Paying Attention to the Integrity, and Correctly Handling the Relationship Between the Local and the Whole
III. Paying Attention to the Integrity, and Correctly Handling the Relationship Between the Local and the Whole 1. Regulating yin and yang On the most fundamental level, disease results from a breakdown in the equilibrium of yin and yang, and the weakness or abnormal predominance of yin or yang. When dealing with the weakness or predominance of yin or yang, one should examine which is the predominant or insufficient, and then regulate yin and yang to make them return to equilibrium. Thus, the regulation of yin and yang, the reduction of the predominant and the restoration of the deficient, and the replenishment of the relative balance between yin and yang, all make up one of the basic principles of treatment. In practice, this principle of regulating yin and yang is divided into two aspects: reducing the redundancy and reinforcing the deficiency. 1) Reducing the Redundant This method is applied when there is an abnormal predominance of yin or yang. For instance, when treating a case of excess heat-syndrome characterized by exuberant heat,drugs of a cold nature should be given to clear away the excess heat. This is the method of "treating heat syndrome with drugs of cold nature" (also known as "to cool the heat syndrome"). When treating a case of excess cold-syndrome characterized by exuberant endogenous cold, drugs of hot nature should be administered to eliminate and disperse the cold. This is the method of "treating cold syndrome with drugs of hot nature. " It is said in Plain Questions that "exuberant yin leads to yang deficiency; and exuberant yang leads to yin deficiency. " In a disease of yin or yang predominance, the excessive yin or yang usually injures its corresponding opposite. In other words, the exuberant heat tends to consume yin-essence and body fluid and the predominant cold tends to lessen yang. So when treating predominant yin or yang, one must notice whether there is a relative weakness of yin or yang. If this condition occurs, one should replenish the insufficiency by tonifying yang or nourishing yin. 2) Reinforcing the deficiency When treating cases in which yin or yang is comparatively deficient, the method of reinforcing the deficiency should be administered. For instance, when yin is deficient, it often fails to check or restrain yang, and a syndrome of deficiency-heat type due to yin weakness and yang predominance occurs. In this condition, one must nourish yin in order to restrain yang. When yang is insufficient and unable to restrain yin, yin will be exuberant, leading to a deficiency-cold syndrome. Here, the reinforcing method should be adopted to tonify yang and restrain yin. Usually, yin deficiency or yang deficiency tends to result in the deficiency of kidney-yin or kidney-yang. When kidney-yin deficiency occurs, one should "strengthen the governor of water to restrain hyperactivity of yang";when the deficiency of kidney-yang occurs, it should be treated by "boosting the source of fire to eliminate abundance of yin"; when both yin and yang are deficient, they should be replenished simultaneously. It must be pointed out that yin and yang are interdependent on each other, so the deficiency of yin may lead to the deficiency of yang, and vice versa. In the treatment of yin or yang deficiency, one should remember to obey two principles. "reinforcing yin from yang" and "reinforcing yang from yin. " This refers to the need to administer appropriate drugs to invigorate yang when replenishing yin, and to give suitable drugs to nourish yin when reinforcing yang. It is said in The Complete Works of Zhang Jingyue (Volume 50) that. "It's a marvelous phenomena that yin and yang help and improve each other. So those who are good at invigorating yang are bound to replenish yang from yin; this ensures that yang is helped by yin and that yang will reproduce endlessly. Those who are good at nourishing yin always replenish yin from yang, and thus make certain that yin is improved by yang and that its source is inexhaustible. " In addition, yin and yang are also general principles for syndrome differentiation. Pathological changes are merely reflecting an imbalance of yin and yang. The breakdown of the relative state of balance results in concrete conditions such as a disturbance in the ascending, descending, exiting, and entering of the vital energy, the increase and decrease of heat or cold, the deficiency or exuberance of genuine-qi or evil-qi, the disharmony between nutritive qi and defensive qi, and between blood and qi. Therefore, in a wide sense, many therapeutic methods belong to the scope of regulating yin and yang, such as dispelling the superficial evils, purging the endogenous excess, emetic methods, improving urination, helping the lucid qi ascend and the turbid qi descend, warming cold and coo1ing heat, reinforcing deficiency and eliminating excess, regulating nutrient-qi and defense-qi, and regulating blood and qi. As it is said in Plain Questions: "To throw up what is in the upper part of the body; to drain what is in the lower part of the body; to purge from inside when there is a feeling of fullness in the middle; to steep the body when the pathogens are in the superficial part; to sweat when evils are in the skin; to subdue what is hyperactive; to purge and disperse what is excessive. One must examine yin and yang, differentiate them from each other; thus, to treat yin in cases of yang nature, and to treat yang in cases of yin nature. To regulate blood and qi and ensure their normal functioning. " 2. Regulating Functions of the Viscera There are harmonious relationships between the zang-viscera and fu-viscera; they regulate and improve each other in physiological conditions. However, in conditions of disease, the pathological changes of zang-viscera and fu-viscera also may influence each other, leading to transmission of diseases. Therefore, the diseas of one viscus tends to influence the others. When treating diseases of the viscera, one should regulate relationships among the viscera,rather than imply dealing only with on viscera's illness. There are two main principles of treatment in such cases: indireetly strenghening or reducing;and treating the five sense organs from the five zangviscera. 3.Regulating Qi and Blood Qi and blood are fundamental substances which maintain the normal life activities of the, viscera and other organs. Qi and blood both have their own particular functions, but they depend on each other. Once this physiological relationship changes in an abnormal fashion, a variety of syndromes of disharmony between blood and qi will result. Therefore, regulating blood and qi is a principle which reflects the holistil concept. This principle is mainly embodied in the following methods: To reduce the excess; and to replenish the deficiency. Through these methods the normal relationships between blood and qi are resumed. Qi can produce blood; so deficiency of qi may lead to deficiency of blood. When both li and blood are deficient, drugs should be given to replenish qi and blood simultaneously,rather than simply to nourish blood. Qi propels blood circulation, and a deficiency or stagnation of qi may lead to blood stagnation or blood stasis. This causes a syndrome of qi deficiency with blood stasis or stagnation with blood stasis. In this case, one should strengthen qi and improve blood circulation, or improve the circulation of qi and blood, thus removing blood stasis. Additionally, abnormal circulation of qi may lead to abnormal circulation of blood. For example, abnormal ascending of liver-qi may lead to a rushing up of blood, and as a result, coma or hemoptysis may occur. In this case, one should lower the rushing qi and regulat blood. Because qi controls blood, deficiency of qi may impair this function, and lead to leaking of blood from the blood vessels and hemorrhage. In this case, the method.of tonifying qi should be applied to control blood. Finally, because blood is the mother of qi, blood deficiency may lead to qi deficiency, and blood exhaustion may lead to qi exhaustion. According to the principle of "tonifying qi when blood is exhausted," one should tonify qi when treating blood exhaustion.
