The Eight Fundamental Patterns of Disharmony and the Pathology of Essential Substances, Organ Systems, and Channels
Chinese medicine texts do not discuss diseases or disorders as we know them in the West. You don’t catch an illness; you develop a disharmony.
In the beginning, that may make it difficult to understand how your Chinese medicine practitioner describes what ails you. For example, when you go for help because you have migraines, the practitioner may offer to treat you for disharmonies such as Stagnant Liver Qi, Liver Heat, Dampness, Deficient Qi and Xue, or Excess Yang. The Chinese diagnosis depends on the signs and symptoms that accompany your headache. The headache is viewed as a symptom and not the underlying disorder that requires treatment.
This chapter is designed to help you clarify the differences between Chinese and Western concepts of illness and disharmony. Therefore, I outline the Eight Fundamental Patterns of Disharmony, and I explain how Chinese medicine describes disturbances in Organ Systems, Channels, and Essential Substances.
WESTERN DISEASES AND ASSOCIATED CHINESE MEDICINE DISHARMONIES
In Chinese medicine, the diagnosis of a disharmony is highly individualized: Two people with the same Western ailment may not have the same disharmony. A disharmony—unlike a disease—is not defined only by its physical manifestations but also by how it influences the harmony of the Essential Substances, Organ Systems, and the mind/body/spirit as a whole.
DISEASES AND ASSOCIATED DISHARMONIES
This table offers examples of Western diseases and syndromes and associated Traditional Chinese Medicine patterns of disharmony.
Possible Chinese Medicine Patterns
Wind-Heat, Wind-Cold, Taiyang Stage Cold Disease, or Qi Stage Hot Disease
Shen Disturbance, Stagnant Liver Qi, or Deficient Heart Xue
Hyperactive Liver Yang, Deficient Kidney Yin, Deficient Qi and Xue, or Deficient Yin/Excess Yang
Summer Heat or Food Stagnation in Stomach
Liver/Gallbladder Damp-Heat, Spleen Damp-Heat, Spleen Damp-Cold, Stagnant Liver Qi, Deficient Spleen Qi, Deficient Xue, or Stagnant Xue
Deficient Kidney and Liver Yin, Deficient Kidney Yang, Deficient Liver Xue, or Deficient Kidney Yin and Yang
Irritable bowel syndrome
Deficient Spleen Qi, Dry Large Intestine, Deficient Spleen Yang, Heat in Large Intestine, Spleen Dampness, Stagnant Liver Qi, or Large Intestine Damp-Heat
Wind-Damp, Wind-Damp-Heat, Wind-Damp-Cold, Lung Phlegm-Heat, or Spleen Dampness
THE EIGHT FUNDAMENTAL PATTERNS
The Eight Fundamental Patterns, which are paired as Interior, Exterior; Heat, Cold; Excess, Deficiency; and Yin, Yang, describe the way in which the External Pernicious Influences and the Seven Emotions create disharmony in the mind/body/spirit. They also reveal the dynamic association of complementary yet opposed forces (Yin/Yang) within the body that have been thrown off balance by the presence of an influence or other disharmony.
Interior and Exterior patterns tell the practitioner where the disease resides.
Interior patterns of disharmony are indicated if the disharmony is chronic, produces changes in urine and stool, if there is discomfort or pain in the torso, and if there is no aversion to Cold or Wind.
Exterior patterns of disharmony often come on suddenly and are acute. Common signs include chills, fever, a dislike of cold, and an achy feeling overall.
Heat and Cold describe the activity of the body and the nature of the disease. Deficient Yang or an External Pernicious Cold Influence cause Cold Patterns. With Cold, everything slows down, and a person becomes withdrawn and sleeps in a curled-up position. Pain is relieved by warmth, bodily secretions are thin and clear, and there is a desire for warm liquids. Heat Patterns are caused by invasion of an External Pernicious Heat Influence, the depletion of Yin substances, as well as Excess Yang. With Heat, the body’s processes speed up, and a person may talk excessively, have a red face and a hot body, and prefer cold beverages. Secretions become thick, putrid, and dark.
Excess and Deficiency express the impact of the disharmony on the body’s resistance to disease (Normal Qi). With Deficiency, there is underactivity in the Organ System(s), weakness and tentative movement, a pale or ashen face, sweating, incontinence, shallow breathing, and pain that is relieved by pressure. Excess is associated with overactivity of bodily functions; heavy, forceful movements; a loud, full voice; heavy breathing; and pain increased by pressure.
You can enhance your ability to harmonize your mind/body/spirit by learning to “read” your body and to then associate what you observe with Chinese medicine’s way of describing balance and imbalance.
Take a minute to think over your medical history. Have you ever had an illness that you could identify as Excess? As Deficient? Can you recall having an illness that made you have an aversion to the cold? How about one in which cold did not bother you?
Yin and Yang encompass the other six Fundamental Patterns. Yin encompasses Interior, Cold, and Deficient. Yang encompasses Exterior, Heat, and Excess.
To determine Yin/Yang disharmony, the doctor searches for clues about whether your disharmony is Interior or Exterior, for clues about patterns of Heat and Cold, and for clues about patterns of Deficiency and Excess. These can be translated into clinical symptoms. Patterns of Heat and Excess, for example, show themselves in fast, forceful movements and pain that is intensified by pressure and soothed by cold. If these qualities are observed during your consultation, the doctor will then diagnose you with a Heat Excess Yang condition. (See chapter 5, page 76, for details.)
