| Objective: The five body constituents is a collective term of skin,muscle,vessels,tendons and bones,which constitutes the main frame of human body.The five body constituents theory is an important part of the human body structure theory in Huangdi Neijing(hereinafter referred to as Neijing),which mainly discusses five-body structure,physiological function,pathological changes and methods of diagnosis and treatment.The five body constituents are interrelated through the meridians and other specific structures.Each of them internally belongs to certain five-zang organs and externally related to five elements,which is the theoretical basis of TCM in diagnosis and treatment.Besides,Theory of five body constituents is an essential part in the basic theory of modern TCM.A relatively systematic academic view of five body constituents theory has been established since the period of Neijing.However,the five body constituents theory hasn’t been paid as much attention as the Zang-fu organs,meridians,Qi and blood theories,so the research on the five body constituents theory is relatively insufficient,resulting in the fact that the five body constituents theory is often marginalized.Neijing puts forward relevant theories,and uses the five body constituents theory to elaborate the changes of qi and blood in the four seasons,to diagnose location and pathogenesis of diseases,to name diseases,and to explain various processes of acupuncture in treatment of diseases.Which has a profound influence on the development of TCM.Based on the morphological structure and physiological functions of the five body constituents in Neijing,in combination with the annotation of later doctors,this paper further explores the morbid condition of the five body constituents and unique diagnosis and treatment in Neijing so as to standardize and systematize the five constituents theory,lay a literature foundation for the in-depth study of the five constituents theory,and to provide theoretical support for clinical diagnosis and treatment.Research methods and contents:With the help of various humanistic research methods such as philology,hermeneutics,linguistics and so on,this paper sorts out the relevant provisions of the five body constituents theory in Neijing.On the premise of the medical background in the era of Neijing and combined with the comments of later doctors,the paper makes an in-depth analysis and concludes the morphological structure,physiological function,etiology,pathogenesis,diagnosis and treatment of the five body constituents theory.The specific contents are as follows:The first part illustrates the morphological structure of the five body constituents in Huangdi Neijing.The "five body constituents" discussed in this paper refers to the five organizational structures of skin,muscle,vessels,sinew and bone that constitute the human form,which is the basis of the human form structure.It is the division of the external tissues of the human body from the inside to the outside according to the anatomical characteristics.The overall division of skin,muscle,vessels,sinew and bone is basically similar to that of skin,muscle,blood vessel,tendon and bone dissected in Western medicine.Based on the structure of five body constituents,this paper discusses the division of the five body constituents structure from the perspectives of the genesis and exegetics of Neijing.The second part introduces the physiological functions of the five body constituents in Huangdi Neijing.The five-body structure is the basis of human life activity and physiological function,which is prerequisite for normal life activities.The Neijing centered on the five-zang organs and established the five body constituents theory with the five-zang organs as the core.The five body constituents are connected with the five-zang organs through the channels and collaterals,which is the external manifestation of the five viscera,and the functions of the five body constituents are dominated by the five viscera.Based on the five body constituents theory of Neijing,this paper systematically summarizes the physiological functions of the five body constituents,its connection with the viscera,channels and collaterals,and establishes a complete physiological system of five body constituents-viscera.The third part expounds the etiology and pathogenesis of the five body constituents in Huangdi Neijing.By systematically arranging provisions of etiology and pathogenesis of five body constituents disease in Neijing,and combining with the comments of later doctors,this paper analyzes the pathogenesis and symptoms of five body constituents disease in Neijing,hoping to lay a theoretical foundation for the diagnosis and treatment of five body constituents diseases.The fourth part elaborates the application of five body constituents theory in diagnosis of Huangdi Neijing.The five body constituents is the basis of the human body,and it is external manifestations of the five-zang organs.The five body constituents depends on the nourishment of the five-zang organs.In turn,the functions of the five-zang organs and the conditions of their essence can be reflected outside through the five body constituents.Clinically,it is often possible to judge whether the viscera is in morbid condition or not by observing the five body constituents,and the pathological changes of the five body constituents can also be observed through various methods.By summarizing the five body constituents diagnosis scriptures in Neijing,we can diagnose the location,nature,severity and prognosis of diseases by means of inspection and pulse-taking.which lays a theoretical foundation for the view of modern TCM diagnostics that "Viscera inside the body must manifest itself outside." and "understanding the inside condition through external manifestations".The fifth part discusses the characteristic therapy guided by the five body constituents theory of Huangdi Neijing.According to the characteristics and the functions of the five body constituents structure,the Neijing forms characteristic methods of diagnosis and treatment based on the five body constituents.The treatment of the five body constituents in the Neijing were mostly based on the five body constituents hierarchy,mainly includes physical and breathing exercise,heat needle,medicinal ironing,acupuncture,Bian stone,warm ironing,massage,medicinal bath and medicinal wine,etc.The treatment methods vary according to parts of the five body constituents.The treatment based on the theory of skin and muscles can guide the treatment of surgery and dermatology in traditional Chinese medicine,and the treatment based on the theory of muscles and bones can be applied to treat soft injuries and bone injuries,all of which represent characteristic treatment of traditional Chinese medicine.Conclusion:1.The five body constituents consist of five parts: skin,muscle,vessels,sinew and bone,each of which has an independent structure.The morphological structure of the skin includes skin,its appendages hair,skin texture and sweat pores.In addition to the hair,the appendages of skin also include the long hair of the human body,such as eyebrows,moustache,whiskers and mustaches.The morphological structure of muscle contains the texture,meat texture,interstices,striae,subdivision,separation,etc.,which is the texture of muscle.