中医“致中和”思想 "

Hello, every one.

Last class we have discussed the benevolent basis of the Chinese Medicine ethics

then this class I will talk about the moderate ideology (zhizhonghe)of traditional Chinese medicine

in the review of Confucianism

we once talked about that "neutralization and mean" is one of the core ideas

so what is "neutralization"?

it is called "zhong" when people do not express his feelings,

while called "he" when express out his feelings but control it

let us read the definition in the Book of Rites·Mean

Zhong is the root of all human

He is the universal rules followed by people

when reached Zhong and He, everything will develop properly

what is it mean?

Zhong is the foundation of social stability

He is the methods of interaction with others

when reaches Zhong and He

everything will in its proper place

and develop naturally

therefore, it is a very good state

an ideal state

when understanding this thought

the mistake that people always made is to pursue absolute neutralization

but in fact it should be harmonious as a whole and unification of diversity

from social angle

the development with absolute mean and without difference is lack of motivation

from human himself, even the healthy person

yin and yang in the body(briefly understood as substance,energy etc. in western medicine) are constantly changing

if you do not quite understand yin and yang

I can say some index of modern medicine for your understanding

such as blood sugar, blood fat, blood pressure and so on are all in the dynamic change

I once made an electrocardiogram named 24 hours

it is very interesting

I found my heart rate is constantly changing

it is probably around seven clock,

the heart rate changes most rapidly

and it is most slowly at three or four clock at night

many people may not image how frequent it is

just over twenty times

that is to say these index are changing dynamically in one day

however in fact, he is a healthy man at that time

so it is a dynamic balance

from the perspective of nature

there are the change of four seasons, temperatures and the movement of sun and moon

they are all changing in a certain range

therefore, Zhi Zhong He is a kind of dynamic trend and stability in time and space

the idea of Zhi Zhong He has already permeated in many areas of traditional Chinese medicine and pharmacy

then let us see the first effect of Zhi Zhong He on TCM Etiology

let's see the unbalance of emotions

Chinese Medicine considers that,seven human emotions are happy, anger, worry, love,sorrow, fear,and hate

happy comes from heart,anger from liver, love from lungs, fear from kidney

in the normal condition, the change of seven emotions is normal and will not bring disease

over the degree will hurt the body, namely when spirit boost is too intensively or lasts too long

beyond the ability of self-control

these parameters I just said is changing everyday

but it has a certain range

for example, your blood pressure cannot over 160

it is generally considered that over 150、160 is hypertension

and your diastolic pressure can not over 90

it has a limit

when beyond the ability of human self-control

it will cause the imbalance of human system

and affect human health

the imbalance of seven emotions will lead to the air loss and disorder of five organs

I just said seven emotions are related to the function of five organs

so," diseases are all from pneuma, it is caused by anger, smoothed by joy and removed by sorrow

down by fear, chaotic by surprise and heal by love

it is referred in Huangdi Nei jing·plain questions

the up, down, removed, smooth, chaotic and heal discussed here

is referred to the disorder of pneuma caused by over emotions

the doctor of tradition Chinese medicine thinks qi movement is important

it is an manifestation of normal human body function

so it is said joy and surprise make heart-broken

when said this, can you think about in Chinese ancient stories

is there a story in which

some character has this condition

joy、surprise make heart-broken

maybe many people think of immediately

oh, it is Fanjin

the story is about Fanjin whose family members are all poor common people,

but he, surprisingly passed the provincial civil service examination

this was the biggest good news for his whole family 82

however,he was over joyful,and became sick

joy, surprise damage heart

then how to understand anger impairing liver

you maybe see many people get angry

do you ever notice their action when they fly into a rage

someone may cover the lower right rib after their anger

because they feel the liver uncomfortable

and contemplation hurts spleen is also the crucial reason

nowadays many people like thinking

contemplation hurts spleen also causes disease

dose anyone can recall in the Chinese history

is there any character in the novel having spleen hurt by contemplation

you may think about the Dream in Red Mansions

there is a character named Lin Daiyu

she got lovesickness

she felt sorrow when she heard Jia Baoyu would engage soon

then she got sick

at last she pined away for eating nothing

Lin is very slim, right?

