Category Archives: TCM Theory

A basic intro into how your herbalist looks at things
 
Ancient Chinese people were greatly interested in the relationships and patterns that occurred in nature. Instead of studying isolated things, they viewed the world as a harmonious and holistic entity. In their eyes, no single being or form could exist unless it was seen in relation to its surrounding environment. By simplifying these relationships, they tried to explain complicated phenomena in the universe, as well as states of disease and wellness within the human body

Ba Gong

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The Ba Gong (The 8 categories or questions) is a way of clarifying the various symptoms and more closely aproximating the underlying syndrome.  When we encounter a patient we take in all the various complaints and look for the underlying pattern.  We ask ourselves is the problem:

Interior or Exterior ?

Hot or Cold ?

Excess or Deficiency ?

Yin or Yang ?

Interior and exterior is the category where the disease is located.

Exterior conditions are still on the periphery of the skin, in the muscles and channels, and interior conditions affect the organs and bones.  The exterior of the body is the area where the lung defensive chi operates.  For example, if you are fighting a cold and have aches in the muscles, this is an indication of an exterior pattern.  The syndromes that are happening on the exterior happen quickly and resolve quickly.  Disharmony that has gone to the internal organs take more time to build up, and then take longer to resolve.

Interior problems happen when the internal organs are affected.  A problem may have originated from the exterior, but not dealt with properly it became a pattern of internal organs.

Cold and Hot is the second category of Ba Gong.

In a hot problem there is fever and thirst, whereas in a cold problem there are chills and sensation of coldness. Think of hot and cold in terms of next category of Ba Gong; empty and full.

Hot and cold has to do with our understanding of Yin and Yang.

In Full-Heat,the yang increases beyond normal, heats up the body and evaporates the yin. For example a man eats chili peppers, his body gets hotter and the results are that he is thirsty.   To resolve this pattern one would treat the excess yang.

In Empty-Heat, yin is deficient and yang remains normal, so one would treat the yin deficiency.  For example the man is working, but he has not been drinking enough water, and becomes yin deficient.

Similarly there is the full-cold, where folks are suffering from an excess of yin.  Here, the man ate too much ice cream and gets a stomach pain, excess of cold.

Empty-cold is more difficult to resolve.  It has happened over a longer period of time where the yang has diminished.  For example, men that have too much loss of seminal fluid create a condition of tiredness and coldness. His yang is too low and must be tonified.

Full problems have a pathogenic factor and there is intact full body chi reacting to it.  The Chi of the body is responding to the pathogen.

An Empty condition is where there is diminished bodily chi, and no pathogenic factor.

Yin and yang summarize the other six.  For instance if it is interior, empty and cold, that is all yin.  If it exterior, full and heat, this is all yang.

Qi and Blood

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 Qi has variously been translated as life energy, vital energy or life force  It is matter on the verge of becoming energy,or energy at the point of materializing. As the Chinese say, When Qi gathers,so the physical body is formed; when Qi disperses, so the body dies. 
What are the types and functions of Qi?

 

We begin with Original Qi (Yuan Qi),also known as Prenatal or Before Heaven Qi, which is inherited from our parents at conception.

This is augmented by Postnatal or After Heaven Qi, which is derived from the Qi in the world we live in. There are two main sources of Postnatal Qi: food and air.

Gu Qi is derived from the food we eat,and the main organ associated with this process is the Spleen. Kong Qi is derived from the air that we breathe, and the main organ associated with this process is the lung.

Gu Qi and Kong Qi mix togehter to form Gathering Qi (Zong Qi), sometimes known as Qi of the Chest.

Finally, the Zong Qi is catalyzed by the action of the Yuan Qi to form Normal or Upright Qi (Zheng Qi), which becomes the Qi that circulates through the channels and organs of the body. Since Zheng Qi flows around the body,several functions are based on it, as we now see.

Zheng Qi forms the basis of Nutritive Qi (Ying Qi),which id essential in the process of nourishing all the tissues of the body. It also forms the basis of Defensive Qi (Wei Qi), which circulates on the outside of the body and protects it from the external factors that might give rise to disharmony and illness.

When the Zheng Qi flows through each of the various internal organs of the body,the Qi functions with respect to the characteristics of that organ. Thus, for example, the activity of Liver Qi will be different from that of Lung Qi,but they are both manifestations of Zheng Qi. This is called Organ Qi (Zangfu Zhi Qi).

