Fantastic Traditional Chinese Medicine Fantastic Traditional Chinese Medicine.

Fantastic Traditional Chinese Medicine Fantastic Traditional Chinese Medicine

Traditional Chinese Medicine Chapter One Introduction

Preface Western Medicine is based on laboratory.Western Medicine is based on laboratory. Traditional Chinese Medicine is based on philosophy and practice.Traditional Chinese Medicine is based on philosophy and practice. Western medicine is based upon chemical materials.Western medicine is based upon chemical materials. TCM is based upon natural plants.

What is Traditional Chinese Medicine?

How TCM Thinks 1.Chinese medicine is a complete medical system. 2. All of creation is born from the marriage of two polar principles, Yin and Yang: 3.The strategy of Chinese medicine is to restore harmony.

According to TCM There is a life force or energy (qi) in every body. Qi must be balanced and flowing freely. The ultimate goal of TCM treatment is to balance the yin and yang.

What is the history of TCM? 1.While searching for food they found herbal medicines. 2.While warming themselves around a fire they discovered moxibustion. 3.In the course of using stone implements as tools of production, they discovered acupuncture therapy.

How to diagnosis? interview pulse diagnosis tongue examination

Interview The first step in diagnosing a patient’s condition is an extensive interview. The practitioner will ask detailed questions. The practitioner is also trained to use the senses of observation, listening, and smelling.

Pulse Diagnosis Western doctors locate one pulse on the radial artery in the wrist. A practitioner of TCM feels for six pulses in each wrist. The twelve pulses correspond to the internal organs. The Chinese have developed an elaborate vocabulary to describe a pulse.

Tongue Examination The Chinese believe that the changes of the tongue is a manifestation of human health. They developed an elaborate system to describe the condition of the tongue. In this system, each part of the tongue corresponds to the condition of an organ.

How to treat diseases with TCM? Acupuncture

How to treat diseases with TCM? Moxibustion

How to treat diseases with TCM? Suction cups (cupping)

How to treat diseases with TCM? Massage

How to treat diseases with TCM? Herbal medicine

How to treat diseases with TCM? Diet and exercise

Qi gong Internal Qi gong: External Qi gong:

What is TCM good for?  Obesity; diabetes; high cholesterol

What is TCM good for? Asthma, allergy

What is TCM good for? addictions

Addictions Acupuncture treatments, taken enough times, clear the mind, build energy, and give a sense of well being. Western science has confirmed that acupuncture treatments change levels of chemicals in the body and act on the nervous system.

What is TCM good for? Various pains

chronic pain is the third most common health-care problem. According to TCM, nothing in the human body can function independently. Clinical studies support that acupuncture is an effective modality in the treatment of almost all kinds of pain conditions.

What is TCM good for? Anxiety, Depression and Other Nervous Disorders, sleep disorders

Some important ancient books 1."Huangdi Neijing"(Huangdi’s Classic of Internal Medicine) 2."Shennong Bencao Jing (Shennong's Herbal Classic)" 3."Shanghan Zabing Lun" (Treatise on Exogenous Febrile and Miscellaneous Diseases) 4.Bencao Gangmu (Compendium of Materia Medica)

The Essential Characteristics of TCM 1. The Concept of holism 2. Treatment Determination Based on Syndrome Differentiation

The Essential Characteristics of TCM 1.The Concept of holism The Concept of holism means that the human body is an organic whole and that human being are interrelated with nature.

1. The Concept of holism (1) The human body is an organic whole  The structures of composing the human body are organic wholeness.  The physiological functions of the body are organic wholeness.  Organs and tissues may also influence each other pathologically.

① The structures of the human body are organic wholeness the human body tissues organs the five tissues: the tendons, the blood vessels, the muscles, the skin and hair, the bones. the four limbs; all the skeletal parts the five zang viscera : the liver, the heart, the spleen, the lung and the kidney. the six fu-viscera : the gallbladder, the small intestine, the stomach, the large intestine, the bladder the five sensory organs : the eyes, the tongue, the mouth, the nose, the ears. the nine orifices : two eyes, two nostrils, two ears, one mouth, anus and genitalia.

② The physiological functions of the body are organic wholeness. In physiology, different organs have their own respective functions, but they cooperate with each other in function. Every function, however, is a component of the general activity and thus effects the unity of the whole body.

The processes of digesting food and nutrients absorbed and waste discharge the digestion of food the absorption of nutrients accomplished and the discharge of waste by concerted actions of a number of organs. (mouth,stomach,intestine, liver, gallbladder, anus,)

③ Organs and tissues may also influence each other pathologically. In pathology, dysfunctions of the viscera may be reflected in the body surface through the meridians; while disorders of the body surface may involve the related viscera through the meridians. The five zang-viscera and the six fu- viscera may also influence each other through the meridians.

⑵ The Relationship between Human and Nature Various changes taking place in nature may directly or indirectly affect the human body and bring on corresponding physiology or pathological responses. Geographical conditions also affect the physiological activity and pathological state of the body.

The Essential Characteristics of TCM 2. Treatment Determination Based on Syndrome Differentiation Definition: Syndrome differentiation and treatments means to analyze, synthesize, judge and summarize the clinical data of symptoms and signs collected with the four diagnostic methods (namely inspection, 1istening and smelling ， inquiry ， taking pulse and palpation) into certain syndrome. Then the therapeutic methods are decided according to the result of syndrome differentiation. Syndrome differentiation and treatments is a basic principle in TCM to understand and treat disease.

Syndrome differentiation "Syndrome differentiation" is a summarization of the pathological changes of a disease at a certain stage in its course of development, including the location, cause and nature of a disease as well as a situation of mutual conflict between pathogenic factors and power of resistance. Compared with single symptom, syndrome can more extensively completely and correctly demonstrate the nature of a disease.

Symptom( 症 ) ： change syndrome （证）： a set of symptoms general symptoms local symptoms

catch cold cold syndrome ： warm drugs heat syndrome ： cool drugs

※ Although a disease is the same, because of different syndrome, treatment is different. This is called “treating the same diseases with different methods”. ※ While, different diseases, as long as they express the same syndrome in nature, can be treated with the same treatments. This is called “treating different diseases with the same method”

on the basis of the differentiation of syndromes establish different therapeutic methods pick out proper drugs or points Treating diseases

Traditional Chinese Medicine Chapter Two Yin-yang and the Five Elements Doctrines

Chapter Two Yin-yang Theory 1.How to form the doctrine of yin and yang? the ancients found any things had contradictory two aspects of yin and yang, and it was further recognized that interaction of yin and yang promoted the origination, development and transformation of things. So, yin-yang was used as a tool to reason things out and to explain various phenomena in nature, and formed the doctrine of yin and yang.

What is yin and yang?

Definition of Yin-yang 2. Concepts of Yin-yang Theory ※ Yin and yang is a summary of certain related and contradictory things and phenomena in nature. Yin and yang can represent two contradictory things. Yin and yang also can summarize two contradictory aspects in the same things. Generally speaking, the things and the phenomena that have the properties of being warm, active, bright, ascending, happy, strong, invisible, etc is yang; while the things and the phenomena that have the properties of being cold, dim, static, descending, depressed, weak, visible, etc is yin.

Yin or yang attribute of a thing is not absolute, but relative ① Yin and yang can transform each other under a given condition. ② On the other hand, within yin or yang there still might be further subdivided yin and yang. ③ This phenomenon that things are both mutually opposite and related is infinite in nature.

Major Contents of Yin-yang Theory 1.Opposition of Yin-yang 2. Interdependence between Yin and Yang 3. Wax-wane of Yin-yang 4. Transformation of Yin-yang

Major Contents of Yin-yang Theory 1.Opposition of Yin-yang ① Opposition of yin and yang means that in nature two opposite aspects exist for all things and phenomena. ② Two opposite aspects of yin and yang are not still, but constantly repel and restrain each other. ③ It is important to keep the balance of yin and yang.

Major Contents of Yin-yang Theory 2. Interdependence between Yin and Yang ※ Interdependence between Yin and Yang means the two opposite sides of yin and yang depend on each other for existence in an object. Yin depends on yang, and yang depends on yin. Any side can’t exist solitarily without the opposite other side. ※ This relationship of relying on each other is called interdependence of yin and yang.

Major Contents of Yin-yang Theory 3. Wax-wane of Yin-yang ※ The two inter-opposite and interdependent sides of yin and yang are not in a state of stillness, but in a state of constant change, or in a state of "yin wane with yang wax" and “yang wane with yin wax”. This dynamic change of wane and wax between yin and yang is called “wane-wax of yin and yang”. ※ Under normal condition, wane-wax between yin and yang are maintained to a relative balance.

Major Contents of Yin-yang Theory 4. Transformation of Yin-yang ※ This relates to two sides of yin and yang under certain conditions transforming themselves into each other, such as yin may turn into yang, and yang into yin. Concerning the movement and change of things, the "wane-wax of yin and yang" is a process of quantitative change, and the "transformation of yin and yang" is a process of qualitative change. In the progress of a disease, a change from yin to yang or from yang to yin frequently occurs.

Application of Yin-yang Theory in TCM 1. To explain the tissues and the structures of the human body. ※ TCM believes that the body is an organic whole and that all the tissues and organs in the body depend on each other in function. Furthermore, all organic structures are closely related and divided into two mutually opposite parts of yin and yang. ※ Each organ itself can be further divided into yin and yang. ※ In short, all tissues and organs may be summarized and explained in terms of yin and yang.

Application of Yin-yang Theory in TCM 2. To explain the physiological functions of the body ※ TCM also uses the theory of yin-yang to summarize and explain the body's physiological functions, claiming that the normal activities of the human body result from the balance between yin and yang in their unity and opposition. ※ Therefore the relationship between the functions and the substances is the mutual opposition, interdependence, wane and wax as well as transformation of yin and yang.

Application of Yin-yang Theory in TCM 3. To explain pathological changes of the body ※ When the balance between yin and yang in the body is damaged, it leads to various diseases known as “imbalance between yin and yang”. Though pathogenesis is complicated, pathological changes generally fall into two categories: an excess of either yin or yang and a deficiency of either yin or yang, according to the analysis of pathogenesis with the theory of yin and yang.

Application of Yin-yang Theory in TCM The onset and development of a disease relate to ※ The healthy energy ※ the evil factor affecting health:various etiological factors constitutions and the functions of the body the ability of resistance against disease the ability of regulation and recovery by oneself the adaptability of exterior and interior environment struggle yin-fluid yang-qi yin- evils yang-evils

Application of Yin-yang Theory in TCM (1) An excess of either yin or yang ※ An excess of either yin or yang means the level of either yin or yang is higher than normal in pathologic state. ※ The invading yang-evil may lead to an absolute excess of yang and injure yin, causing a heat syndrome. ※ The invading yin-evil may lead to an absolute excess of yin and injure yang, causing a cold syndrome.

An excess of either yin or yang yin yang Abnormal An excess of Yang yin yang Normal Yang evil yin yang Normal Yin evil yin yang Abnormal An excess of Yin cold syndrome heat syndrome

Application of Yin-yang Theory in TCM (2) A deficiency of either yin or yang ※ A deficiency of either yin or yang means the level of either yin or yang is lower than normal in pathologic state. ※ Deficient yang-qi can not restrain yin and lead to a relative excess of yin and appear a deficient-cold syndrome. ※ Deficient yin-fluids cannot restrain yang and lead to a relative excess of yang and appear a deficient-heat syndrome.

A deficiency of either yin or yang yin yang Abnormal A deficiency of Yang yin yang Normal yin yang Normal yin yang Abnormal A deficiency of Yin a deficient-cold syndrome a deficient-heat syndrome

Application of Yin-yang Theory in TCM 4. To make a diagnosis ※ The onset and development of a disease is due to imbalance between yin and yang. ※ All diseases come under the two categories of a "yin syndrome" or a "yang syndrome." ※ A right diagnosis should first distinguish between yin and yang.

Application of Yin-yang Theory in TCM 5. The Application of Yin-yang in Treatment of Disease ※ Since an excess or deficiency of yin or yang is the root cause for onset and development of disease, regulating yin and yang to restore its relative balance is the guiding principle in treatment. ※ The therapeutic treatment principle of restoring a relative balance between yin and yang is "treating yin for a yang illness and treating yang for a yin illness."

Teat an excess of either yin or yang yin yang Yin (cold) Yang (heat) Abnormal An excess of Yang Balance yin Balance yang Abnormal An excess of Yin Reduce heat in cooling methods Reduce cold in heating methods cold syndrome heat syndrome

Teat a deficiency of either yin or yang yin yang Abnormal A deficiency of Yang yin yang Balance yin yang Balance yang Abnormal A deficiency of Yin Reinforce yang Reinforce yin a deficient-cold syndrome a deficient-heat syndrome

The five-element doctrine 1. What are the five elements The five elements include wood, fire, earth, metal and water.

The five-element doctrine 2. How to form the five- element doctrine? ① The ancient Chinese people recognized that wood, fire, earth, metal and water are the five indispensable materials in human life. ② People looked to the properties of these five materials to explain the whole physical world. ③ They also believed that the five materials not only inter-promotion and inter-restriction, but are also in a constant state of motion and change.

The five-element doctrine 3. What is the five- element doctrine? ※ “The five-element doctrine" refers to the movement and transformation of these five elements(wood, fire, earth, metal and water) as well as their interrelationships.

Major contents of the five-element doctrine 1. Characteristics of the five elements ① The primary properties of the five elements "water moistens and flows downward", "fire flames up", "wood can be flexed and extended", "metal can be changed in form" and "earth can grow crops“.

1. Characteristics of the five elements ② The abstract properties of the five elements  the properties of flexing and extending, growth and development as well as free activity the category of wood.  the properties of warmth; heat; ascending and brightness the category of fire.  the properties of reception, cultivation and transformation the category of earth.

1. Characteristics of the five elements ② The abstract properties of the five elements  the properties of change, depuration and astringency the category of metal the category of wood.  the properties of moistening, downward, movement, cold and coolness as well as closure and storage the category of water.

1. Characteristics of the five elements ③ To analyze and sum up various things ※ In the light of the basic properties of the five elements, analogy and induction can be used to categorize things in order to decide the properties of different things. The first step is to compare the image, properties and functions of things with the abstracted properties of the five elements respectively. If it is similar to the properties of one element, then it pertains to the category of that element.

Human body and nature match the five elements

Inter-generation and inter-restraint 2. Normal condition:Inter-generation and inter-restraint generation ( 1) Inter- generation generation Inter- generation means that one thing produces effect of promoting or generating another among the five elements. The order of promotion is as follows: wood generates fire, fire generates earth, earth generates metal, metal generates water, and water in turn generates wood.

Inter- generation and inter-restraint

Inter-generation and inter-restraint 2. Normal condition:Inter-generation and inter-restraint generation ( 1)Inter- generation generation In the generation of the five elements, each element has two aspects of "being generated" and “generating." The generating element is called the "mother," while the generated element is called the "child." So the inter-promotion relationship among the five elements is also called the "mother-child relationship." As an example, because wood generates fire, wood is the mother of fire; and wood is generated by water, thus it is the child of water.

Inter-generation and inter-restraint 2. Normal condition:Inter-generation and inter-restraint ( 2) Inter-restraint Inter-restraint means that one thing controls and restrains another thing among the five elements. The order of restraint is as follows: wood restricts earth, earth restricts water, water restricts fire, fire restricts metal, and metal restricts wood.

Inter-generation and inter-restraint 2. Normal condition:Inter-generation and inter-restraint ( 2) Inter-restraint In the restriction of the five elements, each element possesses two aspects of "being restricted" and "restricting." The restricting element is the "dominator," and the restricted element is the "subordinate." With wood as an example, the element that restricts wood is metal, so metal is the dominator of wood. The element that is restricted by wood is earth, thus earth is the subordinate of wood.

Inter-generation and inter-restraint 2. Normal condition:Inter-generation and inter-restraint generation (3) The relationship between inter-generation and inter-restraint Inter-generation and inter-restraint among the five elements are in fact inseparable. Without generation, nothing can grow and develop; without restraint, there would be no way to prevent harm caused by excessive development of things. Only when restraint exists in generation and generation in restraint can maintain the normal development of things.

Over restraint and reverse restraint 3. Abnormal condition: Over restraint and reverse restraint ( 1) Over restraint Over restraint refers to an abnormal state in which one element among the five elements excessively restrains another element. The order of over restraint is the same as that of inter-restraint, i.e. wood over restraining earth, earth over restraining water, water over restraining fire, fire over restraining metal and metal over restraining wood.

Over restraint and reverse restraint 3. Abnormal condition: Over restraint and reverse restraint ( 1) Over restraint There are two causes responsible for over restraint: One is that one element among the five elements becomes too powerful and in turn excessively restrains the element that it normally restrains, damaging the normal restraint relationship between them.

Over restraint and reverse restraint 3. Abnormal condition: Over restraint and reverse restraint ( 1) Over restraint There are two causes responsible for over restraint: The other is that one element among the five elements becomes weak and therefore provides the element normally restraining it a chance to excessively restrain it, damaging the normal restraint relationship between them.

Over restraint

Over restraint and reverse restraint 3. Abnormal condition: Over restraint and reverse restraint ( 2) Reverse restraint Reverse restraint refers to an abnormal state in which one element among the five elements reversely restrains and bullies another element. That is why this phenomenon is called reverse restraint. The order of reverse restraint is just opposite to that of inter-restraint, i.e. wood reversely restraining metal, metal reversely restraining fire, fire reversely restraining water, water reversely restraining earth and earth reversely restraining wood.

Over restraint and reverse restraint 3. Abnormal condition: Over restraint and reverse restraint ( 2) Reverse restraint There are two causes responsible for reverse restraint: One is that one element among the five elements becomes very powerful and turns to restraint the element that it is normally inferior to, damaging the normal inter-restraint relationship between them. For example, if wood becomes too powerful, it will reversely restrain metal; if fire becomes too strong, it will reversely restrain water.

Over restraint and reverse restraint 3. Abnormal condition: Over restraint and reverse restraint ( 2) Reverse restraint There are two causes responsible for reverse restraint: The other is that one element among the five elements becomes weak and is restrained by the one that it is normally superior to, damaging the normal inter-restraint relationship between them. For example, if metal becomes weak, it will be reversely restrained by wood; if earth is weak, it will be reversely restrained by water.

Reverse restraint

Application of the Five Elements in TCM 1. Explaining the physiological functions of the five Zang-viscera and their relationships 2. Explaining interaction of the five zang viscera pathologically 3. Diagnosis and Treatment Application

1. Explaining the physiological functions of the five Zang-viscera and their relationships (1) The five zang-organs correspond to the five elements The theory of the five elements explains the physiological characteristics and functions of the five zang-organs according to the attributes of the five elements, pairing each of the five zang-organs with the corresponding one of the five elements.

1. Explaining the physiological functions of the five Zang-viscera and their relationships Wood is free development Liver prefers freedom to stagnation Fire is hot and tends to flame up heart-yang warms the whole body Earth receives and generates Spleen transforms food nutrients Metal depurates and astringes lung-qi maintain inside and descends Water moistens and closes Kidney stores essence and manages water metabolism Liver Wood Heart Fire Spleen Earth Lung Metal Kidney Water

1. Explaining the physiological functions of the five Zang-viscera and their relationships (2) Inter-generation and inter-restraint of the five zang-organs The functional activities of the five zang- organs also reflect the relationships of inter- generation and inter-restraint. So they can be explained with the theory of inter-generation and inter-restraint among the five elements.

Inter-generation of the five zang-organs liver -blood heart -spirit Spleen- transport and transformlung kidney nourish help nourish Descends qi help receive qi kidney-yin liver-yin nourish

inter-restraint of the five zang-organs liver -qi heart -fire Spleen- stagnation lung Yin-kidney Descends qi liver-yin the spleen governs metabolism of water edema due to abnormal flow of kidney-water the warmth of heart-yang prevent

Application of the Five Elements in TCM 2. Explaining interaction of the five zang viscera pathologically According to the theory of the five elements, there are two aspects of pathological transmission among the five zang-organs. One includes over restraint and reverse restraint, the other includes disorder of the mother- organ involving the child-organ and disorder of the child-organ involving the mother-organ.

over restraint and reverse restraint Over restraint and reverse restraint are pathological transmissions due to abnormal change of inter-restraint relationship. Over restraint refers to transmission of disease due to excessive restraint, the order of which is the same as that of inter-restraint. Reverse restraint refers to transmission of disease due to reversely restrains, the order of reverse restraint is just opposite to that of inter- restraint. 2. Explaining interaction of the five zang viscera pathologically

over restraint and reverse restraint liver -qi heart -fire Spleen- qi lung Yin-kidney liver-fire

Mutual transmitting of the mother-organ and the child-organ The mother-organ transmits the child-organ Mutual involvement or affection of the mother- organ and the child-organ reflects pathological transmission due to abnormal change of inter- generation relationship. Disorder of the mother- organ involving or affecting the child organ means that the disease is transmitted from the mother-organ into the child-organ, the order is the same as inter- generation. Such a transmission is called disorder of the mother- organ involving the child-organ.

disorder of the mother-organ involving the child-organ. Liver-fire Heart-fire Spleenlung kidney

Mutual transmitting of the mother-organ and the child-organ the child-organ transmits the mother-organ Disorder of the child-organ involving or affecting the mother-organ indicates that the disease is transmitted the child-organ into the mother-organ, the order is just opposite to inter- generation. Such a transmission is called disorder of the child-organ involving the mother-organ, also known as "the child-organ consuming qi of the mother-organ".

disorder of the child-organ involving the mother-organ Liver-yin Heart Spleenlung kidney-yin

Application of the Five Elements in TCM 3. Diagnosis and Treatment Application  Since the five zang-organs pair with the five elements, the five colors, the five flavors and the five pulses respectively, and because the disorders of the internal organs can manifest on the surface of the body, clinically the theory of the five elements can be used to analyze the changes of complexion, taste and pulse in order to decide which viscus and meridian are involved.  The five colors, the five flavors and the five pulses correspond to the liver, the heart, the spleen, the lung and the kidney respectively. So they can be directly used to diagnose disease.

Diagnose disease applying the five elements

Of course, using the theory of the five elements to diagnose disease is only one of the methods used in clinical diagnosis. In order to reveal the nature of disease and make correct diagnosis, this method should be used together with other methods for differentiation of syndrome, such as yin and yang, zang xiang (visceral and their manifestations), qi, blood and body fluid. Through information gained by using the four diagnostic methods, practitioner can make a correct diagnosis.

