The Progression of Disease According To Oriental Medicine: Part 2

In Part 1 of this series, I presented the overview of the progression:

1. Normal discharge and elimination

2. Abnormal discharge and general fatigue

3. Aches and pains signalling sluggish blood circulation

4. Blood quality decline with chronic discharge

5. Accumulation of excess nutrients in circulation

6. Storage of excess nutrients in various compartments

7. Nervous system disorders

8. Delusion

In that post I also presented what happens in stage 1, health, and stage 2, temporary changes in elimination and physical, emotional, and mental activities as the bodymind attempts to metabolize the excess nutrients.  In this part, I will look at stages 3 and 4.

3. Aches and pains signaling sluggish blood circulation


In Chinese medicine, we have a principle:  "If there is pain, there is impaired flow; if there is good flow, there is no pain."  This encapsulates the direct experience that if anything impairs circulation to any part of the body, that part will suffer some type of discomfort.  From this experience, Chinese physicians realized that if any part of the body suffers from some discomfort, this signifies an impairment of circulation of vital blood, nutrients, fluids, and nerve impulses to that part or associated parts.

(By the way, this principle applies equally to social-political and environmental disorders as well.  Social-political disorders arise from poor circulation of resources, allowing some parts of the body politic to suffer deficiencies while others have excesses, creating tension and inflaming passions.  Environmental disorders arise when one organism monopolizes excessive resources while other organisms suffer deficiencies.)

All assimilated nutrients temporarily affect the composition of the blood.   After meals, we see increases of blood fats, sugars, amino acids, vitamins, and minerals.  The body tries to maintain healthy blood levels of water, fats, glucose, cholesterol, minerals, etc. regardless of diet.  If a meal contributes more of any of these factors than the body can readily manage or easily store, it will temporarily affect blood circulation while the body works to remove the incoming nutrients from the blood and store them in appropriate places.  

However, if a person continuously eats three or more meals daily providing excess nutrition, more than the body can use quickly or easily store in an appropriate location in a non-toxic form, this can result in a more or less continuous overabundance of nutrients in the blood, and that can result in a more or less continuous alteration in blood circulation. 

Most people in industrialized nations have had the experience of eating a large holiday meal (feast) and feeling simply overloaded, sluggish, short of breath, and fatigued afterwards.  This provides a direct experience of how excessive nutrition places a burden upon the body, particularly the cardiovascular system, and the effect can last for several hours or more.  If a person feasts 3 times daily, the cardiovascular system will have to deal with excessive nutrition almost continuously through the day. 

High-fat blood sample. Source: Case Reports in Medicine

As I have discussed here, Western research has also shown that rich, i.e. high-fat, meals increase blood coagulation factors. High-fat meals have been shown to increase platelet aggregation, fibrinogen, factor VII, and other hemostatic factors; meals rich in saturated fats (e.g. butter) having the strongest procoagulant effect, followed by meals rich in monounsaturated fats (e.g. olive oil).(1, pdf ) 

Thus it seems that Western research may support the Oriental medicine perspective that an excessive intake of rich foods can produce sluggish blood circulation.  The thick sluggish blood can’t properly nourish, lubricate, or detoxify the tissues, including the heart and brain.  The tissues don't get enough oxygen, and waste products accumulate faster than they are removed.  These internal changes reach our awareness as aches and pains and disturbances of normal function.

In line with this, Kuo et al found that fat ingestion can induce myocardial pain (angina pectoris) in patients with coronary artery disease (2).  Afaq et al found that patients with excess blood cholesterol had reduced oxygen delivery to the calf muscles and consequent shorter time to claudication, which involves pain in the calves along with decreased ability to walk (3).  Mattson et al demonstrated that dietary cholesterol affects serum cholesterol in a dose-response fashion; a cholesterol-free, 40% fat diet produced average serum cholesterol of 164 mg/dl; adding 126 mg cholesterol produced an average serum cholesterol of 174 mg/dl; 212 mg cholesterol daily raised serum cholesterol to an average of 181 mg/dl; and 317 mg cholesterol daily raised the average to 198 mg/dl (4).  Hunter-gatherers, non-human primates, and wild animals have serum cholesterol levels below 150 mg/dl (5, pdf), showing that nature prefers a serum cholesterol below 160 mg/dl.   

