TCM I - Lecture 1 - Part II - 03 May 2025

Sheng Nong Ben Cao Jing (Divine Farmer’s Classic of Materia Medica)

• Oldest surviving Chinese pharmacopeia.
• Compiled during the Han Dynasty (100-200 CE).
• Attributed to the legendary emperor Sheng Nong.
• Actual authors were likely herbalists of the Han era.
• Honors Sheng Nong as the father of Chinese agriculture and herbal medicine.
• He supposedly tasted hundreds of herbs to understand their properties.
• First systematic attempt to categorize medicinal substances.
• China's First Pharmacopeia (earliest systematic manual of herbal medicine).
• Originally divided into three volumes, with 365 herbal entries.
• Each herb is classified by key therapeutic attributes:
  • Nature/temperature
  • Taste
  • Channel tropism
  • Primary clinical actions

Example: Mahuang (Ephedra)

• Nature: Warm, hot.
• Taste: Pungent (opens up the lungs).
• Tropism: Lung and bladder.
• Primary Actions:
  • Induces sweating
  • Releases wheezing (dilates bronchial muscles).
  • Promotes urination (lung helps urinary bladder function).
• Western medicine equivalent: Ephedrine.
  • Used for weight loss (stimulates adrenergic receptors).
  • Used for asthma, bronchitis, and allergy medication (dilates bronchial muscles).
  • Banned/heavily regulated in the US and Canada because of misuse.
• Ancient Chinese physicians identified Mahuang's properties long before Western medicine.

Three categories of herbs:

• Upper Grade (Upper Herbs):
  • Nontoxic
  • Tonic in nature (tonifies the body)
  • Promotes longevity and preserves health
  • Examples: Ginseng, Reishi mushroom
• Middle Grade (Middle Herbs):
  • May have mild toxicity
  • Used for nourishing and regulating internal systems
  • Treats imbalances, not just symptoms
• Lower Grade (Lower Herbs):
  • Strong action and often toxic
  • Example: Fuzi (highly toxic but very powerful; used for yang collapse).

Key features of each herb entry:

• Flavor and nature
• Meridian of penetration (aka tropism; which organ it goes to)
• Function and indications (what it does)
• Toxic level
• Yin-yang balance
• Five flavors (sweet, sour, bitter, pungent, salty)
  • Sweet taste has a tonifying effect
• Qi (temperature: cold, hot)
• Directional flow (ascending, descending, inward, outward)
  • Pungent herbs (like Mahuang) open up nasal pathways (outward and ascending).

Legacy and Influence:

• Foundation for all subsequent materia medica texts.
• Especially the Shang Han Lun and Jin Gui Yao Lue. Based on this textbook
• Still referenced today in herb training, formulation, and clinical use.

Other Influential Medical Theories and Textbooks

Wenbing Theory (Warm Disease Theory)

• Studied more deeply in TCM 2.
• Developed from observations of epidemic illnesses.
• Initially thought that diseases attack through the skin layer (Wei level), penetrating deeper if untreated.
• Later, physicians realized that infection also occurs through the nose and mouth.
• Led to a framework for dealing with warm diseases.
• Four Levels in Wenbing Disease:
  • Wei Level
  • Qi Level
  • Ying Level (Nutrient Level)
  • Xue Level (Blood Level; most internal level)

Yan Tianqi developed this four-level theory.

• Warm diseases are different from cold diseases, often with more severe symptoms like sore throat.

Sanjiao Theory

• Studied in TCM 2.
• Sanjiao is not an organ but more like an interstitial space in Western medicine.
• Is a system where fluid moves through in the body.
• Three levels:
  • Upper Jiao: Contains the lungs and heart.
  • Middle Jiao: Contains the stomach and spleen.
  • Lower Jiao: Contains the large intestine, urinary bladder, and the rest of the lower body.

Evolution of Acupuncture and Moxibustion Techniques

• Developed alongside TCM theory.
• Prehistoric Times:
  • Rubbing, pressing, and pain relief were found to have therapeutic effects.
  • Bian (sharpened stones) became tools for lancing abscesses and sores (releasing pus helped healing).
• Ling Shu (Spiritual Pivot):
  • Lays out theory of meridians and points.

Zhen Jiu Jia Yi Jing (The Systematic Classic of Acupuncture and Moxibustion)

• Compiled by Huangfu Mi.
• First known complete manual on acupuncture and moxibustion.
• Describes 349 acupoints.
• Classifies points along 14 channels.
• Organizes treatment strategies. This is Still used today in practice.
• Integrated theoretical knowledge with clinical experience.
• Established acupuncture as an independent medical discipline.

