Li Dongyuan was a prominent Chinese medical scholar of the Jin-Yuan Period, specifically during the 13th century. He is perhaps best known for the work Pi Wei Lun, (Treatise on the Spleen and Stomach). In this text, Li Dongyuan elucidates the concept of yin fire, an important theory that seeks to explain certain pathological signs and guide interventions.
To understand yin fire, it is necessary to first consider the basis: yin-yang as two unified, fundamental concepts in Chinese philosophy and medicine. Yang represents qualities like heat, light, and activity, while yin represents cold, darkness, and rest. In a healthy state, yin-yang swirl in balance.
In the context of traditional Asian medicine, fire usually aligns with yang as it embodies heat, light, and transformation. However, Li Dongyuan's concept of yin fire is subtle and potentially unintuitive at first glance. It assigns a traditionally yang property (fire) to yin. This fire is considered pathological and is a result of imbalance.
Yin fire can be described as a "smoldering fire," metaphorically akin to hot embers buried under ashes. It isn't the full-blown, consuming fire one would associate with yang; rather, it is a fire that festers in conditions of yin excess or stagnation. This occurs when the body's fluids and essence are depleted and/or stagnant, leading to a relative predominance of dampness. The body attempts to counteract this imbalance by generating internal heat (fire), but because the system is fundamentally compromised, this fire is pathological, weak, and persistent—hence, yin fire.
Although many doctors such as Zhu Zhen Heng (1281-1358) identified ‘Minister Fire’ with the Fire of the Gate of Life (and therefore the Kidneys), others, such as Zhang Jiebin (1563-1640), identified the ‘Minister Fire’ with such internal organs as the Kidney, Liver, Triple Burner, Gallbladder, and Pericardium. In fact, the Minister Fire is said to go upwards to the Liver, Gallbladder and Pericardium (in so doing it is compared to the ‘Fire Dragon flying to the top of a high mountain’) and downwards to the Kidneys (in so doing it is compared to the ‘Fire Dragon immersing in the deep sea’).
Maciocia, G. (2021). The practice of Chinese medicine: The treatment of diseases with acupuncture and Chinese herbs (3rd ed., p. 425). Churchill Livingstone.
Yin fire tends to be associated with conditions of dampness, turbidity, and deficiency in the body, particularly in the digestive system (spleen and stomach in TCM terms). When the spleen is weak, it fails to efficiently transform and transport fluids, leading to dampness. The "smoldering" quality of yin fire is essentially a failed attempt by the body to dry out this pathological dampness. To do this end, the fire of the gate of life (命門火: mìngmén huǒ) plays a role.
“Ming Men” translates to "Gate of Life," and the Ming Men Fire is associated with the Kidneys, specifically Kidney Yang. This fire is considered the root of metabolic processes and the foundation of yin-yang within the body. It is essential for the functioning of the zang-fu organs (the body's functional entities in TCM), including the spleen and stomach.
In the Pi Wei Lun, Li Dongyuan emphasizes the importance of Ming Men Fire for transforming and transporting fluids and food essences. When this fire is deficient, the spleen and stomach cannot perform their functions well, leading to various pathological conditions, including the accumulation of dampness and phlegm, which may give rise to yin fire.
The Yin Fire theory developed by Lǐ Dōngyuán has this as the basis: if the Central Qì (Zhong Qì) is effulgent, the yuán qì is sourced in a balanced way, and the ministerial fire stays hidden within the water of the kidneys, causing no signs of heat while generating warmth and healthy transformative power within the system. This generation of qì comes from the transformation of essence, stored in the kidney. When there is enough essence and yin, and the heat is not excessive, but also not minimal, there is a steady and appropriate sublimation of essence to qì which is then transported and transformed throughout the Three Burners (Sān Jīao).
Stumpf, S. (2022, April 14). Yijing and Yin Fire: An Exploration. Santi Medicine. https://www.santimedicine.com/...
