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发布时间:2014/11/7 20:44:54



        第一部分: 历史悠久的中国传统医学
        Traditional Chinese medicine ( TCM) has a history of several years. Its origin can be traced back to remote antiquity.In a long course of struggling against diseases, TCM evolved into a unique and integrated theoretical systcm of TCM. It is an important part of Chinese culture. More than 2,000 years ago, came out Huangdi’s Classic on Medicine( Huang Di Nei jing ), which is the earliest medical classic extant in China. It consists of two parts—Basic Questions ( Su Wen ) and Miraculous Pivot( Ling Shu ), each comprising) nine volumes, each of which, in turn, contains nine chapters, totaling up to 162 chapters.The book gives a complete and systematic exposition to the following various subjects : the relationship between man and nature, the physiology and pathology of the human body, and the diagnosis, treatment and prevention ot diseases. It also uses the theories of yin-yang and the five elements to deal fully with the principles of treatment by differentiation of syndromes (TDS) according to the climatic and seasonal conditions, geographical localities and individual constitution. Hence( giving expression) to the holistic concept of taking the human body as an organic whole and taking the human body with the surrounding environment as the integrity. It laid a preliminary foundation for the theoretical formation of TCM. After Huangdi’s Classic on Medicine another classic of medicine, Classic on Medical Problems ( Nan Jing ), was given birth to the world before the Eastern Han Dynasty. The book deals mainly with the basic theory of TCM, such as physiology, pathology, diagnosis and treatment of diseases and so on. It supplemented what Huangdi’s Classic on Medicine lacked. From then on, many medical schools and various classics on medicine were brought into being in succession, each having its own strong points.
        中医有着几千年的历史, 起源可追溯至远古时代。在长期与疾病的斗争中,中医演化并形成了一套独特且完整的理论体系。2000多年前出现的《黄帝内经》是中国现存的最早医著。它由《素问》和《灵枢》两部分组成。每部分包含9卷,每卷又有9章,总计162章。该书对人和自然的关系、人体的生理及病理、疾病的预防和诊治等方面进行了系统全面的说明。同时它运用阴阳和五行理论全面阐述了因时、因地、因人而异辩证论治的原则并且表达了整体观念的思想即把人体看作一个整体,把人与其周围的环境看作一个整体。这为中医理论的形成奠定了初步的基础。继《黄帝内经》之后,东汉时期之前出现了《难经》。该书涉及了中医的基础理论如生理、病理和疾病的诊治等。它补充了《黄帝内经》的不足。自此许多不同的学派及经典著作相继出现,各抒己见。
        Shen Nong’s Herbal ( Shen Nong Ben Cao Jing ), also known as Classic on the Herbal (Ben Cao Jing ) or The Herbal ( Ben Cao ), is the earliest book on materia medica in China, which appeared in about the Qin-Han Period with its authorship unknown. Not only does it list 365 medicinal item —among which 252 are herbs, 67 are animals, and 46 are minerals, but also divides them into three grades according to their different properties and effects. The book also gives a brief account of pharmacological theories—principal (jun ), adjuvant (chen ), assistant ( zuo ) and guide (shi ); harmony in seven emotions ( qi qing he he ), four properties of medicinal herbs ( si qi ) and five tastes of medicinal herbs ( wu wei ).
        In the Han Dynasty (3rd century AD ), Zhang Zhongjing, an outstanding physician, wrote Treatise on Febrile and Miscellaneous Diseases ( Shang Han Za Bing Lun ), which is divided into two books by later generations, one is entitled " Treatise onFebrile Diseases", ( Shang Han Lun ) , the other Synopsis of Prescriptions of Golden Cabinet (Jin Kui Yao Lue ) . The book established the pnriciple of TDS(Treatment of Differentiation Syndromes;Technical Data System 技术数据系统), thereby laying a foundation for the development of clinical medicine.
        In the Western Jin Dynasty. Huang Fumi, a famous physician, compiled A-B Classic of Acupuncture and Moxibustion (Zhen Jiu Jia Yi Jing ) The book consists of 12 volumes with 128 chapters, including 349 acupoints. It is the earliest extant work dealing exclusively with acupuncture and moxibustion and one of the most influential works in the history of acupuncture and moxibustion.
        The Sui and Tang Dynasties came into their own in feudal economy and culture. In 610 AD, Chao Yuanfan et al. compiled General Treatise on the Etiology and Symptomology. The book gave an extensive and minute description of the etiology and symptoms of various diseases. It is the earliest extant classic on etiology and symptoms in China. In 657 AD, Su Jing together with 20 other scholars, compiled Newly-Revised Materia Medica ( Xin Xiu Ben Cao ) , which is the first pharmacopoeia sponsored officially in ancient China, and the earliest pharmacopoeia in the world as well. Sun Simiao (581-682 AD) devoted all his life to writing out the two books: Valuable Prescriptions for Emergencies (Bei Ji Qian Jin Yao Fang ) and Supplement to Valuable Prescriptions ( Qian Jin Yi Fang) . The hooks deal with general medical theory, materia medica, gynecology and obstetrics, pediatrics, acupuncture and moxibustion, diet, health preservationand prescriptions for various branches of medicine. Both books are recognized as representative works of medicine in the Tang Dynasty. Sun Simiao was honored by later generations as "the king of herbal medicine".
        In the Song Dynasty, more attention was paid to the education of TCM . The goverment set up"the Imperial Medical Bureau" for training and bringing up qualified TCM workers. In 1057 AD, a special organ named "Bureau for Revising Meidical Books" was set up in order to proofread and correct the medical books from preceding ages, and to publish them one after another. The books revised have been handed down till now and are still the important classics for China and other countries to study TCM.
        In the Jin and Yuan Dynasties, there appeared four medical schools represented by Liu Wansu ( 1120-1200 AD ), Zhang Congzheng ( 1156-1228 AD), Li Gao ( l180-1251 AD) and Zhu Zhenheng ( 1281-1358 AD). Among them, Liu Wansu believed that "fire and heat" were the main causes of a variety of diseases, and that the diseases should be treated with drugs cold and cool in nature. So he was known as "the school of cold and cool" by later generations, Zhang Congzheng believed that all diseases were caused by exogenous pathogenic factors invading the body, and advocated that pathogenic factors should be driven out by methods of diaphoresis, emesis and purgation. So he was known as the "school of purgation". The third school represented by Li Gao held that "Internal injuries of the spleen and stomach will bring about various diseases". Therefore, he emphasizeed that the most important thing, clinically, should be to warm and invigorate thespleen and stomach because the spleen is attributed to the earth in the five elements. So he was regarded as the founder of the "school of reinforcing the earth". And the fourth school was known as the "school of nourishing yin" by founded Zhu Zhenheng. He believed: "Yang is usually redundant, while yin is ever deficient". That is why the body "often has enough yang but not enough yin". So he usually used the method to nourish yin and purge fire in clinical practice.
        Li Shizhen (1518-1593 AD), a famous physician and pharmacologist in the Ming Dynasty, wrote The Compendium of Materia Medica ( Ben Cao Gang Mu ). The book consists of 52 volumes with 1,892 medicinal herbs, including over 10,000 prescriptions and 1,000 illustrations of medicinal items. In addition, his book also deals with botany, zoology, mineralogy, physics, astronomy, meteorology, etc. It is really a monumental work in Materia Medica. It is a great contribution to the development of pharmacology both in China and all over the world. During the same period, acupuncture and moxibustion reached their climax. Many literature concerning acupuncture and moxibustion for the ages were summarized and developed.
        李时珍(公元前1518-1593年)是汉朝著名的内科医生及药师,撰写了《本草纲目》。该书共有52卷,记载了1892种药,10000首方剂和1000条医理注释。另外该书还涉及了植物学、动物学、地质学、 药理学、天文学、气象学等学科,是一部真正的药物学不朽著作。它对中国乃至全世界药学的发展作出了巨大的贡献。在同一时期,针灸也达到了发展的高潮,许多历代的涉及针灸的文化得到了总结和发展。
        Since the founding of New China, our government has paid great attention to inheriting and developing the heritage of TCM and Materia Medica. A series of policies and measures have been taken for developing TCM. In 1986, the State Administrative Bureau of TCM and Materia Medica was established. This leading body is the guarantee of developing TCM and Materia Medica smoothly. Never before has TCM been as prosperous as it is today. TCM has experienced many vicissitudes of times but always remains evergreen. There is no doubt that TCM will take its place in medical circles of the world as a completely new medicine.
        第二部分: 中医的独特性与深刻意义 Part Two: Specific And Profound Tcm
        TCM, one of China's splendid cultural heritages, is the science dealing with human physiology, pathology, diagnosis, treatment and prevention of diseases. TCM summed up the experience of the Chinese people in their long struggle against diseases and, under the influence of ancient naive materialism and dialectics, evolved into a unique, integral system of medical theory through long clinical practice. During several thousand years it has made great contributions to the promotion of health, the proliferation and prosperity of the Chinese nation, and the enrichment and development of world medicine as well. The formation of the theoretical system of TCM was greatly influenced by ancient Chinese materialism and dialectics. The theoretical system takes the physiology and pathology of zang-fu organs and meridians as its basis, and TDS as its diagnostic and therapeutic features.
        中医是中国辉煌的传统文化之一,它是一门涉及人体生理、病理、诊断、治疗和疾病预防的科学。它是在古代朴素的唯物主义和辨证法的影响下对中国人民长期与疾病斗争经验的总结, 并在长期的临床实践中演化成了一套独特完整的医学理论。在过去的几千年里,中医为中华人民健康水平的提高、民族的繁荣昌盛及世界医学的丰富及发展做出了巨大的贡献。中医理论系统的形成受到古代中国的唯物主义和辩证法的极大影响。这套理论系统以脏腑经络的生理病理为基础,以辨证论治为其诊断特色。
        TCM has its own specific understanding both in the physiological functions and pathological changes of the human body and in the diagnosis and treatment of disease. TCM regards the human body itself as an organic whole interconnected by zang-fu organs, meridians and collaterals.And TCM also holds that the human body is closely related to the outside world. In regard to the onset and development of a disease, TCM attaches great importance to the endogenous pathogenic factors, namely the seven emotion, but it by no means excludes the exogenous pathogenic factors, namely the six pathogens. In diagnosis, TCM takes the four diagnostic methods ( inspection, auscultation ant olfaction,inquiry, pulse-taking and palpation as its principal tcchniques, eight principal syndromes as its general guideline, and differentiation of syndrome according to the zang-fu theory, differentiation of syndromes according to the six-meridian theory, and differentiation of syndromes according to the theory of wei, qi, ying and xue as its basic theories of the differentiation of syndromes. It also stresses the prevention and preventive treatment of disease, and puts forward such therapeutic principles as "treatment aiding at the root cause of disease". "strengthening vital qi and dispelling pathogens, regulating yin and yang and treating diseases in accordance with three conditions" (i. e. the climatic and seasonal conditiont, geographic localities and the patient's constitution).
        These characteristicts, however, can be generalized as the holistic concept and treatment by differentiation of syndromes (TDS)
        l. The Holistic Concept 1.整体观念
        By "the holistic concept" is meant a general idea of, on the one hand, the unity) and integrity within the human body and, on the other, its close relationship with the outer world. The human body is composed of various organs and tissues, each having its own distinct function, which is a component part of the life activities of the whole body. And in TCM the human body is regarded as an organic whole in which its constituent parts are inseparable in structure, interrelated and interdependent in physiology, and mutually influential in pathology. Meanwhile, man lives in nature, and nature provides the conditions indispensible to man's survival. So it follows that the human body is bound to be affected directly or indirectly by the changes of nature, to which the human body, in turn, makes corresponding responses. TCM says: "Physicians have to know the law of nature and geographical conditions when diagnosing and treating diseases." That's why TCM not only stresses the unity of the human body itself but also attaches great importance to the interrelationship between the body and nature in diagnosing and treating diseases.
        2. Treatment by Differentiation of Syndromes 辨证论治
        TCM, on the other hand, is characterized by TDS. Differentiation means comprehensive analysis, while syndrome refere to symptoms and signs. So differentiation of syndromes implies that the patient's symptoms and signs collected by the four diagnostic methods are analyzed and summarized so as to identify the etiology, nature and location of a disease, and the relation between vital qi and pathogens, thereby determining what syndrome the disease belongs to. By treatment is meant selecting the corresponding therapy according to the outcome of differentiating syndromes. Taken as a whole, TDS means diagnosis and treatment based on overall analysis of symptoms and signs.
        As concerns the relationship between "disease" and "treatment", TCM takes two different clinical ways on the basis of TDS. One is "treating the same disease with different therapies", by which is meant that the same disease may manifest itself in different syndromes at different stages or under different conditions. Therefore, the therapies of the same diease should be adopted towards different therapies according to the patient's constitution, the geographical environment, the climatic and seasonal changes. Take flu for example, it may be caused by wind-cold,wind-heat, summer-heat and dampness or other pathogens. So is advisable to adopt dispersing wind-cold, eliminating wind-heat, clearing away summer-heat and dampness respectively. The other is called "treating different diseases with the same therapy", by which is meant that different diseases manifesting themselves in the same syndrome may be treated with the same therapy. For example prolapse of the rectum due to protracted diarrhea and hysteroptosis are two different diseases. However, if they are both marked by themselves in the same syndrome of qi of sinking of the middle energizer, they can be treated in the same therapy by lifting qi of the middie energizer. From the above it becomes obvious that TCM does not focus its attention on similarities or dissimilarities between diseases but on the differences between the syndromes. Generally speaking, the same syndromes are treated with basically same therapies, while different syndromes with different ones.
        To sum up, the principle that different contradictions in essence are handled by different methods in the course of development of a disease is the core of TDS.
