(2) Promotion, restriction, subjugation and violation of the five elements
(1) Promotion and restriction
Promotion indicates promoting arid improving the orderly funclion among the five elements. The order of promotion is as follows:
wood promotes fire, fire promotes earth, earth promotes metal, metal promotes water, and waler in turn promotes wood.
Restriction implies checking and bringing under control among the five elements. The order of restriction is: wood restricts earth, earth restricts water, water restricts fire, fire restricts metal, and metal restricts wood.
In the relationship of the five elements, neither promotion nor restriction is separated, Without promotion, there wood be no birth and growth of things; within restriction, there would be abnormal changes.
¢ÆInvasion by another elernent
Invasion indicates ¡°encroaching on that which is weak¡±. It is an abnormal manifestation n the normal co-ordinative relationship. Violation in relation to the elements is ¡°using one¡¯s strength to bully another one¡±. That is, one of the five elements becomes too excessive, thus the clement that originally restricts it can not restrict it any more, and is restricted by it. This is called ¡°counter-restriction.¡±
?
2.4.6 How about application of the nyc elements in 1CM?
(1) Physiological function of the five Zang-viscera and their reationship
Promotion in the fivc elements may be used to explain the interpromotion relationships among the five Zang-viscera. Restriction in the five elements may be used to expound the inter-restriction relationships among the five Zang-viscera.
(2) Inter-affection disorders of the five Zang-viscera
The five elements not only can be used to explain the relationships among the viscera physiologically, hut also may be used to explation inter-affection of the viscera pathologcally. This relates to the laws of promotion, restriction, subjugation and violation of the five elements.
(3) Diagnosis and treatment application
Abnormal changes in furicuonal activities of the viscera and their rclationships can all be reflected in the complexion, Voice, taste and pulse. For example, a patient whose complexion is greenish with a preference for sour food and a wiry pulse may be diagnosed as having a liver disease.
In addition, the onset and development of some diseases are related to the promotion and restriction relationships among the viscera.Thus in treatment while treament the diseased viscus, one should also consider the other related viscera in order to stop the transmission of disease. Examples might include treatment principles such as reinforcing earth to strengthen metal.
What are visceral theory of TCM
TOM classifies the internal organs of the body into three kinds:
the fivt Zang-viscera, or the heart, liver, spleen, lung and kidney, all of which have the common physiological funection of producing and storing essential Qi. The six Fu -viscera, or the gallbladder, stomach, small intestine, large intestine, urinary bladder and San-Jiao, which have the common physiological function of reedving, transforming, and transporting food and water, The extraordinary Fu - viscera include the brain, narrow, bone, vessel, gallbladder and ujerus, and are distinct from the bit-viscera in function, and are thus known as the extraordinary Fu - vi seem.
2.8 How are the function of heart of TCM?
The heart is located in thorax and guarded externally by the per icardium. Its physiological function is governing blood and the vessels, and giving motive power for blood circulation. The bean also governs spiritual activities, and opens to the tongue, manifests on the face.
2.9 How are the function of lungs of TCM
The lungs are situated in the thorax. They related to the throat and open to the nose. The major function of the lungs include governing Qi, contorlling resp iraton, dispersing? and descending, and smoothing water passages, governs the skin and hair.
2. 10 how are the function of spleen of TCM?
The spleen is located in the middle-Jiao. Its major physiological function include governing transformation and transportation. contrlling blood, and ascending essence. It dominates the muscles and limbs, opens to the mouth, manifests on the lips.
2 11 How are the function of liver of TCM?
The liver is located in the hypochondrium. It is responsible for regulating the smooth flow of Qi , storage of blood, and donimates the tendons. The liver opens to the eyes, and manifests on the nails.
2.12 How are the function of kidneys of TCM?
The kidneys are located in the lumber region.The kidneys store vital essence, manufact marrow. domation bones, and are the source for growth, development, and reproduction. They also govern water metabolism and the reception of Qi. The kidneys open to the ears, and manifest in the hair.
