gui Ban. These two additions are substances which deeply nourish Kidney and Liver Yin making You Gui Wan one of the strongest herbal formulas for targeting Yin deficiency syndromes. This formula has deep clinical application in cases of long-term chronic disease where the Yin substance of the body has been heavily depleted. While strong in therapeutic action, You Gui Wan must be used long-term for drastic Yin deficiency syndromes as the road to recovery in such cases takes many months and patients must be counseled on this clinical reality.
In all cases of Yin Deficiency, clinicians should counsel patients on the importance of sleep hygiene and sleep quality in healing syndromes of Yin Deficiency. No amounts of herbs or needles can replace the healing quality of deep restorative sleep. Both clinicians and patients alike should always keep this concept of the importance of sleep in mind. In regard to Yin cycles in the body, I often have patients take such formulas as Liu Wei Di Huang Wan, You Gui Yin, and You Gui Wan before bed in order to harmonize with the Yin cycles of the body. This process can even become a part of the patient’s evening sleep hygiene schedule to help them understand how every evening is one more step towards deep restorative healing.
By Craig Williams, L.Ac., R.H. (AHG)About the Author: Craig Williams is a licensed acupuncturist, clinical herbalist, ACE-certified health coach and certified holistic nutritionist specializing in Ayurveda, TCM and nutrition. He is also an ACE Certified Behavior Change Specialist, East-West certified herbalist and certified running coach. Craig is in private practice in Austin, Texas. For more information, visit www.AyurvedaAustin.com.