TCM newsletter (1).
Different systems in
Traditional Chinese Medicine
This is a
series of articles introducing Traditional Chinese Medicine
(TCM), especially its herbal therapy. It is designed for those
acupuncturists, who have no access to the TCM books since they
do not speak Chinese, but who have desire to increase their
skill level of Chinese herbal therapy. If you speak Chinese, and
if you have no interests to read
more articles about TCM herbal therapy since you believe that
you already know all the knowledge about TCM from your TCM text
book, you can stop now and click the “unsubscribe” button below.
We will no longer bother you in future.
of articles will start from the introduction of our TCM bible
Shanghan Lun. Later we will introduce the use of the herbal formula
in this book, which we call it Jing Fang (it means the principle
of herbal formula), as well as some commonly used conventional
herbal formula. The information here is the summary of the
experience of the author during his own study of the book, and
also the experience of other famous TCM doctor in the use of the
Jing Fang. The author feels worthwhile to share his experiences
with those who want to learn more about Chinese medicine.
The author would feel pity that his experience is lost after his
Fang, such as Da Qinglong Tang, would have no
much chance to be used in clinic, if we only learn how to
use them from the book
Shanghan Lun or from TCM text book. Many TCM doctors may use
such formula only several times through his whole life in clinic
work. However, it has been used very common in our clinic. We
are in Edmonton, the northwest of Canada. The main indication for
using this herbal formula is the “Cold folds Fire”. It means
that the body is cold syndrome in the outside layer of the body,
but hot inside. People live in the north of the Canada (even in
China, or on the whole earth), tend to be such body
live in the south of the earth tend to be “Fire folds Cold”,
e.g. outside of the body is hot but inside is cold）.
Many times, for a patient who suffers from a syndrome which is
typically diagnosed as Wind-hotness syndrome and needs the
herbal formula - Yin Qiao San for the treatment.
However, we use Da
Qinglong Tang. It works much faster. The illness consistently
that there are different disease patterns in different parts of
the earth, for the different weathers, different life styles,
etc.; therefore there should have different patterns
of herbal therapies, e.g. some herbal formulae would be
used more frequently than others. For example, the weather in Vancouver is humid, warm,
and windy. There is more Dample-hotness syndrome, so the doctors
need to use more Cold and wet-removing herbs for the treatment.
In our city -
Edmonton, the weather is cold and dry. We
use more warm herbs, such as formula Guizhi Tang, Mahuang jia
Zhu Tang, Guizhi Fuzi Tang, Fuzi Tang, etc. Our aim here is to
share such experiences, thus
increase the healing level of TCM doctors.
several major styles of Traditional Chinese medicine. The TCM
here mostly means the Chinese herbal therapy of the TCM system.
For example, we have Jing Fang style, conventional style, and
college style, etc. As a professional TCM doctor or an
acupuncturist, you should know that what you learn from TCM
school is not the whole TCM. What you learnt in school is only
an information mixture of TCM from various TCM sources.
see how many major styles the TCM has:
Jing Fang style.
the TCM style that based on the TCM book
Shang Han Lun. This
book is regarded as our TCM holy bible. This book focuses on the
treatment of diseases that are caused by the Wind- and
Cold-attack, which we call Shanghan disease, though it actually
also introduced the principles for the diagnosis and treatment
for the diseases caused by the Wind- and Hotness-attack, which
we call it Wen disease.
doctor mostly uses the herbal
formula from the book
Shang Han Lun, we call his style is the Jing Fang style.
Jing here means the principle, the bible. Fang means herbal
Shanghan Lun system, the diseases are separated into six stages. The
disease develops from an early stage into further deeper stages.
