绪章Introduction

Introduction

●0.1What is TCM?

What is TCM

第一章The fundamental Characteristics of TCM

Traditional Chinese Medicine is a subject that deals with the physiology and pathology, as well as diagnosis, prevention and treatment of disease. The systematic theory of TCM, based on the Ancient Chinese philosophy, under the guidance of ancient materialism and dialectics, after years of accumulation of experience in diseases prevention and curing, was originally established 2000 years before with the witness of the publication of the book, The Yellow Emperor’s Inner Classic(《黄帝内经》). Now, after thousands of years’ development and enrichment, TCM stands among various kinds of medicine in the world with its unique theoretical system and excellence in diagnosis and treatment, playing an important role in the field of medical care and health preservation. The most fundamental features of TCM as well as the essential that guides the theories of TCM are holistic concept (整体观) and treatment based on syndrome differentiation (辨证论治).

●1.1Holistic concept

The holistic concept holds the opinions that a man lives on the earth, his body is a holistic unit, moreover, he and the external environments where he lives are united together, which in TCM are known as The integrity of the human body (五脏一体观) and The unity between the body and its external environments (天人相应观).

●1.2Treatment Based on Syndrome Differentiation

Syndrome (证) is a very special term in TCM. When TCM makes diagnosis, rather than diagnosing a disease, he diagnoses a syndrome, or sometimes combines the idea of disease and syndrome to describe the stage of illness. A “syndrome” should include the information as the cause, the location, the property and the condition of pathogenic factors and healthy qi. Once syndrome is differentiated, strategies of treatment will be formulated accordingly.

第二章Philosophical Foundations of TCM

TCM is a traditional medicine dealing with human life, health and disease with a unique theoretical system and abundant clinical experience. The systemization and development of TCM theoretical system was deeply influenced by ancient Chinese philosophical thought. The theory of qi also known as qi monism, the yin-yang Theory and the five-element theory are the most influential philosophical thought and methods for the formation of the TCM system.

●2.1Theory of Qi

Qi is a kind of ceaseless moving but invisible micro-substance that exists in the universe, and it is the principle or noumenon that constitutes everything in the universe. Qi monism of the ancient Chinese philosophy has turned into a worldview and methodology used to understand the natural phenomena and vital activities after being applied into TCM.

●2.2The Yin-yang Theory

The yin-yang theory is a plain dialectical thought based on materialism as well as a unique worldview and methodology to understand and explain the origin and changes of the universe. Yin-yang theory states that the world is a material unity which continuously develop and changes under the interaction of yin qi and yang qi. Yin-yang is the generalization for two opposite aspects of interrelated things or phenomena in the natural world. The basic contents in yin-yang theory include: opposition and restriction between yin and yang, mutual dependence and interaction between yin and yang, wane-wax and equilibrium between yin and yang, and mutual transformation between yin and yang.

●2.3The Five-Elements Theory(1)

The five-element theory holds that everything in the universe is composed of the five basic matters of wood, fire, earth, metal and water, and the ceaseless motion and interaction of these five matters brings the developments and state changes for all objects and phenomena in the nature. There are mutual generation and restrictions among five elements, and in abnormal conditions, problems may transmit from one element to another due to these kinds of interrelationships. Moreover, theory of five elements are widely applied in TCM to analyze and treat diseases.

●2.4The Five-Elements Theory(2)

The five-element theory holds that everything in the universe is composed of the five basic matters of wood, fire, earth, metal and water, and the ceaseless motion and interaction of these five matters brings the developments and state changes for all objects and phenomena in the nature. There are mutual generation and restrictions among five elements, and in abnormal conditions, problems may transmit from one element to another due to these kinds of interrelationships. Moreover, theory of five elements are widely applied in TCM to analyze and treat diseases.

第三章Visceral Manifestation

The theory of visceral manifestation is based on zang-fu organs, with the five zang as the center. It is the core content of the TCM theoretical system which occurs throughout all aspects of anatomy, physiology, pathology, diagnosis, prescription, prevention and treatment. In this chapter, contents are focus on physiological functions of each zang-fu organ, as well as their mutual relations.

