Preventative treatment is the most important practice within Chinese medicine. Once pain or disease manifests, it is typically difficult or too late to successfully treat the condition. In modern times, we do not even understand the topic of prevention. Perhaps people have some general idea of eating well, exercising or frequent or hand-washing. This does not take into consideration changing seasonal conditions, individual physiology and predisposition, proper and improper treatment, and preventative diagnostics. Chinese medicine discusses these topics in depth.
Changing Seasonal Conditions
There are three causes of disease in Chinese medicine. This grouping of categories of disease causation, referred to as “San Yin”, first appears in the Song dynasty text written by Chen Yan in 1174 named San-yin Fang (Three Categories of Pathogenic Factors). The causes of disease are the: internal causes (nei yin); external causes (wei yin); neither external nor internal causes (bu wei bu nei yin). The internal causes are the negative emotions. The external conditions are the pathogenic climactic factors of weather. The neither external nor internal factors are diet, lifestyle, trauma and miscellaneous factors. The external causes of disease/weather/changing seasonal conditions refers to the nature of the external climate (wind, cold, heat, dryness, dampness and summer heat) and the body’s response to it. This is the discussion of the Six Qi in Chinese medicine. The relevant point here is that illness can arise in response to external pathogenic factors in predictable ways, and treatment (both proper and improper) can lead to predictable results.
Chinese cosmology describes many cycles that are important in the context of health and medical treatment. The cycle of seasonal nodes, which includes the period of the equinoxes and solstices, is one of the most useful to understand and utilize in treatment. This cycle describes 24 periods, or nodes, of observable changes in climate. We are most vulnerable to illness during these periods, particularly the times of seasonal transitions. These include the mid-points of seasons, which are the solstices and equinoxes; and the periods of time 6 weeks prior that mark the early changes of season in Chinese cosmology. During these times, is very beneficial to strategically utilize acupuncture and Chinese herbs for preventative treatment. These nodes, times of seasonal changes and appropriate corresponding treatment are outlined in the article Optimal Treatment Dates According to the Cycle of Seasonal Nodes.
Individual Physiology and Predisposition
We develop illness according to our physiology, which refers to the state of our functional health (i.e., biology, biochemistry, organ function, etc.); and according to our predisposition (genetics, constitution, tendencies, etc.) These factors can be identified in many way, and there is a specific methodology for this in Chinese medicine (see below Preventative Diagnostics). Consideration of physiology and predisposition offer insight and prediction into the possibility and even likelihood of future illness and disease.
Proper and Improper Treatment
Improper treatment and resolution of illness is one of the primary causes of disease according to Chinese medicine. In our society and medical system, we typically make no association between what is happening now, and what has happened in the past. In Chinese medicine, literally every single thing matters and plays a role in where we are right now. This is only common sense, yet it is completely overlooked and dismissed in relation to the manifestation of illness. The result is almost every person I treat saying something like “I never had this before, it came out of nowhere.” Nothing comes out of nowhere. Everything has prior cause. The only issue is our ability to perceive and recognize it. Chinese medicine has a detailed clinical model for doing exactly this…observing and considering past influences on our health.
In the 3rd century text Shanghan lun (Treatise on Cold Damage), the author Zhang Zhongjing outlines the concept of “huai bing”, meaning deteriorated or ruined disease. This means improper treatment causing an illness to penetrate deeper into the body, contributing to disease that will manifest in the future. Whether from pharmaceuticals, herbal remedies, acupuncture, or any other form of medicine, improper treatment will always have some lasting effect on and in the body. It then takes time and treatment through the seasons to correct this damage. For this reason, even when symptoms quickly resolve, Chinese medical treatment sometimes needs to be administered over time to address deeper causes of disease that will simply return in another form if not remedied. Seasonal treatment is not just to try and get ahead of allergies or colds when the weather turns; it is to clear lingering pathogens and restore balance to damaged organ systems, thereby preventing more serious illness in the future.
Preventative Diagnostics
Chinese medicine pays attention to every aspect of a person to access, evaluate and treat their condition, and this includes specific preventative treatment. Diagnosis in Chinese medicine is a complex and highly individualized system. The Huangdi Neijing, or the Yellow Emperor’s Classic of Internal Medicine, written sometime around the 2nd century BCE, organizes the diagnostic aspects of Chinese medicine into four categories: looking, listening and smelling, asking and touching. All of these methods play a role in evaluating a person’s physiology, leading to preventative measures that are specific for that individual. The Nan Jing, or Classic of Difficult Issues, written during the 1st or 2nd century CE, states that “To know by looking is called divine.”
Discussions of Preventative Care, Diagnosis and Treatment in Classical Chinese Medical Literature
The famous Chinese medical doctor Huangfu Mi tells a story in the preface to his classic medical text from 282 CE entitled Zhen Jiu Jia Yi Jing (The Classic of Acupuncture and Moxibustion). The story is of Zhang Zhongjing (referenced above in this article), who encounters a young man named Wang Can who eventually becomes a well-known Chinese poet and scholar. Zhang needs only look at this man to see the very beginnings of disease that would not manifest for decades. He offers advice and preventative treatment, which the young man does not follow. Decades later when the disease manifests exactly as predicted by Zhang, it is too late and Wang eventually passes from the illness. Zhang did not ask any questions, run any tests, check Wang’s pulse, or use any methodology other than looking. The Chinese term is “wang zhen”, inspection. This method of inspection is, in this context, considered to be the highest form of diagnosis.
The great Chinese doctor Sun Simiao, writes in his text Beiji Qianjin Yaofang (Essential Formulas for Emergencies Worth a Thousand Ducat in Gold), that the superior doctor treats disease before it arises, and can successfully cure 9 out of 10 cases. A mediocre doctor treats disease as it begins to manifest and can cure 8 out of 10 cases. And only the inferior doctor treats disease once it has already developed, and can cure 6 out of 10 cases. Sun Simiao advocated the approach of Yangsheng, nurturing life.
The Yellow Emperor’s Classic of Internal Medicine (referenced above) describes seasonal illness that results from negative actions or damage that occurs in prior seasons. For example, a fever illness in spring may be caused by excessive sweating and lack of rest in the previous winter. In modern times, we think only of a virus or allergies that occur at the moment of sickness.
Conclusion
For centuries, the greatest of Chinese medical doctors have emphasized the importance of preventative care and treatment, including consideration of changing seasonal conditions, individual physiology and predisposition, proper and improper treatment, and preventative diagnostics. Chinese medicine includes specific practices and treatments to safely and effectively treat illness and disease, and help prevent future or worsening conditions. Zhi Wei Bing – treat disease before it happens.