All Chinese in one :)

HSC3521 1: WEEK 1 Lecture

“Is Chinese Medicine an art? Is it a science? If we mean by science the relatively recent intellectual and technological development in the West, Chinese Medicine is not scientific. It is instead a tradition that has survived into the modern age and remains another way of doing things. But it does resemble science in that it is grounded in conscientious observation of phenomena, guided by rational, logically consistent, and communicable thought process.”

---The Web That Has No Weaver, page 18-19

What is TCM? Chinese Medicine, also known as Traditional Chinese Medicine or TCM, has been practiced in China for thousands of years. Historically, it has played an important role in the prevention and treatment of diseases in China.

With its complete theoretical system, firm clinical foundations and significant therapeutic effects, most of the major western nations have now realized the value of this ancient healing art.

Central to the philosophy of Chinese Medicine is the premise of the self healing mechanism active in the body.

The goal of Chinese Medicine is to promote this mechanism from within. TCM presents the processes of the

human body as interrelated and in constant interaction with the environment. Therefore signs of disharmony, known as illnesses in Western Medicine, are observed from both the external and internal environment of a person in order to understand, treat and prevent further illness and disease. *********************************************** *********************************************** *************************** "Biomedicine, a more accurate name for Western Medicine, is primarily concerned with isolable disease categories or agents of disease, which it zeroes in on, isolates, and tries to change, control, or destroy."

"The Chinese Physician, in contrast, directs his or her attention to the complete physiological and psychological individual. All relevant information, including the symptom as well as the patient's general characteristics, is gathered and woven together until it forms what Chinese medicine calls a "pattern of disharmony."

-----The Web That Has No Weaver, pages 3-4

What form of medicine is best?

One concept is not better than the other; instead, the two offer different perspectives, each with its own validity and limitations. Within each discipline, there is an enormous amount of time tested information that has its own logic and usefulness. In my opinion, both Western and Chinese systems have their place in the present healthcare system.

Together they provide the best healthcare available.

Chinese Medicine vs. Western Medicine China many hospitals have the two medicines integrated, combining the best of each medicine for the In

patient's benefit. The Chinese study both with an open mind to discover which medicine works best for what condition. A person with a broken leg will clearly benefit from a medical doctor rather than an acupuncturist. But once the bone is set, acupuncture can help speed recovery.

Cancer patients in China may receive radiation treatment or chemotherapy. At the same time, they are advised to receive appropriate herbs and acupuncture, because it is recognized that this will help ameliorate the side-effects and help improve quality of life for the patient.

In America over the last hundred years, we have all benefited immensely from advances in western medicine. It has produced numerous unimaginable miracles such as organ transplants, in-vitro fertilization, bio-engineered medicine and the mapping of human genes. Let's not forget the emergency care provided for traumatic events and pharmaceutical drugs that allow quick remedies for acute problems, such as respiratory, sinus, bladder and many other infections. Having acute conditions in mind and in regards to society and meeting Americans needs, Western medicine is crucial to fast paced lifestyles and demanding schedules. Unfortunately, the side effects to a "quick fix" drug can be quite undesirable. When relying only on

Western drugs and last minute healthcare people find their immune systems compromised and overall health to be poor. In this case, Chinese Medicine would be a great "alternative" form of therapy. Chinese Medicine remains the primary to many Chinese but here in the U.S. is referred to as "alternative". Well, the alternative is sometimes best.

For Corporate America, Chinese Medicine can be used to decrease and ultimately diminish acid reflux, indigestion, insomnia, restless leg, irritability, road rage, etc....., many of the common illnesses treated with pharmaceutical drugs.

Once these imbalances are harmonized, preventative measures can be applied. Chinese Medicine utilizes the body's natural occurring healing system to remedy any imbalance; therefore, "preventative medicine" has been the most recent term associated with Chinese Medicine.

The origin of Traditional Chinese Medicine, or TCM, has roots deep within Taoist beliefs and culture dating several thousand years ago. The present practice, extracted from these foundations, is now practiced throughout the world.

Various forms of therapy and treatment are implemented balancing the body’s internal function and physical form with external influences and environmental conditions.

Unlike Western Medicine a Chinese physician will not have a diagnosis based solely on the main complaint. Main complaints are recorded along with an overall observation of the patient, presenting symptoms, attitude, emotional state, diet, exercise routine, relaxation techniques and past medical history. All of these components are considered when creating a pattern of disharmony.

Overall, it is important to recognize the many great advances in Western Medicine, but when choosing the best care you must take into consideration the approach that each form uses in treatment. Western medicine approaches the human body from an anatomic and biochemical standpoint. It regards us as physical and biochemical beings made of many parts that can be dissected into tiny, independent components (cells), and all internal changes can be expressed by biochemistry equation. Chinese Medicine approaches the human body from an energetic and functional standpoint. TCM treats each person on an individual basis of their individual nature and regards the human body as an organic whole. It regards us as living organisms made of energetic, physical, emotional and spiritual parts that are intimately related.

One concept that is central to Chinese medicine that the scientific world is still struggling to accept is the presence of "Qi". According to Traditional Chinese Medicine, the practice of Feng Shui and many martial arts, qi is a "life force". Qi exists within every living being and within the space where we live, between heaven and Earth. In the West, Qi is translated as energy, an intangible force that cannot be viewed through a microscope and cannot be detected with any scientific instruments. Many Americans and several cultures embrace the existence of this life force.

Yogis refer to qi as prana, or breath. Martial artists sometimes feel it as heat in the palms of their hands, or warm liquid moving through the body. Patients of acupuncture treatment compare qi sensation to tingling, aching, a muscle spasm or electric current. Feng Shui

practitioners claim areas of a home or office feel crowded; induce irritability and confusion when qi is stagnant and not able to flow freely through a space. These Qi based practices rely on a smooth, free flow of qi to produce proper function and maintain sufficient form, thereby, presenting good health. Any form of stagnation will lead to a disharmony, and ultimately imbalance.

Chinese Medicine treats health problems by working with the resources of the body itself. It uses acupuncture, acupressure, Tuina (Chinese massage), moxibustion and herbal medicine to re-establish a harmonious relationship amongst the organs and organ system to achieve a healthy state. Most importantly, Chinese Medicine is free from fear of side effects and limits a patient's need for medical intervention.

• Acupuncture: application of special fine needles to harmonize and activate the body’s own healing ability and to promote health and longevity.• Acupressure: application of touch along specific areas for well-being and self-help• Herbal medicine: an advanced and effective system that uses herbs both as food and medicine. • Diet: a unique and effective system teaches how to eat to restore and maintain health by understanding the energetic qualities of food. • Healing movement: Qi Gong and Tai Qi promote health, longevity and a calm heart. • Breath: simple awareness of breath in our daily lives and combined with movement and meditation can promote health.• Moxibustion (moxa): therapeutic application of heat with specially prepared herbs• Meditation: to promote inner quiet and peace,

essential for well-being.• Tui Na: Chinese medical massage

Treatment of Yin Yang Everything in the universe can be described in terms of Yin or Yang. This is one of the underlying philosophies of Chinese Medicine that you will learn in the next lecture.

HSC3521 1: WEEK 1 Lecture

Yin Yang Over the centuries, the Chinese have developed ways of conceptualizing what the causes of bodily sickness are and ways of acting to prevent or to stop its course once it has begun. The concept of yin-yang is the most important and distinctive theory of Chinese Medicine. It also permeates all aspects of Chinese culture and philosophy. It has been said that all Chinese medical physiology, pathology, and treatment can eventually be reduced to this fundamental and basic concept of yin-yang.

Yin and Yang Yin and Yang is one of the most fundamental concepts in Traditional Chinese Medicine, as it is the foundation of

diagnosis and treatment. The earliest reference to Yin and Yang is in the I Ching (Book of Changes) in approximately in 700 BC. In this work, all phenomena are said to be reduced to Yin-Yang.

The Chinese character for Yin translates literally as the "dark side of the mountain" and represents such qualities as cold, stillness, passiveness, darkness, within, and potential.

The Chinese character for Yang translates literally as the "bright side of the mountain" and represents such qualities as heat, activity, light, outside and expression.

Four Main Aspects of Yin and Yang Relationship Yin-Yang are oppositesThey are either on the opposite ends of a cycle, like the seasons of the year, or, opposites on a continuum of energy or matter. This opposition is relative, and can only be spoken of in relationships. For example: Water is Yin relative to steam but Yang relative to ice. Yin and Yang are never static but in a constantly changing balance.

Interdependent: Can not exist without each otherThe Tai Ji (Supreme Ultimate) diagram shows the relationship of Yin & Yang and illustrates interdependence on Yin & Yang. Nothing is totally Yin or totally Yang. Just as a state of total Yin is reached, Yang begins to grow. Yin contains seed of Yang and vise versa. They constantly transform into

each other. For Example: no energy without matter, no day without night.The classics state: "Yin creates Yang and Yang activates Yin".