●3.1An Overview on Visceral Manifestation

Visceral Manifestation, as a very special term in TCM, refers to the internal organs and the external manifestation of their physiological functions and pathological changes, and their association with natural world. Based on the theory of visceral manifestation, internal organs are classified into five zang-organs (heart, lung, spleen, liver and kidney), six fu-organs (stomach, small intestine, large intestine, urinary bladder, gall bladder and sanjiao), and extraordinary fu-organs (brain, marrow, bones, vessels, gall bladder and uterus).

●3.2Heart

The heart in ancient China was regarded as the basis of life and further thought to be the main organ of thought, spirit and consciousness, moral concept, etc. It is recorded in The Yellow Emperor’s Inner Classic that the heart holds the position of ruler; spirit brilliance comes from here (心者，君主之官，神明出焉). In specific, main physiological functions of heart include that heart governs blood and vessels, and heart governs Shenming. Furthermore, heart is connecting to blood vessels, manifesting on face, opening into tongue, relating to joy, and corresponding to summer.

●3.3Lung

Lung is the highest viscera among all the internal organs, so it is named as “canopy (华盖)”. Lung is very sensitive to cold and heat, and easy to be invaded, so it is also called “delicate organs （娇脏）”. It is recorded in The Yellow Emperor’s Inner Classic that the lung holds the position of counselor assistant; management and regulation come from here (肺者，相傅之官，治节出焉). In specific, main physiological functions of lung include that it governing qi, it frees and regulates the waterways, it links with all vessels and it governs management and regulation. Moreover, lung is connecting to skin and manifesting on body hair, opening into nose, relating to sorrow, and corresponding to autumn.

●3.4Spleen

Spleen is located in the middle jiao, and belongs to the earth in five elements. Main physiological functions of spleen include that it governs transportation and transformation, it governs rise of the clear and it controls blood. Furthermore, spleen is connecting to muscle and manifesting on four limbs, opening into mouth, relating to contemplation, and corresponding to later summer.

●3.5Liver

The liver holds the position of general and strategies come from here (肝者，将军之官，谋虑出焉), as recorded in The Yellow Emperor’s Inner Classic, liver is an unyielding zang-organ (刚脏) which mainly functions in governing the free flow of qi and storing blood. These two aspects of liver’s physiological functions actually reflect its special property that liver is yin in form because of its storage of blood, but yang in function because of its dredging and soothing nature. In addition, liver is connecting to sinews and manifesting on nails, opening into eyes, relating to anger, and corresponding to spring.

●3.6Kidney（1）

The kidney governs dormancy; it is the root of sealing up and storing as well as the location of the essence (肾者，主蛰，封藏之本，精之处也), as recorded in The Yellow Emperor’s Inner Classic. One of the physiological function of kidney is to govern the storage of essence, which is composed of congenital essence and acquired essence. The essence stored in kidney promotes the growth, development and reproduction of human body, and is the motivation of qi transformation of zang-fu organs.

●3.7Kidney（2）

In addition to governing the storage of essence, kidney has the functions of governing water and governing reception of qi. Governing water means that kidney takes part in water metabolism of human body and regarded as “the lower source of water”; governing reception of qi refers to that kidney maintains the depth of respiration. Furthermore, kidney is governing bones and producing marrow, manifesting on hair, opening into ears and two lower yin-orifices, relating to fear, and corresponding to winter.

●3.8Main Physiological Functions of Six Fu-organs

According to theory of visceral manifestation, the general function of six fu-organs is to transport and breakdown things without storage, including stomach, small intestine, large intestine, urinary bladder, gall bladder and sanjiao. Generally speaking, six fu-organs mainly cooperate with each other working in the digestive process.

●3.9Mutual Relations among Zang-fu Organs

The human body is an organic whole, which takes the five zang-organs as the center and connects all the other organs, body and orifices by meridians. The relationships among the organs are mutually connected and restricted and coordinated in function and structure. Therefore, it is important to understand the rules of the coordinating functions of the organs on the basis of their physiological function and from the aspect of qi movements of zang-fu organs.

