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The Eight Guiding Principles

In addition to the theory of the five elements, TCM (Traditional Chinese Medicine) practitioners employ the Eight Guiding Principles to analyze and differentiate the energetic imbalances in the body or the nature of a patient’s condition. The eight guiding principles actually consist of four polar opposites: yin/yang, cold/heat, deficiency (xu)/excess (shi), and interior/exterior.

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  • Cold/Heat: This principle is used to determine the overall energy of the patient. A cold condition would be one marked by a slow metabolism, chills, pale skin, and a low-grade fever, while a hot condition would be characterized by a heightened metabolism, sensations of heat in the body, high fevers, and a flushed complexion.
  • Interior/Exterior: This principle describes symptoms in terms of the location of the patient’s problem. Exterior conditions are those caused by the invasion of the body by pathogens, and are usually acute and superficially located with a short duration. Exterior symptoms are those that affect the hair, skin, muscles, joints, peripheral nerves and blood vessels. Interior conditions result from pathogens that enter the interior of the body. Interior symptoms affect the organs, deep vessels and nerves, brain, spinal cord, and bones.
  • Deficiency/Excess: This principle describes the strength of an illness. In TCM, a deficient condition would be viewed as a lack of blood (such as in anemia), energy (Qi), heat, or fluids. Chronic illness would fall in this category. An excess condition, by contrast, means that the body has too much of something, such as Qi or blood. In TCM, an acute condition would be seen as an excess condition.
  • Yin/Yang: These principles are the generalization of the above principles, and a condition can be categorized in terms of the relative dominance of either yin and yang. In Chinese medicine, all organisms have both yin and yang qualities and a balance of the two is necessary for good health. In general, yin energy is associated with cold, female energy, and represents the solid organs. Yang is associated with hot, male energy, and represents the hollow organs. Chronic illness is seen as yin, while acute illness is seen as yang.

According to TCM, the combination of these principles determine the nature or quality of the three consituents of the body, which are energy (Qi), moisture, and blood. As described above, Qi is vital life energy. Moisture is the liquid medium which protects, nurtures, and lubricates tissue, and blood is the material foundation out of which we create bones, nerves, skin, muscles, and organs.