TCM Week 1

Question 1

Causes of disease

Answer 1

TCM focuses on disharmony, but identifying the cause of disharmony is important
Eg. We see a patient with loose stools,no appetite and fatigue. We think of Spleen Qi Deficiency and consider treatment for that diagnosis.
But SP Qi Deficiency is not the cause of the disharmony, but merely an expression of the disharmony
The cause of this disharmonyis found to be inthe person’s dietary habits, lifestyle, relationships, environment, sleep and physical exercise

Identifying the cause of disease is important for the patient
We can advise the patienton how to avoid it
Minimize it, or
Prevent its reoccurrence.
If we give a treatment without addressing thecause of disease, it would be like pouring water into acontainer with a leak at the bottom

Question 2

What are the 4 things that should be balance as a key to health?

Answer 2

Rest and exercise
Diet
Sexual activity
Climate

Question 3

What are 6 long-term imbalance can become a cause of disease?

Answer 3

Too much rest (too little physical activity)
Too much physical activity
Too much work
Too much or inadequate sexual activity
Unbalanced emotions
Extreme climatic conditions

Question 4

What are the internal causes of disease?

Answer 4

Emotional strain
Internal emotions will affect the internal organs first (whereas external causes of disease affect the Exterior first)
Emotions include:
Anger,Joy, Sadness, Worry
Pensiveness,Fear, Shock

Question 5

Body-mind in western medicine vs chinese medicine CHARTS

Answer 5

Question 6

View on emotions: western vs chinese medicine

Answer 6

In Western Medicine:
The brain is set at the top of the pyramid and emotions affect the limbic system in the brain
Nerves send impulses down the hypothalamus,and through the sympathetic and parasympathetic nerve centres
In Chinese Medicine:
Rather than a pyramid, the body-mind is a circular interaction between the Internal Organs, Emotions and Mind.

Question 7

When emotions become a problem

Answer 7

There are positive and negative connotations to certain emotions
Feelings such as sadness, fear and anger become causes of disease when they take over our mind.
When we no longer possess these feelings, but they ‘possess’ us
Emotions are mental stimuli that influence our affective life. Under normal circumstances, they are not acause of disease. Hardly any human being can avoidbeing angry, sad, aggrieved, worried, or afraid at sometime in his or her life but those states will not lead toany disharmony.
Eg. the death of a relativeprovokes a very natural feeling of grief.

Emotions become causes of disease only when theyare either long-lasting, or very intense, or both. It isonly when we are in a particular emotional state fora long time (months or years) that they become acause of disease
If a particular family orwork situation makes us angry and frustrated in anongoing way, this will affect the Liver and cause aninternal disharmony.
In a few cases, emotions canbecome a cause of disease in a very short time if theyare intense enough.
Eg. Shock in a specific situation

Question 8

Generating and controlling sequences of the Five Elements in emotions

Answer 8

Question 9

Emotions and the internal organs

Answer 9

Anger affects the Liver, sadness counteracts anger

Joy injuresthe Heart, fear counteracts joy
Pensiveness injures theSpleen, anger counteracts pensiveness

Worry injures theLungs, joy counteracts worry
Fear injures the Kidneys,pensiveness counteracts fear

Each emotion is said to counteractanother along the Controlling Sequence of the FiveElements.

For example, fear pertains to the Kidneysand Water, Water controls Fire (Heart), the emotionrelated to the Heart is joy; hence fear counteracts joy.

This thinking presents some interesting ideas, whichare certainly true in practice, for example, that ‘angercounteracts pensiveness’ or that ‘fear counteracts joy’

Question 10

Effects of emotions on qi

Answer 10

Anger makes Qi rise
Joy slows Qi
Sadness dissolves Qi
Worry knots Qi
Pensiveness knots Qi
Fear makes Qi descend
Shock scatters Qi

Question 11

All emotions affect the Heart

Answer 11

Question 12

Effects of emotions on qi

Answer 12

Although each emotion has a particular effect on Qi, all emotions have a tendency tocause some stagnation of Qi after some time

Eg. Even though sadness depletes Qi, by depleting Qi from the Lung, the deficient Qi in the chest (Zong Qi) fails to circulate properly causing stagnation of Qi in the chest

Question 13

Disruption of Qi Mechanism by emotional strain and Qi stagnation resulting from emotional strain CHART

Answer 13

Question 14

Emotions and qi stagnation

Answer 14

When Qi stagnates, it may lead to Blood stagnation
Remember: The relationship between Qi and Blood

Question 15

JOY: Cause of disease? What does it disturb? Symptoms?

Answer 15

‘Joy’ as a cause of disease is obviously not a state of healthy contentment but one ofexcessive excitement and craving

Excessive stimulation disturbs the Mind (Shen) and itmay even displace it from Heart Blood. When considering our modern lifestyle, there are plenty of factorsleading to excessive stimulation, such as alcohol, recreational drugs, advertising, ambition, even sex.

