After fever is gone and the patient is in recovery, diet must be light and without protein to prevent evils from coming back. Later, proper diet, acupuncture, alternative and other supplements are helpful for better recovery. Notice that the warm-heat infections are serious and can be fatal; they need to be handled by professionals with great care. 5.1.4. TCM 5-Organ Pathology In the years of 1000-2000 B.C., HuangDiNeiJing has already pointed out that there are 14 syndromes belonging to the 5-evils and 5 syndromes belonging to the 5-Organs. The evil-caused symptoms were discussed earlier; the following are syndromes of the 5-Organs, without infections caused by microbial pathogens (but many symptoms can be observed during infections too). These are of special importance since they cannot be cured by the “kill-germs” approach. Using the 8-Indicator method, since organ syndromes are internal, they can only be categorized by Xu (void or emptiness, deficiency or weakness) or Shi (filled or evil- infected) of the Yin (material bases), Yang (functions), Han (cold or subsided), Re (hot or excited), Qi (functional/nervous/gas) and Xue (blood) aspects. 18.104.22.168. The Heart Syndromes In TCM, the Heart has two major functions, i.e., serving as the power source (pumping) of the circulatory system and as a microprocessor for certain CNS functions. 22.214.171.124.1. The void (Xu) syndromes of the Heart A. Weak pumping functions (Yang-QiXu): generic symptoms are shortness of breath, which becomes more serious during exertion, palpitations, pale tongue, and white furring, including: *Moderate weak functions (QiXu): showing tiredness, lack of energy, pale face. Herbs: RenShen, DangShen, HuangQi, ShanYao, etc. *Very weak functions (YangXu) show sweating, fear of cold, cold limbs, chest congestion, heart pain, weak, thin pulses, and irregular heart beat. Herbs: FuZi, RouGui, GanJiang, GuiZhi, ZhiShi, etc. *Extremely weak heart or shock conditions (lost-Yang) show lots of sweat, reversed-cold limbs, blue lips, fainting, very weak or no pulses. Herbs: RenShen, FuZi, GanJiang, MuLi, or modified SiNiTang, etc. All heart void- (Xu-) problems should add some nerve soothing herbs as SuanZaoRen, BaiZiRen, FuShen, YuanZhi, YeJiaoTeng, LongGu, CiShi, etc. B. Low in essence-blood supply (Yin-XueXu) generic symptoms are panic, insomnia, lots of dreams, forgetfulness, annoyance, easy to be surprised, thin pulses, including: *Low in blood supply (XueXu, or anemia) shows fainting, a pale face and tongue, thin and weak pulses. Herbs: DangGui, BaiShao, LongYanRou, DanShen, ShuDiHuang, AJiao, ZiHeChe, etc.
*Low in essence (true-YinXu, or lack of some endocrine secretions) shows low fever, hot flashes, night sweating, dry mouth, red tongue tip, thin and fast pulses. Herbs: MaiDong, ShengDiHuang, BaiHe, etc. 126.96.36.199.2. The filled (Shi, excluding infections) syndromes of the Heart A. Blood clogging and mucus blocking (XueYu and TanZu), chest congestion, stinging or stuffy pain in front of the heart behind the sternum, panic or palpitation, the serious ones can have cold limbs, blue face, nails and lips, deep red tongue, with maculae, sluggish pulses. This indicates blood clogging and mucus blocking in the heart vessels. Herbs: for blood clogging, DanShen, TaoRen, HongHua, YuJin, PuHuang; mucus blocking can be relieved by GuaLou, XieBai, GuiZhi, etc. Add QiXu herbs if weak heart-pumping symptoms are present. B. Nervous system messed-up (TanMi, TanHuo): vacuous expression or stupor, confusion, with mucus, tight tongue, won’t talk, white and filthy furring, smooth pulses - these are TanMi symptoms. Herbs: BanXia, FuLing, TianNanXing, ZhiShi, ChenPi, GanCao, etc. If fever is present, the patient could have insanity or madness behavior, with smooth but fast pulses, these are Tan-Huo symptoms; add herbs as HuangQin, DaHuang, ChenXiang, MengShi, etc. 188.8.131.52. The Liver Syndromes The Liver has several major functions, i.e., it produces bile for the digestion, decomposes toxins, absorbs nutrients, stores and nourishes blood for the circulatory system, and soothes tendons and nervous signal flows for CNS. 184.108.40.206.1. The Liver-void syndromes include anemia, symptoms of lean-blood, i.e., low in quantity and nutrient essence of the blood (YinXu and XueXu), fainting, head-rushes or vertigo, dry eyes, blurred vision, numbness, cramps, pale face, late or little menstruation, red tongue, no furring, tight and thin pulses. Herbs: DangGui, BaiShao, HeShouWu, JiXueTeng, GouJiZi, ShuDiHuang, ShanYao, FuLing, ShanZhuYu, etc. If present with fearfulness, anxiety, panic, frequent sighing, palpitation, this indicates weak nervous control-related Liver/gallbladder weakness, add WenDanTang. 220.127.116.11.2. The Liver-filled syndromes A. Gas stagnation (unbalanced liver and stomach functions), mismatched digestive tract bile secretion and stomach function. Symptoms include acid reflux, congestion or pain, bloated stomach and intestines, diarrhea, digestive problems, white and filthy furring, tight pulses. Herbs: BaiZhu, ShanYao, ShaRen, DouKou, BaiBianDou, FuLing, etc., to harmonize the stomach and liver secretions. B. Nervous signal stagnation (Gan-QiYu): irritability, easily angered, chest and hypochondria congestion or pain, bitter mouth, nausea, dry heaving, white thin furring, tight pulses. These indicate that the nerves are not nourished due to lean blood, causing signal stagnation. Herbs: ChaiHu, HuangQin, YuJin,
ChuanLianZi, YanHuSuo, XiangFu, QingPi, ZhiKe, MuXiang, etc. More serious stagnation could have lumps due to enlargement of the liver or spleen; use de-clogging herbs: DanShen, WuLingZhi, and PuHuang. C. Blood-lean or clogging in the liver and brain; as toxins or other wastes accumulate in the liver; the blood will be loaded with debris and mucus, thus causing clogging in the liver and the brain. Symptoms include stuffy head, red face, bitter mouth, fainting, head-rush, and headache; If present with blurred vision, tinnitus, chord thin or smooth pulses, indicating overactive liver (Gan-YangKang) due to low Liver/Kidney fluids (as in certain types of hypertension), use TianMa, GouTeng, ShiJueMing, JuHua, ZhiZi, XiaKuCao, SangYe, etc. If also present with irritability, easily jolted, red and painful eyes, stuffy or painful chest, yellow or red urine, red tongue rim and tip, yellow furring, strong, tight and fast pulses, indicating high liver-fire (Gan-Huo, including certain types of hypertension and blood clogging problems), add herbs such as LongDanCao, ShengDiHuang, HuangQin. D. Toxins or mucus flowing into the brain: CNS and PNS symptoms as shaking, shivering, sudden fainting or coma, spasm, convulsion, slant-distorted eyes or mouth, over-turned staring eyes, indicating liver-wind (Gan-Feng) and mucus-fire (TanHuo) caused by infections, high fever, or previously damaged CNS functions; use ZiXueDan, ZhiBaoDan, NiuHuangWan, DaoTanTang, etc. 18.104.22.168. The Pancreas Syndromes The organs in TCM Pancreas include the pancreas, the stomach, the intestines, and the spleen. The functions include digestion and metabolism, immune functions, and bleeding control (via spleen), etc. The Pancreas syndromes are again categorized by void and filled. 22.214.171.124.1. The Pancreas-void syndromes A. Weak immune and digestive functions (spleen and Pancreas-QiXu) Tiredness, yellowish face, shortness of breath, low voice, dropped organs, bad appetite, wet stool, cold diarrhea, bloated stomach, painful belly but comfortable when pressed, hiccups, dry heaving, light color tongue, white thin furring, weak soft slow pulses. These indicate low immune and digestive functions. Herb: DangShen, HuangQi, BaiZhu, ShanYao, YiRen, BaiBianDou, FuLing, add ChenPi, BanXia, MuXiang, ShaRen, and DouKou, to adjust stomach functions. B. Weak nutrient/energy generation (Pancreas-YangXu) Same symptoms as A, plus symptoms of coldness: cold limbs, wasting or muscle atrophy, lack of spirit, clear and lots of urine, or less urine but with edema, affinity for warm food or drinks, may have cold diarrhea for a long time, weak, thin and slow pulses. These indicate malnutrition due to persisting bad digestive functions, or energy generation is insufficient. Herbs: FuZi, GanJiang, DingXiang, WuZhuYu, GaoLiangJiang, and YiZhiRen. C. Weakness in water/fluids metabolism (dampness-hampered Pancreas)
