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Any evil arising internally in the body, including internal equivalents of the six excess except summerheat, and the internal products phlegm-rheum and static blood.

All the six excesses except summerheat have counterparts that arise internally. Hence, these are often referred to as the five internal evils (内生五邪 nèi shēng wǔ xié) or simply internal evils (内邪 nèi xié).

Internal Wind

Internal wind (内风 nèi fēng), also called wind qì stirring internally (风气内动 fēng qì nèi dòng), results from severe yīn-yáng imbalances characterized by yáng exuberance or yīn vacuity and manifests in abnormal movement or non-movement of the sinews. Since the sinews belong to the liver, internal wind is understood to be a liver disorder, hence the Sù Wèn (Chapter 74) states, All wind with shaking and dizzy vision is ascribed to the liver (诸风掉眩, 皆属于肝 zhū fēng diào xuàn, jiē shǔ yú gān). Hence, internal wind is called liver wind stirring internally.

Internal wind arises in the following ways:

• Extreme heat engendering wind: Externally contracted heat evil in children that manifests in high fever can transform into wind, causing convulsions and arched-back rigidity, a condition known as fright wind.
• Liver yáng transforming into wind: Ascendant hyperactivity of liver yáng can transform into wind, causing dizziness and unsteady gait or even wind stroke marked by hemiplegia, deviated eyes and mouth, and in some cases numbness and tingling.
• Blood vacuity engendering wind and yīn vacuity stirring wind: Blood vacuity and yīn vacuity depriving the sinews of nourishment and disrupting the movement of qì and blood can give rise to mild forms of internal wind manifesting in mild spasms or tremor. This pathomechanism is reflected in a maxim of treatment: to treat wind first treat the blood; when the blood moves wind naturally disappears (治风先治血, 血行风自灭 zhì fēng xiān zhì xuè, xuè xíng fēng zì miè).
• Phlegm and stasis engendering wind: Some modern Chinese texts include phlegm obstructing the network vessels causing blood to stagnate and cause chaotic movement of qì that results in liver wind stirring internally, which in turn results in stroke. This is attributed to fondness of sweet and fatty foods giving rise to phlegm or obesity with qì vacuity giving rise to copious dampness and phlegm. The formulation of this pathomechanism seems to have been influenced by the biomedical understanding of stroke. See wind stroke below and phlegm and stasis binding together.

Internal Wind Diseases

Internal wind figures in wind stroke, fright wind, and epilepsy.

Wind stroke (中风 zhòng fēng): A disease characterized by the sudden development of deviated eyes and mouth, stiff tongue and sluggish speech, and hemiplegia, sometimes heralded by sudden collapse and loss of consciousness, from which recovery may not be total. The classical form corresponds to what we call stroke (apoplexy, cerebrovascular accident). Mild forms in which there is only deviated eyes and mouth correspond to facial paralysis (Bell’s palsy) in biomedicine.

Originally ascribed to externally contracted wind evil, wind stroke was later attributed in many cases to internal causes, primarily liver wind stirring internally, which arises most commonly when insufficiency of kidney and liver yīn fails to keep liver yáng in check so that liver yáng becomes hyperactive and transforms into wind. Phlegm is invariably a factor in wind stroke too, so the cause of the disease is often described as wind-phlegm. Blood stasis may also be a factor.

Fright wind (惊风 jīng fēng): A disease of infants and children, characterized by convulsions and loss of consciousness.

Acute fright wind: An externally contracted febrile disease in infants and children characterized by clenched jaw and convulsion of the limbs. It is attributed to extreme heat engendering wind resulting from external contraction of warm evil. The disease starts with vigorous heat effusion with vexation and agitation, red face and limbs. When the warm evil causes phlegm congestion and qì stagnation, there is oppression in the chest and hasty breathing. As heat engenders wind, clenched jaw, the first sign of fright wind, appears. If the condition worsens, convulsion of the limbs, rigidity of the neck and nape, and arched-back rigidity appear.

Chronic fright wind: A disease in infants characterized by intermittent mild convulsions associated with pale-yellow facial complexion or a mixed green-blue and white facial complexion. In most cases, heat effusion is absent. It is attributed to liver exuberance and spleen vacuity.

Internal Wind Patterns

Internal wind occurs in repletion and vacuity patterns:

Liver yáng transforming into wind (肝阳化风 gān yáng huà fēng): Ascendant hyperactivity of liver yáng with sudden stirring of wind, in severe cases with clouding collapse and hemiplegia (wind stroke).

