Heart and Kidney Yin deficiency
with Empty Heat

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Chinese Balls for Contemplation Copyright Jonathan Clogstoun-Willmott, www.acupuncture-points.org

Heart and Kidney Yin deficiency with Empty Heat is one step further along the spectrum from Heart Yin deficiency with Empty Heat.

This syndrome exists when life has been out of balance for too long. Contemplate the picture of the two balls!

Most of this site tries to not be too technical, but this page probably makes more sense to acupuncturists. If you're not an acupuncturist you may get a flavour of it by just ploughing on!

As you read more about Chinese medicine, with its constant discussion of health in ENERGY terms - very different from Western medicine - eventually the penny may drop. At least, so we hope.

As we write more pages, some of the unfamiliar terms below will be explained, and there'll be links to them.

In Chinese medicine, the Heart and Kidney energies should work together with Kidney supplying the original jing-essence that creates Mind, which is housed by the Heart. The Heart sends Fire down to warm the Kidneys: in return the Kidneys send pure fluids up to nourish the Heart. 

So the Heart pushes down, the Kidney pushes up and pulls down, and in health they balance one another. In Heart and Kidney Yin deficiency with Empty Heat, however, the Heart downward pushing and Kidney pulling is severely reduced. This leaves only upward pushing, giving too much Yang, so forming Empty Heat. 

('Empty' because it occurs when there is not enough cooling, Yin energy, to combat it. Imagine a car engine running normally in a cool country. Now imagine that its engine runs out of coolant. The car will overheat, not because it is being worked too hard or because it is a hot country, but because of the lack of Yin - the coolant.)

Empty Heat occurs when the body itself, because it’s out of balance, appears to be hot. Heart and Kidney Yin deficiency with Empty Heat is sometimes mistaken by orthodox doctors for a low, ongoing fever without obvious cause.

This Empty Heat fever may be more one of sensation than measurable by thermometer, but in some people there is a small increase in body temperature, usually quantifiable (if at all) towards evening.


(Full Heat occurs when there is an invasion of the body by some external pathogenic factor. In orthodox terms this would be a bacterial or viral infection to which the body responds with fever. Full Heat fevers are easily measurable with a thermometer.)

Causes of
Heart and Kidney Yin deficiency with Empty Heat

The causes of Heart and Kidney Yin deficiency with Empty Heat are not so different from those of Heart Yin deficiency with empty Heat.

When, through long years of overwork (constantly on the go) and inadequate or irregular dietary habits, or prompted by the menopause (or for men, too much sex), both Heart and Kidney Yin are exhausted, then all the conditions are in place for empty Heat as well.

Heart and Kidney Yin deficiency with Empty Heat doesn’t usually arrive overnight, although some of its symptoms, like tinnitus, may be noticed suddenly one evening.

Treating it is by no means impossible, but usually takes time.

Unfortunately, these days, people are less willing to wait for treatment to work, or not until they have exhausted other possibilities - by which time their condition will normally have worsened.

However, even then, there is usually room for improvement.

Heart and Kidney Yin deficiency with Empty Heat has anxiety, depression and insomnia as possible expressions in our mental health. Modern orthodox treatments include medication - often with undesirable side-effects - and psychotherapy, which if it does nothing else should help sufferers learn to slow down. 

Slowing down in itself is not enough, however, because by the time this syndrome has taken effect, there are large gaps in the patient’s ability to recover naturally.

Treatment of some kind is needed: you won’t get better by taking a long holiday, good though that would be!

Edinburgh Castle by Evening

Take Time to Enjoy the View!


As explained above, when there is a yin deficiency, yang appears to be stronger. Both Heart and Kidney in good condition have powerful means to slow the body, the Heart through directing life to healthier ways and the Kidneys through providing the jing-essence and Water to nourish and cool the Heart Fire.

The Heart should, in health, send Fire downwards to warm the Kidneys but lacking Yin, the Heart fails to do this. When the Kidneys are exhausted by constant demands on their resources, their Qi is drained and they cannot anchor the Heart energy.

Kidney Qi exhaustion leads to both Kidney Yin depletion and and Kidney Yang deficiency. Without the support of Kidney Yang, Spleen Yang is weakened and nutrition not absorbed, so Blood becomes deficient which leads to Heart Blood deficiency which reinforces Heart Yin deficiency and the progression to Heart Yin Deficiency with Empty Heat.

So when Yang predominates for an extended period, constant upward movement (Yang is warming and heat rises) generates empty Heat symptoms.

If severe, Heart and Kidney Yin deficiency with Empty Heat becomes self-perpetuating. Inability to sleep means that Kidney Yin is further depleted, making good sleep even more difficult.


The symptoms of Heart and Kidney Yin deficiency with Empty Heat are a mix of both Heart and Kidney Yin deficiency syndromes, with those of Empty Heat. So some symptoms pertain to Heart (palpitations), others to Kidney (backache).

In the lists below, many more symptoms could have been included, such as (from Kidney) weak, sore knees, thinning hair and poor teeth but what follow are the more usual ones.

Please don’t think that if you have this syndrome you will have all the symptoms shown! Much depends on your own constitution and mental make-up. (The only one that I have is mild tinnitus, which started years ago when I was overworking and took no notice.)

Symptoms will tend to worsen in the afternoon and evening, when Kidney qi would normally be strong but in this syndrome is weakened.

