TCM: Pulse. Clinical Observation notes, CO405 Spring 2014

I . Pulse diagnostics:
Start creating logs of patients
Radial artery- touch and feel, develop sensitivity in finger ‘pad’.
Wrist should not be up down, it anatomically changes the artery. Use a small pillow.
-Notate the pulse, describe it through words.

Essentials of pulse diagnosis-
1. Understand the basic concepts of what you are feeling. Absorb all pertinent information about the different pulses.
2. Inability to label the feeling correctly means the practitioner cannot correlate the Diagnostic signs/symptoms with the treatment principles and treatment plan.
3. Feeling of the pulses are dirt simple feelings, getting the correct label on that feeling is the issue.
4. Correct labeling is essential for communication with colleagues, essential also for 3rd party payment: woker comp, PPO, HMO, etc.
5. Disease mechanisms- to understand the pulses according to their disease mechanisms allow one to discern the various possible reasons that produce the various pulse images.
6. In TCM the PULSE is NOT used to make the pattern of diagnosis, it is only used to confirm or deny what the physician thinks may be the pattern. It is only to corroborate and be the LAST piece of information to be considered.

We learn from the patient. Looking for concepts from 1000’s of years ago, for modern illnesses and stress.

Huang Di Neijing (Yellow Emperor Classic) is first place of discussion.
The Nanjin (Classic of Difficulties) continued on and divided pulse into SAN BU- 3 positions.
“The lungs face the 100 vessels”, all the Qi of the body passes through the lungs and returns. The pulse is on the wrist because nanjin describes the source of all points is LU9,
Influential part of the vessels. Qi enters Lungs first, passes through lungs, returns to lung. Radial artery runs through lung channel.
12 meridians

Taiyin and Yangming meridians:
1. Lung meridian of Hand Taiyin- middle burning space to the tip of the thumb.
2. Large intestine meridian of Hand Yangming- tip of thumb and small finger to large intestine.
3. Stomach meridian of Foot-Yangming- from middle of nose to the middle of foot.
4. Spleen meridian of foot- Taiyin. From the great toe to the lower part of tongue.

Shaoyin and Taiyang meridians:
5. Heart meridian of the hand Shaoyin- from the heart to the inside of the little finger.
6. Small Intestines meridian of the hand Taiyin- from the little finger to the small intestines.
7. Bladder meridian of the Foot Taiyang- from the inner corner of eye to the little toe.
8. Kidney meridian of Foot shaoyin- from the little toe to the root of the tongue.

Jueyin and Shaoyang meridians:
9. Pericardium of the hand Jueyin- from the middle of the stomach to the top of middle finger.
10. San Jiao of hand Shaoyang- from the tip of the little finger to the 3 burning places.
11. Gall Bladder of the Foot shaoyang- from the outer angles of the eye to the little toes.
12. Liver meridian of the foot Jueyin- from the hairy spot of big toe to the vertex of the head.

See images on the Nanjin

Li Shi-zhen way used in modern pulse diagnosis.

Three positions:
Cun- upper jiao: heart, lungs chest, head, arms. Throat, sinus eye, ear, mouth, etc.
Guan- middle jiao- liver gall bladder, stomach, spleen, diaphragm to navel. Ribs, Mid-back, abdomen.
Chi- lower jiao- kidneys, bladder, intestines, navel to toes, legs, knees, ankles, pelvis, uterus, lower back, sex organs.

4 head ropes-
1. Floating/sinking: depth and force of yang qi.
2. thin/wide: blood, yin. Is it a wide or thin feeling vessel (tube)?
3. Strong/weak force: yang qi. Is it forceful or weak?
4. Fast/slow: yang qi. Is it rapid or slow?

Floating/sinking: Yang nature is to float up and out. If floating, yang is in the upper and outer part of body. Excess yang qi and insufficient yin. If sunken: yang is insufficient, something is obstructing.
Thin/Wide: latitude of the pulse tells about the content of vessels, Yin, Blood, Body fluids.
Strong/Weak: strong force is sufficiency, exuberance of yang. Weak/forceless is insufficiency of yang.
Fast/Slow: excess of Yang or yang vacuity.

Technique: thumb anchors on triple warmer point, apply one figer at a time after relocating under the boney landmark. 10 sec. feel pulse, patient and self breathing, press deep and shallow, side to side, in and out, long and short.
Duration of examination: short period to long period, up to 15 minutes.
Cultivate stillness, feel calm, meditation- mind of no judgment, no expectations, open, and logical.
Time of day- Chinese clock.
Season- is it summer, fall, winter, spring.
Circumstance/situation: patient eat? Come from gym, traffic, stress.
Posture- patient can sit or lying. Practitioner is upright, relaxed and not distracted.

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Yang Tai Chi Chuan: Mapping out my place in the Tai Chi Universe.

“Lineage is not a true indication of skill, though I have trained, and still continue to train with outstanding people. Kung fu is “ever progressing”, humbly learning from everyone within common reason. We believe in hard work, the same way steel has to be forged with fire and water. 24 years of Tai Chi Chuan is really only a starting point on this pagoda of life. Many floors to continue to walk up and see the view from higher stand points on the journey”. -Matt Stampe

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TCM for Allergies: seminar notes

TCM and Allergies:
Allergies is a hypersensitivity disorder of the immune system.
Body releases histamine- inflammation response: phlegm, red eyes, sneezing, etc.

Symptoms include:
Nose swelling,
sinus infection,
eyes red and itchy,
airways- sneeze, cough, bronchoconstriction, asthma.
Ears- full or pain.
Skin- rash, eczema, hives.
G.I. tract- abdominal pain, vomit, diarrhea.

Western drugs- hide symptoms, histamine is body way of telling you something.
Alternative to drugs: herbs, acupuncture, tea, qigong.

Common allergic reactions:
Foods: milk, shellfish, peanuts.
Skin- poisonous plants, animals, pollen, latex.
Injection: bee sting, medication.
Medication: various drugs, nuts-shellfish.
Inhalation: pollen, dust, mold, mildew, animal dander.