Extreme heat engendering wind (热极生风 rè jí shēng fēng): High fever and clouded spirit with convulsions, rigidity of the neck and nape, arched-back rigidity, upward-staring eyes, and clenched jaw (fright wind).

Blood vacuity engendering wind (血虚生风 xuè xū shēng fēng): Tremor; twitching of the flesh; inhibited bending and stretching; dizziness; tinnitus; liver blood vacuity signs.

Yīn vacuity stirring wind (阴虚动风 yīn xū dòng fēng): Wriggling of the extremities; dizziness; tinnitus; liver yīn vacuity signs.

Blood dryness engendering wind (血燥生风 xuè zào shēng fēng): Dry skin or encrusted skin with itching and scaling. It is attributable to any of several causes: enduring illness wearing the blood; depletion of essence and scantness of blood in advancing years; insufficient blood production stemming from poor nutrition; or static blood binding internally, preventing new blood from arising.

Internal Cold

Cold also arises internally from insufficiency of yáng qì. This is called internal cold (内寒 nèi hán).

Internal Cold Patterns

The most common patterns attributed to vacuity cold arising internally are the following:

Heart yáng vacuity (心阳虚 xīn yáng xū): Heart palpitation or fearful throbbing; stifling oppression and possibly pain in the chest; yáng vacuity signs (vacuity cold). This develops from heart qì vacuity.

Spleen yáng vacuity (脾阳虚 pí yáng xū): Continual cold pain in the stomach duct and abdomen that likes warmth and pressure; signs of vacuity cold. It develops from enduring spleen qì vacuity; excessive consumption of raw and cold foods or excessive use of cold and cool medicinals; or kidney yáng vacuity depriving the spleen of warmth.

Stomach yáng vacuity (胃阳虚 wèi yáng xū): Continual cold pain in the stomach duct relieved by warmth and pressure; vacuity cold signs. It is caused by raw and cold foods, spleen vacuity affecting the stomach, or enduring illness.

External Cold and Internal Cold
		Pathomechanism	Clinical Manifestation
External Cold	Cold Damage	External contraction of cold evil, fettering defense yáng.	Aversion to cold, heat effusion, absence of sweating, headache and generalized pain, joint pain, a pulse that is floating and tight.
	Cold Strike	Cold evil directly striking the center, damaging the spleen and stomach, and affecting upbearing and downbearing.	Cold pain in the stomach duct and abdomen, vomiting and retching, decreased food intake, rumbling intestines, diarrhea (usually with aversion to cold and with headache and generalized pain).
Internal Cold		Yīn cold arising internally from insufficiency of yáng qì, with loss of warming and qì transformation.	Fear of cold, cold limbs or counterflow cold in the limbs, vomiting of clear water, clear-grain diarrhea, fatigue, localized cold pain.

Kidney yáng vacuity (肾阳虚 shèn yáng xū): Cold aching lumbus and knees; poor reproductive functions (impotence, infertility, low libido); profuse urination at night; yáng vacuity (vacuity cold) signs. It results from: constitutional yáng vacuity; general debilitation stemming from advancing age; enduring illness damaging yáng (as spleen or heart yáng vacuity affecting the kidney); sexual intemperance.

Large intestine vacuity cold (大肠虚寒 dà cháng xū hán). Uncontrollable diarrhea (efflux diarrhea) and fecal incontinence; vacuity cold signs. It mostly results from enduring diarrhea or dysentery that fails to be treated adequately.

Internal Dampness

Internal dampness (内湿 nèi shī) arises when, owing to impaired qì transformation, fluids are not distributed and discharged from the body as normal and instead collect in the form of water-damp. Internal dampness is related to the lung, kidney, but chiefly to the spleen. Hence, the Sù Wèn states that All dampness with swelling and fullness is ascribed to the spleen.

Internal dampness arises in the following ways:

• inability of the spleen’s yáng qì to warm and transform fluids and causing them to gather into water-damp;
• excessive consumption of raw or cold foods that damages the spleen’s yáng qì;
• excessive consumption of rich sweet and fatty foods or alcohol that tends to clog the action of the spleen and produce dampness.
• Internal heat.