MENTAL Symptoms of
Heart and Kidney Yin deficiency with Empty Heat

‘Shen’ (your Mind) is disturbed: 

  • anxiety (strong to severe)
  • agitation which worsens through the day
  • great mental restlessness
  • inability to relax
  • depression: sometimes a sense of dread
  • poor memory
  • laughter at unsuitable times or in inappropriate situations

PHYSICAL Symptoms of
Heart and Kidney Yin deficiency with Empty Heat

  • Insomnia: waking often, sleep restless: you feel hot but sweating chills you. (As it cools you, sweating also depletes your yin-fluids. When Kidney Yin is depleted, Kidney Yang is also weakened and can’t warm you up again quickly.) 
  • Nights sweats can be drenching, requiring change of bed-clothing
  • Sleep; disturbed by many dreams; not deep enough or long enough to really refresh you
  • Sexual – men: ejaculation during sleep. Desire may be increased at times, but ejaculating worsens this whole syndrome, leading (for example) to even poorer sleep, more backache, tinnitus etc
  • Sexual – women: reduced libido and/or lack of lubrication
  • Mouth and throat are often dry, or the lower teeth feel dry. You often want to sip (cool) water or suck a sweet or chew an ice-cube. 
  • Dizziness: not just postural (ie occurring when you sit up or stand up) but at any time. Often experienced as a kind of ‘headiness’ or a rush to the head, with inability to stay vertical. Usually improves after lying down for a while, or after refreshing sleep. Made worse by exertion, mental or physical. 
  • Tinnitus: noises in the ears or head which hum or whistle or buzz or drone. May improve after sleep or a good rest or holiday, but worsens as you tire and towards evening. Worsened by coffee (eg caffeine) and other stimulating drugs (though these worsen all the other symptoms too, but it is tinnitus that people often notice first.) Worsened by very loud noises.
  • Hearing gradually reduces. Worsened by very loud noises or long periods exposed to loud noises, even if liked or musical. 
  • Back pain, mainly in the lumbar area and particularly at the level of the 2nd and 3rd lumbar vertebra. However, can occur elsewhere, for instance at level of the fifth and sixth dorsal vertebrae. 
  • Heart beat may be faster than normal. 
  • Palpitations – the heart races, often when thinking about it, or if anxious. Sometimes worse later in the day.
  • Sensation of warmth is more than normal. For example in hands and feet, on palms and soles. The centre of your chest may also feel warm. Your ears may feel hot, even glowing. To others these areas may also feel warm to the touch. 
  • Heat sensation increases later in the day and particularly in the evening. 
  • Phlegm: if you already have phlegm, perhaps from a previous illness, this syndrome will incline it to move towards what is called 'dry' phlegm. And if you have dry phlegm already, having Heart and Kidney Yin Deficiency with Empty Heat will make it much harder to clear. For more on this, and to identify what kind of phlegm you have, read my book Yuck! Phlegm!
  • Ear: may have a vertical line running up the outside of the lobule (ear-lobe). 
  • Urine: unless you drink a great deal of water, will be dark and reduced in volume. You’ll be surprised how little you urinate compared with how much you drink. 
  • Stools: may be dry and difficult to pass. 
  • Tongue: red without a tongue coating, and an even redder tip. A crack runs down the midline of the tongue towards the tip: the closer this runs to the tongue tip the longer the symptoms of this syndrome will have gone on for. 
  • Pulse: 'floating' and 'empty', rapid. Can be 'deep' at the rear positions and 'overflowing' at the front positions. (The rear positions are those of the Kidney pulse. Its weakness makes it deep to the touch. The front positions, nearest your wrist represent the energy of your Upper Burning Space, your chest, with your over-heating Heart and Lung energies within. Overflowing pulses often feel 'great' and 'healthy' when felt by  the inexperienced: but they are actually ‘over the top’, lacking inner strength: 'all show and no substance', representing all Yang and no Yin.)

Treatment of
Heart and Kidney Yin deficiency with Empty Heat

Calm the Mind

The aim of treatment is to calm the Mind, to clear empty Heat and to nourish the Yin of Heart and Kidney.

Points such as the following may be chosen by your acupuncturist, but patients should be encouraged to eat the right foods at regular intervals, to put more order and space into their lives and to take exercise that is harmonising and within their capabilities.

Acupuncture treatment needs to be frequent at first: a little and often. Acupuncturists should not use all the points together!

  • KI-2, to clear empty Heat;
  • Liv-3, to spread Liver Qi and nourish Liver Blood;
  • Lu-7 and KI-6 to nourish Yin;
  • Du-20 to calm the Mind;
  • St-36 and Sp-6 to nourish Qi and Blood;
  • He-7 to nourish Heart: 
  • He-6 to strengthen Heart Yin;
  • P-6 to regulate the Heart and steady the Mind;
  • Ren 14 and 15 to steady the Heart;
  • Ren-4 to strengthen Yin.
  • In cases of severe deficiency Yin-Heat, points to cool Blood might include:
  • Sp-10 and LI-11.
  • Points to raise or steady the Spirit might also be used such as Shenfeng, Ki-23 and Shentang Bl-44.
  • For other suggestions see the lower half of the page on Yin deficiency.
  • Chinese herbal formulae for this syndrome have existed for millennia, but you need to keep taking the prescription for quite a while.

Other Heart syndromes

For other syndromes of the Heart, click on the links below:

If you have this syndrome, my book on 'Yin Deficiency - Burnout and Exhaustion - What to Do!' may help.

It's easy to read and not too long.

Also, the last thing you need on top of all this is Qi Stagnation.

Read my book on that too - but it's a good bit longer, though the reviews are very favourable!

To get back from Heart and Kidney Yin deficiency with Empty Heat to Acupuncture and Anxiety, click here.


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Jonathan Clogstoun-Willmott Books

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Qi Stagnation - Signs of Stress

Yin Deficiency - Burnout and Exhaustion

Yang Deficiency - Get Your Fire Burning Again!

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Western Astrology and Chinese Medicine

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