Heavy head and body, very low appetite, nausea, a feeling of tastelessness or stickiness in the mouth, no strength, edema, bloated belly, cold diarrhea, pale tongue, white thick furring, soft, sunken, slow and thin pulses. These are dampness in the digestive system which hampers its functions. Herbs: CangZhu, HouPu, HuoXiang, PeiLan, ZeXie, ZhuLing, CheQianZi, and herbs used in A and B. D. Insufficient stomach-fluids (stomach-YinXu) Dry mouth and lips, dry heaving, no appetite, stuffiness after eating, constipation, low fever, dry and red tongue, no furring, thin fast pulses. These indicate low stomach fluids. Herbs: ShaShen, MaiDong, ShiHu, TianHuaFen, LuGen, YuZhu, ShengDiHuang. E. Weak in bleeding control (weak spleen) Symptoms of A and bleeding under skin, in stool or urine, heavy menses or with spots, pale tongue, white furring. These are impaired bleeding control functions caused by malnutrition. Use herbs in A and bleeding suppressing herbs: CeBaiYe, HuaiHua, DiYu, XianHeCao, XueYuTan, PuHuang, ZaoXinTu. 126.96.36.199.2. The Pancreas-filled syndromes are inflammation or stomach-fire (WeiHuo) Symptoms include bloating and pain in the stomach, fear of being pressed, thirst, affinity for cold drinks, eating a lot but still feeling hungry, sometimes vomiting, bad mouth smell, gum inflammation, constipation, red tongue, yellow thick furring, strong and fast pulses. These indicate inflammation and lack of fluids in stomach. Use herbs in 188.8.131.52.1.D., plus ShiGao, HuangLian, HuangQin, ZhiMu, DaQingYe, ZhuYe. 184.108.40.206. The Lung Syndromes The Lung functions include respiratory and immune systems, therefore they relate to air and water vapor (lung-fluids based) exchanges, as well as the defense against infections. When evils are not strong, problems include: A. Weak immune functions (Lung-QiXu) Coughing, shortness of breath, labored breathing, lots of thin and clear mucus, low voice, do not like to talk, fear of cold, sweating, pale tongue, thin, white furring, weak and thin pulses. These indicate weak immune functions. Herbs: HuangQi, DangShen, ShanYao, BaiZhu, GanCao, BaiHe, ZiWan, and WuWeiZi. B. Insufficient Lung-fluids (Lung-YinXu) Coughing, no mucus or a little sticky mucus, sometimes with blood spots, dry throat, nose, mouth, coarse voice, hot flashes, night sweating, insomnia, low fever at a fixed time, warm palms and centers of feet, red dry tongue, thin, fast pulses. These indicate low fluids in the lungs. Use the same herbs as are used in case of insufficient stomach-fluids plus heat soothing herbs such as QinJiao, QingHao, BieJia, SangBaiPi, and DiGuPi. C. Lung fluid-retention (drinks in the Lungs)
Coughing, lots of sticky mucus, sloshing noise in the throat, hyperventilation or labored breathing, forceful exhalation, congested and painful chest, cannot lie down, filthy, sticky furring, smooth pulses. These indicate retained fluids in the lungs; they could combine with infections to show hot-lung or cold-lung symptoms. Herbs: TingLiZi, SuZi, LaiFuZi, DaZao, GuaLou, ZiWan, BaiBu, SangBaiPi, and BaiJi. 220.127.116.11. The Kidney Syndromes The functions of the Kidneys include those of the urinary, reproductive, and endocrine systems, hence its syndromes can related to those of the genitourinary and endocrine disorders, including problems with brain, bone, bone marrow, hair, ear, libido, spirit, growth, aging, and reproductive organs. TCM categorized the Kidney syndromes as: A. Body essence/fluids deficiency (Kidney-YinXu) Low fever, warm palms and centers of feet, night sweating and fever, hot flashes, dry mouth, fainting, head-rush, ear tinkling (tinnitus) or hearing loss, vision deterioration, soreness, soft knees, legs, and waist, lots of urine, no menses, low sperm counts, red tongue, no furring, thin and fast pulses. Herbs: ShuDi, YuanShen, ShanZhuYu, GouJiZi, NuZhenZi, HeShouWu, HanLianCao, BieJia, and GuiBan. B. Pituitary-adrenal/endocrine deficiency (Kidney-YangXu) Slimmed-down body, darkened face, fear of cold, cold limbs, waist, back, sore and painful waist and lumbar area, low libido, erectile dysfunction, premature ejaculation, edema, low urine, low appetite, soft stool or cold diarrhea, labored breathing, pale tongue, white furring, sunken, slow, thin or weak pulses. These indicate low or unbalanced pituitary-adrenal and other endocrine secretions. Herbs: FuZi, RouGui, DuZhong, BuGuZhi, BaJiTian, XianLingPi, and RouCongRong. There are syndromes with both body fluids and endocrine deficiency symptoms and can use herbs for both syndromes together. 18.104.22.168. Syndromes Involving More Than One Organ There are syndromes involve two Organs, use herbs of both syndromes together. A. Unmatched Heart and Kidney Both the Heart-YinXu and Kidney-YinXu symptoms appear at the same time, including palpitation, hearing loss, night sweating, lots of dreams, erectile dysfunction, wet dreams, sperm leaks, waist pain, low fever, short and red or burning urine, red tongue, little furring, fast, thin or weak pulses. B. Void Heart and Pancreas Both the Heart-QiXu and Pancreas-QiXu symptoms appear, including palpitation, insomnia, shortness of breath, low appetite, bloated belly, cold
diarrhea, pale face, slenderness, fatigue, irregular menses, pale tongue, little furring, thin and weak pulses. C. Void Pancreas and Lung Both the Pancreas-QiXu and Lung-QiXu symptoms appear, including persistent coughing, lots of clear mucus, pale face, slenderness, fatigue, weakness, low appetite, bloated belly, cold diarrhea, pale tongue, white furring, and thin weak pulses. D. Void Pancreas and Kidney Both the Pancreas-YangXu and Kidney-YangXu symptoms appear, including tiredness, reluctant to talk, labored breathing, noisy throat with mucus, weak and cold limbs, wet stool or diarrhea before dawn, fear of cold, cold waist, edema or fluid retention in the belly, white and watery furring, and thin weak pulses. E. Void Lung and Kidney Both the Lung-YinXu and Kidney-YinXu symptoms appear, including coughing with little mucus, shortness of breath, pale face but with red lateral flesh, fever at fixed time, warm palms and centers of feet, slenderness, insomnia, night sweating, dry mouth, soft and sore waist and legs, semen leaks, red tongue, little furring, thin and fast pulses. 22.214.171.124. Damp-Heat (ShiRe) Syndromes in Organs It is convenient to discuss more details of the organ syndromes caused by damp-heat evils here, since we have covered them only briefly in the infection sections. A. Heart inflammation or Heart-fire (XinHuo): ulcers in the mouth or on the tongue, irritability, insomnia, thirst, short and yellow urine, pain during urination, red tongue tip, yellow furring. These are inflammation due to fungi or other infections. Herbs: ZhuYe, LianZiXin, HuangLian, HuangQin, ZhiZi, etc. B. Damp heat in the liver and gallbladder (GanDan-ShiRe): e.g., jaundice, hepatitis, bright yellowish eyes and skin, bitter mouth, dry throat, hypochondria pain, may have fever, nausea, fatigue, no appetite, bloated belly, diarrhea, etc. Herbs for fever include LongDanCao, PuGongYing, BanLanGen, HuangLian, HuangQin, HuangBai, and SangZhi; herbs for dampness include YinChen, JinQianCao, and HuZhang. C. Damp heat in the Pancreas (PiWei-ShiRe): e.g., pancreatitis, moving pain in hypochondria, pain can propagate to the shoulder and back, fear of palpating pressure, intermittent fever comes and goes, bitter mouth, dry throat, no appetite, nausea, vomiting, constipation, yellow urine, red tongue, yellow and filthy furring, fast and strong pulses. These indicate inflammation in the pancreas or the digestive tract. Herbs: YinChen, JinQianCao, ZhiZi, LongDanCao, DanPi, ChiShao, DaHuang, MangXiao, ChaiHu, ZhiKe, EZhu, and herbs to deplete dampness.
