How disease emerges
By Are S. Thoresen DVM
Veterinarian acupuncturist homeopath osteopath agronomist
We must learn to observe the animals: In everyday life, different species and different animals within a species have different abilities to meet heavy work, irregular or poor nutrition and the many and varied stresses. The more specialized an animal or an organ is, the less it can cope with new or ongoing stressors involved in everyday wear and tear. This is due to differences in breeding (genetics), natural environments, special needs for feed, special areas of use and varying stresses.
In holistic thinking, >a Process Imbalance (usually deficiency) is the root cause of disease; an imbalance in one of the 12 Fundamental Processes of the body allows disease to manifest. For example, consider the high yielding dairy cows. Such cows have extremely "stressed" udders. For them, the udder is often the Weak anatomical Structure and mastitis is one of their most prominent disorders. Conventional veterinary medicine usually treats mastitis with antibiotics or other remedies to reduce infection, in addition to other udder supporting treatments. Treatment is aimed at the mastitis producing pathogens. In contrast, holistic medicine has a very different approach. It regards a Process Imbalance as essential to allow the Stressor to manifest as Lesion-Symptom Complexes in the Weak Structure. In this example, the Process Imbalance allows the mastitis to manifest. It might have been a Process Imbalance (deficient) in KI, due to too many calvings, allowing a Stressor, such as severe Cold, or Wind to weaken it even more. It might have been a Process Imbalance in LV Process, due to chronic malnutrition and in which LV was weakened further by a sudden change in feed.
When deciding on which treatment to institute, conventional medicine ignores the underlying and/or initiating cause:
- Theunderlying (predisposing)cause is the Process Imbalancethat allows the stressor to precipitate mastitis.
- Theinitiating (precipitating) cause may be an External or Internal Stressor that overcomes the capacity of one or more of the Processes to adapt, i.e. it imbalances one or more Processes over its limit.
- External Stressorsinclude the Six Evil Qi Factors of TCM (Heat / Summer Heat, Damp, Dryness, Cold and Wind), change of feed, food spoilage, or trauma. It also includes other environmental stressors, as recognized in western medicine, such as heavy infectious or parasitic challenge, allergens, toxicity, serious defects of management or husbandry, geopathic effects, or adverse effects of lunar, solar or other cosmic stimuli, etc.
- Internal Stressors include emotional imbalance, particularly serious Excess or Deficiency of excitement, obsession, grief, fear and anger, or their related emotions.
It takes a great challenge (External or Internal Stressor) to precipitate serious illness if the body has perfect inner equilibrium, i.e. if all Processes are balanced. Unfortunately, few individuals are perfectly balanced. That is why there is so much international interest in training programs that help people to become physically and mentally "fit". Such programs include physical fitness and exercise training, the martial arts, Tai qi, meditation and stress-control programs (yoga, Qigong, etc) and state-sponsored schemes to encourage healthy living. The latter schemes include legislation on pollution and sanitation, safety-at-work, personal- and food- hygiene, nutritional health, antismoking campaigns, control of alcohol and drugs, etc. In spite of all these efforts, many people do not take steps to develop a full physical and mental balance.
A Process Imbalance seriously weakens the adaptive capacity of the body to withstand Internal or External Stressors; both act as stressors. If a cow also has a Weak Structure, then this combination allows disease to manifest (mastitis, if the udder is the Weak Structure), even if the Stressor is relatively minor.
Recent research in high-yielding cows shows that fertility (conception rates, days from calving to conception, etc) decreases as milk yield increases. In nature, to feed her suckling calf, a cow needs to produce only 400-600 kg milk per lactation. She can do this with minimal intake of feed dry matter and minimal metabolic stress on the gastrointestinal tract, LV, SP and KI. Today however, because of genetic manipulation and selection for high milk yield, many dairy herds produce an average 7000-9000+ kg of milk per lactation. This puts enormous metabolic stress on all the systems of the cow. Apart from mastitis and lameness, sub fertility is a huge problem in such herds, which often have conception rates to a given service of <40 %, as compared with 60-70 % in lower yielding herds. Such cows have "prioritized" milk yield over pregnancy. In TCM, pregnancy / reproduction falls under the control of KI (Water Phase) and LV (Wood Phase).
In those cows, KI and LV can be the Deficient Processes, and KI and LV Deficiency can be the foundations of mastitis or reproductive problems.
1. Process Imbalances
We, humans, are proud of our unique individuality. Even if we may seem to be as alike as peas in a pod, or drops of water, even if we have the same Weak Anatomical Structures springing from the same kind of work, no two of us are the same. We all have our genetic differences, our specialties, our strengths and weaknesses, our joys and sorrows, our fears and loneliness. And it is subtle differences in these that make one individual unique from another. We are each unique beings, and so too are animals. The more I work with animals, the more I am astonished at how different and individual they are. Two trotters that may perform the same kind of work, have the same training and eat the same food, and yet may have totally different weak Processes that are unique to them. One may have a weak BL-process, and get easily scared and one may have a weak spleen and thus get digestion problems after change of feed.
