Chinese Medicine – Causes of Disease – Excesses and Emotions

Modern Western medical science attempts to isolate purely physical factors as the cause of all diseases. Germs and bugs, bacteria and viruses, chemical compounds, and other tangible factors are blamed for virtually every illness. The Chinese, however, view many of these “causes” merely as symptoms of the disease; because a certain organ is already weak and unable to resist outside invasion, it therefore is prone to attack by germs. Killing the germs eliminates the immediate symptoms but does nothing to restore the yuan qi of the diseased organ and tissues. It is only a matter of time before it is attacked again.

Of course, ancient China did not have the technological means to observe and identify minute germs. But even modern practitioners of the ancient art consider the presence of germs to be a more a manifestation rather than a cause of disease. Why do germs attack some people and not others? Why do common bacterial infections invade the lungs of one patient, the knees of another, and the bowels of a third? The reason, according to Chinese theory, is that germs gather and thrive only in weakened parts of the body of patients with low resistance. Thus, the true cause of disease are those conditions which lower a patient’s resistance, weaken certain parts of his body, and expose him to attack by germs. Similarly the true cure for disease is not simply to kill germs. It is to counteract those conditions which permit disease to develop in the first place; to re-establish the body’s optimum relative balance of energies and tonify the primordial energies of the weakened organs. Germs simply cannot attack strong healthy organs.

Chinese medicine attributes the cause of most diseases to external cosmological and internal emotional factors. These factors conform with and act according to the principles of yin-yang and the Five Elements. The small percentage of diseases which do not fall into either of these two categories are listed under “miscellaneous causes” such as traumatic in- jury, food poisoning, major epidemics, and so forth.

The external cosmological causes of disease are called the “Six Excesses” and are governed by the meteorological conditions of season and climate. “The Six Excesses are the mother of germs,” states a modern treatise called The Art of Acupuncture by Cheng Mingchi. When certain meteorological conditions are in excess, they tend to have adverse effects on the body. Heat, damp, cold, dryness, and various combinations thereof accumulate in weakened parts of the body of patients with low resistance. It is a well known fact that each type of germ thrives only under certain exact conditions of temperature, humidity and other elements. The delicate art of fermenting wines, for example, attests to this fact. Careful control of heat, moisture, air-circulation, and other meteorological conditions regulates the activities of the yeast germs. The same is true in the body. When meteorological excesses invade a weak body, they establish the conditions favorable to the growth of germs. While Western doctors treat what they can see with their microscopes, i.e., germs, Chinese doctors treat the conditions which attract and support germs. When those conditions are corrected, the germs can no longer thrive, and the disease disappears.

Six Excesses

The Six Excesses are wind, cold, summer-heat, dampness, dryness, and fire. They are briefly described below:


Wind belongs to the element Wood and dominates in spring. In spring, the body is unaccustomed to the warm temperatures and the pores dilate easily making it easier for “evil-wind” excess to enter the body Symptoms of “wind-injury” are coughing stuffy or runny rose, headache, dizziness, and sneezing. Wind often combines with heat, “wind-heat,’ or cold, “wind-cold,” depending on the weather, and such winds induce symptoms of both excesses. There is also an “inner-wind,” unrelated to weather, which originates in the heart, liver, or kidneys due to energy imbalances. Symptoms of “inner-wind injury” are fainting, weakness, nervous spasms, blurry vision, and stiffness in the muscles and joints.


Cold is associated with the element Water and dominates in winter. Belonging to Water, cold is a “yin-evil,”which usually injures the body’s yang-energy. If cold enters the exterior surface of the body, it produces symptoms of fever, aversion to cold, headache, and body pains. If it reaches the meridians, it produces muscle cramps and pains in the bones and joints. If it enters as far as the internal organs, cold-excess causes diarrhea, vomiting, abdominal pains, and intestinal noises. “Inner-cold,” again unrelated to weather, is usually caused by deficiency of yang-energy in the stomach and spleen, inducing the internal cold symptoms of nausea, diarrhea, coldness in the limbs and a pallid complexion. Excessive consumption of cold foods (“cold” in sense of energy, not temperature) can also induce inner-cold.