第四章Essence,Qi,Blood and Body Fluid

Essence, qi, blood and body fluid, they are the basic materials to form and sustain life activities of the human body, and the material basis to carry out physical activities of zang-fu organs, meridians, tissues and orifices. They have their own concentration on physiological functions, while they also coordinate with each other to perform functions.

●4.1Essence

Essence refers to the substance of human beings derived from parents and acquired from food essence, which is the origin of life and the basic material to form and sustain life activities of the human body. Functions of essence mainly include promoting growth, development and reproduction, generating marrow, blood and qi, and nourishing the body.

●4.2QI（1）

Different from focusing on the philosophical qi in the section of qi theory, in this chapter, qi refers to qi of the human body, which is a kind of very active, ceaseless moving, as well as imperceptible substance that composes the human body and maintains its all life activities. Qi is generated from congenital qi which is from parents and acquired qi which is from food essence and fresh air. The fundamental feature of qi is constantly moving. Qi Movements, also known as qi activities (气机), refers to different forms of movements of qi inside the body, generally including ascending, descending, entering and exiting. Only by the movements of qi can various changes which is named as qi transformation (气化) be achieved and all life activities be maintained.

●4.3QI（2）

The main physiological functions of qi are promoting, warming, defending, consolidating, and transforming. In TCM, based on generation, distribution and function, qi usually is classified into original qi, pectoral qi, nutritive qi and defensive qi.

●4.4Blood

Blood is the fluid, red in color, circulating inside blood vessels and also one of the basic materials to form and sustain life activities. Blood composes of body fluid and nutritive qi, and mainly functions in nourishing, moistening and carrying.

●4.5Body Fluid

Body fluid is the general term for all normal water inside the human body. The generation, distribution and discharging of fluid depend on collaboration among different zang-fu organs. Functions of body fluid include nourishing and moistening, transforming into blood, regulating yin-yang balance, carrying qi and discharging waste after metabolism.

●4.6Mutual Relations among Essence,Qi,Blood and Body Fluid

As the basic materials to form and sustain life activities, essence, qi, blood, and body fluid actually work together to fulfill physiological functions. For example, the effect of qi on blood is described as qi the general of blood, while the effect of blood on qi is described as blood is the mother of qi; and there are mutual transformation and generation among them, etc. Therefore, it is important to understand relations among essence, qi, blood and body fluid so as to reach a compressive understanding.

第五章Etiology and Pathogenesis

Etiology and pathogenesis of TCM elaborates upon the causes of diseases, including the theory, knowledge and discipline of its occurrence, development and variation. Etiology is classified into four categories, exogenous pathogenic factors, endogenic pathogenic factors, pathological products and the others. Pathogenesis theory explains the mechanism of disease’s onset, progression and prognosis, and mainly elaborates upon the basic pathogenesis and disease transmission variation and outcomes.

●5.1Six Pathogenic Factors (1)

The exogenous pathogenic factors mainly include the six pathogenic factors (六淫) and pestilent qi (疠气). In the natural world, there are six climate changes, namely wind (风), cold (寒), summerheat (暑), dampness (湿), dryness (燥) and fire (火). When abnormal climate occurs, or when people are weak in resistance and cannot even adapt to normal climate changes, disease occurs. Six pathogenic factors (六淫) is the generalization of pathogenic wind, pathogenic cold, pathogenic summerheat, pathogenic dampness, pathogenic dryness and pathogenic fire. In this section, feature of wind and cold, as well as their characteristics in causing diseases will be explained respectively.

●5.2Six Pathogenic Factors (2)

In this section, feature of dampness and dryness, as well as their characteristics in causing diseases will be explained respectively.

●5.3Six Pathogenic Factors (3)

In this section, feature of fire and summerheat, as well as their characteristics in causing diseases will be explained respectively.