1. Host factor: age, gender, hereditary etc.
2. Environment: pollen, diet, ect.

Allergic Rhinitis: symptoms of nose: dust, pollen, dander.

1. Lifestyle: avoid allergens
2. Medications: anti-histamines, corticosteroids, decongestants.
3. Herbal: “Jade wind screen”- immunity boosting herbal formula.
4. Prognosis- is good with patient willing to try alternatives.
5. Acupuncture- strengthen the “defensive Qi” immune system.
6. Herbs: list of herbs provided.
7. Teas- sample various teas. Common teas: green tea, astragalus tea, flower tea (chrysanthemum).
8. Qigong: 8 piece brocade/”ba dua jin” is a basic set to try.

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TCM: Qigong Notes. Spring 2014 semester

Qigong Class:
Qi- vital energy, everything is generated by movement of qi.
Gong: accumulation of “time”, or “work” or “energy level”.
Qigong- time spent accumulating your vital energy and reaching a higher energy level.
Neigong- Internal work and adjustments.

1. Health by balance of vital energy: physical, mental, emotional improvement.
2. Ability to treat disease.
3. Martial arts/self-defense: above average human ability.
4. Mind-Body communication: body is basis of mind, mind commands the body.
5. Latent abilities- develop more than 10-20% of normal brain ability.

Influences of Qigong:
1. Taoist- focus on present life and accumulating energy, longevity.
2. Buddhist- focus on next life, relieve suffering in present life.
3. Medical- heal and improve health.
4. Martial art- qi for martial arts purposes.
5. Folk qigong- “catch-all” of various other types of qigong.

Types of Qigong Practice:
1. Static- holding still postures, no outside movement.
2. Dynamic- coordination of movement with breathing.
3. Meditation- can be sitting, lying down, standing, moving. Deep consciousness training.

Mediation Types:
1. Guided meditation: teacher guides.
2. Mindfulness meditation: let thoughts come and go. Observe thoughts.
3. Transcendental meditation: small and smaller, less thoughts. counting numbers smaller and smaller.
4. Moving types: Qigong, Taiji, yoga, etc.

Adjustments: body, mind, breath. integrate 3 as one.
Body adjustment:
1. external:
standing postures: holding, raising, pressing, lifting.
sitting: plain chair, single cross leg, double cross leg (lotus).
Lying down- supine, lateral (3 connectings).

2. Internal adjustments:
head and neck- raise head, tongue on roof of mouth.
upper limbs- empty in the armpits.
chest and back- pulling the chest.
waist and hips- sitting on stool.
Lower limbs- relaxed and steady.

Warm-up: neck, shoulders, wrist, waist, knees, ankels.
Standing basic: feet hip apart, hands at tan tien (below navel center), breathing normally, naturally, no force.
Qi feeling exercise:
1. Rub hands, feel energy between palms, palms move close and far from each other.
2. Sword fingers- point sword fingers at laogong in center of palm, circle sword fingers to feel qi.

Baduajin: 8 brocade qigong
1. Uphold sky with both hands- 3 warmer/san jiao. Lu, Ht, Kd.
2. Draw bow, shoot hawk- heart and lung channel.
3. Separate heaven and earth- spleen and stomach channel.(middle jiao) GB LV.
4. Look back- heart calming fire.
5. Sway head/shake tail-
6. Two hands hold feet- kidney and bladder channel.
7. Punch with fist, widen eyes- liver and gallbladder.
8. Raise toes, drop heel-

Close qigong.

Guided meditation: tree mediation: seed, to root, to tree growing.



Adjustments of breath:
chest breathing
abdominal breathing
fetal breathing
pause breathing
anus lifting breathing
sound producing breathing

Breathing Air:
wind breathing- scatters Qi
pant breathing: Blocks qi (often used in martial arts, sharp exhale on a punch)
Air breathing- exhausts qi
Rest breathing- Calms Qi- motionless undetectable type of breathing.

using qigong in medicine:
-Yin-yang theory:
excess and deficiency
breathing in (yang) vs breathing out (yin): expelling toxins.
mental visualization

five elements:
organs: liver, heart, spleen, lungs, kidneys (tonify or sedate). Mother theory: if son is weak build up the mother.
example: if heart is weak, strengthen the Liver.
emotions: anger-joy-over thinking-sadness-fear.

Zhang-fu organs:
Relationships amoung fu and zhang organs.

Meridian theory

3 treasures: Essence-Qi-Spirit or Jing-Qi-Shen.

Medical Qigong:
scanning of qi flow.
manipulation of qi flow.

Clinical application of microcosmic orbit.
Qigong: non-drug therapy.
-like acupuncture and Tui-na.
-Self-cultivation methods.
-Teaching patients to self-practice.
-helping others by manipulating qi flow.

Some common examples prescribed with Baduanjin:

-Chronic fatigue syndrome, Insomnia, Lower back issues, Leg pain, Cervical Spondylosis.

Microcosmic Orbit
Movement of Qi:
Ren 4- Lower Dan tien. tonify Yuan Qi, Defiency of yin, Yang, Qi and blood.
Ren 1- Perineum. Regulate lower yin orifices, CV, GV, and chong mei channels.
Du 1- Tip of Coccyx. calm spirit, Lou connection point.
Du 4- Mingmen. tonify kidney, lumbar spine, clear heat, gate of life, heat of the 5 zhang.
Du 14- below spine process of C7. relieve exterior syndrome, clear heat, tonify deficiancy pacify wind.
Du 16- EOP (external occipital proturbance). eliminate wind, nourish the “sea of marrow” head, neck, spirit.
Du 17- Eliminate wind and pain, benefit the eyes, calm spirit.
Du 20- Bai Hui vertex. Crossing of Bladder, San jiao, and Liver meridians. Subdue Yang, help sense organs and brain.
Yintang (Extra 2)- upper dan tien. Hall of Seal. calm spirit, stress, anxiety.
Ren 17- Middle dan tien. Tonify and move qi of chest and lungs, gather Qi.