Pathomechanisms-InternalDampness

Although external dampness often lodges in the fleshy exterior or in the channels, it can also affect the spleen. In this regard, external and internal dampness are mutually conducive. External dampness can damage the spleen, causing damp turbidity to arise from within. Conversely, internal dampness, being associated with spleen qì vacuity manifesting in the spleen’s failure to move and transform water-damp, can make the patient more prone to contraction of external dampness. Internal dampness, like external dampness, gives rise to repletion patterns (vacuity complicated by repletion). Hence the two are poorly distinguishable. Furthermore, both external and internal dampness affecting the spleen are treated in the same way, notably by fortifying the spleen and percolating dampness, using agents such as fú líng (Poria). Hence, whether the dampness is of internal or external origin is irrelevant in the context of the spleen. What matters more in the diagnosis and treatment of dampness patterns is where the dampness is located.

Dampness affecting the spleen tends to develop either with heat or cold. When the cause is spleen yáng vacuity or excessive consumption of cold and raw foods, cold-damp is the result, while excessive consumption for sweet and fatty foods or the presence of internal heat produces damp-heat.

Dampness forming with cold (湿从寒化 shī cóng hán huà): Spleen yáng vacuity (spleen qì vacuity with cold signs) in the absence of any heat-producing influence causes dampness to form with cold, creating cold-damp patterns. Cold-damp refers to dampness encumbering the spleen accompanied by cold, which is attributed to yáng vacuity. It is marked by abdominal distension, diarrhea, heavy-headedness or heavy cumbersome limbs, and in some cases, water swelling, together with fear of cold and cold limbs.

Dampness forming with heat (湿从热化 shī cóng rè huà): Rich sweet and fatty foods tend to clog the action of the spleen and produce dampness. They also produce intense stomach fire. The dampness and heat exacerbate each other. Spleen-stomach signs include glomus and oppression in the stomach duct, aversion to food, retching and vomiting, markedly yellow urine, and sloppy stool.

Because dampness is heavy and turbid, it can cause heavy-headedness and heavy cumbersome limbs. It carries heat down to the lower body to affect the large intestine, bladder, genital area, and lower limbs.

When the heat gives rise to heat effusion, the obstructive nature of dampness makes it take the form of generalized heat failing to surface or fluctuating generalized heat effusion that is unrelieved by sweating. Dampness trapping heat within the body accounts for itchy skin and exudative skin conditions.

Liver, bladder, and large intestine

• Both spleen damp-heat and cold-damp obstruct the qì dynamic and affect the liver’s free coursing, causing jaundice. Damp-heat in the liver channel can also give rise to yellow vaginal discharge.
• Damp-heat can pour downward to affect the bladder, large intestine, genital regions, or lower limbs. This results in any of the following conditions: damp-heat strangury; damp-heat diarrhea or dysentery with pus and blood in the stool; genital itching or sores; yellow vaginal discharge; or sores of the lower limbs. Conditions of this kind are attributed to the heaviness of dampness carrying heat downward.

Phlegm-rheum: Dampness can gather and concentrate to form phlegm or rheum. When there are signs of both dampness and phlegm, the condition is attributed to phlegm-damp.

Internal Dampness Patterns

The most common patterns attributed to dampness arising internally are as follows:

Cold-damp encumbering the spleen (寒湿困脾 hán shī kùn pí): Distension and pain in the stomach duct and abdomen; nausea and vomiting; sloppy stool; signs of cold-damp collecting internally. It develops from insufficiency of spleen yáng vacuity; contraction of external dampness; consumption of raw and cold foods.

Damp-heat brewing in the spleen (湿热蕴脾 shī rè yùn pí): Glomus and distension in the stomach duct and abdomen; nausea and vomiting; bitter taste in the mouth; aversion to food; signs of damp-heat brewing internally. It develops from externally contracted damp-heat or from excessive consumption of fatty or sweet foods or alcohol.

Bladder damp-heat (膀胱湿热 páng guāng shī rè): Urinary urgency; frequent urination; inhibited urination with scorching pain in the urethra; damp-heat signs. It results from externally contracted damp-heat or from dietary irregularities causing internal damp-heat that pours down into the bladder.

