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Hu Dongpei (Ed.)
Traditional Chinese Medicine

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Traditional
Chinese Medicine


Theory and Principles

Edited by
Hu Dongpei

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This work is co-published by Tsinghua University Press and Walter de Gruyter GmbH.

Contributors Committee
Editor-in-Chief: Hu Dongpei
Chinese Chief Reviewer: Li Qizhong
English Chief Reviewer: Portia Barnblatt
Assiociate Chief Editors: Zhang Ting, Xie Ning
Editors (in alphabetical order of surnames):
Cheng Liguo (Medical College of Ji’Nan University)
Hu Dongpei (Shanghai University of Traditional Chinese Medicine)
Ji Lijin (Fujian University of Traditional Chinese Medicine)
Li Jing (Anhui College of Traditional Chinese Medicine)
Li Qizhong (Shanghai University of Traditional Chinese Medicine)
Li Xiaoqian (Shanghai University of Traditional Chinese Medicine)
Liang He (Henan College of Traditional Chinese Medicine)
Liu Xiaoyan (Changchun University of Traditional Chinese Medicine)
Lü Zhiping (Southern Medical University)
Ma Shuran (Beijing University of Traditional Chinese Medicine)
Meng Jingyan (Tianjin University of Traditional Chinese Medicine)
Ni Xianghui (Guiyang College of Traditional Chinese Medicine)
Portia Barnblatt (America College of Traditional Chinese Medicine)
Shi Jianmei (Shanxi College of Traditional Chinese Medicine)
Wang Yingxiao (Shanghai University of Traditional Chinese Medicine)
Xie Ning (Heilongjiang University of Traditional Chinese Medicine)
Yu Ling (Shanghai University of Traditional Chinese Medicine)
Zhang Qingxiang (Shandong University of Traditional Chinese Medicine)
Zhang Ting (Shanghai University of Traditional Chinese Medicine)
Zhu Manjia (Chengdu University of Traditional Chinese Medicine)

ISBN 978-3-11-041729-6
e-ISBN 978-3-11-041766-1
e-ISBN (EPUB) 978-3-11-041780-7

Library of Congress Cataloging-in-Publication data

A CIP catalog record for this book has been applied for at the Library of Congress.

Bibliographic information published by the Deutsche Nationalbibliothek

The Deutsche Nationalbibliothek lists this publication in the Deutsche Nationalbibliografie; detailed
bibliographic data are available in the Internet at http://dnb.dnb.de.

© 2016 Walter de Gruyter GmbH, Berlin/Boston and Tsinghua University Press, Beijing
Cover image: Yi Lu/iStock/Thinkstock
Typesetting: Lumina Datamatics
Printing and binding: CPI books GmbH, Leck
♾ Printed on acid-free paper
Printed in Germany

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Preface
Management of teaching materials is one of the basic requirements for high quality
education in traditional Chinese medicine (TCM). This requirement applies to training
of TCM practitioners as well. Since the establishment of the universities of traditional
Chinese medicine, teaching materials have been developed by the state-unified TCM
colleges and universities. They have played an important role in the application of
TCM, systematically improving teaching quality as well as cultivating talents in the
TCM field. With the rapid development of the TCM field and the need for globally
expanding TCM education, comprehensive teaching material, incorporating digital
features of the English language, has become important. With the help of such high
quality teaching material, Chinese culture and knowledge of TCM may be spread
worldwide without loss of its essence.
The basic theory of TCM is an important part of the curriculum of TCM. The
theory is not only a basic course for the Chinese-medicine profession but also a com-
pulsory content for the license examination of domestic and international Chinese-
medicine practitioners. It is the foundation for continual education in the field of
TCM diagnosis, Chinese herbal medicine, Chinese herbal formula, TCM classics, and
TCM clinical education. It includes the study of basic TCM philosophy, TCM visceral
manifestation, TCM etiology and pathology, and the TCM treatment principle. This
book is most suitable for TCM universities and western-medicine practitioners. It is
also an important reference book for TCM clinical practice and research.
As on date, there are about 50 kinds of teaching materials for topics in basic
theory of TCM and TCM foundation. But none of those include the digital features in
the English language. The existing materials are written in the traditional and classi-
cal form, without effectively using modern scientific means and methods to repre-
sent knowledge with regard to the simplicity of the ancient Chinese language, its
profound concept, and the difficulties commonly encountered in the teaching of
TCM theory. Current scholars in the TCM field concur that materials on TCM theory
require significant improvement to enhance readability and understanding.
This book is intended to break the inherent model and establish a culture that
promotes independent learning ability. The basic theory of TCM supports multi-
media digital teaching and changes the merely simple text mode effectively. The
content is rich while the text is concise and focused. Using videos, pictures, and ani-
mation, the book creates a vivid, innovative, and lively learning mindset. It departs
from the old and dull teaching models of the previous educational system, cultivat-
ing interest in the student to explore and learn TCM. The bilingual form of this mate-
rial mitigates the language barrier often faced by international exchange students; it
stimulates students’ interests in learning as well as activates a classroom atmo-
sphere. By using the digital production for the entire material will lead the reform in
the teaching textbooks.

