A dichotomy encountered endlessly in Chinese medicine exists between those treating symptoms, and those who treat conditions. It is my practice, described elsewhere, to acquire exhaustively all symptoms through an organized interview process that includes a comprehensive review of systems (ROS), once the initial complaints have been detailed. I then translate all symptoms into Chinese medical conditions, organize these conditions, and collate them with signs such as the pulse, tongue, eyes, and sometimes the abdomen.
There are many ways of organizing the acquired information in Chinese medicine. There are the eight principles, the five phases, substances, solid or hollow organs, and pathogenic factors (external and internal). Let us assume that, after having gone through the diagnostic process described above, we have established a diagnosis, and arrive at ‘Heat in the Blood’ as the Chinese medical condition most in need of attention. We have many well-
However, assuming that our treatment reduces the ‘Heat in the Blood’ and symptoms such as hypertension are ameliorated, what will keep the ‘Heat in the Blood’ from returning if we do not also eliminate the source of the ‘Heat in the Blood’? To determine this, we need to ascertain what caused the condition initially, and what aspects of the patient’s lifestyle may perpetuate it.
There are many possibilities. These can be external causes, such as working in a very hot unventilated environment (restaurant kitchens), summer heat and meningitis, are easily identified. Internal causes, such as excess heat in the Stomach-
An inefficient digestive process due to Spleen-
While most symptoms have multiple aetiologies, probably the most common contribution to heat in the blood is repressed emotion (Liver Qi stagnation). This sets off a process which involves the Liver mobilizing metabolic heat to move the stagnation. If this process does not succeed, the heat will become toxic, and the Liver must remove it. Since the Liver stores the Blood, it will usually move the toxic heat there. Being retained in the Blood, the heat will then become a pathogenic entity in itself, usually raising blood pressure over time. Some of the other causes of ‘Heat in the Blood’ could be medications, or heat-
To where does all of this lead? It brings us to the personal questions we must somehow ask patients: what emotions are being repressed, why does someone eat to assuage his emotional pain, why is he eating so rapidly in order to realize his ambitions. Now, we are getting closer to the Root.
The Root usually lays in the deepest part of a person’s psyche, or in the earliest experiences at conception, in utero, at birth or shortly thereafter. Equally, the Root can be emotional shock, such as the loss of a parent or sexual abuse in childhood, or another emotional insult. Each of these complex issues is the subject of further in-
The point of this exercise is to demonstrate that our conventional approaches to diagnosis and treatment –