understanding and treating disease in TCM
In TCM (Traditional Chinese Medicine), there are 6 evils we look at as causes of disease. These 6 evils first appear in the Shen Nong classic. They help acupuncturists diagnose patients while understanding the potential source of the disease, the symptomology, and how to best treat it. This allows acupuncturists to help chronic pain, autoimmune diseases, allergies, and everything in between. But what exactly are these evils, how do they work, and why are they are so important in TCM?
The 6 pathogenic evils
These ‘evils’ are not spiritual evils or anything particularly negative or inherently evil. They are just associated with energies and influences that enter our body as an intrusion on our constitutional health. Once they enter, they wreak havoc on our body in different ways. Depending on our own immune system, also known as our ‘Wei Qi’ in TCM, we may be able to fight them off when they attempt an invasion.
These 6 pathogenic evils linked to causes of disease are all external, outside influences. To better understand this concept as a whole, I will first explain what these 6 pathogenic evils of disease are (summarized from this article):
Wind - AKA ‘the cause of 100 diseases’. This evil can bring the other evils in with it. Usually causes rapid onset/changes, sudden movement, rashes, spasms, etc. and is most common in Spring.
Cold - weakens, slows, and makes you feel cold. Easily effects the low back, knees, joints, stomach, intestines, and liver. Causes qi and blood to stagnate, causing pain and stiffness.
Damp - mucous or discharge anywhere in the body, bad odor, nasal discharge, edema, swelling, arthritis, candida, etc.
Heat - redness, feeling hot, produces wind signs in the body, restlessness, agitation, or red, itchy, painful rashes.
Summer Heat - high fever, restlessness, high thirst, dizziness, headache, constipation, sweating, etc.
Dryness - dry skin, hair, eyes, lips, throat, stools, etc. Dry cough or dry phlegm. Could be from dry climate or smoking.
Each of these ‘evils’ are considered intruders, pathogens, and negative impacts on our health when they penetrate and enter the body and cause further imbalances in our system. Acupuncturists can better understand the potential source of the imbalance/disease by drawing connections between the symptoms and the characteristics of these evils.
How these evils cause disease
The 6 evils can enter the body through any of our orifices, the nape of the neck, the chest, the ankles, and any other area of the body that is exposed to these elements for an extreme time period. Remember the old worry of children playing in puddles because it may make them sick? This is because they are exposing their body to extreme cold and damp at the same time - two evils combined! When someone with an already weakened immune system is exposed to these evils, they tend to get sick shortly after. This is why it is so important in TCM to always cover your next in the fall and winter with a scarf, to always wear socks to protect your feet from the cold, and to avoid sitting on cold chairs (just to name a few).
Once the evils enter the body, they can wreak havoc on any of your organs, meridian pathways, and bodily functions overall. This all depends on the type of evil that has invaded, your own constitution and immune system at that time, and also the stage that these evils are in while being trapped in your body. Sometimes evils can enter the body and we can fight them off by taking a bath, taking herbs, vitamin C, supplements, etc. But other times, the illness doesn’t leave, and can actually drive deeper into the body and manifest in different ways depending on your own body and how it handles those evil influences.
Understanding progression of disease in TCM
So let’s assume you have symptoms associated with the common cold - sneezing, slight cough, runny nose, clear snot, chills, maybe a fever, fatigue, change in smell/taste, etc. This would be considered an invasion of a ‘wind cold’ in TCM and treated as an ‘excess’ pattern by an acupuncturist. So we would suggest hot baths, ginger tea, maybe even cayenne, and an acupuncture treatment involving warm cupping and needles. Because the character of these symptoms show an invasion of a wind cold pathogenic evil, we would treat the body with the opposite elements to help the body expel and remove the excess that has invaded and isn’t needed.
But let’s say you can’t do that - you have to work overtime that week, you can’t find a baby sitter, your kids are also sick, etc. You may feel better overall in a couple weeks as the immune system will still fight it off in any way it can. But let’s say you end up generating a slight cough that won’t go away after the common cold symptoms leave. Or you find your energy just isn’t the same again. Or you find you are now cold all the time but didn’t used to be. It could manifest in different ways, but this may indicate that the initial pathogenic evil invasion has now moved to a deeper level and may cause an excess or deficient status in your body.
In TCM, we know the initial signs of chills and fever usually indicate that the pathogen is in the ‘Wei level’, meaning it is in the boundary between entering the body and leaving for good. Once it goes deeper, it will stop presenting with chills and/or fever and may target a specific organ or pathway and show symptoms there. In time, this may continue, or may go unnoticed or untreated, which could cause it to go even deeper.
There are 4 stages for warm disease and 6 six stages for cold diseases, each of them showing different signs depending on what pathway and organ system they are effecting (see article here and here for more info). There are also excess and deficient patterns acupuncturists look at in order to understand what treatment would be best. This ‘syndrome differentiation’, and understanding of outside evils, help acupuncturists understand disease progression, symptoms, and treatment without being limited to the diagnosed name of a disease. The symptoms and progression of your condition(s) is what matters most. Our goal is to bring harmony to your body, mind and spirit. By understanding the nature, origin, and progression of your disease, we can facilitate natural healing.
advice for understanding and healing your disease
I have encountered many autoimmune conditions, chronic pain, chronic migraine, hormonal imbalances, etc. in my life and practice. I find it is most important to own your health and to learn to be your own advocate. Ask questions, research things, trust your intuition, and explore the right care team for you. Every time you have an attack, a flare up, or pain, just try sitting with it to see where it is, how it feels, how it makes your spirit feel, and what helps it lessen. You are the only one that knows you best.
If I could provide helpful tips to anyone battling any illness, this is what they would be:
Detach a bit from the name or diagnosis of your disease/condition. 10 people could come in with a migraine, or Crohn’s, or lupus, and each of them would get an entirely different treatment. This is because everyone is different and symptoms appear differently for everyone, no matter what the name is. It is best to know YOUR condition, not the norm or average.
Focus on how you feel, in every way, at every moment. Where do you feel the aches, the pain, the stiffness, the itch? Does it change? What time of day is it worse at? What helps make it feel better? Is it worse during certain seasons? Did any life event occur around the time of it getting worse? Focus on the timeline, your best and worse days, and what your ultimate goal in treating your disease is.
Set a goal for your disease. Do you just want to feel better overall? Do you want one particular thing to go away first? Do you want to get off your medications? Do you want to change your lifestyle? Decide on your main goal and be specific.
Try different things and decide to do what resonates with you the most. There are many different modalities to choose from when treating your condition, and none of them are wrong. Pick the one that works best for you and makes the most sense to you. Set a goal and track the progress. Pivot when needed! Remember you are just exploring the journey of your body, mind and spirit through this imbalance. Be open and optimistic as often as possible.