The causes of diseases from acupuncture/TCM’s point of view.

When acupuncture/TCM was developed about 2000 years ago, there were no advanced equipment to observe bacteria and viruses, nor were there machines to perform laboratory tests. Yet, people would get sick as we do today. So ancient doctors tried to understand diseases with natural phenomena. Let’s take a look at how etiology is like in acupuncture/TCM.

In acupuncture/TCM, there are 6 categories of the cause of diseases.

 六淫 – Six Evil (6 pathogens) : Wind, Cold, Dampness, Dryness, Summer-heat, Fire(heat)

The 6 evils are natural phenomena of the changes of weather under normal circumstances, they are only evil when the changes happen abnormally (a cold spell in spring or an Indian summer). The abnormal changes plus a weakened immune can cause sickness. The 6 evils can affect the body solely, or combined; they can invade a person from the external environment, also can generate within the body.

风–Wind

• External Wind invades the body through the skin and pores, and it often combines with the other 5 pathogenic factors. When there is strong wind blowing, one should cover up, especially if one just took a shower or exercised, the pores are open, which allows wind to invade. For example, Common cold is called wind-cold in acupuncture/TCM.
• Internal Wind is generated by other pathogenic factors. Convulsion that happens with fever(热极生风-extreme heat generating wind), essential tremors(血虚生风-blood deficiency causing wind), and seizures(肝阳化风), are all under pathogenic wind category

寒–Cold

• External Cold can invade the body in two ways. It can invade the body from the environment, such as commom cold (wind-cold), or gets into the body with cold food/drinks. Many females with menstraul cramps find warmth helps relieve the pain, this is thought to be due to ingestion of too much cold food/drink, such as ice water.
• Internal Cold is due to the body’s lack of Yang. For example, chronic loose stool/diarrhea is due to Yang deficiency of the stomach/spleen. Sometimes external Cold can damage the Yang and transform into internal cold.

暑–Summer Heat

• Summer heat only invades the body externally. It is the same concept of heat stroke in western medicine.

湿–Damp

• External damp comes from the environment, where there is heavy moisture, such as a house by a river. Some types of skin diseases such as cellulitis are categorized under damp-toxic in acupuncture/TCM. (bacteria grow much easier in a damp environment, which could cause skin infection)
• Internal damp often caused by improper diet. When a person consumes too much heavy food, such as cheese, fried food, etc., there will be internal damp accumulates. Symptoms include stick stool with constipation, etc. (Obesity is a type of damp disease)

燥–Dryness

• Dryness is an external evil. It often invades the body in fall and winter, especially in northern part of a country, such as Minnesota. Dryness attacks the respiratory system. This correlates with western medical concept: when the mucosa of the nasal cavity is dry, it loses it defensive mechanism, as a result we get upper respiratory track infection, aka common cold.

火–Fire

• External fire invades the body from the environment. Viral/bacterial infections are under external fire category. (Infections cause localized swelling, redness, warmth, even fever)
• Internal fire often caused by emotional/Yin-Yang imbalance. Stress, anger or over insomnia can generate internal fire.
• Fire can also be generated when the other 5 pathogens accumulate. For example, common cold is caused by the invasion of wind-cold, and when wind-cold accumulate to certain level, it turns into fire, results in a fever.

How does acupuncturists/TCM practitioners make diagnoses?

Have you ever wondered how acupuncturists choose points to needle? Is it just random selection or is there some methods behind it?

Every treatment starts with a diagnosis. Unlike modern medicine, aka western medicine that uses diagnostic imagining, such as X-ray, and lab tests to make diagnoses, TCM has its own diagnostic procedures.

TCM’s diagnoses consist 4 approaches: 望-observing, 闻-listening/smelling, 问-inquiring, 切-palpating

• 望-observing: What is observed is a patient’s overall appearance, such as complexion, gait, body type, and the tongue. Complexion can tell a person’s current bodily condition. For example, pale complexion indicates the patient is lack of Qi, or energy, which can be seen on patients with anemia.

Observation of the tongue is an important part of TCM diagnosis. What are observed are the colors, shapes, coating and size of the tongue.

• 闻-listening/smelling: What a practitioner listens and smells is a patient’s voice, breathing pattern and breath. A weak voice or shallow breathing indicates a deficiency pattern, which is often seen in heart and lung diseases. A bad breath without dental issue indicates a digestive condition.

