The Tai Yang Syndrome and the Tao He Cheng Qi Tang of Clause 106 - Essay Example

Running head: SHANG HAN LUN Shang Han Lun: The Tai Yang Syndrome and The Tao He Cheng Qi Tang of Clause 106 Table of Contents Introduction3 The six Channels..4 Tai Yang: The Greater Yang Syndrome4 Signs and Symptoms...6 Treatment...7 Clause 106.7 Tao He Cheng Qi Tang -Decoction Semen Persicae Chengqi8 Drug Study.9 Conclusion...12 Table 14 Table 29 Introduction Zhang Zhong Jin wrote the traditional medicine classic "Shang Han Lun" in the late Han dynasty, circa 20-200 A.D., wherein the differentiation of syndromes according to the 6 channels appeared (TCM Diagnosis, 2007). "Shang Han Lun," which means "On Cold Damage" has been a widely used treatment theory and practice source for almost two millenia (Redwing Book Co., 2007b). The "Shang Han Lun," with 397 sections and 112 herbal drug therapies, remains to be a crucial reference in today's medical practice (Fan, n.d.). It is the first extensive and exhaustive exposition on externally contracted diseases, which explores the medicine of systematic correspondence and the channels and networks of vessels (Redwing Book Co., 2007a). The "Shang Han Lun" also incorporates medicial therapy into theory and patterns of diseases. Zhang Zhong Jin used short and simple sentences yet the words were layered with different meanings, and lets readers provide their own interpretation (Fan, n.d.). Thus, it is easy and very useful for doctors in various fields to apply in their own practices. In addition to this, discussion is focused on the more difficult and complicated cases because Zhang Zhong Jin expected that doctors already know the treatment and cure for common medical scenarios (Fan, n.d.). Again, this makes his theoretical discussions more interesting and useful to the practice of medicine. The "Shang Han Lun" establishes that diseases can be diagnosed through syndrome differentiation according to the 6 channels: the tai yang, yang min, shao yang, tai yin, shao yin, and jue yin. This method of diagnosis and differentiation examines the pathological changes over the route of an exogenous disease or disease due to an external factor, especially for cold induced diseases known as the "Shang Han" (Shen Nong Ltd., 2006). The six Channels Based on the differentiation of diseases, syndromes are divided between the yang meridian, which focuses itself on external factors, and the yin meridian, which is about internal factors. The yang meridian is further classified into three: the tai yang, the yang ming, and the shao yang. The yin meridian is the classified into the tai yin, shao yin, and jue yin. The usual pathway of the progression of a disease through the six channels is illustrated below. Table 1. a diagram of the progression of diseases from Shen Nong Limited. Tai Yang: The greater Yang Syndrome The location of the three yang meridians are on the exterior parts of the body and as an evil develops the disease's symptoms will worsen along the more internal yin meridians (Shen Nong Ltd., 2006). The tai yang or the greater yang, refers to cold damage in general. It is also known as the exterior syndrome (Shen Nong Ltd., 2006). It focuses itself on externally contracted diseases that is caused by evils that enter the body from the outside (Greater yang disease: Pulses and signs; treatment). It refers to the original attack of an external cold evil through the pores and interstices of the skin ("TCM diagnosis," 2007). The tai yang is the first to be affected because this is the greater channel that rules the exterior of the body, such as the skin, the muscles, and the hair. This stage is broad in scope yet milder in its manifestations of symptoms, being external in essence. There are three major forms of the greater yang syndrome: (1) wind strike, (2) cold damage, and (3) warm disease. These three basic forms reflect Zhang Zhong Jin's understanding that exogenous diseases are due to the wind, the cold, or the warmth. However, less attention is given to the warm disease, and is rendered less significant than the first two forms because it only has one line of disease under its wing. The typical symptoms of the tai yang syndrome are chills, headache, stiff neck, and a floating pulse (Reading from Shang Han Lun). The stiff neck and headache are situated in the tai yang areas of the body, namely the bladder and the small intestines, while the floating pulse is found at the exterior ("TCM diagnosis," 2007). A fever follows after the cold evil invades the surface of the body. The fever is mild, as the body's defenses are still stronger than the cold evil and because the invasion is only superficial. If the disease is taken forgranted, lack of treatment may result to the cold evil's progression or invasion of the other channels, giving rise to further complications. If the body's defenses becomes weak, and the invading evil becomes stronger, then the fever will increase, as the penetration reaches the yang ming and the shao yang channels ("TCM diagnosis," 2007). Signs and Symptoms A floating pulse refers to a pulse that can be felt when there is light pressure applied to the area, and then disappears when the pressure is deepened. In the greater yang disease, a floating pulse usually indicates that an evil has invaded