These stages are named Taiyang, Yangming, Shaoyang, Taiyin,
Shaoyin and Jueyin stage. Master Zhang Zhongjing called these
stages also diseases, such as Taiyang disease, Yangming
disease…. and Jueyin disease. In this way, most of clinic
problems can be summarized into these six kinds of diseases. It
makes the clinic situation much simple and easy to handle.
example, if a patient feels chilly, has pain on the head and
neck, and if his pulse is floating, we will say that the patient
suffers from Taiyang disease, or we will say that his disease is
in the Taiyang stage of the Shanghan disease. If a patient has
bitter taste in mouth, dry in throat, and feels dizziness, we
will say that the patient has Shaoyang disease, or we will say
that his disease in the Shaoyang stage of a Shanghan disease.
treatment, each disease has a main formula for the treatment. In
most cases, the main formula contains only 4 to 6 herbal
ingredients. Many herbal ingredients used in the formula, such
as Ma Huang, Da Huang, Shi Gao, Fu Zi, etc., are rarely used by
TCM doctors in College style (see below).
They are afraid to use them, fear of possible side
effects. However, in our clinic practice, the side effects from
those herbs are not as severe as they think.
Jing Fang style, its understanding of herbal function appears
based on the book Shen Nun
Ben Cao Jing, not on the book
Ben Cao Gang Mu that
is used by College style of TCM.
healing effects from these herbal formulas are excellent indeed,
if the diagnosis is correct. If we say that the success rate
with the use of these formula are more than 80%, then
with the use of herbal formula in other herbal therapy
styles might be only 50% to 60%, according to our comparison in
problem with the Jing Fang style is that it is hard to learn in
the beginning. However, once we really understand it, it works
very well. In my experience, it should not be studied only from
the book itself. We should learn from other doctors’ clinic
experiences in the use of this Jiang Fang style. Therefore, once
we really understand the way to use such formula for the
treatment, it would be easier to feel success in clinic
Wen Being style.
system is a development, not a completely new, from the
Shanghan Lun system
introduced by Master Ye Tianshi and Wu Jutong (Qing dynasty). It
is the supplementary of the
Shanghan Lun in the
treatment of epidemic diseases characterized by fever. Wen means
hot or fever. Being here means a disease. So, the Wen Being
means epidemic diseases that characterized as fever.
Being system bases on Wei Qi Ying Xue and Three Jiao diagnosis
system. As mentioned above, it is mostly used with epidemic
disease. It is not a commonly used diagnosis system in daily
Si Shen Xing Yuan style.
introduced by Master Huang Yuanyu and further completed and
explained by Dr. Peng Ziyi. Si means number four; Shen means
sages, and the Xing Yuan means the secret experience in heart.
system focuses more on the
Qi movement in the
body: its rising and falling and its round circle in the body.
The aim of the diagnosis is to find if the problem is due to the
block on the way of the Qi
rising, or on the way of the
Qi falling, or both.
It believes that fixing the block
and improving the Qi
in circle in the body would solve the disease.
diagnosis, this system pays much more on the pulse.
Doctor in this TCM style needs to
have very fine feeling on the pulse. In this style, its
understanding of the herbal function is somehow different from
other TCM styles.
Fang Liao Fa style.
small; Fang means formula; Liao Fa means therapy. This system
treats disease with very little herb ingredients and less amount
of ingredients in formula.
of TCM is developed by Master Guo Zhicheng. Xiao Fang means
small formula - using only
several herbs and using small doses for each herb.
It works to improve body energy movement smoothly in the four
cavities of the body (e.g. the chest, the upper belly, the lower
belly, and the spine cavity.) It believes that the energy of the
body, the Qi, moves in
circle from the spine cavity to the lower belly cavity, up to
the upper belly cavity, to the chest, and then turns down to the
spine cavity again. If there is any blocks in the way of the
Qi circle, the person
will get sick. To remove the block and to improve the
Qi circle in such a way in the body, the disease can be cured.
treatment, it used only very limited total amount of herbs, say
about 20 to 30 kinds of herbs in total. For each formula, it
uses only 4, or only 6 herbs, for the treatment.
diagnosis, it focuses much more on the tongue. Its understanding
on the shape and size of the tongue, as well as the color and
the thickness of the tongue covering, is much different from the
TCM text book. Its understanding
of the herb function is also much more different than
any other TCM styles.