D. Damp heat in large intestine Belly pain, hot diarrhea, sticky stool with pus or blood, dark and short urine, red tongue, filthy thick furring, fast sunken or smooth pulses. Serious cases could have high fever, irritability, or fainting. These are infections in the large intestine, Herbs: YiRen, GeGen, HuangLian, HuangQin, BaiTouWeng, MaChiXian, QingPi, HuaiHua, DiYu, and JinYinHua. E. Damp heat in the bladder Urgent and frequent urination, with pain or difficulty, dark yellow urine, with pus, blood, or stones, lower belly bloating and pain, red tongue, yellow filthy furring, soft, smooth and fast pulses. These are infections in the urinary tract. Herbs: FuLing, ZhuLing, CheQianZi, ZeXie, DongGuaPi, MuTong, HuaShi, BianXu, QuMai, DongKuiZi, BiXie, HaiJinSha, and JinQianCao. 5.1.5. Syndromes Summary It is clear that a syndrome is not a disease; in fact, a disease could have many syndromes in different stages of sickness, and many diseases could have the same syndrome at some occasions. Therefore, treating syndromes instead of treating diseases is the central idea of TCM, which is different from the norm of the western medicine. The main advantage is that there are fewer syndromes than diseases. Also, TCM can address health problems without knowing what has caused the syndromes, especially before the chemical methods and scientific instruments are available to identify the pathogens exactly. Even when available, it often takes days or weeks to positively identify the pathogens and the patients have to suffer for a longer time. When pathogens cannot be identified or no drugs are available for some diseases, treating syndromes is the only approach both in TCM as well as in western medicine. However, in actual experiences with patients, there are Chinese herbs found to be especially effective for certain diseases, e.g., raw QingHao for malaria; thus the one herb-one disease approach has been also used in TCM, despite the classical norm of treating syndromes. One added advantage of using natural herbs is that there are fewer side effects than using synthetic drugs of western medication, and the side effects may be very important in many situations. The reasons for side effects are not very clearly understood. However, since most western drugs are synthetic, that is, the drug molecules are non-existent in the natural world. This may imply that the drugs are more unnatural or less compatible with naturally existing beings, such as humans; hence the drugs can cause more unexpected side effects, than the natural herbs can. 5.2. Cause Diagnosis Methods Since the 20th century, western microscopic diagnosis methods including chemistry and instrument examinations are more accurate to identify the true
causes of disorders. It is now suggested by all doctors to use western diagnosis methods in most cases, except when facilities are not available immediately, or correct diagnosis are not possible even with chemistry or instrument examinations. However, in reality, the fact that western diagnostic methods are often slow (chemistry exams, bacterial culture, etc., require days if not weeks to get results), expensive, not available in many locations, and difficult in the early stage of any disorder. Also for babies and old persons in poor health, any invasive diagnosis method including taking blood samples, inducing diarrhea to empty the digestive tract, exhaustive exercise, etc., could further damage their health, the western exams need to be performed with extra care. TCM methods are best suited for these situations. The TCM elementary diagnosis methods described in Chapter two are very helpful and used widely by most TCM doctors to identify syndromes as well as the rough causes of a disorder. Then relieving the symptoms or syndrome will often solve the problems before actual causes are identified (thus often rendering the western exams unnecessary). TCM is also used as preventive means before small abnormalities developed into severe diseases. Therefore, an improvement to western methods is to combine the “symptoms relieving” means of TCM to the western “scientific diagnosing” means, thus one can at least reduce the suffering of the patients and prevent worsening of many disorders before the real causes are identified. This TCM approach has been proven over years of practice. 5.3. Methods of Treatment Once the problems and causes are identified, treating the direct cause (kill the germs) is only part of the solution. In addition to treating the syndromes, TCM emphasizes the energy and strength of the patient are just as important as the “to kill the germs” method. Therefore, supplementing (Bu) the body system (promoting life) is a very important method of TCM treatments. Depending on whether the body is void or filled as the dominant reason, TCM uses supplementing or evil-expelling methods (including kill-germs, expel-toxins, purge-heaps, etc.), respectively. Notice that both supplementing and expelling methods can be used at the same time in the same formula, according to the patient’s conditions. Therefore, TCM treatment methods often deal with syndromes, causes, location of disorders on the body, the individual’s conditions, etc., at the same time. Each typical TCM (this book deals with internal medicine mainly) formula (Chapter 7) can contain one or more methods and each method can contain one or more formulas. Nevertheless, the basic ideas of the TCM treatment methods are given in the following. 5.3.1. Proper and Counter Treatments