Similarly, when Zheng Qi flows through the channels or meridians of the body it is called Meridian Qi (Jing Luo Zhi Qi).
Five Functions of Qi

1.Source of body activity and movement

Every aspect of movement in the body,both voluntary and involuntary, is a manifestation of the flow of Qi. Qi is constantly ascending, descending,entering,and leaving the body,and health and well-being are dependent on this continuous dynamic activity.

2. Warming the body

The maintenance of normal body temperature is a function of the warming action of Qi.

3.Source of protection for the body

Wei Qi is responsible for protecting the body from invasion by external environmental factors such as Cold,Heat,Damp,and other pathogenic factors that may cause illness.

4. Source of transformation in the body

The action of Qi in the body is crucial in transforming food and air into other vital substances, such as Qi itself,Blood, and Body Fluids.

5.Governing retention and containment

Healthy and strong Qi is vital in holding the various organs, vessels,and tissues of the body in their correct place,hence facilitating their correct functioning. This would be analogous to the manner in which the correct pressure is needed in a tire to bind it to the wheel and to facilitate the movement of the vehicle.
Problems with Qi:

1.Deficient Qi (Qi Xu)

In this instance there will be insufficient Qi to carry out adequately the various functions. thus,for example,in older people a deficiency of Qi resulting from aging can lead to chronic cold because the Qi is not performing its warming function adequately.

2.Sinking Qi (Qi Xian)

If the Qi is very deficient then it may no longer adequately perform its holding function and it may sink. This is most obviously seen in conditions such as organ prolapse.

3. Stagnant Qi (Qi Zhi)

If normal Qi flow is impaired for any reason,this can lead to sluggish flow or blockages.A single bump on the arm will cause localized swelling and pain because of the stagnation of Qi in the meridians. Stagnation can also affect internal organs, leading to more serious disharmonies.

4. Rebellious Qi (Qi Ni)

In this instance, the Qi flows in the wrong direction.For example, Stomach Qi is characteristically considered to flow downward, carrying food to the intestines. If the Stomach Qi rebels, it will move upward,leading to problems such as hiccups,nausea,and, in extreme cases,vomiting.
Much has been written about energy fields. It is suggested that the physical body is merely the densest level of energetic matter that exists within a frequency range that makes it both tangible and visible. There are other levels of energetic matter surrounding the physical with increasingly subtle frequency distributions. The various levels that are believed to exist are: physical,etheric,astral,mental (containing instinctive,intellectual,and spiritual sublevels) and pure spirit or causal.It has been suggested that the energy levels cannot be considered to have dstinct divisions. In this view,each level interacts with its neighbor, and the development and organization of the physical body are preceded by stimulation of the higher-frequency energy bodies. In other words, the organizational field commences at the pure spirit or causal level, which then creates an organizational matrix at the mental level, which in turn causes the same to happen at the astral level,thence at the etheric level;and finally the organizational matrices manifest in physical form-the human body. An energetic view of the body dramatically differs from a mechanistic view,as it suggest that energetic organization precedes the body ‘ s physical organization, and not the other way around!
It seems that Qi flow in the body and the meridian or channel networks that carry it operate at the cusp between the physical and the nontangible energetic systems. Thus,as the etheric body is seen to be closest to the physical system,the meridians may be seen as forming what Richard Gerber calls the physical-etheric interface.The Qi energy of the universe enters throught the etheric energy level, accessing the body through the major and minor acupuncture points and flowing to the cellular structures by way of the energy gradients and the concentrations that we term the meridian sysyem. Thus,when a disharmony appears in the body it has firstly manifested itself at the etheric level. Physical illness comes at the end of a chain of energetic processes.
Blood in Chinese medicine is not merely the physical substance that id recognized as blood in Western medicine. Closely allied to Qi, it nourishing the body and the shen.Chinese medicine sees Blood as a very material and fluid manifestation of Qi. In considering Blood we will slightly alter the focus of our discussion, looking at origin of blood functions of blood interrelationships with blood disharmonies of blood.
It is thought there are two ways in which blood is produced for use throughout the body.As will be seen, in Chinese medicine, the Spleen, Stomach, Lungs, Heart, and Kidneys all have important roles to play in the development of blood.1.Transformation of blood

Food and Drink are transformed into Blood, starting with the Spleen. The Spleen extracts Gu Qi from the food ingested into the Stomach and this is sent upward to the chest area. The Lung Qi begins the process of transformation into blood, and the Gu Qi is then sent from the lungs to the Heart where the Yuan Qi and Jing facilitates the further transformation into Blood.

