Essentials of TCM

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Essentials of TCM

• ACR Class 1

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Yin Yang
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FOUR ASPECTS OF YIN-YANG RELATIONSHIP

• The main aspects of the Yin-Yang relationship can
  be summarized into four.
• 1) Opposition of Yin and Yang
• 2) Interdependence of Yin and Yang
• 3) Mutual consumption of Yin and Yang
• 4) Inter-transformation of Yin and Yang

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YIN-YANG AND THE BODY

• Yang........................................Yin
• Superior...................................Inferio
  r
• Exterior...................................Interio
  r
• Posterior-lateral......................Anterior-me
  dial
• Back.........................................Front
  
• Qi..........................................Blood-
  Body Fluids

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• Basic Yin-Yang qualities used in clinical
  practice
• Yang...................................Yin
• Fire...................................Water
• Hot...................................Cold
• Restless.............................Quiet
• Dry...................................Wet

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• Clinical signs associated with Yang and Yin
• Yang..........................................Yin
• Acute disease.....................Chronic disease
• Rapid onset.........................Gradual onset
• Rapid disease changes..........Lingering disease
• Heat.......................................Cold

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• Yang........................................Yin
• Restlessness, insomnia.....Sleepiness,
  listlessness
• Throws off bedclothes..........Likes to be
  covered
• Likes to lie stretched..............Likes to curl
  up
• Hot limbs and body................Cold limbs and
  body

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The Five Elements
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• The Generating Sequence
• Wood generates Fire, Fire generates Earth, Earth
  generates Metal, Metal generates Water and Water
  generates Wood.
• The Controlling Sequence
• Wood controls Earth, Earth controls Water, Water
  controls Fire, Fire controls Metal and Metal
  controls Wood. For example, Wood controls Earth,
  but is controlled by Metal.

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Generating (Sheng) Sequence
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Controlling (Ke) Sequence
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• The Over-acting Sequence
• This follows the same sequence as the Controlling
  one, but in it, each Element "over-controls"
  another, so that it causes it to decrease.
• The Insulting Sequence
• This sequence is literally called "insulting" in
  Chinese. It takes place in the reverse order than
  the Controlling sequence.
• Wood insults Metal, Metal insults Fire, Fire
  insults Water, Water insults Earth, Earth insults
  Wood.

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• Colors
• Wood - Green
• Fire - Red
• Earth - Yellow
• Metal - White
• Water - Black

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• Tastes
• Wood - Sour
• Fire - Bitter
• Earth - Sweet
• Metal - Pungent (Acrid, Spicy)
• Water - Salty

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• Climates
• Wood - Wind
• Fire - Heat
• Earth - Dampness
• Metal - Dryness
• Water - Cold

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• Yin organs
• Wood - Liver
• Fire - Heart
• Earth - Spleen
• Metal - Lungs
• Water - Kidneys

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• Yang organs
• Wood - Gallbladder
• Fire - Small Intestine
• Earth - Stomach
• Metal - Large Intestine
• Water - Bladder

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• Sense organs (Orifices)
• Wood - Eyes
• Fire - Tongue
• Earth - Mouth
• Metal - Nose
• Water - Ears

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• Tissues
• Wood - Sinews
• Fire - Vessels
• Earth - Muscles (Flesh)
• Metal - Skin
• Water - Bones

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• Emotions
• Wood - Anger
• Fire - Joy
• Earth - Pensiveness
• Metal - Sadness
• Water - Fear

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• Sounds
• Wood - Shouting
• Fire - Laughing
• Earth - Singing
• Metal - Crying
• Water - Groaning

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Vital Substances
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• The Vital Substances are
• Qi
• Blood
• Essence (Jing)
• Body Fluids
• Some sources include Mind or Spirit (Shen)

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ESSENCE ?

• "JING" is usually translated as "Essence".
• used in three different contexts with slightly
  different meanings
• "Pre-Heaven (or Pre-Natal) Essence"
• "Post-Heaven (or Post-Natal) Essence"
• The Essence (or Kidney-Essence).

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• Pre-Heaven Essence
• determines each person's basic constitutional
  make-up, strength and vitality can be influenced
  only with difficulty in the course of adult life.
  
• Post-Heaven Essence
• a general term to indicate the essences produced
  by the Stomach and Spleen after birth, as opposed
  to the Pre-Heaven Essence which is formed before
  birth.

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• The Essence (aka Kidney-Essence)
• derives from both the Pre-Heaven and Post-Heaven
  Essence.
• interacts with the Post-Heaven Essence and is
  replenished by it
• determines growth, reproduction, development,
  sexual maturation, conception and pregnancy.

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Functions of Essence

• 1. basis for growth, reproduction and
  development.
• controls the growth of bones in children, teeth,
  hair, normal brain development and sexual
  maturation.
• 2. basis of Kidney-Qi
• 3. produces Marrow
• 4. basis of constitutional strength

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QI ?