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VI  Preface

The content of this book is based on China’s TCM undergraduate educational

syllabus. It covers all the materials for TCM licensing exams domestically and inter-
nationally as well as fully embodies the basic theory, knowledge, and skills related
to TCM. It integrates every aspect of the basic TCM theory in accordance with the
nature of the subject and the scope of the study. The book reflects the disease spec-
trum of today’s society and provides guidance to the modern clinical practice of
TCM. The features of modern international education have been integrated into this
book, which gives full consideration to beginners and foreign students, particularly
focusing on the way they think and learn and the difficulties they face in learning
TCM. To enhance readability and practicality for foreign students, this book reorga-
nizes every concept concisely in a simple, correct, and orderly digital way in both
Chinese and English. This book summarizes the essence of Chinese medicine and
records the results of modern research; learn from the experience of textbook writ-
ings of the entire country in China, maintain and carry forward the characteristics of
traditional Chinese medicine. This book is written under the guidance of the high
starting point, high standard and high concept, as well as endowed with an innova-
tive mode of thinking and the positive learning attitude. I believe this book will play
a positive role in improving the quality of teaching of the basic theory of TCM, pro-
specting the Chinese medicine and spreading the TCM culture.
I thank the office of academic affairs from the university and members of the
department of fundamental medicine college, who gave me huge encouragement
and support during the writing of this book.
There might be flaws in this book despite my efforts to eliminate them. I welcome
advice from experts in this field to make the book better.

Hu Dongpei
March 2013
Contents

1 Introduction  1
1.1 The discipline, nature, and properties of traditional Chinese
medicine  1
1.1.1 TCM is characterized by its natural science nature  1
1.1.2 TCM has the characteristics of social science  1
1.1.3 The mutual influences of TCM and ancient Chinese philosophy  2
1.1.4 TCM is a product of multidisciplinary interactions  2
1.2 The main characteristics of TCM theory  3
1.2.1 Concept of holism  3
1.2.2 Differential diagnosis and treatment  5

2 The Philosophical Basis of Traditional Chinese Medicine  7

2.1 Theory of yin-yang  7
2.1.1 The basic concept of yin-yang  7
2.1.2 The basic contents of yin-yang theory  8
2.1.3 The applicable examples in traditional Chinese medicine of the yin-
yang theory  10
2.2 Five elements theory  14
2.2.1 Fundamental concepts and characters of the five elements  14
2.2.2 The classification of the five elements  16
2.2.3 The cycle of generation, restriction, over-restriction, and counter-
restriction in five elements  18
2.2.4 The application of five elements theory in TCM  19

3 Visceral Manifestation  24
3.1 Summarization of visceral manifestations  24
3.2 Five zang-organs  25
3.2.1 Heart  25
3.2.2 Lung  27
3.2.3 Spleen  30
3.2.4 Liver  34
3.2.5 Kidney  38
3.3 Six fu-organs  43
3.3.1 Gallbladder  43
3.3.2 Stomach  44
3.3.3 Small intestine  45
3.3.4 Large intestine  45
3.3.5 Urinary bladder  46
3.3.6 Triple-jiao  47

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VIII  Contents

3.4 Extraordinary fu-organs  48

3.4.1 Brain  48
3.4.2 Uterus  49
3.5 The relationships among the zang-organs and fu-organs  50
3.5.1 The relationships among the six fu-organs  56
3.5.2 The relationship between the five zang-organs and six fu-
organs  57