2. The action of marrow

Marrow is also involved in the process of the production of blood. In this instance, the Jing that is stored in the Kidneys produces Marrow. This is turn produces Bone Marrow, which further contributes to the manufacture of blood.
It is thought there are three main functions of Blood in the body.1.Nourishing the bodyProbably the most important function of Blood is that by continuously circulating throughout the body it carries nourishment with it to all the organs, muscles, tendons, and so on. Remember that in Chinese medicine, blood is seen as an aspect of Qi and as such it helps carry the nutritive aspects of Qi.

2.Moistening the body

Being a fluid, blood has an important role in moistening and lubricating throughout the body.

3.Aiding the mind (Shen)

Chinese medicine sees the blood as helping to anchor the mind, allowing for the development of clear and stable through processes. When an individual is blood-deficient, there can be a tendency toward irritability and anxiety because the blood is not adequately anchoring the mind.
Blood has important relationships with all the Yin organs (zang) of the body. This will be discussed in greater detail when we look at the function of the various organs.It is, however, worth saying a little more about the intimate interdependency between the Blood and Qi. Blood is an aspect of Qi. Qi can be considered Yang with respect to blood since it is more ethereal; and ,by implication, blood is considered Yin with respect to Qi since it is more tangible. This close relationship can be seen in the following ways.
*Qi produces blood.*Qi moves blood around the body.

*Qi holds the blood in the blood vessels.

*Blood nourishes Qi.

The Chinese sum up this close relationship between Qi and Blood by stating that

Qi is the commander of blood, and blood is the mother of Qi.
Three main types of blood disharmonies are thought to exist.1. Deficient Blood (Xue xu)If blood is deficient, this is usually connected with the Spleen ‘ s ability to move Gu Qi for blood production. Typically, this can lead to pale complexion, dry skin, and dizziness on occasions.

2. Stagnant Blood (Xue Yu)

If Qi is weak or stagnant, it may fail to move the blood adequately, thus leading to stagnation of blood. Typically, this will lead to attacks of sharp and often intense pain. There may also be the development of tumors.

3.Heat in the Blood

This usually results from internal heat generated by the disharmony of another organ-usually the liver. Heat in the blood can lead to skin conditions and mental/emotional problems, among many other disharmonies.

The Five Phases

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Based on observations of nature, ancient Chinese people recognized patterns of transformation and change in the universe. Initially, these observations were interpreted using yin yang logic, but later these interpretations were expanded using a theory called the five phases. The five phases theory evolved from the study of various processes, functions, and phenomena of nature. The theory asserts substances can be divided into one of five basic phases: wood, fire, water, metal and earth, which contain their own specific characteristics and properties. Today, the five phases theory is still used as a tool for grouping objects, and as a method for analyzing changes of natural phenomena.

The key thing to keep in mind with the Chinese medical application of the five phases is that it is only a model, and it is known to have exceptions.

 

Movement

Wood

Fire

Earth

Metal

Water

Planet

Jupiter

Mars

Saturn

Venus

Mercury

Mental Quality

Sensitivity

Creativity

Clarity

Intuition

Spontaneity

Emotion

anger

happiness

love

grief, sadness

fear, scare

Zang (yin organs)

liver

heart/pericardium

spleen/pancreas

lung

kidney

Fu (yang organs)

gall bladder

small intestine/San Jiao

stomach

large intestine

urinary bladder

Sensory organ

eyes

tongue

mouth

nose

ears

Body Part

Tendons

Pulse

Muscle

Skin

Bones

Body Fluid

Tears

Sweat

Saliva

Mucus

Urine

Finger

index finger

middle finger

thumb

ring finger

little finger

Sense

sight

speech

taste

smell

hearing

Taste[5]

sour

bitter

sweet

pungent

salt

Smell

Rancid

Scorched

Fragrant

Rotten

Putrid

Life

birth

youth

adulthood

old age

death

Animal

scaly

feathered

human

furred

shelled

 

Within five phase theory there are four main relationships or ways in which the phases interact. The first of these is the generating (sheng, mother-child) cycle. This cycle describes the ways in which each phase, serving as a mother, promotes the growth and development of the following child phase.

Examples of this cycle are the Wood phase providing the generative force for Fire, Fire providing the generative force for Earth, etc. This relationship provides the foundation for understanding five phase theory and, consequently, where imbalances may arise within the cycle. If Earth, for example, is weakened from a poor diet and overwork you will see that more nourishment is requested from the Fire phase to nourish Earth. Additionally, if Earth is weakened the Metal phase may also be effected.

