Diagnosis in TCM takes many factors into consideration, not least of
which are the Pathogens. These are classified as either External or Internal.
The External Pathogens are really based on climatic influences: Wind,
Cold, Damp and Heat. These are considered to be capable of entering the
body to cause disease. When present in excess, a body with deficient
defences, or Wei Qi, will be susceptible to invasion by them. Thus, External
Pathogens can become internalized, moving deeper from the meridians
into the organ systems where they can cause considerable damage to
the delicate energy balances. Each type of pathogenic invasion produces
distinctive symptoms, allowing the Pathogen to be recognized. Cold tends
to produce a deep pain, generally static in nature with loss of joint movement
- 'freezing' in effect. Damp is associated with excess fluid, oedema,
heaviness, swelling of the lower limbs and a dull pain, often a headache.
Wind is characterized by a volatile or mobile symptomatology. Joint pain
caused by Wind will not have a constant focus but is likely to move from
joint to joint. Heat is relatively straightforward, causing an increase in
internal heat, shown by a rise in body temperature or drying of body fluids
and a burning type of pain.
More than one Pathogen can invade at the same time; if a patient is suffering
from influenza, there will be a fever and also muscular aches that
wander all over the body. This is defined as an invasion of the Pathogens
Wind and Heat.We treat this using acupuncture needles.
Internal Pathogens are those arising from within the body itself and are
thought to be excess emotions. These emotions are a normal part of life,
and normal emotional activity does not lead to illness. Illness results from
emotions only when the emotional pressure is too strong, or the patient is
highly sensitive for some other health reason. Anger, fear or worry taken to
excess can lead to pathogenic damage to the energy systems within the
body. Particular emotions are said to affect specific body organs (Table 1.4);
for example, the Liver is particularly susceptible to damage by anger and
the Lungs by grief.
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