Summer-heat belongs to the element Fire and is predominant during the mid-summer season. Major symptoms of summer heat are excess body heat, profuse sweating, parched mouth and throat, constipation, and heart palpitations. When summer-heat combines with dampness, it produces abdominal pains, vomiting, and intestinal spasms. Iced drinks taken in the heat of mid-summer sometimes cause “yin-summer-heat.” The two excesses combine in the stomach and induce symptoms of unpleasant chills, dull headache, abdominal pains, and profuse perspiration.


Dampness is associated with the element Earth and is most active in late-summer. Ailments of damp-excess can be induced by sudden exposure to fog or mists, immersion in water or exposure to rain, and living in excessively damp locations or climates. The symptoms —lethargy, aching joints, and oppressive sensations in the chest — are characteristically heavy and sluggish in nature and tend to block the flow of energy throughout the body. “Inner-dampness” is caused by excess consumption of liquor, tea, cold melons, and sweet, greasy foods. These impede spleen functions and cause symptoms of abdominal swelling, vomiting, and diarrhea.


Dryness belongs to the element Metal and dominates in autumn. Two types are distinguished: “cold-dryness” and “hot-dryness,” depending on other conditions. Dry- excess easily injures the lungs, causing symptoms of heavy coughing, blood in the sputum, dry nose and throat, and pains in the chest. Dry- excess is also harmful to the body’s fluid balance. ” Inner-dryness” is caused by excessive loss of fluids due to too much sweating, vomiting, bleeding, or diarrhea. Use of herbal medicines which induce sweating, vomiting, or purging of the bowels can also induce inner-dryness. Characteristic symptoms are dry, wrinkled, or withered skin, dry hair and scalp, dry mouth and cracked lips, dry stomach, and hard, dry stools.


When any of the five excesses as described above become too extreme, they often transform to fire- excess. The symptoms are usually more intense forms of those associated with the original excess, plus symptoms of extreme heat-excess. “Inner-fire” is caused by excess emotional activity or by over-indulgence in food, drink, and sex. Violent anger, for example, often causes a sensation of heat rising from the upper abdomen, where liver-fire is raging. Too much strong food and drink causes fire to collect in the stomach; deep grief or passion will often cause it to rise in the lungs.

The Six Excesses which occur during the four seasons do not affect every person in the same way. In- deed, exceptionally healthy persons are not adversely affected by any of them. An “evil-excess” will attack the body only when and where it is weak and only when the protecting- qi is deficient somewhere along the surface of the body. One of the purposes of preventive medicine is to keep the body strong and resistant to such outside attacks.

Disease of the Six Excesses are most likely to occur under abnormal weather conditions, when the body is prepared for the dominant seasonal excess and suddenly faces an opposite force. Sudden cold spells in mid-summer, for example, often cause epidemics of influenza. Similarly, people who travel or move from a cold, dry place to a warm, damp climate are more vulnerable to invasion by local meteorological excesses than natives of the region.

The Seven Emotions are the major internal causes of disease in Chinese medical theory. Emotional activity is seen as a normal, internal, physio- logical response to stimuli from the external environment. Within normal limits, emotions cause no disease or weakness in the body. However, when emotions become so powerful that they are uncontrollable and overwhelm or possess a person, then they can cause serious injury to the internal organs and open the door to disease. It is not the intensity as much as the prolonged duration of an extreme emotion which causes damage. Diseases of the Seven Emotions are essentially psychosomatic in nature. While Western physicians tend to stress the psychological aspects of psychosomatic ailments, the pathological damage these ailments cause to the internal organs is very real indeed and is of primary concern to the Chinese physician.

Seven Emotions

Excess emotional activity causes severe yin-yang energy imbalances, wild aberrations in the flow of blood and qi blockages in the meridians, and impairment of vital organ functions. Extreme emotions, when permitted to dominate a person for too long, result in damage to the organs, allowing disease to enter the body from the outside or to develop from some mild, inherent weakness inside. Once physical damage has begun, it is insufficient to eliminate the of- fending emotion to effect a cure; the prolonged emotional stress will require physical action as well.

The Seven Emotions are joy, anger, anxiety, concentration, grief, fear, and fright. In excess, each of these emotions has debilitating effects on specific organs. They are described briefly below.


“When one is excessively joyful,the spirit scatters and can no longer be stored,” stated the Chinese texts. Since the heart houses the spirit, excessive and prolonged joy —such as fits of uncontrollable laughter — injures the heart. It has already been noted that people who laugh a lot (Fire sound) are often found to have over-active hearts (Fire organ).


