Therapeutic Methods

Treatment

Acupuncture Herbology

Massage Qigong
• Prevention is meant taking certain measures to
avoid the occurrence and progress of diseases.
• TCM has always attached great importance to
prevention. As early as in Essential Question, the
preventive thought of "preventive treatment of
diseases" was advanced.
• This theory involves two aspects: preventive
treatment before the occurrence of diseases and
preventing deterioration after the occurrence of
diseases.
• “put prevention first” is one of the four
great policies of the medical and health
work in China.
• And it is also a principle of preventing the
occurrence and the progression of a disease
in TCM.
Preventive Treatment of Disease
• It refers to taking various measures to prevent
diseases from occurring.
• The occurrence of a disease is related to both
pathogenic factors and health Qi.
• The former is the important condition for the
occurrence of a disease, which the deficiency of
the latter is the intrinsic factor for the occurrence
of a disease.
• Therefore, preventive treatment of a disease must
start with both strengthening the resistance inside
the body and preventing pathogens from invading
the human body.
• Basic Questions States:" The body with
health Qi is never attacked by pathogenic
factors."
• To prevent the disease from occurring the
following preventive measures must be
taken.
1.Strengthening health Qi's capacity to resist
pathogens
• Regulating mental activities to maintain the Health
• Keeping regular hours
• Doing regular physical exercises
• Using drug prophylaxis and providing artificial
immunization
2. Defending the body against pathogens
• Keeping away from six exogenous pathogens
• Avoiding various infectious diseases and trauma
• Developing hygienic habits and preventing
environmental pollution, as well as water and food
contamination
 Preventing the deterioration of disease
• Though prevention prior to the occurrence of a
disease is the best policy, timely diagnosis and
effective treatment to control the deterioration of
disease is also important.
• Therefore, once a disease occurs, it should be
early treated so as to cure it in its initial stage.
• Ye Tianshi, a famous practitioner of the Qing
Dynasty, advised:" Be sure to treat the parts which
the pathogens have not involved yet."
• This is also an important method of preventing the
disease from further deteriorating.
 Principles of Treatment
• To study TCM treatment, attention should be paid
to the therapeutic principles which must be
followed in the treatment of disease.
• They are formed under the guidance of holistic
concept and treatment based on syndrome
differentiation, and they have the guiding
significance for establishment of the therapeutic
principles and prescriptions of a recipe.
• Therapeutic principles differ from therapeutic
methods.
• The former refer to the general principles for
guiding therapeutic methods,
• while the latter are the concrete methods of
treatment under the guide of the therapeutic
principles.
• There are different kinds of therapeutic principles
in TCM.
For example
• treatment aiming at the primary cause of a disease,
• strengthening health Qi and eliminating
pathogenic factors,
• readjusting Yin and Yang,
• regulating the Zang-Fu's functions,
• regulating Qi-blood
• treatment in accordance with the three factors
(climate, locality and individual).
 Treatment aiming at the root cause of a disease

• By treatment aiming at the root cause of a disease is meant

treating a disease on the basis of its root cause.
• It is not until the fundamental cause of a disease is found
out that it is possible to get to the essence of the problem
and to make a proper treatment.
• Basic Questions points out, " In treating search for the its
root cause of a disease in treatment. "
• When treatment aiming at the root cause of a disease is
used clinically, routine treatment or contrary treatment and
treating the primary (ben) and or treating the secondary
(biao ) must be dealt with correctly.
 Routine treatment
• includes the following methods:
 treating cold syndrome with hot natured
drug,
 treating heat syndrome with cold natured
drug,
 treating deficiency syndrome by
replenishment,
 treating excess syndrome by purgation
 Contrary treatment
• has the following methods:
2. treating pseudo-heat syndrome with hot-
natured drugs,
3. treating pseudo-cold syndrome with cold-
natured drugs,
4. treating obstruction-syndrome with
tonification
5. treating diarrhea with purgation.
• Treatment of the primary and the
secondary includes the following
methods:
2. treating the secondary for emergency,
3. treating the primary for chronic cases
4. treating both the primary and the
secondary aspects.
Strengthening health Qi and Eliminating Pathogens

