Principles for disease prevention and treatment Lecturer: QU Hongyan.

Principles for disease prevention and treatment

Lecturer: QU Hongyan

Preventive principles

Principles for disease prevention and

treatment are a general term for preventing

and treating disease. Under the guidance of

concept of holism and treatment based on

syndrome differentiation, it refers to the criteria

of preventing and treatment disease, and it is

an important part of the basic theories of TCM.


These refer to the criteria of preventing the occurrence, development and transmission of disease made in accordance with the laws of the occurrence, development and transmission of disease.

The earliest preventive thought, known as “treating the undiseased”

was advanced in Huangdi’s canon of medicine.

1

Prevention of the occurrence of disease

11 22

Prevention of

development

and

transmission

of disease

33

Prevention of

the recurrence

of disease


Prevention of the occurrence of disease

It means that various measures should be

taken in advance to prevent the occurrence of

diseases.

Health preservation

Prevention of the invasion of pathogenic qi

Health preservation

It means to cultivate life, aiming to direct people to take various regulative to build up constitutions ,avoid disease, postpone the aging process, keep fit and prolong life span.

Complying with

nature

Cultivating mental

facultiesProper diet

Moderate work

and rest

Proper living

habits

Health preservation

1. Complying with nature

According to the concept of holism, life activities of the

human body must comply with the waning and waxing laws

of yin and yang all along the four seasons; otherwise,

diseases would occur.

Therefore, psychological activities, living habits and diet

are all required to be regulated consequently according to

the seasonal changes.

Health preservation

2. Cultivating mental faculties

It means to regulate psychological state, consciousness

and mental activities to keep healthy physically and mentally.

Psychological andEmotional changes

Reflect the normal Psychological

activities

Build up constitutionsresist disease,

prolong life span

Abnormal Psychological and emotional

changes

Qi movement of viscerawill be affected and various

diseases will followsubsequently

Health preservation

3. Moderate work and rest

Suitable work, exercise and rest are essential for maintaining life and keeping fit. But overwork and over-rest will affect health and cause diseases. Therefore, health preservation and disease prevention mean both to avoid overwork, overstrain and sexual strain, and to avoid ove-rest.

Health preservation

4. Proper diet

Regular, moderate,diverse and sanitary

diet are taken in

The human body will absorb necessary

nutrient substances

The normal growth andphysiological function

are maintained

Health preservation

5. Proper living habits

Living habits include work, rest, living conditions, clothing, etc.

According to seasonal changes and individual conditions, the work rest schedule should be set reasonably, and the living habits should be regulated appropriately; the living environments should be kept quiet, clean and comfortable; the clothing should be clean and comfortable, not too thin or too thick.

Prevention of the invasion of pathogenic qi

Pathogenic qi is a major factor of causing disease and harming health.

Attention should be paid to hygience, prevent environmental, water and food pollution

Avoid the invasion of the pathogenic factors

Attention should be paid to avoid accidental injuries

Prevention of the transmission and development of disease

It means that effective measures of diagnosis and

treatment should be taken the development and

transmission of disease at the early stage of disease.

1. Early diagnosis

At the early stage, disease is easy to treat because it i

s mild and healthy qi has not declined yet. If not treated ti

mely, disease will become complicated and worse becaus

e pathogenic qi is transmitted from the exterior into the int

erior and healthy qi is exhausted. Therefore, early diagnos

is and treatment is the key to recovery, significant for prev

enting the transmission, development and aggravation of

disease.

The development and transmission of any disease follow its unique rules. So according to these rules, "treating the unaffected area first", cutting off the transmission link of disease, is a major measure to prevent the development and aggravation of disease.

e.g. Since liver disease is most likely to transmit to the spleen,

measures should be taken to strengthen the spleen in the treatment of liver disease in order to prevent liver disease from transmitting to spleen.

2. Controlling transmission and development of disease

when the body has not yet completely restored to the normal state after disease is somewhat relieved or cured, disease easily recurs due to improper diet, emotional disturbance, etc.

e.g.

when just recovering from diarrhea, infants should have light food, as functions of the spleen and stomach have not

completely restored to the normal state

3. Prevention of the recurrence of disease

Therapeutic principles

Some concepts

Therapeutic principles are the criteria of treating all diseases.

Therapies refer to the therapeutic rules and methods in accordance with various syndromes.

Therapeutic methods are those specific for various syndromes, limited in the range of therapeutic rules, such as nourishing blood to induce tranquilization, and releasing superficies with pungent-warm drugs, etc.

Therapeutic rules are the criteria of classified treatment and give guidance to the therapeutic methods.