●5.4Internal Damage Caused by Seven Emotions

Endogenic pathogenic factors include internal damage caused by seven emotions (七情内伤); improper diet (饮食失宜); overstrain and lack of exercise (劳逸过度), etc. Seven emotions refer to the seven kinds of human mental activities, namely joy (喜), anger (怒), grief (忧), thinking (思), sorrow (悲), fear (恐) and fright (惊). Internal damage caused by seven emotions means that inappropriate emotional stimuli will cause dysfunction of zang-fu organs, qi and blood, and lead to onset of disease. The characteristics of seven emotions in causing diseases are directly damaging internal organs, disordering qi movements and affecting state of illness.

●5.5Phlegm and Fluid Retention

During course of disease, disordered flow of qi, blood and body fluid, and dysfunction of zang-fu organs generate phlegm, fluid retention, blood stasis, and calculus, which in turn become new pathogenic factors for the body, either to aggravate illness or cause secondary diseases. These factors are named as pathological products, also known as secondary pathogenic factors. Phlegm and fluid retention, as one of the common pathological products, usually obstruct movements of qi and blood, affect metabolism of body fluid, confuse minds, and cause complicated symptoms with various changes.

●5.6Blood Stasis

Blood stasis is a pathological product when blood stops circulation properly, which also known as one of the secondary pathogenic factors. Blood stasis usually obstructs qi movement, affects blood circulation and the generation of fresh blood, and symptoms caused by blood stasis are various and mostly marked with fixed location, and with high possibility to progress into critical illness.

●5.7The Onset of Disease

The onset and change of disease is a reflection of the struggle between the healthy qi and the pathogenic factors. The pathogenesis is the mechanism of onset, development and change of a disease, which are associated with the strength and physical of the patient and the nature of the pathogenic factors. It includes three aspects: causes of disease, the types of onset and basic pathogenesis.

●5.8Basic Mechanism of Pathogenesis

The struggle between the health-qi and pathogenic factors decide the onset of disease, and the pathological processes generally can be classified into three laws: the predominance and decline of health qi and pathogenic factors; imbalance between yin and yang; disorder of qi, blood and body fluid.

第六章Diagnositic Methods in TCM

Diagnostic methods in TCM, a discipline guided by TCM theories, explores the basic theories, knowledge and techniques related to diagnostic methods, as well as disease and syndrome differentiation. As a bridge linking the basic theories of TCM and clinical subjects, it is one of the most fundamental studies in the TCM system.

●6.1An Overview on TCM Diagnositics

The content of Diagnostics can be classified into two parts: “ZHEN” which includes inspection, auscultation and olfaction, inquiry, taking pulse and palpitation, named as four diagnostic methods; the other part is “DUAN”, referring to syndrome differentiation, is the process of analysis through which a TCM doctor determines the syndrome after a comprehensive analysis on information collected by four diagnostic methods.

●6.2The Inspection of Complexsion

Inspection is the diagnostic method by which a practitioner visually observes a patient’s external manifestations so as to infer the internal condition. Based on the basic theories of TCM, judging the internal from the external is the rationale for diagnosis of TCM, well, the SHEN, the complexion and physique are the major parts during observing the external manifestations.

●6.3The Inspection of Physique and Behavior

The inspection of the physique refers to the practitioner makes a diagnosis through observing whether the patient has a strong or weak, obesity or emaciated, the constitution and abnormal manifestations. Meanwhile, inspection of behavior refers to observing the patient’s posture and body movement for diagnostic purpose.

●6.4Tongue Diagnosis

The tongue inspection is a diagnostic method to understand the physiological and pathological condition of the human body through observing the tongue manifestation, which includes the tongue body and the tongue coating. The tongue inspection is one of the most unique diagnostic methods in Chinese Medicine.

●6.5Auscultation and Olfcuation

The auscultation and olfaction refer to the examinations of listening to the sounds and detecting the odor of the body, which are the result of physiological and pathological changes of zang-fu organs. Differentiating sounds and smells can help practitioners get evidence for their diagnosis of the disease and syndrome.

●6.6Inquiry

The inquiry is an investigational method to collect clinical information from the causes, development, medical procedures, current symptoms and general information of the patient.

