Practical Foundations of TCM Syndrome Differentiation and Treatment

Author: Chief Editor: Sun Zengqi et al
Publisher:
Publishing Date: 1999-06-01
Features: The theory of syndrome differentiation and treatment is rich in content and runs through the entire theory and practice of Traditional Chinese Medicine (TCM). It is currently the basic principle for TCM to understand and treat diseases, as well as one of the most important characteristics of TCM. To correctly apply syndrome differentiation and treatment in clinical practice, one must study TCM theory diligently, gradually master the steps and methods of syndrome differentiation and treatment, and verify them in clinical practice. By doing so, one can gradually advance into the realm of TCM, handle complex and changing syndromes with simplicity and effectiveness, seek the root cause, and treat flexibly to improve therapeutic outcomes. To meet the needs of those who are dedicated to the TCM profession and wish to systematically study the theory of syndrome differentiation and treatment, the author has compiled this book based on years of teaching experience and clinical practice, serving as an introductory guide to learning TCM syndrome differentiation and treatment. The book consists of six parts: Part 1 introduces the basic knowledge of syndrome differentiation and treatment; Parts 2 and 3 introduce commonly used Chinese herbal medicines and formulas for syndrome differentiation and treatment; Part 4 introduces the basic principles of syndrome differentiation and treatment; Parts 5 and 6 introduce the syndrome differentiation and treatment of common symptoms and diseases. Each part includes (special lectures) to illustrate and expand upon the content, enabling a deeper understanding of each section. The book features theoretical elaboration combined with practical application, adherence to tradition with innovative insights, a comprehensive and profound approach, emphasis on key points with practical content, and clear and accessible language. It is suitable for students of TCM schools and self-taught individuals, as well as clinical TCM practitioners who can refresh their knowledge and gain new insights. Excerpt: Chapter 1 Basic Knowledge of Syndrome Differentiation and Treatment
Section 1 The Basic Characteristics of Traditional Chinese Medicine
The understanding of human physiological functions, pathological changes, disease diagnosis, and treatment in Traditional Chinese Medicine (TCM) differs from Western medicine in many aspects. These characteristics are primarily reflected in the following five areas.
Subsection 1 The Application of Ancient Philosophical Concepts of Qi, Yin-Yang, and the Five Elements
The ancient philosophical concepts of Qi, Yin-Yang, and the Five Elements were derived from the long-term life and production practices of ancient Chinese laborers. Through countless observations of various natural phenomena, they abstracted these concepts. Ancient philosophy holds that the world is material and that all phenomena are unified under the principle of Qi. Qi has Yin and Yang, which are divided into heaven and earth, transformed into the Five Elements, and give rise to all things. The aggregation, dispersion, and dynamic changes of Qi are the result of the interaction between Yin and Yang. The attributes and relationships of things generated from Qi are the outcome of the dynamic changes of the Five Elements. If Yin and Yang represent the ancient Chinese understanding of the nature and developmental patterns of things, the Five Elements fall within the realm of their understanding of the properties and interrelationships of matter. The theories of Qi, Yin-Yang, and the Five Elements form the three major pillars of ancient Chinese philosophy. They are closely integrated, mutually supportive, and collectively constitute the naive materialist dialectical thought system of ancient China. TCM originated from the long struggle of the Chinese laboring people against diseases. As TCM gradually evolved from empirical experience into a systematic theory, it coincided with the flourishing period of classical Chinese philosophy during the Spring and Autumn and Warring States periods. Therefore, ancient philosophical thought naturally permeated the field of medicine. This naive materialist dialectical thought became the philosophical foundation of TCM theory. Ancient philosophy permeates the entire theoretical system of TCM over thousands of years, runs through various academic schools of TCM and TCM books, and has long been closely linked with medical practice. It contains not only the understanding of the general laws of things' movement but also substantial medical content, forming a unique medical theoretical system in China. The theories of Qi, Yin-Yang, and the Five Elements were applied and evolved in medicine. In physiology, they are based on the dynamic changes of human internal organs and meridians, and in pathology, they are grounded in clinical pathological phenomena. Through long-term medical practice and continuous summarization of experience, closely linked with the general laws of things' movement in nature, they have integrated physiology, pathology, diagnosis, and treatment organically, permeating all aspects of TCM and forming a complete theoretical system. These theories not only greatly promoted the development of TCM in history but also retain their practical significance in current clinical practice. They will continue to play an active role in the inheritance, innovation, and modernization of TCM.
Section 2 Emphasis on the Concept of Holism
Holism refers to unity and completeness. TCM places great emphasis on the unity and completeness of the human body and its relationship with nature. It views the human body as an organic whole, where all its components are structurally inseparable, functionally coordinated, and mutually supportive, and are mutually influential in pathology. TCM also recognizes the close connection between the human body and the natural environment. This idea of the unity of internal and external environments and the inherent holism of the body is known as the concept of holism. It includes two aspects.
