External pathogenic factors causing diseases are often difficult for people to understand. Some may have a straightforward understanding; for example, as a rheumatologist, patients with joint pain subconsciously say they have rheumatism. Wind and dampness belong to the “Six Excesses” that cause disease. Patients may express that they have not been exposed to wind or do not have significant dampness, so why do they suffer from rheumatism? From the patient’s perspective, there is a conflict in thinking.
Currently, experts from the Chinese Rheumatology Association often criticize Traditional Chinese Medicine (TCM). For instance, when discussing rheumatic diseases in TCM, they refer to systemic lupus erythematosus as a rheumatic disease. Is this caused by wind and dampness? They also claim that arthritis is unrelated to rheumatism, even though the incidence of rheumatism in Northeast China is similar to that in the South.
In fact, there is a conceptual confusion here. In TCM, rheumatism refers to the Six Excesses, so the concept of rheumatism in TCM differs from that in Western medicine, which refers to connective tissue diseases or autoimmune diseases, translated as rheumatic diseases. Even experts cannot distinguish between them, let alone ordinary non-medical personnel.
Although Chinese civilization is the only one among the four great civilizations that has continued to this day, many words have changed in meaning to varying degrees. For example, the term “Six Excesses” is not used in the same way by modern people. Xu Shen’s Shuowen Jiezi states: “Excess refers to encroaching and infiltrating according to the body’s surface.” This means gradually permeating based on the body’s surface, and it also refers to excessive or overindulgent behavior.
The Six Excesses refer to the six Qi: wind, cold, summer heat, dampness, dryness, and fire. These are normal operations of nature, and both excess and deficiency can cause disease.
The diseases caused by the Six Excesses are not only related to the seasons but also to the living environment. The Six Excesses themselves are the dominant Qi of the five seasons in nature. Therefore, wind diseases are more common in spring, fire diseases in summer, summer heat and dampness diseases in late summer, dryness diseases in autumn, and cold diseases in winter. These concepts can be extended; for example, those living in damp environments or engaged in aquatic work are more prone to cold and dampness, while those working in high temperatures are more likely to suffer from summer heat diseases.
Diseases caused by the Six Excesses are often not isolated. For example, “wind-cold” or “wind-heat” refers to the invasion of the body by a single wind or cold pathogen. “Wind-cold external invasion” is the combination of wind and cold pathogens invading the body, while “Bi syndrome” refers to the combination of wind, cold, and dampness invading the body’s meridians.
After the Six Excesses invade the body, under certain conditions, they can transform into one another. The nature of the pathogenic Qi can change depending on the individual’s constitution. For instance, an external cold pathogen can transform into heat internally, or prolonged exposure to summer heat and dampness can lead to heat damaging Yin.
The Six Excesses are external pathogens, thus they often invade the body through the skin. Therefore, one should adapt to the changes of the four seasons and be cautious of abnormal weather.
It has been over sixty days, and the feeling of being confined at home is very unpleasant. Not only is there a lack of the usual hustle and bustle, but the general silence in society is hard to adapt to. Some people even choose to leave this world in their youth, which reflects a deep despair.
I can continue to share some insights on TCM with friends every day, but please understand that TCM emphasizes personal cultivation. Once placed in a certain position or given a certain responsibility, it is no longer a purely academic issue.
Issues related to food, education, healthcare, and society are all much larger than TCM issues. TCM is also a part of society; it should not be viewed in isolation or exaggerated.