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TCM: East and Western medical history notes Spring semester

last edit 6-12-2014

recent TCM history China, USA, California.
1912- end of Qing dynasty
1929- china banned everything non-scientific.
1942- Mao banned TCM for his followers.
1949- Communism takes over in China.
1953-1954: saw a resurgence of TCM, hospitals and universities in major cities. “Symbol of China”.
1966-1976: Cultural revolution, old tradition and followers of TCM persecuted and ridiculed. Reformation of thinking to get rid of the “4 olds” Old Customs, Old Culture, Old Habits, and Old Ideas.
1972- Nixon went to china, New York Times report James Reston get acupuncture for emergency appendectomy.
1972- board of medical Examiners begins regulating acupuncture in USA.
1975 California governor signed bill to create Acupuncture advisory committee.
1976- Miriam Lee first licensed acupuncturist after court case involving her needle practice in California. She used Tung points method.
1978- acupuncture as “primary health care provider” and eliminate “prior diagnosis or referral” by doctor dentist, or chiropractor.
1980- Acupuncture Examine committee replaces former Acupunture advisory committee, expand scope of practice within acupuncture.
1988- included acupuncture as a treatment of works compensation.
1990- Acupuncture examing committee changed to Acupuncture Committee.
1991- Tiananmen Square protest and massacre.
1997- National Institute of health formally recognizes acupuncture as mainstream medicine.
1998-legislation passed changing ‘Acupuncture committee’ to ‘Acupuncture Board’.

Western medicine -
4 parts: Greek, Rome, Middle Ages, Modern
Famous Doctors:
Surgions- surgery, he carried forceps, scapels, catheteres, used a anestesia from opiates.
Alcmaeon- author of a book on anatomy.
Humor theory- air, yellow bile, black bile, phlemgn.
Hippocrates- famous for many of his terms used in medicine today:
Acute, chronic, endemic (disease specific to a people in a specific area), epidemic, crisis, peak, paroxysm (spasm), convalescence (recuperation time). Hippocratic oath.
Pedanius Dioscorides- classified western herbs and medicines.
Herophilus- female nurse who studied intelligence was in the brain and connected it to nervous system, understood difference in the vein and artery, pulse.
Erasistratus- also mapped out veins and nervous system, brain, understood air in lungs created spirit to brain and nerves.
Galen- first good surgoen, but surgery not seen again for 2 millennia due to church regulations and working on people and cadavers.

Timeline of events- famous doctors and their books.

Antiquity- before 1700 BC.
Discovery of fire, cooked foods, hot water, moxibustion, hot stones, shamans, Huang di, shen Nong, Fu Xi.

Shang dynasty – (1700-1100 BC)
Yin and yang, laws of nature, 5 elements.

Zhou dynasty- (1100-221 BC) 4 periods: Western, Easter, Spring/autumn, Warring states.
Confucius, Lao Tzu (western). Beginning of organized medical system (Eastern),Bian que Nanjin (spring and Autumn),
Huang di nei jing (Yellow emperor classic),
Wushier Bingfang- the 52 prescriptions.

Qin Dynasty-(221-207 BC)
Burning of the books and killing of scolars by emperor Qin Huangdi.

Han dynasty- (western and eastern) (200 BC to 220 AD)
Silk road, search for immortality elixirs, medical system and education, apprenticeships,
Shennong Ben Cao jing- classic of herbal medicine.
Chunyu Yi – first doctor to keep medical records.
Fu Weng and Gou Yu- acupuncture and moxa doctors to court.
Zhang Zhongjing- Shanghan Lun- (Classic on febrile diseases).
Hua to- surgery and 5 animal qigong.

Chinese Middle Ages: (200-581 AD)3 kingdoms (Wei , shu han, and wu), Jin dynasty, southern dynasty, Northern dynasty.
Buddhism, appointment of medical students, acupuncture for pain.
Huangfu Mi- Zhenjiu Jiayijing (ABC of Acupuncture and Moxabustion.
Wang shuhe- maijing (Classic of pulse).
Ge Hong- alchemist Zhouhou Jiuzufeng (Emergency Prescriptions).
Tao Honjing- commentaries on Shennong Bencaojing (Classic of Herbal medicine. Zhouhou Baiyi Fang (101 emergency prescriptions).
Lei Xiao- Leigong Baozhilun (treatise on the Prepararation of lei gong’s remedies).

Sui dynasty- 581-618 AD
Chao Yuangfang- zhubing Yuanhoulun (Treatise on causes and symptoms of diseases)

Tang dynasty- 618-907 AD
Peak of Buddhism. Imperial academy, herbal gardens, tough examination process, pharmacopeias.
Su jing- Xinxiu Bencao (Revised material medica).
Influence in foreign countries: India, Arabia, Persia, Tibet.
Sun Simiao- Qianjin Yaofang (prescriptions worth 1000 gold). He unders stood cholera and diarrhea from food, tuberculosis as lung disease, leprosy, goiter (lack of iodine), Nyctalopia (lack of vitamin A), Beriberi (lack of vitamin B1), diet before medicine.

5 dynasty period: (later Liang, Later Tang, Later Jin, later han, later Zhou), (907-960 AD)
Liao dynasty (916-1125 AD).
-short lived dynasties and independent states.
Liao dynasty- song dynasty paid money to Liao to maintain peace.

Song Dynasty (Northern and southern) 960 AD to 1279 AD.
Confucianism saw resurgence (neo-Confucianism).
Healthcare system like dispensaries, hospitals, institutions.
Publishing boom- woodblock printing.
Taiping Shenghuifang- (Prescriptions from the Pharmacy of harmonious Assistance)-16834 prescriptions.
Medical Education: 9 dept.- internal medicine, obstetrics, pediatrics, ophthalmology, dermatology, acupuncture, trauma, wind diseases.
Sanyin- 3 causes: endogenous, exogenous and one or both.
Chen Yan- Jiyi Bingzheng (a treatise on pathology)- 3 causes.
Wang Weiyi- Shuxue zhen jiu tujing (illustrated manual of the Bronze man showing acupuncture points). –Bronze acupuncture statue.
Song Ci- Xiyuan jilu (Washing away the wrongs).
Qian Yi- pediatrics. Xiao’er Yaozheng Zhijue (the appropriate way of recognizing and treating infant maladies).smallpox, chickenpox, measles.
Chen Ziming- Furen Daquan Liangfang (Collection of gynecology Treatise) menstruation, pregnancy, child birth.

