TCM causes of disease

According to the philosophy behind Traditional Chinese Medicine (TCM), everything is interconnected and, as a result, one part of the whole can not only influence the whole, but the whole is also reflected in each one of its parts. This law applies to everything that exists. The definition of what constitutes the "whole" varies depending on the context. We could at various times consider the Universe, the solar system, our planet, our specific ecosystem, a species, or a single living being as whole entities. Thus, each of us may be thought of as a "whole" made up of every single part of the body, as well as the mind, emotions, and spirit. In terms of our health, this means that anything that produces changes in any part of us - i.e anything that happens in either our external or internal environments-  can have a definite effect on the whole of our beings and either support our health or cause illness. As a result of this way of thinking, TCM views on how our body works and what may cause disease are radically different to what we are used to and people are often surprised when they come for Chinese medicine treatment for a seemingly simple symptom and end up being questioned about unrelated parts of the body, as well as their relationships, sleep patterns, lifestyle, etc.

Our society is now riddled with highly complex chronic conditions such as diabetes, autoimmune diseases, neurological, mental, and emotional conditions, just to name a common few. Conditions such as these, are not the result of a single agent but are caused by a variety of factors that include our lifestyle, diet, and genetic make up. Nevertheless, we are still stuck trying to find a single cause and a single solution to everything, including disease. Chinese medicine has a unique understanding of the  interconnection between all the systems of the body, between the body, mind and emotions, and of the relationship between us and our environment which enables practitioners to see more clearly how a chronic disease was developed in a particular individual. Thus, the climate we live in, our emotions, our relationships, specific aspects of our lifestyle and diet, and our exposure to pollutants may become important parts of the puzzle of chronic illness.


TCM causes of disease
Traditional Chinese Medicine classifies the causes of disease in this way:
External Causes, which refer to a variety of climatic and environmental factors
Internal Causes, which are specific emotional and mental factors
Miscellaneous Causes, which mostly refer to lifestyle  and infectious and polluting agents


External causes of disease

In this category, we find six climatic and environmental factors that can turn into pathogenic influences as they "invade" the body.  Each of these factors is predominant

Climatic and environmental factors can cause disease

during a specific season although they may also be present at other times of the year depending on the latitude and altitude we live in or because of unusual climatic changes. They can also be created artificially in our heated and air conditioned homes. The six external pathogens or "evils" are listed below:

• Wind: Predominant in spring, and also produced by fans, airconditioning and drafts, Wind tends to cause a sudden onset of symptoms and affect the upper parts of the body. Wind often combines with other pathogens such as Heat, Cold and Damp, helping them penetrate the body. Sneezing, itching, headaches, twitching, and symptoms that rapidly change location can all be caused by Wind invasion.
• Cold: Predominant in winter, and also easily contracted diving into cold water, Cold makes the body chilly and produce excessive watery discharges. Symptoms that can result include watery eyes, a runny nose, and frequent copious urination. As cold contracts matter, this pathogen can also cause pain and stiffness in different locations of the body.
• Damp: Predominant in late summer - a humid season in some parts of China -, Dampness tends to affect the lower parts of the body more than the upper parts and, amongst other things, can cause a sensation of heaviness, aching joints, swellings, thick and sticky discharges, and sluggishness in the digestive system. In the SW of the UK where I live and work, this pathogen is prevalent throughout the year.
• Heat: Predominant in summer, Heat can cause symptoms such as sensations of heat , fever, dryness in different parts of the body, thirst. inflammation, constipation, sweating, and dry skin.
• Summerheat:  This pathogenic factor is like Heat but much stronger in its effect, and can also occur in summer. Summerheat can also easily combine with Damp pathogens causing symptoms such as nausea, vomiting, diarrhoea, heaviness and sticky discharges as well as severe fever, sweating, and thirst.
• Dryness: Predominant in the autumn - although not where I live!-, Dryness can affect bodily fluids resulting in symptoms such as dry eyes, dry nose, dry mouth, dry cough, dry stools, and thirst. This pathogen can easily be caused by different types of heaters and air conditioning systems.

External pathogenic factors invade the body either singly or in combination. They start on the superficial layers of the body where, depending on the strength of the pathogen and of our defensive energy, they may be expelled back out or move inwards causing further symptoms and damage. Symptoms like chills and fever, skin rashes, body aches, sudden swelling of the joints, and headaches can be caused by external invasions.



Internal causes of disease
 In Chinese medicine, it is understood that the body, mind, emotions, and spirit are but different manifestations of Qi. Rather than being separate from each other, these different aspects of ourselves constitute a fluid continuum of energy that goes from the density of the physical body to the lightest, more ethereal Spirit. TCM explains that when Qi, or any of its manifestations, does not flow smoothly or its flow is impaired, this can result in the development of symptoms. It is in this way that an imbalance in our emotions can transfer into a denser form of our Qi and cause physical symptoms. The internal causes of disease consist of seven specific emotions that can turn into pathogenic factors because of our failure to healthily express or otherwise deal with them,  or because of the emotions being so sudden and excessive that we cannot protect ourselves from their effect.