Shu Liao Fa
代表 肝；3 代表
Shu Liao Fa style uses number (1, 2, 3, 4, …) for the treatment.
Xiang means a phase, a stage, a status, or a direction. For
instance, the spring, the summer, the autumn, and the winter,
are different phase, different stage, different status, or a
different direction. Shu means number, one, two, three, four… up
to ten. Liao Fa means a therapy.
behind this style is the five element theory in TCM, in which
liver is associated with, connected to, affected by, the figure
4; heart, by figure 3; spleen, 8; lung, 2; kidney, 6; gall
bladder, 5; stomach, 7; small intestine, 3; large intestine 1;
urinary bladder, 6; and the three Jiao, 3.
treatment, the patient is asked to patter in heart the numbers.
The chose of the number is decided by the nature of the disease
and the relationship between the organs that was involved in the
diseases. For example, if the disease is diagnose as lung
Qi deficiency, the
patient is asked to patter 820. The 8 represents the function of
Spleen; the 2 represents that of Lung. To patter zero here is to
enhance the healing effect. To patter number 8 will improve the
function of Spleen, and patter 2 will improve that of Lung. By
this way, the function of the lung is improved directly by
pattering 2 and indirectly by pattering 8. Therefore, pattering
820 can solve Lung Qi
deficiency condition. This is one of the principles in the chose
of numbers for the treatment.
Apparently, the Xiang Shu Liao Fa does not use any herb at all.
It is a completely different therapy in the TCM scope while it
still applies the basic concept in the TCM for the diagnosis and
(6). Shi Fang style
Fang style of TCM means the conventional TCM style. Doctors
this style follows various TCM systems developed by other
doctors in the history, but also have their own contributions to
the development of the TCM. Their contributions complete and
make supplementary to the whole TCM. For example, Dr. Li
Dongyuan developed the Spleen-stomach theory; Dr. Zhu Danxi
developed Yin-nourishing theory.
Qingren developed the way to solve blood stasis condition. Dr.
Chen Shaodong contributed to the treatment of external damage
(trauma). Dr. Fu Qingzhu contributed to the treatment of
disorders in the male and female system. Dr. Zhang Xichun
contributed to the treatment of later stage diseases, in which
the patient’s condition is very
complex and the treatment becomes very difficult. Dr. Zheng Qing
contributed to the use of herb Fuzi in the treatment of various
many famous TCM doctors in Chinese history. For the treatment of
some diseases, their herbal formulas work better than the
Shanghan Lun style, so
that their formulae are still popularly used in current days.
(7). The College system.
is developed from the TCM text book that is still used in
and out of
text book is a mixture of the TCM literatures and styles from
various sources. It is not developed by a single doctor or a
group of doctors in the history, but edited by a group of
western medicine doctors in about 1950s’, who
wanted to learn TCM and
wanted to make the TCM easier to learn. It is pretty much as a
mixture of Chinese food, Indian food, Italian food, and French
food, all in one dish.
follows the Organ diagnosis and
Qi, Blood, Yin, Yang,
Phlegm…diagnosis system. It pays more on the tongue
diagnosis and pulse diagnosis. It focuses to use “safe” herbs
for the treatment, so that it dares not to use “stronger” herb,
those of which are used commonly in Jing Fang style.
understanding of herbal function, this style follows the book
from Dr. Li Shizheng Ben
Cao Gang Mu. It also
pays more attention to the use of meridian-guiding herbs in a
herb formula (the guiding herbs brings the rest of herbs working
in a specific part of the body).
practice, doctors in this style usually use only the harmonizing
therapy, warming therapy, cleaning therapy and supplying
therapy, but less the sweat therapy, vomiting therapy, or
colon-cleansing therapy. They tend to use less strong herbs for
the treatment, such as Mahuang, Shigao, Dahuang or Fuzi, etc.