Diaphoresis, emesis, purgation, mediating, warming, heat-clearing, resoluting and rei

nforcing

Searching for the fundamental of disease

in treatmentguidelines

Therapeuticprinciples

Routinetreatmentcontrary treatment

Treating fundamentalaspect and incidental

aspect

Reinforcing the healthy and eliminating

the pathogenic

Regulatingyin and yang

Treatment inaccordance with

seasonal conditions, local conditions

and patient’s individuality

Therapeutic rules

Eight therapeuticrules

Therapies Therapeuticmeasures

Therapeutic

principles

Searching for the fundamental of

disease in treatment

Reinforcing the healthy and eliminating

the pathogenic

Regulating yinand yang

Regulating qi and blood

Treatment inaccordance with seasonal

conditions, local conditionsand patient’s individuality

Searching for the fundamental of disease in treatment

• It means to find the fundamental cause of a disease and focus the treatment on it.

The nature of disease, refers to the pathogenesis and changes of yin-yang

in a diseaseRoutine treatment and contrary treatment

Treating fundamental aspect and incidental aspect

Routine treatment and contrary treatment

Routine treatment

It refers to the treatment of disease adverse to its manifestations , also known as “adverse treatment”. It is suitable for disease with nature in conformity withIts manifestations.

Warm syndrome is marked by warm manifestations,

Cold syndrome by cold manifestations,

Deficiency syndrome by deficiency manifestations

Excess syndrome by excess manifestations.

e.g.

Routine treatment

Treat cold with heat

It means that the cold syndrome, with cold manifestations, should be treated with warming or hot formula.

releasing superficies with pungent-warm drugs is used to treat wind-

cold syndrome of exterior type.

we apply pungent-hot drugs to warm interior and treat the interior

clod syndrome

e.g.

Routine treatment

Treat heat with cold

It means that the heat syndrome, with heat manifestations, should be treated with cold or cool formula.

releasing superficies with pungent-cool drugs is used to treat wind-

heat syndrome of exterior type.

we treat heat accumulation in the stomach and intestines with bitter-

cold drugs to relieving interior.

e.g.

Routine treatment

Treat deficiency with tonifying

It refers to deficiency of healthy qi, with deficiency manifestations, should be treated with tonifying and replenishing formula.

replenishing qi is used to treat the qi deficiency syndrome

nourishing yin to treat the yin deficiency syndrome

e.g.

Routine treatment

Treat excess with purging

It means that excess of pathogenic qi, with excess manifestations, should be treated with offensive purgative formula.

dispelling retained water is used to treat internal retention of water

promoting digestion and removing food stagnation to treat food

stagnation

e.g.

Routine treatment and contrary treatment

contrary treatment

It refers to the treatment of disease agreeable to its manifestations, also known as "agreeable treatment“.

It is applicable to complicated morbid states in which the nature of disease is not completely in conformity with its manifestations, or even marked by false manifestations.

contrary treatment

Treat heat with heat

it means that diseases with manifestations of false heat should be treated with warm or hot formula or measures.

It is applicable to the syndrome of true cold with false heat caused by exuberant yin with repelled yang.

Tong Mai Si Ni Decoction, a warm and hot formula, can deal with this

condition

e.g.

contrary treatment

Treat cold with cold

it means that diseases with manifestations of false cold should be

treated with cold or cool formula or measures,

it is applicable to the syndrome of true heat with false cold caused

by exuberant yang with repelled yin.

Bai Hu Decoction, a cold and cool formula, is used to treat heat sync

ope caused by exuberant internal yang with yin repelled externally.

e.g.

contrary treatment

Treat stuffiness with tonic

It means that diseases with manifestations of stuffiness

should be treated with tonifying and replenishing formula or measures, also known as"relieving stuffiness with tonic“.

It is applicable to the syndrome of stuffiness and stagnation caused by deficiency.

Abdominal distension and fullness, caused by deficiency of spleen and stomach and qi stagnation, is treated by invigorating spleen and replenishing qi.

Constipation due to qi deficiency is treated by replenishing qi

contrary treatment

Treat diarrhea with purgative

It means that diseases with manifestations of diarrhea

should be treated with purgative formula or measures,

It is applicable to the syndrome of diarrhea caused by stagnation of excess pathogens.

dysentery caused by stagnation of damp-heat in the large intestine abdominal distension and fullness is treated by clearing heat and draining heat as well as promoting qi flow and relieving stagnation. When damp and heat are cleared away, diarrhea will be stopped spontaneously.

e.g.


Concepts of fundamental aspect and incidental aspect

The fundamental and the incidental are two relatively opposite

concepts. Their relationship is often used to generalize and explain

the essence and the outward appearance. In the course of a disease,

its fundamental aspect and incidental aspect are determined by the

development of the disease.

healthy qi is the fundamental aspect, and pathogenic qi the incidental aspect;

the cause of disease is the fundamental aspect, and the symptoms incidental aspect;

primary disease is the fundamental aspect, and secondary disease the incidental aspect.

e.g.


