Chinese Medicine

Welcome to the Coursera Course – Everyday Chinese Medicine! This introductory course aims
to familiarize the public, as well as the healthcare professionals on the basic principles of
Chinese medicine . Our primary goal is to empower healthcare choices by promoting awareness
and practical application on Chinese medicine diagnostic and therapeutic approaches, and to
facilitate interprofessional education between Chinese and conventional clinicians.
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Learners will develop skills in applying theories of Chinese medicine for understanding health
and illnesses. We will discuss how Chinese medicine conceptualizes health through the
relationship between Yin Yang; how the Zang – Fu organs maintain vital functions of human
body, and how Qi, Blood and Body Fluids contributes to well-being. We will also describe the
principles of pathogenesis in Chinese medicine,explaining how the six exogenous agents,
seven emotions, and other pathogenic factors can lead to occurrence of illnesses. Base on such
understanding, we will then demonstrate the practical diagnostic procedure in Chinese medicine
using the Four Examinations, and illustrate how the syndrome differentiation process provides a
basis for formulating treatment strategies in Chinese medicine. There are exercises and tasks in
each session to facilitate better understanding of the practical principles of Chinese Medicine.
We hope you enjoy learning the ancient wisdom of China!

Reading list for Session 1

Recommended Reading:

Chapter 1 of Xue-sheng, Z. (2007). Chinese medicine study guide: Fundamentals. People's

Medical Publishing House.

Chapter 6 of Kaptchuk, Ted. (2000). The web that has no weaver: understanding Chinese
medicine. The McGraw-Hill Companies.

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The Initiation of Chinese Medicine
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The theory of Chinese medicine developed and expanded mainly from long term repeated
practice and experience. As early as four thousand years ago, the ancient Chinese created
preventive medicine in their struggle with nature and disease. During the process of
experimenting with indigenous plants and most minerals as food, they soon understood that
some of these substance could relieve or even eliminate some diseases. From this came the
development of Chinese herbal medicine and its applications. Using the power of fire to warm
the body also came from those times of antiquity. The ancients found that applying heat to the
stones or hot sand, wrap with leather, or certain types of bark, could relieve pain or discomfort.
Gradually, they developed the method of using hot compresses and moxibustion. During the
process of using stone and animal bones for use in the production of tools, they found that when
one part of the body is penetrated, a disorder in another part of the body can be relieved. Hence
the entrance created a method of using stone or bone needles for therapeutic use. From these,
acupuncture was developed and soon after acupuncture channel theory.

Chinese medicine pays much more attention to the unity and integrity of the body, and the
interrelation between the human body and the outside world.The human body, as an organic
whole, is composed of a number of visceral organs and tissues, which have their own
respective functions.Every function, however, is a component of the body's overall
activity.Meanwhile, man lives in nature, and nature provides conditions indispensable to man's
survival.As a result, the human body is bound to be affected directly or indirectly by the changes
in nature to which it is subjected.In the field of Chinese medicine, there is a saying,physicians
have to know the laws of nature and geographical conditions when diagnosing and treating
diseases. That is why Chinese medicine not only stresses the unity of the human body itself, but
also attaches great importance to the interrelationship between the body and nature in
diagnosis and treatment of a disease.

The term differentiation means comprehensive analysis. While the term syndrome refers to
signs and symptoms.So differentiation of syndromes implies that the patient's symptoms and
signs collected by the diagnostic methods in Chinese medicine are analyzed and summarized to
identify the etiology, nature, and location of a disease.thereby determining what syndrome the
disease belongs to.The term treatment refers to selecting the corresponding therapy according
to the outcome of differentiating the syndromes.Taken as a whole, treatment by differentiation of
syndromes means diagnosis and treatment based on the overall analysis of signs and
symptoms.Concerning the relationship between disease and treatment, Chinese medicine can
show two different categorical clinical manifestations based on the system of treatment by
differentiation of syndromes.The first category is treating the same disease with different
therapies.
The term differentiation means comprehensive analysis. While the term syndrome refers to
signs and symptoms.
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So differentiation of syndromes implies that the patient's symptoms and signs collected by the
diagnostic methods in Chinese medicine are analyzed and summarized to identify the etiology,
nature, and location of a disease.
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thereby determining what syndrome the disease belongs to.
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The term treatment refers to selecting the corresponding therapy according to the outcome of
differentiating the syndromes.
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Taken as a whole, treatment by differentiation of syndromes means diagnosis and treatment
based on the overall analysis of signs and symptoms.
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Concerning the relationship between disease and treatment, Chinese medicine can show two
different categorical clinical manifestations based on the system of treatment by differentiation of
syndromes.
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The first category is treating the same disease with different therapies.
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For example, influenza, from a Chinese medicine perspective, may be caused by a variety of
different pathogens. Some common terms to describe these pathogens are, wind-cold,
wind-heat or summer-heat.
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These syndromes, may also show signs of another pathogen, known as damp.
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Because there is more than one possibility of a diagnosis, the treatment approach can vary. This
includes dispersing wind-cold, eliminating wind-heat, clearing away summer-heat, and dispelling
dampness.
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The second category is based on treating different diseases with the same therapy.
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To elaborate, even though a disorder may have two different biomedicine disease diagnoses, if
the Chinese medical pathology is the same, then the treatment will be the same.
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For example, ischemic stroke and myocardial infarction can occur due to various reasons from a
biomedicine perspective.
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However, according to the principles of Chinese medicine, even though the biomedicine
diagnosis may be different,
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If the ischemic stroke and myocardial infarction is caused by the Chinese medical syndrome
known as blood stasis, then the treatment method of removing blood stasis will be used.