As stated earlier, relieving heat in a patient with cold herbs, relieving coldness in a patient with hot herbs are called Proper-treatments, since the herbs properties act to relieve the symptoms. Similarly, treating void-body with supplementing methods and treating filled-body with expelling methods are also proper treatments. However, there are cases that many symptoms are opposite to the true causes of disorder; proper treatment following these symptoms will lead to wrong results. Thus the herbs chosen should act with (not against) the symptoms, e.g., using cold herbs for cold or hot herbs for heat symptoms, these are called Counter-treatments. But in reality, these apparently opposite treating methods are following the true causes instead of the symptoms. Therefore, if the true causes are identified and followed, Counter-treatment is still one kind of Proper-treatment method. For instance, in some acute infections of a weak person, the person could have heat-symptoms such as high fever, lots of sweating, coarse breathing, etc., but the pulses are weak. Treatment is not to cool the person with cold herbs, but rather to increase his/her energy with warming herbs. Thus, according to other symptoms it is a Counter-treatment and according to the pulses it is still a Proper-treatment. This example is also called as a “true-cold but false-heat” condition; experiences have shown that treatment methods follow the “weakness symptoms” are often safer before a true cause is identified. 5.3.2. Treating Causes or Symptoms In general, treating the true cause may be the best method; this approach is used widely in the western medicine. However, there are limitations when: *The true cause is not identifiable. *No drug or herb is available to cure the true cause. *Emergency situations where symptoms could be fatal without treatment quickly, such as shock, heart attack, heavy bleeding, or stroke. In cases like these treating symptoms first is the best method. In fact, most TCM methods are based on treating symptoms/syndromes instead of true causes due to the lack of scientific measurement to detect and identify the true causes. This is where the TCM physiology and pathology become more relevant; often, when the symptoms are completely relieved, the problems (together with the true causes), also disappeared. But for problems without symptoms at all, such as early HIV infection, TCM can not do anything unless diagnosis is given by western methods ahead of the time when symptoms are detectable. The concept between basic reasons and symptoms is also important. For instance, if a person is weak then infected, the basic reason is body system weakness and symptoms indicate infection. If a person is infected first then becomes weak, the basic reason is infection and the weakness is a consequence of the infection. In both cases, the overall symptoms may be the same but treatment methods could
be different. The general rule is to treat the most pronounced symptom first and treat chronic problems later. Note that when treating the most pronounced symptom, one should not make other symptoms worse. 5.3.3. 8-Methods The proper methods corresponding to the 8-Indicators (5.1.1.) are the 8 standard methods of treatment. 126.96.36.199. Dispersing Methods for Surface Infections (Biao-Zheng) When evils infect the external surfaces, including the skin and upper respiratory tract, use dispersing (including induced/forced sweating) methods to promote circulation and dilate peripheral capillaries to expel the evils. Depending on the herbs used, evil types, location, and body conditions, dispersing methods are further refined as: A. According to herbs used a. Pungent-warm dispersing: use pungent-warm herbs to induce sweating for cold evils at the skin surface. Main symptoms include fever, fear of cold, no sweating, headache, tight neck, and body pain. The typical formula is MaHuangTang; during summer months or less severe infections, when sweating is easier, use XiangSuYin instead. b. Pungent-cool dispersing: use pungent-cool herbs to induce sweating, for hot evils at the skin surface; main symptoms include fever, fear of heat, with or without sweating, sore (itching, uneasy, or painful) throat. The typical formula is YinQiaoSan; when accompanied by coughing or wheezing, fast breathing, high fever, thirst, this indicates more severe lung and/or lower respiratory tract infections - use MaXingShiGanTang. c. Pungent-cool dispersing and bitter-detoxifying cooling: use pungent–cool herbs like SangYe, JuHua, and ManJingZi for surface dispersing (symptoms: fever, headache, fear of cold, little sweating, floating fast pulses), and bitter-detoxifying herbs like LianQiao, DaQingYe, and ShanDouGen to cool internal evils (symptoms: thirst, throat pain, yellow furring), at the same time. B. According to evil types Wind-evil dispersing: as stated earlier, wind-evils cause movable thrombosis stagnation, depending on the additional symptoms to the generic syndrome: headache, fever or chills, stuffy nose, no or little sweating. Wind evils include: *Cold wind evils: symptoms include body pain and no sweating, use pungent-warm dispersing herbs such as ZiSu, JingJie, FangFeng, BaiZhi, and GaoBen. *Warm-wind evils: symptoms include uncomfortable throat, sweating and fear of heat, use pungent-cool dispersing herbs such as BoHe, SangYe, GeGen, and NiuBangZi. *Damp-wind evils: symptoms include body or joint soreness; use de-dampness pungent-warm or cool dispersing herbs such as QiangHuo, DuHuo, and GuiZhi. *Damp-warm evils (strictly speaking, these are not wind-evils, but are very important but different kinds of surface infection): symptoms include a heavy-feeling in the head and body, as well as filthy furring; use SanRenTang when
dampness and drowsiness are more severe, or use GanLuXiaoDuDan when heat or fever is more severe. *Acute edema with fever and chills: symptoms include swelling below the lower eyelids and in the upper body or urine difficulties; use YueBiTang or MaHuangTang can relieve edema faster than just the use of diuretic formulas. *Dermatological symptoms including hives, maculae, papules, etc, with itchy rashes; use SangYe, MaHuang, FuPing, BoHe, etc., to clear allergic reactions or help measles eruption. C. According to evil location a. Surface infections with additional symptoms in: *The muscles: with back and neck muscle tightness/stiffness, add GeGen to increase body fluids and clear clots. Use with GuiZhiTang for cold wind; use ChaiGeJieJiTang for hot wind. *The lungs: with coughing or wheezing and mucus; use herbs like XingRen, QianHu, JieGeng, NiuBangZi, BoHe, to induce exhalation for slight evils in the lung and upper respiratory tract. When accompanied by cold-drinks (symptoms: coughing with lots of clear mucus), use XiaoQingLongTang. *The heart: with internal heat caused annoyance/uneasiness feeling or with slight edema; use DaQingLongTang. b. Surface infections with internal evil-filled symptoms: *With food heaps: add HouPu, DaHuang, ZhiShi, to GuiZhiTang and delete ShaoYao. *With high fever, rambling, and fainting: use SanHuangShiGaoTang. *With hot-diarrhea: use GeGenQinLianTang. *With dysentery: use RenShenBaiDuSan. *With maculae: add XiHeLiu and FuPing to pungent-cool dispersing formulas. *With papules: use HuaBanTang. *With edema: use MaHuangLianShaoChiXiaoDouTang. D. Supplementing dispersing methods according to body conditions For people with void, weakness, low body fluids, low immune-defense functions (Qi), low metabolic energy (Yang), or low blood supply, one must add supplementing herbs to disperse surface infections (generic symptoms include slight headache, slight fever or chills, no or low sweating; the basic herbs include CongBai, DouShi, GeGen, SuYe). Examples include: *Low fluids: symptoms also include annoyance, thirst with dry throat, warm extremities, red tongue, and fast pulses; add YuZhu, BaiWei, honey baked GanCao, etc. *Low immune defense functions: symptoms also include tight/full-chest, congestion, and weak pulses, add RenShen, ZhiKe, etc. *Low energy: symptoms also include cold extremities, tiredness/fatigue, low voice, and sunken weak pulses; add HuangQi, RenShen, FuZi, and XiXin. *Low blood: symptoms also include low blood cell counts due to bleeding or anemia, sleepiness, pale face, and pale tongue; add DiHuang, MaiDong, etc.