Treat disease applying the five elements In the treatment of disease, the theory of the five elements is mainly used to control the transmission of disease and decide therapeutic principles. The onset and development of some diseases are related to the generation and restriction relationships among the viscera. Thus in treatment while treating the affected viscus, practitioner should also consider the other related viscera in order to stop the transmission of disease.

Treat disease applying the five elements For example, liver disease, according to the theory of five elements, tends to transmit to the spleen, so preventive measures should be taken in advance to protect the spleen in the treatment of liver disease.

Treat disease applying the five elements Usually the therapeutic principles are decided in the light of inter-generation and inter-restraint relationships. Such as reinforcing spleen (earth) to strengthen lung (metal), replenishing kidney (water) to nourish liver (wood), inhibiting liver (wood) to assist spleen (earth), or replenishing kidney (water) to reduce heart (fire). These principles are based on the five element laws of inter-generation, inter- restriction, over restraint and reverse restraint.

Visceral Theory ※ The visceral theory is the core of the theoretical system of TCM. ※ The conceptions of zang-fu organs in TCM are quite beyond the range of anatomical morphology. ※ It is generally believed that the functions of the zang-fu organs in TCM are extensive, not only including part of the functions of organs with the same names in modern medicine, but also covering certain functions of other related organs. Obvious the zang-fu organs in TCM are not just the conceptions of anatomy, but synthetic functional units.

Visceral Theory ※ The concept of the liver in TCM includes: seeing ; muscle and tendon. ※ The Spleen means all the functions of the spleen and pancreas. ※ The genital organs belong to the Organ Kidney.

Visceral Theory The concept of Kidney in TCM includes: (a) Hearing (b) Balance (equilibrium of the body) (c) The functions of joints. The integrity of the bones (d) Reproduction. Secondary sexual characteristics (e) Excretory functions (f) Head hair (g) Genetic and Hereditary (h) Stress mechanisms (i) Water balance (j) Conservation of vital materials (k) Nails (also related to the Liver and lungs) (l) The Kidneys store the Essences (m) Regulates blood pressure

TCM classifies the internal organs of the body into three kinds: Five zang-viscera:the heart, liver, spleen, lung and kidney producing and storing essential qi Six fu-viscera: gallbladder, stomach, small intestine, large intestine, urinary bladder and san-jiao receiving, transforming, and transporting food and water. Extraordinary fu-viscera:brain, marrow, bone, vessel, gallbladder and uterus similar to “the six fu-organs” in morphology, but their functions are similar to the five zang-organs, storing essence.

Heart Five Zang-viscera — Heart ※ physiological function: 1.Governs Blood and the Vessels 2.Controls Mental Activities 3.Sweat is the Fluid from Heart 4.The Heart Opens to the Tongue and Manifests on the Face

1. Governs Blood and the Vessels The heart can circulate blood through the vessels to nourish the whole body. WM: the heart can pump blood depending on muscle contraction TCM:the heart can pump blood depending on heart qi. The function of the heart in governing blood and the vessels is carried out by heart qi. Heart qi circulate blood incessantly. Heart qi the function of circulation are the passage of blood circulation.

2. Controls Mental Activities WM:mental, conscious and activities of thought the function of the brain. TCM: mental, conscious and activities of thought the five zang-viscera and in particular, the heart. (why?) The material basis of mental activities is the blood. The functions of the heart in controlling mental activities are closely related the blood. the blood and qi of the heart the physiological functions of the body are normal, and mind is clear, the blood and qi of the heart abnormal, disorder of mind.

3. Sweat is the Fluid from Heart ※ Sweat is derived from a body fluid which is a related and important component part of blood. ※ Blood is governed by the heart. ※ "blood and sweat share a common source" ※ "sweat is the fluid from the heart." ※ Too much sweating can injure heart-blood and heart qi, manifesting palpitations or weak or short breath. ※ Profuse sweating can injure heart yang, leading to a critical condition known as "depletion of yang resulting from profuse sweat."

The Heart Opens to the Tongue and Manifests on the Face ※ Because a branch of the heart meridian goes up to the tongue and the face, the state of the tongue and face can reflect the physiological functions and pathological changes of the heart. ※ TCM practitioners often look at the tongue and face to examine the underlying condition of the heart and blood. ※ If heart-qi, heart-blood, heart-yin and heart-yang are normal, the face is ruddy and lustrous in appearance, the tongue is free in movement, soft in texture, keen in taste and fluent in speaking.

The Heart Opens to the Tongue and Manifests on the Face ※ If heart-blood is deficient, there will be a pallor complexion and pale tongue. In the case of stagnation of heart-blood, the complexion will be purplish and dark, or have purplish patch or point. If there is a dysfunction of the heart in governing mental activities, the tongue will be stiff, there will be difficult speech, or aphasis. ※ In addition, hair is dependent upon the nourishment of blood, and thus it is said that "hair is the extension of blood." In the case of a deficiency of heart blood, the hair will be withered.

Five Zang-viscera — Lungs ※ physiological function: 1.Governing Qi and regulating respiration 2.In Charge of Dispersing and Descending 3.Regulating Water Metabolism 4.Governs the Skin and Hair 5.Opens to the Nose

1. Governing Qi and regulating respiration (1) Governs qi of respiration: The lungs are the place where the air is exchanged in and out of the body. Through respiration, the lungs inhale fresh air (oxygen), and exhale the waste air (carbon dioxide) so as to maintain the normal metabolism. (2) Governs Qi of the Whole Body: ① The first aspect is the production of the pectoral qi. ② The second aspect is the regulation of qi activity. ③ The third aspect is to assist the heart to promote blood circulation.

(2) Governs Qi of the Whole Body: ① The first aspect is the production of the pectoral qi. The pectoral qi fresh air essential qi Combination: stored in the thorax is transported and distributed the dispersing and descending functions of the lung the function of heart to control blood the whole body warm and nourish viscera and tissues maintain their normal physiological functions

(2) Governs Qi of the Whole Body: ② The second aspect is the regulation of qi activity. Qi is flowing constantly in the body. The movement of qi ascending coming-out descending coming-in is influenced by the lung dispersing descending dispersion descent respiration of the lung normal meridian qi visceral qi in ascending descending coming-out coming-in

③ The third aspect is to assist the heart to promote blood circulation. ※ The heart controls blood vessels and the heart beat is the basic motive power to propel blood to circulate in the vessels. ※ The lung is closely related to the vessels in the whole body. Through the vessels blood from the whole body converges in the lung and then is distributed to all parts of the body. ※ The lungs assist the heart to promote blood circulation and to accomplish the respiration. the qi of lungs respiration shortage of breath, weak

2. In Charge of Dispersing and Descending The lungs Dispersing ascending spreading-out the driving action of lung qi qi, blood and body fluids can go everywhere to the viscera and meridians to the muscles and skin The lungs Descending cleaning going down the action of lung qi lung qi fails to descend cough, asthma, and chest distress

3. Regulating Water Metabolism ※ Lung qi has the action of promoting and maintaining water metabolism equilibrium. This function is carried out through the dispersing and descending actions of lung qi. Discharge of metabolized water in the body mainly includes four processes: urine, sweat, respiration, and feces. Sweat and urine are the major means through which water is released by the body.

3. Regulating Water Metabolism The body fluids food water dispersing useless part nourish the body descending the kidneys urine turned urinary bladder discharged This function of the lungs promotes water metabolism is called "the lung is the upper source of water."

4. Governs the Skin and Hair The lungs distribute body fluids and spread out the skin and hair moisten and nourish the skin and hair the skin becomes compact and hair is healthy the ability of resistance against exogenous evils is strong. lung qi can not disperse the essence to the skin and hair defensive qi easy to infect disease The body might be subject to invasion of exogenous evils

5. Lungs open to the nose the nose the gate of the lungs the passage for air out and in function receiving air sense of smell lung qi is normal the sense of smell will be sharp. the lungs are invaded by exogenous evils lung qi will not flow smoothly and might cause nasal obstruction, runny nose, and hyposmia the nose is the orifice of the lungs the evils invade the lungs through the mouth and nose

Five Zang-viscera — Spleen ※ The spleen is located in the abdomen, governs digestion and absorption. As the source of qi, blood and body fluid, the spleen plays a vital role in maintaining life activities. Such a function of the spleen only comes into play after birth. That is why it is called that “the spleen is the acquired base of life” and “the source of qi, blood and body fluid”.

Five Zang-viscera — Spleen ※ physiological function: 1.Governs Transformation and Transportation 2.Controls Blood 3.Sends up Essence 4.Governs Muscles and Limbs 5.Opens to the Mouth, Manifests on the Lips

1. Governs Transformation and Transportation (1) The spleen governs transformation and transportation of food. The spleen transforms and transports essential substances from food. The spleen has the function of digesting, absorbing and transporting nutritive substances.

(1) The spleen governs Transformation and transportation of food. After digestion the essential substances from food and fluids are absorbed by the spleen are transported upward to the lung and heart be distributed to through out the body to nourish the viscera, limbs, bones, skin and hair, tendons. Therefore, transformation and transportation of the spleen include the actions of digesting, absorbing and transporting nutrients.

(1) The spleen governs Transformation and transportation of food. If spleen transformation and transportation functions are weakened, poor appetite, abdominal distention, diarrhea, lassitude, and emaciation will become evident.

1. Governs Transformation and Transportation (2) The spleen governs transformation and transportation of water. The spleen also absorbs and transports water to moisten and nourish various tissues of the body during transformation and transportation of food.

(2) The spleen governs transformation and transportation of water. The metabolized water is then transported downward to the kidneys where it is turned into urine and moves through the urinary bladder to be discharged out of the body. This process of water distribution and transportation is performed together by the lung qi's dispersing and descending actions and the spleen qi's transforming and transporting actions.

(2) The spleen governs transformation and transportation of water. The spleen nourishes and moistens tissues, and acts to avoid retention of water, thus maintaining water metabolism balance in the body. If this function becomes weakened, diseases such as edema, phlegm-dampness syndrome, and diarrhea might soon follow.

2. Controls Blood ※ The spleen has the function of controlling blood and circulating it within the vessels and prevents blood from extravasating. ※ spleen qi is deficient fails to control blood bleeding, hemafecia, metrorrhagia strengthening the spleen qi

3. Sends up Essence ※ Spleen qi has an upward, ascending nature. Thus there is a saying “spleen qi is in charge of ascending”. ※ Essence implies the essential substances derived from food and fluids. ※ Sending up the essence means that the spleen absorbs and transports the nourishment of essential substances derived from food and fluids up to the heart, lung, head and eyes. The actions of the heart and lung then convert this nourishment into qi and blood which in turn nourishes the entire body.

3. Sends up Essence ※ Spleen qi ascends normally the spleen functions well ※ The spleen fails to ascend the essence (qi sinks ) Chronic diarrhea, rectocele and uterine prolapse.

4. Governs Muscles and Limbs ※ The spleen governs the muscles and the four limbs means that the muscles and the four limbs depend on the nutrients transported and transformed by the spleen to nourish. ※ The spleen functions normal sufficient qi and blood will be transformed from food nutrients. Both the muscles and the limbs will be nourished and become strong.

4. Governs Muscles and Limbs ※ If the function of spleen is abnormal, the absorption of nutrients will be reduced, leading to insufficient production of qi and blood and bringing on malnutrition of the muscles and the limbs with the symptoms of emaciation, lassitude of the limbs or even atrophy of the limbs.

5. Opens to the Mouth, Manifests on the Lips ※ The spleen opens to the mouth means that the functional states of the spleen can be observed from the manifestations on the mouth. (why?) ※ Since digestion is governed by the spleen, the mouth is the starting point of the digestive canal. Appetite and taste are closely related to the transformation and transportation functions of the spleen. ※ If the spleen is normal in function, the appetite and taste in the mouth will be normal; if the spleen is abnormal in function, it will lead to anorexia, tastelessness, or a sweet or sticky taste in the mouth.

5. Opens to the Mouth, Manifests on the Lips ※ The spleen opens the mouth and the lips are the external parts of the mouth. So the functional states of the spleen can be observed from the color and shape of the lips. ※ If the spleen is normal in function, qi and blood will be sufficient, and the lip will be ruddy and lustrous; if the spleen is abnormal in function, qi and blood will become scanty, and the lips will be pale, lusterless or even sallow.

Five Zang-viscera — Liver ※ physiological function: 1.Regulates the Smooth Flow of Qi 2.Stores Blood 3.Governs Tendons and Manifests on the Nails 4.Opens to the Eyes.

1. Regulates the Smooth Flow of Qi The smooth flow of qi means that the liver dredges the routes and regulates the movement of qi so as to ensure smooth flow of qi in the body. The physiological activities of all the internal organs and tissues depend on the normal movement of qi the liver can regulate The liver plays an important role in regulating

1. Regulates the Smooth Flow of Qi ※ The function of the liver to regulate qi activity includes four aspects: (1) To promote circulation of blood and metabolism of body fluid: (2) To assist the spleen and the stomach to digest and absorb food: (3) To regulate mental activity: (4) To regulate menstruation:

(1) To promote circulation of blood and metabolism of body fluid: Blood circulation and body fluid metabolism depend on the propelling function of visceral qi, The normal flow of the visceral qi relies on the smooth flow of liver qi. If the liver qi does not flow smoothly the activity of qi will be stagnated blood circulation will be obstructed water passages will be stagnated pain and/or distention in the hypochondrium, breast, or lower abdomen phlegm, rheum and edema If the liver qi is hyperactive easy to agitate or angry haematemesis

(2) To assist the spleen and the stomach to digest and absorb food food digestion absorption are accomplished spleen stomach liver regulate liver qi flow smoothly spleen stomach secretion of bile regulate maintain normal digestion and absorption liver qi does not flow smoothly spleen qi fails to ascent stomach qi fails to descent the secretion and excretion of the bile are abnormal abdominal distension and pain, diarrhea gastric distension and pain, vomiting and hiccup jaundice and anorexia

(3) To regulate mental activity the liver function of smoothing the flow of qi is normal can harmonize the spirit, mental activities, and emotions a good mood, relaxed mind, and quick thought the smoothing action of liver qi is hypoactive depression, sorrow, suspicion, sighing, and hypochondriac distress. the smoothing action is hyperactive over excitement, irritability, dizziness, vertigo, insomnia, and dream disturbed sleep.

(4) To regulate menstruation The physiological characteristics of women menstruation pregnancy delivery Are closely related to blood. The liver regulates the activity of qi enable blood to flow downward the uterus to meet menstruation pregnancy delivery The liver qi does not flow smoothly various women diseases dysmenorrhea irregular menstruation amenorrhea sterility

2. Stores Blood The liver storing blood the liver has the function storing blood regulating the volume of blood The sufficient liver- blood nourish the liver itself, the tissues and organs prevent liver-yang hyperactive The liver storing blood is a course blood enters the liver blood comes out the liver means

2. Stores Blood The circulation of blood in different parts of the body differs according to various physiological states. at rest or in a sleep state the body's demand for blood any surplus blood returns to and is stored in the liver. at work or excited the body's demand for blood the liver will release storing blood to meet the need of physiological activities.

2. Stores Blood the liver fails to store blood liver blood deficiency blurred vision night blindness contracture of muscles and tendons scanty flow of menstrual blood amenorrhea influence the normal activities of the body

3. Governs Tendons and Manifests on the Nails The tendons the muscles the skeleton the joints contraction relaxation The tendons The liver governing the tendons the physiological functions of the tendons means liver-blood liver-yin liver-yin and liver-blood nourish tendons the joints move flexibly and powerfully nourish tendons not the joints move un-smoothly tremor of hands and feet numbness of limbs susceptibility to fatigue control

Manifests on the Nails ※ the nails are the extensions of the tendons liver-blood nourish liver-blood often affects the color and quality of the nails the liver-blood the nails are firm and bright, ruddy and lustrous the liver-blood the nails are soft and thin, or even deformed or brittle

4. Opens to the Eyes The functions of eyes are relationship with the liver. Why? ① The liver meridian connects to the eyes. ② The eyes are nourished by liver-yin and liver-blood. the state of the liver can be observed from the manifestations of the eyes. the liver opens into the eyes liver yin and blood dryness of the eyes blurred vision liver-yang dizziness and vertigo

4. Opens to the Eyes wind-heat evils invade the liver meridian congested eyes itching pain liver-fire flares up congested eyes nebula the internal stirring of liver-wind upward staring of the eyes squint

Five Zang-viscera — Kidney The kidneys are located in the waist. The waist is the house of the kidney The kidneys are the prenatal base of life Since the kidney-essence comes from parents and is the primary substance for constituting human body and conceiving new life, TCM regards the kidney as “the prenatal base of life.

Five Zang-viscera — Kidney ※ physiological function: 1.The kidneys store vital essence, govern growth, development and reproduction. 2.Governs Water Metabolism. 3.Governs the Reception of Qi. 4.Kidneys govern bone and manufacture marrow to form the brain and manifests in the hair. 5. The kidneys open to the ears, the external genitals and the anus.

1. The kidneys store vital essence The kidneys store vital essence congenital essence acquired essence congenital essence is inherited from parents acquired essence is derived from food and fluids is transformed by the spleen and stomach transported to the viscera becomes visceral essence the body's physiological activities any surplus being stored in the kidneys viscera need essence kidney essence functions of the viscera affect

1. govern growth, development and reproduction kidney- essence qi blood is called the kidney qi growth development reproduction after birth childhood youth period mid-age old age the kidney-essence becomes abundant developing kidney qi dental transition growth of hair and body qi is further enriched male sperm is generated female menarche arrives qi develops to its peak sturdy build, rich vitality strong tendons and bones qi gradually declines sexual function declines the ability to reproduce

2. Governs Water Metabolism water metabolism is related to many organs the lung regulates water passage the spleen transports and transforms water the liver that promotes the metabolism of water the triple energizer serves as the passage of water the kidney governs water is key to the water metabolism.

2. Governs Water Metabolism water enters the stomach is absorbed by the spleen is transported to the lung dispersing descending all parts of the body after being used water is collected into the kidney qi-transformation separates useful part useless part lung ascend keep amount of water transform urine bladderexcreted qi-transformation disturbance of water metabolism profuse urine, enuresis and incontinence of urine, scanty urine, anuria, edema

3. Governs the Reception of Qi Definition: Reception means acceptance and storage. To govern reception of qi means that the kidney can receive fresh air inhaled by the lung to assist the lung to govern respiration. the lungs inhale the fresh air be descended into the kidney keep the respiration into a certain depth the lungs govern respiration, the kidneys govern reception of qi kidney-qi receiving qi the lung respire smoothly normal kidney-qi receiving qi weak the fresh air cannot be descended to the kidney more exhalation and less inhalation, shortness of breath and frequent asthma

4. Kidneys govern bone and manufacture marrow The kidney stores essence transform into marrow cerebral marrow, spinal cord and bone marrow the bones nourish kidney essenceoriginal marrow the bones not nourish weak delayed closure of the fontanel and weak bones in children Teeth are an extension of bone the nourishment of kidney essence depend on kidney essence the teeth will be firm kidney essence teeth will become loose, even fall out.

4. to form the brain and manifests in the hair The spinal cord is connected with the brain nourishes functions is normal the brain is called “the sea of marrow” the cerebral marrow kidney essence clear thoughts, sharp vision, keen hearing kidney essence lumbar pain and with weak knees, dizziness, amnesia, insomnia, slow thought.

4. manifests in the hair The production of blood food nutrients the kidney-essenceblood Promote, transform kidney-essenceabundant production of blood kidney-essence insufficient production of blood kidney-essence and blood hair will flourish and be lustrous "the kidney manifests in the hair." kidney-essence or blood hair is sparse, withered, falling out, or white or falling out early nourishing the kidney and replenishing the blood

5. The kidneys open to the ears, the external genitals and the anus. The hearing function of the ear nourishment from kidney essence qi depends on kidney essence qi the hearing will be sharp kidney essence qi tinnitus, and a decline hearing The external genitals the anus discharges feces reproduction urination the urinary bladder qi transformation the function of the kidney kidney yang/qi kidney yang frequent urination and impotence constipation and diarrhea

Life-Gate (ming men) Life-gate refers to the root and foundation of life, it is generally believed that it is related closely with the kidney. life-gate water fire kidney-yin kidney-yang decline of life-gate-fire insufficiency of kidney-yang reinforcing life-gate-fire invigorating kidney-yang

Six Fu-viscera ※ The six fu-viscera refer to the gallbladder, the stomach, the small intestine, the large intestine, the bladder and the triple energizer. ※ The common physiological functions of the six viscera is “to transmit and transform food”. ※ The six fu-viscera should be unobstructed in order to transmit and transform food.

Gallbladder ※ physiological functions : 1. Storing bile and discharging bile. Bile originating from the liver is excreted into the intestine and has the action of promoting digestion of food and fluids. 2. One’s courage is related to the gallbladder, the gallbladder has the function of making decisions.

Stomach ※ physiological functions : 1.receive and transform chyme and further digest and absorb it, then separates the lucid (nutrients) from the turbid (waste). 2.The essential substances are absorbed by the small intestine, then transported by the spleen to the entire body and the waste is transmitted to the large intestine. The useless water is poured into the urinary bladder.

Small Intestine ※ physiological functions : 1.to receive and digest food and drink. 2.The stomach depends on the propelling of stomach-qi to perform its function. 3.Stomach-qi must descent and can transmit food and water downwards smoothly. 4. If dysfunction of the stomach will lead to poor appetite, indigestion, belching, hiccup, nausea, and vomiting.

Large Intestine ※ physiological functions : The large intestine receives waste material transmitted down from the small intestine. After absorbing part of the water in it, the large intestine transmits the waste downward and transforms it into stool to be excreted from anus. The large intestine is the passage of transmitting waste. If the large intestine is dysfunction in transmitting waste, diarrhea or constipation may occur.

Urinary Bladder ※ physiological functions : 1.Storing and discharging urine. 2.depending on qi transformation of kidney. 3.Deficiency of qi transformation often brings on symptoms of un-smooth urination, dripping urination and anuria.

San-jiao ( the triple energizer ) the triple energizer the upper-jiao the middle-jiao the lower-jiao above the diaphragm the heart and lungs in the epigastrium the spleen and stomach in the below umbilicus the liver, kidney, intestines and urinary bladder Inspiration, blood vessels digesting food, transporting nutriment separating the clear from the turbid and discharging waste.

