Health Concepts in Chinese Med

Basic Theories in Chinese Medicine?

Module 1.1 – Historical Outline of Chinese Medicine?I will start this course by showing you the historical outline on the development of Chinese Medicine. After watching the video show, you have already got a brief idea about the representative literature of Chinese Medicine. In this video, I am going to explain further the development of Chinese Medicine up to the 16th Century. In the second half of the fifth century B.C., a feudal society began to develop in China. Chinese Medicine evolved into a unique and integrated theoretical system over a period of 700 years. The long years of accumulation of documented experience and repeated testing culminated in the initial establishment of the four important components of the theoretical basis of Chinese Medicine namely, theory, methodology, prescription, and pharmacy. More than 2000 years ago, Huangdi’s Classic on Medicine, the earliest medical classic extant in China, appeared. The book consists of two parts: Basic Questions and Miraculous Pivot. The book gives a complete and systematic exposition to the following subjects, including: the relationship between man and nature; the physiology and pathology of the human body; and the diagnosis, treatment and prevention of diseases. In addition to the book on medicine, Shen Nong’s Classic on Herbalism, also known as Classic on the Herbal, is the earliest book on materia medica in China - it appeared around the Qin-Han Period but its authorship being unknown. Not only does it list 365 medicinal items – among which 252 are herbs, 67 are animal parts, and 46 are minerals, but it also divides them into three categories according to their different properties and effects. Shen Nong’s Classic on Herbalism also gives a brief account of pharmaceutical/formulation principles. The underlying pharmaceutical theories, which still serve as a useful guide in contemporary clinical practice, had profound influence on the development of pharmaceutical science in China. In the Han Dynasty (3rd century A.D.), Zhang Zhongjing, an outstanding physician and renowned as “The Father of Medical Prescription”, authored “Treatise on Febrile and Miscellaneous Diseases”. The treatise was later sub-divided into two books; one entitled “Treatise on Febrile Diseases” and the other “Synopsis of Prescriptions of Golden Cabinet”. The book established scientific principles, which are still used nowadays, to guide the clinical practice of Chinese Medicine. These scientific principles of clinical practice include: Classification of Symptoms according to the six Meridians, Four Diagnostic Methods of Chinese Medicine, namely, inspection, listening and auscultation, questioning, and pulse-taking/ 1 palpation, Eight Principal Syndromes and Eight Therapeutic Methods, Three Causes of Disease, in that the etiologies of all diseases are viewed as falling into one of the three categories. The book recorded 375 prescriptions, involving 214 medicinal items. These included most of the commonly used prescriptions in clinical practice and a variety of pharmaceutical dosage forms. In the Western Jin Dynasty, Huang Fumi, a famous physician, compiled “A-B Classic of Acupuncture and Moxibustion”. It is the earliest extant work dealing exclusively with acupuncture and moxibustion, and indeed is one of the most influential works in the history of acupuncture and moxibustion. In 610 A.D. (during the Tang Dynasty), Chao Yuanfan and his co-workers compiled “General Treatise on Etiology and Symptomology”. This is the earliest extant classic on etiology and symptoms in Chinese Medicine. In 657 A.D., Su Jing, together with 20 other scholars, compiled “Newly-Revised Materia Medica” which is the first pharmacopoeia sponsored officially in ancient China and also the earliest pharmacopoeia in the world. Sun Simiao in Tang Dynasty devoted all his life to composing two books: “Valuable Prescriptions for Emergencies” and “Supplement to Valuable Prescriptions”. These two books deal with general medical theory, materia medica, gynecology and obstetrics, pediatrics, acupuncture and moxibustion, diet, health preservation, and prescriptions for various medical conditions. Because of the profound contribution, Sun Simiao was honored as “The King of Herbal Medicine”. The two books are representative medical publications in the Tang Dynasty. Li Shizhen (1518-1593 A.D.), a famous physician and pharmacologist in the Ming Dynasty, compiled “The Compendium of Materia Medica”. The book consists of 52 volumes with 1,892 medicinal herbs, including over 10,000 prescriptions and 1,000 illustrations of medicinal items. After understanding more about the development of Chinese Medicine, we can see that a complete theoretical system of Chinese Medicine is established by the accumulation of more than two thousand years of work and experience. In the coming videos I will introduce some basic theories in Chinese Medicine.