After we examine the effect of the Eight Pernicious Influences and the Seven Emotions and the patterns of disharmony, the next step is for us to explore the pathologies of the Essential Substances, Organ Systems, and Channels. This will demonstrate how these lead to disharmony, the many ways that disharmonies can manifest themselves, and what disharmonies do to the balance of the mind/body/spirit.
THE PATHOLOGY OF THE ESSENTIAL SUBSTANCES
Now we need to explore the pathology of the Essential Substances: Qi, Shen, Xue, Jing, and Jin-Ye. We’ll talk about disharmonies of each in turn.
When Qi moves harmoniously throughout the body, there is wholeness and good health. When Qi is disrupted, disharmony and illness can arise. Unbalanced Qi may become Excess, Rebellious, Deficient, or Sinking or Collapsed.
Excess Qi almost always collects and pools and becomes Stagnant. Excess Qi and Stagnant Qi are associated with blockages in the Channels and Organ Systems. These blockages interfere with the circulation of Qi and cause it to pool up, deprive some areas of the body, and flood other areas. The blockages may occur due to suppressed emotions, External Pernicious Influences, poor diet, or traumatic injury. Symptoms of Excess and Stagnant Qi are pain that worsens with pressure and is not easy to pinpoint, a feeling of fullness, and belching may relieve the pain. You may ache all over and have trouble sitting still. Often the pain waxes and wanes, and it is related to your emotional state.
When Stagnant Qi becomes more severe, it may actually reverse direction and become Rebellious Qi. This disharmony causes vomiting, belching, hiccups, coughing, asthma, liver disturbances, and fainting.
Deficient Qi occurs when bad diet, lack of exercise, respiration problems, and/or disharmony of the spirit and mind use up Qi and don’t replenish it. It can trigger spontaneous sweating, fatigue, weakness, lack of a desire to move, a weak voice, a pale but bright face, disharmony of a particular Organ System, and symptoms that become worse when you exert yourself. Deficient Qi is relatively Yin.
If the condition worsens, Deficient Qi may become Sinking or Collapsed Qi, which develops if Deficient Qi is left unchecked for a period of time. Sinking or Collapsed Qi is associated with organ prolapses (when it sags or falls down, such as a prolapsed uterus or bladder), dizziness, lack of stamina, and a bright, pale face.
Shen disharmonies are usually triggered by emotional disharmonies (an imbalance of the Seven Emotions). They are often accompanied by Stagnant Qi (often found in depression) and disharmony of the Heart and Liver Systems. With Deficient Heart Xue leading to Disturbed Shen, there may also be an underlying Deficient Spleen condition.
Disturbed Shen causes forgetfulness, disorientation, memory lapses, insomnia, and lackluster eyes. Extreme disharmony is associated with madness.
Lack of Shen is associated with a flat affect and inability to communicate. The classic phrase “The lights are on, but no one’s home,” describes this state.
To a Chinese medicine doctor, it makes no sense to heal the corporal body without healing the Shen. The physical and spiritual are inseparable parts of the human being. Disharmony in your Shen is often the first hint of developing disharmonies and disease. Feeling out of sorts, fatigued, blue, grumpy, and dispirited may indicate that an illness is developing. If the practitioner and the client intercede early, when your Shen is only mildly unbalanced, the development of full-blown disorders and disease may be forestalled for you.
Deficient Xue is associated with malnutrition, loss of blood, Deficient Spleen, depletion of Qi, and emotional stress. It can trigger insomnia, dry skin, dizziness, hair loss, palpitations, menstrual irregularities, and blurry vision. When there is Deficient Xue, your body doesn’t receive sufficient nourishment, often in one or more Organ Systems. When the whole body is Deficient in Xue, your skin has a pallor and is dry.
Excess or Stagnant Xue (also called Xue Stasis) is either caused by direct damage to the body’s tissues (such as falling while skateboarding) or is a result of Stagnant Qi, Deficient Xue, and Cold Obstructing Xue. Symptoms include sharp, stabbing, fixed pain, tumors, or swollen organs. Pregnancy is a unique time in which an increase in Xue and Jin-Ye is part of a normal healthy body and is not necessarily associated with an Excess disharmony.
We are born with Jing, and we can either deplete or replenish it throughout our lives. It always tends toward Deficiency. Deficient Jing symptoms include congenital disabilities, improper maturation, premature aging, sexual problems, and infertility. Disharmony of Jing is associated with Deficient Kidney.
Jin-Ye may be either Deficient or Excess. Deficient Jin-Ye is associated with dry lips, hair, eyes, and skin. Excess Jin-Ye is related to accumulation of fluids and produces edema and swelling.
THE EFFECTS OF DISHARMONY ON THE ORGAN SYSTEMS
When External and Internal Pernicious Influences create disharmony, they upset the balance within and between each Organ System and the various Channels. Each Organ System has its own patterns of disharmony and associated symptoms.
Disharmonies in the Zang (Yin) Organ Systems
Each of the Zang (Yin) Organ Systems—the Kidney System, Spleen System, Liver System, Lung System, Heart System, and Pericardium System—can experience disharmony.
When the Kidney System becomes imbalanced, it may have one of four patterns of disharmony: Deficient Yang, Deficient Qi, Deficient Yin, or Deficient Jing. Such disruptions are often associated with the emotional state of Fear and with the exercise of (or lack of ability to exercise) the will.