“If blood has a surplus, then there is anger.” Quality and quantity of available blood are controlled by the liver, and anger is the emotion associated with it. An excess of rich blood in the system makes one prone to anger. It is commonly observed that ruddy, “full-blooded” people with flushed faces (blood-excess) are more prone than others to sudden fits of rage at the slightest provocation. Rather than burn itself out, anger feeds itself. It weakens the blood and injures the liver. This causes liver-qi to flare up even more uncontrollably, which in turn rushes upward and feeds the anger even more uncontrollably, which in turn rushes upward and feeds the anger even more. Uncontrolled fits of anger are extremely injurious to the liver.


“When one feels anxiety, the qi is blocked and does not move.” Anxiety injures the lungs, which control qi through breathing. Common symptoms of extreme anxiety are retention of breath, shallow and irregular breathing, and breathing only with the upper chest. The shortage of breath experienced during periods of anxiety is common to everyone. Anxiety also injures the lungs’ coupled organ, the large intestine. For example, over-anxious people are highly prone to ulcerative colitis.


Over-concentration is said to harm the spleen, which houses the mind. This emotion refers to the type of obsessive fixation with the sort of problem which occupies one’s mind from dawn to dusk. Such excessive, prolonged brooding impedes spleen and stomach functions, impairing digestion and causing abdominal pains.


Grief is not associated exclusively with one organ. Depending on its origin, grief can come to rest in either the heart, lungs, pericardium, or triple-warmer. It has a very debilitating effect on the body’s store of qi.


“If the qi of the kidneys is weak, then one is prone to fear.” The kidneys house the human attribute of will-power. When will-power is weak, one easily succumbs to fear. Excess fear injures the kidneys, and weak kidneys in turn arouse further feelings of fear. Again, the cycle of emotional excess and physical damage becomes a vicious circle. The phenomenon of involuntary urination during moments of intense fear has been observed often enough, demonstrating its association with the kidneys (and thus with its coupled organ, the bladder.)


Fright is the other emotion not specifically related to only one organ. It is distinguished from fear by its sudden, unexpected nature. Fright primarily affects the heart, especially in its initial stages, but if it persists for some time, it becomes conscious fear and moves to the kidneys.

Other Causes of Disease

In addition to the meteorological and emotional causes of disease — which comprise the vast majority — the Chinese also acknowledge a variety of other causal factors for certain diseases. Excess food and drink or improper diet can cause a variety of ailments, with symptoms such as heartburn, constipation or irregularity, foul breath, and loss of appetite. Ingestion of rotten foods is cited as the primary cause of dysentery. Stomach aches, vomiting, diarrhea, and abdominal swelling are often attributed to too much “cold” or “cool” foods in the diet. Excessive indulgence in one of the five flavors associated with the Five Elements injures the associated organ. The various ailments caused by excess intake of alcohol are similar to those in the West.

Proper exercise is considered vital to maintaining health, and its absence is one of the miscellaneous causes of disease. Lack of physical exercise impairs health by making the flow of blood and energy sluggish. This accelerates the natural process of deterioration in the vital organs, muscles, and qi. On the other hand, excessive physical labor or fatigue will also promote weakness and dis- ease in the body. “If there is exhaustion, the qi deteriorates.”

Epidemics, serious wounds, insect and animal bites, worm infestation, penetrating poisons, and hereditary diseases are other factors which appear under “miscellaneous causes.” Diseases which fall under this heading are the exception, not the rule.

Keeping the Balance is Vital

In Chinese medical theory, all diseases have a definite cause, either internal or external in origin. Of the two, internal factors are more important because it is internal weakness which first permits invasion by external excess forces. A strong, healthy, well-balanced body and spirit will resist attack from even the most extreme environmental excesses. This again explains the important and repetitious stress in all Chinese medical texts on basic preventive care through diet, exercise, breathing, regulated sex, and preventive herbal prescriptions.

The relative balance among the body’s vital energies and the environment’s cosmic forces are the primary regulators of health and vitality. In the end, it boils down to a battle between “evil-qi” and “pure-qi” The Internal Book of Huang Di states, “where evil-qi gathers, it will cause weakness….When pure-qi is inside, evil-qi cannot interfere with the body. .. .When pure-qi prospers, evil- qi flees…When evil-qi is driven out, pure-qi grows.” The beginning and end of Chinese medical theory is the concept of qi and its many manifestations, and it is qi that is manipulated in the practical applications of Chinese herbal medicine.