External Dampness and Internal Dampness
	Pathomechanism	Clinical Manifestation
External Dampness	Dampness damaging the fleshy exterior	Aversion to wind or cold; heat effusion; heavy cumbersome head and body; aching of the limbs
	Dampness stagnating in the channels (impediment)	Heaviness and pain in the joints; inhibited bending and stretching
Internal Dampness	Spleen failing to move and transform, causing water-damp to gather; external dampness	Slimy taste in the mouth; poor appetite; oppression in the chest; nausea and vomiting; distension and fullness in the stomach duct and abdomen; heavy cumbersome head and body; diarrhea; turbid urine; vaginal discharge; water swelling

Liver-gallbladder damp-heat (肝胆湿热 gān dǎn shī rè): Distending pain in the rib-side, aversion to food, abdominal distension, yellowing of body and eyes, genital itch with signs of damp-heat. It results when dampness of external or internal origin combines with heat to form damp-heat that binds in the gallbladder.

Internal Dampness Diseases

Jaundice (黄疸 huáng dǎn): Jaundice is a disease characterized by generalized yellowing of the skin and whites of the eyes (sclerae). It arises when contraction of external evils or dietary irregularities cause damage to the spleen and stomach and give rise to damp evil. The damp evil obstructs the center burner and affects the liver and gallbladder. This causes the bile to deviate from its normal path and spill into the blood, and from the blood into the skin. Jaundice can take the form of yīn yellowing (also called yīn jaundice) or yáng yellowing (also called yáng jaundice), depending on whether the dampness forms with cold or with heat.

Damp-heat strangury (湿热淋 shī rè lìn): Often referred to simply as heat strangury (热淋 rè lìn). Dribbling urination (frequent, short, rough voidings) with scorching pain in the urethra and tension in the smaller abdomen (lower abdomen). In some cases, there is pain stretching into the lumbus or abdomen. Damp-heat strangury may be caused by dampness and heat either of external or internal origin. Distinction is made between heat strangury, stone strangury, blood strangury, and unctuous strangury. Pathomechanisms and signs differ according to the type of strangury. Strangury is most commonly caused by damp-heat, but other causes exist.

Internal Dryness

Internal dryness (内燥 nèi zào) is usually referred to as, damage to liquid. However, the term often denotes depletion of fluids affecting blood and essence, marked by emaciation, dry skin, vexing thirst, dry retching, bound stool, amenorrhea. A specific form of internal dryness is a form of blood vacuity called blood dryness, which manifests in emaciation, rough dry skin, in serious cases encrusted skin, itchy skin, brittle nails, lusterless hair, hard stool, and dry tongue.

External Dryness and Internal Dryness
	Pathomechanism	Clinical Manifestation
External Dryness	External contraction of dryness evil causing non-diffusion of lung and defense qì	Aversion to cold, heat effusion, headache, floating pulse, dry pharynx and mouth, dry cough with scant phlegm that is sticky and difficult to expectorate, short voidings of scant urine
Internal Dryness	Depletion of fluids affecting blood and essence	Emaciation, dry skin, vexation and thirst, dry retching, bound stool, amenorrhea

Internal Fire and Internal Heat

Fire and heat may also arise internally. This is internal fire (内火 nèi huǒ) or internal heat (内热 nèi rè). There are repletion and vacuity forms.

Internal repletion fire (repletion heat) is marked by acute, constant, and generalized signs of heat, movement, redness, and dryness: heat effusion and sweating (usually throughout the day); vexation and agitation and a rapid pulse; a red complexion; thirst, dry mouth, and desire for cold fluids; short voidings of reddish urine. It arises in the following ways:

• Exterior evils transforming into heat and, in the process, passing into the interior.This occurs, for example, in cold damage greater yáng (tài yáng) exterior patterns, when defense qì fails to expel the cold evil and allows it to lie depressed. Under these circumstances, the cold transforms into heat and forces its way into the interior. This is seen when the original greater yáng (tài yáng) exterior signs (aversion to cold and a floating pulse) give way to a yáng míng (yáng míng) disease pattern characterized by high fever and constipation.
• Externally contracted warm-heat evils penetrating the interior.These are sometimes considered to be internal heat, even though, unlike cold transforming into heat, the heat is the same in nature as the originally invading evil.
• Affect-mind disturbances causing liver qì to become depressed and transform into fire (liver fire), which flames upward to cause upper-body fire signs.
• Phlegm, static blood, food accumulations, and worm accumulations lying stagnant and giving rise to heat.
• Hyperactivity of yáng qì may also be a predisposing factor for the development of internal fire.

