TCM Spleen & Stomach Functions PDF

NMT150: NATUROPATHIC THERAPEUTICS I TRADITIONAL CHINESE MEDICINE (TCM) E-LEARNING LECTURE 5 T C M S P L E E N A N D S TO M A C H FUNCTIONS AND THEORY Author: Dr. Romi Fung, ND, M.Sc, Ph.D (cand.) LEARNING OBJECTIVES Learn the functions of TCM Spleen and Stomach TCM SPLEEN FUNCTIONS TCM SPLEEN F...

NMT150: NATUROPATHIC THERAPEUTICS I TRADITIONAL CHINESE MEDICINE (TCM) E-LEARNING LECTURE 5 T C M S P L E E N A N D S TO M A C H FUNCTIONS AND THEORY Author: Dr. Romi Fung, ND, M.Sc, Ph.D (cand.) LEARNING OBJECTIVES Learn the functions of TCM Spleen and Stomach TCM SPLEEN FUNCTIONS TCM SPLEEN FUNCTION Governs transformation and transportation The Spleen transforms the ingested food and drink to extract Qi from it: this is called Food-Qi and is the basis for the production of Qi and Blood. Once Food-Qi is formed, the Spleen transports this and some refined parts of food, called ‘food essences’, to the various organs and parts of the body TCM SPLEEN FUNCTION Governs transformation and transportation Crucial to the process of digestion and production of Qi and Blood. If this function is normal, the digestion will be good, with good appetite, normal absorption and regular bowel movements. If this function is impaired, there may be poor appetite, bad digestion, abdominal distension and loose stools. TCM SPLEEN FUNCTION Governs transformation and transportation The Spleen separates the usable from the unusable part of the fluids ingested; the ‘clear’ part goes upwards to the Lungs to be distributed to the skin and the space between the skin and muscles, and the ‘turbid’ part goes downward to the Intestines where it is further separated TCM SPLEEN FUNCTION Governs transformation and transportation If Spleen function is normal, then transformation and movement of fluids will be normal. If this function is impaired, the fluids will not be transformed or transported properly and may accumulate to form Dampness and edema TCM SPLEEN FUNCTION Governs transformation and transportation Implication here is that the Spleen must always be treated when there is Dampness, Phlegm or oedema. Moreover, the Spleen is also easily affected by external Dampness, which may impair its function of transformation and transportation TCM SPLEEN FUNCTION Governs transformation and transportation ‘The Spleen loathes Dampness’ Dampness easily obstructs the Spleen, causing a dysfunction of its activity of transformation and transportation. This can cause abdominal fullness, urinary problems or vaginal discharges. In the head, Dampness prevents the rising of Spleen-Qi, causing a dull headache and a feeling of heaviness. TCM SPLEEN FUNCTION Governs transformation and transportation ‘The Spleen likes dryness’ In connection with the transformation of food and digestion, it is said that the Spleen ‘likes dryness’: this means that the Spleen’s activity of transformation and transportation can be easily impaired by the excessive consumption of cold liquids or icy drinks (so common in many Western countries). In contrast, the Stomach ‘likes wetness’, i.e. foods that are moist and not drying. TCM SPLEEN FUNCTION Controls the ascending of Qi The Spleen separates the usable from the unusable part of food and directs Food-Qi upwards to the Lungs to combine with air to form Gathering Qi and to the Heart to form Blood TCM SPLEEN FUNCTION Controls the ascending of Qi The ascending of Spleen-Qi has another important function as it serves to ‘lift’ the internal organs to keep them in their proper place. The failing of this ascending movement may cause prolapse of an internal organ TCM SPLEEN FUNCTION Controls Blood ‘Control’ in this case has two separate meanings: Spleen Qi keeps or ‘holds’ the blood in the vessels; on the other hand, it means that the Spleen plays an important role in the making of Blood TCM SPLEEN FUNCTION Controls Blood Spleen Qi is healthy, Blood will circulate normally and stay in the vessels. If Spleen Qi is deficient and not ascending properly, Blood may spill out of the vessels, resulting in haemorrhage. The failure of the ascending of Spleen Qi and the failure in controlling Blood normally causes bleeding downwards, for example from the uterus, bladder, and bowels. TCM SPLEEN FUNCTION Controls Blood In fact, the Spleen extracts Food-Qi from food and this forms Blood in the Heart with the assistance of the Original Qi from the Kidneys. The Spleen is therefore the central, essential organ for the production of both Qi and Blood. This is another reason why it is called the ‘Root of Post-Heaven Qi’. In this context, ‘Qi’ in the expression ‘Post-Heaven Qi’ should be intended in a broad sense which includes Blood. If we wish to tonify the Blood, therefore, we must always tonify the Spleen. TCM SPLEEN FUNCTION Controls the muscles and four limbs Spleen extracts Food Qi from food to nourish all tissues in the body. This refined Qi is transported throughout the body by the Spleen. If the Spleen is strong, refined Qi is directed to the muscles, particularly those of the limbs. If Spleen Qi is weak, the refined Qi cannot be transported to the muscles and the person will feel weary, the muscles will be weak. TCM SPLEEN FUNCTION Controls the muscles and four limbs Spleen is the most important factors determining the amount of physical energy a person has. Tiredness is a common complaint and in these cases the Spleen must always be tonified. TCM SPLEEN FUNCTION Opens into the mouth The action of chewing prepares food for the Spleen to transform and transport its food essences. For this reason the mouth has a functional relationship with the Spleen. When Spleen-Qi is normal, the sense of taste is good and chewing is normal. If Spleen-Qi is abnormal, there may be impairment of the sense of taste, difficulty in chewing and lack of appetite TCM SPLEEN FUNCTION