Jin and Yuan period 1115-1368 AD
Genghis and Kulai khan- warring period. Marco Polo.
Master Heijia (Liu Wansu) Heijia school: 5 movement (yun) 6 influences (qi) school ‘school of cooling” heat vs cold, prescribed cooling herbs.
Zhang Congzheng- 6 doors 3 methods school (wind, heat, damp, dry, fire, cold) 3 methods (sweating, vomit, purge).
Zhang Yuansu (Master of the Yishui school), Yixue Qiyuan (Explanation of Medicine) illness as imbalance in Zhang and fu organs.
Li Gao “old gentle of the eastern wall”. Piweilun (Treatise on the spleen and stomach) vitality declined if spleen and stomach were injured by lifestyle and emotions.
Zhu Zhenheng “minister of fire”, Gezhi Yulun (theories of in-depth research) . Fire consumes Yin energy.
Dou Guifang- Huangdi mingding jiujing (4 volumes on acupuncture and moxa).
Bone setting and Traumatic surgery
Qi Dezhi- Waike Jingyi (The Essentials of External medicine) decoctions, pills, powders, ointments.
Wei yilin- Shiyi Dexiaofang (Efficacious Remedies of the physician), setting fractures, dislocations, anesthetics.
Eating for heath: Hu Sihui (dietician) Yinshan zhengyao (Important principles of food and drink)- moderation in eating. Lists foods.
Ge keijiu- Shiyao Shenshu (Classic on tuberculosis)
Zeng Shirong- Houyou xinshu (study of Pediatrics).

Ming dynasty- 1368-1644
Western Jesuits like Matteo Ricci worked with Chinese scholars.
Debates between various schools on methods: Nourish yin school, Warming and invigorating school, School of Epidemic diseases.
Zhu Zhenheng- School of Nourishing the Yin: quench the fire.
Li Gao- School of warming and invigorating “wenbu”.- tonify spleen and stomach to prevent disease.
Xiu Jie- Neike Zhaiyao (A summary of Internal medicine) Waike Shuyao (Essentials of External medicine), Waike Fahui (the development of external medicine), nuke cuoyao (A resume of gynecology), zhengti Leiyao (A repertory of Traumatology) and Kouchi Leiyao (A Repertory of Stomatology).
Zhao Xianke- theory of Mingmen “gate of vitality” and fire yang and water yin.
Zhang Jiebin- yang was source of life and root of existence.
School of Epidemic Disease (wenbing)- Wang Lu: formulated precise features of various febrile diseases and cold induced illnesses.
Wu Youxing- Wenyilun- Classic on Pestilence) theory of Liqi (excessive influences) was cause of small pox and other infectious diseases.
Advancement in surgery: depression, fried, spicy and charred foods caused cancer. analgesia, asepsis, and hemostasis in surgery.
Chen Shigong- Waike zhengzong (the Genuine surgery).
Wang Ji- decoction of the four rules to fight venereal disease.
Chen Sicheng- Meichuang Milu (Secret writings on Putrid ulcers) on syphilis (use of arsenic and mercury).
Yang Jizhou- Zhengjiu Dacheng (the great success of Acupucture and moxibustion).
Li Shizhen- Bencao gangmu (Compendium of Materia medica) 1000’s of herbs and formulas: water, fire, earth, metal, stone, plant, cereal, vegetable, fruit, tree, insects,, shells, bird, quadrupeds.
He was first to identify gall stones and lived by Confucian principle to extend care to everyone.
Zhu su and Teng shuo- Puji Feng (Prescriptions for saving the public).

Qing dynasty 1644-1911
Opium wars, China refuses to go into modern age, autocratic and despotic. Western colonization.
Wang Mengying- Wenre Jingwe (Fever related illnesses)
Liu Baoyi- Wenre Fengyuan (the source of fevers).
Lei Feng- Shibinglun (Seasonal illnesses)
Anatomy advancement-
Wang Qingren- Yilin Gaicuo (Errors corrected from the forest of physicians).
Yu Maokun- Douke Fujijie (Inoculation against Smallpox) used dry scabs of smallpox patients to make vaccine.
Zhao Xuemin- Bencao Gangmu shiyi (Compendium of material medica) 921 drugs listed.
Publishing boom in Encyclopedias and medical books on gynecology, pediatrics, massage, external medicine, skin diseases and trauma.
Gujin Tushu Jicheng (Collection of ancient and modern works).
Wu Qian- Yizong Jinjian (Golden mirror of medicine).
Zhang Lu- zhangshi Yitong (A summary of master zhang’s medical thoughts).
Cheng Guopend- Yixue Xinwu (An understanding of medicine) 4 methods of examination, diagnostic principles, and therapeutic techniques.
Li Yongcui- Zhengzhi Huibu , this book was devoted to illnesses, symptoms, that relied on internal medicine for treatment.
Western medicine rises:
Huang Kuan- first Chinese to study at Edinburgh University in Scotland.
Zhu Peiwen- Huayang Zangxiang Yuezuan (A combining Chinese and western anatomy illustrations).

Modern China- 1912 to present.
Qing dynasty falls to sun Yat sen and Koumingtang. Rise of the communist party and Mao Zedong.
1929- TCM associations congregated and formed national Union for TCM.
“School of Sino-western convergence and intercourse” emerged.
Tang Zonghai- Zhongxi Huitong yijing jingyi, book that supported strengths and weakeness of both eastern and western medicine.
1954- Dept. of Chinese medicine ws established under the Ministry of public health.
1957- TCM Institutions in Shanghai, Beijing, Chengdu, Guangzhou, and Nanjing.
2000 chinese physicians trained in western medicine to study TCM.
Cultural revolution- set back for TCM, books destroyed, teachers and doctors imprisoned.
After revolution:
Preservation of China traditional herbs and growing conditions systematically grown.
New medicines: pills, tablets, capsules, granules, suppositories, creams, lotions, and suspensions.
Hospitals grew: surgery acupuncture for surgery, Taijiquan, use of X-rays.
Increase in hospitals for both Western and TCM medicine.
Western medicine has a progression where old theories die and new theories arise by scientific evidence. Something from 100 years ago is disregarded based on new scientific data and results.
Eastern Medicine has many theories that are used today that date back thousands of years, TCM doctors use many of the medical findings by doctors throughout the history.