Application of treating fundamental aspect and incidental aspect

treating fundamental aspect in case of

lesser urgency

Treating incidental aspect in case of

urgency

Treating both fundamental and incidental

aspects

Treating fundamental aspect in case of lesser urgency

For chronic disease or acute disease at the recovery stage treatment should be focused on the fundamental aspect of a disease, for the incidental aspect usually originates from the fundamental aspect.

Take cough due to tuberculosis for example. Yin deficiency of the lung and kidney are the fundamental aspects, while cough is the incidental aspect. Therefore, it should be treated by nourishing yin of the lung and kidney, which is to treat the fundamental aspect. When yin fluid of the lung and kidney moistens,cough will he relieved naturally.

e.g.

Treating incidental aspect in case of urgency

• When the incidental aspect of a disease is so urgent and serious that it affects the treatment of the fundamental aspect and endangers patient's life, treatment should be focused on it first.

Hematorrhea of any reason should be treated by arresting bleeding

first, which is to treat the incidental aspect. When bleeding is stopped, its fu

ndamental aspect should be further searched for and treated later on.

e.g.

Treating both fundamental aspect and incidental aspect

When the incidental and fundamental aspects of a disease are both serious or both not urgent, treatment should be concentrated on both fundamental and incidental aspects.

To a common cold caused by qi deficiency, qi deficiency is the fundamental aspect, and cold is the incidental aspect. Then simply replenishing qi will cause stagnation of pathogenic qi and cold cannot be cured; simply releasing superficies will impair healthy qi. So we should replenish qi and release superficies, can cold get relieved.

e.g.

Reinforcing the healthy and eliminating the pathogenic

Reinforcing the healthy

It refers to tonify the healthy qi, build up constitutions, and improve the body’s resistance against disease and recovery ability.

Eliminating the pathogenic It means to remove the pathogenic qi and to relieve the invasio

n and impairment of pathogenic qi.

Treat deficiency by tonifying

Treat excess by purging

Reinforcing the

healthy

Eliminating the

pathogenic

Prevent and dispel pathogenic qi

Conserve and recover healthy qi

On one hand:

On the other hand:

Drugs of reinforcing

the healthy

Make the pathogenic qi

retain in the body

Drugs of eliminating

the pathogenicImpair the healthy qi

Application of reinforcing the healthy and eliminating the pathogenic

During the treatment, attention should be paid to differentiation what is primary from what is secondary and what is urgent from what is less urgent, so that reinforcing the healthy and eliminating the pathogenic can be taken up in order of importance and priority.

Single application

Combined application

Alternate application

Reinforcing the healthy

It is applicable to deficiency syndrome in which deficiency of healthy qi is the primary contradiction and meanwhile pathogenic is not exuberant.

Single application

Qi deficiency is treated by replenishing qi

Eliminating the pathogenic

It is applicable to excess syndrome in which exuberance of pathogenic qi is the primary contradiction and meanwhile healthy qi does no decline.

Excess of exterior pathogens is treated by inducing sweating to

release superficies

Reinforcing the healthy combined with eliminating the pathogenic

It is applicable to syndromes with deficiency of healthy qi as the primary contradiction and exuberance of pathogenic qi as the secondary contradiction.

combined application

Eliminating the pathogenic combined with reinforcing the healthy

It is applicable to syndromes with exuberance of pathogenic qi as the primary contradiction and deficiency of healthy qi as the secondary contradiction.

damage of yin by heat should be treated by clearing away heat combined with nourishing yin

Reinforcing the healthy prior to eliminating the pathogenic

It is applicable to syndromes of deficiency of healthy qi with excess of pathogenic qi, in which healthy qi cannot withstand attack.

Alternate application

Eliminating the pathogenic prior to reinforcing the healthy

It is applicable to syndromes of excess of pathogenic qi with deficiency of healthy qi, in which pathogenic qi needs eliminating urgently and healthy qi can still withstand attack.

Regulating yin and yang

Reducing excess Applicable to preponderance of yin or yang

Supplementing

Nourishing yin to restrict yang

Applicable to yin

deficiency

Tonifying yang to restrict yin

Applicable to yang

deficiency

Supplementing both yin and yang

Applicable to deficiency of both yin

and yang

Treating yang for yin

Applicable to deficiency of both yin

and yang with yin deficiency as the

primary contradiction

Treating yin for yang

Applicable to deficiency of both yin and yang with yang

deficiency as the primary contradiction

Disorders of qi and blood will involve the whole body, while pathological changes of any part of the body will cause disorder of qi and blood. Therefore, it is an important therapeutic principle.

Regulating qi and blood

It means that therapeutic principles should be determined according to seasonal, local and individual conditions, also known as ”treatment in accordance with three factors”.

Treatment in accordance with seasonal conditions, local conditions and patient’s individuality

Treatment in accordance with seasonal conditions

Treatment in accordance with local conditions

Treatment in accordance with patient’s individuality