Module 1.2 – Yin-Yang Theory?In this video, we will discuss the Yin-Yang Theory. The Yin-Yang Theory is one of the most fundamental theories guiding the practice of Chinese Medicine in the prevention and treatment of diseases. As mentioned in the video show, matter/subject (such as the Sun and the Moon, female and male gender) has opposing Yin and Yang aspects. According to ancient Chinese philosophy, these are mutually controlled and inhibited by each other, resulting in a state of dynamic equilibrium or balance. If the relative balance between Yin and Yang is disrupted within the body, it will exhibit either an excess or a deficiency of Yin or Yang, which can lead to the development of disease. The Yin-Yang concept is not unique to Chinese culture; there are many analogous examples in science – such as positive ions and negative ions, anode and cathode, cGMP and cAMP, and sympathetic and parasympathetic nervous system, all of which are mutually opposing and therefore comparable to the Yin-Yang concept. Prof Sutherland earned a Nobel Prize in 1971 by demonstrating the antagonistic actions of cGMP and cAMP in regulating cellular function in a similar fashion to the Yin and Yang concept. Furthermore, the opposing action of parasympathetic and sympathetic nervous systems is exemplified by slowing down the heart beat and accelerating the heart beat, respectively. According to Chinese Medicine theory, there is an inter-dependence between Yin and Yang in the body, which is reflected in the relationship between material (which is Yin) and function (which is Yang). Whereas Yin refers to the material/structural basis of functional activity, Yang is the functional activity itself. A dissociation of Yin and Yang can lead to death. The activity (Yang) of the body is nourished by its physical structure/form (Yin), and the physical structure/form is created and maintained by the body’s activity (Yang). As such, Yin and Yang rely on each other to achieve a balanced state of health. The presence of Yin in a Yang system and vice-versa allows the two components to interact in three fundamental modalities. First of all, Yin and Yang are opposing forces in a system. For example, one calendar day consists of day time and night time. Temperature is felt as hot or cold. The hand has a backside and a palm side, and the body has a dorsal and a ventral side. A disease can be viewed as progressing or regressing. There is the co-existence of Yin and Yang and a dynamic equilibrium between them – the change in one aspect is compensated for by a reciprocal increase or decrease in the opposite component. 1 Secondly, Yin and Yang are inter-dependent, meaning that there is no Yin without Yang and no Yang without Yin. The character of Yin manifests itself in the presence of Yang. A little Yin can check the excessive expansion of Yang. A total separation of Yin from Yang will inevitably result in the collapse of the system. Thirdly, Yin can transform into Yang and vice-versa. There is a common Chinese saying that “a matter reaching its extreme will turn into its opposite”. Thus, in a state of excessive Yin, the Yang component will grow. By the same token, the chill one feels during a sustained high fever is an indication of an inadequate energy supply. At this point it is important to keep the body warm by food or by covering instead of cooling it. In extreme debility, it is necessary to warm the body by food or medicine even though one feels warmth in the palms and soles. This is a state of “virtual fever” but not actually a febrile symptom. Chinese Medicine theory proposes that Yin-Yang disharmony can be the cause of diseases. Disharmony indicates that the proportions of Yin and Yang are unbalanced. There are many factors that can cause Yin and Yang disharmony. All related to “pernicious evils” (that means, pathogenic factors) and the flow of Qi throughout the body. As described in the video show, the interaction between Yin and Yang in the body generates Normal Qi (simply called Qi), which then circulates along Meridians in a fixed pattern and cyclic manner. When Qi flows smoothly in the body, it functions well and has a fully operational immune system, allowing a speedy recovery from illness. Qi is comprised of Defensive-Qi (responsible for defense) and Nutritive-Qi (responsible for nutrition), whereas the so called “pernicious evils” consist of Yang types, namely wind dryness, summer heat and fire, and Yin type, namely, cold and dampness. Hence in Chinese Medicine, disease is viewed as resulting from either a deficiency of Qi or an excess of “pernicious evils”. By applying the Yin-Yang theory in the diagnosis and treatment of diseases, YinYang harmony can be restored and a healthy status can be achieved and maintained.

