therapeutic methods

8/14/2019 Therapeutic Methods

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Therapeutic Methods
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Treatment

Acupuncture Herbology

Massage Qigong
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Prevention is meant taking certain measures toavoid the occurrence and progress of diseases.

TCM has always attached great importance to prevention. As early as in Essential Question, the preventive thought of "preventive treatment of diseases" was advanced.

This theory involves two aspects: preventivetreatment before the occurrence of diseases and preventing deterioration after the occurrence of diseases.


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put prevention first is one of the four great policies of the medical and healthwork in China.

And it is also a principle of preventing theoccurrence and the progression of a disease

in TCM.


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Preventive Treatment of Disease It refers to taking various measures to prevent

diseases from occurring. The occurrence of a disease is related to both

pathogenic factors and health Qi. The former is the important condition for the

occurrence of a disease, which the deficiency of the latter is the intrinsic factor for the occurrenceof a disease.

Therefore, preventive treatment of a disease muststart with both strengthening the resistance insidethe body and preventing pathogens from invadingthe human body.


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1.Strengthening health Qi's capacity to resist pathogens

Regulating mental activities to maintain the Health Keeping regular hours Doing regular physical exercises

Using drug prophylaxis and providing artificialimmunization2. Defending the body against pathogens Keeping away from six exogenous pathogens

Avoiding various infectious diseases and trauma Developing hygienic habits and preventing

environmental pollution, as well as water and foodcontamination


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Preventing the deterioration of disease

Though prevention prior to the occurrence of adisease is the best policy, timely diagnosis andeffective treatment to control the deterioration of disease is also important.

Therefore, once a disease occurs, it should beearly treated so as to cure it in its initial stage.

Ye Tianshi, a famous practitioner of the QingDynasty, advised:" Be sure to treat the parts whichthe pathogens have not involved yet."

This is also an important method of preventing the

disease from further deteriorating.


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Principles of Treatment

To study TCM treatment, attention should be paidto the therapeutic principles which must be

followed in the treatment of disease. They are formed under the guidance of holistic

concept and treatment based on syndromedifferentiation, and they have the guidingsignificance for establishment of the therapeutic

principles and prescriptions of a recipe.


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Therapeutic principles differ from therapeuticmethods.

The former refer to the general principles for guiding therapeutic methods, while the latter are the concrete methods of

treatment under the guide of the therapeutic

principles. There are different kinds of therapeutic principlesin TCM.


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For example

treatment aiming at the primary cause of a disease, strengthening health Qi and eliminating

pathogenic factors, readjusting Yin and Yang, regulating the Zang-Fu's functions,

regulating Qi-blood treatment in accordance with the three factors

(climate, locality and individual).


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Treatment aiming at the root cause of a disease

By treatment aiming at the root cause of a disease is meanttreating a disease on the basis of its root cause.

It is not until the fundamental cause of a disease is foundout that it is possible to get to the essence of the problemand to make a proper treatment.

Basic Questions points out, " In treating search for the itsroot cause of a disease in treatment. "

When treatment aiming at the root cause of a disease isused clinically, routine treatment or contrary treatment andtreating the primary (ben) and or treating the secondary(biao ) must be dealt with correctly.


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Routine treatment

includes the following methods:treating cold syndrome with hot natureddrug,treating heat syndrome with cold natureddrug,

treating deficiency syndrome byreplenishment,treating excess syndrome by purgation


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Contrary treatment

has the following methods:2. treating pseudo-heat syndrome with hot-

natured drugs,3. treating pseudo-cold syndrome with cold-

natured drugs,

4. treating obstruction-syndrome withtonification5. treating diarrhea with purgation.


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Treatment of the primary and thesecondary includes the following

methods:2. treating the secondary for emergency,3. treating the primary for chronic cases4. treating both the primary and the

secondary aspects.


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Strengthening health Qi and Eliminating Pathogens

Strengthening health Qi is to increase bodyresistance.

Since victory or failure in the struggle betweenhealth Qi and pathogens determines theaggravation or alleviation of a disease, one of theimportant principles in clinical treatment is tochange the relative strength of health Qi and

pathogens. In so doing, the disease will take a turn for the

better.


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Eliminating pathogens means getting rid of pathogenic factors to facilitate and recover

the strength of health Qi. Therefore, eliminating pathogens, like

strengthening health Qi, is also one of the

important principles clinically.


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They have the following methods:2. driving out pathogens first and then

strengthening health Qi,3. strengthening health Qi first and then

eliminating pathogens

4. strengthening health Qi and eliminating pathogens simultaneously.


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Strengthening health Qi and eliminating pathogens supplement each other:

the former helps the elimination of pathogenic factors and the latter helpsstrengthening health Qi.

So, clinically, they should be applied in thelight of the variations of the cases.