Deficient Kidney System Yang is associated with impotence, hearing loss, and incontinence. It is often associated with cold limbs, lack of Shen, swollen limbs, profuse clear urine, sore lower back, and loose teeth.
Deficient Kidney System Qi may trigger frequent urination, incontinence, bed-wetting, asthmatic breathing, and low back pain.
Deficient Kidney System Yin is associated with hot palms and soles, dry mouth, thirst, constipation, red cheeks, afternoon fevers, night sweats, insomnia, ringing in the ears, premature ejaculation, forgetfulness, and low back pain.
Deficient Kidney System Jing may lead to infertility, premature aging, retarded growth, lack or retardation of initial menstrual periods, and stiff joints.
Anya, a thirty-three-year-old woman who was unable to become pregnant, came to the clinic after having been given the hormones progestin and Clomid by her gynecologist, which made her ill. She hadn’t had her period for six years since going off birth control pills. As a teenager, she had painful periods associated with vomiting. Anya said she was cold most of the time.
I diagnosed her with Deficient Kidney Qi, and I treated her with Korean constitutional acupuncture, moxibustion, and herbs.
After several treatments, Anya reported she felt warmer. After two months, her pulse changed from slow, which is associated with Cold, to wiry, which is associated with Stagnant Qi. She became angry and depressed for a while, as her body went through a series of adjustments. We then had to change the treatment to regulate the Qi. At the same time, Anya started ovulating, and she began to have regular menstrual periods.
Twelve months after beginning treatment, Anya became pregnant, and she then gave birth to a healthy baby boy. Three years later, she came in again for some acupuncture support, and she had another healthy baby, this time a girl.
Spleen System disharmony in general manifests in loose stools, abdominal fullness and distention, nausea, and poor appetite. Anxiety and the inability to concentrate are also associated with Spleen System imbalance. Congenital weakness, malnutrition, chronic diseases, and excessive mental activity are caused by Interior Spleen disharmonies.
Deficient Spleen System Qi symptoms are loose stools, poor appetite, abdominal distention and pain, pale complexion, fatigue and lethargy, weight gain due to fluid retention, edema, shortness of breath, and a pale bright face.
Sinking Spleen System Qi is a subset of Deficient Spleen Qi. Muscular weakness and prolapsed organs—particularly of the uterus, bladder, and rectum—characterize this disharmony.
Spleen System Not Able to Govern the Xue, another subset of Deficient Spleen Qi, is associated with Xue circulating outside its proper pathways. The symptoms are chronic bleeding such as bloody stools, nosebleeds, varicose veins, hemorrhoids, excessive menstrual bleeding, non-menstrual uterine bleeding, easy bruising, and purpura—purple spotting indicative of bleeding beneath the skin.
One of the most persistent cases of Deficient Spleen Qi leading to Spleen Not Being Able to Govern the Xue was found in Esther, a young woman in her thirties. She had gone to her Western doctor for spotting between periods, easy bruising, varicose veins, excessively heavy periods, fatigue, and abdominal distention. He was unable to solve her problems.
I recommended that Esther switch to a diet with no raw foods and use moxibustion on certain acupuncture points to help reduce bleeding and eradicate the pain of the varicose veins. After six weeks, the spotting stopped, and her energy returned.
Deficient Spleen System Qi Leading to Dampness is a Deficiency condition leading to Excess.
Deficient Spleen System Yang develops from chronic Deficient Spleen Qi and Cold. The symptoms are the same as for Deficient Spleen Qi, plus clear copious urine, cold extremities and body, edema, weak digestion, and the desire for hot beverages.
Deficient Spleen System Yin appears in end-stage, life-threatening illness, such as AIDS and diabetes without the benefit of insulin. The symptoms include severe dryness, especially of the skin and lips, unquenchable thirst, loss of lean muscle mass, and severe wasting. Fever appears every afternoon and often in the evenings.
Externally caused Excess Spleen System patterns are often a result of an underlying Deficient Spleen System condition. They include Damp-Cold and Damp-Heat in the Spleen System.
• Damp-Cold occurs when Spleen Yang becomes trapped by exposure to excessive Dampness. This can happen if you are being drenched by rain, wade through cold water, or are exposed to damp and cold temperatures for a prolonged time. The associated symptoms are lack of appetite, watery stools, fatigue, no thirst, and a lusterless, yellow face.
• Damp-Heat occurs when External Dampness and Heat invade the body or when Deficient Spleen System Qi leads to Excess Damp and combines with Heat. It results in the slowing of bodily functions, and it causes an accumulation of fluids. The symptoms are lack of appetite, a feeling of fullness in the stomach, fatigue, and scanty, dark urine. Sometimes it is associated with thirst without the desire to drink, itchy skin, and fever. It may also be associated with acute viral hepatitis.
Repression of emotions is the most frequent cause of Liver System problems, which can manifest themselves in various patterns.
Stagnant Liver System Qi is the most common and usually the first Liver System disorder to appear when the system becomes imbalanced. It is an Excess condition, and it is relatively Yang. The main causes of Stagnant Liver Qi are emotional suppression and trauma. This leads to depression, uncomfortable feelings, and discomfort and pain between the ribs and in the chest, breast, and diaphragm. There may also be abdominal distention, restlessness, premenstrual congestion or distention, and a quick temper.
Stagnant Liver System Xue is characterized by fixed, sharp, stabbing pains and palpable masses. It often develops from Stagnant Liver Qi as well as Deficient Xue. In women, it is associated with missed menstrual periods, menstrual clotting and cramps, or severe trauma. In men, this pattern’s appearance is almost always the result of severe trauma or severe illness.
