TREATING ENDOGENOUS DISEASE

Since TCMs recent introduction to the West in the late 60s and early 70s its grown quite the popularity amongst the general public. But considering its ever-growing popularity it's still relatively not the most understood system. Being a Doctor of TCM in Canada I still see a large number of my new patients naïve to the fact that TCM is a complete and advanced medical system (not just acupuncture!) that developed in response to treating all manifestations of disease. Although it is an ancient medical practice it has evolved itself over several millennia to effectively treat some of the most extreme cases of illness. Classical Chinese medicine was not just used for relaxation and mild feel-good spa-like treatment effects. Acupuncture in particular is well-known for its ability to treat musculoskeletal conditions and stop pain, but the efficacy of traditional Chinese medicine as a whole in treating more severe internal medical conditions is still not the most common of knowledge. This most likely stems from the fact that acupuncture continues to be what epitomizes our TCM understanding in the west, and because of the fact these needles are inserted into the periphery it's assumed that it can only treat the area locally. The other reason I suspect is that due to our material-dominant attempt to understand health and the body in the west, we don't have a strong grasp of how endogenous disease ought to be treated. So what exactly is endogenous disease? Endogenous disease includes all disease and dysfunction that results from the body's own doing. This can be the result of diet and nutritional deficiencies, emotional stress, postural deficiencies, physical depletion, or genetic, just to provide some of the key culprits. But it is the patterns that originate within these areas that lead to serious forms of endogenous disease. The symptoms that display themselves can happen all over and when we only look at them from a local and reductionistic standpoint they can seem to be a messy array of completely unrelated circumstances. A few examples of endogenous disease include: autoimmune disease, diabetes, hypertension, cancer (an endogenous virus), hormonal imbalances, IBS, asthma, chronic fatigue, migraines, and many other chronic and difficult to treat conditions.

In the "western" world we have a relatively good understanding of the mechanism behind many of the symptoms that present when unhealthy, but we can lack the ability to effectively determine and address the deeper roots of endogenous disease. As a result, the typical way we treat such symptoms is by simply shutting off the mechanism and hoping that the rest will just resolve itself on its own. TCM recognizes that these symptoms are not the disease itself but rather the expression of the disease. In shutting off the expression of the disease we are relieving that which causes pain and discomfort, but we fail to address the more important aspect which is health itself. The modern western medical system typically shuts off these endogenous disease symptoms but the disease itself remains, continues to progress and likely will express itself elsewhere in the body. Being able to shut-off symptoms is incredibly helpful, it can improve our quality of living and ensure we are capable of performing and being occupational. The mistake lies in a lack of education or sometimes shear ignorance on our part in the belief that this alone is enough. Our symptoms act as a metaphorical engine-light indicating that something needs to be done to correct the imbalance, for a majority of us relieving our symptoms is enough of a treatment, and so we go on to continue living not so healthy lifestyles no longer in seek of solutions to our health.

Then there is exogenous disease - the other half. In the west we have quite a good understanding of exogenous disease which includes trauma and infection. Exogenous disease means a disease that results from outside triggers and influences. Our therapies for exogenous diseases such as antibiotics and surgery do a great job at curing disease and dysfunction, although they typically provide a more extreme approach. The modern western medical system does have a few specific therapies that can cure endogenous disease but it still has a ways to go when compared with the Chinese medicine’s more integrative nature (see the previous blog post for more info). Even our general western understanding of diet is often under-utilized in treating disease. For this reason it is necessary that the future of medicine in the western world integrates these techniques and therapies into its framework.

Traditional medicine in the west is likely more advanced in treating exogenous disease over endogenous disease because it often considers our biology from a mechanistic standpoint failing to see things from a holistic and interrelated standpoint. With this sort of thinking fixing a cough is done like changing the headlight or oiling the axles. The issue with this is our bodies are not as simple as an amalgamation of moving parts. We are much more than just the sum of our physical pieces. We are a living entity, with an interconnected communication system and the innate ability to repair, restore, replenish, and even create and give birth to new life. In these ways we must also consider our biology from a non-mechanistic standpoint, maybe more similar to how we view a plant. When a plant becomes nutritionally deficient its leaves may exhibit blemishes and discolouration in different ways, but this does not mean that we must fix the leaf itself with chlorophyll transfusions. But at the same time we must consider this trait along with the others and establish a differential diagnosis directing us how to restore this deficiency. It is for this reason that we must also take a holistic approach with our treatment.

The backbone of TCMs ability to cure disease lays in its diagnostic skills. This is the observation of holistic functional trends and the correlations identified between specific signs and symptoms. These signs and symptoms are then accounted for with differential diagnostics developed over several millennia of extensive recordkeeping to confirm or modify the theoretical framework. Although often the mechanism is beyond our understanding, TCM has established a theoretical framework to correlate the data in ways which guide an effective therapeutic approach. It does so by anatomizing function as opposed to structure. The Daoist scientists believed it was best to divide functional aspects into odd divisions for the reason that odd numbers are not evenly divisible meaning that they are unstable mimicking the nature of perpetual change. This functional divide that is unique to oriental medicine recognizes that all physiological happenings are dominated by specific movement trends that total a grand homeostasis when we are in good health. Simply put, when specific movement trends become excessive then specific signs and symptoms will reveal themselves. Considering one symptom alone is not enough context to determine the grand movement trend or what I like to call one’s biological climate.

