ii) The
Unity between the Human body and NatureMan
lives in nature and takes nature as his vital conditions for living. In the meantime, he
is influenced directly or indirectly by the movements and changes in nature, to which he
is bound to make corresponding physiological and pathological responses. For example, as
the climate varies with the four seasons in a year, the normal pulse conditions (including
pulse rate, rhythm, volume, tension, etc.) are also varied. The pulse becomes string-like
in spring, full in summer, floating in autumn and sunken in winter. This provides a basis
for doctors to distinguish abnormal pulse conditions from the normal ones during the
clinical diagnosis. The occurrence, development and changes of many diseases are seasonal.
For example, spring witnesses more epidemic febrile diseases; summer more sunstroke; fall
more cases with symptoms of dryness and winter more cold-stroke syndromes. Of course,
people can certainly reduce or eliminate some seasonal diseases by doing physical
exercises, transforming nature and taking active measures of prevention. TCM physicians
also have observed that along with alternation of early morning, late afternoon, daytime
and night in a day, a disease may become severer or milder. For instance, the monograph
entitled "Ling Shu Shun Qi Yi Ri Fen Wei Si Shi Pian" (Regarding a Day as a Year
Consisting of the Four seasons, a chapter of Miraculous Pivot) says, "There are
various diseases, most of which become milder in the morning, better during the daytime,
worse again in the late afternoon and even severer at nigh". This is because "In
the morning the vital energy of the human body begins to grow stronger, while the
pathogenic factors weaker; at midday the vital energy of the human body is predominant and
lords it over the pathogenic factors; in the late afternoon the vital of the human body
begins to become weaker; while the pathogenic factors stronger; at midnight, the vital
energy of human body returns to the internal organs, while the pathogenic factors come
into leading place". In modern times, someone has also noticed that human pulse
condition, temperature, the amount of oxygen consumed, carbon dioxide released and hormone
have biorhythms during the 24 hours of a day. This finding may promote the round-the-clock
exploration of the physiological and pathological changes of the human body
Based on the theory of the circulation of qi
characteristic of TCM, the pathogenesis of the human body is often influenced by the
periodic changes of the climate, which take place every 12 years or every sixty years. In
recent years, scientists have realized that the law of these periodic changes has
something to do with the cycle of sunspots, which is formed every 1l to 12 years. Their
movements bring about periodic changes in the radiation of sunlight, interfere with the
magnetic field of the earth, and change the climate around the earth, thus exerting impact
upon the physiology and pathology of the human body.
TCM believes that different geographical surroundings
produce different effects on the physiology and pathology of the human body. The effects
are even so great as to extend or shorten human lives. For instance, "Su Wen Wu Chang
Zheng Da Lun" (On Conventions of the Five Circuit Phases, a chapter of Plain
Questions) says: "People who live in the high areas have a long life, while those who
live in the low ones die young. Living areas differ in altitude. A little difference in
height causes a little difference in life, while a great difference in height results in a
great difference in life. Therefore, physicians have to know the law of nature and
geographical conditions". Modern researches have shown that the mountain area between
1,500 and 2,000 meters above the sea level is the ideal geographical surroundings for a
long life, because it is a place where hydrogen anions are concentrated.