Liver System Yang (or Fire) Rising develops when Stagnant Liver System Qi becomes more congested and severe. It is associated with an accumulation of heat. Symptoms include headaches, eye pain, red eyes, sharp chest pain, scanty yellow urine, vertigo, nosebleeds, fits of anger, and dry stools. If left unchecked, this pattern can develop into a more serious condition—Interior Liver System Wind—that is associated with strokes, high fever with convulsions, paralysis, and loss of consciousness.
Deficient Liver System Xue is characterized by general dryness without any Heat symptoms. The symptoms are dryness of the eyes and nails, blurry vision, dizziness, muscle spasms, reduced menstrual periods, twitching, and a pale, lusterless face.
Deficient Liver System Yin includes all of the symptoms of Deficient Liver System Xue, plus red cheeks and eyes, restlessness, hot flashes, headaches, dizziness, numb limbs, night sweats, dry mouth and throat, ringing in the ears, and a quick temper.
Beatrice, a thirty-eight-year-old woman, in her first month of pregnancy, came for treatment of severe nausea that lasted all day and was uncontrolled by food intake. The symptoms were clear signs of Stagnant Liver Qi. In addition, Beatrice was an enthusiastic jogger. She used it to control stress, but she was unable to continue running. This only increased her disharmony.
Beatrice was put on a program of diet therapy and acupuncture. We asked her to eliminate chicken and turkey for the duration of the pregnancy because they congest Liver Qi and cause Qi Stagnation. She also received one acupuncture treatment and a short course of herbal therapy. Within two days, the nausea stopped. A month later, when she tried to eat chicken, her nausea returned briefly.
Damp-Heat of Liver System can occur when the diet is of poor quality and food is heavily spiced and fatty. It can also result from invasion of an Epidemic Factor, which is now known as viral hepatitis. The symptoms are discomfort in the top of the shoulders and rib cage, a bitter taste in the mouth, poor appetite, jaundice, fever and chills, and scanty, dark urine. Damp-Heat of the Liver System is associated with hepatitis and inflammation of the gallbladder.
Cold Obstructing the Liver Channel tends to be a male disharmony. Symptoms include a swollen scrotum and distention in the groin that is relieved by warmth.
Deficient Liver System Qi is rare. It creates Deficient Qi in the whole body, leading to a breakdown in joint function, general lethargy, shallow breathing, a lack of forcefulness in voice, and spontaneous sweating.
General symptoms of Lung System disharmonies include dry skin or skin eruptions, shortness of breath on exertion, cough, asthma, allergies, nose and throat disorders, low resistance to External Pernicious Influences, and reduced energy. Grief and the inability to let go at the proper time are also associated with the Lung System. There are also symptoms associated with specific types of Lung System disharmonies.
Exterior Excess Lung System patterns include the following.
Wind Cold is associated with chills, head and body aches, a lack of sweating, and frothy, thin, clear or white phlegm.
Wind Heat is associated with fever, slight chills, sore throat, some sweating, a coarse cough, and thick, yellow, sticky phlegm.
Wind Dryness is associated with a fever with chills, headache, dry throat and nose, and scant, dry phlegm.
Patterns of the Interior Excess Lung System include the following.
Dampness is generally triggered by a pre-existing lack of Spleen and Kidney function. It is associated with a full, high-pitched cough, chest inflammation, difficulty breathing when lying down, wheezing, copious phlegm, no thirst, and a swollen face.
Heat is generally triggered by overactive Liver and Heart Systems or the penetration of an External Pernicious Influence. When the Liver Invading the Lung causes it, the symptoms are dryness, pain in the chest or ribs, chest distention, and choking cough with thick green phlegm. When the Heart System causes it, the symptoms are insomnia, restlessness, cough, agitation, and confusion. When caused by an External Pernicious Influence, the symptoms are fever, sweating, cough, shortness of breath, and a rapid, superficial pulse.
Deficient Lung System patterns include the following.
Deficient Lung System Qi appears when the External Excess Pernicious Influence remains in the Lung and injures the Qi or when there are other Interior disharmonies that affect the Lung. The symptoms include a whispering voice, reluctance to speak, weak respiration, susceptibility to colds, weak cough, spontaneous sweating, shortness of breath that is worse with exertion, lack of warmth, and thin white phlegm.
Jon, a forty-year-old man who had suffered with asthma since he was a child, came to the clinic after a bout of mononucleosis, which had lowered his resistance to pollens and molds. He was fatigued, and his asthma had become so severe that he had to give up regular exercise and was constantly using two kinds of inhalers. Jon was coughing up white phlegm, and he was short of breath and quite lethargic.
I diagnosed Jon with Deficient Lung Qi with Dampness due to Deficient Spleen. His prescribed treatment included acupuncture and moxibustion to the Lung System points on his upper back along with other Organ System tonification points. For acute asthma attacks, I prescribed herbal pills for him to use as needed. For the underlying Deficiency, he was given a constitutional herbal formula.
“After a few months, I noticed that the herbs had reduced the phlegm,” Jon said. “I was able to wean myself off of the inhalers. During the last allergy season, which was a pretty intense one, I felt great.”
