Previously, we discussed how to collect data using the four diagnostic methods of observation, listening, inquiry, and pulse-taking. After gathering this data, we draw conclusions that guide our clinical practice. The manifestation of these “conclusions” is represented by Yin-Yang, deficiency-excess, exterior-interior, and cold-heat, collectively known as the “Eight Principles of Diagnosis” (Ba Gang Bian Zheng).The Eight Principles of Diagnosis is a particularly practical method in clinical practice. Once you understand this method, you can simplify complex issues in a straightforward manner. A Traditional Chinese Medicine (TCM) practitioner ultimately aims to find a main thread that simplifies all complex phenomena.Yin-Yang, deficiency-excess, exterior-interior, and cold-heat continue to describe Qi and Blood, which remain the core subjects. If we can use Qi and Blood to unravel the concepts of Yin-Yang, deficiency-excess, exterior-interior, and cold-heat, focusing on Qi and Blood, we can resolve issues. Otherwise, the more knowledge we acquire, the more confused we may become, unsure of where to start. Therefore, we will further dissect these terms using Qi and Blood.
1.
Which is Yin and which is Yang, Qi or Blood? Anything bright, active, and lively belongs to Yang, while anything moist and relatively stagnant belongs to Yin. Therefore, Qi is Yang, and Blood is Yin.
2.
When do we call something deficiency, and when do we call it excess? Deficiency is caused by the depletion of essence and Qi, while excess is due to the prevalence of pathogenic Qi.What is pathogenic Qi? There is a saying, “Qi that exists out of season”, for example, in winter, heating is normal, but if it is excessive, it becomes harmful. In an extremely hot environment, a person may feel agitated.For instance, in the summer, if it is very hot outside and one suddenly enters an air-conditioned room at eighteen degrees, it is easy to fall ill. Summer is inherently hot, but the excessive cold created by air conditioning is an example of “Qi that exists out of season.”There is also “objects in inappropriate places”. For example, if the entrance is meant to be a passageway, but someone places a pile of clutter and a table there, it obstructs the passage, altering its intended function. This is an example of “objects in inappropriate places.”Modern medicine uses a term that I find very accurate, called “occupying space.” Our ancestors also had a similar term, called “the cuckoo occupying the magpie’s nest,” which refers to something inappropriate appearing in a place where it should not be. This “cuckoo occupying the magpie’s nest” represents pathogenic Qi.
Pathogenic Qi can be divided into internal and external.External pathogenic factors are referred to as the six excesses, or epidemic Qi.“Wind, cold, heat, dampness, dryness, and fire” are considered excessive or insufficient when they exceed the body’s tolerance, termed the six excesses. For example, we need warmth, but if it is too warm, it becomes hot, leading to heatstroke. Conversely, when dampness is excessive, we desire dryness for relief. However, if it is too dry, like in a desert, it can lead to dehydration, and we would prefer some moisture. But if a person is soaked in water, they will also feel uncomfortable.There are also internal pathogenic factors. Internal pathogenic factors refer to excessive or insufficient emotions such as joy, anger, worry, thought, sadness, fear, and shock.Any emotion should be expressed in moderation. What does it mean to express in moderation? It means to be balanced, without excess or deficiency. For example, if I get angry and break a teacup, that is normal. But if I throw the teacup at someone’s head, that is excessive. If a person never expresses anger and suppresses their emotions, that is insufficient.Studying TCM is about learning moderation. When there is no moderation, it becomes pathogenic.What is righteous Qi? Having moderation is righteous Qi; lacking moderation is pathogenic Qi. The so-called pathogenic Qi can be summarized as Qi and Blood being disturbed by external or internal pathogenic factors, losing their normal flow or frequency.The body has a natural frequency of operation; when it maintains this frequency, it functions normally. If it exceeds this frequency, the person becomes ill. In fact, all our treatments aim to restore Qi and Blood to their normal trajectory and frequency. As long as this is achieved, healing occurs.I have mentioned four words: “Qi and Blood in disorder”.These four words represent the pathogenesis of all diseases. Regardless of internal or external causes, they all arise from this result. Therefore, by addressing this result and restoring the disordered Qi and Blood, the illness can be cured.
3.
What do we mean by exterior and interior? It primarily refers to exterior syndrome and interior syndrome.What is the relationship between exterior-interior and Qi-Blood?Exterior-interior, deficiency-excess, cold-heat, although these terms differ, they all hint at a relative Yin-Yang principle.When discussing deficiency-excess, where there is deficiency, there must be excess; when discussing cold-heat, where there is cold, there must be heat; similarly, whenever we see “exterior,” we must not forget its “interior”; Qi and Blood are always “interior and exterior as one”.For example, if we want to release the exterior and induce sweating, but the body is already dry inside, how can we induce sweating to release the exterior?Thus, understanding the “interior and exterior as one” of Qi and Blood is key to our learning.Therefore, regardless of how we discuss pathogenesis, we know it is the “discrepancy between interior and exterior” of Qi and Blood.
4.
Temperature can be divided into three types: one is perceived temperature, one is psychological temperature, and the other is objective measured temperature.Perceived temperature, for instance, sometimes two people stand in the same place, one feels cool while the other feels cold. Why do they feel differently in the same environmental temperature? Because their Qi and Blood, volume, and flow speed are different.Another type of temperature is psychological temperature. As the saying goes, “A kind word warms three winters, while harsh words hurt in June,” referring to psychological temperature.Objective measured temperature is the temperature of the environment and body that can be measured by instruments.Cold can also be divided into internal and external cold.Internal cold is caused by slow Qi and Blood circulation within the organs.When Qi and Blood do not circulate, they stagnate and do not generate heat. When they flow quickly and smoothly, warmth is produced. If it is internal cold, no matter how many layers of clothing you wear, use heating pads, or hide under blankets, it may not completely resolve the issue. However, if it is external cold, simply hiding under a blanket or warming up can suffice. Therefore, when discussing cold, we still relate it to the volume and flow speed of Qi and Blood.
External cold Qi is called “guest Qi”; thus, for external cold, we can expel the pathogenic factors.If it is internal cold, we need to enhance the speed of Qi and Blood circulation. It is simply a matter of knowing where this Qi originates, allowing us to apply appropriate methods.Because humans are always in communication and interaction with the external environment. The reason our Qi and Blood can flow is due to two elements from the outside: one is Yang, and the other is Yin. Yin and Yang are originally two sides of the same coin; heaven represents Yang, and earth represents Yin. The interaction between heaven’s Qi and earth’s Qi leads to various changes, which also express exterior-interior, deficiency-excess, and cold-heat.Previously, we used Qi and Blood to explain the terms Yin-Yang, exterior-interior, cold-heat, and deficiency-excess. If we do not connect them through Qi and Blood, we may always be unsure of where to start. With Qi and Blood as our focal point, we realize that these are also transformations of Qi and Blood, representing another aspect of Qi and Blood.From the four diagnostic methods to the Eight Principles, we have been learning about Qi and Blood: one is collecting data on Qi and Blood, and the other is analyzing the volume and flow speed of Qi and Blood. The concepts of storage volume and flow volume of Qi and Blood are not contradictory. Once you can connect these concepts, when you encounter a person, you will know how to approach them.
● Pulse Diagnosis: Between the tangible and intangible● Observation of Qi● Observation Diagnosis: Not by sight, but by spirit (1)(This article is compiled from the TCM course recordings of Dr. Lin Jie)