The American Syndrome
By E. Douglas Kihn, OMD, L.Ac.
Defining American Pathology
For a nation of immigrants, the culture of the United States is remarkably uniform in its habits and attitudes. American pathology reflects this uniformity, which eases the job of diagnosis. In the average American clinic, a handful of major excess-caused patterns with minor variations repeat themselves over and over again.
Below are listed the six most frequently occurring primary Chinese medical syndromes in America, those that cause most health problems in the U.S. Together, these six generate probably 95% of the cases who walk into the average holistic clinic. The first three conditions are so widespread in the U.S. and occur so commonly in conjunction with one another that they can be termed a separate syndrome altogether.
- Liver Qi Stagnation
- Heart Heat
- Spleen Damp
- Qi and Blood Stagnation in the Channels
- Exterior Wind Invasion
- Wei Qi Deficiency
The combination of liver qi stagnation, heart heat, and spleen damp, which are the result of American worry, hurry, and too much food, are as common as dirt and are what I call the American Syndrome.
Liver Qi Stagnation and Worrying
This endogenous pathology is nearly universal in 21st century America, but it wasn’t always so. Before the industrial revolution and the rise of modern capitalism, liver qi stagnation (your Chinese liver) was a relatively rare event in the U.S. Similarly, in the rural society of historical China, liver qi stagnation was not a common problem.
All forms of neurosis and neurosis-related disorders, known precisely in Chinese medicine as liver qi stagnation, are at high levels and rising in the United States and around the world, with new forms emerging at regular intervals.
Chronic fear, worry, anxiety, stress, insecurity, guilt, obsessive thinking, all are optional thought patterns - behavioral choices - that stagnate liver qi. American culture promotes the desire to control everything, including the uncontrollable, especially the past, the future, and the actions and opinions of other people. Traditional Asian, Native American, and other cultures do not.
Given the rapid changes in diagnosis and treatment methods in the last two decades, reliable statistical evidence on the increased incidence of mental disorders in the U.S. is difficult to pinpoint. With that caveat, we do know the following to be true.
- The utilization of psychological counseling among Americans is at an all-time high.
- The use of prescribed anti-depressants in the U.S. is extremely popular and continues to increase. With 5% of the world’s population, Americans consume 65% of all psychotropic drugs.
- The use of illicit drugs and alcohol for the purpose of misery-control continues its upward path, in spite of the U.S. government's decades-long "War on Drugs" and high number of incarcerated drug offenders.
- The use of food as an emotional sedative, especially among politically and economically disadvantaged groups, is widespread in obesity-plagued America, and still growing.
- The United States holds the world record for number of miserable residents locked up behind bars, both in terms of per capita and in total numbers. It has been estimated that the United States, with 5% of the world’s population, incarcerates 25% of the world's prisoners.
- The U.S. is always a nation at war – the War on Drugs, the War on Terrorism, the War on Cancer, the War on Iran, Cuba, N. Korea, and so many others.
Fear-generated liver qi stagnation reveals itself physically as a conscious and in most cases unconscious tightening or a constricting of muscles – held tight for long periods of time - as part of a fight or flight response to a perceived emergency. Literally any organ or tissue can become strangled and diseased in this manner. The resulting decrease in circulation in the American body/mind impedes and halts the functioning of the cardiac muscle and lungs, allows growths and tumors to form and grow, constrains the uterus and causes all sorts of menstrual and fertility problems, constricts the reproductive and urinary organs and reduces their function, and tightens the digestive organs leading to a multitude of digestive diseases. Fear contracts structural muscles, thereby causing mysterious pains, forcing dislocations of bones, and preventing the healing of injuries. All of the foregoing health problems are quite common in American medical clinics.
Psychosomatic illnesses, those that are heavily fear-based and that respond well to faith healing and other placebo treatments, are commonly found in America and are on the increase. Some everyday examples are fibromyalgia, irritable bowel syndrome, digestive ulcers, chronic fatigue syndrome, common hypoglycemia, Crohn’s disease, post-traumatic stress disorder, stress headaches, bronchial asthma, sexual impotence, urinary retention or incontinence, pre-menstrual syndrome, and high blood pressure.
Heart Heat and Hurrying
Inflammatory disorders, including what are termed auto-immune disorders, are at record levels in the U.S., and rising. The primary cause is a syndrome practically unknown in Chinese history - heart heat.
The science of physics and the science of Chinese medicine agree that movement creates friction, which creates heat, known in Western medicine as inflammation. Too much movement creates too much heat, which easily finds its way to the heart, the body’s headquarters for friction and movement. After all, you can lay down and hold your breath, but your heart will continue beating.
Excessive movement in both duration and velocity creates the chronic excess heat of the heart. It is likely that a majority of Americans carry with them their whole lives a low level of inflammation - heart heat - the basic clinical evidence of which is an agitated shen (spirit, which lives in your Chinese heart) - hyperactivity, irritability, insomnia, and a red-tipped tongue.
