Traditional Chinese Medicine and Ayurveda

Key Texts and Figures

(Pre 1000 B.C.) Yi Jing Book of Changes
Laws of transformation ability to predict

(~1000 - 200 B.C.) Basic Medical Theory

Huang Di Nei Jing Yellow Emperors Interior Classic
anatomy, physiology, etiology, diagnosis, and treatment.

(~200 B.C.) Materia Medica

Shen Nong Ben Cao Jing Divine Husbandmans Classic of the Materia Medica - 365 Entries

(~250 A.D.) Anesthesia, and surgery - Hua Tuo

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Key Texts and Figures

(~250 A.D.) Huang Fumi
Earliest known text on acupuncture
Zhen Jiu Jia Yi Jing - A-B Classic of Acupuncture and Moxibustion

(~300 A.D.) Zhang Zhong Jing

Earliest known text on herbal prescriptions
Shang Han Lun - Treatise on Febrile Disease exterior pathogens Jin Gui Yao Lu - Synopsis of Prescriptions of the Golden Chamber internal medicine
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Key Texts, Figures, and Events

(610 A.D.) Medical Specialties
internal medicine, surgery, gynecology, pediatrics, five sense organs, and parasitology.

(1026 A.D.) Imperial Medical Bureau NIH

Extensive curriculum, and bronze statue for acupuncture, editing bureau of medical texts.

Key Texts, Figures, and Events

(1518-1593) Li Shi Zhen

Ben Cao Gang Mu - Compendium of Materia Medica: 1,892 entries and 10,000 prescriptions
(11th century) - First vaccination for smallpox. (17-19th century) - First ideas of epidemic pathogens: Entry via nose and mouth 20-21st century - Influence of western medicine, Combination of the two medicines.
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Central Concept of TCM

Organism as a whole
Relationships
Between organs

Between human and nature

Different diseases occur during different seasons

Circadian rhythm seasons and insomnia

Central Concept of TCM

Balance
Yin Yang / Wu Xing (Five Phases) Homeostasis

Overall analysis to reach diagnosis Treatment principles

Finding the root cause

Yin Yang

Yi Jing Book of Changes Character meaning Yin Radical is about mound or hill, root describe the side facing away from the sun and mist.

Yang - Radical is about mound or hill, root describe the side facing toward the sun.
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Yin Yang

Yin cold, weak, restricted, dark, visible, heavy, turbid, downward, inward.
Yang hot, excited, moving, strong, bright, invisible, light, clear, upward, outward.
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Yin Yang

Opposition and Interdependence

Relative: Back / Chest

Concept of health plant analogy

Rise and Decline
Transformation - Extreme decrease in Yin leads to a Yang condition and vice versa
Insomnia
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Wu Xing - Five Phases (Elements)

Fire, Earth, Metal, Water, Wood. Categorizing tool
Separate according to innate qualities.

Related to Yin and Yang.

More concrete categorization. Synthesize and summary with observation of nature.

Xing = Phases
Denotes movement of energies
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Wu Xing Five Phases Cycle

FIRE

WOOD

EARTH

WATER

METAL
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Five Phases and Human Body

Viscera
Wood Liver

Bowels
Gall Bladder

Sense Seasons Emotions Organs

Eyes Spring Anger

Fire
Earth Metal Water

Heart
Spleen Lung Kidney

Small Intestine
Stomach Large Intestine Urinary Bladder

Tongue
Mouth Nose Ear

Summer
Long Summer Autumn Winter

Joy
Concern Grief Fear
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Zang Fu (Organ Systems)

To Summarize

Categorizes and unifies different parts of the body Spans different systems in Western anatomy Need clarification during interpretation &

translation
Example: Liver Qi stagnation
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Qi
Qi Energy
Different types with different functions Derive from two major sources:
Food (Gu) and Fresh Air (Qing)
Nutrient & oxygen metabolism

Functions: Promote movements, warmth, immunity, consolidation, control, metabolism,

and transformation.
Example: Peristalsis
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Blood Body Fluids

Blood Xue
Formation from food essence, and essence transformation through bone marrow. Main function: Nourish

Body Fluids Jin Ye

Function also to nourish and moisten. It is considered a component of blood.

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Meridians

Jing Luo Main Route and Net (Network)

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What is Acupuncture?
Many studies in animals and humans have demonstrated that acupuncture can cause multiple biological responses mediated mainly by sensory neurons to many structures within the central nervous system. This can lead to activation of pathways affecting various physiological systems in the brain as well as in the periphery... Considerable evidence supports the claim that opioid peptides are released during acupuncture and that the analgesic effects of acupuncture are at least partially explained by their actions. That opioid antagonists such as naloxone reverse the analgesic effects of acupuncture further strengthens this hypothesis. Stimulation by acupuncture may also activate the hypothalamus and the pituitary gland, resulting in a broad spectrum of systemic effects. Alteration in the secretion of neurotransmitters and neurohormones and changes in the regulation of blood flow, both centrally and peripherally, have been documented. There is also evidence of alterations in immune functions produced by acupuncture. Which of these and other physiological changes mediate clinical effects is at present unclear.
18 Acupuncture. NIH Consensus Statement Online 1997 Nov 3-5; month, day]; 15(5):1-34.