5 elements:
1. Water- downward.
2. Fire- radiates.
3. Wood- upward.
4. Metal- destroys.
5. Earth- absorbs.

Chinese has several creation and destruction cycles. One is star pattern, other has Earth in center. See diagram on notes.
Korean has fire in center and with 4 body types. See diagram in notes.
5 zhang- solid organs.- must have or die.
6 Fu- hollow organs, can remove.

High level doctors alter the patient’s lifestyle.
Average doctors- help the internal problem.
Poor doctor- can fix the local problem.

Treating problems that are not healing: treat the part of body/balance not letting the body heal itself.
3 week sports injury- should see healing results after a few treatments.
4 month sport injury not going away- should see results after a 10 or more treatments.
Problem persisting for years: 40 to 50x treatments.

Shennong: herbal godfather, father of agriculture, tested foods and labeled them: cold, cool, warm, hot.

7 types of qi
1. Congential qi: called yaun qi and it is from parents at conception, kidneys-jing.
2. Acquired qi: 6 types.
1. Kong qi- air/lungs
2. Gu Qi- from food
3. Zong qi- collects to heart (yuan+kong+gu)
4. Zhen qi- true qi. Channels.
5. Ying Qi- inside channel, acupuncture/moxa
6. Wei qi- outside channel. Qigong.

Acquired qi- is like a battery.
Congenital qi- like computer memory, cannot change.

Herbs, metals, minerals-
Gold: gathers and promotes circulation
Silver- disperses energy.

Quote: All food is good food, there is no bad food or good food in a dualistic sense, there is only food that is not right for you.

Ginseng: earthy-absorbing.
Chinese and Korean is red are labeled HOT.
American is a white ginseng and is Warming.
Ginseng: uses nutrients from the soil. Once a ginseng is harvested, you cannot plant a crop there for 5-10 years.
It is best to let ginseng grow about 6 years.

Does not add or remove qi, it just moves it around.
Example: if your kidneys are weak and your heart is too strong, a good TCM doctor will move some of the heart qi to the kidney qi.
Acupuncture is a science, not an art of mystery.

Different approaches to treating a patient:
Example: a student has poor grades and not study well.
1. The poor study is due to being hungry, having girlfriend problems. Treatment: feed the hungery, get rid of girlfriend.
2. Poor study: make the student study more.

San jiao- triple warmer- separates body into 3 sections.
A C-section birth cuts the san jiao, can cause san jiao dis-eases.

Winter- do not ‘train hard’ in winter time, do not stress lungs. The Cold air, or “air qi” is weak outside. It can hurt your lungs. gain a few pounds in winter is ok. this will help for Spring time.
Fat/weight gain: men tend to get round in stomach area when weight gain, women accumulate in butt area.

Allergy analogy: If body is strong, allergy is like a 5 year old bully.
If body is weak allergy is like a 300 lb. biker brawler.


4/17/2014 East and West history: Eastern and Western medicine overview:

Traditional Chinese medicine (TCM) is an ancient medical system that takes a deep understanding of the laws and patterns of nature and applies them to the human body.

TCM is a holistic medical system which combines the use of acupuncture, herbs, nutrition, massage, and physical movement like Qigong and Tai Chi, to bring body into balance.

Western medicine looks closely at a symptom and tried to find an underlying cause, TCM looks at the body as a whole. Each Symptom is looked at in the relationship to all other presenting symptoms. The goal of the TCM practitioner is to assess the entire constitution of the patient—considering both physiological and psychological aspects.

The practitioner first observes the general characteristics of the patient, then tries to discern a relationship between symptoms in order to establish what is called a “pattern of disharmony”.
Treatment is aimed at restoring harmony and brining the body into balance.

Basic concepts:
I. Qi and Blood:
-the circulating life energy that in Chinese Philosophy is thought to be inherent in all things.
-Blood: meaning jing, hormones, lymph, yin, and blood.
-Qi: meaning: yuan, kong, gu, zhen, zong, ying, and wei varieties.
Nutrition Qi is ying qi. Helped with herbs and acupuncture.
Defensive Qi or Wei qi is helped with Tu-Na, Dao-yin, Qigong, Tai chi, etc.

II. Yin and Yang theory:
The shape of the yin sections of the symbol, actually gives you a sense of continual movement of these two energies, yin to yang, and yang to yin,
causing everything to happen: just as things expand and contract and temperature changes from cold to hot.
-Inside vs outside
-lower vs higher part.
-softer part vs. harder part.
-Blood vs. Qi.
- Lu,Sp,Ht,Kd,Pc,Lv vs. Li,St,Si,Bd,Sj,Gb.
-Yin is important part and essential part (holds things in).
-Yang is less important in terms of life threating (it passes through).

Yin/yang- balance, understand one is stronger and weaker. Restore the balance, know the proportions of yin and yang.

Upper Body- Yang, Face is hottest part.
Lower Body- Yin, feet is coldest part.
When you are Sick- face gets extra hot, feel temperature at forehead, this is a way to measure if it is a blood circulation problem due to excessive heat. Use cold towel to help balance.
When sick- warm-up the feet in the Yin part.

Men- are more Yang body is warm and hot temperature.
Women are colder more Yin, because of blood loss monthly. Tend to cold limbs. This changes at menopause when menstruation stops. Body will begin to get warm, thus ‘hot flashes’.
Healthy women- adjust to menopause in weeks’ time and get used to new internal system.
Unhealthy women- takes several years to adjust, have a hard time adjusting to new internal system.