According to Andrew Weil, the author of many popular books on health, including Healthy Aging, "In recent years, scientists have begun to recognize that misplaced, unnecessary, and prolonged inflammation may be a common root of many chronic, degenerative diseases that until now have appeared to have nothing in common. Cardiologists agree that coronary heart disease and atherosclerosis begin as an inflammatory process in the lining of arteries. Alzheimer’s disease begins as inflammation in the brain. In all the autoimmune diseases, like rheumatoid arthritis and lupus, the damage to tissues and organs is the result of inappropriate inflammation. Rheumatoid arthritis is more common in young people, but most of these inflammatory disorders become more prominent with age; in fact, they account for much of the age-related disease we would like to prevent."
Any disorder with itis attached to the end is an inflammatory condition that is encouraged by the chronic condition of excess heart heat. Reddish skin disorders, widespread throughout the U.S., are flare-ups of internal heat that erupt onto the body surface. Extreme menopausal heat flashes, uncommon in most parts of the world, are familiar occurrences to middle-aged women in North America who carry within them a climate of internal heart heat.
Heart heat is both a cause and a result of the rapid agitated behavior so common and normal in the United States, with daily habits that include fast driving and tailgating, fast walking, rapid speech, rapid continuous working without breaks, multitasking, constant productivity during waking hours that includes paid and unpaid work, working impossibly long hours, and going without sleep. This behavior understandably contributes to a high rate of accidents on the road, at home, and in the workplace.
In historical China, the closest analogy to heart heat is called heart fire. In standard Chinese medical texts, scant attention is paid to heart fire, because it was rarely encountered in the slow moving farming communities of rural China. The nickname for heart fire was new parent syndrome, since the only people who were severely sleep-deprived were new parents who had to rise at all hours of the night to tend to babies, and then get up early and work all day on the farm. And as soon as the infants grew and became more stable, the heart fire would calm down and extinguish itself, as fire usually does. Like most American excesses, chronic heart heat was never a major concern for Chinese medicine.
Heart heat easily spreads to the liver, setting off common American behavioral disorders that are associated with frustration, anger, aggression, and frenzy, disorders with such monikers as autism, including Asperger’s syndrome and logorrhea, attention deficit hyperactivity disorder, dyslexia, panic attacks, Tourette’s syndrome, road rage, and violent outbursts.
Conversely, liver qi stagnation causes liver heat, which can easily climb up into the heart and set off heart heat.
The U.S. is now a nation of workaholics and unemployed. According to the International Labour Organization, since the beginning of the new millennium, Americans work more hours than workers in any other industrialized country. In just 20 years Americans added an hour and a half per week – or over a week of extra work per year. The average full-time worker in the United States worked 1,979 hours in 2001, compared to the notoriously busy Japanese worker who worked 1,842 hours, the difference being that the Japanese take more vacation time. The average French worker spent just 1531.7 hours on the job in that same year. Americans worked 29% more hours in 2001 than their cooler French counterparts.
A RoperASW study published in the May 2003 issue MONEY Magazine – before the crash of ‘08 - found that Americans would rather have more money than more free time – 57 percent to 27 percent. Another RoperASW survey from 2001 found that the top reason for Americans to consider changing jobs was money at 57 percent. More personal time clocked in at just 12 percent.
Keeping busy, achieving goals, earning money, competing for promotion, disparaging leisure, denigrating underachievers, and describing sleep as a waste of time seem to be central doctrines of American morality that have become exaggerated since the economic speedup of the early 1980s. This pathological behavior is even given the high-sounding name of A-Type Personality by American scientists, as if these inflammatory habits would earn a person an A grade in the school of life.
There exists an American epidemic of sleep deprivation. It is a fact that most Americans deprive themselves regularly of sleep. This behavior is considered a high virtue by many, bestowing bragging rights upon the sleepless.
Sleep is the most important activity for the purposes of cooling heart heat and eliminating and preventing inflammation. Although the heart keeps beating throughout the night, it beats slower for a long period of time. Decreased activity in the heart and in the entire body means decreased friction and reduced heat in all of the organs and tissues.
There is even a strong connection between sleep deprivation and the American epidemic of obesity. It has to do with the yin-supplying effect of food and body fat upon the yang-excessive shen – clobbering a chronic excess with another chronic excess!
Spleen Damp and Overeating
Anywhere from two-thirds to 95% of Americans can be diagnosed with some degree of spleen damp. Spleen damp (your Chinese spleen) can be called yin excess – a term never found in standard Chinese medical textbooks or classrooms. All excess body fat - that which is not needed for optimal performance - is part of a spleen damp picture.
