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TCM Therapy
   Introduction

   Prevention Theory

   Therapeutic Principles
   ICWM
 
Types Of  Cancer
Bladder Cancer
Bone cancer
Breast Cancer
Carcinoid Tumors
Colon Cancer
Esophageal Cancer
Gallbladder Cancer
Gastric Cancer
Hodgkin Lymphoma
Liver Cancer
Lung Cancer
Malignant Mesothelioma
Melanoma
Nasopharyngeal Cancer
Non-hodgkin lymphoma
Osteosarcoma
Ovarian Cancer
Pancreatic Cancer
Prostate Cancer
Rectal Cancer
Renal Cancer
Skin cancer
Testicular Cancer
Thymoma and Thymic Carcinoma
Thyroid Cancer
Uterine Cancer
 
 
 
Introduction: What is TCM?
 
Importance of prevention
 
Energy Stagnation
Organ-Function Disorder
Internal Cold
Emotional Imbalance

Therapeutic Principles

 
1 Concentrating treatment on the root cause
  1.1 Significance
  1.2 Application
2 Strengthening healthy qi and eliminating pathogenic factors
  2.1 Significance
  2.2 Application of strengthening healthy qi and eliminating
pathogenic factors
3 Regulation of yin and yang
  3.1 Reducing excess
  3.2 Supplementing insufficiency
4 Abidance by individuality, locality and seasons
  4.1 Abidance by individuality
  4.2Abidance by locality
  4.3 Abidance by seasonal variation
   

Progression of Cancer

Traditional Chinese medicine (TCM) recognizes four conditions that can lead to cancer:

1. Energy Stagnation

Cancer begins with a condition known as energy stagnation. At this stage, a patient may suffer from vague, intermittent discomforts: headaches, stomachaches, constipation, and menstrual problems like bloating.

Although these symptoms are often shrugged off as just a fact of life, they are actually early warnings of energy imbalances that can lead to serious health problems. Any type of ailment, no matter how minor, is a sign of energy stagnation somewhere in the body.

Conventional medicine does not recognize energy stagnation, and so the condition frequently goes untreated and is allowed to progress. From a TCM perspective, energy stagnation is an early-stage problem and is relatively easy to correct using acupuncture, herbs, exercises like qigong, and even just rest.

2. Organ-Function Disorder

Left untreated, energy stagnation can advance to a condition known as organ-function disorder. Specifically, organ-function disorders of the liver, stomach, and kidney are directly related to cancer. Their symptoms vary widely and can include migraine headaches, acute menstrual cramps, adult acne, and mood swings.

When a patient suffers from an organ-function disorder, her symptoms become harder to ignore. He may sense something is wrong with his body, yet his conventional medical tests show nothing. This can be frustrating, especially for men with severe symptoms, who are often told that the problem is just "in their head."

Because conventional medicine has no method of identifying organ-function disorder, it is rarely treated until it progresses to a physical problem, at which point medical tests do detect the problem.

3. Internal Cold

Internal cold is a common and easily cured condition. However, paired with a liver-, stomach-, or kidney-function disorder, it can lead to cancer.

Symptoms of internal cold include menstrual cramps, having cold hands or feet, and always feeling chilled. There are three ways that internal cold can enter the body:

  • Never fully recovering from the common cold or flu. Conventional medical treatments often suppress symptoms, allowing people to get on with their lives sooner. Unfortunately, it also discourages people from resting as much as they need to for their immune systems to fully expel the sickness from their bodies. This can result in the cold essence of the sickness remaining in the body, causing problems in the future if the immune system becomes weakened again.
  • Exposure to cold. Not dressing adequately in cool or cold weather can also lead to internal cold. The midriff and the back of the knee are two areas particularly vulnerable. Simply wearing enough clothing can prevent this.
  • Eating cold foods and drinking cold beverages. Continually introducing cold into your body through the foods you eat -- for example, by drinking ice water every day -- is a sure way to develop internal cold.

Internal cold can be alleviated by eliminating cold foods from the diet and eating foods that TCM recognizes as having a warm essence, such as ginger, scallions, and fennel.

4. Emotional Imbalance

Many people live with an organ-function disorder and internal cold for years. Once at this stage, an emotional imbalance can trigger the formation of cancer.

