Causes of Disease in Traditional Chinese Medicine

What comes to your mind when you hear Liver Fire Blazing? Maybe something out of a fantasy book, right?

This type of language is used to name and describe the causes of disease in Traditional Chinese Medicine. While for you this sounds a lot like shamanism or just unscientific vocabulary, let me tell you these terms have been proven to be extremely accurate and useful when speaking about and treating diseases using TCM.

The causes of disease in Traditional Chinese Medicine are divided into three main groups: External Pathogenic Factors (Heat, Dampness, Dryness, Cold, and Wind) and internal Pathogenic Factors (Elation, Worry, Sadness, Grief, Fear, Fright, Anger.), and those called Non-External Non. Internal pathogenic factors (mostly lifestyle choices). Diseases happen when the Pathogenic factors overrun the Antipathogenic factors (Defensive Qi), and then the Patterns of Disharmony occur.

In this article you are going to learn how the ancient Chinese looked at the health-disease relationship, why they used such a singular vocabulary, as well as learning what are the different causes of disease in Traditional Chinese Medicine.

​Causes of Disease in Traditional Chinese Medicine

The first step to understanding the causes of disease in TCM is to start with the concept of health in Traditional Chinese Medicine. For Traditional Chinese Medicine, health is described as the dynamic balance between Yin and Yang and the appropriate flow of Qi and Blood through the meridians. When that balance is disturbed, disease arises.

This concept may sound vague but it is a condensed view of how the body must work:

• The balance between Yin and Yang is the ultimate goal, the balance between catabolic (Yang) processes and anabolic (Yin) processes, between the pathogenic factors, and the protective factors. Yin and Yang talk about the classification of all life’s processes.
• The adequate flow of Qi and Blood talks about the proper functioning of the Organ Networks. If Qi and Blood are circulating smoothly and sufficiently the body is healthy.

Even though this concept sounds weird, it gives a more accurate view of health than the one given by the World Health Organization. Using the Chinese classical vernacular they are capable of setting standards by which we can assess someone’s state.

Let’s analyze their classical vernacular for a moment.

​Chinese classical vernacular

One amazing thing about Chinese culture is the fact that everything is related. You can learn about calligraphy and you are going to get accustomed to the Five Elements Theory, when studying martial arts you will also learn about ancient Chinese philosophy, Chinese medicine, and overall culture. It became a very homogeneous culture.

That explains their use of simple and colloquial terms when referring to medical issues and concepts.

Traditional Chinese Medicine uses a prescientific vocabulary that is a reflection of their culture. You may struggle when understanding what is having a headwind, but a Chinese person will get it right away. Ancient doctors used a vocabulary that was already there to refer to their medical concepts, it also allowed the people to understand what the doctor was saying.

This contrasts our Western medical vocabulary where we have developed a specific vocabulary for such topics, mainly based on Greek and Latin.

The use of Greek and Latin in science allows for the creation of new terms assembling and creating words through the use of prefixes, suffixes, and particles.

In Chinese however, this is virtually impossible, if you change one stroke of a character you might go from talking about a horse to talking about toilet paper.

​TCM’s view on diseases

The approach of Traditional Chinese Medicine when it comes to identifying and describing diseases is unique. TCM does not make a distinction between the cause of disease and the disease itself, Chinese medicine talks about patterns rather than diseases.

According to the theory, the pattern is both the cause and the manifestation of the disease. They use circular thinking where there is no defined beginning or end but rather that everything is included.

For example: when there is a pattern of Damp Heat in the Spleen, TCM doctors mean that Dampness and Heat have attacked the Spleen and are showing symptoms of both Dampness and Heat. ‘A is in B’, the cause is included in the pattern. The causes are also the outcome.

That’s why there is no definition of specific diseases like they are known in the West where it is more ‘A leads to B’.

​How the Body protects itself

In your body, your Qi performs multiple functions, one of which is to protect you against the Pathogenic factors. This type of Qi is called Zheng Qi which refers to all the Antipathogenic energies in your body. Within this type exists the Wéi Qi which is the Protective Qi, it covers the body, circulates inside and out of the body, covers the skin, and fights external pathogenic factors.

Zheng Qi can be related to the Immune system in the way that they both fight external infections. However, that concept also refers to the body’s potential to defend itself against non-infectious factors like emotional disturbances, lifestyle choices, and poor sleep, among others. It is best referred to as your body’s homeostatic potential.