The United States leads the industrialized world in spleen damp disorders. The world has never witnessed a political entity of 300 million residents in which one third are obese and another one third is noticeably overweight. For example, in 1990, while the obesity rate for the United States was 22%, France had an obesity rate of just 6%. That number climbed to 11% in 2003 for the French, but it shot up to 34% for Americans during the same time period. This is particularly interesting in light of the fact that the French are notorious for eating rich high-calorie food – so-called "fattening food."
Childhood overweight and obesity, previously rare occurrences in the world, have become a public health menace in the United States during the last thirty years. The obesity rate for American children - world leaders in this category - is currently between 15% and 20%, up from 5% in 1966. This trend, along with other American cultural norms, seems to be spreading around the world. The World Health Organization estimates that the number of obese children in the world has doubled since the 1960s.
Understandable is the fact that the British rate of obesity is the highest in Europe, closely behind that of the U.S. British patterns of behavior strongly resemble American ones. A British survey by the Priory Clinic in Cardiff found that almost half of adults readily admit to turning to food to stifle feelings of boredom, loneliness, and anxiety.
American culture encourages people to overeat. In a study published by the Journal of the American Medical Association, it was found that adopting the American lifestyle means putting on weight for most immigrants. Obesity is relatively rare in the foreign-born until they have lived in the United States for a while. Only 8 percent of immigrants who had lived in the United States for less than a year were obese, but that number jumped to 16 percent among those who had been in the U.S. for five years, and 19 percent for those who have stayed beyond ten years.
Since the early 1980s when the U.S. obesity epidemic started to take off, it has been necessary for American society to make enormous adjustments to keep pace with this startling development. Public furnishings, including hospital rooms and beds, have needed to be enlarged to accommodate obese Americans. Weight loss books continue to outsell all other categories of book titles, with cookbooks a close second.
The number of health problems statistically associated with excess body fat and spleen damp is impressive. They include most of the top killers in the U.S. such as heart disease, cancer, stroke, hypertension, liver disease, diabetes type 2, and accidents. The close connection between spleen damp and food stagnation implicates spleen damp in food allergies, gastric hyperacidity, constipation, gall bladder and urinary stones, and skin disorders.
Spleen damp that stagnates becomes damp heat, leading to toxic conditions in all organs and contributing to heart and liver heat. Stagnant damp promotes liver qi stagnation with heat and inflammatory qi/phlegm disorders such as Alzheimer's, multiple sclerosis, and elevated serum cholesterol.
A damp spleen is a spleen that has to contend with more calories that it can immediately use. Put simply, Americans eat more food than they need for their daily requirements – mostly in an effort to maintain calm, a subject for another time.
Qi and Blood Stagnation in the Channels
Bodily injury constitutes a very large percentage of clinical cases in any society, the U.S. being no exception. Contrasted with economically poor countries, many cases of channel qi and blood stagnation in the United States are the result of sedentary and repetitive behavior, poor posture, excess body weight, thin bones and weak muscles due to the avoidance of lifting heavy weights, the blind worship of speed, and the devaluing of sleep, rest, and leisure.
External Wind Invasion
The common cold and influenza are extremely common problems for Americans. When the wei qi (protective energy) is temporarily weakened for some reason and it lets down its guard, that’s when exterior wind and other pathogens find opportunities to invade. The ultimate causes of wei qi distraction and exterior wind invasions in the U.S. can all be traced to the usual problems of excess – worrying, hurrying, and overeating.
In times past – in historical China for example – virulent and dangerous exogenous invasions caused epidemics and plagues in which millions perished. Many doctors spent their entire careers trying to figure out and combat these pestilences. The Chinese texts brought to these shores are still preoccupied to some extent with diseases that currently ravage the underdeveloped world but that have been rendered largely impotent by antibiotics and modern Western medicine.
Wei Qi Deficiency
When the body's protective qi is weakened for a period time, exterior wind invasions become a chronic problem. While the body's energy reserves are called for duty elsewhere – to protect the interior organs – the ramparts are left unguarded. All sorts of barbarian invaders can come and go, while valuable resources are allowed to be pilfered.
Lingering cold and flu symptoms along with overall exhaustion are the main features of wei qi deficiency. Occasionally, the wei qi cannot sufficiently regulate the pores of the skin to the extent that body fluid is not retained. This is called spontaneous sweating, and can occur with the slightest exertion.
In historical China, this syndrome was the logical result of chronic deficiencies – malnutrition, starvation, and lack of shelter and warm clothing. In America, it occurs as the direct result of chronic excesses – the American Syndrome. Worry, hurry, and overeating will exhaust, distract, and impede the wei qi to such an extent as to make this problem more common than Chinese doctors of old would ever have expected.
This pattern must be distinguished from simple exterior wind invasion because it is treated very differently. Chinese medicine, especially herbology combined with health counseling, is quite effective at resolving wei qi deficiency and preventing its return.
E. Douglas Kihn, OMD, L.Ac. is the author of Chinese Medicine for Americans, and currently operates a clinic in West Los Angeles. He can be reached through his website at