4 The Theory of Qi, Blood, and Body Fluids  59

4.1 Qi  59
4.1.1 Concept of qi  59
4.1.2 Production of qi  59
4.1.3 Movement of qi  60
4.1.4 Functions of qi  61
4.1.5 Classification of qi  62
4.2 Blood  65
4.2.1 Concept of blood  65
4.2.2 Production of blood  65
4.2.3 Functions of blood  66
4.2.4 Blood circulation  66
4.3 Body fluids  67
4.3.1 Concept of body fluids  67
4.3.2 Metabolism of body fluids  68
4.3.3 Function of body fluids  69
4.4 The relationships among qi, blood, and body fluids  69
4.4.1 The relationship between qi and blood  70
4.4.2 The relationship between qi and body fluids  71
4.4.3 The relationship between blood and body fluids  72

5 Theory of Meridians and Collaterals  73

5.1 Overview of the theory of the meridians and collaterals  73
5.1.1 The concept of the meridians and collaterals  73
5.1.2 Composition of the meridian  73
5.2 Twelve meridians  75
5.2.1 Nomination of 12 meridians  76
5.2.2 Route and connection of the 12 meridians  76
5.2.3 Distribution of the 12 meridians  77
5.2.4 Exterior–interior relationship  78
5.2.5 Circulating sequence of the 12 meridians  78
5.2.6 Travelling routes of the 12 meridians  79
5.3 Eight extra meridians  90
5.3.1 Concept and functions of eight extra meridians  91
 Contents  IX

5.3.2 Distribution and physiological functions of the eight extra

meridians  91
5.4 Physiological functions and applications of the meridians  99
5.4.1 Physiological functions of the meridian  99
5.4.2 Application of the theory of the meridian  100

6 Constitutional Theory  101

6.1 Concept of constitutional theory  101
6.1.1 Basic concept of constitution  101
6.1.2 Signs and characteristics of constitution  102
6.2 Factors affecting constitution  102
6.2.1 Relationship of the constitution to viscera, meridians, essence, qi,
blood, and body fluids  103
6.2.2 Factors which affect the constitution  103
6.3 Classification of constitution  106
6.3.1 Balance constitution  107
6.3.2 Yang-inclined constitution  107
6.3.3 Yin-inclined constitution  107
6.4 Application of the constitution theory  108
6.4.1 Explanation of the susceptibility of individual to certain
pathogens  108
6.4.2 Illustrating the etiology  109
6.4.3 Explaining the pathological changes  109
6.4.4 Guiding syndrome differentiation  110
6.4.5 Guiding treatment  110
6.4.6 Guiding the health maintenance  111

7 Onset of Disease  112

7.1 Concepts of pathogenesis  112
7.2 Cardinal principle of disease onset  112
7.2.1 Deficiency of vital qi is the intrinsic factor for the
pathogenesis  113
7.2.2 Pathogenic qi is an important factor to cause the disease  114
7.2.3 Struggle between pathogenic and vital qi determines the progress and
prognosis of disease  115

8 Etiology  117
8.1 Exogenous pathogens  117
8.1.1 Six evils  117
8.1.2 Pestilential pathogens  125
8.2 Endogenous pathogens  127
8.2.1 Internal injury due to mental disorders  127

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X  Contents

8.2.2 Injury due to improper diet  129

8.2.3 Injury due to overstrain and over-idleness  131
8.3 Pathogens from pathological products  132
8.3.1 Water-dampness, phlegm, and retained fluid  133
8.3.2 Blood stasis  135
8.3.3 Calculus  137
8.4 Other pathogens  139
8.4.1 Medicine abuse  139
8.4.2 Iatrogenic pathogen  141

9 Pathogenesis  143
9.1 Exuberance and debilitation between vital and pathogen  143
9.1.1 Concept of pathogen, vital, exuberance, and debilitation  143
9.1.2 Changes of deficiency or excess  145
9.1.3 The relationships among pathogen, vital qi, excess, and deficiency as
well as the outcome of disease  147
9.2 Imbalance of yin and yang  150
9.2.1 Concept of imbalance of yin and yang  150
9.2.2 Types of imbalance of yin and yang  150
9.3 Disorders of qi, blood, and body fluids  155
9.3.1 Disorders of qi  156
9.3.2 Disorder of blood  158
9.3.3 Disharmony between qi and blood  160
9.3.4 Metabolic disorders of body fluids  161
9.3.5 Disharmony among qi, blood, and body fluids  163

