TCM II - Lecture 2 Review - Part II 2

Quizlet and Flashcards

• Quizlet can be downloaded on your cell phone for studying.

• It allows you to listen to flashcard content, useful while driving.

• You can slide cards left (don't want to review) or right (need to remember).

• This helps focus on memorizing difficult information.

Chapter Assignments

• Tanel created flashcards for the previous week.

• Irene also sent flashcards via email.

• Flashcards will be shared with the class.

• Barney and another student will work on the second chapter.

Inguinal Hernia

• Inguinal hernia is related to internal organ issues and connective tissues, not sinew channels.

• Sinew channels address skeletal and muscular issues.

Back Pain Considerations

• Back pain is complex and not always related to sinew channels.

• Muscle strain can be diagnosed using sinew channels.

• Kidney stones or internal organ referral pain can also cause back pain.

• Differentiation is important to determine the root cause of the pain.

• Sinew channels may provide relief if diagnosing correctly.

• Using the correct channel (e.g., sinew channel for psoas muscle pain) is crucial for effective treatment.

Internal Imbalance and Back Pain

• Using external channel points doesn't definitively indicate a digestive imbalance.

• Functional issues or overuse of muscles (e.g., psoas) can cause back pain.

• Coldness and tightness in muscles, unrelated to digestion, can contribute to pain.

• Water retention and pathogen presence near the psoas muscle may cause pain.

• Chronic infections can also be a factor contributing to the pain.

Treating Multiple Meridian Symptoms

• When treating, meridian acupoints are used for related channel issues.

• Meridian acupoints treat everything related to one channel.

• For psoas muscle pain, Stomach 36 (on the meridian) can be used.

Severe Lower Back Pain

• Shooting pain down the leg indicates nerve involvement.

• Determine the cause of nerve compression (muscle tightness).

• Acupuncturists differ from chiropractors by focusing on loosening muscles, not just adjusting bone position.

• Identify the tight muscle compressing the nerve using sinew channels.

• Use points on the corresponding channel to treat the pain and shooting sensation.

Pain Location and Meridian Treatment

• Treat the primary meridian even if the pain isn't directly on the meridian.

• If pain is between two channels, use both channels for treatment.

• Collateral vessels can also be used, especially for muscle or chronic pain.

Unexpected Diagnoses

• Symptoms' location do not always directly correlate to a meridian for treatment.

• For example, heart attack pain may manifest behind the scapula, where the heart channel doesn't run.

• The UB channel goes to the heart via the divergent channel.

• Cold can trigger a heart attack because the UB channel goes directly to the heart.

Acupuncture Points

• Massage along the channel.

• Specific points (e.g., 10 specific points) are used in traditional Chinese acupuncture.

• Jing River point treats disorders along the meridian, including divergent and sinew channels.

• Shu Stream and C-cleft points are good for pain by increasing blood flow.

• Luo-connecting points can also treat pain well.

• Local (Ashi) points are used directly.

Pulse Diagnosis

• Pulse diagnosis is essential.

• It can reveal dangerous conditions even with mild symptoms (e.g., heart attack).

Muscular Injury and Meridians

• Primary meridians are used to treat diseases; other meridians offer diagnostic clues.

• For example, nasal blockage may indicate stomach channel involvement.

• When treating, primary meridian acupoints are used.

Internal Disorders and Body Surface Manifestations

• Internal disorders can manifest on the body's surface, serving as diagnostic clues.

Temperature Changes

• Local points on the stomach can reveal coldness, indicating cold food/drink consumption.

• Touching the spleen line can reveal coldness due to cold water consumption.

• This coldness affects the lymph system.

• "Cold" refers to temperatures below body temperature.

• Coldness reduces lymph system function and can cause water retention.

• Arthritis-related temperature changes (cold vs. hot) guide point selection (local vs. distal).

Meridian Tension Changes

• Tightness along meridians (e.g., lung meridian for typists) indicates issues.

