Transcript MSBH6002 Culture, Medicine and Behavioral Health

MSBH6002
Culture, Medicine and
Behavioral Health
SESSION TWO
Chinese medicine and
health concept & behavior of
Chinese
Session preview
1.
2.
3.
4.
Traditional Chinese philosophies and
Inner Canon of Medicine
Chinese medicine core theories
Chinese medicine yangsheng
Health behaviour of Chinese people and
Chinese medicine
1.
Traditional Chinese philosophies
and Inner Canon of Medicine
Inner Canon of Chinese Medicine
Written ~BC 1st Century, Western Han
Dynasty
 Symbolized the birth of Chinese medicine
as a coherent medical model
 Before that, no theorized medical model,
just:
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Medicine by experience
Religious/philosophical resolution
Superstitious healing
Basis for theory building
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Clinical experience accumulated
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Knowledge in anatomy and physiology
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Usages of herbs, acupuncture & physical
manipulation
Already surprisingly sophisticated
Prevailing philosophies, especially:
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Yin-yang and Five-element Theory
Daoism (Taoism)
Yin-yang Theory
Main reference: I-ching (Book of Change)
 Systems theory in ancient language
 Basic assumption:
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All things in the world can be categorized into
yin-yang pairs
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e.g. moon-sun, night-day, female-male, soft-hard…
There is a universal pattern of changes
between a yin-yang pair
Referring to such pattern, one can understand
and predict all phenomena in the world, from
microscopic to celestial matters
Normal patterns
Mutually
 Mutually
 Mutually
 Mutually
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facilitative
repressive
dependent
embracing
Yin contains Yang
Yang contains Yin
Relativity & infinitely dividable

e.g. A Yin may subdivided into infinite number
of relative Yin’s & Yang’s
The Daoism logo
Abnormal pattern (1)
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When one is “hyper”, the other may
become:
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“Hypo” (more common), or
“Hyper” too
When one is “hypo”, the other may
become:
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“Hyper” (more common), or
“Hypo too”
陰陽失衡四組合
陽盛
實熱
清熱
“飲涼茶”…
陰 陽
陰盛
實寒
散陰
荊芥、防風、蘇葉、生薑水….
陰 陽
陰虛
虛熱
補陰
六味地黃丸、百合固金湯…
（肝腎陰虛、肺陰虛）
陰 陽
陽虛
虛寒
補陽
乾薑、杜仲、羊肉……
陰 陽
Abnormal patter (2)
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At the extreme: transformation
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Yang
Yin


Yin
Yang
Five-element Theory
Concept: similar to Yin-yang Theory
 Main difference:
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5-category system, instead of 2
Wood
Water
Metal
Five Elements
Fire
Earth
Facilitating Force
Repressing Force
Wood
Liver
Water
Fire
Kidney
Lung
Metal
Five Zhangs
Heart
Spleen
Earth
Facilitating Force
Repressing Force
Wood
Liver
Anger
Water
Kidney
Fire
Heart
Fear
Joy
Sorrow
Lung
Worry
Spleen
Metal
Earth
Five Emotions
Facilitating Force
Repressing Force
Wood
Liver Anger
Benevolence
Water
Kidney Fear
Fire
Heart Joy
Wisdom
Faith
Justice
Lung Sorrow
Metal
Modesty
Spleen Worry
Earth
Facilitating Force
Repressing Force
Symbolic Interaction of
Systems of the Five Elements
Wood
Fire
Earth
Metal
Water
Anger
Joy
Worry
Sorrow
Fear
Liver, Gall Heart,
Spleen,
Bladder Small
Stomach
Intestine
Lung,
Large
Intestine
Kidney,
Urinary
Bladder
Eye
Tongue
Mouth
Nose
Ear
Benevolence
Faith
Reason
Wisdom
Will
Daoism
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Advocates:
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Harmony with the Nature
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True freedom from:
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Respect nature, including its rules, e.g. life is limited
Follow rhythm of nature, e.g. day-night, 4 seasons
Fusion
&
Reduced desires
Simple life
Differentiation 
True knowledge  Frustration 
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“Know knowing is knowing
Know not-knowing is not-knowing”
Inner Canon of Medicine
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Some selected readings
2.
Chinese medicine core theories
2 core characterizing theories
1.
2.
Holistic perspective (整體觀念)
Syndromatic diagnosis as the basis for
treatment formulation (辨證論治)
Cai, J. (1995). Advanced Textbook on Traditional Chinese Medicine and
Pharmacology Vol. 1. Beijing: New World Press
1. Holistic perspective (整體觀念)
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Systems
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Inside a person
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Body – bodily systems
Mind
Person and environment
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Social environment
Natural environment
Meridians  an integrated whole
 In dynamic equilibrium
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Ying-yang Theory
Five-element Theory
2. Syndromatic diagnosis as the basis for
treatment formulation (辨證論治)
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2 levels of diagnosis:
1.
2.
Disease diagnosis
Syndromatic diagnosis
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Diagnosis on the status of equilibrium
Treatment focus
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Not on:
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Disease agents
Symptoms
But on:
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Restoring system balance
 facilitate self-healing
Dual factors etiology theory
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Disease agent
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Necessary but insufficient for onset of disease
Internal factor
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Considered as more crucial
 In prevention, treatment & rehabilitation:
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Restoring health status >
 More important than fighting against
disease agent
Answer
It is the unique Chinese medicine theory
that matters
 Risk:
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Modernization of Chinese medicine 
Abandoning the 2 core theories?
3.
Chinese medicine yangsheng
Definition
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In Chinese:養生
Literal meaning: “nurturing life”
 “A branch of health science within Chinese
medicine that, basing on Chinese medicine
theories, studies the etiology and course
of aging, prevention of illnesses, and
enhancement of wellness in midlife and
old age” (Ng, 2003)