10 Principles of Prevention and Treatment of Diseases  165

10.1 Principles of disease prevention  165
10.1.1 Disease prevention prior to its outbreak  165
10.1.2 Controlling the development of an existing disease  165
10.2 Principles of treatment  166
10.2.1 Treating the root of a disease  166
10.2.2 Strengthening the vital and dispelling the pathogen  170
10.2.3 Regulating yin and yang  173
10.2.4 Regulating qi and blood  175
10.2.5 Regulating the viscera  175
10.2.6 Three optimal treatment administrations  175

References  179
1 Introduction

1.1 The discipline, nature, and properties of traditional

Chinese medicine

Key points
– TCM belongs to the category of natural science.
– TCM has the characteristics of social science.
– TCM is profoundly influenced by ancient Chinese philosophy.
– TCM is the product of multidisciplinary interactions.

Traditional Chinese medicine (TCM) is a life science that originated from ancient
China, focusing on researching human health, illness, and disease prevention. It has
a close relationship with the geographic culture in China and belongs to the tradi-
tional-science category of the Orient. TCM is an important part of the world’s knowl-
edge of medical science; its characteristics and properties are discussed in the
following sections.

1.1.1 TCM is characterized by its natural science nature

Natural science is a subject which studies the law or nature of material movement
and change and development in nature. Medical science is a scientific system
which studies the process of life and its fight against disease. It belongs to the cate-
gory of natural science. The study of TCM is focused on human beings, especially
on the basic law of birth, growth, aging, and death. TCM also emphasizes the
mechanism of physiology, pathology, and disease prevention. It has the character-
istics of medical science. Therefore, TCM belongs to the category of natural
science.

1.1.2 TCM has the characteristics of social science

Social science is a subject which studies the change of human society and its devel-
opment. Human beings are not only the highest product of natural evolution but
also have social attributes. TCM focuses on studying different physiological func-
tions from different angles of the social background. It also studies the social roots
and the personal relationship and how they affect the physical as well as the mental
health of human beings. These features reflect distinctively the social and scientific
characteristics of TCM.

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2  1 Introduction

1.1.3 The mutual influences of TCM and ancient Chinese philosophy

Philosophy is a science which studies the general rules of the common movement in
nature, society, and thoughts. The development of any object is related to philoso-
phy. The interactive relationship between TCM and philosophy is reflected in two
aspects.
Firstly, TCM was constantly receiving the development of philosophical research
during its process of formation and development. Since its initiation, TCM has unceas-
ingly absorbed research progress from ancient Chinese philosophy; a series of TCM
phenomena may be explained through important philosophical concepts. For example,
yin-yang, a philosophical concept in Huangdi Nei Jing, is used to explain the relative
attributes and their relationships of the two opposite aspects of correlative things or
two opposite aspects within one thing. Combining with the other terms, it formulates
the special TCM terms which are used to explain the physiological functions and
pathological changes of the human body. Therefore, yin-yang is a methodology which
is used to direct the development of TCM theory and is also applied repeatedly in
TCM research. The same concept is applied to the theories of yuan-qi and the five
elements.
Secondly, TCM enriched and developed ancient Chinese philosophy. For
example, the relationships between yin and yang and the laws of promotion,
restriction, counter-restriction, and over-restriction among the five elements were
first put forward and fully discussed in the TCM literature. Many philosophers
also used the TCM theory to do philosophical research. Therefore, TCM not only
enriched ancient Chinese philosophy but also promoted the development of the
ancient philosophy.

1.1.4 TCM is a product of multidisciplinary interactions

To a certain extent, the development of TCM is also the medical application

history of multidisciplinary knowledge. Besides ancient Chinese philosophy,
our ancient astronomy, geography, meteorology, phenology, agronomy, biology,
botany, mineralogy, specialties, mathematics, and metallurgy played an impor-
tant role in the initiation and development of TCM. For example, meteorological
knowledge is an important factor in the development of the initial theory of
the six climatic pathogens. By comparing the four seasons, TCM recognized the
differences in pulse according to the changes of the four seasons. With knowl-
edge of geography, ancient TCM scholars developed the theory of treatment
according to environmental changes. Therefore, TCM is a product of multidis-
ciplinary interactions. Multidisciplinary knowledge promotes the development
of TCM.
 1.2 The main characteristics of TCM theory  3

1.2 The main characteristics of TCM theory

The theoretical system of TCM is influenced by ancient philosophical thought and

developed over long-term clinical practice. TCM theory consists of two aspects:
holism and differential diagnosis and treatment.