• 问-inquiring: There are 10 categories of questions asked.

1. Natural body temperature: A warm body temperature indicates a heat/excess pattern, often seen in menopause, a cold body temperature indicates a cold/deficiency pattern, such as eating disorders.
2. Sweating: Sweating on light exertion indicates a deficiency pattern, often Qi deficiency, such as in heart and lung diseases, or chronic fatigue syndrome. Running a fever without sweating indicates the condition is at its peak, which is often seen in fever caused by a cold.
3. Head and overall body: Questions including headaches (type, location, manifestation) and musculoskeletal aches/pain.
4. Bowel movements and urination: Times of bowel movements within a day, constipation (dry stool or feeling lack of movement)/diarrhea. Is there pain/urgency with urination, incontinence while laughing, coughing or sneezing,etc.
5. Digestion: How is the appetite, the pattern of hunger (barely hungry-stomach cold or always hungry-stomach heat). Bloating, belching, acid reflex, etc.
6. Chest: Is there heart palpitation, chest oppression/pain, shortness of breath, etc.
7. Vision and hearing: Are there floaters in vision?(a liver pattern), is there ringing in the ear or diminished hearing/sudden deafness?(a kidney or kidney/liver dual pattern)
8. Thirst: Are the mouth and throat often get dry even with adequate water intake? (a dry condition, often the lung, which is seen in smokers, also could be other heat patterns)
9. Past medical history
10. Overall life: This includes life style, changes (sudden or gradual) in one’s life

• 切-palpating : What is palpated is the pulse on the radial side of the wrists. There 3 positions on each wrist to asses, each position represents 2 organs on a upper and deep levels. There are 28 types of pulsations, and they are categorized by speed, forcefulness, pulsating patterns and depth.

Acupuncture and Meridians, continued

Before we dive in further in meridians, we need to take a look at the Five-Element theory first, because it is deeply related with the meridians.

let’s start with what the Five-Element theory is.

The Five-Element theory is one of the fundamental theories of Traditional Chinese Medicine philosophy. It thinks that the entire universe and everything it contains consist of 5 elements, which are Metal, Water, Earth, Wood, and Fire. These five elements form two types of sequences – the generating sequence and the restrain sequences.

In the restrain sequence,
• Fire restrain Metal (fire melts metals)
• Metal restrain Wood (metal tools can cut wood)
• Wood restrain Earth (imagine trees’ roots grasping earth)
• Earth restrain Water (imagine earth being dams)
• Water restrain Fire (water extinguishes fire)

With the above being said, what is the role of the Five-Element theory in acupuncture?

In acupuncture, organs are assigned with those 5 elements.
• Fire: Heart and Small Intestines
• Metal: Lungs and Large Intestines
• Wood: Liver and Gallbladder
• Earth: Stomach and Spleen(pancreas)
• Water: Kidneys and Urinary Bladder

Now let’s use a couple of examples to see how this works in a practical way.
• Control sequence: Fire-Heart(hyper emotions, such as anxiousness ) restrains Metal-Lungs(results in irregular breathing, such as hyperventilation)
• Generate sequence: Fire-Heart(Happy emotions) generates Earth-stomach(results in good appetite)
The examples above is a type of diagnostic modalities often used in acupuncture to determine the causes of patients’ current conditions.

The Five-Element theory goes hand by hand with the meridians, I will explain more in future blogs. Stay toned!

Yin & Yang Theory in Acupuncture
Yin Yang – Great ultimate
Yin & Yang theory is one of the fundamental building blocks of acupuncture.
According to this theory, Yin and Yang are the sole building blocks of the universe and everything it contains, including the human beings.

• Yin and Yang are interdependent
• Yin and Yang are opposite
• Yin and Yang are mutually consuming and supporting
• Yin and Yang transform into each other

What acupuncture needs to do for Yin and Yang?
Since everything is built upon Yin and Yang, everything contains both Yin and Yang. There needs to be a balance and harmony between the two. For example, the heart’s Yin is what keeps us calm and the heart’s Yang is what keeps us energetic. When there is a lack of heart Yin due to too much heart Yang, a person may be hyped up all the time, and a lack of heart Yang could result in lethargy. With acupuncture, the point HT7(神门) on the heart meridian can be needled to tonify heart Yin, and the point UB15(心腧) can be needled to tonify heart Yang.

HT7 Shen Men, 神门   |   UB15 Xin Shu, 心腧