Chinese Medicine Newsletter – Summer 2010
Welcome to the Chinese Medicine Newsletter. For past newsletters please refer to “patient resources” on
my website at www.acupuncturefamilyhealth.com. As I have described in other articles, Chinese Medicine
understands symptoms in relation to the underlying patterns of disharmony in order to address imbalances
at their root. In this light I thought it would be illustrative to take a commonly experienced symptom such as
“fatigue” and look at how it can be the result of very different underlying patterns and thus very different
Most of us at various times have complained of fatigue and tiredness. When this becomes a consistent
concern, however, other than a relatively brief complaint from a temporary state of affairs, i.e. lack of sleep,
etc. then it must be systemically addressed.
Tiredness, in most cases, comes from a condition of deficiency in the system. For example, qi (pronounced
chi) is the activating energy in our system. It has the functions of “transporting and transforming”. Any
activity, whether it is digestion, elimination, walking, talking, breathing, thinking, etc., requires the sufficient
quantity of qi to work properly. For example, our qi energy is what transforms the food we take in and
converts it into usable energy. If this is weak, we are not extracting the energy we need from our food.
Someone deficient in qi would likely feel tired and lethargic. They might find it difficult to mobilize their
energy for activity, whether physical or mental. Their pulse would feel weak and their tongue might be
slightly pale and swollen, indicating deficiency of energy.
Their tiredness needs to be resolved by tonifying or strengthening their qi energy so that their metabolic
functions have the required energy. Acupuncture and possibly herbs would be directed to this end. Until
their energy is restored, they would benefit greatly by eating easily digestible foods, i.e. more cooked than
raw, getting proper sleep and not overextending until more reserves are built up. This is clearly fatigue as
the result of a deficiency, in this case a deficiency of qi energy. Fatigue can also be the result of a deficiency
of other aspects in our system, such as yang (warming energy), yin (cooling energy) or blood. All of these
would present differently.
Conversely, someone else complaining of fatigue may present with signs that would seem to indicate their
underlying energy is weak and deficient. They may appear quiet and subdued, possibly walk slowly and
speak softly. However, in contrast, upon investigating their tongue and pulses, a different story emerges.
Their pulses feel wiry and full and their tongue is reddish-purple, both indications of an excess condition.
This is called stagnation, i.e. their energy is blocked and constricted. They might also feel irritable due to the
restriction inside. These signs confirm that although they appear weak, their underlying condition is one of
fullness where their energy is bound up and unavailable to the rest of their system. Thus, the fatigue. Many
times this can be a result of suppressed anger or frustration over a long period of time.
Unlike the above case where the person’s qi energy needed to be strengthened, this person’s qi energy
needs to be unblocked so it can flow. If their energy was inappropriately tonified or enhanced instead of
being dispersed and calmed, they would most likely feel worse; no relief from the fatigue and more internally
constrained and irritable. This is because their energy is stuck. Trying to add more instead of moving it
would just exacerbate their condition. Thus, this is a case of long term exhaustion as a result of an excess
condition that needs to be dispersed and freed up. Acupuncture is very effective for this. Also, being
physically active helps, since it encourages the person’s energy to move and become unstuck, the same goal
we are working toward with acupuncture and maybe some Chinese herbs.
Just as the above examples reveal that fatigue can be rooted in a deficient or excess underlying dynamic, it is
not uncommon for people to suffer from severe fatigue due to a combination of the two, referred as a mixed
excess/deficiency energetic. An example of this is someone who has an underlying deficiency of qi, as in the
first example, but also has an accumulation of “damp” which is excess fluids that are the result of their qi
being too weak to transform these fluids, thus they burden the system. These unwanted fluids, unlike
healthy fluids, are called “damp” in Chinese medicine.
Dampness feels heavy and cumbersome. This can manifest as too much fluids, as in edema, congestion or
excess weight. It can also be the energetic quality of feeling loggy, burdened and slowed down. This fatigue
feels heavy, like we are carrying around a weight most of the time. This person would feel worse in humid
and damp weather conditions Damp is reflected on the tongue with a thicker coat and swollen body. The
pulse actually reflects the damp quality by feeling “slippery,” i.e. too much sogginess.
In this person a dual treatment strategy is needed. Firstly, the accumulation of damp needs to be resolved
and removed. This is taking care of the “excess” aspect. Secondly, the “deficient” aspect needs to be
addressed by strengthening the underlying qi energy so that it is sufficient to properly transform fluid so that
the damp does not return in the future. Acupuncture would be directed to this aim. There also could be
some herbs prescribed that help eliminate damp in the system. It would be important for this person to limit
consumption of “damp producing foods.” These include greasy, heavy foods, excess dairy and sugar.
It is easy to see from these examples how fatigue and tiredness, from the Chinese Medicine perspective,
must be addressed individually to get the desired results. A treatment strategy that works for one person
may be contraindicated for another. Fatigue may look similar from the outer symptoms, but, upon closer
examination, the underlying causes can vary greatly and require a very tailored approach to resolving them.
On a final note, this has obviously been an extremely hot summer. Sufficient hydration is very important as
well as eating lighter meals. Foods are classified in Chinese Medicine according to many categories, including
warming and cooling foods. Watermelon is a wonderful cooling food that replenishes fluids. Other fruits in
the cooling category are apple, banana, lemons, limes, melons, pears and mangos. Some cooling vegetables
are watercress, lettuce, summer squash, tofu, spinach, asparagus, radish and tomatoes.
For those among you who love to unabashedly sweat, enjoy this weather to your heart’s content.
Sometimes in the summer I think of a song I learned in childhood as to how hippos deal with the heat. Here
it is for any who may want to emulate the hippo’s strategy.
Mud, mud glorious mud,
Nothing quite like it for cooling the blood.
So come follow, follow
Down to the hollow
Where we will wallow
In glorious mud.