Therefore, the dispersing methods are more than just to induce or force sweating of the surface sweat-glands: since TCM herbs are multifunctional, a dispersing formula could also kill-germs, supplement energy, improve the immune system, relieve fever, and is an analgesic or sedative to pain, etc., at the same time. For patients that already have sweating or after induced-sweating procedure, if they still fear of cold, one can use induced-sweating again; if the patient does not fear of cold but the fever persists or increases, which means evils are too strong to be expelled by sweating, one needs to use other methods. Induced-sweating always consumes some body fluids of the patient: too much sweating can cause seizure or shock. Thus for patients with anemia, a weak heart, with ulcers or bleeding, etc., induced-sweating methods can only be used with great caution as in D. Induced or forced sweating is only one of the narrow-sensed dispersing methods, sweating can be achieved by hot or steam bath, heat-smoking, etc., which just force sweating without other detoxifying or supplementing functions of the dispersing herbs, must be used with care because these methods also consume body fluids and energy. For disorders with internal weakness problems (LiXu-Zheng), summer-heat and WenRe evils with dry and sore throat symptoms, summer-dampness as meningitis, etc., do not use these narrow-sense induced sweating methods. 188.8.131.52. Purging Methods for Acute Internal-Heap Syndromes (LiShi-Zheng) When evils infect the digestive tract and combine with food residues to form heaps, generic symptoms are a painful and full belly and constipation; induced-diarrhea is the fastest way to get rid of the accumulation of the toxins. Also, for acute abdominal pains or obstructions, purging can often unblock the digestive tract blockages quickly and cure the problems. Since the purging herbs (such as DaHuang, BaDou, MangXiao) used are multifunctional, often with detoxifying, deobstruent, cooling, and antiseptic functions in addition to the cathartic and carminative functions, purging is more than just to induce diarrhea in a narrow sense. However, the names purging and induced-diarrhea are used exchangeably in this book. Depending on the types of evils and body condition, induced-diarrhea methods include: A. Cold-purging, use bitter and cold herbs to cause diarrhea quickly, to force out the hot-evils-combined solid heaps. Additional symptoms include fever, heat or inflammation. The typical formulas include the three ChengQiTang and DaChaiHuTang. The cold purging method applies to most constipation due to infections, hot-diarrheas due to ameba diseases, and acute abdominal pains including acute pancreatitis, acute appendicitis, acute inflammation of the gallbladder, hepatitis, pierced stomach ulcer, acute intestinal obstructions, etc. The herb DaHuang is also used in treatment of upper digestive tract bleeding, coughing blood from bronchi, erupted ectopic pregnancy, etc., (since DaHuang helps re-absorb strayed blood in the body cavities and dispels it via the
intestines), and most infections with yellow furring and bloating fullness of mid/lower-belly. B. Warm-purging: use bitter and warm herbs to induce diarrhea of cold-evil heaps. Additional symptoms include cold extremities and no heat syndromes. Use BaDou, XingRen (without inflammation), or DaHuangFuZiTang if belly pain and coldness (with inflammation) are more pronounced. C. Moistening purging: use oily herbs like HuoMaRen, YuLiRen, honey, or body fluid generating bitter salty herbs such as YuanShen, ShengDi, MaiDong, to help intestinal secretions, to force out the mild-soft heaps (usually in a chronic or non-solid-filled condition). E. Fluid-purging: when edema are caused by evil-filled conditions, use bitter and cold herbs such as DaJi^, YuanHua, GanSui, ShangLu, QianNiu, to induce diarrhea in order to purge retained fluids in organs and belly, (such as in ascites due to cirrhosis; mucus, clots, or fluid retention in lung, liver, or body). The induced diarrhea method always consumes a lot of body fluids, thus can result into lost-Yin and shock conditions. When a person is weak, or is too young or too old, with low Yin-fluids, pregnant or menstruating, induced-diarrhea usually cannot be used, or must be used with supplements for energy, fluids, functions, or blood, according to body conditions of the patient. 184.108.40.206. Harmonizing Methods for Half-surface/Internal Syndromes (half Biao-Li-Zheng) 220.127.116.11.1. When problems are due to infections between the external surfaces and internal organs, such as at the muscle membranes, diaphragm, tendons, nerves and the nervous system, these are called half-surface/internal syndromes. Neither induced sweating nor induced diarrhea will cure these disorders. The evils can only be killed by the immune defenses, chemical decomposition in the liver, or detoxifying herbs. Harmonizing is to promote the liver’s chemical decomposition (immune defense) functions, activate the fever-relief function of the CNS, and to kill-germs by the detoxifying properties of certain herbs as ChaiHu, HuangQin; it includes the kill-germs and immune-enhancing methods of the western medicine and is called harmonizing methods in TCM. Several forms of harmonizing methods for evil infections include: A. Harmonize ShaoYang: When evils are at half-surface/internal, symptoms include alternating fever and chills, with bloating/pressing chest and hypochondria (half-surface symptoms) and/or bitter mouth, dry throat, head-rushes (half-internal symptoms). The typical formula is XiaoChaiHuTang. If present with bloated stomach, constipation, vomiting or nausea, high fever, yellow furring, uses DaChaiHuTang. Note that the herb ChaiHu should not be used if the patient has stomach/duodenum ulcers or hypertension, because ChaiHu lowers the Liver-Yin fluids.
