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Understanding Traditional Chinese Medicine

 

The diagnostic language used within Traditional Chinese medicine (TCM) is quite different from that used within Western medicine (WM). In this section of the site, I will attempt to provide a simplified explanation of some of the common terms used and explain some of the more common patterns of disharmony.

It must be noted that TCM diagnosis forms a complex interwoven pattern or “clinical landscape” that serves to understand, for each patient “what is going on?” in a truly holistic sense. This is not a linear process that sees symptoms in isolation but weaves together an intricate pattern of imbalances that explains the whole.

Try reading “The web that has no weaver” by Ted Kaptchuk

 

The Fundamental Substances (the basic ingredients of human life)

Jing

quote openJing or ‘Essence’can be described as that which we bring into the world. It determines our constitutional make-up and is formed at conception by fusion of the Jing of our parents. In Western terms, this could be described as our DNAquote close/genetic make up. Jing determins our growth, maturation and development, our brain function, our constitutional strength and resistance to disease. It is said to be fixed in quantity but naturally declines with age. By living a moderate and balanced lifestyle, our Jing is preserved enabling a long healthy life. By living beyond our energy, working too hard, consuming too many stimulants, overloading our digestive system, not balancing our rest and activity, our Jing is depleted and we will age prematurely and our bodies suffer from disharmony which leads to disease.

Signs of Jing deficiency include:

premature aging, early hair loss/graying, infertility, poor memory and weakening of the bones.

Qi

The concept of qi is complex. If we look at the Chinese character for qi, the upper part represents a vapour, steam or gas, whereas the lower part represents a cooking pot or uncooked rice. It therefore represents something both immaterial and material. The term ‘energy’ is usually used to translate this character, which may be acceptable to modern physicists who appreciate the continuum of matter and energy. For diagnostic purposes, qi should be regarded as an physiological abstraction or metaphor which is used to describe the dynamic processes of the body.

Signs of Qi deficiency include:

tiredness, weak voice, spontaneous sweating, lack of appetite, loose stools and poor immunity.

Blood

The term ‘Blood’ is used in a broader sense in TCM. It refers to the blood in our veins, but also menstrual blood and the deep nutrition of our body. Blood nourishes the tissues and organs especially eyes, hair and skin but also muscles and bones. It moistens the tissues of the body, provides a material foundation for the mind and anchors our spirit.

Signs of Blood deficiency include:

tiredness, anxiety, palpitations, dizziness, dry hair and skin, abscent or scanty menstruation, insomnia and floaters before the eyes.

Shen

quote openIt is the ‘spark of our being which shines through our eyes when we arquote closee truly awake’. The Shen refers to our consciousness or spirit, specifically the mind. In TCM, the Shen is said to be housed by the Heart. A healthy Shen is said to be evident by the ‘glitter’ in a person’s eyes.

 

The Eight Principles

Yin and Yang

The symbol itself has been adopted by popular bohemium culture yet it’s meaning within TCM is both simple yet profound. It represents the opposite yet complementary nature of things which goes against the Aristotelian logic of Western thinking which is opposed to the idea of contraries. Yin and Yang represent the cyclical and symbiotic nature of things, the interdependence of each. It can be used to express the nature of all things, the universe, cycles of nature and of course the human body.

Yin

cooling, moistening, quiescience/night-time, nutritive elements of the body.

Signs of Yin deficiency include

feelings of heat in palms, soles of feet and chest or face, night sweating, insomnia, nervousness and emaciation.

Yang

warming, drying, activity/daytime, dynamic elements of the body.

Signs of Yang deficiency include

tiredness and feelings of cold, frequent pale urination, lack of motivation and timidity.

Excess (shi) and Deficiency (xu)

It is important when making a diagnosis to determin whether a pattern represents an Excess or a Deficiency. In practice, the two conditions will often co-exist, which means clearing the excess whilst improving/tonifying the deficiency.

Excess

Not surprisingly, an Excess condition refers to too much of something. This is best demonstrated in relation to pain conditions: an acute, stabbing pain which is relieved by movement would likely indicate an excess.

Deficiency

A deficiency is usually caused by overworking a particular body system or in some cases, by a constitutional weakness. To use the example of pain conditions, a dull, aching pain which is improved by rest would indicate a deficiency.

Interior and Exterior

The distinction between interior and exterior conditions is essentially quite simple. Interior conditions are internal disharmonies rather than via an external influence such as a cold virus (pathogen).

Heat and Cold

Cold may develop due to a deficiency of Yang, the bodies warming energy or manifest as a result of an external pathogen. Similarily, Heat occurs as a result of excess of yang (full heat) or a deficiency of yin (empty heat) or as a result of an external pathogen.

