TCM Theory continued…

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). 

inter-transformation of yin and yang in medicine

in medicine also, yin and yang transform into one another, but only when conditions are right. the right moment determined by internal qualities of the given situation or phenomenon. in clinical practice, the above principle is important. disease is prevented by achievement of balance in lifestyle

• i.e., excessive work (yang) without rest leads to deficiency (yin) of energy. 
• i.e., excessive consumption of cold food (yin) leads to deficiency of body’s yang energy. 
• i.e., smoking (= putting heat (yang) into lungs) leads to deficiency of yin of lungs (and eventually kidneys) 

the principle is observable in pathological changes seen in disease,

• i.e., exterior cold (cold weather) can invade body and can change to heat (sore throat). 
• i.e., deficiency of yang of excess interior dampness (yin). 

five element relationships

it was observed over the years that the five elements relate to each other in different ways.

• sheng cycle (generating sequence)
• ko cycle (controlling sequence)
• destructive cycle (overacting sequence)
• anti ko cycle (insulting sequence).

sheng cycle

the generating gequence or mother-child relationshipAs in the cycle of the seasons, each element generates another, i.e., one element is the “mother” of the next.

naturally, therefore, each element is generated by another: fire is the child of wood, earth is the child of fire, etc. in nature, we see this in the seasonal changes: winter transforms into spring, spring changes into summer.

ko cycle

controlling sequence or father-child relationship.

each element is said to control, check, or regulate another.

1. wood controls earth.
2. fire controls metal.
3. earth controls water.
4. metal controls wood.
5. water controls fire.

each element is of course then controlled by another.

earth is controlled by wood, wood is controlled by metal, etc.

this cycle ensures that a balance is maintained between elements.  the “father- child” symbolism relates to traditional family roles, where the father was the patriarchal head of the household. the mother, by comparison, is seen as the creative and nurturing force.

destructive cycle

overacting sequence.

this is the same as the ko cycle, but in this sequence, one element is said to “over-control” or “destroy” another, causing the controlled element to become deficient. this happens when balance breaks down so that one element becomes excessive in relationship to another.

e.g. an excess of wood energy will over-control earth, causing earth to become deficient.

anti-ko cycle

insulting sequence.

this cycle is the reverse of the ko cycle or controlling sequence. in the nsulting sequence, the element that should be controlled becomes imbalanced and excessive, and controls the element that normally controls it.

example: instead of metal controlling wood, if wood becomes excessive, it can “insult” metal, causing it to become imbalanced. this is akin to the child rebelling and insulting or trying to discipline its father.

four possible pathologies

1. element in excess overacts on another (overacting sequence).
2. element in deficiency insulted by another (insulting sequence).
3. element in excess drains from mother (pathological sheng cycle).
4. element in deficiency fails to nourish child (pathological sheng cycle).

what is Qi? (chi)

it has been translated as “vital energy”, “life force”, or “breath” but no single english word will suffice.this is because of the nature of Qi. it can have different manifestations in different situations.

Qi can even be material and is said to “condense” into matter. this is what occurs according to TCM, when a child is conceived and a human being develops. Qi condenses to form a material being. In pathology, when Qi flow slows down and stagnates, masses, lumps or tumors can appear.

the concept of Qi representing a continuum between immaterial and material is not so far from the concepts of matter and energy in modern physics. matter is not “solid”, but its particles are vibrating at various speeds; the faster they vibrate, the more rarefied the matter becomes. in the same way, the manifestations of Qi cover the continuum of matter-energy.

characters for Qi mean “vapor” or “steam” and “uncooked rice”.

this illustrates that Qi can appear in different states ranging from more immaterial like steam to dense and material like rice.

it also illustrates a central idea in TCM, that the major source of Qi is transformed from the food that we put into our bodies.

overview of Qi in traditional chinese medicine (TCM)

ancient philosophers saw human Qi as the result of the interaction between the Qi of heaven (yang) and earth (yin). they stressed the interaction between a human being’s Qi and the forces of nature.

TCM, following these ancient philosophies, stresses the relationship between human beings and natural forces, both cosmic and local (the environment).

1. we are under the influence of natural rhythms and cycles, (lunar, circadian and solar cycles) with which we should strive to stay in balance in order to maintain health.

2. we are susceptible to pathological conditions resulting from attack by pathological climatological energies (wind, cold, damp, heat, summer heat and dryness).

3. Qi manifests both on the physical an spiritual/psychological level.

4. Qi is in a constant state of flux and its immaterial/material state constantly varies. when Qi condenses, it accumulates to form physical shape.

example: poor circulation of Qi in the body can result in condensation of Qi to form lumps, masses or tumors.

1. although there are many types of Qi in human beings, all these types are ultimately one Qi, manifesting in different forms.

2. Qi changes form according to its locality and function.

two major uses of the word Qi in TCM

1. Qi is a refined substance produced by the internal organs, to nourish the body, mind and spirit (its form varies according to its location and function).

2. the word Qi is also used to mean the complex of functional activities of a given internal organ.

example: when we say spleen Qi, we mean the complex of the functional activities of the spleen.

example: defensive Qi circulates primarily in the exterior to protect the body. nutritive Qi circulates in the Interior, to nourish the organs. these two are different manifestations of Qi. when either is unable to perform its functions, specific pathological symptoms will result.

the causes of illness

the six evils (external causes)

wind, cold, damp, heat, summer heat, dryness.

the seven emotions (internal causes)

anger, fear, fright, grief, joy, worry and pensiveness.