The emotional imbalance is often brought on by a traumatic life event, such as a divorce or the death of a loved one. It can also result from chronic, deep-seated emotions that have built up over time. When this happens, the anger, sadness, and stress take a quantum leap and transform into a tumor or cancer.

Although this idea may seem foreign, it does not conflict with the theories of Western science. In contrast to conventional medicine, which focuses exclusively on the physical, traditional Chinese medicine recognizes that energy, such as emotions, can change into matter, such as tumors and cancers. This is not a theoretical construct. The basis of this has been scientifically proven by Western science, and it is the essence of Albert Einstein's famous formula E=mc2. As Einstein explained:

Mass and energy are both but different manifestations of the same thing -- a somewhat unfamiliar conception for the average mind. Furthermore, the equation E=mc2 ... showed that very small amounts of mass may be converted into a very large amount of energy and vice versa. The mass and energy were in fact equivalent.

Almost everyone experiences energy stagnation, organ-function disorder, and internal cold at some point in their lives. It is their ability to deal with their emotions in a healthy way that determines whether these preconditions will lead to a tumor and whether that tumor will become cancerous. The important thing to remember is that no matter how serious the health problem, the body always has the potential to heal itself or at least control the progression of the disease.

 

 

 

Therapeutic Principles

Therapeutic principles are decided according to the concept of holism and treatment based on syndrome differentiation, clinically guiding the composition of prescriptions and the selection of herbs.

Therapeutic principles and therapeutic methods are different. The former guides the latter and the latter specifies the former. Their difference is relative. In fact, some minor therapeutic principles are quite similar to certain major therapeutic methods and vice versa. The so-called ¡°major therapeutic method¡± in clinic can be taken both as a therapeutic method and a therapeutic principle.

1 Concentrating treatment on the root cause

1.1 Significance

¡°Ben¡± (root) and ¡°biao¡± (branch) are two relatively opposite concepts with varied connotations in different cases. In exogenous diseases, the invasion of pathogenic factors is ben and the disorder of visceral qi and blood is biao. In endogenous diseases, the disorder of visceral qi and blood is ben and the clinical manifestations are biao, In terms of etiology and symptoms, the cause of disease is ben and the symptoms are biao. In terms of the sequence of diseases, old disease and primary disease are ben while new disease and secondary disease are biao. In the expression ¡°concentrating treatment on the root cause¡±, ¡°ben¡± emphasizes the cause of disease while ¡°biao¡± refers to the clinical manifestations.

Concentrating treatment on the root cause means to find the root cause of a disease and focus the treatment on it because the root cause is responsible for the emergence of syndrome, For this reason the process of searching root cause is the same as that of syndrome differentiation. That is why treatment based on syndrome differentiation becomes a typical feature of TCM.

For each disease, there are various symptoms, but the root cause is just one. If you find the root cause, you can successfully treat any disease no matter how complicated it is. If you cannot find the root cause of a disease, it is very hard for you achieve successful treatment. Take headache for example. It may be caused by exogenous factors or endogenous factors. Only when the root cause is found can it be successfully treated. Exogenous headache can be treated by external relief therapy with acrid and warm herbs if it is caused by pathogenic wind-cold or by external relief therapy with acrid and cool herbs if it is caused by wind-heat. Endogenous headache may be caused by insufficiency of yin-blood, blockage of vessels, upward disturbance of phlegm-dampness and hyperactivity of liver-yang. So different therapeutic methods have to be used to deal with endogenous headache due to different causes, such as nourishing yin and invigorating blood, activating blood to resolve stasis, drying dampness and resolving phlegm, and soothing the liver and suppressing yang, etc.

1.2 Application

1) Treating biao in emergency

This means to treat the secondary symptoms first and then deal with the root cause in emergency. These symptoms are usually acute and bring on great suffering to the patients, or threaten life or tend to transmit and change. If they are overlooked, the pathological conditions may be aggravated or make it difficult to treat ¡°ben¡±.

Clinically the following symptoms can be regarded as acute symptoms requiring immediate treatment: massive hemorrhage, extremely high temperature, sharp pain, violent vomiting or diarrhea, constipation and anuria, severe abdominal distension and fullness, serious ascites and edema, dyspnea and inhibited respiration, and mania, etc. In any case immediate measures should be taken to deal with these acute symptoms no matter what disease it is.