 

The Five Zang

The five Zang are the Yin organs of the body which are also paired with the Fu or Yang organs. The important distinction here is to understand that when talking about, for example: the ‘Liver’ we are not necessarily talking about the organ itself but the systems/functions associated with it. I’ve included below, information on some of the more common patterns we come across in practice. There are however, many more and usually patients will present with a number of overlapping patterns of disharmony.

There are complex inter-relationships between the ZangFu. For example, when the Spleen is overloaded or weak and unable to transform food and fluids, phlegm is produced. This can manifest in the lungs as excess mucus. Too much fatty or greasy food and/or stress can stagnate the Liver producing excess heat which flares up and injures the Heart. When formulating a TCM diagnoses, the aim is to find the root cause of the patients symptoms.

Liver

“Like a millitary commander who formulates strategy and tactics, the Liver exercises authority in collecting and directing the Blood. Since Blood is never stationary but constantly circulating, and since Qi courses inseperably through the body with the Blood, the Liver equitably distributes all resources, assuring the maintance of smooth flow”. (ref Beinfield and Korngold, Between Heaven and Earth, Ballantine books, 1991 p105)The Liver is associated with the flow of qi and Blood around the body and is particularly prone to stagnation particularly through feelings of frustration and anger but also through overly stimulating foods as well as coffee and alcohol. The Liver is associated with the element of wood which needs a sense of growth and flexibility which gives rise to a sense of self determination and contol.

The Liver’s main function is to store the Blood and in turn regulates hormonal balance. It is responsible for nourishing tendons and muscles and has a close relationaship with the eyes. The emotion connected with the Liver is anger. The Liver is most susceptible during the Spring and is paired with the Gallbladder.quote openLiver qi is most commonly affected by stress which interupts the ‘smooth flow’ of procequote closesses of the body.

Liver Qi Stagnation

Symptoms may include:

Tension, irritability, anger, depression, abdominal distension, constipation, Irregular periods, painful periods and PMT/pre-menstrual breast distension.

Liver Blood stagnation

Symptoms may include:

Irregular or late periods, severe menstrual pain and/or dark, clotted menstrual flow, heavy or scant menstrual flow (period not getting going), fixed abdominal masses.quote openAs qi stagnates, so too does quote closeBlood eventually..

Liver Blood deficiency

Lack of available nutrients in the blood gives rise to Blood deficiency. Vegetarians who are not careful about getting good quality proteins in their diets are prone to this but so too are those who have a poor diet, suffer severe blood loss, for example during childbirth, ongoing heavy periods or who generally ‘work beyond their energy’.

Symptoms may include:

muscle cramps, spasms, muscle weakness, numbness and tingling in the limbs, dry hair and skin, hair loss, blurred vision, floaters, tired, dry or gritty eyes. Dry brittle or withered nails. Infrequent, scanty or lack of periods (amenorrheoa). Dizziness, fainting, poor memory, tiredness, vivid dreams.

Heart

The Heart is considered the ruler because like a benevolent and enlightened monarch, it is all knowing and ever-present, sharing it’s wisdom unconditionally for the good of the whole. Our Fire aspect represents fulfillment: the total expression and integration of our being, the full extent of our expansion, maturation and development. (ref Beinfield and Korngold, Between Heaven and Earth, Ballantine books, 1991 p109) The Heart governs the circulation of blood and the blood vessels themselves. The Heart is said to house the Shen, our conscious mind which is particularly sensitive to emotions. The Heart is most susceptible during early Summer and it is paired with the Small Intestine.

Heart Qi deficiency

quote openHeart qi is affected mainly by quote closeemotional strain.

Symptoms may include:

Palpitations, shortness of breath, excessive sweating, general fatigue and weakness, stuffiness/suffocating feeling in the chest.

 

Heart Blood deficiency

Symptoms may include: Palpitations, Insomnia. Dream disturbed sleep. Anxiety and propensity to be startled. Dizziness.quote openHeart Blood deficiency is usually seen as a progression of Liver quote closeBlood deficiency.

Spleen

As a minister of agriculture oversees the production and distribution of farm resources, the Spleen supplies the nourishment that sustains the organism. The raw material of food and experience is ingested, digested, and assimilated to fuel the life of the body and mind. This fuel, called Nutritive Essence, is extracted and converted into an abundance of Qi and Blood. Gathering and holding together is the dominion of Earth. Like Mother Earth, the Spleen is the constant provider, the hearth around which the body gathers to renew itself. (ref Beinfield and Korngold, Between Heaven and Earth, Ballantine books, 1991 p112) The Spleen is responsible for the transformation and transportation of food and fluids. Whilst it provides the raw materials to produce Blood, it is said to also hold the blood and those with weak Spleen qi may bruise easily or suffer prolonged uterine bleeding.

The Spleen is said to maintain lightness and raises our qi. The Spleen is most susceptible during late Summer. The emotion associated with the Spleen is worry. It is paired with the Stomach.

