Introduction: It is often heard from experienced TCM practitioners the phrase “扶正祛邪” (fǔ zhèng qū xié), but what does it specifically mean? Perhaps not many people know. In TCM, the occurrence of disease is related to the balance of the body’s righteous (正气, zhèng qì) and evil (邪气, xié qì) energies. The outcome of a disease can also be seen as a result of the struggle between these two forces. Clinically, how should we effectively utilize “扶正祛邪”? Let’s first listen to the clinical experiences of seasoned TCM practitioners!
Righteousness and Evil in TCM
In TCM, the concept of “正气” (zhèng qì) is broad and rich. In terms of pathogenesis, it refers to the body’s structural integrity, subtle substances, their functional activities, disease resistance, recovery ability, and the body’s adaptability and regulatory capacity to external environments.
Righteousness is also abbreviated as “正” (zhèng). TCM believes that when the internal organs function normally and righteousness is abundant, the body is filled with qi and blood, making it difficult for evil to invade, thus preventing disease. Even if evil qi attacks the body, righteousness will rise to resist it. If righteousness is strong, evil is hard to invade, or if it does invade, it will be promptly eliminated by righteousness, making disease less likely to occur, and if it does, it is usually mild and easily recoverable. Various pathogenic factors exist in nature, but not everyone exposed to them will become ill; this is the result of righteousness overcoming evil.
When righteousness is insufficient, or the pathogenic capacity of evil exceeds the resistance of righteousness, the balance of power between righteousness and evil manifests as evil being strong and righteousness weak. Righteousness is unable to resist evil, and after being affected by evil, it cannot promptly expel it, nor can it quickly repair the damage caused by evil to the body, leading to the occurrence of disease.
Evil qi is abbreviated as “邪” (xié), also known as “虚邪” (xū xié) or pathogenic evil, which is a general term for all pathogenic factors. In TCM, evil qi includes external pathogenic factors such as the six excesses (六淫, liù yín), epidemics, internal injuries from emotions, diet, work and rest, as well as external injuries and insect bites. Evil qi is an important factor in the onset of disease and can even play a leading role under certain conditions.
Pathogenic evil qi is omnipresent. As long as the body’s righteousness is sufficient, even in the presence of evil qi, it cannot harm or cause disease. Only when righteousness is insufficient, and the defensive capacity declines, or when the pathogenic capacity of evil exceeds the resistance of righteousness, can external evil invade and cause disease. Therefore, it is said that “where evil gathers, its qi must be deficient.”
In treatment, there are eight methods: sweating, vomiting, purging, harmonizing, warming, clearing, resolving, and tonifying, which can be summarized into the two major principles of supporting righteousness and expelling evil. The occurrence of disease is closely related to the weakness of righteousness; thus, supporting righteousness cannot ignore the expulsion of evil, as expelling evil can eliminate pathogenic factors. Hence, the ancients said, “when righteousness is sufficient, evil will naturally depart,” and “when evil departs, righteousness will naturally be at peace.”
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