Manifests in the lips The Spleen influences the lips. Indeed, the lips are a reliable indicator of the state of the Spleen. When the Spleen is normal, the lips are rosy and moist Controls saliva As the Spleen controls the mouth, it naturally controls the secretion of saliva. The Chinese word ‘xian’, which is used to describe the fluid related to the Spleen. Saliva’s function is to moisten the mouth and to aid digestion by mixing the food with fluids to ease digestion TCM SPLEEN FUNCTION Controls raising of Qi Spleen produces a ‘lifting’ effect on the organs: this ‘raising’ of Qi is also an expression of the ascending of Spleen Qi. It is this force that makes sure that the internal organs are in their proper place. If Spleen Qi is deficient and its ‘raising Qi’ function weak, there may be prolapse of various organs such as uterus, stomach, kidney, bladder or anus. TCM SPLEEN FUNCTION Houses the Intellect (Yi) The Spleen is said to be the ‘residence’ of the Intellect (Yi). The Intellect resides in the Spleen and is responsible for applied thinking, studying, memorizing, focusing, concentrating, and generating ideas TCM SPLEEN FUNCTION Affected by pensiveness Pensiveness is very similar to worry in its character and effect. Pensiveness consists in brooding, constantly thinking about certain events or people (even though not worrying), or nostalgic hankering after the past. In extreme cases, pensiveness leads to obsessive thoughts. In a different sense, pensiveness also includes excessive mental work in the process of one’s work or study. TCM SPLEEN FUNCTION Affected by pensiveness Pensiveness affects the Spleen and, like worry, it knots Qi; however, worry will tend to knot Qi in the Upper Burner, while pensiveness knots Qi in the Middle Burner. Stagnation of Qi in the Middle Burner will cause poor digestion and a feeling of distension of the epigastrium TCM STOMACH FUNCTION TCM STOMACH FUNCTION The Stomach controls 'receiving' Food and drink enter the mouth and then reach the stomach via the pharynx and oesophagus. Therefore the Stomach ‘receives’ food and drink and keeps them down. ‘Receiving’ here does not merely indicate the obvious fact that the Stomach receives ingested food and drink but it implies also that the Stomach holds these down too. TCM STOMACH FUNCTION The Stomach controls 'receiving' The Stomach function of receiving also has a relationship to the appetite: a good, healthy appetite indicates a strong Stomach ‘receiving’ Apoor appetite indicates a weak Stomach ‘receiving’; and the total absence of appetite denotes the complete collapse of the Stomach ‘receiving’. Belching, nausea and vomiting also indicate a weak Stomach ‘receiving’ and Stomach Qi ‘rebelling’ upwards TCM STOMACH FUNCTION The Stomach controls the 'rotting and ripening of food' Stomach transforms ingested food and drink by fermentation Prepares the ground for the Spleen to separate and extract the refined essence from food. After transformation in the Stomach, food is passed down to the Small Intestine for further separation and absorption. TCM STOMACH FUNCTION The Stomach controls the 'rotting and ripening of food' Strong Stomach Qi indicates good prognosis; weak Stomach Qi indicates poor prognosis No matter how serious the disease, if Stomach-Qi is still strong, the prognosis will be good. Hence the saying ‘If there is Stomach-Qi there is life, if there is no Stomach-Qi there is death.’ TCM STOMACH FUNCTION The Stomach controls the transportation of food essences The Stomach, together with the Spleen, is responsible for the transportation of food essences to the whole body and limbs TCM STOMACH FUNCTION The Stomach controls the descending of Qi The Stomach sends transformed food downwards to the Small Intestine: for this reason in health, Stomach Qi has a downward movement. If Stomach-Qi descends, digestion will be good and trouble-free. If Stomach Qi fails to descend, food will stagnate in the stomach, leading to a feeling of fullness and distension, sour regurgitation, belching, hiccup, nausea and vomiting. TCM STOMACH FUNCTION The Stomach is in the origin of fluids To rot and ripen food the Stomach needs an abundance of fluids, just as sufficient fluids are needed to extract the vital principles from a herbal decoction or a soup. If Stomach fluids are abundant, digestion will be good and the sense of taste normal. If Stomach fluids are deficient, a person will be thirsty, the tongue will be dry and cracked and digestion will be poor. One of the main reasons for deficiency of Stomach fluids is eating too late at night. REFERENCES Maciocia, G. (2015). Foundations of Chinese Medicine. Third Edition. NMT150: ACUPUNCTURE – WEEK 4 E-LEARNING LECTURE 4: C L E A N N E E D L E T E C H N I Q U E D E M O N S T R AT I O N N E E D L I N G T E C H N I Q U E S D E M O N S T R AT I O N Dr. Neemez Kassam, M.Sc, ND, R.Ac IN THIS E-LEARNING SERIES Review of Needling for the Lung and Large Intestine meridians Demonstration of Proper Clean Needle Technique Setup Demonstration of Needle angles and techniques LEARNING OBJECTIVES Review the Lung and Large Intestine meridian points for method of needling Review the clean field setup and equipment needed for acupuncture administration Learn the correct angles for needle insertion Learn the different types of needle insertion techniques: One hand with tube, two hand with tube, long needle with cotton, free-hand, and subcutaneous running NEEDLING SESSIONS Students receiving acupuncture (model) should be lying on the treatment table, rather than sitting or standing Student administering acupuncture (practitioner) should be standing in a comfortable stance wearing closed-toed footwear  Lung 6 Kongzui (Biggest Hole) Xi-Cleft Point L: On the anterior aspect of the forearm, 7 cun proximal to Lu 9 (or the transverse wrist crease) on the line joining