The Exterior And Interior Causes Of Disease
Why do we get ill?
In the most simplistic of terms, we get ill because something is out of balance in our body. Likely you’ve heard of term ‘homeostasis’ that is used by many healthcare practitioners. Homeostasis presents the idea that the body reaches a healthy point and then stays there. Personally, I do not like the word – as our body and health is anything but static. It is far more dynamic, having times of stability with slight adjustments and other times when we must hold on despite the wind. I prefer homeodynamic, because our body and mind is constantly adjusting to maintain health. It’s a very active, ever adjusting process not one that reaches a plateau and then becomes static. We are tight rope walkers. Sometimes it’s easy to balance, and other times not so much.
It’s not always clear sometimes why we get sick, however the 8 Principles theory of Chinese Medicine can help us identify the functional disharmony and thereby focus treatment. Like Five Elements, Organ theory, and the 6 Jiao; the 8 Principles is just one of theories and tools that a Chinese Medicine practitioner has available to identify patterns and thereby hone treatment to the individual.
To simplify the 8 Principles are 4 categories of opposites and allow the practitioner to identify the disease and thereby treat by category. Is the pattern –
Exterior or Interior
Hot or Cold
Excess or Deficient
Yin or Yang?
Once the practitioner identifies the processes at play they can appropriately treat. For example in a pattern of cold, we would warm the person. If the pattern is excess, you decrease.
Let’s look at interior and exterior…
Illness arises if the body is too weak OR the pathogen is exceptionally strong.
Imagine fighting off a cold. For some people–no problem, others may battle for days or are constantly fighting something off. An exceptionally strong pathogen like the black plague or more recently Covid can wipe out thousands or millions simply because of its strength. How well we fight off disease is an indicator of our constitution, immune strength, age, living conditions, relative health, and the strength of the disease at the time of attack. Lots of moving parts there.
External Causes of Disease
These patterns come from the ‘exterior’ or outside. We may or may not have control over them. For example: we might not be able to control a car accident, but we can decrease our chances of catching a cold by dressing appropriately for the weather and taking in adequate and proper nutrition.
Accidents —Injuries; whether from vehicle accidents, falling down the stairs or physiological traumas like sudden death of a loved one, will disturb the energy system. Humans are resilient and usually the body will rebound, depending on the level of damage sustained and especially if organs and tissues are involved. Here, the Amma therapist’s goal is to aid recovery by circulating Qi to help drain lymph and reestablish energy flow through the channels.
Environmental pathogens — What’s the weather like? Climatic conditions (wind, cold, and heat especially) can have an effect on our body, especially if you go from one extreme to the next. Those with weaker defensive (wei qi) may ‘catch something.’ Pathogens also include exposure to pesticides, noxious chemicals, air and water pollution–even noise pollution. This could also arise from ongoing stressful living situations or work conditions.
Chinese medicine breaks these down even further identifying the Six Pernicious Influences (sometimes called the Six Evils–but don’t take it personally). The Six Pernicious Influences identify a climatic factor based on how it behaves in the environment and how that is mirrored in the body.
Wind —Moves quickly and blows throw the body “shaking the tops of the trees” – meaning it often attacks the upper body. Exceptionally windy conditions can quickly invade the body and causing colds, allergies, tremors, frozen should and Bell’s Palsy.
Heat —Heat creates fever, sweating, thirst, yellow discharges and scanty urine. It makes the blood move quickly and dries up fluids. Think of fevers, from just the common cold to extreme heat like a plague.
Damp — The most tenacious pattern, dampness causes the fluids int he body to slow down and thicken. It sinks and creates discharges, excess mucus and phlegm. Exterior damp patterns include: allergies when there is a lot of phlegm, colds, and sinus congestion. Damp happily marries with either cold or heat patterns.
Cold — Cold slows and stagnates – decreasing the circulation. It presents with chills, desire for warmth, aches that better with heat, clear or thick white discharges. Think of your average to the extreme of hypothermia. Another example: sitting on cold surfaces in extreme weather that results in cramping and diarrhea.
Dryness — Excessively dry environments will rob the body of fluids and create patterns of dehydration, thirst and depletion of all yin (fluids).
Summer heat —It doesn’t have to be summer to get an invasion of summer heat. This can happen if the temperature is unseasonably hot, or you travel to an exceptional hot environment. Summer heat presents with fever and chills, thirst or lack of thirst, vomiting, diarrhea or constipation. It’s a pattern of dichotomy–heat stroke in western medicine terms.
Improper Nutrition and Consumption of Drugs and Chemicals — A poor diet can lead to the manifestation of many forms of disease, as we see in the epidemics of diabetes and obesity. Poor nutrition creates a systemic imbalance in the body. Foods that are filled with pesticides, preservatives, stabilizers, colorings, and chemicals require more energy from our body to detoxify—if we can. Certain foods Like highly refined carbs, sugar and dairy put great stress on the body and mind and can create mucus. Many foods are devoid of nutrient value. Other ingested poisons include, over the counter and prescription drugs. In some cases medication is useful however it is become rampantly over used. Think of over the counter drugs, anti depressants, antibiotics – all suppress the immune system and lead to long-term chronic disease, like chronic fatigue syndrome. No treatment of any disease should be devoid of intelligent and appropriate dietary recommendations.
Microorganisms —Any sort of infectious process, viral, bacterial, fungal or parasitic. Generally the mindbody in this state of homeodynamic balance integrates, tolerates or passes such organisms through the body. When we are weak or already leading towards imbalance then we become susceptible to invasion. When the system is already leaning towards imbalance do we become susceptible to invasion.
