Essentials of Chinese Medicine
اسلاید 1: www.tabaye.ir
اسلاید 2: Essentials of Chinese MedicineRobert Hayden, M.S.O.M.
اسلاید 3: Class 1IntroductionChinese Medicine - What is it?Chinese Medicine history overviewChinese Medicine in the WestChinese Medicine & Biomedicine
اسلاید 4: Chinese MedicineTherapeutic system founded in China Continuous history from circa 300 BCE to presentOften abbreviated TCM - “Traditional Chinese Medicine”, though widespread throughout East Asia
اسلاید 5: Therapeutic MethodsAcupuncture and Moxibustion - Stimulation of superficial body tissues with needles and heat; includes accessory techniques such as cupping and scraping
اسلاید 6: Chinese Herbal Medicine - Internal and external application of complex formulations of botanical, zoological and mineral originDietary therapy - Medicated and non-medicated diet
اسلاید 7: Manual therapy (Tui Na) - Massage and manipulation of soft tissues and bonesQi Gong - Encompasses meditation, breathing, exercise, as well as emission of healing energy
اسلاید 8: Literary and non-literary (oral) transmissionLiterary transmission dates back to circa 300 BCE -- Mawangdui manuscriptsEarly stone needles (Bian) date to prehistoryHistorical Development
اسلاید 9: Huang Di Nei Jing a.k.a Yellow Emperors Classic of Internal Medicinecompiled circa 100 BCEFoundation classic of TCM and most other forms of AOM.
اسلاید 10: Huang Di Nei Jing Two books exist:1) Huang Di Nei Jing Su Wen (Basic Questions, Simple Questions)2) Huang Di Nei Jing Ling Shu (Divine Pivot, Spiritual Axis)
اسلاید 11: Su Wen is primarily concerned with theory where Ling Shu is specifically concerned with acupuncture. The language in both is archaic, cryptic and often difficult to understand.All OM based on Yin-Yang & Five-phase theory may be considered to stem from differing interpretations of the Nei Jing .
اسلاید 12: Historical Background: Chinese Dynastiescommentary from Birch and Felt, 1996
اسلاید 13: -1523 to -1027: Shang Chinese bronze age. “Demonological beliefs and ancestral propitiation indicate that a medicine distinct from religion has yet to develop”
اسلاید 14: -1027 to -772: early ZhouAgriculture and feudalism. “Wu shamen lead a ritual-based religious system in which medicine is rooted in magical and demonological beliefs”
اسلاید 15: - 772 to -480: middle ZhouRecorded history begins, Confucianism arises“Medicine, although dominated by magical correspondences and demonology, begins to develop as a distinct activity”
اسلاید 16: - 480 to -221: late Zhoua.k.a. Warring States period. “Chinese culture descends into a chaos of warring principalities. Daoism arises and the five phases emerge as medicine begins to develop as an institution”
اسلاید 17: -221 to -206: QinChina unified“Book burning”Autocratic rule creates an empire that establishes and consolidates social and cultural institutions by creating a governmental bureaucracy
اسلاید 18: -206 to 220: HanPeriod of systematization. “Medicine of systematic correspondence dominates acupuncture through seminal texts such as the Nei Jing and Nan Jing. Shang Han Lun is also written in this era, its incorporation of naturally occurring drugs into the medicine of systematic correspondence fails to find followers”
اسلاید 19: 220 to 589: 6 Dynasties, time of disunityBuddhism rises; “medicine of systematic correspondence becomes more formal and a technical literature develops”Systematic Classic is written 590 to 617: Sui, a period of reunification. Chinese culture, including acupuncture, spreads throughout Asia
اسلاید 20: 618 to 906: Tang Chinese medical ideas are diffused and absorbed throughout Asia“Chinese developments are dominated by the search for alchemical immortality during a period of immense wealth and cultural fecundity”
اسلاید 21: 907 to 960: Five Dynasties, a period of disunity. 960 to 1264: Song Period of neo-Confucianism. “Medicine of systematic correspondence predominates. Traditional medicine as drug therapy is incorporated into the qi paradigm”
اسلاید 22: 1264 to 1368: YuanMongols control China. European influences begin to take hold. First independent medical college established
اسلاید 23: 1368 to 1643: MingPeriod of restoration. “Democratization of the Confucian bureaucracy leads to an information explosion, greater heterogeneity, individualism. The extremely influential Zhen Jiu Da Cheng and Ben Cao Gang Mu are written”
اسلاید 24: 1644 to 1911: QingThe end of the empire. “The decline of traditional medicine becomes severe as the Chinese people lose faith in their traditions. Acupuncture largely lost.”