What are Meridians?

Despite considerable efforts to understand the anatomy and physiology of the "acupuncture points," the definition and characterization of these points remain controversial. Even more elusive is the scientific basis of some of the key traditional Eastern medical concepts and other related theories, which are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture.
Acupuncture. NIH Consensus Statement Online 1997 Nov 3-5; month, day]; 15(5):1-34.

The acupuncture points or biological active points (BAP), also known as low-resistance spots or good electro-permeable points, have relative lower electric resistance than the surrounding tissues This preliminary study presented here shows there exists a bilateral symmetry of the skin resistance of the corresponding BAPs from the left and the right hands of all chosen subjects over a range of measuring pressure. .
Conf Proc IEEE Eng Med Biol Soc. 2004;4:2995-8
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Questions & Discussion

Next Causes of Illness

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Theories and Causes of Disease

Imbalance
Yuan Qi deficiency
Yuan: primary, original, core

Pathogenic factors invasion

Combination of internal and external causes

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Pathogenic Factors - 6 Evils Wind

Cold
Heat Dampness Dryness Fire

External and Internal, related to seasons

May be relate to epidemic pathogenic factors
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Internal injury, Seven Emotions and Lifestyle

Emotions and organ relationships according to Five Phases.
Prolonged or excessive display of an emotion will hurt the corresponding organ. Excessive or malnourished diets.

Excessive or little work and rest.

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Five Element and Human Body

Viscera
Wood Fire Earth Metal Water Liver Heart Spleen Lung Kidney

Bowels
Gall Bladder Small Intestine Stomach Large Intestine

Sense Organs
Eyes Tongue Mouth Nose

Seasons
Spring Summer Long Summer Autumn Winter

Emotions
Anger Joy Concern Grief Fear

Urinary Bladder Ear

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Diagnosis - 4 Steps SOAP

Viewing
Smelling / Listening

Questioning
Palpating (pulse)
9 position on each hand Rate and Quality
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Treatment Principles SOAP

RESTORE BALANCE Expel pathogenic factors or parasites external

Fortify Yuan Qi - internal

Treat according to symptoms which reflect

current imbalance (status) of the patient.

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Treatment Methods Acupuncture

Regulate Qi and Blood
Balance autonomic nervous system
neuroendocrine Call attention to diseased areas or systems and invoke healing response
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Treatment Methods
Herbs
1-3 herbs for each imbalance
Cooking methods very important Pre-add, post add, different forms Toxic effects of herbs add other herbs to moderate
Licorice (Gan Cao)
Ginger (Sheng Jiang) long cooking
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Treatment Methods

Chinese Physio-Massage / Manipulation (Tui Na)

External force to move Qi and Blood
Unblock stasis

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Qi
Qi Energy
Different types with different functions Derive from two major sources:
Food (Gu) and Fresh Air (Qing)
Nutrient & oxygen metabolism

Functions: Promote movements, warmth, immunity, consolidation, control, metabolism,

and transformation.
Example: Peristalsis
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Ayurved a
Carli Hill

Objectives
Introduction to Ayurveda
Tridosha theory Reported benefits Reasons for caution Current Research

Conclusions

Introduction to Ayurveda
Comprehensive system that places equal emphasis on the body, mind and spirit, and it strives to restore the innate harmony of the individual
Ayurveda is the combination of two Sanskrit words
ayu meaning long life ved meaning knowledge Knowledge or science of life

 Practiced in India for over 5000 years Covers all medical fields

Diagnosis done by observation, touch, and questioning

Four components to disease management
Physician, Drug, Patient, Attendant (such as a nurse)

 Clinical exam includes

Pulse diagnosis Urine examination Stool examination Tongue examination Examination of body sounds Eye examination Skin examination Assessment of total body appearance

 Treatment has four main parts

Shodan cleansing Shaman palliation Rasayan rejuvenation Satwajaya mental nurturing and spiritual healing

 Imbalance in the doshas is the main cause of disease or poor health

 Slowing the aging process

Reported Benefits

Promoting health of all the organs of the body

Reducing fatigue and stress

Nurturing the body with proper diet

Healing disorders of the nervous system

Caution
Herbal/metal/mineral Ayurvedic treatments
Safety dependent on following a complex procedure Many include heavy metals such as mercury, lead, and arsenic 1 in 5 herbal products produced in South Asia have toxic levels Reports of lead poisoning

A biostatistical approach to Ayurveda: quantifying the Tridosha. Joshi R. J Altern Comp Med. 2004;10;5;879-889.

Objective create an equation to quantify the three doshas Methods

280 subjects Add worth-coefficients to dosha characteristics Individual doshas predicted using equation Predictions compared to qualitative diagnosis

Results equation predicted correct dosha over 90%