A healthy body has a Zheng Qi capable of impeding the pathogenic factors to overcome the body’s defensive potential.

Once the defensive potential of the body has been overcome, the pathogenic factors manifest themselves and start damaging the body. It is here when the disease enters the body.

​Pathogenic Factors

Chinese medical theory recognizes three different kinds of pathogenic factors: External, Internal, and Non-External Non-Internal. In Chinese, they are recognized as Xié Qì or Pathogenic Energies. Their classification as External or Internal is based on the origin of the Pathogenic factor and how it attacks your body.

An External one can become Internal if the disease becomes chronic (It becomes a long-lasting disease) or if its origin is from within the body.

e.g. An internal Deficiency of Yin will create a pattern of Internal Heat (Fire).

​External Factors

External factors refer to the SixWeathers, they attack the body from outside and if they prevail they invade the body causing disease. These factors refer to natural conditions and weather that cause specific signs similar to the characteristics of such weather.

Chinese doctors through the ages spent time analyzing and observing the different patterns their patients would show and record them. They noticed there were some similarities between the pattern’s behavior and the qualities of certain environmental phenomena and made an association.

So if a pattern showed a rapid onset, pain that switches places frequently, stuffed nasal passages, and fear of drafts they categorized it as Wind because of how the wind behaves and how they feel when there’s windy climate.

The External Factors are:

• Dampness
• Dryness
• Cold
• Wind
• Heat
• Summer Heat.

Summer heat is sometimes talked about as a subset of Heat while on other sidesis treated as a separate entity.

Any one of the SixWeathers can attack any of the Zhang-Fu organs depending on your health state, but they tend to have more affinity towards one organ above the others.

Being in contact and influenced by an External factor does not mean you will develop that specific pattern, you can be in a cold environment and experiment with a Damp pattern.

​Internal Factors

The Internal factors are the Seven Emotions, normally you experience emotions in a healthy and controlled manner, it is when the Emotions become excessive that they begin to affect your health and then become a pathogenic factor. Pathological emotions damage your Zhang-Fu organs and cause disease. The Six Emotions are:

• Excessive Joy/Elation
• Excessive Worry
• Excessive Sadness
• Excessive Grief
• Excessive Fear
• Fright.
• Excessive Anger.

​Non-External Non-internal factors

Non-External Non-Internal factors refer to the causes of disease that don’t share the characteristics of the previous Pathogenic factors and don’t have an external or internal origin per se. This set of factors is used to talk about lifestyle choices and behaviors, as well as your inherited traits.

Conducts like excessive eating, sleeping, or working affect your organs, deplete your vital substances, and cause disease.

​What About Infections and Epidemics?

Traditional Chinese Medicine places little emphasis on the causes of disease as Western medicine does. Given that they use patterns of disharmony rather than specific and fixed entities as diseases, Chinese medical theory can obviate topics like infectious diseases and epidemics (as a cause) because it doesn’t matter the cause but the pattern they create.

As a general rule of thumb, viral infections are mostly linked to Disharmonies by Cold, and bacterial infections are mostly related to Heat Disharmonies.

Does it mean there’s no investigation into infectious diseases in Traditional Chinese Medicine?

Of course not. There have been several texts and treatises talking about infectious diseases and how to treat them, but it’s always through the lens of the patterns they cause.

Now let’s move on to the explanation of the Pathogenic factors…

​Description of External Pathogenic Factors

​Heat

Heat is also referred to as Fire. The distinction comes whether it is External Fire or Internal Fire, Internal Heat is regarded as Fire and External Heat is regarded as Heat. This is a Yang Pathogenic factor. It tends to affect mostly the Heart and Small Intestine Networks.

The symptoms are:

• Feeling the whole body or parts of it hot.
• Preference for cold.
• Fever (especially if it’s an External Heat)
• Red face, Red eyes, red darkish urine.
• Secretions affected by the fire will appear sticky, thick, and feel hot: coughing yellow mucus, stools with blood, and pus also indicate Heat.
• As heat evaporates liquids, you will find signs of dehydration: dry tongue, stools, scant urination.
• Can lead to hemorrhages and eruptions in the skin.
• Irritability, or delirium.

​Summer Heat

This is a subset of Heat that is caused by exposure to extreme heat and always happens suddenly. It causes high fever and extreme sweating, it damages the fluids and Qi.

This one can be seen in sunstrokes.

