www.active-health.org Diagnostics in brief Principal of Treatment in TCM • The Four Diagnostic Methods – Looking, asking, feelings, listening, smelling, • The Differentiation of Syndromes – According to the eight principals, pathogenic factors, emotions, diet, lifestyle, physical exertion, – According to Qi, Blood, Body Fluids – According to the Zang Fu – According to the meridians and collaterals – According to the six meridians – According to the four levels – According to the San Jiao
[email protected] James O’Sullivan Lic.Ac. (China)
[email protected] Review Clinical Practice • 4 diagnostic methods (Collect information) • Patterns of Disharmony: Differentiate the presenting complaint and its associated signs and symptoms • What are we going to do about it? (Principal of Treatment) • How are we going to achieve this? (Treatment Protocol: Prescription of points, Tuina, herbs?)
[email protected] Principal of Treatment • Pattern of Disharmony – – – – – Spleen Qi Deficiency Heart Qi Deficiency Invasion of Lungs Stomach Qi Deficiency Liver Qi Stagnation g – Heart Blood Stasis – Heat in the Intestines • Principal of Treatment – – – – – Reinforce Spleen Qi Invigorate Heart Qi Tonify the Lungs Strengthen Stomach Qi Promote the Smooth Flow of Liver Qi – Move Heart Blood – Clear Heat • Is it that simple?
[email protected] Primary & Secondary • What is the cause (primary) of the disharmony? • What is the manifestation or symptoms (Secondary)? • Do we treat the acute or the chronic? • To tonify or reduce, that is the question? Principle of Treatment • is the basis for guiding clinical practice. • The clinical picture is analysed and generalised to find the causes, nature, and interrelations of the disease and to treat the disharmony accordingly • They include the principle of treating a disease by analysing both its root cause and symptoms or manifestations.
[email protected] [email protected] [email protected] 1 they should be treated first. the primary or root cause should be found first. they should be taken into account at the same time james@active-health. and the latter is the secondary. but if the symptoms are acute.active-health.org Holism • The Human Body is an integral whole. Zang Fu Qi. We must look at factors such as climatic and seasonal conditions. the former is the primary. • determining which is the primary and secondary aspects of the pathology. while the complication is the secondary. • This concept represents the two opposite aspects of one entity during the course of a disease. • Analysed by the aetiology and manifestation. • As for the clinical course of a disease the original is the primary. Yin and Yang and dispelling the pathogenic factors from the body. geographic localities.www. • If the symptoms and root cause are both serious.org james@active-health. james@active-health. and the patient's personal conditions e. the aetiology is the primary. and the manifestation is the secondary.org Treatment Considerations • Along with strengthening the Zhen Qi. age.org Ben and Biao • The symptom is generally the branch and the secondary aspect.
[email protected] Ben and Biao • In terms of the Wei Qi and pathogenic factors. Ben and Biao • Under general circumstances.org Ben Biao • The Principal of Ben Biao in TCM involves looking at the complete clinical picture and determining the Root (Ben) and Branch (Biao) of that particular disease process.org 2 . an organic entity • Outside influences have an affect on internal organs • Emotions can cause disharmony in the Zang Fu • Pathological changes of the internal organs may reflect on the body surface
[email protected]. constitution.org james@active-health. whereas the root is generally the cause and the primary aspect. james@active-health. in spring and summer. that's why they are susceptible to gastric distension due to accumulation of Cold for which Moxibustion is advisable. shallow acupuncture is applied.www.org Geographical locations • In Chapter 12 of Plain Questions it says.active-health. foggy and dewy. so they have tight muscles and red skin.it is damp. People there prefer outdoor dwelling and milk. weak. and in winter. they are most likely to attack the muscles.org 3 . “In the north. pregnancy and puerperal problems. more Cold. so the points should be careFully selected when treatment is given. people live in highlands and mountains exposed to bitter wind and severe Cold." james@active-health. “Generally. "In the south. in summer. the deep acupuncture is preferred. james@active-health. and in autumn and winter.org Climate & Seasonal conditions • In treatment of such disorders.org Spleen Qi Deficiency with Dampness • Spleen Qi Deficiency is primary – Dampness is secondary Climate & Seasonal conditions • It is said in Chapter 9 of Miraculous Pivot. men and women are different in physiology. women have menstruation.org james@active-health. • What if Diet was full of Dairy and Wheat • What if patient lived in extremely Damp environment • What if there is a family history of that particular disease james@active-health. As to constitution. the pathogenic factors are most likely to attack the superficial layer. Geographical locations • In Chapter 12 of Plain Questions it says. more Heat. there are strong. the techniques should remain consistent with the seasons.. they are most likely to attack the skin. for which acupuncture is advisable.org james@active-health. For example. in autumn. People of different ages are different in physiology and pathology. they are most likely to attack the tendons and bones. sex and constitution. People in this region are susceptible to cramps of tendons and rheumatism.org james@active-health. “In spring.org james@active-health. people there prefer to sour taste and preserved food.." Individual conditions • Treatment is also based on age. www. After the common Cold is relieved. they must be treated at the same time. “A middle aged strong person with sufficient Qi and Blood. whereas.” • It is further pointed out in Chapter 5 of Miraculous Pivot that " a deep needling with the needle retained for some time should be applied to physical labourers.” Symptoms versus Original • a patient with chronic cough and asthma caught a common Cold. " james@active-health. acupuncture treatment is given twice a day with shallow needling and weak stimulation.” james@active-health. It says again. • and when caused by invasion of Wind Cold would be treated by Dispelling Wind Cold.org james@active-health. and hard skin may. james@active-health. if being attacked by the pathogenic factors.org james@active-health. • The Principal of treatment is to “nourish Kidney Yin” • This is called “treating different diseases with the same method.org 4 . But if the primary and secondary aspects are both serious. “Since an infant has weak muscles and less volume of blood and Qi. • This is called “treating the same disease with different methods.org
[email protected] james@active-health. The common Cold should be treated first because it is the acute aspect.org Treatment • Treat the root (Ben) only • Treat the branch (Biao) first then the root (Ben) • Treat both Ben & Biao together Sore Throat • due to Yin Deficiency of the Kidney and low back pain due to Yin Deficiency of the Kidney.org Individual conditions • In the Chapter 38 of Miraculous Pivot. accompanied with fever and aversion to Cold. " Individual conditions • In the Chapter 38 of Miraculous Pivot.active-health. be treated by a deep needling with the needle retained for some time. slow insertion of the needle should be given to mental workers. treat chronic cough and asthma which are the primary aspect. • but when caused by both Qi and Blood Deficiency would be treated by reinforcing Qi and Blood. it says.org Headache • due to Hyperactive Liver Yang would be treated by nourishing Yin to reduce Yang. etc.active-health.www. It includes prevention before the attack of a disease and prevention from deterioration after occurrence of a disease. such as Qigong.org Prevention • Prevention is an important aspect in treating the primary aspect. Acupuncture and Moxibustion is also one of the traditional remedies to prevent diseases. • What point is an important tonification point?
[email protected] [email protected] 5 . • China has long rich experience in health care. Tai Qi.