Key points
– The main characteristics of the theoretical system of TCM:
– Concept of holism
– Differential diagnosis and treatment

1.2.1 Concept of holism

Key points
– The concept of holism includes the following:
– The human body as an organic whole
– The unity between human and environment

Wholeness signifies the unity and integrity of an object. TCM holds that the human
body is an organic whole in which all constituent parts are structurally insepar-
able, functionally coordinative and interactive as well as pathologically inter-
influencing. The human body is closely related to the natural and social environ-
ments. Through the process of adaptation, it maintains its balanced activities. The
concepts of unity between the internal and external environment, the connection,
the integrity of the body itself as well as the balance represent the wholeness of
TCM theory. The wholeness concept is an important thinking method permeating
in various areas such as physiology, pathology, diagnosis, health care and
treatment.
1. The human body as an organic whole
The human body is composed of different viscera and tissues. Each of them has
different functions which are the constituent part of the whole activity. A
human’s normal physiological activity is affected by the whole activity. On the
other hand, it also influences the functions of other viscera and tissues. This kind
of function is the whole activity. From the viewpoint of TCM, integral unity is
established by connecting the five zang-viscera, six fu-viscera, the five body con-
stituents, the sensory organs, the nine orifices, the four limbs, and the bones
through the meridian systems: The liver, gallbladder, tendon, and eye constitute
the liver system; the heart, small intestine, vessel, and tongue constitute the
heart system; the spleen, stomach, muscle, and mouth constitute the spleen
system; the lung, large intestine, skin, and nose constitute the lung system; and

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4  1 Introduction

the kidney, urinary bladder, bone, ear, and anus constitute the kidney system.
These constituents form the whole unity and accomplish its functional activities.
Any local areas belong to the parts of the whole unity. Local illness, diag-
nosis, and treatment must be based on the concept of wholeness. Otherwise,
whole pathological changes will affect local disorder.
2. The unity between human being and external environment
Human being is a by-product of natural evolution. From the TCM point of view,
a human being is materially connected with the external environment. Human
beings live in nature. Therefore, the external environment will directly or indir-
ectly affect the functional activities of the human body. The body’s beneficial
adaptations to environmental changes belong to the category of physiologically
adaptive adjustments. Otherwise, they are called pathological reactions and will
result in diseases. This idea is referred to as the unity between the human being
and the external environment.
A. The unity between human being and nature
Human beings live in nature. Natural factors, for example, seasonal and cli-
matic changes, day and night as well as the geographical differences, can
directly or indirectly affect the body’s physiological functions and patholo-
gical changes.
In general, it is warm in spring, hot in summer, damp in late summer, dry
in autumn, and cold in winter. Under the influence of these climatic changes,
there are many adaptation changes for living things: germination in spring,
growth in summer, change in late summer, reap in autumn, and storage in
winter. Just as any other living thing, human beings must also adapt them-
selves to climatic changes. For example, in spring and summer, yang-qi rises
upward and flourishes whereas qi-blood of the body trends to circulate superfi-
cially, which often results in loose skin, profuse sweating, and less urination.
During autumn and winter, yang-qi goes inward and becomes astringent
whereas qi-blood of the body trends to go internally, which often results in
tight skin, less sweating, and more urination. These adaptations indicate that
seasonal climatic changes can influence the body’s physiological functions.
Although daily temperature changes are not as obvious or regular as
seasonal changes, long-term regular changes will result in the same rhyth-
mic change as the day and night to adapt to the changes in the environment.
Geographical differences in living environment are also an important
factor, which can directly influence the physiological function of the human
body. Regional climate and different cultures and customs are all geographi-
cal differences. They can affect the body’s physiological function and mental
activities to a certain degree. For instance, the southern region of China is
usually damp and hot, and the striae of the human body tends to be loose
and body shape thin; the northern part of China is dry and cold, and the
striae of the human body tends to be tight and the body shape is stronger.
 1.2 The main characteristics of TCM theory  5

B. The close relation between human beings and society

Human beings live in society. Different social environments also result in
different physical and mental functions.
The change of social status definitely brings differences to the indivi-
dual’s spiritual life. Social development enriches humans, widens living
room, elevates levels of health care and promotes human living conditions
and lengthens life span. On the other hand, with a turbulent society or war
occurring frequently, an individual’s physical and mental functions will be
affected more. The progress that society makes will undoubtedly bring
many benefits to human health.
Due to the relationships of unity and opposition between the human
being and the external environment, the principles of treatment according
to time, different locations and each individual have become the important
rules in the TCM treatment. Therefore, more attention should be paid to the
organic relationships between the external environment and the overall
functional activity during the treatment process.

