Deficiency and Excess in TCM
What are deficiency and excess in tcm?
The deficiency (Xu) and excess (Shi) in TCM are the concepts that help to interpret between the forces of the body’s resistance to pathogens and the disease itself. In other words, deficiency refers to the conditions as a result of the body’s weak resistance. On the other hand, excess indicates the conditions that are caused by the populous amount of pathogens that exist in the body (Shen Nong, n.d.)
Firstly, the syndromes of the deficiency in TCM can be attributed to “Qi deficiency, blood deficiency, Yang deficiency, Yin deficiency, body fluid deficiency, bone marrow depletion, nutrient stage deficiency, and protective Qi deficiency” (Shen Nong, n.d., para. 14). Furthermore, the common symptoms of deficiency are “fatigue, low-spiritedness, pale or sallow complexion, palpitation, breath shortness, cold limbs, sweating, diarrhea, loose stools, urinary frequency or incontinence… pale tongue, and weak pulse” (Shen Nong, n.d., para. 15). The deficiency in TCM is usually seen in those that have chronic illnesses or are physically disabled (Shen Nong, n.d.).
Secondly, the syndromes of the excess in TCM can be a consequence of “Qi stagnation, blood stasis or blood stagnation, phlegm obstruction or stagnancy of fluid flow” (Shen Nong, n.d., para. 16). Some of the symptoms of having this condition are “fever, distension pain that becomes worse when pressed, chest stuffiness, irritability, coarse breathing, excessive throat discharges, constipation, urinary difficulty, and even unconsciousness…thick and greasy tongue, and faster pulse ” (Shen Nong, n.d., para. 16). The excess in TCM happens to those with a strong physique, newly developed illness, and harsh clinical treatments (Shen Nong, n.d.).
Four major excesses in tcm are Wind, Dampness, Fire,
and Blood Stagnation
According to the Acupuncture and Massage College (AMC) located in Miami, Florida, U.S.A (2021):
Wind is a “yang pathogen'' and causes Bing (illness) to change” (para. 18).
Dampness is a “yin pathogen that causes sluggishness” (para. 19).
Fire or heat is a “yang pathogenic factor” (para. 20).
Science Direct (2009) explains blood stasis or blood stagnation is caused by “yin deficiency that causes fire or heat to flare up” (para. 11).
What are the functions and symptoms of the following patterns if each excess attacks the Zang-organs?
Dampness: Liver/Gallbladder, Spleen, Lung
Dampness can happen in Liver and Gallbladder channels and it causes a blockage in the flow of Qi in these channels (Sacred Lotus Chinese Medicine, n.d). This obstruction can lead to abdominal pain below the cartilages and chest. The dampness in Liver can also invade Stomach, causing nausea, vomiting, loss of appetite, and abdominal pain (Sacred Lotus Chinese Medicine, n.d).
The Spleen in TCM has the function of transforming and transporting food and drink as well as preventing water retention. It keeps the internal organs secured and sends messages to the head, prevents hemorrhages, controls the energy in the muscles, limbs, and saliva production. It also helps one to think more clearly (AcuPro Academy, 2020). Dampness in Spleen means the body is incapable of transporting body fluids efficiently; therefore, it causes the body to over-accumulation of body fluid. Some symptoms of this illness are bloating, nausea, vomiting, dizziness, and heavy sensation in the body or limbs, and a thick greasy tongue (Eu Yan Sang, 2020).
Moreover, Lung controls the respiratory system and governs the flow of “Qi.” It controls actions, such as descending down and inward to purify “Qi” and dispersing up and outward to spread the “Qi” to the skin to fight off diseases. It regulates the water inside our body and sends it to needed places. The excess symptoms in these organs include “greasy tongue coating and symptoms of Lung dysfunction” (AMC, 2021, para. 19).
Blood Stagnation: Liver, Heart, Lung
The symptoms of having blood stagnation in Liver can result in “pain along the ribs, fullness in the upper abdomen, irritation, moodiness, depression, angry, muscular pain, feeling a lump in the throat, finger/toenail problems, breast detention or tenderness, irregular periods, and stomachache, etc (AOMA Graduate School of Integrative Medicine, n.d., para 2).
Having blood stagnation in Heart can lead to “chest pain and palpitation” (Carolinas Natural Health Center, 2014, para. 2). Some common symptoms of blood stagnation in Lung include “a feeling of a lump in the throat, difficulty in swallowing, a feeling of oppression or distension of the chest, slight breathlessness, sighing, sadness, slight anxiety, and depressed mood” (Giovanni Maciocia, n.d. para. 12).
According to the TCM theory, the functions of the Liver are: storing blood, ensuring the smooth flow of Qi, controlling tendons and movement, manifesting in the nails, opening into the eyes, corresponding to tears, and housing the ethereal soul (AcuPro Academy, 2020). Some symptoms of the excess that can happen to Liver are “paralysis, itching, and convulsion” (AMC, 2021, para. 18).
Fire: Heart, Liver, Spleen/Stomach, Lung, Kidney
Heart is responsible for blood circulation in the body. It controls pulse strength and blood vessel movements. It houses in the mind and the spirit through mental activities, memory, consciousness, thinking, and dreams. Furthermore, it is responsible for happiness and joy. It also controls sweat (AMC, 2021). When Heart is attacked by fire, it can result in “restlessness, anxiety, sweating… palpation, irregular heartbeat, insomnia, disturbing dreams, mouth sores, thirst, red face, constipation, and dryness” (Release Integrative Medicine, n.d.).