Lu 9 and Lu 5. I: Cough, asthma, wheezing, bronchitis, hemoptysis, sore throat, pain and motor impairment of the elbow and arm. A: Regulates Lung Qi, descends Lung Qi, relieves pain, clears heat (acute), and stops bleeding. M: Puncture perpendicular 0.5-1.0 inch. N: The lateral antebrachial cutaneous nerve. C: Cephalic vein, the radial artery and vein. METHOD OF NEEDLING: ANGULATION Needle angle relative to the skin Perpendicular: 90° Oblique: 15 – 75° Subcutaneous: < 15° Based on underlying structures METHOD OF NEEDLING: DEPTH Based on several factors including location, underlying structures, and thickness of muscle Examples: corner of nailbed on finger = 0.1” depth Lateral aspect of gluteus maximus = 2 – 4” depth NEEDLE LENGTH Needles come in several lengths (mm): 6, 15, 25, 30, 40, 50, 75, 100, 150. Select needle length based on maximum depth + ¼” 1” (25mm) maximum depth = 30mm needle length Avoid long needles for shallow depth 40mm (1 ½”) needle for 15mm (~½”) depth NEEDLE THICKNESS Come as thin as.12mm diameter and as thick as.45 diameter 0.20 - 0.25mm diameter is recommended for most body parts 0.16 – 0.18 generally used for more sensitive patients or thinner areas like the face LUNG MERIDIAN Points to be needled: 6, 7, 10 LARGE INTESTINE Points to be needled: 1, 4, 5, 7, 10, 11, 14, 15, 20 REFERENCES Kassam, Neemez et al. Fundamentals of Clinical Acupuncture. Toronto, ON: CCNM Press, 2009. Liangyue, Deng et al. Chinese Acupuncture and Moxibustion. Beijing, China: Foreign Languages Press, 1996. Maciocia, Giovanni. The Foundations of Chinese Medicine. Pittsburgh, PA: Churchill Livingstone, 2005. Ross, Jeremy. Acupuncture Point Combinations – The Key to Clinical Success. London: Churchill Livingston, 1998. Tyme. Student Manual on the Fundamentals of Traditional Oriental Medicine. San Diego, CA: Living Earth Enterprises, 1997. LUNG MERIDIAN POINTS Learn the locations for Lung 1, 2, 5, 6, 7, 8, 9, 10, 11 Understand the associated anatomy and cautions THANK YOU A N D H AV E A LO V E LY D AY NMT150: NATUROPATHIC THERAPEUTICS I TRADITIONAL CHINESE MEDICINE (TCM) E-LEARNING LECTURE 4 TCM HEART AND SMALL INTESTINE FUNCTIONS AND THEORY Author: Dr. Romi Fung, ND, M.Sc, Ph.D (cand.) LEARNING OBJECTIVES Learn the functions of TCM Heart and Small Intestine TCM HEART FUNCTION TCM HEART FUNCTION The Heart governs Blood Transformation of Gu-Qi from Food into Blood occurs in the Heart The Heart is responsible for circulation of Blood TCM HEART FUNCTION The Heart controls the Blood Vessels The state of the Heart is reflected in the state of the blood vessels If Heart Qi is strong, the blood vessels will be in a good state and the pulse full and regular TCM HEART FUNCTION The Heart manifests in the complexion If the Heart governs Blood and blood vessels, then it also helps distribute blood throughout the body The state of the Heart and Blood can therefore be reflected in the complexion If the complexion is pale vs purple, or yang-deficient? Or too much heat? TCM HEART FUNCTION The Heart houses the Mind The Heart is the residence of the Mind (Shen) Firstly, in a narrow sense, Shen indicates the complex of mental faculties which are said to ‘reside’ in the Heart. In this sense, the Shen corresponds to the Mind and is specifically related to the Heart TCM HEART FUNCTION The Heart houses the Mind A second way to characterize Shen is whole sphere of mental and spiritual aspects of a human being. In this sense, it is related not only to the Heart but also it encompasses the mental and spiritual phenomena of all the other organs, notably the Yin organs: that is, the Ethereal Soul (Hun), Corporeal Soul (Po), Intellect (Yi), Willpower (Zhi) and the Mind (Shen) Translated as 'Spirit' TCM HEART FUNCTION The Mind of the Heart Mental activity and conscious resides in the Heart State of the Heart (and Blood) reflects the mental activities including emotional state, conscious, memory, thinking and sleep. If the Heart is strong and Blood abundant, there will be a normal mental activity, a balanced emotional life, a clear consciousness, a good memory, keen thinking and good sleep TCM HEART FUNCTION Mind of the Heart If the Heart is weak and Blood is deficient, there may be some emotional problems, poor memory, poor sleep, dull thinking, and in extreme cases, unconsciousness. TCM HEART FUNCTION The Heart is related to Joy 'Joy makes the Mind peaceful and relaxed, it benefits the Nutritive and Defensive Qi and it makes Qi relax and slow down.’ 'The Heart controls joy, joy injures the Heart, fear counteracts joy.' TCM HEART FUNCTION The Heart is related to joy 'Joy’ as a cause of disease is obviously not a state of healthy contentment but one of excessive excitement and craving which can injure the Heart. Continuous mental stimulation (however pleasurable) or excessive excitement: in other words, a life of ‘hard playing’. Define ‘excess joy’ as ‘overstimulation’. Overstimulation is indeed a cause of disease in patients (e.g. overstimulation from drugs, some medicinal drugs, advertising, consumerism, alcohol, etc.) TCM HEART FUNCTION The Heart opens into the tongue The Heart controls the colour, form and appearance of the tongue; it is in particular related to the tip of the tongue. TCM HEART FUNCTION The Heart opens into the tongue The condition of the Heart also affects speech and abnormalities may cause stuttering or aphasia. Heart also influences talking and laughing. Often a disharmony of the Heart can cause a person to talk incessantly or laugh inappropriately. TCM HEART FUNCTION The Heart controls sweat Since the Heart governs Blood and this has a relation of mutual interchange with Body Fluids, of which sweat is part TCM HEART FUNCTIONS The Heart controls sweat Since the Heart governs Blood and this has a relation of mutual interchange with Body Fluids, of which sweat is