B. Harmonize toxic infections: When intermittent (comes and goes) high fever is accompanied by chest congestion, nausea, red tongue, thick white powdery furring, this indicates toxic infections such as malaria; uses DaYuanYin. 18.104.22.168.2. In addition, when evil is not present; the method of harmonizing has different meanings: A. Harmonize Qi-flow: use pungent and aromatic herbs to soothe the Qi-flow (nervous signals) and liver vein blood-flow stagnation; symptoms include alternating fever and coldness, painful hypochondria, headache, dry mouth and throat, tiredness/fatigue, low appetite, irregularity, moodiness and some sentimental problems. A typical formula is XiaoYaoSan; it is widely used in women’s depression disorders. B. Harmonizing liver and pancreas: use pungent-bitter herbs to balance the secretions of the liver and pancreas to stabilize the digestive and nervous system functions. Symptoms of the imbalance include reversed cold limbs, may have a painful chest, hypochondria and belly, or diarrhea. The typical formula is SiNiSan. C. Harmonizing stomach and intestines: use both bitter cold and pungent warm herbs together to harmonize the mixed damp/hot (bloating, vomiting, or nausea) stomach and cold (gurgling or cold-diarrhea) intestine, or cold stomach (low appetite) and hot intestine (hot-diarrhea without pain) problems. The typical formula is BanXiaXieXinTang. Therefore, the basic ideas of harmonizing methods are to improve and soothe the Liver’s Qi-flow and chemical/digestive functions. 22.214.171.124. Warming Methods for Coldness Syndromes (Han-Zheng) Coldness (Han) indicates weak metabolism, energy, or functions of body systems, including external surface and internal coldness. The external surface coldness is cured by the pungent-warm induced-sweating methods; internal coldness is helped by the warming methods. Warming methods usually include: A. Warming of (Pancreas) the digestive system: generic symptoms include vomiting clear watery fluids, wet and light colored (cold) diarrhea, belly pain but no aversion to palpation, sunken, submerged, slow and weak pulses. Use sweet or bitter warm herbs to improve the digestive functions, such as BaiZhu, PaoJiang, RouGuo, WuZhuYu, ShengJiang; add DingXiang, DanDouShi, if present with dry heaving. There are three basic methods depending on the main symptoms: a. Main symptoms are cold-diarrhea, cold extremities, but not thirsty; use LiZhongTang. b. Main symptoms are both coldness (acute belly pain, tenesmus, or with sore and painful limbs, or with genital contraction) and heat (dry mouth and throat,
warm extremities, or palpitation, or with annoyance feeling); often after nose bleeding or wet dreams, use XiaoJianZhongTang. c. Main symptoms are vomiting or dry heaving with foamy saliva, headache, and cold extremities; use WuZhuYuTang. B. Warming (of Heart) by supply energy (Yang-Qi): generic symptoms include self-sweating, fear of cold, low and short voice, soft limbs, tiredness, urinal incontinence, low libido, etc. Use energy enhancing herbs such as FuZi, GanJiang, RouGui, to improve metabolism and energy supply. Use a heavy dosage with RenShen, BaiZhu, GanCao, for pre-shock lost-Yang condition with cold sweats, cold extremities, cold breath, etc. (Use ShengMaiSan with LongGu, MuLi, for lost-Yin pre-shock condition with lots of sweat, but with warm skin and extremities, thirst, shortness of breath, annoyance, and uneasy feeling.) C. Warming to improve (Kidney- or life-gate-fire) adrenal secretions: generic symptoms include cold hands and feet, cold diarrhea, low libido, cold belly but with slight fever feeling on the skin and surfaces. Use Yang supplementing herbs plus LuRong, GouJiZi, BaJiTian, BuGuZhi, YiZhiRen, PaoJiang, ShuDi, WuWeiZi, etc. D. Warming along meridian lines: when coldness along meridian lines with painful limb joints, difficulty in movement, more severe during the night, use WuTou, FuZi, GuiZhi, MaHuang, XiXin, QianNianJian, CangZhu, etc. For women, when coldness is along ChongMai and RenMai meridians (may be due to low adrenal secretion) with menses irregularity or late menstruation, use WuZhuYu, GuiZhi, FuZi, and JiaoAiSiWuTang. E. Warming for heart congestion: when pain radiates from the chest to the back, with shortness of breath, slow pulses, this indicates subsided heart functions due to blockages, use GuaLouXieBaiBaiJiuTang; if pulses are weak, use LiZhongTang; if heart rate is low, add ZhiShi, HuangQi, GuiZhi or use MaHuangFuZiXiXinTang; when pulses are disappearing with cold limbs, use TongMaiSiNiTang to increase pulses and heart pumping strength. F. Pre-shock conditions indicate emergent circulation failure, when with cold extremities, use SiNiTang or ShenFuLongMuTang to warm up the heart pumping. Warming methods are not suitable for people with low-Yin, dry mouth, throat pain, bleeding due to internal heat, and who are in fake-cold but true-heat situations. 126.96.36.199. Cooling Methods for Heat Syndromes (Re-Zheng) This is the same as the “kill-germs” method of the western medicine. Heat (fever or Re) indicates active defense functions or hyperactive metabolism of body systems. When infections are present, use WeiQiYingXue methods in section 188.8.131.52. After a long period of time, most infections indicate fire (Huo-evil) or
inflammation symptoms. When fever is high, diseases are often called filled-fire (ShiHuo). Inflammation with low fever is called hectic fever or pseudo-fire (XuHuo), often due to body fluid consumed by the infections. Therefore, cooling methods include: *Evil-dispersing in surface defense-function (WeiFen) aspect; *Cooling of the heat in organ-function (QiFen) aspect; *Cooling of the heat in control-function (YingFen) aspect; *Cooling of the heat in blood-function (XueFen) aspect; *Cooling of the heat in organs; *Cooling of the heat by supplementing Yin-fluids. Herbs used are pungent- or bitter- or sweat-cold or cool, and are mostly antibacterial or antiviral; they are cooling, detoxifying, anti-inflammatory, and they can improve immune functions or are anti-cancerous. In actual usage, the above methods can be combined for each case. Details of these methods are given in 184.108.40.206, 5.1.4, and 220.127.116.11.1. HuangDiNeiJing has given 19 syndromes to indicate inflammations with or without evil infections, which are summarized in the following. 18.104.22.168.1. Inflammation with infections The first step in diagnosis is to determine if a patient has evil-infections or not. A general rule is that “fever often indicates evil-infections.” However, there can be inflammation fever without pathogens; one needs to observe the following EARLY symptoms to confirm an infection by pathogens: *Fever, fear of cold or wind, or headaches; these are usually continuous. *The left hand pulses are stronger than the right hand pulses. *The body, tendons, or bones may be painful but not heavy nor without strength, nor feel-like sleeping. *The back of the hands are warmer than the palms. *Early infections may have a stuffy nose or nose mucus, but still with good sense of taste and appetite, no diarrhea, and no tiredness/fatigue. Thus, when evils are present, common syndromes include: *All muscle soreness, pain, swelling, heat, or redness of skin indicates inflammation. *All scabies, skin infections, itching or pain are related to Heart-fire inflammation. *All dry feelings, rough or cracked skins are related to internal dryness inflammation. *All fever-induced fainting, spasms; muted, jittering, jolted, involuntary movement, insane behavior, rambling, etc., are related to inflammations of the nervous system. *All fluid retention, sudden diarrhea, dark urine, vomiting, acid reflux, edema, bloated belly, etc., are related to digestive or urinary inflammations.