Mutual consumption of Yin and YangRelative levels of Yin Yang are continuously changing. Normally this is a harmonious change, but when Yin or Yang are out of balance they affect each other, and too much of one can eventually weaken (consume) the other.Four (4) possible states of imbalance: Preponderance (Excess) of Yin Preponderance (Excess) of Yang Weakness (Deficiency) of Yin Weakness (Deficiency) of Yang Inter-transformation of Yin and Yang.One can change into the other, but it is not a random event, happening only when the time is right. For example: Spring only comes when winter is finished.

Yin and Yang in Medicine All physiological processes, signs and symptoms can be reduced to Yin-Yang.

In general, every treatment modality aims to: Tonify Yang Tonify Yin Yang Disperse excess Yin

Disperse excess

In practice, depending on the condition, strategies may be combined, for example: disperse excess Yin & tonify Yang.

Yin and Yang and the Six Pathogenic Factors

Yin

Yang

Wind Cold

Heat

Dampne Dryness ss Summerhe at Yin and Yang and the Human Body Yin

Yang

Front (chest-abdomen)

Back

Body

Head

Interior (organs)

Exterior (skin, muscles)

Below waist

Above waist

Anterior-medial

Posterior-lateral

ventral surface of the trunk and limbs

back and dorsal surface of the limbs

Structure

Function

Blood/Body Fluids

Qi

Conservation/storage

Transformation/change

Yin Organs: Heart, Lung,

Small Intestine, Lg. Intestine

Liver, Spleen, Kidney,

Gall Bladder, Stomach, Bladder

Pericardium

San Jiao

"Solid Organs"

"Hollow Organs"

Front and BackFront is more soft and vulnerable (Yin).

Back contains spine that holds ribs: protection. When human depicted as crouching, back receives sun (Yang) and front faces the earth (Yin), is in shade and is protected.

All Yang channels (except the Stomach channel) flow on

the dorsal or dorsolateral surface of the trunk and limbs.

They carry Yang energy and protect the body from pathogenic factors. Yin channels flow on the anterior or anteromedial surface of the trunk and limbs.

Body and Head Yang channels either end or begin on the head. Acupuncture points on the head can be used to raise Yang energy . When Yang energy is not cooled by Yin, it may rise to the head, causing signs such as red face and eyes. The head is easily affected by Yang pathogens such as heat and wind. The chest and abdomen (Yin) areas are more easily affected by Yin pathogens such as Cold and Dampness.

Interior and ExteriorThe exterior of the body such as the skin and muscles is more Yang. The exterior protects body from attack by external pathogenic influences such as Cold, Wind, etc. The classics state: "Yang is on the outside and protects Yin".

Below the waist and Above the WaistBelow waist closer to earth = YIN Lower part more affected by Yin pathogens, i.e. cold damp.

Above, closer to Heaven = YANG Upper part more affected by Yang pathogens, i.e. wind.

Anterior/Medial and Posterior/Lateral Surface of the LimbsYin channels flow on anterior-medial aspect of trunk/limbsYang channels flow on posterior-lateral aspect

of trunk/limbs Structure and FunctionStructure = something substantial, i.e. Matter (Yin)Function = something insubstantial, action, energy (Yang)All parts of the body have a structure (a physical form), and a function (their activity)However, all is relative. Even within the Yang category of function, there are Yin functions (i.e. storage, conservation) and Yang functions, i.e. transformation, transportation, digestion, excretion.Within the Yin category of form there are Yin forms ("solid") and Yang forms ("hollow") Blood, Body Fluids, and QiQi is Energy = YANGBlood = denser and more material = YIN But note that "Xue" (blood) not exactly like our concept of Blood. More like "thicker" form of Qi. Note: there are several types of Qi. Each is relatively more Yin or Yang. Ancestral QI = more Yin, more slow moving., moves in long, slow cyclesYing Qi = more Yang than Ancestral Qi, moves with Blood with which it is closely related. Ying is more Yin than Wei Qi.Wei Qi the most Yang form of Qi. Circulates in the exterior in the daytime to protect us from pathogenic influences, and regulates opening/closing of pores.

Conservation/Store (Yin) and Transformation/Change (Yang)Yin Organs store Blood, Body Fluids, Essence, etc.

Yang Organs constantly transform, transport and excrete the products of digestion.

Solid and Hollow Organs (Zang Fu)Yin Organs are

"Solid": constantly active, involved in production and storage of the body's vital Substances (Qi Blood, Body Fluids, Essence) Yang Organs are "Hollow": receive and circulate but do not store, involved in digestion, transformation, excretion.

HSC3521 2: WEEK 2 Lecture

Zang Fu Organs  Zang is Yin and Fu is Yang Zang Fu is another name for the Internal Organs, six Zang or Yin organs, six Fu or Yang organs and the extra Fu organs.

Zang or Yin Organs Extra Fu Organs

Fu or Yang Organs

Heart

Small Intestine

Lung Vessels

Large Intestine

Liver Bones

Gallbladder

Spleen Marrow

Stomach

Kidney

Urinary Bladder

Brain

Uterus Pericardium Gallbladder

Triple Burner/Sanjiao

The Pericardium is considered part of the Heart as it carries out the functions of the heart and acts as the heart’s protector. Therefore, you will find that some texts refer to the Internal Organs as the five Zang and six Fu. The main functions of the Yin Organs are to manufacture and store essential substances, including vital essence, qi , blood and body fluid.

The main functions of the Yang Organs are to receive and digest food, and transmit and excrete impure substances and waste.

“The so-called five Zang organs store pure essential qi without draining it off, and for this reason they can be filled up but cannot be overfilled. The six fu organs transmit water and food without storing them, and for this reason they may be over supplied but cannot be filled up.”

-Plain Questions, or Huang di Neijing Su Wen

“All organs can be characterized as wither Yin or Yang.

But within each Organ there is both a supportive, nourishing Yin aspect and a dynamic active Yang aspect.” ---Page 84 Heart, “Emperor”

The Heart is said to be the most important of all the Internal Organs, hence it is referred to as the “Emperor”. It is essential for the healthy blood supply to all organs as it controls the circulation of blood and governs both the blood and blood vessels.

The Heart is responsible for Housing the Mind, which is also referred to as “Shen”.

“When the Heart Spirit is disturbed, one has symptoms such as insomnia, situational anxiety, and inappropriate or even bizarre behavior….When the Heart Spirit is intact, one connects with propriety and tact.” ---page 89 If the Heart is supple  a person has vitality and a strong constitution If the Heart is weak  a person will have little strength, endurance and a weak constitution

Transformation of Food Qi into blood takes place in the Heart – The spleen transforms the food we eat and separates Gu Qi (this term is not mentioned in this text, Gu qi is the purest essence of food) from turbid substances that are sent down to the small intestines. Gu Qi is then transported up to the lungs. On the way to the lungs Nutritive qi begins to turn Gu Qi into blood. In the lungs the transformation is complete once Gu Qi is combined with “clear” qi of air, which is the purest form. Blood is then circulated throughout the body via various blood vessels by both Heart qi and Zong qi, qi of the chest. page 53

The Heart manifests in the complexion – The hearts control of the blood supply in circulation is revealed in the complexion. For example, if the heart is strong and the blood is supple the skin will have healthy appearance, almost glowing. If the blood is deficient

and the heart qi is weak, the complexion will be pale or bright white. Blood stasis leads to a bluish-purple complexion and heat in the heart manifests as a very red complexion.

The Heart opens into the tongue – “The ability to choose words wisely, to convey meaning weak, and to connect in dialogue belongs to the Heart Spirit’s relation with the tongue.” ---page 89

Related to the emotion - JOY Liver, “Army General”

Houses the Ethereal, also know as Non-Corporeal Soul ****responsible for Human Kindness

Stores blood “The Liver’s blood is responsible for softening the qi and ensuring that the qi’s dynamic strength is not too tense, restless, and awkward.” ---page 81

Regulates blood volume - during activity blood rushes to contracting muscles and joints, at rest the blood is stored in the liver

Regulates Menstruation – dysfunction to Liver Blood or Liver QI will lead to irregular menstruation

Ensures the smooth flow of qi Essential to all physiological processes “The liver’s blood, by first tempering the Liver’s qi and then the entire body’s qi, ensures the smooth movement of qi.

---page 81Controls tendons, which include sinews ligaments and indirectly the muscles and Manifests in the nails – “When the Liver’s blood is plentiful….the tendons are supple and the nails appear pink and

moist.” ---page 83

The Liver Opens into the eyes - It is a healthy treat for your mind, body, and liver specifically, to designate some time during a busy day to close your eyes and allow the blood to return the liver.

The eyes have time to rest and the liver is given an opportunity to regain a smooth flow of qi throughout the body. Many people in our society suffer from the repercussions of stagnant liver qi.