To go further, the basic qì huā (function and transformation) of the organs involved in the yin fire constellation should be addressed. The spleen is zàng, and through its function of transformation and transportation, the essence of food and drink is extracted to form the Gu Qì, which is sent to the Upper Jiao. If the spleen qì is weakened due to poor/irregular diet, from pathogenic factors such as damp, from liver qì stagnation overacting on Earth, from blood deficiency, or from undisciplined and unfulfilled desires (which incessantly fans the flames of the mingmen), the spleen qì sinks into the Lower Burner and harms the kidney, prompting the flaring of ministerial fire which naturally rises toward the heart, its true source.
The central qì of the Middle Jiao, when healthy and lustrous, prevents ministerial fire from flaring and injuring the body. Li Dongyuan said:
This Yin Fire and the Yuan Qi are mutually opposed [cannot occupy the same place]: when one is victorious, the other is the loser.
When this yin fire does rise uncontrollably, the postnatal qi is further weakened, and there can be damage to the yin of the zàng organs.
Yin Fire can manifest in various ways, including but not limited to:
Chronic fatigue
Sensation of heat or low-grade fever
Poor appetite or digestive issues
Anxiety or restlessness
Palpitations
Insomnia or restless sleep
The clinical approach to addressing yin fire revolves around strengthening the spleen and stomach to resolve dampness, while also nourishing yin to quench the pathological fire. This is often achieved through a combination of herbal medicine, acupuncture, meditation, and lifestyle adjustments like diet and exercise.
Advancing into the clinical realm, a worthwhile discussion revolves around differentiating yin fire from yin deficiency heat (aka empty-heat). The notions of yin fire and yin deficiency heat are related but distinct, and both deal with pathological forms of heat. Understanding the difference requires an appreciation of the nuanced ways TCM conceptualizes imbalances in the body.
As mentioned earlier, yin fire is a concept associated with dampness and turbidity, mainly involving the spleen and stomach. In conditions where the spleen is weak and fails to properly transform and transport fluids, dampness can accumulate. The body tries to "burn off" this pathological dampness, leading to a sort of "smoldering" or "hidden" fire. This is not a physiological or "healthy" fire, but rather a pathological condition that further weakens the body and can result in a variety of symptoms like fatigue, feeling of heat, or digestive issues.
On the other hand, yin deficiency heat is generally due to a lack of yin fluids to cool the body, rather than an attempt to "burn off" dampness. When yin is deficient, it cannot balance yang's heating function, leading to signs of heat such as night sweats, hot palms and soles, a feeling of heat in the chest, or even low-grade fevers. The heat in this case is not "smoldering" but more like a "relative fire"—the body simply lacks the coolant to keep it in check.
The formulations Arouse Vigor (Bu Zhong Yi Qi Tang) and for pets, Lift the Qi, are formulated to address deficiencies of the spleen and stomach Qi, lift Yang Qi, and are traditionally used to address a variety of symptoms related to yin fire. The formula is a classic example of Li Dongyuan's emphasis on the importance of the qi transformation of spleen and stomach in overall health and the focus of the Nourishing Earth School on tonifying original Qi as a fundamental treatment principle.
Key ingredients in Bu Zhong Yi Qi Tang include:
Ren Shen (Ginseng): To tonify the original Qi
Bai Zhu (Atractylodes Macrocephala): To strengthen the spleen and dry dampness
Zhi Gan Cao (Licorice Root): To tonify the spleen and harmonize other herbs
Dang Gui (Chinese Angelica): To nourish the blood
Chen Pi (Tangerine Peel): To move Qi and strengthen the spleen
This formula can be thought of as a template, with further modification addressing pronounced dampness, yin-deficiency, or empty/full heat.
As articulated by Li Dongyuan in the Pi Wei Lun, yin fire represents a nuanced understanding of pathological heat generated under conditions of yin excess or stagnation. This orientation of the Nourishing Earth school revolves around digestion as key for overall health.
The yin fire pattern is particularly notable in the modern world, with the constant stoking and conditioning of desire around every turn. By engaging the inherent intelligence of the Earth within, using the elegant and potent foundational formula Bu Zhong Yi Qi Tang (補中益氣湯), the clear yang rises, like the sparkling light of dawn.
With sound intent, and abundant qi, what remains as impossible?