Module 1.3 Five Element Theory?In this video, I will introduce the Five Element Theory. Together with the Yin-Yang Theory, the Five Element Theory provides the basis for explaining physiological functions in humans. The Five Element Theory evolved from the study of various processes, functions and phenomena in nature. The theory classifies matter into one of the five categories represented by Wood, Fire, Earth, Metal and Water, and this is used in Chinese Medicine to explain the functions of various organs and their inter-relationships such as generation and suppression. The Five Elements have distinct characteristics: Wood grows and flourishes freely like a tree; Fire warms in an upward flaring pattern that can influence functions of organs in the upper part of the body; Earth promotes growth and nourishes life processes like supporting plant growth by soil; Metal descends and clarifies, producing an astringent action relating to the function of the lungs in air exchange; Water moistens, cools and flows downward relating to the function of the kidneys in filtering blood. Organ functions can be characterized by their respective five elements. For example: Liver Qi has an ascending nature; it can influence the function of the brain which is located at a higher position. Heart Qi brings about warmth by enabling the perfusion of organs with blood that supplies fuel molecules for energy production. Spleen Qi is responsible for digestion and transportation of nutrients. Lung Qi has a descending nature and works in concert with organs in the lower part of the body, and Kidney Qi regulates the circulation of water and body fluid relating to the function of kidneys. As one needs more than one material to build or achieve something by combining them, one perceives a particular closer relationship between two Elements than the others. For example, Water supports the growth of Wood but quenches Fire. So, the relationship between these two Elements can be either “Pro” or ‘Con” with a particular Element, or in the words of the Five Element Theory, “generation” or “suppression”. The balance between generation and suppression is important for the normal transformation of the Five Elements. Each Element is under the influence of the other four in some ways (for example, generation Vs suppression, subjugation Vs counter-suppression). In this way, all Five Elements establish an intricate homeostasis in nature. Regarding the process of generation, one can promote, aid or bring forth another; it can be viewed as “mother-child” relationship. In suppression, one can bring under control or restrain another. Generation and suppression among the Five Elements are of functional importance. Without generation, there would be no growth or development. On the other hand, without suppression, there would be no balance or co-ordination during development and change. Subjugation occurs 1 when one of the Five Elements dominates (in terms of suppression) on another when the latter is weak, whereas counter-suppression is the condition when “the strong bullies the weak”, which is the reverse of suppression. The inter-relationships among the functions of Zang-Fu organs can also be depicted by the Five Element theory. In the case of disease states, the Five Element theory, in particular, subjugation and counter suppression, can explain the pathological influences among Zang-Fu organs. For example, Liver can transmit its “disease” to the Spleen by virtue of subjugation from Wood to Earth; On the other hand, “troubled” Spleen affects the Liver by counter-suppression from Earth to Wood. The Five Element Theory is an important reasoning process in clinical application, for example, generation and development of a disease, spreading a disease from one site to another, or approach in disease management. The Yin-Yang and Five Element Theories are often used simultaneously to explain natural phenomena. While Yin-Yang refers to the dynamic changes determining an event, the Five Elements correspond to different aspects of the natural world and the body. Different aspects work closely together and have their own internal orders and patterns.

Module 1.4 Qi and Blood?In this video, we will discuss the Qi and Blood. Qi and Blood are two essential components for supporting life activities in the body. Chinese Medicine recognizes Qi as a substance composed of infinitestimal particles and the power it manifests. More than a fluid substance, Qi permeates everywhere without regard to the vessel that conducts it, or the compartment that contains it, or the organ that holds it. The ancient Chinese believed that Qi was the most fundamental entity making up the world. They thought matter in the Universe resulted from the movement and change of Qi. In Chinese Medicine, Qi is the energy that flows through the body and is responsible for nourishing and maintaining organs and tissues, as well as providing the 'fuel' for metabolic processes in the body. In so doing, Qi travels in energetic pathways called Meridians (also called channels and collaterals through which Qi circulates). There are three origins from which Qi is derived. Firstly, it is Primordial Qi that is passed on to progeny by their parents; this refers to the ensemble of genetic information carried over by the gametes. Secondly, Grain Qi is transformed from water and cereals and, thirdly, Clear Qi is the clean air one inhales; the latter two constitute the postnatal Qi. Grain Qi obviously consists of nutrients and the clean air, oxygen. Clean air is mixed with Grain Qi to form Pectoral Qi, which in turn combines with Primordial Qi to generate Normal Qi. Normal Qi is a collective term of Defensive Qi and Nutritive Qi. Primordial