The principle of yin-yang is the philosophical basis of all aspects of traditional Chinese Medicine including structural, organic, functional, and mental-emotional. This article will focus on the structural aspect.

 Fundamental Duality

Yin-yang is the fundamental duality of everything in the universe. The Chinese word yin means the “shady side”, yang means the “sunny side”.

Yin is dark, internal, receptive, hidden, in shadow, soft, heavy, cool, wet, in closer proximity to the Earth.

Yang is bright, external, active, exposed, lit-up, hard, light-weight, warm, dry, in closer proximity to Heaven.

Taijitu

Yin-yang theory is foundational in Taoist cosmology and in Chinese medicine theory. The symbol for yin and yang is called taijitu, showing the universal polarity in a constant state of harmonious movement. The taijitu is the combination of two identical intertwined fish-like shapes, black for yin, white for yang, with the seed of each present within the opposite.

Relativity and Polarity

Everything has a relative yin-yang nature. Nothing is ever pure yin or pure yang.

Yin and yang are mutually dependent, they exist always in relation to each other. There can never be yin without yang and vice-versa.

Yang and yin are opposites, but each contains the seed of the other. At high noon, when the day begins its descent toward darkest midnight; yang transforming into yin. In the depths of winter the seasons start to shift toward spring and summer; yin transforming into yang.

Yin-Yang Structure of the Body

Yin-yang in the body is traditionally illustrated by a farmer bending over, working in the field. The back and head are exposed to the sun, yang, while the chest and abdomen and feet are in shadow, yin.

Understanding the relative yin-yang structure of the body is important for diagnosing and treating musculoskeletal issues such as injuries, chronic pain, and degenerative diseases.

The skin is yang (outer) relative to the internal organs (inner). The head is yang relative to the feet, because the head is closer to the Sun (yang) and the feet are closer to the Earth (yin). The tops of the feet are yang while the soles of the feet are yin etc.

The back of the body including the neck, shoulders, back, and the outer parts of the arms and legs are yang.

The front of the body including the face, chest, abdomen, and inner parts of the legs and arms are yin.

The upper back is yang and the lower back is yin. The chest is yang and the abdomen is yin.

The spinal curves have a relative yin-yang relationship, meaning they balance each other. Natural spinal curves provide important shock absorbance, allowing for complex movement.

The cervical and lumbar curves are anterior, they sink in relation to the rest of the back; yin.

The thoracic and sacral/pelvic curves are posterior, they rise in relation to the rest of the back; yang.

The cervical and thoracic yet more yang in relation to the lumbar and sacral/pelvic because they are higher up on the body, more exposed, and closer to Heaven (ultimate yang).

Relevant to Treatment

The more yin structures tend to suffer from weakness but benefit from being relaxed, such as the abdomen. The more yang structures suffer from tension but benefit from being strong such as the posterior shoulder muscles.

However, yin is not the same thing as deficiency or weakness and yang is not the same thing as excess or tension.

It’s also worth noting that because of the modern Western lifestyle emphasis on sitting, most people would benefit from increased strength and relaxation overall, just to maintain basic structural balance.

Conditions to Consider

Low back pain is often from weakness in the corresponding yin aspect: weak abdominal muscles mirroring the low back.

Low back pain also shows up as tension in the more yang aspects of the spine: the lower thoracic and upper sacral. Address abdominal weakness or coldness, and treat the upper sacral and lower thoracic tension to relieve low back pain.

Upper back pain is yang-on-yang tension, within which a hidden yin weakness can be found.

Releasing the tight trapezius, supraspinatus, and infraspinatus is one part of treatment, but then look for overstretched and weak rhomboids, and instability in the cervical curve. Ribs that are stuck or “out” in the back will often have a corresponding tenderness in the anterior ribs.

Create leverage for treatment of stubborn and guarded upper back pain by treating the anterior sterno-costal area.

Shoulder pain can be an excess type where the joint is very stiff, difficult to move, perhaps inflamed. Look for weakness in the low back, abdomen, or legs that might be contributing to overuse of the shoulder, or may undermining its ability to heal properly.

Shoulder pain that is more “nervy” and weak is a deficient type. The affected shoulder will often present as lower, either on the top of the shoulder joint or in the scapula.

