Ideas of Preventive in Chinese Medical Classics: "The Inner Canon of the Yellow Emperor"

Hello, dear friends. As we know, it's a tragic year for us, 2020. No more coronavirus pneumonia outbreaks globally with huge influence on our lives. A great number of people suffered from COVID-19 pandemic. Many of them lost their lives forever. Lots of schools in some countries are still closed. Students could do nothing but learning online. China has achieved great success in their novel coronavirus pneumonia treatment and prevention. Everybody complied with the rules by medical epidemiologists with CDC. They wore masks, keep a social distance to prevent themselves from the virus infection. Some people were even isolated to block the widespread virus. In the meantime, traditional Chinese medicine, TCM, played important role as well. This led me to present today the topic ideas of preventive medicine in Chinese medical classics, The Inner Canon of the Yellow Emperor. I would like to talk in the following three aspects. First, brief introduction to the work, The Inner Canon of the Yellow Emperor. And secondly, the idea of preventive medicine in The Inner Canon of the Yellow Emperor. And thirdly, we would like to talk about what would they learn from The Inner Canon of the Yellow Emperor. In the first part of the lecture, let me give some basic knowledge about the work first. The Inner Canon of the Yellow Emperor in China we call the work Huang Di Nei Jin. So I will use the short name Huang Di Nei Jin replace The Inner Canon of the Yellow Emperor through the following talk. Huang Di Nei Jin is actually an ancient medical text enlisted in Yi Wen Zhi of Han Bo. The classical Chinese history completed in 111 AD. Huang Di Nei Jin was originally compiled during the Warring States period. That means 475 to 221 BC. Later, Su Wen and Lin Shu was issued separately. Most of the edition of Su Wen were issued with annotations. One of the earliest edition was from the 6th century during the Six Dynasties period. That means 220 to 589 AD, which was annotated by Qian Yuanqi. In 792, during the Tang Dynasties, Wang Bin rearranged and annotated The Inner Canon based on Qian Yuanqi's work. By the 11th century, during the Song Dynasty, the work was reshaped by imperial order supervised by the physician Lin Yi based on Wang Bin's work. Later, editions mostly used the revised Song version. So the work had been rewritten many times. It's a collection rather than one person's work. Although the author had been known as the Yellow Emperor, the real authors were ancient Chinese scholars by anonymous way. You may wonder what kind of book it is. So let's go on. The Huang Di Nei Jin has two sections, Su Wen and Lin Shu. Each section is nine juans, that means nine volumes, and nine chapters are included in each volume. The first section, named Su Wen, deals with the theoretical foundation of traditional Chinese medicine and extinguished methods. So the first section of Huang Di Nei Jin discuss the basic questions regarding traditional Chinese medicine, mainly how to live healthily. While the second section, named Lin Shu, discuss acupuncture therapy in great detail. The title Huang Di Nei Jin often refers only to more influential Su Wen. The work is structured as a dialogue, cheerfully between the Yellow Emperor and Qi Bo, one of the imperial physician. The Huang Di Nei Jin introduced basic therapies of traditional Chinese medicine, response on internal organs, and discusses main and collateral channels in the human body. Causes of disease, pathology, diagnosis, maintenance of good health, et cetera. It's profound, the theory that the universe is composed of qi and contain simultaneously dual, opposite yin and yang, depend on each other. And everything, or phenomena, could be categorized into the five classes based on wuxin, usually called five elements, or you can find five phases. Then, all the scenes or phenomena could be synced into the network, which connect human being with natural factors, even social circumstances, to form wuxin system. These principles can be rationally understood, and man can stay in balance, or return to balance and health by understanding the laws of this natural force and social intervention. Here, I talk a little more about the yin-yang and wuxin theories, so as everybody can understand the following thinking. Yin-yang is a distinguished thinking way of Chinese, which caught great influence to Chinese neighbors, such as Korean, Japanese, and Southeast Asians, et cetera, in the history. A lot of topics in Huangdi Neijing contain the yin-yang in tide. For example, Su Wen's overview of relations between yin-yang and natural phenomena. Su Wen, on division, reunion of yin-yang, Lin Shu, yin-yang, and the sun and the moon. Lin Shu, yin-yang, and the 25th person. According to Su Wen, overview of relations between the yin-yang and the natural phenomena. Yang accumulates to generate the heaven, and the yin accumulates generates the earth. Yin is steady, while yang is dynamic. Yang and yin promote growth of each other. Yang promotes qi, while yin promotes the body. Extreme coldness produce heat. Extreme heat produce coldness. Coldness produce turbulence, and heat produce lucidness. Lucidness sink, leading to the severe diarrhea. Turbulence rise, leading to flatulence. According to Su Wen's valuable theory in Golden Cabinet, yin and yang are embedded in each other. The period during the dawn to noon is yang of a day. That means from the 6 a.m. to 12 a.m. is yang aspect of yang. The period during the noon to dusk is yang of a day. That means from 12 to 18 is the yin aspect of yang. The period during the dark night to cuckoo is yin of a day. That means 18 to 1 a.m. next day. So it's the yin aspect of yin. The period during the cuckoo to dawn is yin of a day. That means from 1 a.m. to 6 a.m. is yang aspect of yin. This is also true of people. As for yin and yang in people, yang is the external body parts, and yin is the internal body parts. As for yin and yang in the human body, the back is yang and the abdomen is yin. As for yin and yang in zong and fu organs, that means internal organs, zong organs are yin and fu organs are yang. Zong organs include liver, heart, pea, lung, and kidney are yin. Fu organs including gallbladder, stoma, large intestine, small intestine, bladder, and san jiao are yang. In all, ancient Chinese not only feel the yin yang of natural world, but also recognize themselves in yin yang. Hence, know how to keep the balance for hairs as well. So next, I briefly talk about wuxin concepts and the theory. The concept of wuxin is originally from the wu fang, that means five orientation concepts in Shang dynasties. The oracle bone script recorded yin people called Shang dynasty a central Shang, which was parallel with east soil, south soil, west soil, and north soil. They summed up the entire spatial orientation by wu fang, that means five orientations. After theory of wu fang, the wu cai, that means five substance theory appear. Zhi Han in spring and autumn period said, there are five substance wu cai in the world which are all used by the people and none of them is dispensable. What does the wu cai here refers to? Wucai refers to the five substance named mu. You can translate in English, wood. And huo, that mean fire. And tu, can mean soil. And jin, can mean metal. And shui, that mean water. Let me take the five of them. There is a Chinese legend said, Cui Ren Shi discovered the method of making the fire by drilling woods, which completely changed the dietary mode of the hume. Since then, hume have lived in the lifestyle entirely different from the wildlife. The utilization of food and nutrition become more rational and the hume could keep warm by fire. Then live and multiply healthily and continuously. The theory of wuxin including both mutual generation and mutual restriction among the five categories. The generation sequence is from wood to fire and to soil and to metal and to water and then back to the wood in a circle going on forever. And according to the table above, in every part of hume body, each emotion and natural factors, even the notes into the system, we could get mutual generation for everything or mutual generation. Similarly, the mutual restriction could be set up as well. Considering the double system together, there is a simple diagram of wuxin system, which could be applied to recognize interaction among the five systems of hume body and nature, implying hairs living ideals. In summary, the important portion for us is Su Wen, which tell us how to keep hairs in daily life, such as conforming to the way of nature, proper diet, appropriate exercise, et cetera. So I'd like to move to the second part of this talk, the major contents of the lecture, the ideas of preventive medicine in Huangdi Neijing. Disease preventive ideas in Huangdi Neijing are generally summarized as the following three points. The first point is preventive treatment of disease. The second point is early prevention of deterioration of disease. The second point is prevention of relapse. Let me introduce them one by one. Firstly, preventive treatment of disease. According to the chapter two, The Great Theory of Spiritual Cultivation during Four Seasons of Su Wen, it was summarized as the saint prefers preventive treatment to disease treatment. He likes defensive strategies rather than suppression of unrest. It is too late that man will be treated with medicine only after he's ill or contingency plan are drawing up why disturbance is going worse. So he says, is it the same as digging a hole only after one feels thirsty? Making weapons after the war happens. The key idea of prevention is the best choice for man's health. In TCM's view, people should prevent themselves from attacks by varieties of pathogenic factors which we categorize roughly as the four kinds, exopathy, endopathy, second, and other pathogens. Exopathy and endopathy pathogens are the major pathogen factors which will be discussed in detail. Others are less common. So less common include two. The second pathogens may include phlegm, blastasis, lysiasis. So other pathogens may contain traumatic injuries, cuts, insect or animal bites, overtreatment, et cetera. So let's discuss the exopathic pathogen first. The exopathic pathogens, known as external natural force as well, called six climate pathogen factors as wind, cold, summer heat, dampness, dry, and fire, which are named the six devils in Huangdi Neijing. These six external pathogenic factors may bring us common ailments with a variety of symptoms such as headache, fever, cough, asthma, cold, and dryness, et cetera. However, it was said in Huangdi Neijing that all lives originated from the interaction between yin and yang. Harmonious interchange between yin and yang is the foundation of every life. You will be protected from the disease if you adjust to yin and yang change seasonally. Converse, health problems will follow you closely. So the six devils are just over there every year. What people need to do is keeping themselves away from the six devils if they like to be healthy. For example, people should eat clothing in cold weather, reduce clothing in hotter climates. They change their clothes with the fluctuation of the temperature, which was described as yin-yang's fluctuation in Huangdi Neijing. Similarly, people living in dampness circumstance like pungent food. While people in dry area don't like that. Besides six devils, there are a numerous external pathogenic factors called morbid airs, which cause pathogenes occasionally. Ancient Chinese knew that these factors brought epidemic disease with great influence. However, they have no idea what pathogenic factors look like. The name morbid air possibly describe the characters of these pathogenic factors, such as appearing and disappearing like a shadow, pandemic, high mortality rate. Today, we know these factors probably are deadly virus, bacterial, et cetera, which only be visible