Total Cholesterol In H-Gs and Wild Animals.  Source: 5

 Other populations with high immunity to cardiovascular diseases also have average serum cholesterols below 150 mg/dl, including rural Chinese (127 mg/dl, 6), Tarahumaras (125 mg/dl, 7), and Caucasian men eating macrobiotic diets (147 mg/dl, 8).  Based on this data I have revised my views and now consider anything over ~160 mg/dl excess serum cholesterol.

According to Oriental medicine, the following signs and symptoms all reveal developing, diet-induced blood stagnation:

muscle pain and tension

headaches

menstrual cramps

numbness

moderate aches and pains

intermittent abdominal discomforts

sleep disturbances

breathing problems

heart disturbances

chills and fevers

motion and coordination problems

Due to disturbances of blood circulation to the brain and heart, as this stage develops the individual may also experience more frequent mental and emotional disturbances such as hyperexcitability, worry, insecurity, sadness, depression, frustration, and impatience.

To restore balance at this stage, one must remove the causes, maintain a healthy diet with a negative balance of items taken in excess, take appropriate exercise and rest.

Assuming interruption of this process early in its development, recovery from this stage requires restoring the free flow of blood which will require several days to several weeks of healthy diet and lifestyle.

4. Blood quality decline and chronic discharge

If someone continues to consume an excess of some or all nutrients past stage 3, the blood quality gradually declines because the sluggish circulation slows down removal of wastes from the blood by the liver and kidney. Consequently, the whole bodymind system progresses to chronic illness and development of chronic abnormal discharges.

In general, according to Chinese medicine, chronic blockage of blood circulation generates heat (inflammation) in the blood, which gradually affects the entire body if not corrected.

As excess nutrients in circulation gradually but increasingly impair circulation to the lungs, large intestine, liver, kidneys, and skin vessels and pores, the organs can’t properly detoxify the blood and the blood, in turn, can’t properly nourish, moisten, and detoxify the skin.  

In a healthy condition, the body controls the growth of abnormal cells.  However, when the blood  constantly contains excess nutrients that cells need for growth and replication (amino acids, fatty acids, cholesterol, etc.), and the immune system is impaired by poor circulation and accumulation of toxic wastes, abnormal cellular growth can occur unchecked, producing first benign tissue overgrowths like skin tags, moles, bunions, and so on.  If left unchecked, this process eventually leads to malignant growths.

Thus, skin abnormalities herald this stage of disease. As the skin becomes overburdened with metabolic wastes, skin diseases can develop, often in a step-wise fashion from minor to major.  At first the skin diseases may come and go with more or less inflammation or infection.  If left uncorrected, the underlying systemic imbalance will lead next to more constant and serious disorders, generally in a step-wise fashion:

1. pimples, spots, rashes, moles, warts, bunions, dryness, etc.

2. eczema, psoriasis

3. skin cancer
 

As the blood quality declines, while also containing surplus nutrients, it gradually becomes a favorable environment for microbial or abnormal cellular growth, producing blood disorders progressing gradually in seriousness:

1. chronic infections

2. blood malignancies

Other signs of this stage include chronic nasal discharge or sinus congestion, irregular bowel movements, abnormal sweating, rapid respiration, frequent urination, bad breath, chronic vaginal discharges, and chronic unpleasant body odor, all produced as the body attempts to use every possible channel of elimination to get rid of the excess stuff in the blood, attempting to prevent accumulation of these wastes in the tissues. 


By careful observation, Chinese physicians discovered that when the body gets too hot and dry, it produces thicker, darker, more odorous secretions, and when it gets too cold or damp, it produces thinner, lighter secretions.  Thus, darker, drier, concentrated, hard to expel, strong smelling, and more concentrated urine, mucus, feces, sweat, and odor all indicate a body afflicted with heat that can arise from chronic excessive intake of heating and drying, or yang (pronounced "yahng") foods (e.g. red meat, spices), and clear, copious, more watery, runny, and less odorous urine, etc. all can indicate a body imbalanced by excessive intake of cooling and moistening, or yin (pronounced "yeen") foods (e.g. fruits, ice cream).  A person who overconsumes both types of foods can have a mix of both types of symptoms and signs.