Deficient Lung System Yin is associated with Deficient Jin-Ye of the Lung. The causes are Internal Dryness, chronic Deficient Kidney Yin, and the External Pernicious Influence of Heat remaining in the Lung and causing Dryness. Symptoms are fatigue; weakness; dry cough with no phlegm; restlessness; insomnia; afternoon fevers; night sweats; dry mouth and throat; weak voice; red cheeks; varicose veins; a feverish sensation in the palms, soles, and chest (Five Centers Heat); and sometimes scanty phlegm, streaked with blood.
Have you ever experienced Deficient Spleen System Qi—fatigue, lethargy, abdominal distention, fluid retention, and a pale complexion? Or Excess Lung System Wind/Cold—chills, head and body aches, clear or white phlegm, and lack of sweating? In Western medicine, these symptoms may be associated with irritable bowel syndrome and influenza, respectively.
Deficiency patterns of the Heart System include the following.
Deficient Heart System Xue is often associated with Deficient Spleen Qi, because the Spleen is responsible for making the Xue. The symptoms include a pale lusterless face, dizziness, anxiety, confusion, excessive crying or laughing, and difficulty falling asleep.
Deficient Heart System Yin includes the symptoms of Deficient Heart Xue plus Heat symptoms, such as palpitations, agitation, insomnia, waking up at night, warm palms and soles, emotional lability, increased dreams, poor memory, night sweats, and physical and emotional hypersensitivity. It is often associated with Deficient Kidney Yin.
Deficient Heart System Qi is associated with the physiological problems of circulation, such as irregular pulse, arrhythmia, shortness of breath, fatigue, edema, and heart failure. Symptoms become worse with exercise.
Deficient Heart System Yang includes the symptoms of Deficient Heart Qi plus Cold symptoms, such as pain and distention in the chest, cold limbs and/or coldness throughout the whole body, purplish lips, and a slower, weaker heartbeat. It often appears with Deficient Kidney Yang and Deficient Lung Qi.
A subset of Deficient Heart System Yang is Collapse of Yang, in which Yin and Yang can separate, and the person is near death. Symptoms include profuse sweating, extremely cold limbs, purple lips, and confusion.
Harold, a sixty-eight-year-old man with congestive heart failure and arrhythmia, came into the clinic because his cardiologist had not been able to do anything to stabilize his irregular heartbeat or shortness of breath. He also had severe fatigue and swelling in the ankles. Harold was diagnosed as having Deficient Heart Qi, and we started him on a once-a-week program of acupuncture, moxibustion, and leg and foot massage to stabilize his heartbeat and reduce swelling. In addition, he was on crutches because he needed a hip replacement, which made his treatment more difficult. The constant pain and physical strain aggravated his Deficient Qi.
After six months of therapy, the swelling had gone away, and Harold’s Western doctor reported that there had been no further deterioration of his congestive heart problem.
Patterns diagnosed as Excess include the following.
Excess Heart System Fire is caused by extreme emotional excitement, sunstroke, or excess consumption of hot, pungent foods, drinks, or herbs. Symptoms include insomnia, restlessness, red face, inflammation or soreness of the tongue and mouth, thirst, and scanty, burning urine with blood.
Excess Phlegm Obstructing Heart System or Misting of the Orifices may arise from Spleen Dampness or simply from a general internal lack of proper fluid circulation. The symptoms include Shen disharmony, aberrations of consciousness, coma or semi-coma (in Chinese medicine it’s called “dumb like a wooden chicken”), excessive weeping or laughing, depression or dullness, mania, incoherent speech, muttering to oneself, drooling, and predisposition to stroke.
There are two types of Phlegm: Cold and Hot. Excess Cold Phlegm symptoms are a withdrawn, inward manner, muttering, staring at walls, and sudden blackouts. Excess Hot Phlegm symptoms include hyperactivity, agitation, aggression, incessant talking, and violent lashing-out behavior.
Heart System Stagnant Qi is associated with a stuffy chest and difficulty breathing. If it is the result of Stagnant Phlegm, there are the same symptoms plus excess phlegm expectoration, abdominal fullness, nausea, and vomiting.
Heart System Stagnant Xue is associated with angina and pectoral pain, and it results from Deficient Heart Qi or Deficient Heart Yang. Symptoms include palpitations, shortness of breath, irregular pulse, fixed stabbing pain, and a purple face.
Only one major pattern is associated with the Pericardium System, and it is not an independent pattern: Excess Phlegm Obstructing Heart System or Misting of the Orifices (see page 66).
Disharmonies in the Fu (Yang) Organ Systems
Each of the Fu (Yang) Organ Systems—the Stomach System, Triple Burner System, Gallbladder System, Small Intestine System, Large Intestine System, and Urinary Bladder System—also can experience disharmony.
The patterns of disharmony that may afflict the Stomach include the following.
Food Retention in Stomach System is due to irregular eating habits, overeating, or eating hard-to-digest foods. Retention blocks passage of Qi in the abdomen, triggering distention, fullness, and pain in the abdomen; foul belching; regurgitation; anorexia; vomiting; and difficult bowel movements.
Retention of Fluid in Stomach System Due to Cold is associated with a constitutional Deficiency of Stomach and Spleen Qi, complicated by the invasion of the External Pernicious Influence of Cold. Eating too much cold or raw food can trigger this pattern. Symptoms include fullness and pain in the stomach relieved by warmth, reflux of clear fluid, or vomiting after eating. This pattern is associated with prolonged disease.
Hyperactivity of Fire in Stomach System (also called Stomach Heat) may arise from eating too many hot, fatty foods and from depression. The symptoms include burning and pain in the stomach, thirst for cold beverages, bleeding gums, and scant, yellow urine. It’s often associated with stomach ulcers, excessive appetite, constipation, and mouth ulcers.