the fleshy exterior of the body, and the body's defenses, or Qi, are currently trying to eliminate it. On the other hand, headache and stiff neck is experienced because the greater yang syndrome stretches from head to foot, through the back of the body (Greater Yang disease: pulses and signs). Because the defenses are currently trying to block the cold evil, the greater yang channel becomes congested and crowded, and thus cannot move appropriately. When this movement is damaged, the channel loses its litheness, thus resulting to a stiff neck and headache (Greater yang disease: pulses and signs). Cold aversion is not only limited to chills, but also includes simply intolerance to cold. Aversion to cold also refers to the sensitivity to cold even in the absence of coldness or external wind, and canot be relieved by providing warmer clothes and more blankets. This aversion to cold may thus be related to the current defenses of the body being at work. The ability of the body's defenses to warm a person may be inadequate or inhibited by the exterior evil. Fever of heat effusion occurs because the body's defense is struggling to eliminate the external evil that has penetrated the body. Because of the invasion of the evil, the normal functioning of the body's defenses are impaired, thus causing heat effusion. This struggle is alternating between exterior and interior, hence there is alternation with aversion to cold. In some cases, heat effusion is also accompanied by aversion to cold. The presence or absence of sweating depends on the strength of the penetrating evil. There are basically two forms that determine the presence or absence of sweat. In exterior vacuity wind strike, the defense Qi is easily damaged when an evil penetrates, which then makes the defenses insecure and weak. This results to failure of the yin construction, which discharges itself through sweat. On the other hand, in exterior repletion cold damage, the struggle between the defense Qi and the evil causes the strong blockage of the defense Qi. This results to retention of sweat. Treatment There are 112 herbal therapies in the "Shang Han Lun" that pertain to specific patterns of imbalances in the yang and the yin. These therapies are concoctions that are comprised of different Chinese herbs. Each ingredient has a different purpose or drug action. Clause 106 Among the many other patterns of the "Shang Han Lun" are blood amassment patterns wherein a mild pattern of blood heat is trapped in the lower burner; urination is not inhibited. The client manifests a tensed, bound lesser abdomen. In more severe cases, the client may be manic. (Greater Yang disease: pulses and signs). This clause in the "Shang Han Lun" describes a disease wherein heat congeals in the urinary bladder, which happens before the tai yang syndrome is relieved. The tai yang syndrome will only be alleviated when there is blood in the stool (readings for Shang han lun). In this case, a purgative cannot be given before the exterior evil is disposed of. Hence, if the patient feels tension and pain in the abdomen, below the navel, a therapy is prescribed. Tao He Cheng Qi Tang-Decoction Semen Persicae Chengqi Tao he cheng qi tang is a peach pit decoction to order the qi, or the body's defenses. The main action of this herbal concoction is to drain heat and break up blood stasis. The ingredients or composition of this therapy is as follows according to the Shang Han Lun of Zhang Zhong Jin: Tao ren (Semen Persicae), 50 pieces Da Huang (Radix and Rhizoma Rhei), 4 Liang or 12 grams Gui zhi (Ramulus Cinnamomi), 2 Liang or 6 grams Zhi gan cao (Radix Glycyrrhizae Praeparata), 2 Liang or 6 grams Mang xiao (Natrii Sulfas), 2 Liang or 6 grams These herbs would then have to be stewed in seven sheng of water until only 2.5 sheng remain in the pot. The stew would the have to be filtered, and only after which would the Mang xiao (Natrii Sulfas) be added to the decoction. Put it again to a boil, using low heat. Let it cool, and then prepare lukewarm, to be taken at five Ge before meals, three times a day. Diarrhea may manifest after taking the decoction. This decoction may be indicated for acute lower abdominal pain, urinary incontinence, night fevers, restlessness and thirst, and a floatingpulse ("Formulas that invigorate the blood," n.d.). It may also be prescribed for clients with manic behaviour in severe cases. Drug Study The chief actors in this decoction are Tao ren and Da huang. Tao ren is responsible for breaking up and eliminating blood, whil Da huang is for the purging of accumulations and the dispersion of the heat ("Formulas that invigorate the blood," n.d.). Gui zhi is responsible for warming the sinews and unblocking the vessels. Hence, blood will be dispelled from the lower burner ("Formulas that invigorate the blood," n.d.). Mang xiao, on the other hand, is an assisting herb in the function of this decoction. It softens the blood accumulation, making it easier for the other herbs to act on its dispersion ("Formulas that invigorate the blood," n.d.). Another assistant is the Zhi gan cao, which serves as a protector for the stomach and calms the middle burner ("Formulas that invigorate the blood," n.d.). Herb Indication Action Contrindication Tao ren (Semen Persicae) Peach Kernel Amenorrhea, dysmenorhhea, perisistent