From a clinical perspective you may see people develop digestive issues from irregular eating, excessive worry and overwork which leads to a proliferation of dampness which then effects the Metal phase. Within this case you may see a combination of bloating, gas and poor energy with the development of Metal (Lung) symptoms such as sinusitis or phlegm-type asthma.

The controlling (ke, grandparent-grandchild) cycle provides for a check and balance system among all of the phases. Within this cycle Earth, for example, provides a control for Water and is controlled by Wood. An example of this relationship within the body is in cases of anxiety (Fire) which are related to LV Qi Stagnation (Wood) where, over time, you begin to see more Kidney (Water) related signs as the Water phase attempts to control the overactive Fire.

The overacting cycle (cheng) is an imbalance within the controlling cycle where the grandmother phase provides too much control over the grandchild and weakens the phase. Within nature you may see Water putting out Fire, Earth soaking up Water and so on.

A clinical example of this relationship would be Liver (Wood) overacting on the Spleen (Earth). In this case you have an overactive Wood phase over controlling Earth leading to disruptions in the digestive system.

The insulting cycle (wu) is also an imbalance within the controlling cycle where the grandchild insults or returns the controlling force generated by the grandmother. Using examples from nature you can see Fire burning up Water and Water washing away Earth and so on.

Clinically you may see this in cases where people have long-term psychological problems (Fire) which eventually effect the Kidneys (Water) as seen in the development of more Yin (Water) deficiency signs.

 

 

Yin and Yang

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Yin and Yang is perhaps the most fundamental concept in Chinese Medicine, as it is the foundation of diagnosis and treatment.

Yin Character

Yin

 female, passive, negative principle in nature  the moon. shaded orientation north or shady side of a hill south of a river.

 Yang Character

Yang

 positive, active, male principle in nature, south or sunny side of a hill , north of a river.

There are four things you can say about them:

  1. Yin-Yang are opposites
    They are either on the opposite ends of a cycle, like winter and summer or midnight and high noon. This opposition is relative, and can only be spoken of in relationships. For example: Water is Yin relative to steam but Yang relative to ice. Yin and Yang are never static but in a constantly changing balance.
  2. Interdependent: Can not exist without each other
    The Tai Ji (Supreme Ultimate) diagram shows the relationship of Yin & Yang and illustrates interdependence on Yin & Yang. Nothing is totally Yin or totally Yang. Just as a state of total Yin is reached, Yang begins to grow. Yin contains seed of Yang and vise versa. They constantly transform into each other. For Example: no energy without matter, no day without night.
    The classics state: “Yin creates Yang and Yang activates Yin”.
  3. Mutual consumption of Yin and Yang
    Relative levels of Yin Yang are continuously changing. Normally this is a harmonious change, but when Yin or Yang are out of balance they affect each other, and too much of one can eventually weaken (consume) the other.Four (4) possible states of imbalance:

    1. Too much Yin
    2. Too much Yang
    3. Not enough Yin
    4. Not enough Yang
  4. Inter-transformation of Yin and Yang.
    One can change into the other, but it is not a random event, happening only when the time is right. For example: Spring only comes when winter is finished.

 

 

 

Yin

 Yang
Produces form Produces energy
Grows Generates
Substantial Non-substantial
Matter Energy
Contraction Expansion
Descending Rising
Below Above
Water Fire

 

Yin

 Yang
Front (chest-abdomen) Back
Body Head
Interior (organs) Exterior (skin, muscles)
Below waist Above waist
Anterior-medial Posterior-lateral
ventral surface of the trunk and limbs back and dorsal surface of the limbs
Structure Function
Blood/Body Fluids Qi
Conservation/storage Transformation/change
Yin Organs: Heart, Lung, Small Intestine, Lg. Intestine
Liver, Spleen, Kidney, Gall Bladder, Stomach, Bladder
Pericardium San Jiao
“Solid Organs” “Hollow Organs”

 

Structure and Function

Structure = something substantial, i.e. Matter (Yin)
Function = something insubstantial, action, energy (Yang)
All parts of the body have a structure (a physical form), and a function (their activity)
However, all is relative. Even within the Yang category of function, there are Yin functions (i.e. storage, conservation) and Yang functions, i.e. transformation, transportation, digestion, excretion.
Within the Yin category of form there are Yin forms (“solid”) and Yang forms (“hollow”)

Blood, Body Fluids, and Qi

Qi is Energy, more Yang.
Blood = denser and more material (therefore Yin).
But note that “Xue” (blood) not exactly like our concept of Blood. More like “thicker” form of Qi.

