by Bob Flaws

Toxins (毒 du) are one of the causes of disease in Chinese medicine. However, many students and practitioners are not clear about the Chinese medical concept of toxins. In Shan Dong Zhong Yi Za Zhi (Shandong J CM), issue #6, 2004, on page 261, Fan Yan-chao et al. published an article on the role of toxins in atherosclerosis. The first part of that article is a definition of toxins followed by a description of the 10 characteristics of toxins according to Chinese medicine. I think these are worth sharing with non-Chinese-reading students and practitioners.

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Besides the fact that toxins are a type of disease cause (病因 bing yin) in Chinese medicine, Fan et al. start off by saying that toxins are divided into internal and external toxins. Externally assailing (外袭 wai xi) toxins are the result of contraction of one or more of the six environmental excesses which, if they endure and are not eliminated, may brew and bind, thus producing toxins. Internally engendered (内生 nei sheng) toxins are closely related to dysfunction of the viscera and bowels. Dysfunction of the viscera and bowels can produce the engenderment of toxins. Once produced, these toxins can then make the original disease worse and/or produce a new disease condition.

(This latter discussion of internally engendered toxins seems a bit scant to me. Because of dysfunction of the viscera and bowels, the qi mechanism is inhibited. This gives rise to the internal engenderment of various types of evil qi, such as dampness, phlegm, and blood stasis. If these depress the yang qi, such depression transforms heat or, if stronger, fire. Such depressive or transformative heat can then engender toxins.)

As for the 10 characteristics of toxins listed by Fan et al., the first is their sudden onset. Toxic diseases start off very acutely, change and transmute very quickly, and can directly strike the viscera and bowels.

Secondly, their nature is broad or extensive. This means that they can affect the body very broadly, including the viscera and bowels, the channels and network vessels, and the four extremities. In other words, their effect is not necessarily limited to s single, localized area of the body.

Third, toxins have a cruel, fierce, strong nature. This means that they are especially virulent, producing very strong diseases with potentially many, serious symptoms. They commonly lie deeply or hide within the qi and blood, consuming and damaging yin fluids, vanquishing and ruining the viscera and bowels.

Fourth, toxins have a change-promoting nature. This specifically means that they promote changes in the physical substance of the body. They do not just cause functional disease.

Fifth, toxins have a fiery, hot nature. Although there are other types of toxins, most toxins are overwhelmingly hot. When evils transform into toxins, mostly they transform into fire.

Sixth, toxins tend to produce unusual or extreme pathological changes. When toxic evils result in disease, the pathological changes are not common or ordinary. Symptoms tend to be both extreme and abundant or profuse.

Seventh, toxins tend to run or hasten internally. Toxic evils are especially explosive. They commonly quickly enter internally to harm the viscera and bowels, leading to diseases that are rapidly malignant.

Eighth, toxins accentuate the root nature of the original disease evils.This means that toxins amplify the characteristics of the original disease evils which engendered and transformed the toxins.

Ninth, toxins have a simultaneously mixing nature. This means that toxins tend to cause the production of blood stasis and phlegm with which they then mutually bind.

Tenth, toxins' nature is recalcitrant. In other words, toxic disease are very difficult to treat and do not heal easily, if at all. Toxins may also result in a variety of sequelae as well as relapsing-remittent conditions which may return like the "rising of [a swarm of] bees."

In closing, I caution readers not to conflate the Western medical or naturopathic concepts of toxins with the Chinese medical concept of the same name. Doing so typically leads to erroneous assumptions and, more importantly, erroneous treatments. The concepts of Chinese medicine need to be understood on their own terms. That is why an article discussing the various characteristics of Chinese medical toxins is such a welcome read.

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