Traditional Chinese Medicine Disharmony

The concept of traditional Chinese medicine disharmony has evolved over the centuries into a sophisticated system of diagnosis. By following various established diagnostic procedures, a practitioner of traditional Chinese medicine can construct a detailed picture of the status of all the internal organs without the aid of laboratory tests or other types of modern technology.

To identify a pattern of disharmony, the physician will assess the status of the organs, gradually uncovering the cause of the disease by grouping the symptoms into traditional patterns.


Traditional Patterns of Disharmony

During the initial patient visit, the practitioner must organize all of the seemingly unrelated facts gathered about a patient's condition, gradually refining this information into diagnostic categories.

At first, the practitioner organizes the evidence loosely into general categories known as the eight parameters, which consist of four groups of polarities: yin and yang, heat and cold, internal and external, excess and deficiency.

This eight-parameter diagnosis is the basic founda­tion for all diagnostic categories. It gives the practitioner a general overview of the patient's disease, or pattern of disharmony. Once the practitioner has grouped the symptoms according to the eight parameters, he or she can further refine the diagnosis to determine the condition of the vital substances and internal organs.

In this way, the diagnosis evolves from a general image into a specific, clear description of the individual patient's physiologic processes. For example, in organ diagnosis, spleen qi deficiency is a pattern of disharmony. This is a very specific diagnosis. In eight-parameter diagnosis, the same imbalance is classified generally as a deficient internal condition.

Go to the next page to learn about the eight parameters of disharmony in traditional Chinese medicine.

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The Eight Parameters of Disharmony

In Chinese medicine, a balanced lifestyle is conducive to good health.

The eight parameters of disharmony form a system in which illnesses can be categorized. In traditional Chinese medicine, illness is seen as an imbalance, a lack of harmony in the body's systems, and knowledge of the eight parameters allows the practitioner to perceive the location, severity, and nature of the disease process.

This information is then applied to the other diagnostic categories of qi, blood, and internal organs, further narrowing and focusing the diagnosis. It is also important to remember that a physical condition is not fixed; inner processes are always subject to change. In other words, a yin condition can evolve into a yang condition; an exterior pattern can penetrate to the interior; a cold condition might turn to heat; and an excess disease often becomes one of deficiency. In a more complex disharmony, all eight patterns could occur simultaneously!


For this reason, it is always a good idea to maintain a Taoist attitude of flexibility while perceiving the movements of nature. Any diagnostic pattern is simply a snapshot in time; an experienced practitioner recognizes this and is always prepared to adjust the diagnosis and treatment plan to accommodate these changes.


The terms external (or exterior) and internal (or interior) do not refer to where the pathogen comes from; rather, they specify the location of the disease process in the body. The exterior of the body is considered the skin and muscles, while the interior is defined as the internal organs and bones.

In an external pattern, the pathogen fights with the body's defensive qi, or wei qi, which circulates under the skin. Symptoms of this struggle are chills, fever, sensitivity to wind or cold, body aches, sore throat, nasal congestion, and a floating pulse.

If the cause of disease, known in traditional Chinese medicine as the pernicious influence, is not expelled, typically it penetrates the interior.

An interior, or internal, condition has more organ-related symptoms, such as diarrhea, stomachache, intestinal cramps, lung pain, bladder pain, constipation, and changes in the color of the tongue. A pathogen trapped between the interior and exterior exhibits such symptoms as alternating chills and fever, a bitter taste in the mouth, and a wiry pulse.


The possible causes of heat conditions are an external heat pernicious influence (for example, a virus that produces heat symptoms, such as a high fever), internal hyperactivity of yang functions (for example, drinking too much alcohol can cause a red face and headache), or insufficient yin.

The yin aspect of the body includes the "lubricating and cooling" systems. When these systems are depleted, the body tends to overheat due to the deficiency of yin.

In general, heat signs include redness in the face; feeling hot; thirst; colored secretions (such as yellow mucus or other discharges or dark urine); constipation; burning sensations; irritability; red tongue body with a yellow coating; and a rapid pulse.

Conversely, cold arises from external cold pernicious influences (for example, a virus that produces the cold symptoms of chills and a runny nose), an internal yang deficiency, or internal excess cold pathogenic factors.

An internal yang deficiency produces such symptoms as always feeling cold, a low sex drive, and low energy. A person who has acute symptoms of loose stools and abdominal pains from eating too much ice cream likely has an internal excess cold condition.

General signs of cold are a pale face, feelings of cold, lack of thirst, clear secretions (pale urine, clear mucus or discharges), loose stools, muscle tightness, fatigue, pale tongue with a white coating, and a slow pulse.


A disease is classified as an excess condition or a deficient condition. Excess conditions occur when an external pernicious influence attacks the body and creates over-activity (for example, a high fever that is caused by infection with a virus); a body function becomes overactive (for example, redness and swelling that are caused by an infection); or an obstruction of qi or blood causes pain.

Acute conditions tend to be conditions of excess. Deficient conditions arise due to an inherent weakness in the body or a weakness in the body's vital energy (qi), blood, yin, or yang. Symptoms of deficiency include weak movement, pale face, pale tongue, and weak pulse. Chronic conditions tend to be conditions of deficiency.


The most general of all the diagnostic categories, it can be considered a summary of all the others. Heat, excess, and external conditions are yang conditions, while cold, deficiency, and internal conditions are yin conditions. Most conditions include a mixture of yin and yang imbalances. In addition, each internal organ has its yin and yang aspects that must be balanced.

For example, if heart yin is deficient, a person may experience insomnia, poor memory, and palpitations. If heart yang is depleted, poor circulation, pale face, purple lips, edema, and cold extremities can result.

When yin, with its cooling function, is low, heat signs occur. When yang, with its heating function, is low, cold signs occur. Restoring the optimum yin/yang balance of each internal organ is the most important secret of maintaining health and vitality in traditional Chinese medicine.

Go to the next page to learn about syndromes of syndromes and disorders of qi, blood, yin, and yang.

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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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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.