Note: there are several types of Qi. Each is relatively more Yin or Yang.
Ancestral QI (more Yin, more slow moving. Moves in long slow cycles).
Ying Qi (more Yang than Ancestral Qi, moves with Blood with which it is closely related). Ying is more Yin than Wei Qi.
Wei Qi the most Yang form of Qi. Circulates in the exterior in the daytime to protect us from pathogenic influences, and regulates opening/closing of pores.

Conservation/Store (Yin) and Transformation/Change (Yang)

Yin Organs store Blood, Body Fluids, Essence, etc.
Yang Organs constantly transform, transport and excrete the products of digestion.

Solid and Hollow Organs (Zang Fu)

Yin Organs are “Solid”: constantly active, involved in production and storage of the body’s vital Substances (Qi Blood, Body Fluids, Essence)

Yang Organs are “Hollow”: receive and circulate but do not store, involved in digestion, transformation, excretion.

Clinical signs and symptoms can be interpreted via Yin-Yang theory. When Yin Yang are in dynamic balance and relating harmoniously, there are no symptoms to observe. When Yin and Yang are out of balance, symptoms can arise.
For example if Yin does not cool and nourish Yang so Yang rises (headaches, red face, sore eyes, sore throats, nosebleeds, irritability, manic behavior. Or if Yang does not warm and activate Yin (cold limbs, hypo-activity, poor circulation of blood, pale face, low energy.

 

Yin

 Yang
Deficiency Excess
Hypoactivity Hyperactivity
Chronic disease/gradual onset Acute disease/rapid onset
Slowly changing symptoms Rapid pathological changes
Quiet, lethargy, sleepiness Restlessness, insomnia
Wants to be covered Throws off bedclothes
Lies curled up Lies stretched out
Cold limbs and body Hot limbs and body
Pale face Red face
Weak voice, no desire to talk Loud voice, talkative
Shallow, weak breathing Coarse breathing
No thirst/wants warm drinks Thirst esp. for cold drinks
Copious, clear urine Scanty, dark urine
Loose stools (fluids not transformed) Constipation (damage to fluids by heat)
Clear, copious secretions Thick, sticky white/yellow secretions
Excessive moisture Excessive dryness (throat, skin, eyes etc.)
Degenerative disease Inflammatory disease
Pale tongue, white coat Red tongue, yellow coat
Empty pulse Full pulse

In Practice:

Although Yin-Yang essential foundation for understanding symptoms and signs, the above list of signs is too general. We need to distinguish further to get exact diagnosis. i.e., which Organ is involved, which pathogen involved, which channel involved.

Structure and Function
Without structure, function could not occur. Without function, structure would be meaningless.

Mutual Consumption of Yin and Yang
Balance of Yin & Yang is constantly changing. Yin & Yang mutually consume each other.

Four different situations:

1) Excess of Yin 2) Excess of Yang
3) Deficiency of Yin 4) Deficiency of Yang

Excess of Yin: i.e., when excess Cold in the body consumes the Yang (heat). This is an Excess Cold (Full Cold) condition.

Excess of Yang: i.e., when excess Heat (from Exterior or Interior of body) consumes Body Fluids, leading to Dryness or even Heat. This is an Excess Heat (Full Heat) condition.

Deficiency of Yin (Consumption of Yin): i.e., when the body’s Yin energy is depleted, an apparent excess of Yang results, leading to feelings of “empty heat” (mild but very specific heat symptoms, i.e., flushed cheeks, afternoon fever, sweating at night, heat in extremities. This is Deficiency Heat (Empty Heat) condition (i.e., a condition of deficiency and heat), also called “False Fire”.

Deficiency of Yang (Consumption of Yang). When body’s Yang energy is spontaneously deficient – an apparent excess of Yin results, leading to various symptoms involving cold and hypo-activity Deficiency of Yang can also occur after an Excess Cold condition has damaged Yang. This is an Deficiency Cold (Empty Cold) condition (i.e., a condition of deficiency and cold).

Excess of Yin (Full Cold) Excess of Yang (Full Heat)
Excess of Yin is primary aspect Excess of Yang is primary aspect
Yin is in true excess Can eventually cause deficiency of Yin
Can eventually cause deficiency of Yang
Deficiency of Yang (Consumption of Yang) Deficiency of Yin (Consumption of Yin)
(Empty Cold) (Empty Heat of “False Fire”)
Decrease of Yang energy is primary aspect Deficiency of Yin is primary aspect
Yin only apparently in excess Yang only apparently in excess