by Matthew Wood
A similar generalization about disease processes following a threefold cycle was made in the twentieth-century by Dr. Hans Selye, discoverer of the function of the adrenal cortex and originator of the medical concept of “stress”:
We have illustrated, with many examples, that the most varied manifestations of disease depend upon a tripartite mechanism consisting of: (1) the direct action of the external agent—the apparent pathogen; (2) factors that inhibit this action; and (3) factors that facilitate this action (Selye 1974, 314).
Selye further notes that “all bodily activities” tend to move through three stages and are therefore “triphasic.” As an example, he cites the inflammatory response:
If virulent microbes get under the skin, they first cause what we call acute inflammation (reddening, swelling, pain); then follows chronic inflammation (ripening of a boil or abscess); and finally an exhaustion of tissue resistance, which permits the inflamed, purulent fluid to be evacuated (breaking through of an abscess) (Selye 1974, 473).
The rebound effect is an example of a triphasic reaction: pathogenic attack or trauma; primary response (resistance); secondary response (recovery). For centuries we have used the vast majority of herbs, in almost all traditions, to antidote the rebound effect. However, Selye’s observations also form the basis of our understanding of how adaptogens work (Winston and Maimes, 2007). The adaptogen gives the organism greater “nonspecific resistance” to all stimulae, so that the extreme reactions to the rebound effect are lessened and it is less likely to be traumatized by the extreme reactions.
The Six Tissue States
The followers of Alva Curtis were called the “physiomedicalists.” In the generation following Curtis, Dr. Joseph M. Thurston (1900) identified six different “tissue states.” These correspond to the three phases, in excess or deficiency: excitation (overstimulation), depression (understimulation), contraction (tension), relaxation (lack of tension), atrophy (lack of fluid), and torpor (excess of fluid). In a late physiomedical work, A.W. and L.R. Priest (1982, 34) describe only four tissue states: stimulation, sedation, constriction, and relaxation, which can be visualized as follows:
Thurston’s sixfold model represents the entire scope of Greek energetics, including the four qualities and the two tissue states (constriction, relaxation) used by various schools of Greek medicine. They align fairly closely (though not perfectly), as follows:
Heat
Excitation, Irritation, Stimulation
Cold
Depression
Dryness
Atrophy
Dampness
Stagnation
Tension
Tension, Constriction, Contraction
Relaxation
Relaxation
In traditional Chinese and Greek medicine, the state called “relaxation” here is often identified with “dampness” because the tissues are damp, with fluid flowing out of open, relaxed pores. This is a “damp flowing” state. This gives us two damp states: stagnation and relaxation. For ease of use I have kept tension and relaxation as a pair and left out the relationship between relaxation and dampness in the repertory.
The original Latin terms for tension and relaxation were status strictus and status laxus. The TCM term for tension is “wind.” The Ayurvedic equivalent is “space” or “ether”—when there is a lack of space there is tension.
The chart on the following page shows the relationship between the three doshas (constitutions) and the six tissue states.
Heat/Excitation
This tissue state depends on an exaggeration of function. The tissues are overstimulated; circulation and innervation are accelerated. Blood rushes to an area that is over-functioning, resulting in the classical symptoms of inflammation—heat, redness, swelling, and pain. This tissue state, however, is not equivalent to inflammation, which can also result from cold, spasm, dryness, and dampness. Rather, the organism is in a condition where it is too easily pushed into inflammation.
Symptoms of heat: heat, redness, swelling, and tenderness associated with autoimmune excess and exaggeration of function; pink-red (carmine) to dark-red mucosa and skin; dark and concentrated urine; pulse is elevated (beats toward the surface, high in the artery), large, rapid, quick; tongue is elongated, pointed, carmine-red, flame-shaped.