• Strengthening health Qi is to increase body

resistance.
• Since victory or failure in the struggle between
health Qi and pathogens determines the
aggravation or alleviation of a disease, one of the
important principles in clinical treatment is to
change the relative strength of health Qi and
pathogens.
• In so doing, the disease will take a turn for the
better.
• Eliminating pathogens means getting rid of
pathogenic factors to facilitate and recover
the strength of health Qi.
• Therefore, eliminating pathogens, like
strengthening health Qi, is also one of the
important principles clinically.
• They have the following methods:
2. driving out pathogens first and then
strengthening health Qi,
3. strengthening health Qi first and then
eliminating pathogens
4. strengthening health Qi and eliminating
pathogens simultaneously.
• Strengthening health Qi and eliminating
pathogens supplement each other:
• the former helps the elimination of
pathogenic factors and the latter helps
strengthening health Qi.
• So, clinically, they should be applied in the
light of the variations of the cases.
 Readjusting Yin and Yang
• The imbalance of Yin and Yang is the basic
pathogenesis of many diseases, therefore,
regulating relative excess or insufficiency of Yin
and Yang, remedying defects to rectify abuses and
restoring relative balance of Yin and Yang are one
of the basic principles in clinical treatment.
• To restore their balance Yin and Yang are usually
regulated by means of removing the relative
excess or invigorating the relative deficiency.
• Since Yin and Yang are the changes may be
summarized as the imbalance of Yin and Yang .
• Besides, regulating Zang-Fu's functions and
Qi-blood relationship are also two
important therapeutic principles.
• Space lacks for a detailed description of it.
Treatment in Accordance with Three Factors
(climate, locality and individual)
• This is the therapeutic principle that TCM adopts
in treating diseases.
• The occurrence, development and changes of a
disease are involved by various factors, including
the climate, geographical environment, the
patient's constitution, sex and age etc.
• Therefore, when treating a disease, the doctor
must take the three conditions into account, and
make a concrete analysis of concrete conditions
and deal with them in different ways, thereby
working out an appropriate therapeutic method.
Chinese medicinal Herbs
• There is a great variety of Chinese materia
medica, including plants, animal parts and
minerals.
• Among these materials, flowers, herbs and
trees are the ones most frequently used, that
is why Chinese materia medica is called
Chinese medicinal herbs.
 flowers

rose chrysanthemum
Herbs

bamboo
 Trees

cassia twigs
Animal parts

turtle shell
minerals

gypsum
 Four properties and five tastes
• The Chinese medicinal herbs are
characterized by four properties (cold, heat,
warm and cool) and five tastes (sour, bitter,
sweet, acrid or pungent-spicy and salty).
• These terms describe the therapeutic
significance and energetic characteristics of
the actions of herbs.
 Four properties
• Ancient’s physicians discovered that a
particular property could induce certain
therapeutic effects.
 For example
• Herbs like gypsum ( 石膏 ), chrysanthemum( 菊
花 ), relieve heat syndromes and are
characterized by cool or cold nature.
• Herbs such as cassia twigs ( 肉桂 ), which
relieve cold syndromes, are characterized
by warm or hot nature.
• Herbs whose properties are neither cold nor
hot are termed neutral, such as Poria ( 茯
苓 ).
 Five tastes
• Sour
• Bitter
• Sweet
• Acrid or pungent-spicy
• Salty
 Pungent spicy herbs
• Pungent spicy herbs could disperse and
promote Qi flow and invigorate blood. For
instance
• Ginger ( 生姜 ) relieves exterior syndrome
by inducing sweating
• Safflower ( 红花 ) invigorates the blood
 Sweet herbs
• Sweet herbs have the function of tonify,
harmonize and moderate. For example,
• Ginseng ( 人参 ) replenishes Qi;
• Longan ( 龙眼肉 ) nourishes blood
• Licorice root ( 甘草 ) moderates pain and
harmonizes the actions of other herbs.
 Sour herbs
• Sour herbs have the function of absorb and
control. For instance,
• pomegranate rind ( 石榴皮 ) can stop
diarrhea.
• dragon’s bone ( 龙骨 ) and oyster shell ( 牡
蛎 ) are used for spontaneous sweating;
 Bitter herbs
• Bitter herbs have the function of reduce and
dry. For example,
• rhubarb ( 大黄 ) is used to move stool and
reduce heat
• phellodendron bark ( 黄柏 ) dry dampness
and tonify yin.
 Salty herbs
• Salty herbs have the function of soften
hardness and purge stool. For example,
• Mirabilite ( 芒硝 ) is used for constipation
• Based on these primary considerations, the
ancient physicians generalized the actions
of herbs into five tastes.
• Herbs that have a dispersing function are
pungent-spicy
• herbs that tonify are sweet; and soon on.
• Consequently, the tastes of herbs described in the
classical Chinese Materia Medica are only
approximate. For example,
• the “pungent” taste of pueraria root ( 葛根 )
• the “sweet” taste of gypsum ( 石膏 )
• the “salty” taste of scrophularia ( 玄参 )
• are not inline with their actual taste in the mouth.
• More inline with their function.
• The four properties and the five tastes, these two
characteristics are used to describe the
complicated actions of the herb.
2. Ginger ( 生姜 ) is pungent-spicy and warm. It
disperses wind and cold.
3. Lily bulb ( 百合 ) is sweet and cold. It promotes
the production of body fluids.
4. Ginseng ( 人参 ) is sweet and warm. It
replenishes Qi.
 Ascending, descending,
floating and sinking action
• The functional tendencies of herbs are
marked by ascending, descending, floating
and sinking.
• This is a clinically useful categorization
method.