        第三部分:阴阳-自然界的法则 Part Three: AND YANG-THE LAW OF NATURE:
        Yin and yang, which come from ancient Chinese philosophy, are a general term for two opposites of interrelated things or phenomena in the natural world. At first, their connotations were quite simple, referring to the two opposite sides of an object. The side facing the sun is yang and the reverse side is yin in the course of long practice and observation, the ancient Chinese people came to understand that the opposition and wax-wane of yin and yang are inherent in all things. Yi Zhuan says, "Yin and yang are what is called Dao", (Dao means the basic law of the unity of opposites in the universe). In other words, "Everything in the universe contains yin and yang." And they further believed that yin and yang can not only represent two opposite objects but also be used to analyze two opposite aspects existing in a single entity. Generally speaking, things or phenomena which are dynamic, bright, hot, functional, etc..., pertain to the category of yang, while those that are static, dark, cold, substantial, etc. , pertain to that of yin. The yin-yang theory holds that the development and changes of everything in the universe result from the unity of opposites be tween yin and yang. Su Wen says: "yin and yang are the law of heaven and earth, the principles of all things, the parents of all changes, the origin of life and death... " The yin-yang theory is an important constituent of the theoretical system of TCM and runs through every aspect of the system. It is used to explain physiology and pathology of the body and to guide clinical diagnosis and treatment. The basic content of yin-yang theory can be summarized as follows. 阴阳来自古代中国哲学,是自然界中相联系的事物和现象中相互对立面的总称。最初,它们的内涵很简单,指的是事物的对立两方。向阳为阳,背阳则为阴。在长期的观察实践中,古代中国人民开始认识到阴阳的对立和消长存在于一切事物中。《易传》曰:一阳一阴谓之道(道代表宇宙中对立统一的基本规律)。换言之,“宇宙中的每个事物都包含阴阳两方面”。并且他们进一步认为阴阳不仅代表两个对立的事物而且可用于分析一个单独实体中存在的两个对立面。总之,动态的、明亮的、热的、功能的事物或现象属于阳;反之静止的、黑暗的、冷的、实质的事物和现象属于阴。阴阳理论认为宇宙中一切事物的变化发展来自于阴阳的对立统一。《素问》曰:阴阳者,天地之道也,万物之纲纪,变化之父母,生杀之本始。阴阳理论是中医理论系统的重要组成部分并贯穿于该系统的各个方面。它用于解释人体的生理和病理现象并指导临床的诊治。阴阳理论的基本内容可总结为以下几方面。
        l. The Unity of Opposition Between Yin and Yang 阴阳的对立统一
        By the opposition between yin and yang is meant that all things or phenomena in nature have two opposite aspects-yin and yang, such as heaven and earth, motion and quiescence, ascending and descending, exiting and entering, day and night, heat and coldness and so on. The former being yang and the latter yin(P29) in every pair above. The unity is the outcome of mutual opposition and restriction between yin and yang. Without opposition, there would be no unity; Without mutual opposition, there would be no mutual complement. It is only through this kind of opposition and restriction that the dynamic equilibrium can be established. For instance, in the nature world, the motions of celestial bodies, the variations of the four seasons, the alternations of days and nights, as well as sprouting in spring, growing in summer, reaping in autunm and storing in winter, are all the concrete manifestations of the unity of opposites between yin and yang. 阴阳对立指的是自然界中所有的事物和现象都存在对立两面—阴阳,如天地、动静、升降、进出、日月、寒热等等。以上的每对现象中前者为阳,后者为阴。统一是阴阳对立制约的结果。没有对立就没有统一,没有相互对立就没有相互补充。正是这种对立统一,阴阳才能达到动态平衡。例如,天体运动、四季变迁、昼夜交替、以及春生、夏长、秋收、冬藏的变化,皆为阴阳对立统一的具体表现。
        TCM believes that the normal physiological functions of the human body result from the opposite and unified relationship between yin and yang. Both of them are always in a state of dynamic balance. Even under normal physiological conditions of the human body, yin and yang can not be in a state of absolute balance, but in a state of relative balance. If, for any reason, the relative balance is destroyed, there is bound to be excess or deficiency of yin or yang, and then a disease will arise. As is stated in Su Wen , "Yin in excess causing yang disease, while yang in excess leading to yin disease." It is precisely due to the unity of opposites between yin and yang that all things can develop and change ceaselessly and the natural world is perpetually full of life. 中医认为人体的正常生理功能是阴阳对立统一的结果。阴阳总是处在动态平衡的状态。甚至在人体正常的生理条件下,阴阳也不可能达到绝对平衡,而是处于相对平衡的状态。一旦阴阳的相对平衡被打破就一定会导致阴阳的偏实偏虚,疾病也就随之产生了。正如《素问》所指出的“阴胜则阳病,阳胜则阴病”。也正是由于阴阳的对立统一万物才得以发展变化,自然界才得以永生。
        2. Interdependence between yin and yang 2.阴阳相互依存
        Yin and yang are opposed to and yet, at the same time, depend on each other. Neither can exist in isolation without its Opponent's existence. In other words, without yin there would be no yang, and it's the same the other way round. So either yin or yang is the prerequisite for the other's existence. And this kind of coexistent relationship is stated in TCM, "solitary yin or yang failing to live." This interdependence is also reflected in the relationship between substances and functions. The substance corresponds to yin and the function, to yang. The function is the result of material motion, and nothing in the world is not in a state of motion. Thereby, there is not any substance which can't produce its function and there is also not any function which doesn't originate from the motion of its substance. Therefore, Neijing says: "Yin in the interior is the basis for yang; while yang in the exterior is the activity for yin." "Yin" refers to the material,basis of functional activity of yang and "yang" refers to functional activity. The substance and function are interdependent and inseparable. Here is just an imaginable and vivid figure of speech. However, when the interdependent relationships between substances, between functions as well as between substances and functions are abnormal, life activities will be broken, thus bringing about dissociation of yin and yang, depletion of essence-qi. and even an end of one's life. 阴阳是对立的但同时又是相互依存的。缺了对立方,任何一方都不能独立存在。换言之,无阴则阳无以生,反之亦然。所以无论阴或阳都是其对立方存在的先决条件。这种共存关系中医称为“独阳则阴无以化,独阴则阳无以生”。这种相互依存也可在物质于功能的关系上被反映。物质对应阴,功能对应阳。功能是运动的结果,世上的万物都处于运动之中。从而,没有不能产生功能的物质,也没有不从物质产生的功能。因此,《内经》曰:阴在内,阳之守也;阳在外,阴之使也。“阴”指的是物质,是阳功能活动的基础;“阳”指的是功能活动。物质和功能之间是相互依存、不可分离的。这仅仅是一种可以想象的、逼真的言语表述。然而,当物质之间、动能之间或物质和功能之间相互依存的关系异常时,正常的生命活动就会被破坏,从而导致阴阳离绝、元气损耗,甚至生命的终结。
        3. Waning and waxing of yin and yang 3.阴阳消长
        Yin and yang always coexist in a dynamic eqilibrium in which one waxes while the other wanes. In other words, waning of yin will lead to(因果关系的词:causing,inducing,leading to,bring on, give rise to, produce,make,generating) waxing of yang and vice versa. Take the seasonal and climatic variations for example, it gets warm from winter to spring, and hot from spring to sumner. This is the process of "yang waxing and yin waning," Conversely, it gets cool from summer to autumn, and cold from autumn to winter-the process known as "yin waxing and yang waning". Under normnl conditions, the waning-waxing relation of yin and yang is in a state of relative balance.If this relation goes beyond normal limits, the relativc balance of yin and yang will not be maintained, thus resulting in either excess or deficiency of yin or yang and the occurrence of diseasc, so far as to endanger one's life.
        4. Transformation of yin and yang 4.阴阳转化
        In given conditions, either yin or yang may transform into its opposite, i. e. yin may be transformed into yang and yang into yin. If the waning-waxing of yin and yang is said to be a process of quantitative change, then that of their inter-transformation pertains to a qualitative change based on the quantitative chang. Such a process is mostly a gradual one from quantitative to qualitative change. Su Wen states: "Extreme yin gives rise to yang, while extreme yang gives rise to yin." "Extreme cold brings on heat, while extreme heat brings on cold". This is termed"Things will develop in the opposite direction when they become extreme." Pathologically, the yin syndromes can be transformmed into yang syndromes, and vice versa. It must be pointed out that the decisive factor of the mutual transformation is the conditions, including internal and external conditions, without which such transformation will be by no means likely to occur. 在特定条件下,阴或阳都可以向其对立方转化。如阴可以转化成阳,阳也可以转化成阴。如果说阴阳消长是个量变的过程,那么阴阳的相互转化便属于基于量变上的质变。这种过程大多是由量变渐致质变的过程。《素问》曰:重阴必阳,重阳必阴。寒极生热,热极生寒。这就是物极必反。在病理上,阴证可以转化成阳证,反之亦然。必须指出的是阴阳相互转化的决定性因素是条件,包括内部和外部条件,不然,转化便不可能发生。
        The above statement is the basic content of yin-yang theory, which is also illustrated by "Taijitu" (Yin-Yang Diagram) below. In the diagram the white part indicates yang, and the black part yin. The relationships between the two are both opposite and complementary to each other. The white spot within yin shows the yang within yin, while the black spot does yin within yang. Meanwhile, they contain the potential for Intertransformation and inter-wane-wax between yin and yang. 以上所述为阴阳理论的基本内容,它也可以用以下的太极图来说明。在图中,白色部分代表阳 ,黑色代表阴。他们之间存在相互对立、相互补充的关系。阴中的白点表示阴中之阳,黑点表示阳中之阴。同时,他们还包含了阴阳相互转化、此消彼长的意义。
        From the above, we can see that the content of yin-yang theory is composed of four aspects, among which the opposition and waxing-waning contain the opposite of contradiction; the interdependence and transformation contain the unity of contradiction; waxing-waning and transformation contain quantitative change and qualitative change. The former is the precondition for the latter, the latter is the outcome of the former. 从以上我们可以知道阴阳理论的内容由四部分组成。其中阴阳对立和消长代表矛盾对立面,阴阳的相互依存和转化代表矛盾的统一面。消长和转化代表量变和质变。前者为后者的前提,后者为前者的结果。
        第四部分: 阴阳学说的应用 Application Of The Yin-Yang Theory
        The yin-yang theory permeates all aspects of the theoretical system of TCM. The theory is used to explain the organic structure, physiological function and pathological changes of the human body. It also serves as a principle to guide clinical diagnosis
        l . Explaining the Tissues and Structure of the Human Body 1.解释人体组织结构
        The human body is an integrated whole. All its tissues and structures are organically connected and may be classified as two opposite aspects-yin and yang. That is why Su wen states,"Man, having a form, can not deviate from yin and yang." In terms of the anatomical locations, the upper part of the body is yang and the lower part is yin; the exterior is yang and the interior, yin; the back is yang and the abdomen, yin; the lateral aspects of the extremities are yang and the medical aspects, yin. Concerning the zang-fu organs, the zang-organs store but not discharge essence-qi and, therefore, they are yin; while the fu-organs transmit and transform food into essence-qi but not store it, and, for this reason, they are yang. Furthermore, each of the zang- or fu-organs can be redivided into yin and yang. For example, heart-yin and heart-yang, kidney-yin and kidney-yang, stomach-yin and stomach-yang, etc. As concerns yin and yang of the meridian-collateral system, there are two categories: yin meridians and yang meridians; yin collaterals and yang collaterals. All of them are opposite pairs. Thus, in line with the yin-yang theory, the unity of opposites between yin and yang exist in the upper and lower, internal and external, front and back parts of the human body, and within all the internal organs as well.
        2. Explaining the Physiological Functions of the Human Body 2.解释人体的生理功能
        The yin-yang theory believes that the normal life activities of the human body result from the harmonious relation of the unity of opposites between yin and yang. Take the relationship between function and matter for example, function pertains to yang while matter, to yin. Physiological activities of the body are based on matter. Without matter, there would be no sustentation for function activities. And functional activities are the motive power for producing matter. In other words, without functional activities, the metabolism of matter would not be performed. In this way, yin and yang within the human body depend on each other for existence. If yin and yang can't complement each other and become separated from each other, life will come to an end. So Su Wen says:"The equilibrium of yin and yang makes the vitality well-conserved; the divorce of yin and yang essence-qi exhausted."
        3. Explaining the Pathological Changes 3.解释病理改变
        TCM considers that the imbalance between yin and yang is one of the basic pathogenesis of a disease. The occurrence and development of a disease are related to both the vital-qi and pathogenic factors. Although the pathologlical changes which occur in diseases are complicated and changeable, they can still be summarized as excess or deficiency of yin or yang. To be more concrete, "yang excess leads to heat syndrome while yin excess causes cold syndrome"; "yang deficiency results in cold syndrome while yin deficiency causes heat syndromes"; "yang deficiency affects yin while yin deficiency affects yang."
        4. Serving as the Guide to Diagnosis and Treatment 4.指导诊断与治疗
        As the imbalance between yin and yang is the root cause for the occurrence and development of a disease, all clinical manifestations, no matter how complicated and changeable they are, can be explained with the aid of yin-yang theory. So TCM holds, "A skilled diagnostician, first of all, differentiates between yin and yang when observing the complexion and feeling the pulse." In differentiating syndromes, although there are the eight principal syndromes, namely, yin, yang, interior, exterior, cold, heat, deficiency and excess. Yin and yang are regarded as the general principles among the eight ones. According to the yin-yang theory, exterior, heat and excess pertain to yang; while interior, cold and deficiency pertain to yin. When treating a disease, TCM first determines the therapeutic principles, and then preponderance of yang belongs to excess-heat syndrome. It should be treated with cold-natured drugs in order to inhibit excessive yang, i.e, to cool the heat. Cold syndrome caused by preponderance of yin belongs to cold-excess syndrome. It should be treated with hot-natured drugs so as to restrain excessive yin, i.e., to heat the cold. As both syndromes above are excess syndromes, this therapeutic principle is called "treating excess syndromes with the purgation". Deficiency-cold syndrome caused by yang deficiency, should be treated with the drugs warm and tonic in nature to relieve excessive yin. This is said in TCM, "restraining predominant yin by reinforcing yang," also known as "treating yang for yin diseases." The interior heat syndrome resulting from yin deficiency belongs to Deficiency-heat syndrome, which should be treated with the drugs of nourishing yin and replenishing fluids so as to restrict excessive yang, this is what is known in TCM, "restraining predominant yang by strengthening (renal肾) yin," also called "treating yin for yang diseases."
        Zhang Jingyue thought that, in treating deficiency of yin or yang, drugs tonifying both yin and yang should be used, because yin and yang are interdependent. Therefore, reducing the excessive and replenish the deficient can adjust excess or deficiency between yin or yang and restore the balance between them.
        The yin-yang theory is used in not only determining diagnostic principles but summarizing the nature, flavor and action of medicinal herbs. Thus providing a theoretical basis for the clinical application of herbs.
        In terms of the medicinal nature, herbs with cold nature belong to yin and those with warm and hot nature pertain to yang. As concerns the flavors, herbs that are sour, bitter and salty belong to yin and those that are acrid, sweet and bland pertain to yang. In terms of actions, herbs with astringent, descending and sinking actions belong to yin, while those with dispersing, ascending and floating actions pertain to yang.
        To sum up, the principle of treatment should be established in the light of the excess or deficiency of yin or yang, and then relevant(相关的) herbs should be selected according to the attribution(归因) of yin or yang and their functions. So and so only can imbalance of yin and yang be put right, and eventually, the aim of curing diseases is attained.