part, the Heart is related to sweat. Heart Qi Deficiency may often cause spontaneous sweating, while a Heart Yin Deficiency may often cause night sweating and the treatment should be aimed at tonifying Heart Qi or Yin. TCM HEART SUMMARY Controls the Blood vessels Manifests in the complexion Houses the ‘Mind’ Is related to Joy Opens into the tongue Controls sweat TCM SMALL INTESTINE FUNCTION TCM SMALL INTESTINE FUNCTION The Small Intestine controls receiving and transforming Small Intestine receives food and drink from the Stomach to carry out its job of separating a ‘clean’ (i.e. reusable) part from a ‘dirty’ part. The clean part is then transported by the Spleen to all parts of the body to nourish the tissues. The ‘dirty’ part is transmitted to the Large Intestine for excretion as stools, and to the Bladder for excretion as urine TCM SMALL INTESTINE FUNCTIONS Small Intestine controls receiving and transforming Small Intestine has a direct functional relation with the Bladder and it influences the urinary function. Small Intestine points can be used to treat urinary problems TCM SMALL INTESTINE FUNCTION The Small Intestine separates fluids This process is similar to the one outlined above in relation to food, although there is a slight difference. After the ‘dirty’ fluids are passed down from the Stomach, they are further separated by the Small Intestine into a ‘clean’ part, which goes to the Bladder for excretion as urine, and a ‘dirty’ part, which goes to the Large Intestine, partly for reabsorption and partly for excretion in the stools TCM SMALL INTESTINE FUNCTION Small Intestine influences our mental clarity and judgment It is said that it helps us to distinguish our options in any situation clearly in order to come to a decision. REFERENCES Maciocia, G. (2015). Foundations of Chinese Medicine. Third Edition. Chapter 6 Heart Maciocia, G. (2015). Foundations of Chinese Medicine. Third Edition. Chapter 14 Small Intestine NMT150: NATUROPATHIC THERAPEUTICS I TRADITIONAL CHINESE MEDICINE (TCM) LECTURE 3 T C M LU N G A N D L A R G E I N T E S T I N E D I F F E R E N T I A L S Author: Dr. Romi Fung, ND, M.Sc, Ph.D (cand.) Dr. Neemez Kassam, M.Sc, ND, R.Ac METAL ELEMENT Lung and Large Intestine Emotional sound is Weeping or crying Mucous is the secretion Illness sound is Coughing Sadness, grief are the Sense is smell emotions Season is autumn Rotten is the odor Climate is dry & cold Pungent and spicy are the flavors Lung: 3 – 5am, LI: 5 – 7am LUNG FUNCTIONS Governs Qi and Respiration Qing Qi Controls Descending and Dispersing Descends Qi to the Kidney Disperses Qi throughout the body esp. skin and pores Ensures that Wei Qi is available all over the body Regulate Water Passages or Channels Water descends (like to the Kidneys) Vapor circulates or ascends (like to the skin and hair) LUNG FUNCTIONS Controls Skin Manifest in the body hair Opens into the nose Hence all the runny noses with colds Controls the nasal mucous House the Po (Corporeal Soul) The ‘physical’ soul Affected by grief and sadness  en Sple WIND COLD Aversion to cold and/or wind Occipital stiffness and aches Sneezing No sweating or thirst Cough Tongue Runny nose with white d/c Thin, white coat Slight or no fever Pulse Floating, tight pulse WIND HEAT Aversion to cold (Wei qi warms Itchy and sore throat so an impairment makes it Swollen tonsils susceptible to cold) Thirst Sneezing Tongue Cough Red on tip or sides, thin white Runny nose with slight yellow coat mucus Pulse Slight sweating Floating and rapid LUNG QI DEFICIENCY: CAUSES Chronic cough or asthma Insufficiency of Qi production LUNG QI DEFICIENCY: SXS Feeble Cough or Asthma Dizziness SOB, worse on exertion Aversion to cold Low and/or hoarse voice Pale face Fatigue Watery or thin/clear sputum Spontaneous sweating Catches colds easily LUNG QI DEFICIENCY: T&P Tongue Pale tongue with a thin, white coating Pulse Weak or empty pulses especially right cun position LUNG YIN DEFICIENCY: CAUSES Prolonged cough Heat disorders which injure the lung Prolonged dryness LUNG YIN DEFICIENCY: SXS Dry cough Afternoon fever With small amounts of sticky Malar flush sputum With blood-tinged sputum Night sweats Dry mouth and throat Heat sensation in 5 centres LUNG YIN DEFICIENCY: T&P Tongue Red body with a dry coat or little coating and maybe cracks or peeling Pulse Rapid and thready LUNG COLD: CAUSES Pathogenic cold in the Lung Wind cold LUNG COLD: SXS Cough Fever Asthma Headache & body aches Thin, white sputum Itchy throat Absence of thirst Sneezing Runny nose with clear mucus or complicated with aversion to cold LUNG COLD: T&P Tongue White coat, pale body Thin in Wind Cold Thicker in Pathogenic Cold Pulse Slow, strong, and tight LUNG HEAT: CAUSES Pathogenic Heat Pathogenic Cold turning to Pathogenic Heat in the Lung Wind Heat LUNG HEAT: SXS Cough Aversion to heat Asthma Chest pain Yellow sticky sputum Yellow purulent sputum with Thirst blood Sore throat Constipation Scanty, concentrated urine LUNG HEAT: T&P Tongue Red body & thin, yellow coat Pulse Rapid and strong LUNG DRYNESS: CAUSES Pathogenic Dryness Stomach Yin Deficiency Wind Heat Wind Dryness LUNG DRYNESS: SXS Dry cough with little Chest pain sputum Dry skin Sputum too sticky to cough Thirst up Hoarse voice Dry nose and throat LUNG DRYNESS: T&P Tongue Dry tongue with thin coating Pulse Rapid and thready PHLEGM DAMP RETENTION: CAUSES Pathogenic Wind, Cold & Damp Prolonged Cough or Asthma Spleen dysfunction of transportation PHLEGM DAMP RETENTION: SXS Cough with frothy or Gurgling sound with white, sticky sputum sputum in the chest Sputum is easy to SOB expectorate Dislikes lying down Stuffiness and fullness in the chest – “Clogged up” PHLEGM DAMP RETENTION: T&P Tongue Pale with a white, sticky coat Pulse Wiry, slippery, and strong PHLEGM-HEAT OBSTRUCTING: CAUSES Wind-heat invasion Smoking Excess