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Readjusting Yin and Yang

The imbalance of Yin and Yang is the basic pathogenesis of many diseases, therefore,regulating relative excess or insufficiency of Yinand Yang, remedying defects to rectify abuses andrestoring relative balance of Yin and Yang are oneof the basic principles in clinical treatment.

To restore their balance Yin and Yang are usuallyregulated by means of removing the relativeexcess or invigorating the relative deficiency.

Since Yin and Yang are the changes may besummarized as the imbalance of Yin and Yang .


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Besides, regulating Zang-Fu's functions andQi-blood relationship are also two

important therapeutic principles. Space lacks for a detailed description of it.


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Chinese medicinal Herbs


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There is a great variety of Chinese materiamedica, including plants , animal parts andminerals .

Among these materials, flowers, herbs andtrees are the ones most frequently used, thatis why Chinese materia medica is calledChinese medicinal herbs.


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flowers

chrysanthemumrose
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Herbs

bamboo
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Trees

cassia twigs
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Animal parts

turtle shell
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minerals

gypsum
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Four properties and five tastes

The Chinese medicinal herbs arecharacterized by four properties (cold, heat,

warm and cool) and five tastes (sour, bitter,sweet, acrid or pungent-spicy and salty).

These terms describe the therapeutic

significance and energetic characteristics of the actions of herbs.


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Four properties

Ancients physicians discovered that a particular property could induce certain

therapeutic effects.


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For example

Herbs like gypsum ( ), chrysanthemum(), relieve heat syndromes and are

characterized by cool or cold nature . Herbs such as cassia twigs ( ), whichrelieve cold syndromes , are characterized

by warm or hot nature . Herbs whose properties are neither cold nor

hot are termed neutral, such as Poria ().


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Five tastes

Sour Bitter Sweet Acrid or pungent-spicy Salty


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Pungent spicy herbs Pungent spicy herbs could disperse and

promote Qi flow and invigorate blood. For instance

Ginger ( ) relieves exterior syndrome by inducing sweating

Safflower ( ) invigorates the blood
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Sweet herbs Sweet herbs have the function of tonify,

harmonize and moderate. For example,

Ginseng ( ) replenishes Qi; Longan ( ) nourishes blood Licorice root ( ) moderates pain and

harmonizes the actions of other herbs.
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Sour herbs

Sour herbs have the function of absorb andcontrol. For instance,

pomegranate rind ( ) can stopdiarrhea.
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dragons bone ( ) and oyster shell () are used for spontaneous sweating;
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Bitter herbs

Bitter herbs have the function of reduce anddry. For example,

rhubarb ( ) is used to move stool andreduce heat
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phellodendron bark ( ) dry dampness

and tonify yin.
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Salty herbs

Salty herbs have the function of softenhardness and purge stool. For example,

Mirabilite ( ) is used for constipation
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Based on these primary considerations, theancient physicians generalized the actions

of herbs into five tastes. Herbs that have a dispersing function are

pungent-spicy

herbs that tonify are sweet; and soon on.


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Consequently, the tastes of herbs described in theclassical Chinese Materia Medica are onlyapproximate. For example,

the pungent taste of pueraria root ( ) the sweet taste of gypsum ( )

the salty taste of scrophularia ( ) are not inline with their actual taste in the mouth. More inline with their function.
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The four properties and the five tastes, these twocharacteristics are used to describe the

complicated actions of the herb.2. Ginger ( ) is pungent-spicy and warm. Itdisperses wind and cold.

3. Lily bulb ( ) is sweet and cold. It promotes

the production of body fluids.4. Ginseng ( ) is sweet and warm. It

replenishes Qi.
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Ascending, descending,

floating and sinking action The functional tendencies of herbs are

marked by ascending, descending, floating

and sinking. This is a clinically useful categorization

method.

AscendingFloating

DescendingSinking


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Ascending and floating actions

Herbs with ascending and floating actionsare used to promote sweating, raise Yang,

and cause vomiting and open the orifices.


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Example

Ginger The action is upward.


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Descending and sinking actions

Herbs with descending and sinking actionsare used to regulate Qi, promote urination

and defecation, subdue Yang and calm themind.


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Examples

Rhubarb ( ) The action is downward.


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Herb parts such as flowers and leaves thatare light in quality have the functions of

ascending and floating; Herbs or substances that are heavy in

quality such as seeds, fruits and minerals

have the functions of descending andsinking.


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In addition, processing and preparation maychange the taste and property and influence

the functional tendencies. For example, frying causes an ascending function; processing with ginger causes a dispersing

function; preparing with salt causes a downward

function.


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In general, the functional tendency of an herb isrelated to its taste, property, quality and

processing. Herbs featured as ascending and floating must be pungent-spicy or sweet in taste as well as warm or hot in property,

while herbs characterized by descending andsinking must be bitter, sour or salty in taste andcool or cold in property.


