External Causes of Disease
External Pathogenic Factors


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We call these External Causes of Disease because, well, 'External Pathogenic Factors' doesn't quite slip off the tongue, does it?

Yet, probably at least 2000 years before Western medicine discovered bacteria and viruses, Chinese medicine developed a strategy for diagnosing and treating the illnesses they caused - even though doctors didn't know the bugs existed!

External Causes of Disease

NB! As we said, viruses and bacteria aren't included because the ancient Chinese had never heard of them. In fact they came up with what we would recognise as germ-theory only five hundred years ago.

Still, that was well before the West got the idea!

Although they didn't recognise viruses and bacteria as such, Chinese medicine did of course encounter them.

Chinese doctors observed how their patients reacted to these diseases, and the stages of disease through which illness went.

Their treatment methods have stood the test of time.

These six descriptions (Wind, Cold, Damp, Dryness, Heat, Summer-Heat, plus combinations like Wind-Cold and Wind-Heat) describe not weather-related factors but individual reactions to disease.

This means that in a group of people all exposed, say, to very damp conditions, only some of them might react with what Chinese medicine calls Damp.

Others might produce symptoms of Wind, others of Cold, some of Wind-cold, some of Heat etc.

What can be confusing is that they use words of external origin (like 'Wind' and 'Cold') to describe internal states of disease. Once you've got your head round this, however, understanding the rest is easy!

What are called ‘external causes of disease' are conditions that are acute. They arise quickly (though here again it depends on the individual’s particular metabolism). Some of them are generated by what in orthodox medicine are called bacteria or viruses.

Others describe the reactions our bodies make to external conditions. The main idea to grasp is that it is not the predisposing factor, but the individual's reaction to it, that is being described when describing these external causes of disease.

Grasp that, and you may be able to predict some of the symptoms you'd expect to find.

For example, Summer-Heat nearly always comes from very hot conditions in the environment. But the other external syndromes of disease - wind, wind-cold, wind-heat, damp, wind-dampness and fire - could theoretically arise from any external stimulus, not just one with bacteria or viruses, or on a very hot day, or a windy day, or cold weather. It is the reaction of the body that matters, not the actual nature of the external stimulus.

What do these Reactions mean?

These reactions represent acute and healing crises as your body strives to return itself to a healthy balance in the face of this attack from outside. The symptoms show how your body is externalising the disease, and when successful, how it completes the healing crisis.

If these reactions to the external causes of disease are suppressed, the disease process becomes internalised, leading to other symptoms,  usually more sinister, harder to externalise, and lowering the reactive power of your body, so making it more susceptible to further invasion.

What this means is that when an environmental pathogenic force (one of the external causes of disease) invades your body, such as when you catch (the bacteria of) a cold, the body’s reaction is classified as being Wind, or Cold or Wind-Heat or Wind-cold etc. as its immune force joins in combat with the invader.

Typical symptoms of an invasion by one of the external fctors include headache, chills, fever, muscle aches, stiff neck and a floating, fast pulse. These symptoms are typical for many diseases including the common cold, influenza, and upper respiratory infections.

Catching a Cold - Dreamstime

© Katarzyna Bialasiewicz

What happens next depends first on the strength of your immune system, (or in Chinese medicine, your 'Upright Qi'), and your Wei qi, your defensive energy.

Factors include not just your constitutional strength and fitness, but your mental and emotional situation and what level of toxicity your body is carrying.

Another factor is the virulence of the invading pathogenic factor and how familiar the body is with it. However, usually more important than the virulence of the invader is your immune system's strength.

What happens next?

What to do next depends on several factors, and have been thought about, in one case, for almost 2000 years. They are quite big theories, and are still being thought about. Do they work? Yes, they do!

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Click here to read about Internal Causes of Disease.

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Jonathan Clogstoun-Willmott Books

Please note! The Kindle editions are less easy to read!

I'm gradually improving this, but 'Qi Stagnation' and 'Yin Deficiency' still remain to be re-edited.

Although the paper editions cost more, they are much easier to read and to refer back and forth to the contents and index. 

Here are some of the books Jonathan has written:

Qi Stagnation - Signs of Stress

Yin Deficiency - Burnout and Exhaustion

Yang Deficiency - Get Your Fire Burning Again!

Yuck! Phlegm! How to Clear Your Phlegm ...

Western Astrology and Chinese Medicine



Published 1986 and, amazingly, still selling. Was apparently used back then by at least one acupuncture college to help students understand Chinese medicine!

No comments yet: just published. (Despite the lurid cover, it explains the five main types of phlegm and what works best for each type. I hope it's easy to read and will be much more useful than all the websites on the subject.)


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