Frustration, irritability, impatience, headache, tired and red eyes….these are some conditions created with liver qi stagnation.

They only get worse and more chronic if the body is not allowed a balanced routine of work, sleep, relaxation and play. “When the liver receives blood, the eyes can see.” ---page 83

Associated with the emotion and actions of ANGER –Liver qi rises. When this rising is obstructed by imbalances and organ dysfunction liver qi will stagnate and ultimately become pent up and cause erratic and abrupt upheaval. Symptoms of Liver Yang rising and Liver Fire can be avoided through stress management and a balanced lifestyle.

Lung, "Prime MinisterLung, “Prime Minister” Houses Corporeal. Also known as Animal Soul - “….lacks deliberation of reason.” Page 91

The Lung Governs qi and respiration extracts pure and clear qi from the air we breathe.

“The lungs take in Natural Air Qi, propelling it downward. This is inhalation.” Page 91

The Lungs spread QI throughout tissues and organs – “Because the qi of the chest is involved with the movement of all qi and blood of the body, a disharmony of the lungs can produce

Deficient Qi anywhere in the body.”

Page 91

Descending of QI and fluids – The lungs move water in two different ways. “…descending and liquefying, the lungs move water (down) to the kidneys. By ‘disseminating’, the lungs circulate and scatter water vapor throughout the body, particularly through the skin and pores.” Page 92

Controls channels and blood vessels assist the Heart in controlling circulation

Regulates water passages assist in the movement and processing of Body Fluids

Controls skin and hair condition – “…the lungs regulate the secretion of sweat, the moistening of the skin and resistance to External Pernicious Influences. These functions also depend on the Protective (Wei) Qi, which in turn depends on the lungs disseminating ability.” Page 92-93

Opens into the nose – throat and nose disorders are treated through the lungs

Affected by worry, grief and sadness Spleen Governs transformation and transportation the spleen is the central organ in the production of Qi and Blood, also referred to as the root of Post Heaven or Post Natal Qi “If the Spleen is in disharmony, then the whole body, or some part of it, may develop Deficient Qi or Deficient Blood.” Page 79

Houses thought – A Strong Spleen is imperative in maintaining energy, strength and concentration.

“If the Spleen is healthy, a person has clear thoughts, can make decisions, and thus has the insight to faithfully support the needs of other people and situations….If the Spleen is unbalanced, a person can worry easily, have difficulty making decisions, be mentally unclear and confused, be excessively helpful, or just bored and uninterested.” Page 79-80

Controls the "rising qi“ a weak Spleen affects the ascending of qi and effects the Spleen’s function of holding blood in vessels – this results in bleeding from the uterus, Bladder or intestines.

Controls the Blood the Spleen Qi holds blood in vessels and ensures that blood is in its proper path. Qi moves blood and blood withholds qi. “…the Qi commands the blood, and the particular aspect of Qi that holds Blood in place is the Spleen Qi.” Page 80

Controls the muscles and the 4 limbs - Provides the muscles, especially the four limbs, with refined QI and blood “Muscle tone or appearance of the limbs often indicates relative strength or weakness of the Spleen.” Page 80

Pensiveness affects the Spleen - Excessive thinking, overanalyzing and overwork injures the Spleen

Kidney, “Root of Life” Stores essence and governs birth, growth, reproduction and development – “Essence, in one form or another, is the

primordial seed of the life process, the life process itself, and life’s final fruit.” Page 84

The Kidneys Govern water Kidney Yin  substance for birth, growth and reproduction, referred to as Jing or Water, the material foundation for Kidney Yang Kidney Yang  physiological processes, referred to as Ming Men, or Life Gate Fire - activity necessary to transform Kidney Yin. “The Kidneys Rule Water through their Yang aspect, the Life Gate Fire.” Page 85

Produces marrow, fills up brain and controls bones – Kidneys store essence, essence produces marrow and marrow is responsible for creating and supporting the bones. The teeth are also rules by the Kidneys because they are an extension of bone.

“The Kidneys rule the grasping of Qi, ….The kidneys enable the Natural Air Qi to penetrate deeply, completing the inhalation process by what is called “grasping the qi.” Page 88

Opens into the ears and manifest in the head hair – Weak Kidney Qi will result in hearing loss or difficulty and loss or early graying of head hair

Houses will power – “Will” is unique per person “The Oriental Physician can….strengthen the Kidney’s Will.

When the will is not intact, a person can have uncontrollable fear or a dread of death, existential anxiety, or inability to feel the gracefulness of becoming older. “

Pericardium, “Master of the Heart” Heart Protector – related to the organ Connected to the Triple Burner via channel Carries out same functions as the Heart Helps the Heart House the Mind by calming and balancing Aids the Heart and Lungs with the distribution of Zong Qi and Blood

Yang Organs Large Intestine Receives waste material from Small Intestine Absorbs fluids and excretes feces

Stomach Receives and decomposes food Movement of QI is downward

Small Intestine Receives and temporarily stores partially digested food Separates clear from turbid Movement of Qi is downward

Urinary Bladder

Temporarily stores the urine and controls discharge Movement of qi is downward

San Jiao Water metabolism Upper Jiao Middle Jiao Lower Jiao

Gallbladder Stores bile and excretes it to aid in digestion Slide 1 What is Qi?

According to the Chinese, Qi is a vital essence or life force. In the west it is translated as meridians that stretch to every part of the body. A disruption of the flow of qi causes imba may be pain, dysfunction and ill health. Good health is dependent on a balanced distribu "When the Qi from Heaven"

When the Qi from Heaven Descends… and meets the rising of the QI from the Earth …

Life is created Human Qi is nourished Function is given its potential The Origin of Qi = two types

Prenatal Qi, also know as Congenital, Original, Yuan or Before Heaven Qi Stored in the Kidneys Inherited from Parents at Birth Essential to growth and development in vitro and after birth This qi can be supplemented by the second form of qi if needed Postnatal Qi, also know as Acquired Qi or After Heaven Qi Derived from what we consume – food and air Functions of Qi

1) Promote/Activate: All bodily functions, Movement Growth and Development Physiological Activities of Zang Fu 2) Warm = regulation of body temperature 3) Immunity = wei qi, protection 4) Consolidate//Holds in place= Blood Body fluid Essence in body "Original Qi or"

Original Qi or Yuan Qi “Essence Transformed Into Qi”

Yuan -Yin Yuan -Yang Ying Qi nutritive qi “needle qi” Food Qi

Wei Qi defensive qi “immunity”

Also know as Gu Qi Produced by the Spleen Food qi + Air from Lungs = Gathering Qi or Zhong Qi Food qi + Original Qi from the Heart = Blood

Defensive or Wei Qi

Circulates outside the channels in the space between the skin and muscles Mixed with sweat it regulates the opening and closing of the pores Protects the body from external pathogens Warms the muscles Circulates 50 times in 24 hours – 25 during the day and 25 at night "Gathering or Zhong Qi"

Gathering or Zhong Qi = This is another term for the Spleen’s function of “transformation and transportation” Ying Qi or Nutritive Qi = Nourishes internal organs Closely linked to blood Flows in channels and blood vessels Combination of Ying Qi and Wei Qi 1) Breathing 2) Voice 3) Heartbeat 4) Mental- enthusiasm, will power?

Direction of Qi Movement

In Out Up Down Qi Disorders

Deficiency Collapse

Stagnation Counterflow Essence “Jing”

Responsible for Growth and Development, Metabolism and Daily Activities.

3 types Pre Heaven or Prenatal nourish embryo, fetus, genetics Post Heaven from foods/fluids by SP/ST Kidney Essence from pre and post heaven essence Functions of Essence

Growth and Development Basis for Kidney Qi Produces Marrow Basis of Constitutional Strength Disharmonies of Essence

Improper Maturation Sexual Dysfunction Infertility or problems with conceiving Premature aging Congenital Defects "Blood"

Blood A form of Qi Blood is Yin Blood = Ying Qi + Body Fluids Qi Moves Blood Blood Carries the Qi (ying qi) Spleen Lung Kidney Heart  important to forming blood Spleen Liver Heart  important in movement/management Disorders of Blood

Blood Deficiency Blood Stasis Blood Heat Body Fluids = Jin and Ye

Jin: Clear, thin fluids, surface of muscles, warms, nourishes muscles and skin

Ye: thick, heavy fluids in joints, orifices, moistens joints, brain, marrow, nourishes orifices:

"Disorders of Body Fluids"

Disorders of Body Fluids Deficiency of Fluids Accumulation of Fluids Edema, Phlegm

Mind or Shen

“The heart houses the mind”

When the mind or shen is weak, overworked or stressed the Heart qi will become weak a

“Chinese ideas represent a different way of detecting and organizing information about health and disease.”

--- The Web That Has No Weaver, page 143 Why is there disharmony?