iii) The Guiding function of the Concept of the
Organism as a Whole
The concept of the organism as a whole not only embodies
TCM's understanding of the human body itself and the relationship between it and nature,
but also provides the medical workers with a necessary method of thinking in treating
diseases. Such a concept penetrates through the entire theory concerning the physiology
and pathology of TCM, and of great significance in guiding diagnosis and treatment. For
example, TCM believes "The heart has its specific opening in the tongue proper",
so the physiological functions and pathological changes of the heart can be known by
observing the tongue. Pale tongue indicates the blood deficiency of the heart; purple
tongue with petechiae, the blood stagnation of the heart. To cure these diseases, the
first important thing of all is to find out where the key pathogenesis is according to the
relationship between the heart and the tongue, by taking into consideration of the concept
of the organism as a whole, and by making a comprehensive analysis of the case. Another
example, acupuncture therapies of TCM, Zi Wu Liu Zhu (select the acupoint on the basis of
"five shu points" of the twelve channels matching the "heavenly stems and
earthly branches") and Ling Gui Ba Fa (select the acupoint according to the eight
points in the eight extra-channels matching the "heavenly stems and earthly
branches"), have obvious curative effects just because the acupoints and acutime are
determined according to the relationship between the working of the channels, pulse, vital
energy and blood of the human body on one side and time on the other. The most adequate
time should be also chosen for taking herbal medicines. For instance, the Shi Zao Tang
(Ten Jujube Decoction) in the book "Shang Han Lun" (Treatise on Febrile Diseases
written by Zhang Zhongjing in 219 A. D.) is better to be taken on an empty stomach in the
early morning; the Ji Ming San (Cock Crowing Powder); which is recorded in the book
"Zheng Zhi Zhun Sheng" (Standards for Diagnosis and Treatment by Wang Kentang in
1,602 A. D.) should be taken at daybreak when cocks begin to crow. Modern medicine has
also noticed that the effect of digitalis taken by the patient with heart failure at about
4 o'clock in the early morning is 40 times greater than that of it taken at any other
time. And insulin, if taken at the time mentioned above, is most effective for the
patients with diabetes, too. Why does the human body have so close relationship with
nature, and why does the human body itself act in accordance with so strict time rhythm
and regularity? In recent years, not few scholars have pointed out that these result both
from the adaptation of all living things to the changes of physical surroundings such as
the earth's revolution, rotation and so on, and from the domination of some structure
within the body. Now it has been proved that in the nucleus suprachiasmaticus (SCH),
epiphysis, pituitary bodies and adrenal gland, there exist such structures as control the
time rhythm and regularity. From the foregoing it is easy to see that concept of
"Tian Ren Xiang Ying" (relevant adaptation of the human body to natural
environment in TCM) has its material base and a scientific basis as well.
2. Diagnosis and Treatment Based on a Overall Analysis
of Signs and Symptoms
By "Bian Zheng" we mean analyzing the relevant
information, signs and symptoms collected through the four methods of diagnosis
(observation, listening and smelling, inquiring, pulse feeling and palpation) in the light
of the theory of TCM, having a good idea of the cause, nature and location of a disease,
and the relationship between pathogenic factors and the vital energy, and summarizing them
into "Zheng" of a certain nature (syndrome). By "Shi Zhi" we mean
determining the corresponding therapeutic method according to the conclusion of an overall
differentiation of symptoms, signs and others.
In clinical treatment, TCM physicians do not focus their
main attention on the similarities and dissimilarities between diseases but on the
differences between the syndromes they have. Generally speaking, the same syndromes are
treated in similar ways, while different syndromes are treated in different ways. Take
cold for example, if manifests itself in more server chilliness, slight fever, a tongue
with thin and white fur, then it belongs to the exterior symptom-complex caused by wind
and cold, and should be treated with strong sudorific drugs, pungent in taste and warm in
property, to dispel the wind and cold; if its manifestations are more server fever, milder
chilliness, a tongue with thin and yellow fur, then it belongs to the exterior
symptom-complex caused by wind and heat, and should be treated with mild diaphoretics,
pungent in taste and cool in property, to dispel the wind and heat. This is called
"treating the same diseases with different methods". Sometimes, different
diseases have same syndromes in nature, so their treatment is basically the same. If
clinical analysis and differentiation show that persistent dysentery, prolapse of the
rectum, uterus and others belong to the syndrome of "sinking of the qi"
(functional activities of the middle warmer, the middle portion of the body cavity housing
the spleen and stomach), then their treating method should be the same one, lifting the qi
of the middle warmer. This is called "treating different diseases with the same
method".
In China, quite a number of colleges of medicine and
pharmacy and scientific research institutes are undertaking the researches on the essence
of "Zheng" (syndrome) in TCM. For example, Chongqing Medical College holds that
"Zheng" is the comprehensive manifestation of the disorderly relations,
resulting from the pathogen and pathogenic condition between the whole body and its
reactive characteristics on one side and its surroundings (including nature and society)
on the other, between viscera, bowels, channels and collaterals, between cells themselves
and between cells and body fluid; that "Zheng" is a reaction of life substances
characterized by time-phase and essentiality in the course of a disease; and that
"Zheng" is a whole-finalized pattern of reaction which mainly manifests itself
in the clinical functional changes. Other scholars believe, from the point of vague
mathematics, which "Zheng" is a vague collectivity made up of such materials as
symptoms, signs and characteristics.
Of course diagnosis and treatment based on an overall
analysis and differentiation of symptoms and signs should not remain at the present level
or stand still or refuse to make any further progress, but instead, be enriched, renewed,
developed and improved continually alongside the advancing of modern natural sciences.