| ObjectiveTreatise on Febrile Diseases, written by Zhang-Zhongjing in the Western Han Dynasty, is often considered a necessary read for all Chinese medicine practitioners. It laid the basis for the Chinese medicine syndrome differentiation and covered a wide range of topics including medical theories, methods, formulas and prescriptions. In this classic, the six-channel theory was introduced to analyse pathogenesis and treatment. The theory has profound influence on Chinese medicine and has been under ongoing study and interpretation by physicians since its introduction. In recent years, the theory of circular motion has been steadily gaining attention for offering unique perspectives on the understanding and application of classic prescriptions. It is in particular recognised for applying the less studied theory of internal organs pivot angle in prescription analysis and discussion. This paper aimed to employ circular motion theory to explore the correlation and law between the six-channel pattern identification in Treatise on Febrile Diseases and circular motion.MethodsThis paper first gave a literature review on circular motion theory. The review included relevant literature and research materials about circular motion theory, in various forms such as academic papers, journals, parliamentary information and books. Following the literature review, the circular motion theory was analysed. It attempted to (a) give an overview on the history of the theory that comprehends its germination, development, improvement and mature stage;(b) explore relevant concepts in the theory, specifically the yin and yang, the five elements, six qi, twelve meridians, fire and water, and the opening and closing movement of the pivot circle. These concepts were used in correlating the circular motion theory with the six-channel theory in Treatise on Febrile Diseases. The circular motion theory was further applied in studying the principles of six-channel pattern identification. Finally, reinforced by a compilation of theoretical insights and medical records of circular motion by Vulcan practitioners, the report presented how circular motion theory could be applied in the six-channel theory and the significance of such application.ResultsThis thesis composes of the following sections:1. Literature Review on Circular Motion TheoryThe relationship between Chinese Medicine and the history of circular motion theory was investigated. Circular motion theory can be considered to have originated from Hetu and Bagua. Its principles could be observed in The Yellow Emperor’s Inner Canon, an ancient medicine book on human physiology and pathology. Later, in the six-channel pattern identification by Zhang Zhongjing, the San-ying and San-yang theory also included traces of circular motion theory. The theory was finally fully formed by Huang Yuenyu and Pang Ziyi, who combined the previous grounds to write the book Circular Motion of Ancient Chinese Medicine, officially coining the term "circular motion".Circular motion when being conceived was intertwined with "Book of Changes"(a Hetu classic) and Bagua. Combining various ideas in Hetu (the number of ten, wu xing, also known as the five phrases, yin yang, etc), Huang Yuenyu was able to develop the ideas of circular motion, and established wu xing as the core foundation of the circular motion theory. Based on natural bagua, the nurtured bagua reflects that the four development stages (birth in spring, growth in summer, harvest in fall and preservation in winter), as well as the changes in solar terms, follow rules in circular motion. These formed the basis for circular motion theory.The theory’s application in physiological and pathological fields started with The Yellow Emperor’s Inner Canon. The Canon states that the upward and downward motions of the qi in wu xing inside human bodies are the origins of human well beings. Abnormal behavior of qi causes sickness. Although the word "circular motion" was not heard of at the time The Canon was published, but traces of circular motion are observable in the book. In the Han Dynasty, when Zhang Zhongjing founded the six channel identification approach to perfect a syndrome differentiation system, the identification method clearly contained principles in circular motion. The core of the six channel included the organs and meridians, as well as the opening and closing of its gasification and pivot; all these demonstrates the laws of circular motion, especially the opening and closing movement of the pivot:TaiYang as on, YangMing as close, Shaoyang as pivot; TaiYing as open, Jueyin as close, ShaoYin as pivot. The movements form the circular motion of six channels and organs.In the Qing Dynasty, Huang-YuanYu in his work Four Sacred Heart Sources recorded detail discussions on the theory of circular motion, and the circular