Ascending Descending
Floating Sinking
 Ascending and floating actions
• Herbs with ascending and floating actions
are used to promote sweating, raise Yang,
and cause vomiting and open the orifices.
 Example
• Ginger
• The action is upward.
 Descending and sinking actions
• Herbs with descending and sinking actions
are used to regulate Qi, promote urination
and defecation, subdue Yang and calm the
mind.
 Examples
• Rhubarb ( 大黄 )
• The action is downward.
• Herb parts such as flowers and leaves that
are light in quality have the functions of
ascending and floating;
• Herbs or substances that are heavy in
quality such as seeds, fruits and minerals
have the functions of descending and
sinking.
• In addition, processing and preparation may
change the taste and property and influence
the functional tendencies. For example,
• frying causes an ascending function;
• processing with ginger causes a dispersing
function;
• preparing with salt causes a downward
function.
• In general, the functional tendency of an herb is
related to its taste, property, quality and
processing.
• Herbs featured as ascending and floating must be
pungent-spicy or sweet in taste as well as warm or
hot in property,
• while herbs characterized by descending and
sinking must be bitter, sour or salty in taste and
cool or cold in property.
• Li Shizhe, a well known doctor in the Ming
Dynasty once described the relationships this way:
 "Sour or salty herbs have no function of
ascending,
 pungent-spicy or sweet herbs have no function of
descending,
 cold herbs have no function of floating
 and hot herbs have no function of sinking."
 Selective for meridians
• An herb may selectively act upon a
particular part of the body to relieve
pathogenic changes in specific meridians
and organs.
• The meridians that an herb enters depend on
the corresponding symptoms to be relieved
by it.
 For example
• Ephedra ( 麻黄 ) promotes sweating, relieve
asthma and improve urination.
• It is indicated for fever, chills and absence of
sweating due to invasion by exogenous pathogenic
wind and cold, dysuria, edema and so on.
• Judged by the above indications and analyzed in
accordance with the theories of the Zang-Fu
organs and meridians, it can be determined that the
herbs would enter the lung and urinary bladder
meridians.
• Jujube ( 大枣 ) tonifies Qi in the spleen and
stomach.
• It is indicated for poor appetite and loose
stool due to weakness of the spleen and
stomach.
• So we deduce that the herb enters the
meridian of the spleen and stomach.
 Toxicity or Nontoxic
• In the Chinese Materia Medica, the words "toxic,
nontoxic, strongly toxic or slightly toxic” often
appear.
• The toxicity of herbs and substances can cause
reactions as well as adverse effects on tissues.
• Nontoxic herbs are moderate in nature and,
generally speaking, do not have any side-effects.
• For example, jujube ( 大枣 ) and Poria ( 茯
苓 ) are nontoxic herbs,
• while prepared aconite root ( 附子 ) is toxic
herbs.
 Eight basic therapeutic methods
• Traditional  diaphoresis ——exterior syndrome
methods fall  emesis ——excess syndrome
into eight  purgation ——excess syndrome
categories.  resolution ——excess syndrome
• These methods  reinforcing —— deficiency syndrome
are commonly  warming ——cold syndrome
used in clinical  heat-cleaning ——heat syndrome
 mediation ——half-exterior and half-interior
treatment.
 Diaphoresis
• also known as exterior relieving method, is a
therapeutic method used to open the muscular
interstices and relieve exterior syndrome with
herbs,
• which can relieve the exterior and induce
sweating.
• This method is mainly used to treat exogenous
disease at the early stage with the symptoms of
chills and fever, headache, whitish tongue coating
and superficial pulse, etc.
 Application
• Diaphoresis is either induced by herbs acrid
in taste and warm in nature or by herbs
acrid in taste and cool in nature.
 Application
• herbs acrid in taste and •
warm in nature is
applicable to diseases
caused by exogenous
wind-cold, like ginger;
Application
• herbs acrid in taste and
cool in nature is
applicable to diseases
caused by exogenous
wind-heat and warm-
dryness, like
chrysanthemum.
 Emesis
• is a therapeutic method used to direct
pathogenic factors or toxic materials to
come out of the body through the mouth.
• Emetic therapy is usually used to treat
excess syndrome with urgency to vomit out
things retained inside.
• Emesis is a therapeutic method used for
emergency.
• Proper use will have immediate effect,
while wrong application tends to damage
healthy Qi.
• So great cares must be taken in using this
therapy.
• Emesis is usually forbidden to being used to
treat the patient with critical illness, various
types of hemorrhage and dyspnea;
• or to be used to treat deficiency of Qi and
blood in the aged and young as well as
pregnant and postpartum woman.
 Purgation
• is a therapeutic method used to discharge
feces, eliminate retention of substance and
fluid inside the body and relieve
accumulation of excess-heat with the
prescriptions and herbs effective for
catharsis.
• Purgation therapy is usually used to treat
excess syndrome.
 Application
• What can Aloe do?
• Aloe is is a herb which have function of
Purgation, it is used to discharge feces
Clinically purgation is divided into five types:

1. cold purgation, applicable to interior excess-heat

syndrome;
2. warm purgation, applicable to retention of cold in the
stomach and intestines;
3. dispelling water, applicable to excess syndrome of water;
4. moistening purgation, applicable to insufficiency of fluid
in the intestines and constipation due to loss of yin and
deficiency of blood;
5. e1iminating stasis, applicable to retention of stagnant
heat in the lower energizer, or the patients with dry blood
inside ,blood stasis and strong constitution.
 Resolution
• is a therapeutic method used to remove the
retention of food and eliminate stagnation
with herbs effective for promoting
digestion.
• This therapy is mainly used to treat chronic
abdominal mass due to disorder of Qi and
blood, improper diet, phlegm and retention
of fluid.
• is usually used to treat excess syndrome.
 Example
• Hawthorn is a herb which have function
of Resolution, it is used to used to remove
the retention of food and effective for
promoting digestion.
 Reinforcing therapy
• is a therapeutic method used to treat deficiency
syndrome by means of supplementing essence,
blood and body fluid with the prescriptions and
herbs effective for tonifying and reinforcing the
body.
• This therapy is mainly used to treat deficiency
syndrome of Qi, blood, Yin and Yang, such as
physical weakness, spiritual lassitude, loss of
blood and body fluid.
Clinically invigorating therapy is divided into
four types:
• Invigorating Qi, •
applicable to
syndromes caused by
Qi-deficiency;
• For example, ginseng
can invigorate health
Qi to treat the Qi-
deficiency syndrome
• Tonifing blood,
applicable to
syndromes caused by
blood-deficiency;
• Longan invigorate
blood to treat the
blood-deficiency
syndrome
• Invigorating Yin,
applicable to
syndromes caused by
deficiency of essence
or insufficiency of
body fluid;
• For example, lily
• Invigorating Yang, •
applicable to
syndromes caused by
deficiency of the
spleen-Yang and
kidney-Yang.
• For example, walnut
 Warming therapy
• known as cold-eliminating therapy, is a
therapeutic method used to eliminate
pathogenic cold and invigorate Yang-Qi
with the prescriptions and herbs warm and
hot in nature.
• Warming therapy is usually used to treat
cold syndrome.
• This therapeutic method is mainly used to treat
interior cold syndrome, such as excess-cold
syndrome due to invasion of pathogenic cold into
the viscera and interior exuberance of yin-cold.
• It is also applicable to excess-cold syndrome due
to endogenous cold resulting from deficiency of
Yang-Qi. For this purpose, it is usually used in
combination with the therapy for improving
deficiency.
Cinnamon
 Heat-clearing therapy
• is a therapeutic method used to clear away
heat by means of reducing fire, removing
toxin and cooling blood with the
prescriptions and herbs cold and cool in
nature.
• Heat-clearing therapy is usually used to
treat heat syndrome.
• This therapy is
mainly used to treat
interior excess-heat
syndrome.
• Leaves of bamboo
 Mediation
• is a therapeutic method used for eliminating
pathogenic factors and supporting healthy
Qi.
• Half-exterior and half-interior syndrome
 Treatment based on syndrome
differentiation
• The therapeutic methods mentioned above
are the basic ones generalized according to
the eight principles.
• Since pathological conditions are
complicated, the use of these methods in
clinical treatment has to be made the basis
