TRADITIONAL CHINESE MEDICINE

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TRADITIONAL CHINESE MEDICINE AND MODERN
MEDICINE --- WHEN EAST MEETS WEST QIONG DI
WU, MSc, BSc, LICACU, TCMCI TUNG-CHI TRADITIONAL
CHINESE HEALTH CENTRE
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TRADITIONAL CHINESE MEDICINE (TCM) Simplified
Chinese ??? Traditional Chinese ??? Pin
Yin zhong yi xué
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HISTORY OF TRADITIONAL CHINESE MEDICINE

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TCM Several Thousand Years
MODERN MEDICINE Several Hundred Years
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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
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PRACTICES OF TRADITIONAL CHINESE MEDICINE
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MODERN MEDICINE Internal Medicine Surgery Immuno
therapy Radiotherapy Chemotherapy
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• 1. Chinese Herbal Medicine ??
• 2. Acupuncture and Moxibustion ??
• Cupping
• Gua Sha ??
• 3. Chinese Massage Tui Na ??
• Die-da or Tieh Ta ??

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THE BASIC THEORIES OF TRADITIONAL CHINESE MEDICINE
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MODERN MEDICINE Anatomy Biology Physiology Bioche
mistry Immunology Microbiology Genetics Pathology
Radiology
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• Yin-Yang Theory
• The Five Elements
• Zang-Fu Therory
• Meridians (Channels and Collaterals)
• Qi, Blood, and Body Fluid

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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
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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 Female Foot Abdomen Internal Zang
organs Substances Xu (deficiency)
Yang Male Head Back External Fu
organs Functions Shi (excess)
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THE FIVE ELEMENTS
Wood Liver
Fire Heart
Water Kidney
Inter-promoting
Metal Lung
Earth Spleen
Inter-acting
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MERIDIANS (CHANNELS AND COLLATERALS)
The body's vital energy, qi, circulates through
the body along specific interconnected channels
called Meridians (Jing-luo ??) There are 12
regular channels and 8 extra channels, which
connect 400 acupuncture points
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• The twelve regular channels
• Hand or foot
• Yin or yang
• A zang or a fu organ

The spleen channel of foot-taiyin
The small intestine channel of hand-taiyang
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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
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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
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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
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THE ZANG ORGANS

• Heart
• Controlling blood and vessels (blood circulation
  and nourishment of the whole body)
• Housing mind (governing mental activities, i.e.
  spirit, consciousness, thinking, and sleep)
• Opening into the tongue the tongue is the mirror
  of the heart (colour, form, motility, and sense
  of taste of the tongue)

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• Liver
• Storing blood (regulating the volume of
  circulating blood)
• 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)
• Controlling the tendons (the yin and blood of the
  liver nourish the tendons)
• Opening into the eye

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• Spleen
• Governing transportation and transformation
  (digestion, absorption, and transmission of
  essential substances, and normal functioning of
  the spleen is required for good appetite)
• Controlling blood (keeping blood circulating
  inside the vessels and preventing it from
  extravasation)
• Dominating the muscles (maintaining muscle
  thickness and strength)
• Opening into the mouth

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• Lung
• Dminating qi (air) and controlling respiration
  (inhaling clean qi to supply the bodys functions
  and exhaling waste qi)
• 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)
• Dominating the skin and hair (regulating the
  opening and closing of the pores on the entire
  body surface)
• Opening into the nose

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• Kidney
• 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)
• Producing marrow, dominating the bones, and
  manufacturing blood
• 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)
• Opening into the ear

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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
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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
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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
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THE ETIOLOGY OF TRADITIONAL CHINESE MEDICINE
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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
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THE DIAGNOSIS OF TRADITIONAL CHINESE MEDICINE
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MODERN MEDICINE Physical Examination Standard
Laboratory Tests Special Examinations
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METHODS OF DIAGNOSIS
Inspection (wàng ?) Smelling (wén ?) Inquiring
(wèn ?) Palpation (qiè ?)
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• Observation of the tongue
• Tongue proper
• Pale - xu in qi and blood, or cold syndrome due
  to weaknee of yang qi
• Red - heat syndrome of either shi (excess) or xu
  due to consumption of yin
• Deep red - xu due to exhausted yin
• Purplish stagnation of qi and blood
• Flabby larger than normal and whitish, xu in
  bth qi and yang
• Crached xu of yin and loss of the essnce of the
  kidney

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• Tongue coating (thin or thick, sticky or dry)
• White thick white coating indicates retention
  of food (xu in spleen), white sticky coating
  invasion of cold damp
• Yellow yellow sticky coating indicates
  accumulation of damp-heat in the interior dry
  yellow coating indicates accumulation of heat
  (damage to the yin)
• Peeled (geographic tongue) long illness and
  gross xu (deficiency) in the yin

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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
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PALPATION - RADIAL ARTERY PULSE
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• Abnormal pulse
• Superficial pulse
• Deep pulse
• Slow pulse
• Rapid pulse
• Pulse of the xu (deficiency) type
• Pulse of the shi (excess) type
• Wiry pulse
• Rolling pulse
• Thready pulse
• Short pulse
• Knotted pulse
• Intermittent pulse
• Long clinical experience is required to correctly
  identify the different types of pulse

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DIFFERENTIATION OF SYNDROMES BY TRADITIONAL
CHINESE MEDICINE
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MODERN MEDICINE According to the
causes According to the systems or organs
involved According to the degrees or the
properties of the diseases
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DIFFERENTIATION OF SYNDROMES
Traditional Chinese Medicine differentiates
syndromes systematically in three ways

• According to the eight principles
• According to the theory of zang-fu
• 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
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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
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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
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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
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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)
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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
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THE THEORY OF ZANG FU

• To identify visceral diseases
• Syndromes of the heart, liver, spleen, lung,
  kidney, and pericardium
• Syndromes of the small intestine, gall bladder,
  stomach, large intestine, and urinary bladder

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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
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PRINCIPLES OF TREATMENT BY TRADITIONAL CHINESE
MEDICINE
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TCM Treats Humans
MODERN MEDICINE Treats Diseases
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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
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Equilibrium of yin and yang - Healthy
Preponderance of yang consumes yin (Heat syndrome
of the shi type)
Preponderance of yin consumes yang (Cold syndrome
of the shi type)
Weakness of yang causes preponderance of yin
(Cold syndrome of the xu type)
Weakness of yin causes preponderance of yang
(Heat syndrome of the xu type)