1.2.2 Differential diagnosis and treatment

Key points
– Syndrome
– A syndrome is a pathological summary during a stage of disease onset. It includes etiology,
the location of the disease, the pathology as well as the relationship between right and evil
pathogen.
– Differential diagnosis
– Differential diagnosis refers to the analysis, differentiation, recognition, and summarizing of
the syndrome of a disease by the collection of medical history, symptoms and signs through
the four traditional methods of inspection, olfaction, inquiry, and palpation.
– Treatment determination
– Treatment determination refers to the choice and formulation of the corresponding therapeutic
principle as well as the method according to the result of the differential diagnosis.
– Same disease but different treatment
– This method refers to the different treatment principles due to different disease onsets, differ-
ent disease locations, different body reactions or different stages of the disease originating
from the same kind of a disease. In other words, treatments are based on the different syn-
dromes.
– Different diseases but same treatment
– This method refers to the same treatment principle based on diseases with similar etiology,
and pathology.

There are fundamental differences among the syndromes, symptoms, and diseases.
Symptoms refer to the complaints by a patient, such as headache and abdominal
pain. The same symptom may have different reasons. And its pathological mechanism

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6  1 Introduction

can also be completely different. Disease refers to a complete morbid process, includ-
ing the specific etiology, disease onset, typical clinical presentation, prognosis, and
outcome. For example, common cold, stroke, and dysentery are all diseases. There-
fore, compared to symptom and disease, syndrome reflects much profound pathologi-
cal change than the disease itself and symptom. Differential diagnosis refers to the
analysis, differentiation, recognition, and summarizing of the syndrome of a disease
by the collection of medical history, symptoms, and signs through the four traditional
methods of inspection, olfaction, inquiry, and palpation.
Treatment determination refers to the choice and formulation of the correspond-
ing therapeutic principle as well as the method according to the results of differential
diagnosis.
Differential diagnosis is the prerequisite and basis for treatment determination,
whereas treatment determination is the means and method for treating disease
based on the result of differential diagnosis as well as its execution. On the other
hand, treatment result can test the precision of differential diagnosis and treatment
determination. During clinical treatment, two different therapeutic methods – different
treatments for the same disease and the same treatment for different diseases – can
be applied separately according to the results of differential diagnosis.
Same disease but different treatment refers to different treatment principles
employed due to different disease onsets, different disease locations, different body
reactions or different stages of the disease originating from the same kind of a
disease. In other words, different treatments are based on different syndromes.
Different diseases but same treatment refers to the use of the same treatment
principle based on the different diseases with similar etiology and pathology. In
other words, the syndromes are the same.
On the whole, TCM treatment is based on the syndrome instead of different dis-
eases. Because the same syndrome represents the same patho-mechanism, the same
or similar treatment can be given; and different syndromes represent different
patho-mechanisms, therefore, the treatment must be given differently. This reflects
the true essence of differential diagnosis and treatment.
Yin-yang and the five elements belong to ancient Chinese philosophy. It is the
methodology by which our ancestors recognized and explained nature. The five ele-
ments permeate TCM and become an inseparable part of TCM. The yin-yang and five
elements theory is applied in TCM and has become the theoretical tool and metho-
dology of TCM. It determines the thinking mode of TCM and directs its clinical
practice.
2 The Philosophical Basis of Traditional
Chinese Medicine

2.1 Theory of yin-yang

2.1.1 The basic concept of yin-yang

Key points
– Yin and yang
– Yin and yang are the summarization of the attributes of two opposite aspects of correlative
subjects or phenomena in universe.

