WHO INTERNATIONAL STANDARD TERMINOLOGIES ON TRADITIONAL MEDICINE IN THE WESTERN PACIFIC REGION WHO Library Cataloguing in Publication Data WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region 1. Medicine, Traditional. 2. Terminology ISBN 978 92 9061 248 7 (NLM Classification: WB50) © World Health Organization (2007) Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. For rights of reproduction or translation of WHO publications, in part or in toto, application should be made to the Office of Publications, World Health Organization, Geneva, Switzerland, or to the Regional Office for the Western Pacific, Manila, Philippines. The World Health Organization welcomes such applications. 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TABLE OF CONTENTS FOREWORD v ACKNOWLEDGEMENTS vii INTRODUCTION 1 GENERAL 9 BASIC THEORIES 13 Essential Qi Theory, Yin-yang Theory, and Five Phase Theory 13 Essence, Spirit, Qi, Blood, Fluid and Humor 17 Viscera and Bowels 21 Meridian and Collateral 28 Body Constituents and Orifices of Sense Organ 35 Cause of Disease 39 Mechanism of Disease 46 Others 76 DIAGNOSTICS 79 Inspection 80 Listening and Smelling Examination 87 Inquiry 88 Palpation 100 Eight Principle Pattern Identification/Syndrome Differentiation 106 Disease Cause Pattern Identification/Syndrome Differentiation 116 Qi-Blood Pattern Identification/Syndrome Differentiation 124 Fluid-Humor Pattern Identification/Syndrome Differentiation 129 Visceral Pattern Identification/Syndrome Differentiation 130 Various Pattern Identification/Syndrome Differentiation 146 Six-Meridian Pattern Identification/Syndrome Differentiation 152 Defense, Qi, Nutrient and Blood Pattern Identification/Syndrome Differentiation 156 Triple Energizer Pattern Identification/Syndrome Differentiation 160 DISEASE 162 Internal Medicine 162 External Medicine 177 Gynecology and Obstetrics 184 Pediatrics 189 Ophthalmology 194 Otorhinolaryngostomatology 198 Orthopedics and Traumatology 202 Others 202 THERAPEUTICS 204 Method of Treatment 205 ACUPUNCTURE AND MOXIBUSTION 233 Acupuncture 233 Moxibustion 251 Cupping 254 MEDICINAL TREATMENT 255 Medicinal 255 Formula 264 CLASSICS OF TRADITIONAL MEDICINE 271 Internal Classic 271 Cold Damage and Golden Chamber 271 Diagnostics 272 Warm (Pathogen) Disease 272 Materia Medica 273 Prescriptions/Formularies 274 Acupuncture and Moxibustion 276 Miscellaneous 277 REFERENCES 283 INDEX 285 ANNEX 349 v FOREWORD Traditional medicine has been practised for thousands of years. It was the only available method of health care in this part of the world before western modern medicine was introduced to our Region. Even after the advent of modern medicine, traditional medicine plays an important role in many countries. Since the Declaration of Alma-Ata mentioned the role of traditional practitioners in the primary health care in 1978, WHO started to pay attention to traditional medicine. Almost three decades later, in the Fifty-ninth World Health Assembly in Geneva in 2006, the 192 Member States were encouraged to integrate traditional medicine into their public health systems and to promote harmonization with western modern medicine. It shows how traditional medicine has rapidly and intensively strived and innovated in recent decades. In many ways, the WHO Western Pacific Region is playing a leading role in promoting the appropriate use of traditional medicine within the Organization. The main theme of our traditional medicine programme is “standardization with evidence-based approaches”. In this context, standardization of such areas of traditional medicine as terminology, acupuncture point locations, herbal medicine, research, clinical practice and information is ongoing. Science and civilization have developed because of language. Likewise, traditional medicine has been developing for thousands of years with its own set of terms. However, historical conditions have brought about various expressions in traditional medicine. Its subjective features have even intensified its diversities. Although traditional medicine can be defined with indigenous characters, its terminology should be standardized for modern usage. International standard terminology will greatly expedite scientific communications in traditional medicine societies. It is the very first step towards the globalization of traditional medicine. The WHO Regional Office for the Western Pacific has convened three meetings for developing international standard terminology on traditional medicine in Beijing, China in October 2004; Tokyo, Japan in June 2005; and Daegu, Republic of Korea in October 2005 and gained successful outcomes as shown in this monograph. I would like to express, on behalf of the World Health Organization, our sincere gratitude to those experts and institutes participating and supporting development of the WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region. It is hoped that this publication will contribute to the exchange of information throughout the world. Shigeru Omi, MD, Ph.D. Regional Director vii ACKNOWLEDGEMENTS The World Health Organization, Regional Office for the Western Pacific expresses its appreciation to all those who contributed to the production of this document. WHO recognizes the people who dedicated their lives to the development of traditional medicine in our Region from ancient times particularly the ancestors who are symbolized as Huangdi and Shennong. Appreciation is also extended to the experts who attended the meetings on development of International Standard Terminologies held in Beijing, China; Tokyo, Japan; and Daegu, Republic of Korea, as well as the external peer reviewers. We also wish to extend our gratitude to the Ministry of Health and Welfare, Republic of Korea for their financial support, to the State Administration of Traditional Chinese Medicine China, the Japan Liaison of Oriental Medicine and the World Federation of Chinese Medicine Societies, without which we would not have been able to publish this book. WHO INTERNATIONAL STANDARD TERMINOLOGIES ON TRADITIONAL MEDICINE IN THE WESTERN PACIFIC REGION 1 INTRODUCTION In the Western Pacific Region, the major system of traditional medicine which originated from ancient China has continued to develop not only in China but also in neighbouring countries and areas, particularly in Japan, the Republic of Korea and Viet Nam, with certain variations in accordance with local conditions, i.e. availability of natural resources, indigenous culture and political climate. Different names have been designated for this system of traditional medicine as it developed in various countries, such as Oriental medicine, traditional Chinese medicine, traditional Korean medicine, Kampo medicine and traditional Vietnamese medicine. They are collectively called traditional medicine (TRM) in the Western Pacific Region. Traditional medicine is a comprehensive system of medicine characterized by its own theoretical basis and practical experience. It includes herbal medicine, acupuncture and other non-medication therapies. Owing to its unique paradigm and remarkable efficacy with fewer adverse effects, this system of medicine has been attracting more and more interest internationally. Considering the recent rapid increase in the worldwide use of TRM, there is a pressing need for a common language, i.e. an international standard terminology. In 1981, the World Health Organization (WHO) Regional Office for the Western Pacific organized a Working Group for the Standardization of Acupuncture Nomenclature. After 10 years of effort, a consensus on the proposed standard international acupuncture nomenclature was reached by the Regional Office for the Western Pacific’s Working Group and then by the WHO Scientific Group in Geneva. In 1991, A Proposed Standard International Acupuncture Nomenclature was published by WHO in Geneva and a revised edition of Standard Acupuncture Nomenclature (Part 1 and 2) was published by the Regional Office for the Western Pacific in Manila. Practical use has proven these WHO publications to be invaluable contributions to international information exchange on acupuncture. However, the publications are still quite limited, only including nomenclature for the 14 meridians, 361 classical acupuncture points, 8 extra meridians, 48 extra points, 14 scalp acupuncture lines and a few terms related to acupuncture needles. Moreover, to meet the increasing demands of practice, education, research and exchange of information, there is an urgent need to develop standardized terminology and nomenclature for TRM as a whole. In 2004, recognizing that the main role of standards is for upgrading levels of quality, safety,