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 energy.

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. Tension 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 results.

tcm uses four different patterns (see sidebar right) as a way to simplify the understanding of how your body might react to stress. These should 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 a 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 that 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 can 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 today.

With the aging population and their predominance of slow onset diseases the focus shifts back to the founding principles of medicine that allow us to more easily understand and treat the complex mechanisms that are involved in a gradual deterioration of health. Chinese medicine with its somewhat simplistic terms and concepts is leading the way in the treatment of complex illnesses by addressing the more simple, naturalistic building blocks of health care and therefore avoids the structural complexity of the current western model.

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Kevin Scrimgeour is a doctor of Traditonal Chinese Medicine in Tofino. Reach him at 725-2555