Therapeutic Principles and Reinforcement and Reduction of Tuina
Therapeutic principles are also called therapeutic laws. They are the general directive therapeutic rules drawn for clinical cases under the guidance of the fundamental theory of holism and differentiation of syndromes o decide treatment in TCM. Therapeutic principles are ifferent from concrete therapeutic methods in that the atter is always decided by the former and based on a definite therapeutic principle. From the viewpoint of the relationship between body resistance or vital qi and pathogenic factors, for example, all kinds of diseases can be assorted into struggles between body resistance and pathogenic factors and changes of vicissitudes. Therefore, Strengthening body resistance to ward off pathogenic factors is a therapeutic principle, under guidance of which nourishing the kidney, strengthening the spleen and invigorating yang, etc. are concrete methods of strengthening body resistance, while diaphoresis, catharsis, etc. are concrete methods of eliminating pathogenic factors.
Diseases are manifested by quite different signs and symptoms. Pathological changes are very complicated.Cases vary from each other in degree of seriousness and emergency. Pathological changes and transformations are also different in different individuals, different places and at different times. Therefore, it is very important for a doctor to get hold of the primary cause of a disease from its complicated and changeable phenomena and do an active and correct treatment.
There are mainly the following principles in tuina treatment.
Treatment aiming at the primary cause of disease
Searching for the primary cause of a disease in treatment is one of the fundamental principles of differentiation of syndromes to decide treatment in Chinese Tuina. Searching for the primary cause refers to understanding the nature and the principal contradiction of a disease and conducting treatment aimed at the basic etiopathogenesis.
Ben or the origin or the root or primary cause of a disease is opposite to Biao or superficiality in relationship. They are a pair of opposite concepts and have several implications, which can be used to illustrate the principal and secondary relations of various contradictions in the course of pathological changes. As far as vital qi and pathogenic factor are concerned, the former is ben, the primary, while the latter is biao, the secondary. Judging from the pathogenesis and symptoms of a disease, the former is ben, the primary, whereas the latter is biao, the secondary. As for location of pathological changes the viscera are ben, the primary and the superficiality is biao, the secondary. As regards the sequence of a disease the original or preceding diseases are ben, the primary, while the newly developed or accompanying ones are biao, the secondary.
Occurrence and development of any diseases are always manifested through some signs and symptoms, but they are only the phenomena of a disease, do not always reflect the nature of a disease and sometimes are even some false manifestations. Only based on a full understanding of all aspects of a disease, including its various symptoms and signs, through comprehensive analysis can a doctor grasp the nature of a disease beyond the phenomena, find out its primary cause and determine a correct corresponding therapeutic method. Take pain in the lumbus and the limbs for example, which can be caused by malposition of the vertebra, rheumatism in the lumbus and leg, strain of the lumbar muscles and many other problems. Instead of simple expectant treatment of arresting pain, therapeutic methods such as correction of malposition of the vertebra, expelling wind and activating blood, relaxing tendon and activating the meridians can be adopted respectively after finding out the basic pathological changes by means of general and comprehensive analysis.Only by doing so, can a desirable result be attained, and that's the real significance of treatment aiming at the primary cause of a disease.
Strengthening vital qi to eliminate pathogenic factors
The course of a disease, in a sense, is that of the struggle between the vital qi and pathogenic factors. In the struggle, if pathogenic factors predominate over vital qi, diseases will develop; otherwise if vital qi surpasses pathogenic factors, diseases will be subdued. So in treatment of diseases it should be done to support vital qi, eliminate pathogenic factors, change the ratio of strength between vital qi and pathogenic factors so as to make diseases change for better. Strengthening vital qi to eliminate pathogenic factors is also a fundamental principle guiding clinical tuina therapy.
An excess syndrome results when the invading pathogenic factors are exuberant, and exhaustion of vital essence brings about deficiency syndrome. Wax or wane of pathogenic factors and vital qi determine asthenia and sthenia of pathological changes. Asthenia syndrome requires reinforcement while sthenia syndrome requires reduction. Invigorating deficiency and purging excess is the concrete application of the principle of strengthening vital qi to eliminate pathogenic factors. Strengthening vital qi is a reinforcing method, which is indicated in asthenia syndromes, and eliminating pathogenic factors is a reducing method, which is applied to sthenia syndromes.Strengthening vital qi and eliminating pathogenic factors interplay of each other and supplement each other though they are two different therapeutic approaches with different implications. Strengthening vital qi is to strengthen the healthy qi or body resistance and is helpful in resisting and driving away pathogenic factors, while eliminating pathogenic factors can get rid of invasion, disturbance of pathogenic factors and their impairment of healthy qi, so it is helpful in retaining and restoring vital qi.
The TCM approach is fundamentally different from that of Western medicine. In TCM, the understanding of the human body is based on the holistic understanding of the universe as described in Daoism, and the treatment of illness is based primarily on the diagnosis and differentiation of syndromes.
The TCM approach is fundamentally different from that of Western medicine. In TCM, the understanding of the human body is based on the holistic understanding of the universe as described in Daoism, and the treatment of illness is based primarily on the diagnosis and differentiation of syndromes.
Questions and Answers
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Generally speaking, after a period of conscientious training, for those with some knowledge of medical science, it is not too hard to cross the threshold of tuina within a short period of time. But it is difficult to come up to professional standards, particularly hard to gain a perfect command and serviceable application of some tectmically difficult manipulations such as pushing manipulation with one finger meditation, rolling manipulation in clinic.
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Generally speaking, after a period of conscientious training, for those with some knowledge of medical science, it is not too hard to cross the threshold of tuina within a short period of time. But it is difficult to come up to professional standards, particularly hard to gain a perfect command and serviceable application of some tectmically difficult manipulations such as pushing manipulation with one finger meditation, rolling manipulation in clinic.
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