• Review the various forms of Qi

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• Original Qi (Yuan Qi, Source Qi) ??
• 1. Motive force - arouses and moves the
  functional activity of all the organs.
• 2. Basis of Kidney-Qi - closely related to the
  Gate of Vitality and shares in providing heat
  necessary to the body's functional activities
• 3. Facilitates the transformation of Qi
• 4. Facilitates the transformation of Blood
• 5. Comes out at the Source points

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• Food-Qi ?? (aka "Gu Qi")
• first stage in transformation of food into Qi.
• Spleen extracts Food-qi and sends it up to the
  Lung where it may transform into various other
  kinds of qi (e.g. Zong Qi) or blood.

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• Gathering (or Ancestral, or Pectoral) Qi ?? (aka
  "Zong Qi")
• 1. nourishes Heart and Lungs
• 2. promotes Lung function of controlling Qi and
  respiration, and Heart function of governing
  Blood and blood vessels
• 3. controls speech and strength of voice
• 4. promotes blood circulation to extremities.

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• True Qi (Zhen Qi)??
• final stage of Qi transformation
• circulates in channels and nourishes organs.
• originates from the Lungs
• assumes two different forms Nutritive Qi (Ying
  Qi) and Defensive Qi (Wei Qi)

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• Nutritive (or Construction) Qi (Ying Qi) ??
• nourishes internal organs and the whole body
• closely related to Blood and flows in the blood
  vessels channels.
• is activated whenever a needle is inserted in an
  acupuncture point

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• Defensive Qi (Wei Qi) ?? (??)
• coarser form of Qi than Ying Qi
• flows on the outer layers of the body
• protects the body from attack of exterior
  pathogenic factors

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• warms, moistens and partially nourishes skin and
  muscles
• adjusts the opening and closing of the pores (and
  therefore regulates sweating)
• regulates the body temperature (chiefly by
  regulating sweating)
• under the control of the Lungs.

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• CENTRAL QI (Zhong Qi)??.
• refers to the Qi of Stomach and Spleen.
• also used in cases of deficiency of Spleen-Qi
  which result in prolapse of an organ
• UPRIGHT (or Correct) QI (Zheng Qi)??
• usually only used in relation and contrast to
  PATHOGENIC FACTOR (Xie Qi), and indicates the
  body's resistance to exterior diseases.

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Basic Functions of Qi

• Transforming
• Transporting
• Holding
• Raising
• Protecting
• Warming

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BLOOD (Xue) ?

• Function
• nourishes the body
• moistens the body tissues
• provides the material foundation for the Mind

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Blood-Qi relationship

• very close relationship between Qi and Blood.
• Qi is Yang compared to Blood, Blood is Yin
  compared to Qi.
• Qi and Blood are inseparable the Nutritive Qi
  circulates with Blood in the blood vessels.
• "Qi is the commander of Blood Blood is the
  mother of Qi".

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• There are four aspects to the Blood-Qi
  relationship.
• Qi generates Blood
• Qi moves Blood
• Qi holds the Blood
• Blood nourishes Qi

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BODY FLUIDS (JIN-YE) ??

• originate from our food and drink.
• transformed and separated by the Spleen a
  "clean" (Clear) part goes up from the Spleen to
  the Lungs, which spreads part of them to the skin
  and sends part of them down to the Kidneys.
• A "dirty" (Turbid) part goes down to the Small
  Intestine where again it is separated into a pure
  and impure part.

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• The pure part of this second separation goes to
  the Bladder and the impure part goes to the Large
  Intestine, where some water is re-absorbed.
• The Bladder further transforms and separates the
  fluids it receives into a pure and impure part.
• The pure part flows upwards and goes to the
  Exterior of the body where it forms sweat.
• The impure part flows downwards and is
  transformed into urine.

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Types of Body Fluids

• There are two types of body fluids
• Fluids in Chinese called JIN ?
• Liquids in Chinese called YE ?(Wiseman Translates
  this as Humors)

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• Fluids (JIN)
• clear, light and thin-watery move relatively
  quickly, circulate with Wei Qi on the Exterior.
• under the control of the Lungs, which spreads
  them to the skin all over the body.
• moisten and partially to nourish skin and
  muscles manifest as sweat, tears, saliva and
  mucus.
• Also become a component of the fluid part of
  Blood.

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• Liquids (YE)
• turbid, heavy and dense circulate with Nutritive
  Qi in the Interior.
• They move relatively slowly.
• moisten the joints, spine, brain and bone marrow
  and lubricate the orifices of the sense organs,
  i.e. eyes, ears, nose and mouth.