Since the blood serves as the material foundation of the mind, as the blood becomes continuously and progressively sluggish and toxic, more chronic mental and emotional disorders arise, such as nervousness, oversensitivity, depression, hyperactivity, confusion, and disorientation (loss of purpose), along with an increasing sense of alienation from one’s community.

Chinese medicine categorizes foods according to whether they are relatively more yin—or cooling, moistening, and draining—or relatively more yang—heating, drying, and congesting.   In terms of mental-emotional effects, excess intake of more yin items (e.g. ice cream, sugar, fruits) produces a more withdrawn, passive affect,  and excess of yang items (e.g. red meat, spices, greasy foods) produces a more aggressive affect. 

To restore balance at this stage one must eliminate the excess intake, eat an appropriate diet, take exercise and rest, and employ special medicinal foods, drinks, and compresses. Recovery will take from 10 days (for plasma renewal) to 4 months (for red blood cell renewal).

The Progression of Disease According to Oriental Medicine: Part 1

Warning:  This series of blogs presents an alternative Chinese-scientific perspective on the development of disease.  I won't and can't provide 'research' to back everything largely because modern scientists have not shown much interest in understanding the directly observable marks of deteriorating health, due to their entrancement by laboratory tests which may distract them from direct observation of the people they attempt to help.

In the Yellow Emperor’s Classic of Internal Medicine (Huang Di Nei Jing), Qi Bo, the emperor’s personal physician, says (paraphrased): 

“Those who wait to treat disease until it has already arisen are like those who wait until they are thirsty to dig a well, or wait until they are in battle to forge weapons.  Are not these actions too late?”

Due to this preventive perspective, for several thousand years of development Chinese physicians focused on identifying early signs of imbalance so that they could take actions to avert health disasters by adjusting their own, and their patient’s diets and lifestyles.   Perhaps as a consequence, famous traditional Chinese physicians had extraordinary healthy lifespans for their times.    For example:

Dr. Sun Su Mao (Ssu-Mo) (581-682) – lived 101 years, an impressive feat for the 6th century.  He once said “Anyone over 40 years old should try to avoid laxatives, which will weaken his body, and begin to take tonics.  Anyone over 50 years old should take tonics all year round; such are the secrets of nourishing life to enjoy longevity.”

Dr. Meng Shen (621-713) – lived 92 years.  He once said “A person who really knows how to nourish the body should always keep good foods and herbs handy.”

Dr. Luo Ming Shan (1869-1982) lived 113 years.

In Chinese Foods for Longevity, Henry Lu points out that according to Outstanding Chinese Physicians in the Past and their Medical Theories published by Peking College of Chinese Medicine in 1964, the 37 most outstanding Chinese physicians between 581 CE and 1964 CE had an average lifespan of 80.56 years.

Many of these guys lived well before the 18^th century, yet, on average they lived 10 years longer than the average modern citizen of modern industrialized nations.

Over the millennia of its development,  due to their considering dietetics one of the essential branches of medicine, Chinese physicians realized that many supposedly ‘minor’ symptoms arise from dietary imbalances, and that if left unchecked the process producing these 'minor' symptoms would eventually produce a major disease.  Gradually this came to formulation as an understanding of how the bodymind (Chinese medicine considers mind and body as one unit) progresses from minor to major diseases based on an imbalance between dietary intake and elimination or expenditure.

The Chinese perspective rests on the realization that to maintain homeodynamics (health) the bodymind must have just the right amount of nutrition, neither too much nor too little.  Like Plato, ancient Chinese physicians noticed a clear division of disease incidence between wealthy aristocrats and ordinary peasants.  

So long as they had adequate quantity and variety of simple plant foods and a little animal products, the peasants remained lean, healthy and fit and had long lives.  If they suffered food shortages, often due to excessive taxation (taxes were paid in bushels of grain) by overlords, they developed deficiency diseases marked by infectious disease susceptibility, weakness, wasting,  mental and physical listlessness, and pallor. 