The patient may not want the affected shoulder to be touched or treated. The excess type of tension will often be found on the opposite side of the upper back, especially near the vertebrae and paraspinal muscles.

Treating the Whole Person

Yin-yang diagnosis can go even further for pain conditions, especially with incorporating in-depth channel theory, zangfu treatment, and herbal remedies for maximum benefit.

Yin-yang in the body should be functional and natural, creating a harmony of movement for our lives. When it is pathological we use the same principles of balance to address pain and dysfunction.

Qi is foundational in the theory and practice of Chinese medicine. Qi as a concept is widely accepted in East-Asian cultures, but in the West is often negated or ignored, leading to misunderstandings about the validity of Chinese medicine.

Qi is often described as “energy”, an invisible force that exists in all of nature. Chinese medicine theory tells us that qi travels along channels that connect all parts of the body and disease is the result of the qi being blocked, deficient, or otherwise imbalanced. The use of acupuncture needles or other stimulation at responsive points along the channels rebalances the qi and restores health.

There are a few keys for a deeper understanding of qi and a better appreciation of the sophistication and insight of ancient Chinese medicine.

Qi is movement and functionality

This wonderful illustration is from The Expressiveness of the Body and the Divergence of Greek and Chinese Medicine by Shigehisa Kuriyama, showing the difference between the body as purely function or structure.

Life is movement, everything in our bodies from our heart beat and blood flow, to the delicate balancing of hormones and cellular respiration, is a constant dance of movement.

Functionality in the body is always related to physiological movement on some level. The exchange of ions that generate nerve signals, muscle contraction and relaxation, fluid regulation, blood and lymph circulation, the processes of digestion and so on, are all movement.

Qi is invisible because it is the actual activity and function of everything working together in a healthy human person. Qi is the natural movement of our life processes and we cannot see it because it is a description of the healthy functioning of our very lives. When the qi is blocked- that is, when our cells, biochemistry, or organs are not functioning properly- then we have disease and illness.

Modern Western medicine is based on the ancient Greek worldview which emphasized structure and form. We see this in the beauty of Greek art with its perfection of visible structures of the human body.  Greek medicine was based on the body structures found in a dissected cadavers. As the medicine developed into modern allopathic medicine the understanding all of health and life was still based on physical, inert forms. The focus stayed on structure, the keys to health being sought through reductionism instead of holism.

Chinese medicine is based on the ancient Eastern worldview of movement and natural changes. The Chinese model is based on observable function in a living person, within the context of nature, making it a holistic system of medicine. The acupuncture illustration is depicting life and dynamic movement, something time-based in the human body, not static.

Qi is a confluence of several body systems working together

Modern Western medicine divides biological systems into discrete functions based on structures.
The basic systems of the body from a Western perspective are musculoskeletal, nervous, integumentary, reproductive, urinary, digestive, endocrine, cardiovascular, respiratory, and lymphatic. Psychological and behavioral functions are considered somewhat separate, unless there is psychological pathology and neurological drugs are brought in.

An integrative discipline called psychoneuroendocrinoimmunology is a Western medical study of how human psychology, neurology, endocrine, and immune systems interact and effect one another. This is a a limited holistic outlook based on a reductionist model, trying to reintegrate systems that are already divided.

Chinese medicine, developed thousands of years ago, started with the philosophy of holism of the body, community, nature, and spirit.

Chinese medicine uses qi to describe the natural confluence among all the systems, including the psychological state, the shen or heart-mind. In Chinese medicine, if the qi is flowing properly then everything is in working physiological and psychological order. If one of the systems is injured or blocked then it naturally effects several other systems simultaneously.

As a simple example is a severe injury to a limb that effects what the Western model would consider 5 different systems: nervous, musculoskeletal, lymphatic, circulatory, and integumentary, the injury causes lack of function in all these areas.

From a qi-based model,  pathology is in the channel of functionality, causing pain and lack of flow of qi (lymph, blood, correct nerve signaling, mobility etc). Stimulating responsive points in the area or in another area to release blockages in the fascia will resolve the issue.

The treatment approach of unblocking the qi with acupuncture, massage, or herbal medicine simply returns the musculoskeletal structure, blood flow, nerves, and lymph flow to proper functioning. Qi in this case is an elegant shorthand for describing the function or lack thereof of several body systems.