Vacuity heat (vacuity fire) manifests in chronic, intermittent, and localized signs of heat, movement, redness, and dryness: tidal heat effusion and night sweating; heart vexation; a rapid fine pulse; reddening of the cheeks; dry mouth, short voidings of yellow urine. It results from yīn vacuity. Vacuity fire is synonymous with vacuity heat, that is, heat from yīn vacuity, but refers to more intense heat and is often referred to as yīn vacuity with effulgent fire. See note below on Terms Denoting Fire-Heat Arising Internally.

Important Distinctions

Repletion fire, depressed fire, vacuity fire, floating yáng must be carefully distinguished because they require different methods of treatment.

External Fire and Internal Fire
	Pathomechanism		Clinical Manifestation
External Fire-Heat	External contraction of wind-fire evil		Initially, heat effusion with aversion to cold, headache and a floating pulse. Later, vigorous heat effusion, heart vexation, thirst, and a pulse that is surging and rapid.
Internal Fire-Heat	Repletion fire	Hyperactivity of yáng qì of the bowels and viscera	Internal heat with heart vexation, thirst, reddish urine, bound stool, red tongue, rapid pulse	Repletion heat signs in the heart, lung, liver, gallbladder, or stomach, a tough red tongue, and a pulse that is rapid and forceful.
	Vacuity fire	Yīn vacuity causing internal heat		Vexing heat in the five hearts; insomnia; tidal heat, night sweating, red tender-soft tongue with scant fur, and a pulse that is fine and rapid.

Repletion fire: Diseases caused by heat or fire evil manifest as repletion heat (or fire) patterns and are therefore treated with cold and cool agents that clear fire or drain fire.

Depressed fire: Repletion fire also includes depressed fire that may arise under the following conditions:

• when fire is enveloped by an external evil (e.g., a cold enveloping fire), meaning when there is an unresolved exterior pattern together with exuberant internal heat manifesting in symptoms such as a red, sore throat;
• when there is deep-lying, internal heat prior to maculopapular eruption; orwhere phlegm or damp complications cause binding of phlegm and fire and dampness trapping hidden heat (湿遏热伏 shī è rè fú) characterized by glomus in the chest, and heart vexation.

Treatment of Depressed Fire
Depressed fire cannot be effectively eliminated with cold and cool agents alone. Depressed fire is treated by effusion, which means that by effusion fire is dispersed and heat discharged by effusing sweat, outthrusting papules, and resolving phlegm-damp. This calls for outthrusting or upbearing dispersion to allow the heat out of the body. Where phlegm-damp is a factor, agents that resolve phlegm-damp are needed. Outthrusting agents include cōng bái (Allii Fistulosi Bulbus), dàn dòu chǐ (Sojae Semen Praeparatum), zhī zǐ (Gardeniae Fructus), lián qiào (Forsythiae Fructus), niú bàng zǐ (Arctii Fructus), and chán tuì (Cicadae Periostracum). Agents that resolve phlegm-damp include xìng rén (Armeniacae Semen), bái dòu kòu (Amomi Fructus Rotundus), chén pí (Citri Reticulatae Pericarpium), and jié gěng (Platycodonis Radix).

Floating yáng (阳浮 yáng fú): Vacuous yáng floating astray (虚阳浮越 xū yáng fú yuè), which is sometimes called floating fire (火浮 fú huǒ), must be distinguished from true fire-heat. This usually occurs in yáng collapse vacuity desertion and is marked by red facial complexion, agitation, and thirst with desire for fluid. Although these are signs of heat, all other symptoms indicate cold attributable to yáng vacuity. Careful observation reveals that since the thirst is allayed by intake of fluid and the complexion has the floating-red characteristic of upcast yáng patterns, the heat signs are false, and the vacuity signs are those of extreme yáng vacuity (yáng collapse). Floating fire is the manifestation of the floating of vacuity yáng that results from exuberant internal yīn cold.

Treatment of Floating Yáng
Floating yáng is treated with warm agents such as fù zǐ (Aconiti Radix Lateralis Praeparata), ròu guì (Cinnamomi Cortex), rén shēn (Ginseng Radix), and gān cǎo (Glycyrrhizae Radix), which return yáng and conduct fire (yáng) back to its origin, combined with heavy agents such as lóng gǔ (Mastodi Ossis Fossilia), mǔ lì (Ostreae Concha), and cí shí (Magnetitum) that subdue yáng.