        Special phrases 特殊词组
        treating...with... “治法+证名”=“……者……之”
        treating excess syndrome with purgation purging excess 实者泄之
        treating deficiency syndrome with invigoration, (or invigorating deficiency) 虚者补之
        treating cold syndrome with hot-natured drugs,( or heating the cold ) 寒者热之
        treating heat syndrome with cold-natured drugs,( or cooling the heat ) 热者寒之
        Part Five: The Five-Element Theory—Natural Philosophy In Ancient China
        The five elements refer to wood, fire, earth, metal, and water and their motions. The five element theory resulted from the observations and studies of the natural world by the ancient Chinese people in the course of their lives and productive labor. Since ancient time, wood, fire, earth, metal and water have been considered as basic substances to constitute the universe and they are also indispensable for life. Zuo's Interpretation of the Spring and Autumn Annals (Zuo Zhuan) says:" The five kinds of materials in nature are all used by people. None of them cannot be dispensed with". Another classical work Shang shu states: "water and fire are used for cooking, metal and wood are used for cultivating and earth gives birth to all things, which are used by people." These five kinds of substances are of the relationships of generation and restriction and are in constant motion and change. In TCM the five-element theory, as a theoretical tool, is used to explain and expound different kinds of medical problems by analogizing and deducing their properties and interrelations. It also used to guide clinical diagnosis and treatment. The theory, like the theory of yin-yang, has become an important component of the theoretical system of TCM. 五行指的是木、火、土、金、水和它们的运动。五行理论来自于古代中国人民在生活和生产劳动中对自然界的观察和学习。自古代以来,木、火、土、金、水就被认为是宇宙组成的基本物质,也是生命不可缺少的物质。《左传》曰:天生五材,民并用之,废一不可。另一部经典著作《尚书》曰:水火用于炊煮,金木用于耕耘,土壤用于孕育万物,一切皆为民所用。这五种物质存在相生相克的关系,并处于持续的运动变化之中。中医的五行理论,作为一种理论工具,通过分析和推理用于详细说明五种不同医学问题的性质和它们之间的关系。它也用于指导临床的诊断与治疗。该理论如阴阳理论一般已称为中医理论系统的重要组成部分。
        Classification of Things in Light of the Five-Element Theory. 根据五行理论进行归类
        In ancient China, the five-element theory was unceasingly developed and gradually became perfected. In time it came to recognize that everything in nature might be respectively attributed to one of the five elements. For instance, wood has the nature of growing freely and unfolding. So, anything that is similar to the characteristics is attributed to the category of wood. Fire has the nature of flaring up. Thereby the things similar to the nature of fire are classified into the attribute of fire. Earth has the nature of giving birth to all things. Thus, those that possess the nature of earth are attributed to earth. Metal has the nature of purifying and descending. Hence, those with the nature of metal can be attributed to metal category. Water has the nature of moistening and flowing downwards. For this reason, the things that have moistening, downward movement and coldness correspond to water. The following table shows the classification of partial things according to the five-element theory.(See Tab. 1)
        Among the five-elements, there exist the relationships of generation, restriction, subjugation and counterrestriction, and mutual affection between mother-organ and child-organ. Generation implies that one kind of thing can promote, aid or bring forth another, i. e., wood generates fire, fire generates earth, earth generates metal, metal generates water, and water, in turn, generates wood. Each of the five elements contains the dual nature -"being generated" and "generating". This relationship of the five elements is called the "mother-child" relationship. The element that generates is called the "mother", while the element that is generated is called the "child". Take wood for example, because wood produces fire, it is the mother of fire; but it is produced by water, so it's water's child. 五行当中存在生、克、乘、侮和母子相互影响的关系。生意味这一种物质可以促进、援助、产生另外一种物质,例如,木生火、火生土、土生金、金生水、水生木。五行中的任何一行都有生我和我生的双重性质。五行的这种关系叫做“母子”关系。五行中生我者为“母”,我生者为“子”。以木为例,因为木生火,故木为火之母;但是它由水所生,故又为水之子。
        Tab. 1 the Classification of Things According to the Five Elements 表1.事物的五行归类
        Restriction means bringing under control or restraint.The order of restriction goes as follows: wood restricts earth, earth does water, water does fire, fire does metal, and metal, in turn, does wood. Any one of the five elements has two aspects-being restricted and restricting. For example, the element restricting wood is metal, and the element that is restricted by wood is earth.
        Generation and restriction have the correlations inseparable in the five elements.And they oppose each other and yet also complement each other.Without generation,there would be no growth and development of things;without interrestriction there would be no balance and coordination during development and change,and excessive growth would bring about harm.For example,on the one hand,wood generates fire,and,on the other hand,it restrains earth;while earth, in turn,generates metal and restricts water.Precisely because generation resides in restriction and restriction resides in generation,the natural world and life processes are full of vitality,on the one hand and excessive growth will not bring about harm on the other hand.Thus,the relative balance maintained between generation and restriction ensures normal growth and development of things. 五行中的生克关系是不可分离的。它们相互对立,也相互补充。没有生就没有事物的成长和发展;没有克就没有在发展变化中的协调平衡,过渡生长会造成危害。例如,一方面,木生火;另一方面,木克土;同时土又生金及克水。正因为克中有生和生中有克,自然界和生命才拥有旺盛的生命力,这是一方面;另一方面,过度生长会造成危害。因此,生克之间维持相对平衡是事物生长和发展的保证。
        That is, ecological equilibrium in nature and physiological balance in the human body result from such relationships of generation and restriction. These relationships are illustrated in the following figure. 这就是自然界中的生态平衡,人体的生理平衡来自于生克关系的平衡。这些关系将在以下的数据中阐述。
        Fig. 2 Relationship of generation and restriction (or subjugation) of the Five Elements 表2.五行中的生克关系
        However, once any one of the five elements becomes excessive or insufficient, there would appear abnormal intergeneration and counter-restriction known as subjugation and counter-restriction (or reverse restriction). By subjugation is meant that one of the five elements overacts upon another one when the latter is weak. Therefore, it is also called "double restriction". For instance, excessive wood may over-restrict earth, resulting in insufficiency of earth, so called wood subjugates earth. This is the abnormal manifestation of disorder of inter-restriction among things.
        Counter-restriction means that the strong bulliesthe weak. It is also a morbid condition in which one element fails to restrict the other in the regular order, but in reverse order. It is clear that the order of counter-restriction is just the opposite to that of inter-restriction. For example, under normal conditions, metal should restrict wood, but in case of wood-qi excess, or metal-qi deficiency, wood will counter-restrict metal instead of being restricted by metal, which is known as "wood counter-restricts metal." Therefore, Su Wen states :"When qi of a certain element is sufficient, it will encroach the restricted element and counter-restrict the restricting element. When qi of a certain element is insufficient, it will be subjugated by the restricting element and counter restricted by the restricted element," This is another manifestation of the disturbance of the equilibrium between substances (see Fig. 3). 侮指强制弱,这是一种病态表现,是一行失去对另一行的正常克制,而反被其克制。很显然,侮是相克关系的相反表现。例如,在正常情况下,金克木,但在木气过剩或金气不足时,就会出现木反克金而不是金克木,这就是“木侮金”。因此,《素问》中说:“气有余,则制已所胜而侮所不胜;其不及,则已所不胜,侮而乘之,已所胜,轻而侮之”。这是事物之间平衡失调的另一表现。(见表3)
        Fig. 3 Relalionship of subjugation and Counterrestriction of the Five Elements 表3.五行的乘侮关系
        "Affecting between mother and child" refers to abnormal intergeneration in the five elements. The generated element is considered as the child, and the generating element as the mother. Here "affecting" means having harmful influence, including both "the diseased mother-organ affecting the child-organ" and "the diseased child-organ involving the mother-organ." The former is same as the order of intergeneration, and the latter is just the reverse order of intergeneration. For instance, normally, water generates wood, which is called "mother organ's disorder affecting its child-organ"; but abnormally, water involves wood, which is called "child organ's disorder involving its mother organ" when wood affects water. (See the following figure). “母子相及”指的是五行中的异常相生。我生者为子,生我者为母。这里的“及”意味着有害的影响包括“母病及子”和“子病及母”。前者与相生的规则同,后者则与其规则相反。例如,正常情况下,水生木。当水病及木时,叫“母病及子”;当木病及水时便叫做“子病犯母”。(见下表)
        Fig. 4 Subjugation and Counter-restricting Among The Five Elements 表4.
        Special phrases 特殊词组
        1.reinforcing the spleen (earth) to strengthen the lung (metal) 1.培土生金
        2.failure of water (kidney) to nourish wood (or failure of the kidney to nourish the liver) 2.水不涵木
        3.five movements and six climates 3.五运六气
        4.wood tending to spread out freely 4.木喜条达
        5.Depression of the liver (wood) generating fire 5.木郁化火
        6.fire of the liver (wood) impairing the lung (metal) 6.木火刑金
        7.fire tending to flare/flame upward 7.火性炎上
        8.excessive fire impairing the lung (metal) 8.火盛刑金
        9.failure of fire to generate earth 9.火不生土
        10.coordination between water (kidney) and fire (heart) 10.水火相济
        11.incordination between the kidney (water) and the heart (fire) 11.水火不济
        12."being restricted" and "restricting" 12.“克我”和“我克”《内经》称“所不胜”与“所胜”
        Part Six: The Five Zang-Organts-The Organs Of Producing And Storing Essence-Qi
        The heart, Lungs, spleen, liver and kidneys are together known as the five zang-organs, whose common physiological function is preducing and storing essence-qi. They store but not eliminate essence-qi.
        1. Heart 1.心
        The heart is situated in the chest, above the Diaphragm, and is enveloped by pericardium externally. TCM believes(holds, think, find, consider, deem, judge, feel, take, make) that the heart governs all the other zang-fu organs and, therefore, is a "monarch organ". The heart, pertaining to fire in the five elements, consists of heart-yin, the material structures containing the heart-blood, and heart-yang, the functional activities.As for physiological functions, the heart is thought to, first, dominate blood and vessels since it is the motive force for blood circulation. The blood vessels are the physical structures containing the blood. The blood vessels are linked with the heart to form a closed system, and blood circulation is performed by the cooperation of the heart and the blood vessels. Under the impulse of heart-qi, blood is transported to all parts of the body for nutritive prupose. Thereby the condition of heart-qi and the blood volume may be shown in both the pulse condition and the complexion. That's why Basis Questions (Su Wen ) says, "The heart has its outward manifestation in the face or complexion". As a result, whether heart-qi and heart-blood are sufficient or not can affect the strength, rate and rhythm of the heart.
        The heart houses the mind, also known as the heart dominating the mental activities. The mind, in its broad meaning, refers to the outward manifestations of the life activities of the whole body, and, in its narrow sense, to mental activities controlled by the heart, including consciousness, spirit, thinking, etc. The zang-fu theory holds that mental activities and thinking are to take the heart's functions as their basis. Spirit, consciousness, thinking, memory and sleep are all related to the function of the heart in housing the mind. Therefore, Miraculous Pivot (Ling Shu ) says, "The heart is the residence of the mind" and also, "The heart takes on the performance of activities." The heart opens into(have one's specific body opening;...be reflected on ...) the tongue. "Resuscitation", in TCM, means the close relationship between a particular zang-organ and one of the sense organs in the structure, physiology and pathology. So the heart, though being in the body, is connected with the tongue by the heart-meridians. Through such a connection, whether the heart functions normally or not can be clearly learnt from the tongue condition. In other words, the tongue condition may show the physiological and pathological changes of the heart. So TCM holds: "The tongue serves as the mirror( or body opening ) of the heart". In addition, the heart has its outward manifestations in the face. The heart corresponds to joy in the emotions. (open into;have one's specific body opening;...be reflected on...)And its meridians connect with associate with, be related to)the small intestine with which they are internally-externally related.
        心主神志,也叫做心主精神活动。神,广义上指的是整个人体活动的外在表现;狭义上指的是心所控制的精神活动包括意识、精神、思想等。脏腑理论认为精神活动和思考都以心的功能为基础。精神、意识、思考、记忆和睡眠都以心主神志的功能有关。因此,《灵枢》曰:“心为神之宅”且“所以任物者谓之心”。心开窍于舌。“开窍”在中医指的是脏和器官在结构、生理和病理上的紧密联系。所以心虽然在体内,但通过心经与舌联系。通过这种联系,无论心的功能正常与否都可以有舌象表现出来。换言之,舌象可以体现心的生理和病理改变。所以,中医认为:舌为心之镜。此外,心其华在面,在志为喜,且通过经脉与小肠相表里。 Appendix: Pericardium 附注:心包
        The pericardium, serving as the peripheral tissue surrounding the heart, plays a part in protecting the heart When exogenous pathogenic factors attack the heart, the pericardium is always the first to be attacked. The heart, if invaded by the pathogens, will be impaired and diseases will ensue. For example, high fever, coma and red tongue are described as "heat-pathogen attacking the pericardium," and, in fact, the clinical manifestations of the pericardium invaded by exogenous pathogens are the same as those of the heart. For this reason, the pericardium is usually regarded as an attachment to the heart.
        2. Lungs 2.肺
        The lungs, including the two lobes, one on the left and right separately, are situate in the thorax. They are compared to the "canopy" becausea of its uppermost position among all the zang-fu organs. They are also termed "delicate zang organs".
        The lungs dominate qi and respiration. They are the place of exchange between the gases inside and outside the body. Basic Question ( Su Wen ) says, "atmosphere communicating to the lungs". The lungs also govern dispersing and descending, and regulates water passage, and communicate with numerous vessels to coordinate functional activities of the whole body, assisting the heart to adjust normal circulation of qi and blood. The lungs corresponds to melancholy in the emotions and are related to the skin and hair externally. They open into the nose and their conditions are reflected on vellum(牛皮纸) hairs. In the meridian-collnteral relation,the lungs and the large intestine are exteriorly-interiorly related because of interconnecting-interpertaining of the Lung Meridianof Hand-Taiyin and the Large Intestine Meridian of Hand-Yangming.
        3. Spleen 3.脾
        The spleen is located in the middle energizer, below the diaphragm. The spleen's meridians connect with the stomach, with which it is exteriorly-interiorly related. TCM is widely divergent from Western medicine in the understanding of the spleen. TCM holds it true that the spleen is divided into spleen-yin, its material structures; spleen-yang, its functions; and spleen-qi which merely refers to its functions, and that the spleen may be the main organ of the digestive system. The spleen is of great importance because, for one thing, it controls transporting and transforming food and water and, for another, it controls the blood of the whole body. Thereby, keeping the blood circulating normally within the vessels to prevent it from extravasating. The spleen is also viewed as the source for the production and transformation of qi and blood, as is said in TCM, " The spleen is the foundation of postnatal life".
        4. Liver 4.肝
        The liver is at the right hypochondriac region below the diaphragm in the upper abdomen. The liver and gallbladder make a pair of zang-fu. The liver meridian connects with the gallbladder to form an exteriorinterior relationship.
        People are apt to associate the livcr with its functions of storing blood and governing normal flow of qi. The former is concerned with the liver's capability in storing blood and regulating the blood volume. A certain amount of blood stored in the liver can restrict liver-yang hyperactivity so as to maintain the normal flow of qi. If the liver fails to function normally in storing blood. Such pathological changes as liver-blood deficiency or bleeding will occur. The liver also play a principal role in regulating the blood volume,especially the volume in the peripheral portion of the body. The latter, governing the normal flow of qi, is an important link in regulating qi movement, promoting the circulation of blood and body, as well as harmonizing emotional activities. The liver's another function is incarnated in its regulating emotional activities, promoting digestion and absorption and keeping qi and blood flowing normally. Besides the above, the liver are also closely related to the tendons, nails and the eyes. It has its specific body opening in the eyes and its outward manifestation on the nails.
        5. kidney 5.肾
        The kidneys, situated in the lumbar zone, one on either side of the spinal column, store the congenital essence and are, therefore, considered as the "foundation of prenatal life". Their main physiological functions are: storing essence; dominating growth, development and reproduction; regulating water metabolism and receiving qi. The kidneys also take charge of the bone and manufacturc marrow. Meanwhile, the kidneys have their conditioias revealed on hairs and open into the ears and, the two"private parts"-urethra and anus. The kidneys' meridians connect with the urinary bladder, with which they are internally-externally related.
        Part Seven: The Six Fu-Organs And The Extraordinary Fu-Organs
        TCM refers the gallbladder, the stomach, the large intestine, the small intestine, the urinary bladder and the triple energizer to the six fu-organs. it is not only that, besides the functions of their own, they are characterized by their common role ofdecomposing and digesting water and food, and discharging the wastes, but that, in the process of digesting and absorbing food and excreting the wastes, they are closely related to each other both physiologically and pathologically. Their functional feather is excretion without storage and taking descending and unobstruction as their normal functional state. TCM's rational knowledge of the interrelationship of the six fu-organs is well grounded on ancient anatomical knowledge, the observation of the physiological and pathological changes of the six fu-organs and the summarization of long-term and rich medical experience.
        Food entering the stomach is decomposed into chyme which after digested by the stomach, is transported to the small intestine in which it is further digested by means of bile excreted by the gallbladder. The small intestine "separates the clear from turbid".The clear, refers to food essence, is transported and distributed to all parts of the body by the spleen; while the turbid is the residues of water and food. Of them waste water goes into the kidney, and then into the urinary bladder where it is turned into uruie to be excreted from the body. And the other is conveyed to the large intestine where it is changed into feces and leaves the body via the anus. In the whole process of the transportation and transformation of water and food, the triple energizer dominates qi transformation and qi movement of the whole body.
