* This page is presented for informational
purposes only. In all cases of serious illness it is recommended
that a qualified practitioner be consulted.
Diagnosis is of crucial importance in any medical
or healing system that works on the body. Metaphysical healing
systems tend to pay far less attention to the body assuming that
removing emotional and mental causes will automatically remove
the physical symptom. While this is a legitimate approach, in
the meantime, the body still needs to be looked after. The following
is a brief overview of the diagnostic approach of Traditional
The point of diagnosing is to design a treatment.
An improper diagnosis will lead to an improper treatment and as
often as not a worsening of the conditions.
Even though the approach of TCM seems fairly straightforward,
the fact is that most often one encounters numerous and often
contradictory symptoms in the same patient.
There is a lot more to diagnosing then, than simple
observation of symptoms. One must take account of the relative
strengths of symptoms, whether they are getting stronger or weaker
in relation to other symptoms, the relative strength of the patient,
and other such intangibles. Intuition is as important a diagnostic
tool as knowledge and experience.
The most common method
of diagnosis in Traditional Chinese Medicine is the so-called
8 Principals. Diagnosing a disharmony consists of asking
whether the condition is
Internal or External,
Hot or Cold,
a Deficiency or an Excess,
whether it has a Yin character or a Yang
Causes of Disease According to Traditional Chinese
There are many factors that can cause disease.
In Chinese medicine in fact illness is characterized as a 'syndrome.'
That is a collection of symptoms that together make up a pattern
of disharmony in the body. Nor are these symptoms restricted to
the body. Along with physical symptoms, emotional and even mental
states are considered in the diagnosing of a syndrome.
Causes of disease generally speaking fall into
a number of general categories.
a) 6 Exogenous Factors,
b) 7 Endogenous (emotional) factors,
c) conditions arising from improper diet,
d) too much activity (hyperactivity),
e) too little activity stagnation,
f) traumatic injury,
g) insect, animal or reptile bite.
Within each category there are a number of differentiating
categories to look at. For example the 6 Exogenous factors are;
These will quickly be recognized as conditions
that exist in nature. Under ordinary circumstances these are not
pathological to the human body, but become so when conditions
are extreme, sudden or the body's resistance is low.
Exogenous factors are seen as those that enter
the body from the exterior and are closely related to seasonal
For example what we call Colds and Flu, seen most
often in the fall when seasons are changing, are characterized
in TCM as invasions of Wind, invasions of Wind/Cold, or invasions
of Wind/Heat, depending on the severity of symptoms and depth
of penetration into the body.
Heat and Fire Syndromes are seen most often in
the summer. Dampness syndromes
are seen most often in later summer. Dryness is seen most often
in Autumn. Cold Syndromes are seen most often in the Winter.
Ambient pain in the muscles and joints called
by various names in Western medicine is characterized in Chinese
Medicine as 'Bi Syndrome' caused by invasion of Wind/Cold/Dampness.
There are several different kinds of 'Bi Syndrome.'
Ancient physicians, of course had little notion
of invading microscopic organisms like bacteria or viruses and
while treatment options do include 'expulsion of pathogenic factors'
it is not enough to simply expel the particular factor. Proper
treatment most often includes tonifying specific organs or the
body as a whole both to help with expelling the invading pathogen
and to speed recovery.
Signs and Symptoms
External cause - characterized by sudden
onset affecting the exterior of the body, sensitivity to
Cold or Wind, slight fever, thin coating on the tongue and
a superficial pulse.
Internal cause - characterized by longer
term onset as the pathogen works its way into the interior
of the body. In most cases the internal organs are affected
and signs and symptoms of channel and organ disharmony are
seen. See below for symptoms of each organ system disharmony.
Cold - characterized by aversion to Cold,
pale tongue, preference for hot drinks, pale face, thin
Heat - characterized by aversion to heat,
red tongue, preference for cold drinks, flushed face, full
Deficiency - deficiency refers to not enough
Qi to ward off pathogenic factors. Deficiency manifests
in the body in different ways including deficiency of Qi,
deficiency of Blood, Deficiency of Yin or Yang.
Symptoms are varied but include; emaciation,
listlessness, feeble breathing, loss of strength, shortness
of breath, spontaneous sweating, night sweats, incontinence,
and pain that is alleviated by pressure.
Excess - refers to hyperactivity of Qi in
the body. Excess manifests in the body in different ways
including excess Qi, excess Blood, Excess Yin or Yang.