To now provide some examples, symptoms that are governed by an upward-outward movement trend include headaches, dizziness, acid reflux, anger, hypertension, sweating, etc. Symptoms which are governed by an inward-downward movement trend - or you could also say aggravated by an inward-downward seeking biological climate - include diarrhea, depression, hypotension, pitting edema, hypothyroidism and hypometabolic conditions, etc. Now this is an oversimplified explanation. The goal of this article is to merely shed some light rather than serve as a detailed textbook. Understanding these distinctions of symptom trends in this way can provide an understanding of one’s quality of health in a way that zoning in on a single symptom alone never would be able to achieve. This is kind of similar to the idea that analyzing the mechanics of a car engine doesn’t help us much to understand the phenomenon of gridlock.

Once the overall movement trend(s) have been recognized, the next step is determining why. Typically symptoms manifest together and so determining the correlation allows us to treat things at a deeper common denominator. Traditionally Chinese medicine has done so by determining whether there is an excess or a deficiency, and then locating where exactly it is affecting. This is the realm that we are now beginning to explore within our western understanding of medicine. We are beginning to focus in on the role that nutrition plays in substantiating deficiencies that lead to endogenous disease. We are also beginning to recognize structurally unrelated correlations such as the relationship between the large intestine and skin, or the lung and bladder. I couldn’t be more happy with the fact that our western medical system beginning to value these aspects more and more. With that being said, I still believe the classical Chinese medical system to be more advanced in this realm, mainly for the reason that it recognizes these deficiencies beyond the realm of macro and micro nutrition. Classical Chinese medicine also considers the directional affinities that belong to food and how food can influence our biological climate. This particularly pertains to how alkaloids, oils and other components of natural medicinals influence phenomenon like sweating, chills, urination, and other changes in subjective body sensation. In addition, classical Chinese medicine does a better job of integrating emotional and psychological phenomenon with our understanding of physiology.

For these reasons Chinese medicine treats disease in a very different way and can provide results with diseases that a more reductionistic approach might fail to do. With endogenous disease predominated by an excess, treatment can be very quick acting. But measures must also be taken to adjust lifestyle patterns that contribute to this associated excess. Examples of excess endogenous pathogens include qi and blood stagnation, tumors and masses, GI obstructions of toxins like fecal matter and partially digested food, excess phlegm and mucus, and emotional stress. A collection of Chinese therapeutic modalities work together to assist the body in eliminating these sorts of excesses. At the same time certain measures are taken to minimize symptoms and treat what is known as "the branch".

Ideally we hope that these conditions are purely a result of an excess but naturally we are a lot more complex than this. It is often that we find excesses that coexist alongside deficiencies. In the realm of deficiency-based endogenous disease the treatment is typically longer. Examples of deficiency are a lack of nutrition, dryness and lack of fluids, hormone deficiencies, poor quality and quantity of blood, deficient and dysfunctional posture, and lack of cellular energy. To create substantial changes and build these things back up takes time as we need to establish new lifestyle habits and consistently provide a surplus so the body can accumulate its buffer of stores over time.

To put things in terms that can be more easily understood by our western understanding, the mechanisms that guide and support our physiology require key biochemicals including but not limited to: sugars, polypeptides, triglycerides, vitamins, minerals and electrolytes. These components exist in many places and forms. Sugars can exist in the blood or be stored in inactive forms like glycogen. When our body is deficient in these biochemicals our physiological processes become dysfunctional and produce signs and symptoms that are endogenous in nature. This is endogenous disease. Sometimes it can be one electrolyte that we're deficient/imbalanced in that sets off a whole cascade of neurological dysfunction. Other times it can be a deficiency or imbalance of several nutrients that cause disease. This is one of the reasons that Chinese medicine has chosen not to isolate and extract individual components from natural medicinals. It holds to the belief that nature knows better than we do, and trusts that the complex of components are there for a reason as they have developed and adapted to demands in nature together with a sort of codependence on one another. With more recent botanical biological studies, we now observe that fruits proven to be good for specific aspects of our health do so as a result of a myriad of nutritional components working together in this way just as the Chinese had theoreticized. This naïve trust may be another reason why traditionally Chinese medicine has achieved results. And interestingly when natural medicinals elicit negative and toxic effects the Chinese herbalists reconciled this with both processing and preparation methods, as well as selective formulations working to harmonize and moderate such undesirable effects.

If you’re reading this and feeling that you may be experiencing symptoms that fall under the classification of endogenous disease, we recommend that you consider visiting your closest doctor of Traditional Chinese Medicine. They will work alongside you by analyzing any all aspects of your life that may be contributing to and perpetuating your disease or dysfunction. They will provide you with day-to-day lifestyle modifications including diet, exercise, emotional regulation, and other biohacks, as well as use herbal and various manual therapies to assist the body in restoring the balance needed to eliminate symptoms and achieve the highest degree of health.