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According to Chinese pathology, there are three principal causes of the
disharmony that brings about disease: external factors, emotions, and
irregularities in day-to-day living.

External Causes
External causes embrace a range of environmental conditions: wind, cold,
fire, dryness, dampness, and summer heat.

Wind causes movement and change. It invades the body to cause dizziness,
twitching, stiffness, and convulsions. When combined with cold, it engenders
colds, chills, flu, and fever. It is related to the liver and can cause
epilepsy and stroke. Its effects are thought to be strongest in the Spring.

Cold constrains movement and warmth, often leading to stagnation. As well as
possibly causing colds and chills when combined with wind, it can affect the
lungs, resulting in expectorated mucus, and also affect the stomach and
spleen, leading to vomiting or diarrhea.

Fire dries and its associated ailments include fevers, inflammations,
constipation, and infrequent urination. Psychologically, it results in
irritability, lack of concentration, delirium, and manic behavior. In
children it can sometimes result in hyperactivity.

Dryness has a similar action to fire but with a tendency to dry body fluids.
Symptoms include dry skin, cracked lips, a persistent cough with no phlegm,
and constipation. Dampness brings feelings of heaviness and sluggishness.
Typical symptoms include headaches, lethargy, bloating, nausea, and stiff,
swollen, and aching joints.

Summer heat causes heatstroke, exhaustion, and dehydration. It can result in
fever and nausea.

Internal Causes
The importance of a balanced state extends to the emotions and mind as well
as the body. An excess or a lack of emotional expression can lead to a
disharmony that will manifest itself in both emotional and physical symptoms.
No particular emotion is regarded as good or bad — any imbalance is seen as
a potential cause of illness.

Joy in excess leads to over-excitement or agitation, injury to the heart,
insomnia, palpitations, and hysteria.

Anger causes resentment, frustration, rage and bitterness, injury to the
liver, headaches, high blood pressure, menstrual problems, and ailments of
the stomach or spleen.

Sadness affects the lungs and the heart and also causes breathlessness,
fatigue, lowered immunity, and insomnia.

Pensiveness is caused by mental overwork or intellectual overstimulation and
may lead to obsessiveness. It affects the spleen and also causes poor
concentration, lethargy, loss of appetite, and anemia.

Fear affects the kidneys, causing incontinence in adults and bed-wetting in
children. It also reduces fertility, libido, and general immunity to
infection.

Shock affects the kidneys and the heart. Imbalances also lead to
palpitations, insomnia, and fatigue.

Lifestyle Causes
The Chinese desire for balance in all things naturally includes the way we
live our lives. Again, excesses or deficits are seen as generators of disease.

Diet is very important in traditional Chinese medicine. A good diet is the
foundation of good health and many ailments are cured simply by addressing
basic nutritional imbalances. The ideal Chinese diet is comprised of food
which is slightly warm to slightly cool in energy, such as fish, chicken,
pork, beef, grains, cooked vegetables, and certain fruits. Certain hot foods,
especially fried foods, and drinks such as coffee, tea, chocolate, as well as
cold foods, including salads and frozen foods like ice cream, should be taken
in very limited amounts. Salt, sugar, caffeine, and alcohol are regarded as
toxins.

Exercise supports the flow of energy. Without it, the Qi will stagnate.
Excessive exercise, however, will lead to lowered immunity. In Chinese terms,
exercise takes the form of techniques such as Tai Chi and Qi Gong (pronounced
chi kung), which focus on balance and concentration, the movements of the
body being informed by both mind and spirit. Energetic exercise, for example
aerobic exercise, has no role to play in the Chinese philosophy.

Excessive libido and repeated childbirth can damage the health by sapping Qi
energy. They can also result in lower back pain, and failing hearing and
eyesight.

Patterns of Disharmony
Disharmony may be caused by external and internal factors or the excesses and
deficiencies of an unbalanced lifestyle. Depending on the nature of the root
cause, a pattern of disharmony is set up within the body and mind. It is the
diagnosis of this underlying pattern that is the basis of the Chinese
physician’s treatment.

There are numerous patterns of disharmony, many of which overlap, but most
Chinese herbalists work from approximately 75 patterns, with innumerable
further variations on these. The patterns themselves rest upon the Eight
Principles: yin and yang, interior and exterior, cold and heat, deficiency
and excess.

Yin and yang make up the basic guiding principle for diagnosis. Yang embraces
exterior, heat, and symptoms and conditions related to excess. Yin embraces
interior, cold, and symptoms and conditions related to deficiency. There are
four potent imbalances: yang excess exhibits itself in fever, impatience, bad
temper, headaches, rapid pulse, and high blood pressure. Yang deficiency
often shows itself in night sweats, exhaustion, constipation, backache, and
impotence. Yin excess, which is very rarely seen, manifests itself in
lethargy, aches, shivering, fluid retention, and excessive mucus occurring in
the lungs and nasal passages, in the bowel and as a vaginal discharge. Yin
deficiency is exhibited in nervous exhaustion and tension, hot flushes, and
fevers.

The words ‘interior’ and ‘exterior’ refer to the location of the ailment.
Exterior conditions are caused by external factors and affect the skin, nose,
mouth, and hair. Symptoms include colds and fevers, injuries, sweating and
skin problems. They are usually mild and often relieved by inducing sweating,
Interior conditions are more severe and are usually caused by emotional and
lifestyle factors. There is a range of symptoms, depending on the organ
affected, including constipation, diabetes, infertility, impotence, lowered
energy, and heart problems. Treatment depends upon which organ is affected.