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The Functions ofthe Zang-Fu
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The Functions of the Heart
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The functions of the Heart

• It governs Blood
• It controls the blood vessels
• It manifests in the complexion
• It houses the Mind
• It opens into the tongue
• It controls sweat.

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• "THE HEART LOATHES HEAT"
• "THE HEART CONTROLS SPEECH"

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The Functions of the Liver
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• The functions of the Liver are
• It stores Blood
• It ensures the smooth flow of Qi
• It controls the sinews
• It manifests in the nails
• It opens into the eyes
• It houses the Ethereal Soul

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• Liver stores Blood
• regulates Blood volume according to physical
  activity
• It regulates menstruation.
• moistens eyes and tendons

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• Liver ensures the smooth flow of Qi
• normal direction of movement of Liver-Qi is
  upwards and outwards in all directions to ensure
  the smooth and unimpeded flow of Qi everywhere
• Influences emotional state
• Influences digestion
• Influences secretion of bile.

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• "THE LIVER IS A RESOLUTE ORGAN"
• "THE LIVER INFLUENCES RISING AND GROWTH"
• "THE LIVER CONTROLS PLANNING"
• The General

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• "THE LIVER IS A REGULATING AND HARMONIZING ORGAN"
• "THE LIVER LOATHES WIND"
• "THE LIVER CAN CAUSE CONVULSIONS"
• "THE LIVER ARISES FROM THE LEFT SIDE"

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The Functions of the Lungs
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• The functions of the Lungs are
• govern Qi and respiration
• control channels and blood vessels
• control dispersing and descending

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• They regulate Water passages
• They control skin and hair
• They open into the nose
• They house the Corporeal Soul

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• "THE LUNGS GOVERN THE 100 VESSELS"
• "THE LUNGS LOATHE COLD"
• "THE LUNGS GOVERN THE VOICE"
• The Canopy
• The Tender Organ

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The Functions of the Spleen
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• The functions of the Spleen are
• It governs transformation and transportation
• It controls the Blood
• It controls the muscles and the four limbs

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• It opens into the mouth and manifests in the lips
• It controls the "raising Qi"
• It houses Thought.

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• "THE SPLEEN GOVERNS THE FOUR LIMBS"
• "THE SPLEEN TRANSFORMS FLUIDS FOR THE STOMACH"
• "THE SPLEEN IS THE ROOT OF POST-HEAVEN QI"
• "THE SPLEEN RAISES THE CLEAR (YANG) UPWARDS"

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• "THE SPLEEN LOATHES DAMPNESS"
• Wet/Damp organ, likes Dryness
• "Granary official from whom the five tastes are
  derived".

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The Functions of the Kidneys
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• "Root of Life" or the "Root of the Pre- Heaven
  Qi".
• foundation of the Yin and Yang for all the other
  organs.
• Kidney-Yin and Kidney-Yang are also called
  "Primary Yin" and "Primary Yang" respectively
• the source of Fire in the body which is called
  the "Fire of the Gate of Vitality"

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• The functions of the Kidneys are
• They store Essence and govern birth, growth,
  reproduction and development
• They produce Marrow, fill up the brain and
  control bones
• They govern Water
• They control the reception of Qi

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• They open into the ears
• They manifest in the hair
• They control the two lower orifices
• They house Will Power

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THE GATE OF VITALITY ("MING MEN")

• A) IT IS THE ROOT OF THE ORIGINAL QI
• B) IT IS THE SOURCE OF FIRE FOR ALL THE INTERNAL
  ORGANS - provides heat for all our bodily
  functions
• C) IT WARMS THE LOWER BURNER AND BLADDER

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• D) IT WARMS THE STOMACH AND SPLEEN TO AID
  DIGESTION
• E) IT HARMONIZES SEXUAL FUNCTION AND WARMS THE
  ESSENCE AND UTERUS
• F) IT ASSISTS THE KIDNEY FUNCTION OF RECEPTION OF
  QI
• G) IT ASSISTS THE HEART FUNCTION OF HOUSING THE
  MIND

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• "THE KIDNEYS CONTROL OPENING AND CLOSING"
• "THE KIDNEYS CONTROL STRENGTH AND SKILL"
• "THE KIDNEYS ARE THE ROOT OF PRE-HEAVEN QI"
• "THE KIDNEYS LOATHE DRYNESS"

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The Functions of the Pericardium
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• functions as an external covering of the Heart,
  protecting it from attacks by exterior pathogenic
  factors.
• "Simple Questions" chapter 8 "The Pericardium is
  the ambassador and from it joy and happiness
  derive".
• The Pericardium is of secondary importance to the
  Heart and it displays many of the same functions.

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The Functions of the Yang Organs

• THE FUNCTIONS OF THE STOMACH

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THE FUNCTIONS OF THE STOMACH

• The Stomach is the most important of all the Yang
  organs.
• Together with the Spleen, it is known as the
  "Root of Post-Heaven Qi".