Precipitating factors of illness:

1. Environment – Six Pernicious Influences or ix Evils 2. Emotional Responsiveness – Seven Emotions

3. Way of life – Diet, physical activity, sexual activity, relaxation, miscellaneous factors Hereditary – Medical History is imperative in both Chinese and Western Medicine

The Six Pernicious Influences or Six Evils internally generated = chronic, constitutional pattern of disharmony, imbalance between yin and yang externally generated = acute, statement of exposure “…the microcosm is affected ‘directly’ by the macrocosm.” ---page 146 If the Wei Qi of the body is weak, external influences can invade the superficial layers of the body and have the potential to affect the internal functions of the organs.

Dampness - yin, cold, wet, turbid, heavy.

This Evil easily affects the Spleen’s role in the production of qi and blood.

“Dampness can readily ‘distress’ the Spleen and interfere with its ‘raising’ of pure foods and fluids” ---page 147 Dampness symptoms are created and exacerbated with the intake of oily and greasy foods, as well as wet, damp and humid weather.

These symptoms may include swelling, obesity, the formation of cysts, tumors, and lumps, and an increased production of phlegm, or mucus.

Mucus is a chronic, more concentrated form of dampness. Mucus in the lungs can affect the sinuses and upper respiratory passages, including the lungs and bronchioles. Mucus affecting the Heart Spirit will induce a foggy-like state, along with confusion and poor concentration. Mucus in the throat creates a plum-pit sensation where the patient feels as though, he/she cannot clear their throat.

Wind – yang, quick, consistent movement, light and dry.

“Wind in human activity resembles wind in nature.” Page 150 Internal Wind – easily affects the Liver. The liver stores blood and controls the smooth, free flow of qi throughout the body.

Symptoms are dizziness, tremors, twitching, convulsions, shifting pain, numbness, etc….

The liver is associated with anger and irritability, therefore these emotions are often present with Wind affecting the Liver.

External Wind – Easily affects the Lungs and is the most prevalent of the six external factors. Wind refers to the ability of an illness to spread within the body and resembles what Western Medicine refers to as infectious or contagious disease. External Wind is always paired with one of the other Six Evils: Wind Heat, Wind Cold or Wind Dampness.

General Symptoms of Wind include chills, fever, colds, flu, nasal congestion, headaches, allergies, arthritic and rheumatic conditions, as well as dizziness and vertigo.

Cold – yin, slow, lacks warmth, obstructs normal movement Internal cold = insufficient yang which is associated with weakened Kidneys. “…Cold signs include frail legs and back, frequent urination and edema, needing extra blankets at night, failure to develop or thrive, or lack of sexual desire. “ ---page 153 External Cold = sudden onset, chills, aversion to cold, body aches, mild fever.

“Usually chills are more pronounced than the fever, and the fever is interpreted as the body’s effort to expel the External Influence.” ---page 153 Chills are present due to the fight between the Wei qi and The external pathogen. A fever presents to expel the pathogen and hopefully induce sweating.

Cold related imbalances manifest as conditions that diminish the

body's immune system, such as colds, cough, upper respiratory allergies, as well as poor circulation, anemia, and weak digestion.

Heat – External Influence Fire – Internal Influence = yang, heat ,active.

Aversion to heat, preference to cold Induces “reckless movement” of Heart Spirit – high fever, confused speech, delirium And “reckless movement” of Blood – hemorrhaging, skin eruptions External Heat – high fever, headache, swollen throat and tonsils, dry mouth, thirst, desire for cold, irritability, delirium, etc….

Wind Heat – high fever and severe headaches Wind Cold – low fever, sever chills and body ache Heat conditions are described as hot and inflammatory, exacerbated by hot weather and exposure to direct heat.

Internal heat develops from disharmony of yin and Yang

Dryness – yang, related to symptoms of Heat Dehydration, redness and hotness, dry nostrils, lips tongue, cracked skin and dry stools Dryness can damage vegetation, and creates similar imbalances within the body, causing disorders of the lungs, sinuses, large intestine, skin, digestion, and reproductive organs.

Summer Heat – exposure to extreme heat, sudden high fever, heavy sweating.

An overexposure to sunlight and hot weather can yield conditions such as heat stroke, dizziness, nausea, extreme thirst, and exhaustion.

“Summer Heat easily injures the Qi, causing exhaustion, and

depletes the Fluids.” ---page 156 Often occurs with Dampness – Summer Heat Damp ***Great reference for the Six Pernicious Influences: http://www.sacredlotus.com/theory/illness/six_evils.cfm

The Seven Emotions The seven internal causes, otherwise known as the Seven Emotions, are illnesses brought about by intense, prolonged, or suppressed feelings, and are defined as follows:

Joy in Chinese Medicine refers to excess, or overabundance, and relates to illness relative to overindulgence. Damage to the heart may result, and the conditions of hysteria, muddled thought, and insomnia may arise.

Sadness decreases the flow of qi in the lungs and heart, and is associated with depression, fatigue, and amenorrhea, shortness of breath, asthma, allergies, cold and flu.

Grief is similar to sadness, and injures the lungs, decreases immunity to colds and flu, as well as chronic upper respiratory diseases such as emphysema, allergies, and asthma.

Pensiveness or over-engaging the mind in activities such as worry, thought, or study can deplete spleen qi, and may result in edema, digestive disorders, low appetite, and fatigue.

Fear, or paranoia causes qi to descend, resulting in potential

harm to the kidneys, lower back, or joints when this emotion is ever present.

Fright or shock is unlike fear in the sense that the onset is very sudden, causing one's qi to diverge. The rapid change in flow first affects the heart in symptoms such as breathlessness and palpitations, then moves to the lower body in a similar fashion to fear, damaging the kidneys, lower back, and joints. Fright is associated with the Gallbladder and Kidneys.

Anger, associated with the Liver, encompasses all the negative emotions of rage, irritability, frustration, and resentment, and causes the qi to rise inappropriately. Anger is associated with headaches, mental confusion, dizziness, and hypertension.

Way of Life Diet –“Because the Stomach receives food and the Spleen is responsible for transforming it into Qi and Blood, these two organs are most affected by diet.” ----page 161 Factors that disrupt bodily harmony: Too much or too little food Quality of food and beverages Time of eating Emotional state during eating Too much external stimulation during eating “Patients are often taught correct diet, proper attitudes, and healthful lifestyles.” --page 164 Proper Diet is specific to each patient’s body constitution. Food

therapy is commonly used to treat disharmonies. In fact, food was the original form of herbal medicine.

Sexual Activity – “……the East Asian physician recognized sexuality as a basic and fundamental force in the human landscape.” ----page 163 Sexual roots lie in the Kidney’s Essence, therefore dysfunction is related to a Kidney disharmony.

Spleen – allows sexuality to be nurturing Liver - allows assertiveness Heart – allows warmth and affection

Physical Activity and Relaxation– “All life activity, to the Chinese, should point toward the goal of living in harmonious balance with the seasons and one’s own constitution and stage of life.” ---page 163 Yang – morning, Spring season, youth – should be active Yin – night, Winter season, old age – should be quiescent “Physical activity is important to harmonize the flow of Qi and Blood to develop strength in the body.” ---page 163 There must be a balance of activity with a time of rest and relaxation. This harmony is imperative to the body’s ability to produce qi and blood as well as the flow of qi and blood.

Sufficient blood and an efficient flow of qi allows the body to be strong, supple and free of imbalance.

Miscellaneous Factors “…burns, bites, parasites and trauma – sudden, easily identifiable conditions and proximal causes of disease.” Page 165

HSC3521 3: WEEK 3 Lecture

Lecture 2 Week 3 Let me take a moment to summarize where we have been and where we are going. I realize that we are all experiencing and reacting to the class in different ways. Frustration, anger, confusion, elation and the wonder of it all seems to be the whole spectrum of feelings. Allow your open mind to lead you through the readings.

During ancient times, cultures engaged in tilling, sowing and cultivating the land. These agrarian cultures experienced power through nature and aspired to be in harmony with the seasons, rhythms, and cyclic patterns. Nature was seen as one unified system (Tao), with polar and complementary forces (Yin/Yang). When the elements of nature are in balance, life is harmonious and flourishes and when the elements are out of balance disaster is at hand.

One of the corner stones of Eastern world view is that the human body is a microcosm of Nature, a small universe. The life forces and substances that flow in nature also flow in the human body. These forces are known as: Yin/Yang, Qi, Blood and Fluids and The environmental influences. Efrem Korngold, in his book "Between Heaven and Earth", describes the Eastern doctor as a gardener. The purpose is to work with the body to facilitate the body's own healing processes. This analogy I believe, is a clear description of how the Chinese doctor navigates the bodily landscape.

Nature is a symphony composed of complex, interweaving patterns of form and movement. These patterns are recapitulated in every micro system that exists. Chinese medicine works from the presumption that if you reorganize the existing patterns of disharmony into a harmonious pattern, the original cause will disappear, because the onditions in which it was rooted cease to exist.