        The triple energizer is one ot the six fu-organs, and among all the zang-fu organs, it is the largest fu-organ in the human body. Huangdi's Classic on Medicine holds: "The triple energizer is separated from the zang-fu organs and yet is within the body. It encloses all organs and is the largest one." And the book also advanced a viewpoint that "The triple energizer exists in name only but is not the entity". Triple energizer has no exterior-interior relationships with the zang-organs, it is therefore called "solitary fu-organ". Its main functions are to pass various kinds of qi and to serve as the pathway for body fluid. It is divided into three parts: the upper energizer, middle energizer and lower energizer. The triple energizer with the related zang-fu organs, each having its own function to perform, accomplish jointly a complicated physiological process in the digestion, absorption, distribution and excretion.
        The upper energizer refers usually to the part above the diaphragm, including the heart, lungs and head as well. Its main physiological function is to distribute essence-qi throughout the body. In other words, in combination with the heart and the lung, the upper energizer distributes essence-qi to the whole body to warm and nourish the skin and muscles, tendons and bones. This function is described in Miraculous Pivot "The upper energizer resembles a sprayer." This is a metaphor, which is used to describe the function of the upper energizer to sprinkle fog-like cereal essence.
        The middle energizer refers mainly to the abdorminal part between the diaphragm and umbilicus, and includes such zang-fu organs as the spleen, stomach, liver and gallbladder. Its main physiological functions are to decompose food and transform nutrient substances into qi and blood, and to discharge the wastes and steam body fluid. This function is mentioned in Miraculous Pivot: "The middle energizer is likened to a fermentation tun." By "fermentation tun" is meant the place where food is decomposed and digested.
        The lower energizer refers, generally, to the portion located below the stomach, including the small intestine, large intestine, kidneys, urinary bladder. etc. Its main function is to discharge food residuces and urine. So there is also a saying in Miraculous Pivot, "The lower energizer works like a sewer." Here "sewer" is used to describe the function to excrete the wastes. However, with the development of visceral manifestations (zang xiang), essence and blood of the liver and kidney as well as primordial qi are generally attributed to the lower energizer by later generations.
        In short, the triple energizer dominates all kinds of qi and qi transformation of the human body, and serves as the pathway for water. Therefore, Basic Questions says: "The triple energizer, as the waterways, is an organ in charge of the water circulation, flowing along the waterways."
        While the six fu-organs transport and tranform water and food, the process of reception, digestion, transportation and excretion are also in progress. The six fu-organs are usually in a state of the alternations between emptiness and fullness. And they transform food into essence but not store it. That's why TCM believes: " the six fu-organs function well when they are unobstructruction, the unobstructed is the normal functional state for the six fu-organs; where the regular descent is their normal functional activities."Pathologically, disorders among the six fu-organs often affect each other. For instance, when body fluid is consumed because of excessive heat in the stomach, the large intestine is bound to have trouble in transportation, and, in consequence, constipation occurs. A disturbance of the large intestine in transmission and transformation not only leads to the obstruction of the large intestine itself, but also affects the regular descent of stomach-qi, causing repeated vomiting. A dominant gallbladder fire often interferes with the stomach and results in vomiting bitter fluid.Dampness and heat accumulated in the stomach and spleen burn and steam the liver and the gallbladder. This may cause the bile to overflow, and give rise to jaundice.
        Apart from the six fu-organs, there are the brain, marrow, bones, vessels, gallbladder and uterus termed the "extraordinary fu-organs". Like the fu organs morphology, the extraordinary fu-organs are mostly hollow but not the pathways for the digestion and excretion of cereal food and, like the zang argans functionally, they also store essence-qi. With the exception of the gallbladder, they have no exterior-interior relationships.
        The brain is located in the skull and connects with the spinal marrow. It is the organ of spirit, consciousness and thinking. Basic Question says: "The head is the house of intelligence".(,the head is the residence of intelligence)Li Shizhen of the Ming Dynasty pointee out, "The brain is the seat of the mind", and the heart governs all funcctions of the whole body, including mental activities. In the Qing Dynasty, Wang Qingren stated: "The intelligence and memory onginate from the brain but not from the heart." And he also considered: "Thinking, memory, vision, hearing, smelling and speaking are all controlled by the brain." Although TCM has some knowledge of the brain's physiology and pathology, it still ascribes the functions of the brain to the heart, the liver and respectively to the five zang-organs, and holds that spirit, consciousness and thinking are related to the five zang-organs.
        The uterus, or womb(wu:m), situated in the lower abdomen posterior to the urinary bladder in women, is an inverted pear-shaped organ where menstruation occurs and the foetus is bred. They are two complex physiological processes in which tiangui, a kind of refined nutritious substance transformed from the kidney-essence, plays the most important role. Both Chong and Ren meridians originate from the uterus. The uterus is also closely related to the heart, liver and spleen, because normal menstruation and the nourishment of the foetus rely on the blood dominated by the heart, stored by the liver and controlledby the spleen. Therefore the dysfunction of the above organs will affect the normal functions of the uterus, bring about menstrual disorder and sterility.
        It should be pointed out that according to the theory of visceral manifestation, the names of the zang-fu organs correspond to those of the modern human anatomy and refers to the substantial internal organs. However, in the physiology and patholoty, the knowledge of TCM differs greatly from that of western medicine, which has been learnt a lot from the above.
        第八部分: 脏腑器官的相互关系
        Part Eight: The Relationship Between The Zang-And Fu-Organs
        While the relationship among the zang-fu organs is quite a complicated matter--so much so that (so such an extent that )it deserves to be devoped a lot of pages, yet, thanks to TCM's concise and brilliant summarization, it may just as well be briefed in a broad outline. In TCM, the zang organs pertain to yin and are thought of as interior, while the fu-organs to yang and, naturally enough, as exterior. The interior-exterior relationship between them is formed by the connections of their meridians. This relationship as well as their physiological cooperation and pathological interaction can be clearly seen in the interrelations between the heart and the small intestine, the lung and the large intestine,the spleen and the stomach, the liver and the gallbladder and the kidney and the urinary bladder.
        The heart and the small intestine are connected by the heart meridian and the small intestine meridian to form an exterior-interior relationship. Thus making the two pathologically related to each other. The excessive heart-fire tends to go into the small intestine resulitng in oliguria, burning pains during urination,etc. Conversely, the excessive heat in the small intestine may go upward along the meridian to the heart and cause internal hyperactivity of heart-fire. Leading to dysphoria, crimson tongue, oral ulceration and so on.
        The lung and the large intestine form an exterior-interior relationship by mutual connections of their meridians. The dispersing and deseending functions of the lung help the large intestine to perform its transporting task. When the lung functions normally, the large intestine does well. Conversely when the descending function of the lung qi do not work well, it will affect the functionof the large intestine in transportation, causing difficult bowel movements. On the other hand, loose stools and the stoppage of fu-qi may affect the descent of lung-qi, giving rise to asthmatic cough and chest distress.
        Both the stomach and the spleen lie in the middle energizerand are connected by their meridians to form an exterior-interior relationship. The stomach governs the reception, while the spleen governs the transportation and transformation. The relationship between the two is that "the spleen conveys the booy fluid for the stomach". If pathogenic damp attacks the spleen, it will injure the transporting and transforming functions of the spleen and affect the reception and the descending action of the stomach, resulting in poor appetite, vomiting, nausea and gastric distention. So the spleen and the stomach share out the work and cooperate with each other to jointly accomplish the task of the digestion, absorption and distribution of food. On the contrary, intemperance of food intake (improper diet)and dyspeptic retention of the stomach will bring about both the dysfunction of the stomach in descent but that of the spleen's transportation and transformation, causing such symptoms as abdominal distention, diarrhea.
        The gallbladder is attached to the liver, and they are connected by their meridians to form an exterior-interior relationship. Bile derives from surplus qi of the liver. It is stored and excreted by the gallbladder located under the liver. Only when the liver performs its function successfully can bile be secreted, stored and excreted normally. On the other hand, when bile is excreted properly, the liver can give full play to its function in regulating the normal flow of qi. Conversely, when bile fails to be excreted normally, the liver function will be affected, too. Therefore, the liver and gallbladder are closely related physiologically and pathologically. The diseases of liver often involve the gallbladder and the contrary is also true. Therefore, the liver and gallbladder cannot be completely separated physiologically and pathologically. For example, excessive fire of both the liver and the gallbladder may present such symptoms as qi-stagnation and heat-dampness.
        The kidney and urinary bladder, like the other zang-fu organs, form an exterior-interior relationship through their meridians. The kidneys control opening and closing, while the urinarybladder governs storing and excreting urine. Both are related to water metablism. Whether the function of the urinary bladder is normal or not depends on the sufficiency or deficiency of kidney-qi. When kidney-qi is sufficient and its astringency is right, the urinary bladder will open and close regularly, thus maintaining normal water metabolism. In case kidney-qi is deficient, there will be the disturbance of its qi transformation and astrictive action, causing the irregular opening and closing of the urinary bladder, manifested as dysuria, incontinence of urine, enuresis and frequency of micturition.
        So far the text has just briefly discussed the relationship between the five zang-and the six fu-organs. To have a thorough understanding of their interrelations and the zang-fu theory, it is also important to know the relationship between the five zang-organs and that between the six fu-organs as well, which, as space is limited, have to be reluctantly parted with here.
        In short, although the zang-and fu-organs have different physiological functions, there is a close relationship between them in maintaining the normal functions of the body, and it is the meridian-collateral system that makes them internally-externally interconnected. Without the interconnecting pathways of the meridians and collaterals, each of the zang-fu organs would become an isolated and static organ and unable to perform its functional activities. A case in point to show the relationship is what is said in Basic Questions . "The zang-organs are all connected with the meridians to perform the circulation of qi and blood."
        Part Nine:The Root Of Life-Qi
        In TCM books, qi is always mentioned in the same breath with blood and body fluid, for they are all the fundamental substances constituting the human body and maintaining its life activities. However, among them qi is particularly important for the human body. That is why TCM often explains the life activities of the human body in the viewpoint of qi. For this reason, ZhangJingyue said: "Man's life relies entirely upon this qi." Classic onMedical Problems states:"qi is ihe root of the human body; once the root is damaged, the stem and leaves would turn withered". And, also, Basic Questions points out : "One's life is the combination of qi of heaven and earth".
        Qi in the human body is composed of congenital qi and acquired qi. The former is inherited from one's parents before birth,the latter is derived from cereal essence transformed by the spleen and stomach and fresh air inhaled from the natural world by the lung. Therefore, qi is a combination of three kinds of factors. It is easy to see that the source or production of qi is related to innate endowment, acquired nutrition and environmental conditions, and the actions of the kidney, spleen, stomach, lung as well.
        Congenital qi and acquired qi complement each other. Congenital qi is the material foundation for the production of acquired qi, and acquired qi continuously supplements congenital qi with nourishments. Both of them are, therefore, described as an interdependent relation-congenital qi promoting acquired qi,which, in turn, nourishing congenital qi. There are all kinds of qi and, their functions are too intricate to be expounded in a few words .To provide a precise exposition, let's discuss them under six heads.
        1 . Promoting Action of Qi 1.气的推动功能
        Qi, as a sort of refined substance full of vigour, plays a promoting and activating role in the growth and development of the human body, the physiological activities of the zang-fu organs and meridians, the production and circulation of blood, as well as the production, distribution and excretion of body fluid. If the above functions are weakened due to qi-deficiency, the following pathologic changes will occur: tardy growth and development of the human body, hypofunction of the zang-fu organs and meridians, stagnation of blood, fluid retention, etc.
        2. Warming Action of Qi 2.气的温煦功能
        Whether man's body temperature is normal or not depends on the warming action of qi. Classic on Medical Problerns says:" Qi is responsible for warming." Only through the warming action of qi can all zang-fu organs,meridiarns and other structures perform their normal functional activities, and can such liquid substances as blood and body fluid circulate normally. As the saying goes: " Blood flows in warmth, while it coagulates in cold."For example, the insufficiency of yang-qi may impair the warming action of qi, causing an aversion to cold, cold limbs. Lowered body temperature and so on. Conversely, qi excess may result in the failure of qi to disperse heat, marked by preference for cold, fever, etc. Basic Questions states, "Qi excess preduces heat, while qi deficiency produces cold."
        3. Defending Action of Qi 3.气的防御功能
        Qi has defending function to defend the body surface against the exogenous pathogens and to combat with the invaded exogenous pathogens to drive them out of the body. The book Basic Questions, therefore, states:" When vital qi exists in the body, the exogenous pathogens can not attack the body." And " If the pathogens invade and occupy the body, qi-deficiency is bound to ensue." Thereby leading to illness.
        4. Controlling Action of Qi 4.气的固摄功能
        Qi also has controlling action, by which is meant the ability to control the liquid substances and fix the internal organs in the body. This is shown in the following aspects:
        (1) Keeping the blood flowing within the vessels to prevent it from extravasating without reason.
        (2) Controlling and regulating the secretion and excretion of sweat, urine, sperm, saliva, gastrointestinal juices, etc , to maintain a relative balance of water metabolism.
        (3) Firming the internal organs in their normal positions without prolapse.
        If this action is impaired, hemorrhage, premature ejaculation, spontaneous sweating, urinary incontinence, and spermatorrhea will occur. If this action fails to work normally,such prolapses as gastroptosis, nephroptosis, hysteroptosis will be brought about.
        The promoting and controlling actions of qi are the two aspects of mutual opposition and mutual complement. Provided these two actions work harmoniously, blood circulation and water metabolism can be normally carried on.
        5 . Action of Qi Transformation 5.气的气化功能
        Qi transformation may be defined as various kinds of changes brought about by the movement of qi. Concretely speaking, it refers to the respective metabolism of essence, qi, blood and body fluid and their reciprocal transformation. For instance, food is transformed into qi, blood and body fluid; body fluid are converted into sweat and urine by metabolizing, and the residues of food,after digestion and absorption, are turned into feces to be discharged from the body. All these processes are all the specific manifeatations of the action of qi transformation. If qi transformation is out of order, it will affect the digestion, absorpiion of food, the metabolism and transformation of essence, blood and body fluid, the excretion of sweat, urine and feces and so on .To put it briefly, qi transformation is actually the process in which the substances in the body are metabolized and intertransformed. Although the above five actions of qi differ from one another, they are indispensable to maintaining human life. Their harmonious cooperation and mutual support ensure that the physiological activities are completed smoothly.
        The Movement of Qi is known as "qi ji", qi activity. Qi in the human body travels throughout the body and reach all the zang-fu organs and meridians to promote and activate the physiological activities of the human body.
        Qi has four basic forms: ascending, descending, exiting and entering. These four forms are the basis of human's life activities.Once these movements stop, it means that the life activities ceaseand death ensues.
        The ascending, descending, exiting and entering of qi are mainly embodied in the physiological activities of the zang-fu organs, meridians and other processes of metabolism. For example,the lung governs respiration, exhaling pertains to exiting, inhaling to entering; and dispersing pertains to ascending, lowering to descending. The spleen sends the clear upward and the stomach passes the turbid downward. So all kinds of physiological activities in the human body, essentially, are reflected in the four movements of qi.
