General concepts of treatment This chapter deals with the basic principles of making a decision about which treatment

methods and prescriptions to use. This decision is reached by following the guidance of the TCM holistic concepts about differentiation of the syndromes. The principle of treatment differs from the method of the treatment, as the former refers to the rules of the treatment, whereas the latter refers to the steps of the treatment, which are determined by the principle of treatment. For instance, all kinds of pain, as a rule, are caused by conflict between the antipathogenic Qi and pathogenic factors, so the basic principle of treatment is to regulate the anti-pathogenic Qi and eliminate the pathogenic factors. Following the guidance of this principle, the general treatment method would be to nourish the Qi, tonify the Yang, circulate the Qi and Blood, and so on. However, in practice there are various different types of pain with rather complicated pathologies, and differences in severity and intensity, as well as in the seasons, the exact circumstances and the constitution of patients, so it is impossible that just one or a few fixed treatment methods will treat all kinds of pain. The only way to obtain good therapeutic results, therefore, is to master a number of other principles of treatment, which include: searching for the root cause and secondary symptoms supporting the anti-pathogenic Qi and expelling the pathogenic factors regulating Yin and Yang

 determining the treatment in accordance with climate and season, geographical location and individual constitution. Searching for the root cause and secondary symptoms The concepts of the root cause and secondary symptoms can have different meanings, but here they mainly refer to the nature and primary aspect of the pain, and the phenomena associated with the pain. Pain should be assessed clinically to determine the primary and the secondary aspects, the root cause, the symptoms, whether acute or chronic so as to ascertain the main contradictions, and then should be treated accordingly. Generally speaking, the root cause should be treated first, and the secondary symptoms second. For instance, if a headache is caused by invasion of External Cold, the root treatment would be to dispel the External factor and promote the circulation of Qi and Blood in the head, and this would be done first of all. However, if the secondary symptoms are acute and severe, they would be treated first. Again taking headache as an example, if headache is very severe, treatment should first aim to sedate the pain and only afterwards to dispel the Cold. If both the symptoms and the root cause are serious, they should be treated simultaneously. Supporting the anti-pathogenic Qi and expelling pathogenic factors The occurrence of pain, according to TCM theory, is an indication of a process of struggle between the antipathogenic Qi and pathogenic factors, so strengthening the antipathogenic Qi to defeat the pathogenic

factors is the correct method of curing the pain. Strengthening the anti-pathogenic Qi means improving Treatment differentiation treatment differentiation 33 the bodys resistance and building up its energy. Once resistance against pathogenic factors is increased, the pathogenic factors are naturally eliminated. Clinically, the condition both of the anti-pathogenic Qi and of the pathogenic factors should be observed carefully, in order to determine whether to strengthen the body resistance or to eliminate the pathogenic factors first. If a patient has weak resistance and low energy but the pathogenic factors are not yet very strong, the body resistance and energy are strengthened first. If a patient is suffering from Excessive pathogenic factors but the body resistance and energy have not yet been damaged, the primary task is to eliminate the pathogenic factors. But some patients have weak body resistance and low energy and the pathogenic factors are also overwhelming, so in these cases both methods need to be employed simultaneously. Regulating Yin and Yang The occurrence of pain is, fundamentally speaking, caused by an imbalance of Yin and Yang, either an Excess or Deficiency. So it is very clear that treatment also needs to restore the balance between Yin and Yang. Clinically, Excess of Yin makes Yang suffer, and Excess of Yang makes Yin suffer. For such Excess of Yin or Yang, the best treatment is to reduce or remove the Excess. But whilst correcting this Excess, attention should also be paid to whether a corresponding Yin or

Yang Deficiency exists. If one of these is deficient, the treatment given should be either simultaneous Yang reduction and Yin reinforcement, or Yin reduction and Yang reinforcement. Also a Deficiency of Yin or Yang may cause failure of the other to be controlled, leading to a state of Deficient-Heat or Deficient-Cold. Treatment in this case should be given to reinforce either Yin or Yang so as to eliminate Deficient-Heat or Deficient-Cold. If there is a Deficiency of both Yin and Yang then the treatment needs to tonify both Yin and Yang simultaneously.