eating of hot and greasy foods PHLEGM-HEAT OBSTRUCTING: SXS Barking cough Profuse yellow or green sputum that is foul smelling Asthma Heavy feeling in the chest SOB PHLEGM-HEAT OBSTRUCTING: T&P Tongue Red body with a thick, sticky yellow coating Pulse Rapid, slippery, and strong INVASION BY WIND-WATER: CAUSES Wind-cold + damp invasion INVASION BY WIND-WATER: SXS Sudden swelling of eyes Aversion to wind Gradually spreading to face Fever Bright-shiny complexion Cough Scanty and pale urine Breathlessness INVASION BY WIND-WATER: T&P Tongue Sticky white coating Pulse Floating and slippery COLD-PHLEGM IN LUNGS: CAUSES Repeated wind-cold invasions Excessive consumption of raw, cold, or dairy COLD-PHLEGM IN LUNGS: SXS Cough with white, watery Dizziness sputum Heaviness in the chest Worse cold exposure Feeling of cold in the chest Feeling of cold Feeling of heaviness Cold hands Dizziness of the head Phlegm in throat COLD-PHLEGM IN LUNGS: T&P Tongue Swollen and wet with a sticky white coating Pulse Slow, slippery, and strong DRY-PHLEGM IN LUNGS: CAUSES Excessive consumption of greasy and/or dairy Elderly mainly DRY-PHLEGM IN LUNGS: SXS Dry cough Heaviness in the head Difficult to expectorate Dry throat SOB Wheezing Heavy feeling in chest Pasty-dry complexion Scanty phlegm in throat DRY-PHLEGM IN LUNGS: T&P Tongue Swollen with dry, stick coating Pulse Fine and slippery LARGE INTESTINE FUNCTIONS Receives food and drink from the small intestine and extracts fluids from it Excretes the stools Mentally in charge of “Letting Go” LI DAMP HEAT: CAUSES Excessive consumption of hot and greasy foods Pathogenic summer heat, damp and heat LI DAMP HEAT: SXS Abdominal pain Offensive stool odor Tenesmus. Thirst with no desire to Blood and mucus in the drink stools Scanty, deep yellow urine Burning sensation in the anus Fever Diarrhea with yellow Sweating watery stools LI DAMP HEAT: T&P Tongue Red body with yellow, sticky coating Pulse Rapid, slippery, and strong LI HEAT CONSUMPTION OF FLUID: CAUSES Excessive consumption of hot foods (lamb, beef & alcohol) LI HEAT CONSUMPTION OF FLUID: SXS Constipation with dry stools Burning sensation in the mouth Burning and swelling in the anus Dark, scanty urine LI HEAT CONSUMPTION OF FLUID: T&P Tongue Red body with thick yellow or brown, dry coat Pulse Full and rapid COLD INVADING LI: CAUSES Chronic exposure to cold weather with abdomen exposed Sitting on cold, wet surfaces for long periods COLD INVADING LI: SXS Sudden abdominal pain Diarrhea with pain Feeling of cold Cold sensation in the abdomen COLD INVADING LI: T&P Tongue Thick, white coating Pulse Deep, wiry, slow, and strong LI DRYNESS: CAUSES Blood or Yin deficiency Elderly Women after a delivery Late stages of febrile disease Dry and warm climates LI DRYNESS: SXS Dry stools Constipation Dry mouth and throat Yellow, scanty urine LI DRYNESS: T&P Tongue Dry, red or pale body without coating Pulse Thready LI QI STAGNATION Irregular eating habits On the run While standing While reading Frustration, anger LI QI STAGNATION: SXS Abdominal distention & pain Constipation with bitty stools Irritability Aggravated by mood LI QI STAGNATION: T&P Tongue Normal to slightly red sides Pulse Wiry on both chi positions LI COLLAPSE: CAUSES Spleen & Stomach deficiency Excessive physical work LI COLLAPSE: SXS Chronic diarrhea Cold limbs Anal prolapse Decreased or absence of Hemorrhoids appetite Fatigue after bowel Mental exhaustion movements Better with abdominal massage LI COLLAPSE: T&P Tongue Pale Pulse Deep, fine, weak REFERENCES Liangyue, Deng et al. Chinese Acupuncture and Moxibustion. Beijing, China: Foreign Languages Press, 1996. Maciocia, Giovanni. The Foundations of Chinese Medicine. 2ed. Philadelphia, PA: Churchill Livingstone, 2005. Tyme. Student Manual on the Fundamentals of Traditional Oriental Medicine. San Diego, CA: Living Earth Enterprises, 1997. Kaptchuk, Ted. The Web That Has No Weaver. Chicago, IL: Congdon & Weed, Inc, 1983. TENESMUS (NOUN) TE· NES· MUS | \ TƏ-ˈNEZ-MƏS \ DEFINITION OF TENESMUS : A DISTRESSING BUT INEFFECTUAL URGE T O E V A C U AT E T H E R E C T U M O R B L A D D E R LI Damp Heat NMT150: NATUROPATHIC THERAPEUTICS I TRADITIONAL CHINESE MEDICINE (TCM) E-LEARNING LECTURE 3 T C M LU N G A N D L A R G E I N T E S T I N E FUNCTIONS AND THEORY Author: Dr. Romi Fung, ND, M.Sc, Ph.D (cand.) LEARNING OBJECTIVES Describe Lung and Large Intestine Organ Functions TCM ORGANS AND VITAL SUBSTANCES One of the main functions of the TCM organs is to ensure the production, maintenance, replenishment, transformation and movement of the Vital Substances In order to understand pathology, it is important to know the functions of each organ INTRODUCTION TO TCM ORGANS Zang-Fu Organs Zang is to Yin Organs, and Fu is to Yang Organs Zang means 'to store;' these organs store essences of the body In TCM, the internal organs are seen as a complex energetic system encompassing its anatomical entity and its mental, emotional and spiritual aspects Therefore, each internal organ is not simply an anatomical entity Each organ is correlated to a particular emotion, tissue, sense organ, mental faculty, colour, climate, taste, smell and more. INTRODUCTION TO TCM ORGANS Vital substances Fluids Tissues Odours Sense organs Colours Emotions Tastes Spiritual aspects Sounds Climates External manifestations TCM LUNG FUNCTION TCM LUNG FUNCTION Lungs Govern Qi and Respiration Lungs extract 'clean Qi' for the body Air Qi and Food-Qi (from the Spleen) combines to form Gathering Qi (Zong Qi) The Lungs spread Gathering Qi (Zong Qi) all over the body to nourish tissues and promote all physiological processes Gathering Qi (Zong Qi) resides in the chest and aids in the Lung and Heart functions to promote good circulation to the limbs and controlling the strength of the voice This is why weak Lung Qi can therefore cause