Furthermore, Liver can also be attacked by fire. Some common symptoms of this illness are irritation, frequent headaches, muscle tension in their necks and shoulders, constipation, and nosebleeds (Gustafson, 2019).
In addition, the Spleen/Stomach aids digestion, harmonizes sexual function, and supports all the other organs. Having excess fire can cause symptoms that include “high fever, red tongue, inflammation, constipation, and dry skin” (AMC, 2021, para. 20).
When fire attacks Lung, it causes breathlessness, asthma, cough, headache, dizziness, red face, bitter taste, thirst, and constipation (Sacred Lotus Chinese Medicine, n.d.).
The Kidney controls birth, growth, reproduction and development, and bones. It produces bone marrow and controls the flow of “Qi” to Lung. It further provides heat for the body to function correctly (AMC, 2021). When the Qi flow is not smooth, it results in “dryness of the mouth and throat, feverish sensation in the palms, soles, and chest, low-grade tidal fever and night sweats, constipation, deep yellow urine, a red tongue with scanty or no coating, and a thread rapid pulse” (Dong et al., 2017, pp. 319-320).
What modalities do TCM professionals use to remove excess?
One of the effective modalities is the usage of traditional Chinese herbs, which are used by TCM professionals to remove the excesses. The five foundation elements composed in Chinese herbal medicine are wood, fire, earth, metal, and water, which complement the five tastes of sour, bitter, sweet, pungent, and salty (Better Health Channel, 2014). The Chinese herbs that are used in TCM are plant-based with the inclusion of minerals and animal products. The styles of herbs are prepared to be in powder, granule, paste, pills, tablets or capsules, and tincture, lotion, or patch for external use (Better Health Channel, 2014).
The four herbal formula categories in TCM are ministerial, deputy, assistant, and envoy. Each of these categories has its function. The ministerial herbs address the pattern of disease. The deputy herbs assist the ministerial herbs and treat co-existing conditions. The assistant herbs reduce the potential side effects caused by the ministerial and deputy herbs. Lastly, envoy herbs direct all the herbs in the formula to a certain part of the body (Beth Israel Lahey Health, 2021).
At Rapha Acupuncture, we use Chinese herbal formula in granule for intake. These classic and customized formulas are well made in cGMP facilities in the US, South Korea and, Taiwan. The easy-to-bring package makes the herb teas are convenient to carry around for daily use, less hustle, and more enjoyable.
Acupuncture and Massage College, (2021). Health and illness in traditional chinese medicine (TCM). https://www.amcollege.edu/blog/health-illness-traditional-chinese-medicine-tcm
AcuPro Academy, (2020). The zang-fu organs theory in chinese medicine. https://acuproacademy.com/zang-fu-organs-theory-chinese-medicine/
AOMA Graduate School of Integrative Medicine. What is liver qi stagnation and what can I do about it? https://www.aoma.edu/assets/uploads/files/What_is_Liver_Qi_Stagnation_and_What_Can_I_do_About_it.pdf. PDF download.
Beth Israel Lahey Health, 2021. Traditional chinese herbal medicine. Winchester Hospital. https://www.winchesterhospital.org/health-library/article?id=37410
Better Health Channel, (2014, August 31). Chinese herbal medicine. https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/chinese-herbal-medicine#the-five-elements-in-chinese-herbal-medicine
Carolinas Natural Health Center, (2014, April 30). A look at blood stasis and common chinese herbs for treatment. https://carolinasnaturalhealth.com/a-look-at-blood-stasis-and-common-chinese-herbs-for-treatment/#:~:text=The%20location%20of%20the%20blood%20stasis%20will%20determine,can%20show%20up%20as%20chest%20pain%20and%20palpitation.
Dong J., Wang, T., Zhao, L., & Chen, X., (2017). Pattern of disharmony between the heart and kidney: theoretical basis, identification and treatment. Journal of Traditional Chinese Medicine Sciences, 4. 317-321. https://www.sciencedirect.com/science/article/pii/S2095754818300085
Eu Yan Sang, 2020. TCM: understanding the role of the spleen. https://www.euyansang.com.sg/en/tcm%3A-understanding-the-role-of-the-spleen/eystcmorgans5.html
Giovanni Maiocia, n.d. Stagnation of lung-qi and heart-qi in chinese medicine. https://giovanni-maciocia.com/on-stagnation-of-lung-and-heart-qi/
Gustafson, J. (2019, March 18). Finding your flow: balancing liver disharmonies with classical chinese medicine. https://www.reverieacupuncture.com/liver-patterns/
Release Integrative Medicine, n.d. Heart afire: the fire element. https://www.releasellc.com/blog/heart-afire-the-fire-element
Sacred Lotus Chinese Medicine, n.d. Liver and gallbladder pattern differentiation in chinese medicine. https://www.sacredlotus.com/go/diagnosis-chinese-medicine/get/zang-fu-liver-gallbladder-patterns-tcm
Science Direct, (2009). Blood stasis. European Journal of Integrative Medicine. https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/blood-stasis
Shen Nong, (n.d.). Syndromes differentiation according to the eight principles. http://www.shen-nong.com/eng/exam/diagnosis_eightprinciples.html#043