“Jun((?))” refers to the fat muscle;The gaps or depressions where muscles are connected are valleys;The deep muscle near the bone is flesh;The area where muscles and joints connect is called “roujie(肉节)”.The main form and structure of the vessels is the pulse,which is the passage for qi and blood circulation.The structure of tendons includes tendons and sinews.Tendons are divided into large tendons and small tendons;Fascia and tendons are the convergence of tendons;Convergence of multiple tendons and fascia forms “zongjin(宗筋)”.The morphological structure of bone consists of scleromere or bone genera;Osteolysis refersto sutura;Interosseous space is the space between two bones;Phalangeal margin of bone is called “gulian(骨廉)”;Bone marrow is a fat paste in the bone cavity.2.The five body constituents is the structural and functional basis of human life activities.The normal physiological functions of five body constituents depends on the nourishment of essential qi transformed by the five-zang organs.The five body constituents protect zang-fu organs from external damage.It is obvious that the five body constituents and the zang-fu organs are interdependent and inseparable.The meridians are the channels connecting the viscera and the five body constituents.Physiologically,viscera transform essential qi to nourish the five body constituents through meridians.And the five body constituents can also reflect the physiological conditions of the viscera.The five body constituents,the zang-fu organs as well as channels and collaterals are closely related to each other in physiology.The causes of five body constituents diseases are mainly divided into external and internal injuries.Exogenous pathogenic factors are usually six excesses,among which wind,cold and heat tend to invade the skin,dampness to damage the flesh and muscles,while fire and heat tend to damage the muscles and bones;The internal injuries often includes emotional stimulation,improper diet and overwork.Generally speaking,the pathological changes of five body constituents usually result from malnutrition of five body constituents due to the strength of healthy qi,disharmony of nutrient qi and defense qi,imbalance of qi,blood,yin and yang,disorders of body fluid metabolism and dysfunction of zang-fu organs and meridians.3.The diagnosis of five body constituents is discussed in great detail in Neijing,mainly focusing on differentiating color and pulse-taking.Inspection of skin mainly consists of twelve skin divisions,facial area and medial area between elbow joint and wrist joint.While pulse-taking mainly centers on three body parts and nine pulse taking sites,the comparison of renying and cunkou and exclusively taking the wrist sites.Neijing emphasizes the importance of examining the five body constituents when diagnosing diseases.Doctors should first carefully follow the pulse signs,palpate the muscles,touch the skin,press the tendons and bones to identify the physical type of the patient.Then judging the nature of the disease,whether it is cold or heat,and the condition of qi and blood.Finally,adopting appropriate treatment according to the comprehensive analysis of the diagnosis.Neijing lays emphasis on the comprehensive analysis of four diagnoses and the five body constituents.Its rich diagnostic content has provided abundant theoretical basis for later doctors and modern medicine to diagnose diseases.4.The treatment of the five body constituents in Neijing is based on the basic therapeutic principles of nourishing the five body constituents during four seasons,regulating the five body constituents with five flavours,treating the five body constituents with appropriate diagnosis and treatment,dividing the five body constituents with yin and yang,treating the five body constituents with qi and blood,and classifying the five body constituents into different levels.The commonly used external therapies are acupuncture,moxibustion,massage,ironing,physical and breathing exercise.etc..Specific methods of acupuncture are expounded completely in Neijing.Five,nine and twelve techniques of needling all contain the levels of five body constituents,which provides a theoretical basis for later physicians to treat five body constituents diseases.At the same time,it also stressed that the depth of needling should be limited,otherwise,it will violate the law of acupuncture and cause adverse effects.Innovation points:1.This paper systematically sorted out the morphological structure of the five body constituents on the basis of the Neijing.The morphological structure of the five body constituents is built on anatomical theory of Neijing and the structure of the five body constituents.The five body constituents and their appendages were divided and defined in great detail.2.This paper completely arranged the form structure,physiological function,etiology,pathogenesis,diagnosis and treatment methods of the five body constituents of Neijing,and initially constructed the theoretical framework of the five body constituents system.3.The diagnosis of five body constituents in Neijing focuses on skin color diagnosis and pulse diagnosis.Inspection of skin mainly consists of twelve skin divisions,facial area and medial area between elbow joint and wrist joint.While pulse-taking mainly centers on three body parts and nine pulse taking sites,the comparison of renying and cunkou and exclusively taking the wrist sites.Neijing emphasizes the importance of examining the five body constituents when diagnosing diseases.It stresses comprehensive analysis of four diagnostic methods and inspection of five body constituents.Its abundant diagnosis content has provided a rich theoretical basis for later doctors and modern medicine.4.The treatment of the five body constituents in Neijing is based on the basic therapeutic principles of nourishing the five body constituents during four seasons,regulating the five body constituents with five flavours,treating the five body constituents with appropriate diagnosis and treatment,dividing the five body constituents with yin and yang,treating the five body constituents with qi and blood,and classifying the five body constituents into different levels.The commonly used external therapies are acupuncture,moxibustion,massage,ironing,physical and breathing exercise.etc..The treatment based on the theory of skin and flesh can guide the treatment of surgery and dermatology in traditional Chinese medicine,and the treatment based on the theory of muscles and bones can be applied to treat soft injuries and bone injuries.The five-body diagnosis in Neijing is unique though it tend to be ignored by modern clinical treatment.Therefore,systematically exploring the five-body theory of Neijing is beneficial to guiding the external treatment of clinical departments and providing solid theoretical basis and clinical value for the treatment of five body constituents. |
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