Constitution depends on:
- Parents' health in general, especially at conception
- Mother's health in pregnancy
- Conception in state of drunkenness
- Mother conceiving when too old
- Consuming alcohol or smoking during pregnancy
- Receiving a shock during pregnancy (affects fetal Heart Qi)
A person's basic constitution is largely determined at conception, and it can also be affected during the mother's pregnancy.
At conception, fusion of Qi of "heaven and earth" produces human being.
Ancestral Energy of parents is passed to fetus.
Constitution is largely fixed at this time.
However, those with weak constitution can develop Qi by balanced lifestyle, avoidance of stress and excess (work or sexual activity), adequate rest, right nutrition, breathing exercises, and strengthening "inner" exercises such as Qi Gong and Tai Ji Quan (that originated in ancient Taoist longevity and immortality practices but are still applicable for health promotion).
Assessment of constitution in clinic: detailed history including childhood diseases (especially pertussis; indicates inherited weakness of Lungs)
Appearance: small ears indicate weak constitution
Pulse: scattered, minute or leather pulse: weak constitution
Tongue: very flabby, with no "spirit"
Assessment of constitution is essential for accurate prognosis; what can realistically be expected from treatments.
Common cause of disease in West.
Need to have balance of rest and exercise.
When we work or exercise we use up Qi; when we rest we restore Qi.
(Post-Heaven Qi, i.e., Qi transformed from food and drink on a daily basis).
In daily activities we use Qi: Jing provides material base for long term changes but is foundation of our inner strength and vitality.
Qi used in normal work and exercise is quickly replenished by proper food and rest. (If your patient appears weak and depleted, ask about recent excesses of work or study or lack of sleep).
Qi is used up quickly but rapidly restored.
If overwork occurs over months or years, Qi cannot be restored quickly enough by Spleen. Person then draws on the Jing as a reserve. This way the Jing can become depleted and signs of Deficiency of Yin may begin to appear. This situation takes a long time to remedy.
- Mental Overwork
Very common in western society: long hours of stress and mental activity very common together with irregular meals taken in hurry. These things affect Stomach, Spleen and Kidneys. Irregular diet (or eating late at night) can cause deficient Stomach Qi or Stomach Yin.
- Physical Overwork
Depletes primarily Spleen Qi (SP dominates flesh and muscles). However, excessive physical exercise also demands that the Liver supply its Blood and Yin to the tendons/muscles; therefore excessive exercise can deplete Liver Blood and Yin (including workouts).
Excessive use of one part of body (i.e., repetitive movement) can cause Qi to stagnate in that part.
Excessive lifting weakens Kidneys and lower back.
Excessive standing weakens the Kidneys.
The Classics discuss the 'Five Taxations':
Excessive use of the eyes injures the Blood (the Heart)
Excessive lying down injures Qi (the Lungs)
Excessive sitting injures the muscles (the Spleen)
Excessive standing injures the bones (the Kidneys)
Excessive exercise injures the sinews (the Liver)
- Excessive Physical Exercise
Exercising to exhaustion depletes Qi, also Liver Blood and Yin.
Especially bad during puberty for girls (leads to later menstrual problems).
Certain types of exercise can cause stagnation of Qi in one area
E.g. Weightlifting: lower back
E.g. Jogging: knees
E.g. Tennis: elbows
- Lack of Exercise
Regular exercise ensures proper circulation of Qi.
Lack of exercise can lead to stagnation of Qi.
Certain exercises (e.g., Yoga and Tai Ji Quan) are aimed at developing Qi rather than muscles and are useful for those with Deficient Qi who have to little energy for Western style exercises.
Excessive Sexual Activity
i.e., leading to ejaculation or orgasm
Depletes Kidney Jing, mostly in males.
Male sexual fluids are external manifestation of Kidney Jing: hence loss of these lead to temporary loss of Kidney Jing. Female sexual fluids primarily Jin-Ye.