Deficient Stomach System Yin occurs when hyperactivity of Fire in the Stomach consumes the Stomach Yin or when Stomach Jin-Ye dries up because of persistent Heat due to a prolonged disease with fever. Symptoms include burning stomach pain, hunger without appetite, dry heaves, hiccups, dry mouth and throat, constipation, and an empty, uncomfortable feeling in the stomach.
TRIPLE BURNER SYSTEM
One theory of disharmonies in the Triple Burner identifies the External Pernicious Influence of Damp Heat as the cause of disease.
Damp Heat in the Upper Burner can happen when Damp invades the body and stays in the muscles and upper body, damaging Spleen Qi. Symptoms include extreme dislike of cold, mild or no fever, feeling like there is a soft band around the head, heavy arms and legs, a feeling that an elephant is standing on your chest, lack of thirst, distended abdomen, noisy bowels, loose stools, and lack of facial expression.
Damp Heat in the Middle Burner can arise from the External Pernicious Influences of Summer Heat and Damp. It can also occur when Damp Heat from the Upper Burner sinks into the Middle Burner. Poor nutrition is also a trigger. Symptoms are similar to those for invasion of Damp and Heat in the Stomach and Spleen: heavy arms, legs, and trunk; full, distended chest and stomach; nausea; vomiting; anorexia; loose but difficult stools; dark urine; feeling thirsty with little desire to drink; and a fever that can’t be felt at the first touch of the skin but that becomes evident after the skin is felt for a rather long time. In severe cases, the Shen is disturbed, and mental abilities are affected.
Damp Heat in the Lower Burner affects the Intestine Systems and Urinary Bladder System. It is associated with difficulties with urination and elimination. Symptoms include constipation, thirstiness with little inclination to drink, and a hard, distended lower abdomen.
THE GALLBLADDER SYSTEM
Disharmony with the Gallbladder System manifests similar to disharmony with the Liver System, specifically Liver Damp-Heat. The symptoms associated with that pattern include discomfort in the chest, a bitter taste in the mouth, poor appetite, fever and chills, jaundice, and scanty, dark urine. General Gallbladder dysfunction can cause you to become angry and impulsive, along with an inability to make up your mind and exhibiting general weakness of character.
SMALL INTESTINE SYSTEM
Pain Due to Disturbance of Small Intestine System Qi may result from poor nutrition, carrying overly heavy loads, and wearing clothing that’s inappropriate for the weather, making you vulnerable to External Pernicious Influences. Symptoms include acute lower abdominal pain, abdominal distention, noisy bowels, and a heavy, downward-pushing sensation in the testes accompanied by lower back pain.
Heart Fire Moving to the Small Intestine System includes the symptoms of Heart Fire (see “Excess Heart System Fire” on page 66), plus irritability, cold sores, sore throat, frequent painful urination, and a full feeling in your lower abdomen.
LARGE INTESTINE SYSTEM
Large Intestine System Damp-Heat is sometimes called Damp-Heat Dysentery. This pattern often occurs in hot climates in the summer and autumn when the External Pernicious Influences of Summer Heat, Dampness, and Toxic Heat invade the Stomach and Intestines. It also arises when a person eats too much raw, cold food, or unsanitary food or eats at irregular times. Symptoms include abdominal pain, a feeling of urgency along with difficult bowel movements, watery diarrhea, bloody stools with mucus, burning anus, and dark-colored urine. Sometimes it is accompanied by fever and thirst.
Consumption of Jin-Ye of Large Intestine System is often seen in the elderly, after childbirth, and in the later stages of disease with fever. Symptoms include constipation, dry stools, and dry mouth and throat.
Intestinal Abscess is known in Western medicine as appendicitis. The symptoms include acute pain in the lower right quadrant, aversion to touch, and possibly a fever.
URINARY BLADDER SYSTEM
Damp Heat in the Urinary Bladder System is the main pattern of disharmony associated with the Urinary Bladder System. This pattern can arise from the invasion of External Pernicious Damp and Heat or from a diet of excessively hot, greasy, and sweet foods. Symptoms include painful, frequent, urgent urination; cloudy, dark urine; back pain; blood in the urine; feeling of fullness in the lower abdomen; burning pain in the urethra; and difficult urination.
Disharmonies of the Extraordinary Organs
Each of the Extraordinary Organs—the Marrow and Brain and Uterus—also can experience disharmony.
Marrow and Brain: When the Marrow is Deficient, the Brain becomes unbalanced. Symptoms include ringing in the ears, vertigo, shakiness, poor eyesight, and difficulty thinking. Weak bones and retarded bone growth can also occur.
Uterus: If there is Deficient Heart Xue, the Heart Qi does not descend to the Uterus, and the menstrual periods may become irregular or stop altogether. Failure of Kidney Jing to descend to the Uterus can result in infertility, irregular periods, or complete cessation of menstruation. Disturbances of the Extraordinary Channels, such as the Chong Mai and Ren Mai (which arise in the Uterus), can also cause Uterus disharmonies.
Because of the interdependence of the Uterus on other Organ Systems and Channels, treatment for all menstrual and reproductive problems is through the Liver, Kidney, Spleen, or Heart Organ System and related Primary and Extraordinary Channels.