Exercise and Rest —What? Inappropriate exercise can make you weaker. What you have to find is what is appropriate for your current state. Are you 50 and still trying to run like you did when you were 18? Proper quantity and quality of exercise and rest is essential to good health. If it is lacking there will be weakness and atrophy of the muscles, skeletal misalignment, poor circulation and poor metabolism. If it’s excessive (too much for what you can handle) the physical structure will weaken or fail eventually.
That’s it for the exterior causes…let’s go inside.
Internal Causes of Disease
Interior disharmonies come from within. They are not acted upon us. We may be born with them (skeletal problems) or we may be creating them as with excessive emotional indulgence, or they manifest because of organ dysfunction. They tend to be chronic in nature.
Emotions — Classic Chinese texts say that a true emotion last 7 seconds, anything else is holding on. Well, that explains a lot. To be clear emotions are not bad, they become a problem when we perpetuate them or stay in them too long. Our culture has built a pattern of indulging in emotions to the point they become detrimental to us. Any chronic emotion will disrupt the flow of qi and deplete the immune system, and each emotion influence the body in a particular way. There are 7 broad categories of emotions.
Anger — Including hatred, frustration and angst; makes the Qi rise and affects the Liver causing heat and stagnation.
Joy —How can joy be bad? It’s not–it’s when you are in it too long. Joy slows the Qi down and affects the Heart.
Worry— Over-thinking, perpetuating thought knots and tangles the Qi. It affects the Lungs and the Spleen.
Pensiveness — Think of this as worry with anxiety. It knots the Qi and affects the Spleen and Lungs.
Sadness — Dissolves the Qi and affects the Lungs. It leaves us feeling breathless and empty in the chest.
Fear — Descends the Qi, sinking and harms the Kidneys.
Shock — Scatters the Qi and affects the Kidney and Heart.
To reiterate, emotions aren’t bad if they are used appropriately. There are times when it is appropriate to be angry, handle the situation and move on. Holding grief from the loss of a loved one 8 years ago is too long, the lungs and body will suffer. Emotions are harmfully if we find ourselves constantly angry, in a state of worry, fear or shock, etc.
Muscle-skeletal difficulties — You can be born with these – a scoliosis, cerebral palsy, or you can create these with poor posture and skeletal misalignment, etc.
Physiological malfunction — This includes congenital defects, weaknesses, or constitutional factors that we are born with. They present as interior disharmonies of the 12 Zang Fu (Organs) such as deficiency of Jing, Qi, Blood, or Fluids that come from a constitutional/heredity factor or when the organs have been depleted over a long period of time or severely damaged. For example, a person whose Spleen was punctured first had an exterior attack - an injury. Likely, that will leave the person’s Spleen weaker and compromised in function for the rest of their life - a chronic condition of Spleen Yang Deficiency that came about after injury.
Remember the 6 Pernicious Influences in the exterior patterns? All of those terms can be applied to interior patterns as well. The difference is, they are not acute —they are chronic— arising either from an exterior pattern that was incompletely treated or from organ disharmony.
Wind — Interior wind arises if an exterior pattern isn’t treated it will move deeper. It can also come from extreme heat in the system or deficiency of blood, or constitution. Interior wind patterns include epilepsy, tremors, twitches and shaking disharmonies such as Parkinson’s. Remember Kathryn Hepburn’s constant shake? That was an interior wind pattern.
Heat — Heat can arise from an exterior pattern that isn’t treated and drives deep into the body. Herpes —a form of damp heat —is an excellent example. It begins as an exterior heat pattern that can remain in the body dormant, or latent, until conditions are right and it pops up again. Heat can also come from excessive emotions – too much anger will generate heat. Eating excessively hot foods will deplete the yin and create heat.
Damp — Interior damp is most often caused by our diet. Too much rich, greasy, refined and sweet foods deplete the spleen that then generates dampness. The pattern arises if the body lacks the yang function to properly transform fluids – instead it makes damp.
Cold —Like the other pathogens, this can begin from the exterior and then drive deep into the body if not treated. Internally, it arises from a lack of Yang (a warming function) which can be caused by constitutional deficiency of Yang, eating excess raw or cold foods that damage the Yang functions of Spleen, Kidney, Triple Warmer and Lungs over a period of time. It can also arise from inability to communication or connect meaningfully with others–making us cold and distant.
Dryness — Yin (fluids) decline from a number of reasons – especially too much heat and lack of fluids. Menopause naturally depletes yin and without proper balancing appropriate to this stage of life, dryness may arise. Here again, heat from emotions held too tight will can dry a person out too.
Phlegm —Phlegm is an interior pattern that most commonly arises from damp foods and diet. However it can arise from damp exterior conditions that are left untreated and bog down the Spleen Yang. Damp and phlegm exist on a continuum. Untreated damp can start to congeal and thicken. It combines easily with fire or cold.When we work to transform phlegm, we thin it out moving back towards damp to move it out of the body. It’s a bit like playing with gravy.
Assessment of patterns of disharmony and their underlying source is identified through detailed questioning, observation, pulse assessment, tongue assessment and palpitation – all are clues and guides to identifying the pattern. Although terminology may be different and unfamiliar, the ways in which Asian/Chinese Medicine identifies disease is logical, powerful and poetic.
Here’s to staying well!
Check out my Simple Remedies Course for tips on how to assess and treat common ailments as they arise.
April