Use common sense, listen to your body.
One thing is that in some western practices they may have mother who just gave birth take a cold bath. Taking a cold bath is not good after giving birth.
It is best to use warm. In Asian culture many new mothers are expected to stay away from cold 100 days after giving birth. Warm heals faster than cold.
Ice and cold are for pain, but if you do not feel a lot of pain and are just sore, use heat. Some women have a heat linament rubbed on legs after giving birth.

Yin and yang are relative:
-water is yin, but water is yang because ice is yin.
-fire is yang, but fire is yin, and laser is yang.
Age: boy is yang, but old man is yin.
Yin and yang standout in people, for example: Old woman has a very yang personality, but is old and female: yin.

Front of body is yin (soft organs) while back of body ins yang (hard bones of spine). However this is for upper body, lower part of body, front is yang (hard bones of knee) and back of legs are Yin (soft muscles).

Change happens in months, conditions of patient change with the seasons. A herb prescribed 6 months ago may not be needed to be taken. A new diagnosis may be needed to determine if you still need same herb or new formula.

Acupuncture and herbs combination:
Acupuncture is like teaching someone how to study, and herbs is like extra material a teacher will give to improve the studying: books, charts, handouts. Herbs add more help to the acupuncture. This is a good combination.

The patient is sick, you have to find out how they got sick, not just fix the symptoms of the sickness. Interview the patient, find where/how they got sick.
A patient says is feeling better and ask if they can stop taking the medicine: If you stop taking a shower will you stop getting dirty? You will get dirty, thus you will get sick.
Example: a patient with high blood pressure stops taking medicine, high blood pressure will come back.

3 types of patients that cannot be healed/cured:
1. Shamanic/faith healer: have irrational ways and lack logic. Example: snake handler religion, think snake/god will take care of sickness.
2. Money greedy: people who sacrifice money over health. Will not spend money on things they will help them and improve life. No exercise, just work to make money.
3. People who keep secrets. Not telling the doctor everything, truth. Not telling about lifestyle or bad habits.

3 ways of getting sickness:
1. Outside/External influence (Evil Qi): virus, bacteria, germs, cold energy, damp, heat, winds, ect.
2. Inside imbalance: food, emotion/stress: excessive joy, anger, fear, worry, sad, over-thinking.
3. Qi/blood Blockage: maybe from outside influence, inside influence or both.

Body signals: Use common sense, listen to your body.
Sometimes the craving you have are from the body and other times from the mind. You need to really sense what your body and mind are saying: for example you are craving seafood, this is salty, your body is telling you need some salt, but wanting something fatty and unhealthy is a mind craving. Eating the food that is not right for you will cause an internal imbalance and blockage.

External/Outside/”Evil Qi” for example it is very cold outside: the cold can get under layers: the skin, under muscles, under the blood vessles and meridians, penetrate to the bones, and finally the Zhang/Fu organs.
(Cold weather sample) into layers:
————blood vessel/meridian
Zhang/Fu organ.

When the outside influence penetrates deep to the bone and organ, it is very hard to fix.
Different methods treat the different layers:
Massage can help with skin, muscle, and blood levels.
Acupuncture helps the deeper layers of meridian, bone, and organ.

5 Element theory:
5 Element theory- heart fire, water kidney. “raise water-drain fire”. Metal- decrease, Wood- expand/rise, Earth- absorb.

5 images used to describe forces, and specific relationship to one another.

5 Elements: personality, body shape, organs, climate, taste, tissue, sense, direction, season, color, yin/yang organ, etc.

Talk on Calcium
- Milk is best for baby (baby cows that is), not adults. Digestion in humans change with age and harder to adjust to dairy when older.
- Milk is not always the best source of calcium.

Yin and yang theory is best for acupuncture, while 5 Element theory is best for Chinese herbs. This is saying that 5 element theory in acupuncture has been researched in the history of chinese medicine and found to be not as useful, using yin-yang theory in acupuncture history found this practice yields better results.
Trends in Eastern History in Chinese Medicine:

Pre-history, Antiquity:
Early inhabitants found foods that could relieve illnesses, others were poisonous.
Discovery of fire allowed for food to be cooked.
3 shaman leaders:
1. Fu xi- I-ching, yin-yang, and bagua theory.
2. Shennong- father of agriculture and herbs.
3. Huang di- Yellow emperor. Su wen book on lifestyle and Ling Shu- book on acupuncture clinical practice.

Shang dynasty (1700-1100BC)-
-use of wine and hot water a medicine.
-needles and bronze knives as surgical instruments.
-yin and yang theory and 5 element theory are basically common knowledge at this point.
Concepts of Qi, moxibustion, herbal decoctions, needles.

Zhou dynasty (1100-221BC)-
Taoism and Confucius time.
-organized medical systems developed: court appointed physicians.
Spring and Autumn period of Zhou dynasty:
Bian Que: Book: Nan Jing. patient diagnostics improved, questions, observer eyes, throat, etc.
Warring states period: book- Wushier Bingfang: 52 prescriptions early pharmacology.

Qin Dynasty (221-207 BC):
-Emperor Shi Huangdi burned books and killed scholars in 213 BC.

Han dynasty (206 BC-220 AD):
Most TCM theory and practice.
Qi and Blood fully entrenched in practice of TCM.
Examinations to recruit qualified physicians were introduced.
Silk road- communication and trade route.
Bencaogang (Classic of herbal medicine)- 365 medicines, 252 plant origin, 67 from animals, 46 from minerals.

Zhang Zhongjing- Shanghan Zabinglun.
Huang Fu Mi- Zhenjiu Jiayijing. ABC book of acupuncture and Moxibustion.
Wang Shuhe- The Maijing (Pulse classic, manual of the pulses.)
Hua To- surgeon and battlefield doctor, developed anesthesia, and exercise for body based on animal movement.
Tao hanjing- commentaries on the Shennong Bencaojing (Classic of herbal medicine).

-Emperor Wen of Song Kingdom: appoint physicians to teach medical students, government assigned teachers to educate higher standard of TCM.