THE EFFECT OF DISHARMONY ON THE CHANNELS
Channels are affected by disharmonies that are distinct from those afflicting Organ Systems and the Essential Substances. Some practitioners who solely practice acupuncture will primarily diagnose and devise treatments through the diagnosis of Channel disharmonies.
When a pathogen causes disharmony in a Channel, the acupuncture points become tender to the touch. The tender spots are useful in diagnosis because they clue the practitioner to the location and nature of the imbalance along the Channel and in the associated Organ System(s).
The following are the pathologies identified by the TCM school of thought that correspond to the Twelve Primary Channels, Eight Extraordinary Channels, and Fifteen Collaterals. (Not all schools of acupuncture accept these indications for diagnosis and treatment, however.) Let’s talk about each in turn.
Pathologies of the Twelve Primary Channels
Each of the Twelve Primary Channels is associated with distinct disharmonies. These disharmonies, which arise when the flow of Qi is disrupted, create symptoms in the part of the body through which the Channel flows. Each Channel has exterior and interior pathways. The exterior pathways are relatively near the surface of the skin, and they contain the acupuncture points. The interior pathways are relatively deep, and they cannot be needled directly.
Lung Channel of Hand—Taiyin: Symptoms associated with disharmonies of the Lung Channel include cough, asthmatic breathing, coughing up blood, congested and sore throat, the feeling that a baby elephant is standing on your chest, pain in the neck, pain in the upper chest, and pain running along the lower section of the inside of the arm.
The Large Intestine Channel of Hand—Yangming: Symptoms associated with disharmonies of the Large Intestine Channel include nosebleeds, runny nose, toothaches, congested and sore throat, neck pain, pain in the front of the shoulder and the front edge of the arm, noisy bowels, abdominal pain, diarrhea, and dysentery.
The Stomach Channel of Foot—Yangming: Symptoms associated with disharmonies of the Stomach Channel include noisy bowels, distended abdomen, edema, vomiting and stomach pain, hunger, bloody nose, a droopy mouth, congested and sore throat, chest and abdominal pain, pain along the outside of the leg, fever, and mania.
After a decade of performing surgery, Sonia developed chronic pain in her right wrist. An orthopedist diagnosed it as repetitive use syndrome, and Sonia was told her options were to have surgery or to suffer progressive nerve damage.
“I’m a Western doctor, through and through,” Sonia said. “But I figured I had nothing to lose by trying acupuncture. I never thought it would really work, but I was desperate.”
Sonia came to the clinic from out of town, saying she could only stick around for one treatment. She was diagnosed with an injury to the Large Intestine Channel due to trauma. I suggested that she get a wrist splint and make changes in her surgical schedule. I gave her an herbal trauma salve to apply to her wrist daily. Sonia then had a thirty-minute acupuncture treatment with electro-stimulation and moxibustion on her wrist.
A week later, Sonia called the clinic to report that she was 80 to 90 percent better—after only one treatment. Six weeks later, she received another treatment, and after that she reported a 95 percent improvement. Sonia vowed that every time she came to San Francisco, she’d get a tune-up treatment. She also learned how to use self-care to avoid re-injury.
The Spleen Channel of Foot—Taiyin: Symptoms associated with disharmonies of the Spleen Channel include belching, vomiting, stomach pain, distended abdomen, loose stools, jaundice, overall feeling of lethargy and heaviness, inflexibility and pain where the tongue attaches to the mouth, and swelling and cold along the inside of the knee and thigh.
The Heart Channel of Hand—Shaoyin: Symptoms associated with disharmonies of the Heart Channel include heart pain, palpitations, chest and rib pain, insomnia, night sweats, dry throat and thirst, hot palms, and pain along the inside of the upper arm.
Small Intestine Channel of Hand—Taiyang: Symptoms associated with disharmonies of the Small Intestine Channel include deafness, yellowing of the whites of the eyes, sore throat, swollen cheeks and throat, pain along the back edge of the shoulder and arm, and lower abdomen distention and pain.
Urinary Bladder Channel of Foot—Taiyang: Symptoms associated with disharmonies of the Urinary Bladder Channel include bed-wetting or trouble urinating, depression and mania, blocked and stuffy nose, teary eyes (particularly in the wind), runny nose, eye pain, bloody nose, headache, and pain along the Urinary Bladder Channel from the nape of the neck to the middle of the backs of the legs.
The Kidney Channel of Foot—Shaoyin: Symptoms associated with disharmonies of the Kidney Channel include bed-wetting, too-frequent urination, nocturnal emission, impotence, asthmatic breathing, coughing up blood, dry tongue, congested and sore throat, edema, lower back pain, irregular periods, pain along the back edges of the insides of the thighs, weak legs, and hot soles of the feet.
Pericardium Channel of Hand—Jueyin: Symptoms associated with disharmonies of the Pericardium Channel include heart pain, palpitations, tight chest and trouble breathing, emotional restlessness, depression and mania, flush face, swelling in the armpits, arm spasms, and hot palms.
The Triple Burner (Sanjiao) of Hand—Shaoyang: Symptoms associated with disharmonies of the Triple Burner Channel include distended abdomen, bed-wetting, painful urination, deafness, ringing in the ears, pain at the outer edge of the eyes, swollen cheeks, congested and sore throat, pain behind the ears, shoulder pain, and pain in the backs of the arms and elbows.
The Gallbladder Channel of Foot—Shaoyang: Symptoms associated with disharmonies of the Gallbladder Channel include headache, pain at the outer edges of the eyes, jaw pain, blurry vision, a bitter taste in the mouth, swelling and pain in the upper chest and armpits, pain along the outside of the chest and rib area, and pain in the outsides of the thighs and lower legs.
