Essentials of Disease and Therapy

H UANG Di stated, "People and nature are inseparable. In nature the cyclical movement of the heavenly bodies produces atmospheric influences that exert control over the rhythms of the seasons and is responsible for change to the myriad living and nonliving things. These cycles are repeated endlessly with patterns of predictability, and yet simultaneously with a tendency toward chaos. It is this chaos in the macrocosm that upsets the balance of the delicate ecology within people that produces disease."

Huang Di then asked, "Please tell me what are the essentials of disease and therapy."

Qi Bo replied, "The six atmospheric influences of jueyin/wind, shaoyin/heat, taiyin/damp, shaoyang/fire, yangrrung/dryness, and taiyang/ cold that occur in nature form the basis for the birth and death of all things as well as for illnesses in people. Each influence is dominant, or rules normally in a sequential way on a seasonal and yearly rotation. It is within this rotation that chaos may occur, when a guest influence comes to dominate at inappropriate times, that the balanced ecology becomes disturbed. To restore balance within people one may utilize herbal medicine that possess counter properties to the offending pathogenic influence. For instance if shaoyang/fire was the invading influence, use salty, bitter, and cold herbs to cool and clear the fire. This approach of counteracting the pathogen by using herbs with control properties is called zheng zhu, diametric treatment. Sometimes when the cause of a condition is in opposite nature to the manifested signs and symptoms, for instance, taiyang/cold invasion manifesting fevers, the use of herbs with properties that may be alike to the manifestations such as sweet, pungent, and hot would be called for. In this situation, the approach of using like properties to cure a like manifested condition is called fan zhi, homeopathic treatment."

Huang Di asked, "How do the pulses reflect these differing yearly circuits?"

Qi Bo replied, "If one's pulses do not correspond to the prevailing influence, that indicates trouble. The normal pulses should be slightly wiry for jueyin, flooding for shaoyin, sinking for taiyin, large and floating for shaoyang, short and choppy for yangming, and large and long for taiyang. If the influence is present and the pulses are absent, or if the influence has passed but the pulses are still present, or any other variant from the normal are considered pathological."

Huang Di inquired, "Can you please describe the pathology for each organ system and its connection with the atmospheric influences?"

Qi Bo responded, "Symptoms of tremors and shaking of the limbs, dizziness, and vertigo are usually caused by wind and associated with the liver. Many conditions of contraction and spasms are usually due to cold and associated with the kidneys. Symptoms of rapid, labored breathing, chest tightness, and obstruction are caused by dryness and related to the lungs. Symptoms of edema, bloating, and distension are usually caused by dampness and associated with the spleen. Symptoms of disorientation, confusion, convulsions and seizures, pain, and itching are usually due to fire and related to the heart. Symptoms of either obstruction or incontinence of urine and feces and many types of syncope are usually due to disorder of the lower jiao/cavity. Symptoms of nausea, vomit, cough, asthma, and many types of wei/flaccidity conditions are usually due to disorder of the upper and middle jiao. Symptoms of neck and jaw stiffness and spasm and contracture of muscles and tendons are usually due to dampness. Symptoms of lockjaw, mental and emotional disturbance, anxiety, and swelling and inflammation are usually due to fire. Many acute-onset conditions with generalized stiffness are usually caused by wind. Symptoms of abdominal swelling, borborygmus, tympany of the abdominal cavity, vomit of foul matter, and acute dysentery of blood and mucus in the stools are usually due to heat. Symptoms of chills and diarrhea with clear and watery stools are usually caused by cold. When caring for a patient, a physician discovers the cause and understands the pathology, analyzes the zany and fu organ connections, counteracts the pathogens, revives the flow of qi and blood, and finally restores the balance of the human body."

Huang Di asked, "Can you discuss the nature and property of different herbs by their flavors and the composition of an effective formula?"

Qi Bo replied, "Pungent and sweet herbs disperse and fortify. Bland herbs promote diuresis and get rid of dampness. These herbs are considered yang. Sour and bitter herbs induce expelling in either direction. Salty herbs lubricate and dissolve hardening. These herbs are considered yin.

"The composition of a herbal formula is dependent on several criteria. First determine the seriousness of the patient's condition. Second find out the nature of the pathogen or deficiency. Third ascertain the treatment principle. There are three proportionally different formulas. A large formula is used for severe and complex conditions and involves one king herb, three ministerial herbs and nine assistant herbs. A medium formula is used for moderately complex situations and consists of one king herb, three ministerial herbs and five assistant herbs. A small formula is used for relatively mild cases and is made up of one king herb and two ministerial herbs. Treatment principles consist of warming to dispel cold, cooling to clear heat, dispersing to remove congestion, purging to eliminate buildup, catharsis to dispel water, lubricating to moisten dryness, fortifying to strengthen deficiency, decelerating to arrest acute progression, invigorating to accelerate flow, inducing vomiting to expel food or phlegm, calming to tranquilize anxiety, and softening to dissolve mass. Other methods such as bathing with herbs and massage can be used as adjunctive therapies.

Yellow Emperor's Classic, chap74