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Li Shizhe, a well known doctor in the MingDynasty once described the relationships this way:

"Sour or salty herbs have no function of ascending, pungent-spicy or sweet herbs have no function of descending,cold herbs have no function of floatingand hot herbs have no function of sinking."


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Selective for meridians

An herb may selectively act upon a particular part of the body to relieve

pathogenic changes in specific meridiansand organs.

The meridians that an herb enters depend on

the corresponding symptoms to be relieved by it.


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For example

Ephedra ( ) promotes sweating, relieveasthma and improve urination.

It is indicated for fever, chills and absence of sweating due to invasion by exogenous pathogenicwind and cold, dysuria, edema and so on.

Judged by the above indications and analyzed inaccordance with the theories of the Zang-Fuorgans and meridians, it can be determined that theherbs would enter the lung and urinary bladder meridians.


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Jujube ( ) tonifies Qi in the spleen andstomach.

It is indicated for poor appetite and loosestool due to weakness of the spleen andstomach.

So we deduce that the herb enters themeridian of the spleen and stomach.
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Toxicity or Nontoxic

In the Chinese Materia Medica, the words "toxic,nontoxic, strongly toxic or slightly toxic oftenappear.

The toxicity of herbs and substances can causereactions as well as adverse effects on tissues.

Nontoxic herbs are moderate in nature and,generally speaking, do not have any side-effects.


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For example, jujube ( ) and Poria () are nontoxic herbs,

while prepared aconite root ( ) is toxicherbs.
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Eight basic therapeutic methods

Traditionalmethods fallinto eightcategories.

These methodsare commonly

used in clinicaltreatment.

diaphoresis exterior syndrome emesis excess syndrome

purgation excess syndrome resolution excess syndrome reinforcing deficiency syndrome warming cold syndrome

heat-cleaning heat syndrome mediation half-exterior and half-interior


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Diaphoresis

also known as exterior relieving method, is atherapeutic method used to open the muscular interstices and relieve exterior syndrome withherbs,

which can relieve the exterior and inducesweating.

This method is mainly used to treat exogenousdisease at the early stage with the symptoms of chills and fever, headache, whitish tongue coatingand superficial pulse, etc.


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Application

Diaphoresis is either induced by herbs acridin taste and warm in nature or by herbs

acrid in taste and cool in nature.


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Application

herbs acrid in taste andwarm in nature isapplicable to diseasescaused by exogenouswind-cold, like ginger;
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Application

herbs acrid in taste andcool in nature isapplicable to diseasescaused by exogenouswind-heat and warm-dryness, like

chrysanthemum .
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Emesis is a therapeutic method used to direct

pathogenic factors or toxic materials tocome out of the body through the mouth.

Emetic therapy is usually used to treatexcess syndrome with urgency to vomit outthings retained inside.


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Emesis is a therapeutic method used for emergency.

Proper use will have immediate effect,while wrong application tends to damagehealthy Qi.

So great cares must be taken in using thistherapy.


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Emesis is usually forbidden to being used totreat the patient with critical illness, various

types of hemorrhage and dyspnea; or to be used to treat deficiency of Qi and

blood in the aged and young as well as

pregnant and postpartum woman.


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Purgation

is a therapeutic method used to dischargefeces, eliminate retention of substance and

fluid inside the body and relieveaccumulation of excess-heat with the

prescriptions and herbs effective for

catharsis. Purgation therapy is usually used to treatexcess syndrome .


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Application

What can Aloe do? Aloe is is a herb which have function of

Purgation, it is used to discharge feces
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Clinically purgation is divided into five types:

1. cold purgation, applicable to interior excess-heatsyndrome;

2. warm purgation, applicable to retention of cold in the

stomach and intestines;3. dispelling water, applicable to excess syndrome of water;4. moistening purgation, applicable to insufficiency of fluid

in the intestines and constipation due to loss of yin anddeficiency of blood;

5. e1iminating stasis, applicable to retention of stagnantheat in the lower energizer, or the patients with dry bloodinside ,blood stasis and strong constitution.


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Resolution

is a therapeutic method used to remove theretention of food and eliminate stagnation

with herbs effective for promotingdigestion. This therapy is mainly used to treat chronic

abdominal mass due to disorder of Qi and blood, improper diet, phlegm and retentionof fluid.

is usually used to treat excess syndrome .


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Example

Hawthorn is a herb which have functionof Resolution, it is used to used to remove

the retention of food and effective for promoting digestion.
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Reinforcing therapy

is a therapeutic method used to treat deficiencysyndrome by means of supplementing essence,

blood and body fluid with the prescriptions andherbs effective for tonifying and reinforcing the

body. This therapy is mainly used to treat deficiency

syndrome of Qi, blood, Yin and Yang, such as physical weakness, spiritual lassitude, loss of blood and body fluid.