Emotional imbalances are Internal causes of disease

- Suppressed emotions -  for example, unexpressed anger, frustration, or grief - can cause Qi to stagnate. This can in turn cause a myriad of symptoms which may include pain in any part of the body.
- Chronic emotional states - such as constant worry, stress, anxiety, and sadness that are not addressed or resolved- not only disturb our mind and general wellbeing but can also consume our energy which may result in a gradual decline in the functioning of the whole body.
- Sudden, strong emotions - such as fright, trauma, and euphoric or elated states like those artificially caused by chemical substances - can scatter Qi and may interrupt and disrupt its flow to such an extent that it may be hard for it to be restored again. This can result in ongoing mental, emotional and physical disturbances.

The close relationship between each of the seven emotions and a specific organ of the body means that when a particular emotion is out of balance its related organ will be affected first. As all TCM relationships are reciprocal, this also means that when an organ is out of balance its corresponding emotion will be exacerbated. In addition to this, all types of emotional imbalances affect the Heart which, in TCM theory, is the seat of consciousness and of the spirit, and whose energy is involved in any type of emotion we experience.

These are the seven emotions and their corresponding organs:

• Anger and related emotions such as rage, annoyance, frustration, jealousy, etc; affect the Liver and its functions causing Qi to ascend and go the "wrong way". This can result in a variety of symptoms ranging from headaches and digestive difficulties, to pain and disturbances in the menstrual cycle

• Joy, as well as elation, euphoria, overexcitement, etc; affect the Heart and may cause the Qi to slow down and scatter around as well as produce excessive heat that can result in sleep disturbances, nightmares, agigation, and an inability to concentrate or relax.

• Sadness - which includes gloom, despair, etc- affects the energy of the Lungs and tends to deplete the Qi resulting in lack of energy, weakness and weak immunity

• Grief affects the  Lungs and Heart and has a similar effect on the energy as Sadness, weakening the Qi.

• Pensiveness, which manifests as overthinking, circular thinking, and worry, affects the Spleen, causing Qi to get knotted and stuck,often resulting in digestive difficulties

• Fear affects the Kidneys and causes the Qi to descend. This is the reason why in times of extreme fear there may be incontinence of urination or defecation.

• Fright (shock) also affects the Kidneys, causing Qi to become chaotic. It then may take a long time for Qi to recover its normal course as it happens in some cases of PTSD

Miscelaneous causes of disease
Our constitutional weaknesses, what we eat and how we eat it, the amount and type of exercise that we do, and our exposure to chemicals, pollutants, and to parasitic or infectious agents, can all be factors involved in the development of disease and are classified in TCM as miscelaneous causes of disease.

Having healthy parents greatly contributes to our health

Our constitutional strength is a direct result of the health of our parents at the time they conceived us, and the health of our mothers during pregnancy. When we are born, this constitutional strength is further shaped by the appropriateness of the nourishment we are given as well as the environment we live in. Just as we may end up with a weak or strong immune systems, we may be more or less able to cope with certain activities, foods, or environmental factors. It is common in the West to be oblivious of this. We instead tend to believe in the "once-size-fits-all" approach to lifestyle, exercise, and diet and often unwittingly cause harm to our bodies by doing and eating things that are detrimental to our individual health. Becoming aware of our own constitutional strengths and weaknesses and honouring them by adopting a lifestyle that promotes our wellness is one of the keys to good health and it is something that Chinese medicine is particularly good at because of its deep understanding of how the body works and how it relates to the outside environment. I consider this the most important part of my work as a TCM practitioner as I believe it is not enough to alleviate symptoms but it is also necessary to find ways to prevent their recurrence so that each person has control of their own health.


Although in TCM identifying infectious agents is not important per se, treating infections and intoxication from different types of chemical pollutants is possible through identifying the manifestation of their toxicity in a particular individual and treating them accordingly. Preventing the development of diseases caused by toxicity from infections and chemicals is essential in our modern world where we are subjected to increased pollution and to a chemical overload in our food and many household products, and where our immune systems have been bombarded with antibiotics while we are exposed to increasingly strong infectious agents. Fortunately, it is possible to reduce our exposure to toxins by choosing more natural products and we can also strengthen our immune system through our diet and lifestyle. TCM treatment for this kind of condition consists of aiding the detoxification of the body while strengthening the body's resistance to disease. This is done with a combined strategy that would include diet and lifestyle changes as well as herbal remedies and acupucture.


In contrast with the simplistic view of disease we have in the West, where we think that a complex chronic disease can result from a single cause (sugar- diabetes, cholesterol- heart disease/stroke, chemical imbalance in the brain - depression, and so on); in TCM, disease - particulary when chronic - results from a distorsion or diruption of the equally complex relationships between internal and external factors. As a result, prevention and treatment of disease are processes that involve identifying and addressing the pathogenic factors that have caused the symptoms so that there is relief, as well as harmonising the relationships both between the internal organs and between the individual and the environment so that the symptoms are corrected in the long term.