• Stomach channel tightness can indicate cold food consumption or IBS.

Nodules

• Nodules along meridians signify stagnation or dysfunction.

• Long-term presence doesn't mean it's normal; compare to children's channels.

• Nodules give indications of where to put the needle.

• She Cleft Point (narrowest part of meridian): stagnation occurs here.

• Needling enlarges the cleft, which increase flow, for pain relief.

• Luo-connecting points are useful for non-painful nodules long-term.

• Nodules are connective tissue vs. masses (in the abdomen).

• Liver 3 (alongside bone) and Spleen 3/9 can be painful.

High Pigmentation

• Pigmentation patches indicate poor circulation.

• Compare sinew channels; tightness impairs circulation, increasing pigmentation.

Diagnosing Internal Organs

• Rely on signs and symptoms.

• Understand each organ's function from a TCM perspective.

• Treat the root cause in interconnected disorders.

• For example, cough can originate from the heart (blood deficiency), anger, or spleen (dampness).

Heart

• Element: Fire

• Manages: Blood vessels

• Governs blood and vessels (mostly arteries).

• Propels blood circulation and nourishment.

• Issues: Pale face, weak pulse, palpitations.

• Governs Shen (mental spirit): Anxiety, forgetfulness.

• Related to Sweat.

• Complexion: Redness.

• Tongue: Sprout of the heart

• Syndromes: Palpitation, cold limbs, chest pain, insomnia, purple lips, tongue/mouth ulcers, sweat disorder.

Lung

• Element: Metal

• Covers: Qi, respiration and DND (dispering, descending).

• Interconnected with Heart

• Weak lung qi: Shortness of breath, weak voice, spontaneous sweating (due to weak defensive qi).

• Impaired function: cough (reversed qi - thus, treat via descending the Qi), nasal congestion (dispering), difficulty breathing, water metabolism, edema.

• Lung and blood circulation: Lung is the meeting of the vessels.

• Lung qi deficiency affects blood circulation.

• Overlap with heart (pale complexion).

• Specific to lung: blocked nose, loss of smell, cough, the susceptibility to cold can be due to lung qi not nourishing.

• Syndromes: cough, wheezing, asthma, dry throat, excess mucus, being susceptible to the cold

Spleen

• Element: Earth

• Governs: Transportation and transformation and ascending.

• Lymphatic system together with veins are ascending system pass.

• Pancreas is included into the spleen in TCM.

• Governs: Transportation transformation: weak function -> Poor appetite, bloating, diarrhea, loose stool.

• Transportation transformation includes utilization of those nutrients is until cells level: pancreas or insulin

• Ascending movement: Spleen send the Nutrients up to the lung; small source of the spleen: low nutrients supply in the blood.

• Dizziness is common with spleen.

• Organ prolapse (prolapse of the organ) can be due to lymph system not transforming/transporting -> connective tissue not nourished also -> organ thus drops from connective tissues -> organ prolapse.

• Muscle is spleen.

• Four extremities are spleen (hand, fingers are extremities).

• Fluid retention/spleen deficiency -> damp accumulating. -> limbs fatigue+sore/pain.

• Managed the mouth and is the earth of the mouth: dysfunction -> poor taste perception/abnormal mouth sensation: the severe damp heat cause sweet taste, loss in taste and smell (or other other organs).

• Syndromes: Loose stool, fatigue, poor appetite, bruises/easy brushing, organ prolapse/herniation.

Liver

• Element: Wood

• Governs：a free flow of qi: Qi stagnation -> bloating, pain, menstrual irregularities.

• The liver tends to store blood. Liver regulates blood volume. At night time the vessels become narrowed and blood goes to the liver.

• Liver blood deficiency: Dizziness, dry eyes, pale complexion.

• The liver is good for the emotions (synthetic symbiotic system). Anger, frustration may cause headache, dizziness, red eyes because emotions are mainly liver.

