A bit more background to Traditional Chinese Medicine

A bit more background to to Traditional Chinese Medicine Sunny K. Pak, MSTCM, LAc 1 Key Texts and Figures • (Pre 1000 B.C.) Yi Jing – Book of Changes – Laws of transformation – ability to predict • (~1000 - 200 B.C.) Basic Medical Theory – Huang Di Nei Jing – Yellow Emperor’s Interior Classic • anatomy, physiology, etiology, diagnosis, and treatment. • (~200 B.C.) Materia Medica – Shen Nong Ben Cao Jing – Divine Husbandman’s Classic of the Materia Medica - 365 Entries • (~250 A.D.) Anesthesia, and surgery - Hua Tuo 2 Key Texts and Figures • (~250 A.D.) – Huang Fumi – Earliest known text on acupuncture • Zhen Jiu Jia Yi Jing - A-B Classic of Acupuncture and Moxibustion • (~300 A.D.) – Zhang Zhong Jing – Earliest known text on herbal prescriptions • Shang Han Lun - Treatise on Febrile Disease – exterior pathogens • Jin Gui Yao Lu - Synopsis of Prescriptions of the Golden Chamber – internal medicine 3 Key Texts, Figures, and Events • (610 A.D.) Medical Specialties – internal medicine, surgery, gynecology, pediatrics, five sense organs, and parasitology. • (1026 A.D.) Imperial Medical Bureau  NIH – Extensive curriculum, and bronze statue for acupuncture, editing bureau of medical texts. 4 Key Texts, Figures, and Events • (1518-1593) Li Shi Zhen – Ben Cao Gang Mu - Compendium of Materia Medica: 1,892 entries and 10,000 prescriptions • (11th century) - First vaccination for smallpox. • (17-19th century) - First ideas of epidemic pathogens: Entry via nose and mouth • 20-21st century - Influence of western medicine, • Combination of the two medicines. 5 Central Concept of TCM • Organism as a whole • Relationships – Between organs – Between human and nature » Different diseases occur during different seasons » Circadian rhythm – seasons and insomnia 6 Central Concept of TCM – Balance • Yin Yang / Wu Xing (Five Phases) • Homeostasis – Overall analysis to reach diagnosis – Treatment principles – Finding the “root” cause 7 Yin Yang • Yi Jing – Book of Changes • Character meaning – Yin – Radical is about mound or hill, root describe the side facing away from the sun and mist. – Yang - Radical is about mound or hill, root describe the side facing toward the sun. 8 Yin Yang Yin – cold, weak, restricted, dark, visible, heavy, turbid, downward, inward. Yang – hot, excited, moving, strong, bright, invisible, light, clear, upward, outward. 9 Yin Yang • Opposition and Interdependence • Relative: Back / Chest • Concept of health – plant analogy • Rise and Decline • Transformation - Extreme decrease in Yin leads to a Yang condition and vice versa » Insomnia 10 Wu Xing - Five Phases (Elements) • Fire, Earth, Metal, Water, Wood. • Categorizing tool – Separate according to innate qualities. – Related to Yin and Yang. • More concrete categorization. • Synthesize and summary with observation of nature. • Xing = Phases – Denotes movement of energies 11 Wu Xing Five Phases Cycle FIRE WOOD EARTH WATER METAL 12 Five Phases and Human Body Viscera Wood Liver Bowels Gall Bladder Sense Seasons Organs Eyes Spring Emotions Anger Fire Earth Heart Spleen Small Intestine Stomach Tongue Mouth Summer Long Summer Joy Concern Metal Water Lung Kidney Large Intestine Urinary Bladder Nose Ear Autumn Winter Grief Fear 13 Zang Fu (Organ Systems) To Summarize… – Categorizes and unifies different parts of the body • Spans different systems in Western anatomy • Need clarification during interpretation & translation »Example: Liver Qi stagnation 14 Qi • Qi Energy – Different types with different functions – Derive from two major sources: • Food (Gu) and Fresh Air (Qing) – Nutrient & oxygen metabolism • Functions: Promote movements, warmth, immunity, consolidation, control, metabolism, and transformation. » Example: Peristalsis 15 Blood Body Fluids • Blood – Xue – Formation from food essence, and essence transformation through bone marrow. – Main function: Nourish • Body Fluids – Jin Ye – Function also to nourish and moisten. It is considered a component of blood. 