Recommended herbs for heat: • Achillea (excitation, depression, relaxation; capillary stasis from venous relaxation) • Amygdalus (excitation, atrophy, immune excess) • Asperula (excitation, depression) • Citrus limonum (excitation, relaxation) • Crataegus (excitation; cardiovascular, mind) • Cucurbita citrullus (excitation, atrophy; kidneys) • Curcuma • Galium (excitation, atrophy; lymph, kidneys, nerves) • Lonicera (excitation) • Lavendula (excitation, tension; circulation, nerves) • Medicago sativa (excitation, torpor, atrophy) • Melilotus (excitation from blood stagnation or tissue depression) • Melissa (excitation; nervous system) • Nigella sativa (both excess and deficiency) • Passiflora incarnata • Prunus serotina (excitation; lungs, heart, small intestine, skin, mind, emotions) • Rheum (excitation, tension; colon; “restless spirit, irritability, easily excited, and fever with sweating”—Huang) • Ribes nigrum (excitation; adrenal cortex) • Rosa (excitation, relaxation; rose hips) • Rumex acetosa (excitation) • Rumex crispus (excitation, relaxation, torpor; colon, liver, skin) • Sambucus spp. (excitation; perspiration; channels of elimination) • Trifolium pratense (excitation; cools through the surface, thins blood) • Vaccinium macrocarpon (excitation, relaxation) • Vaccinium myrtillus (excitation; high blood sugar) • Viburnum trilobum (excitation, tension).
Cold/Depression
This tissue state represents the opposite condition to heat/excitation: tissues fail to respond to stimulation; hence there is a generalized or local depression. The extremities are usually cold; the skin is cold and inactive, failing to perspire and lacking water and oil. The complexion is pale due to lack of blood at the surface, or lack of good blood; or it may be darkish due to lack of oxygen (grey), coagulation (blue), sepsis (purple), or necrosis (black).
Symptoms of cold: deep cold; tissues are pale, white, dark, grey, blue, purple, or black, indicating decreased oxygenation; lessened sensation and function; lack of response to stimulation; cold hands and feet (also see wind/tension); low and slow pulse; pale or dark tongue body.
Recommended herbs for cold: • Achillea (depression, excitation, relaxation; vascular system) • Anethum (diffusive; depression) • Angelica archangelica (warming/stimulating; dries water, generates oil) • Arnica (warming/stimulating; congealed blood) • Artemisia absinthium (warming/stimulating, softening, anthelmintic) • Artemisia annua (warming/stimulating, antiperiodic, antimicrobial) • Artemisia vulgaris (warming/stimulating, softening; uterus) • Baptisia (stimulating, antiseptic, antimicrobial) • Barosma (warming/stimulating, antiseptic; urinary tract) • Calendula (warming/stimulating, antiseptic; lymph/immune) • Capsella bursa-pastoris (stimulating, emollient) • Capsicum (stimulating; heats the interior, cools the exterior) • Carthamus (warming/stimulating; congealed blood) • Curcuma (inflammatory conditions from tissue depression; bacteria living off debris) • Echinacea (stimulating/cooling, antiseptic) • Erigeron (stimulating, astringent) • Foeniculum (mildly warming/stimulating) • Gnaphalium obtusifolium (warming/stimulating, sweet/nourishing, blood-thinning) • Helianthus (warming/stimulating, oily/nourishing) • Helianthemum (stimulating antiseptic) • Helichrysum (warming/stimulating, sweet/nourishing, blood-thinning) • Hyssop (warming/stimulating, opening/moistening) • Inula (warming/stimulating, carminative, thinning/mucolytic) • Isatis (stimulating antiseptic) • Juglans nigra (warming/stimulating, alterative, anthelmintic; hull) • Larrea (warming/stimulating, alterative) • Monarda fistulosa (stimulating, warming/cooling) • Origanum (warming/stimulating, relaxing) • Pinus strobus (stimulating antiseptic, expectorant) • Propolis (warming/stimulating) • Rosmarinus (warming/stimulating, drying; circulation and nerves) • Rubia tinctorum (depression; blood) •
Salvia (warming/stimulating, astringent to water, nutritive to oil) • Sassafras (warming/stimulating, blood-thinning) • Sinapis (stimulating carminative) • Solidago spp. (stimulating, carminative) • Thymus (warming/stimulating, antibacterial) • Turnera (stimulating, relaxing) • Tsuga canadensis (warming/stimulating, penetrating topical) • Zingiberis (warming/stimulating, acrid/relaxing, sweet/nourishing).
Tension
This tissue state is called “wind” in Traditional Chinese Medicine. It includes both psychological and physical tension, and corresponds to conditions occurring due to nervous constriction, tension, and spasm. These range from closure of the sweat pores to torsion, convulsion, and epilepsy, including spasm, chills, chills alternating with fever, sudden onset of symptoms, alternating or periodic symptoms (diarrhea alternating with constipation, chills with fever, or chills at a specific time of day), backward-type movements (hiccough, nausea, esophageal reflux, vomiting), uncontrollable movement, trembling, shaking, etc. All of these are connected to imbalances of the nerves; without nerves, there would be no wind/tension tissue state.