1. The Human Body as an Organic Whole
TCM considers the human body as an organic whole, meaning that all its components are organically interconnected. This connection is centered around the five internal organs (zang-fu), paired with the six fu organs, and is achieved through the meridian system, which "internally connects to the zang-fu and externally links to the limbs and joints." This holistic connection is reflected in the physiological and pathological aspects between the zang-fu organs and each other, as well as between the zang-fu organs and various tissues and organs of the body. For example, the heart corresponds to the small intestine, governs blood vessels, and opens into the tongue. When heart fire flares up, it may manifest as mouth and tongue ulcers. When heart fire moves downward to the small intestine, it can cause red, hot, and painful urination. Clearing heart fire and draining small intestinal fire can treat mouth and tongue ulcers. This illustrates that TCM consistently adheres to the fundamental view that "the human body is an organic whole" when explaining physiological functions, pathological changes, disease diagnosis, and treatment.
2. Humanity and Nature as an Organic Whole
TCM holds that humans live in nature and are closely connected to it. Nature provides the necessary conditions for human survival, such as air and food. The Spiritual Pivot·Guest states: "Humans correspond to heaven and earth." For instance, the four seasons bring changes in temperature—warm springs, hot summers, cool autumns, and cold winters. The human body adapts to these changes with different physiological functions. When seasonal changes are excessive or insufficient, or when the climate is abnormal, the body may fail to adapt, potentially leading to disease. Factors such as geographical environment and dietary conditions can also affect physiological functions, pathological changes, and disease outcomes. Therefore, TCM places great importance on treatment principles that consider the time and place.
Section 3 Foundational Theory of Zang-Xiang (Internal Organ Manifestation) Theory
TCM, based on long-term clinical practice, carefully observed the manifestations of physiological and pathological changes in the human body, combined with the phenomena and changes of all things in nature, and recognized that the human body has similar patterns of change to natural phenomena. Using ancient philosophical thought—the naive materialist dialectics—and logical reasoning methods such as "analogy" and "inference," as well as the approach of "zang → xiang → zang," TCM explains the opposing and unified physiological and pathological phenomena in nature and the human body, as well as their complex organic connections. This formed TCM's holistic understanding of the body and established a medical theory centered around the Zang-Xiang theory, along with a unique clinical method of syndrome differentiation and treatment. This theory was repeatedly applied to guide clinical practice, continuously summarized and developed, and gradually perfected into a great medical treasury with a unique theoretical system and diverse medical methods.
The Zang-Xiang theory, centered around the zang-fu organs and meridians, holds that the internal balance and coordination between them, as well as their holistic unity, are the main foundation for maintaining normal life activities. External environmental influences on the body are primarily reflected through changes in the balance and coordination of the zang-fu organs and meridians. The health of the human body, as well as the occurrence, development, formation, and resolution of diseases, are closely related to the functional states of the zang-fu organs and meridians. This theory guides clinical practice effectively.
The Zang-Xiang theory was summarized by the Chinese laboring people through long-term medical practice against diseases. Its formation has a philosophical foundation. First, it is based on the knowledge of human anatomical structure from ancient medical practitioners. Second, it is based on observations of the physiological and pathological phenomena of living humans. The essence of any thing must manifest through certain phenomena, and any phenomenon reflects the essence of a thing from a certain perspective. Although the activities of internal organs are invisible and intangible, the principle "what is internal must manifest externally" applies. Therefore, ancient physicians, based on the theory that "zang-fu organs reside internally, while their manifestations appear externally," carefully observed the various external manifestations of internal organ activities under normal physiological and pathological conditions, accumulating knowledge about the patterns of zang-fu organ activities. For example, it was observed that the heartbeat and pulse rate are generally consistent, leading to the conclusion that the heart governs blood vessels through pulse diagnosis to assess the flow of Qi and blood. Another example is that during hot weather, sweating is excessive and urination is less, while in cold weather, sweating is less and urination is more. This led to the understanding that sweat and urine share the same origin. Thus, ancient physicians, based on preliminary knowledge of the morphology and physiological functions of the zang-fu organs, combined with long-term observations of life phenomena and medical activities, further developed and deepened their understanding of the physiological functions and pathological changes of the zang-fu organs. They proposed theories such as "the heart governs blood vessels," "the lungs govern Qi," "the kidneys govern water," "the brain is the sea of marrow," "the stomach is the sea of grains and liquids," "the kidneys are the root of congenital essence," and "the spleen and stomach are the root of acquired essence." These theories played a significant role in the formation and development of the Zang-Xiang theory. The third source of Zang-Xiang theory understanding is the summary of long-term medical practice experience by the Chinese laboring people. Through the treatment of various pathological phenomena in the struggle against diseases, they gradually summarized and improved their understanding of the patterns of zang-fu organ activities. For example, sudden changes in external climate, such as invasions of wind and cold, may cause fever, chills, lack of sweating, coughing, and shortness of breath. Using the "dispersing" method of treatment, they observed that sweating led to the resolution of fever and chills and the cessation of coughing, thus recognizing the close relationship between the body's surface and the lungs.