*All sudden gas up-rush, hearing loss, mouth, teeth, or throat pain, inflamed eyes, bleeding from the nose, etc., are related to inflammations in the head. Methods to treat these syndromes are given in 22.214.171.124 and 126.96.36.199.1. 188.8.131.52.2. Inflammation without infections When no evils are present, some common syndromes are related to the internal organs, and treated accordingly, such as: *Sudden spasms and involuntary muscle contractions are related to the Liver stagnation. *All fear of cold, cold limbs, reversed cold limbs, clear urine or vomiting, and clear diarrhea are related to the Kidney coldness. *All chest bloating, breathing difficulties and asthma are related to Lung weakness. *All edema, fullness, and water/fluid retentions are related to Pancreas dampness. The methods to treat these are given in the 5-Organ pathology 5.1.4. Also, when no infections are present, additional cooling methods include detoxification and nerve soothing: often use bitter cold herbs to detoxify, and neutral sweet herbs or minerals for nerve soothing. Bitter cold herbs should be used with care, especially for weak persons, women after giving birth, and people with diarrhea or low appetite. Cooling methods are not for extended use, must stop right after the infection fever has been quelled. 184.108.40.206.3. Herbs used *High fever over all body: use bitter cold herbs HuangLian, HuangQin, HuangBai, DaHuang, and ZhiZi. *High fever due to toxic-evils: use DaQingYe, BanLanGen, YuanShen, and MaBo. *Fever with dampness: use HuangQin, HouPu, HuaShi, BanXia, TongCao, and YiRen. *Fever with maculae or nodules: use ShengDi, ShiGao, DanPi, ChiShao, and DaDouJuan. *Fever with fainting: use ZiXueDan, NiuHuangWan, and ShenXiDan. *Lower-Burners inflammation due to infections: use herbs as LongDanCao, HuangQin, HuangBai, ZhiZi, MuTong, and ChiShao. *Women with early-menses, or mouth bleeding, or lots of bloody discharges with or without fever: use ShengDi, DanPi, CeBaiYe, OuJie, and HuangQin. 220.127.116.11. Supplementing Methods for Void Syndromes (Xu-Zheng) To supplement (Bu) is to add nutrients or essential elements to recover all deficient symptoms of the body systems. When evil infections are present, methods of supplementation are usually not used because they could also enhance the evils. Depending on the body metabolism, use a pungent-sweat warm supplement for YangXu and a sour-sweat cool supplement for YinXu, and a neutral supplement for general weakness without heat or cold symptoms. Use a strong supplement or a mild supplement for acute or chronic deficiency,
respectively. QiXu and XueXu use different herbs to supplement energy/function and blood, respectively. For severe weakness, one may need herbs to soothe the nerves or supplement body fluids and bone marrow, etc. Using astringent herbs are considered as a supplementing method. Symptoms include abnormal body discharges as sweating, coughing, bleeding, semen leaks, leucorrhoea, cold-diarrhea, etc., often are due to system weakness. Adding sour-warm astringent herbs with proper supplementing formulas can stop the discharges and help the recovery of health quickly. E.g., use/add JinYingZi, LianXu, LianRou, LongGu, for semen leaks; use/add BaiBianDou, KeZi, ChiShiZhi, YuMiKe, for long time cold-diarrhea. 18.104.22.168. Dissolving Methods for Chronic-Filled Syndromes (JiJu-Zheng) “Filled (JiJu = 积聚)” here includes un-digested food, solid heaps, clot-lumps, stones, mucus accumulations, etc., which are formed gradually over a long time in the body. Most lumps (non-infectious or diet-caused) in the upper- and mid-Burners are due to mucus and Qi stagnation discussed earlier. For quickly-formed lumps in the lower-Burners, use purging methods of 22.214.171.124. to eliminate the heaps or fluid retentions. Here we will discuss only the chronic filled heaps and lumps, including cancers. Dissolving methods are gradual processes, including: A. Dissolving of digestive heaps: undigested food can accumulate in the stomach or intestines, to form heaps or lumps, causing belly bloating, fullness, or diarrhea. Using slow eliminating herbs can dispel these lumps gradually. For recent food indigestion, use BaoHuoWan; for persistent indigestion, use JianPiWan which also improves digestive functions. In addition, for digestive heaps, use expelling herbs such as: *Overeating injuries: add ShenQu, ShanZha, and LaiFuZi. *Parasites: add ShiJunZi, LeiWan, BingLang, and WuGuChong. *Filthy accumulations: add GeGen, ShanYao, BaiBianDou, and ChenPi. *Dry constipation: add HuoMaRen, YuLiRen, and GuaLouRen. *To expel food debris accumulation and inflammation, use bitter, salty, eliminating and carminative herbs such as DaHuang, ZhiShi, and XuanMingFen. *To eliminate damp-heat heaps and/or hot-diarrhea, use a bitter, cold eliminant such as MuXiang, ZhiShi, HuangLian, QingPi, and BingLang. This is the most widely used herb combination for heap-stagnation in the digestive tract. B. Dissolving of clot-lumps: blood clots and wastes can form lumps in lymphatic and blood vessels and organs including uterus or lymph nodes. The clots cleansing herbs HongHua, TaoRen, DanShen, ChiShao, SanLing, EZhu, and BieJia are helpful to eliminate these lumps gradually. These herbs are often used in de-clogging dissolving practices. C. Dissolving of mucus lumps: mucus and debris can form lumps or stagnation of energy flow in organs and in the body, including lung, pancreas, liver, muscle,
skin, etc. Use of mucus cleansing herbs like XiaKuCao, HaiZao, KunBu, BeiMu, BanXia, ChenPi, and ZhiKe, can gradually shrink these lumps. This will be discussed in methods for mucus lumps. D. Dissolving of stones: abnormal osmosis can cause uric acid retention in the body or organs to form stones, diuretic and eliminating herbs can help dispel these retentions. Use XiaoShiFanShiSan for both kidney and gallbladder stones; SanJinTang for urinary tract stones; DanDaoPaiShiTang for gallbladder stones. C. For cancerous lumps, the above methods may be combined, together with anti-tumor and/or supplementing formulas as needed (see Chapter 8). 126.96.36.199. Induced Vomiting Methods for Emergent-Filled Syndromes In an urgent emergency situation, when food, toxin, or mucus, stagnate in the stomach, throat, esophagus, lung, or chest area, it is convenient to use induced vomiting methods to expel these accumulations quickly. Emetic herbs including GuaDi, LiLu, DanFan, ZaoJiao, and RenShenLu are used to induce vomiting for these solid or toxic-fluid/mucus aggregates in the digestive tract or stomach, as well as mucus blockages in the throat caused by acute infections or neurological disorders. Vomiting can quickly relieve the congestion and fullness symptoms and avoid further toxic or other damages to the body. However, for a weak person, women after giving birth, people with cold limbs, and people who have already vomited, do not induce vomiting because it may further weaken the body systems. Physically means, including using a finger or feather inserted into the throat, can also induce vomiting; they may be more convenient and cleaner than using herbs. Nevertheless, induced vomiting methods are seldom used now due to the difficulties and dangers involved. In short, the 8 methods can be categorized as: Yin syndromes are general deterioration of system functions, and should be treated by warming, supplementing, or supplementing induced-sweating methods. Yang syndromes are generally hyperactive system functions, usually indicate evil-filled situations, and should be treated by cooling, dissolving, detoxifying harmonizing, induced sweating, induced vomiting, or induced diarrhea methods. These methods are usually combined to treat a sub-syndrome since most disorders have combined 8-Indicator symptoms. Methods for Qi and blood disorders are discussed in later sections. 5.3.4. Additional Common Methods To summarize, there are several guiding principles in TCM methods, including: *Treating syndromes, not just symptoms. *Treating the body as a whole, therefore, methods could be: 1) to balance Yin & Yang; 2) indirect treatment between organs; 3) treating external or internal disorders along the same meridian line; 4) treating 5-facial organs disorders through the 5-Organs.
