Traditional versus modern Acupuncture

d. External and Internal Syndromes

External Syndromes result from invasion of the superficial areas of the body by exogenous factors. Onset is sudden and duration is short. Exterior Syndromes are usually mild. They are the early signs of exogenous disease but may develop to Internal Syndromes.

Internal Syndromes result from penetration of exogenous factors to the Interior of the body, as in an External type which was unsuccessfully controlled, or by direct attack of the organs by exogenous factors. Internal Syndromes are usually severe and involve functional or organic damage of the organs. Dysfunction of the organs is also an Internal Syndrome.

Both External and Internal Syndromes can be complicated by Cold, Heat, Xu (Deficient) and Shi (Excess) Syndromes.

External Syndromes:

Cold: Fever; no sweating; chills; pulse superficial and strong; tongue coating thin and white

Hot: Fever; intolerance of wind; may sweat; mild thirst; pulse superficial and rapid; tongue coating thin and yellow.

Xu: Sweating; intolerance of wind; pulse superficial and slow

Shi: No sweating; general aches; pulse superficial and strong; tongue coating white

Internal Syndromes:

Cold: Chills; cold limbs; pallor; no thirst; stool loose; urine clear and profuse; pulse deep and slow; tongue pale

Hot: High fever; thirst; irritable and restless; face flushed; eyes red; constipation; yellow scanty urine; pulse rapid; tongue red with yellow coating.

Xu: Breathing feeble; apathy; lassitude; palpitation; dizziness; pulse deep; tongue flabby and pale, with white coating

Shi: Breathing coarse; voice strong; irritability; fullness of chest; distended abdomen; constipation; pulse deep; tongue rough, with thick coating

Thus, TCM has a set of 8 criteria (the Eight Principles) to define disease Syndromes (the type (nature) of disease), based on the clinical signs. By combining one type from each of the 4 categories (Yin or Yang; Hot or Cold; Shi or Xu; External or Internal), 8 possibilities arise (1 X 2 X 2 X 2 = 8). Syndrome classification by the Eight Principles is discussed further in Lee and Cheung (1978); The Essentials of Chinese AP (1980); Turner and Low (1981); Porkert (1983).

As well as classification by the Eight Principles, Syndromes are classified according to the main organs involved and the energy imbalance in them. Each of the following strangely-named Syndromes has defined clinical and functional upsets:

LU Syndromes:LU Yin Deficiency; Wind attack on LU; LU Damp-Phlegm Retention; LU Heat-Phlegm Retention

LI Syndromes:Damp-Heat invasion of LI; LI Obstruction; Blood and Heat Obstruction of LI

ST Syndromes: Retention of food; Retention of fluid; ST Fire Excess

SP Syndromes:SP Qi Deficiency; Cold-Damp invasion of SP

HT Syndromes:HT Qi Deficiency; HT Yin Deficiency; Obstruction of HT Blood; Excess HT Fire; disturbed Shen (mental derangement)

SI Syndromes:SI Heat

BL Syndromes:Damp-Heat invasion of BL; BL dysfunction

KI Syndromes:KI Qi Deficiency; KI Yin Deficiency; KI Yang Deficiency

PC Syndromes:Heat invasion of PC

GB Syndromes:Damp-Heat invasion of GB

LV Syndromes:LV Qi Deficiency; LV Fire Excess; Cold Obstruction of LV; LV Blood Deficiency; LV Wind stirred by Heat

There are many other types of Channel Syndromes (see Porkert 1983).

Disease is classified also according to the main Channel involved (LU, LI, ST, SP, HT, SI, BL, KI, PC, TH, GB, LV). It may be classified also by disturbance in the Eight Mai (Vessels or Extra Channels):GV; CV; Chong; Dai; Yang Chiao; Yin Chiao; Yang Wei; Yin Wei). Each of these Channels and Vessels has its own symptomatology.