16 Meridians • Jing Luo – Main Route and Net (Network) 17 What is Acupuncture? • Many studies in animals and humans have demonstrated that acupuncture can cause multiple biological responses… mediated mainly by sensory neurons to many structures within the central nervous system. This can lead to activation of pathways affecting various physiological systems in the brain as well as in the periphery... Considerable evidence supports the claim that opioid peptides are released during acupuncture and that the analgesic effects of acupuncture are at least partially explained by their actions. That opioid antagonists such as naloxone reverse the analgesic effects of acupuncture further strengthens this hypothesis. Stimulation by acupuncture may also activate the hypothalamus and the pituitary gland, resulting in a broad spectrum of systemic effects. Alteration in the secretion of neurotransmitters and neurohormones and changes in the regulation of blood flow, both centrally and peripherally, have been documented. There is also evidence of alterations in immune functions produced by acupuncture. Which of these and other physiological changes mediate clinical effects is at present unclear. 18 Acupuncture. NIH Consensus Statement Online 1997 Nov 3-5; month, day]; 15(5):1-34. • • • What are Meridians? • Despite considerable efforts to understand the anatomy and physiology of the "acupuncture points," the definition and characterization of these points remain controversial. Even more elusive is the scientific basis of some of the key traditional Eastern medical concepts … and other related theories, which are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture. Acupuncture. NIH Consensus Statement Online 1997 Nov 3-5; month, day]; 15(5):1-34. • The acupuncture points or biological active points (BAP), also known as low-resistance spots or good electro-permeable points, have relative lower electric resistance than the surrounding tissues… This preliminary study presented here shows there exists a bilateral symmetry of the skin resistance of the corresponding BAPs from the left and the right hands of all chosen subjects over a range of measuring pressure. . Conf Proc IEEE Eng Med Biol Soc. 2004;4:2995-8 19 Questions & Discussion Next… Causes of Illness 20 Theories and Causes of Disease • Imbalance • Yuan Qi deficiency – Yuan: primary, original, core • Pathogenic factors invasion • Combination of internal and external causes 21 Pathogenic Factors - 6 Evils Wind Cold Heat Dampness Dryness Fire External and Internal, related to seasons May be relate to epidemic pathogenic factors 22 Internal injury, Seven Emotions and Lifestyle • Emotions and organ relationships according to Five Phases. • Prolonged or excessive display of an emotion will hurt the corresponding organ. • Excessive or malnourished diets. • Excessive or little work and rest. 23 Five Element and Human Body Viscera Wood Liver Bowels Gall Bladder Sense Organs Eyes Seasons Spring Emotions Anger Fire Earth Heart Spleen Small Intestine Stomach Tongue Mouth Summer Long Summer Joy Concern Metal Water Lung Kidney Large Intestine Nose Autumn Winter Grief Fear Urinary Bladder Ear 24 Diagnosis - 4 Steps SOAP Viewing Smelling / Listening Questioning Palpating (pulse) 9 position on each hand Rate and Quality 25 Treatment Principles SOAP RESTORE BALANCE • Expel pathogenic factors or parasites external • Fortify Yuan Qi - internal • Treat according to symptoms which reflect current imbalance (status) of the patient. 26 Treatment Methods – Acupuncture • Regulate Qi and Blood – Balance autonomic nervous system » neuroendocrine – Call attention to diseased areas or systems and invoke healing response 27 Treatment Methods • Herbs – 1-3 herbs for each imbalance – Cooking methods very important » Pre-add, post add, different forms – Toxic effects of herbs– add other herbs to moderate » Licorice (Gan Cao) » Ginger (Sheng Jiang) » long cooking 28 Treatment Methods • Chinese Physio-Massage / Manipulation (Tui Na) – External force to move Qi and Blood – Unblock stasis 29 Qi • Qi Energy – Different types with different functions – Derive from two major sources: • Food (Gu) and Fresh Air (Qing) – Nutrient & oxygen metabolism • Functions: Promote movements, warmth, immunity, consolidation, control, metabolism, and transformation. » Example: Peristalsis 30