The fundamental principle of Chinese medicine is that human beings are a microcosm of the natural world beyond us. The environment inside the body, like that outside it, should have a balance of the five elements–Fire, Earth, Metal, Water, and Wood–and the five climactic influences to which they correspond: heat, dampness, dryness, cold, and wind, respectively. If excessive or “excess,” however, any of these climactic influences can become pathogenic factors and cause disharmony.
All conditions pertain to either excess or deficiency in Chinese medicine. Excess conditions result from pathogenic factors of interior or exterior origin. Dampness, for example, can be generated internally from a poor diet, or externally from living in the Pacific Northwest (famous for its “liquid sunshine”). Deficiency conditions affect the “vital substances:” the physiological aspects of the body that protect it against pathogenic factors. Qì, Blood, yīn, yáng, or jīng (often translated as “essence”) can all become deficient. (For a more in-depth explanation of qì than the following, see the Qì Gōng page).
Each organ has its own qì, as well as a yīn and yáng aspect. Qì and Blood both nourish the body, but Blood has an additional moistening function and it serves as the material foundation for the mental aspect of the Heart. (Each of the five elements corresponds to a mental aspect said to “reside” in one of its corresponding organs). This influence on the Heart-mind is one of the functions distinguishing capitalized Blood (the Chinese medicine concept) from lowercase blood (the conventional medicine concept). The Chinese character for jīng—composed of one part meaning uncooked rice, like the character for qì, and another meaning “clear” or “refined” when combined with the water radical—implies something that has gone through a process of refinement and that therefore warrants close guarding in order to protect it.1 Jīng has three different aspects: prenatal jīng, derived from conception; post-natal jīng, derived from food and fluids after birth; and Kidney jīng, derived from the pre- and post-natal jīng. Therefore, the concept of jīng acknowledges the interplay of genes and environment, nowadays referred to as epigenetics.
Various disharmonies can result if any of these substances—qì, Blood, yīn, yáng, or jīng—becomes deficient. The pathogenic factor that can develop from qì deficiency depends on the type of qì deficiency involved. For example, Lung qì deficiency invites external pathogenic factors such as wind with either cold or heat to enter the Lung, as the Lung has a direct connection to the external environment (via the trachea), while Spleen qì deficiency invites internal dampness to accumulate, as the Spleen governs the transformation of nutrients into the basis for the production of qì and Blood and easily becomes excessively damp if it cannot process these nutrients properly (think of a forest lacking trees and soil to soak up rain). Blood deficiency invites internal wind to develop because the Blood does not fill the vessels (veins and arteries) as it should, allowing wind to blow within them (think of an open area like a field allowing no refuge from gusts of wind). Yīn deficiency invites heat and dryness to develop, as yīn pertains to cold and has a moistening capacity. However, one must differentiate this type of heat and dryness from the excess type. Yáng deficiency invites cold and dampness to develop, as yáng pertains to heat and function (versus form, which pertains to yīn), and part of function involves the transformation and transportation of fluids so that they do not accumulate. Again, one must differentiate this type of cold and dampness from the excess type.
These basic principles help determine the pattern underlying a given condition, which in turn determines the treatment. If the pattern is Spleen qì deficiency, the treatment may involve acupuncture points and/or herbs that tonify or replenish the Spleen qì. While Chinese medicine does not have its roots in modern science, it is very logical!
- Maciocia G. The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists. 2nd ed. Edinburgh: Churchill Livingstone/Elsevier; 2005.