Constitution, Mental State, Environment, Nutrition, and Physica Activities-Their relation to Disease
1. Constitution
People have different constitutions. TCM deems that one's constitution is related to congenital disposition, and the characteristics of the parents' constitutions can pass to the descendants, making constitutions individual in nature. Regarding this point, chapter 6 Spirit Pivot says: Human temperaments can be vigorous or mild; human constitutions can be weak or strong ; human figures can be short or tall ; and human physiological characteristics can he yin-natured or yang-natured. " The variety of congenital dispositions possesses certain significance to the occurrence of disease. Generally, there are two phenomena: the first is that, upon being attacked by the evils, some people catch disease and some do not, and the second is that, upon being attacked by the same evil, people can catch different diseases according to their different inherent diathesis; and this can be observed through their clinical manifestation related to different pathological changes. For example, in case of being attacked by the wind and cold evils, due to different congenital diathesis, some people suffer from the deficient exterior syndrome due to wind, and sot people suffer from the excessive exterior syndrome due to cold.
In addition, different constitutions are greatly affected by one's physical development, or obese and lean states; and are related to different diseases and different patho1ogical changes. For example, people with an obese diathesis are liable to be deficient in yang and tend to suffer from dampness and phlegm; people with a lean constitution are liable to be deficient in yin and tend to suffer from fire and dysfunction of qi. Also, it is generally held that a yang deficient or yin predominant body, when being invaded by the evil-qi,tends to undergo a cold transformation, and is transformed from a state of yin into a state of cold with pathological changes related with excessive cold syndrome or deficient cold syndrome; likewise, when a yin deficient or yang predominant body is invaded by the
Evil-qi, it tends to undergo a heat transformation, and is transformed from a state of yang into a state of heat with pathological changes related with excessive heat syndrome or deficient heat syndrome.
Age and constitution also have certain relationships with the occurrence of disease.For example, young children have "tender yin" or "tender yang" constitutions, so upon being invaded by the evil-qi, they will undergo a heat transformation with the wind syndrome and body fluid over-consumption. Young and middle-aged adults have strong and vigorous constitutions, so upon being invaded by the evil-qi, they will undergo fierce struggles between the evil-qi and the genuine-qi with excess syndrome and heat syndrome. Aged people who have weak constitutions accompanied by the insufficiency of qi and blood and weakness of primordial yin and yang, tend to suffer from cold deficiency syndrome. All the above-mentioned conditions can be used to explain the close relationship between constitution and disease when the occurrence and development of disease are concerned.
2. The Mental State
Mental factors can directly affect the functions of the viscera, yin, yang, qi and blood; and as endogenous pathogenic factors, they can cause the dysfunction of the body and lead to disease. As chapter 66 in Spirit Pivot says: "Over-joy and great anger disturb the viscera; the disturbed viscera can cause diseases to arise from the yin aspect of the body. " This quotation means that strong emotions can lead to endogenous diseases, which are clinically related to diseases caused by psychic factors.
Also, an unhealthy mental state can make the body's genuine-qi weak and insufficient, causing the exogenous evils to launch their attacks on the body. For example, when one is mentally depressed at all times, he will suffer from insomnia, poor appetite and weakness, and suffer from some pathological changes such as dysfunction of the visera, disturbed circulation of qi and blood, and weak resistance against diseases; in such a case, the evil-qi can attack the human body easily. Therefore, clinically, in order to restore their health, patients should be encouraged to improve their self-confidence and keep a optimistic spirit to defeat disease.
3.Environmen
People live and work in different environments and have different habits and customs, all of which exerts some influences on the occurrence of disease. Chapter 12 in Plain Questions points out that due to the geographical variety of the eastern, southern,western, northern, and middle regions, and the different climates and different habits and customs of these locales, the same kind of disease that develops in different geographical regions has differing features. This shows that the ancient Chinese doctors understood the significance of different geographical environments and the different habits and customs. Generally, people who live or work in damp places are liable to suffer from the cold-damp syndrome; and those who live in mountain area are liable to suffer from goiter(or endemic goiter due to iodine deficiency), etc.
In addition, TCM also holds that long periods of staring impair the blood; lying in bed for a long time impairs qi; sitting for a long time impairs muscles; standing for a long time impairs bones; walking for a long time impairs tendons; over-using the brain impairs the heart and spleen; and over-using physical strength impairs the liver and kidney, leading to weak functions of tendons and bones. All of the above-mentioned conditions play guiding roles to the clinical diagnosis of disease, especially to some local or occupational diseases.
4. Nutrition and Physical Activities
Nutrition and physical activities are important to the strengthening of the body's genuine-qi and its ability to resist diseases. When people enjoy a nutritious diet and normal physiological digestion and absorption, they will have sufficient qi and blood, strong genuine-qi and normal ability against disease, and in this case they can resist the invasions launched by the evil-qi and will not suffer from disease. If people live on a poor or partial diet, they will suffer from insufficient qi and blood, deficient genuine-qi, a weakened ability against disease, and eventually, certain diseases.
Taking part in labor and physical activities is an important way of promoting the circulation of qi and blood, strengthening the body, and promoting metabolism. This is described as "Running water is never stale and a wooden door-hinge never gets worm-eaten. " On the contrary, lack of labor and physical activities will lead to stagnant qi and blood, weak tendons and bones, declining genuine-qi and weakened ability against disease.
It can be perceived from this discussion that TCM pathogenesis regards diseases as results of the dysfunction of yin, yang, qi, blood, viscera, meridians, which are brought forth by attacks of the evil-qi on the human body. This dialectical understanding of diseases, which not only pays attention to the external environment, but also pays greater attention to the internal environment, possesses very important value in perceiving the nature of disease and pursuing clinical practice.
