TRADITIONAL CHINESE MEDICINE AND MODERN MEDICINE --- WHEN EAST MEETS WEST
BY MK Sastry TRADITIONAL CHINESE MEDICINE (TCM)
Simplified Chinese: 中医学 Traditional Chinese: 中醫學 Pin Yin: zhōng yī xué HISTORY OF TRADITIONAL CHINESE MEDICINE TCM MODERN MEDICINE
Several Thousand Years Several Hundred Years Huang-di Nei-jing (Canon of Medicine): Suwen and Lingshu The earlist medical classic in China Compiled between 500 – 300 B.C.
Summary of the medical experience and theoretical knowledge including yin-yang, the five elements, zang- fu, meridians (channels and collaterals), qi (vital energy) and blood, etiology, pathology, dignostic methods, differentiation of syndromes, As well as basic knowledge of acupuncture points and needling methods PRACTICES OF TRADITIONAL CHINESE MEDICINE MODERN MEDICINE
Internal Medicine Surgery
Immunotherapy Radiotherapy Chemotherapy 1. Chinese Herbal Medicine 中药
2. Acupuncture and Moxibustion 針灸 Cupping Gua Sha 刮痧
3. Chinese Massage – Tui Na 推拿 Die-da or Tieh Ta – 跌打 THE BASIC THEORIES OF TRADITIONAL CHINESE MEDICINE MODERN MEDICINE
Anatomy Biology Physiology Biochemistry Immunology Microbiology Genetics Pathology Radiology 1. Yin-Yang Theory
2. The Five Elements
3. Zang-Fu Therory
4. Meridians (Channels and Collaterals)
5. Qi, Blood, and Body Fluid THE THEORIES OF YIN-YANG AND FIVE ELEMENTS
The theories of yin-yang and the five elements were two kinds of outlook on nature in ancient China
Chinese ancient physicians applied these two theories in traditional Chinese medicine, which have guided clinical practice up to the present YIN-YANG THEORY
The theory yin-yang holds that the every subject or phenomenon in the universe consists of two opposite sepects, namely, yin and yang
Yin Yang
Female Male Foot Head Abdomen Back Internal External Zang organs Fu organs Substances Functions Xu (deficiency) Shi (excess) THE FIVE ELEMENTS
Wood Liver
Inter-promoting Metal Earth Inter-acting Lung Spleen MERIDIANS (CHANNELS AND COLLATERALS)
The body's vital energy, qi, circulates through the body along specific interconnected channels called Meridians (Jing-luo 经络)
There are 12 regular channels and 8 extra channels, which connect 400 acupuncture points The twelve regular channels 1. Hand or foot 2. Yin or yang 3. A zang or a fu organ The spleen channel of foot-taiyin
The small intestine channel of hand-taiyang ZANG FU THEORY
Six zang organs: heart, liver, spleen, lung, kidney, and pericardium To manufacture and store essential substances including vital essence, qi (vital energy), blood, and body fluid
Six fu organs: small intestine, gall bladder, stomach, large intestine, urinary bladder, and sanjiao To receive and digest food, absorb nutrient substances, transmit and excrete wastes ZANG FU THEORY
Each zang organ is linked with a fu organ by a channel, a situation known as external-internal relation
Heart - Small intestine Liver - Gall bladder Spleen - Stomach Lung - Large intestine Kidney – Urinary bladder Pericardium - Sanjiao ZANG FU THEORY
Each zang organ opens into a sense organ, indicating a close structural or physiological and pathological relationship between the internal organs and the sense organs
Heart – Tongue Liver – Eye Spleen – Mouth Lung – Nose Kidney - Ear THE ZANG ORGANS
Heart
1. Controlling blood and vessels (blood circulation and nourishment of the whole body)
2. Housing mind (governing mental activities, i.e. spirit, consciousness, thinking, and sleep)
3. Opening into the tongue: the tongue is the mirror of the heart (colour, form, motility, and sense of taste of the tongue) Liver
1. Storing blood (regulating the volume of circulating blood)
2. Maintaining patency for the flow of qi (promoting functional activities of the human body including all other zang-fu organs, and regulating emotional activities, especially depression and anger)