In the next few chapters, universal patterns of disharmony will be

introduced, along with the tools and methods of gathering information.

These patterns are perceptual templates, so to speak. Try not to concern yourself with every detail, but look at the broader strokes and process at work.

Remember, it is better to try and stumble than to not try at all.

Acupuncture Diagnosis In Acupuncture and TCM diagnosis, there are many patterns we might identify. We have the choice of using Five Element diagnosis, 8 Principles, internal organs, pathogenic factors, the vital substances, or other diagnostic processes. Quite often, our diagnosis combines one or more of these systems to get a clear picture.

The Traditional Chinese Medicine system of Acupuncture is actually a modern system that was put together in China during the Communists' Cultural Revolution. Chinese cultural traditions, (like Chinese medicine and martial arts) were outlawed when the western world began influencing China, but were revived by the government in the Cultural Revolution.

Acupuncture, Chinese Herbal Medicine and the full scope of Chinese Medicine, were rebuilt in a way. The scholars/physicians of the time gathered information and experience, and merged ideas and theories. Herbal medicine and Acupuncture historically differed in practice in some ways.

Herbalists had a much more extensive approach to pulses than Acupuncturists. But, when TCM was redefined, or created, the systems were merged. So, in a Traditional Chinese Medicine school it is not uncommon to see one system of pulse taking...the herbal system, taught for acupuncture as well. Many of the deeper diagnostic mechanisms were more for the herbalist. In Acupuncture tradition, prior to the creation of TCM, the main goal in treatment was considered to be balancing yin and yang.

As you will read, the 8 principles start with Yin and Yang. It is important to understand, that the other 6 are just divisions of yin or yang. It is those 6 qualities that we seek in taking pulse in Acupuncture. The 8 principals are also the starting point or foundation of the other diagnostic systems.

8 Principles and their pulse qualities Yin

Yang

Interior (deep pulse)

Exterior (superficial pulse)

Deficient (weak pulse)

Excess (overly strong pulse)

Cold (slow)

Hot (Rapid)

External cause - characterized by sudden onset affecting the exterior of the body, sensitivity to Cold or Wind, slight fever, thin coating on the tongue and a superficial pulse.

Internal cause - characterized by longer term onset as the pathogen works its way into the interior of the body. In most cases the internal organs are affected and signs and symptoms of channel and organ disharmony are seen. See below for symptoms of each organ system disharmony.

Cold - characterized by aversion to Cold, pale tongue, preference for hot drinks, pale face, thin pulse.

Heat - characterized by aversion to heat, red tongue, preference for cold drinks, flushed face, full pulse.

Deficiency - deficiency refers to not enough Qi to ward off pathogenic factors. Deficiency manifests in the body in different ways including deficiency of Qi, deficiency of Blood, Deficiency of Yin or Yang.

- Symptoms are varied but include; emaciation, listlessness, feeble breathing, loss of strength, shortness of breath, spontaneous sweating, night sweats, incontinence, and pain that is alleviated by pressure.

Excess - refers to hyperactivity of Qi in the body. Excess manifests in the body in different ways including excess Qi, excess Blood, Excess Yin or Yang.

Again symptoms are varied but include; agitation, loud voice, heavy breathing, fullness and/or bloating in the chest and/or abdomen, pain aggravated by pressure, constipation, irritability, thick tongue coating and full pulse.

Yin & Yang are a pair of principals used to generalize categories of syndromes.

HSC3521 3: WEEK 3 Lecture 2

Pulse diagnosis : Three positions on each wrist Left:

Cun: Heart Guan: Liver Qi: Kidney Yin

Right: Cun: Lungs Guan: Spleen Qi: Kidney Yang

Three Levels or Depths of the Pulse • Superficial – Reflects state of qi, indicates an exterior pathogen, provides insight to the functions of the Heart and Lungs • Middle – Reflects the state of the qi and indicates disharmony of the Stomach and Spleen

• Deep – State of yin, interior organs, interior diseases, reflects condition of the Liver and Kidneys http://www.yinyanghouse.com/theory/chinese/pulse_diagnosis#lev els Pulse diagnosis is one of the original set of four diagnostic methods that are described as an essential part of traditional Chinese medical practice (1). The other three diagnostic methods are: inspection: general observations of the patient, including facial expression; skin color and texture; general appearance, and the shape, color, and distinctive markings of the tongue and the nature of its coating; and smelling (noting any unusual smell of the body, mouth, or urine); listening: to the quality of speech (including responsiveness to questions, rapidity of talking, volume of the voice); to the respiration; and to sounds of illness, such as coughing, gurgling from the intestines; and Inquiring: obtaining information about the patient's medical history and their symptoms and signs, such as chills/fever, perspiration, appetite and dietary habits, elimination, sleep, and any pains; also, for women inquiring about menstruation, pregnancy, leukorrhea and other gyno-obstetric concerns.

All of these diagnostic methods yield information that helps to determine the syndrome and constitution to be treated.

While the Chinese pulse and tongue diagnosis methods, because of their frequent mention and somewhat unique quality among traditional medical systems, receive much attention, the other aspects of diagnosis cannot be ignored

or downplayed.

Inspection Shen (Spirit) Observing and tuning in to a patient's Shen (spirit) is particularly important to help determine the overall state and prognosis of an imbalance. The Shen gives vital information about vitality, and mental, emotional, and spiritual well being. The Shen shows in the eyes, complexion, and state of mind.

Appearance and Demeanor Includes posture and movement of body as a whole and of individual parts, e.g. eyes, face, mouth, limbs, fingers.

Hair Hair relates to Blood or Kidney Jing.

Hair loss and premature graying of the hair may be due to Blood Deficiency or Kidney Jing Deficiency.

Dandruff usually relates to Liver Blood or Yin Deficiency Face Two light and shallow lines between the eyebrows indicates a healthy Liver.

Two deep lines or three line between the eyebrows can indicate a Liver problem, such as frequent anger A single line can indicate a more serious Liver problem. This can occur after considerable hardship.

Face Color Represents the strength of the Qi and Blood of the Zang Fu organs, and especially the Heart. The complexion should be moist and lustrous.

Observation of Sense Organs

Eyes - The eyes reflect the state of the Shen and Jing. It is said, "The Jing of the five Yin and six Yang organs ascends to the eyes."

We observe the "expression" of the eyes to see the spirit.

The Liver opens to the eyes (sense organ associated with Wood element)Eyesight changes tend to relate to the Liver Teeth and Gums - Teeth are considered an extension of bone and are influenced by Kidneys. Gums are influenced by the Stomach.

Ears - Observe color, discharge, skin tone, any spots or discoloration.

Limbs - Flesh around wrists and ankles should be a good color and firm: indicates a good condition of the fluids.

Skin Skin relates to the Lungs in Five Element Theory.

Skin also indicates the condition of the Blood (and therefore the Liver, which stores Blood).

Many skin conditions relate to Heat in the Blood or stasis of Blood and may relate to Liver.

Skin disease can also relate to Heat in the Stomach which can cause Blood Heat.

Listening The Sound of the Voice A loud and course voice indicated an Excess pattern A weak and low voice indicates a Deficient pattern A lack of desire to speak indicates a Deficient Cold pattern Incessant talking indicates a Heat pattern Hoarse Voice or Loss of Voice Acute onset of a hoarse voice is usually indicative of Exterior Pathogenic Wind, especially if the throat is red and sore.

A chronic or recurrent hoarse voice usually indicates an interior

disease such as Deficient Lung Qi or Lung Yin A gradual loss of voice also usually indicates Deficient Lung Qi or Yin Loud Voice with Incoherent Speech This is usually accompanied by impaired mental function and indicates Heat is disturbing the Shen (Spirit/Mind) 5 Element Associations in the Voice Shouting is a Liver imbalance Constant Laughing is a Heart imbalance Chronic weeping, whimpering, sadness is an Spleen imbalance Groaning is a Kidney imbalance Cough - Coughing is usually related to Lung's ability to properly disperse and descend Lung Qi, leading to rebellious Lung Qi Wheezing or rattling from the Lung is usually mucus or Phlegm in the Lung Explosive or very loud coughing indicates an excess pattern A weak cough indicates a Deficient pattern A dry hacking cough is usually indicative of Heat and Dryness in the Lung An unproductive cough with small amounts of sticky sputum indicates Heat scorching the fluids Breathing Loud and coarse breathing indicates an Excess pattern Shortness of breath, weak and/or difficult breathing may indicate the Kidney is too weak to grasp the Qi. This would include a Deficient type asthma.

Loud and coarse breathing with a preference for exhaling indicates pathogens retained in the Lung. This would include Excess type asthma.

Frequent Sighing Usually related to Liver Qi Stagnation Hiccups - Usually related to Rebellious Stomach Qi

BorBorygmus Usually related to Deficient Spleen Qi or Deficient Spleen Yang, especially if there is loose stools and bloating.

