traditional chinese medicine and modern medicine
TRANSCRIPT
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TRADITIONAL CHINESE MEDICINE
AND MODERN MEDICINE
--- WHEN EAST MEETS WEST
BY MK Sastry
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TRADITIONAL CHINESE MEDICINE
(TCM)
Simplified Chinese: 中医学
Traditional Chinese: 中醫學
Pin Yin: zhōng yī 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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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
Huang-di Nei-jing (Canon of
Medicine): Suwen and
Lingshu
The earlist medical classic in
China
Compiled between 500 – 300
B.C.
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PRACTICES OF
TRADITIONAL CHINESE MEDICINE
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MODERN MEDICINE
Internal Medicine
Surgery
Immunotherapy
Radiotherapy
Chemotherapy
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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
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THE BASIC THEORIES OF
TRADITIONAL CHINESE MEDICINE
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MODERN MEDICINE
Anatomy
Biology
Physiology
Biochemistry
Immunology
Microbiology
Genetics
Pathology
Radiology
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1. Yin-Yang Theory
2. The Five Elements
3. Zang-Fu Therory
4. Meridians (Channels and Collaterals)
5. 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
Metal
Lung
Water
Kidney
Earth
Spleen
Fire
Heart
Inter-promoting
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 经络)
There are 12 regular channels and 8 extra
channels, which connect 400 acupuncture
points
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The twelve regular channels1. Hand or foot
2. Yin or yang
3. A zang or a fu organ
The small intestine channel of hand-taiyang
The spleen channel of foot-taiyin
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ZANG FU THEORY
Six zang organs: heart, liver, spleen, lung,
kidney, and pericardiumTo 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 sanjiaoTo 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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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
ZANG FU THEORY
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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)
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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
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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
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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
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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
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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 FactorsWind, Cold, Summer heat, Damp, Dryness, and
Heat (fire, mild heat)
Seven Emotional FactorsJoy, 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 望)
Smelling (wén 聞)
Inquiring (wèn 問)
Palpation (qiè 切)
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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
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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
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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
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
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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
1. According to the eight principles
2. According to the theory of zang-fu
3. According to the theory of meridians
(channels and collaterals)
Traditional Chinese Medicine differentiates syndromes
systematically in three ways
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:
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
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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 yin consumes yang
(Cold syndrome of the shi type)
Preponderance of yang consumes yin
(Heat 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)