Terms denoting Fire-Heat Arising Internally

In the context of fire-heat arising internally, fire and heat often imply nuances. The specific connotations of fire-heat terms are as follows:

• Exterior evils (external evils in the exterior) passing to the interior are usually said to transform into heat, rather than fire.
• Excesses among the seven affects causing qì depression are usually said to give rise to fire formation rather than heat.
• Fire often connotes more intense forms of internal fire-heat. For example, stomach fire is more intense than stomach heat. The standard pattern name is intense stomach heat, but an alternate name is intense stomach fire. Similarly, yīn vacuity gives rise to heat, and this is called yīn vacuity with heat. However, when the heat it generates is of great intensity, it is often called yīn vacuity with effulgent fire.
• Fire also connotes heat among the bowels and viscera that affects the upper part of the body, notably the head and face. For example, liver fire flaming upward denotes liver fire manifesting in red face and eyes. Hyperactive heart fire is also expressed as heart fire flaming upward when it manifests in a red face, a red-tipped tongue, and mouth and tongue sores.

Internal Fire-heat Patterns

The most common patterns attributed to fire or heat arising internally are:

Yáng míng (yáng míng) patterns (阳明证 yáng míng zhèng): Repletion heat disease patterns arising when external evils (wind and cold) leave the exterior and pass into the interior, giving rise to high fever, sometimes with constipation. There are variations depending on whether the heat is confined to the yáng míng (yáng míng) channel or affects the yáng míng (yáng míng) bowels (stomach and large intestine).

Hyperactive heart fire (心火亢盛 xīn huǒ kàng shèng): Also called intense heart fire (心火炽盛 xīn huǒ chì shèng). Vexation and agitation (or even manic agitation and delirious speech); mouth and tongue sores; repletion heat signs (e.g., heat effusion). It develops from excesses among the seven affects, causing qì to become depressed and transform into fire; from excessive consumption of rich, fatty, and hot spicy foods; or from external fire invading the interior.

Phlegm-fire harassing the spirit (痰火扰心 tán huǒ rǎo xīn): A repletion pattern marked by deranged spirit and phlegm-heat signs. It is seen in mania, that mental disease marked by manic agitation or externally contracted disease marked by clouded spirit with delirious speech. It develops by concentration of fluids either by externally contracted heat evil or by fire resulting from transformation of depressed qì.

Liver fire flaming upward (肝火上炎 gān huǒ shàng yán): A repletion fire pattern marked by dizzy head, distending pain in the head, scorching pain in the rib-side, and impatience, agitation, and irascibility, together with repletion fire signs. It stems from depressed liver qì transforming into fire; from excessive consumption of hot-spicy, fatty foods, sweet foods, alcohol, and smoking, which all foster fire formation; externally contracted heat; and/or from liver yīn vacuity.

Treatment of Floating Fire
Floating yáng is treated with warm agents such as fù zǐ (Aconiti Radix Lateralis Praeparata), ròu guì (Cinnamomi Cortex), rén shēn (Ginseng Radix), and gān cǎo (Glycyrrhizae Radix), which return yáng and conduct fire (yáng) back to its origin, combined with heavy agents such as lóng gǔ (Mastodi Ossis Fossilia), mǔ lì (Ostreae Concha), and cí shí (Magnetitum) that subdue yáng.

Heart yīn vacuity (心阴虚 xīn yīn xū): Heart palpitation; heart vexation; insomnia; profuse dreaming; yīn vacuity signs (vacuity heat). It results from enduring illness; from excessive sweating, vomiting, or diarrhea; from damage by fire resulting from depressed qì; from lung, liver, and/or kidney yīn vacuity causing damage to heart yīn.

Lung yīn vacuity (肺阴虚 fèi yīn xū): Dry cough with scant sticky phlegm or no phlegm; yīn vacuity signs. It stems from dryness or heat evil assailing the lung; from contraction of pulmonary consumption; from smoking, alcohol, and hot-spicy dry foods; and/or from enduring cough or other enduring illness damaging lung yīn.

Kidney yīn vacuity (肾阴虚 shèn yīn xū): Aching lumbus and knees; seminal emission; scant menstruation; dizziness; tinnitus; yīn vacuity (vacuity heat) signs. It results from enduring illness affecting the kidney; from damage to yīn in the advanced states of warm-heat disease; from excessive consumption of warm and dry medicinals; and/or from sexual intemperance.

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