Treating biao in emergency does not contradict concentrating treatment on the root cause. The former paves the way for the latter. When acute
symptoms are relieved, treatment can be
concentrated on the root cause. In fact
treating biao in emergency is an emergent
treatment. For mild cases, the treatment
should certainly focus on the root cause.

Clinically you may encounter disease
marked by emergency or non-emergency
of both the biao. In any case simple
treatment of the biao or the ben is
ineffective. The right way to deal with this
case is to focus the treatment on both the ben
and the biao. For example, impairment of yin by pathogenic heat and exhaustion of yin-fluid are the ben, while abdominal fullness, hardness and pain as well as retention of dry feces are the biao. This disease is obviously marked by emergency of both the biao and the ben. So the treatment of purgation and nourishing yin has to be resorted to in order to relieve abdominal fullness, hardness and pain, eliminate constipation and restore yin-fluid. If a weak person is attacked by exogenous pathogenic factors, simple treatment of supporting healthy qi to consolidate constitution cannot remove exogenous pathogenic factors, while simple treatment of eliminating pathogenic factors and the biao will further exhaust healthy qi. The right way to deal with this problem is to treat the ben and the biao simultaneously by means of supporting healthy qi and relieving the superficies.

2) Contrary treatment

Contrary treatment is just the opposite of routine treatment. The latter refers to treatment opposite to the nature of disease, suitable for the treatment of a majority of diseases. For example, treating cold syndrome with heat herbs, treating heat syndrome with cold herbs, treating deficiency syndrome with tonic herbs and treating excess syndrome with herbs for eliminating pathogenic factors are all routine therapeutic methods that are opposite to the nature of disease and agree with the principle of concentrating treating on the root cause.

Contrary treatment means treating disease according to its false manifestations. The false manifestations of a disease do not agree with the nature of the disease. Cares should be taken to find the root cause and not be puzzled by the false manifestations. Since contrary treatment just agrees with the false manifestations, it is in fact opposite to the nature of the disease. In this sense contrary treatment is also a kind of routine treatment.

Routine treatment is an inhibiting therapy while contrary treatment is an inducing therapy. For example, emetic therapy, instead of the therapy for stopping vomiting, is used to treat nausea and vomiting caused by retention of phlegm in the upper energizer; purgation, instead of the therapy for stopping diarrhea, is used to treat diarrhea due to accumulation of dampness in the lower energizer. Contrary treatment also can be used to treat disease at the initial stage with predominant pathogenic factors which cannot be treated by inhibiting therapy.

The following are some of the commonly used contrary therapeutic methods.

i) Treating false heat syndrome with hot-natured herbs: That means to use hot-natured herbs to treat disease with false hest symptoms. This therapy can be used to treat syndrome of real cold and false heat due to exuberant internal cold that drives yang outward. Take the case of extreme deficiency of kidney-yang and exuberance of internal cold for example. It is marked by cold feet and hands on the one hand, and no aversion to cold and reddish complexion on the other. These manifestations actually indicate predominance of cold drives yang floating outside. Since the root cause is internal exuberance of yin-cold, warm herbs should be used to treat real cold. When the real cold is eliminated, false heat disappears naturally.

ii) Treating false cold syndrome with cold-natured herbs: That means to treat disease with false cold symptoms with cold-natured herbs. This therapy can be used to treat syndrome of real heat and false cold due to exuberance of internal heat that drives yin outside. Take syncope in febrile disease for example. Though there are symptoms of high fever, dysphoria, thirst and preference for clod water, but the four limbs are cold and the pulse is deep. It is a syndrome caused by deep latent heat that prevents yang from extending to the external. Since exuberance of internal heat is the root cause, cold herbs must be used to treat real heat. When the real heat is eliminated, false cold disappears naturally.

iii) Treating blockage with tonic herbs: This therapy can be used to treat syndrome of real deficiency and false excess due to hypofunction of the viscera caused by decline of qi and blood. Take abdominal distension in patients with spleen deficiency, constipation in old people due to deficiency of qi and blood and amenorrhea due to exhaustion of blood for example. These syndromes are all marked by real deficiency and false excess and cannot be treated by purgation. Instead, nourishing therapy should be used to promote the flow of qi and blood, invigorate the functions of the viscera and dredge the meridians and collaterals.