lochia post partum, constipation, swelling and pain due to trauma, deficiency of Yin and body fluid Acts on the heart, lung, liver, and large intestine channels in the body, which has functions of dispersion and purgation. It promotes blood circulation by relieving blood stasis and blood masses. (Eastern Chinese Medicine Export Company, 2007) Pregnant women Da huang (Radix and Rhizoma Rhei) Constipation, blood clots, inflammation and pain, amenorrhea, burning during urination, diarrhea, liver and gallbladder complaints, haemorrhiods, and skin erruptions due to an accumulation of toxins Its principal action is balancing the digestive system in general. Its roots contain anthraquinones, which promote purgation as well, and contains tannins and bitters that have an opposite astringent effect. It also has an anti-bacterial effect. (Plants for a future, 2000) Pregnant or lactating women, and clients with intestinal obstruction Gui zhi (Ramulus Cinnamomi) Cinnamon Twig Urinary tract disorders, syphilis, mucus membrane inflammation. Acts on the heart, lung and bladder channels. It has an antipyretic effect that promotes swelling and dilutes the blood vessels of the skin, therefore reducing flushing. It also has an anti-spasmodic and antibiotic effect. It lowers blood sugar and promotes urination. It also has a blood-purgative effect. (Chu, 2006) Pregnancy, excessive bleeding during menstration, heat in blood with vomitting, Zhi gan cao (Radix Glycyrrhizae Praeparata) Licorice root, Sweet grass Addison's disease, peptic ulcer, tuberculosis, Hepatitis, arrythmia, Spleen and stomach deficiencies, cough and dyspnea, abdominal and muscle cramps or pain, food poisoning, and drug interaction Tonifies the spleen, enhances the qi, dilutes phlegm, relieves pain, serves as an antidote for various poisoning circumstances. It is used to neautralize the side effects of other herbs, in addition to its sweet taste. It has mineralcorticoid, glucocorticoid, antiinflammatory, antiarrythmic, and immunologic effects. It also has anti-spasmodic, antitoxic, antitussive, and analgesic effects. (Chen & Chen, 2004) Nausea and vomitting, chest and abdominal fullness, abdominal distention. The herb is incompatible with Gen sui, Yuan hua, and Hai zao. Mang xiao (Natrii Sulfas) Glauber's salt, Sodium sulfate Tension and pain in the abdomen, constipation, conjunctivitis, boils, sore throat Targets the stomach and large intestine channels. It promotes intestinal motility and thus inducing diarrhea. It has also been reported to have antibiotic and antiinflammatory effects. (Chu, 2005) Pregnant and lactating women, clients with spleen deficiency Table 2. Drug study of the herbal ingredients of Tao he cheng qi tang-Decoction Semen Persicae Chengqi. Conclusion Zhang Zhong Jin's "Shang Han Lun" is indeed a very useful guide in the treatment of various diseases. It integrates different theories of Chinese beliefs and Chinese medical practice, which has indeed proven effective for medical practice may it be in the east or the west. However, there are still certain medical issues regarding the prescription and use of Chinese herbal therapies. The tai yang syndrome and the clause 106 have served as examples of how the Shang Han Lun is a fundamental aspect in every medical aspect. Not only does it take into consideration the disease process and its signs and symptoms, but it also balances the different states of a person with his body and environment. In the drug study, it is evident how the two principal herbs (Tao ren and Da huang) help in the treatment of blood amassment. References Chen, J. & Chen, T. (2004). Gan Cao: Radix Glycyrrhizae. Chinese Medical Herbology and Pharmacology. Retrieved May 18, 2007, from AOMpress.com: http://www.aompress.com/SingleHerb/GanCao.pdf Chu, J.H.K. (2005). Mang xiao. Retrieved May 18, 2007, from http://alternativehealing.org/xuan_ming_fen.htm Chu, J.H.K. (2006). Gui zhi. Retrieved may 18, 2006, from http://alternativehealing.org/gui_zhi.htm Eastern Chinese Medicine Export Company. (2007). Introduction to peach kernel. Retrieved May 17, 2007, from http://www.tcmtreatment.com/herbs/0-taoren.htm Fan, J.M. (n.d.). Shang Han Lun and the Golden Chamber. Pacific College of Oriental Medicine. Retrieved May 15, 2007, from http://www.pacificcollege.edu/alumni/newsletters/summer2001/shang_hun_lun.html "Formulas that invigorate blood." (n.d.). Retrieved May 16, 2007, from http://www.orientalmedicine.edu/Formulas%20that%20Invigorate%20the%20Blood.pdf Plants for a future. (2000). Rheum palmatum tanguticum. Retrieved May 18, 2007, from http://www.ibiblio.org/pfaf/cgi-bin/arr_htmlRheum+palmatum+tanguticum Redwing Book Co. (2007a). Preface from the shang han lun. Retrieved May 15, 2007, from http://www.redwingbooks.com/html/catalog/desc/ShaHanLunYiShi_P.pdf Redwing Book Co. (2007b). Shang han lun (on cold damage)-Translation and commentaries. Retrieved May 15, 2007, from http://www.redwingbooks.com/products/books/ShaHanLunYiShi.cfm Shen Nong Ltd. (2006). Syndrome differentiation according to the six meredians. Retrieved May 13, 2007, from http://www.shen-nong.com/eng/exam/diagnosis_sixmeridians.html "TCM Diagnosis." (2007). Sacred Lotus Arts. Retrieved May 14, 2007, from http://sacredlotus.com/diagnosis/six_stages.cfm#taiyang Read More