tiredness, a weak voice, and slight breathlessness. TCM LUNG FUNCTION Lung diffuses and descends Qi Diffusing Qi ensures Defensive Qi is equally distributed all over the body and under the skin Warming the skin and muscles and protecting the body from external pathogenic factors If Lung Qi is weak and its diffusing function is impaired, Defensive Qi can not reach the skin and the body will be easily invaded Lungs are upper-most organ, Qi must descend to get to the body Lung Qi must descend to communicate with the Kidneys If Lung Qi does not descend, Qi will accumulate in the chest, causing cough, breathlessness and a feeling of oppression TCM LUNG FUNCTION TCM Lung control the skin and the space between skin and muscles Lungs receive fluids from the Spleen and spreads them to the skin and the surface between skin and muscles all over the body Pores are well regulated, and sweating will be normal If this function is impaired, skin will be deprived of nourishment and moisture, and the skin may be rough and dry TCM LUNG FUNCTION TCM Lung manifests in body hair Lung diffuses Defensive Qi to the skin and hair Lung also diffuses fluids to the skin and hair Nourishes and strengthens body hair Body hair should be lustrous, glossy and healthy If Lungs do not diffuse Qi and fluids properly, the body hair will lack nourishment and will have a withered, brittle, and dry quality TCM LUNG FUNCTION TCM Lung opens into the nose The nose is the opening of the lungs If Lung Qi is strong, the nose will be open and breathing will be easy and the sense of smell will be normal If Lung's Defensive Qi is invaded by an exterior pathogen, the nose will be runny If Lungs are invaded by Dampness, the nose will be clogged and blocked If Lungs have heat, there may be bleeding from the nose TCM LUNG FUNCTION TCM Lung control nasal mucous If the diffusing of Qi and fluids is normal, the nose is properly moistened and lubricated by normal mucous secretion If the diffusing of Qi and fluids is impaired, nasal secretion may accumulate causing a nasal discharge or stuffed nose If the Lungs are affected by Heat or Phlegm-Heat, nasal mucous may be thick and yellow If the Lungs are affected by Dryness, nasal mucous is insufficient and the nasal mucous is too dry TCM LUNG FUNCTION TCM Lung houses the Corporeal Soul or 'Po' The most physical and material part of the human being's soul The Lungs are a physical manifestation of the soul and given the name Corporeal Soul(Po) Yin, the counterpart of the Ethereal Soul(Hun). The Corporeal Soul transports Essence and helps the physiological processes to defend against exterior pathogenic factors. TCM LUNG FUNCTION SUMMARY Lungs Govern Qi and Respiration Lung diffuses and descends Qi Lung control the skin and the space between skin and muscles Lung manifests in body hair Lung opens into the nose Lung control nasal mucous Lung houses the Corporeal Soul TCM LARGE INTESTINE FUNCTION TCM LARGE INTESTINE FUNCTION TCM Large Intestine controls Passage and Conduction Receives digested food from the small intestine; transform into stools Qi has a downward movement; stagnation of Qi often affects LI resulting in distention and constipation Transforms Stools and Reabsorbs Liquids Final transformation of digested food to form stools Reabsorbs some of the fluids TCM LARGE INTESTINE FUNCTION Mental Aspect of Letting go Main mental-emotional aspect of LI Not dwelling on the past Several LI points affect our capacity of letting go and many 'Calm the Mind.' REFERENCES Maciocia, G. (2015). Foundations of Chinese Medicine. Third Edition. NMT150: NATUROPATHIC THERAPEUTICS I TRADITIONAL CHINESE MEDICINE (TCM) WEEK 1 A U T H O R : D R. R O M I F U N G , N D, M. S C , P H. D ( C A N D. ) LEARNING OBJECTIVES Causes of Diseases from a Western and Eastern Perspective Internal Causes of Disease: Emotions External Causes of Disease: Exterior CAUSES OF DISEASE TCM focuses on disharmony, but identifying the cause of disharmony is important Eg. We see a patient with loose stools, no appetite and fatigue. We think of Spleen Qi Deficiency and consider treatment for that diagnosis. But SP Qi Deficiency is not the cause of the disharmony, but merely an expression of the disharmony The cause of this disharmony is found to be in the person's dietary habits, lifestyle, relationships, environment, sleep and physical exercise CAUSES OF DISEASE Identifying the cause of disease is important for the patient We can advise the patient on how to avoid it Minimize it, or Prevent its reoccurrence. If we give a treatment without addressing the cause of disease, it would be like pouring water into a container with a leak at the bottom CAUSES OF DISEASE Balance as a key to health: Rest and exercise Diet Sexual activity Climate CAUSES OF DISEASE Any long-term imbalance can become a cause of disease Too much rest (too little physical activity) Too much physical activity Too much work Too much or inadequate sexual activity Unbalanced emotions Extreme climatic conditions INTERNAL CAUSES OF DISEASE Emotional strain Internal emotions will affect the internal organs first (whereas external causes of disease affect the Exterior first) Emotions include: Anger, Joy, Sadness, Worry Pensiveness, Fear, Shock VIEW OF EMOTIONS Interactions of body and mind; In Chinese, emotions can be a cause of disease VIEW ON EMOTIONS In Western Medicine: The brain is set at the top of the pyramid and emotions affect the limbic system in the brain Nerves send impulses down the hypothalamus, and through the sympathetic and parasympathetic nerve centres In Chinese Medicine: Rather than a pyramid, the body-mind is a circular interaction between the Internal Organs, Emotions and Mind. WHEN EMOTIONS BECOME A PROBLEM There are positive and negative connotations to certain emotions Feelings such as sadness, fear and anger become causes