        According to the sources, functions and distributions, qi is divided into four types: primordial ( yuan qi), genuine qi (zhenqi) , pectoral qi (zong qi) , nutritive qi( ying qi) and defensive qi(wei ai) .
        l . Primordial qi, also known as genuine qi (zhen qi) is the most important of the four kinds of qi. It is the primary motive force of life activities. Primordial qi derives from the congenital essence stored in the kidney, and depends on the acquired essence regenerated by the spleen and stomach. The book Miraculous Pivot makes it clear by saying, "Genuine qi (Zhen qi) is inherited from heaven ( the parents) and combined with cereal essence to replenish the body." 1.元气,也叫做真气是四种气中最重要的一种。它是人体活动的原动力。元气源于先天之精,储藏于肾中,依赖脾胃化生的后天之精滋养。《灵枢》中明确说:“真气者,所受于天,与谷气并而充身者也.。”
        2. Pectoral qi is formed from a combination of the fresh air inhaled by the lung and the cereal essence conveyed by the spleen and stornach. Pectoral qi performs two main functions. One is traveling through the respiratory tract to prormote respiration and the sufficiency or insufficiency of pectoral qi influences the conditions the voice. speech or breath and so on. The other is running through the heart-meridians to promote the circulation of qi and blood. The vicissitude of Pectoral qi is related to the flow of qi and blood, the body temperature and the activities of the trunk and limbs, the visual and aural perceptibility, as well as the strength and rhythm of the heart beat. 2.宗气由肺吸入的清气和脾胃化生的谷气混合而成。宗气主要执行两种功能。一种是走息道以行呼吸,宗气的充足与否会影响到声音、言语和呼吸的状态。另一种是贯心脉以行气血,宗气的充足与否与气血的运行、体温、四肢活动、视觉、听觉能力以及心脏搏动的力量和节律有关。
        3.Nutritive qi is the qi that circulates together with blood in the vessels. Nutritive qi originates from the pure part of cereal essence transformed by the spleen and stomach and bears responsibility for the blood production and the nutrition of the whole body. Nutritive qi is considered as yin, so it is also called nutritive yin ( ying-yin) . 3.营气是与血共同运行脉中的气。营气源于脾胃运化的水谷精微的纯净部分,并承担着血液的产生和濡养全身的职责。营气属于阴,所以也称作营阴。
        4 . Defensive qi, like nutritive qi, comes from cereal essence,but, unlike nutritive qi, it runs outside the blood vessels. Defensive qi has the following functions: protecting the body surface against exogenous pathogens, controlling the opening and closing of the pores, adjusting the excretion of sweat, warming and nourishing the zang-fu organs. muscles and the skin with hairs, etc.,maintaining a relatively constant body temperature. It is given the name "defensive qi" precisely because of its antiexogenouspathogenic action. Defensive qi belongs to yang, so it has another name defensive yang ( wei-yang) ," which presents a strinking contrast with ying-yin as mentioned above. 4.卫气,如营气一般,来自水谷精微,但是却行于脉外,这与营气不同。卫气有以下功能:保护体表免受外邪侵犯,司毛孔的开合,调节汗液排泄,温养脏腑组织、肌肤毛发等和维持体温的恒定。“卫气”这一名字正是因为它有抗御外邪的功能。卫气属阳,所以别名叫“卫阳”,这正好与以上提及的营阴形成鲜明的对比。
        The Types Of Qi And Their Movements
        气的分型与运动 Types of Qi Movement
        Yuan Qi(Primordial Qi) starting from between the two kidneys, passing through tri-energizer and circulating through the while body, inward to zang- and fu-organs and outward to the muscles and skin. 元气始于两肾之间,行于三焦,周行全身,内至脏腑,外达肌肤。
        Zong Qi(Pectoral Qi) stored in the chest and poured into the meridians of the heart and the lung. 宗气藏于胸中,注于心肺两经。
        Ying Qi(Nutritive Qi) originating from tri-energizer, entering the meridians by way of the lung, and circulating all over the body. 营气源于三焦,由肺入脉,周行全身。
        Wei Qi(Defensive Qi circulating outside but leaning against the meridians, vaporized to the diaphragm and scattered in the chest, travelling between the skin and flesh. 卫气行于脉外,上行至膈,散于胸中,周行肌表。
        Special phrases 特殊短语
        As the saying goes, As=in the way that,as the story goes/runs 或云;相传
        as the matter stands 照目前情形
        as the case may be 依照情况
        as things are 照此情况
        as things run 照通常顺序、情形、性质等
        Part Ten:Blood And Body Fluid-The Material Basis Of Life Activities
        Blood, circulating in the vessels, is a red liquid substance rich in nutrients. It is one of the indispensable substances that constitute the human body and maintain its life activities. Blood originates from cereal essence transformed by the spleen and stomach, and has the functions of nourishing and moistening the whole body.
        Nutritive qi and body fluid are thought of as the material basis of blood formation. As both of them derive from cereal essence, the quality of the food intake and the conditions of the spleen and the stomach are bound to have a direct bearing on blood formation. Either a long-term malnutrition or a lasting hypofunction of the spleen and stomach may cause insufficient blood formation, resulting in blood deficiency. That's why TCM states" Reinforcing the spleen and the stomach enables blood to develop spontaneously."
        Normal blood circulation comes of the joint action of the heart, the lung, the spleen and the liver. The heart-qi is the fundamental motive power to propel blood circulation. The lung is in charge of qi of the whole body and, therefore, has an important bearing on the formation of zong qi. When zong qi gets in the heart meridian, it may promote the movement of qi and blood. The spleen may keep blood flowing within the vessels and prevent it from extravasating. And the liver, besides its function of storing blood, adjusts the volume of blood flow and maintain the normal flow of qi and blood. In case any one of the above organs fails to work properly, abnormal blood circulation is certain to occur. The heart-qi deficiency, for instance, may lead to heart-blood stagnation. The spleen-qi deficiency fails to control blood, leading to bleeding, etc. The disturbance of qi flow of the liver and blood circulation may bring about such pathological changes as blood stasis or swelling, abnormal menstruation, dysmenorrhea or amenorrhea in women.
        Blood circulates within the vessels, by which it is carried to the zang-fu organs internally and to the skin, muscles, tendons and bones externally. It circulates ceaselessly Like a ring without end to nourish and moisten all the organs and tissues. In this, normal physiological activities are maintained. Basic Questions says:"The liver with blood is able to ensure normal vision. the feet with blood are able to walk. the palms with blood are able to grip things, the fingers with blood are able to grasp". "When discussing the relationship between blood and the tendons, the bones and the joints, Miraculous Pivot points out:"When blood is normal, the tendons and the bones are strong and the joints are nimble." Thus, it can be seen that the sensation the the movement of the body never for a moment deviate from the nutrients provided by blood.
        Blood is also the material basis of mental activities. Sound mental activity results from normal circulation and a sufficient supply of blood. So any blood trouble, whatever the causes maybe, will bring about symptoms of mental activities varying in degrees. Basic Questions advises people: " Qi and blood are the foundation for human mental activities and have to be nursed with caution." And Miraculous Pivot informs us, " Harmonious blood vessels ensure a vigorous spirit." These famous remarks show the close relationship between blood and mental activities. Deficiency of blood, therefore, will cause mental disorder. For example, heart-blood or liver-blood deficiency will lead to such symptoms as palpitation, insomnia and dreaminess.
        Body fluid is called jinye in TCM, including all kinds of fluids in the organs and tissues and their secretions, such as gastricjuice, intestinal juice, nasal discharge, tears, sweat, urine and so on. Just like qi and blood, body fluid is also one of the essential substances constituting the human body and maintaining its life
        jin and ye are always mentioned in the same breath because of the fact that, for one thing, both of them derive from food and water transported and transformed by the spleen and stomach. and for another, they can transform into each other. But they are actually different in thickness, property, function and distribution. By and large, jin is the fluid which is clear and thin and flows easily. It is distributed in the skin, muscles and orifices, furthermore, it permeates the blood vessels to keep them moistened. Ye, on the contrary, is thick fluid with flowing less easily. It is distributed in the joints, brain, marrow and internal organs to nourish them. Jin and ye may transform into each other. These two fluids are hard to be separated completely and, for this reason, they are jointly referred to as "jinye" (body fluid) . In case of the impairment of jin or exhaustion of ye, the two must be identified in TDS.
        The formation, distribution and excretion of body fluid are the complex physiological process in which they are accomplished by the joint action of many organs. As is pointed out in Basic Questions : "After food and drink enter the stomach, they are digested and transformed into food essence and then, transmitted upward to the spleen, which disperses the essence upward to the lung and the lung regulates water pathways downward to the urinary bladder. And by doing so body fluid is finally disseminated to all parts of the body along all the meridians and collaterals. " This description suggests that, 1) body fluid is formed from food and water by digestion and absorption of the stomach, separating the clarity from the turbidity of the small intestine and tramformation of the spleen; 2) the distribution and excretion of body fluid are accomplished by the joint action of many zang-fu organ, such as the transforming function of the spleen, the dispersing and descending function of the lung, the steaming and ascending function of the kidney; and 3) body fluid takes triple energizer as its passageway for distribution and excretion.
        Body fluid bears two physiological functions: moistening and nourishing:body fluid distributed to the body surface moistens and nourishes the muscles and skin with hairs; body fluid permeated through the body orifices moistens and protects the eyes, nose,mouth and other openings; body fluid infiltrated into the blood vessels nourishes and smooths them and is also the basic component of blood; body fluid poured into the internal organs nourishes and moistens them, and body fluid in the bone nourishes and moistens the bone marrow, spinal cord and brain marrow.
        Part Eleven:QI, BLOOD AND BODY FLUID OF MUTUAL CAUSALITY 第十一部分:气、血、津液的相互关系
        Despite their differences in nature, form and function, qi, blood and body fluid have something in common with each other. They are the basic materials that constitute the human body and maintain life activities; they all derive from cereal essence; they, physiologically, depend on each other for existence and restrain and utilize each other; they, pathologically, act upon each other and have causality between them.
        Qi and blood are closely related. Qi is the "commander" of blood, and blood is the "mother" of qi. As the commander of blood, for one thing, qi is the motive power for blood formation, or rather, it produces blood. Blood is formed from mutritive qi and body fluid, both of which come from food and water. All these cannot be separated from the functions of qi. Blood circulation depends on the propelling function of heart-qi. For another, qi controls blood and keep it flowiing in the blood vessels without extravasation. This function of qi is performed by spleen-qi. When qi is deficient, it fails to control blood, thus leading to hemorrhage. Blood is referred to as the mother of qi because, on the one hand, blood is a carrier of qi; and on the other, blood provides adequate nutrients for qi. Therefore, it is impossible for qi to exist without its"mother", blood.
        The relationship between qi and body fluid is rather similar to that between qi and blood. This is shown in the following four aspects. First, qi produces body fluid. The formation, distribution and excretion of body fluid depend upon all the movements of qi and its warming, promoting and controlling functions. The existence of qi in the body not only depends upon blood, but on body fluid which is formed from food essence by the functions of the stomach and spleen. So, whether body fluid is adequate or inadequate depends upon the conditions of spleen-qi and stomach-qi. Second, qi promotes the transportation of body fluid. The movements of qi are the motivity for the transportation, and distribution of body fluid, and the excretion of sweat and urine. Therefore, In case of deficiency of qi or dysfunction of qi, disturbance of body fluid in transportation, distribution and excretion will occur. Thereby leading to the stagnation of body fluid. Third, qi controls body fluid. Qi may control the excretion of body fluid and maintain the balance of the metabolism of body fluid, In case qi fails to control the excretion of body fluid some of body fluid will run off. Fourth, body fluid is a carrier of qi.(Qi resides in body fluid, Body fluid serves as a carrier of qi) That is, body fluid carries qi. Qi cannot exist without body fluid. This is the reason why the loss of body fluid often damages qi. If qi fails to attach to body fluid, qi-deficiency and even qi prostration will ensue. So the medical book Prescriptions of the Golden Cabinet says:"No one has perfect qi after hidrosis, vomiting etc." Examples in point are:hidrosis, polyuria, enormous vomiting and diarrhea cause great loss of body fluid, which, in turn, gives rise to qi colapse.
        Blood and body fluid are liquids and, what's more, they both perform the nourishing and moistening functions. Body fluid will become and important component of blood when infiltrating into the blood vessels. As blood and body fluid originate from the essence of food and water, they are known as "body fluid and blood are derived from a common source." Recurrent or severe bleeding may do damage to body fluid, resulting in thirst, scanty urine and dry skin. And severe consumption or loss of body fluid will affect the source of blood, leading to the exhaustion of both blood and body fluid. For this reason, it is not advisable to use diaphoretics for haemorrhagic patients, and the methods of breaking blood or pricking blood should be avoided in treating patients with the inadequate of body fluid and hidrosis. Miraculous Pivot states:" The patients lost bolld should avoid perspiring; while the patients lost perspiration should avoid Losing blood." And "the first contraindication refers to emaciated patients; the second to patients lost blood; the third to patients after severe perspirationl;the fourth to patients after severe diarrheal and the fifth to patients of postpartum hemorrhage. Purgation is contraindicated in all these cases."
        To sum up, the close and complicated relationships between the three are often shown in physiology and pathology, and are of great importance in TDS.
        Part Twelve: Meridians And Collaterals-The Pathways To Link The Whole Body
        The meridian-collateral theory is concerned with the physiological functions and the pathological changes of the meridian-collateral system, and their relationships with zang-fu organs. It is an important component of the theoretical system of TCM. And it is considered as a theoretical basis of all clinical subjects of TCM, especially that of acupuncture, moxibustion, tuina and qigong. Besides, it guides the clinical practice of other branches of TCM.
        The meridians and collaterals are pathways along which qi and blood circulate through the whole body. The meridians are the major trunks of the meridian-collateral system and run longitudinally within the body, while the collaterals are the branches of the meridians and are reticularly distributed over the whole body. Hence, the meridians and collaterals, connecting the zang-fu organs with extremities, the upper with the lower and the internal with ihe external portions of the body, make all the body's organs and tissues an organic whole.
        The Composition of the Meridian-Collateral System 经络系统的组成
        The meridian-collateral system consists of meridians and collaterals as well as their subsidiary parts. This system, internally, links the zang-fu organs and, externally, joins the tendons, museles and skin.
        The meridians are classified into three categories: the regular meridians and the extra meridians and the divergent meridians. There are twelve regular meridians, namely the three yin meridians as well as the three yang meridians of the hands and feet. They are known collectively as "the twelve regular meridians", which are the main passages for qi and blood circulation and start and terminate at given seats, run along fixed routes and meet indefinite orders. They are directly connected with the relevant zang-fu organs. The eight extra meridians are composed of Du,Ren, Chong, Dai, Yinqiao, Yangqiao, Yinwei and Yangwei meridians. They are interlated with the twelve regular meridians and perform the functions of dominating, connecting and adjusting the twelve regular meridians. And they are not directly related to the internal organs in addition, the twelve divergent meridians are the extensions of the twelve meridians. They originate from the limbs, run deeper into the zang-fu organs and emerge from the shallow neck.
        Their action is to enhance the Links between every pair of meridians exteriorly-interiorly related in the twelve meridians and complement the organs and bodily areas to which the regular meridians can not get.
