Causes of Disease in Chinese Medicine
Ancient Chinese medicine does not talk about viruses or bacteria as triggers of disease or disorders. Instead, it talks about influences, which cause disharmony in Yin/Yang, the Essential Substances, the Organ Systems, the Channels, and the Five Phases.
Several categories of influences produce disharmony: the Six Pernicious Influences, Epidemic Factors, the Seven Emotions, and other factors, such as poor nutrition.
THE SIX PERNICIOUS INFLUENCES
The Six Pernicious Influences—Cold, Heat, Dampness, Dryness, Summer Heat, and Wind—are external climatic forces that can invade the body and create disharmony in the mind/body/spirit. For example, if you are exposed to excess Heat, Cold, or Wind for a long time, or if you are exposed to such Influences when your body is already weak, you may develop an illness. This illness, triggered by External Pernicious Influences, can migrate inward and become more serious. For example, a slight cold may become pneumonia. This happens when the External Pernicious Influences overpower the body’s natural protection against disease.
Cold
When hypothermia hits a skier or a mountain climber, muscle control fades, motion becomes slow and awkward, fatigue sets in, and the body shuts down. That’s the same effect that the Cold Pernicious Influence has. It saps the body’s energy, and it makes movements cumbersome. The tongue becomes pale; the pulse is slow. A person may develop a fear of cold and feel like sleeping in a curled-up position. Cold is Yin, and when it invades the body, it chills all or part of it. If there’s pain, it’s eased by warmth.
When External Cold attacks the body, acute illness may develop, along with chills, fever, and body aches. When the External Cold moves inward and becomes an Interior Cold disharmony, it is associated with a chronic condition that produces a pale face, lethargy and grogginess, a craving for heat, and sleeping for longer than usual periods of time.
Heat
Heat disorders feel like you’ve been playing tennis for two hours in the blazing sun. You’re weary, and at the same time, you feel strangely cranked up. You can’t stop talking about the game, but your words stick in your mouth. You won’t feel like yourself again until you cool down and quench your thirst.
Heat disorders cause overactive Yang functions or insufficient Yin functions. They are generally associated with bodily heat, a red face, hyperactivity and talkativeness, fever, thirst for cold liquids, and a rapid pulse. Symptoms include carbuncles and boils, dry mouth, and thirst. Confused speech and delirium arise when Heat attacks the Shen.
Dampness
Think about what happens to your backyard when it rains for two days. It becomes soggy, and water collects in stagnant pools. That is how Dampness affects the body. Damp pain is heavy and expansive, blocks the flow of Qi, and causes a stuffy chest and abdomen.
When External Dampness invades, it enters the Channels and causes stiff joints and heavy limbs. When Dampness invades the Spleen, it can cause an upset stomach, nausea, lack of appetite, a swollen abdomen, and diarrhea.
Interior Dampness—caused by either the penetration of External Dampness to the Interior or by a breakdown in the Spleen’s transformation of fluids—may transform into Phlegm, which in Chinese medicine is more than simply a bodily secretion. It can cause obstructions and produce tumors and coughing. If Phlegm invades the Shen, it can lead to erratic behavior and insanity. Once Dampness has taken root, it is hard to displace. Severe Dampness is known as Phlegm.
Dryness
Dryness is a frequent partner with Heat. Think about the cracked bottom of a dried-up riverbed. But where Heat creates redness and warmth, Dryness creates evaporation and dehydration. External Dryness invading the body may create respiratory problems, such as asthmatic breathing and a dry cough, acute pain, and fever.
Summer Heat
Summer Heat feels like the humid, oppressive weather that creates the dog days of August. It attacks the body after exposure to extreme heat and causes a sudden high fever and total lethargy. It is an External Influence and often arises with Dampness.
Wind
Wind animates the body, stirring it from repose into motion just as wind moves the leaves of a tree. When Wind enters the body, it is usually joined to another influence, such as Cold or Dampness.
If the body is infiltrated by Wind, the first symptoms usually appear on the skin, in the lungs, or on the face. Tics, twitches, fear of drafts, headaches, and a stuffed-up nose are symptoms.
When External Wind invades the body more deeply or when Wind arises due to internal problems, it is identified as Internal Wind. This can be associated with seizures, ringing in the ears, and dizziness.
Stages of Heat- and Cold-Induced Patterns of Disharmony
When Heat or Cold invade the body, they create stages of disharmony. The symptoms associated with these stages help in the process of diagnosis and treatment. (Remember, Chinese medicine is not linear. These stages can appear in any order, or not at all.)
When there is a Cold invasion, it may pass through the following six stages:
• Taiyang (tie-yang) is characterized by cold, fever, headache, a stiff neck, and what is called a floating pulse.
• Yangming (yang-ming) is characterized by fever, no fear of cold/aversion to heat, irritability, thirst, possible digestive symptom such as fullness and constipation, and a full pulse. This is a stage of Interior Heat disharmony because Cold induces Heat in both the first and the second stages.
• Shaoyang (shau-yang) is characterized by malaria-like alteration of cold and fever, no appetite, a bitter taste in the mouth, tenderness along the sides, the urge to vomit, and a wiry pulse.
• Taiyin (tie-yin) is characterized by vomiting, loss of appetite, pain, and diarrhea, but no thirst. This is associated with a Deficient Spleen System.
