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Introduction to the Causes of Disease

by Todd Luger, L.Ac.

According to the theories of traditional chinese medicine, the causes of disease can be divided into three categories:

1) External causes - These were originally limited to the climactic factors of wind, cold, damp, heat, and dryness. Many of the conditions associated with these factors are acute, such as colds, flus, sudden onset rheumatism and gastroenteritis. Some researchers have associated these factors with viruses and bacteria. The framework of modern behavioral medicine suggests another idea. The pathogenic nature of the climactic factors is due to the stress response induced when the weather (or one's living conditions) changes rapidly or becomes extreme in nature. Classical studies of stress actually involve exposing animals to extreme conditions, and then studying the changes in their body systems. The results demonstrate that if an individual cannot adapt fast enough to the changes occurring in his environment, his system will be overwhelmed and his immunity temporarily weakened. Depending upon which climactic factor has injured the individual, certain types of normally harmless microorganisms (or allergens) can then cause disease. This is why colds (and allergy) are seasonal phenomena. By correcting the influence of the climactic factor, immunity is restored, and the disease is vanquished. The best advice for preventing infection is eating properly and dressing warmly. Chinese medicine advises that one avoid exposure to wind or cold after sweating. One should also take particular care at the change of seasons. Dressing too lightly is a common precipitator of colds.

A more recent addition to the list of external causes is the concept of toxin. Toxins are virulent pathogens, that are not associated with climactic factors, and can attack even the normally resistant individual. Diseases caused by toxins are generally acute and feverish, possibly epidemic, and were often fatal, until the advent of modern medicine. This category is quite similar to the modern concept of viruses and bacteria. The concept of slow acting or hidden toxins was also recognized. A possible modern parallel might be the HIV virus. Many toxin diseases (diphtheria, cholera, influenza, typhoid, tuberculosis) were related to poor public health measures and inadequate sanitation. Though vaccines are credited with the decline in such diseases, the evidence shows that most were in decline long before vaccines were developed. Certain toxin diseases have been impacted by vaccines, but others are more related to personal hygiene, behavior, and malnutrition. Antibiotics eventually proved curative of several of these diseases, at least temporarily. However, as the use of antibiotics becomes more and more risky (due to the increasing prevalence of drug resistant strains of common germs), chinese medicine can offer proven therapy for many of these complaints. Viruses, in particular, have never yielded to modern medicine. The chinese medical approach is to use herbs that promote the attack function of the immune system, varying the approach according to the chronicity of the ailment and the strength of the patient. It is important that infections be treated thoroughly, as many common viruses are thought to be involved in several chronic diseases (diabetes, lupus, arthritis, for example).

2) Miscellaneous causes - These include diet, environmental pollutants, parasites, poor posture, overwork, lack of exercise, stress, poor sleep, drug/alcohol use, excessive sex, and other habits. It is vitally important that the individual attend to these areas, most of which will be addressed in future handouts. These factors affect the capacity of the individual to resist external factors, and can greatly disrupt the internal factors described below. Chinese medicine can facilitate behavioral changes by improving the will-power and well-being of the individual. Chinese medicine can aid the relaxation process to counteract some of these factors (stress, poor sleep, addiction). However, chinese medicine cannot completely compensate for problems in these areas. The best solution to these problems is often group activities (support groups, exercise or yoga classes, meditation classes, hobby classes, etc.). It is especially important to cultivate one's will, in order to succeed in making lifestyle changes. The healthy will should not be repressive, but rather firm and flexible simultaneously; it can be a stable guiding center. Medicine can aid the development of one's will, but it is ultimately a personal undertaking. This subject will be discussed more in the next handout.

3) Internal causes - These are the seven affects or emotions (anger, joy, worry, grief, fear, anxiety, fright). Excesses of these feelings are said to impair certain systems of the body. Overworking the mind (excess intellectual pursuits) can be a source of strain, as well. In America, the way people deal with such problems has been highly variable. Methods include religion, addiction, psychotropic drugs (legal and illegal), counseling, occult practices, and meditation, to name a few. Historically, the chinese have tried most of these approaches, as well.

One's goal should not be to repress the emotions. It is to identify with the žeye of the stormÓ, so to speak, rather than being caught up in tumult around oneself. Chinese medicine can facilitate this emotional harmony and catalyze psychological transformation, but the burden of change remains with the individual. Again, this involves the cultivation of the skillful will. There are many ways to develop one's will. If one is to achieve a measure of good health, you must find a method that works for you. Without the steering function of the will, deep self exploration (whether through therapy, meditation or prayer) is not truly possible.

The combined damage to the body systems, due to miscellaneous causes and emotional excess, causes pathogenic factors to arise from within. Along with damp, cold, heat, wind, and dryness (metaphors derived from their resemblance to climactic factors of the same name), there may appear stagnation of food, phlegm, blood, and qi (the influences that organize and integrate the body systems). Chinese medicine addresses these pathogenic accumulations, as well as the weakness or exhaustion of various body systems. While Chinese medicine acknowledges that the root of all disease is behavioral and emotional, it also recognizes the existence of environmental influences (pollutants, germs, climactic stress). Unfortunately, behavior and emotions cannot be permanently (and beneficially) altered by medicine alone. While a drug or herb may temporarily help one regain some control over one's existence, dependence can only weaken one's will even further. Unless one is suffering acutely, on a psychological level, the emotional component of illness should not be žtreatedÓ exclusively with the ingestion of medical substances.


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