motion theory with the spleen as the center was formed. Wood, fire, gold and water were the four images that embody the ups and downs of yin and yang with the spleen being the central qi that determines any changes in the circular movement of internal organs.When it came to the late Qing Dynasty, Zheng Yingan in his book A True Transmission of Chinese Medicine’s Principles repeatedly stressed the importance of water and fire interaction in the kidney and heart, with true Yang rising and true yin dropping, in order to maintain the body’s balance of yin and yang, as well as fire and water. This reflected ideas in the yang qi’s moving up and down in the body.Finally, at the end of the Qing dynasty, Pang ZhiYi summed up the experience of physicians and views in different books. He formally proposed the term "circular motion" as a mean to explain the natural order as well as the patterns observed in human physiology and pathology like the twenty four solar terms, yin and yang, six qi, and twelve meridians. He also established the motion theory with five organs as the center of the circle, and had a theoretical analysis of medication in six channels theory from a standpoint in the circular motion theory.2. Different Movements in Circular MotionPrinciples of circular motion theory in TCM theory were worth attention in several lights: i. Yin-yang circular motionThe yin and yang originated from a single qi, and the changes of the qi with lifting movement is yin and yang. Other the concept of yin and yang being opposing ideas, there are also the concepts of "middle" and "pivot ". This is the most basic law in the theory of circular motion,ii. Wu xing circular motionWu xing, the five phrases, also originated from a single qi. Different phrases are the manifestations of different states of yin and yang in circular motion. The liver, heart, lung, kidney and spleen represent the lifting, floating, dropping, storing and transporting motion respectively. The functionality of internal organs correspond stages of yang movement,iii. Six qi circular motionIt is considered that the sky, or the heaven in some context, and the ground constitute the world. In The six qi represent the sky while wu xing represent the ground. Diseases occur due to an excess of any particular qi, and there can be no disease if all qi are balance. Six channels diseases in Treatise on Febrile Diseases were related to six qi. TaiYang was sick due to fire, Yangming was sick due to dry, Shaoyang was sick due to heat, TaiYin was sick due to wet, ShaoYin was sick due to cold, JueYin was sick due to wind. These were helpful in understanding the pathogenesis in Treatise on Febrile Diseases.iv. Twelve meridians circular motionThe downward movement of three Yin meridians of hand are coordinated with the upward movement of three Yan meridians of hand. Similarly, the downward movement of three Yan meridians of foot are coordinated with the upward movement of three Yin meridians of foot. Thus, twelve meridians of hand and foot are moving upward and downward under co-ordination with each another, and form the circular motion of twelve meridians.v. The circular motion of opening and closing movement of the pivotTaiYang releases yang qi in Sun Yang, Yangming causes yang qi to drop, and Shaoyang transports yang qi. TaiYing governs the opening of the yin qi for the admission of yang qi into Sanyin, Shaoyin is the pivot to bring the yang qi to Jueyin and bring it up again when it is ready to be issued to Sanyang. The opening and closing movements of pivot in yang qi clearly follows the same law of motion with wu xing, therefore the circular motion of opening and closing pivot reflects the law of circular motion, vi. Fire and water circular motion The human body should have two roots, or bases:water and fire. In the body, fire and water move up and down through the internal organs, generating fire and water circular motion in the body."Gas is not separated from the water, the water is not separated from the gas"; the circular movement of liquid water running in the five organs of action rely on yang qi, rule of law of gasification and its internal organs’circular movements have coincidentally similar motion rules, vii. Twenty four solar qi circular motionTwenty-four solar qi is the description of the seasons in Chinese calendar, and it is an archetype of changes in Yin and Yang. Twenty-four solar law is basically a match with the law of six elements and six qi circular motion. Yang qi still rises in spring (representing wood), floats in spring (representing fire), drops in fall (representing gold), and is stored in winter (representing water). Earth is centered at four seasons with Sang-f ire and autumn gold both dropping in the water.3. Correlation study of six-channel pattern identification and circular motionSix-channel pattern identification in Treatise on Febrile Diseases determines the diagnosis and treatment from the angle of SanYin and SanYang. The identification process is actually an integrated system that includes the opening and closing pivot, organs and meridians, all of which can be correlated with circular motions in certain ways.All things in the world follow laws in circular motions because circular motions are the manifestation of movements of yin and yang. Hence, everything, from the opening and closing pivot, organs, twelve meridians, six qi to the six-channel itself, follows circular motion. This of course covers the content in the Treatise on Febrile Diseases. Therefore, the circular motion theory can be a way to research and explain the Treatise.The opening and closing of pivots is a unique feature of the six-channel pattern identification, distinguishing it from an array of other syndrome differentiation methods. Also, the six channels see major implementation in organ study. As such, these two characteristics would be the starting point from which the research on Treatise on Febrile Diseases using circular motion theory begins. The movement characteristics of yang qi during the opening and closing of the pivots are in line with the theory of circular motion. They also concur with the circular movement characteristics of internal organs. These two comparable movement (pivotal qi movement and organ circular movement) can both be used to study Treatise on Febrile Diseases.However, the six-channel pattern identification and the five organ circular motion are not an identical match. This is because the six-channel theory originated from yin and yang and also fire and water, and its middle is occupied by the pivot in Sanyin and Sanyang, namely Shaoyin and Shaoyang. The organs circular motion has its middle occupied by the stomach.In the research, the opening and closing of the pivot (six channel approach) can be integrated with the organ circular approach so that a more in-depth and comprehensive study on Treatise on Febrile Diseases can be done.4. Rules in six-channel pattern identification by "circular motion"In this paper, rules in six-channel pattern identification will be discussed using the ideas of opening and closing movement of the pivot and organs circular motion. In other words, six-channel pattern identification is analyzed through the yang qi movement and the physiological and pathological of organs.Taiyang controls the opening of the yang. It controls San-yang to release yang qi from the inside out, distributing the qi over the muscle and skin. When Taiyang commands the release of yang qi, the yang qi is at its strongest, and its release represents the apex of the circular movement.From the view of the opening and closing of the pivot, the disease of Taiyang occurs when the external illness or evil hinders the opening of Taiyang. The external illness can be dispersed by applying warm herbal such as mahuang and Guizhi to stimulate the release of yang, restoring the opening of Taiyang.From the view of circular motion of organs, the evils invades the lung which guards the body from outside harms. Also, when the opening of Taiyang is suppressed, the water of Taiyang becomes stagnant and unable to flow through the body. This imbalance can be cured by using Guizhi to warm Taiyang and gasify the liquid water, followed by fuling, zexie, zhuling, baizhu to remove the stagnant water. Therefore, the pathogenesis of the disease in Taiyang in the sense of circular motion is the combined effect of the suppression of opening of Taiyang, invasion of bladder and superficial meridian by the evil, and the failure of the guarding function of the lung; this effect hinders gasification of cold water of Taiyang. Because of this, the most commonly used drug is Guizhi, followed by mahuang, and the Taiyang bad disease is most commonly cured by also Guizhi followed by FulingShaoyang governs the transport of Sanyang and is related to both the opening and closing of Taiyang while Yangming are related to the transport of Shaoyang. No matter of the flow direction (Sanyang into Sanyin or Sanyin into Sanyang), the transportation process is always associated with the Shaoyang.In the circular motion of organs and yang qi, the Shaoyang is represented by the wood and it provides the driving force for the upward and left-turning circular motion. This occurs at the time of the release of yang qi in the yin-to-yang process. Shaoyang disease is half-superficial and half-interior level. Yang qi is relatively weak, and is under circular motions that cause the qi to ascend and be released. External evil interferes with this process, leaving yang stagnant, and the body is under alternate attacks of chill and fever.The fire evil dries up bodily fluids, causing syndromes of dry mouth and throat. It also causes dull