●6.7Pulse Taking & Palpation

The diagnostic method of palpation includes pulse diagnosis and palpation. The pulse-taking means a physician uses his fingers to feel and press a patient’s pulse and according to the pulse condition, the physician gets to know the disease and differentiates the syndrome. The palpation is a method adopted by a physician to touch or press certain parts of a patient’s body which can infer the disease site, nature and severity.

第七章Syndrome Differentiation

Syndrome is a very important concept in TCM, while syndrome differentiation refers to the analyzing process of diagnosis. Based on experience and summarization of medical experts during past dynasties, the most widely-used differentiation methods for now include: eight-principle syndrome differentiation, qi-blood-body fluid syndrome differentiation, zang-fu organ syndrome differentiation, meridians-based syndrome differentiation, syndrome differentiation of etiology, wei-qi-ying-xue syndrome differentiation and the sanjiao syndrome differentiation.

●7.1The Eight-principles Syndrome Differentiation

Eight-principle syndrome differentiation is a method which identified the nature of disease based on the information collected from the four diagnostic methods. It differentiates the disease from the perspectives of location referring to exterior or interior, nature referring to cold or heat, the confrontation level between the healthy qi and pathogenic qi which is describes as deficiency or excess, and the attribution of yin-yang. The eight principles are the general guidelines obtained from the characteristics of specific some syndromes

●7.2Syndrome Differentation of Six Exogenous Pathogenic Factors

The six exogenous pathogenic factors include wind, cold, summer-heat, dampness, dryness and fire. Syndrome differentiation of six exogenous pathogenic factors is to explore disease cause according to the natural characteristics and pathogenic features of the six pathogenic factors.

●7.3Qi-Blood and Body fluidSyndrome Differentiation

Qi, blood and body fluid have close connection with functional activities of zang-fu organs, the pathological changes of them will not only reflect the metabolism situation of human body, but also can infer the functional situation of zang-fu organs. The qi-blood and body fluid syndrome differentiation will help lay a foundation for learning syndrome differentiation of zang-fu syndrome differentiation.

●7.4Zang-fu Syndrome Differentiation

This syndrome differentiation is analyzing the pathological characteristics and manifestations of zang-fu, so as to infer the site of the disease and its specific pathological nature. Being the diagnostic foundation for all medical branches, it plays a significant role in the syndrome differentiation system.

第八章Preventive and Therapeutic Principles and Methods

This chapter include two aspects: the preventive methods which means taking a certain measure in advance to stop the occurrence and development of disease, the second part is the therapeutic principle and methods, which guiding the clinical treatments.

●8.1Health Maintenance & Priciples for Prevention

Health maintenance is also called health prevention, which means taking a certain measure in advance to stop the occurrence and development of disease. This includes two aspects of prevention before a disease (“treating the undiseased”) and treatment before a disease develops.

●8.2Principles for Treatment & Therapies

The therapeutic principle is the rule for treating disease. It is the general rule aiming at the clinical disorder and guiding the methods, which formulated under the guidance of the holism and treatment determination based on syndrome differentiation. It is a universal guiding principle for determination of methods, formula and medicinals clinically. The therapeutic method is the concrete method aiming at a concrete syndrome, being the concrete embodiment of the principle. In the process of treatment, establishment of therapeutic principle and choice of therapeutic methods are of very important signification.

第九章Chinese Medicinals and Formulas

Chinese materia medica and formulaology, are disciplines to study the basic theory and clinical application of Chinese medicinals and their prescription. It is composed of two independent and closely related courses, Chinese materia medica and formulaology. Chinese materia medica is to display the natures and functions of Chinese medicinal, while the formulaology is to elucidate the principles, compatibility and clinical application of formulation. In this chapter, we will have an overview on both Chinese materia medica and formulaology, and take some medicinals and formula as examples to demonstrate how does TCM apply them in diseases treating.

●9.1Flavours and Efficacy of Chinese Medicinals

In this section, we would introduce the four natures of Chinese medicinal, including cold, hot, warm, and cool; five flavors contain pungent, sweet, sour, bitter, and salty. There are actions of lifting, lowering, floating and sinking, which are moving direction tendency of herbs. The nature, flavor, actions of lifting, lowering, floating and sinking are medicinal properties which actually determine the function of each medicinal.