Relativity: The original meaning of yin and yang was very simple and was from
hieroglyphs. It mainly referred to the directions facing toward the sun and away
from the sun. Facing toward the sun belongs to yang, while facing away from the
sun belongs to yin. Based on the yin-yang theory, the ancient scholars made
further inferences and extensions. Anything with the characteristics of facing
toward the sun was classified as yang, while anything facing away from the sun
was classified as yin. Generally speaking, the things that bear the properties of
being active, external, ascending, warm, and bright pertain to yang, while the
things that bear the properties of being static, internal, descending, cold, and dark
pertain to yin.
Separability: The ancient scholars realized that all kinds of things and phenom-
ena had two opposite sides. The mutual actions of the two opposite sides promote
the formation, development, and change of things. Therefore, yin-yang was used to
explain all kinds of natural things that were inter-opposite and mutually wane or
wax. The interactions between yin and yang exist intrinsically within all kinds of
things. Thus, yin-yang is refined to a specific philosophical concept. It is the sum-
marization of the attributes of the two opposite aspects of correlative things or phe-
nomena in universe.
Correlation: Yin-yang refers to the attributes of two opposite aspects of correla-
tive things or phenomena. It can be used to distinguish all kinds of phenomena
under the condition that yin-yang stands for two correlative things or two opposite
aspects within one thing.
The ancients realized that all things can be divided without limitation. Any cor-
relative things or phenomena in the universe can be summarized as yin or yang.
Any aspect of yin or yang within one thing can be further classified into yin or yang.
This classification is called the infinite divisibility of yin-yang.
Everything is in constant motion. Therefore, the attributes of things in yin-yang can
change as well, which means that one side of yin-yang under a certain condition can

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8  2 The Philosophical Basis of Traditional Chinese Medicine

transform itself into the other, that is, yin may change into yang and yang may change
into yin. Obviously, the yin-yang attribute is in relative motion and changes constantly.

2.1.2 The basic contents of yin-yang theory

The basic contents of yin-yang theory are mutual opposition and restriction, mutual
rooting and dependence, waxing and waning, and balance as well as mutual
conversion.

Key points
– The basic contents of yin-yang theory
– Mutual opposition and restriction of yin and yang
– Mutual rooting and dependence of yin and yang
– Waxing – waning and balance of yin and yang
– Mutual conversion of yin and yang

1. Mutual opposition and restriction of yin and yang

The opposition and restriction of yin and yang include two aspects. One
aspect refers to the opposition of yin and yang, while their properties are
opposite in the universe, such as heaven and earth, day and night, cold and
heat, active and static, internal and external, ascending and descending,
and entering and exiting. The other aspect refers to the complicated rela-
tionships of mutual restriction and opposition between yin and yang, such
as the four seasonal changes. It is warm and hot in spring and summer
because ascending yang qi restricts the cold-cool qi, while it is cool and
cold in autumn and winter because ascending yin qi restricts the warm-hot
qi. These are results of mutual restriction between yang qi and yin qi in
nature.
2. Mutual rooting and dependence of yin and yang
Yin and yang are rooted in each other. One cannot exist without the other. For
example, upper belongs to yang and lower to yin, and without the lower there
would be no upper, and vice versa. Left belongs to yang and right to yin, and
without left there would be no right, and vice versa. Thus, it is obvious that yin
and yang rely on each other. Interdependence of yin and yang refers to the
mutual generation and promotion among certain categories of yin-yang rela-
tionships. Take, for example, heaven and earth and cloud and rain. The water
on the earth can be carried up to the heaven to form cloud and mist by the
ascending of earthly qi, while the cloud and mist in the sky can fall onto the
surface of the earth in the form of rain by the descending of heavenly qi. This
reciprocal process of cloud and rain and heavenly qi and earthly qi is called the
interdependence of yin and yang.
 2.1 Theory of yin-yang  9

3. The waxing – waning and balance of yin and yang

The waxing and waning of yin-yang refers to the movement of yin and yang.
The two opposite and interdependent forms are not in a state of stillness but
constantly change. This change includes the following two types.
In the first type, yin wanes while yang waxes or yang wanes while yin
waxes. The mutual restriction of yin and yang leads to such a consequence. For
example, considering the four seasonal changes, from winter to spring and
summer, the weather becomes warmer gradually, which is called yin wanes and
yang waxes, while from summer to fall and winter, the weather becomes colder
gradually, which is called yang wanes and yin waxes.
In the second type, yin wanes the yang also wanes or yin waxes the yang also
waxes. Under the condition of reciprocity of yin and yang, any side of yin-yang
becoming too deficient to promote its counterpart will make it weak, while any side
of yin-yang becoming abundant will promote its counterpart, so yin-yang also gets
abundant. For example, in qi and blood, qi belongs to yang and blood belongs to
yin. Qi promotes blood production and its deficiency may further cause blood defi-
ciency, resulting in manifestation of deficiency of both qi and blood. Tonifying qi
can promote the generation of blood. Thus, qi and blood are both sufficient. The
former is called waning of yin-yang and the latter is called waxing of yin-yang.
The waxing and waning movement of yin-yang is absolute and endless.
When waxing and waning of yin-yang can be kept within a certain range,
degree, and period, it will not be recognized and things will be in a relatively
stable state. On the contrary, when waxing and waning of yin-yang are not kept
within a certain range, degree, and period, things will be in an abnormal state.
4. Mutual conversion of yin and yang
Mutual conversion of yin and yang refers to yin-yang conversation among them-
selves under certain circumstances. It is the change of the attribute of yin-yang.
Anything has two aspects of yin-yang and is in the state of waxing and waning
motion. When the motion is out of a certain range, one side of yin-yang can
transform itself into the other. This change often occurs in the extreme phase
during the changing cycle. The waxing and waning of yin-yang is a process of
the quantitative change, while the transformation of yin-yang is a process of the
qualitative change based on the quantitative change.
The transformation of yin-yang can be a gradual process such as the alter-
nation of cold and warm during the four seasons. It can also appear to be a
sudden process such as the sudden shock or fainting as well as the cold extre-
mities during the acute febrile disease symptoms change suddenly from yang to
yin. No matter which kind of form it converses, it will always experience a
process from quantitative change to qualitative change.
Therefore, the mutual rooting and interdependence of yin-yang is the foun-
dation for the transformation of yin-yang. And the waxing and waning of yin-
yang is an important prerequisite for the transformation of yin-yang.

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10  2 The Philosophical Basis of Traditional Chinese Medicine

2.1.3 The applicable examples in traditional Chinese medicine of the

yin-yang theory

1. To interpret the structure of human body

All the tissues and organs in the body are not only organically related to each
other but are also categorized into two parts of yin and yang. Generally speaking,
the upper part of the body pertains to yang, while the lower part to yin. The exter-
ior of body belongs to yang, while the interior of the body to yin. The back pertains
to yang, while the abdomen to yin. The lateral side of the four limbs pertain to
yang, while the medial side to yin. When considering the functions of the viscera,
the five zang-viscera pertain to yin because they store the essence but do not trans-
port and transform food. The six fu-viscera pertain to yang because they transport
and transform food but do not store essence. Among the five zang-viscera, the
heart and lung are located in the upper (thorax), so they pertain to yang, while the
liver, spleen, and kidney are located in the lower (abdomen), so they pertain to
yin. Each viscera itself can be further divided into yin and yang aspects, such as
heart-yin and heart-yang, kidney-yin, and kidney-yang.
Overall speaking, every part of the human body, superior – inferior, inter-
nal – external, interior – exterior, and anterior – posterior as well as the inner
organs may all be applied by yin-yang theory.
2. To explain physiological functions
The coordination and balance of yin-yang result in normal human life activity.
In terms of substances and functional activities, their relationship embodies the
unity of the opposite aspects of yin-yang. The physiological function of the
human body is based on the substances of the body. Without the movement of
the substances, there would be no physiological function. On the one hand, the
physiological activities consume energy and substances, but on the other hand,
they constantly promote metabolism as well as receive and store the energy.
Once the physiological activities are blocked to function normally, it will affect
the normal metabolism. Therefore, the relationship between the physiological
activities and substances is the process of mutual restriction, production as well
as waxing and waning of yin-yang. From the point of view of qi and blood, qi
belongs to yang while blood belongs to yin, and qi can generate, move, and
control blood. Therefore, the normal function of qi helps the blood to have the
normal production and circulation. Blood can generate and hold qi. Therefore,
the abundance of blood can promote qi’s normal function. The correlation
between qi and blood reveals the mutual rooting and interdependence of
yin-yang.
3. To explain pathological changes
The harmony and balance between yin and yang in Chinese medicine is consid-
ered as healthy symbol, whereas the imbalance of yin-yang is regarded as the
basic reason of the occurrence, development, and change of the disease.
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