pain in the liver and gallbladder. The upward movement of circular motion of wood needs stomach cooperation. When the wood qi is stagnated, fire move upward, which in turn affects the upward movement of spleen and downward movement of stomach. This leads to vomit and anorexia. Using this view, Shaoyang disease is the most commonly treated by applying chaihu followed by Huangqin. Chaihu can enhance metabolism, removing the old including everything that causes liver and stomach disorders.Yangming dominate close, receiving yang qi from Shaoyang and Taiyang, and press yang qi into yin. Yangming is related to gold, lung and gastrointestinal organ, hand down the driving force for the circular motion, so the fall of yang qi, gastrointestinal bowel gas movement, as well as downward movement of lung gas, are all related to the closing function of Yangming. Yangming disease is associated with organs and meridians, its pathogenesis is stomach excess, including Yangming heat evil and stool in intestines so that causing Yangming closing disorders. From the pathological point of view in circular motion, for the reason of function lost in Yangming closing, one is a tangible obstacle in the road of downward movement, the other is the invisible evil impede closing operation. In the treatment of Yangming disease, the most commonly used medicine is Rhubarb, followed by Magnolia officinalis and citrus aurantium, these are the medicine that capture and pass down Yangming gastrointestinal organ, aims to clear heat evil, closing down the yang qi, and prescription is primarily White Tiger Decoction and Chengqi Decoction.Taiyin primary open to receive yang qi to come inside, played collection of all things, and the transportation of Water Valley and the role of the central axis of the movement. Taiyin pivoting movement in a circle is stomach, and it is the initial stages of yang qi come into Sanyin, just as the sun goes down in the evening to become darkness. In the world of all things Taiyin is wet soil, the soil is the element to seal liquid water so that water and soil Hede, everything was able to germinate and grow. Yang go inside when Taiyin open, and it is the external portals of Sanyin, the inevitable channels for the fall of yang qi, and it is the theoretical foundation for future generations of Wenqian method in Vulcan though. The Taiyin disease is due to spleen weakness, illness has entered Sanyin, yang is insufficient in this disease. From the point of view of opening and closing circular motion, Taiyin mainly store yang qi, in the other view of organ circular motion, spleen transport nutrients upwards, so Taiyin spleen has the receiving and transporting function. If Taiyin spleen can not receive yang qi, spleen will lose momentum and not move upward, at the same time it cannot digest food and transport nutrients. In the five elements fire generate soil, this soil can be considered as kidney fire generate earth. If kidney fire is enough, Spleen yang is sufficient, so spleen can transport and disperse nutrients. Thus, Taiyin spleen and Shaoyin kidney have close relationship in sanyin disease, open of spleen cause storage in the kidney, sufficient of kidney fire generate spleen and earth, so the treatment of taiyin spleen with the decoction of Siyi classShaoyin govern kidney, which is the origin of storage, the pivot of sanyin, as well as pivot of fire and water. Shaoyin is the place for the storage of yang qi, and also the place for the storage of water in the kidney, so it govern the storage of both fire and water. From the view of circular motion for analysis, yang qi start to be received at taiyin, store and transport at shanyin kidney, and then to the closing pivot of jueyin. Shaoyin disease can be divided into cold syndrome and heat syndrome, which shaoyin cold syndrome is due to lack of fire, and lack of upward circular motion; Shaoyin heat syndrome is due to insufficient kidney water, excess of fire evil at heart, the rise of liquid water is sufficient in circular motion, leading to drowsy state. From the view of circular motion for analysis, shaoyin cold syndrome is the insufficient of yang qi motion in circular motion,, Shaoyin kidney yang unable to evaporate water to rise upward, while not warming the spleen that cause pivoting disorders, and thus weak pulse and diarrhea appeared, so to warm yang by aconite, and ginger warm Spleen, licorice keep the heat in spleen. For the shaoyin heat syndrome, shaoyin govern heart fire and kidney water, so insufficient of kidney water cause excess of heart fire evil. At the time of treatment, on the one hand eliminate heart fire evil by Scutellaria baicalensis and Coptis chinensis, on the other hand soften and five nutrition to the liver by Donkey hide gelatin and peony, because wood is wilt by lack of water, at the same time preventing aggravation