●9.2Compatibility and Composition of Chinese Medicinals

In this section, the compatibility of Chinese medicinal and formation of prescription are introduced. There are four good relations and two bad relations in the compatibilities of Chinese medicinal. Good relationships include mutual reinforcement, mutual assistance, mutual restraint and mutual detoxication, while bad relations include mutual inhibition and incompatibility. As concerns of formulating prescription, components in a formula usually consist of four types of medicinals that are chief medicinal, deputy medicinal, assistant medicinal and envoy medicinal.

●9.3Rén Shēn,Fú Líng,Chén Pí

In this section, we will have three medicinals Rén Shēn, Fú Líng and Chén Pí as examples to explain the nature, function and application of them based on TCM theories. From the learning of these contents, students are supposed to get a general understanding on how does Chinese medicinal treat diseases.

●9.4Bái Sháo,Shú Dì Huáng,Bái Zhĭ

Bái Sháo, Shú Dì Huáng and Bái Zhĭ are explained in this section. Bái Sháo mainly functions in nourishing the blood; Shú Dì Huáng is good at nourishing the blood and yin; Bái Zhĭ is to release the exterior and dispel cold, and expel wind to stop pain.

●9.5Huò Xiāng,Jīn Yín Huā,Bò He

In this section, three medicinals are all in the category of medicinals of relieving exterior syndrome, Jīn Yín Huā and Bò He are good at dispersing wind-heat, and Huò Xiāng is good at transforming dampness, stopping vomiting, and dispelling summerheat.

●9.6Four Gentlemen Decoction - Sì Jūn Zĭ Tāng

Why can only four medicinals make a representative formula? You will find the answer in this section. It’s called Four Gentlemen Decoction - Sì Jūn Zĭ Tāng from Tai Ping Hui Min He Ji Ju Fang (《太平惠民和剂局方》).It’s for treating the spleen and stomach qi deficiency composed of Ren Shen, Fu Ling, Bai Zhu and Gan Cao.

●9.7Free Wanderer Powder -Xiāo Yáo Săn

The formula we’re going to learn is Free Wanderer Powder-Xiāo Yáo Săn. It’s a very famous formula from Tai Ping Hui Min He Ji Ju Fang (《太平惠民和剂局方》). Simply from this name, what can you think of? Which organ do you think it effects? Let’s begin this course with these questions in the mind.

●9.8Six-Ingredient Rehmannia Decoction-Liù Wèi Dì Huáng Wán

Six-Ingredient Rehmannia Decoction-Liù Wèi Dì Huáng Wán is a classical formula from Xiao Er Yao Zheng Zhi Jue (《小儿药证直诀》), used in treatment of kidney yin deficiency. Several Chinese patent medicines derived from this formula are widely used today. In this course, you will find its charm.

●9.9Lonicera and Forsythia Powder-Yín Qiào Săn

The formula we’re going to learn today is called Lonicera and Forsythia Powder-Yín Qiào Săn from Wen Bing Tiao Bian (《温病条辨》). It’s a very famous exterior-releasing formula with acrid and cool medicinals. It is broadly used for warm disease at the early stage. It belongs to the “sweat promotion” of “the eight medicinal treatment methods”.

●9.10Agastache Qi-Correcting Powder - Huò Xiāng Zhèng Qì Săn

Agastache Qi-Correcting Powder - Huò Xiāng Zhèng Qì Săn , from Tai Ping Hui Min He Ji Ju Fang (《太平惠民和剂局方》), is the formula we’re going to learn today. It’s a very practical formula for summer. It’s used to release the exterior syndrome, eliminate dampness, rectify qi flow and harmonize the middle energizer. Pay attention to its composition and combination due to its complexity.