San-jiao ( the triple energizer ) ※ physiological functions : 1.controlling the qi transformation of the entire body,transforming essential substances from food and drink. 2.The passage of water metabolism. 3.The reception, digestion and absorption of food and fluids. 4.Discharge of metabolism materials.

Extraordinary fu-organs ※ Extraordinary fu-viscera: brain, marrow, bone, vessel, gallbladder and uterus The extraordinary organs are characterized by hollowness, similar to “the six fu-organs” in morphology, but their functions are similar to the five zang-organs, storing essence.

brain ※ The function of the brain relates to mental activity, governs the five zang-organs and six fu-organs. ※ The viscera theory emphasizes the importance of the five zang-organs, so the functions of the brain are attributed to the five zang-organs respectively. Clinically mental activities are most closely related to the heart, the liver and the kidney. That is why mental diseases are clinically treated from the heart, the liver and the kidney.

Uterus ※ The physiological functions of the uterus are to produce menses and conceive fetus. the physiological functions of uterus the healthy kidney essence rich qi and blood the physiological function of liver spleen and heart in regulating qi and blood

Heart and Lungs ※ Physiologically, the lung governs qi and assists the heart to propel blood circulation; the heart governs blood and blood nourishes the lung and maintains the respiratory function of the lung. ※ Pathologically, the deficiency of lung-qi and disorder of the lung in dispersing and descending will affect the function of the heart to propel blood, blood stagnation will occur with chest distress, palpitation, and cyanosis of lips etc. On the contrary, the heart qi/yang is insufficient that can’t propel the blood circulate, the respiration of the lung will be affected with cough and asthma etc.

Heart and Spleen The relationship between the heart and spleen embodied between blood circulation and blood produced. The heart blood circulation The spleen keeps blood circulating within the vessels The spleen is the source of producing the qi and blood The blood of the heart comes from the food essence the spleen absorbs heart blood spleen qi and blood the spleen qi heart blood the heart and spleen deficiency

Heart and Liver ※ The relationship between the heart and the liver is signified by circulation of blood and regulation of mental activities. The heartcontrols blood circulation The liver stores and regulates blood volume The blood is produced by the spleen is stored in the liver is circulated by the heart normal blood circulation liver-blood heart-blood affect liver-blood and heart-blood

Heart and Liver the heart controls the mental activities the liver regulates the mental activities The liver-qi can’t flow smoothly stagnation of liver-qi lasts too long can transform fire and produce wind heart and liver yin hyperactivity of heart and liver fire affect dysphoria, insomnia, irritability and susceptibility to rage

Heart and Kidney the heartfire descend tothe kidneywarm kidney the kidney water ascend tothe heartprevent heart fire This is called “harmony between heart and kidney”. If heart fire can’t descend to the kidney and kidney can’t ascend to the heart, This is called “disharmony between heart and kidney”. vexation, insomnia and dreamy sleep

Lung and Spleen The relationship the forming of the qi the metabolism of water The lung inhales air The spleen is the resource of qi are mainly material of the qi The spleen transports essential substances the water and dampness the lung The lung can promote The spleen can’t transport the water and damp it will form phlegm manifesting with cough and asthma

Lung and Liver The relationship is embodied in the regulation of the qi activity lung qi descending liver qi ascending keep balance maintain the normal flow of qi Descending function of lung qi is insufficient Liver-fire invades the lung cough and hemoptysis cough and asthma

Lung and Kidney The relationship the water metabolism the respiration The lung regulates water passage Kidney controls water coordination maintains the normal water metabolism The kidney receives qi The lung governs respiration work together accomplish respiratory activity

Lung and Kidney disorder of the lung in regulating water passage weakness of the kidney in transforming qi disturbance in water metabolism edema oliguria failure of the lung to disperse and descend failure of the kidney to receive qi cause disorder in respiration cough, chest oppression, shortness of breath and frequent dyspnea

Liver and Spleen The relationship digestion and blood circulation Normal transformation and transportation of spleen need the help of the liver smoothing the flow of qi The spleen keeping blood circulating within the vessels The liver storing blood Un-smooth the flow of liver qi disharmony between liver and spleen pain and fullness in chest and costal part, abdominal distention and diarrhea

Liver and Kidney liver storing blood kidney storing vital essence nourish kidney essence or yin liver blood or yin affect kidney yin liver yin liver yang liver yinkidney yin prolonged both liver-yin and kidney-yin

Spleen and Kidney The kidney is congenital base of life The spleen is postnatal base of life inter-dependence Spleen absorbs and transports food nutrients the kidney nourish kidney-yang spleen-yang warm the spleen to transform and transport Spleen transports and transforms water the kidney governs water metabolism coordinate

The relationship between the five zang-viscera and the six fu-viscera The five zang-viscera belong to yin The six fu-viscera belong to yang The internal is yin The external is yang The relationship between the zang-viscera and the fu-viscera is the relations between yin and yang as well as the internal and external.

Heart and Small intestine ※ The channels of heart and small intestine connect to each other. ※ So the heart and the small intestine are mutual internal and external relationship. heart excess-firedescend to small intestine reddish urine, scanty urine and pain in urination small intestine fire ascend to the heart dysphoria and orolingual sore

Lung and Large intestine ※ The channels of lungs and large intestine connect to each other. ※ So the lung and the large intestine are mutual internal and external relationship. Lung qi dispersing and descending The transmission of the large intestine promote Lung qi fails to disperse and descend constipation Large intestine excess-fire Lung qi fails to disperse and descend cough, asthma

Spleen and Stomach ※ The channels of spleen and stomach connect to each other. ※ So the spleen and the stomach are mutual internal and external relationship. The stomach receives food and water the spleen governs transformation and transportation The spleen qi The stomach qi digesting, absorbing The failure of spleen to transform and transport the reception of stomach poor appetite nausea

Liver and Gallbladder ※ The gallbladder is attached to the liver, and its channels connect to the liver. ※ So the spleen and the stomach are mutual internal and external relationship. ※ The bile comes from the liver and stored in the gallbladder. the liver qi doesn’t flow smoothly the normal production and excretion of bile affect the diseases of the liver and gallbladder always occur at the same time.

Kidney and Urinary Bladder ※ The channels of kidney and urinary bladder connect to each other. ※ So the kidney and the urinary bladder are mutual internal and external relationship. The functions of the urinary bladder in storing and discharging urine the qi transformation of the kidney depend on kidney qi can’t control the urinary bladder urinary incontinence and enuresis

Chapter Four Qi, Blood and Body Fluids Qi Blood body fluids are the basic substances for life activities is the most active but invisible substance are visible, but must depend on the propelling action of qi to circulate in the whole body. flow constantly inside the body ③ all originate from the viscera ④ are the material base for the organs and meridians in carrying out their physiological activities ① ②

Qi ※ The Concept of Qi Qi is the most essential substance that makes up constituting the body and maintains the life activities of the body.

The Production of Qi ※ The production of qi originates from three aspects: ① the congenital essence-qi stored in the kidney coming from parents is the root of all qi of the body ② the essence-qi of water and grain nourish the whole body coming from food and drink transformed and transported by the spleen and stomach ③ the natural fresh air inhaled by the lungs Qi from the three sources combines together and forms qi of the body.

Qi ※ Therefore, the production of qi is related to the congenital essence-qi stored in the kidney, the acquired qi from the nourishment transformed and transported by the spleen, and the natural fresh air inhaled by the lungs. Especially the function of the spleen and stomach is the most important, because the body depends on the nourishment transformed and transported by the spleen and the stomach, and maintains the normal function.

Functions of Qi 1. Propelling function ① Qi is constantly flowing in the body. The propelling function of qi can stimulate and maintain the physiological functions of the viscera and other organs. ② Qi in different viscera and organs functions differently. Weakness of qi in promotion lead to hypofunction of the viscera and organs cause various deficiency problems

Qi 2. Warming function ※ Qi warms the body and is the source of heat energy in the body. It is very important in maintaining normal body temperature and ensuring the physiological functions of all the viscera and organs and tissues and meridians as well as normal circulation of blood and fluid. qi the function of warming the body fear of chill, cold limbs, temperature drop and slow circulation of blood and fluid

Qi 3. Defending function ※ Qi can protect the body, resisting the invasion of various pathogenic factors and preventing disease. ※ The defending action of qi mainly embodies protecting the body surface and defending attack of exopathic evils. ※ If the defending function of qi is wakened, it mainly leads to decline of body resistance and susceptibility of the body to invasion of pathogenic factors. ※ Therefore, the defending function of qi is related to onset and development and results of diseases.

Qi 4. controlling function ※ The controlling function of qi means qi can control liquid substances, such as blood, body fluid and sperm, to prevent them from losing. ※ Qi controlling blood means that qi keeps blood to flow inside the vessels and prevent it from flowing out of the vessels. ※ Qi holding sweat, urine, saliva and sperm means that qi controls secretion and excretion of these liquids so as to restrict the excretion and prevent loss.

Qi ※ Besides defecation and location of the viscera are under the influence of the controlling function of qi. If the controlling function of qi is weakened, it will lead to loss of blood, body fluid and sperm, also lead to protracted diarrhea, incontinence of urine and stool as well as the prolapse of the stomach, uterus, anus.

Qi 5. Transforming function ※ Qi-transformation means changes caused by the movements of qi. ※ The process of qi transformation is actually a process of substance metabolism and a process of substance and energy conversion. ※ Digestion and absorption of the food and drink, excretion of waste substances and water metabolism are related to qi- transformation. ※ If qi-transformation is weakened, the whole process of life will be in disorder or decline, leading to various diseases.

Movement of Qi ※ The moving types of qi can be divided into four kinds, namely ascending, descending, coming in and going out. liver-qi is ascending lung-qi is descending spleen-qi is ascending stomch-qi is descending coordinate maintain the normal functions of the body

Classification of Qi ※ Because qi of the body differs from the sources and parts, the functions of qi and the names of qi are different. There are the following major kinds of qi. 1.Primordial qi 2. Pectoral Qi 3.Nutritive Qi 4.Defensive Qi

1. Primordial qi (1)Formation and Distribution Formation: Primordial qi mainly comes from the parents during pregnancy, so the primordial qi is also called“the congenital qi”. Distribution: Primordial qi is stored in the kidney and distributed to all parts of the body through the triple energizer. (2) Major Function : to promote growth and development of the body and warm and impulse the functions of various tissues and organs.

2. Pectoral Qi (1)Formation and Distribution Formation: pectoral qi is formed by a combination of the fresh air inhaled by the lung and essential qi from food and drinks obtained by the spleen and stomach. Distribution: pectoral qi accumulates in the chest. pectoral qi infuses into the heart and the lungs and flows in the vessels and respiratory tract. (2) Major Function: ① to help respiration ② to promote blood circulation If the pectoral qi is insufficient, it will lead to palpitation, shortness of breath and weak voice, etc.

3. Nutritive Qi (1)Formation and Distribution Formation: Nutritive qi mainly originates from the refined part of the essential qi of food and water. It is formed in the chest. Distribution: distributes in the vessels as a component of blood, and flows through the vessels to nourish the whole body. (2) Major Function: The major function of nutritive qi includes nourishing the body and producing blood.

4. Defensive Qi (1)Formation and Distribution Formation: Defensive qi is transformed from the essential qi of food and drink obtained by the spleen and stomach. Distribution: it mainly circulates outside the vessels, between the skin and the muscles, and distributes to whole body, and spreads among the viscera. (2) Major Function: ① guarding the body surface and resisting invasion of the exopathic factors. ② warming the body. ③ controlling the opening and closing of the striae of the skin and regulating sweat secretion to maintain proper body temperature.

Blood 1.The concept of blood ※ Blood is a red liquid circulating within the vessels, being one of the basic substances constituting the body and maintaining its vital activities. 2. The production of Blood ※ Blood is mainly composed of nutritive qi and body fluids. Kidney-essence may transform into blood each other.

Blood 3. Function of Blood ※ Blood has the function of nourishing and moistening the whole body. Blood is also the major base of material for the spiritual activities of the body. 4. Circulation of Blood ※ Blood circulates endlessly within the vessels throughout the whole body. ※ Circulation of blood is closely related with the functions of heart, lungs, liver and spleen.

Blood ※ Of these, the functions of the heart, lungs and liver mainly make up the driving force; while the storing function of the liver and containing function of the spleen form a controlling force. It is the coordinative balance between these two forces that maintain the normal circulation of blood. If this balance is disorder, it may lead to bleeding that is due to hyper- driving function or hypo-controlling function, or might result in blood stasis due to hypo-driving function.

Body Fluids 1. The Concept of Body Fluids ※ Body fluid is a general term for all normal liquids 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 activities.

Body Fluids 2. Production, Distribution and Discharge of Body Fluids ※ These processes involve many viscera, and depend mainly on the function of the stomach, spleen, lungs, kidneys and san-jiao. ※ Body fluids are produced through the digestion and absorption of drink and food by the stomach, separation of the clear from the turbid by the small intestine, and then transportation of body fluids by the small intestine to the spleen. The spleen again transports the body fluids to the entire body and to the lungs.

Body Fluids ※ By dispersion, the lungs spread body fluids over the entire body to nourish and moisten, and a portion of the body fluids in the body surface is turned into sweat which is discharge out of the body. ※ Through its descending action, the lungs send body fluids down to the kidneys and the urinary bladder where metabolized fluids are changed into urine to be discharged. Additionally exhalation also discharges water. (This process is related to qi- transformation of kidney)

Body Fluids 3. Function of Body Fluids ※ Body fluids have the physiological functions of moistening and nourishing. For example, the fluid distributing onto the body surface moistens the skin and hairs; the fluid flowing into the orifices moistens and safeguards the eyes, mouth, and nose.

Qi, Blood and Body Fluids ※ They are the most fundamental substances constituting the body and maintain its vital activities. ※ They all rely on the essential substance from food and drink obtained by the spleen and stomach. ※ Physiologically, they are inter-dependent and interactive. ※ Pathologically, they also affect each other.

The Relationship Between Qi and Blood 1.Qi Produces Blood The component and production processes of blood qi and qi transformation depend on Body fluids and nutritive qi the major components of blood are Food and drinks are ingested and transformed into essential qi turned into nutritive qi and body fluids become blood

The Relationship Between Qi and Blood 2. Qi Circulates Blood ※ Blood belongs to yin and is characterized by stillness. Blood can not move itself and relies on the driving function of qi. As qi moves, blood follows. Qi deficiency or qi stagnancy may cause slow flow of blood, and qi deficiency failing to drive while qi stagnancy may cause blood stasis.

The Relationship Between Qi and Blood 3. Qi Controls Blood ※ Controlling blood is one function of qi. Blood circulating within the vessels and without extravasating out of them depends mainly upon the controlling function of qi.

The Relationship Between Qi and Blood 4. Blood, the Mother of Qi ※ This means blood is the carrier of qi, and provides qi with ample nourishment. Owing to its strong activity, qi is apt to escape and it must attach itself to blood or body fluids so as to exist within the body.

The Relationship Between Qi and Body Fluids 1. Qi produces Body Fluids ※ Body fluids come from ingested food and fluids, dependent on the transformation and transportation qi in the spleen and stomach.

The Relationship Between Qi and Body Fluids 2. Qi Circulates Body Fluids ※ The flow and distribution of body fluids rely on qi movement in ascent, descent, exit and entrance, such as, dispersion and descending of lung qi, sending up the clear substances of the spleen and sending down the turbid substances of the stomach qi, transformation action of the kidney qi.

The Relationship Between Qi and Body Fluids 3. The Relationship Between Body Fluids and Blood ※ Both blood and body fluids come from the essential substances of food and drink, from which they are produced. Thus, there is a saying that “fluid and blood share the same source.” Generally speaking, body fluids are the major component of blood while blood includes body fluids and nutritive qi.

Chapter Five Etiology and Pathology ※ TCM holds that the human body maintains a relative dynamic Balance among viscera and tissues, and between the body and its external environment. ※ In such a manner the body maintains normal physiological activities. ※ Whenever this dynamic balance is disharmonious due to some factors and cannot be recovered by self- regulation, illness will immediately ensue.

Chapter Five Etiology and Pathology ※ Factors that cause disharmony 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, an improper diet, overstrain and stress, traumatic injuries, and insect or animal bites. ※ The pathological mechanisms that pathogenic factors invade the body are many and varied, and the pathological mechanisms are complicated. Different diseases have their own pathological character.

Etiology ※ There are many factors that can cause diseases, including: 1. six exopathic factors 2. seven emotional factors 3. improper diet 4. overstrain and overeat

1. six exopathic factors ※ Six exopathic factors are a collective term used for six kinds of exogenous pathogenic factors including wind, cold, summer-heat, dampness, dryness and fire. ※ Under normal conditions, wind, cold, summer heat, dampness, dryness and fire are called "six climatic factors," being normal climatic changes in nature. As humans have developed certain adaptive powers in life, the six climatic factors do not normally cause disease.

1. six exopathic factors ※ Only when the climatic change is sharp or the resistance of the body becomes weak, the six climatic factors will become pathogenic factors, thus causing the body to be ill. The six climatic factors are then called six exopathic factors. Since six exopathic factors are abnormal, they are also referred to as the "six evils," and are causes of exogenous diseases.

Wind ※ Wind prevails in spring, but it may occur in any season. While invasion by wind evil may often occur in spring, it is not limited to spring. Wind evil mostly invades the body from the surface to cause exogenous diseases. In TCM it is thought that wind evil is a very important pathogenic factor in causing exogenous diseases.

Wind ※ The nature and pathogenic character of wind evil are as follows: (1) Wind is a yang evil, and is characterized by dispersing. Wind evil tends to move constantly, possessing a nature of dispersal, upward and outward movement, and thus belongs to yang. The dispersal means that when it invades the body, it tends to loosen the striae of the skin and muscles, and open the pores. Wind evil is apt to invade the upper portion of the body (head and face) and body surface, resulting in headache, sweating, and aversion to wind.

Wind (2)Wind is characterized with constant movement and rapid change. "Constant movement" implies that the diseases caused by wind evil possess the feature of migration. "Rapid change" denotes that disease caused by wind evil is characterized by sudden attack and quick transformation. For instance, the urticaria is changeable in location and rising one after another. The diseases caused mainly by wind evil are generally abrupt in onset and rapid changing.

Wind (3) Wind is characterized by sway This means that the symptoms and signs of a disease caused by wind evil have the character of constant moving, including tremor, convulsion, and vertigo.

Wind (4) Wind is the first and foremost factor in the cause of disease Wind, a leading exopathic factor, is the precursor of exogenous evils causing disease and other evils usually follow wind to invade the body. Wind evil often invades the body with other evils. For example, wind-cold, wind-heat, and wind-dampness may attack to the body exogenously.

Cold Cold is prevalent in winter exogenous cold endogenous cold from outside occur inside Although exogenous cold and endogenous cold are different, they are mutually related and influence each other. A patient with endogenous cold due to deficiency of yang is predisposed to an invasion of an exogenous cold evil; whereas exogenous cold evil invading and staying in the body for a long period of time is likely to damage yang-qi, and can lead to endogenous cold.

Cold (1) Cold is a yin evil, and apt to damage yang-qi The Nature and Pathogenic Character of Cold Evil cold attacks the surface of the body damage yang-qi in the superficies cannot warm and transform qi cold evil tends to damage yang-qi cold syndrome due to functional decline aversion to cold and anhidrosis cold attacks the internal of the body damage the visceral yang-qi different viscera, manifestation is different cold attacks the spleen and stomach damage the spleen yang-qi cold pain, vomiting and diarrhea

Cold (2) Cold tends to stagnate and obstruct Physiologically, Qi, blood and body fluid flow continuously inside the body because they are constantly warmed and propelled by yang-qi cold evil invades the body cause stagnation of qi, blood and body fluid various kinds of pain cold attacks the viscera the visceral qi and blood will be stagnated causing abdominal pain cold attacks the muscles and joints qi and blood in the muscles and joints will be stagnated pain in the muscles and joints

Cold (3) Cold tends to contract When cold evil invades the body it may restrain qi movement, shrink and tighten the muscles, tendons, vessels and meridians. cold evil attacks the body surface resulting in a depression of defensive yang chills, fever, and anhidrosis cold evil invades the blood vessel the flow of qi and blood will stagnate pain in the head and trunk cold evil invades the meridians and joints the meridians and tendons will tighten and contract spasm and pain of the limbs and joints and impaired movement

Summer-heat ※ Summer- heat prevails in summer, Summer- heat is a pure exogenous evil, and there is no such thing as endogenous summer heat. The nature and pathogenic character of summer- heat evil are as follows:

Summer-heat (1) Summer-heat is a yang evil characterized by burning heat. Summer heat is transformed from the fiery hotness of summer. As fiery hotness belongs to yang, summer heat is a yang evil. Invasion of the body by summer heat evil often results in high fever, fidgets and thirst, flushed face, and a surging pulse.

Summer-heat (2) Summer-heat is characterized by rising and dispersion, and apt to consume qi and body fluids. summer heat invades the body make the striae of the skin and the muscles open resulting in heavy sweating consumes body fluids a shortage of body fluids thirst, deep yellow and scanty urine qi escapes with release of body fluids resulting in qi deficiency shortness of breath, lassitude, sudden collapse

Summer-heat (3) Summer-heat often combines with dampness In summer, it is often rainy and is moist. Heat evaporates damp, increasing the level of humidity. Invasion of summer-heat, therefore, often combines with damp evil to attack the body. In addition to fidget and thirst, lassitude with a heavy sensation of the limbs, chest distress, nausea, vomiting, and sticky and loose stools usually appear.

Dampness exogenous damp endogenous damp from outside water-damp accumulates internally influence The nature and pathogenic character of damp evil are as follows:

Dampness (1) Dampness is a yin evil, apt to damage yang-qi and hinder the movement of qi. The nature of damp is similar to that of water, and thus it is a yin evil. Damp evilinvades the body damage yang qi the spleen yang can’t transport water and damp staying in the viscera and meridians Damp evil obstruction of qi movement and disharmony of qi in ascending and descending

Dampness (2) Dampness is heavy and turbid, and tends to sink downward. ※ Heaviness caused by damp evil usually has symptoms such as a heavy sensation in the head, general lassitude, aching and a heavy feeling in the limbs. ※ Turbidity means that diseases caused by damp evils are represented by filthy and foul discharges or secretions, such as pus, bloody stools, turbid urine, leukorrhea, eczema with filthy purulent fluid. ※ Sinking downward means the symptoms of diseases caused by damp evil mostly appear in the lower part of the body, leukorrhea, diarrhea, turbid urine.

