Traditional Chinese Medicine and Tai Yang Syndrome - Essay Example

Tao He Cheng Qi Tang Introduction: Traditional Chinese Medicine (TCM) perceives human body from the perspectives of physical and energetic levels, both as part of the surrounding environment and indeed as a part of the Universe. The body, as a result, is affected by natural and environmental factors as well as factors that originate from the body itself internally. Continuous movement is intrinsic both in the external environment and in the internal milieu of the human body, and this is considered health. Disease, on the contrary, is considered as restriction in the movement. According to TCM, the mother of all diseases is stagnation, that is, any substance that is in excess or not moving is potentially toxic or dangerous and will prevail a disease state. Therefore, cleaning these stagnations will lead to relief from the disease. Basically, therapy in TCM is dependent on principles of cleaning the involved toxicity and then giving a tonic if indicated to strengthen the system. Qi is the energy field in the Universe of which human beings are also a part of. Qi is omnipresent and omnipotent. According to TCM, Qi motivates all physical functions, such as, synthesis of various body fluids and substances, circulation and regulation of substance dynamics, immunity against harming agents, thermoregulation of the body system, and maintenance of functional integrity and activity and harmony among organ systems (Ko, K.M. and Chiu, P.Y., 2006). External Factors: The external or exogenous factors are Wind, Heat, Cold, Damp, and Dryness. It would not be justified to understand these Chinese medical terms in light of English language meaning. These terms mean more than just the literal meaning as it appears in an English language dictionary. Wind means something that causes a sudden movement of a condition (Liu, Y.H., Ding, F., and Ding, J., 2003). Examples are onset of cold, fever, chills, vertigo, spasms, or twitches. Heat, on the other hand, means, hot and inflammatory, such as, fever. If blood stasis is present, Qi will transform into heat. This represents an overactive metabolic state. Sometimes, yin or yang deficiencies will cause empty heat syndrome that is characterized by hot flashes, irritability, mood swings, or night sweats. Cold signifies reduced functional level of an organ system. The patients will present with chills, body aches, poor circulation, fatigue, anorexia, indigestion, diarrhoea, arthralgia or joint pains, slow speech and tardy movements, aversion to cold and inclination to warmth or heat. This embodies patients with hypoendocrine conditions. Damp indicates fluid excess in the body with lack of thirst, abdominal bloating, anorexia, nausea, vomiting, sense of heaviness of the body, and joint pains with stiffness and soreness. Dryness is the reverse of dampness where the clinical picture consists of dry hair, lips, mouth, nose, skin, throat; excessive thirst and constipation (Wang, H.M., 2006). Tai yang syndrome is the Chinese name of Wind/Cold. This is a disharmony, and if this progresses or moves deeper into body, it may convert into Shao Yang, where Wind/Cold may come to exist side by side with Wind/Heat. Each phase of symptoms has characteristic signs and symptoms and specific treatment directed to reversal of the condition. When a physician consults patients, the first step is to exclude extrinsic or exogenous disease. When excluded, the next step is to identify intrinsic disease. The exogenous diseases are identified by two methods. These are syndrome differentiation according to six meridians or syndrome differentiation according to defense system, wei; vital energy, qi; nutrient, ying; or blood, xue. The six meridian method investigates pathological alterations over an exogenous disease, specially for shanghan, which is acute disease caused by exogenous cold evils. This is recognized clinically as chills, general aches and pains, belching, a tense pulse with or without fever. Based on the distribution of the three yang meridians, tai yang, yang ming, and shao yang and the three yin meridians, tai yin, shao yin, and jue yin, the clinical expression of disease contacted from the exogenous sources are classified into six stages that correspond to one of these particular meridians. The three yang meridians are located on the exterior of the body, and as the evil progresses, the disease will progressively involve the more deeply located yin meridians. Hence the staging of the disease will happen upon the manifestations of signs and symptoms displayed upon these meridians. The more interior the meridian, the more is the severity of the disease (Hinton, D., Hinton, S., Pham, T., Chau, H., and Tran, M., 2003). There are eight principles that differentiate different syndromes. These are Yin and Yang; exterior, biao and interior, li; deficiency, Xu and excess, Shi; and cold and heat. Seen from the point of view of pathogenesis, these syndromes signify the anatomical locations of the pathological changes, the nature of pathology, the body immunity of resistance, and aetilogical factors or pathogenic factors. These eight principles appropriately applied will provide the differential diagnosis in any disease state. Let us investigate tai yang syndrome from these angles. Diseases of the yang meridian usually originate from the exogenous sources, and they usually are seen as heat excess or shi syndromes, and when there are changes in any of the meridians, symptoms associated with the specific meridian organs or other inter-related meridians will appear. Exterior and interior are two principles indicating the depth and development of disease. Exterior syndromes refer to the pathological changes and syndromes that are caused by invasion of the body surface by external aetiopathologic factors. The pathologic course will be entrance of the external cold and wind evils through skin and muscular striae. They pass along the meridians and eventually attack the internal organs along particular pathways to the internal milieu of the organ system and progressively deplete the body of its qi. These conditions are sudden onset, short duration, and seen early in the exogenous diseases. The major manifestations are aversion to cold or wind, fever, a thin tongue coating, and a floating pulse. Associated symptoms may be headache, general body aches, nasal congestion and rhinorrhoea, sore throat, and cough. The interior syndromes result from transmission of exogenous disease into the interior organ system or progression of the disease to involve the deeper organs, for instance, the tai yang syndrome will pass along the meridians of small intestine and urinary bladder. This disease can be classified into syndromes of Tai Yang channel and syndromes of the Tai Yang Fu (organ), the urinary bladder. The description of the syndrome will be, as mentioned, aversion to cold, fever, thin white tongue coating, and a floating pulse indicating that the disease involves the exterior only. The exogenous pathogenic factors attack the body surface injuring the defensive Yang Qi. There is also headache, neck pain, and neck rigidity for Qi of the Tai Yang channel is affected. Going to a deeper level, this may be associated with syndrome of Tai Yang Fu organ, that is, urinary bladder. A floating pulse indicates that the pathological changes are exterior. If the symptoms of Tai Yang syndrome are accompanied by sweating, aversion to wind, and floating and superficial pulse, these are known as wind stroke syndrome of Tai Yang. This is also known as exterior Xu syndrome. This occurs when the defensive Qi is invaded by the exogenous pathogenic wind. This may lead to a disharmony between defensive and nutrient Qi. If cold intolerance is not accompanied by sweating and a floating tense pulse, the TCM calls it Tai Yang febrile syndrome caused by cold or exterior Shi. This is acclaimed to be a resulting from exogenous pathologic cold obstructing the body surface and blocking the Yang Qi flow. Lung dominates skin and hair, hence the attack of exogenous pathogenic factors attacking the body surface would lead to dysfunction causing nasal obstruction, cough, and asthma. The classic literature above is related to the Fu syndromes of Tai Yang (Liao, H., Banbury, L.K., and Leach, D. N., 2007). The Tai Yang Fu organ syndromes are due to aggravation of tai yang channel syndromes are not cured in the early stages of the disease and gets transmitted along the channel to the urinary bladder. This syndrome is further classified into damping or water retention syndrome and blood retention syndrome. Notwithstanding such classification, the bladder syndromes may present as frequency, urgency, pain with urination, dribbling, turbidity, bloody and purulent urine, urine with stones, yellow sticky tongue coating, and rapid pulse. The explanation is accumulation of damp heat in urinary bladder blocks Qi activity, thus causing dribbling urination. A downward propulsion of damp-heat into the urinary bladder causes injury to the blood vessels, and there may be haematuria, and this will lead to frequent painful urination with considerable urgency (Kavoussi, B., 2007). The water retention syndromes of Tai Yang Fu will present with fever, extreme sweating, irritability, thirst with or without preference for drinks, vomiting after drinking, and dysuria. This happens due to exogenous pathogenic factor transmitted to urinary bladder resulting in Qi activity dysfunctions in the urinary bladder. This further worsens the flow of body fluids, and the result is fluid retention. Consequently, the patient suffers from irritability and manic state and thirst with urge for fluids, vomiting after drinking, and dysuria (Wang, W.J., 2007). The blood retention syndrome is talked about in this classic literature. The symptoms that the patient suffers from is pain and lump in the lower lateral abdomen, mania followed by normal urination. The patient suffers pain in the lower lateral abdomen and a sensation of lump in that location resulting from pathological heat transmitted along the Tai Yang channel and mixing with blood in the lower jiao. Mental mania is caused by an upward disturbance due to retention of blood and pathogenic congealation of heat. Since the location has now shifted to lower jiao, there is no urinary bladder symptom at this stage, and the patient has normal urination (Wang, Y.K., Lang, Q.B., and Li, G.G., 2005). This syndrome is treated by Chinese herbal medicine with Tao He Cheng Qi Tang that consists of decoction comprising of the following ingredients, Tao Ren (semen persicae) 12-15g, 50 pieces, Da Huang (radix & rhizoma rhei) 4 liang, Gui Zhi (ramulus cinnamomi cassiae) 2 liang, Zhi Gan Cao (honey fried radix glycyrrhizae) 2 liang, and Mang Xiao (mirabilitum) 2 liang [add to strained decoction]. Now, we shall analyse these gradients in order into examine the therapeutic effects of these herbal medications as applicable to these conditions. The main ingredient is Tao Ren, peach kernel, botanically known as Semen presicae. In the decoction, 12 g of this is used. This is bitter-sweet to taste, neutral, acts on large intestine or jiao channel. It functions as dispersive and purgative agent. This promotes blood circulation and relieves blood stasis, and its has a strong action resulting in promotion of blood flow. The main indication for which it is used here is that it is an effective treatment for a sensation of mass in the lower abdomen. It is reach in