Syndromes and Disorders of Qi, Blood, Yin, and Yang

This section covers syndromes and disorders of qi, blood, yin, and yang. Analyzing disease according to the eight parameters is essential in arriving at a diagnosis. However, it is only the first step; it usually does not provide enough information for a truly focused treatment plan.

For example, a person might have chronic fatigue -- according to the eight parameters, chronic fatigue indicates an internal deficiency. The practitioner might recognize at this point that the person needs tonifying herbs to nourish and alleviate the deficiency, but which herbs?

With further inquiry, the practitioner learns that the person also has loose stools and a poor appetite. Since these symptoms are related to the functions of spleen qi, the practitioner now knows that the syndrome is an internal deficiency of spleen qi.

By combining the eight parameters with knowledge of the vital substances and the organs, the diagnosis is now detailed enough to make a focused treatment plan: tonify spleen qi. Tonifying herbs improve overall function of a particular organ and strengthen the entire organism when used long-term.

Remember that qi flows in a system of channels, called meridians, in the body, and each organ is linked to a meridian. Acupuncture can affect or manipulate qi to treat a specific imbalance. A practitioner might choose herbs that tonify spleen qi and use acupuncture or moxibustion (the application of heat) at acupuncture points that affect the spleen.

For example, a point on the spleen meridian known as Spleen 6 can be activated to strengthen the spleen. Since the spleen and stomach meridians are directly connected, needling or applying moxibustion to a point on the stomach meridian also strength­ens the spleen. In this way, a wide variety of treatment options are available to a practitioner once an accurate diagnosis is at hand.

Disorders of Qi

There are four disorders of qi: deficient qi, stagnant qi, sinking qi, and rebellious qi.

When qi is deficient, the principal symptoms are fatigue, a bright pale face, a weak or soft voice, spontaneous sweating, a pale tongue, and a weak pulse. These general symptoms could occur in any type of qi deficiency. The treatment is to tonify qi.

Another type of qi imbalance is stagnant qi, an excess type of disharmony. Since health depends on the smooth flow of qi, stagnant qi can cause discomfort or pain almost anywhere in the body. It is typically associated with feelings of pain or distention that move from place to place, irritability, and soft lumps anywhere on the body that come and go. Premenstrual syndrome is a condition of stagnant qi in the liver.

The treatment principle is to smooth the flow of qi through the affected organs or meridians. In the disorder of sinking qi, a deficiency syndrome, the function of supporting the organs is impaired. Prolapse (sagging) of the bladder, rectum, transverse colon, or uterus occurs. Herbs that have an uplifting action, along with acupuncture and moxibustion, are used to treat this condition.

Finally, in patterns of rebellious qi, the flow of qi is the reverse of normal. For example, the normal direction of flow for stomach qi is downward. When rebellious stomach qi occurs, symptoms of nausea, vomiting, belching, or hiccups exist. The treatment principle is to return the flow of qi to normal, usually with herbs and acupuncture treatments. It is also necessary to rectify any underlying excess or deficiency that caused the problem.

Disorders of Blood

Three types of blood disorders can occur: deficiency, stagnation, and excess of heat. Blood deficiency syndrome is especially common among women due to their monthly loss of menstrual blood. It can also arise as a result of improper nutrition or spleen qi deficiency, which prevents full assimilation of nutrients. Symptoms include a dull pale face, pale lips, pale tongue, dizziness, blurry vision, numbness or tingling of extremities, poor memory, dry skin and hair, scanty menses, and a thin pulse.

The treatment principle is to tonify the blood with herbs, acupuncture, or moxibustion. In blood stagnation, which is an excess pattern, the primary symptom is a fixed, stabbing pain, which can occur anywhere in the body as a result of injury, stagnation of qi or cold, or deficient blood conditions.

Tumors or painful menstrual flow with clots may also occur. The treatment depends on the nature of the stagnation, but the common treatment principle is to activate or move the blood with herbs that stimulate circulation.

Acupuncture is especially effective in treating the pain resulting from the stagnation. With an excess condition of heat in the blood, symptoms of hemorrhage, skin rashes, itchiness, blood mixed in with bodily secretions, irritability, and sensations of heat can occur. Treatment includes using herbs that cool the blood along with hemostatic herbs to stop the bleeding.

Disorders of Yin

In disorders of yin deficiency, the cooling, moistening action of the body is depleted, leading to symptoms of reddish cheeks, red tongue with little or no coat, dry throat, heat in the "five palms" (palms, soles, and sternum; sometimes called "five hearts"), night sweats, irritability, and a small, rapid pulse. The presence of additional symptoms depends on the organ system affected. The treatment principle is to tonify the yin and clear deficiency heat. In conditions of yin excess, there can be feelings of cold, mucus, and a general sluggishness. Treatment varies, depending on the particular type of excess yin, but it usually involves the use of warming herbs or diuretics.

Disorders of Yang

Yang deficiency is a chronic syndrome characterized by cold extremities, lack of sexual desire, infertility, an aversion to cold, pale face, tongue, and lips, and a slow, weak pulse. Other signs and symptoms depend on the particular organ systems affected. The treatment principle is to tonify the yang.

In yang excess disorders, signs and symptoms include headache, body aches, fever, sweating, thirst, red eyes, concentrated urine, constipation, mental restlessness, a red tongue with a yellow coating, and a full, rapid pulse. In this condition, the treatment principle is to clear excess heat.

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ABOUT THE AUTHORS:

Bill Schoenbart has been practicing traditional Chinese medicine (TCM) since 1991, when he earned a Masters degree in TCM. He teaches TCM medical theory and herbalism at an acupuncture school in California, and also maintains a clinical practice.

Ellen Shefi is a licensed massage technician, licensed acupuncturist, and registered dietitian. She is a member of the American Association of Acupuncture and Oriental Medicine, the American Herb Association, and the Oregon Acupuncture Association.