In contrast, among wealthy and overfed overlords who used some of the grains procured by taxation to produce grain-fed animal products for their own feasting, physicians saw diseases of excess marked by abnormal accumulations:  obesity, diabetes mellitus (identified by Chinese physicians by 700 AD,  900 years before Europeans), tumors, restlessness, tension, and sluggishness.

This led the Chinese philosopher-physicians to both political and medical conclusions.  On the political side, they vigorously opposed taxation, as recorded in the Tao Te Ching and many works of Confucius, Mencius, and other so-called Confucians:

"Human hunger is the result of overtaxation; For this reason, there is hunger."  Tao Te Ching Chapter 75

They also developed a unique view of the role of the physician, and identified three ranks of physicians:

Lower doctors:  Those who treat and heal sicknesses symptomatically but do not treat the whole personality of the patient or guide to a healthy lifestyle.

Middle doctors:  Those who treat and heal by guiding the patient to change his or her personal habits and attitudes, including diet, exercise, meditation, and ethics.

Highest doctors:  Those who treat and heal the sicknesses of society, nation, and world through philosophy and education to align self with others, and humanity with nature. 

The "Confucian" Classic of Great Learning encapsulates some of the central tenets of "higher medicine" as conceived by Chinese philosopher-physicians.

On the medical side, by treating both the wealthy and the poor, Chinese physicians developed a clear understanding of how disease develops. 

On the one hand, deficiency of intake relative to requirements (elimination and expenditure) will create deficiency diseases, and on the other hand, excessive intake relative to requirements will create diseases of excess, accumulation, congestion, blockage, and stagnation. Chinese philosopher-physicians saw this process occurred whether talking about diet (excess or deficiency of food) or other matters (excess or deficiency of clothing, shelter, possessions, etc.).  

To the Chinese, health, whether personal, mental, social, or political, could arise only through achieving the Golden Mean, a concept held in common with Aristotle.

These days, in modernized industrial nations, a majority of the people live like the royalty of the past, with plenty of rich food to eat.  Consequently, people in modern industrialized nations suffer primarily from nutritional excess diseases such as obesity (accumulations of body fat), diabetes (excess fat and sugar in the blood), cardiovascular diseases (accumulations, congestion, and blockage of blood vessels causing stagnation of blood circulation), neurological diseases involving accumulation of plaque (Alzheimer’s, multiple sclerosis), and numerous others. Among affluent populations, deficiencies occur almost always in a context of excesses.

Oriental medical theory maintains that in most cases these late stages of psychophysical degeneration are preceded by a long gradual process of apparently minor alterations in health that herald the oncoming or eventual disaster and offered opportunities for self-correction.   Chinese physicians taught their patients to stay aware of this process and to self-correct using food therapy.  

However, one must understand that these food therapy methods work well only in the context of the basic healthy diet developed and integrated into Asian cuisine:  starch-based, low in fat and animal products, rich in colorful vegetables.  You can't overturn the ill effects of a very imbalanced diet by adding a few servings of a medicinal food.  

Basically, if you understand how disease progresses from minor to major, you can interrupt the process before it becomes so deeply rooted that you will have trouble correcting it with natural approaches.  Updated application of this perspective using traditional Chinese medical theories (yin-yang, Eight Principles, and Five Transformations) can easily incorporate and make sense of otherwise inexplicable medical findings, such as why many people with skin disorders have a history of respiratory allergies or asthma as well.    

In outline form, the progression looks like this:

1. Health:  Balanced intake and normal discharge

2. Abnormal discharge and general fatigue

3. Impairment of blood circulation and aches and pains

4. Impaired blood quality with chronic discharge

5. Accumulation of excess material in circulation

6. Storage of excess material in various compartments

7. Nervous disorders
8. Diseases of mind and spirit, summed as self-delusion

1. Healthy condition: Balanced Intake and Discharge

We take in nutrients from foods and beverages as well as influences from climate (hot, cold, damp, dry) and social environment (emotions, sounds, colors, etc.).  All of these inputs have some effect on our physiology.  To maintain health we have to retain what we need and discharge any excess.

We all transform or discharge inputs through respiration, perspiration, urination, defecation, and physical and metal activities. Women have additional avenues of discharge through menstruation, parturition, and lactation.