​Dampness

As its name says, Dampness refers to something stagnant, viscose, and wet. It is of Yin nature and affects the Spleen network the most. It is one of the most difficult to treat as it has a clinging nature. Picture Dampness as your body fluids become more viscose and what that causes.

People with Dampness experience symptoms like this:

• The feeling of heaviness of the body and head.
• Chest tightness, the feeling of fullness in the abdomen.
• Cloudy urine
• A general sensation of being heavier, like you are now a balloon filled with water.
• Heaviness, soreness, or stiffness of the joints.
• Cloudy urine, heavy diarrhea, heavy vaginal discharge

Psychologically, Dampness affects the Yi (Shen of the Spleen) and creates sensations of excessive worry and obsession, feeling that activities that once were exciting are now a burden, being over-nurturing, neglecting yourself to help others to the point of self-sabotage.

There is also a more critical state of Dampness which is called Mucus, this is translated as Condensed Dampness and the symptoms are more critical than normal. It can lead to the formation of lumps and nodules, heavy expectoration, and a deep sense of grief, when attacking the psyche it can create mental states like extreme rumination, obsessive thinking, and comalike status.

​Dryness

Dryness is a less talked about factor. Also Yang in nature, affects the Lungs. Some of its unique symptoms are dry cough with little phlegm, thirst, bleeding nose, or chest pain, as well as the signs of suddenness, fever, and body aches.

This kind of state can be experienced in dry areas, there is a time of the year in Spain when the temperatures rise considerably, and along with their dry climate, you can suffer from a pattern of Dry Heat.

​Cold

Cold is a pathogenic factor of Yin nature, it affects the Kidneys the most. Two of the most indicative symptoms of a person experiencing a Cold pattern are the need for warmth because they feel cold, and seem to be unusually slow. Some of the other symptoms are:

• Sharp and stabbing pain in the limbs that is relieved by warmth.
• Aversion to cold and preference for hot environments (they can even wear extra clothes).
• A general sense of hibernation and sluggishness.
• External Cold can manifest with body aches, mild fever, and chills.
• Secretions are clear and white with an appearance of cold. An example of this is the common cold, that clear transparent fluid that comes out of your nose.
• When affecting the psyche, Cold can create trouble with relationships, have a difficult time bonding, and feel separate. (Just like ‘being a cold person’).

​Wind

Wind is Yang in nature, it affects the Liver the most. It is linked with having a volatile quality. As wind moves unpredictably, always changing course, Wind is related to pains and symptoms that change locations quite easily and frequently. When Wind invades the body it rarely does it by itself, most commonly it will come along with another Pathogenic factor.

Some of the main symptoms are:

• Rapid onset, sudden headaches, pain that shifts location, fear of drafts, stuffed nasal passage, sore throat.
• Dizziness.
• Passing gas.
• Pressured feeling in the abdomen or head.
• Tinnitus, numbness of the limbs.
• Tremors, twitching, convulsions, tetany, and apoplexy.

​Description of Internal Pathogenic Factors

The Internal Pathogenic Factors are also called the Seven Emotions. These emotions become Pathogenic factors when they overcome the body’s recovery threshold. Emotional responsiveness is necessary for a healthy body, having no emotional reactions would indicate a disease, but when those emotions go unchecked they can create unbalances and lead to the creation of Patterns of Disharmony.

Just like in the case of the External ones, the Emotions are the cause as well as they are the symptoms and outcome, A is within B.

These emotions are Elation (Excessive happiness/joy), Worry, Sadness, Grief, Fear, Fright, and Anger.

Whenever any emotion is excessive they damage an Organ and create a Disharmony. Generally, they affect the Organs they are mostly linked to and create patterns of internal Wind, Fire, Dampness, Cold, and Dryness.

As the body and mind are interconnected, this way one affecting the other works the other way around also: Emotions can create disturbances in the organs, and disturbances in the organs can lead to an emotional disturbance.

​Final Thoughts

As you can see, in Traditional Chinese Medicine there is not a great interest in naming every cause of disease but in identifying the patterns they create. Now you understand why TCM doctors use such poetic nomenclature like Liver Fire.

According to the theory, the Six weathers and Seven emotions influence your body and if your protective factors are not strong enough, they will enter your body and cause disease.

Learning to spot the symptoms can be of great help and will allow you to seek treatment earlier.

If you have anything you want me to write about please leave a comment below.

See you in the Next post!