This can also be due to Liver Qi Stagnation invading the Intestines

Smelling In general, secretions and excretions related to Excess Heat type patterns have a foul odor. Less odorous secretions and excretions usually relate to Cold and Deficiency type patterns.

Odors Urgent diarrhea with foul stools indicates Damp-Heat in the Large Intestine.

Belching with a foul or sour odor indicates retention of food.

Leucorrhoea with a strong or foul odor indicates Damp-Heat in the Lower Jiao affecting the Uterus.

Chronic Halitosis (Bad breath) indicates Stomach Heat 5 Element Associations of Smell Rancid "goatish" odors are related to the Liver Scorched or burned odors are related to the Heart Fragrant, sweet, or cloying odors are related to the Spleen Rank or Rotten odors are related to the Lung Putrid odors are related to the Kidney

Inquiring Questioning or interviewing a patient during intake covers many topics, including: Past medical history Origin of the current problem Living and environmental conditions Current and past emotional issues, including family relationships, partner relationships, work issues etc.

Eating patterns and Diet Specific questions relating to bodily systems Traditionally, there are ten areas of questioning.

Emotions Energy (1/10) Chills and Fever Sweating Bowel Movement Urination Perspiration Sleep Thirst Menstruation

Tongue Diagnosis

Lower JiaoThe Base of the tongue corresponds to the Kidney, Urinary Bladder, Large Intestine and Small Intestine Meridians.

Middle JiaoThe sides of the tongue correspond to the Liver and Gall Bladder meridians. Some theories place the Gall Bladder on the patients left side and the Liver on the patients right side.The Middle of the tongue corresponds to the Stomach and Spleen Meridians.Upper Jiao The tip of the tomgue corresponds to the Lung and the Heart Meridians.

Channels/Meridians Reaching the Tongue

Heart Channel - The Luo connecting channel connects to the root of the tongue.

Spleen Channel - An internal branch of the primary channel spreads over the lover surface of the tongue.

- The tongue is penetrated by the Spleen Divergent channel.

Kidney Channel - An internal branch of the primary channel terminates at the base of the tongue.

Bladder Channel - A branch of the muscle/sinew channel binds to the root of the tongue.

San Jiao Channel - A branch of the San Jiao muscle channel links with the root of the tongue.

Tongue Diagnosis Method and Cautions LightingSunlight will give the most accurate color of the tongue body and coat. If sunlight is not available, use a second light source such as a small flashlight to compare the tongue color to the original light source.

PositionThe tongue should be extended in a relaxed manner, and should not be held out for an extended duration.

Food and DrinkFood and drink, such as coffee, green tea, and candy may alter the color of the tongue coating.

Brushed TongueSome patients may brush their tongue to help freshen their breath or as an Ayurvedic practice. Ask the patient not to brush their tongue, at least the day of their TCM tongue diagnosis.

Seasons of the Year In Summer, there may be more Dampness present in the tongue coating, leaving it slightly thicker and light yellow.In Fall or Autumn, the tongue may be thinner with a coating that is more dry.In Winter, there may also be more moist or damp presenting in the tongue.In Spring, the tongue should be normal.

Time of DayThe coating of the tongue usually becomes thinner as the day progresses, while the color of the tongue body becomes more red and shiny.

Patient's Age In the elderly, Qi and Blood Deficiency is more common, so the tongue may present with dryness and cracks.

Infants tend to have white thick coating that is easily removed, peeled tongues are also common.Overweight patients usually have more Damp and/or Phlegm and therefore their tongues may be larger and lighter in color.Thin patients tend towards redder tongues.

References: http://www.itmonline.org/arts/pulse.htm http://www.yinyanghouse.com/theory/chinese/tongue_diagnosis http://www.sacredlotus.com/diagnosis/tongue/index.cfm

HSC3521 4: WEEK 4 Lecture 2

Lecture 2 Week 4 TCM Review This lecture will give an overview of some of the material that we have covered in our text and lectures. Please don’t use it as your only source of studying for the exam – the exam will cover your text, lectures and power point presentations.

The Meridians The circulating pathways of the twelve Meridians flow from the face to the feet, from the feet to the chest, from the chest into the hands, and from the hands back to the face.

Yin Meridians The Yin Meridians pass along the inward side of the limbs and along the front of the body. It has already been mentioned that the pathways leading to or from the arms are called Hand Meridians, and those that descend to the legs or ascend from the legs are the Foot Meridians.

The three Yin foot meridians ( Liver, Kidney, and Spleen) travel from the foot to the chest. This describes the circulation of energy over the entire body and delineates the pathways in which Qi flows.

The three Yin Hand Meridians (Lung, Heart, and

Pericardium) will flow from the chest to the fingertips, upward along the forward portion of the arm.

Yang Meridians The Yang Meridians flow along the outward side of the limbs and along the back of the body.

The three Yang foot meridians (Gallbladder, Urinary Bladder, Stomach) travel from the head to the foot.

The energy in the three Yang Hand Meridians (Large Intestine, Small Intestine, and the San Jiao) will be flowing from the fingertips, downward on the back part of the arm, to end their flow in the face.

The Stomach Channel is one exception. Although it is a Yang Meridian, it runs on the front of the body with the Yin Meridians, instead of up the back like the rest of the Yang Meridians. The other exception is the Governor Vessel, which is a Yang Meridian in the center of the back, in which energy flows upward as opposed to the rest of the major Yang Meridians in which energy flows downward.

The Governor Vessel, or Du Mai (Du or GV), follows the spine upward on the back, travels over the head and ends on the inner surface of the upper lip. It has no direct connections to any internal organ. Its energy flow is Yang and ascends from the bottom of the pathway beginning near the anus. It connects with all the Yang Meridians of the body, and is important in many conditions requiring manipulation of the Yang energy of the body.

The Conception Vessel, or Ren Mai (CV or Ren) travels up the midline in front of the body. It runs from near the anus to the mouth, and its energy is Yin, ascending from the lower body to the upper, as does the Governing Vessel. In effect, these two

meridians vertically encircle the body on its midline, front and back.

These two Vessels are not bilateral. They do not form a direct part of the organ meridian's energy circulation network, nor are they associated with any one organ. They belong to the eight Extra Vessels.

As Qi circulates through the Primary Meridians, it alternates in coupled pairs of Yin and Yang Meridians, staying for two hours in the Yin and two hours in the Yang, in a smooth alternating rhythm.

On acupuncture charts, the meridians appear as thin surface lines connecting a series of dots that represent the acupuncture points. Every Channel has an inner pathway and an outer pathway, and it is usually the outer pathway with its acupuncture points that is shown on most charts or drawings, and the inner pathways are not accessible to manipulation by needling.

According to the Chinese, each Channel is connected to all the tissues, organs and functions over which its acupuncture points have an influence or produce an effect, whether in the immediate area of the points or at a much distant area.

Summary We have 12 bilateral Meridians. The two special vessels (the Conception Vessel and the Governor Vessel) are not bilateral.

They are singular channels, which follow the midline of the body, one in front and one on the back.

There are a number of ways in which the Primary Meridians can be classified. One method is to classify them into two groups, according to their polarity of Yin and Yang.

You will also note that these pairs are also coupled ie., Lung with Large Intestine, Spleen with Stomach, Heart with Small Intestine, Kidneys with Bladder, Pericardium with San Jiao, and Liver with Gall Bladder.

Yin Channels (Organ)

Yang Channels (Organ)

Lung

Large Intestine

Spleen

Stomach

Heart

Small Intestine

Kidneys

Bladder

Pericardium

San Jiao

Liver

Gall Bladder

Functions of Meridians/Collaterals 1) Transport Qi and blood and regulates yin and yang 2) Resist pathogens and reflect symptoms and signs (may transmit pathogens deeper) Internal diseases may also "show"

along meridians/collaterals.

3) Transmits needle sensation and regulates deficient and excess conditions.

The key to an Acupuncture treatment is to regulate yin and yang Arrival of Qi is essential to obtaining therapeutic effects. Both patient and physician should feel Qi come to needle

8 Principles and their pulse qualities Yin

Yang

Interior (deep pulse)

Exterior (superficialpulse)

Deficient (weak pulse)

Excess (overly strong pulse)

Cold (slow)

Hot (Rapid

Meridian Gutter is a point on the Lung meridian (Metal Element). It helps to clear out old debris, allowing a fresh perspective Bubbling Spring is the first point on the Kidney meridian (Water Element). This point is where our feet come into contact with the earth. A bubbling spring refreshes, vitalizes, and cleanses.

Returning Current is a point on the Kidney meridian (Water Element) that serves as the transition between the Metal and Water Elements. It helps to allow the wisdom to flow freely

once the letting go has occurred.