Tang and Song Dynasties (Golden Age)

• Acupuncture and moxibustion were institutionalized.
• Taught in Imperial Medical Colleges.
• Copper acupuncture models were developed for teaching purposes.
• Life-sized models with meridians and acupoints were used.
• Models had movable limbs and internal structures.
• Some models contained water to test acupuncture point accuracy and depth.

Qing Dynasty

• Acupuncture was not widely practiced.
• Greater focus on herbal prescriptions.
• Emphasis on Zang-Fu (organ) theory: connecting symptoms to specific organ disorders.
• Modern TCM: Tendency to relate symptoms to organ disorders, possibly influenced by Western medicine.
• Need to consider channel disorders as well.

20th Century

• People's Republic of China: TCM integrated into modern medical education.
• 1972: New York Times reporter witnessed acupuncture anesthesia during Nixon's visit to China, spurring Western interest.
• Today: Acupuncture is globally recognized and endorsed by the World Health Organization for numerous conditions.

Acupuncture Tools

• Early tools: Sharpened stones.
• Evolution to needle-like forms.
• Modern clinic: Disposable needles.

Moxibustion

• Paintings from Feng Dynasty show depiction of moxibustion.
• Modern moxibustion:
  • Korean moxa is well-known.
  • Japanese loose form moxa.
  • Caustic moxa
  • Various forms for clinic use.
• Similar practices exist in other cultures (e.g., Zimbabwe: heated bottle to treat ringworm).
• Moxibustion:
  • Heat to suck out the toxic conditions
  • Can be amazing, but consider: don't use with heat sign in your patient.
  • Use when patient has a cold sign (diarrhea by ice cream is very good to stop diarrhea.

Fundamental Characteristics of TCM Theory

• Nature and Body are One (shaped by Taoism).
• Confucian ideas heavily influenced TCM.

Two Fundamental Pillars:

• Holism
• Syndrome Differentiation-Based Treatment

Holism

• Integrated view of a human being in relation to body, mind, nature, and society (all are integrated).
• Emphasizes health arising from internal harmony and alignment with external conditions.
• Body should not be treated as isolated parts but as interconnected whole.
• Western: Disease with a name, and treatments are done on specific symptoms.
• TCM: External can affect internal. and disorder is made in certain type of disease.
• heavily influenced by Taoist philosophy

Taoism

• Human is a microcosm

• Tao (the way) balance of yin and yang

• Balance five elements

• Harmonize with the nature, the universe and environment.
  *Not just nature, but your social environment as well.

• Cosmic balance

• Comparison of Perspectives

  • TCM: Improve balance and treat the whole not a specific disease, with clinical observations.
  • Western: Symptoms, imaging, and getting medication to target the test results, and symptoms.
    *Broader Prevention by TCM and Western focuses on managing symptoms.
    Key Contribution of Taoism is non-duality

• Balance and Flow Interplay between Yin and Yang; always with the natural forces

• Step For natural order dont against the, you know, natural water. Right? Like, go to bed if sunset and get eat seasonal vegetables.
  And emotional well-being in focus

Confucian

• Shaped by the TCM's whole vision of nature and cosmos like relationship to the body and mind
• Shaped Politics and ethnics with the harmony of society.
  *influences TCM by ethics with self dicsiline and is resposible

Pattern-Based Diagnosis (Syndrome Differentiation)

Syndrome Differentiation

• Process of identifying underlying pattern of imbalance.
• Understanding how and why the body is out of harmony.
• Not just leveling diseases.
• Includes: DISEASE / SYMPTOMS & SIGNS / SYNDROME

Disease

• General pathological condition or diagnosis (e.g., headache, arthritis).
• Often broad term that may apply to many individuals

Syndrome

• Particular pattern of imbalance or dysfunction identified through clinical signs and symptoms.
• Defines the nature, location, and cause of illness.
• Actual focus of treatment in TCM.

Symptoms & Signs

• Symptoms: Subjective experiences reported by the patient (e.g., fever, sore throat)
• Signs: Visible observations by the practitioner (e.g., tongue color, pulse quality)

Example Mr. Smith vs Mrs. Smith Insomnia.

• Mr. Smith has: Liver Qi stagnation (Difficult to fall asleep w Hyochondriac pain and red tongue).
• Mrs. Smith has: Heart Yin deficiency (Difficulty to stay asleep, Night Sweat and dry mouth w Red tongue).

Four Diagnostic Methods

• Inspection
• Auscultation and Olfaction
• Inquiry
• Palpation the 4 ways you come up with treatment principles.
• They can be done 3 different types or same diseases types and all 3 can be treatment Principles.

Treatment Principles

• Same Disease, Different Treatment
• Different Disease, Same Treatment
• Same Disease, Different Stages