2. 13 What arc the major functions of six Fit-viscera of TCM?
(1) Gallbladder: The mainly physiologic functions of the gallbladder are store and discharge of bile which helps digestion of food and fluids.
(2) Stomach: The major physiological functions of the stomach include receiving and digesting food and fluids.
(3) Small intestine: The major functions of the small intestine are transforming chyrne and separating the clear from the turbid.
(4) Large intestine:The large initestine receives waste material sent down from the small intestine, and after the remained watex- it still contains absorbed stool is formed and finally it discharges the stool through the anus.
(5) Urinary Bladder: The major functions of the urinary bladder include storing and discharging urine.
(6) San-Jiao: The San-Jiao is a collective term including the upper-Jiao, middk-Jtho and lower-Jiao, The upper-Jiao is in above the diaphragm; the rniddle-Jiao is in the epigastrium, and the lower-Jiao is in below the umbilicus.
The mainly functions of the San-Jiao are controlling Qi of body. and also are passageway of digesting drink and food. and of fluid metabolism. Food in body from receiving, digesting to spreading essential Qi and discharge of netabolite all relating to the San-Jiao.
2.14 What are Qi, blood and body fluid of TCM?
Qi, blood and body fluid arc the basic substances constituting the body and are the material base for the organs arid meridians in carrying out their respective physiological activities. The energy for the physiological acrivties of ihe viscera and meridians, is derived form Qi , blood and body fluids. The production and metabolism of substances are dependent upon the normal physio1ogical activities of tissues, organs and the meridians. So, there are close relations lnth physiologically and pathologically among Qi, blood and body fluid and the organs, tissues and meridians. Qi, bloud and body flu-id , either from the congenital or essential substances of food arid drink are the material base for maintaining the viscera and meridians perfomi their normal physiological activities while at the same rime these substances are consumed and produced.
2.15 What is the concept of Qi?
The concept of Qi in TCM is derived from Qi in ancient Chnese phihphcrs believed that Qi was the most essential substance making up die world and that everything in the universe was generated by the motion and change of Qi, the concept of Qi as the root of a myriad of things was introduced into TCM as a theory and concept. Qi was then looked upon as the essential substance constiwting the body and maintaining the life activities of the body.
2. 16 What is the concept of body fluid?
Body fluid is a general term for all normal liquid in The body, including interstitial fluid in the viscera and other tissues and organs, and normal secretions such as gastric juice, intestinal juice, nasal discharge, tears, etc. Body fluid, like Qi and blood, is a basic substance constituting the body and plays an important in maintaining its normal life activitives.
2.17 How about etiology and pathology of TCM
TCM think, factors that cause d5sharniony of the relative balance and lead to disease are the causes of disease, or are known as pathogenic factors. Pathogenic factors resulting in disease are many and varied, such as abnormal climatic changes, pestilence infection, emotional stimulation improper diet, oversirain and stress, traumatic injuries, and insect or animal bites. In the course of a disease, cause and effect are often inter-active. An effect in a pathological stage may be a cause in another pathological stage.. Examples are phlegm-stagnant-fluid and stagnant blood, which are pathological outcomes of a disturbance of the functions of viscera, Qi and blood and may become pathological factors in causing disease.
The pathological mechnisms allowing pathogenic factors to invade the body are many and varied, and the pathological mechanisms involved are complicated.
2.18 What are the concept of prevention of TCM?
Prevention includes taking certain measures in advance to stop the occurrence and development of diseases. TCM has always attached great importance to the Prevention of disease. As early as two thousand years ago, the Huandgi Neijing (Huangth¡¯s Internal Classic) put forward the concept of ¡°treating the undiseased,¡± which includes treatment to prevent disease and before disease develops.
2. 19 What is trcatincnt principles of TCM?