        经可以分为三类:正经、奇经和经别。有十二正经即手足三阴三阳经。它们被总称为“十二正经”,是气血循行的主要通道,有固定的起止点,按照一定的路径循行并按一定顺序交接。它们与相对应的脏腑直接相连。奇经八脉由督、任、冲、带、阴蹻、阳蹻、阴维和阳维脉组成 。它们与十二正经相互联系,并行使控制、联系和调节十二正经的功能。另外,它们不与脏腑直接相关。十二经别是十二正经的延续。它们起于四肢,深入脏腑,浅出于项部。它们的作用是加强十二正经表里两经的联系,并补充十二正经所不能到达的脏腑和身体区域。
        The collaterals are the branches of the meridians. They are divided into three groups: the divergent collaterals, superficial collaterals and tertiary collaterals. The divergent collaterals are the larger and main collaterals. The divergent collaterals originate from the twelve meridians as well as Du and Ren meridians respectively. Together with a large splenic collateral, they are altogether "fifteen divergent collaterals". Their chief task is to strengthen the links between every pair of meridians exteriorly-interiorly related on the body surface. The superficial collaterals are ones that run through the surface layer of the human body, and often emerge on the surface. And the tertiary collaterals refer to the smallest and the thinnest ones of the whole body.
        In addition, there are the subsidiary parts of the meridian system, including the twelve skin zones and twelve musculature zones. Therefore, they are the parts that connect the twelve meridians with the superficial portions and the muscular portions of the body respectively. Considering the important place of the twelve meridians and the eight extra meridians in the meridian-collateral system. we are going to take them as the main subject for discussion.
        Tab. 2 The Nomenclature and Classification of the Twelve Meridians 表2.十二正经的命名和归类
        Tab.2 shows that every meridian consists of three parts. 表2说明了每条经都由三部分组成。
        1 ) Hand or foot: (1)手或足
        The meridians starting or terminating at the hand are named "Hand", while those starting or terminating at the foot are named "Foot". So the twelve meridians are divided into four groups: three yin meridians of hand, three yang meridians of hand, three yin meridians of foot, and three yang-meridians of foot. Each of the meridian is named according to the medial or the lateral aspect of hand or foot, the names to which zang and fu pertain, and the nature of yin or yang.
        2 ) Yin or yang:
        The meridians going in the medial aspect of the limbs are named "yin", whereas those in the lateral aspects are named "yang". The medial aspect of the limbs is subdivided into the anterior border, midline and the posterior border. And the yin meridians running through these parts are named Taiyin,Jueyin and Shaoyin respectively. The lateral surface of the limbs is also subdivided into the anterior border, the midline and the posterior border. And yang meridians are termed "Yangming","Shaoyang", and "Taiyang".
        3) Zang or fu: (3)脏或腑
        The nomenclature of zang or fu is determined in the light of the nature to which zang or fu pertains. For example, the meridian pertaining to the kidney is named the kidney meridian, and the rest may be deduced by analogy.
        To sum up, it is quite evident that there is no name that does not involve hand or foot, yin or yang, zang-organ or fu-organ in the twelve meridian.(To Be Continued)
        Part Thirteen:Meridians And Collaterals-The Pathways To Link The Whole Body (2)
        Courses, Connections, Distributions, Exterior-lnterior Relations and Flowing Order of the Twelve Meridians
        1. The Coursing and Connecting Law of the Twelve Meridians 1.十二正经的起源和交接规律
        The coursing and connecting law of the twelve meridians is: the three yin meridians of the hand travel from the chest to the end of the fingers where they connect with the three yang meridians of the hand; the three yang meridians of the hand go up from the end of the fingers to the head on which they connect with the three yang meridians of the foot; the three yang meridians of the foot descend from the head to the the end of toes where they join the three yin meridians of the foot; the three yin meridians of the foot ascend from the toes to the abdomen and chest in which they meet the three yin meridians of the hand. Thus, the twelve meridians are connected with each other, forming a circle like pathway along which yin and yang smoothly circulate without terminus. See the following diagram.
        Fig. 5 Flowing direction and Connecting Law of the Twelve Meridians 表5.十二正经循行方向及交接规律
        It is clearly seen from fig. 5 that the three yang meridians of the hand terminate at the head from which the three yang meridians of the foot start. The three yang meridians of the hand and the foot meet at the head So, TCM says:"The head is the junction of all yang meridians"
        2. Distributions and Exterior-Interior Relations of the Twelve Regular Meridians1) Distributions 2.十二正经的分布和表里关系
        The twelve meridians are distributed symmetrically on the left and right sides of the body and run along their fixed courses. Distribution in the limbs: The medial aspect of the limbs attributes to yin, the lateral to yang. Each limb is distributed by Taiyin and Yangming meridians are on the anterior border, Shaoyin and Taiyang meridians are on the posterior border, and Jueyin and Shaoyang meridians are on the midline.
        Distribution on the head and face: Yangming meridians run through the face and forehead, Taiyang meridians run through the cheek, vertex and occiput of the head and Shaoyang meridians run through both sides of the head.
        Distribution in the body trunk: The three yang meridians of hand run through the scapular part. Among the three yang meridians of foot, Yangming meridians run in the front of the trunk (thoracico-abdominal aspect), Taiyang meridians along the back (the dorsal aspect) , and Shaoyang meridians along the sides. All the three yin meridians of the hand come out of the axillae without exception, all the three yin meridians of foot run along the ventral aspect. The meridians running through the ventral aspect from the medial to the lateral are, in turn, termed Foot-Shaoyin, Foot-yangming, Foot-Taiyin and Foot-Jueyin(note: as regards the medial sides of the two lower limbs, at 8cun (24cm) above the medial malleoli, Jueyin is located in theanterior, Taiyin in the middle and Shaoyin in the posterior part.)
        The Exterion-Interior Relations between the Twelve Meridians 十二正经的表里关系
        The twelve regular meridians, connected with each other by the divergent meridians and divergent collaterals, form six pairs of exterior-interior relationships. Their exterior-interior relationships are as follows: the Large Intestine Meridian of Hand-yangming and the Lung Meridian of Hand-Taiyin; the Tri-energizer Meridian of Hand-Shaoyang and the Pericardium Meridian of Hand-Jueyin; the Small intestine Meridian of Hand-Taiyang and the Heart Meridian of Hand-Shaoyin; the Stomach Meridian of Foot-yangming and the spleen Meridian of Foot-Taiyin; the Gallbladder Meridian of foot-Shaoyang and the Liver Meridian of Foot-Jueyin; and the Urinary Bladder Meridian of Foot-Taiyang and the Kidney meridian of Foot-Shaoyin. The Taiyang meridianand Shaoyin meridian of foot are exteriorly-interiorly related, and so are the Shaoyang meridian and the Jueyin meridian of foot,and the Yangming meridian and Taiyin meridian of foot. These are called the"yin and yang of foot"; while the Taiyang meridian and the Shaoyin meridian of hand are exteriorly-interiorly related, and so are the Shaoyang and the Jueyin meridians, and the Yangming and the Taiyin meridians of hand. These are called the"yin and yang of hand".
        The exterior-interior relationship of the twelve meridians not only strengthen the connection between each specific pair of meridians with exterion-interior relationship, but also promote each pair of zang-fu with the exterior-interior relationship to coordinate each other physiologically and influence each other pathologically. In treatment, acupoints of the two meridians with the exterior-interior relationship may be alternatively used.
        3) The Flowing Order of the Twelve Meridians十二正经的走行规律
        The circulation of qi and blood inside the Twelve meridians is like the circular movement endlessly. Their circulation starts from the lung meridian of Hand-Taiyin, runs to the liver meridian.
        Etiology is defined as various kinds of factors that cause diseases. As TCM sees it, etiology mainly includs the six exogenous pathogens, pestilence,(epidemic pathogenc factors ) the seven emotions, emotional frustration, improper diet, overwork, maladjustment between work and rest, traumatic injuries, insect or animal bites, phlegm retention, blood stasis, etc. Zhang ZhongJing of the Eastern Han Dynasty pointed out: "Despite numerous diseases, they would not exceed three categories". Up to the Song Dynasty, Chen Wuze put forward the theory of the three categories of etiologic factors i. e., exogenous pathogenic factors, endogenouspathogenic factors and non-endo-exogenous pathogenic factors. To be more specific, six pathogenic factors invading the body from the outside pertain to exogenous pathogenic factors; the seven emotions directly involving the internal organs are attributed to endogenous pathogenic factors; other pathogenic factors, such as improper diet, overwork, traumatic injury, insect and animal bites, etc. , are said to be non-endo-exogenous pathogenic factors. "The theory of the three categories of etiologic factors" caused strong repercussions in later ages and promoted the research into the etiology.
        In discerning etiology, besides having a sound knowledge of the objective conditions that possibly lead to illness, TCM centers attention on the clinical manifestations of diseases, and inquires into the etiology through analyzing the symptoms and signs so that a basis for treatment and medications may be is provided. This method is called "seeking cause of disease through differentiation of syndromes."The six exogenous factors are a general term for wind, cold, summer-heat, damp, dryness and fire. Under normal conditions, they are six climatic factors. TCM calls them the "six qi." They are not harmful to human beings but rather are the essential conditions of the growth of all living things in nature. Thus, the six qi will not cause diseases normally. However, when the six qi become too excessive or deficient, or when the body's resistance is too weak to adapt itself to the abnormal changes, the six qi will be changed into the pathogenic factors to attack the human body and cause diseases. They, as such, are known as "six exogenous pathogens" (liu yin). Of the six exogenous pathogens the five result from the dysfunction of the zang-fu organs rather than the exogernous factors invading the body from the outside though they also have the symptoms similar to wind, cold, dampness, dryness and fire.(Of...是介词短语提前。前置同倒装等一样,是强化信息的重要手段之一。有如:a. Of the two the latter is far better than the former. b. Of the 100 cases treated with this therapy, 60 are male and 40 female. ) In order to distinguish them from the six exogenous pathogens, they are termed the "five endogenous pathogens", i.e., the endogenous wind,endogenous cold, endogenous dampness, endogenous dryness and endogenous fire.
        The pathogenic features of the six exogenous pathogens are as follows. 六淫的病理特征如下:
        (l) The six exogenous pathogens have close relationships with the seasonal changes and living environment. For example, diseases caused by wind-pathogen mostly occur in spring; summer-heat diseascs usually appear in summer; damp diseases often happen in later summer, dry diseases arise most often in autumn and cold diseases are often seen in winter. And the people who live in damp circumstances are susceptible to damp diseases, while the people living under a high temperature are liable to contract fire or dryness diseases. (1)六淫与季节变化和生活环境有密切关系。例如,风邪致病多在春季;暑邪致病通常在夏季;暑邪致病通常发生在夏至后;燥邪致病多在秋季;寒邪致病见于冬季。生活在潮湿环境的人易感受湿邪,而生活在高温环境下的人则易感染火邪或燥邪。
        (2) The six exogenous pathogens may singly invade the body by a single pathogen and simultaneously and invade the body by more than two pathogen. For example, common cold results frequently from pathogenic wind and cold; diarrhea is caused by pathogenic dampnese and heat; bi-syndrome (arthralgia) is causcd by pathogenic wind, cold and dampness and so on. (2)六淫可以单独侵犯人体也可两种以上同时侵犯人体。例如,普通感冒通常由风寒之邪所致;泻泄由湿热之邪所致;风寒湿夹杂而致痹症等。
        (3) They may be transformed into each other. Examples are: pathogenic cold in the body may be transformed into heat and prolonged summer-heat dampness may bring about dryness and fire to impair yin. (3)六淫之间可以互相转化。例如,体内寒邪可化热,暑湿可以化火化燥伤阴。
        (4) The last featurc of the six exogenous pathogens is that they invade the human body via the body surface or from the mouth and nose or through both concurrently. This is known as"affection resulting from six exogenous pathogens." (4)六淫的最后一个特点是它们可以由体表或口鼻或同时侵犯人体。这就是“外感六淫”。
        The seven emotions refer to the human mental activities. In TCM, they are classified into seven classes: joy, anger, melancholy, anxiety, grief, fear and terror.They are the different responses to the environmental stimuli in the human body in general circumstances, they belong to the normal physiological activities and will not cause diseases. When sudden, strong,long or protracted (prolonged)emotional stimuli go beyond the body's adaptability and endurance, the emotional stimuli will become pathogenic factors, which cause dysfunction of qi, blood and the zang-fu organs and imbalance of yin and yang, hence leading to diseases. This is known as "internal injury caused by the seven".
        The seven emotions are different from the six exogenous pathogens in causing diseases. The six exogenous pathogens, as mentioned ahove, usually invade the body through the skin, mouth and nose, and it is mostly exterior syndromes at the early stage of the onset. The seven emotions, however, directly affect the corresponding zang-fu organs to bring on diseases because a certain zang-fu organ is closely related to a certain emotional activity. (不定式短语 to bring on ... 在句中作结果状语。又如:a. Arthur returned home to be struck by another blow. b. What have I done to deserve so much? c. He made a long speech only to show his ignorance of the subject. )So TCM says, "Anger impairs the liver; excessive joy impairs the heart; grief or melancholy impairs the lung, anxiety impairs tbe spleen, and fright or fear impairs the kidney", The abnormal emotions mainly influence qi activity of the internal organs, so as to cause the dysfunction in ascending and descending of qi. Concretely speaking, "Anger causes the qi (to the liver)to ascend: joy makes the qi (of the heart) sluggish; sorrow makes the qi (of the lung) consumed; fear induces the qi (ofthe kidney) to dissipate; fright causes the disorder of the qi (of the heart) ; and anxiety brings about the depression of the qi (of the spleen)." As concerns other pathogenic factors such as pestilence, improper diet, maladjustment of work and rest, parasites, surgical trauma, phlegm retention, blood stasis, etc,we have to, though they are of equal importance, give them upon account of limited space.
        Special phrases 特殊短语
        1.Pathogenic factors; pathogens 1.邪气
        2.exogenous pathogenic factors; (exogenous pathogenic) 2.外邪
        3.seasonal pathogenic factors (seasonal pathogens) 3.时邪
        4.pathogenic wind 4.风邪
        5.endogenous wind 5.内风
        6.exogenous wind 6.外风
        7.Wind is the first and foremost factor to cause various diseases 7.风为百病之长
        8.Sudden spasm and rigidity of muscles result from wind. 8.诸暴强直,皆属于风
        9.Vomiting with sour vomitus of spouting diarrhea with tenesmus is caused by wind. 9. 诸病吐酸,暴注下迫,皆属于热。
        10.Abdominal distension is mainly related to heat 10.诸胀腹大,皆属于热
        11.visible phlegm 11.有形之痰
        12.invisible phlegm 12.无形之痰
        13.excess of sexual intercourse 13.房劳过度
        第十五部分:病机 Part Fifteen: PATHOGENESIS
        What is meant by pathogenesis? By pathogenesis is meant the mechanism of the occurrence, development and outcome of diseases. The occurrence, development and outcome of diseases are closely related both to the body's vital qi and to the nature of the pathogenic factors. When the pathogens attack the human body, the body's vital qi is bound to rise against the pathogens, forming the conflict between vital qi and pathogens. Their conflict is bound to destroy the relative balance of yin and yang to cause the dysfunction of the zang-fu organs and meridians, or the disturbance of qi and blood. Thus bringing about a variety of local or general pathological changes. Notwithstanding various diseases and complicated clinical manifestations, their changes of pathogenesis, in general, are inseparable from the excess or deficiency between the vital-qi and the pathogens, the imbalance of yin and yang, or the abnormably of qi and blood and the dysfunction of the zang-fu organs and meridians.
        The conflict between the vital-qi and pathogens is not only related to the occurrence of a disease, but also directly affects its development and final outcome. Meanwhile, it has a direct influence on deficient or excessive changes of the syndromes in a certain sense, the processes of many diseases are seen as those of the changes of excess and deficiency in the contest between the vital-qi and pathogens. Therefore, vicissitudes of vital qi and pathogens are considered to be one of the pathogenesises.