of disease when they take over our mind. When we no longer possess these feelings, but they 'possess' us Emotions are mental stimuli that influence our affective life. Under normal circumstances, they are not a cause of disease. Hardly any human being can avoid being angry, sad, aggrieved, worried, or afraid at some time in his or her life but those states will not lead to any disharmony. Eg. the death of a relative provokes a very natural feeling of grief. WHEN EMOTIONS BECOME A PROBLEM Emotions become causes of disease only when they are either long- lasting, or very intense, or both. It is only when we are in a particular emotional state for a long time (months or years) that they become a cause of disease If a particular family or work situation makes us angry and frustrated in an ongoing way, this will affect the Liver and cause an internal disharmony. In a few cases, emotions can become a cause of disease in a very short time if they are intense enough. Eg. Shock in a specific situation EMOTIONS AND THE INTERNAL ORGANS Anger affects the Liver, sadness counteracts anger Joy injures the Heart, fear counteracts joy Pensiveness injures the Spleen, anger counteracts pensiveness Worry injures the Lungs, joy counteracts worry Fear injures the Kidneys, pensiveness counteracts fear EMOTIONS AND THE INTERNAL ORGANS Each emotion is said to counteract another along the Controlling Sequence of the Five Elements. For example, fear pertains to the Kidneys and Water, Water controls Fire (Heart), the emotion related to the Heart is joy; hence fear counteracts joy. This thinking presents some interesting ideas, which are certainly true in practice, for example, that ‘anger counteracts pensiveness' or that 'fear counteracts joy' EFFECTS OF EMOTIONS ON QI Anger makes Qi rise Joy slows Qi Sadness dissolves Qi Worry knots Qi Pensiveness knots Qi Fear makes Qi descend Shock scatters Qi EFFECTS OF EMOTIONS ON QI Although each emotion has a particular effect on Qi, all emotions have a tendency to cause some stagnation of Qi after some time Eg. Even though sadness depletes Qi, by depleting Qi from the Lung, the deficient Qi in the chest (Zong Qi) fails to circulate properly causing stagnation of Qi in the chest EMOTIONS AND QI STAGNATION When Qi stagnates, it may lead to Blood stagnation Remember: The relationship between Qi and Blood JOY 'Joy’ as a cause of disease is obviously not a state of healthy contentment but one of excessive excitement and craving Excessive stimulation disturbs the Mind (Shen) and it may even displace it from Heart Blood. When considering our modern lifestyle, there are plenty of factors leading to excessive stimulation, such as alcohol, recreational drugs, advertising, ambition, even sex. Heart symptoms: Palpitations, overexcitability, insomnia, restlessness, red tip on tongue ANGER Should be interpreted very broadly to include several other allied emotional states, such as resentment, repressed anger, irritability, frustration, rage, hatred, indignation, animosity or bitterness. If they persist for a long time, any of these emotional states can affect the Liver, causing stagnation of Liver Qi or Liver Blood, Liver Yang rising or Liver Fire Anger makes Qi rise and many of the symptoms and signs will manifest in the head and neck, such as headaches, dizziness, tinnitus, neck stiffness, red blotches on the front part of the neck or a red face. One of the most common symptoms caused by anger is headache ANGER Anger does not always manifest outwardly with outbursts of anger, irritability, shouting, red face, etc. Some individuals may carry anger inside them for years without manifesting it. SADNESS Weakens the Lungs affects the Heart, and the Lungs suffer in consequence, since heart and lungs are both in the Upper Burner. Sadness includes the emotions of grief and regret, as when someone regrets a certain action or decision in the past and the Mind is constantly turned towards that time. The Lungs govern Qi and sadness dissolves/depletes Qi. This is often manifested on the pulse with a weakness of both Front positions (Heart and Lungs). In particular, the pulse has no ‘wave’ and does not flow smoothly Symptoms: breathlessness, tiredness, a feeling of discomfort in the chest, depression or crying WORRY Worry knots Qi, which means that it causes stagnation of Qi, and it affects both Lungs and Spleen: the Lungs because when one is worried breathing is shallow, and the Spleen because this organ is responsible for thinking and ideas. If worry affects the Lungs it will cause an uncomfortable feeling of the chest, slight breathlessness, tensing of the shoulders, sometimes a dry cough, weak voice, sighing and a pale complexion If worry affects the Spleen it may cause poor appetite, a slight epigastric discomfort, some abdominal pain and distension, tiredness and a pale complexion. WORRY Worry is the emotional counterpart of the Spleen’s mental energy, which is responsible for concentration and memorization. When the Spleen is healthy we can concentrate and focus on the object of our study or work; the same type of mental energy, when disturbed by worry, leads to constantly thinking, brooding and worrying about certain events of life PENSIVENESS Pensiveness is similar to worry in its character and effect. It consists in brooding, constantly thinking about certain events or people (even though not worrying), nostalgic hankering after the past and generally thinking intensely about life rather than living it. In extreme cases, pensiveness leads to obsessive thoughts. In a different sense, pensiveness also includes excessive mental work in the process of one’s work or study. FEAR Fear includes both a chronic state of fear and anxiety and a sudden fright. Fear depletes Kidney Qi and it makes Qi descend. Examples of Qi descending are nocturnal enuresis in