Symptoms of tension: tension of mind, body, or both; symptoms come on suddenly; symptoms repeat or alternate (diarrhea alternates with constipation, or chills alternate with fever); gas and bloating comes and goes suddenly; symptoms reverse direction of normal movement (hiccough, nausea, vomiting); cold hands and feet; cold in the joints; tongue tremors; pulse wiry, tense, resistant, hard.
Recommended herbs for tension: • Agrimonia (relaxing astringent) • Chamomilla (relaxing, stimulant, bitter and sweet digestive tonic) • Cnicus (bitter acrid antiperiodic, alterative) • Cornus florida (bitter acrid antiperiodic) • Dipsacus sylvestris (bitter acrid antiperiodic) • Eupatorium perfoliatum (bitter acrid antiperiodic, diaphoretic) • Lactuca (bitter acrid relaxant, antiperiodic) • Lobelia (acrid diffusive relaxant, antispasmodic, diaphoretic) • Humulus (acrid bitter relaxant) • Magnesium salts (in solution is best) • Mentha piperita (relaxant, diaphoretic) • Nepeta (acrid bitter relaxant, antispasmodic) • Passiflora (relaxant) • Sambucus (cooling, sedative, relaxant, slightly stimulating aromatic) • Umbellularia (acrid stimulating relaxant, entheogen; leaf, nut) • Taraxacum (muscle spasm; flower) • Valeriana (acrid relaxant) • Verbena (acrid bitter, relaxant, diaphoretic; neck tension) • Viburnum opulus (tension) • Viburnum trilobum (tension, excitation) • Zingiberis (tension, depression).
Relaxation
This is one of two states associated with excess dampness; the other is stagnation. In the former state, the tissues are moist (including the skin, since it is an excretory organ), and water readily sheds from the body. In the latter case, the water is stuck, or stagnant, inside the body cavities; it does not flow through them, but fills them and stays there. This represents another type of loss of tone, which the old doctors called “torpor,” referring to heavy, waterlogged, soggy, toneless tissue.
Symptoms of (excessive) relaxation: tissues lacking in tone; collapse, prolapse, leaking fluids, free secretion of mucin, sweat; diarrhea; clear, copious urine; cool, clammy skin; pale skin with veins showing through; low energy; tongue moist, streamers between the center and the sides of the tongue, sometimes a white, yeasty coat; yeast infection (systemic or vaginal); easy vomiting in children; pulse relaxed, soft, empty, languid.
Recommended herbs for (excessive) relaxation: • Achillea (excitation, relaxation) • Aesculus hip. (relaxation, tension) • Agrimonia (tension, relaxation) • Alchemilla (relaxation) • Angelica (depression, relaxation, atrophy, tension) • Calendula (depression) • Cinnamomum spp. (depression, relaxation) • Equisetum (relaxation, depression, atrophy) • Hypericum (depression, relaxation) • Juglans nigra (relaxation; leaf) • Potentilla (astringent, slightly mucilaginous) • Rubus canadensis (nourishing and astringent) • Sanguisorba (astringent) • Myrica (astringent and stimulating) • Quercus (strongly astringent) • Rosmarinus (mild pungent warming stimulant) • Urtica (stimulating, diffusive, earthen/mineralizing, diuretic/drying) • Vaccinium spp. (astringent; leaf).
Dry/Atrophy
There are two kinds of moisture—water and oil. Nutrition requires water and oil to get from the gastrointestinal system to the tissues. Therefore, dry/atrophy can be due to lack of water, oil, or nutrition, or the body’s inability to handle one or all of these substances. The early signs of dry/atrophy are tissue dryness due to lack of fluids; later signs include withering from poor nutrition.
Symptoms of dryness: dry, wrinkled, withered, hardened tissues; poor scalp health, falling out of hair; weakness; bloating, gas, constipation, hard stool; tongue is thin (side-to-side, or upper surface to lower), dry, cracked in some cases, and withered in severe cases; pulse is narrow on one or both sides, and sometimes tense on one side.