*The same disease can be treated differently and different diseases can be treated the same way, as long as the syndromes are the same. *Treating causes of symptoms if possible, not just symptoms. *Treating syndromes by relieving all or several main symptoms. *Preventive treatment: including disease prevention, early treatment of (to anticipate and prevent) pending symptoms. For instance, an evil-filled situation in the liver (such as cancers) can cause weakness in digestive functions (symptoms include diarrhea, fatigue, wasting, etc.) indicating that the evils are going to propagate into the digestive tract. Therefore, by supplementing the Pancreas functions, one can often prevent the disease propagation from the Liver to the Pancreas and sometimes could cure the disease (e.g., cancer) in the liver. [JinKuiYaoLue: when the Liver is sick, one should supplement the Pancreas first.] *Treatment according to an individual’s health conditions, location, and time. Thus actual TCM treatment prescriptions are often tailor-made for each individual and situation. *Priority of treatment: treat the most pronounced symptom first; treat the severe (more life threatening) condition first; in an acute condition treat symptoms first, in chronic cases treat causes; when both symptoms and causes are acute, the practitioner must treat both at the same time. *Promote body energy to defend against infections or toxins. *Analyze true or false symptoms; treatment often follows the weakness symptoms if no surely-diagnosed hyperactive syndromes are present. *One can treat upper body disorders by lower body (acupuncture) points, or vice versa. *One can treat Yang symptoms by increasing Yin, or Yin symptoms by decreasing Yang; and vice versa. *Methods to expel evil-filled (Shi) conditions include: purging heaps, clearing mucus, cleaning clots, dissolving lumps, de-clogging stasis, warming coldness, cooling summer-heat, de-dampening, moisturizing dryness, and quelling inflammation. *To supplement weakness or void (Xu) includes: supplementing Qi, blood, Yin, and Yang. *To modulate includes: relieving spasm, calming hyperactivity, soothing Qi-stagnation, subsiding gas up-flow, suppressing over reaction, lifting up dropped organs. *Do not induce sweating for people with bleeding or weakness; do not induce bleeding for people who have sweated a lot. Do not hurt the digestive functions by over using cold purgative herbs unless hot-heaps have been confirmed. *Dispersing heat-stagnation in the lung and heart to relieve low fever; clearing dampness in the digestive tract to improve digestion; clearing edema by promoting kidney function, not just using diuretic herbs. *To supplement the weakness of one organ by supplementing its mother-organ (e.g., use LiuWeiDiHuangWan to promote Kidney-Yin in order to relieve the Liver’s asthenia fire); to clear evils in one organ by clearing its son-organ (e.g., use XieXinTang to clear heart fire in order to clear Liver hyperactivity).
With the above guiding principles, TCM common methods are further categorized according to three aspects: i.e., the cause of disease (188.8.131.52.); the body condition-type; time and the location of a patient (184.108.40.206.). 220.127.116.11. Methods According to Causes Methods have also been developed based on causes given in Chapter 4, which are thus proven and useful for treating similar disorders. 18.104.22.168.1. Methods for External Causes or Infections HuangDiNeiJing has summarized the basic ways of using herbs to treat 5-evil symptoms as follows, which are useful in all other cases with or without evil infections. The basic method follows the promotion and suppression relations in the 5-Xing theory and the 4-Qi and 5-flavor properties of the herbs. *Stagnated infections (Feng, wind) usually associate with heat or fever: use pungent (herbs to disperse stagnation by warming and promoting Qi and blood-flows) and cool (herbs to relieve heat) to cure, use bitter to alleviate over-pungent, sweet and sour to promote warming and Qi-flow. Sparely use salty for wind-symptoms. *Heat infections (Re, including Huo and Shu) usually with fever and heat: use salty and cold to cure, sweet to alleviate over-salty, bitter to quell fire, and sour to relieve fire. Sparsely use pungent for heat-symptoms. *Dampness infections (Shi) usually are cool with heaviness or swelling: use bitter and warm to cure, sour and pungent to relieve, sweet and neutral to repel dampness. Sparely use salty for dampness-symptoms. *Dryness symptoms (Zao) are usually cool with skin dryness and lack of moisture: use bitter and warm to cure, pungent, sour, and sweet to promote Yin-fluid production. Sparely use salty for dryness-symptoms. *Cold symptoms (Han) are usually accompanied by weakness and cold limbs: use sweet and hot to cure, pungent to help heat-energy, bitter to alleviate over-heating, and salty to relieve cold-dampness. Sparely use sour for internal-cold symptoms. *Pungent and sweet herbs used together can promote Yang (energy and pituitary/adrenal secretion); sour and sweet herbs used together can promote Yin (fluids and essence). A typical formula is GuiZhiTang, which can promote and harmonize both Yin and Yang, thus is widely used in many disorders, especially in their early stages. Detailed methods for infections are given in the 6-Meridian, 3-Burners, and the WeiQiYingXue syndromes and defense sections. 22.214.171.124.2. Methods for Internal-external Causes With respect to the internal-external causes of disease including diet, parasites, wounds and injuries, toxins/epidemic, and dermatological causes of Chapter 4, proven methods can often be summarized as in formulas of Chapter 7. Thus details will be given when the related formulas are discussed.
126.96.36.199.3. Methods for Internal Causes As stated in 4.4.2, internal causes including sentiments, overexertion, function-blood, water/fluids, and mucus. All these causes are often subtle but interrelated; the methods of treating these types of causes need further elaboration. Basically, each cause-type has one or a few main treatment formulas for either excessive or deficient situations. A. Sentiments Excessive sentimental and nervous disorders Often called internal-wind (NeiFeng): symptoms include annoyance, irritability, numbness, rambling, shaking, spasm, vertigo, fainting, coma, neurological disorders, or insanity, etc. When internal-wind in infections with high fever or some fever, treat as YingFen and XueFen problems of WeiQiYingXue syndromes (188.8.131.52). In addition, nervous disorders need salty cool herbs and minerals to soothe. Use BaiShao, JuHua, TianMa, GouTeng, MuLi, GuiBan, BieJia, DaiMao, LongGu, ZhenZhuMu, and ShiJueMing, for low Liver-Yin with liver stagnation as in high blood pressure or in pre-stroke conditions. The no-fever non-infectious problems include: *Hyperactive Liver-Yang: symptoms include headache, fainting, tinnitus or deafness, irritability, facial fever, dry mouth and throat, poor sleep, red tongue, fast thin chord pulses. Use TianMa, GouTeng, JuHua, BaiJiLi, JiangCan, and DiLong. *Liver fire: with the above hyperactive Liver-Yang symptoms and red face, eyes, bitter dry mouth, hypochondria pain, constipation, vomiting yellow fluid or blood, yellow furring, fast chord pulses, yellow urine, sometimes with fever; use LongDanXieGanTang. *Overexcited nerves: with the above hyperactive Liver-Yang symptoms and uneasiness, palpitation, and insomnia; use sedative minerals like LongGu, MuLi, ZhenZhuMu, ShiJueMing, CiShi, and DaiZheShi. If with muscle numbness or shaking, paralysis, add herbs for hyperactive Liver-Yang. *Spasmodic: symptoms include sudden muscle spasms and/or shaking. Use YuZhenSan for infected cases; use GuiBan, MuLi, BieJia, and DaiMao, for low Liver-Yin caused spasms. Deficient sentimental disorders *Syncope: when fainting or coma is the main symptom, with cool limbs, no fever, use warm aromatic herbs as in SuHeXiangWan. When accompanied by fever or mucus, problems are treated by methods of 184.108.40.206 or with de-mucus formulas including WenDanTang. *Neurological and psychiatric disorders: symptoms include moodiness, anxiety, depression, insanity, epilepsy, etc.; almost all involved excessive mucus, use WenDanTang and add herbs according to actual case. B. Overexertion (Lao)