For example, influenza, from a Chinese medicine perspective, may be caused by a variety of
different pathogens. Some common terms to describe these pathogens are, wind-cold,
wind-heat or summer-heat.

These syndromes, may also show signs of another pathogen, known as damp.
Because there is more than one possibility of a diagnosis, the treatment approach can vary. This
includes dispersing wind-cold, eliminating wind-heat, clearing away summer-heat, and dispelling
dampness.Yin yang is a splendid cultural concept in Chinese civilization. It represents the two
fundamental principles or forces in the universe. Ever opposing and supplementing each other.
Even today, Chinese medicine practitioners continue to apply these two concepts in daily practice

They are the foundation for explaining the physiological functions, pathological changes, diagnosis,

and treatment of the human body.

Yin-yang was originally included in the category of being an ancient philosophy of China.
Yin-yang in the simplicity refers to whether a place is exposed to sun or shade. The place being
exposed to the sun is warm by nature, so it belongs to Yang. The place not having exposure to
the sun is cold in nature, so it belongs to Yin. Such as a mountain, the southern side belongs to
Yang while the northern side of it belongs to Yin.

Furthermore, through the process of long-term observation, practice and investigation of these
original characteristics of Yin-yang, people have come to realize that Yin and Yang exist in all
things. Their interaction promotes the occurrence, development, and transformation of all things.
In consequence, Yin-yang is used as a means of reasoning and analyzing all phenomena in the
physical world.

The impact of the Yin-yang theory in the science of Chinese medicine, has promoted the
formation and development of its own theoretical system. Yin-yang has become an essential
component and a foundation of Chinese medicine theory.

The content of Yin-yang theory can be described briefly by using the four aspects of opposition,
Opposition of yin-yang means that all the things and phenomena in the physical world, contain
two opposite aspects. Now try to match these phenomena to the Yin Yang concepts:

Yin-yang not only oppose, but also contain each other. Neither of them can exist on their own
without the other. For instance, there can be no day without night, and vice versa. There's no
outside without there being the presence of the inside, and vice versa. This relationship of
co-existence is known as interdependence. Chinese medicine regards functional movement
belongs to Yang and nourishing substance belongs to Yin. And that the one cannot exist without
the other. For instance, the beating action of the heart belongs to Yang, while the heart organ,
per se, belongs to Yin. Both need to exist for maintaining life.

The opposition and interdependence of the Yin-yang are not stagnant. On the contrary, they are
in a dynamic state. The constant cyclical change from day to night or the change in the seasons
and temperatures is an example of this.
Transformation means Yin-yang will transform into each other. Under certain conditions, Yin can
transform into Yang and Yang can transform into Yin. If using the terms waxing and waning of
Yin-yang, it is referring to the process of quantitative change. The terms transformation between
Yin-yang is a process of qualitative change. Yin and Yang are in a constant state of division.
Yin-yang can be still divided into another pair of Yin-yang. For instance, day is of a Yang nature
and night is of a Yin nature. By both day and night can be divided even further. The period from
dawn till noon is the Yang aspect of the day, Yang part of the Yang.

And the period from noon till dusk is the Yin aspect of the day, Yin part of the Yang. The period
from dusk till midnight is the Yin aspect of the night, Yin part of the Yin. And the period from
midnight til dawn is the Yang aspect of the night, Yang part of the Yin. It should be pointed out
that the properties of the Yin or Yang and how they relate to things is not absolute. It's relative.
The embodiment of Yin-yang is in every aspect of Chinese medicine theory. It is used to explain
the physiology and pathology of the human body. It also serves as a principle guide to clinical
diagnosis.

Chinese medicine believes that the normal physiological function of the human body results
from the unifying, opposing, and coordinating relationships between Yin and Yang. Yin-yang are
always in the state of the dynamic union of the opposites. One of the classic theories of Chinese
This refers to a Yin being involved in the process of producing and preserving the life essence.
While Yang is involved in the process of decomposing substance and releasing energy.
Physiological function is based on substance. Without substance, including the essence of life,
Blood, and Fluids, there would be no source for function. If the Yin-yang mechanisms of the
body were to separate from each other and will not assist each other, life will come to an end.

If the normal function of Yin preserving the Essence and Yang transforming the Qi were to break
down, the human body would be in an abnormal state, resulting in the onset of disease. For
example, Yin of the heart will be depleted when structural parts of the heart are damaged in a
myocardial infarction. This will reduce the heart's ability to pump, which can be understood as
the function of the Heart-yang.

Because one of the basic pathogeneses of a disease is the imbalance of Yin and Yang, any
disease, no matter how intricate and volatile its clinical manifestation, can be diagnosed with the
theory of Yin-yang.