Ng, S. M. (2003). Chinese Medicine Yangsheng and Body/Mind/Spirit
Wellness. Hong Kong: Veritas Book House (in Chinese).
History
Over 2,000 years history
 Inner Canon of Medicine
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Written BC 1 century
Defined core theories of Chinese medicine
Strongly influenced by Daoism
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Simple living
Reduced desire
Harmony with nature, etc.
Great emphasis on yangsheng
Wang, H. T., Chiu, M. S., & Hong, P. (2000). Selected Readings from the
Inner Canon of Chinese Medicine. Shanghai: Shanghai Science &
Technology Publishing House (in Chinese)
The 2 basic principles of Yangsheng
1.
2.
Respect the way of nature
Nurturing both body and mind
Ng, S. M. (2003). Chinese Medicine Yangsheng and Body/Mind/Spirit
Wellness. Hong Kong: Veritas Book House (in Chinese).
1. Respect the way of nature
NOT about pursue for forever youthfulness
or endless life
 Admit & accept there is a natural limit of
life
 Make the best use of precious life
 Harmonious relationship with nature
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2. Nurturing both body and mind
Holistic perspective:
Body  Mind
 Pay attention to bodily health alone is
insufficient
 Mind/spirit health is relevant & important
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Five yangsheng modalities
1.
2.
3.
4.
Herbal medicine yangsheng
Nutritional yangsheng
Acupuncture and tuina (therapeutic
massage)
Traditional health exercise
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5.
e.g. tai chi, qigong
Traditional counseling and pursue for
spirituality
Ng, S. M. (2003). Chinese Medicine Yangsheng and Body/Mind/Spirit
Wellness. Hong Kong: Veritas Book House (in Chinese).
Preview: more in
4.
Health behaviour of Chinese
people and Chinese medicine
Influences

Both positive & negative!
1988 China
 Poor
 But life expectance already reached middle-
income countries!
Country
GDP/capita
Life expectance
male
female
China
301
68
71
India
333
58
58
Egypt
568
59
62
Brazil
2,451
62
68
Hong
Kong
West
Germany
USA
9,613
73
79
19,743
72
78
19,815
72
79
Why?
Genetics?
 Environmental?
 Health behaviour of Chinese?
 ………..
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Influences on health behaviour
of Chinese
Medicinal herb-food integration
 Diet:
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Cereals as basis
Balanced diet
Living with environment:
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Seasonal changes
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Geographical
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Chinese lunar calendar: 24 nodes a year
e.g. Guangdong: hot & humid
Disciplined life routine
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Emphasis on physical exercises
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Tai chi, qigong, folk dances
Early morning training
Spiritual
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Reduced desire
Threats
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Over-commercialization
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Promote expensive tonifying herbs, nutritious
food
Exaggerating claims of efficacy
Promote “great masters”, e.g. qigong master
claims possessing extraordinary healing power
Giving false hopes
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Delay necessary interventions
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Overly complicated
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Too redundant: e.g. numerous schools of tai
chi & qigong
Herbal & nutritional yangsheng guidelines only
comprehensible to persons at least at “semipro” level
Deceasing influences on younger
generation?
Future research foci
Theory
&
model
building
Protocol
standardization
& efficacy
study
Recommended reading

吳兆文 (2003). 天年共享：中醫養生與身心靈健
康. 香港：匯美書社