3. Controlling the tendons (the yin and blood of the liver nourish the tendons)
4. Opening into the eye Spleen
1. Governing transportation and transformation (digestion, absorption, and transmission of essential substances, and normal functioning of the spleen is required for good appetite)
2. Controlling blood (keeping blood circulating inside the vessels and preventing it from extravasation)
3. Dominating the muscles (maintaining muscle thickness and strength)
4. Opening into the mouth Lung
1. Dminating qi (air) and controlling respiration (inhaling clean qi to supply the body’s functions and exhaling waste qi)
2. Regulating water passages (promoting water metabolism by turning one part of the body fluid into sweat to be excreted, also sending other part of the body fluid down to the kidney to be excreted as urine)
3. Dominating the skin and hair (regulating the opening and closing of the pores on the entire body surface)
4. Opening into the nose Kidney
1. Storing essence and dominating reproduction, growth and development (essence in the kidney - the yin of the kidney, either inherited from the parents or acquired from the essential substances of food)
2. Producing marrow, dominating the bones, and manufacturing blood
3. Dominating water metablism (one part of the bod fluid sent down by lung is divided by the yang function of the kidney into clear and turbid parts)
4. Opening into the ear QI, BLOOD AND BODY FLUID
Qi, blood, and body fluid are fundamental substances in the human body to sustain normal vital activities
Qi, blood, and body fluid, together with the zang-fu organs and the meridians (channels and collaterals), constitute the theoretical basis of human physiology in traditional Chinese medicine Qi
Qi is involved in physiology, pathology, and clinical treatment
Qi implies both substances and function: clean qi, waste qi, and qi from essence of food are material qi the qi of the zang organs, and the qi of meridians are functional qi
Source qi (yuang-qi) – the qi of the kidney Essential qi (zong-qi) – nourishing the heart and lung Defensive qi (wei-qi) – defending the body against exogenous etiological factors Blood
Blood is constituted of nutrient qi, body fluid, and essence of the kidney, and its formation requires the co-ordination of the zang organs including spleen, kidney, heart, and lung
Blood and qi are closely related. Clinically, xu (deficiency) of qi often leads to xu (deficiency) of blood, and xu (deficiency) of blood, in turn, often results in xu (deficiency) of qi THE ETIOLOGY OF TRADITIONAL CHINESE MEDICINE ETIOLOGY
Six Exogenous Factors Wind, Cold, Summer heat, Damp, Dryness, and Heat (fire, mild heat)
Seven Emotional Factors Joy, Anger, Melancholy, Meditation, Grief, Fear, and Fright THE DIAGNOSIS OF TRADITIONAL CHINESE MEDICINE MODERN MEDICINE
Physical Examination
Standard Laboratory Tests
Special Examinations METHODS OF DIAGNOSIS
Inspection (wàng 望)
Smelling (wén 聞)
Inquiring (wèn 問)
Palpation (qiè 切) Observation of the tongue
Tongue proper
1. Pale - xu in qi and blood, or cold syndrome due to weaknee of yang qi 2. Red - heat syndrome of either shi (excess) or xu due to consumption of yin 3. Deep red - xu due to exhausted yin 4. Purplish – stagnation of qi and blood 5. Flabby – larger than normal and whitish, xu in bth qi and yang 6. Crached – xu of yin and loss of the essnce of the kidney Tongue coating (thin or thick, sticky or dry)
1. White – thick white coating indicates retention of food (xu in spleen), white sticky coating invasion of cold damp 2. Yellow – yellow sticky coating indicates accumulation of damp-heat in the interior; dry yellow coating indicates accumulation of heat (damage to the yin) 3. Peeled (geographic tongue) – long illness and gross xu (deficiency) in the yin Observation of the tongue proper is to differentiate xu (deficiency) or shi (excess) state of the zang-fu organs, qi, blood, and body fluid
