Electra Peluffo

notes on chinese medicine

 


Presentation

Introductory words of Prof. Ye Chenggu of Beijing presented to his pupil, the author of this text.

Introducción:

Since 1998 the author has belonged to the body of professors in the Masters Course of Acupuncture in the Faculty of Medicine of Valencia. For this she had to prepare guide notes for students, doctors of Western medicine, on themes regarding the fundamental philosophy of Chinese medicine that they knew little or nothing about.

The approach and way of thinking between one school of thought and another appear to be very different and in certain aspects they are. In the book Apuntes de Medicina China a parallel is established between the pre-Socratic Greek thinking on nature and its Chinese equivalent in that era: Lao Tse, Confucius, Mencio, with the end object of explaining the coincidences and the differences between both philosophies and the origin of ideas and concepts which both cultures shared and which are still valid in Chinese Medicine.

/ This resort to comparisons was useful so that Chinese ideas are not considered strange as the result of a manner of observing nature unrealistically, in fact quite the contrary.

Hippocratic medicine has moved away from the bases on which it was founded and the author believes that in going back to the Greek foundations to look for explanations many points of contact will be found between naturalist Hippocratic medicine and the prevailing concept of Chinese medicine. This approach will improve the comprehension of students about the basic development of Chinese medical thinking. Dra. Peluffo dedicates a good part of the first part of the text of her book to this co-incidence in order to get rid of the esoteric or anomalous image that Chinese medicine has. At the same time in the introduction of the book she criticizes contemporary practice of western medicine, as if seeking an explanation of the tendency now for the public as well as doctors to concern themselves with other techniques or diagnostic and therapeutic procedures.

The book is directed towards doctors and students of medicine, to physiotherapists and reflexologists, to those who know or who are studying acupuncture as well as other Chinese medical techniques, to orientalists, to psychologists and to those interested in the relation between western and oriental thought.

In the text she tackles subjects that through her teaching experience appear to be more difficult to understand and assimilate in order to have a beneficial training in acupuncture the practice of which she explains is only a part of traditional Chinese medicine resulting from philosophic naturalistic thinking in the far east.

It is not a descriptive text as is usual in other books on this topic; it is more an explicative text based on the Chinese culture and its language whose linguistic and etymological structure differ greatly to our European languages. It is not meant to be a treatise on the matter but discusses the medico-philosophic themes of China, not well known among us, attempting to explain their origin and evolution and their possible equivalent in western medicine.

The idea is a text that integrates both medicines, which is highlighted in the final part with a few clinical cases that combine diagnosis and treatment in the West and the Orient. If you are a doctor, and acupuncture is a medical act, an entry into the skin with therapeutic results after a diagnosis, it is not impossible to combine both forms of thought for a better service to a patient.


Yinyang

I detail the aetymology of yinyang through the significance of the ideograms with which both terms are written. With the objective of fathoming and clarifying the importance of yinyang in Chinese thinking I revert to the classic Greek theories whose reflections are closer and more familiar to the West. I also investigate the common origins of the yinyang concept already implied in previous ancient cultures or in contemporary cultures with China. It is interesting to incorporate the idea of yinyang into diagnostic and therapeutic medical reasoning as it is the product of the observation of nature and the microcosm transposition which were seen and attracted from the macrocosm.

How yinyang is expressed, how it is created and how it moves and evolves in nature (sky and earth) and mankind as in normal and pathological circumstances, for which I give anatomical Taoist references (references in Chinese medicine that have an important functional component) that make clear the points both medicines have in common. The imagery of the body is different for both cultures and I show how the body appears to the Chinese. The understanding of yinyang exists in the West but is not used as a tool. In this respect I emphasize the importance of the concept and I give examples to facilitate this work.


Wuxing. Five elements

Through the aetymology and the evolution of the idea and its origins in the West, I explain why they are called elements when they are not, not even in the Chinese term by which they are defined. Detailed explanation of the crucial growth of these "elements" in ancient Greece, the reasoning behind this development and the incorporation of this into classic medical thinking. Detailed and explained are the series of horizontal and vertical association of characteristics which define how the elements are used in the diagnostic and therapeutic diagnosis processes in Chinese medicine.

For this I revert to the Chinese cosmology and to the yinyang energy concepts which moves the "elements" from a primogenital state of initial matter (the previous Heaven) until its distribution according to laws which established the relation between the wuxing in their expression of nature (the later Heaven) and the parallelism of the evolution of mankind. How the concepts of medicine and the bagua trigrams of Yi Jing relate as a data base of naturalistic reasoning in all the branches of knowledge in Chinese thinking. How the "elements" relate to each other (divided energies) and with a great general movement of cosmic energy.


Qi. Qixue. Blood. Energy

The third basic pillar of Chinese medicine. Qi or energy embraces all, and thus it divides into yin and yang, into subtle energy and organic blood matter. Yinyang appears again and the corresponding movements that induce energies. I enumerate normal and perverse energies giving detailed explanations of the contents of both ideograms and the reason for its translations to western languages.

I enlarge upon the description of cosmology and the previous and posterior heavens, cardinal points, climatic seasons, time and space. I explain the different energies into which the great energy is divided and its origins, its movements, the body timetable and how its malfunction in any of these aspects shows up an illness or triggers it off. The movements of energy on the surface and interior of the body can be compared with the Greek concepts "splanchna".

I begin, and later expand upon, these movements of energy in space and time in relation to the phases and levels of energy, of the energies that correspond with the seasons and the organs to which they relate. At all times I try to elucidate on the concepts of Chinese medicine in order to bring them closer to the ideas of western medical reasoning, to point out coincidences, to facilitate understanding and to root out exotic ideas, unreality or difficulty of access.


Xue

Blood as seen as another form of energy, its functions, origins, production and circulation. The explanation of the pulse in Chinese medicine (an important theme which will be developed in the clinical part) begins with the purpose and function of blood.
An important concept in making diagnostic and therapeutic decisions is through the description of blood, its paths, its qualities and functions in the body, and the proportion of blood and energy which each organ contains and how its meridian functions.


Jinye. Body liquids

Another form of energy in the body as a material component of itself, which in reality is the one and only liquid that takes on different forms and functions.
I explain how it is produced, how it is secreted, how it is stored in its different forms, how one can appraise its state observing the quality of the skin and mucus and the aspect of the organic secretions and excretions.

Zangfu. Organs and Bowels

A subject that occupies much space in order to explain the different anatomical and physiological concepts between the Orient and the Occident, to understand the interrelations between the organs themselves and the bowels and more important how they tie up in general and in particular how they form the coupled functions.

I have established the Chinese concept of organ comparison with that of Western medicine and for this we revert to the aetymology of zang and of fu and the yinyang physiological relation of functional pairs. In the cases in which it is possible we revert embryology and uncover the embryo of some organs to explain Chinese physiology.

I indicate aetymologically the concepts of biao/lin and nei/wai as forms of yinyang to explain the relation of the zangfu as applied to the organism, on which tissues such as nails, hair, tendons and teeth depend.

As well as the anatomical and functional component of each organ and the bowels I explain and specify the important effective and mental aspect of these, Shen and shens, to establish a type of emotional inseparable anatomical-physiological organic function attributed to each system of coupled zangfu. In the same way I show the relation of the zangfu with the seasons, with the evolution of the same in their successive stages as well as the very close tie between zangfu and wuxing.


Fuqihen. Extraordinary Organs

As the physiological anatomy which the Chinese demonstrate revolves around an open but unchanging system, fuqihen seems to stay outside this and one has to incorporate into the system these important and basic organs of the organism.

