The Six Conformations in Chinese Medicine – Part 1

Whole Systems Healthcare

Chinese Medicine has a number of models of human functioning and physiology. One major system is known as the six conformations, also known as the six stages, or the six divisions. I find this system to be both fascinating and extraordinarily useful in understanding the human being. What follows is a brief introduction to this ancient system.

This model originates in the six environmental factors: cold, heat, dry, damp, wind, and fire. Also known as climactic influences, these six were seen as encompassing all influences that came from the environment. For instance, in the winter the weather is cold. During the rainy season, the weather is damp. And so on. Each climactic factor influences the body in a particular way, giving rise to each of the six conformations.

A given disease (from any source, internal or external) can be said to reside “in” one of the six conformations. What this really means is that the function of a particular conformation becomes impaired, giving rise to characteristic signs and symptoms.

Another way of perceiving the conformations is in how they move yin and yang. Yin and yang both move inward and outward in normal physiology. This movement can be broken down and understood in six parts, corresponding to the six conformations.

Each conformation can be understood as a psycho-emotional level as well.

Finally, I will attempt to make some connection between each conformation and a biomedical system, drawing on the systems model of Dr. Shen.

Taiyang – Bladder and Small Intestine

Often considered the first conformation, Taiyang is associated with the environmental influence of cold. Characteristic signs and symptoms are aversion to cold and wind, tightening of the shoulders, upper back, neck, and head, floating pulse, and a slight fever. There might be sneezing, or a runny nose, like with the common cold. Allergies are often Taiyang in nature, as are certain types of acute asthma, and certain types of urinary tract infections. Whenever cold invades the surface layer, such as the skin, muscles, or mucus membranes, Taiyang symptoms will arise.

Taiyang means greater yang, and is associated with the outward movement of yang. It represents the body’s ability to bring yang, the basic vitality of the being, upwards and outwards, to create expression, and to create boundaries. It fills the space between the inner core and the periphery of the person, and creates an outer boundary that keeps out unwanted influences. It is the presence of a person in the world.

At a psycho-emotional level Taiyang is responsible for asserting the energy of life into the world: fear, and joy. On the side of fear, this is the ability to act instinctually when your life is threatened; if a lion is chasing you, Taiyang provides the energy and ability to run away. If a virus enters your nose, the Taiyang provides the energy to sneeze it out. On the side of joy, Taiyang is the expression into the world of your Heart. It provides the energy and ability to put your creative inspiration into words, so they can be understood by the world.

On a biomedical level Dr. Shen compares Taiyang to the nervous system. More specifically, the fight-or-flight response of the sympathetic nervous system is a major part of Taiyang. I also see certain elements of our innate immunity as part of Taiyang. The first layer of defense against the world, such as dendrocytes in the dermis, and IgA antibodies on mucus membranes, are all expressions of Taiyang. The movement of neural signals from the central nervous system to the periphery is an aspect of this conformation.

Yangming – Stomach and Large Intestine

Considered either the second or third conformation (depending who you ask), Yangming is associated with the environmental influence of dry. Characteristic signs and symptoms are high fever, heavy sweating, high thirst, and big, strong pulse. Yangming can also present with abdominal pain and distention that is worse with pressure, and constipation with dry stool. Congestion in any part off the body that is caused by a drying out of body fluids is a Yangming situation. Yangming typically presents with a lot of heat, because high heat is the main cause of acute dryness.

Yangming means yang brightness, and is associated with the inward movement of yang. It represents the body’s ability to internalize yang, to bring sensory perception and food inwards from the outside. It creates a boundary by keeping yang inside, opposite of Taiyang. It is responsible for creating structure.

At a psycho-emotional level Yangming is responsible for defining the boundaries of the self. By keeping yang inside Yangming energies differentiate between outside and inside, self and not-self. It also represents the ability to internalize the world, beginning the process of incorporating new information into one’s body and identity. The ability to break down and digest things, both food and experiences, is part of Yangming. Vomiting is symbolic of how Yangming might reject something unwanted from the body; it is interesting to note that vomiting is often a reaction to an unwanted experience (seeing blood or gore) as well as bad food.

Biomedically Yangming is considered by Dr. Shen to be the digestive system. The Yangming organ systems, Stomach and Large Intestine, encompass the entire digestive tract, and more specifically represent the hollow space within the stomach and intestines. The stomach acid, digestive enzymes, and microbiome, all substances contained within the digestive space, are part of this conformation. The understanding of our perceptions is an aspect of Yangming, which brings in elements of the limbic system in the brain. Much of the gut-brain axis falls under the umbrella of Yangming, something that is still only partially understood.

Shaoyang – Gallbladder and Triple Burner (Mesentery)

Shaoyang is the third of the yang conformations, and is associated with the environmental influence of fireFire is also known as summerheat, and is the combination of heat and damp. The damp component makes the heat get stuck. Characteristic signs and symptoms are alternating fever and chills (hot and cold), localized inflammatory pain anywhere in the body, and ‘inflammation’ of the emotions resulting in irritability. Shaoyang symptoms are quite varied; sore throat, nausea, tightness in the chest, one-sided symptoms of any kind, general bodily discomfort, all can be part of this conformation.

Shaoyang means lesser yang, and is associated with the pivoting between Taiyang and Yangming. It represents the body’s ability to pivot the yang between moving out and moving in, and thus also represents our ability to transition and change direction. Shaoyang is about flexibility and smooth flow.

At a psycho-emotional level Shaoyang is about flexibility and integration. It represents the impetus to move, both outwards and inwards, forwards and backwards. It initiates movement, and therefore controls decision-making, the ability to change the mind, and the integration between what’s coming in and what’s going out. Irritability, frustration, or impatience is a major sign of stuck Qi in the Shaoyang, as emotional flexibility is lost. Alternating between joy and depression might be another way disharmony manifests in this conformation.

Shaoyang is considered by Dr. Shen to be the circulatory system. As a part of circulatory function I consider one aspect of Shaoyang to be the resting tone of the sympathetic nervous system, which controls the smooth muscle surrounding the arteries and thus plays a significant role in the circulation. The circulation of lymphatic fluid should be included here, as should the movement of fluids through the fascia that creates the extracellular matrix. This connects with the mesentery, an organ recognized recently by biomedicine that corresponds well with the Triple Burner.

I’ll continue with the three yin conformations in part 2 of this series.


  • Kye Peven

    Dr. Kye Peven, ND, DSOM, EAMP, earned a B.S. from UC Berkeley in Materials Science and Engineering, with minors in Nuclear Engineering and Energy Management, believing that applying his interest in technology would help make the world a better place. He then completed a Doctorate of Naturopathic Medicine (ND) and a second Doctorate of Science in Oriental Medicine at the National University of Natural Medicine (NUNM). Dr. Peven serves as Director of the WSHC Clinical Care Initiative and is the founder and Clinic Director of the WSHC Seattle Clinic.

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