اسلاید 25: 1950s: Revolutionary ChinaChinese traditional medicines received support from Mao. “TCM”: Political committees scientize/standardize traditional medicine to serve Chinas vast primary-care needs. The major traditional medical schools were established.
اسلاید 26: 1950s: Acupuncture and moxibustion developed in France, Germany, Austria, and other European countries; France limited the practice of acupuncture to physiciansAcupuncture exported to the USSR and other Eastern bloc countries.
اسلاید 27: 1958-1959 The Great Leap Forward in China; traditional and modern medicine began to be integrated1960 Acupuncture integrated into the health-care system in Vietnam1960s Acupuncture started to be promulgated in the UK through the works of Mann, Worsley, and others
اسلاید 28: 1969: Barefoot Doctor program in China1971: James Reston wrote about his postsurgical acupuncture experiences; acupuncture made headlines in the West1972: American President Richard Nixon visited China. Interest in acupuncture begins to develop in the USA and worldwide.
اسلاید 29: 1978: WHO begins advocating the use of traditional medicines, including the promotion of acupuncture.1980: Chinese Government strongly promoting integration of TCM and Western medicine
اسلاید 30: Early 1980s: Texts on acupuncture by Western practitioners who studied in China are published in English. TCM introduced into the USA and UK. Late 1980s - 1990s: TCM continues to expand in the USA; other systems such as Japanese and Korean acupuncture become better known in the West
اسلاید 31: Chinese Medicine and Western Medicine
اسلاید 32: Chinese medicine is now international. Kaptchuk: Many Westerners have strange notions about Chinese medicine: VoodooPlacebo effectMore true than Western medicine
اسلاید 33: Chinese medicine is a coherent and independent system of thought and practice that has been developed over two millennia. Result of a continuous process of critical thinking, as well as extensive clinical observation and testing.
اسلاید 34: Developed its own perception of health and illness. Chinese medicine considers important certain aspects of the human body and personality that are not significant to Western medicine.
اسلاید 35: Western medicine observes and can describe aspects of the human body that are not perceptible to Chinese medicine, for example: nervous systemendocrine systemmicrobial causes of disease
اسلاید 36: Chinese medicine uses terminology that is strange to the Western ear:“Dampness”, “Heat”, or “Wind” are causes of disease.Terms (such as organ names) may have distinct meanings from anatomical correlates: Liver, Spleen, Blood
اسلاید 37: Logical structure underlying the methodology differs radically. Biomedicine (Western medicine) is primarily concerned with isolable disease categories or agents of disease , which it tries to change, control, or destroy.
اسلاید 38: The Western physician starts with a symptom , then searches for the underlying mechanism - a precise cause for a specific disease. The Chinese doctor looks for patterns of disharmony rather than specific disease agent.
اسلاید 39: Patterns of disharmony (Zheng) are basis for treatment in TCM. Different from diseases because they cannot be isolated from the patient in whom they occur. “Many diseases, one pattern; Many patterns, one disease”
اسلاید 40: “To Western medicine, understanding an illness means uncovering a distinct entity that is separate from the patient s being ; to Chinese medicine , understanding means perceiving the relationships among all the patient s signs and symptoms in the context of his or her life.”
اسلاید 41: The Chinese method is based on the idea that no single part can be understood except in its relation to the whole. A discrete symptom is not traced back to a cause, but is looked at as a part of a totality.
اسلاید 42: “If a person has a complaint or symptom, Chinese medicine wants to know how the symptom fits into the patients entire being and behavior. Illness is situated in the context of a persons life and biography... The Chinese system is not less logical than the Western , just less analytical .”