Whereas observation of the tongue coating is to judge the condition of pathogenic factors PALPATION - RADIAL ARTERY PULSE Abnormal pulse
1. Superficial pulse 2. Deep pulse 3. Slow pulse 4. Rapid pulse 5. Pulse of the xu (deficiency) type 6. Pulse of the shi (excess) type 7. Wiry pulse 8. Rolling pulse 9. Thready pulse 10. Short pulse 11. Knotted pulse 12. Intermittent pulse
Long clinical experience is required to correctly identify the different types of pulse DIFFERENTIATION OF SYNDROMES BY TRADITIONAL CHINESE MEDICINE MODERN MEDICINE
According to the causes
According to the systems or organs involved
According to the degrees or the properties of the diseases DIFFERENTIATION OF SYNDROMES
Traditional Chinese Medicine differentiates syndromes systematically in three ways
1. According to the eight principles 2. According to the theory of zang-fu 3. According to the theory of meridians (channels and collaterals)
Each of these three lays stress on a particular aspect, at the same time connecting with and supplementing one another EIGHT PRINCIPLES
Exterior vs Interior – the depth of the disease
Cold vs Heat – nature of the disease
Xu (deficiency) vs Shi (Excess) – the opposing force in the struggle between the anti-pathogenic and the pathogenic factors
Yin vs Yang – the categories of the disease Exterior vs Interior – the depth of the disease
Exterior syndromes are mild and superficial
Interior syndromes are mostly severe and deep, with damage of the zang-fu organs Cold vs Heat – nature of the disease
Diseases caused by pathogenic cold and damp are mostly cold syndromes
Diseases caused by heat, summer heat and dryness are mostly heat syndromes Xu (deficiency) vs Shi (excess) – the opposing force in the struggle between the anti-pathogenic and the pathogenic factors
Syndromes of xu type indicate function of the body is weak, the anti-pathogenic factor is insufficient and the co-ordination of yin and yang is impaired Treatment – reinforcing (bu)
Syndromes of shi type indicate body function is not to the point of impairment and the anti-pathogenic factor is still sufficient Treatment – reducing (xie) Yin vs Yang – the categories of the disease
Yin and Yang are the chief principles among eight
Yin category – interior syndromes, cold syndromes and syndromes of the xu (deficiency) type
Yang category – exterior syndromes, heat syndromes and syndromes of the shi (excess) type THE THEORY OF ZANG FU
To identify visceral diseases:
1. Syndromes of the heart, liver, spleen, lung, kidney, and pericardium
2. Syndromes of the small intestine, gall bladder, stomach, large intestine, and urinary bladder THE THEORY OF MERIDIANS (CHANNELS AND COLLATERLS)
Differentiation of diseases on the basis of the physiology of meridians gives direct guidance to clinical therapy by acupuncture and moxibustion PRINCIPLES OF TREATMENT BY TRADITIONAL CHINESE MEDICINE TCM MODERN MEDICINE
Treats Humans Treats Diseases The human body is endowed with the ability to resist the invasion of different pathogenic factors. This ability is called anti-pathogenic qi (factor)
Traditional Chinese medicine attaches the great importance to the anti-pathogenic factor
For example, well-balanced human bodies can resist most everyday bacteria and viruses, which are ubiquitous and quickly changing. Infection, while having a proximal cause of a microorganism, would have an underlying cause of an imbalance of some kind. The traditional Chinese medicine would target the imbalance, not the infectious microorganism Equilibrium of yin and yang - Healthy
Preponderance of yin consumes yang Preponderance of yang consumes yin (Cold syndrome of the shi type) (Heat syndrome of the shi type)
Weakness of yang causes preponderance Weakness of yin causes preponderance of yin (Cold syndrome of the xu type) of yang (Heat syndrome of the xu type)