Normally this is made up (by postnatal Jing) and does not lead to depletion. However, when sexual activity is excessive, body does not have time to restore the Jing.
What is "excessive" = resulting in marked fatigue, especially if accompanied by dizziness, blurring of vision, low back pain, weak knees, and frequent urination.
Adjust sexual activity according to constitution, age, physical condition. (See chart in book pg. 138 as broad guideline).
Seasons: increase in Spring; decrease in Winter.
In treating sexual problems, i.e., impotence, often a decrease in sexual activity is important.
In men, the Kidney Jing is depleted by excessive sexual activity; in women it is depleted by repeated childbirth.
Lack of sexual activity can traditionally be a cause of disease.
Sexual desire is measure of strong Kidney Qi and Kidney Yang.
Deficient Kidney Yang: lack of libido.
Deficient Kidney Yin: excessive interest in sex and inability to be satisfied, erotic dreams and nocturnal emissions.
Other important causes of unsatisfactory sexual life: (e.g., lack of warmth and love, relationship issues) can be causes of disease especially where they cause a lot of anxiety and unhappiness.
Diet and Nutrition
Important cause of disease
However, Chinese dietary theories do not take into account our modern food preservatives, colorings, pesticide residues, etc.
Dietary habits can cause disease: e.g., poor quality or imbalanced quantity of food. Malnutrition not only in 3rd world countries but also in the west, from poverty and "fad" diets.
Trying to slim by "starving" weakens SP Qi and can actually cause increase in weight because SP will be too weak to transform and transport fluids and food. Proper foods need to be eaten to strengthen SP & St.
Overeating also weakens SP & ST and leads to accumulation of Phlegm and stagnation of food.
Excessive consumption of cold energy and raw food can weaken the Spleen.
Refrigerated food and iced water, ice cream are contraindicated.
Raw vegetables, salads and fruit in excess can weaken Spleen Yang:
Contraindicated in those with preexisting weakness in this area.
Excessive consumption of hot energy and spicy foods (curry, chili, hot sauce, lamb, beef) causes Heat especially of Stomach and Liver.
Excessive consumption of greasy/fried foods (deep fried foods, milk, cheese, cream, butter, bananas, fatty meats, nuts) cause Phlegm or Damp which can obstruct Spleen function of transformation and transportation.
How food is consumed is important.
Eating in a hurry, eating late in evening, eating when upset, discussing work while eating, etc., interfere with digestion and cause deficiency of Stomach Yin.
NOTE: Foods, like herbs, have their own energetic properties and can be used therapeutically to strengthen the body and treat disease. It is very useful to understand Chinese dietary therapy in order to be able to suggest to the patient the foods they should eat and those they should avoid.
Sources of information on Chinese dietary therapy:
- The Tao of Healthy Eating (Bob Flaws)
- Chinese Foods for Longevity (Henry Lu)
- Chinese System of Food Cures (Henry Lu)
Cause local stagnation of Blood & Qi
Slight trauma causes stagnation of Qi
Severe trauma causes stagnation of Blood
(Both produce swelling, bruising and pain)
Trauma can affect an area for a long time and produce local stagnation of Qi and/or Blood.
Old accidents/falls can cause or contribute to current disease especially if compounded by later re-injury or later contraction of pathogen (e.g., Wind Damp will often invade a previously injured area where there is an underlying weakness in the circulation of Blood & Qi).
Parasites and Poisons
Infestation of worms is more common in children.
Contributory factor: poor diet, especially excessive consumption of greasy and sweet food which leads to Dampness (perfect breeding ground for worms and also Candidiasis).
Acupuncture can cause ill effects.
Incorrect use of moxa (i.e., use where heat is present) can aggravate a heat condition. Chinese herbs however have more specific effect than acupuncture.
E.g., if one tonifies Yang (heating herbs) by mistake when there is deficient Yin (producing heat signs) one can seriously aggravate the condition.