The Four Levels of Chronic Fatigue
by Kevin Scrimgeour, Tofino
Health Care has been grappling for the past hundred years with the
treatment of disorders of human energy. It was not until 1988 that
physicians at the American Center for Disease Control established the
new working case definition of Chronic Fatigue and Immune dysfunction
Syndrome. Early on similar pathologies were seen as mononucleosis and
later Chronic Epstein-Barr virus. The disease has also been labeled "yuppie
flu", Chronic Mononucleosis or epidemic and sporadic Neuromyastenia
and Post Viral Fatigue Syndrome. These are just a few of the numerous
descriptions for what is now known as chronic fatigue. A modern illness
that with the rapid rate of modern life we are seeing more and more
of: people who are suffering from chronic tiredness, burnout or low
The most troublesome part of Chronic Fatigue type illness is that
medial researchers from many sides state this is a relatively new disease
with no known cause and therefore untreatable. Some even seem to think
this is a mental disorder. It is a mistake to allow the discussion
of chronic fatigue to remain only in the scientific medical circles.
They have not been able to explain these phenomena for two centuries
and only further drain the system with symptomatic treatments. Many
other reliable therapies are available for this condition. Traditional
Chinese Medicine (tcm) appears to be one modality that has been effective.
What tcm asserts is that it is not a physical disease but a vital energy
disorder. Many healing arts recognize this and treat the symptoms that
lead up to chronic fatigue through stress management and other treatment
regimens. Even in chronically exhausted patients progress can be made.
One useful tcm concept that helps us understands fatigue is 'false
fire'. This is a tcm term that represents a state where a person
has become so out of touch with their vital energy as to display what
appears to be an excess of energy but is actually due to a deficiency.
The yin or nutrient cooling and sedating qualities of the body are
drained and so the yang or heat and active qualities appear in excess.
This is literally like running on empty much like a car on rocket fuel
will soon lead to breakdown despite its high performance at present.
Vital energy or the lack of it (fatigue) are explained in detail
by Chinese Medicine. The syndrome of 'false fire' is a common
symptom seen today. One is heated up and revved, but at the vital or
core level is exhausted. This is just one example of a physical syndrome
that is clearly identified but only recognized in tcm.
This break down can be described as a slow spastic constriction in
various parts of the body. Just as stress leads to tension and tightness
in the muscles chronic stress leads to deeper constrictions. The human
body is a living organism with fluids gases and solid matter and even
organs moving around one another. Living anatomy is not the same as
cadaver anatomy many textbooks are based on. Our organs move around
when sitting standing or laying down. This motion when put to the extreme
will create imbalances. With chronic stress – when there is too
much strength – the fluids will thicken and the solids harden,
the fiber slackens and the blood becomes thin. Either one of these
imbalances will lead to breakdown and the appearance of disease.
In Japanese studies of the abdomen or Hara used extensively in shiatsu
therapy diagnosis can be found by palpating and finding sensitive
areas on the abdomen. These tender spots are seen as energy obstructions
causing muscle tension by acupuncturists and massage practitioners.
This tension leads to compression of various conduits of fluids.
on the lymph vessels lowers the immune system. Constricting the blood
vessels leads to accumulation of waste materials like co2 and lactic
acid with pooling of blood. When arteries are constricted there is
poor oxygenation and nutrition to the tissues. When nerve branches
are constricted, irritation and pain and possibly organ malfunction
tcm uses four different patterns (see sidebar right) as a way to
simplify the understanding of how your body might react to stress.
be seen as signs that you need to reassess your attitudes towards
life. These patterns may jump around form one to the other or two patterns
may coexist at the same time. What is important from a Chinese or
massage therapy perspective is not what is diagnosed but what is
felt. What is felt is a holding pattern that needs to be released so
the body can return to normal function and a balance of flow or fluid
and energy in the body. This is why a massage can be so beneficial.
It helps one to let go of holding patterns and this works on the
mental level as well.
These ideas were developed form early German medicine in World War
ii when Japan and Germany were exchanging information in many areas.
It was discovered that physical constriction serves often as pre-symptomatic
signs of disease. Physical dysfunctions appeared to be more common
in patients with gastrointestinal and cardiac problems than those
with pulmonary disease.
The mechanisms were difficult to prove using western terminology
but are an excellent way to understand how acupuncture and massage
treat internal illness. This is known as classification medicine,
which has been repeated for centuries. The specific disease is
not as important
as the nature of it. Is it hot cold, stagnant or excess? These
concepts, which predominated early medicine, are making a comeback
With the aging population and their predominance of slow onset
diseases the focus shifts back to the founding principles of
allow us to more easily understand and treat the complex mechanisms
are involved in a gradual deterioration of health. Chinese
medicine with its somewhat simplistic terms and concepts is leading
way in the treatment of complex illnesses by addressing the
naturalistic building blocks of health care and therefore avoids
the structural complexity of the current western model.
Kevin Scrimgeour is a doctor of Traditonal Chinese Medicine in Tofino.