Dampness (3) Dampness is sticky and stagnant. ※ These characteristics of dampness usually affect people in two ways. First, the disease caused by dampness is not brisk. For example, the secreta and excreta are too sticky to be excreted. Second, the disease caused by dampness is a long course, relapse repeatedly, and is lingering and difficult to cure. Such as Damp bi (arthralgia), eczema, and damp-warm disease are a few examples.

Dryness  Dryness is prevalent in autumn. Dryness invades the body mostly via the mouth and nose to attack the lung defense. There are differences between warm dryness and cool-dryness diseases.  In early autumn summer heat lingers, and dryness combines with warm-heat to invade the body, leading to a warm-dryness disease.  In late autumn, early winter cold appears, dryness and cold usually associate with each other to attack the body, and thus cool-dryness disease.  The nature and pathogenic character of dryness evil are as follows:

Dryness (1)Dryness is xerotic and unsmooth. ※ Exogenous dryness evils invading the body are most likely to consume body fluids, resulting in various dry symptoms and signs, such as dry mouth and nose, thirst, dry, rough and chapped skin, dry hair, scanty urine, and constipation. dryness evils exogenous dryness endogenous dryness

Dryness (2) Dryness tends to impair the lung.  The lung is a "delicate organ," easier to be invaded by wind, cold, dampness and dryness.  Dry evils invading the body via the mouth and nose is most likely to consume lung fluids, making the lungs fail in dispersing and descending with such symptoms as a dry cough with little sputum, or sticky sputum that is difficult to be coughed out, blood tinged sputum, asthma, and chest pain.

Fire  Heat (fire) is prevalent in summer. Fire and heat are both yang in nature. Though they are similar, yet there are still differences. Heat is the lesser stage of fire, and strong heat results in fire. Heat is mostly from the outside, such as wind-heat, summer heat, and damp-heat, while fire is usually generated from the inside, such as flaring up of the heat-fire, hyperactivity of liver-fire, and gallbladder-fire.

Fire  In addition, invasion of the body by wind, cold, summer heat, dampness, dryness, or emotional stimulation may all give rises to fire under certain conditions. It is thus said that the "five climatic factors generate fire" and "five emotional factors generate fire."  The nature and pathogenic character of fire evil are as follows:

Fire (1)Fire is a yang evil characterized by burning heat. ※ Yang is characterized by restlessness and an upward direction. Fire (heat) burns and leaps up, and thus fire is a yang evil. Therefore, invasion of the body by fire often leads to high fever, aversion to heat, fidgets, thirst, sweating, and a surging and rapid pulse.

Fire (2) Fire is tends to flaring up. ※ Diseases caused by fire evil mostly have symptoms in the upper part of the body, such as in the head and face. Fire evil invading the body often goes upward to disturb the heart spirit, marked by fidgets with insomnia, mania, and even coma and delirium. If heart-fire flares up, it will lead to a red tongue tip and mouth or tongue ulcers. If stomach fire is flourishing, it will cause toothache with swelling gums. If liver fire flares up, it will result in red eyes with swelling and pain.

Fire (3) Fire is likely to consume qi and fluids. ※ Fire evil invading the body is most likely to result in a loss of fluids and consumption of yin-fluids, thus symptoms of thirst with a desire for drink, dryness in the throat and tongue, deep yellow urine scanty in volume, and constipation appear. Fire evil consumes anti pathogenic-qi. So, diseases caused by fire evil may have the symptoms of shortness of breath, reluctance to talk, and general weakness.

Fire (4) Fire is apt to stir up wind and cause bleeding. ※ Fire evil invading the body often consumes yin-fluids, can’t nourish tendons and lead to an internal liver- wind, called "wind resulting from extreme heat," marked by high fever, coma, delirium, convulsive limbs, upward starting of the eyes, rigid neck, and opisthotonos. At the same time, fire evil may accelerate blood circulation, force blood to flow out of the vessels and lead to bleeding such as hematemesis, epistaxis, hemafecia, hematuria, ecchymosis, and uterine bleeding.

Fire (5) Fire tends to cause swelling and ulceration. ※ Invasion of a fire evil into the blood level may accumulate in a local area, weakening muscles and thinning blood. It will also result in carbuncles and abscesses marked by redness, swelling, hotness and pain, pyogenesis, and ulceration. ※ In addition, fire corresponds with the heart. The heart governs blood and vessels, and houses spirit. Fire may cause restlessness, fidgets, delirium, mania or coma syndromes of fire evil disturbing the heart.

2. The Seven Emotions ※ The seven emotions include joy, anger, melancholy, thinking, sorrow, fear and fright. Under normal conditions, the seven emotions do not cause diseases. Sudden, intense or prolonged emotional stimulation beyond the regulatory range of physiological activities of the body can cause disturbances of qi movement, disorders of yin- yang and the qi-blood of viscera thus giving rise to the onset of disease. As they are major pathogenic factors in causing endogenous diseases, they are also known as the "endogenous seven emotions."

Relations of the Seven Emotions to Qi-Blood and Viscera ※ TCM theory holds that emotional activity is closely related to the viscera, and functional activities of the viscera depend on the driving and warming functions of qi, and the nourishment of blood. A viscus is generally related with an emotion. the heart joy the kidney the liver the lung the spleen anger melancholy fear thought Different emotional changes have different impacts on the viscera, and changes in qi-blood and the viscera also influence emotional changes.

Pathogenic Character of the Seven Emotions ※ There are differences between the seven emotions and six exopathic factors in their pathogenicity. Six exopathic factors invade the body through the skin or mouth and nose. At the early stage, the disease is an exterior syndrome. An endogenous injury by the seven emotions however, directly affects the relative viscus, causing a disorder of qi movement in the viscus, a disturbance of qi-blood, and thus resulting in a variety of diseases.

Pathogenic Character of the Seven Emotions (1)Direct Injury of the Viscus  "rage hurts the liver," "over joy hurts the heart," "over thinking hurts the spleen," "over grief hurts the lungs" and "great fear hurts the kidneys".  over thinking and overstrain of mind often harm the heart and spleen, leading to a deficiency of both qi and blood in the heart and spleen. This condition is seen as a disorder of the heart spirit and failure of the spleen in transformation and transportation. Emotional depression and rage harm the liver.

Pathogenic Character of the Seven Emotions (2) Influence on Qi Movement of the Viscera  "Rage causes qi to go upward, over joy causes qi to relax, grief causes qi to be consumed, great fear causes qi to sink, great fright causes qi to become disordered, over thinking causes qi to be depressed”.  Over anger may cause liver qi to go adversely upward, blood following with it. Too much joy will make heart qi follow slowly. Great fear might be incontinence of urine and feces. Great fright causes qi to become disordered.

Pathogenic Character of the Seven Emotions (2) Influence on Qi Movement of the Viscera  Over thinking depresses qi. Over thinking and anxiety can harm both the spleen qi and the heart spirit. Over thinking may also cause the consumption of the heart-blood and result in a loss of nourishment for the heart spirit, manifesting with palpitation, amnesia, insomnia, and dreaminess. Over thinking may also lead to qi stagnation, causing the spleen to fail in transformation and transportation, and the stomach to fail in receiving and digestion. Thus loss of appetite, abdominal distention, and loose stool may occur.

Pathogenic Character of the Seven Emotions (3) Emotional upset may aggravate the patient's condition or rapidly exacerbate it. ★ For example, if a patient with a history of hypertension becomes enraged, liver yang will suddenly rise, and blood pressure will rapidly increase. This can result in dizziness, sudden coma, hemiplegia, and deviation of the eye and mouth. A patient with heart disease may be aggravated by emotional upset.

Dietary Factors, Overstrain and Over ease ＊ Proper diet, work and rest are indispensable to human life. However, diet should be moderate, with reasonable amounts of work and rest. Otherwise, they will negatively influence the physiological functions of the body, disordering qi movement, damaging anti- pathogenic qi, and hence disease will ensue.

Dietary Factors, Overstrain and Over ease 1. Improper diet Improper diet mainly damages the spleen and stomach, disorders the ascending and descending of qi, can lead to accumulation of dampness, production of phlegm, generation of heat, or other disorders. (1)Immoderate Diet (2)Unsanitary Diet (3)Dietary Bias Starvation overeating shortage of qi and blood harm the spleen and stomach Intake of dirty food may cause a variety of gastrointestinal diseases results in a deficiency of nutrients

Dietary Factors, Overstrain and Over ease 2. Improper Work and Leisure (1) Over-work includes three aspects: physical over strain, mental over-strain and sexual over-strain. Over-work consumes qi and blood Mental over-strain consumes heart blood and harms spleen qi Sexual over strain consumes kidney-essence (2) Over-ease cause stagnation of qi and blood

Phlegm, Stagnant Fluids, and Stagnant Blood ＊ Phlegm, stagnant fluids, and stagnant blood are the pathological outcome of the course of disease due to pathogenic factors. Once formed, they may directly or indirectly disturb viscera and tissues, resulting in new disorders. Hence they are also pathogenic factors.

1. Phlegm and Stagnant Fluids (1) Definition: Phlegm and stagnant fluids are the pathological result of a water metabolism disorder. Generally, phlegm is thick and turbid, and stagnant fluid is thin and clear. Phlegm visible phlegm invisible phlegm is coughed up stagnate in the viscera and tissues Stagnant fluid implies body fluid accumulation in a certain area of the body.

1. Phlegm and Stagnant Fluids (2) Formation of Phlegm and Stagnant Fluids  Phlegm and stagnant fluids form as body fluid stagnates in water metabolism disturbances due to dysfunctions of the lungs, spleen, kidneys and san- jiao in qi transformation.  After formation, stagnant fluids usually stay in the stomach, intestines, hypochondrium, chest, and subcutaneous areas. Phlegm follows the ascending and descending of qi into the viscera internally, and tendons, bones, skin and muscles externally, leading to a variety of disorders.

1. Phlegm and Stagnant Fluids (3) Character of Disorders Caused by Phlegm and Stagnant Fluids  The disorders have different manifestations clinically according to the location of the phlegm and stagnant fluids. When they block meridians, they may adversely influence the circulation of qi, blood and physiological functions of the meridians. When stagnating in the viscera, they may influence the functions of the viscera and the ascending-descending movement of qi.

1. Phlegm and Stagnant Fluids (3) Character of Disorders Caused by Phlegm and Stagnant Fluids  For example, phlegm staying in the lung may cause cough, asthma and expectoration; phlegm in the heart may cause chest distress and palpitation due to an unsmooth flow of heart blood; phlegm in the stomach may lead to a failure in the descending of stomach qi, marked by nausea, vomiting, epigastric distress and fullness; phlegm in the meridians, tendons and bones may cause numbness of the limbs, hemiplegia.

2. Stagnant Blood (1) Stagnant Blood Stagnant blood Extravasated blood staying in the body Blood flows sluggishly pathological outcome pathogenic factor qi deficiency (2) Formation of Stagnant Blood qi stagnation blood-cold blood-heat can’t propel circulation of blood make the vessels contract and spasm make blood concentrate various traumas qi deficiency blood circulation

2. Stagnant Blood (3) Character of Blood Stagnation ※ Disorders caused by blood stagnation is differentiated by their location and cause and clinically manifest differently. For example, stagnant blood in the heart may cause palpitation, chest distress and cardiodynia; stagnant blood in the lungs may cause chest pain and hemoptysis; stagnant blood in the stomach and intestines lead to hematemesis and melena; stagnant blood in the liver may cause hypochondriac pain and abdominal masses; stagnant blood in the uterus may cause menstrual disorders, dysmenorrhea, amenorrhea, deep colored menstrual flow with clots, metrorrhagia.

2. Stagnant Blood (3) Character of Blood Stagnation ※ Manifestations of Blood Stagnation: pricking pain; fixed pain; immobile abnormal masses; menstrual blood is often purplish with clots; a deep colored complexion; purplish lips and nails; a dark purplish tongue with petechiae; The pulse will be thready, unsmooth, deep and wiry.

Pathogenesis ※ Pathogenesis is the mechanism of onset, development and change of a disease. The onset, development and change of disease are related to the strength and physique of the patient and the nature of the pathogenic factors. Pathogenesis includes two aspects, the attack mechanism and basic pathogenesis.

1. Attack of Disease ※ Under normal conditions, qi, blood and yin-yang are in a harmonious balance and the viscera and meridians function well. This state is known as "balance of yin and yang". When the body is invaded by pathogenic factors, the physiological functions of the viscera and the meridians become disordered, and the harmonious balance of qi blood and yin yang break down, leading to an "imbalance of yin and yang" manifested by various clinical symptoms as well as the onset of a disease.

1. Attack of Disease (1)The onset of disease is related to anti-pathogenic-qi and pathogenic factors Anti-pathogenic qi, also known as "healthy energy," includes functional activities (including the functions of the viscera, meridians, qi and blood) and the resistance and recovery capacity of the body. Pathogenic factors generally include various factors causing disease and are known as "the evils." The onset and change is a reflection of the struggle between the healthy qi and evils qi in a certain condition.

(1)The onset of disease is related to anti- pathogenic-qi and pathogenic factors ① A deficiency of anti pathogenic-qi is the first step in the onset of a disease. anti pathogenic qi is vigorous qi and blood are abundant external defensive power is strong pathogenic factors cannot invade the body anti-pathogenic-qi becomes weak the defensive power declines resistance is not sound pathogenic factors invade the body, leading to disease

(1)The onset of disease is related to anti- pathogenic-qi and pathogenic factors ② The invasion of pathogenic factors play a significant role in the onset of a disease Sometimes pathogenic factors play an important role in the onset of a disease. For example, diseases are caused by pestilent factors or traumatic injury.

(2)anti-pathogenic-qi and pathogenic factors  The struggle between anti-pathogenic-qi and pathogenic factors not only involves the onset of a disease, but also governs the development and prognosis of the disease.  When anti-pathogenic-qi defeats pathogenic factors, no disease occurs in the process of the struggle between the healthy qi and the evil qi. As an example, in nature various pathogenic factors exist, but not everyone exposed to them becomes ill.  When pathogenic factors defeats anti-pathogenic-qi, disease occurs.

(2)anti-pathogenic-qi and pathogenic factors After the onset of a disease, different syndromes may appear because of differences in the strength between anti-pathogenic-qi and pathogenic factors, the quantity of the invading evil, and the depth or location of the pathogens. For example, pathogenic factors invade the lung and cause cough, asthma.

(3)Various Factors Influencing Anti-pathogenic-qi The major factors that influence anti-pathogenic qi are the constitution and psychological state of a patient. ① The Relation of the Constitution to Anti-pathogenic-qi A person with a strong constitution, fully functioning viscera, abundant essence, qi, blood, body fluids, is seen as having strong anti-pathogenic-qi. A person with a weak constitution has weakly functioning viscera, deficient essence, qi, blood, body fluids, is looked upon as having weak anti-pathogenic-qi. The constitution of an individual is related to heredity, nutrition, and physical training. Strong genetic factor reasonable diet and usual physical exercise help form strong constitution and enhance anti-pathogenic qi.

(3)Various Factors Influencing Anti-pathogenic-qi ② The Relation of the Psychological State to Anti pathogenic-qi The psychological state of an individual is directly influenced by emotional factors. A relaxed mind and happy feeling contribute to smooth movement of qi, harmony of qi and blood, and cooperative functions of the viscera, thus, the anti-pathogenic qi will be vigorous. Conversely, an uneasy mind and depressed feeling may cause disturbances of qi movement, imbalances of yin yang and qi blood, and dysfunctions of the viscera, hence, weak anti-pathogenic-qi.

(3)Various Factors Influencing Anti-pathogenic-qi A strong constitution and happy mood contribute to sound anti-pathogenic-qi with strong resistance, in which case pathogenic factors won't be able to invade the body. Or if they are able to invade the body, they are easily driven out and disease would not develop. If the constitution is weak and the mood is unhappy, the anti pathogenic-qi will be deficient, resistance weak, and thus the body will be easily invaded by the pathogenic factors to cause disease.

Basic Pathogenesis  Pathology means the mechanism of onset, development and change of disease. The onset, development and change of disease are related to the strength of constitution of the patient and the nature of pathogenic factors. When a pathogenic factor invades the body, anti-pathogenic-qi fights against the evil and leads to imbalance of yin and yang, disorders the ascending and descending qi movements  Pathological processes generally fall under the struggle between the healthy energy and the evil, imbalances of yin and yang, or disorders in the ascending and descending of qi.

Basic Pathogenesis (1) The struggle between the healthy energy and the evil This kind of struggle not only concerns the onset of disease, but also governs the development and conversion of disease. Meanwhile, it also directly influences the deficient and excessive changes of a syndrome. In fact, the course of many diseases is the outcome of the struggle between the healthy energy and the evil.

Basic Pathogenesis (1) The struggle between the healthy energy and the evil ① the deficient and the excessive In their struggle, both the healthy qi and the evil qi display signs of growth and decline. In general, as the healthy qi grows the evil qi declines, and as the evil qi grows the healthy qi declines. Following the outcome of the growth and decline of the healthy qi and the evil qi, the patient will present with pathologies and syndromes of deficiency and excess.

(1) The struggle between the healthy energy and the evil ① the deficient and the excessive Excessive in this case means that the pathogenic factors are excessive. It is a pathological reflection indicating that excessive pathogenic factors are the principal aspect in the struggle of health and disease. When pathogenic factors are excessive, the anti-pathogenic-qi is in a state of decline but yet strong enough to fight against the pathogenic factors, thus the struggle between the healthy qi and the evil qi is acute. Clinically this condition is looked upon as an excess syndrome.

(1) The struggle between the healthy energy and the evil Excessive is often seen in the early or middle stages of exogenous diseases, and in disorders caused by stagnation of phlegm, food, blood or water. For example, such clinical symptoms as high fever, mania, speaking lustily, coarse breathing, abdominal pain aggravated by pressure, retention of urine and stool, and a forceful pulse all come under the category of excess syndromes.

(1) The struggle between the healthy energy and the evil ① the deficient and the excessive A deficiency implies that the anti-pathogenic-qi is deficient. This condition is a pathological reflection of deficient anti-pathogenic qi and is the principal aspect in such a syndrome. When pathogenic-qi is deficient and fails to fight against pathogenic factors, the pathological reaction lacks intensity, and clinically one might see a series of hypoactive and weak syndromes.

(1) The struggle between the healthy energy and the evil ① the deficient and the excessive Deficient syndromes usually occur in patients with a weak physique, in the late stage of a disease, or in chronic disease. Consumption of essential qi due to a serious or protracted disease, consumption of qi, blood, body fluids, or the yin-yang of the body due to hyper-hidrosis, profuse vomiting or diarrhea, may cause a deficiency of anti-pathogenic-qi with hypofunction, manifesting as listlessness, lassitute, palpitation, shortness of breath, spontaneous or night sweating.

(1) The struggle between the healthy energy and the evil ② The conversion of disease According to the outcome of the struggle between the healthy qi and the evil qi, the conversion of disease is estimated. In the course of a disease, if the healthy qi is sufficient and resistance is strong, the disease gradually turns better; while if the evil qi is abundant and resistance declines, the disease gradually turns worse.

(2) Imbalance of Yin-yang When various pathogenic factors act on the body such as the six exopathic factors, seven emotions, improper diet, and overstrain, they can lead to an imbalance of yin and yang in the body causing disease, the imbalance of yin and yang is again the foundation in the onset and development of disease. An imbalance of yin and yang includes excess of yin or yang, deficiency of yin or yang, mutual affecting of yin and yang and depletion of yin or yang.

(2) Imbalance of Yin-yang ① Excess of yin or yang yang-evil invading the body may cause excess of yang and yin evil invading the body may cause excess of yin. Excess of yin is a pathological state that results in a course of a disease with hypoactive functions and an accumulation of pathological products metabolized. Excess of yin will cause cold syndrome manifesting a cold body and limbs, a pale tongue, abdominal pain with a cold feeling aggravated by pressure, and loose stools. Excess of yin will consume yang and cause deficient yang.

An excess of either yin or yang yin yang Abnormal An excess of Yang yin yang Normal Yang evil yin yang Normal Yin evil yin yang Abnormal An excess of Yin cold syndrome heat syndrome

(2) Imbalance of Yin-yang ② Deficiency of yin or yang Deficiency of yang leads to a cold syndrome (deficient cold), deficiency of yin leads to a heat syndrome (deficient heat). Deficiency of yang can’t restrain yin and cause relative excess of yin manifesting a deficient-cold syndrome with an aversion to cold, cold limbs, restlessness, lying curled up, abdominal pain relieved by warmth and pressure, loose stools, clear and profuse urine, and a slow and weak pulse.

(2) Imbalance of Yin-yang ② Deficiency of yin or yang Deficiency of yin can’t restrain yang and cause relative excess of yang manifesting a deficient-heat syndrome with a feverish feeling in the five centers, tidal fever as if spreading out from steaming bones, a flushed face, emaciation, night sweating, a dry throat and mouth, a red tongue with little coating, and a thready, rapid weak pulse.

A deficiency of either yin or yang yin yang Abnormal A deficiency of Yang yin yang Normal yin yang Normal yin yang Abnormal A deficiency of Yin a deficient-cold syndrome a deficient-heat syndrome

(2) Imbalance of Yin-yang ③ The mutual affecting of yin and yang The mutual affecting of yin and yang means that a deficiency of yin or yang can affect each other, resulting in a pathological state of deficiency of both yin and yang. The deficiency of yin affecting yang implies that because of a shortage of yin fluids, the illness involves yang-qi, leading to a pathological state of deficiency of both yin and yang, but with more yin deficiency.

(2) Imbalance of Yin-yang ③ The mutual affecting of yin and yang For instance, in deficiency of kidney-yin, there is dizziness and vertigo, and soreness and weakness in the lower back and knees. Once the production of kidney yang is affected, it may lead to kidney-yang deficient symptoms such as impotence or cold limbs. The illness might then turn into a deficiency of both yin and yang due to yin affecting yang.

(2) Imbalance of Yin-yang ③ The mutual affecting of yin and yang The deficiency of yang affecting yin implies that because of a shortage of yang qi, the illness involves yin fluid, leading to a pathological state of deficiency of both yin and yang, but with more yang qi. For instance, edema due to yang deficiency will affect production of yin-fluid, and manifest yin deficiency symptoms such as emaciation, restlessness, or chronic convulsion.

