Clearing Up the Confusion about Primary and Secondary Patterns
I want to talk about the difference between primary patterns and secondary imbalances, or patterns. There tends to be a lot of confusion surrounding this because Chinese medicine isn’t cut-and-dry like Western medicine, which generally takes a singular look at a symptom and equates it with one condition.
If I happen to say that something like loose stools or spotting mid-cycle is a sign of spleen Qi deficiency, it’s easy to automatically assume that’s your pattern. Pump the brakes! Not necessarily so.
Very often, someone will ask a question about a symptom and want to know what it means. The thing is, just having one symptom doesn’t mean anything if I don’t know the whole picture.
So let’s clear up some confusion on primary and secondary patterns and talk a little more about how to view things through the lens of the “whole picture.”
Everything in Chinese medicine builds off of the four substances at play, the blood, Qi, yin and yang. They work together to regulate a menstrual cycle. The more balanced they are, the more fertile the cycle, and each of these substances has a very specific purpose inside the body.
To quickly review the four substances: Blood provides, well, blood and nourishment for the organs. It’s like food for the organs.
The closest translation to Qi is energy. It’s like electricity running through your house: You know it’s there, even though you can’t see it. Or the current running through the battery of your car. Qi is vital: As you can imagine, if there’s no electricity to power the house, or if the battery in your car dies, it causes major problems. I suppose you could use candles if your house is dark, but it’s not efficient, and you wouldn’t be able to do half the things you normally do.
The concept of yin and yang is slightly more abstract. The easiest way to think about them is that they’re the feminine and masculine energies of the body.
Yin is cooling, lubricating, fluid, liquid. So it’s similar to estrogen, and it’s responsible for keeping us cool, especially at night, because we need to rest. It lubricates our skin, our eyes, and it’s responsible for one of the most important things for fertility, the cervical mucus.
Yang, on the other hand, is the more masculine energy, so it’s warming. It keeps the uterus warm for implantation. It’s also lifting, so it helps to sustain a pregnancy.
And within these four substances, there are two types of patterns that can occur: stagnation and deficiency.
Stagnation means the substance is stuck, it’s not moving— like a traffic jam. Deficiency means there’s not enough of it, like a desert, where the plants don’t get enough water.
Stagnations or deficiencies happen when one or some of your organ systems are not functioning the way they’re supposed to. Let’s dive even deeper and talk about the organ systems that control these four substances.
First, there are three organs that make, store, and circulate blood: heart, liver and spleen. The heart organ makes the blood; it gets stored in the liver; and spleen makes sure the blood stays within the vessels that it’s supposed to be in.
Let me explain: Liver stores blood until it’s ready to be used. So if you’re exercising, then the liver releases blood to the body so your muscles will have energy. Spleen contains blood. If you bruise easily, that’s a sign of weak spleen because it’s not able to hold the blood; if you have spotting mid cycle, it’s also a sign of spleen not containing the blood, so it bleeds outside of its normal time.
The two organs that are important for making and distributing Qi are liver and spleen. You can see how important the liver and spleen are. Spleen takes the food that we eat and turns them into useful energy, and liver distributes the Qi to where it needs to go.
The two common patterns we see with Qi are Qi stagnation and Qi deficiency. Qi stagnation is usually caused by the liver, and this will show up in symptoms like late ovulation, long cycles, irregular cycles and PMS. Someone who has Qi stagnation tends to be highly emotional, high-strung, type A, perfectionist.
Spleen Qi deficiency will show up with digestive problems, mid-cycle spotting and fibroids.
Yin and yang are never in stagnation. They’re always deficient because yin and yang are mainly stored in the two kidneys, which are the reproductive energy savings bank.
All of that info — I know, that was a lot! — brings us back to primary and secondary patterns.
We all have imbalances with every single organ in our body, and every single one of these four vital substances. They’re all connected, too. Imbalance in one area will lead to imbalance in another. What matters is the severity of the imbalances.
Most people will typically have 1-2 primary patterns, which tend to be the deficiencies or stagnations where you show the most symptoms. Say you have mid-cycle spotting, but it’s the only symptom you have in the Qi deficiency category. That means it’s a secondary pattern for you, and it’s happening because of another imbalance somewhere else. Frequency of a symptom matters too. If one pops up for a month, it’s not a pattern.
Or, let’s say you don’t see cervical mucus as you should. That doesn’t automatically mean you have yin deficiency. It could be a sign of other imbalances causing the yin deficiency symptom. Make sense?
Chinese medicine is the only system that pinpoints exactly what you need to do to fix your imbalances. And when we look at the whole picture — the four substances, the organs that govern them, the different kinds and severities of patterns — we can start making a whole lot more sense of your health, your fertility and how to restore them.