On initial assessment, it is very important to distinguish between the Weak Structure and the Process Imbalance of the same animal.
- The Weak Structure is a physical weakness because of a special anatomical structure, or because of special use.
- The Process Imbalances (dysfunctions of Internal Jing-Qi balance) may be due to Deficiency (Weak Jing-Qi) or to Excess (Full Jing-Qi).
It is also very important to have in mind that different Process Imbalances may elicit similar Lesion-Symptom Complexes because the Weak Structure is like "an accident waiting to happen". As water or electricity find the lines of least resistance, differing Process Imbalances may manifest in the Weak Structures of the animal.
It is equally important to distinguish between the Internal Stressor (destructive emotions) and the Imbalanced Process. The latter usually is a lifelong weak Internal Process, while the Internal Stressor usually is the combination of day-to-day mental stressors that are an inevitable part of living. All Internal Stressors more or less weaken the Imbalanced Process. However, if the Internal Stressor correlates with the Imbalanced Process, it has much more adverse effects than if it did not correlate. This is explained in more depth at page 00 & 00.
It is very important to understand that all animals or people have their own individual Process Imbalances. Under attack by an acute or prolonged Stressor, the Process Imbalances are the main determinants that elicit Lesion-Symptom Complexes at their individual Weak Structures.
In trotters, which normally have great stress on their joints, especially on the right carpus, any strain or stress combined with a Weakest Process can elicit pain in this joint. Many owners ask me to treat horses with such carpal disorders. Instead of treating the joint, I search for the Weakest Process. In some cases it may be a KI Deficiency due to giving birth (and exaggerated by cold weather or prolonged Wind), a SP Deficiency due to many changes of the feed (and worsened by irregular feeding) or a LU Deficiency present at birth (and worsened due to dust inhalation). Having determined the Weakest Process, I treat that as the root cause. If I have managed to identify the Stressor, I will of course try to eliminate that also (keep the animal away from cold wind, irregular feeding or dust). Having done all this it is usually not necessary to treat the painful joint, but we may of course treat the painful joint as well.
This holistic concept is very important. It means that two horses with the same symptom (right carpal pain) are treated very differently, depending on which Process Imbalance is the underlying energetic cause. Conversely, if we correctly diagnose and treat the Process Imbalance, the carpal disorder disappears sooner (usually much sooner) than usual and the disorder usually does not recur for a long time. Other complaints as headache, bad skin and dandruff will also disappear if we treat the deficient process.
In contrast, if one treats the Lesion-Symptom Complexes only, for example using "Cookbook Points" for carpal pain, or conventional symptom-suppressive analgesic/anti-inflammatory drugs, the clinical results may be as good, but the disorder recurs sooner. Additional complaints will not disappear together with the main ailment if the treatment is just symptomatic.
2. The Stressor
A Stressor is necessary for Lesion-Symptom Complexes to manifest in the Weak Structure. Stressors, whether physical, psychic or spiritual, include all influences that stress and weaken the body. We often are aware of this Stressor. For example, we often see that the "cause" of a disorder is that we eat too much for supper, that the racetrack was harder or much wetter than usual, or that the animals had undergone much more stress, or a totally different routine than usual. But the Stressor is not the real cause of the disease; it is not even the most important factor, unless it is extremely strong. The same applies for the Weak Structure, unless it is very weak. Also, it is very difficult for a mild Stressor to manifest as disease in a body that is well balanced (i.e. has no Process Imbalance).
A strong Stressor may precipitate Process Imbalances
It is important to consider all the factors in diagnostic evaluation, and to decide if the Stressor may have been strong enough to create a deficient process by itself.
- A horse exposed to cold weather (say –20o C), or that stands in (or drinks!!) too much cold water, may develop a deficient KI.
- A horse submitted to frequent changes of feed may develop a deficient SP (digestive disorder or weak iliopsoas muscle)
If a Stressor is strong enough to trigger disease, one should try to eliminate the future Stressors of the same kind. This is really good preventive medicine. The main aim is to create a strong and well-balanced animal, an animal that can withstand ever-changing conditions and everyday wear and tear, without reacting to these influences by manifesting disease.
In TCM, the best therapy is one that builds up or balances Qi, (if there is a Process Imbalance), or removes the Stressor, Qi Obstruction, Phlegm, etc. All symptomatic therapy is inferior.
