Traditional Chinese Medicine

Getting my Head around the Pathological States (according to TCVM)

Do you feel hot? Is it because it’s 40℃ outside, or because your body cannot cool down?

Is it cold? Is it because someone turned the AC on or you haven’t eaten for days and have no energy to keep yourself warm?

The TCVM practitioner try to find the root cause of the Yin Yang imbalance. If a patient is feeling cold, he or she has to figure out if it’s because of Yin excess or Yang deficiency and balance accordingly. Keep boosting Yang into a Yin excess patient may help symptomatically, but cannot get to the root cause of disease, just like turning off the AC may help one feel warmer, but deficiency in nutrients will persist and the person will continue to feel cold in normal temperature.

There are 4 possible pathological states of imbalance. One has to first determine the patient’s character (sort of like history and signalment in conventional medicine) by age, chronicity and other clinical signs. We then determine if what the patient is experiencing is heat or cold signs and from there assign him/her into the 4 possible pathological states.

To help myself understand better, I made a little table and drawings below:


Young, Active, Strong patient

Acute disease


Old, weak patient

Chronic disease

Heat Signs Yang Excess/Excess Heat/濕熱 Yin Deficieny/False Heat/虛熱
Cold Signs Yin Excess/Excess Cold/濕寒 Yang Deficiency/False Cold/虛寒
Course of Action Remove and dispel excess Yang or Yin Tonify, nourish and reinforce Yin or Yang

濕熱 (Excess Heat= Yang Excess)

Characteristic: Invasion of excess Yang. Yang overpower Yin. Yin is not weaker, but Yang is too strong for Yin to calm down.

The aim in treating Yang Excess is to “clear heat” or “sedate Yang”

濕寒 (Excess Cold= Yin Excess= True Cold)

Characteristic: Invasion of excess Yin. Yin overpowers Yang, more cooling than warming.

Treatment aim is to “eliminate cold” or “reduce Yin”

虛寒 (False Cold= Yang Deficiency)

Characteristic: weak Yang unable to match cooling property of normal Yin.

Treatment aims to strengthen/tonify Yang

虛熱 (False Heat= Yin Deficiency)

Characteristic: weak Yin unable to match warming property of normal Yang.

Treatment aims to nourish/tonify Yin


I have to say that at this point I am still kind of confused. For example, young, active and strong patients usually are classified as excess… but what is the cut off point? What is the age that one would be considered in the deficiency class? Could you possibly have a patient with a mixture of the 4 pathological imbalances?





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