 

Every physical or mental activity we express reflects the quality of what we have ingested.

Accordingly, in addition to climate, time and place, diet exerts an influence on culture through its psychophysical effects on the creators/participants.  Thus, different climates and diets produced different historical qualities of art, music, architecture, literature, games, sports, etc..  For example, the traditional Chinese diet produced people who resonated with the traditional Chinese music, the Indian diet produced people who resonated with traditional Indian-style music, and the diet of certain youth in the U.S. produced people who resonated with heavy metal rock.  

What comes out reflects what went in.

 2. Excessive intake and abnormal discharge.

If from a healthy state you ingest or inhale or otherwise absorb an input that supplies something that exceeds the bodymind’s needs and the capacity of normal routes of discharge, the bodymind will manifest alterations of function, most moving the excess input out of the body, such as:

• coughing and sneezing
• more frequent defecation
• more frequent urination
• increased and spontaneous sweating and sudden rashes
• fidgeting, tapping, muscle spasms and tension, acute hyperactivity
• rapid blinking
• irritability, anger
• anxiety, excitability

The more extreme the imbalance of intake, more extreme the output, such as:  shivering, trembling, nausea, vomiting, crying, shouting, screaming.

The input here could include healthy food (subtle reactions), spoiled food or an allergen (strong reactions), or traumatic experience like witnessing some aweful crime, losing a loved one, or enduring a natural disaster, among many other possibilities. 

Chinese physicians did not recognize a dichotomy of body and mind, nor did traditional Western physicians or culture. Chinese physicians watched the development of internal organ disorders and saw mental and emotional effects of those disorders, and also the reverse, that sudden emotions resulted in altered operations of internal organs.  They correlated fear with the kidneys, anger with the liver, joy with the heart, rumination with the digestive system, and grief with the lungs, by noticing how emotions affected or were affected by the organs.  

So for example, in fear people may lose control of urination, in anger they may get indigestion marked by reflux, bloating and pain, rumination can destroy the appetite, overjoy (excitement) can affect heart rate and strength, and grief affects respiration (sobbing).

 In English, we still have words reflecting this ancient understanding.  For example, an disrespectful person "has the gall,"  referring originally to an imbalance of the gall bladder,  a depressed person has 'melancholy,' an imbalance of the bile (chol-), and an aggressive or angry person is 'bilious' or 'choleric,' again, an imbalance of the bile, or liver/gallbladder system [1].  And how about being "pissed off" and "so scared I shit my pants"?  Chinese medicine has a way of physiologically understanding the actual experiences that gave rise to these locutions as well.

I know, where are the 'studies' to support this?  I don't know of any, yet.  Chinese physicians discovered that eating animal liver would treat night blindness hundreds of years before laboratory science discovered retinol (vitamin A) and showed that night blindness results from retinol deficiency.  If they had waited for double-blind, placebo-controlled studies and modern biochemistry to confirm that eating animal liver treats night blindness, thousands of people would have gone blind from deficiency over the years.  

Modern laboratory and clinical science creating 'top-down' knowledge only studies a quite small part of reality and moves very slowly compared to empirical discovery growing from 'bottom-up.'

Check your own experience. For my part, I see these relationships in my clinic on a daily basis.

Anyway, these signs, among others, indicate that the specific organ(s) have taken the brunt of the dietary excess:

• A tendency to obsessive thinking, rumination, whining, complaining can indicate an overload of the digestive system.

• A tendency to anger, impatience, or shouting can arise from an overload of the liver and indecision can arise from an imbalance of the gall bladder.

• A tendency to anxiety and fear can arise from an imbalance affecting the kidneys, urinary bladder, or endocrine system.

• A tendency to fall into crying or grief can indicate an imbalance affecting the lung or large intestine.

• A tendency to nervousness, hyperexcitability, or inappropriate laughter can indicate an imbalance affecting the heart.

At this stage of imbalance we may also feel general fatigue resulting from the burden placed on body organs by the overload of input. 

At this stage of disease, recovery requires removal of the dietary and other causes, and improvement of diet and exercise.  Since the imbalance does not have deep roots, it may take only several hours to several days to recover.

I'll go through the  rest of the stages in future posts.