iv) Treating outthrust with dredging therapy: This therapy can be used to treat outthrust syndrome due to internal accumulation of pathogenic factors. For example, sweating due to attack of pathogenic wind, diarrhea due to food retention, sudden uterine bleeding due to blood stasis and urgent and frequent urination are all outthrust syndromes of excess in nature. However, they cannot be simply treated by astringing therapy otherwise pathogenic factors will be retained inside. The right way to deal with them is to induce the pathogenic factors to leave the body with dredging therapy.

 

2 Strengthening healthy qi and eliminating pathogenic factors

The duration of a disease is a process of struggle between healthy qi and pathogenic factors, the result of which decides the development of the disease. If healthy qi succeeds, the disease gets improved and gradually heals; if pathogenic factors succeed, the disease becomes worsened or leads to death. In order to enable the disease to develop along a favourable route, it is necessary to support healthy qi and eliminate pathogenic factors. So supporting healthy qi and eliminating pathogenic factors is an important therapeutic principle in clinic treatment.

2.1 Significance

1) Strengthening healthy qi

Strengthening healthy qi usually refers to ¡°nourishing therapy¡± which includes various methods, such as herbs, acupuncture and moxibustion, tuina therapy, diet regulation and exercise, etc. Nourishing therapy is usually used to treat deficiency syndromes such as qi deficiency, blood deficiency, yin deficiency, body fluid deficiency and kidney-essence deficiency. That is why it is said in TCM that ¡°deficiency syndrome should be treated by nourishing therapy¡±. Nourishing therapy can be further divided into different therapeutic methods to deal with different pathogenic factors, such as qi-nourishing therapy, blood-nourishing therapy, yin-nourishing therapy, yang-warming therapy, fluid-generating therapy and essence-enriching therapy, etc. By means of strengthening healthy qi, deficiency can be improved, body resistance can be reinforced and pathogenic factors can be eliminated. In fact the purpose of strengthening healthy qi is to eliminate pathogenic factors. However, excess syndrome with predominance of pathogenic factors cannot be treated by nourishing therapy because nourishing therapy may retain pathogenic factors in the body.

2) Eliminating pathogenic factors

Eliminating pathogenic factors refers to ¡°purgation therapy¡± (also known as ¡°attack therapy¡±) with herbs or acupuncture and moxibustion. Purgation therapy is used to treat excess syndromes such as attack of exogenous pathogenic factors, retention of food, internal accumulation of phlegm-dampness, internal retention of water, internal blockage of blood stasis, stagnancy of qi activity, exuberance of fire and stagnation of pathogenic clod, etc. That is why it is said in TCM that ¡°excess syndrome should be treated by purgation therapy.¡± Purgation therapy can be further divided into different therapeutic methods to deal with different pathogenic factors, such as diaphoresis therapy, emetic therapy, defecation-promoting therapy, water-draining therapy, blood-activating therapy, dampness-resolving therapy, stasis-breaking therapy, heat-clearing therapy and cold-dissipating therapy, etc. Eliminating pathogenic factors is helpful for restoring and strengthening healthy qi. However, deficiency syndrome due to insufficiency of healthy qi cannot be treated by purgation therapy because purgation therapy tends to impair healthy qi.

2.2 Application of strengthening healthy qi and eliminating pathogenic factors

In applying the principle of strengthening healthy qi eliminating pathogenic factors, one must carefully analyze the state of pathogenic factors and the condition of healthy qi, differentiate the nature of the syndrome in question and distinguish the relationship between healthy qi and pathogenic factors in order to select the right therapy. Generally speaking, simple deficiency can be treated by strengthening healthy qi and simple excess syndrome can be treated by eliminating pathogenic factor. For the treatment of syndrome mixed with both deficiency and excess, the therapy for strengthening healthy qi and the therapy for eliminating pathogenic factors can be used simultaneously. Since the order and urgency of deficiency of healthy qi and excess of pathogenic factors are different, there are three methods for strengthening healthy qi and eliminating pathogenic factors i.e. purgation prior to tonification, tonification prior to purgation and simultaneous application of purgation and tonificaton.