Heart symptoms:
Palpitations, overexcitability, insomnia, restlessness, red tip on tongue

Question 16

ANGER: Cause of disease? What does it disturb? Symptoms?

Answer 16

Should be interpreted very broadly to includeseveral other allied emotional states, such as resentment, repressed anger, irritability, frustration, rage,hatred, indignation, animosity or bitterness.

If they persist for a long time, any of these emotionalstates can affect the Liver, causing stagnation ofLiver Qi or Liver Blood, Liver Yang rising or LiverFire

Angermakes Qi rise and many of the symptoms and signs willmanifest in the head and neck, such as headaches, dizziness, tinnitus, neck stiffness, red blotches on the frontpart of the neck or a red face. One of the most commonsymptoms caused by anger is headache

Anger does not always manifest outwardly with outbursts of anger, irritability, shouting, red face, etc.

Some individuals may carry anger inside them foryears without manifesting it.

Question 17

SADNESS: Cause of disease? What does it disturb? Symptoms?

Answer 17

Weakens the Lungs affects the Heart, and the Lungs suffer in consequence,since heart and lungs are both in the Upper Burner.Sadness includes the emotions of grief and regret, aswhen someone regrets a certain action or decision inthe past and the Mind is constantly turned towardsthat time.

The Lungs govern Qi and sadness dissolves/depletes Qi. This isoften manifested on the pulse with a weakness of bothFront positions (Heart and Lungs). In particular, thepulse has no ‘wave’ and does not flow smoothly

Symptoms:breathlessness, tiredness, a feeling of discomfortin the chest, depression or crying

Question 18

WORRY: Cause of disease? What does it disturb? Symptoms?

Answer 18

Worry knots Qi, which means that it causes stagnation of Qi, and it affects both Lungs and Spleen: theLungs because when one is worried breathing isshallow, and the Spleen because this organ is responsible for thinking and ideas.

If worry affects the Lungs it will cause anuncomfortable feeling of the chest, slight breathlessness, tensing of the shoulders, sometimes a dry cough,weak voice, sighing and a pale complexion

If worry affects the Spleen it may cause poor appetite, a slight epigastric discomfort, some abdominalpain and distension, tiredness and a pale complexion.

Worry is the emotional counterpart of the Spleen’smental energy, which is responsible for concentrationand memorization.

When the Spleen is healthy we canconcentrate and focus on the object of our study orwork; the same type of mental energy, when disturbedby worry, leads to constantly thinking, brooding andworrying about certain events of life

Question 19

PENSIVENESS: Cause of disease? What does it disturb? Symptoms?

Answer 19

Pensiveness is similar to worry in its character andeffect. It consists in brooding, constantly thinkingabout certain events or people (even though not worrying), nostalgic hankering after the past and generallythinking intensely about life rather than living it.

Inextreme cases, pensiveness leads to obsessive thoughts.

In a different sense, pensiveness also includes excessivemental work in the process of one’s work or study.

Question 20

FEAR: Cause of disease? What does it disturb? Symptoms?

Answer 20

Fear includes both a chronic state of fear and anxietyand a sudden fright. Fear depletes KidneyQi and itmakes Qi descend.

Examples of Qi descending are nocturnal enuresis inchildren and incontinence of urine or diarrhea inadults following a sudden fright

Question 21

SHOCK: Cause of disease? What does it disturb? Symptoms?

Answer 21

Mental shock ‘suspends’ Qi and affects Heart andKidneys.

It causes a sudden depletion of Heart Qi,makes the Heart smaller and may lead to palpitations,breathlessness and insomnia

Question 22

External causes of disease (6)

Answer 22

External Pathogenic factors: Cold, Heat, Wind, Dampness
Bacteria and viruses inrelation to ‘Wind’
Climate as a cause of disease
Climatic factors as patterns of disharmony
Artificial ‘climates’ as causes of disease
Fever

Question 23

Pathogenic wind

Answer 23

In Western medicine acute respiratory diseases are dueto invasion of the body by bacteria or viruses.

TCM did not have a knowledge of theexistence of bacteria and viruses and acute respiratoryinfections were considered to be due to invasion of‘Wind’ or other climatic pathogenic factors.

Question 24

Chinese character for wind and insect

Answer 24

Question 25

Penetration of exterior pathogenic factors according to the ‘yellow emperor’s classical of internal medicine’ CHART

Answer 25

Question 26

Climate as a factor: When does it become a cause of disease?

Answer 26

Theweather becomes a cause of disease only when theequilibrium between the body and the environmentbreaks down
Either because the weather is excessive orunseasonal (for instance too cold in summertime or toohot in wintertime), or because the body is weak relative to the climatic factor

Question 27

Climatic factors (6)

Answer 27

Wind
Cold
Summer-Heat
Dampness
Dryness
Fire