Needles and Yin: Beyond the Kidney Meridian

One of the most important concepts in Chinese medicine is yin. When examining characteristics and concepts related to yin, it becomes clear how it is fundamentally essential to deep health, graceful aging, immunity, and long-term vitality.

It is also well-known in Chinese medical theory that nourishing yin and treating patterns of yin deficiency are notoriously challenging, particularly with acupuncture alone. Let’s discuss how practitioners can use acupuncture in unique ways to help support patients with yin deficiency patterns beyond the standard kidney meridian points.

Acupuncture is typically not considered the primary therapy when attempting to nourish or regenerate yin, with more emphasis placed on dietary therapies and herbal medicine. I do agree that diet and herbal medicine are extremely important when targeting patterns of yin deficiency. We can use classic formulas such as Liu Wei Di Huang Wan and Zuo Gui Wan, foods such as Gou Qi Zi, walnuts, game meats, eggs, organ meats and quality oils such as ghee and olive oil to deeply nourish yin.

With that said, acupuncture therapy can play a creative and unique role in nourishing yin – and as stated, this can be accomplished without simply choosing predictable points from the kidney meridian!

Targeting Yin Deficiency

Two of the most fundamental concepts to keep in mind when addressing yin deficiency patterns involve behavior change therapies targeting sleep quality; and lowering the perception of daily stress or “stress management.” These two areas often include deeply ingrained patterns of habitual behaviors and require slow and steady long-term health coaching and often cognitive therapy.

For the scope of this article, let’s focus on sleep quality and how the smooth flow of liver qi contributes to both sleep quality and yin deficiency.

Nourishing Yin and Sleep

One of the most important aspects of quality sleep is the idea that during deep sleep, the body is able to rest and rejuvenate. A commentary by Wang Bing (Tang Dynasty) on the Nei Jing includes the following statement: “The Liver stores the Blood and the Heart moves it. When a person moves, Blood moves through all the channels; when a person is still, the Blood returns to the Liver.”

In Chinese medicine, the concept of the blood returning to the liver during sleep is key. There is an intimate connection between liver blood and the smooth flow of liver qi. As the Ling Shu states: “The Liver stores the Blood; Blood is the abode of the Ethereal Soul.” It is thought in Chinese medicine that if the liver has a plentiful store of blood during sleep, the ethereal soul has a “place to rest” and sleep is deep and restful.

It is also known in Chinese medicine that blood and kidney essence share an intimate relationship. We see that the nourishment of blood is directly connected to sleep and the smooth flow of liver qi. With all of this in mind, we can conceptualize the idea of how the quality of sleep is directly related to overall supplies of blood and yin, as well as the smooth flow of liver qi.

Practitioners of Chinese medicine also know that the flow of liver qi is related to how the mind and the physical body handle and process stress; and that stress and worry contribute to poor sleep. This dynamic can be a viscous cycle, with stress causing sleep disturbances and the consequent sleep disturbances leading to increased perception of stress. And all of this leads to yin deficiency.

There are two key ideas to always keep in mind when encountering patients with yin deficiency: “How is the patient sleeping?” and “What is the state of the smooth flow of the patient’s liver qi?” This can be easily ascertained via insightful dialogue and patient rapport; as well as the examination of the tongue and the pulse.

Target the Heart and Liver

When treating yin vacuity with acupuncture while considering sleep and liver qi, we can create acupuncture protocols targeting the heart and liver meridians to calm the mind and course the qi, leading to deeper sleep and consequently, deeper nourishment of both blood and yin.

Liver Combinations

For patients who suffer from signs of yin deficiency and liver qi stagnation, we can create protocols such as:

• Du 24 + Yin Tang + Pc 6 + Liv 3 (front treatment) / BL 15 + BL 18 (back treatment); or
• Sp 6 + Liv 3 + LI 4 + Ren 4 + Yin Tang (front treatment) / BL 15 + BL 18 (back treatment)

These two acupuncture prescriptions course the liver qi and calm the mind / shen, allowing for deeper, restful sleep and a calmer state of mind – both of which combine to assist in the regeneration of yin.

Heart Combinations

For patients who suffer from signs of yin deficiency with less obvious signs of liver qi stagnation and more direct sleep issues, we can create protocols such as:

• Ht 5 + Ht 7 + Yin Tang + Ren 4 + Sp 6
• Ht 7 + P 6 + SI 7 + Ren 6 + Yin Tang

Clinical Takeaway

Be creative with point combinations when trying to improve sleep quality and the state of the liver qi in patients with yin deficiency. You can of course select points such as Kid 3 and Kid 6, as these points support the yin. However, it is just as important to focus on how we can calm the mind, course the qi, and improve sleep quality; as all of these actions directly feed into the nourishment of yin.

This is a deep subject pregnant with options for clinical creativity. I hope this article inspires you to creatively view acupuncture as a significant factor in helping patients suffering from yin deficiency conditions.