of syndrome differentiation.
Traditional Chinese Medical
Prescriptions
• The art of prescriptions (also known as recipes or
formulas) in TCM has undergone significant change
through the centuries.
• The prescriptions in TCM are not merely collections
of medicinal substances in which the actions of one
herb are simply added to those of another in a
cumulative fashion.
• They are complex recipes of interrelated substances,
each of which affects the actions of the others in the
prescription.
• It is this complex interaction, which makes the
prescriptions so effective, but also makes them more
difficult to study.
• Every medicinal substance has its strengths and its
shortcomings.
• An effective prescription is one in which the
substances are carefully balanced to accentuate the
strengths and reduce the side-effects.
• The combination of substances in a prescription
creates a new therapeutic agent that can treat
conditions more effectively and completely than a
single substance.
• Constructing an effective prescription involves
more than simply putting ingredients together to
obtain a certain effect.
• One needs an organizing principle to guide the
construction so that the ingredients are combined
in an optimal fashion.
• The orderly arrangement of ingredients in a
prescription is called a hierarchy.
• Traditional Chinese society was always
very conscious of rank, which revolved in
the first instance around the emperor and
his court.
• For this reason, the terms used to signify the
importance or rank of the ingredients in a
prescription reflect those used in the royal
court.
• The four ranks of ingredients in the hierarchy of a
prescription are
 King Herb - The herb which is directed
to and has the strongest effect on the
most important imbalance/pathology
 Minister Herb - This herb is directed to
the main imbalance/pathology and to
the secondary imbalance/pathology
 Assistant Herb - there are three types:
 Helpful Assistant - strengthens the
effect of the King
 Corrective Assistant - reduces or
eliminates the harsh or toxic effects of
the King and/or Minister herbs
 Opposing Assistant - decreases the
effect of the King. This role is mostly
used for complex combinations of
imbalances/pathologies.
 Guide Herb - focuses actions of the
other herbs on a particular organ,
channel or region of the body.
• For example
 symptoms
• Breathlessness
• weak voice
• spontaneous sweating
• poor or no appetite
• Tiredness
• loose stools
• Pulse: empty,
• Tongue: somewhat faded in color
• dislike of speaking
• pale complexion
 Question
• Is there an Excess syndrome?
 NO/YES
• What is Deficient in this situation?
 Health Qi/ Pathogenic factors
• Which Treatment Principle do you choose?
 Invigoration/Purgation
 SI JUN ZI TANG
ROLES AND PROPERTIES OF INGREDIENTS

• King – 人参 - Ginseng
King Actions: tonifies Source Qi, tonifies Lung & Spleen
Qi.
• Minister – 白术 - White Attractylodes
Minister Actions: Tonifies Qi, tonifies Spleen, Resolves
Damp.
• Assistant – 茯苓 - Poria
Assistant Actions: Drain damp, tonifies Spleen.
• Guide – 甘草 - Licorice Root
Guide Actions: enters all 12 main channels,
harmonizes herb combinations (mitigates harsh effects),
tonifies Spleen.
 Review
• Traditional methods fall into eight
categories.
• Four properties and five tastes
• The functional tendencies of herbs are
marked by ascending, descending, floating
and sinking.
• Traditional Chinese Medical Prescriptions