08.30.08
The Concepts of Exterior and Interior in Chinese Medicine
Exterior and interior of the body (called “Biao Li†in Chinese) are important concepts in traditional Chinese medicine. These concepts describe and define the locations of the diseases, and are very important for diagnosis and the selection of treatment methods. Exterior and interior are two of the eight principal syndromes (Ba Gang), indicating the relative positions and severity of the disease.
“Exterior†refers to the relatively superficial parts of the body. “Interior†refers to the relatively internal or “deeper†parts of the body. “Exterior syndromes (‘Biao Zheng’ in Chinese)†are conditions that the external parts of the body are attacked by exogenous factors such as cold and wind. “Interior syndromes (‘Li Zheng’ in Chinese)†are conditions that the internal parts or organs of the body are affected by pathogenic factors.
There are exterior meridians and interior meridians. Diseases can be transmitted between exterior (e.g., Taiyang or Major Yang) and interior (e.g., Shaoyin or Minor Yin) meridians, which is called the “exterior-interior transmission (‘Biao Li Chuan’ in Chinese).â€
When the exterior defensive Qi is unconsolidated (called “Biao Qi Bu Gu†in Chinese), the person can become susceptible to exogenous pathogenic factors such as cold and wind. Such conditions are usually the factors of infectious diseases.
If there are symptoms occurring at both exterior and interior parts, it is called “illness of both the exterior and interior (‘Biao Li Tong Bin’ in Chinese).†Such conditions usually show symptoms and signs of cold or heat in both the exterior and interior positions. In such cases, both exterior and interior parts should be treated, e.g., using diaphoretics and purgative herbs simultaneously, which is called “resolving both exterior and interior (‘Biao Li Shuang Jie’ in Chinese).â€
The “half-exterior and half-interior syndrome (‘Ban Biao Ban Li Zheng’ in Chinese)†is a complex syndrome that the attack of exogenous pathogens is between the exterior and the interior of the body. This condition may show symptoms as alternate fever and chills, fullness over the chest, hypochondria, irritability, restlessness, nausea and vomiting, bitter taste in the mouth, and taut pulse.
“Exterior cold (‘Biao Han’ in Chinese)†means that there are pathogenic wind and cold factors attacking the exterior or external part of the body. Such conditions may show symptoms as chills, fever, headaches, joint pains, and floating and tense pulse.
“Exterior heat (‘Biao Re’ in Chinese)†means that there pathogenic wind and heat factors attacking the exterior or external part of the body. Such conditions may show symptoms as fever, aversion to wind, headaches, thirst, and floating and rapid pulse.
When there are cold factors in the exterior and heat in the interior (called “Biao Han Li Re†in Chinese), the condition may be caused by pre-existing internal heat and the attack of exogenous cold or wind. It may be also due to the existence of cold in the exterior, with the accumulation of heat during the process of the transmission of the external pathogenic factors inward. Such conditions may show symptoms of exterior-cold such as chills, fever, headaches, asthma, as well as symptoms of interior-heat including irritability, thirst, constipation, and yellow urine.
When there are heat factors in the exterior and cold in the interior (called “Biao Re Li Han†in Chinese), the condition may be caused by pre-existing deficiency and cold of the stomach and spleen, with the attack of exogenous pathogenic wind and heat factors. Such conditions may show symptoms of exterior-heat such as fever, headaches, aversion to wind, and internal-cold symptoms including cold limbs and diarrhea.