Again symptoms are varied but include; agitation,
loud voice, heavy breathing, fullness and/or bloating in
the chest and/or abdomen, pain aggravated by pressure, constipation,
irritability, thick tongue coating and full pulse.
Yin & Yang are a pair of principals
used to generalize categories of syndromes. Once we have
looked at all the symptoms presented we can say whether
a condition is mostly Yin or mostly Yang. *see Yin/Yang
For example Cold syndromes are Yin in character.
Heat syndromes are Yang in character. Deficiency syndromes
are Yin in character. Excess syndromes are Yang in character.
External syndromes are Yang in character. Internal syndromes
are Yin in character.
It is rare of course that one finds a condition
that is purely Yin or purely Yang, but from a diagnostic
perspective one may be able to gauge the relative strength
and direction of movement in the body. This is important
information for designing treatments. For Yang syndromes
we need to reduce. For Yin syndromes we need to tonify.
Key to Chinese thinking is balance and harmony.
Everything must be balanced with everything else in order to achieve
harmony. In the area of diet, the Chinese have separated all foods
into 5 different categories according to taste. Each of these
categories has a specific effect on the body and why Chinese cooking
makes every effort to balance all five tastes. This is known as
5 Elements theory.
The five tastes are;
For more information see *5
Elements Theory page
In theory, then one can eat pretty much what one
wants as long it is balanced. By this though, I am not necessarily
referring to the over processed sugar based packaged snacks so
popular in the West these days. The food one eats must have at
least some nutritive value.
So it is not so much that specific diets are bad
for you, it is the overindulgence of specific kinds of diets that
lead to illness. For example, overindulgence in a hot spicy diet
will lead to symptoms of Heat or Fire and excess in the body.
A strictly vegetarian diet of raw vegetables will lead to symptoms
of Cold and Deficiency. A diet with too much Dairy in it will
lead to symptoms of Cold and Phlegm.
For optimum health, though, certain diets are
As well as the kinds of foods that are consumed
attention must also be paid to how food is prepared and how it
is consumed. In Taoist philosophy there is a lot more to food
than just eating it.
Each of the tastes characterized above, according
to the 5 Elements theory is linked to a major organ system.
1. Sweet taste is linked to the Spleen/Stomach
2. Sour taste is linked to the Liver organ system,
3. Bitter taste is linked to Heart organ system,
4. Salty taste is linked to the Kidney organ system,
5. Pungent taste is linked to the Lung organ system.
It is often the case in Chinese medicine that
appropriate treatment for an illness is a change in diet. The
line between what is food and what is medicine is quite blurred,
and many items that are considered food or spice in the west are
consumed for their medicinal properties in the East. Among these,
onions, garlic, pumpkin seeds, scallions, ginger, leeks, rhubarb,
watermelon, mustard seeds, cinnamon, chives, and cloves.
Hyperactivity, Stagnation, Traumatic
Injury, Insect, Animal or Reptile Bite,
These are all variations on a similar theme. Physical
activity, beyond one's limit leads to injuries to muscles and
tendons. These can be relatively minor or quite serious. Relatively
minor injuries not treated and persistently aggravated can lead
to serious injury over time.
Not enough physical activity leads to atrophy
of muscles and tendons.
The treatment is either to slow down or speed
up. In other words figure out what the appropriate amount of physical
exercise is for you and do that.
We in North America tend to think being bitten
by insects, animals or reptiles as little more than an annoyance.
Certainly here in Southern Ontario where I am, there's nothing
too dangerous. Still there are many parts of the world where this
sort of thing is a serious concern and an important cause of illness
that TCM concerns itself with.
Endogenous causes of illness are characterized
in Chinese medicine as the 7 Emotions. They are;
1. Anger - associated with the Liver system
2. Joy - associated with the Heart system
3. Worry/ Overthinking - associated with
the Spleen/Stomach system
4. Grief - associated with the Lung system
5. Sorrow - (chronic grief) associated with
the Lung system
6. Fear - chronic condition (phobias) associated
with the Kidney system
7. Fright - acute condition - associated
with the Kidney system.
Emotional responses have an effect on the body.
This is nothing new. When we are fearful or severely angry, the
stomach tightens, we sweat, the heart pumps faster and stronger,
we breathe faster, adrenaline and other chemicals are released
into the blood to stimulate some organ systems and shut others
down. When we are in grief or in joy we don’t feel much
like eating, sleeping is difficult, we may have heart palpitations,
or we may feel disoriented.
