整体论

The basic characteristics of TCM

Concept of syndrome differentiation and treatment are the two basic characteristics of TCM in understanding human physiology and pathology as well as diagnosis, treatment and prevention of disease.

(1) Concept of holism: The concept of holism means that the human body is an organic whole and that human beings are interrelated with nature.

1) Organic wholeness of the body

TCM believes that the human body is composed of various tissues and organs, including the viscera, the meridians, the five sensory organs, the nine orifices, the four limbs and all the skeletal parts. These different tissues and organs are united into an organic whole because they are closely related to each other in structure, physiology and pathology. In structure, the body centers round the five zang-organs, namely the heart, the liver, the spleen, the lung and the kidney. Through the system of the meridians and the functional activities of the corresponding six fu-organs, the five constituents, the five sensory organs and the nine orifices, the body becomes a unified whole that is connected with the upper and lower as well as the internal and external. In physiology, the viscera, though different in functional activities, cooperate with each other in functions. Take food for example. When it enters the mouth, the stomach digests it first and then transmits it to the small intestine where it is further digested with the functions of the spleen to transform and the small intestine to separate the clear from the turbid. Then the nutrients are absorbed and transformed into qi and blood to be transported to all parts of the body. The waste part is transmitted to the large intestine where it is transformed into feces and then discharged through the anus.

Actually the liver, the gallbladder and the triple energizer are also involved in this digestion process. It is obvious that the digestion of food, the absorption of nutrients and the discharge of waste are accomplished by concerted action of a number of organs. In pathology, morbid change in any part of the body will affect the other viscera and tissues or even the whole body. Similarly, general pathological change of the body will affect the functions of the local viscera. Take the liver for example. If it fails to dredge and disperse, it may lead to dysfunction of the spleen, affecting the digestion and absorption of food. Take the heart for another example. Stagnation of heart-blood will inhibit the flow of lung-qi, leading to disorder of respiration. So in clinical diagnosis and treatment of disease, thorough examination of the five sensory organs, physical condition, complexion and pulse must be made to analyze the pathological changes of the viscera so as to decide correct therapeutic principles and methods.

2) Correlation between man and nature

Human beings live in nature and nature provides them with various necessities, such as sunlight, air and water. On the other hand, various changes taking place in nature may directly or indirectly affect the human body and bring on corresponding physiological or pathological responses. For example, warmth in spring, heat in summer, coolness in autumn and cold in winter may affect the human body in different ways. In spring and summer it is warm and hot, and yang-qi is in predominance. So the skin is loose and the sweat pores are open. That is why there is profuse sweating and infrequent urination in spring and summer. In autumn and winter it is cool and cold, and yang-qi gradually declines. In these two seasons the skin is tense and sweat pores are closed. That is why there is frequent urination and scanty sweating in autumn and winter. This shows that the metabolism of water in the body is regulated automatically with the variations of the four seasons, If the variations of the seasons are too violent and beyond the automatic adjustment of the body, or if the body resistance declines and the self-regulation function becomes abnormal, frequently encountered seasonal disease and epidemic disease will occur.

Usually wind disease tends to occur in spring, summer-heat disease in summer, dry disease in autumn and cold disease in winter. Take some aged patients with chronic disease for example. They tend to have ailments when the season changes. Such ailments may further lead to the onset or aggravation of diseases.

Geographical conditions, similar to the seasonal variations, also affect the physiological activity and pathological state of the body. In the warm areas with sufficient rain, for example, people are easily to be affected by exogenous pathogenic factors because their skin is loose and their constitution is comparatively weak. But in the dry areas, people are prone to endogenous impairment because their skin is tense and their constitution is comparatively strong, making it difficult for exogenous pathogenic factors to invade them. It is obvious that different geographical conditions are responsible for different constitutions of the human beings. That is why it is difficult for people to be quickly accustomed to new geographical conditions when they moved to a new place.

(2) Bianzheng lunzhi (Syndrome differentiation and treatment) :

1) Implication of syndrome differentiation and treatment

Syndrome differentiation and treatment means to analyze, induce, synthesize, judge and summarize the clinical data of symptoms and signs collected with the four diagnostic methods ( inspection, auscultation,interrogation,palpation). Then the therapeutic methods are decided according to the result of syndrome differentiation. Syndrome differentiation and treatment is a basic principle in TCM to understand and treat disease.

2) Differentiation of syndrome and differentiation of disease

Clinically differentiation of syndrome and differentiation of disease are intrinsically interrelated on the one hand, and different on the other. It is generally thought that disease includes the whole pathological course while syndrome is just the summarization of disease at a certain stage of its development. For this reason one disease may display different syndromes while different diseases may demonstrate the same syndrome in their courses of development. Therefore in TCM, the understanding and treatment of disease mainly focus on differentiating syndrome and analyzing them of differentiating disease. For example, one disease may demonstrate different syndromes which should be treated with different therapies due to difference in constitution, onset of disease, geographic conditions, or stage of development. Take common cold for example, clinically it is divided into wind-cold syndrome and wind-heat syndrome due to difference in pathogenic factors. The former is treated by relieving superficial pathogenic factors with drugs acrid in taste and warm in property while the latter with drugs acrid in taste and cool in property, which is known as " Treating the same disease with different methods" in TCM.

However, same therapeutic method can be used to treat different diseases with the emergence of the same syndrome in their courses of development. Take dysentery and jaundice for example. They are two different diseases. But if they all demonstrate damp-heat syndrome, both of them can be treated by the therapeutic method for clearing away damp-heat, which is known as "Treating different diseases with the same method" in TCM.