        Basic Questions says "the exuberance of pathogens results in excess syndrome, while the depletion of essence-qi may bring on deficiency syndrome." Excess refers to excess of pathogens, or a pathogenic reaction with excessive pathogens as the principal aspect of the contradiction.
        That is to say, the pathogens are excessive, the vital qi is also strong. Clinically, a sort of pathological reactions of excess ensue with the fierce and obvious struggle between vital qi and pathogens, which is known as excess syndrome. It is mostly found in the early or middle stage of diseases caused either by the six exogenous pathogens or by the phlegm retention, undigested food, blood stasis, etc. , characterized by high fever, mania, high voice and coarse breathing, abdominal pain with tenderness, obstructive urination and defecation, and full and forceful pulse.
        By deficiency syndrome is meant a syndrome caused by inadequate of vital qi, or a pathological reaction with the deficiency of vital qi as the dominant factor of the contradiction. That is, the vital qi become too deficient to resist pathogens because of the dysfunctions of qi, blood, body fluid, zang-fu organ and meridians. Consequently, the conflict of vital qi and pathogens may not produce intense pathological reaction and a series of insufficient manifestations arise, so called deficiency syndrome. This types of syndrome is mostly seen in patients with weak constitutions or in the later stage of a disease and in different kinds of chronic cases, marked by lassitude, pallid complexion, palpitation, short breath, spontaneous perspiration, night sweat feverish sensation in the chest, palms and soles or aversion to cold, cold extremities, feeble pulse, etc.
        The rise and fall of vital qi and pathogens can bring about mixed syndromes of excess and deficiency in protracted and complicated diseases. Such syndromes have mainly two kinds of pathological changes: deficiency syndromes mixed with excess ones and excess syndromes mixed with deficiency ones. However, under some particular circumstances, there will be two types of pathological changes: true excess syndrom with pseudo-deficiency symptoms and true deficiency with pseudo-excess symptoms. The former is said to be "symptoms of pseudo-excess in extreme deficiency", while the latter is said to be "symptoms of pseudo-deficiency in extreme excess". From the above, to identify a deficiency or excess syndrome of pathogenesis we must see through the appearance to get at the essence and
        so only can we not be misted by false phenomena and accurately grasp the changes of excess or deficiency syndrome .
        In the course of a disease, the conflict between vital qi and pathogens not only gives rise to their deficiency or excess, but also causes the outcome of a disease. When vital qi prevails over pathogens, the disease tends to improvement or even complete recovery. Otherwise, when pathogens prevail over vital qi, the disease tends to deterioration or even life comes to end.
        In the course of occurrence, development and final outcome of a disease, disharmony of yin and yang will occur under the action of pathogens, resulting in such pathological manifestations as relative excess or deficiency of either yin or yang, mutual impairment, repellence and depletion of yin and yang.
        The Disturbance of qi and blood refers to a morbid state caused by deficiency and dysfunction of qi and blood, and the breakdown of their interdependent relationship. Qi and blood in the body are the material basis for the physiological activities of the zang-fu and meridians. Therefore, their disturbance will inevitably affect the body's function to cause diseases. Basic Questions states: "The disharmony between qi and blood will result in various diseases". However, qi and blood are the products of the functions of the zang-fu organs. Pathological changes of the zang-fu organs may not only lead to qi-blood disturbance, but also affect qi and blood of the whole body. Thus, the pathogenesis of qi-blood disturbance, like that of the rise and decline of vital qi and pathogens and the imbalance of yin and yang, is not only the root cause of pathological changes of the zang-fu organs and meridians, but also the basis for the analysis and research of the pathogenesis of various diseases.
        The failure of qi activity refers to such pathological changes as qi stagnation, adverse flow of qi, qi sinking, qi blockage and qi exhaustion due to disturbance in its ascending, descending, exiting and entering. Ascending, descending, exiting and entering are the basic form of qi movement, on which functional activities of the zang-fu organs and meridians as well as the relation ships between the zang-fu organs and meridians, qi and blood, and yin and yang depend to maintain their relative balance. Fort his reason, the disorder of qi activity may bring about various morbid conditions involving the zang-fu organs, qi and blood, yin and yang, exterior and interior, four limbs and nine orifices.
        The disorder of blood includes deficient blood production, blood deficiency caused by massive hemorrhage, over consumption of blood caused by prolonged illness, or dysfunction of blood nourishment; it also includes the accelerated blood circulation caused by blood heat and blood stasis caused by sluggish blood circulation.
        The metabolism of body fluid is essentially the processes of continuous production, distribution and excretion of body fluid. The disturbance of the metabolism means the disturbance of distribution and the imbalance between production and excretion, thus causing deficiency production of body fluid to form fluid retention in the body, So, normal metabolism of body fluid is the basic condition maintaining normal distribution, production and excretion. Normal production, distribution and excretion of body fluid are inseparable from ascending, descending, exiting and entering movement of qi and its transforming function. And also. they cannot be separated from the functions of the lung, spleen, liver, kidney and the triple energizer.
        The five endogenous pathogens refer to the pathological changes caused by the dysfunction of qi, blood, body fluid and the zang-fu organs, namely endogenous wind, endogenous cold, endogenous dryness , endogenous fire and endogenous dampness. They are not pathogenic factors; they are five comprehensive changes of pathogenesis.
        Special phrases 特殊短语
        1.The disharmony of qi and blood may cause various diseases. 1.气血不和,百病乃变化而生
        2.Heat-transformation, fire-transformation, wind-transformation, dryness-transformation, dampness-transformation 2.化热、化火、化风、化燥、化湿
        3.Insufficiency of vital qi is the intrinsic factor of the occurrence of disease. 3.正气不足是发病的内在根据
        4.Pathogenic factors are the predominant factor of disease. 4.邪气是疾病发生的重要条件
        Part Sixteen: The Four Diagnostic Methods-The Methods To Observe And Diagnose Diseases
        The four diagnostic methods, namelv inspection, auscultation and olfaction, inquiry, and pulse-taking and palpation, refer to the four basic procedures used in diagnosing a disease, They are the presuppositions of correct differentiation and effective treatment in TCM.
        When a disease occurs, there must be its abnormal outward manifestations from which the pathological changes may be inferred, as is stated in Danxi's Experience on Medicine ( DanxiXin Fa) , "To want knowing the internal conditions of the body, the external manifestations of the body should be observed ; to diagnose the external parts of the body may also know the internal conditions. That is because the internal conditions of the body are always reflected on the exterior of the body".The four diagnostic methods examine and learn about the pathological conditions from different angle and aspect and find out the etiology and pathogenesis, thereby providing the basis for TDS. The four methods are related to and supplement one another. They cannot be separated from one another, each having its specific function that cannot be substituted for the others. In clinical practice, only when the four techniques are organically combined can a disease be understood all-sidedly. Thus, a correct diagnosis can be made.
        1. Inspection 1.望
        Inspection is the first diagnostic procedure by which the physician may observe the patient's vitality, complexion, physical build, head, neck, five sense organs, skin, tongue, external genitalia and anus on purpose so as to understand the condition of a disease. TCM holds that the human body is an organic whole. The exterior of the body is closely related to the internal organs. Take observation the vitality and complexion for examples, the vitality refers to the general external manifestations of life activity of the human body, including spirit, consciousness and thinking. And it is the outward sign of the conditions of qi and blood, yin and yang, or the zang-fu organs. The vitality is manifested in manifold aspects, such as eyesight, complexion, facial expressions, physical build, behavior and so on, among which the expression of the eyes is the most important. This is because "all the vital essence from the five zang and six fu organs converges into the eyes." From the observation of vitality the physician may infer the abundance or inadequacy of the vital essence, analyze mildness or the severeness of the disease and predict the prognosis of disease. It is quite evident that the observation of vitality is of an important significance in diagnosing a disease. The manifestations of vitality are as follows; being of vitality, pseudo-vitality, and loss of vitality.
        The observation of complexion is a diagnostic method for inspecting the colour and lustre of the face. TCM divides the facial colours into blue, yellow, red, pale and black, also known as the "five colours", whose changes may indicates the nature and the location of a disease. Generally speaking, red complexion indicates heat syndromes; white complexion indicates cold and deficiency syndrome; yellow complexion deficiency and dampness syndromes; blue complexion suggests pain and cold syndrome,blood stasis and convulsion; and black complexion hints deficiency of the kidney, blood stasis and fluid retention. Inspection also includes observation of the physical build. By the observation of sturdiness, weakness, obesity or emaciation as well as the posture of the movement and stillness, different kinds of diseases may he found out. And, in particular, the observation of the tongue is a unique procedure in TCM diagnosis. It is used to observe the changes of the tongue proper and the tongue coating so as to determine the abundance or decline of vital qi, tell the location of a disease, distinguish the nature of pathogenic factors and infer the degree of seriousness of a disease.
        2. Auscultation and Olfaction 2.闻
        Another diagnostic method is auscultation and olfaction. Auscultation means listening to the patient's voice, speaking, respiration, coughing and moaning. By auscultation, the doctor can not only learn about the changes of the phonatory organ, but also infer the pathological changes of the internal organs. While olfaction means smelling the patient's odor of the secretion and excretion. By and large, stench odor usually indicates heat syndromes of excess; stinking(烂醉) odor suggests cold syndromes of deficiency; and foul and sour odor implies retention of food.
        3. Inquiry 3.问
        This is a diagnostic method in which the patient or his companion are inquired to collect the information concerning a disease. The content of inquiry includes the chief complaints, present case history past history, life history, family history, as well as age, sex, native place, occupation, address and so forth inquiry, though covering a wide range of topics, should be conducted step by step in a planned way, with questions focused on the chief complaint and the history of present disease. Therefore, when asking a patient. the physician should focus his attention on the chief complaint to understand both the main reasons for the disease and clearest, the most suffered symptoms of the patient. Besides, the physician should understand the occurrence, progress, diagnosis and treatment of a disease through asking. Here is an outline of inquiring about the present illness:
        A. Asking about Chills and Fever A.问寒热
        (a) . aversion to cold and heat
        It means that the patient feels cold with a high temperature.
        (b) . Alternate spell of chills and fever (b)寒热交替
        They are the manifestations of half exterior and half interior seen in shaoyang disease or malaria.
        (c). Chills without fever (c)寒战无热
        It implies that the patient only has an aversion to cold but no heat sensation or fever, which is a sign of the deficiency and cold syndrome.
        (d) Fever without chills (d)发热无战
        This suggests that the patient with fever has a aversion to heat but not to cold, which pertains to interior heat syndrome.
        B. Asking about Perspiration
        This is a procedure for the physician to differentiate the conditions of interior and exterior, heat and cold, deficiency and excess of a disease. Asking about perspiration includes the presence of sweating, the location of sweating, the time of sweating and the amount of sweating.
        C. Asking about Diet and Appetite
        Asking diet and appetite may know the conditions of the spleen and stomach. It includes: thirst and drinking appetite and amount of food taste.
        D. Asking about Defecation and Urination D.问二便
        This is also a procedure in which the physician may learn whether the digestion and absorption as well as fluid metabolism are normal or not, and also learn about frequency, time, amount, quality, color, odor of defecation and urination and accompanied syndromes.
        E. Questioning about Pain E.问痛
        (a) Asking about nature of the pain helps tell the cause and pathogenesis; (a)问疼痛的性质可以帮助了解病因和病机
        (b) Asking about locality of the pain helps understand pathological changes of internal organs and meridians; (b)问疼痛的部位可以帮助了解脏腑经络的病理改变。
        F. Questioning ahout Sleep F.问睡眠
        It refers to inquiring about insomnia, dreaminess and lethargy to know excess and deficiency of yin and yang.
        Besides, chest and abdomen, ears and eyes, women's diseases, pediatric diseases may be asked.
        4. Pulse-taking and Palpation
        It is the fourth diagnostic methnd, including pulse-taking and, on the other, palpation of different parts of the body. The former is a diagnostic procedure by which the physician may feel the patient's radial arteries with the finger-tips to judge pulse condition, thus learning and inferring the condition of illness. The latter is also a procedure by which the physician may touch, feel, push and press certain parts of the body to detect local abnormal changes, thereby determining the location and nature of the disease.
        The location for feeling the pulse at present time is the patient's "cunkou", also named "qikou", or "maikou". Cunkou refers to obvious pulsative place of the radial artery on both sides of the wrist, and is divided into three regions: cun, guan and chi (inch, bar and cubit), which, on the left hand, reflect respectively the conditions of the heart, liver and kidney and, on the right hand, the conditions of the lung, the spleen, the stomach and the kidney. TCM holds that each of the six regions for pulse-feeling corresponds to one of the internal organs and reveals the pathologic changes of the relevant organ. For this reason, cunkou pulse-taking is commonly accepted by practitioners through the ages and still used today. The pulse is differentiated in terms of depth (superficial or deep), speed ( rapid or slow), strength (forceful or weak), shape ( thick or thready, soft or hard) and rhythm. Different pulse condition indicate different syndromes. For example, superficial pulse (fu mai), which is easily felt with gentle touch, indicates exterior syndromes and is present at the early stage of exogenous diseases; while deep pulse( chen mai), which is felt only by heavy pressure, indicates interior syndromes, and so on.
        Palpation may be conducted in three procedures: touching, stroking and pressing. Touching is used to feel a certain part of the body, like the forehead or limbs with the fingers of palms, thereby detecting the body temperature, dampness or dryness; stroking refers to examining the patient's some parts of the body with the hands, e.g., a swelling, to learn the shape, size and sensation of the swelling; pressing means pushing and pressing over some parts of the body with the hands, e. g. , the chest or abdomen, to make sure if they are tenderness, or have any cakings when pressed.
        Inspection, auscultation and olfaction, inquiry and pulse-taking and palpation are the four diagnostic methods to understand the pathological conditions. They can not be separated, but are related to and complement one another. In clinical practice only by combining the four can a comprehensive and systematic understanding of the condition of a disease be gained, thereby, making a correct diagnosis.
        Part Seventeen: Differentiatlon Of Syndromes——The Precondition For Treatment
        Differentiation of syndromes (bian zheng) in TCM is a method to analyse and recognize the syndrome of disease. In otherwords, it is also a process in which the location, nature, occurrence and development of a disease as well as the condition of vital qi and pathogenic factors are identified according to the clinical data obtained from the four diagnostic methods. From the above it becomes obvious that differentiation of syndromes is the premise and foundation of treatment. Correct differentiation and appropriate treatment are the prerequisite for achieving the hoped-for results. There are a number of methods to differentiate syndromes in TCM, such as differentiation of syndromes according to the eight principles; differentiation of syndromes according to the theory of qi, blood and body fluid; differentiation of syndromes according to tbe zang-fu theory; differentiation of syndromes according to the theory of six meridians; differentiation of syndromes according to the theory of wei, qi, ying and xue, and differentiation of syndromes according to the theory of triple energizer. Each method, while having its own features and laying stress They should be applied flexibly and accurately so as to understand a disease comprehensively, thereby providing the basis for treatment.
        The eight principal syndromes, also known as "eight principles" (ba gang), refer to yin, yang, exterior, interior, cold, heat, deficiency and excess. The differentiation of syndromes according to the eight principles is the general guideline of TDS and important components of TCM diagnostics. Complicated as the clinical manifestations of diseases may be, they are classified under the eight principles. For example, the classification of syndromes-yin or yang; the location of disease-exterior or interior; the nature of disease-cold or heat; and the preponderance or discomfiture of vital qi and pathogens-deficiency of vital qi or excess of pathogen. Differentiation of syndromes according to the eight principles generalizes the intricate and volatile syndromes into four pairs: exterior and interior, cold and heat, deficiency and excess, and yin and yang. Therefore, in the diagnostic process, the eight principles can play a role in bring out the essentials.