(2) Imbalance of Yin-yang ④ Depletion of Yin or Yang  Depletion of yin or yang is a pathological state of critical illness caused by a sudden massive loss of yin- fluids or yang-qi of the body.  Depletion of yang is a pathological state of the sudden collapse of bodily functions caused by a sudden exhaustion of yang-qi.  Depletion of yin is a pathological state of collapse of the functions of the entire body caused by a sudden and massive loss or consumption of yin-fluids.

(3) Disorders of Ascending and Descending Qi  Disorder in the ascending and descending of qi is generally a pathological state reflecting a disturbance of visceral qi in ascent, descent, exit and entrance, along with disorders of yin-yang and qi-blood. Since qi movements in ascent, descent, exit and entrance concerns various aspects of the viscera, meridians, qi- blood and yin yang, disorders in ascending, descending, exiting and entering may lead to dysfunctions of various tissues and organs such as the viscera, limbs, sense organs, and orifices.

Chapter Six Diagnostic Methods  Traditional Chinese diagnostic methods includes two parts: diagnosis and differentiation of syndromes.  Diagnosis is a way to identify the manifestations and nature of a disease by the unique diagnostic methods adopted in traditional Chinese medicine;  Differentiation of syndromes is process in which the characteristics of a disease and syndrome are decided through interpretation and summing up of the phenomena collected from the four basic methods of diagnosis.

Chapter Six Diagnostic Methods  The four diagnostic methods: Inspection, auscultation and olfaction, inquiry and pulse-feeling and palpation.  Inspection: it includes inspection of the physique, facial expression, color of the complexion and physical condition and behavior.  Auscultation 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.

Chapter Six Diagnostic Methods  Inquire: It is a way to interview the patient, his or her family to determine the patient’s health state, major complaints, progress and duration of an illness.  Pulse-feeling and palpation: Pulse-feeling is an approach by which a physician understands the condition of a disease, meridians and collaterals, qi and blood and the relative strength of pathogenic qi. Palpation means to examine various parts of the body touching to find out abnormal conditions.

Inspection  Inspection is a diagnostic method, by which a physician visually inspects a patient's abnormal changes of his expression, color of complexion, physique, behavior and excretions to collect information related to the disease and infer the pathological changes of the internal organs.

Inspection  We may know the condition of someone's internal organs and the place in which the disease occurs by observing the external manifestations (Why?)  The exterior of the body is closely related to the internal organs and tissues through meridian, and disturbance in yin and yang, qi and blood of the zang-fu organs must reflect on the exterior of the body. That is why observation of the abnormal manifestations helps diagnosis.

Inspection 1.Observation of the Mental Faculty Mental Faculty a broad definition a narrow definition it refers to life mental activity or spirit Observation of the mental faculty helps to identify the condition of qi, the case and its prognosis. sound health and vigorous spirit abundance of qi weak body build and lack of vitalitydeclining of qi

Inspection  Focal Points in Observation of the Mental Faculty Mental faculty is reflected in spirit, consciousness, language, breathing, patterns of movement and reaction, but most important in observing a person's mental faculty are the eyes, for eyes are dominated by mentality and their function is closely related to abundance or deficiency of qi and essence of the five zang and six fu organs

Inspection Content of Observation of the Mental Faculty It includes the following five aspects: vigorous spirit, lack of vitality, loss of vitality, pseudo vitality and mental disturbance. Vigorous spirit: Signs of vigorous spirit are attentiveness, a sparkling in the eyes, lustrous face, full consciousness, natural expression and posture, clear utterance, easy breath, fine-looking flesh and sharp response, known as" possession of vitality", implying a mild case without serious damage of qi and injury to functions of the zang fu organs. If it is a serious case, favorable prognosis is expected.

Inspection Lack of vitality: Lack of vitality may be inferred when a patient appears spiritless with dull eyes, slow movements, shortness of breath and feeble voice, weariness and sleepiness, implying deficiency in the heart and spleen, or insufficient kidney yang, attributed to a deficiency syndrome. Loss of vitality: In the course of a disease a patient shows a dull look in the eyes, luster less complexion, apathetic expression, lassitude, sluggish response, coma, delirium, sudden loss of consciousness, and urinary and fecal incontinence, implying exhaustion of essence and qi. It indicates a serious case with poor prognosis.

Inspection 2. Tongue Inspection Tongue inspection is also known as tongue diagnosis, an important component part of observation. Traditional Chinese medicine places much emphasis on the inspection of the tongue as a method of diagnosis. (1) The relationship between Tongue and Zang-fu Organs The tip the heart the middle the spleen and stomach the root the kidney the edges the liver and gallbladder

(2) How to Inspect the Tongue Inspection of the tongue observation of the tongue body observation of the tongue coating pattern surface condition color shape the color of the tongue coating the quality of the tongue coating

(2) How to Inspect the Tongue normal healthy tongue: a “slight" red tongue with thin white coating" Abnormal tongue abnormal tongue body abnormal tongue coating ① Observation of tongue body a. Surface condition: lustrous tongue lusterless tongue lustrous tongue : It means the tongue is moist, red and lustrous, suggesting normal condition or mild case.

(2) How to Inspect the Tongue ① Observation of tongue body lusterless tongue : It means the tongue is wizened, suggesting abnormal condition and a severe case. b. Color: Pale, reddened, crimson red and purple. Pale tongue: A pale tongue indicates syndromes of deficiency and cold caused by insufficient yang-qi and blood, usually seen in diseases due to deficiency of yang and blood.

(2) How to Inspect the Tongue ① Observation of tongue body Reddened tongue: A reddened tongue indicates a heat syndrome, usually seen in the syndrome of interior heat, or endogenous heat due to yin deficiency. Crimson: A deep red tongue is a sign of severe endogenous heat. It is also a sign of exogenous heat invading the ying and blood systems, usually found at the advanced stage of febrile diseases, or in protracted and critical cases, suggesting hyperactivity of fire due to deficiency of yin.

(2) How to Inspect the Tongue ① Observation of tongue body Purple: A purple tongue is seen in either cold or heat syndromes. A purple tongue with deep red coloration indicates inadequate fluid; it suggests that excessive heat has led to consumption of yin and fluid, and stagnation of qi and blood. A pale purple or moist blue-purple tongue indicates a blockage of vessels due to preponderant endogenous cold. Purple spots on the tongue also suggest stagnation of blood.

(2) How to Inspect the Tongue ① Observation of tongue body c. Shape: Enlarged tongue, thin tongue, cracked tongue, tongue with teeth imprints and thorn tongue. An enlarged tongue: It is larger than the normal, divided into two kinds. The first is the flabby tongue pale in color, indicating insufficiency of spleen-yang and failure in the transformation of body fluids and retention of phlegm and dampness. A swollen, crimson tongue indicates excessive heat in the heart and spleen. A swollen, dark blue purple tongue usually indicates poisoning.

(2) How to Inspect the Tongue ① Observation of tongue body A thin tongue: It is small and shrunken, indicating consumption of yin and blood. A thin and pale tongue is attributable to deficiency of qi and blood. A thin, deep red and dry tongue indicates hyperactivity of fire due to deficiency of yin and consumption of fluid. A cracked tongue: It has crack of different depth on its surface, indicating consumption of yin and fluid. A cracked, deep red tongue indicates injury to body fluids due to excessive heat. A pale cracked tongue found in a healthy person does not have any clinical significance.

(2) How to Inspect the Tongue ① Observation of tongue body A tongue with teeth imprints: It is a tongue with teeth imprints along its outer edge as a result of the pressure of dental coronae on the puffy tongue. This is why teeth imprints are seen in flabby tongues, indicating deficiency of spleen-qi. A pale, moist tongue with teeth imprints is due to hypofunction of the spleen and excess of cold-dampness.

(2) How to Inspect the Tongue ① Observation of tongue body d. Observation of the Tongue pattern: Rigid, flaccid, trembling, wagging, deviated and shortened. A rigid tongue: It is a stiff tongue body, unable to move freely, caused by heat, accumulation of phlegm or disorder of body fluids in cases of high fever and excess of heat, usually found in exogenous affection of heat. It is also a sign of impending apoplexy found in various diseases.

(2) How to Inspect the Tongue ① Observation of tongue body A flaccid tongue: It is a weak tongue, unable to protrude and curl or move freely, often attributable to severe consumption of qi and blood and yin fluid, resulting in failure of the tongue muscles and vessels to be nourished. A pale and flaccid tongue in protracted diseases is a sign of deficiency of qi and blood. A crimson, flaccid tongue suggests extreme depletion of yin. In a recent illness, a dry, red and flaccid tongue is due to impairment of yin by heat.

(2) How to Inspect the Tongue ① Observation of tongue body A trembling tongue: It is a tongue trembling continuously and involuntarily. In a protracted illness, a trembling tongue indicates deficiency of qi and blood or hypofunction of yang-qi. But in exogenous affection of heat, it is attributable to production of wind caused by extreme heat, or stirring-up of endogenous wind due to deficiency of liver-yin.

(2) How to Inspect the Tongue ① Observation of tongue body A wagging tongue: It is a tendency to stick out the tongue or to play with it, suggesting heat in the heart and spleen. Protrusion of the tongue is seen in cases of the heart attacked by pestilential heat or depletion of qi. Playing with the tongue is a sign of the wind syndrome or poor mental development in children.

(2) How to Inspect the Tongue ① Observation of tongue body A deviated tongue: It is a tongue turning to one side, a sign of apoplexy or a precursor of apoplexy. A shortened tongue: It is a shortened, contracted tongue, indicating a critical disease. A pale, blue, moist and shortened tongue is due to excessive cold; a puffy and shortened tongue is due to accumulation of phlegm-dampness; a crimson dry and shortened tongue is due to impairment of fluid.

(2) How to Inspect the Tongue ② Observation of the Tongue Coating Tongue coating is produced by the upward steaming of stomach-qi. The tongue coating of a healthy person is thin and whitish, moderately moist and neither smooth nor dry, indicating normal stomach-qi. On the other hand, a morbid tongue coating is created by upward steaming of stomach-qi together with evil qi. The condition of the tongue coating tells us the condition of the zang-fu organs. In this way, observation of the tongue coating assists diagnosis..

(2) How to Inspect the Tongue ② Observation of the Tongue Coating Inspection of the tongue coating consists of observing its color and texture. a.Observation of the color of the tongue coating. There are four colors: white, yellow, grey and black. A white tongue coating: It is usually seen in an exogenous syndrome and a cold syndrome. A yellow tongue coating: It indicates heat and interior syndromes. Created by excessive heat, it indicates a heat syndrome.

(2) How to Inspect the Tongue ② Observation of the Tongue Coating A grey tongue coating: It indicates an interior syndrome, either of interior heat or cold-dampness. A moist, grey coating indicates accumulation of cold- dampness or retention of phlegm and fluid while a dry grey coating indicates impairment of body fluids due to abundant heat, or excess of fire due to deficiency of yin.

(2) How to Inspect the Tongue ② Observation of the Tongue Coating A black tongue coating: It indicates an interior syndrome either of extreme heat or abundant cold. A black coating usually develops out of a grey or brown coating, often seen in critical cases. A black, dry, cracked or thorny coating is a sign of extreme heat and exhaustion of body fluids. A black moist coating indicates deficiency of yang and excess of cold.

(2) How to Inspect the Tongue ② Observation of the Tongue Coating b. Observation of the quality of the tongue coating: The quality of the tongue coating includes a thin or thick coating, a moist or dry coating, a sticky and like curd coating, a peeled coating, a firm or loose coating.

(2) How to Inspect the Tongue ② Observation of the Tongue Coating A thin or thick coating: A thin coating refers to a thin layer of fur through which the tongue body is faintly visible. A thick coating, however, refers to a thick layer of fur through which the tongue body is invisible. In general speaking, a red tongue with thin coating belongs to deficiency of yin; thick coating is caused by stagnation of phlegm and dampness or food.

(2) How to Inspect the Tongue ② Observation of the Tongue Coating A moist or dry coating: A moist coating is a normal one, indicating plenty of body fluids; A glossy coating, feeling wet, is created by excessive dampness, indicating retention of fluids. A dry coating is caused by deficiency of body fluids. An excess of heat or consumption of yin fluid can be attributable to deficiency of body fluids. If a dry coating turns moist, pathogenic heat has decreased and the fluid has been replenished. If a moist coating turns dry, body fluids have been impaired usually by excessive beat.

(2) How to Inspect the Tongue ② Observation of the Tongue Coating A sticky and curd like bean coating: A sticky coating is a layer of turbid, slimy, compact and little grain like fur on the tongue, difficult to be scraped off. It is caused by dampness. A curd-like coating is a thick, soft, flabby coating that resemble the crushed bean curd. It is easy to be scraped off, usually formed by upward steaming of turbid, stale qi from the stomach due to excessive heat. It is common in cases of dyspepsia or retention of phlegm.

(2) How to Inspect the Tongue ② Observation of the Tongue Coating A peeled coating: If the coating of a tongue is suddenly peeled, even comes out bare, glossy surface, known as the " tongue like mirror ", it indicates depletion of stomach-yin and complete exhaustion of stomach-qi. If the coating is partially peeled, and the peeled parts look bare and smooth, it is called " tongue like map ", indicating impairment of stomach qi and yin. A peeled coating associated with sticky coating indicates unsolved phlegm and damage of the anti-pathogenic- qi. It is a complicated case.

(2) How to Inspect the Tongue ② Observation of the Tongue Coating A firm or loose coating: If a coating closely adheres to the tongue surface, difficult to be scraped off and it seems a part of the tongue, it is a firm coating. If a coating does not closely adhere to the tongue surface, and looks like a paint on the tongue, easy to be scraped off, it is a loose coating. In general, a firm coating indicates an excess syndrome, a heat syndrome and strong stomach-qi, whereas a loose coating indicates a deficiency syndrome, cold syndrome and weakened stomach-qi.

(3) The Tongue body and Tongue Coating In general, there is a unified change of the tongue body and tongue coating. For example, interior heat in an excessive condition is manifested as a dry reddened tongue with yellow coating and a cold and deficiency syndrome is marked by a pale and white coating. Sometimes the change of the tongue body is not united with the shift of the tongue coating. For instance, a crimson tongue usually indicates a heat syndrome, while a white coating is seen in a cold syndrome. But sometimes, crimson tongue and white coating are found simultaneously. it indicates excess of fire due to deficiency of yin, together with retention of phlegm and food.

(4) Clinical Significance of Tongue Inspection It has been proved by clinical practice that the change of the tongue condition may relatively and objectively reflect the prosperity and decline of qi and blood, the nature of pathogenic factors, location of a disease, its alleviation or deterioration and prognosis. Under certain conditions, it serves as the chief basis in differentiation of syndromes.

(5) Methods of Tongue Diagnosis and Precautions On inspection of the tongue stress is laid on light, the posture to protrude the tongue and the stained tongue coating. Light: On inspection of the tongue, sufficient natural light is needed, and it is better to have the light directly shining the mouth. At night it is not easy to make an accurate diagnosis by inspection of the tongue and a recheck seems necessary in daytime.

(5) Methods of Tongue Diagnosis and Precautions The Posture to Protrude the Tongue: It is requested that the tongue should stick out naturally to expose the tongue body sufficiently, the tip of the tongue slightly goes down ward and its surface keeps flat. It should not be rolled up or struck out too much to affect its color. Stained tongue coating: The tongue coating may be discolored by food or drugs taken, e. g. black plum or olive may turn the coating into black; cigarette smoking may turn the coating into grey.

3. Observation of Excretions of the Body Excretions of the human body include sputum, vomitus, feces and urine ① Sputum and Morbid Fluid white, dilute sputum wind and cold syndrome Profuse white sputum easy to expectorate dampness thick, sticky and yellow sputum heat syndrome Scanty yellow sputum difficult to expectorate or bloody sputum dryness or fire

3. Observation of Excretions of the Body ② Vomitus The color, amount and shape of vomitus coming from the stomach must be noticed, e.g Thick, foul vomitus suggests heat in the stomach or indigestion, while no foul vomitus implies cold in the stomach. ③ Feces Constipation is caused by fire/heat/deficiency of yin Chronic diarrhea or loose stool is caused by deficiency of spleen and abundant of dampness.

3. Observation of Excretions of the Body ④ Urine Clear profuse urine a cold syndrome scanty dark brown urine or hematuria a heat syndrome

Ausculation and Olfaction Ausculation includes giving attention in hearing of a patient's voice, speaking, respiration, coughing, vomiting, hiccup, belching, sighing, sneezing and bowel sound. Olfaction means to us the nose to tell various odors of the body, secretions, excretions and wards. 1.Listening to the Sound of Voice Abnormal changes of sound of voice are related to the condition of lung qi. Speech:

Ausculation and Olfaction 1.Listening to the Sound of Voice Dysphasia: due to a stiff tongue and blockage of meridians by wind-phlegm. Sound of Breathing: Loud, coarse breathing indicates an excess syndrome due to exogenous pathogenic factors, while faint breathing indicates a deficiency syndrome due to impairment of qi.

Ausculation and Olfaction 2. Smelling the Odor The Odor from the Mouth: A foul breath is a sign of indigestion or decayed teeth or a filthy mouth. An acid foul breath indicates indigestion; a foul breath indicates heat in the stomach. A fetid breath indicates the internal ulcer or abscess. The Smell of Sweat: Sweating with a smell of fish and mutton suggests accumulation of damp-heat in the skin and steaming of body fluids. The Odor from the Nose: A foul odor from the nose associated with a continual running nose and pus like discharge is usually indicative of sinusitis.

Inquiry Asking includes making inquiries of a patient about his entire condition, main complaints, case history and the present problem. ※ Asking about the General Condition ※ Asking about the Chief Complaints ※ Asking about the History of Present Illness ※ Asking about the Present Symptoms

Inquiry 4. Asking about the Present Symptoms The topics of "The Ten Questions" are as follows: "1. Chill, fever and a feverish sensation; 2. perspiration; 3. pain; 4. defecation and urination; 5. state of diet and sense of taste; 6. chest; 7. hearing; 8. thirsty; 9. previous illnesses; 10. disease cause and herbal medicines taken; menstruation, menstrual cycle, amenorrhea and uterine, bleeding in women patients and small pox and measles in children".

Inquiry (1) Asking about Chills and a Feverish Sensation A patient is firstly asked whether he has chills, fever or a feverish sensation. Chills and Fever If chills and fever are found at the initial stage of a disease, it is an affliction with exogenous pathogenic factors, extreme chills and mild fever slight chills and high fever wind-cold syndrome wind-heat syndrome

Inquiry (1)Asking about Chills and a Feverish Sensation Chills without Fever or a Heat Sensation a sign of the deficiency-yang and cold syndrome Fever without Chills High fever: no sweating cold syndrome; profuse sweating and thirst heat syndrome Tidal fever: It is usually in the afternoon. Tidal fever due to deficiency of yin: It marked by a feverish sensation in palms, soles and the heart region, night sweats, flushed cheeks, dryness of the mouth and throat, and a reddened tongue and less saliva.

Inquiry (1)Asking about Chills and a Feverish Sensation Tidal fever due to damp-heat: The skin is not felt hot at a stroke, but if you keep your hand on the skin, a burning sensation is felt. It is often accompanied by stuffiness in the chest, nausea, sluggishness of the head and body, loose stools and a sticky tongue coating. Tidal fever due to stomach problems: It is caused by accumulation of dryness-heat in the stomach and intestines. The accompanied symptoms are abdominal distension, aggravated by pressure, dry stools, palm and sole sweating, a yellow and dry tongue coating or even a thorny tongue.

Inquiry (1)Asking about Chills and a Feverish Sensation Prolonged low fever: It refers to a long-term low fever (in general not over 38 ℃ ) or a subjective feverish sensation without presence of a higher body temperature. A prolonged low fever is often associated with poor appetite, fatigue, shortness of breath and dislike to speak, a pale tongue and a weak pulse. It is caused by deficiency of spleen-qi or deficiency of yin.

Inquiry (1)Asking about Chills and a Feverish Sensation Alternate spells of chills and fever: Alternate spells of chills and fever at irregular intervals are often accompanied by a bitter taste in the month, a dry throat, dizziness, stuffiness in the chest and hypochondriac region, loss of appetite and a wiry pulse, manifestations of the liver and gallbladder disease.

Inquiry (2) Asking about Perspiration The purpose of asking about perspiration is to determine whether sweating is occurring, when and where it is occurring, how much it is occurring and its accompanied symptoms. A detailed description is as follows: Perspiration in an Exterior Syndrome: absence of sweating with fever, headache, indicates cold syndrome; sweating with a fever indicates heat syndrome.

Inquiry (2) Asking about Perspiration Perspiration in an Interior Syndrome: Spontaneous sweating: It refers to breaking out in a sweat during the day, intensified when active. It is a syndrome of yang deficiency, usually accompanied by lassitude, fatigue, shortness of breath, aversion to cold-manifestations of yang deficiency. Night sweats: It refers to sweating during sleep and ceasing of sweating while one awakes. It is a syndrome of yin deficiency, usually accompanied by a feverish sensation in palms, soles and the heart region, insomnia, flushed cheeks, dryness in the mouth and throat.

Inquiry Local Perspiration: Sweating on the head: It implies that much sweating over the head is usually caused by pathogenic heat in the upper-jiao or by steaming of accumulated damp-heat in the middle-jiao, or by upward floating of yang in a deficiency condition. Perspiration on one side of the body: It may occur on either side or on either the upper or lower of the body due to blockage of meridians by wind phlegm or wind dampness, or disturbance in qi and blood.

Inquiry (3) Asking about Pain Questions about pain focus on its onset, quality and duration. Site of pain Headache: Headache due to exposure to wind, cold, summer heat, dampness; fire or to phlegm, blood stasis is an excess syndrome, whereas that due to consumption of qi, blood, essence and body fluids, which fails to nourish the head is a deficiency syndrome. If a sudden onset of continuous headache involving the neck, it is an exogenous syndrome. Long- term intermittent headache accompanied by dizziness is an interior syndrome.

Inquiry (3) Asking about Pain Chest pain: Since the chest is the place where the heart and lung are located, a chest pain may result from impeded qi flow in this area due to insufficient yang- qi, cold, blood stasis, phlegm obstruction or injury to vessels due to fire heat. Hypochondriac pain: Since the Liver and Gallbladder Meridians run past the hypochondriac region, a hypochondriac pain indicates impeded flow of liver qi, damp heat in the liver and gallbladder or stagnation of qi and blood, and retention of fluid in the hypochondriac region.

