In Western medicine, we often think in terms of individual symptoms of illness and look for their relief one at a time. If you have a headache, you seek an analgesic. If you experience acid reflux, you reach for an antacid. If you can’t sleep, you take a sleep aid. In Traditional Chinese Medicine (TCM), that kind of nearsighted focus on a single specific health concern is considered an inferior sort of medicine.
TCM is a holistic healing practice that sees the body as an interrelated whole. In TCM, a headache cannot be considered as separate from things like reflux and insomnia. Indeed, they are all part of a pattern of imbalance and, when grouped together, form a “syndrome” that is used as a starting point for treatment. When the syndrome itself is properly identified and treated, the individual symptoms associated with it should each dissipate. History has shown that the body remains imbalanced and chronic conditions appear when symptoms are treated individually (as conventional medicine does).
In TCM, a syndrome is a specific set of signs and symptoms that are grouped together. The basics of TCM diagnosis consist of what are known as the “eight principle syndromes.” While there are many syndromes associated with the viscera, or internal organs and structures, they are all based on a set of eight fundamentals. The eight principles syndromes are only part of the differentiation of syndrome diagnosis, but play a major role in understanding and identifying health problems. From time to time, I like to write about something unique that can help readers gain a different perspective on their health issues. The TCM syndrome model is one such example.
The eight principle syndromes consist of four binary categories: 1) yin and yang, 2) exterior and interior, 3) cold and heat, 4) asthenia and sthenia. When these are grouped with the other TCM syndromes (visceral syndrome; vital energy, blood and fluid syndrome; meridian syndrome), you can more clearly differentiate each syndrome from the others. This gives TCM practitioners a much clearer view of what is happening in the body and why it may be happening. Treatment suggestions and methods are then chosen to address the differentiation of syndromes. As the pathology or course of the syndrome changes with the health of the patient, treatment modality also changes.
Let’s look at the basics of the four groups of eight principle syndromes.
Yin And Yang Syndrome
The theory of yin and yang guides the understanding of all the syndromes. While the respective yin and yang syndromes are identified separately, they are grouped as pairs and considered in unison. In theory, yin and yang are seemingly contradictory elements (like hot and cold, up and down). However, in practical terms, they are relative to one another. Just as you can’t define something as large without identifying what is considered small, you can’t define yin without yang.
Within the TCM model, there are many different categories of yin and yang (e.g., primordial yin, kidney yin, blood yin, liver yang, kidney yang). These paired symptoms provide insight into how these syndromes differ:
|Yin Syndrome||Yang Syndrome|
|Weak breathing||Heavy breathing|
|Lack of thirst||Very thirsty|
|Slow pulse||Rapid pulse|
|Cold extremities||Hot body and extremities|
|Aversion to cold||Aversion to heat|
Exterior And Interior Syndromes
The exterior syndrome concerns the exterior of the body (shell, skin, head, limbs) and the exterior pathogens that can affect one’s health (dampness, mold, humidity, virus, etc.). Signs and symptoms associated with exterior syndromes are usually apparent at the onset of an illness or disease. If identified as such, they can be addressed early on to avert the potential for a more serious condition. Signs of Exterior Syndrome include:
- Aversion to cold and wind
- Wide-ranging body pain
- Stuffy nose
- Thin nasal discharge
- Thin, white coating on the tongue
The Interior Syndrome concerns the viscera (internal organs): blood vessels, lymph, adrenals and so on. Interior Syndromes can be caused by an “invasion of exopathic evils.” Yes, the language of TCM is archaic and poetic, but it points to the significance of many external components that can, over time, cause damage to the body’s internal balance. These include:
- Excess exertion
- Too much sleep
- Not enough sleep
- Poor diet
- Excessive emotional changes
- Lack of physical exercise
- All forms of stress
Cold And Heat Syndromes
Cold syndromes are caused by the cold temperature of the environment (outside and within the home and workspace), from an excess of the things associated with yin syndrome and a deficiency of things associated with yang syndrome (as noted above). Heat syndromes are caused by external temperature and environment and also by an excess of things associated with yang syndrome and a lack of things associated with yin syndrome. Again, yin and yang must be in balance.
Cold and heat syndromes are differentiated further by their location (exterior or interior; see above) and their nature (asthenic, weakness or sthenic, exuberance). For example:
|Exterior Cold Syndrome||Interior Heat Syndrome|
|Aversion to cold||Visceral heat|
|Fever, no sweat||High fever, no chills|
|Headache||Desire for cold drinks|
|Copious, clear urine||Scanty, dark urine|
|Arthralgia||Red complexion, rash|
In general, signs and symptoms of cold syndrome are treated with warm or hot-natured food, beverages and herbals, while heat syndrome is treated with cool or cold-natured foods, beverages and herbals.
Asthenia And Sthenia Syndromes
In layman’s terms, these are weakness and vigorous syndromes, respectively. Asthenic syndrome is characterized by debility of health energy (qi), weak immune system and poor or weakened organ and visceral functions. Sthenic syndrome is characterized by intense body reactions resulting from an external pathogen (toxin, virus, bacteria) or internal visceral dysfunction. Both asthenic and sthenic syndromes are considered morbid conditions requiring immediate care and are differentiated in terms of the overall quality of energy, immunity, blood, fluids, organs, yin and yang.
While all this may sound confusing, or even overly simplistic, keep an open mind. It is part of a larger system of syndrome differentiation used to identify root causes of the patterns of health imbalances. I present such material to give a bit of insight into how other medical models work or proceed, given the same health information. TCM, in general, seeks to treat the whole body with the idea that a simple headache or insomnia or reflux is not caused in isolation. These problems occur as a result of a broader imbalance in the body that needs to be addressed if a stronger or more permanent solution is to be found. With the basic information ascertained for the Eight Primary Syndromes presented here, you can start to see how binary patterns can emerge and seek to keep them in balance.