第十章Acupuncture and Moxibustion

The science of acupuncture and moxibustion, under the guidance of TCM, is an important component of TCM and a practical science of preventing and treating diseases with acupuncture and moxibustion. It includes four aspects: the meridians and collaterals, acupoints, manipulating techniques and clinical treatments. With such advantages as wide range of indications, distinct therapeutic effects, simple administration, safety, etc, acupuncture and moxbustion is very popular among Chinese people. It has made great contributions to the popularization and prosperity of the Chinese nation for thousands of years; and is playing an increasingly important role in medical and health care all over the world today.

●10.1What do you know about acupuncture?

Acupuncture has a long history. Experts believe that the origin of acupuncture can be traced back to the Neolithic age. In ancient times, the Ming Dynasty was the peak time for the development of acupuncture. After the foundation of the People’s Republic of China, acupuncture was popularized and improved in a scale unmatched by previous periods. Acupuncture is becoming more and more popular at home and abroad in recent years.

●10.2What are meridians and collaterals?

The origin of meridians remains a mystery. TCM holds that meridians and collaterals (Jing Luo) are passages through which Qi and blood can be conducted. Meridians are the main trunks and collaterals are the branches. The human body has twelve regular meridians, eight extra vessels and numerous collaterals, which pertain to Zang-fu organs interiorly and extend to the extremities and joints exteriorly.

●10.3What are acupoints?—just ordinary points?

Acupoints are special sites through which Qi of Zang-fu organs and meridians is transported to body surface. Acupoints can be divided into three categories including acupoints of the fourteen meridians, extra points and Ashi points. The name of an acupoint usually has its specific meaning, which helps to understand the location, functions and indications of this acupoint. In addition, we also explain the effects of acupoints: diagnostic effects and therapeutic effects.

●10.4Methods for locating acupoints

Locating acupoints accurately is extremely important for the therapeutic results. There are mainly four methods of locating acupoints, including anatomic landmarks, simplified measurement, finger measurement and bone-length measurement. Among the four methods, the simplified measurement is the simplest one while the bone-length measurement is the most difficult but accurate one.

●10.5“Dazzling super stars” in acupoints

There are 361 acupoints of the fourteen meridians and hundreds of extra points on the human body. However, there are only about 100 acupoints commonly used in clinic, which are super stars in acupoints. Here we introduce the location and indications of six acupoints: Baihui, Fengchi, Neiguan, Hegu, Dubi and Zusanli. And Zusanli is the most dazzling super star among them.

●10.6Needling instruments in acupuncture clinic

Today the most commonly used needling instrument is filiform needle which is usually made of stainless steel. Experts believe that acupuncture needles were developed from the ancient Bian stone needles (bian shi). A filiform needle may be divided into five parts and it varies in length and diameter. In addition to the filiform needle, other needles are also used for different diseases such as three-edged needle, cutaneous needle, intradermal needle and so on.

●10.7Manipulating techniques with filiform needle

The needling manipulation can be divided into five steps: holding needle, inserting needle, manipulating needle, retaining needle and withdrawing needle. We briefly introduce the five steps one by one. In addition, we also explain what is getting qi and how to judge whether the patient has gotten qi.

●10.8Moxibustion—the fire of health

Moxibustion is a therapy which treats and prevents diseases by means of heat stimulation from moxa fire to the points and meridians. The commonly used moxibustion techniques can be roughly divided into four kinds: moxibustion with moxa cone, moxibustion with moxa roll, warming needle moxibustion and moxibustion with apparatus. Nowadays, moxibustion is very popular among Chinese people as one kind of health care method.

●10.9Cupping—a marvelous treatment

In the last decade, cupping therapy has become more and more popular at home and abroad with advantages of distinct therapeutic effects, simple administration and safety. In clinical practice, different cupping techniques are selected based on different patient’s’ pathological conditions, including retaining cupping, moving cupping, flashing cupping, needle-retaining cupping as well as bloodletting and cupping. We briefly introduce the manipulations of the above five cupping techniques.

第十一章Tuina and Its General Applicaion

Chinese Tuina is a branch of TCM, its theory is based on the fundamental theory of TCM and supplemented by subjects as anatomy, etc. Tuina applies different manipulations to stimulate on the points, channels and muscles and adjusting dislocated joints to adjust the channels and collaterals, and physiological functions of zang-fu organs to treat and prevent diseases.