  • Purgation prior to tonification

Purgation prior to tonification means to eliminate pathogenic factors first and then strengthen healthy qi. If a syndrome mixed with deficiency of healthy qi and excess of pathogenic factors is marked by predomination of pathogenic factors that must be eliminated immediately and deficiency of healthy qi that still can bear attack, the therapy for strengthening healthy qi may reinforce pathogenic factors instead of strengthening healthy qi. In this case purgation should be used first. After pathogenic factors are reduced, nourishing therapy can be used to strengthen healthy qi. Take sudden uterine bleeding due to blood stasis for example. If blood stasis is not eliminated, hemorrhage cannot be stopped. Though hemorrhagia should be treated by nourishing therapy, tonic herbs may make it difficult to eliminate blood stasis. If hemorrhage continues, blood deficiency cannot be rectified. In this case measures should be taken to activate blood to resolve stasis in order to stop bleeding. Then nourishing therapy can be used to invigorate blood.

  • Tonification prior to purgation

Tonification prior to purgation means to strengthen healthy qi first and then eliminate pathogenic factors. This therapy can be used to treat syndrome mixed with deficiency of healthy qi and excess of pathogenic factors. Though pathogenic factors should be eliminated, healthy qi is too deficient to bear attack. Early application of purgation may impair healthy qi. In this case tonifying therapy should be used first to strengthen healthy qi. Take as-cites for example. Since healthy qi is deficient for a long time and cannot bear purgation, measures should be taken to strengthen healthy qi. After healthy qi is reinforced, purging therapy can be used to eliminate pathogenic factors and drain water.

  • Simultaneous application of purgation and tonification

This therapy means to strengthen healthy qi and to eliminate pathogenic factors simultaneously. It can be used to treat syndrome mixed with deficiency of healthy qi and excess of pathogenic factors. Because simple use of tonification may make pathogenic factors linger inside and simple use of purgation may impair healthy qi. Take common cold due to qi deficiency for example. It can be treated by supplementing qi and relieving superficies at the same time.

3 Regulation of yin and yang

TCM believes the root cause of disease is imbalance between yin and yang. So the sole purpose for treating disease is to readjust yin and yang and restore the normal balance between yin and yang. Since the main manifestations of imbalance between yin and yang are relative predomination of yin and yang and relative decline of yin and yang, the purpose of regulating yin and yang is to reduce the excess and supplement deficiency.

3.1 Reducing excess

Relative predomination of yin or yang means excess. Relative predomination of yin means excess of yin and relative predomination of yang means excess of yang. Reduce excess means to reduce relative predomination and restore the normal state of yin or yang. Since the syndrome caused by excess of yin or yang is of excess in nature and the treatment of excess syndrome is purgation, the principle for ¡°reducing excess¡± is also known as ¡°excess should be treated by purgation¡± in TCM.

Relative predomination of yin causes excess-cold syndrome while relative predomination of yang causes excess-heat syndrome. The therapeutic principle for treating excess-cold syndrome is ¡°to treat cold syndrome with heat therapy¡± while the therapeutic principle for treating excess-heat syndrome is ¡°to treat heat syndrome with cold therapy.¡±

Since yin and yang are opposite to each other, predomination of yin may damage yang and predomination of yang may impair yin. So in the treatment of syndromes due to predomination of yin or yang, cares should be taken to differentiate the state of the other side so as to take both sides into consideration if necessary, i.e. dispersing yin-cold in combination with strengthening yang and clearing yang-heat in combination with nourishing yin.

3.2 Supplementing insufficiency

Relative decline of yin or yang means insufficiency. Relative decline of yin means insufficiency of yin and relative decline of yang means insufficiency of yang. Supplementing insufficiency means rectifying decline and restoring the normal state of yin or yang. Since the syndrome caused by relative decline of yin or yang is of deficiency in nature, the general principle for treating deficiency syndrome is ¡°supplementation¡±.

