Modern medicine understands the state of qi and blood deficiency described in Donguibogam as complex conditions such as chronic fatigue syndrome or myalgic encephalomyelitis. Beyond the simple level of feeling tired, it refers to a condition accompanied by various symptoms such as lethargy, impaired concentration, memory impairment, sleep disorder, headache, muscle pain, and joint pain, along with extreme fatigue persisting for more than six months. It is difficult to pinpoint a single cause for this condition, but multiple complex factors are considered to be involved, such as stress, infection, immune system disruption, and genetic factors.
A factor particularly worth noting is autonomic nervous system imbalance. The autonomic nervous system in our body consists of the sympathetic nerve and the parasympathetic nerve; the sympathetic nerve is activated during tension and activity, while the parasympathetic nerve is activated during rest and recovery. Patients with chronic fatigue often develop problems with the regulatory ability of this autonomic nervous system, leaving the body constantly in a state of excessive tension or conversely unable to properly switch to recovery mode. This shares the same context as the body becoming exhausted when qi and blood cannot circulate properly in Donguibogam.
In addition, dysfunction of the brain's hypothalamic-pituitary-adrenal axis is cited as an important cause of chronic fatigue. The hypothalamic-pituitary-adrenal axis is an essential system that regulates the stress response, but under chronic stress, this axis becomes exhausted and fails to function properly. Our body becomes unable to properly secrete cortisol, a stress hormone, which triggers a chronic inflammatory response, weakens immunity, and ultimately leads to a vicious cycle that deepens the decline in vitality and fatigue. Imbalances in brain neurotransmitters such as serotonin or dopamine also contribute to cognitive decline and lethargy.
Furthermore, mitochondrial dysfunction is being studied as one of the major mechanisms of chronic fatigue. Mitochondria are the cellular powerhouses of our body, and if energy cannot be properly produced here, the cells lose vitality and our whole body falls into a state of chronic energy deficiency. This can be viewed as the modern interpretation of the qi deficiency mentioned in Donguibogam. In the end, chronic fatigue syndrome is not merely a problem arising from weak physical strength, but an overall crisis signal occurring because the major systems of our body—such as the nervous system, endocrine system, and immune system—are comprehensively exhausted. This signal should not be ignored, and with careful attention, it can be addressed step by step.