Spleen Qi deficiency

Spleen qi deficiency can be thought of as a general weakness of the digestive system which can be caused by overeating or overloading ourselves with food. Putting too many demands on our bodies (through overwork both physically and mentally) without time for recouporation taxes the Spleen and in time, it becomes weak.

Symptoms may include:

Fatigue, anorexia, tired heavy limbs, abdominal distension after eating, loose stools, acid reflux, shortness of breath.

Spleen Yang deficiency

Spleen Yang deficiency can be thought of as a coldness of the digestive system, also cxaused by overwork which affects the Yang of the body.

Symptoms may include:

Early morning diarrhoea, cold limbs, loose watery stools containing undigested food, mental fatigue.

Spleen Qi deficiency with Damp

When the Spleen becomes deficient, it becomes unable to process foods and fluids adequately enough which gives rise to damp. This is most often caused by overeating, or eating too many heavy fatty foods.

Symptoms may include:

Oedema in limbs (especially legs) Stuffy feeling in the chest, heavy limbs, weight gain.

Lung

In the Lung, the Qi of Heaven (air) joins with the Qi of Earth (nutrition), forming the Qi that vitalises human life. Like a minister who conducts affairs of state and determins territorial borders, the Lung governs the relationship between the inside and the outside, setting limits and protecting boundaries. With restraint and delicacy, expanding and contracting, the Lung collects, mixes, and scatters the Qi, instilling rhythm and order. (ref Beinfield and Korngold, Between Heaven and Earth, Ballantine books, 1991 p117) The Lung ‘governs respiration’. The pure qi inhaled by the lungs combines with food qi extracted by the Spleen to produce ‘gathering qi’ that provides support for the whole body. The Lung supports the descending and dispersing of body fluids. The Lung has a close relationaship with the skin and body hair as well as the nose and voice. The qi of the Lung maintains our connectedness with the real world. The emotion connected with the Lung is grief.

The lungs are sometimes called the ‘delicate organs’ because of their susceptability to invasion of pathogens (i.e. Colds and flu). The Lung provides our defensive qi likened to our immune system. Mucus in the lungs (other than infection) is caused by the inability of the Spleen to transform food and fluids. Sadness, worry and grief weaken the qi of the Lung. Lung qi can also be weakened by life habits such as: sitting, bent over a desk which impair breathing, smoking and excessive use of the voice (i.e teachers, singers). The Lungs are most susceptible during Autumn.

Lung Qi deficiency

Symptoms may include:

Shortness of breath. Cough. Weak voice. Spontaneous daytime sweating. Dislike of cold. Bright white complexion. Propensity to colds.

Lung Yin deficiency

quote openSmoking is probably the most common cause of Lunquote closeg Yin deficiency.

Symptoms may include:

Dry cough. Heat signs late afternoon/evening.

Kidney

The Kidney consolidates and stores the Qi that initiates and keeps life growing. Like a minister of interior who conserves natural resources, stockpiling essential raw materials for use in times of growth, crises, or transition, the Kidney preserves what is essential, the Essence, of human life. As well of vitality and endurance, the Kidney is the germ of intellect, creativity, and houses our instinct to procreate and survive. (ref Beinfield and Korngold, Between Heaven and Earth, Ballantine books, 1991 p121) The Kidneys store Jing and are closely connected with our growth, developement and reproduction. The Kidneys are said to produce marrow and maintain bone health and brain function. The Fire of MingMen (associated with Kidney Yang) provides the ‘warmth’ needed for sexual function.

The Kidneys generally dominate the lower jiao (“jow”) i.e. Bladder, Large Intestine and Uterus. The emotion associated with the Kidney is fear. Kidney qi can be affected by hereditary weakness such as poor health or old age of parents. Long term emotional strain, excessive sexual activity, chronic illnes and overwork will eventually weaken Kidney qi. Kidney qi naturally declines with age. The Kidneys are most susceptible during Winter.

Kidney Yang deficiency

Symptoms may include:

Coldness, lower back pain-weakness of the knees (maybe feelings of cold in back and knees), impotence, infertility, excessive urination, oedema (swelling, usually of legs/ankles)

Kidney Yin deficiency

Symptoms may include:

Thirst, dry mouth, constipation, scanty dark urine. Tinnitus, Dizziness, vertigo, poor memory. Night sweating, hot flushes. Low back pain and weakness. Weak restlessness.

 

Student Resources

Below are some of the notes I used whilst studying Chinese Medicine. They are designed as quick crib sheets or to be put up on the wall. Feel free to print and use, I hope they are helpful.

Beginners

The Five elements

The Five Zang (functions/signs & symptoms)

Heart    Spleen    Lung    Kidney    Liver

Intermediates

The Five Zang (patterns, symptoms & points)

Heart   Spleen   Lung   Kidney   Liver

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