The Liver Channel of Foot—Jueyin: Symptoms associated with disharmonies of the Jueyin Channel include low back pain, fullness in the chest, pain in the lower epigastric area, hernia, pain on the top of the head, dry throat, hiccups, bed-wetting, painful urination, and mental disharmony.
Pathologies of the Eight Extraordinary Channels
These Channels are closely related to the Liver System, Kidney System, Uterus, and Brain and Marrow, and they serve to connect the Twelve Primary Channels and regulate their Qi and Xue. The pathological manifestations listed here are based on the physiological functions and the area of each Channel’s influence. You can work with them during self-massage and acupressure. These Channels have a big role in disharmonies of women’s reproductive cycles.
Du Mai (Governing Channel): Symptoms associated with disharmonies of the Du Mai include stiff, painful spine, severe muscle spasm causing arching of the back, headache, and epilepsy.
Ren Mai (Conception Channel): Symptoms associated with disharmonies of the Ren Mai include vaginal discharge, irregular periods, infertility in women and men, hernia, nocturnal emission, bed-wetting, urinary retention, stomach pain, lower abdominal pain, and genital pain.
Chong Mai (Penetrating Channel): Symptoms associated with disharmonies of the Chong Mai include spasm and pain in the abdomen, irregular periods, asthmatic breathing, infertility in women and men, and in my observations, emotional and physical problems arising from various forms of abuse.
Dai Mai (Belt Channel): Symptoms associated with disharmonies of the Dai Mai include weak lower back, vaginal discharge, uterine prolapse, trouble moving the hips and legs, weakness and muscular atrophy of lower limbs, and an unaccountable feeling like one is sitting in water.
Yangqiao Mai (Yang Heel Channel): Symptoms associated with disharmonies of the Yangqiao Mai include insomnia, redness and pain at the inside corners of the eyes, pain in the back and lower back, turning out of the foot, spasm of the lower limbs, and epilepsy.
Yinqiao Mai (Yin Heel Channel): Symptoms associated with disharmonies of the Yinqiao Mai include epilepsy, lethargy, leg spasms, turning in of the foot, lower abdomen and lower back pain, and hip pain that causes referred pain in the pubic region.
Yangwei Mai (Yang Linking Channel): Symptoms associated with disharmonies of the Yangwei Mai include External symptoms, such as chills and fever.
Yinwei Mai (Yin Linking Channel): Symptoms associated with disharmonies of the Yinwei Mai include Internal symptoms, such as chest and heart pain and stomachaches.
Pathologies of the Fifteen Collaterals
The Fifteen Collaterals branch off of the Primary Channels with which they are associated. They strengthen the relationships between the paired Channels, and they move Qi and Xue to organs and tissue in the body. When disharmony occurs, the Collaterals compound the symptoms of the Primary Channel with which they are associated.
Collateral of the Lung Channel of Hand—Taiyin: Symptoms associated with disharmonies of this Channel include hot palms and wrists, shortness of breath, bed-wetting, and frequent urination.
Collateral of the Large Intestine Channel of Hand—Yangming: Symptoms associated with disharmonies of this Channel include toothache, deafness, cold teeth, and a stifling feeling in the chest and diaphragm.
Collateral of the Stomach Channel of Foot—Yangming: Symptoms associated with disharmonies of this Channel include depression and mania, atrophy of muscles and weakness in the lower legs, congested and sore throat, and sudden attacks of hoarseness.
Collateral of the Spleen Channel of Foot—Taiyin: Symptoms associated with disharmonies of this Channel include spasm of the abdomen, vomiting, and diarrhea.
Collateral of the Heart Channel of Hand—Shaoyin: Symptoms associated with disharmonies of this Channel include chest and diaphragm fullness and aphasia.
Collateral of the Small Intestine Channel of Hand—Taiyang: Symptoms associated with disharmonies of this Channel include weak joints, muscular atrophy, impaired movement in the elbows, and skin warts.
Collateral of the Urinary Bladder Channel of Foot—Taiyang: Symptoms associated with disharmonies of this Channel include stuffed-up sinuses, runny nose, headache, back pain, and bloody nose.
Collateral of the Kidney Channel of Foot—Shaoyin: Symptoms associated with disharmonies of this Channel include low back pain, urinary retention, mental restlessness, and a stifling sensation in the chest.
Collateral of the Pericardium Channel of Hand—Jueyin: Symptoms associated with disharmonies of this Channel include (physical) heart pain and mental restlessness.
Collateral of the Triple Burner (Sanjiao) of Hand—Shaoyang: Symptoms associated with this Channel include flaccidity or spasm on the insides of the elbows.
Collateral of the Gallbladder Channel of Foot—Shaoyang: Symptoms associated with this Channel include cold feet, paralysis of the legs, and the inability to stand upright.
Collateral of the Liver Channel of Foot—Jueyin: Symptoms associated with this Channel include constant erection, itching in the pubic area, swollen testes, and hernia.
Collateral of the Ren Mai: Symptoms associated with this Channel include abdominal pain that exerts an outward pressure and itching of the abdominal skin.
Collateral of the Du Mai: Symptoms associated with this Channel include stiff spine, heavy sensation in the head, and head tremor.
The Great Collateral of the Spleen: Symptoms associated with this Channel include overall achiness, muscle pain, and weakness in the arms and leg joints.