Inquiry (3) Asking about Pain Epigastric pain: A pain in the stomach is often due to invasion of it by pathogenic cold, retention of undigested food in the stomach or a disturbance in the stomach caused by stagnation of liver qi. Abdominal pain: A dull abdominal pain, alleviated by warmth and pressure, associated with loose stools indicates deficiency of spleen qi and cold. A sharp abdominal pain, alleviated by warmth and aggravated by pressure with diarrhea is a cold syndrome ; alleviated by cold and aggravated by pressure with constipation is a heat syndrome.

Inquiry (3) Asking about Pain Low back pain: The kidney is housed in the low back and a low back pain often indicates pathological changes of the kidney. When it is caused by obstruction of meridians and collaterals by wind, cold and dampness or blood stasis, it is an excess syndrome, whereas when it is produced by insufficient kidney essence or deficiency of kidney- yin and kidney-yang and failure of the kidney to be warmed and nourished by them, it is a deficiency syndrome.

Inquiry (3) Asking about Pain Pain of limbs: A pain of limbs, joints, muscles or meridians is usually caused by an attack by wind, cold and dampness, impeding smooth flow of qi and blood, or by hypofunction of the spleen and stomach and failure of the limbs to be nourished by food essence. A heel pain, involving the low back in severe cases, indicates deficiency in the kidney.

Inquiry (3) Asking about Pain Quality of Pain Distending pain: It may be found in various parts of the body, especially in the chest and abdomen. A distending pain is caused by stagnation of qi, and a distending pain in the head, however, tends to be seen in hyperfunction of liver-yang or upward flaming of liver-fire. Pain with a heavy sensation: It is often found in the head, limbs and low back caused by stagnation of qi and blood due to dampness. Dampness in nature is weighty, turbid and sticky, so a feeling of heaviness appears.

Inquiry (3) Asking about Pain Quality of Pain Pricking pain: It is a sign of blood stasis, frequently seen on both sides of the abdomen, in the lower abdomen and chest. Burning pain: A burning pain is relieved by exposure to cold and often found in the hypochondriac region and stomach due to pathogenic fire, deficiency of yin. Pain with a cold sensation: A pain with a cold sensation, alleviated by warmth is usually seen in the head, low back, chest and abdomen caused by an attack of meridians by cold or insufficient yang.

Inquiry (3) Asking about Pain Quality of Pain Dull pain: It is a pain, tolerable and lingering, usually caused by insufficient qi and blood, stagnation of qi and blood. It often occurs its the head, chest, abdomen and low back, characterized by deficiency. Radiating pain: It is usually caused by undernourishment or blockage of tendons and muscles. Problems of the liver often produce a radiating pain as the liver dominates tendons.

Pulse-Taking and Palpation 1. The Principle of the Formation of Pulse Conditions and the Clinical Significance of Pulse-Taking The Principle of the Formation of Pulse Conditions: Qi and blood are circulating in meridians and vessels under the power of heart qi. The circulation of qi and blood without an end depends on two elements. Firstly, the heart governs blood and vessels. Secondly, heart-qi is the power of blood circulation. "pulse is produced by heart beating". The pulse condition is not only related to the heart, blood and vessels, but to an overall functional activities of the zang-fu organs.

Pulse-Taking and Palpation (2) The Clinical Significance of Pulse Taking: Since the formation of the pulse condition is closely bound up with the condition of qi and blood of the zang-fu organs, pathological changes of qi and blood may impede smooth flow of them, resulting in a change of the pulse condition. Then, through pulse taking we may predict the location of a disease and its prognosis.

Pulse-Taking and Palpation (3) To determine the location of an illness, its nature and the condition of the body resistance and pathogenic factors: Although the manifestations of diseases are quite complicated, diseases can sum up the exterior or interior, the cold and heat, deficiency and excess syndromes. floating pulse the exterior the interior deep pulse the slow pulse the cold the fast pulsethe heat the weak pulse the powerful pulse excess deficiency

Pulse-Taking and Palpation (4) To determine the development and prognosis of an illness: In a chronic case, if the pulse condition turns to better, it is a sign of recovery, because stomach-qi is going to restore. A full pulse is seen in a protracted illness or consumptive disease leading to deficiency of qi, or in loss of blood. It indicates a critical condition due to exuberance of pathogenic factors and declined body resistance.

Pulse-Taking and Palpation 2. How to take pulse? (1) The position of taking pulse The position of taking pulse is located at the area next to the crease in the wrist where the radial artery throbs. (2) Portions of taking pulse Portions of taking pulse name Cun-pulse, Guan-pulse, Chi-pulse respectively. Cun is next to the wrist, Guan is located radial malleolus, Chi is next to Guan one by one. Firstly the location of Guan-pulse must be determined, and then the locations of Cun-pulse, Chi- pulse are decided.

Pulse-Taking and Palpation 2. How to take pulse? (3) The position of the finger Taking pulse often use fingertip, index finger corresponds to Cun-pulse, middle finger corresponds to Guan- pulse, fourth finger corresponds to Chi-pulse. (4) How to pressure? Firstly, the three fingers touch the radial artery throbs with the slight pressure, then secondary pressure, heavy pressure, and feel changes of the pulses. Secondly, each finger repeats slight pressure, then secondary pressure, heavy pressure, and feel changes of the pulses.

Pulse-Taking and Palpation 3. What meaning represents taking pulse? (1) The relationship between the pulse and organs On the left hand, the cun, guan and chi correspond to the heart, liver, gallbladder and kidney respectively. On the right hand, the cun, guan and chi correspond to the lung, spleen stomach and kidney respectively. 4. The Normal Pulse A normal pulse has a frequency of about four to five beats per breath (or 72-82 per minutes). It is even, stable, harmonious and forceful with regular rhythms. When a heavy pressure is applied to the chi pulse, one may feel a forceful beating. A normal pulse means adequacy of stomach-qi, Existence of Vitality and kidney-qi.

Pulse-Taking and Palpation 5.Abnormal Pulses and Their Suggestion of Problems The pulse condition reflecting various pathological changes of a disease is known as the abnormal pulse. In general, besides pulses due to normal physiological changes and individual physiological specificity, all is included in the abnormal pulses. The pulse condition is known by its location, beating, quality, shape and force. For instance, a floating pulse and deep pulse indicate the depth of location of the pulse, and a slow pulse and rapid pulse indicate the coming speed of the pulse, a feeble pulse and excessive pulse indicate the force of beating. Some pulse conditions, such as the full pulse and thready pulse concern about the shape and force.

Pulse-Taking and Palpation Types of the Poise Condition and Their Suggestion of Problems (1) The floating pulse Pulse condition: It responds to the finger when pressed lightly but feels weak when a heavy pressure is applied. Suggestion of problems: It indicates the exterior syndrome and deficiency syndrome.

Pulse-Taking and Palpation (2) The deep pulse Pulse condition: It only responds to the finger when pressed heavily. Suggestion of problems: It indicates the interior syndrome. A deep forceful pulse indicates an interior syndrome of excess; a weak deep pulse indicates an interior syndrome of deficiency. (3) The slow pulse Pulse condition: A slow pulse is one with three or fewer beats per breath. Suggestion of problems: It indicates the cold syndrome, or accumulation of cold when it is forceful, or cold and deficiency when it is forceless.

Pulse-Taking and Palpation (4) The rapid pulse Pulse condition: A rapid pulse is one with more than five beats per breath. Suggestion of problems: It indicates the heat syndrome, or presence of excessive heat when it is forceful. If it beats without force, the condition is usually one of heat in a deficiency condition. (5) The deficient pulse Pulse condition: A feeble pulse can be felt with a light, moderate and heavy pressure but feels forceless and void to the fingers. Suggestion of problems: It indicates deficiency of qi.

Pulse-Taking and Palpation (6) The excessive pulse Pulse condition: An excessive pulse is palpable under light moderate and heavy pressures. Suggestion of problems: It indicates the excess syndrome. (7) The surging pulse Pulse Condition: A surging pulse feels large and its beat is likened to dashing waves that rise forcefully and then decline suddenly. Suggestion of problems: It indicates excessive heat in the qi system.

Pulse-Taking and Palpation (8) The faint pulse Pulse condition: It is an extremely thready and soft pulse, palpable faintly. Suggestion of problems: It indicates deficiency of yang-qi and deficiency of yin, yang, qi and blood. (9) The thready pulse Pulse condition: A thready pulse is fine, however, it is clearly perceptible under a pressure. Suggestion of problems: A thready pulse is a sign of the deficiency syndrome. Sometimes, it points to pathogenic dampness.

Pulse-Taking and Palpation (10) The scattered pulse Pulse condition: A scattered pulse is one that feels diffusing with irregular beats. Suggestion of problems: It indicates exhaustion of qi. (11) The smooth pulse Pulse condition: A smooth pulse feels slippery and flowing, like beads rolling on a plate. Suggestion of problems: It indicates retention of phlegm, fluid and undigested food and excessive heat.

Pulse-Taking and Palpation (12) The unsmooth pulse Pulse condition: An unsmooth pulse is fine, short and slow, coming and going unsmoothly, opposite the smooth pulse. Suggestion of problems: It indicates injury to vital essence, insufficiency of blood, stagnation of qi and blood, retention of phlegm or undigested food. (13) The long pulse Pulse condition: The pulse stretches to a longer length, beyond its original region. Suggestion of problems: It indicates abundant liver-yang, abundance of yang and internal heat.

Pulse-Taking and Palpation (14) The short pulse Pulse condition: It is a pulse with short extent, only palpable at the Guan region but distinct at the Cun and Chi regions. Suggestion of problems: A short pulse throbbing with force indicates stagnation of qi and slow circulation of blood; while a short pulse throbbing without force suggests deficiency of qi and blood, retention of phlegm or undigested food.

Pulse-Taking and Palpation (15) The wiry pulse Pulse condition: To the fingers the wiry pulse gives the sensation of pressing on a violin string. Suggestion of problems: It indicates disorders of the liver or gallbladder, pains, retention of phlegm and fluid and malaria. (16) The hollow pulse Pulse condition: It is a pulse that feels floating, large and hollow like a scallion stalk. Suggestion of problems: It indicates severe loss of blood and injury to yin.

Pulse-Taking and Palpation (17) The tense pulse Pulse condition: A tense pulse is one that feels tense and forceful, like a stretched, twisted cord. Suggestion of problems: It indicates syndromes of cold, pains and retention of undigested food. (18) The moderate pulse Pulse condition: A moderate pulse is one with four beats per breath. Suggestion of problems: It indicates a dampness syndrome and hypofunction of the spleen and stomach

Pulse-Taking and Palpation (19) The tympanic pulse Pulse condition: It is an extremely wiry and hollow pulse, giving the feeling like touching the surface of a drum. Suggestion of problems: It indicates depletion of blood or essence, miscarriage and uttering bleeding. (20) The firm pulse Pulse condition: It is a pulse forceful, large, wiry and long on a heavy pressure. Suggestion of problems: It indicates abundance of internal cold, hernia and lumps in the abdomen.

Pulse-Taking and Palpation (21) The weak pulse Pulse condition: It is a pulse that feels extremely soft, deep and thready. Suggestion of problems: Deficiency of qi and blood (22) The soft pulse Pulse condition: It is a pulse that feels floating, thready and forceless. Suggestion of problems: It indicates the deficiency syndrome and dampness syndrome.

Pulse-Taking and Palpation (23) The hidden pulse Pulse condition: A hidden pulse is felt on pressing hard to the bone or it is difficult to feel. Suggestion of problems: It indicates a deep invasion of the body by pathogenic factors, syncope, a severe pain and declined yang. (24) The tremulous pulse Pulse condition: It is a pulse that feels smooth, quick and forceful, like a bouncing pea. Suggestion of problems: It is seen in cases of terror and pain.

Pulse-Taking and Palpation (25) The running pulse Pulse condition: It is a pulse that feels hasty and rapid with irregular intermittence. Suggestion of problems: It indicates exuberance of yang and heat, stagnation of qi and blood and retention of phlegm and undigested food. (26) The knotted pulse Pulse condition: It is a pulse that feels slow with irregular intervals. Suggestion of problems: It indicates stagnation of qi due to abundant yin and accumulation of phlegm due to cold and blood stasis.

Pulse-Taking and Palpation (27) The intermittent pulse Pulse condition: It is a pulse that feels slow and weak, pausing at regular long intervals. Suggestion of problems: It indicates hypofunction of the zang organs, wind and pain syndromes, terror and traumatic injury. (28) The swift pulse Pulse condition: A swift pulse is one with seven to eight beats per breath. Indication: It indicates exhaustion of yin due to over exuberance of yang or prostration of the primordial qi.

Pulse-Taking and Palpation 6.When the Pulse Contradicts the Symptoms, What to Do? Generally, a pulse condition agrees with the symptoms of a patient. Sometimes, however, a pulse may contradict the observed symptoms. The pulse condition is only one of the clinical manifestations, and it cannot be considered as the exclusive diagnostic evidence. Only by analyzing the data gathered from the fourth diagnostic methods can a comprehensive and correct diagnosis be made.

Chapter Seven Differentiations of Syndrome 1. Differentiations of Pathological Changes in Accordance with the Eight Principal Syndromes The eight principal syndromes serving as guide lines in diagnosis are yin, yang, exterior, interior, cold, heat, deficiency and excess. It is a method of differential diagnosis used to determine the nature-heat or cold, and the location-deep or superficial, the confrontation between the healthy qi and pathogenic factors and the category of diseases-yin or yang, based on a comprehensive analysis of all the data obtained by means of inspection, auscultation and olfaction, inquiry, pulse-taking and palpation.

Chapter Seven Differentiations of Syndrome (1) Differentiation of the Exterior and Interior Syndromes Exterior and interior are the principles that describe the location and tendency of a disease. In general, an exterior syndrome refers to an attack of the superficies-skin and hair, texture and interstitial spaces by pathogenic factors; an interior syndrome indicates disorders in the internal organs, blood and vessels and bone marrows. Exterior syndrome can transmit inside and become exterior syndrome; exterior syndrome may also company with exterior syndrome.

(1) Differentiation of the Exterior and Interior Syndromes ① Exterior Syndromes They refer to an attack of the superficies by the six exogenous pathogenic factors through the skin, hair, mouth and nose. Clinical Manifestations: Fever, aversion to cold (or wind), headache and general aching, a stuffy and running nose, an itchy throat and coughing, a sore throat and a thin, white yellow coating on the tongue. Treatment: Relieving the exterior syndrome with herbs pungent in flavor and cool in property.

(1) Differentiation of the Exterior and Interior Syndromes ② Interior Syndromes They are characterized by pathological changes in the zang-fu organs, qi and blood systems, and bone marrows. Except the exterior ones all syndromes are under the head of the interior syndromes. Clinical Manifestations: a high fever or tidal fever, absence of chills,aversion to heat, thirst, abdominal distension or pain, nausea or vomiting, dry stools or hot offensive stools, scanty deep yellow urine, coma, irritability or delirium, a red tongue with thick, yellow coating and a surging pulse or deep, rapid and forceful pulse.

(1) Differentiation of the Exterior and Interior Syndromes ② Interior Syndromes Treatment: In the interior syndrome of excessive heat, internal heat must be eliminated. But the interior syndrome covers a wide range and there are varieties of treatment, including reinforcing the body resistance, eliminating pathogenic factors or "regulating the functional relation among the internal organs", employed in light of particular conditions.

③ Differentiating the Exterior and Interior Syndromes a present disease with a short course an exterior syndrome a present disease with a long course an interior syndrome coexistence of fever and chills fever, no chills or chills no fever an exterior syndrome an interior syndrome little change of the tongue coating much change of the tongue coating an exterior syndrome an interior syndrome A floating pulse A deep pulse an exterior syndrome an interior syndrome

(2) Differentiation of the Cold and Heat Syndromes Cold and heat are the principles that identify the specific nature of a disease. Since cold and heat reflect exuberance and discomfiture of yin and yang, differentiating syndromes of cold and heat, in fact, is telling the condition of yin and yang. In general, cold syndromes are provoked by insufficient yang-qi or exposure to pathogenic cold. Heat syndromes result from hyper functioning and preponderance of yang or exposure to pathogenic heat.

(2) Differentiation of the Cold and Heat Syndromes ① Cold Syndrome They are caused by exposure to exogenous pathogenic cold or insufficient yang of the body due to a protracted illness, consumed yang-qi or by intake of cold foodstuffs, giving rise to internal cold. The cold syndromes include cold in the exterior, cold in the interior, cold in a deficiency condition and cold in an excess condition.

(2) Differentiation of the Cold and Heat Syndromes ① Cold Syndrome Clinical Manifestations: The commonly-seen ones are intolerance to cold, preference for heat, pallor, cold limbs, huddling up with cold, a diminished sense of taste in the mouth, absence of thirst, clear and thin sputum, saliva and nasal discharge, clear profuse urine, loose stools, a pale tongue with white, glossy coating and a slow or tense pulse. Treatment: Expelling cold by medicinal herbs warm in property.

(2) Differentiation of the Cold and Heat Syndromes ② Heat Syndromes They are caused by exogenous fire, internal heat turned from cold or the seven emotions or irregular diet, by hyper function of yang due to yin deficiency. The heat syndromes include heat in the exterior, heat in a deficiency condition and heat in an excess condition.

(2) Differentiation of the Cold and Heat Syndromes ② Heat Syndromes Clinical Manifestations : Manifestations vary in different heat syndromes, but the commonly-seen ones are intolerance to heat and preference for cold and cold beverages, thirst, flushed complexion and reddened eyes, irritability, thick, yellow sputum and nasal discharge, hematemesis, nose bleeding, concentrated urine, constipation, a reddened tongue with dry, yellow coating and a rapid pulse. Treatment: Clearing up heat and purging fire.

(3) Differentiation of the Deficiency and Excess Syndromes Deficiency and excess conditions describe the struggle between the antipathogenic qi and pathogenic factors. Deficiency denotes a condition in which the body resistance is lowered and its function is weak. Excess denotes a condition in which the pathogenic factors are hyperactive.

(3) Differentiation of the Deficiency and Excess Syndromes ① Deficiency Syndromes Deficiency syndromes are conditions in which the body resistance is lowered, its physiological functions are weak or declined. Clinically, however, many conditions attribute to sole deficiency of qi or blood, yin or yang. As to the condition of pathogenic factors-presence or absence, preponderance or discomfiture, a concrete analysis is made clinically.

(3) Differentiation of the Deficiency and Excess Syndromes ① Deficiency Syndromes Clinical Manifestations: The deficiency syndromes vary greatly; however, they may be grouped under the following four heads: deficiency of yin, deficiency of yang, deficiency of qi and deficiency of blood with various clinical manifestations.

(3) Differentiation of the Deficiency and Excess Syndromes ① Deficiency Syndromes Clinical Manifestations:Symptoms are pallor or a sallow complexion, general lassitude, listlessness, palpitation, shortness of breath, chills and cold limbs, a feverish sensation in palms, soles and the heart region, spontaneous sweating or night sweats, incontinence of feces and urine, a pale tongue with thin coating or no coating and a fine and weak pulse. Treatment: Restoring qi and blood to strengthen the body resistance (including therapies of warming yang, reinforcing qi, nourishing blood and replenishing yin).

(3) Differentiation of the Deficiency and Excess Syndromes ② Excess Syndromes The excess syndromes are provoked by either overabundance of exogenous pathogenic factors and functional hyperactivity of the body, or functional disorders of the organs or metabolic system that result in accumulation and stagnation of pathological products. In general, although the excess syndromes are characterized by hyperactivity of pathogenic factors, the body resistance is still strong enough to combat them, indicating an intense struggle between the body resistance and pathogenic factors.

(3) Differentiation of the Deficiency and Excess Syndromes ② Excess Syndromes Clinical Manifestations:The chief indicators of an excess syndrome are: fever, pain and distension in the abdomen, aggravated by pressure, a suffocating feeling in the chest and irritability. In severe cases the symptoms may also include coma, delirium, harsh breathing, excessive phlegm and saliva, constipation, difficulty of urination, an excessive, forceful pulse and a thick, sticky coating on the tongue. Treatment: Eliminating pathogenic factors.

(4) Differentiation of Syndromes of Yin and Yang As already mentioned, yin and yang are two guidelines in differentiation of syndromes. Clinically, syndromes vary and are changeable, but they are always under two classes-either yin or yang. Thus on diagnosis, yin and yang must be differentiated first. Thus, syndromes of the exterior, heat, and excess conditions are classified as the yang syndromes, while those of the interior, cold and deficiency conditions are the yin syndromes.

(4) Differentiation of Syndromes of Yin and Yang ① Yin Deficiency Clinical Manifestations:Emaciation, a gaunt appearance, a tidal fever in the afternoon, a feverish sensation in palms, soles and the heart region, night sweats, flushed cheeks, fidgets, insomnia, dizziness, blurred vision, ringing in the ear, nocturnal emission, a dry throat and mouth, a red tongue with scanty coating or no coating and a thread, rapid pulse. Treatment: replenishing yin

(4) Differentiation of Syndromes of Yin and Yang ② Yang Deficiency Clinical Manifestations: Pallor, cold limbs, chills, listlessness, feeble voice, shortness of breath, spontaneous sweating, a cold feeling below the low back, weak and aching legs, impotence, seminal emission, a diminished sense of taste, poor appetite, clear, profuse urine, loose stools, a thin, white coating and a deep, slow or large and forceless pulse. Treatment: warming yang.

2.Differentiation of Syndromes in Accordance with the State of Qi, Blood and Body Fluids Differentiation of syndromes in accordance with the state of qi, blood and body fluids deals with pathological changes of qi,blood and body fluids to recognize the exact syndrome. Physiologically,qi, blood and body fluids are the material basis of the functional progress of the zang-fu organs, and the product of the functional activity of them as well. Thus, pathologically, any disorder of the zang-fu organs must affect qi, blood, and body fluids and any disturbance in qi, blood and body fIuids inevitably affects some zang-fu organs.

2.Differentiation of Syndromes in Accordance with the State of Qi, Blood and Body Fluids (1) Differentiation of Syndromes According to the State of Qi Disorders of qi cover a wide range and among various diseases of the zang-fu organs,many are related to qi disturbance. Thus, the state of qi plays an important role in syndrome differentiation. Differentiation of syndromes according to the state of qi includes differentiation of the syndromes of qi deficiency, sinking of qi, stagnation of qi and adverse flow of qi.