If a Stressor overcomes the Wei Qi (Antipathogenic Qi of the organism), it leaves its "fingerprint" (its peculiar set of signs) behind. A deep knowledge of the Five Phases is especially useful to help us categorize the Stressor. Once we recognize it, we can deduce the origin of the initiating factor (Stressor). Classification of the Lesion-Symptom Complex is based on the specialty or peculiarity of the Lesion-Symptom Complex. The symptoms may be dry, painful, hot or damp (edematous). TCM designated or symbolized this after the Phase to which the symptom belongs (also see page 00, 000 & 000). This is very important. Such observations can indicate
- Which element the Stressor belongs to
- Which element the deficient process belongs to
- Which remedy or acupuncture-point to use
- How deep the disease is rooted in the body (6 divisions, see page 00)
3. The Weak (anatomical) Structure
All humans and animals are mortal creatures. Each creature has its "Achilles' Heel", its Weak Structures or points where disease, strain or stress develop, or manifest more easily. Stress manifests in different ways in different people. Some develop angina or heart infarction. Others develop one or more of the following Lesion-Symptom Complexes: acid reflux, gastro-duodenal ulcers, muscle spasm, asthma, constipation, colitis, uro-genital or reproductive disorders, arthritis, arthrosis (restricted joint movement), headaches, etc. Some develop the psychic or mental equivalents of these physical symptoms: insomnia, excitability or mania, obsession, apathy or mental fixation, claustrophobia, tension, impotence, aggression, or fear etc.
Every stress, disease or imbalance appears at the Weak Structure. Therefore we reach the wrong conclusion if we think that LU symptoms must originate in the lungs, KI symptoms in the kidneys, HT symptoms in the heart etc. If an animal has a predominant Weak Structure, for example the udder of the high yielding cows, all Process Imbalances will manifest primarily as mastitis. If an animal has no Weak Structures, then disease cannot appear easily. In that case, the Lesion-Symptom Complex usually relates to the specificity of the Stressor or the Process Imbalance. Bur usually disease can manifest only if the Stressor is strong enough, or if the Process becomes imbalanced enough relative to the weakness of the weak structure. If we know the Weak Structure of the animal, we should usually look elsewhere to find the real origin (Process Imbalance, the Predisposing Cause) and precipitating cause (Stressor) that induced the disease to manifest in the Weak Structure.
- Dogs have very different individual constitutions. Some are big and heavy and have great stress on the joints, especially the elbow and the hip. Such dogs often develop elbow arthrosis and hip dysplasia. (HD). Small "sausage dogs", like dachshunds, suffer less stress on the joints but their backs are vulnerable because of their length and C shape; this is also the case in pigs. Small dogs kept as pets (lapdogs) get too little exercise and too much food; these dogs usually suffer stress on their digestive and metabolic system, circulation and heart. Such dogs usually react to Process Imbalances and Stressors by developing circulatory disorders, heart disorders and epilepsy. Generally the dogs assume their owners' disorders, because the dog usually shares the owners' lifestyle.
- Cows in intensive dairy herds are under extreme stress from selective breeding and management to produce higher and higher milk yield. This weakens the udder, which often is the main Weak Structure in high-yielding cows. Combined with very little exercise, most of our cows are balancing on the brink of mastitis and diarrhoea. For most of the year, most cows in Scandinavia are kept in a barn; this makes their legs grow weak. Very little extra stress inevitably precipitates disease, such as laminitis, mastitis, etc. A change of relief-milker for one weekend may be a sufficient stressor to precipitate an increase in somatic cell count in the milk, followed by mastitis some days later.
- Horses have very different lives. Riding horses are usually less stressed than trotters and the disorders of riding horses usually vary more than those of trotters. Trotters suffer from repetitive stress every day. They are forced to trot in an abnormal way and at a speed that should be a canter or gallop. They are forced to do this day after day in the same trails, races or tracks. This is grossly abnormal for horses. These stressors induce extreme wear and tear on the joints, and manifest then especially in the fetlocks and the carpus (the Weak Structure). The slightest change in feed, care, surroundings or training (the Stressor) can then precipitate joint disorders if a Process Imbalance is present. In all types of riding horses like dressage-, jumping- or event-horses the weak structure is usually the same, namely the joints. In the development of the disease, the Stressor varies as well as the Internal Process. Usually the rider/handler is the main Stressor of these horses. Personal communication from a German physiotherapist has shown me that all horses that are ridden over a period of two years “take over” the problems (symptoms) of their rider. They develop malfunction in the same structures or joints where the rider has problems.
We must learn to assess and integrate all the presented data and clinical findings holistically, in such a way that we are able to see and recognize the real disorders and to distinguish between the External and the Internal causes (Process Imbalances, imbalanced emotions). This must be done in a way that enables us to deduce these factors back to environmental-, feed-dependent-, breed-dependent-, psychological-, acquired-, or inherited- Process Imbalances.
In most cases of disease, all three factors (Process Imbalance, Stressor and Weak Structure) must interact. This interaction allows disease to manifest, and the most important root cause of disease is the Process Imbalance.
The relationship and dependence between the Weak Structure, the Stressor and the Process Imbalance in the development of Lesion-Symptom Complexes may vary from disease to disease. It is very important to evaluate all these three factors when we are to evaluate every patient.