Qi stagnation Emotional stress is the major cause of Qi stagnation: whatever the emotion, they all upset the proper flow of Qi in the Qi mechanism and lead to Qi stagnation. Each emotion has a certain effect on Qi (e.g sadness depletes Qi, worry knots Qi, etc), but, after a short time they all lead to some Qi stagnation, even those that deplete Qi.

PATHOLOGY

Qi stagnation is essentially a disruption of the Qi mechanism (Qi Ji) which means it affects the whole body Qi mechanism the flow of Qi in all organs of the body and all cavities, joints, skin, muscles, Fat, Membranes, etc.

Implicit in the Qi mechanism is the flow of Qi in the proper direction in each place or organ: the flow of Qi in and out of organs, in and out of cavities, in and out of joints, and so on.

The Qi mechanism is like a vast system of roads and motorways where traffic needs to be regulated by one-way streets.Two essential movements of Qi need to be coordinated: the ascending and descending of Qi, and the entering and exiting of Qi.

The Review Continues:

The Heart 1. The Heart governs the Blood. The Blood Vessels (tissue associated with the Heart and part of the whole system of the Heart in TCM) are where it circulates.

2. The Blood is made in the Heart, via the Heart Fire (Yang).

Blood on the other hand, cools the Fire and prevents it from flaring up.

The Spleen 1. Spleen produces Food Qi, which is the basis for the formation of Blood.

2. Spleen Qi keeps the Blood in the Vessels so that it does not extravasate.

(Deficient Spleen Qi can result in Qi being unable to hold the Blood, resulting in hemorrhages.)

The Liver Liver stores the Blood.

When person is active, Blood flows to the muscles and tendons (governed by the Liver). When person lies down, Blood flows back to Liver.

Liver Blood moistens the eyes, ensuring good eyesight and also moistens the sinews, promoting flexibility of joints.

Liver Blood supplies the uterus with Blood, together with the Penetrating Vessel (Chong Mai - one of the eight

Extraordinary or Ancestral Vessels), with which it is closely related. Therefore Liver Blood is very important for regular and healthy menstruation.

Lungs 1. Assist Spleen in sending Food Qi to the Heart to form Blood.

2. Control the channels and Blood Vessels by filling the Blood Vessels with Qi to assist the Heart's pushing action.

Kidneys 1. Original Qi (stored in Kidneys) is needed to transform Food Qi into Blood.

2. Kidney stores Jing, which produces Marrow. Marrow generates bone marrow, which contributes to the formation of Blood.

To nourish Blood in TCM, we must therefore tonify (increase energy of) the Spleen and Kidneys.

However, the Heart, Spleen & Liver have the most direct relationship with the Blood: Heart governs Blood, Spleen holds Blood in the Vessels and the Liver stores Blood.

Solid and Hollow Organs (Zang Fu)Yin Organs are "Solid": constantly active, involved in production and storage of the body's vital Substances (Qi Blood, Body Fluids, Essence) Yang Organs are "Hollow": receive and circulate but do not store, involved in digestion, transformation, excretion.

Zang Organs (Yin): Lungs, Spleen, Heart, Kidneys, Liver Fu Organs (Yang): Large Instestine, Small Intestine, Stomach, Urinary Bladder,Gall BladderForms of Qi:Yuan Qi, Zong Qi, Zhen Qi, Zhong Qi,Ying Qi,Wei Qi.

Functions and Movement of Qi:Qi can transform, transport, hold, raise, protect, and warm. Qi also has a normal flow or direction of movement associated with each Yin Yang organ.

HSC3521 2: WEEK 2 Lecture

Zang Fu Organs  Zang is Yin and Fu is Yang Zang Fu is another name for the Internal Organs, six Zang or Yin organs, six Fu or Yang organs and the extra Fu organs.

Zang or Yin Organs Extra Fu Organs

Fu or Yang Organs

Heart

Small Intestine

Lung Vessels

Large Intestine

Liver Bones

Gallbladder

Brain

Spleen Marrow

Stomach

Kidney Uterus

Urinary Bladder

Pericardium Gallbladder

Triple Burner/Sanjiao

The Pericardium is considered part of the Heart as it carries out the functions of the heart and acts as the heart’s protector. Therefore, you will find that some texts refer to the Internal Organs as the five Zang and six Fu. The main functions of the Yin Organs are to manufacture and store essential substances, including vital essence, qi , blood and body fluid.

The main functions of the Yang Organs are to receive and digest food, and transmit and excrete impure substances and waste.

“The so-called five Zang organs store pure essential qi without draining it off, and for this reason they can be filled up but cannot be overfilled. The six fu organs transmit water and food without storing them, and for this reason they may be over supplied but cannot be filled up.”

-Plain Questions, or Huang di Neijing Su Wen

“All organs can be characterized as wither Yin or Yang.

But within each Organ there is both a supportive, nourishing Yin aspect and a dynamic active Yang aspect.” ---Page 84

Heart, “Emperor”

The Heart is said to be the most important of all the Internal Organs, hence it is referred to as the “Emperor”. It is essential for the healthy blood supply to all organs as it controls the circulation of blood and governs both the blood and blood vessels.

The Heart is responsible for Housing the Mind, which is also referred to as “Shen”.

“When the Heart Spirit is disturbed, one has symptoms such as insomnia, situational anxiety, and inappropriate or even bizarre behavior….When the Heart Spirit is intact, one connects with propriety and tact.” ---page 89 If the Heart is supple  a person has vitality and a strong constitution If the Heart is weak  a person will have little strength, endurance and a weak constitution

Transformation of Food Qi into blood takes place in the Heart – The spleen transforms the food we eat and separates Gu Qi (this term is not mentioned in this text, Gu qi is the purest essence of food) from turbid substances that are sent down to the small intestines. Gu Qi is then transported up to the lungs. On the way to the lungs Nutritive qi begins to turn Gu Qi into blood. In the lungs the transformation is complete once Gu Qi is combined with “clear” qi of air, which is the purest form. Blood is then circulated throughout the body via various blood vessels by both Heart qi and Zong qi, qi of the chest. page 53

The Heart manifests in the complexion – The hearts control of the blood supply in circulation is revealed in the complexion. For example, if the heart is strong and the blood is supple the skin will have healthy appearance, almost glowing. If the blood is deficient and the heart qi is weak, the complexion will be pale or bright white. Blood stasis leads to a bluish-purple complexion and heat in the heart manifests as a very red complexion.

The Heart opens into the tongue – “The ability to choose words wisely, to convey meaning weak, and to connect in dialogue belongs to the Heart Spirit’s relation with the tongue.” ---page 89

Related to the emotion - JOY Liver, “Army General”

Houses the Ethereal, also know as Non-Corporeal Soul ****responsible for Human Kindness

Stores blood “The Liver’s blood is responsible for softening the qi and ensuring that the qi’s dynamic strength is not too tense, restless, and awkward.” ---page 81

Regulates blood volume - during activity blood rushes to contracting muscles and joints, at rest the blood is stored in the liver

Regulates Menstruation – dysfunction to Liver Blood or Liver QI will lead to irregular menstruation

Ensures the smooth flow of qi Essential to all physiological processes “The liver’s blood, by first tempering the Liver’s qi and then the

entire body’s qi, ensures the smooth movement of qi.

---page 81Controls tendons, which include sinews ligaments and indirectly the muscles and Manifests in the nails – “When the Liver’s blood is plentiful….the tendons are supple and the nails appear pink and moist.” ---page 83

The Liver Opens into the eyes - It is a healthy treat for your mind, body, and liver specifically, to designate some time during a busy day to close your eyes and allow the blood to return the liver.

The eyes have time to rest and the liver is given an opportunity to regain a smooth flow of qi throughout the body. Many people in our society suffer from the repercussions of stagnant liver qi.

Frustration, irritability, impatience, headache, tired and red eyes….these are some conditions created with liver qi stagnation.

They only get worse and more chronic if the body is not allowed a balanced routine of work, sleep, relaxation and play. “When the liver receives blood, the eyes can see.” ---page 83

Associated with the emotion and actions of ANGER –Liver qi rises. When this rising is obstructed by imbalances and organ dysfunction liver qi will stagnate and ultimately become pent up and cause erratic and abrupt upheaval. Symptoms of Liver Yang rising and Liver Fire can be avoided through stress management and a balanced lifestyle.

Lung, "Prime MinisterLung, “Prime Minister” Houses Corporeal. Also known as Animal Soul - “….lacks deliberation of reason.” Page 91

The Lung Governs qi and respiration extracts pure and clear qi from the air we breathe.

“The lungs take in Natural Air Qi, propelling it downward. This is inhalation.” Page 91

The Lungs spread QI throughout tissues and organs – “Because the qi of the chest is involved with the movement of all qi and blood of the body, a disharmony of the lungs can produce Deficient Qi anywhere in the body.”