2.Differentiation of Syndromes in Accordance with the State of Qi, Blood and Body Fluids (1) Differentiation of Syndromes According to the State of Qi ① The Syndrome of Deficiency of Qi It indicates functional recession of the zang-fu organs. Clinical Manifestations: Dizziness, lack of strength to breathe and speak, general lassitude, spontaneous sweating that is worse when active, a pale tongue and a deficient and forceless pulse. Treatment : Strengthening qi

2.Differentiation of Syndromes in Accordance with the State of Qi, Blood and Body Fluids (1) Differentiation of Syndromes According to the State of Qi ② The Syndrome of Sinking of Qi Sinking of qi is a kind of deficiency of qi, characterized by failure of qi to rise. Clinical Manifestations: Dizziness, blurred vision, lassitude, a bearing-down sensation in the abdomen, prolapse of rectum or uterus, a pale tongue with white coating and a weak pulse. Treatment : Strengthening and lifting qi

2.Differentiation of Syndromes in Accordance with the State of Qi, Blood and Body Fluids (1) Differentiation of Syndromes According to the State of Qi ③ The Syndrome of Stagnation of Qi It refers to impeded flow of qi in a certain part of the body or in an individual organ. Clinical Manifestations: A suffocating feeling marked by pain, e. g. a distending pain at the hypochondriac region or chest and abdomen. Treatment : Promoting qi flow

2.Differentiation of Syndromes in Accordance with the State of Qi, Blood and Body Fluids (1) Differentiation of Syndromes According to the State of Qi ④ The Syndrome of Adverse Flow of Qi It refer to a disturbance in the downward function of the qi of the body, due usually to upward attack of lung-qi and stomach-qi or liver-qi. Clinical Manifestations: Ascending of lung-qi : Coughing and shortness of breath Ascending of stomach-qi: Hiccup, belching, nausea and vomiting Excessive ascending of liver-qi: Headache, dizziness, coma and hematemesis Treatment : Bringing the adverse flow of qi down

2.Differentiation of Syndromes in Accordance with the State of Qi, Blood and Body Fluids (2) Differentiation of Syndromes According to the State of Blood While there are many syndromes that involve disorders of the blood, they may be grouped into four classes : deficiency of blood, stagnancy of blood or stasis of blood, heat in blood and cold in blood.

2.Differentiation of Syndromes in Accordance with the State of Qi, Blood and Body Fluids (2) Differentiation of Syndromes According to the State of Blood ① The Syndrome of Deficiency of Blood The syndrome of deficiency of blood is thus named when there is a failure of the zang- fu organs and vessels to be nourished owing to the decreased quantity of blood. Clinical Manifestations : Pallor or sallow complexion, pale lips, dizziness, palpitation, insomnia, numbness of the hands and feet, scanty menstruation, delayed menstrual cycle or amenorrhea, a pale tongue and a thready, forceless pulse Treatment : Tonifying blood

(2) Differentiation of Syndromes According to the State of Blood ② The Syndrome of Stagnancy of Blood and Stasis of Blood It covers a wide range of blood disorders, e. g. escaped blood from vessels, blocked blood in meridians, zang-fu organs and tissues. Clinical Manifestations: Pain, blood clots, hemorrhage, ecchymosis, dark red lips and nails, a dark red tongue with purplish spots or patches and an unsmooth pulse Treatment: Invigorating blood flow to remove stagnancy and stasis of blood

(2) Differentiation of Syndromes According to the State of Blood ③ The Syndrome of Noxious Heat in Blood It refers to heat in blood or invasion of the blood system by pathogenic heat. The condition is caused by a hyperactivity of yang-qi or production of internal fire turned from excessive emotional excitation, or by over-intake of food pungent and dry in property or by exogenous pathogenic heat invading the blood system. Clinical Manifestations: Irritability or mania,coma in severe cases, thirst without a desire for drinks, a feverish sensation in the body, that is worse at night, a deep red tongue and a rapid pulse seen in hemorrhage. Treatment: Clearing up heat and cooling blood

(2) Differentiation of Syndromes According to the State of Blood ④ The Syndrome of Cold in Blood It is also known as the syndrome of cold in blood vessels characterized by impeded flow of blood due to cold that makes qi stagnate. Clinical Manifestations: Pain of hands, feet and lower abdomen, relieved by warmth, accompanied by aversion to cold, cold limbs, delayed menstrual cycle, dark red menses with clots, a pale tongue with white coating and a deep, slow and smooth pulse Treatment: Warming meridians to activate blood circulation

(3)Differentiation of Syndromes in Accordance with Disorders of Qi and Blood Qi pertains to yang and blood to yin. Because they are interpromoting and interdependent, they affect each other when a disease occurs, i. e. disorders of both qi and blood appear. The frequently seen syndromes are deficiency of qi and blood, deficiency of qi and loss of blood, prostration of qi after massive loss of blood, deficiency of qi and stasis of blood and stagnancy of qi and blood.

(3)Differentiation of Syndromes in Accordance with Disorders of Qi and Blood ① The Syndrome of Stagnancy of Qi and Blood It refers to impeded blood flow due to stagnation of qi and eventually stasis of blood. Clinical Manifestations : Fullness and a distending pain in the chest and hypochondriac region, irritability, presence of a painful mass, aggravated by pressure, a dark red tongue or with ecchymosis on it, amenorrhea, dysmenorrhea with discharge of dark red blood and blood clots and a distending pain in the breast. Treatment :Reinforcing qi to promote blood circulation

(3)Differentiation of Syndromes in Accordance with Disorders of Qi and Blood ② Deficiency of Both Qi and Blood It refers to simultaneous existence of deficiency of qi and blood. Clinical Manifestations: Lack of strength to breathe and speak, lassitude, spontaneous sweating, pallor, sallow complexion, palpitation, insomnia, a pale, moist tongue and a thready, weak pulse. Treatment: Reinforcing qi and blood

(3)Differentiation of Syndromes in Accordance with Disorders of Qi and Blood ③ Deficiency of Qi and Loss of Blood It refers to loss of blood due to insufficient qi, which fails to control blood. Hemorrhage due to deficiency and sinking of qi is known as "bleeding resulting from exhaustion of qi“. Clinical Manifestations: Hemorrhage, shortness of breath, lassitude, pallor, a faint and weak pulse and a pale tongue Treatment: Reinforcing qi to keep blood flowing in vessels

(3)Differentiation of Syndromes in Accordance with Disorders of Qi and Blood ④ Prostration of Qi after Massive Loss of Blood Clinical Manifestations: Massive hemorrhaging associated with pallor, cold limbs, profuse sweating, fainting, and a feeble, thready or hollow pulse. Treatment: Invigorating qi to prevent collapse

(3)Differentiation of Syndromes in Accordance with Disorders of Qi and Blood ⑤ Deficiency of Qi and Stagnancy of Blood It refers to impeded blood flow or stasis of blood due to deficiency of qi. Clinical Manifestations: Lassitude, lack of strength, spontaneous sweating, pain aggravated by pressure, a dark red tongue with ecchymosis. Treatment: Invigorating qi to promote smooth flow of blood.

(4) Differentiation of Syndromes in Accordance with the State of Body Fluids Disorders of body fluids can be classified into two categories : insufficiency of body fluids and retention of water. ① Insufficiency of Body Fluids Insufficiency of body fluids refers to dryness in some zang-fu organs and tissues owing to lack of body fluids caused by inadequate production and over- consumption of it. Clinical Manifestations : Dryness in the mouth, lips and tongue, dry skin, scanty urine, constipation, a red tongue with scanty saliva and a thready, rapid pulse Treatment : Promoting production of body fluids.

(4) Differentiation of Syndromes in Accordance with the State of Body Fluids ② Retention of Water It refers to general or local retention of fluid, usually seen in edema, tympanites and retention of phlegm and morbid fluid. Here is a description about how to differentiate edema and retention of phlegm and morbid fluid. Edema, It can be found in any part of the body, such as the head, face, eyelid, chest, back and the whole body. Clinically it is divided into two types-yang edema and yin edema.

(4) Differentiation of Syndromes in Accordance with the State of Body Fluids ② Retention of Water Yang edema : It is an excess condition caused by exposure to cold, obstruction of lung-qi, or invasion by dampness and failure of the spleen in transport. Clinical Manifestations: Puffy lids and face, edema of limbs and the whole body by a quick attack, sluggishness of limbs, difficulty of urination, aversion to wind-cold, fever, a thin, white coating on the tongue and a floating, tense pulse; or a sore throat, a red tongue and a floating, rapid pulse ;

(4) Differentiation of Syndromes in Accordance with the State of Body Fluids ② Retention of Water or general edema developing slowly, sluggishness of limbs, scanty urine, fullness in the chest, loss of appetite, nausea, a white, sticky coating on the tongue and a deep, slow pulse. Treatment : Dispelling wind and promoting the dispersing function of the lung,strengthening the spleen to remove dampness, activating yang and promoting diuresis.

② Retention of Water Yin edema : It is a deficient condition usually caused by weakened antipathogenic qi due to protracted diseases lassitude, internal injury and excessive sexual activities. Clinical Manifestations : Edema, severe below the low back, difficulty of urination, fullness in the chest, abdominal distension, lack of appetite, loose stools, pallor or sallow complexion or an aching pain and a cold sensation in the low back and knees, cold limbs, aversion to cold, listlessness, a pale, puffy tongue with white, smooth coating and a deep, slow, forceless pulse Treatment : Invigorating yang to promote fluid flow

② Retention of Water Retention of phlegm and morbid fluid : Phlegm and morbid fluid are pathological products due to functional disturbance in the zang-fu organs and disorders of water metabolism. The syndrome of phlegm ; Phlegm is the retained fluid of thick quality. The syndrome of phlegm means local obstruction by phlegm or phlegm flows over the body. It is produced by contracting exogenous pathogenic factors or excessive emotional excitation, leading to functional disturbance of the zang-fu organs.

② Retention of Water Clinical Manifestations: Coughing, shortness of breath, a suffocating feeling in the chest, fullness in the gastric region, nausea, loss of appetite, dizziness, delirium, mania, raling, numbness of limbs, hemiplegia, scrofula, goiter, nodules of the breast, a foreign body in the throat,a white, sticky or yellow, sticky coating on the tongue and a smooth pulse Treatment : Eliminating phlegm

② Retention of Water Retention of morbid fluid: It is a syndrome due to retention of thin, clear morbid fluid in the zang-fu organs and tissues, usually caused by constant deficiency of yang and contracting cold and dampness, or by irregular diet or overwork, resulting in disturbance of water distribution and excretion.

② Retention of Water Clinical Manifestations : Distention of the stomach and abdomen,retention of morbid fluid in the stomach and intestines, vomiting of clear fluid, dizziness, palpitation, fullness in the chest and hypochondriac region, productive coughing, pain on breathing, dyspnea with chest distention, difficulty to lie flat, edema and an aching pain of limbs, difficulty of urination, a white, smooth coating and a wiry pulse Treatment : Expelling phlegm and retained morbid fluid

3. Differentiation of Syndromes in Accordance with the Theory of Zang-fu Organs Differentiation of syndromes in accordance with the theory of zang-fu organs is the diagnostic basis of any branch of clinical medicine, and an important component part of the study of differentiation of syndromes adopted in traditional Chinese medicine. Based on the physiologlcal function of the zang-fu organs and their pathological manifestations, symptoms and signs are analysed to detect pathogenesis, the location and nature of diseases and preponderance and discomfiture of the antipathogenic qi and pathogenic factors.

3. Differentiation of Syndromes in Accordance with the Theory of Zang-fu Organs (1) Differentiation of Syndromes of the Heart and Small Intestine The heart is in the chest and it is covered by the pericardium. The Heart Meridian of Hand-Shaoyin connects the Small Intestine Meridian of Hand- Taiyang, forming a zang-fu pair. The heart governs blood and vessels, controls mental activities and is linked to the tongue. The small intestine differentiates the rarefied substances from the non-usable and converts food into useful substances.

(1) Differentiation of Syndromes of the Heart and Small Intestine ① Syndromes of Deficiency of Heart-Qi, Heart-Yang and Depleted Heart-Qi Clinical Manifestations : Deficiency of heart-qi : Palpitation, shortness of breath, worse when active, a thready, weak or knotted and intermittent pulse, associated with pallor, lassitude, spontaneous sweating, lack of strength and a pale tongue with white coating.

① Syndromes of Deficiency of Heart-Qi, Heart-Yang and Depleted Heart-Yang Deficiency of heart-yang : Palpitation, shortness of breath worse when active, a thready weak or knotted or intermittent pulse, associated with aversion to cold, cold limbs, sallow complexion, a distending pain in the chest, and a dark red and puffy tongue Depleted heart-yang : Profuse sweating, cold limbs, purplish lips, feeble breathing, a faint pulse, delirium or loss of consciousness

① Syndromes of Deficiency of Heart- Qi, Heart-Yang and Depleted Treatment : Deficiency of heart-qi : Reinforcing heart-qi Deficiency of heart-yang: Replenishing heart-yang Depleted heart-yang: Recuperating depleted yang and rescuing a patient from collapse

② Syndromes of Deficiency of Heart-Blood and Heart-Yin Deficiency of heart-blood and heart-yin refers to lack of heart-blood and heart-yin, which fails to nourish the heart. The two conditions are usually due to consumption of yin-blood in protracted illnesses, or to massive loss of blood, inadequate production of yin- blood or to depression, inner accumulation of fire that consumes yin-blood. Clinical Manifestations : Deficiency of heart-blood : Palpitation, amnesia, insomnia, dream-disturbed sleep, accompanied by dizziness, pallor, a pale tongue and lips and a thready, weak pulse.

② Syndromes of Deficiency of Heart-Blood and Heart-Yin Deficiency of Heart-Yin: Palpitation, amnesia, insomnia, dream-disturbed sleep, accompanied by a feverish sensation in palms, soles and the heart region, night sweats, dryness of the mouth, a red tongue with a little saliva and a thready, rapid pulse. Treatment : Deficiency of heart-blood: Enriching blood to tranquilize the mind Deficiency of heart-yin : Replenishing yin to tranquilize the mind

③ The Syndrome of Hyperactivity of Heart-Fire It refers to a morbid state due to hyperactivity of heart- fire, usually resulting from production of fire due to depression, invasion of the interior by fire or excessive intake of fat, heavy food, or from alcohol drinking and smoking of cigarettes. Clinical Manifestations : Irritability, insomnia, flushed complexion, thirst, an ulcerous mouth and tongue, a red tongue and rapid pulse,or mania,delirium in severe cases,associated with concentrated urine, a pain on urination and hematuria Treatment : Clearing up heart-fire.

④ The Syndrome of Obstruction of the Heart Collaterals and Vessels It refers to a morbid state under the influence of pathogenic factors found in the aged and patients of a weak physique, or in protracted illnesses and lowered body resistance cases, resulting in stagnation of heart-blood, coagulation of phlegm and cold and qi stagnancy.

④ The Syndrome of Obstruction of the Heart Collaterals and Vessels Clinical Manifestations : Palpitation and frequent violent palpitation, an intermittently suffocating pain in the chest, a pain involving the shoulder, back and arm ; a stabbing pain, a dark red tongue with purplish spots or patches on its surface, a thready, unsmooth pulse or knotted, intermittent pulse found in stagnation of heart-blood in the heart collaterals and vessels. Treatment : Activating yang and removing stagnation of qi and blood.

⑤ The Syndrome of Mental Confusion due to Phlegm It refers to problems of consciousness due to invasion of the heart by phlegm. It is also caused by excessive phlegm turned from dampness, or production of phlegm due to emotional upsets and stagnation of qi. Clinical Manifestations : Apathy, dementia depression, improper behavior or sudden loss of consciousness, laryngeal raling, delirium, associated with sallow complexion, a suffocating sensation in the chest, profuse phlegm, a sticky tongue and a smooth pulse. Treatment : Eliminating phlegm to resuscitate

⑥ The Syndrome of Phlegm-Fire Attacking the Heart It is a morbid mental condition due to pathogenic fire and phlegm attacking the heart. Emotional upsets, anger and stagnated qi may produce fire, which scorches body fluid and turns it into phlegm. The invaded pathogenic heat scorches body fluid and turns it into phlegm too. Then phlegm is the chief cause of the condition.

⑥ The Syndrome of Phlegm-Fire Attacking the Heart Clinical Manifestations : Irritability, thirst, insomnia, dream-disturbed sleep. profuse phlegm, a suffocating feeling in the chest, a flushed face, harsh breathing, constipation, concentrated urine, various mental disorders in severe cases, a red tongue with thick, yellow and sticky coating and a wiry, smooth and forceful pulse. Treatment : Clearing up fire and phlegm

⑦ The Syndrome of Excessive Heat in the Small Intestine The syndrome of excessive heat in the small intestine is caused by heart-fire which moves to the small intestine. Clinical Manifestations : Irritability,thirst,ulcer in the mouth and on the tongue,concentrated urine, a pain on urination, hematuria, a red tongue with yellow coating and a rapid pulse. Treatment: Eliminating heart-fire and dark urine

2. Differentiation of Syndromes of the Lung and Large Intestine ① The Syndrome of Deficiency of Lung-Qi It refers to hypofunction of the lung due usually to chronic coughing, shortness of breath or to inadequate production of qi. Clinical Manifestations : Coughing, shortness of breath, lack of strength to breathe worse when active, lassitude, a feeble voice, spontaneous sweating, aversion to cold, pallor, a pale tongue and a feeble pulse. Treatment : Activating lung-qi

2. Differentiation of Syndromes of the Lung and Large Intestine ② The Syndrome of Deficiency of Lung-Yin It refers to inadequate lung-yin and production of inner heat in a deficiency condition. Clinical Manifestations: Coughing without expectoration of phlegm or with sticky phlegm scanty in amount, dryness in the mouth and throat, emaciation, afternoon fever, a feverish sensation in palms, soles and the heart region, night sweats, flushed cheeks, expectoration of bloody phlegm, a hoarse voice, a red tongue with scanty saliva and a thready, rapid pulse Treatment : Replenishing yin to moisten the lung

2. Differentiation of Syndromes of the Lung and Large Intestine ③ Wind-Cold Invades the Lung It refers to the lung attacked by exogenous wind and cold, and impeded movement of lung-qi. Clinical Manifestations: Coughing with expectoration of thin white phlegm, nasal obstruction and watery nasal discharge, slight aversion to cold, a low fever, absence of sweating, a white coating on the tongue and a floating, tense pulse Treatment: Relieving the exterior syndrome with medicinal herbs pungent in property.

2. Differentiation of Syndromes of the Lung and Large Intestine ④ Wind-Heat Invades the Lung It refers to invasion of the lung by wind-heat and injury to the defensive qi. Clinical Manifestations : Coughing with expectoration of thick, yellow phlegm, nasal obstruction and thick, yellow nasal discharge, fever, slight aversion to wind and cold, dryness of the mouth and a sore throat, a reddened tongue tip with yellow coating and a floating and rapid pulse Treatment : Clearing up heat from the lung.

2. Differentiation of Syndromes of the Lung and Large Intestine ⑤ Accumulation of Heat in the Lung It refers to invasion of the mouth and nose by pathogenic heat. Clinical Manifestations : Coughing with expectoration of thick, yellow phlegm, shortness of breath, harsh breathing, high fever, thirst or flaring of nares, a chest pain, expectoration of foul purulent phlegm, constipation, deep yellow urine, a reddened tongue with yellow coating and a smooth, rapid pulse Treatment : Clearing up heat, dissolving phlegm and easing shortness of breath

2. Differentiation of Syndromes of the Lung and Large Intestine ⑥ Dryness Invades the Lung It refers to pathogenic dryness attacking the lung. Clinical Manifestations : Dry cough with no or scanty phlegm, difficulty of expectoration due to thick phlegm, dry lips, tongue, throat, nose and skin, fever, aversion to cold, a chest pain, hemoptysis, a thin coating, scanty saliva on the tongue and a thready, rapid pulse Treatment : Eliminating dryness and moistening the lung

⑦ Phlegm-Dampness Blocks the Lung It refers to phlegm-dampness accumulating in the lung, usually caused by chronic coughing, which leads to production of phlegm-dampness, or by insufficient spleen-qi and accumulated dampness. Clinical Manifestations : Coughing with expectoration of profuse copious phlegm, or thin, white, frothy phlegm, a suffocating feeling in the chest, or rasping in the throat, a pale tongue with white, sticky coating and a wiry, smooth or soft, slow pulse Treatment : Eliminating dryness, dissolving phlegm and regulating the flow of lung-qi.