While modern medicine continues to scratch its
head and wonders if emotional responses can actually have any
lasting effect on the physical body, ancient Chinese physicians
had a useful working model of just how emotions and the body are
intricately linked and affect each other.
Using this system we are able to diagnose internal
disharmonies according to external symptoms observed. The following
are some of the major symptoms that one may observe, the organ
system to which they apply and the emotion that is suggested by
This exercise is intended to help you begin to
understand what it is your body is telling you about your emotional
state. As well it is to help you understand how your emotional
state affects the body. The links between the body and the emotions
are intimate and interactive. Physical symptoms indicate emotional
disharmony and emotional expression indicates physical disharmonies.
Strange as it may seem, I believe that most of us are not nearly
as familiar with our emotions as we might think.
For example; Grief is housed in the Lungs. Grief
would then be seen as an important aspect of Asthma. Any treatment
of Asthma, to be effective from an Wholistic perspective would
have to include reduction or release of Grief. In Acupuncture,
the same point that is chosen to tonify the Lungs also helps to
The following then is a list of symptoms, which
are, in Chinese medicine indicators of disharmony in the five
main organ systems, which according to the 5 elements theory suggests
also an underlying emotional component.
The Spleen’s main function is to Transform
water, food and air into Qi and Transport that Qi throughout the
Needless to say, this is an important function. If the body is
properly nourished, the Spleen can do its job and good health
is the result.
If the Spleen does not receive the proper raw materials it has
to work that much harder to extract the Qi and transport it. As
this function is critical to the organism as a whole, the key
to any treatment for any kind of illness is to feed the body well.
In severe illness this may involve herbal or pharmaceutical medication.
The emotion of the Spleen is Worry or Overthinking. The balance
of Yin and Yang is always the goal.
It is recommended that one eat in peaceful surroundings without
distractions. Some recommend that one not even talk to others
while eating and certainly watching TV, reading, doing homework,
or catching a bite on the run are not healthy things to do.
Of course, this becomes a vicious cycle. The more
we worry, the more deficient the Spleen becomes which in turn
causes us to worry still more.
Nourishing the body is absolutely primary in the recovery from
If the Spleen system is nourished properly, the
better it can nourish all the other systems and their related
In the West, perhaps it is a stretch to grasp that simple changes
to one’s diet can have far reaching emotional and physical
consequences, but in the East it is a fundamental principal. You
may take note of the fact that people who mainly 'think' for a
living often have stomach problems.
The following physical symptoms suggest a Spleen
dysfunction of some kind. Emotionally, they suggest Worry/Overthinking.
Puffy eyelids and puffiness under the eyes
Craving for sweets
Drooling/excess saliva/saliva leaking
Anything to do with the mouth or lips
Prolapse of any vessel including uterus,scrotum,intestine,anus
Easy bruising or bleeding
Rashes of any kind
A thick or swollen tongue with teeth marks on the side.
Borborygmus or stomach/intestinal gurgling.
Painful, numb or tingling extremities, especially the feet.
It is often the case that these symptoms come
and go related directly to our diet and our propensity for worry.
Often we don’t pay much attention until something becomes
chronic and starts to affect our lives. If a symptom is not too
much of an inconvenience we either ignore it or cover it up and
go on with what we were doing.
Since Fatigue is a major symptom of Spleen dysfunction,
if you have Chronic Fatigue Syndrome it might be a good idea to
look at your propensity to worry or over-think things, as well
as your diet, not only what you eat but how you eat.
Disharmony in the Lungs takes 2 forms; a)
acute such as the response to sudden loss of a family member,
and b) chronic - characterized as 'sorrow' which may be
held in the body for months or years.
The Lungs are associated with the emotion
of Grief. Symptoms indicating a Lung system disharmony and
by association Grief as an underlying component include;
Asthma/any kind of breathing problem
Any kind of nasal problem (as the nose is associated with
Phlegm in the lungs or sinuses
Susceptibility to colds, flu, or other ambient infections
Lungs govern the skin so any kind of skin problem may indicate
Grief as an underlying component.
Inability to urinate fully
Sneezing (an explosive clearing of pathogenic factors)
Sweating, especially spontaneous sweating in the absence
of a cold or flu, indicates a Lung deficiency, or perhaps
a clearing of grief along with other pathogenic factors.
Spontaneous sweating is a common symptom of cleansing.