oils that will lubricate the large intestine channel, and it relaxes the bowel. Hence, it is used to treat constipation associated with body fluid depletion and dry colon. For treatment of blood stasis, abdominal mass in the lower abdomen, it can be used with other ingredients, such as, Da Huang, Gui Zhi, Mang Xiao, and Zhi Gan Cao as in Tao He Cheng Qi (Tang Bruneton, J., 1999). The next ingredient is Rhubarb or Radix et Rhizoma rhei. The amount used is 4 Liang. This is bitter in taste, cold in characteristics, and apart from other channels, it works prominently on large intestine channel. This bitter and cold material is used for clearing heat, and sinking downward, it can settle in the large intestine to effect bowel movements. The ease of bowel movement thus releases stagnation in the gastrointestinal tract and clears fire of excess type and removes toxic or inflammatory heat. When constipation occurs due to accumulation of heat of excess type or when there is fecal impaction due to excess heat leading to further heat accumulation, it is critical to get rid of the constipation, and this compound acts successfully in doing that. This herb also has action on blood. This removes pathological heat and toxic substances from blood. This is a promoter of blood circulation and hence relieves stagnation of blood. Therefore, the therapeutic effects can be summarized as purgation of pathological heat, cathartic effect on constipated bowel, removing heat from blood or clearing toxins, and promoting blood circulation to relieve stasis. The therapeutic uses can be for febrile disease and stagnation of gastrointestinal tract with symptoms of pyrexia, delirium, abdominal distention, constipation, all taken together as excessive heat syndrome. During treatment, it is often used in combination with mirabilite (Natrii sulphas) for eliminating heat and loosening the bowels and purgation of digestive Qi and abdominal distention. The unprepared herb has major purgative effect. The prepared herb has mild action, and the carbonated prepared herb is used in haemorrhagic condition in combination with mirabilite (Natrii sulphas) and peach kernel for bleeding due to blood heat, for removal of heat and toxic material (Cupps, M. 2000). The next ingredient is Cinnamom Twig (gui zhi) or Ramulus Cinnamomi. Pungent sweet in flavour, warm, and acts in this context on the bladder channel. Pungent and warm hence causes dispersion; sweet, hence mild and causing mild sweating that could damage yang. This herb is used for treatment of exterior syndromes of both deficiency and excess types caused by pathogenic wind cold. This also invigorates the pulse, reinforce Yang, and promote Qi flow. This herb has important use in treating pains due to cold, deficiency of yang, and water retention or damping. The usefulness can be summarized as induction of hyperhidrosis to dispel external pathogens, warming the channels to clear obstruction, and reinforcement of yang to promote Qi flow. This is mainly used in this decoction to treat exterior deficiency syndromes of wind cold, aversion to wind, and floating and slow pulse Advanced Textbook on TCM and Pharmacology, 1995). Another component of this therapy is Zhi Gan Cao (honey fried radix glycyrrhizae). Sweet and neutral, moist, and mild, this herb can relieve spasm, and the main rationale for use in this decoction is harmonizing the other herbal ingredients and alleviating toxic and drastic properties of other herbs. The effects can be summarized as purging fire to remove toxins, relieving spasm to alleviate pain, and moderation of other herbal components. In this decoction, this mainly acts as a buffer. This is used unprepared for clearing heat and used stir-baked with honey mainly for others (Bensky, D. and Gamble, A., 1990). The last component is Mirabilite (mang xiao) Natrii Sulphas. It is a salty bitter crystal, cold in nature, acts on large intestine channel. This is effective for interior syndrome of excess heat of the gastrointestinal tract, dry stools, and constipation. Thus, it is indicated in tai yang fu syndrome manifested as fever with constipation, delirium, and manic state. The effects hence can be listed as purging heat, loosening of bowels, softening hard masses and moistening, clearing way heat, and eliminating oedema. This is a justified ingredient in the decoction of Tao He Cheng Qi Tang, since it can treat successfully the accumulation of excess heat in large intestine with dry stools, constipation, abdominal pain and distention, high fever and delirium (Yeung, H., 1983). From the above discussion, it is evident that this decoction with all its ingredients directed towards purging will relieve the tai yang syndrome. Reference List Advanced Textbook on TCM and Pharmacology. (several volumes) (Beijing New World Press, State Administration of TCM, 1995. Bensky, D. and Gamble, A., (1990). Chinese Herbal Medicine: Formulas and Strategies. (Eastland Press). Bruneton, J., (1999). Pharmacognosy, Phytochemistry,Medicinal Plants. (Paris: Lavoisier Publishing. Cupps, M., (2000). Toxicology and Clinical Pharmacology of Herbal Products. (New Jersey: Humana Press. Hinton, D., Hinton, S., Pham, T., Chau, H., and Tran, M., (2003). Hit by the Wind' and Temperature-Shift Panic among Vietnamese Refugees. 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Foundation And Application Of Aggregation Syndrome Theory In Traditional Chinese Medicine, Zhong Xi Yi Jie He Xue Bao; 5(2): pp. 111-114. Wang, Y.K., Lang, Q.B., and Li, G.G., (2005). Study On Diagnostic Standard For Dampness Syndrome In Patients With Chronic Gastritis, Zhongguo Zhong Xi Yi Jie He Za Zhi; 25(11): pp. 975-979. Yeung, H., (1983). Handbook of Chinese Herbs.(Institute of Chinese Medicine, California . Read More