TRADITIONAL CHINESE MEDICINE

INTERPRETATION OF PATHOLOGICAL SIGNS

According to traditional Chinese medicine, a disease occurs under the influence of pathogenic factors, which cause disturbances in yin and yang, qi and blood, pathological changes of the zang-fu organs and meridians.

The pathogenic factors that may cause diseases are:

a) External factors, which attack the body from the outside, through mouth, nose or pores:

  • climatic conditions: wind, cold, heat, damp, dryness, and fire
  • pestilence: extremely noxious epidemic factors (common diseases: chickenpox, variola, erysipelas, etc.)<.li>
  • traumatic injuries: animal and insect bites, burns, frostbite, contusions, cuts, gunshot wounds

b) Internal factors, which originate inside the body and directly influence the internal organs:

  • emotions: excessive joy, anger, melancholy, anxiety, grief, terror and fright
  • irregular diet
  • excessive or lack of physical work and exercise.

Four methods are used to diagnose diseases:

      –      inspection – observing the vitality, complexion, body constitution and posture, tongue, head and hair, neck, sense organs, skin;

      –      auscultation and olfaction – listening to the sound of the patient’s voice, breathing, coughing, and smelling the patient’s odors;

      –       interrogation – asking questions to obtain information about the occurrence and progress of the disease, symptoms, habits, etc.;

      –      pulse feeling and palpation – feeling the pulse and palpating the skin, hands and feet, chest and abdomen.

The information obtained using the four diagnostic methods is used to identify the nature of a disease; this process is called syndrome differentiation based on which treatment is then established.

In Chinese medicine, symptom designates the manifestations of a disease, such as headache, fever, sweating, thirst, and syndrome is the generalization of various symptoms and signs that occur at a certain stage of a disease, or the pathological changes occurring at a certain stage of disease: location, cause, nature of the disease, and the relations between the pathogenic factors and the antipathogenic ones.

Syndrome differentiation is done according to the following methods (theories):

  1. The eight principles (yin – yang, exterior – interior, cold – heat, deficiency – excess)
    –      yin and yang – the major principles that include all the others: exterior, heat and excess are yang, and interior, cold and deficiency are yin
  • yin syndromes – have general yin properties, e.g. inhibition, listlessness, lassitude
  • yang syndromes – have general yang properties, e.g. irritability, hyperactivity, restlessness

–      exterior (biao) and interior (li) – principles used to determine the depth of a disease

  • exterior syndrome – diseases caused by the invasion of the six exogenous pathogens (wind, cold, heat, dampness, dryness and fire) through the skin, hair, mouth and nose
  • interior syndrome – when the zang-fu organs, qi, blood and marrow are affected

–       cold (han) and heat (re) – principles used to differentiate the nature of a disease; they reflect yin and yang imbalances in the body

  • cold syndrome – diseases caused by the invasion of exogenous pathogenic cold or yang deficiency in the body
  • heat syndrome – diseases caused by the invasion of exogenous pathogenic heat or excessive yang or yin deficiency in the body

    –      deficiency (xu) and excess (shi) – principles used to determine the strength of the antipathogenic qi and pathogenic factors

  • deficiency syndrome – indicates qi insufficiency
  • excess syndrome – indicates a preponderance of pathogenic factors
  1. Etiology – involves the examination of clinical manifestations in terms of characteristics of pathogenic factors:
    –      syndromes of the six exogenous pathogenic factors and pestilence: wind syndrome, cold syndrome, heat syndrome, dampness syndrome, dryness syndrome, fire syndrome, pestilence syndrome
    –      syndromes due to emotional factors: overjoy syndrome, anger syndrome, anxiety syndrome, melancholy syndrome, terror syndrome
    –      syndromes due to improper diet, stress, overstrain or lack of physical exercise
  1. The theory of qi, blood and body fluids – involves identifying different syndromes in terms of physiological and pathological characteristics of qi, blood and body fluids
    –      qi syndromes: qi deficiency, sinking of qi, stagnation of qi, perversion of qi
    –      blood syndromes: blood deficiency, stagnation of blood, heat in the blood, cold in the blood
    –      syndromes of both qi and blood: deficiency of both qi and blood, blood loss due to qi deficiency, exhaustion of qi resulting from hemorrhage, stagnation of blood due to qi deficiency, blood stasis due to qi stagnation
    –      syndromes of body fluid disorder: insufficiency of body fluids and retention of fluids
  1. The theory of zang-fu organs – involves the differentiation of syndromes in terms of pathological changes in the zang-fu organs
    –      syndromes of the heart and small intestine
    –      syndromes of the lung and large intestine
    –      syndromes of the spleen and stomach
    –      syndromes of the liver and gallbladder
    –      syndromes of the kidney and bladder
    –      complicated syndromes (when more than two organs are affected)
  1. The theory of meridians and collaterals – involves the examination of pathological manifestations in order to determine the affected meridians:
    –      syndromes of the 12 regular meridians
    –      syndromes of the 8 extra meridians
  1. The theory of the six meridians – classifies the diseases caused by exogenous pathogenic factors into 6 syndromes, depending on their stage of development:
    –      Taiyang, Yangming, Shaoyang (yang syndromes)
    –      Taiyin, Shaoyin, Jueyin (yin syndromes)
  1. The theory of wei (defensive), qi (vital energy), ying (nutrient), and xue (blood) – used to diagnose epidemic febrile diseases, the four stages representing the occurrence of a disease, its course of development, and its transmission (from shallow to deep and from mild to severe)
  2. The theory of the triple jiao (san jiao) – used to identify the stages of febrile diseases according to the pathological changes of the zang-fu organs in relation to the triple burner:
    –      syndrome of the upper jiao (corresponding to the lung meridian): the disease has not penetrated deep into the body and is not serious
    –      syndrome of the middle jiao (corresponding to spleen and stomach): the disease has progressed and worsened
    –      syndrome of the lower jiao (corresponding to liver and kidneys): the disease has penetrated deep into the body and become dangerous