• Liver's fluid is tear.

• Liver nourishes blood (same principle with eyes).

• Liver and the eyes is blurred vision and has a great connection. So that leads to night blindness etc.

• Syndromes: Vision issue, tendon causing cramp, anger/easy to get anger, dry eyes, irritability.

Kidney

• Element: water/Winter

• Stores essences:

  • Pre-heaven essence.

  • Post-heaven: essence from your food can replenish for the reproduction of functions.

• When eating and absorbing you’re offering functions/mechanisms/materials

• Governments: development issues/reproduction/infertility/premature aging. To essence deficiency: the patient develops issues -> all du to essence deficiency; will the hair fall premature or what.

• Governing: water metabolism – imbalance -> edema/excessive or what – related to what: water metabolism to, with the kidney.

• Bone and marrows -> weak spleen will lead to: osteoporosis and week: Marrow and what. (Marrows: brain is the sea of the marrows). Memory will be poor and what. Lower backs

• Feel the emotion -> if the sudden fear of a trauma could have loss of movement etc.

• Functions related to kidney: Ears and hair and Gray hair = is the kidney ascence deflation, it comes with the essence. Loise of hair goes

• Weaker lower back and fatigue, cold limbs and reproduction and urination/edema imbalance -> mostly kidney related

Gall Bladder

• Secret bile; poor function lead to digestion and bitter taste in the mouth

• Gall bladder is well related with the decision making - fearful.

• Syndromes are: bitter taste, jaundice, nausea, that has that relation.

• Also is has a hipocondriac pain and is said it has a gallbladder channel.

Stomach

• First up is the rotting function -> food will be in the stomach, not absorbing function and is prepared and there's what is absorbed or what. It likes it prepares for a dish or meal to be digested.

• So weakness of the stomach will lead to bloating and not enough food/preparation and they food or meal won't be fully prepared. Stomach has a descending food

• And when there's reversing of the system (disorder of the descending what what. We normally is what? For cough we reverse QI with stomach 36 to descend it, regulates it, controls it etc). Stomach generates fluid, that is very important for dysfunction and it leads to dry mouth.

Small intestine

• When there is too much heat and has too much water, the bladder and urinary systems might the UTI.

• It has also a lot to do with digestion and also relates with poor bloating and overlaps with the stomach

• Syndromes are red tongue, burning sensations burning sensations. When there is too much heat in the lower jaw, the the system with UTI, mostly caused by heat in the lower system, it causes scanty what? But for Chinese systems, but if it had overlaps with the heart what happens.

Large intestine

• Constipation false stool etc. It is related with the fluid system

• governments are transforming as well – imbalance – lead to bloating and stool. And related with fluid. 1 is very poor because there’s not enough lubricant

• Abdomen might not be the the. I will see that we have firm symptoms/signs. And water balance.

Urinary Bladder

• Urination and QI transformations; it's good transform. As the fluid will be and has the system with bladder urinary

• The urination and transforming is well the weak and has issues with urine the kidney function etc. We actually treat kidney not other the thing in the system what said and for what's happening in that time. If if overlaps which will which symptoms should we look for and focus.

San Jiao

• water passage; for to me it more important, from a water to have them more high passage. In a 3 systems, with tissue and outside systems etc is the to be considered. and membranes also see see see this, It's also related to your
  Sand gel is the water metabolism. There will be some metabolic imbalances that can manifest in various symptoms, such as edema or excessive thirst, which we need to identify for effective treatment.

San Jiao, also known as the Triple Burner or Triple Energizer, is an organ system in Traditional Chinese Medicine (TCM).

• It's not a physical organ but a functional system regulating fluid metabolism and Qi circulation.

• It encompasses the Upper, Middle, and Lower Burners, each associated with different regions and functions.

Functions of San Jiao:

1. Water Passage:

   • TCM believes that water in the urinary bladder comes not only from the kidneys but also from San Jiao, which connects to tissues outside the organs.