Jin Dynasty- (265 AD to 960 ad)
Classic of pulse
First pharmacopeia
Imperial medical school
Systematic acupuncture and moxibustion
Disease and symptioms by Chao Yuanfeng
1000 golden prescriptions Sun simiao

Sui dynasty (581-618 AD)
Physician Chao Yuangfang- Zhubing Yuanhoulun (Treatise on Cause and symptoms of disease) book.

Tang dynasty (618-907 AD)

Imperial academy: Medical school system and Pharmacy system.
Sun Simiao- Hippocrates of TCM (body over disease)
His book: The Qianjian Yaofang- (Prescriptions worth a 1000 gold for emergencies, or Precious prescriptions for emergencies).

Song dynasty (960-1270 AD)
Wood Block printing, many books on TCM were printed under government supervision.
-Yellow Emperor’s classic, Classic of herbal medicine, Pulse classic, ABC of Acupuncture and moxibustion in publication.
Acupuncture statue.
New theory: The 3 causes.

Yuan dynasty (1270-1370)
Discussion on new methods: pathology, gynecology, pediatrics.
Liu Wansu: 5 movement, 6 influence. School of cooling: nourishing yin.
Zhang Congzheng- 6 doors , 3 methods.
Zhang Yuansu- illness was result of imbalance in zhang and fu organs.
Li Gao- how lifestyle affects body, spleen and stomach were vitality, emotions affect Qi.
Zhu Zhenheng- Minister of fire- fire and heat school.

Bone setting and tramatic surgery.
Eating for health.
(era of different schools)

Ming Dynasty- (1368-1644)
Debates, 3 schools:
1. Nourishing yin school,
2. Warming and invigorating school,
3.epidemic disease school.
Advancement in surgery
Waike zhengzong- early surgery records in TCM.
Li shizhen- Bencao Gangmu (Compendium of material medica.)

Qing dynasty (1644-1912 AD)
Western influence
Publishing of many encyclopedias.
Medical standards.
Integrated TCM.

Modern times (1912- today)
TCM to the world.
Combine western and eastern medicine.
National and international standards.

Parts of China and what they influenced based on climate to TCM:
North: moxibutions (cold)
South- herbs (warm) grasses.
Eastern region- (sea) acupuncture.
Western- (dry) qigong.


East West medicine:
Doctor and Book:
Fu Xi- i-ching
Shen Nong- Ben Cao jing , Herbal medicine.
Huang Di- Huang di nei jing- Classic of internal medicine.
Bian Que- Nanjing- commentary of huang di nei jing.
Hua To- Wuqinxi- 5 animal play.
Zhang Zhong Jing- Shang han Lun- study of febrile diseases.
Wang Shuhe- Mai Ching- Pulse diagnosis.
Sun Simio- Qian Jin Yi Fang; emergency formulas worth 1000 gold.
Huangfu Mi- Zhenjiu Jiayi Jing: systematic practice of acupuncture and moxa.

Most Chinese are Han. Many rulers have controlled China, but it is called Chinese history because it happened in China region.

North- moxibustion
West- qigong
East- acupuncture
South- herbology

2nd history theory:
Moxa- Tibet
Qigong- India
Herbs- southeast asia
Acupuncture- korea.

Historical Timeline divided into 4 core parts:
1. TCM part 1: antiquity to Zhou dynasty: fundamental time, learning how to recover from disease.
2. Part II: Han to Tang dynasty: how to repair the body.
3. Part III: Song to Ming dynasty: how to diagnose disease.
4. Part IV: Qing to Modern: combine western diagnosis and TCM.

Febrile diseases: feverish, hot, flushed, inflamed, delirious.


TCM history/theory:
Origin of Qi-
Normal/Upright Qi (zheng qi) or True qi (zhen qi). comes from 3 sources:
1. Original Qi- yuan qi: from parents, genetics, jing stored in Kidneys (reproductive system testes/ovaries).
2. Grain Qi- (gu qi) extracted from food, the qi from food and digestion.
3. Natural air Qi- (kong qi) oxygen/air we breathe.

Body or action Qi-
Organ qi- zhang fu zhi qi
Meridian qi- jinglou zhi qi
nutritive qi- ying qi: blood full of food nutrients from stomach, air from lungs, hormones/jing from kidneys, in the jinglou.
Protective qi- wei qi: skin, muscles, hair, chest abdominal. outside the jinglou.
Chest/ancestral qi- zhong qi: heart/lungs, vessels. Normal/True and nutritive qi goes to heart- heart to body.

5 elements: pulse taking, understanding the 5 fu and 6 zhang organs, yin and yang (inner and outer) of patient.
organ: Liver| heart| spleen| lung| kidney|
color: green| red| yellow| white| black|
direction: east| south| center| west | north|
sense organ:eyes| ears| mouth| nose| sex organ|
body part: nerves| heart| tongue| back | body cavity|
taste: sour| bitter| sweet| pungent| salty|
element: wood| fire| earth| metal| water|
animal: chicken| sheep| ox| horse | pig|
grain: wheat| glutinous| millet| rice | bean|
planet: Jupiter| mars | Saturn| evening star| morning star|
season: spring| summer| long summer| fall | winter|.
number: 8| 7| 5| 9| 6|


TCM notes for 5/8/2014
Western medicine -
4 parts: Greek, Rome, Middle Ages, Modern
Famous Doctors:
Surgions- surgery, he carried forceps, scapels, catheteres, used a anestesia from opiates.
Alcmaeon- author of a book on anatomy.
Humor theory- air, yellow bile, black bile, phlemgn.
Hippocrates- famous for many of his terms used in medicine today:
Acute, chronic, endemic (disease specific to a people in a specific area), epidemic, crisis, peak, paroxysm (spasm), convalescence (recuperation time). Hippocratic oath.
Pedanius Dioscorides- classified western herbs and medicines.
Herophilus- female nurse who studied intelligence was in the brain and connected it to nervous system, understood difference in the vein and artery, pulse.
Erasistratus- also mapped out veins and nervous system, brain, understood air in lungs created spirit to brain and nerves.
Galen- first good surgoen, but surgery not seen again for 2 millennia due to church regulations and working on people and cadavers.

Middle Ages: Barber shops- blood letting, holes in cranium (trepadation), barber shop symbol- white is bandage, red is blood, blue is body.