Pathology on deeper levels can effect the hormones, immune system, digestion, the psychological state etc, which is still a pathology of qi – a disruption of physiological function– in these interdependent systems.

Qi travels along the fascial planes, which connect limbs and organs

Fascia is the great ignored organ of the human body. Fascia is a gossamer-thin yet strong and impervious connective tissue that wraps every muscle, bone, and organ.

Fascia layers in between the muscle cells and binds the body together. It also creates important compartments on the body between the organs and different muscles. Fascia connects and creates boundaries and without it the body would not be able to function.

The purpose of fascia is difficult to appreciate from a structural perspective based in cadaver dissection. Early anatomist would have to cut through all this web-like material in the cadaver to get to the muscles, bones, and organs. Most of modern Western medicine anatomy is based on the information from cadavers, not living, breathing, moving, people. The role of fascia was minimized until a more recent interest in the Western medical community rediscovered its importance.

Daniel Keown in The Spark in the Machine: How the Science of Acupuncture Explains the Mysteries of Western Medicine, attributes the mysterious triple burner (san jiao) organ of Chinese medicine to the fascia. In an important Chinese medicine text, the Huang Di Nei Jing, the triple burner is said to have “name but no form”. The fascia is an organ with many specific functions, and has been overlooked in Western medicine, but helps to explain acupuncture channel theory and qi.

Fascia physically connects organs and limbs. The fascial planes often line up exactly with acupuncture channels, at both superficial and deep levels. This is one way of understanding why stimulating a point on the arm can effect lung function.

Fascia is composed of collagen, which is piezoelectric, meaning it generates an electric charge with mechanical stress. Our bodies have mechanical stress all the time from gravity, not to mention movement and exercise, and the electrical charge generated through the collagen keeps bones strong because the charge signals osteoblasts to lay down more fibers on the bones.

According to Daniel Keown we can see the absence of this in astronauts in space, who lacking the mechanical stress of gravity, lose at least 1 percent of their bone mass per month, even with vigorous exercise.

This is all to say that the body has an innate electrical charge which has vital properties, and travels along lines of the fascia, mirrored in the acupuncture channels.

Qi is electricity, the life force of our body

The picture above uses Kirlian photography to capture the electrical energy of a living flower. Electricity can also be defined as energy, or a type of energy, which is matter in movement. The famous axiom E=MC2 is a way to express that qi is everything (matter) in movement.

Qi is the movement and function of the piezoelectric charge that runs along the fascia, as well as the motor and sensory nerve signals, the autonomic signals that keep our heart beating, the blood flowing in the vessels, the release of hormones from glands, the balance of fluids in the body, the metabolism of cells etc. etc.

Electricity is invisible but we know it exists by its effects. Qi is invisible and will never be found in a cadaver, but we know it exists because of its effects. Electricity has healing and regenerative properties, and modern hospitals use special machines that induce piezoelectricity to help heal bones.

Qi is intelligent and works within a model of universal order

Qi is an intelligent force within the body that creates order, organization, healing, and proper function. The organization and development of a living human from two cells in only nine months is still the great mystery of embryology.

Qi reminds us that our bodies function is a holistic system that cannot be divided up to be healed. We are a part of nature, and we are all connected through a shared life force, and none of this is an accident. It is no surprise then that the best way to achieve health is with good nutrition, moving and exercising every day, appreciating nature, and honoring our community. The qi will do the rest.

   “Tao is empty- Its use is never exhausted
Bottomless- the origin of all things…
Deeply subsistent-
I don’t know whose child it is.
It is older than the Ancestor.”
-Tao Te Ching, 4

Creation and Tao

“Tao engenders One
One engenders Two,
Two engenders Three, 
Three engenders the ten thousand things.
The ten thousand things carry shade
And embrace sunlight.
Shade and sunlight, yin and yang.
Breath blending into harmony.”
-Tao Te Ching, 42

Tao translates to “way”. It also implies the void nature of the universe that exited before creation. In Taoist cosmology it is said that from tao (“nothing”) came the the one. The one is called wuji, the infinite space. Wuji is stillness within stillness, inner stillness, inner essence, beneath and interior to any movement.

The one engenders the two, called taiji, the great ultimate.

Taiji is the harmony of opposites of yin and yang.

The two engenders the three, and from the three all of creation, the “ten thousand things”.

The Five Phases

The five phases, or wu jing shen, represent the movement of the energies of nature: fire, earth, metal, water, and wood.