The treatnient principle is the general method in treating disease. It is formulated under the guidance of the concept of wholism and treatment determination based on syndrome differentiaton. It has a universal guiding principle for the detennination of methods, formula and dosage.
(1)Treatment aimed at the source of disease
Treatment aimed at the source aspect of a diseaise means a cardinal principal of treatment based on syndrome differentiation,
(2) Strengthening the vital and dispelling the cvil
The course of a disease, in a certain sense, is the process of the struggle between the two contradictory aspects, the vital and the evil. The outcome of the struggle between the vital and the evil decides the progress of a disease. When the evil gains the upper hand the disease will progress; when the vital gains the upper hand, the disease will weaken. Thus in treatment strengthening the vital and dispelling the evil should be carried out to change the ratio in strength of the two sides of the vital and evil in order to gain recovery. Therefore, strengthening the vital and dispelling the evil arc important
principles in chnical treatment.
(3) Regulating Yin and Yang
The occurrence of a disease s essentially the outcome of the supeiority or inferiority of Yin or Yang arid destruction of the relative balance they share. Therefore, regulating Yin and Yang to remedy and restore their relative balance is a cardinal principle in treattmnet.
(4) Treatment depend on the season, locality and individual These concepts involve determining a suitable treatment for disease according to differences in seasonal local and the patient¡¯ s constitution, sex and age, etc.
3 The Knowledge of the Diagnostics of TCM
3.1 What is the synopsis of traditional Chinese medicine diagnostics?
It embraces two Parts: the four diagnostic methods and differentiation of syndromes.
The four diagnostic methods: Inspection, auscuLation and olfaction, inquiry and pulse-feeling and palpation.
Inspection: It refers to examining the general condition of the body, the mental faculty, signs, secretions and excretions of the patients. In a word, includes inspection of the physique, facial expression, color of the complexion and physical condition and behavior.
Ausculatioxt and olfaction: It. is a method to gather information about the body from the sounds of the voice and breathing, and smelling of the odor of the body.
Inquiry: It is a way to interview the patient, his or her family to deierrnine the patients health states major complaints , progress and duration of an illncss
Pulse-feeling and palpation: Pulse-feeling is an approach by which a physician understands the condition of a disease. medians and collaterals, Qi and blood and the relative strength of pathogenic factors and the antipathogenie Qi. Palpation mains to examine various of the body by touching to find out abuonnal conditions.
In traditional Chinese medicine,¡±symptom¡±, ¡°syndrome¡± and ¡°diseaset¡± are different in nature, but they are closely connected. ¡°symptom¡± means a change in the body or mind which shows disease or dirder, including abnorrnal tongue arid pulse manifestation, eg. fever, aversion to cold bitter tasie in the mouth, stuffiness sensation in the chest, loose stools, yellow tongue coating and wiry pulse.¡±Syndrome¡±refers to a collection of medical symptoms at a certain stage in a disease course, For instance, common cold has two typessyndrome of wind-cold and syndrome of wind-heat.
¡±Differentiation of disease¡±is a process in which a disease name is established in light of the main clinical manifestations and characteristics.
Differentiation of syndromes: It includes differentiation of syndromes in accordance with the eight principal syndromes, d ifferentiation of syndromes in accordance with the state of Qi, blood and body fluid, differentiation of syndromes in accordance with the state of the zang-fu urgans, differention of the syndromes in accordance with the theory of the six meridians, differentiation of syndromes in accordance with the Wei, Qi, Ying, and Xue systems, and differentiation of syndromes in accordance with the theory of San-Jiao.
3.2 What is the conception of the Mental Facnlty?
According to traditional Chinese triedicine, the mental faculy of a person reveals his or her vitality as well as mental and spiritual state. In a broad sense, it rcfers to life, but in a narrow scnse. it refers to mental activity or spirit.The two must he included in observation of the mental faculty.