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• The functions of the Stomach are
• It controls the "rotting and ripening" of food
• It controls the transportation of food essences
• It controls the descending of Qi.
• It is the origin of fluids.

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THE FUNCTIONS OF THE Small Intestine

• controls receiving and transforming
• separates fluids.
• Separates Clear from Turbid
• From a psychological point of view, the Small
  Intestine has an influence on mental clarity and
  judgement.

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THE FUNCTIONS OF THE LARGE INTESTINE

• The main function of the Large Intestine is to
  receive food and drink from the Small Intestine.
• Having re-absorbed some of the fluids, it
  excretes the stools.

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THE FUNCTIONS OF THE GALL BLADDER

• only Yang organ that does not deal with food,
  drink and their waste products, but stores bile
  which is a refined product.
• Is one of the Extraordinary Fu

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• functions of the Gall Bladder
• It stores and excretes bile
• It controls judgement / decisions
• It controls sinews.

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THE FUNCTIONS OF THE BLADDER

• stores and excretes urine, and participates in
  the transformation of fluids necessary for the
  production of urine.
• The function of the Bladder is
• It removes water by Qi transformation.

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THE FUNCTIONS OF THE TRIPLE BURNER (San Jiao)
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• "The Triple Burner is the official in charge of
  irrigation and it controls the water passages".
• Name but No Form
• "avenue for the Original Qi"

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• "avenue for the Original Qi"
• "Classic of Difficulties" Original Qi resides in
  the lower abdomen, between the two Kidneys, it
  spreads to the 5 Yin and 6 Yang organs via the
  Triple Burner, it then enters the 12 channels and
  emerges at the Source (Yuan) points.

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THE TRIPLE BURNER AS THE THREE DIVISIONS OF THE
BODY

• The three-fold division of the body is as
  follows
• from the diaphragm upwards is the Upper Burner,
• between the diaphragm and the umbilicus is the
  Middle Burner,
• below the umbilicus is the Lower Burner.

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• As far as organs and anatomical parts are
  concerned, the Upper Burner includes Heart,
  Lungs, Pericardium, throat and head
• the Middle Burner includes Stomach, Spleen and
  Gall Bladder
• the Lower Burner includes Liver, Kidneys,
  Intestines and Bladder.

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• a) The Upper Burner is like a mist
• The main physiological process of the Upper
  Burner is that of distribution of fluids all over
  the body by the Lungs in the form of fine vapor.
• This is an aspect of the Lung dispersing
  function. For this reason the Upper Burner is
  compared to a "mist".

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• b) The Middle Burner is like a maceration chamber
• The main physiological processes in the Middle
  Burner are those of digestion and transportation
  of food and drink (described as "rotting and
  ripening") and the transportation of the
  nourishment extracted from food to all parts of
  the body.

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• c) The Lower Burner is like a ditch
• The main physiological process in the Lower
  Burner is that of separation of the essences of
  food into a clean and dirty part, with the
  excretion of the dirty part.

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The Functions of the Six Extraordinary Yang
Organs
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The Functions of the Six Extraordinary Yang Organs

• The "Extraordinary Yang Organs" function like a
  Yin organ (i.e. storing Yin essence and not
  excreting), but have the shape of a Yang organ
  (i.e. hollow).
• They are Uterus, Brain, Bones, Marrow,
  Gall-Bladder and Blood Vessels.

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THE UTERUS

• has the function of regulating menstruation,
  conception and pregnancy.
• It is closely related to the Kidneys, the
  Directing Vessel (Ren Mai) and the Penetrating
  Vessel (Chong Mai) extraordinary vessels.

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THE BRAIN

• The Brain is also called the "Sea of Marrow".
• In Chinese Medicine, the Brain controls memory,
  concentration, sight, hearing, touch and smell.
• Kidney-Essence produces Marrow which gathers to
  fill the Brain and spinal cord.
• Since Marrow originates from the Kidneys, the
  Brain is functionally related to this Yin organ.

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MARROW

• "Marrow", the common matrix of Bone-marrow and
  Brain, is produced by the Kidney-Essence, it
  fills the Brain and spinal cord and forms Bone
  marrow.
• In Chinese Medicine, the function of Marrow is to
  nourish the Brain and spinal cord and to form
  Bone-Marrow.

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The other Extraordinary Fu

• The Bones are related to the Kidneys. They are
  considered one of the Extraordinary Yang Organs
  because they store Bone-Marrow.
• Blood vessels are considered one of the
  Extraordinary Yang Organs because they contain
  Blood.
• The Gall Bladder is considered one of the
  Extraordinary Yang Organs because, unlike other
  Yang organs, it stores bile, which is a "pure"
  fluid.