The TCM Concept of Disharmony
In TCM, health is a state of dynamic balance and free flow of the body’s fundamental substances (Qi, Blood, Body Fluids) within the framework of Yin and Yang. Disharmony is a disruption of this balance.
Think of your body as a complex, organic garden. Disease isn’t just a weed that popped up (an external invasion); it’s a sign that the overall health of the garden’s ecosystem is out of balance. The symptoms are the warning signs—the wilting leaves, the waterlogged soil, the pest infestations.
1. Qi Disharmonies (气证)
Qi is the animating energy for all bodily functions. When Qi is dysfunctional, it affects everything.
A. Qi Deficiency (气虚 – Qì Xū)
· The Metaphor : The body’s “battery” is low. There’s not enough energy to power basic functions.
· Causes : Chronic stress, overwork, poor diet, prolonged illness, aging, weak constitution.
· Key Symptoms : Fatigue, lethargy, weak voice, shortness of breath (especially on exertion), spontaneous sweating (the body cannot hold fluids), pale complexion, low immunity.
· Affected Organs : Commonly Spleen (digestive fatigue, bloating), Lung (breathlessness), and Heart (palpitations).
B. Qi Stagnation (气滞 – Qì Zhì)
· The Metaphor : A traffic jam of energy. Qi is not flowing smoothly, leading to congestion.
· Causes : Emotional stress (especially frustration, anger, resentment), physical trauma, lack of movement, irregular diet.
· Key Symptoms : Distension, fullness, and pain that moves from place to place. The pain is often described as aching or dull. Sighing, mood swings, feeling of a lump in the throat (Globus Sensation), irritability.
· Affected Organs : Most commonly the Liver (responsible for smooth flow of Qi), but also Stomach (bloating, belching) and Lungs (chest tightness).
C. Qi Sinking (气陷 – Qì Xiàn)
· The Metaphor : A failure of the body’s “lift” or “suspension” system. This is a severe form of Qi Deficiency.
· Causes : Chronic Qi Deficiency, often from the Spleen, which is responsible for “holding” things up.
· Key Symptoms : A sensation of heaviness and drooping. This includes organ prolapse (uterus, bladder, rectum), chronic diarrhea, frequent urination, and a feeling of bearing down in the abdomen. Severe fatigue.
· Affected Organs : Primarily the Spleen.
D. Rebellious Qi (气逆 – Qì Nì)
· The Metaphor : Qi is flowing in the wrong direction. Each organ has a natural direction for its Qi (e.g., Stomach Qi should descend; Lung Qi should descend).
· Causes : Emotional upset, dietary irregularities, external pathogens.
· Key Symptom s: The symptom depends on which organ’s Qi is rebelling.
· Rebellious Stomach Qi : Nausea, vomiting, hiccups, belching.
· Rebellious Lung Qi : Cough, asthma.
· Rebellious Liver Qi : Headaches, dizziness, irritability (Liver Yang Rising).
· Affected Organs : Stomach, Lungs, Liver.
2. Blood Disharmonies (血证)
Blood nourishes and moistens the body. It is considered a denser form of Qi.
A. Blood Deficiency (血虚 – Xuè Xū)
· The Metaphor : The body’s “land” is undernourished and dry. There isn’t enough blood to moisten and nourish the tissues.
· Causes : Poor diet, chronic illness, blood loss (e.g., heavy menstruation), Spleen Qi Deficiency (which fails to make blood).
· Key Symptoms : Pale or dull complexion, pale lips, nails, and tongue. Dizziness, blurred vision, floaters in the eyes. Numbness or tingling in limbs. Insomnia, dream-disturbed sleep, poor memory (as Blood houses the Mind).
· Affected Organs : Primarily the Heart (governs Blood) and Liver (stores Blood).
B. Blood Stasis (血瘀 – Xuè Yū)
· The Metaphor : The river of blood is frozen or clogged with mud. Blood is not moving, leading to localized blockage.
· Causes : Qi Stagnation (if energy doesn’t move, blood won’t move), Cold constricting the blood vessels, trauma, chronic inflammation.
· Key Symptoms : Fixed, stabbing, or piercing pain that is worse with pressure and at night. Dark, purplish complexion, lips, or nails. Purple spots on the tongue or a dark, purple body. Abdominal masses, fibroids, varicose veins. Menstrual blood with dark, clotted blood.
· Affected Organs : Can affect any organ, but commonly the Heart (chest pain), Liver (menstrual pain), and Uterus.