• Shaoyin (shau-yin) is characterized by profound sleepiness, cold, and a weak pulse. Fever disappears. This is associated with Deficient Yang of the Kidney System. Rarely, it is associated with Yin Deficient Heat conditions.
• Jueyin (zh-way-yin) is characterized by upper body Heat and lower body Cold.
When a Heat-induced disharmony moves into the body, it may pass in some order through one or more of the following four stages:
• The Wei (way) stage: The body’s natural defenses are attacked, and the result may be fever, slight fear of cold, coughing, headache, a reddish tongue, and a quick floating pulse.
• The Qi (chee) stage: The Pernicious Influence penetrates the protective defenses of the body. The main symptom is usually high fever without chills, but symptoms vary, depending on which Organ System is affected. For example, Lung Heat produces high fever and coughing, while Stomach Heat produces high fever, abdominal pain, and constipation.
• The Ying (ying) stage: Deeper penetration by Pernicious Heat increases the disharmony in mind/body/spirit. The symptoms of this stage include a bright red tongue, an easily disturbed spirit, restlessness or even mania, a rapid pulse, dark yellow urine, less thirstiness than in the Qi stage, and possible skin eruptions.
• The Xue (sch-whey) stage: In the fourth and deepest stage, the Pernicious Influence of Heat enters the Xue (Blood), exacerbating the Ying-stage symptoms. Severe rashes, skin eruptions, high fever, and even coma may result. Blood in the urine or vomit may appear. Heat can injure the Yin, producing symptoms such as low fever, hot palms, dry teeth, a thin pulse, and stiffness and unresponsiveness.
EPIDEMIC FACTORS
In addition to the Six Pernicious Influences, infectious Epidemic Factors are associated with various pestilences in Chinese medicine. The Epidemic Factors trigger symptoms that are similar to the External Pernicious Influences, but they are severely toxic. They cause the sudden onset of diseases, such as cholera and plague. These Epidemic Factors enter the body through the orifices, and each pestilence is associated with its own Epidemic Factor.
Some diseases—particularly viral diseases, such as HIV—that do not always have an apparent sudden onset are also triggered by Epidemic Factors. In Chinese medicine, Epidemic Factors are known as Li Qi.
THE SEVEN EMOTIONS
While the Six Pernicious Influences are generally external triggers of disharmony, the Seven Emotions—Joy, Anger, Fear, Fright, Sadness, Grief, and Pensiveness/Worry—are internal causes of disease.
The Seven Emotions are as real a source of disharmony in the mind/body/spirit as the External Pernicious Influences are. In Chinese medicine, a disease is never dismissed as being “all in your head.” Chinese medicine does not divide diseases or disorders into neat little packages: This one is physical, that one is emotional, this one is psychological, and that one is spiritual. Rather, Chinese medicine views the human being as a whole. There is no separation between the body and the emotions, between the body and the spirit, and between the body and the forces that shape the quality of daily life.
Despite this recognition of the importance of the Seven Emotions in diagnosing disharmony, TCM, as practiced in post-revolutionary China, does not place as large an emphasis on the Seven Emotions as it does on the Pernicious Influences. On the other hand, the Five Phases System pays special attention to emotions. It offers the TCM practitioner useful insights when diagnosing emotion-based disharmonies.
Disharmonies of the Seven Emotions
An Excess or a Deficiency of any emotion is indicative of disharmony in the mind and spirit, and it alerts the Chinese medicine practitioner to disharmonies in Organ Systems as well. The Heart and Liver are the most susceptible to emotions. The Heart stores the Shen, and unharmonious emotions can disturb the Shen and cause sleeplessness, muddled thinking, inappropriate crying or laughing, and, in extreme cases, fits, madness, and hysteria. Excess or Deficient Joy especially impacts the Heart.
The Liver, which is responsible for the movement of Qi, Xue, and all of the emotions, is associated with anger. If the Liver Qi is stuck or in disharmony, the emotions become suppressed. If the emotions become suppressed, they suppress the function of the Liver. Sadness and grief, which are associated but distinct states, take their toll on the Lung System. If a person worries or overthinks, the Spleen System will become unbalanced. Fear and fright, which are also related but distinct emotions, interfere with the smooth functioning of the Kidney System.
OTHER SOURCES OF DISHARMONY
Several other factors can produce disharmony. Some examples include poor nutrition, unharmonious sex, and excess physical activity.
Poor Nutrition
A balanced diet is an essential component of good health. In Chinese medicine, a balanced diet is used as a powerful therapeutic tool. The Chinese system recognizes that diet exerts a strong influence over the mind/body/spirit. Digestive problems, depletion of energy, depression, and many specific disharmonies can be triggered by eating too much or too little, by eating too frequently or not often enough, by eating food that is too cold, by eating too many raw foods, and by eating food that is impure or unsanitary. This happens, in part, because the Stomach and Spleen Systems, which receive and transform food, are the most sensitive to diet. When they become imbalanced, many associated components of the mind/body/spirit are affected.
Eating a diet that helps counter the disharmonies can restore harmony. For example, if you are suffering from Interior Cold Deficiency, your practitioner may suggest you eat foods that are warming and sweet to help rebuild your Qi. (See chapters 6 and 7, pages 91 and 112.)
Unharmonious Sex
Excessive sex can cause Deficiency disorders, especially in men. For women, similar problems arise from multiple pregnancies.
Excess Physical Activity
Obsessive exercise, overworking, and high-stress situations all deplete the mind/body/spirit. They make the body vulnerable to disharmony and disease.