Yin Fire & Mental-emotional Disease

by Bob Flaws, Dipl. Ac. & C.H., FNAAOM

According to Li Dong-yuan, the author of yin fire theory, any combination of spleen qi vacuity, liver depression, and evil heat will tend to cause yin fire. Yin fire means 1) an evil (yin) heat, 2) a heat often associated with (yin) dampness, and 3) a heat which is engendered in the lower (yin) part of the body, i.e., the middle and lower burners. Although this evil heat is engendered in the lower part of the body, it is heat nonetheless, and heat has an innate tendency to move upward in the body. The heart and lungs are both situated in the upper burner. Therefore, any evil heat in the body will tend to eventually collect in the upper burner, thus affecting the function of either or both of these two viscera. This why two of the symptoms of damp heat in the lower burner are a red tongue and dry mouth, both upper burner signs and symptoms.

According to Chinese medical theory, the main causes of mental-emotional disease are liver depression qi stagnation and the three evil qi which are either directly or indirectly engendered and transformed from this liver qi: heat, phlegm, and blood stasis. The liver controls coursing and discharge, and the qi is yang and, therefore, warm in nature. Hence, if the liver becomes depressed and the qi becomes stagnant, this depressed qi will tend to transform over time into depressive heat or fire. Once transformed, this heat does not necessarily stay within the liver. In fact, it typically counterflows upward. It may counterflow upward along the course of the liver and gallbladder-triple burners channels, it may shift into the stomach channel, following the yang ming upward, and it may also counterflow upward to accumulate in the heart and lungs, some say via the chong mai. If it accumulates in the lungs, it damages and consumes lung qi and yin. If it accumulates in the heart, it also damages and consumes heart qi and yin. However, in addition, when it accumulates in the heart, it harasses the spirit abiding there. This harassment disquiets the spirit, and, when the spirit is disquieted, one's essence spirit or psyche is disturbed. Symptoms of heart spirit disquietude include fright palpitations, throbbing heart, insomnia, profuse dreams, vexation and agitation, deranged speech, a tendency to crying and laughing without constancy, etc. Because heat is a yang evil (even when called yin fire), evil heat harassing the heart spirit causes manic or hyperactive symptoms which the patient has difficulty or cannot control. Within the classical literature, heat in the heart harassing the spirit resulting in manic conditions is often called "double yang."

However, there is also another cause of mental-emotional disease, and that is malnourishment of the spirit. According to Li Dong-yuan, the spirit is nothing other than an accumulation of qi in the heart. In order for the spirit to be constructed, there must be sufficient heart qi. In order for the spirit to be nourished, there must be sufficient heart blood and yin. If either heart qi-yang or heart blood-yin are depleted or debilitated, the spirit may also become disquieted. As we have seen above, yin fire always includes or is associated with spleen qi vacuity, and the spleen is the latter heaven root of the engenderment and transformation of qi and blood. In other words, it is the spleen which manufactures the qi and blood which are then upborne to the heart in order to construct and nourish the spirit. Symptoms of lack of construction and nourishment of the heart spirit include heart palpitations, susceptibility to fear and fright, anxiety and over-thinking, impaired memory, insomnia, profuse dreams, somnolence, and fatigue.

Therefore, in yin fire scenarios, there are usually at least two disease mechanisms leading to disquietude of the spirit: 1) heat ascending to harass the spirit, and 2) lack of construction and nourishment of the heart spirit. These two broad categories of disease mechanisms may then be compounded by phlegm misting the heart orifices and/or blood stasis blocking and obstructing the heart orifices. Thus, when attempting to treat the mental-emotional disorders that are typically a part of yin fire scenarios, one must clear heat from the heart (and liver), disinhibit the qi mechanism so as to undercut the disease mechanisms of depression leading to both spleen vacuity and depressive heat, and nourish and construct the heart spirit. Further, because of the interlocking nature of these disease mechanisms, all these principles must be applied at the same time. Otherwise, any remaining or unaddressed disease mechanisms will quickly re-establish whatever disease mechanisms which have been attempted to be addressed singly.

The main medicinals which Li Dong-yuan, Zhu Dan-xi, and other proponents of Li-Zhu medicine have used to clear fire from the heart (liver, gallbladder, stomach, and lungs) include Rhizoma Coptidis Chinensis (Huang Lian), Radix Scutellariae Baicalensis (Huang Qin), Cortex Phellodendri (Huang Bai), and Rhizoma Anemarrhenae Aspheloidis (Zhi Mu). If one looks at the ingredients of Blue Poppy Herbs' formulas, they will see that most of these formulas contain one or more of these. The main medicinals which Li Dong-yuan and his followers used to disinhibit the qi mechanism include Radix Bupleuri (Chai Hu), Rhizoma Cimicifugae (Sheng Ma), and other exterior-resolvers, such as Radix Ledebouriellae Divaricatae (Fang Feng), and all Blue Poppy Herbs' formulas contain one or more qi-rectifying or exterior-resolving medicinal in order to course the liver and rectify the qi. And the main medicinals which the proponents of Li-Zhu yin fire medicine tend to use for supplementing and nourishing the heart spirit are Radix Astragali Membranacei (Huang Qi), Radix Codonopsitis Pilosulae (Dang Shen), Rhizoma Atractylodis Macrocephalae (Bai Zhu), mix-fried Radix Glycyrrhizae (Gan Cao), Fructus Zizyphi Jujubae (Da Zao), and Radix Angelicae Sinensis (Dang Gui), and all Blue Poppy Herbs' formulas contain a selection of these.

Thus, the overwhelming majority of Blue Poppy formulas address the two main mechanisms of mental-emotional disease - evil heat and lack of construction and nourishment - as well as the main underlying disease mechanism causing this heat and lack of construction and nourishment, liver depression qi stagnation. Therefore, practitioners should not be surprised when using Blue Poppy formulas for non-psychiatric complaints if their patients report that, in addition to alleviating their joint pain, improving their sleep, giving them more energy, or regulating their menstruation, these formulas have also made them feel calmer, more clear-headed, more centered, and more sane. Although Blue Poppy Herbs formulas do not tend to contain heavy, settling and stilling spirit-quieting medicinals, they do quiet the spirit nevertheless. If one understands the ramifications and principles of yin fire theory as well as the composition of Blue Poppy formulas based on that theory, then one should also be able to understand how and why all our formula foster a calmer, quieter spirit.

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