●11.1An Overview on Tuina

Tuina has a long history from 2700 BC to nowadays, many medical classics such as Ten Volumes of Classics on Massage of Yellow Emperor and QiBo, The Yellow Emperor’s Inner Classic and so on, recorded Tuina theories and practice. Tuina has four acting principles which are regulating yin and yang, regulating the function of channels and collaterals, qi and blood, and viscera, recovery of the function of the tendons, bones and joints. Tuina manipulations have function of tonifying and purging. An entire subject of Tuina includes Tuina exercise, manipulations, therapeutics, Tuina on children, Tuina literature and experiment.

●11.2The Basic Knowledge of Tuina Manipulation

Tuina has different types such as adult and children, relaxation and adjustment, etc. Tuina manipulations have “mechanical and kinetic two forms” of movement structures. The general requirements of the manipulation are forcefulness, evenness, softness, deepness and thoroughness. The aim of practice manipulations is once in clinic, touching outside with skillful force inside; changing the manipulations with mind concentrating, and getting principles from the concentration of mind.

●11.3Pushing with One Finger Manipulation

Pushing with one finger manipulation requires more attention on the contact surface (the tip of the thumb, all the whole surface of the thumb, or the side of the thumb) and the upper limb position and movement. The frequency of pushing with one finger is about to 120-160 times per minute. This manipulation can be used on all points and channels, so its clinical applications are wide range.

●11.4Rolling Manipulation and the other Manipulations

Rolling manipulation needs to focus on the contact surface, and the frequency and the movement. Kneading manipulation should be swinging the forearm and kneading slowly and softly. Rubbing manipulation is a circular motion with rhythmical movement. Scrubbing manipulation needs to be operated along a straight line. Grasping manipulation needs to lift and squeeze the symmetrically and slowly, meanwhile hold and twist, knead and pinch the therapeutic part. Pressing manipulation needs to press the therapeutic parts with the force from light to heavy, shallow to deep. Obliquely-pulling of the lumbar vertebrae manipulation requires high on locating the position of both operator and patient. Traction-and counter-traction of cervical vertebrae should be gentle power with patients in supine position.

●11.5Treating the Cervical Spondylosis with Tuina

Tuina treating the cervical spondylosis has three steps generally: firstly, using pushing with one finger manipulation on cervical local points and channels; secondly, rolling on the upper back around neck for relaxing; thirdly, using the traction-and counter-traction of cervical vertebrae in supine position. Be cautious to apply pulling manipulations unless you are quite clear about the type of cervical spondylosis, for example, the type of cervical myelopathy and the vertebral artery can’t be treated with pulling manipulations.

●11.6Treating Lumbar Disc Herniation with Tuina

Tuina therapy is only second to surgical operation concerning the effectiveness in the treatment of the lumbar disc herniation syndrome. Patient should be confined to bed rest and the waist kept warm during the treatment. Once symptoms are relieved, functional exercise of the lumbar region is necessary. Appropriate Tuina manipulations include: rolling, pressing, kneading, traction-counter traction, and pulling obliquely. Acupoints as Ashi points, Shen Shu points, Da Chang Shu, etc, can be selected. The aim of Tuina treatment is to increase the threshold, relax the muscles, reduce the pressure of disc, change the herniation position, soothe the blood circulation and reduce edema.

●11.7Treating Gynecological Diseases with Tuina

Tuina can promote the function of the digestive and the cardiopulmonary system, produce a variety of bioelectric activities spreading to nerves center, as well as adjust the disorder emotion. The general procedure of Tuina to treat the gynecological diseases is divided into three steps: relaxing the muscles of abdomen and lower back, adjusting the disorder of spine joints, and traction and counter-traction the whole spine with hands. For example, dysmenorrhea can be treated with rubbing on abdominal and lumbosacral areas, amenorrhea can be treated with rolling waist and finger pressing on Jian Jing point, and infertility with pushing the waist and rubbing the abdomen. It is very important to maintain a certain frequency of treatment which usually should be three times a week, and last for 3-6 months.