It has something to do with lovesickness which hearts the spleen.

She doesn't want to eat.

surely, besides the lovesickness, her sadness also hurts the lungs.

she is in a depression for a long period.

of course there is another saying that may be she has the phthisis.

all in all, her body degenerated in the end.

you may have some other thinking while mentioning sadness hurts the lungs.

when someone is in great sadness or depression

he may behave some manner unconsciously

i don't know whether you have noticed

what the behaviour is

alas, he sighed

then why he sighed? because his sadness has hurt his lungs

and the sigh made him feel smooth and comfortable

then he will feel relax

what's more, fear hurts kidney

perhaps you have seen some cases like

in some spy TV series, when the betrayers were caught, they might too frighten to pee in their trousers

that means fear hurts kidney

kidney controls the water in our body, that makes sense

too many emotional fluctuation will hurt the heart

therefore, one that good at preserving his health would keep a balance between one's happiness and sadness

this is the highest realm

so anyone who knows this knows how to keep his health in a good state

besides the influence of emotion, some diseases may caused by losing control

such as the abnormal of air, the failure of controlling diets, the imbalance of rest and tired

these are all embodies of losing control

it means the changes of seasons and climates go beyond people's ability of adjusting

the huge decrease of temperature and so on

or the lack of self regulation

makes people couldn't adapt to the climate changes, thus to arouse sickness

secondly, let's take a look at the influence of attaining a state of harmony to our health

as mentioned in the book "Su Wen Tiao Jing Lun"

then yin and yang are balanced, the body becomes robust, the nine indicators of the body's pulses will also be concert. this occurs in a normal, healthy person.

the normal, healthy person means a person has a balanced yin and yang

a professor said in a funny way that

a person without yin and yang means a person with a balanced yin and yang

"Su Wen Sheng Qi Tong Tian Lun" says, the most importance of yin and yang is the gather of yang

if the relationship between yin and yang are messed, then people's body will be messed too

therefore the balance between them is the ideal realm

what does the ideal realm mean here?

it means the golden mean, the saints' realm

then what does "five kinds of impairments caused by overstrained" in Huangdi Neijing mean?

it means that use your eyes overtime hurts your blood.

today many of us may stare at the computer screen for a whole day

then it will hurt our blood

lie in the bed for long time may hurt our qi

if a healthy person always lies in bed, he will be sick in the long run

what is qi? it is our body function in Chinese medicine

his body function is losing

sit to much hurts our body

if a person always sit there without doing some exercise, finally it will hurt the body shape

standing too much hurts the bone

if one always stand, his bone may hurts

of course, modern medicine tells us people couldn't always stand

out skeletal system may bear much pressure

walking too much hurts our tendon

always running and walking outside may hurts our tendon

then what about balance on diet

food may benefit people at the same time hurt people

in normal cases food benefits people

but when you take it wrongly, it hurts.

hence, the mean is catch the balance and take control

confucianism emphasizes not eating too much

modern medicine proves that a low energy intake is good for health

but besides not eating too much, we also emphasizes not eating too little, but to have a good balance

surely, today's many diseases are caused by food

Huangdi Neijing Plain Questions says, eating twice as usual hurts the intestines and stomach

you may know that many Chinese are suffering from intestines and stomach diseases

especially after the reform and opening up policy, people's living condition improved

more people suffered from this kind of disease

that is because people eat too much, not too little

in the old poor days, people don't have enough to eat, and thus suffering from malnutrition

as Sun Simiao says,"if one eat all the five flavors, then he must has a control of not eating too much."