fire evil on heart.Jueyin govern the closing pivot of sanyin, and it is the transformation point of yin qi of sanyin, as well as the time of end of yin qi and born of yang qi, from the view of circular motion for analysis, Jueyin undertake yang qi of taiyin and shaoyin, prepare for yang qi go out from sanyin to Sanyang. Jueyin disease can be broadly divided into two categories,"heat syncope "and" cold syncope". From the perspective of circular motion analysis, jueyin is related to liver, Jueyin liver has the driving force for the upward circular motion, and the body of liver is yin and application of liver is yang, it need to have adequate hepatic blood and temperature for nourishing the liver, so that liver can maintain its normal function." Cold syncope is the lack of blood and the body temperature of the liver, also called deficiency of blood with cold evil, so Zhongjing use Dangguisini decoction as the main prescription for cold syncope, using angelica to warm liver blood, main square Hanjue of soup to warm Angelica nourishing blood, cassia twig to warm liver yang, peony to grab liver blood, asarum to eliminate cold evil. When ascending too much, on one hand it is prone to have heat syndrome, on the other hand right descending motion and closing pivot of Yangming is affected that appears "cold syncope", and thus cold and heat treament can be considered to be used together and use wumeiwan for the treatment.Thus, laws of circular motion are presented in six-channels, which focus on the open and close pivot circular motion and organs circular motion for analysis. Order of six channels in circular motion can be considered in the order of opening and closing movement of the pivot with the corresponding organs and orientation, with taiyan belongs to southern fire and heart, lungs can have same consideration, yangming belongs to the western gold and lung, while considering the case of the stomach and intestine belongs to yangming, shaoyang belongs to eastern liver and gallbladder, taiyin is centered with spleen, shaoyin living north with kidney, jueyin living east with liver. This order make the six channels theory "Treatise on Febrile Diseases" in a more modeling theory and it is beneficial from the point of view of yang and organs in clinical use.5. Applications of circular motion theory on "Treatise on Febrile Diseases "Circular motion theory helps in understanding the human body yang and organs in the qi lifting activities, and Vulcan is a school which pay attention to body yang qi, from yang qi perspective to use classical prescription, in which the idea of dialectical and medication can be explained by circular motion theory. In particular the application of wenqianfa in shaoyin disease,, emphasizing the intersection of congenital heart fire and kidney water, and the importance of the central axis of the stomach, and qianyangdan and fengsuidan is the specific application of circular motion in Fu Yang. On the other hand, in the clinical condition of patients which have both cold and hot syndrome often require combined prescriptions, from the perspective of circular motion analysis, their condition is a matter lesions in organs in different directions, the use of cold and heat treatment will not cancel each other in the same straight line, and is based on a circular motion in the body functioning, which would reflect the view of traditional Chinese medicine one qi circular motion, providing ideas and explanations for clinical diagnosis and treatment.Conclusion Six-channels theory of "Treatise on Febrile Diseases" and "circular motion" are closely correlated, circular motion can be positioned as a method and theory for the theoretical analysis and study of the "Treatise on Febrile Diseases", in order to explore the laws of six-channels theory. Circular motion theory focuses on the lifting of yin and yang in five elements and five organs, and six channels focus on yinyang changes in pivot of sanyin and sanyang and also the organs, the arguments are from different angles to each other, the former emphasis on the internal organs, the latter emphasis on sanyin and sanyang, but both are in line with law of yin and yang circular motion. Analysis and research on six-channel pattern identification can therefore from the perspective of the circular motion, especially the organs circular motion and the opening and closing movement of the pivot, in which the implementation of the organs the opening and closing pivot on six channels can be observed. Later doctors develop the classical prescription from the theory of circular motion, in which the application of wenqianfa in Vulcan school is the best example, while idea of diagnosis and treatment is opened up with the combined use of classical prescription in difficult disease. |
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