Relative decline of yin causes deficiency-heat syndrome while relative decline of yang causes deficiency-cold syndrome. For the treatment of deficiency-heat syndrome, yin-nourishing therapy can be used (to use tonic herbs to nourish yin and supplement blood) ;for the treatment of deficiency-cold syndrome, yang-supplementing therapy can be used (to use tonic herbs of warm nature to strengthen yang and supplement qi). However deficiency-cold syndrome due to relative decline of yang may result from retention of water in the body caused by failure of deficient yang to transform qi. In this case purging therapy cannot be used to eliminate retention of water. Instead, measures should be taken to warm and supplement yang-qi. When yang-qi is activated, qi will flow smoothly and retention of water will disperse naturally. That is why is was said in ancient times that ¡°supplementing the source of fire can eliminate superabundance of yin.¡± On the other hand deficiency-heat syndrome may result from endogenous fire due to failure of deficient yin to control yang. In this case purging and clearing therapy cannot be used to eliminate fire and heat. Instead, measures should be taken to enrich yin-essence. When yin-essence is enriched, the state of yin and yang will be normalized. When yang is able to maintain latent, fire will disappear naturally. That is why is was said in ancient times that ¡°strengthening water source can control predominant yang.¡±

Since yin and yang depend on each other, relative decline of the one will certainly involve the other, eventually leading to decline of both yin and yang which will bring on deficiency of both yin and yang. For the treatment of such a morbid condition, both yin and yang should be supplemented. For this reason, simple yin deficiency syndrome can be treated by yin-nourshing therapy with the addition of herbs for strengthening yang for the purpose of promoting the transformation of yin with the qi-transforming the transforming function of yang, known as obtaining yin from yang; simple yang deficiency syndrome can be treated by yang-nourishing therapy with the addition of herbs for nourishing yin for the purpose of promoting the transformation of yang with the essence-nourishing function of yin, known as obtaining yang from yin.

Besides, the meridians, the viscera and the activities of ascent, descent, out-going and entering all pertain to yin and yang in nature respectively, the principles for regulating yin and yang can be used to generalize other related therapeutic methods. For example, the methods for regulating disorder of the meridians, qi and blood, zang-organs and fu-organs as well as ascent, descent, out-going and entering are all included in the concept of ¡°regulating yin and yang.¡±

4 Abidance by individuality, locality and seasons

The occurrence, development and change of disease involve a number of factors, including individual difference, geographical environment and seasonal variations which may affect the nature, duration and treatment of disease. So in treating disease, apart from following the principles of concentrating treatment on the root cause, strengthening healthy qi and eliminating pathogenic factors as well as regulating yin and yang, one has to make corresponding changes according to individual condition, local environment and seasonal variations.

4.1 Abidance by individuality

Abidance by individuality means to decide treatment according to the age, sex, constitution and living habits of the patients.

1) Age

The physiological functions and the state of qi and blood vary with the age, so the use of herbs has to follow such variations. Generally speaking, infants are vigorous in physiological functions, but their qi and blood are not sufficient yet and their viscera are delicate. For this reason, infants are easy to be affected by cold and heat and tend to have deficiency or excess problems. Once they fall ill, their pathological conditions are prone to change. So in the treatment of infantile disease, drastic herbs are forbidden to use and tonic herbs should be used infrequently with small dosage. In selecting prescription form and taking method, the characteristics of infants have to be taken into consideration. As to the old people, their physiological functions, qi and blood have all declined, so they are easy to have deficiency problems. For the treatment of old people, purgation should be used with great care even for treating excess syndrome because their constitution is weak. Since qi and blood in the aged have declined, their reaction to herbs is slow. So the treatment of deficiency syndrome for the aged with nourishing therapy needs large dosage of herbs and longer course of treatment.

2) Sex

Different sex has different physiological characteristics. TCM emphasizes that women are different from men because they have menstruation, leukorrhage, pregnancy and labor which have to be taken into consideration in treating women disease. For example, herbs used during menstruation should not hinder menses, avoiding the use of herbs of cold and astringent nature; herbs used after menstruation mainly concentrate on supplementation because the vessels are deficient because of menses; during pregnancy, cares should be taken to protect fetus and herbs for drastic purgation, breaking blood and lubrication or herbs tending to migrate or poisonous herbs should not be used or used with great care; after labor, qi and blood are seriously deficient, cares should be taken to supplement more and purge less. If there is lochiorrhea, warming and supplementing therapy can be used to dredge and disperse, cold tonifying and astringing therapy should not be used lest lochia be retained. Since the liver is regarded as the congenital base of life for women and liver-qi is easy to stagnate, the treatment of women diseases often needs to soothe and regulate liver-qi.