with microscope or bioassay. There have been more than 500 infection disease records in Chinese history, including H1N1 and SARS, et cetera, in the past few decades, as well as COVID-19 today. However, Chinese defeated them time after time again because people had the experience to deal with these pathogenic factors. In summary, exoplasmic pathogens are those pathogenic factors exist in nature, which attack the man from outside, through the nose, the mouth, or skin, bitten by the insects. As the endorphins pathogens, they could be classified into three source, improper diet, excessive fatigue or idleness, and seven emotions. Improper diet refers to eating too much, as well as eating too less or not on time. Excessive fatigue or idleness may refer to losing the balance between the work and relax, and seven emotions include joy, anger, melancholy, anxiety, grief, fear, and fright. They normally do no harm to man if there are just short expression of somebody's mood, but when someone experience great emotion changes in any of them, especially last long, they become pathogenic factors, which bring harm to the body, even cause serious disease. So the best way is to keeping the balance among this emotion in Huangdian's view, then hairs will follow you forever. The core idea in Huangdian Neijing for preventive medicine is to keep yourself far away from pathogenic factors. Secondly, I will talk about the early prevention of deterioration of disease. Huangdian Neijing described human being as a whole composed of five systems, Mu, Bo, Tu, Jin, Shui, what we have discussed in Wuxian theory. So it's formed a network by the meridian system. Each system interacts with other four to keep balance normally. However, each system could be influenced by any of the other four, when if it's attacked by pathogenic factors, when disease attacks an organ, it may transfer to another organ according to the law of the mutual generation and restriction between the five elements. Protective measures should be taken in advance in the treatment to protect the possibly implicated organs of the patients. For example, we know the liver disease may transport to the spleen. So we should strengthen the spleen first when we make sure the illness in the liver. Doctors need to take measures according to the actual state of disease to make decision. Most patients cannot make correct decision by themselves. For example, the Qunfei Paitu Caution for COVID-19 Treatment in Wuhan is a compound received, including 21 herbs responsible for the function adjustment to different system. For example, adjustment to gene system to relieve coldness, adjustment to two system to get rid of dampness, et cetera. So it helps lots of patients. Thirdly, I would like to talk about prevention of relapse of illness. For example, some disease such as chronic cough and frostbite often come on in autumn or winter. So we can take preventive treatment in summer before it occurs. But patients should listen to the guidance of the doctor. Similarly, HBV often relapse if patients overstrain or stay up all night frequently after recovery. So these people should avoid fatigue and relax in time to prevent relapse. With the knowledge of these opinions of preventive treatment of disease, we know how to prevent the occurrence of illness. In this case, peers' preservation and preventive treatment of disease are not totally the same. At last, I'd like to move to the third part. What could we learn from the inner canon of Yellow Emperor? To maintain our health, the most important thing for us is prevention. Prevention idea of Huangdi Neijin covers a wide range of health situation, including sub-health, disease, and relapse. So it's important for us to learn from Huangdi Neijin how to prevent ourselves from the attack of different pathogenic factors. Today, we have more methods for prevention after we realize that virus, bacteria, could be morbid airs. We can take a mask and bypass place with clothes when plague prevails, such as H1N1, SARS, COVID-19, et cetera. We could develop the vaccines or special drug to prevent from or treat this disease infected with virus or bacteria. In short, to keep us away from the participating factors should be the best choice to prevent disease. The second trick is how to enhance our health qi so as to improve the ability of resisting disease. The laws of the wise in Huangdi Neijin, according to the Huangdi Neijin's idea, the region where pathogenic factors invades must be deficient in qi. Sufficient health qi inside the body will prevent invasion of pathogenic factors. In other words, pathogenic factors never do harm to those people with inner health qi. It seems hard to translate this sentence, so I just give some example to explain them in detail. According to the above introduction, pathogenic factors, including mainly exopathic and endopathic pathogens, qi is a bit complicated concept in TCM. Bad qi refers to above pathogenic factors, while the good qi refers particularly to those materials in human body with ability to defeat pathogenic factors, called health qi as well. In modern medicine, these materials might be interpreted as humor and cellular immune, such as white blood cells, lymphocytes, et cetera. Some barriers of the nose-gastrointestinal tract might be included as well, so true connotation of this sentence could be that good physique and mental state could help people overcome the attack of pathogenic factors, both exopathic or endopathic pathogens. It probably be explained that why A got flu, why B didn't, although they live together. Other fact is that some people infected virus, like COVID-19, could get recovered or even don't have any symptoms, although lots of people died with the virus globally. To enhance our defense ability is a good option as well, so we need to do these things all by ourselves. Huang Di and Lei Jin tell us how to enhance our health qi in daily life. I'd like to discuss them in labor class in detail. Hope to see you then.