Traditional Chinese Medicine · Treatment Principles
Treatment Principles are the fundamental rules that must be followed when treating diseases.
Establishing Treatment Principles:
The premise and foundation for establishing treatment principles is the differentiation of syndromes (bianzheng). During the process of differentiation, the analysis of data obtained from the “Four Examinations” (four diagnostic methods) is used to explore the causes, locations, nature of the disease, and the dynamics of the struggle between pathogenic factors and the body’s righteous qi, thereby establishing the basic principles that guide the treatment of diseases.
Treatment Principles include:
Early treatment to prevent changes, seeking the root of the disease, supporting the right qi and expelling pathogenic factors, adjusting yin and yang, regulating qi and blood, treating the organs, and adapting to the three causes.
Application of Treatment Principles:
The application of treatment principles should reflect a combination of principles and flexibility. For relatively simple syndromes, a single treatment principle may be used, while for complex syndromes, it is often necessary to combine two or more treatment principles. As diseases progress through different stages, the nature of the disease changes, and different treatment principles should be adopted accordingly.
Understanding the significance of treatment principles:
They are the basic rules that must be followed in all clinical specialties and have important guiding significance for legislation, prescriptions, and medication.
Treatment Principles and Treatment Methods:
Treatment methods are specific therapeutic approaches formulated under the guidance of certain treatment principles, targeting diseases and syndromes. They are highly specific and operable, being more concrete and flexible. For example, the treatment of the same disease may vary (different treatments for the same disease) and different diseases may be treated similarly (same treatment for different diseases).
The contents of “seeking the root of the disease and early treatment to prevent changes” have already been included in the previous three issues, so they will not be repeated here, and we will continue from “supporting the right qi and expelling pathogenic factors”.
II. Supporting the Right Qi and Expelling Pathogenic Factors
(1) What is Supporting the Right Qi and Expelling Pathogenic Factors?
1. Supporting the Right Qi:
This means to assist the righteous qi, enhance the body’s constitution, and improve the body’s resistance and recovery ability. It is applicable to various deficiency syndromes, known as “supplementing when deficient”. Methods such as tonifying qi, nourishing blood, enriching yin, warming yang, replenishing essence, and tonifying the organs are all specific therapeutic methods established under the principle of supporting the right qi.
Specific methods of application include not only oral decoctions but also acupuncture, tui na (Chinese therapeutic massage), qigong, dietary therapy, mental regulation, and physical exercise.
2. Expelling Pathogenic Factors:
This means to eliminate pathogenic qi, resolve the invasion and damage of pathogenic factors, and suppress excessive pathological reactions. It is applicable to various excess syndromes, known as “draining when excessive”. Methods such as inducing sweating, vomiting, purging, guiding, resolving phlegm, invigorating blood, dispersing cold, clearing heat, and expelling dampness are all specific therapeutic methods established under the principle of expelling pathogenic factors. The specific methods of application are also diverse.
Supporting the right qi enhances the righteous qi, which helps the body expel pathogenic factors, known as “when the righteous prevails, the pathogenic will naturally depart”; expelling pathogenic factors, while removing pathogenic qi, reduces damage to the righteous qi, known as “when the pathogenic departs, the righteous will be at peace”. The two complement each other.
(Note: The character “祛” (qu) refers to the use of certain methods to drive away or disperse, which is a commonly used term in TCM. It should not be simply replaced by the character “去” (qu), which indicates a physical separation. The removal of disease refers to driving away the symptoms while keeping the body intact.)
(2) Application of Supporting the Right Qi and Expelling Pathogenic Factors
1. Principles of Application:
First, supporting the right qi is used for deficiency syndromes, while expelling pathogenic factors is used for excess syndromes.
Second, when there is a mixture of deficiency and excess syndromes, the order and priority of supporting the right qi and expelling pathogenic factors should be determined based on the main and secondary aspects and urgency of the deficiency and excess.
Third, care should be taken to ensure that supporting the right qi does not leave pathogenic factors behind, and that expelling pathogenic factors does not harm the righteous qi.
(Note: If everyone does not have a deep understanding of the concepts of yin-yang and deficiency-excess, we will supplement this later.)
2. Methods of Application:
The application of the principle of supporting the right qi and expelling pathogenic factors generally includes the following situations.
(1) Separate Application:
Supporting the right qi is suitable for pure deficiency syndromes, true deficiency-excess syndromes, and states of aging. Expelling pathogenic factors is suitable for pure excess syndromes and true false deficiency syndromes. The application of supporting the right qi should clarify which qi, blood, yin, or yang is deficient and in which organ or tissue it is located; it should also grasp the degree of tonification, as deficiency syndromes generally require gentle tonification, with less use of strong tonics to avoid causing harm. The application of expelling pathogenic factors should clarify the nature, strength, and location of the pathogenic factors, and adopt corresponding treatment methods. It should also be noted to stop when the disease is resolved to avoid harming the body with excessive treatment.
(2) Simultaneous Application:
The simultaneous use of supporting the right qi and expelling pathogenic factors, that is, combining tonification and draining, is suitable for syndromes with mixed deficiency and excess. Since there is a distinction between the main and secondary aspects of deficiency and excess, there is also a distinction in priority when using both simultaneously.
① Supporting the right qi with expelling pathogenic factors: supporting the right qi is the main focus, supplemented by expelling pathogenic factors, suitable for syndromes where deficiency is predominant in mixed deficiency and excess. ② Expelling pathogenic factors with supporting the right qi: expelling pathogenic factors is the main focus, supplemented by supporting the right qi, suitable for syndromes where excess is predominant in mixed deficiency and excess.
(3) Sequential Application:
The sequential application of supporting the right qi and expelling pathogenic factors is also applicable to mixed deficiency and excess syndromes. The order of application should be adjusted based on the severity and urgency of deficiency and excess.
① First supporting the right qi and then expelling pathogenic factors: that is, tonifying first and then draining. This is suitable for cases where deficiency is predominant, and the body cannot withstand aggressive treatment. In this case, supporting the right qi first helps the righteous qi, and when the righteous qi can withstand the treatment, then expelling pathogenic factors can be done to avoid the risk of “the thief leaves and the city is empty”.
② First expelling pathogenic factors and then supporting the right qi: that is, draining first and then tonifying. This is suitable for two situations: first, when excess is predominant, and supporting the right qi would actually assist the pathogenic factors; second, when deficiency is not severe, and the pathogenic factors are strong, and the righteous qi can still withstand the treatment. In this case, expelling pathogenic factors first allows for a quick resolution of pathogenic qi, making it easier for the righteous qi to recover, and then tonifying the deficiency to achieve complete recovery.
In summary, the application of supporting the right qi and expelling pathogenic factors should be flexible and adaptable, choosing different methods based on specific situations.
Note:· The above references: Basic Theory of Traditional Chinese Medicine by People’s Health Publishing House and other books.· The intention is to share and learn about TCM thoughts and basic knowledge.· Specific clinical treatment methods should follow the relevant regulations of national health departments.