3) Constitution

There are different types of constitution which should be treated by different herbs. Generally speaking, strong constitution bears more purgation but less tonification, so it can be treated with large dosage of herbs for purgation but small dosage of herbs for tonification; weak constitution bears more tonification but less purgation, so it can be treated with small dosage of herbs for purgation but large dosage of herbs for tonification. For the treatment of people with frequent predomination of yang or frequent deficiency of yin, warm-natured herbs should be used with great care lest fire be strengthened or yin be impaired. For the treatment to people with frequent deficiency of yang or frequent predomination of yin, cold-natured herbs should be used with great care lest yang-qi be impaired or phlegm be caused.

4) Living habits

Different living habits may exert different effect on constitution. For example, indulgence in drinking of wine may cause insufficiency of liver-yin complicated by phlegm-dampness encumbering the spleen; frequent food partiality tends to cause decline of qi and blood or disharmony between yin and yang; lack of physical exercise often leads to hypofunction of the viscera and slow flow of qi and blood. People in different regions, countries and nations differ greatly in living habits. Such a difference in living habits can be used as evidence to analyze their types of constitution.

4.2Abidance by locality

Locality means to decide treatment according to geographical difference.

People in different regions differ in physiological functions and pathological changes because of geographical location, weather condition and living habits. Take China for example. The plateaus in the west regions are cold and dry with insufficient rain. People live in the mountains, mainly taking milk and meat. So their constitution is strong and their muscular interstices are dense, making it difficult for pathogenic factors to invade them. When at tacked by exogenous pathogenic factors, they can be treated by dispersing therapy with large dosage of herbs for relieving the superficies. The regions in the east and south and along the seas are low and warm with sufficient rain. People live beside water and mainly eat fish and rice. Their constitution is weak and their muscular interstices are loose. So they are easily to be invaded by exogenous pathogenic factors. When attacked by exogenous pathogenic factors, they can be treated by dispersing therapy with small dosage of herbs for relieving superficies.

4.3 Abidance by seasonal variation

Seasonal variation means deciding treatment according to seasonal changes of weather.

Seasonal variations of weather exert certain effect on the physiological functions and pathological changes of the body. Generally speaking, the muscular interstices are loose in spring and summer because the weather becomes warmer and warmer and yang-qi gradually elevates. So herbs acrid in taste and warm in nature cannot be used in large dosage even for wind-cold attack, avoiding excessive purgation and damaging qi and yin. In autumn and winter, the muscular interstices are dense bense because the weather becomes colder and colder, yin becomes predominant and yang deficient. In these two seasons cold-natured herbs should be used with great care except great heat syndrome. In Huangdi Neijing such a use of herbs according to seasonal variation is summarized as ¡°avoiding                                            using cold-natured herbs in winter, cool-natured herbs in autumn,                                                      warm-natured herbs in spring and hot-natured herbs in summer.¡±

TCM                                                                    analyzes the five zang-organs according to the four                                                                      seasons, believing that liver-qi is predominant in
                                                                            spring, heart-qi is predominant in summer,                                                                                 spleen-qi is predominant in late summer,                                                                                 lung-qi is predominant in autumn and kidney-qi                                                                            is predominant in winter. In each season one                                                                                 zang-organ is in predomination, the zang-organ                                                                 that it generates is promoted while the zang-organ that                                                                     it dominates is restricted. Only when such a                                                                      corresponding change of the five zang-organs in the four                                                         seasons and their interrelationships have been taken into consideration in treating disease can damage of healthy qi and promotion of pathogenic factors be avoided. Besieds, interrelationships among the five zang-organs in the four seasons also can be used to decide therapeutic principle and select herbs. Take spring for example. In spring, liver-qi is predominant, but spleen-qi must be restricted. So patients with frequent deficiency of the spleen has to be treated by strengthening spleen-qi in spring. Since predomination of liver-qi can reinforce heart-qi, the syndrome of heart-qi deficiency can be more effectively treated in spring. If it is treated in winter, the therapeutic effect is not so easy to obtain because heart-fire is restricted by kidney-water.

 
 
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