children and incontinence of urine or diarrhea in adults following a sudden fright SHOCK Mental shock ‘suspends’ Qi and affects Heart and Kidneys. It causes a sudden depletion of Heart Qi, makes the Heart smaller and may lead to palpitations, breathlessness and insomnia EXTERNAL CAUSES OF DISEASE External Pathogenic factors: Cold, Heat, Wind, Dampness Bacteria and viruses in relation to ‘Wind’ Climate as a cause of disease Climatic factors as patterns of disharmony Artificial ‘climates’ as causes of disease Fever PATHOGENIC WIND In Western medicine acute respiratory diseases are due to invasion of the body by bacteria or viruses. TCM did not have a knowledge of the existence of bacteria and viruses and acute respiratory infections were considered to be due to invasion of ‘Wind’ or other climatic pathogenic factors. CLIMATE AS A FACTOR The weather becomes a cause of disease only when the equilibrium between the body and the environment breaks down Either because the weather is excessive or unseasonal (for instance too cold in summertime or too hot in wintertime), or because the body is weak relative to the climatic factor CLIMATIC FACTORS Wind Cold Summer-Heat Dampness Dryness Fire SUMMARY Internal Causes of Disease primarily stem from long standing emotions; External Causes of Disease primarily stem from our environment Looking for causes of disease is key once you understand how each TCM Organ functions REFERENCES Maciocia, G. (2015). Foundations of Chinese Medicine. Third Edition. Pp. 251-279 NMT150: NATUROPATHIC THERAPEUTICS I TRADITIONAL CHINESE MEDICINE (TCM) E-LEARNING LECTURE 1 INTRODUCTION AND REVIEW Author: Dr. Romi Fung, ND, M.Sc, Ph.D (cand.) IN THIS E-LEARNING SERIES Review of NMT100: Yin and Yang, Vital Substances, 5 Elements General Pathologies: Deficiency and Excess TCM Organ Functions IN THIS E-LEARNING SERIES Week 1: TCM Review of Yin and Yang, Vital Substances Week 2: General Pathologies: Deficiencies of Qi, Blood, Yin and Yang General Pathologies: Excess Conditions of Heat, Cold, Stagnation, and Dampness Week 3: TCM Lung and Large Intestine Organ Function Week 4: TCM Heart and Small Intestine Organ Function Week 5: TCM Spleen and Stomach Organ Function Week 6: TCM Kidney and Urinary Bladder Organ Function IN THIS E-LEARNING SERIES Week 9: TCM Liver and Gallbladder Organ Function Week 10: TCM Pericardium and Triple Warmer Organ Function Week 11: Point Actions: Tonify Week 12: Point Actions: Clear Excess Week 13: Point Actions for Stagnation LEARNING OBJECTIVES Review Qi, Blood, Yin and Yang, 5 Elements REVIEW OF NMT100 TCM THEORIES AND FOUNDATIONS YIN AND YANG The first character 陰 / 阴 (yīn) means: overcast weather; feminine; moon; cloudy; negative electrical charge; shady. The second character 陽 / 阳 (yáng) means: positive electrical charge; sun. YIN Material Descending Produces Form Below Grows Water Matter Female Contraction FUNCTIONS OF YIN Cooling Nourishes Provides space for rest Substance that is moved Creates the space for conception YIN IN MEDICINE Female Downward and Cold Inward movement Heavy Autumn and Winter Obscured Lower body Earth Interior Night Abdomen YANG Immaterial Rising Produces Energy Above Generates Fire Energy Male Expansion FUNCTIONS OF YANG Warming Transforms Protects Moves Holds Creates the spark for conception YANG IN MEDICINE Male Upward and Outward Hot movement Light Spring and Summer Radiant Upper body Heaven Exterior Day Back QI 氣 “Qi is the root of the human body; the stem & leaves would dry up without a root” - Eight Problems of Classics on Medical Problems QI FUNCTIONS Promoting: Growth & development Warming: Warmth is maintained by readjusting Qi Defense: Wei Qi Protects the body from exterior attacks Checking: Maintains homeostasis Nourishing: Ying Qi or Nutritive Qi Qi Hua: Function of the organs e.g. Lung Qi = Lung function TYPES OF QI Yuan Qi (Source Qi) Gu Qi (Food Qi) Zong Qi (Gathering Qi) Ying Qi (Nutritive Qi) Wei Qi (Protective Qi) Zang-Fu (Organ) Qi BLOOD Formed from mainly Food Qi Food Qi from the Spleen and Stomach rises to the chest where it is acted upon by Yuan Qi At this point it is known as blood But blood is not complete (Blood) until it is sent to the Heart where Heart turns Blood red "Heart Governs Blood" BLOOD FUNCTIONS Nourishment & moisture: Movement of the eyes & 4 limbs Nourishes hair, sinews, bones & bowels Foundation of mental activities; houses the mind Circulates with Ying Qi Determines Menstruation BLOOD AND RELATION TO ORGANS The Heart is where Blood is created from Food Qi “The Heart governs Blood” The Spleen supports keeping Blood in its place “The Spleen makes/controls Blood” The Liver stores Blood 5 ELEMENT THEORY Generating Cycle Controlling Cycle Insulting Cycle Cosmological Sequence/Seasonal Cycle GENERATING CYCLE Wood creates Fire from burning Fire creates Earth from ashes Earth creates Metal by hardening Metal creates Water by containing Water creates Wood by nourishing Mother always creates the child Ie. Fire is the mother of Earth, and Earth is the child/son of Fire CONTROLLING CYCLE Fire controls Metal Earth controls Water Metal controls Wood Water controls Fire Wood controls Earth INSULTING CYCLE Opposite of the controlling cycle when an element ‘back- lashes’ its controller Occurs when the controller is relatively weaker than the controlled  5 ELEMENT CHART Element Wood Fire Earth Metal Water Yin Organs Liver Heart Spleen Lung Kidney Yang Organs Gall Bladder Small Intestine Stomach Large Intestine Bladder Seasons Spring Summer Between Fall Winter Seasons Colours Green Red Yellow White Black Senses Eyes Tongue Mouth/Lips Nose Ears Tissues Sinews Vessels Muscles Skin Bones Emotions Anger Joy Worry Sadness Shock/Fear Taste Sout Bitter Sweet Pungent Salty REFERENCES Maciocia, G. (2005). The Foundations of Chinese Medicine. 2nd Edition. Chapter 2: Pp. 19-40.