The Liver is responsible for the free flow of
Qi in the body. It stores blood and is responsible for maintaining
blood levels and efficiency. The emotion attached to the Liver
Since the Liver’s responsibility is to move Qi in the body,
a Liver disharmony will have an effect on all the other organ
systems and their related emotions.
the basis for the 5 Elements theory is precisely that all organ
systems, their functions, and related emotions is in fact, that
they are interconnected and affect each other, The Liver's effect
is particularly pronounced.
This is consistent with the observation that Anger
is a particularly strong, even primal emotion. Anger is often
seen in combination with other emotions. We often get ourselves
out of fear, grief, or worry, simply by getting angry, at ourselves
or at another.
From a TCM perspective, this is very much, the
body doing what it needs to do to promote Qi flow and return to
wellness. While we tend to take a dim view of someone expressing
Anger, in some situations, it is in fact the healthy thing to
do. The expression of Anger, at least temporarily has the effect
of promoting Qi flow and clearing stagnant blockages in the body.
Suppressing Anger causes Qi to stagnate in the Liver and therefore
affects Qi flow in the body as a whole.
Of course, we must emphasize that the expression of Anger in particular
situations is only a temporary measure. It is what the Body does
when all other measures fail.
Symptoms of Liver dysfunction include;
Pain or distention in the hypochondriac region,
at the sides of the body around the diaphragm is a common sign
of Liver disharmony.
Acute, stabbing pains anywhere in the body
Pain or distention in the eyes
Headaches at the sides of the head including Migraine headaches
Frequent and/or heavy sighing.
In Chinese Medicine, any kind of pain is considered
to be Stagnation of Qi and or Blood. This means that the treatment
principal for any kind pain is usually ‘move Qi & Blood.’
From a TCM perspective then, if you have Fibromyalgia or some
other such condition characterized by 'mystery' pain, it would
be a good idea to look at your Anger.
The heart houses the Mind in Chinese Medicine.
The brain is considered an extraordinary Fu organ, that
is an ‘empty sac’, which is a characteristic
of Fu organs. The Brain is seen as a place to store and
process raw data.
It is in the Heart that a person’s essence and personality
This is why, in Chinese Medicine, many mental problems are
seen as disharmonies of the Heart.
From a TCM perspective, then, there is a medical basis for
the observation that lack of Joy or Love in a person’s
life ultimately makes them crazy.
When you speak from the Heart, you speak from Joy and the
world is truly a brighter place.
Physical Symptoms of a Heart disharmony
Shortness of breath
Sweating (in the absence of disease)
Pallor or pale complexion
Stuffiness in the chest
Palpitations or irregular heart beat
Dream disturbed sleep
Propensity to be startled
Feelings of uneasiness
Muttering to one’s self
The Kidney system is often seen in combination
with dysfunctions of other organ systems. In TCM the Kidneys have
the unique function of housing one’s corporeal essence or
life force. One is born with YUAN QI, also called Primary Qi or
Congenital Qi. According to the theory one is born with only so
much Yuan Qi, which can never be added to, but which can be ‘topped
up’ by Jing or Nutrient Qi from the Spleen.
Yuan Qi, may also be seen as the motive force
of the Corporeal Soul which animates the body. When one’s
Yuan Qi is all gone the body dies and the Corporeal soul dies
with it releasing the Ethereal Soul.
Physical manifestations of weak Yuan Qi are birth defects, problems
with birth, weak constitution, and susceptibility to childhood
Strong healthy babies are said to have strong Yuan Qi.
Whether one has strong or weak Yuan Qi will affect
one throughout life. Weak Yuan Qi, or essence, may lead to complications
or illness later in life, premature aging, or death at a relatively
A man’s essence is manifest in his semen.
The sexual organs are seen as part of the Kidney organ system.
Overindulgence in sex or masturbatory ejaculation are a couple
of ways that Kidney essence may be depleted.
A woman’s essence is manifest in her menstrual
blood and giving birth. Excessive menstrual flow, difficult pregnancies,
and too many pregnancies will deplete a woman’s essence.
Excessive fear over a period of time will also
deplete Kidney essence.
A severe fright or a particularly intense ejaculatory orgasm in
a man, will deplete the Kidney’s essence almost instantaneously.
Physical symptoms of Kidney Disharmony include;
Weak or sore lower back.
Weak or sore knees.
Darkness under the eyes.
Irregular or problematic menstrual flow.