Modern times: microscope, anesthesia, vaccines, chiropractic. radiology, other.

Eastern medicine:

Huang di Nejing- Su Wen and Ling Shu. it departs from shamanic ways of disease by possession. focus on universe, qi- yin yang, 5 elements, and seasons. The natural effects of diet, lifestyle, emotions, environment and age are reasons of disease.
Su Wen- book of plain questions: 24 volumes, converstaion between Yellow Emperor and ministers including Qi bo and Lei gong.
Ling Shu- the vital axis. second book 81 chapters, acupuncture principles.
Nanjing- by Bien Que, “questioning Huang di neijing” refelcts on the earlier book and proposes difficulties and doubts and offers answers. 81 questions in the Nanjing. Pulse taking, zang-fu viscera, meridians and Shu acu-points.
Details on the various types of Qi and their sources, functions, distribution and relevance:
1. Jing (essence): source: parents, gu qi, and wei qi.
function: growth, reporduction, development.
Distribution: kidneys, testes, ovaries.
relevance: weak jing in children lead to poor bone development, slow learning, poor concentration, weak jing in elderly leads to deafness,, osteoporosis, unclear thinking.

2. Yuan Qi- (original Qi)
Source- jing.
function-promote and stimulate functional activites of organs. provideds a foundation and catalyst for production of Zhen Qi.
Distribution: originates in the ming men, circulates via the San Jiao, pools in the meridians at the Yuan source points.
Relevance- deficiencies in Yuan Qi may lead to poor development of acquired qi.

3. Gu qi- (essence of food and grain).
Source: originates from the action of the spleen on the food in stomach.
function: combines with kong and zong qi. some aspects transformed in blood.
Distribution: arises in the ST/SP and is moved to the chest where further distributed.
Relevance: good quality food and strong ST/SP are important to generate energy.
Weaknesses in the SP may lead to bloating, distention, fatigue, loss of appetite.

4. Kong Qi (air qi)
source: orginates from the air recieved by lungs.
function: combines with Gu qi to form zong qi.
distribution: distributed in the chest.
Relevance: good quality air and good breathing practices are essential for the formation of energy.

5. Zong qi- (gathering qi)
source: combination of gu qi and kong qi.
function: nourish the hear and lungs, aids the lungs in their role of respiration and circulationg energy throughout the body, assists the heart in circulation of blood through vessels to body.
distribution: stored in the chest.
Relevance: with a deficiency you will see the HT and LU most effected. low energy, weak voice, poor circulation in the extremeties. Can be treated with CV17 and the yuan source points of HT (HT7) and Lu (LU9).

6. Zhen Qi (True Qi)
Source: derived from Zong Qi when acted upon by Yuan qi.
function: this is the form of qi that circulated in the meridians and nourishes the organs.
Distribution: originates in the chest and is distributed throughout the body by respiration. composite of ying qi and wei qi.
Relevance: deficiencies indicate either and imbalance in the functioning of the creation of acquired qi or in the declining amount of Yuan Qi.

7. Ying qi (nutritive Qi)
Function: nourishes the organs. helps produce blood.
Distribution: circulates in the main meridians. flows with the blood in the main meridians and within blood vessels.
Relevance: this is the aspect of qi that is needled with acupuncture.

8. Wei qi- (defensive Qi)
function: protect the body, warm surface of body, regulate body temperature by open/close pores.
distribution: on the surface of the body, and within muscles and skin, but not within the meridians. circulation is dependent on the lungs.
Relevance: people who catch colds easily often have weiqi deficiency.
deficiency may also make it difficult to regulate body temperature.

Functions of Qi in the body
Catalyzing functions: qi assists in the formation and transformation within the body, for example, the transformation of food into Qi and blood.
Protecting functions: qi defends the body from the external pathogens.
Raising and Stability functions: qi holds organs in their place, keeps blood in the vessels, governs the removal of fluids.
Transporting functions: qi is the foundation of all movement and growth in the body.
Warming fuctions: qi helps to control homeostasis and provides warmth for the body.

Qi disharmonies with signs and symptoms:

4 main imbalances of Qi. Affect part of body, organ, meridian, or area. example: deficiency of qi may effect lungs with symptoms of shortness of breath.
1. Qi deficiency: fatigue, dizziness, worse on exertion, pale face, weak spirit. tongue is pale, thin coat. Pulse is empty.
2. Sinking Qi: qi deficiency signs, down bearing sensation in abdomen, prolapse of organ. tongue is pale/thin coat. pulse is empty.
3. Qi Stagnation: Pain that is not fixed in chest or hypchondriac area. tongue is white coat. Pulse is wiry or tight.
4. Rebellious Qi: coughing, belching, vomiting, hiccup, dizziness. tongue is pale white coat or Red w/yellow coat. Pulse is wiry or rapid.

(not needed from class/exam)
note From Yellow Emperor Classic:

12 meridians

Taiyin and Yangming meridians:
1. Lung meridian of Hand Taiyin- middle burning space to the tip of the thumb.
2. Large intestine meridian of Hand Yangming- tip of thumb and small finger to large intestine.
3. Stomach meridian of Foot-Yangming- from middle of nose to the middle of foot.
4. Spleen meridian of foot- Taiyin. From the great toe to the lower part of tongue.

Shaoyin and Taiyang meridians:
5. Heart meridian of the hand Shaoyin- from the heart to the inside of the little finger.
6. Small Intestines meridian of the hand Taiyin- from the little finger to the small intestines.
7. Bladder meridian of the Foot Taiyang- from the inner corner of eye to the little toe.
8. Kidney meridian of Foot shaoyin- from the little toe to the root of the tongue.

Jueyin and Shaoyang meridians:
9. Pericardium of the hand Jueyin- from the middle of the stomach to the top of middle finger.
10. San Jiao of hand Shaoyang- from the tip of the little finger to the 3 burning places.
11. Gall Bladder of the Foot shaoyang- from the outer angles of the eye to the little toes.
12. Liver meridian of the foot Jueyin- from the hairy spot of big toe to the vertex of the head.

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