that means one could not eat without control, the same knowledge

therefore, "a person good at keeping healthy eats while hungry and drink while thirsty"

that means you eat when you feel hungry

this is mentioned in Qianjin Fangyao

Chinese medicine says eating five flavors may nourish our five organs

but when one tends to one particular flavor, which means the partial eclipse

that hurts five organs too

partial eclipse is normal in us too

that means you could't tend to one particular flavor

you need to keep a balance

modern medicine also requires the balance of nutrition

one must eat vegetables, fruits, staple food and so on

thirdly, let's take a look at the thought of golden mean's influence to Pharmacology of traditional Chinese medicine

here i take two examples

in the first example, there is a kind of soup, called the soup of neutralization

it is made by Rhizoma Atractylodis Macrocephalae,orange peel, ginseng,liquorice,Poria cocos and Mangnolia officinalis

it could adjust our yin and yang, benefits our spleen and stomach, increasing our appetite

so each medicine in the soup benefit our spleen and stomach in a balanced way, not too little nor too much

then reach the aim of the golden mean

it has the medicine of repair our qi

it also has medicine to excreting dampness and promoting the circulation of qi

that is a nutritional supplement without an overtake

as to the influence of the medicine

Xu Dachun in Qing dynasty once said a funny sentence

saints made the prescription for him to nurse one's health

it may useful to one particular disease, or all kinds of problems, it may coordinate with each other, or opposite, or control each other.

so a prescription not only can preserve each medicine's function, but also lose them

making prescription is tricky.

you have to be careful, or it will lose all their respect functions

if done it properly, it will have the combined function of all the medicines

Cheng Jiamo said we should also pay attention to the balance of the medicines.

the key is mean, less is useless, more the medicine will backfire.

pay attention, if you go home to brew medicines

usually, stems should be heated for a longer time

this way it can perform its functions

as for the leafy medicines

such as those for curing flu, you should not brew them too long.

or they will lose their functions

they are all of the same reason

during the process of prescription

we just mentioned the need for cooperation

Chinese traditional medicine is quite tricky

take ephedra decoction for example

ephedra decoction is made up of four medicines

including ephedra, Cassia twig, apricot and liquorice

its function is to induce perspiration and relieve asthma

such as to treat common cold

i believe many of you have been caught up with the flu

that is the result of sudden temperature drop

or the decrease of body resistance

so what are the symptoms of the flu? aversion to cold with fever

aversion to cold means the patient will be extremely sensitive to cold

which means even covered with two blankets, he will still feel cold

but according to his temperature, he is actually burning up. This is aversion to cold with fever.

ache all over the body, including the limbs

the patient will have trouble breathing, but unable to sweat.

but once ephedra decoction successfully induce the perspiration, these symptoms will disappear gradually

in this prescrption, ephedra serves as the main medicine to induce perspiration

like the king ruling the world in the old times

he is the main medicine in this prescription

and Cassia twig mainly serves to help ephedra to perform its function

adding apricot is because apricot could help ephedra to relieve asthma

it tackles the lesser symptom of asthma

it is helpful in that way

lilquorice is also very important. it was called conductant drug, serves to balance the medicines.

monarch drug is the main element while ministerial drug serves to help

and limit its functions

namely prevent it inducing too much perspiration to create a balanced state

and conductant drug is the backup to finish what's been missed by monarch drug and ministerial drug

or balance the two

this is a reflection of traditional Chinese thought.

Fourth, the idea of mean's influence on treatment principle

Chinese traditional medicine believes too much Yin and too much yang are both excessive

too little yin and yang are both insufficient

both excessiveness and insufficiency will cause trouble to our body, as we have mentioned

the so-called yin and yang in equilibrium is not too excessive or too insufficient

the book concise exposition on febrile disease says typhoid fever on the surface will appear as sweat

typhoid fever on the inside will be dealt by the body. those not on the outside or in the inside are not too easy to induce perspiration

or be relieved from the body, in this circumstance, a balanced way is recommanded.

so what is their suggestion, when the problem is not in the body or on the surface,

but in between?

deal with it properly. both perspiration or diarrhoea aim to create the state of balance.

to adopt this kind of treatment

is the result of the idea to attain a state of harmony in medicine field

attaining a state of harmony equals the perfect state of yin and yang in a state of equilibrium

when not, it's called discord

which will lead to sub-health, even serious symptoms.

prevention, treatment, prescription and making are all permeated with this thought

besides personal health, the relationship between man and nature, man and society and interpersonal relationships are all the same

no woner 75 nobel prize winners since 1988 made their co-speech in Paris

that if man were to live in the 21st century, we must back to 2500 years ago and seek wisdom from Confucius,

that's the same reason

that's all for this class

next time we will talk humanistic care in Confucianism thought.

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