C. Blood Heat (血热 – Xuè Rè)
· The Metaphor : The blood is “overheating” and boiling over, forcing itself out of the vessels.
· Causes : External Heat pathogen entering the blood level, chronic Yin Deficiency generating internal heat, emotional stress generating Liver Fire.
· Key Symptoms : Bleeding. This can be nosebleeds, bleeding gums, hemoptysis (coughing blood), hematuria (blood in urine), or heavy menstrual bleeding with bright red blood. Skin rashes that are red and hot. Agitation, restlessness, thirst.
· Affected Organs : Heart, Liver, and the blood vessels themselves.
3. Dampness & Phlegm (痰湿)
These are both considered “pathogenic fluids” resulting from the body’s inability to transform and transport fluids properly.
A. Dampness (湿 – Shī)
· The Metaphor : The body’s internal environment is waterlogged, like a swamp. It’s heavy, sticky, and sluggish.
· Causes : External damp environment, diet (too much cold, raw, sweet, or greasy food), Spleen Qi Deficiency (the Spleen is the key organ for transforming fluids).
· Key Symptoms : A feeling of heaviness in the body or head. Bloating, poor appetite, a feeling of fullness in the chest or abdomen. Lethargy, fatigue. Sticky or sweet taste in the mouth. Thick, white tongue coating. Loose stools.
· Affected Organs : Primarily the Spleen.
B. Phlegm (痰 – Tán)
· The Metaphor : Dampness that has been “cooked down” and condensed into a thicker, more stubborn substance. It can be physical (phlegm in the lungs) or non-substantial (phlegm misting the mind).
· Causes : Dampness that persists, often combined with Heat (forming Phlegm-Heat) or Cold.
· Key Symptoms :
· Substantial Phlegm : Cough with copious sputum, wheezing.
· Non-substantial Phlegm : Nodules, lumps, cysts, fibroids. A feeling of obstruction or “lump” in the body. Dizziness, vertigo, fuzzy or muzzy thinking. In severe cases, it can cause mental disorders (Phlegm misting the Heart Orifices).
· Affected Organs : Lungs (obvious phlegm) and Spleen (root cause), but can affect any organ, including the Heart and Liver.
4. Yin / Yang Imbalances (阴阳失调)
This is the most fundamental level of disharmony, representing the very energy dynamics of the body.
A. Yin Deficiency (阴虚 – Yīn Xū)
· The Metaphor : The body’s “coolant” is low. There is not enough substance to cool, moisten, and nourish, leading to a relative excess of Yang (heat).
· Causes : Overwork, chronic illness, aging, excessive sexual activity, blood loss, smoking.
· Key Symptoms : Tidal fever (feeling hot in the afternoon or evening), night sweats, malar flush (red cheekbones), Five Centers Heat (heat in palms, soles, and chest), dry mouth and throat, thirst with desire to sip small amounts, scanty dark urine, dry stools.
· Affected Organs : Commonly Kidney (root of all Yin), Liver, Lung, Heart.
B. Yang Deficiency (阳虚 – Yáng Xū)
· The Metaphor : The body’s “furnace” is weak. There is not enough energy to warm and activate bodily functions.
· Causes : Chronic illness, aging, overconsumption of cold foods, constitutional weakness.
· Key Symptoms : Feeling cold, cold limbs, preference for warmth and warm drinks. Lethargy, lack of vitality. Pale complexion, clear copious urine, loose stools. Low libido. The tongue is pale, swollen, and wet.
· Affected Organs : Commonly Kidney (root of all Yang) and Spleen.
Clinical Reality : Combination of Patterns
It is crucial to understand that these disharmonies rarely occur in isolation. A TCM practitioner’s skill lies in identifying the complex interplay. For example:
· Qi and Blood Deficiency : Fatigue (Qi Xu) with pale complexion and dizziness (Blood Xu). Very common.
· Qi Stagnation and Blood Stasis : Distending pain (Qi Zhi) that becomes a fixed, stabbing pain (Blood Stasis). Common in gynecological conditions and trauma.
· Liver Fire blazing : A combination of rebellious Liver Qi (headache, irritability) with intense Heat (red face, red eyes, bitter taste).
· Yin Deficiency with Empty Heat : The classic pattern of Yin Xu generating internal heat, causing night sweats and hot flashes.
By identifying the specific pattern(s) of disharmony, a TCM practitioner can create a highly personalised treatment plan using acupuncture, herbs, and dietary advice to guide the body back to its natural state of balance.