The five-pointed symbol here represents the flow of energies in nature. The five phases are not discrete elements like the four elements of classical Greece, but phases of nature which transform into each other in a cyclical way.

These five phases are the basis for Taoist medicine and feng shui, the sciences related to health and harmony in life and nature.

The Cosmic Trinity

Tao engenders the three treasures in different scales of existence, each with its own science for mastery.

Heaven is the cosmic scale with the sun, moon, and stars, and its science is astrology.

Earth is the terrestrial scale with wind, earth, and water, and its science is feng shui, or geographic physiognomy.

Human is the microcosmic scale and has the internal jing, qi, shen, the essence, energy, spirit.

The Human Trinity

The three treasures of humans are the jing, qi, and shen.

Qi is the term for “energy” in the body, and also in all of nature. Qi is movement and functionality, life force.

Jing is the essence, the root of the qi in our body, and the force that can generate new life, or with special efforts, regenerate us spiritually. Jing is related to our DNA, our instinctive animal nature to survive and reproduce.

Shen is the spirit, or translated literally as “heart-mind”. Shen resides in the heart and is nourished by the blood, or vital fluids in the body. Shen is expansive and connects us to our true nature, beyond the body.

Qi is the mediator between jing and shen, matter and spirit.

The Emperor

“The Heart is the emperor, the supreme controller. The Heart is the fire at the center of our being, from which the spirit radiates.” 
-Neijing Suwen (Yellow Emperor’s Classic of Internal Medicine)

From a Chinese medicine perspective, the organs of the body are not just physical but include functional, emotional, and spiritual aspects.

The Heart is called the Emperor because it is the seat of the most important part of our being- the shen, or spirit. According to Chinese medicine and its Taoist roots, humans are of an earthly nature and the divine cosmos. The shen is the divine spark within and governs the individual spiritual aspect of all the other organs.

Shen literally translates to “heart-mind” and mental illness is considered to be a disorder of the shen.

Fire Element

In the body, as in nature, the fire element warms, burns fuel, transforms fluid into vapor, and energizes. In its grossest state it provides metabolic function and in its more rarified state it is the fire of the spirit and of love.

There are two pairs of organ systems classified as fire element: Heart and Small Intestine, and Pericardium and Triple Burner.

Small Intestine

Just as the Heart is the throne of the shen, the Small Intestine is the repository of the blood which is the substance that allows the shen to interface with the body’s function.

“The link with the Heart is key to understanding the subtle levels of the Small Intestine function. The Shen, or pure awareness housed in the Heart and whose influence is distributed throughout the body via the Blood, arrives in the physical body at birth like a ‘stranger in a strange land’. In order to be rooted in the physical confines of the human condition and function appropriately within human existence, it must perform the massive task of assimilating the experience of the physical environment and its conditions.” [source]

Pericardium

Also called the Heart Protector. The Pericardium acts as an intermediary between the Heart and the outside world, functioning on the emotional level as interpersonal love and warmth. Because the Heart is considered sacred and the repository of the divine spirit, in some earlier traditions of acupuncture the Heart channel is not needled. The Pericardium is paired with the Triple Burner organ.

Triple Burner 

Also called the Triple Warmer, Triple Heater, Triple Energizer, or the Chinese term San Jiao. This organ has important functions within the body of metabolizing fluid and regulating temperature.

There is discussion that the Triple Burner corresponds to the lymphatic or fascial systems, but it really has no physical biomedical counterpart.

Chinese Medicine and the Heart

Disorders of the Heart in Chinese medicine are related to anxiety, sleep disorders, and mental illness. Basically an over or under-functioning fire element in relation to general enthusiasm about life. The Heart can be treated directly, or through supporting the Pericardium or Small Intestine systems.

Love and the Heart

“I am certain of nothing but the holiness of the heart’s affections, and the truth of imagination.”
-John Keats

A broken heart is not just an expression but a real understanding that the heart is affected physically by emotional turmoil and trauma. Loving involves an opening of the heart, a connection of the fire element to another person, and even an electromagnetic connection. Loss and heartbreak affects us on an electro-magnetic level and takes time and therapies to heal.

A connection to something greater than ourselves is crucial for a healthy heart whether it is a spiritual, humanistic, community, family, or creative connection.