        Although this differentiating method classifies various syndromes into eight categories, they are interrelated and inseparable from each other. For instance, the exterior syndrome and interior syndrome are related to the cold, heat, deficiency and excess syndromes; the cold syndrome and heat syndrome are related to the exterior, interior deficiency and excess syndromes; the deficiency syndrome and excess syndrome are related to cold, heat, exterior and interior syndromes. These pathologic changes do not occur singly, the exterior and interior, cold and heat, deficiency and excess syndromes are usually found simultaneously. For instance, the disease with both the exterior and interior syndromes; the deficiency syndrome mingling with excess syndromes; intertwinement of the cold and heat syndromes. Under certain conditions these syndromes are often transformed into one another. For example, the exogenous pathogens may invade the interior and vice versa the cold syndrome may be transformed into heat syndrome and vice versa; the deficiency syndrome may be transformed into the excess syndrome and vice versa. With the progress of disease, some false appearances contrary to its nature may appear. e. g. ,cold syndrome with pseudo-heat symptoms and vice versa, deficiency syndrome with pseudo-excess symptoms and vice versa. Thus, when applying differentiation of syndrome according to the eight principles, physicians are required not only to have a masterly command of the characteristics of each syndrome, but also to pay attention to their coexisting, interlacing, transforming, and true or false conditions, so and so only can the disease be understood in an all-round way. Thereby, providing reliable basis for treatment.
        Yin and yang are a pair of principles used to summarize the other three pairs of principles and are also the key principles in the eight principles. So the other three pairs of principles are classified under either yin or yang. Exterior, heat and excess syndromes are classified into the category of yang, while interior, cold and deficiency syndromes fall into the category of yin. Yin syndrome is characterized by deficiency of yang-qi and excess of yin in the body. Yang syndrome in characterized by the hyperactivity of yang-qi and hyperfunctions of the zang fu-organs, resulting from excess of yang-heat in the body. Yin and yang are also used to explain the pathological changes of the zang-fu organ, eg. yin depletion, yang depletion, yin deficiency and yang deficiency, etc.
        Differentiation of syndromes according to the theory of qi, blood and body fluid is a differentiating method to analyse and identify the pathological changes of qi, blood and body fluid according to the theory of qi, blood and body fluid. Qi, blood, and body fluid, are the material basis for the functional activities of the zang-fu organs, their formation and circulation depend upon the normal functions of the zang fu organs. Therefore the pathological changes of qi, blood and body fluid may bring about the dysfunction of the zang-fu organs, and the dysfunction of the zang-fu organs will be bound to cause the pathological changes of qi, blood and body fluid. Hence, both of them should closely coordinate and complement each other. Qi has many syndromes, which are usually classified into four classes: qi deficiency, qi sinking, qi stagnation and reversed flow of qi. As concerns blood syndromes, TCM tends to group them under four heads: blood deficiency, blood stasis, heat in blood and cold in blood. " Physiologically, they complement each other and, pathologically, affect each other. Thereby, forming differentiation of syndromes of the same disease of qi and blood. Clinically, there is qi stagnation and blood stasis, qi deficiency and blood loss, deficiency of both qi and blood, qi deficiency and blood stasis, and qi prostration resulting from hemorrhage. Syndromes of body fluid may be classified into two categories: insufficiency of body fluid and water retention. Insufficiency of body fluid may cause the clinical manifestations: dryness of the mouth and throat, dry lips and tongue, subsidence of eyes, dry skin, scanty urine, constipation, a red tongue with scanty saliva and thready, rapid pulse. Whereas, retention of water may form such pathological substances as water, dampness and phlegm retention. Usually seen in edema, tympanites and phlegm-retention.
        Differentiation of syndromes according to the theory of wei (defensive), qi (vital-qi), ying (nutrient) and xue (blood) is a differentiating method applied to
        analysing and differentiating exogenous febrile diseases. It was developed and created by YeTianshi in the Qing Dynasty. It supplements the differentiation of syndromes by the theory of the six meridians and enriches the differentiation of syndromes and treatment for exogenous febrile diseases in TCM. This theory is the basis used to classify syndromes, to identify transformation and determine treatment. The theory of wei, qi, ying and xue is of great practical value because, for one thing, it generalizes the pathological changes of febrile dis-eases as the four kinds of syndromes: weifen, qifen, yingfen and xuefen, for another, it represents the four different stages: superficial or deep and mild or serious in the development of exogenous febrile diseases. It is also believed as a law of the development and changes of exogenous febrile diseases. Diseases of the wei and qi stages are mild and superficial, whereas those of the ying and xue stages are deep and serious.
        Differentiation of syndromes according to the zang-fu theories a differential method by which symptoms and signs are analysed to clarity the cause, the location and nature of disease as well as the conditions between vital qi and pathogens in light of the theories viscera figure (manifestation) , yin yang and five elements. It is the basis of various hinds of differentiation of syndromes and the basic diagnostic method of all clinical branches of TCM, and an important component part of all differential system in TCM. Differentiation of syndromes according to the theory of the zang-fu organs includes differentiating syndromes of zang-organs diseases, fu-organ diseases and complicated diseases of both zang-organs with fu-organs.
        Differentiation of syndromes acording to the theory of six meridians is a method of differentiating exogenous diseases in TCM. It was put forward in Treatise on Febrile Diseases by Zhang Zhonjing-a distinguished physician in the Eastern Han Dynasty. In Light of the yin-yang theory, the syndromes of the six meridians may be divided into three yang syndromes-taiyang, yangming and shaoyang and three yin syndromes-taiyin, shaoyin and Jueyin. Thereby providing a basis for differential diagnosis and treatment. Six meridians syndromes are the reflections of pathological changes in the zang-fu organs and meridians, among which three yang syndromes take the pathological changes of the six fu organs as their basis, while three yin syndromes take the pathological changes of the five zang organs as the their basis.
        Besides differentiating syndrome in light of the theory of triple energizer is one of methods of differential diagnosis for febrile diseases, put forward by Wu Jutong, a distinguished physician of the Qing Dynasty. Wu Shi takes triple energizer as the guiding principle of differentiation of syndromes of seasonal febrile disease in conjunction with differentiation of syndromes according to the theory of wei, qi, ying and xue, to emphasizes the pathological changes of the zang-fu organs related to triple energizer during the course of seasonal febrile diseases,the characteristics of syndromes and the law of transmission and transformation. Seasonal febrile disease is a general term for all acute febrile diseases resulting from various warm-heat pathogens in the four seasons. Differentiation of syndromes by the theory of triple energizer is also the premise and foundation of treatment.
        As a whole, conditions of differentiating syndromes are complex, what has been discussed in this unit is only those common, typical differentiating syndromes, they should be applied flexibly so as to decide the therapeutic principle on the basis of correct differentiating syndromes.
        Part Eighteen:Principles Of Prevention And Treatment
        Prevention and treatment of disease are two principles that must be followed in TCM work. Both of them are important components of the theoretical system of TCM.
        I. Prevention I.预防
        By prevention is meant taking certain measures to avoid the occurrence and progress of diseases. TCM has always attached great importance to prevention. As early as in Huangdi's Classic on Medicine, the preventive thought of "preventive treatment of diseases" was advanced. This theory involves two aspects: preventive treatment before the occurrence of diseases and preventing deterioration after the occurrence of diseases. Basic Questions states:" Wise men always give the preventive treatment before a disease occurs and prevent a disturbance before it starts…. Not taking medicine until a disease comes on or not preventing a disturbance until it starts is no different from not digging a well until one is thirsty or not making weapons until a battle starts. Isn't that be too late?" After liberation, our government put forward "put prevention first". It is one of the four great policies of the medical and health work of China. And it is also a principle of preventing the occurrence and the progression of a disease in TCM.
        1. Preventive Treatment of Disease 1.未病先防
        It refers to taking various measures to prevent diseases from occurring. The occurrence of a disease is related to both pathogenic factors and vital qi. The former is the important condition for the occurrence of a disease, which the deficiency of the latter is the intrinsic factor for the occurrence of a disease. Therefore, preventive treatment of a disease must start with both strengthening the resistance inside the body and preventing pathogens from invading the human body. Basic Questions States:" The body with vital qi is never attacked by pathogenic factors." To prevent the disease from occurring the following preventive measures mucs be taken.
        (1)Streagthening Vital Qi's Capacity to Resist Pathogens (1)扶正御邪
        a. Regulating Mental Activities to Maintain the Health a.调养精神活动以保持健康
        b. Keeping regular hours b.作息规律
        c. Doing regular physical exercises c.适当的体育锻炼
        d. Using drug prophylaxis and providing artificial immunization d.药物预防和提供人工免疫
        (2) Defending the body against pathogens (2)抗御邪气
        a. Keeping away from six exogenous pathogens and pestilence a.远离六淫疫气
        b. Avoiding various infectious diseases and trauma b.避免感染性疾病和外伤
        c. Developing hygienic habits and preventing environmental pollution, as well as water and food contamination c.养成卫生习惯,防止环境污染及水源和食物污染。
        2. Preventing the deterioration of disease
        Though prevention prior to the occurrence of a disease is the best policy, timely diagnosis and effective treatment to control the deterioration of disease is also important. Therefore, once a disease occurs, it should be early treated so as to cure it in its initial stage. Ye Tianshi, a famous practitioner of the Qing Dynasty, advised:" Be sure to treat the parts which the pathogens have not involved yet." This is also an important method of preventing the disease from further deteriorating.
        II. Principles of Treatment II.治疗原则
        To study TCM treatment, attention should be paid to the therapeutic principles which must be followed in the treatment of disease. They are formed under the guidance of holistic concept and TDS, and they have the guiding significance for establishment of the therapeutic principles and prescriptions of a recipe. Therapeutic principles differ from therapeutic methods. The former refer to the general principles for guiding therapeutic methods, while the latter are the concrete methods of treatment under the guide of the therapeutic principles. There are different kinds of therapeutic principles in TCM. For example, treatment aiming at the primary cause of a disease, strengthening vital qi and eliminating pathogenic factors, readjusting yin and yang, regulating the zangfu's functions, regulating qi-blood and treatment in accordance with the three factors( Climate, locality and individual).
        1. Treatment Aiming at the Root Cause of a Disease
        By treatment aiming at the root cause of a disease is meant treating a disease on the basis of its root cause. It is not until the fundamental cause of a disease is found out that it is possible to get to the essence of the problem and to make a proper treatment. Basic Questions points out, " In treating search for the its root cause of a disease of a disease in treatment. " When treatment aiming at the root cause of a disease is used clinically, routine treatment or contrary treatment and treating the primary (ben) and or treating the secondary (biao ) must be dealt with correctly.
        Routine treatment includes the following methods: treating cold syndrome with hot natured drug, treating heat syndrome with cold natured drug, treating deficiency syndrome by replenishment, treating excess syndrome by purgation, etc.
        Contrary treatment has the following methods: treating pseudo-heat syndrome with hot-natured drugs, treating pseudo-cold syndrome with cold-natured drugs, treating obstruction-syndrome with tonification and treating diarrhea with purgation.
        Treatment of the primary and the secondary includes the following methods: treating the secondary for emergency, treating the primary for chronic cases and treating both the primary and the secondary aspects.
        2. Strengthening Vital Qi and Eliminating Pathogens. 2.扶正驱邪
        Strengthening vital qi is to increase body resistance. Since victory or failure in the struggle between vital qi and pathogens determines the aggravation or alleviation of a disease, one of the important principles in clinical treatment is to change the relative strength of vital qi and pathogens. In so doing, the disease will take a turn for the better.
        Eliminating pathogens means getting rid of pathogenic factors to facilitate and recover the strength of vial qi. Therefore, eliminating pathogens, like strengthening vital qi, is also one of the important principles clinically.
        They have the following methods: driving out pathogens first and then strengthening vital qi, strengthening vital qi first and then eliminating pathogens and strengthening vital qi and eliminating pathogens simultaneously.
        Strengthening vital qi and eliminating pathogens supplement each other: the former helps the elimination of pathogenic factors and the latter helps strengthening vital qi. So, clinically, they should be applied in the light of the variations of the cases.
        3. Readjusting Yin and Yang. 3.调理阴阳
        The imbalance of yin and yang is the basic pathogenesis of many a disease, therefore, regulating relative excess or insufficiency of yin and yang, remedying defects to rectify abuses and restoring relative balance of yin and yang are one of the basic principles in clinical treatment. To restore their balance yin and yang are usually regulated by means of removing the relative excess or invigorating the relative deficiency. Since Yin and Yang are the changes may be summarized as the imbalance of yin and yang.
        Besides, regulating zang-fu's functions and qi-blood relationship are also two important therapeutic principles. Space lacks for a detailed description of it.
        4. Treatment in Accordance with Three Factors (climate, locality and individual). 4.三因制宜(因时,因地,因人)
        This is the therapeutic principle that TCM adopts in treating diseases. The occurrence, development and changes of a disease are involved by various factors, including the climate, geographical environment, the patient's constitution, sex and age etc. Therefore, when treating a disease, the doctor must take the three conditions into account, and make a concrete analysis of concrete conditions and deal with them in different ways, thereby working out an appropriate therapeutic method.
        Beside the above contents, we want to talk about therapeutic methods of TCM. Traditional methods fall into eight categories. 除此之外,我们还想谈谈中医的治疗方法。传统的方法可以归为八种。
        a. Diaphoresis a.汗法
        One of the eight therapeutic methods, which is expelling superficial pathogens by opening the pores of the skin, and regulating the function f ying and wei. It possesses the actions of antipyretics, promoting eruption, reducing edema and rheumatism, etc.
        b. Emesis b.吐法
        Emesis is a treatment to use emetics or physical stimulation to induce vomiting for the removal of retained toxic substances in the throat, chest or stomach. But emesis is prohibited for pregnant women and must be applied cautiously to the weak.
        c. Purgation c.泻法
        This is the therapeutic method for eliminating the undigested food, potent excessive heat and fluid by the application of potent or mild purgatives, generally classified into purgation with cold natured drugs, that with warm natured drugs, that with lubricant natured drugs and hydropathic therapy.
        d. Mediation d.和法
        It is a treatment to dispel the pathogenic factors of shaoyang ( half-exterior and half-interior ) and regulate qi and blood of zang-fu organs by the application of drugs with actions of dispersion and regulation, including relieving shaoyang disorder, dispersing stagnated liver-qi, regulating the function of the liver and spleen or of the liver and stomach, etc.
        e. Warming e.温法
        Warming, as the term suggests, is a therapeutic method using drugs of warm and hot nature to treat cold-syndrome, dispelling cold by warming middle energizer expelling and helps recover yang, removes cold by warming and meridians, restoring yang from collapse and regulating the blood vessels, etc.
        f. Heat-Clearing f.清热
        It is an effective method to clear away pathogenic heat and fire with drugs of cold and cool nature, applicable to excess-heat syndromes.
        g. Resolution g.消法
        A therapeutic method for dispelling pathogenic sthenia by removing retained food and masses due to stagnation of qi, blood stasis, phlegm, undigested food, including regulating the flow of qi, promoting blood circulation, removing dampness through diuresis, dispelling phlegm, etc.
        h. Tonification h.补法
        It's a therapeutic method for various kinds of deficiency syndromes due to insufficiency of yin and yang, qi and blood, generally classified into invigorating qi, enriching blood, invigorating yang, nourishing yin.
        In clinical practice, any of the therapeutic methods mentioned above is unlikely to satisfy the treatment of, especially, complicated cases, so, to keep all the aspects in view, two or more are usually employed in coordination.