Part 1 can be found here

Part 2 can be found here

Part 3 can be found here

Part 4 can be found here

Part 5 can be found here

Arriving at a diagnosis - continued.

As we mentioned in part 5, TCM has developed several systems to help the practitioner determine imbalances within the person, and in relation to the environment. Each of these systems relates the persons presenting symptoms and signs, with the functions of the Substances and Organs.

In this part we will examine the Six Evils and the Seven Emotions.

The Six Evils.

Wind, Cold, Heat or Fire, Dampness, Dryness and Summer Heat.

These are environmental factors which play a part in disease. They are an important factor in many diseases but they are not considered so much a cause of disease as a pattern of disharmony between the body and the environment. They can only occur when there is a relative weakness in the strength of the body Wei Qi (defensive Energy).

Wind.

Wind in the body resembles wind in nature. It produces irregular, symptoms and movements within the body. It has a sudden onset and no fixed location. It can occur due to an external factor such as an infection, or due to internal imbalance.

The External type Wind produces - itching, skin eruptions, stiff aching neck or body muscles, mild fever, sweating, headache, runny or blocked nose, and a tickle in the throat. Wind usually combines with other factors (Cold, Heat, Damp etc) when it invades the body.

Internal Wind is usually related to a Liver Zang disharmony and produces - dizziness, a ringing noise in the ears, tics or twitches of muscles, numbness or tremors of the limbs, skin problems, fits and convulsions.

Cold

Cold, resembles cold in nature. It reduces movement, causes contractions and inhibits body activity. Its main signs and symptoms are - a feeling of being cold which may affect all or parts of the body. Severe, sharp or cramping Pain. Stiffness or inability to move joints and poor circulation to the hands and feet. Clear or white discharges such as clear runny nose or coughing white mucus, drooling or dribbling, vomiting water and profuse pale urine. There maybe chills and mild fever with little or no sweating. There is tiredness, slowness of thinking, speech or movement and a desire for warmth.

Heat, Fire or Toxin.

These may occur throughout the body or in isolated locations. Fire refers to severe Heat and its damaging effects and not to actual fire. They can occur from External influences or from Internal imbalance.

External Heat can cause fever, sweating, cough, delirium, redness, swelling, bleeding and dehydration. In the skin it can lead to boils or ulcers it putrefies tissues to form pus. It can consume tissue and fluids causing wasting of the body and severe thirst. It can promote the reckless movement of Blood and fluids in the body and stir up Wind causing convulsions and fits. It is associated with many of the severe infectious diseases.

Toxin is a specific condition in TCM where Pathogenic factors obstruct local Qi and blood circulation, leading to their destruction. This creates a toxic waste or pus. It is seen in the form of boils and other red, hot and painful swellings. Also as bites or stings, acne, some ulcerative conditions and festering wounds.

Internal heat results from an imbalance of Yin and Yang within the body and tends to produce chronic heat conditions, with afternoon or evening fevers, hot flushes, constipation, dizziness and headaches. Red, sore and dry eyes. Weight loss, thirst and sweating in bed at night.

Dampness and Phlegm.

Dampness is heavy invasive and moves down. It can occur from External or Internal causes and typically produces the following signs and symptoms. Heavy sensations of the limbs, dull aches in the joints, fluid accumulation in the ankles or fingers, tiredness especially in the mornings, cough, headaches, nausea and vomiting. Loss of appetite and poor sense of taste. In TCM damp is very closely related to the functions of the digestion. It is the job of the Spleen and Stomach to transform damp and prevent its accumulation.

Phlegm in TCM is not considered the same as it is in western cultures. It is considered the turbid thickened accumulation of dampness. It produces the mucus in coughs but can also produce lumps and masses in the body. It is even related to the accumulation of weight, or getting fat!

According to TCM if food is not transformed properly by the Spleen and Stomach. It forms an impure digestive residue or Dampness. Over time this dampness is not properly eliminated by the Spleen and Stomach it then thickens to become Phlegm in the TCM sense and may accumulate as Fat! One of the most common reasons for Spleen and Stomachs weakness, or inability to transform food into Qi and Xue (Blood), is overloading them by over eating.

Dryness.

Dryness is not usually seen without Heat. It refers to the relative balance of the symptoms which show more dryness than heat. It leads to signs and symptoms of fluid loss or damage. And includes cracked dry skin, dry hacking coughs, dry nostrils, lips, mouth, throat and hard dry stools.

Summer Heat.

Only occurs from External causes specifically prolonged exposure to heat and humidity. Its signs and symptoms include sudden high fever, heavy sweating, anxiety or delirium and possible sudden collapse.

The Seven Emotions.

TCM recognises that emotions play an important part in health and illness and teaches that the emotional life cannot be separated from the physical. The seven emotions : Joy, Anger, Sadness, Grief, Pensiveness,Fear and Fright all inter-relate to the Zang-Fu (Organs).

Emotional disturbance can impair the normal function of the Zang-Fu and Zang-Fu disease can disturb the emotions. To understand the signs and symptoms of these inter-relations involves an in depth study of the Zang-Fu organs and their actions which is beyond the scope of this article. However some common examples can help you gain a feeling for how this works.

Anger disturbs the Liver and Heart. Over a prolonged time it injures these organs and produces Headaches, reckless actions, insomnia and high blood pressure. Eventually it may lead to a heart attack.

In contrast a heart attack often injures the Hearts ability to experience Joy, so many people suffer depression after a heart attack.

Fear can cause the Urinary Bladder to lose control and urination occurs involuntarily while many people with a Kidney disharmony live in constant fear or anxiety (the Urinary Bladder is the Yang partner of the Kidneys).

Stress and anxiety can often lead to Stomach problems as seen in "Stage Fright". While a stomach ulcer often promotes irritability and intolerance of others.

These are just a few ways that the TCM practitioner inter-relates the emotions and physical problems.

In the next part of the series we will look at how TCM uses the Eight Principles and the Five Phases to help understand and illness and design a treatment.