Recommended herbs for dryness: • Althaea (atrophy, excitation) • Angelica • Aralia racemosa • Arctium (atrophy, stagnation) • Asclepias tuberosa (atrophy) • Betonica (atrophy) • Capsella (atrophy, depression) • Ceanothus (atrophy, relaxation) • Codonopsis (atrophy) • Helianthus • Ligusticum porteri • Linum (fresh ground seed or flaxseed oil) • Liriodendrum (spasm and atrophy) • Mahonia (atrophy, torpor; increases secretions) • Panax ginseng • Panax quinquefolius • Rehmannia (cooked root; nourishing blood tonic) • Ulmus (atrophy, excitation) • Sabal serrulata (sexual organs) • Salvia • Symphytum (atrophy, relaxation) • Trigonella (atrophy, depression) • Ulmus (atrophy; moistens and mineralizes) • Urtica • Verbascum (dry mucosa) • Vinca (cerebral circulation) • Withania.
Damp/Stagnation
This is the most difficult tissue state to understand. It may be visualized as a condition where the fluids can’t get out through the normal channels of elimination; they back up and tend to precipitate and thicken into catarrh, phlegm, or mucus. The old doctors, back to Hippocrates, referred to this as “humors.” The idea was that the “humors” were not being cooked down by digestion and metabolism, and were collecting in the body. Later this condition was called “impure blood” (German) or “bad blood” (American Indian). Today it is frequently called “toxic blood” or “toxic liver.” One or more of the channels of elimination (skin, kidneys, colon, lungs) may not be open, or the metabolism may be faulty. The latter may be due to low preparatory metabolism in the liver, low thyroid, or low cellular metabolism. There may also be lymphatic congestion, with lowered immunity.
When this condition occurs, the tissues were described in nineteenth-century medicine as “torpid,” or in a state of “torpor.” The tissues are heavy, full of water and phlegm, with lessened activity and expression in the eyes and face. The most frequent symptom associated with this condition is skin eruption, since metabolic waste products have to leave through the skin instead of the kidneys and lymphatics, or they are not being adequately processed by either the liver or the skin.
When hypothyroidism was discovered and described in the early twentieth century, many doctors realized that it accounted for the symptoms of “bad blood” (Barnes 1976), which included thickening of the fluids into catarrh; cool, rough, inactive, expressionless skin; loss of expression in the eyes and face; fatigue; and weight gain. Hypothyroidism can, therefore, be a cause of “bad blood” or damp/stagnation. However, this is not always the case; sometimes hypothyroidism can be caused by “bad blood.” There are also times when the thyroid is not involved at all.
Symptoms of dampness: catarrh, phlegm, or mucus; fluids are retained and thickened; tongue is coated white or yellow; dull expression of skin and musculature; dull facial expression; hangover-like feeling, worse in the morning or after taking food or alcohol; pulse obscure (filmy, dull edges), turgid (as if there is thickened water in the blood), or slippery.
Recommended herbs for dampness: • Arctium (atrophy, stagnation; oil metabolism) • Iris • Juglans nigra (stagnation; hull) • Berberis vulgaris • Cassia (stagnation; cathartic) • Cnicus (stagnation, tension) • Mahonia (atrophy, stagnation) • Phytolacca (stagnation, depression) • Rhamnus purshiana (laxati
ve) • Rheum (stagnation, spasm) • Rumex crispus (excitation, stagnation, relaxation) • Scrophularia (stagnation, depression), Stellaria media (external) • Taraxacum (diuretic; water stagnation; leaf) • Taraxacum (alterative; heat stagnation; root) • Trifolium pratense (atrophy, torpor; opens skin, drains lymphatics, detoxifies) • Urtica (detoxifying, nourishing, but diuretic/drying).
I have been accused of making up these tissue states and therefore “traditional Western herbalism.” This shows a complete lack of education on the part of my critics. Anyone who reads the writings of eclectic medicine and physiomedicalism, or even nineteenth-century allopathy, can find these tissue states mentioned throughout the literature. Indeed, look in the index of any contemporary neurology textbook.
Adjuvants, Accelerators, Synergists
One of the great mysteries of herbal medicine is the problem of compounding or mixture. What happens when two or more plants are combined? This question involves both pharmacology and energetics. When volatile oils are mixed they can recombine to form new compounds not found in the original herbs. Other constituents do not mix at all but their effects may harmonize in the new admixture—or not.