Qi is the primary motive force of life activities. Primordial Qi derives from the “congenital” essence stored in the Kidney, and sustained by the acquired essence generated by the Spleen and Stomach. Abundancy of Primordial Qi ensures the unimpeded functioning of various organs, leading to a state of optimal health. Pectoral Qi performs two main functions. One involves traveling through the respiratory tract to promote respiration, and the insufficiency of Pectoral Qi influences can lead to pathological conditions of voice, speech or breath. The other transverses through the Heart Meridian to promote the circulation of Qi and Blood. The relative strength of Pectoral Qi therefore relates to the flow of Qi and Blood, body temperature and activities of the trunk and limbs, visual and aural perceptibility, as well as the strength and rhythm of the heart beat. 1 Nutritive Qi flows in the blood vessels to all parts of the body and becomes an important component of the Blood. Functionally speaking, Nutritive Qi supplies the body with nutrients and promotes blood production to nourish visceral organs. Defensive Qi circulates swiftly outside the blood vessels and travels between skin and muscle. As such, it defends the body’s surface against invasion by exogenous pathogenic factors, warms the visceral organs, muscle, skin and hair, and controls the opening and closing of pores for excretion of sweat to maintain a stable body temperature. Strong Defensive Qi therefore positively correlates with the body’s resistance to diseases and to the ability to maintain a constant body temperature. Put simply, Normal Qi is the supply of energy that sustains life, its development and responses to challenges. On the other hand, Blood is the red color liquid circulating within blood vessels. It nourishes and moistens all parts of the body; it is indispensable for the expression of all body activities. Chinese Medicine theory states that Blood is acted upon and energized by Qi. In Chinese Medicine, the Kidney essence is inter-convertible with Blood and hence plays an important role in Blood formation. The involvement of Kidney in Blood formation is interesting as the importance of erythropoietin (a protein that stimulates red blood cell formation) derived the kidneys is now well known in Modern Medicine. Chinese Medicine is fully aware that there are different aspects of Blood formation, its nourishment, its oxygenation and the controlling factor of red blood cell formation. For the Blood to move along the vasculature in a smooth flow, it must be driven by Pectoral Qi from the Lung, stored and released from the Liver as need and be retained in the blood vessels through the action of the Spleen. In this way, all visceral organs participate in the generation and operation of the Blood, a fact that demonstrates its primary importance in sustaining life.

Module 1.5 Meridian and Zang Fu?Theories To conclude our discussion of the basic theories in Chinese Medicine, I will make brief mentions of the Meridian and Zang Fu Theories. Qi travels in energetic pathways called Meridians. The network of Meridians not only serves as a means of delivering Qi to all tissues and organs, but also acts as a communication network between them. When a disorder of one organ's Qi develops, it influences the functioning of other organs by disrupting the Meridian network as a whole. This forms the underlying basis of “holisicity” in Chinese Medicine, as depicted by the Five Element Theory. Under physiological conditions, Meridians link up various organs and thereby enable the communication between various parts of the body, facilitate the flow of Qi and Blood and defend the body against invading microorganisms. Under pathological conditions, invading microorganisms can move from the external surface to the interior portions of the body via the Meridians, favoring the progress of the disease. With the connection through the Meridians, disorders can be transmitted from one organ to another. “Zang and Fu” refers to all internal organs in the body. The Zang-Fu theory describes how the functional status of various organs can be manifested as external signs and symptoms. Zang and Fu organs and essential elements (those are vital essence, Qi, spirit, blood and body fluid) constitute the body and vitality. The structural and functional relationships between external organs (such as skin, muscle, tendon, bone, blood vessel, mouth, ear, nose and tongue) and internal organs are illustrated. Let’s conclude the basic theories in Chinese Medicine. The Yin-Yang and Five Element Theories represent fundamental methods of reasoning that have given rise to the principles of Chinese Medicine in theory and practice. Put simply, Yin-Yang refers to the dynamic aspect of an event, whereas the Five Element Theory refers to the immutable inherent property of an object or a substance. The two theories can relate to one another through the participation of Qi, the energy that makes things move. In Chinese Medicine, Qi is closely associated with Blood, which is also indispensable for the expression of activity. According to Chinese Medicine theory, following the differentiation of the Universe into Yin and Yang, the reunion between them generates Qi that flows along the Meridians to all Zang Fu organs; the ensemble of Yin, Yang and Qi gives rise to the myriad facets of life. 1 In practical terms, optimal health involves a balance between Yin and Yang elements and consequently a sub-healthy status or disease is seen as the dominance of Yin over Yang, or the contrary, to varying extents. The restoration of Yin-Yang balance and thus a normal Qi flow is therefore essential to regaining a healthy status.