Page 91

Descending of QI and fluids – The lungs move water in two different ways. “…descending and liquefying, the lungs move water (down) to the kidneys. By ‘disseminating’, the lungs circulate and scatter water vapor throughout the body, particularly through the skin and pores.” Page 92

Controls channels and blood vessels assist the Heart in controlling circulation

Regulates water passages assist in the movement and processing of Body Fluids

Controls skin and hair condition – “…the lungs regulate the secretion of sweat, the moistening of the skin and resistance to External Pernicious Influences. These functions also depend on the Protective (Wei) Qi, which in turn depends on the lungs disseminating ability.” Page 92-93

Opens into the nose – throat and nose disorders are treated through the lungs

Affected by worry, grief and sadness Spleen Governs transformation and transportation the spleen is the central organ in the production of Qi and Blood, also referred to as the root of Post Heaven or Post Natal Qi

“If the Spleen is in disharmony, then the whole body, or some part of it, may develop Deficient Qi or Deficient Blood.” Page 79

Houses thought – A Strong Spleen is imperative in maintaining energy, strength and concentration.

“If the Spleen is healthy, a person has clear thoughts, can make decisions, and thus has the insight to faithfully support the needs of other people and situations….If the Spleen is unbalanced, a person can worry easily, have difficulty making decisions, be mentally unclear and confused, be excessively helpful, or just bored and uninterested.” Page 79-80

Controls the "rising qi“ a weak Spleen affects the ascending of qi and effects the Spleen’s function of holding blood in vessels – this results in bleeding from the uterus, Bladder or intestines.

Controls the Blood the Spleen Qi holds blood in vessels and ensures that blood is in its proper path. Qi moves blood and blood withholds qi. “…the Qi commands the blood, and the particular aspect of Qi that holds Blood in place is the Spleen Qi.” Page 80

Controls the muscles and the 4 limbs - Provides the muscles, especially the four limbs, with refined QI and blood “Muscle tone or appearance of the limbs often indicates relative strength or weakness of the Spleen.” Page 80

Pensiveness affects the Spleen - Excessive thinking, overanalyzing and overwork injures the Spleen

Kidney, “Root of Life”

Stores essence and governs birth, growth, reproduction and development – “Essence, in one form or another, is the primordial seed of the life process, the life process itself, and life’s final fruit.” Page 84

The Kidneys Govern water Kidney Yin  substance for birth, growth and reproduction, referred to as Jing or Water, the material foundation for Kidney Yang Kidney Yang  physiological processes, referred to as Ming Men, or Life Gate Fire - activity necessary to transform Kidney Yin. “The Kidneys Rule Water through their Yang aspect, the Life Gate Fire.” Page 85

Produces marrow, fills up brain and controls bones – Kidneys store essence, essence produces marrow and marrow is responsible for creating and supporting the bones. The teeth are also rules by the Kidneys because they are an extension of bone.

“The Kidneys rule the grasping of Qi, ….The kidneys enable the Natural Air Qi to penetrate deeply, completing the inhalation process by what is called “grasping the qi.” Page 88

Opens into the ears and manifest in the head hair – Weak Kidney Qi will result in hearing loss or difficulty and loss or early graying of head hair

Houses will power – “Will” is unique per person “The Oriental Physician can….strengthen the Kidney’s Will.

When the will is not intact, a person can have uncontrollable fear

or a dread of death, existential anxiety, or inability to feel the gracefulness of becoming older. “

Pericardium, “Master of the Heart” Heart Protector – related to the organ Connected to the Triple Burner via channel Carries out same functions as the Heart Helps the Heart House the Mind by calming and balancing Aids the Heart and Lungs with the distribution of Zong Qi and Blood

Yang Organs Large Intestine Receives waste material from Small Intestine Absorbs fluids and excretes feces

Stomach Receives and decomposes food Movement of QI is downward

Small Intestine Receives and temporarily stores partially digested food Separates clear from turbid

Movement of Qi is downward

Urinary Bladder Temporarily stores the urine and controls discharge Movement of qi is downward

San Jiao Water metabolism Upper Jiao Middle Jiao Lower Jiao

Gallbladder Stores bile and excretes it to aid in digestion

HSC3521 2: WEEK 2 Lecture 2

Lecture 2 Meridians – The Invisible Pathways of Qi The meridians were named for the life function associated with them. Through these meridians passes the Qi that enters the body through specific acupuncture points and then flows deeper to the organ structure. The acupuncture points that exist along the meridians can be located by using your hand, micro current or muscle testing.

It is said that yang energy flows from the sun and will run from the fingers to the face and from the face to the feet. Yin energy will flow from the earth to the feet then to the torso and from the torso

along the inside of the arms to the finger tips.

Qi flows in one definite direction and from one meridian to another in a well determined order. When Qi flows freely through the meridians the body is balanced and healthy. But if the energy becomes blocked, stagnated or weakened, it can result in physical, mental or emotional ill health.

An acupuncturist will restore the balance by stimulating the acupuncture points to counteract that imbalance. If the Qi is too cold for example, points will be chosen to warm it. If too weak, points will be used to strength it. Unblocking this energy will result in rebalancing the energy system, restoring health and prevent development of disease.

Please refer the following site to view the meridians and their pathways. http://www.yinyanghouse.com/acupuncturepoints/locations_theory _and_clinical_applications The Horary Cycle In Chinese medicine, the body is believed to go through a 24 hour energy cycle where each energy center peaks during a particular period of time. In 24 hours, you will spend two hours in each of the twelve meridians and end up where you started. The end of one is connected to the beginning of the next, forming ONE complete loop. So each meridian has a two hour peak time and twelve hours later a two hour low point. This is called the Horary Cycle or more familiarly circadian rhythm.

The 12 different meridians are named after organs (liver, lung, etc.). The ancient Chinese calculated which was at its peak during the 24-hour period. If we start at 3:00 a.m., the lung meridian is at its horary period for two hours. Two hours later, the large intestine meridian takes over as the most energized, and holds that position

for another two hours. Others follow suit and continue around the circuit. The last in the cycle is the liver meridian, which is at its energetic zenith from 1:00 a.m. to 3:00 a.m. Then the cycle begins again. This horary period is in relation to the position of the sun.

The Horary Cycle begins with the Lung and end switch the Liver.

Let's Review: There are 12 main meridians 8 extra Meridians, 2 of which have their own points, 6 are "opened" using point combinations from other channels.

2 extra meridians with points are the midline channels up the front and back, DU/Governing and Ren/Conception.

Yin Channels are on the front of the body or the medial/inside of the limbs. Yin energy is said to be from the earth and flows from the feet to the torso and from the torso along the inside of the arms to the fingertips.

Yang Channels flow on the back of the body, and the lateral/outside of the limbs. Yang energy is said to flow from the sun and run from the fingers to the face or from the face to the feet.

The Stomach channel is the exception: on front of face, torso, outside of lower legs.

Also understand that the energy flows in one definite direction and from one meridian to another in a well determined order.

There are 3 Yin Channels of the hand, the flow is chest to hand: Lung, Heart, Pericardium There are 3 yin Channels of the foot, the flow is foot to abdomen Liver, Kidney, Spleen There are 3 yang channels of the hand, the flow is hand to head Large Intestine, San Jiao, Small Intestine There are 3 yang channels of the foot, he flow is head to foot Gallbladder, Urinary Bladder, Stomach***only yang channel on front of body Exterior channel flow: The channels have exterior and interior pathways, the following concerns where the channels flow on the exterior, where we access the points.

Functions of Meridians/Collaterals 1) Transport Qi and blood and regulates yin and yang 2) Resist pathogens and reflect symptoms and signs (may transmit pathogens deeper) Internal diseases may also "show" along meridians/collaterals.

3) Transmits needle sensation and regulates deficient and excess conditions.

The key to an Acupuncture treatment is to regulate yin and yang Arrival of Qi is essential to obtaining therapeutic effects. Both

patient and physician should feel Qi come to needle. As a patient you will know if Qi has been grasped by the needle. The sensations you may feel may be a tingling, heaviness, dull ache or even similar to an electric shock. <> Points and such: There are over 350 points along the main meridian pathways. You can locate these small palpable spots by hand, micro current or muscle testing.

There are many "extra" points that are not associated with any meridian, but are known to have clinical effects.

"Ashi" points are points that hurt "Ashi!" put a needle where it hurts is what MDs, and other amateurs learn, but it does have clinical value. A true prescription of points would include local, distal and ashi points if applicable. Ashi alone will have minor effects, and usually not long term.

As we have been discussing in week 1, we know that when Qi flows freely through the body, or in this case, the meridians, the body is balanced and healthy. If the energy becomes blocked, weakened or stagnated, it can become physical, mental or emotionally ill health.

As we move into our chapter on acupuncture, we see that acupuncturists will restore the balance by stimulating the points on the meridians to counteract that imbalance. Sometimes it can be as simple as choosing points to warm if the Qi is too cold. Or strengthening points if the Qi is too weak.