   • This is based on the observation of water sacs in the connective tissues (membranes) surrounding meat.

   • Promoting urination can replenish water retention in connective tissues due to this connection.

   • The He-Sea point of San Jiao (San Jiao 10) is located on the urinary bladder channel, reflecting this relationship.

   • Modern research has discovered the interstitium, a network of connective tissues with high-speed moving water, supporting the concept of water passage through membranes. The interstitium was officially recognized as a new organ in 2018.

   • TCM believes this water can go directly to the bladder without entering the bloodstream.

2. Passage of Yuan Qi:

   • San Jiao is also the passage of Yuan Qi, which is considered the primary Qi and a fundamental driving force in the body. Yuan Qi is also known as ministerial fire.

   • In TCM, the Kidney houses ministerial fire (Kidney Yang), which provides warmth and energy to the entire body. San Jiao facilitates the distribution of this warming energy throughout the body.

3. Regulation of Qi and Fluid Metabolism:

   • San Jiao divides the body into three burners, each with specific functions related to Qi and fluid metabolism:

     • Upper Burner: Located above the diaphragm and governs the Heart and Lungs. It's involved in respiration and the distribution of Qi and fluids to the upper body. It is often linked to the Lungs and their function of disseminating Qi. Excess water in the Upper Burner can lead to lung issues, such as cough and edema.

     • Middle Burner: Located between the diaphragm and the umbilicus, governing the Spleen and Stomach. It's responsible for digestion and the transformation of food into Qi and blood. Poor Middle Burner function can lead to digestive issues like bloating, poor appetite, and fatigue.

     • Lower Burner: Located below the umbilicus, governing the Liver, Kidneys, Intestines, and Bladder. It separates the pure from the impure and is responsible for the excretion of waste and the regulation of water metabolism. Dysfunction can manifest as urinary problems, edema, and lower abdominal issues.

   • These burners can experience water retention issues, leading to various health problems.

4. Role in Pathogen Accumulation:

   • San Jiao can be a site for the accumulation of pathogens like dampness, water, phlegm, and fluid. This is because it is responsible for the transportation and transformation of fluids throughout the body. When San Jiao is not functioning correctly, these fluids can accumulate and create pathological conditions.

   • Treating dampness involves dredging the San Jiao to improve circulation and resolve water retention. This can be achieved through acupuncture, herbal medicine, and dietary changes.

5. Interconnected System:

   • San Jiao functions as an interconnected system, where water retention in one part can interfere with Qi circulation in other parts. This holistic view is central to TCM.

   • For example, water retention in the Lower Burner can prevent the promotion of sweat in a patient with a fever, requiring the addition of urination-promoting herbs. This highlights the importance of considering the entire system when treating disease.

Common San Jiao Syndromes:

• Edema (swelling)

• Water retention

• Sluggish metabolism

• Irregular body temperature (higher or lower than normal)

These temperature irregularities can be due to stagnant fire or heat trapped by water retention, preventing heat from spreading to the limbs.

Clinical Significance:

While not emphasized in mainstream TCM exams, San Jiao is clinically very important. Recognizing San Jiao patterns can significantly improve treatment outcomes. Approximately 50% of patients in a typical clinic may have San Jiao-related issues. Addressing San Jiao imbalances can lead to more effective and comprehensive treatment strategies, particularly in cases involving complex fluid and energy imbalances.

Treatment Strategies Involving Multiple Organs:

When multiple organ systems are involved, prioritize identifying the primary trigger or root cause. For instance, if Liver Qi stagnation is affecting the Spleen, treat the Liver first. If symptoms persist, then address the Spleen and Stomach. Clinically, Liver imbalances commonly affect Spleen function. Support affected organs with acupuncture, focusing on resolving the root cause.

Differentiation of root causes is crucial, even if definitive diagnosis is challenging. Address all potential factors to provide immediate relief, and analyze collected information from various signs and symptoms.