These organs form a group which are called curious or extraordinary organs in the sense of being outside the rules of zangfu but which accomplish similar laws. I detail their physical state, their relation and their dependency on other viscera and their function.


Jingluo. Meridians and Channels

To clarify the significance of jingluo and the difficulty in translating it into western languages I show the aetymology of the jing and lo characters. The purpose of which is to illustrate which are the jingluo with recourse to yin yang characteristics and a description of their function, organic, mental and affective within the movements of energy, the small circulation of energy and large circulation of energy.

I enlarge upon the relation as to how the six great meridians are formed which interweave energy between the interior and the surface of the body at distinct times of the day, and the year, establishing the connection between Zangfu, meridians and the clock and the calendar. This chapter serves as an introduction to the following; those who deal with the different ways in which the meridians group according to their function: lo, extraordinary, muscle tendinous, different.


Qijing Bamai. Special Meridians

I present the aetymological concept of special meridians and I give a detailed anatomical description of these with the purpose of explaining through its origin its routes and its connections the function of which qijing bamai fulfills. How, as there are eight extraordinary ones between them, there are two which form part of the ordinary or principal network of meridians.

Jingjin. Jingbie. Meridians

An explanatory outline on the differentiation of the types of meridians all pertaining to a network distributing energy with precise functions in each location. How they can be used depending on the diagnosis.

Aetiology in Chinese Medicine

Subthemes 14 and 15 about extraneous and internal energies respectively.

The concept of illness in Chinese medicine and aetiology with recourse to comparisons to classical Greek where aetiology was based on the explanation of cause and effect of the illness and in Chinese medicine it is the precise clarification of the mechanisms for which energy and its movements do not partner normal functions as much for extraneous and internal causes as well as mental and emotional reasons. This is best explained by the Taoist philosophy of human behaviour in the search of good health.

I detail the relation between yinyang and wuxing with the extraneous energies for which purpose I examine the formation of calendars that will begin to clarify how the climate (its movements - trunks and branches) influence the aetiology of illnesses and the preservation of health.

In the subthemes I speak in detail of each one of the six extraneous energies and their bond with the five organs (reference 5/6 already explained in zangfu) and their systematic function to preserve health and prevent illness. I emphasize each variant of the seasons climate, the connection with bafeng or winds and give examples with equivalent pathologies among western doctors to highlight the realistic pragmatism of Chinese medicine. In summing up the text of internal energy I emphasize the close bond of the whole organism both physical and mental. Also the impossibility of an infirmity in a material organ without the involvement of mental and emotional states in an illness and vice versa, which could result in an organic pathology, a concept not unusual in the west whereas it differs in China.

Here, in the west, a general practitioner does not often take charge of similar situations, he recommends the patient to a specialist.


Examination of the Patient

If in the previous chapters there is a reference to the practical application of the theoretic concepts that develop it is from theme 16 in which I describe direct contact with the patient and the value of observation.

The semiotic clinic in Chinese medicine is very rich in the interpretation of facts and the description of the examination of the patient including a thorough inspection, an interrogation, the use of our senses: smell, hearing, touch, heart beat, examination of the tongue. The reader receives orientation about these points detailed further in themes 17, 18, 19 and 20.


Practitioners Clinical Cases

A selection of practical advice where I emphasize diagnosis depending on the examination of the patient and in a treatment following the characteristics of the illness in accordance with the law of yinyang and five elements: the index finger in Pediatrics, Zhongfeng or Apoplexy, Syndrome Bi are some of the points dealt with in this chapter with the intention of familiarizing the reader with the form of Chinese clinical reasoning.


Clinical cases

There are four clinical cases in my consultancy where I show the possibility to synchronize or coincide western medicine with that of China. That is to say, I diagnose the cases with Chinese criteria for different reasons that are explained then I establish the therapy with conventional western medicines.

Epílogue

The text starts with an Introduction and finishes with a short Epilogue that sums up the intentions and desires to relate to you the reader.

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