Diseases are classified as Exterior and Interior according to their locations and as Cold, Heat,
Deficiency, and Excess according to their nature.

As a result, when using the Theory of Yin-yang, Exterior, Heat, and Excess are considered as
Yang. Interior, Cold, and Deficiency are considered as Yin.

In Chinese medicine, when making a diagnosis, the most important thing is to ascertain whether
the disease is Yin or Yang.
For example, in a case where Yang-Heat is exuberant and injures Yin-Fluids. The method of
"Cooling what is Hot" requires the use of medicinal substances that are Cold in nature to reduce
the surplus of Yang.

For a case of excessive Yin-Cold, injuring the Yang-Qi, the method of "Heating what is Cold"
requires the use of medicinal substances that are Hot in nature to restrain excessive Yin.

Because both syndromes are both Excess syndromes, the therapeutic principles is called
"Treating Excess syndromes with purgation".

For a case of hyperactivity of Yang due to Yin-fluids failing to control Yang, or a case of
exuberance of Yin due to depleted Yang-Qi failing to control Yin. The treatment must include
reinforcing the deficiency of Yin or Yang. The therapeutic treatment principle of restoring a
relative balance between Yin and Yang is treating Yin for Yang illness and treating Yang for Yin
illness.

In Chinese medicine, Zang-fu organs of human body can be classified into two major groups.
The "five Zang organs" and the "six Fu organs". The five Zang organs include the Heart, the
Liver, the Spleen, the Lung and the Kidney. The common characteristics of these five Zang
organs are in preserving the vital substances. The six Fu organs are the Gallbladder, the
Stomach, Large Intestine, the Small Intestine, The Urinary bladder and the Sanjiao.

Their basic functions are transporting and digesting water and food.

The human body is an integrated whole. All its tissues and structures are organically connected.
And may be classified into two opposite aspects of Yin and Yang. When discussing Yin-yang
and their relationship to the Chinese medicine perspective of the body's internal organs. The
five Zang organs Heart, Liver, Spleen, Lung and Kidney belongs to Yin. Their functions of
preserving vital substances tend to be stable. The six Fu organs, Gallbladder, Stomach, Large
intestine, Small intestine, Urinary bladder and Sanjiao belong to Yang. Their functions of
transporting and digesting water and food tends to be active.

The relationship between Yin and Yang also remains constant among the five Zang organs. The
Heart and Lung, located in the Upper-jiao, are more Yang in nature. Because of their location, is
anatomically higher than Liver and Spleen of the Middle-jiao. Or the Kidney, which is found in
the Lower-jiao of the human body and is considered the most Yin in nature. When discussing
Yin-yang and how they relate to all the organs, the functional aspect of the organs is yang and
the substantial aspect is Yin. Further more, each of the Zang and Fu organs can be further
divided into Yin and Yang. For example, Heart-yin and Heart-yang. Kidney-yin and Kidney-yang,
Stomach-yin and Stomach-yang etc. When applying the concept of Yin-yang to the substances
of Qi and Blood in the human body. Qi is Yang because it performs a kinetic, functional role in
the human body. While blood is more material and physical in nature.
The internal organs of the human body can be summarized into five systems according to
Zang-fu theory, Zang-fu, Yin-yang, and the exterior-interior relationship between them,

is formed by the connection of their channels and collaterals. The five Zang organs have their
own expression and their own relationship with other parts of the body, with mental activities,
and the external environment.

There is a corresponding link between the outward expressions and inner functions of the five
Zang organs.

Zang-fu organs theory puts stress on evaluating the physiological functions and pathological
changes of the whole body by observing the external manifestations of the organs. An example
of this manifestations could be assessed from the following signs and symptoms. For example,
Ruddy complexion, mental clarity, a strong spirit, a rosy tongue, and a powerful and harmonious
pulse demonstrate the Heart function is normal. If the signs and symptoms are the opposite,
there may be Heart-Qi deficiency.
It must be pointed out that the names used to describe internal organs in Chinese medicine are
similar, or the same as the terms used in biomedicine. But all the concepts are not the same.
For example, the functions of one organ in Chinese medicine may contain the functions of many
organs in biomedicine. Meanwhile, the functions of one organ in biomedicine may be contained
in the functions of several Zang organs in Chinese medicine. This is because the Chinese
medical concepts of Zang-fu organs is not only an anatomical unit, but also a concept of
physiology and pathology. The latter of the two is more important. For instance, the heart in
Chinese medicine refers to the same anatomical entity as in biomedicine. In addition, however,
it also refers to some of the functions of the nervous system and is connected to the spirit. The
differences in the concepts between Chinese medicine and biomedicine are mainly due to the
difference in the way of seeing things. Chinese medicine gathers its knowledge of the internal
organs mainly from repeated practice and observation. Whereas in biomedicine it is based on
the knowledge mainly on repeated autopsies, experiments, and summarizations. Hence, in
learning the theory of Chinese medicine, concerning Zang-fu organs, one should have a clear
idea of what it is about. And then make further inquiries and studies of it through the step by
step adoption on biotechnical know-how and method so as to bring to light to its essence.