Let’s face it, TCM Diagnosis is the HARDEST part of Chinese medicine! My foundation teacher used to say: “There is no wrong treatment in TCM, only the wrong diagnosis!”

So I thought it’d be great to start a new series of posts dedicated to make TCM Diagnosis a little easier to grasp. This one is all on the “Causes of disorders in Chinese Medicine”. Hope you enjoy and benefit from it. Let me know what you think 🙂

And keep rocking it using TCM!

Clara
TCM Geek

PS: more “TCM Diagnosis Made Easy” coming soon! And if you feel like reviewing your TCM Foundation, click here!

The Causes of Disorders in TCM

When seeing a patient for the first time, I use the 4 methods of diagnosis: inquiry, observation, palpation and auscultation & olfaction to help me puzzle together a full TCM diagnosis. But before forming the TCM patterns, I like to be able to figure out the cause(s) of the imbalance.

Once you know the cause, then you can also configure a treatment plan and discuss these causes with the patient to see if they can be removed or not.

For example if lack of exercise is the cause, that can be addressed by the patient being compliant, but if the cause is weak constitution then our role as practitioner is to support the TCM kidneys and Essence (Jing).

There are 3 causes of imbalances according to TCM.

1- The 6 External Pathogens: Wind, Fire, Cold, Damp, Dry, and Summer-Heat.

2- The 7 Emotions: Anger, Joy, Worry, Overthinking, Sadness, Fear and Shock.

3- Others: lifestyle (too much exercise or lack of, taking drugs, smoking, diet, mental overwork, job…), weak constitution, trauma injury, wrong treatment, radiation.

Each of these cause can help you determine patterns of diagnosis for your patient.

The 6 External Pathogens: Wind, Fire, Cold, Damp, Dry, and Summer-Heat. These are mostly acute conditions with symptoms of one of more of these pathogens invading the body and fighting against the Wei Qi (defensive Qi).

• One or more of 2 pathogens can cause disease.
• 6 external pathogens influence each other and can transform into each other.
• They invade the body through the skin, mouth or nose. 

• Most common combination:

  • Wind: wind heat, wind cold, wind dampness.
  • Dampness: damp-cold, damp-heat.
  • Fire: fire wind.

The 7 Emotions

Anger, Joy, Worry, Overthinking, Sadness, Fear and Shock.
Over a long period of time the 7 emotions can turn into fire. They block Qi, blood and affect internal organs (HT mostly), & aggravate a disease.

Anger

• Includes: resentment, repressed anger, irritability, frustration, rage, indignation, bitterness.
• Long time standing, anger causes: LV Qi stagnation, blood stagnation, LV Yang rising & Blazing LV fire.
• Anger causes such symptoms as headache, red face, red tongue, High blood pressure.

Joy

• Includes: excessive excitement, overjoyed, laughing all the time.
• Over joy may cause: HT fire to flare up, HT Yin deficiency
• Joy causes such symptoms: migraine after excitement, insomnia from too much excitement.

Sadness

• Includes: depression, crying often.
• Long time standing, Sadness causes: LU Qi deficiency, HT blood deficiency
• Symptoms: pale, fatigued, weak pulse, breathlessness.

Worry & Overthinking

• Includes: worry-induced situation, over-studying, excessive mental work, nervousness.
• Causes: SP Qi Deficiency, ST Qi rebelling.
• Symptoms: fatigued, no appetite, loose stools, bloated.

Fear

• Includes: anxiety & irrational fear, real threat, feeling of insecurity.
• Causes: KD Qi deficiency, KD Yin deficiency
• Symptoms: in children (enuresis), in adults (insomnia, fatigued, palpitation, sweat at rest)

Shock

• Includes: sudden shock (trauma, injury), mental shock (bad news).
• Causes: KD & HT Qi deficiency
• Symptoms: sweat, sudden uncontrolled urination, dizziness, dry mouth, unconsciousness.

Diet

• Malnutrition due to restricted diets or just lack of wanting variety in eating habits, causes SP & Blood deficiency.
• Overeating will also weaken the SP but with an accumulation of dampness and/or fluid retention.
• Excessive cold food (salads, ice cream, iced drinks) will deplete SP Yang causing bloating, fatigued, chilliness, diarrhea.
• Excess sweet & sugary & greasy foods will cause an accumulation of dampness in the SP (bloating, fullness in abdomen, mucus in stools, yellowish vaginal discharge, heavy head).
• Too much spicy food (curry, alcohol, lamb, beef, chili peppers) will give rise to LV & ST heat (acid reflux, heart burns, thirst). The time one eats and the atmosphere he/she eats in is very important also.

Exercise: too much or a lack of

Career/Job/Stay at home parent

• Mental overwork: Long hours of studying or working, extreme pressure & stress will affect SP, ST & KD and make them deficient.
• Physical overwork: hairdresser shoulders may become painful overtime (Qi stagnation); security guards may get sore back & knees (KD def.); sitting at a desk for long hours (SP def. & Lv Qi stagnation); grocery store cashier with repetitive label scanning may lead to carpal tunnel syndrome (LV Qi stagnation); shift workers like Nurses overtime, will deplete their KD resulting in KD Deficiency.

Trauma Injury

Old or recent injury will cause Blood & Qi stagnation, and can later lead to blood deficiency.

Wrong treatment

Acupuncture could cause pneumothorax if not performed properly. Chinese herbal treatment if not given properly will give rise to problems as well. Moxibustion may also cause problems if used when a person has excess heat.

Drugs side effects and interactions can cause many issue. Wrong western medicine treatments (Bad surgery, wrong surgery…) can results in many problems. Surgery usually results in Blood Stasis.

Weak constitution

Weak constitution, genetic disorders, slow development and growth is a TCM Kd Essence deficiency. A person may have been sick a lot during their life but if they follow a balanced lifestyle, they will have a better chance to stay healthy longer and conserve their Essence (Jing). 1 or 2 vertical long cracks on the tongue often indicate weak constitution.

Excessive sexual activity

Depletes KD Essence (especially in men) if orgasm is achieved. Everyone is different in the amount of sexual activity his/her health can handle. Signs of fatigue, dizziness, lower back pain, frequent urination or constant bladder infection, indicate a Kd Qi deficiency. According to TCM, recommended ejaculation for men is as follows: