Interior & Exterior Conditions in Chinese Medicine

by Hannah Fries |

Interior & Exterior Conditions in Chinese Medicine

If you’ve ever been to an acupuncturist, you’ve likely been surprised (pleasantly, I hope), by the abundance and complexity of questions they ask about you. Like the farmer who spends ample time exploring and observing the land in order to establish a mutually beneficial relationship, the Chinese Medicine practitioner seeks a thorough and meaningful understanding of the patient, so that she may nurture the unique conditions necessary for him to thrive.

Upon gathering her data, the practitioner fits the pieces together like a puzzle using a conceptual matrix known as the Eight Guiding Principle Patterns. “These patterns are the pencil sketch outlines of the human landscape” that put into focus the relative state of Yin and Yang in the body. 

YIN-YANG: Coexisting opposites dancing in harmonious struggle

The Yin-Yang model of fluid reality is one of explicit duality & implicit unity. The mutually-defining & transforming nature of these seemingly opposite poles is responsible for the perpetual creation, destruction, and metamorphosis of all phenomena in the Universe. 

Illness arises when the Yin-Yang balance of the body is off kilter, but more details are needed to understand the best course of action for healing, so we seek guidance...


The Eight Guiding Principles includes the following four sets of polar categories:

  1. Yin-Yang
  2. Cold-Heat
  3. Deficiency-Excess
  4. Interior-Exterior  

Interior and Exterior define the relative depth/location and characteristics of a disharmony, as well as the general directionality of its progression. 

cave representing interior exterior chinese medicine
Exterior Conditions

An Exterior Condition is considered Yang in nature, as it affects the more exposed areas of the body, including the “skin, hair, nails, peripheral vessels and nerves, muscles, tendons, ligaments, joints, eyes, external ears, nose, mouth, teeth, breasts, anus, and external genital organs.”

Exterior Conditions are typically acute disorders, generated by the Six External Pernicious Influences (Wind, Heat/Fire, Cold, Dampness, Dryness, and Summer Heat), that appear suddenly and don’t last for long. They often present with chills, fever, headache, and/or body aches; think migraines or the common cold. Occasionally an Exterior Condition will have a slower onset and symptoms will manifest somewhat more systemically; think joint pain. Or, in the case of our farm analogy, things like pests, drought or frost.

Interior Conditions

Interior Conditions are more Yin in nature, since they impact the deeper tissues and physiology of the “organs, brain, spinal cord, bones, deep vessels and nerves, middle and inner ears, lining of body cavities, and internal reproductive organs”.

They tend to be chronic ailments that ensue when an exterior condition goes untreated (or mistreated) and settles deeper; think common cold that progresses to pneumonia. Typically, however, Interior Conditions stem from Internal Influences, such as constitutional tendencies (i.e., genetic predispositions), extreme emotional changes, improper diet/lifestyle, and stress; think diabetes, irritable bowel syndrome, mental illness, or heart disease. Like barren or poisoned soil microbiomes or compromised root systems on the farm, these challenges tend to require more time for transformation and healing. 

Relativity and the Dream of Harmony

While they are a useful diagnostic tool, Interior and Exterior, like Yin and Yang, are ultimately relative terms, and in truth we cannot separate our Being so simplistically. The reality is always something more complex than what is written in the textbooks. 

“To the frogs in a temple pool

The Lotus stems are tall;

To the gods of Mount Everest

An elephant is small.”

-Taoist poem

However, these concepts can heighten our awareness of Life’s impulses and tendencies, tuning our senses to fluctuations in the balance of Yin and Yang. Whether in the human body, on the farm, or in the wild, these patterns can be identified, and with insightful care and the proper resources we can tend our world back to health.

Hannah Fries is a California-based licensed acupuncturist and herbalist (L.Ac.), writer, and Integrative Body Psychotherapy allied professional. She seeks to discover & alchemize the psycho-emotional and spiritual roots of disharmony in the physical body to help her clients transform the obstacles that interfere with their innate healing capacity. Find out more about Hannah and her work on her website at or on Instagram @friespirit.

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