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Clinically invigorating therapy is divided intofour types:

Invigorating Qi,applicable tosyndromes caused byQi-deficiency;

For example, ginsengcan invigorate health

Qi to treat the Qi-deficiency syndrome
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Tonifing blood,applicable tosyndromes caused by

blood-deficiency; Longan invigorate

blood to treat the

blood-deficiencysyndrome
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Invigorating Yin,applicable tosyndromes caused bydeficiency of essenceor insufficiency of

body fluid;

For example, lily
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Invigorating Yang,applicable tosyndromes caused bydeficiency of thespleen-Yang andkidney-Yang.

For example, walnut
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Warming therapy

known as cold-eliminating therapy, is atherapeutic method used to eliminate

pathogenic cold and invigorate Yang-Qiwith the prescriptions and herbs warm andhot in nature.

Warming therapy is usually used to treatcold syndrome .
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Cinnamon
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Heat-clearing therapy

is a therapeutic method used to clear awayheat by means of reducing fire, removing

toxin and cooling blood with the prescriptions and herbs cold and cool innature.

Heat-clearing therapy is usually used totreat heat syndrome .
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This therapy ismainly used to treatinterior excess-heatsyndrome.

Leaves of bamboo
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Mediation

is a therapeutic method used for eliminating pathogenic factors and supporting healthy

Qi. Half-exterior and half-interior syndrome


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Treatment based on syndrome

differentiation The therapeutic methods mentioned above

are the basic ones generalized according to

the eight principles. Since pathological conditions are

complicated, the use of these methods in

clinical treatment has to be made the basisof syndrome differentiation.


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Traditional Chinese Medical

Prescriptions


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The art of prescriptions (also known as recipes or

formulas) in TCM has undergone significant changethrough the centuries. The prescriptions in TCM are not merely collections

of medicinal substances in which the actions of one

herb are simply added to those of another in acumulative fashion. They are complex recipes of interrelated substances,

each of which affects the actions of the others in the

prescription. It is this complex interaction, which makes the prescriptions so effective, but also makes them moredifficult to study.


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Every medicinal substance has its strengths and itsshortcomings.

An effective prescription is one in which thesubstances are carefully balanced to accentuate thestrengths and reduce the side-effects.

The combination of substances in a prescription

creates a new therapeutic agent that can treatconditions more effectively and completely than asingle substance.


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Constructing an effective prescription involvesmore than simply putting ingredients together toobtain a certain effect.

One needs an organizing principle to guide theconstruction so that the ingredients are combinedin an optimal fashion.

The orderly arrangement of ingredients in a prescription is called a hierarchy.


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Traditional Chinese society was alwaysvery conscious of rank, which revolved in

the first instance around the emperor andhis court. For this reason, the terms used to signify the

importance or rank of the ingredients in a prescription reflect those used in the royalcourt.


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The four ranks of ingredients in the hierarchy of a prescription are

King Herb - The herb which is directedto and has the strongest effect on themost important imbalance/pathologyMinister Herb - This herb is directed to

the main imbalance/pathology and tothe secondary imbalance/pathology

Assistant Herb - there are three types:


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ypHelpful Assistant - strengthens theeffect of the KingCorrective Assistant - reduces oreliminates the harsh or toxic effects of the King and/or Minister herbsOpposing Assistant - decreases theeffect of the King. This role is mostlyused for complex combinations of imbalances/pathologies.Guide Herb - focuses actions of theother herbs on a particular organ,channel or region of the body.


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For example


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symptoms Breathlessness weak voice spontaneous sweating

poor or no appetite Tiredness loose stools

Pulse: empty, Tongue: somewhat faded in color dislike of speaking pale complexion


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Question

Is there an Excess syndrome? NO/YES

What is Deficient in this situation?Health Qi/ Pathogenic factors

Which Treatment Principle do you choose?Invigoration/Purgation


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SI JUN ZI TANGROLES AND PROPERTIES OF INGREDIENTS

King - GinsengKing Actions: tonifies Source Qi, tonifies Lung & SpleenQi.

Minister - White AttractylodesMinister Actions: Tonifies Qi, tonifies Spleen, ResolvesDamp.

Assistant - PoriaAssistant Actions: Drain damp, tonifies Spleen.

Guide - Licorice RootGuide Actions: enters all 12 main channels,harmonizes herb combinations (mitigates harsh effects),tonifies Spleen.
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Review

Traditional methods fall into eightcategories.

Four properties and five tastes The functional tendencies of herbs are

marked by ascending, descending, floating

and sinking. Traditional Chinese Medical Prescriptions

therapeutic methods

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