formulas prescribed by the TCM doctors of College style tend to
use more than ten, even twenty or thirty herb ingredients in a
single formula. Each amount of
the ingredient is also usually very high. It can reach 20 grams,
30 grams, or even more. They tend to solve all the problems of a
patient at the same time, while to make the patient feels as
less discomfort (side effect) as possible from the herbal
the healing effect from the College style of TCM is low and
largely variable among doctors (compared with the Jing Fang
style). The doctors usually tell
patients to take the herbal tea
for one week, or ten days, then come back to check the effect of
the herbal therapy. Once the herbal formula does not work, the
doctor usually has no clear ideas
what to do next.
textbook TCM is easy to learn from beginning, but difficult to
feel success in later clinic work. This is because of the
weakness of the current TCM textbook. For example, if there is a
patient suffering from cough, the TCM textbook teaches the
student to diagnose if the cough is due to Wind-cold cough,
Wind-fire cough, Wind-dryness cough, or Phlegm-accumulating in
lung, Phlegm-fire in lung, Liver-fire attacking the lung, or due
to the Lung Yin deficiency condition. The textbook lists only
one or two herbal formula for the treatment of each of
these different cough conditions.
Therefore, it is easy for student to remember how to diagnose
and how to treat the cough condition. It seems that, a cough
condition, either caused by external
Xieqi attack, or inner
reasons. If it does not belong to Wind-Cold cough, Wind-dryness
cough, it should belong to the Wind-fire cough. The symptoms
among each kind of the cough conditions are so clear for the
diagnosis. This makes students feel that no disease that TCM
cannot solve, because the diagnosis is so clear and the herbal
formula should work – they usually think so.
However, in practice, many patients have no others
symptoms, except cough. We may not get more evidences
from the tongue or pulse to support diagnosis. Such cough occurs
spontaneously but can last for several weeks or months. In this
case, the diagnosis is not so easy at all – I believe so. We
tried all of the herbal formulas that are listed in the
textbook, none worked. If there is no healing effect, or the
cough was not improved at all, what should be next step? What
should we do? The textbook did not teach us.
Furthermore, if the patient has, cough, dizziness, pain in
joints, frequent urination, etc all together. All the symptoms
are equally severe. How should we decide the main symptom for
the treatment? Should we treat all of them the same time, or one
after another? The textbook did not give us more education.
addition, if there some side effects from a herbal formula that
is recommended in the textbook, what does that side effect means
(what the side effect implies to us)? How to prevent such side
effects? The textbook did not include such clinic experience.
Apparently, the textbook only give us a very basic knowledge
about Traditional Chinese medicine. It introduces too less
knowledge for TCM doctor to work
in clinic. If we do not recognize this, and if we believe that
we have already learnt everything about TCM, and refuse and have
no desire to continue update our knowledge after graduation, it
would be easy for us to feel failure in TCM practice. If such
failure happens again and again, we cannot prevent from claiming
that TCM cannot solve any disease! We would be ready to adapt
the western medicine in our clinic thereafter or even completely
quit form the TCM. Wouldn’t you think this is the
introduction above is only some of the TCM styles. They
contributed to the development of TCM more or less. Even for the
textbook style of TCM, it helps to introduce the basic knowledge
to student. In clinic, none of the styles are the perfect, but as a TCM
practitioner, we must first understand how to practice the Jing
Fang style. Without such basis, no one can be a TCM expert. In
TCM history, almost all the famous TCM doctors are at least the
expert in the Jing Fang style.
Millwoods Acupuncture Center is
located in Edmonton, Alberta, Canada and serves Edmonton
surrounding area, including: St. Albert, Big
Lake, Spruce Grove, Stony Plain, Devon, Beaumont, Sherwood Park,
Calgary, Red Deer and Whitecourt, Barrhead, Westlock, Wetaskiwin,
Camrose, Fort Saskatchewan, Grande Prairie. Our clients also come
from Vancouver and Saskatoon.