⑧ Damp-heat invades the large intestine It usually caused by contracting exogenous damp-heat or irregular diet. Clinical Manifestations: Abdominal pain, discharge of bloody and mucous stools, tenesmus or foul diarrhea, accompanied by a burning sensation in the anus, concentrated urine, thirst, or aversion to cold, fever, or fever with aversion to cold, a reddened tongue with yellow, sticky coating and a soft, rapid or smooth, rapid pulse. Treatment: Clearing up heat and dampness

⑨ Insufficient Fluid in the Large Intestine It refers to failure of the large intestine to be moistened owing to insufficient body fluids, usually caused by a weak physique, impairment of yin due to chronic diseases. Clinical Manifestations: Habitual constipation, a reddened tongue with yellow, dry coating, a thready and unsmooth pulse associated with vertigo and foul breath. Treatment: Moistening the large intestine to activate bowels movement

3.Differentiation of Syndromes of the Spleen and Stomach ① The Syndrome of Deficiency of Spleen-Qi It refers to impeded transport and transformation of nutrients, usually caused by irregular diet, overwork and other chronic diseases, which impair the spleen. Clinical Manifestations: Loss of appetite, gastric distension after meals, loose stools, lack of strength to speak, lassitude, emaciation, sallow complexion, a pale tongue with white coating and a slow, weak pulse. Treatment: Invigorating qi and activating the spleen

② The Deficiency of Spleen-Yang It refers to declined spleen-yang and inner production of cold, usually developed from deficiency of spleen-qi, or caused by excessive intake of cold and raw foodstuffs, or insufficient kidney-yang. Clinical Manifestations: Lack of appetite, abdominal distension, gastric and abdominal pain, alleviated by warmth and pressure, a diminished sense of taste and absence of thirst, cold limbs, loose stools, or edema of limbs, a pale and moist tongue with white, smooth coating and a deep, thready or slow, weak pulse. Treatment: Regulating the function of the middle-jiao and removing cold

③ The Sinking of Spleen-Qi It refers to insufficient spleen-qi, which goes downward rather than upward, usually caused by further deficiency of spleen-qi or by protracted diarrhea. Clinical Manifestations: Dizziness, a feeble voice, lassitude, spontaneous sweating, lack of appetite, gastric distension after meals, a bearing-down sensation in the stomach and abdomen, tenesmus, prolonged diarrhea or prolapse of rectum or uterus and a pale tongue with white coating and a weak pulse Treatment: Invigorating the spleen to restore its normal function

④ The spleen fails to keep blood in vessels It refers to failure of the spleen to keep blood in vessels due to deficiency of spleen-qi, usually caused by prolonged diseases and insufficient spleen-qi, or by overwork and impairment of the spleen. Clinical Manifestations : Hemafecia, hematohidrosis, menorrhagia, uterine bleeding and hemorrhage of other parts of the body sometimes accompanied by deficiency of spleen-qi. Treatment : Invigorating qi to control blood

⑤ Cold-Dampness Invades the Spleen It usually caused by irregular diet, over-intake of raw and cold foodstuffs, exposure to rain, cold water, residence in a damp place. Clinical Manifestations: Fullness in the gastric and abdominal regions, lack of appetite,nausea, vomiting, a diminished sense of taste and absence of thirst, abdominal pain and loose stools, the head being tightly bandaged, sluggishness of the body, edema, sallow complexion, yellow tinges of the skin and face, a flabby tongue with white, sticky coating and a soft and slow pulse. Treatment: Eliminating dampness and activating the spleen

⑥ Accumulation of Damp-Heat in the Spleen It usually caused by contracting exogenous damp-heat or excessive intake of heavy, sweet food and alcohol, which turn to heat. Clinical Manifestations : A suffocating sensation in the gastric and abdominal regions, nausea, poor appetite, sluggishness of the limbs and body, loose stools, difficulty of urination, concentrated urine, a yellow tinge of the complexion and sclera, itching skin, fever sometimes, and no alleviation after perspiration, a yellow, sticky coating on the tongue and a soft, rapid pulse. Treatment : Clearing up heat and dampness

⑦ The Deficiency of Stomach-Yin It is usually caused by prolonged gastric disorders or impairment of yin-fluid after a febrile disease or by preference for food pungent and hot in property, or emotional disturbance. Clinical Manifestations: A dull pain in the gastric region, no desire for food when hungry, dryness in the mouth and throat, dry stools, fullness in the stomach or retching and hiccuping, reddened tongue with a little saliva, thready and rapid pulse. Treatment: Replenishing stomach-yin

⑧ The Retention of Food in the Stomach It usually caused by irregular diet, eating too much food at one time, or weakened stomach-qi, resulting in retention of food due to improper diet. Clinical Manifestations : A gastric distending pain, poor appetite, eructation with fetid odor, or vomiting of undigested food, alleviation of pain after vomiting accompanied by borborygmus, flatus, foul diarrhea, a thick, sticky coating on the tongue and a smooth or deep, replete pulse Treatment : Eliminating undigested food

⑨ The Syndrome of Cold in the Stomach It usually caused by exposure of the abdomen to cold,excessive intake of raw and cold foodstuffs or overstrain and contracting cold. Clinical Manifestations : A gastric pain, mild or severe, aggravated by cold and alleviated by warmth, a diminished sense of taste and absence of thirst associated with lassitude, cold limbs and pain relieved after meals ; or associated with a sound of water in the stomach, vomiting of watery fluid; a pale tongue with white coating and a slow or wiry pulse Treatment : Expelling cold by warming the stomach

⑩ The Syndrome of Heat in the Stomach It caused by constant intake of pungent and greasy food, or by emotional upsets. Clinical Manifestations: A burning pain in the stomach, gastric discomfort, acidic regurgitation, vomiting immediately after taking food, thirst and preference for cold beverages, halitosis, gingival ulcer or bleeding, foul breath, constipation, concentrated urine, a reddened tongue with yellow coating and a smooth, rapid pulse Treatment: Clearing up stomach-fire

4.Differentiation of Syndromes of the Liver and Gallbladder ① The Syndrome of Stagnation of Liver-Qi It caused by depression, sudden mental excitation. Clinical Manifestations: Fullness and a distending and wandering pain in the gastric, hypochondriac regions and lower abdomen, preference for deep sighing, emotional depression, irritability, a sensation of foreign body in the throat or goiter, masses in the abdomen, a distending pain in the breast in women, dysmenorrhea, menstrual irregularity or amenorrhea Treatment: Removing stagnation of liver-qi

② The Syndrome of Flare-up of Liver-Fire It caused by emotional upsets, fire transformed from stagnated qi, or fire produced by excessive intake of alcohol. Clinical Manifestations: Dizziness, ringing in the ear, a flushed face, a bitter taste in the mouth and a dry throat, a burning pain in the hypochondriac region, irritability, insomnia, nightmare or hematemesis, epistaxis, constipation, urination with a reddish tinge, a reddened tongue with yellow coating and a wiry, rapid pulse. Treatment : Clearing up liver-fire

③ The Deficiency of Liver-Blood It refers to insufficient liver-blood, usually caused by poor generation of blood, massive loss of blood, or impaired liver-blood in chronic diseases. Clinical Manifestations : Sallow complexion, dizziness, ringing in the ear, dream-disturbed sleep, blurred vision, night blindness, numbness of limbs, spasm of tendons, pale nails, scanty menstrual flow or amenorrhea in women, and a pale tongue and thready pulse Treatment : Replenishing liver-blood

④ The Deficiency of Liver-Yin It caused by constant hyperactivity of yang, or consumption of yin after febrile diseases, or by deficiency of kidney-yin. Clinical Manifestations : Dizziness, dry eyes, blurred vision, a feverish sensation in the face, a burning pain in the hypochondriac region, a feverish sensation in palms, soles and the heart region, a tidal fever, night sweats, a dry mouth and throat, tremor of hands and feet, a reddened tongue with scanty saliva and a wiry, thready pulse Treatment : Replenishing liver-yin

⑤ The Exuberance of Liver-Yang It refers to hyperactivity of liver-yang and hypoactivity of liver-yin, caused by yin deficiency of the liver and kidney, which fails to check excessive liver-yang. Clinical Manifestations : Dizziness, ringing in the ear, a distending pain in the head and eyes, a flushed face, reddened eyes, irritability, palpitation, amnesia, insomnia, dreamdisturbed sleep, weakness of the low back and knees, top-heavy, a reddened tongue and a wiry, forceful or wiry, thready pulse Treatment : Calming the liver and suppressing yang hyperactivity

⑥ Syndromes of Endogenous Wind Stirring in the Liver The Syndrome of Liver-Yang Turning to Wind : It caused by over-consumption of liver-yin and kidney- yin, failure of yang to be checked. Clinical Manifestations : Dizziness, headache, a stiff neck, numbness and trembling of limbs, tremor of hands and feet, tongue rigidity that impairs speaking, walking haltingly, a reddened tongue, a wiry and thready pulse or sudden loss of consciousness, deviation of the eye and mouth, hemiplegia, speaking problem and rasping in the throat in wind-stroke. Treatment : Subduing hyperactivity of the liver and endogenous wind

⑥ Syndromes of Endogenous Wind Stirring in the Liver The Syndrome of Stirring-up of Wind in the Liver by Extreme Heat : It caused by over-preponderance of heat, which scorches the Liver Meridian, or by invasion of the pericardium by heat. Clinical Manifestations : High fever, thirst, convulsions, rigidity of the neck, upward staring of eyes, opisthotonos, coma, a reddened tongue with yellow coating and a wiry, rapid pulse. Treatment : Clearing up pathogenic heat, cooling the liver and subduing the endogenous wind

⑦ The Damp-Heat in the Liver and Gallbladder It is usually caused by contracting damp-heat, excessive intake of alcohol, heavy and sweet food, or by dysfunction of the spleen and stomach, leading to growth of damp-heat. Clinical Manifestations : poor appetite, abdominal distension, a bitter taste in the mouth, nausea, irregular bowels movement, scanty urine with reddish tinges, a reddened tongue with yellow, sticky coating and a wiry, rapid pulse; yellow tinges of the body and sclera, eczema of scrota, or swollen testes, or foul, yellow vaginal discharge and itching of vulva Treatment : Clearing up damp-heat from the liver and gallbladder

5.Differentiation of Syndromes of the Kidney and Urinary Bladder ① The Deficiency of Kidney-Yang It caused by inadequate yang of the body or declined fire of the vital gate in the aged, or deficiency of yang in other organs affecting the kidney, or injury to the kidney due to chronic diseases.

5.Differentiation of Syndromes of the Kidney and Urinary Bladder Clinical Manifestations : Pallor or sallow complexion, aversion to cold, cold limbs, worse below the low back and knees, weakness of the low back and knees, lassitude, impotence, cold sperms, infertility in women due to coldness in the uterus, sexual hypoesthesia, frequent and profuse urine, frequent urination at night, or scanty urine and edema, worse below the low back, abdominal distension, or accompanied by palpitation, shortness of breath, coughing, rasping in the throat, a pale, flabby tongue or a teeth imprinted tongue with white, smooth coating and a weak pulse, worse on both chi portions. Treatment : Warming kidney-yang to invigorate the vital function

5.Differentiation of Syndromes of the Kidney and Urinary Bladder ② The Syndrome of Deficiency of Kidney-Yin It refers to insufficient kidney-yin usually caused by consumption of kidney-yin due to protracted illnesses that impair the kidney, intemperance in sexual life, loss of blood, or to excessive intake of foodstuffs dry in property that impair yin, or to emotional disturbance.

5.Differentiation of Syndromes of the Kidney and Urinary Bladder Clinical Manifestations : Dizziness, ringing in the ear, declined vision, amnesia, insomnia, weakness of the low back and knees, a gaunt form, a dry mouth worse at night, a feverish sensation in palms, soles and the heart region, tidal fever, night sweats, flushed cheeks, seminal emission, scanty menstrual flow, amenorrhea, uterine bleeding, a reddened tongue with thin, dry coating and a thready, rapid pulse. Treatment : Replenishing kidney-yin

③ The Insufficiency of Kidney-Essence It usually caused by congenital weakness, lack of proper care after birth. Clinical Manifestations : Infertility in men due to low sperm count, infertility in women due to amenorrhea, sexual disorders, retarded development in infants, short and small in figure, mental retardation, sluggishness, delayed close of the fontanel, weakness of bones, premature senility, loss of hair, loosened teeth, ringing in the ear, hypoacusis, amnesia and weakness of feet Treatment : Reinforcing kidney-essence

④ The Insufficiency of Kidney-Qi Clinical Manifestations : Lassitude,ringing in the ear, aching pain of the low back, weakness of the knees, frequent and profuse urine, dribbling after urination, enuresis or incontinence of urine, spermatorrhea, premature ejaculation, uterine bleeding, watery vaginal discharge, habitual miscarriage, fecal incontinence, diarrhea, a pale tongue with white coating and a deep, weak pulse. Treatment : Consolidating kidney-qi.

⑤ The Damp-Heat in the Urinary Bladder It caused by affection of damp-heat or irregular diet, leading to inner growth of damp-heat which pours downward into the urinary bladder. Clinical Manifestations: Frequent urination and an urgent need to urinate, a burning pain in the urethra, scanty urine with deep yellow tinges, lower abdominal distension, or associated with fever, pain in the low back, hematuria, urine stones, a reddened tongue with yellow sticky coating and a rapid pulse Treatment: Eliminating heat and dampness

Chapter Eight Treatment And Therapeutic Methods 1.Principles for Disease Prevention and Treatment (1) Prevention Prevention includes taking certain steps in advance to stop the occurrence and development of diseases. ① Prevention Before Disease Occurs This implies that before a disease occurs, various measures should be taken to prevent its occurrence. Increasing Resistance Against Disease The strength of one’s anti-pathogenic-qi depends upon the physique. Generally, one who has a strong physique enjoys vigorous anti-pathogenic-qi.

Chapter Eight Treatment And Therapeutic Methods 1.Principles for Disease Prevention and Treatment (1) Prevention ① Prevention Before Disease Occurs Avoiding Invasion By Exopathic Factors Pathogenic factors are an important consideration in the disease process. To prevent disease before it occurs, in addition to building up a good physique and increasing the power of anti-pathogenic-qi against the evil, one should pay attention in preventing the invasion of pathogenic factors.

Chapter Eight Treatment And Therapeutic Methods 1.Principles for Disease Prevention and Treatment ② Treatment Before Disease Develops Prevention before a disease occurs is the ideal preventative measure. However, once a disease already occurs, one should strive for an early diagnosis and treatment so to stop the disease from further the development and progress.

Chapter Eight Treatment And Therapeutic Methods 1.Principles for Disease Prevention and Treatment ② Treatment Before Disease Develops Early Diagnosis If the internal organs are invaded and the disease condition becomes serious, it is difficult to be cured. Therefore, practitioners should, according to the developing law and transmission of disease, strive for an early diagnosis and an effective treatment to stop the progress of the disease.

Chapter Eight Treatment And Therapeutic Methods 1.Principles for Disease Prevention and Treatment ② Treatment Before Disease Develops Treating the Undiseased First and the Progress Law The liver is wood and the spleen is earth in five elements. The liver wood can subjugate spleen earth. In clinical treatment of a liver disease, the method of strengthening the spleen and normalizing the stomach is often taken as an auxiliary method.

Chapter Eight Treatment And Therapeutic Methods 1.Principles for Disease Prevention and Treatment (2) Treatment Principles ① Treatment Aimed at the Root of Disease The root is judged by comparing it with the branch. They may be used to explain the primary and the secondary in relation to various contradictions in the course of a disease. Clinically when using the principle of treatment aimed at the root of disease, one must understand “routine treatment and contrary treatment,” and “treating the branch and treating the root.”

Chapter Eight Treatment And Therapeutic Methods 1.Principles for Disease Prevention and Treatment (2) Treatment Principles ① Treatment Aimed at the Root of Disease Routine Treatment and Contrary Treatment Routine Treatment is a commonly used therapeutic method which goes against the nature of a syndrome. It is used to treat a disease with herbs and formulas whose natures are opposite to the nature of the disease. In treatment, one must apply the principle of heating what is cold, cooling what is hot, tonifying what is deficient, and reducing what is excessive.

Chapter Eight Treatment And Therapeutic Methods 1.Principles for Disease Prevention and Treatment (2) Treatment Principles ① Treatment Aimed at the Root of Disease Routine Treatment and Contrary Treatment Contrary Treatment is a therapeutic method for the false signs of a disease. It is suitable for cases whose manifestations are opposite of the natures of diseases, for cold syndromes with pseudo-heat symptoms, for heat syndromes with pseudo-heat symptoms, excess syndromes with pseudo-deficient symptoms, and deficient syndromes with pseudo-excess symptoms. For treatment, treat heat with heat, treat cold with cold, treat obstruction with tonics, and treat openness with purgatives.

Chapter Eight Treatment And Therapeutic Methods 1.Principles for Disease Prevention and Treatment (2) Treatment Principles Treating the Branch and the Root Treating the Branch in Emergencies When the branch aspect of the condition is very serious, the Branch should be treated at first. Treatment of the Root in Chronic Condition When the state of disease is mild, the root cause of the disease should be understood and treated. Treating the Branch and Root Simultaneously When both the branch and root are acute of chronic, the branch and the root should be treated at the same time.

Chapter Eight Treatment And Therapeutic Methods 1.Principles for Disease Prevention and Treatment (2) Treatment Principles ② Strengthening the Vital and Dispelling the Evil  Strengthening the Vital, Assisting the Anti-pathogenic- qi, Building up a Good Physique,  Dispelling the Evil, Eliminating Pathogenic Factors to Support the Vital.  Strengthening the vital is important for the body to resist and eliminate pathogenic factors; whereas dispelling evil relates to anti-pathogenic-qi for it eliminates the injuries and its vicious influence produced by pathogenic factors.

Chapter Eight Treatment And Therapeutic Methods 1.Principles for Disease Prevention and Treatment (3) Treatment Principles ③ Regulating yin and yang  Eliminating the Surplus Eliminating the surplus includes treating a case with an excess of yin or yang, yin or yang with reducing measures, or “reducing what is excessive.” Clearing away yang heat in an excess heat syndrome due to exuberance of yang heat or dispelling yin cold in a case of excess cold syndrome due to exuberance of internal yin cold are but a few examples.

Chapter Eight Treatment And Therapeutic Methods 1.Principles for Disease Prevention and Treatment (3) Treatment Principles ③ Regulating yin and yang  Supplementing the Deficient Supplementing the deficient is used in cases of an inferiority of yin or yang, deficiency of either yin or yang with tonifying measures, or “tonifying what is deficient.” For example, nourishing yin to check yang in a deficient heat syndrome due to yin deficiency; supplementing yang to check yin in a deficient cold syndrome due to yang deficiency.

Chapter Eight Treatment And Therapeutic Methods 1.Principles for Disease Prevention and Treatment (3) Treatment Principles ④ Treatment and the Season, Locality and Individual  Suiting Treatment to the season A clinical principle based on the characteristics of different seasons is “suiting treatment to the season.” Generally, in spring and summer, the temperature gradually changes from warm to hot, with yang-qi rising and the striae of skin and muscles loose and open. At this time, even in a case of wind-cold attack, pungent and warm herbs with dispersing actions should not be heavily used in over dosage so as not to injure the qi and yin to prevent too much dispersion.

Chapter Eight Treatment And Therapeutic Methods 1.Principles for Disease Prevention and Treatment (3) Treatment Principles ④ Treatment and the Season, Locality and Individual  Suiting Treatment to Locale A principle in deciding treatment based on geographic characteristics is known as “suiting treatment to locality.” In different regions and geographic environments climatic conditions, people customs, physiological activities and pathological features differ. Thus treatment methods and principles should differ as well.

Chapter Eight Treatment And Therapeutic Methods 1.Principles for Disease Prevention and Treatment (3) Treatment Principles ④ Treatment and the Season, Locality and Individual  Suiting Treatment to the Individual A principle determining treatment based on the characteristics of the patient` s age, sex, constitution, and customs is known as “suiting treatment to the individual.”

Chapter Eight Treatment And Therapeutic Methods 2. Therapeutic Methods Therapeutic methods of TCM are treatments of great specificity based on the ascertained differentiation of the syndrome and the ascertained diagnosis of pathogenic factors and pathogenesis. The traditional treatments fall into eight categories which are referred to as eight therapeutic methods: diaphoresis, emesis, purgation, mediation, warming, heat-reducing, elimination and tonification.

Chapter Eight Treatment And Therapeutic Methods 2. Therapeutic Methods ① Diaphoresis Diaphoresis is a therapeutic method that treats diseases with proper diaphoretics to disperse and relieve the exterior pathogens, mainly for the exterior syndromes and also for the early stage of wind edema, skin and external diseases such as sores, carbuncle and ulcers, and measles without “adequate eruption”.

Chapter Eight Treatment And Therapeutic Methods 2. Therapeutic Methods ② Emesis Emesis is a therapeutic method to expel phlegm, saliva, undigested food or toxic substances that retain in the throat, thoracic cavity or stomach, mainly for the removal of the phlegm and saliva clogging in the throat, or the stubborn phlegm retaining in the thoracic cavity, or the undigested food and toxic substances accidentally taken that still stay in the stomach.

Chapter Eight Treatment And Therapeutic Methods 2. Therapeutic Methods ③ Purgation It is applicable to constipation due to enterogastric pathogenic factors, or to syndromes caused by the domination of pathogen and vital-qi, such as fecal impaction due to heat with both watery discharge, stagnant phlegm and fluid retention, blood stasis and retention of water.

Chapter Eight Treatment And Therapeutic Methods 2. Therapeutic Methods ④ Mediation Mediation is a therapeutic method that eliminates pathogenic factors by way of mediation or regulation, and is mostly used to treat half-exterior and half- interior syndrome. It is applicable to the derangement of visceral qi and blood, or to the simultaneous occurrence of cold, heat-dampness pathogens, or to intermingled asthenic and sthenic syndrome.

Chapter Eight Treatment And Therapeutic Methods 2. Therapeutic Methods ⑤ Warming Warming is a therapeutic method that warms the middle- jiao, dispel pathogenic cold and helps recover yang, removes obstruction in the channels and collaterals, and regulates the blood vessels by getting rid of the cold, recuperating the depleted yang and activating the channels and collaterals. It is applicable to diseases in the viscera and in the channels and collaterals due to pathogenic cold.

Chapter Eight Treatment And Therapeutic Methods 2. Therapeutic Methods ⑥ Heat-reducing Heat-reducing is a therapeutic method that removes pathogenic heat and fire by clearing away heat and purging fire. It is applicable to interior heat syndromes. It has the functions of antisepsis, relieving inflammation and reducing fever. It is applicable to interior heat syndromes, chiefly heat syndromes of excess type, and also to certain heat syndromes of deficiency type.

Chapter Eight Treatment And Therapeutic Methods 2. Therapeutic Methods ⑦ Elimination Elimination is a therapeutic method that gradually eliminates the tangible lumps formed by the accumulation and stagnation of qi, blood, phlegm, retained food, water, worm and the like by promoting digestion and removing stagnancy as well as resolving masses and dissolving lumps.

Chapter Eight Treatment And Therapeutic Methods 2. Therapeutic Methods ⑧ Tonification Tonification is a therapeutic method that nourishes and invigorates the qi, blood, yin and yang of the human body. It is applicable to one or several of zang and fu- organs, or one of the qi, blood, yin and yang, or the weakness of all of them as a whole.

Fantastic Traditional Chinese Medicine Fantastic Traditional Chinese Medicine.

Similar presentations

Presentation on theme: "Fantastic Traditional Chinese Medicine Fantastic Traditional Chinese Medicine."— Presentation transcript:

Similar presentations

About project

Feedback

Log in

Auth with social network:

Fantastic Traditional Chinese Medicine Fantastic Traditional Chinese Medicine.

Similar presentations

Presentation on theme: "Fantastic Traditional Chinese Medicine Fantastic Traditional Chinese Medicine."— Presentation transcript:

Similar presentations

About project

Feedback