اسلاید 43: Idea of causation, central to Western thinking, is almost entirely absent in Chinese thought. “Men do not think they know a thing till they have grasped the ‘why’ of it (which is to grasp its primary cause).” -Aristotle
اسلاید 44: For the Chinese, phenomena occur independently of an external act of creation; no need to search for a cause .
اسلاید 45: “Tao produced the One. The One produced the two. The two produced the three. And the three produced the ten thousand things. The ten thousand things carry the Yin and embrace the Yang and through the blending of the Qi they achieve harmony.” - Dao De Jing 42
اسلاید 46: “The way to Heaven is to take no action . Therefore in the spring it does not act to start life , in summer it does not act to help grow , in autumn it does not act to bring maturity , and in winter it does not act to store up .
اسلاید 47: When the ... Yang comes forth itself , things naturally come to life and grow . When the ... Yin arises of itself , things naturally mature and are stored up .... Originally no result is sought , and yet results are achieved ... Since Heaven takes no action , it does not speak .
اسلاید 48: Since Heaven takes no action , it does not speak . When the time comes for calamities and strange transformations , the [ Qi ] produces them spontaneously .... When there is [ Cold ] in the Stomach , it aches . It is not that man causes it . Rather , the [ Qi ] does it spontaneously ....” - Wang Cong
اسلاید 49: “Conceptions are not subsumed under one another but placed side by side in a pattern , and things influence one another not by acts of mechanical causation, but by a kind of inductance.... The key-word in Chinese thought is Order and above all Pattern...
اسلاید 50: Things behave in particular ways not necessarily because of prior actions or impulsions of other things, but because their position in the ever-moving cyclical universe was such that they were endowed with intrinsic natures which made that behavior inevitable for them.” - Joseph Needham, Science and Civilization in China
اسلاید 51: What does Chinese medicine have to offer the West?Does a medicine based on an alternate description of the universe really work?Advantages and Disadvantages to Both Systems
اسلاید 52: Because TCM is based on Patterns rather than diseases, it is by nature better suited to treating holistically:...all too often biomedicine is... not concerned with general well-being because it can only assess very small, discrete bits of information.
اسلاید 53: Much that is human and medically effective may have been lost or remains to be discovered because modern health care too often avoids seeing... self conscious human beings with feelings, intentions, and self-created meaning.
اسلاید 54: Biomed at its best when disease agent can be isolated and destroyed: tumors, microbesComplex syndromes still poorly understood and no suitable therapy exists
اسلاید 55: Biomed has very little concept of mind-body integrationPsycho-neuro-immunology (PNI) still in its infancy and not widely acceptedTCM posits emotions as primary cause of illness
اسلاید 56: Biomed has no developed concept of Yang Sheng (Nourishing Life)Nutrition only recently gained wide acceptance among MDsLittle notion of Terrain -- where TCM can anticipate diseases before they arise
اسلاید 57: Risk/benefit ratio often very poor:Our medicine parallels our society. New cures often produce side effects of unexpected virulenceTCM intervention usually safer though weaker
اسلاید 58: TCM Patterns have patient-specific dose-adjustment built inChinese Herbal medicine based on polypharmacy; side effects are anticipated and controlled by composition of formula
اسلاید 59: TCM has clear *disadvantages* as wellHolistic emphasis makes TCM less preciseTCM weak on specific prognosis; because disease is de-emphasized in favor of patterns, natural history of diseases poorly understood
اسلاید 60: TCM at a disadvantage in acute or life-threatening situationsOften there is a window of opportunity outside of which TCM is ineffective and Biomed MUST be usedRecovery from illness: TCM once again advantageous where Biomed has no strategy for restoration of health
اسلاید 61: Biomed increasingly based on expensive technology TCM relatively inexpensive, “Low Tech”Problems arise from internationalizing TCM , particularly in Herbal Medicine
اسلاید 62: Scientific method has no respect for tradition; methods quickly become outdated and their merits may not be preservedLeeches are back!
اسلاید 63: Increasing integration of the two systemsEvidence-Based Medicine (EBM) is ever-increasing influence in TCMRCT has changed the game: Biomedicine reconceptualized legitimate healing as a cause and effect relationship between a specific agent between a specific agent or treatment and a specific biological result.
اسلاید 64: Current debate in Western TCM community over increasing science curriculum and professional standing
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