3.3 What is observation of the complexion?
Observation of the complexion refers to seeing the color and luster of the face. According to traditional Chinese medicine there are live basic colors-blue, red, yellow, white and black-that correspond to the condition of the organs and to various pathogenic factors.
3.4 Diagnostic Significance of the Five Colors
Bluish or hhiish-pirprish or bluish-blackish or paLe arid
bluith cumplexiurt
Pale ind bluish corapi-xion
Purplish skin
With high icer, The bluish-purplish color appcain an infantile face, especilv beweeii the eyebrows. to the bridge of the nose or a ound the lips
Flushmg Lu the entire
flushed cheeks
Flushes uccasiori.alIy fr a face
Sallow caaplexion
Yellowish ccruplexioii and an
unhealthy puffy face
RnghUy yellow complexion
Dim, yellow complexion
Syndrome and pailqzcnesb-his Exccss Add Coagulation of cold. conractire of vcssels, cmjx ded circuialion ni blood
Pain: Coraracturc of Vcsst. stagnation of Ii awlblood
Rlocgj stesis Stagnation of Qi and blood Convulsion: Entcrkw stirritir-up Wind
Red Heat, excess-heat: Accelerative flow of birthday abundain blood in vessels
Floating- Ying. a defkiericv cxsxditicn: Up-
ward going of Yang in a deficiacy anhhon
Yellow weakened spleen function; Dysf one of the spleen in transpon and rgiisfunna tioli, insufficient blood
Dampess Failure of the spleen to car. on normal raiispuit trgi rexeryticn of dflipnes
Iaundic
csng jaunrilce Jftter-ior ro;igulaton of dainphcat Yin jaundice: Retention A cold-cblngness
Continued
Snidromc and patIicense Chararrestics
White old: Qi slgnation due to cold Pale cvjnplcxion
fleIicierLcv of Yang Pallor
Qi deficiency: lack of Qi and bloixi j Whitish cunipiexion
hlocxl defciu-iey: Consunipiion of Li? and bhgxi, Rile and etriaciateti face failing to nciunsh the face
Enhall.slloit of Qi rtItiflg frorngrev-white, stcriess rnplei bleojn , or siicklen collapse of Yin?
Deficiency in the kidney: Blackish, dull ociaplexion
Feficicicy of kidiey-Yang Itnpeckd flow of Blackish, dry enniolexion
Deficiency of kidney-Yin Failturt of vftal as-lackih cobr arutoci the orbit
sence In nourish the lace Purplish-blackish complexion
Hetcrinori of fluid: Excess of waict due to weat
cried kidncys, stagnation of Qi and blood
Blood stasis Pain
3.5 How to inspect the tongue?
Inspection usually focuses on the change of the tongue proper, including its muscles and vessels, and the tongue coating, a layer of fur-I ike substance covering the surface of the tongue formed by stomach-Qi - A soft nimble tongue body with lightly red color arid a thin white corninfied layer, neither dry nor moist, is considered as a normal healthy tongue. In brief, it is a ¡°lightly red tongue with thin white coating¡± Abnormal tongue body and coating is discussed as follows.
3.6 Tongue color and Suggestion or disorders
3.7 Tongue Picture and Suggestion of disorders
Type
Pale
Reddened
(rin5ot
Purple |
Color Suggesiiori of dirders
Light than normal Deficiency of Yang-Qi, inadequate Qi and
F bbod, dehlixy, bypofunction
Red color ]teper than n3itiial Heiti syndromes (in an heat or deficiency con Iinghtl red diron)
Deep red Severe enclogenous heat due to invaskn of die Yin or Kue system, or hyperactivity of fire
caused by deficiency of Yin
Puiple with dcp red cxiloranon I Lrn1 slasis, exuberance of heart consumpuon dry and scanty moisture of Yin flukl, stagnation of blcxxl
Palt purple or moist blue-pur- Preponderant eridogenous oId, stagrialion of
plc bbod |