Book summary “The practice of Chinese medicine”: summary

Introduction

You face a major clinical challenge when trying to apply ancient Chinese medical principles to complex modern diseases. Western diagnostic labels rarely match traditional pathological patterns directly, leaving you unsure how to bridge modern pathology with classical treatment methods. Giovanni Maciocia provides a comprehensive clinical guide that bridges Western disease diagnosis and Chinese medical patterns. The book offers precise protocols for internal conditions, mental-emotional disorders, and complex syndromes based on etiology, pathology, acupuncture, and herbal formulas.

The following questions guide this exploration:

• How do you translate Chinese medical concepts accurately into Western clinical terms?
• What causes headaches, dizziness, respiratory conditions, and deep internal organ disharmonies?
• How do you treat mental-emotional problems and neurological disorders through pattern differentiation?

1. Translation Principles and Clinical Fundamentals

Translating Chinese medical terminology requires navigating substance-oriented Western languages, while effective clinical practice bridges diagnostic labels with traditional pathological patterns.

Quoting Roger Ames, Western languages are substance-oriented and suited for discrete, permanent objects. The Chinese world is defined by continuity, process, and becoming. Attempting to find a single one-to-one equivalent for every Chinese character falls into the Fallacy of the Perfect Dictionary, stripping rich terms of their allusive range of meanings.

You can retain Wu Xing as Five Elements because classical Greek philosophers like Aristotle also viewed elements as dynamic interacting qualities rather than static building blocks. Aristotle's primary forms treated elements as dynamic combinations of hot, cold, dry, and wet qualities capable of transforming into one another.

Clinicians outside China operate under the dominant paradigm of Western medicine, meaning patients often present with complaints framed by Western labels. An excellent clinical text bridges this gap by translating those Western disease entities into the view and handling of Chinese medicine. You must explore patterns of disharmony alongside lifestyle, environment, family situation, emotional life, diet, sexual habits, work routine, and exercise to uncover specific aetiology and pathology.

In your clinical practice, you can achieve high patient compliance with decoctions if you use specific methods:

• For children under 3, substantially dilute the decoction and give it throughout the day.
• For children over 3, add honey to the decoction.
• Offer a biscuit or favorite drink immediately after swallowing the mixture.
• Involve children over 3 in dispensing the herbs by letting them help put them in bags.

You must navigate legal restrictions on animal and mineral herbal substances by utilizing safe, effective botanical substitutions:

• Enquire about the laws governing the use of certain herbs or substances in your country.
• Use botanical substitutions based on the action of the herb intended to be replaced, such as using Rhizoma Polygonati and Fructus Lycii chinensis to approximate Plastrium Testudinis.

2. Headaches, Dizziness, and Breathlessness

Headaches, dizziness, and breathlessness are diagnosed through channel pathways and Eight-Principle differentiations, requiring targeted acupuncture and herbal interventions.

The head represents the highest energetic point of the body where potential energy reaches its maximum. Because it concentrates Yang channels, it is intrinsically prone to the rising of pathogenic factors like Liver-Yang. You can localize headaches by identifying the specific channel running through each region:

• Greater Yang governs occipital headaches;
• Bright Yang governs forehead headaches;
• Lesser Yang governs the sides and temples;
• Terminal Yin governs the vertex.

Persistent headaches starting around ages 7 to 10 indicate a constitutional factor. Weak parental Qi or Essence at conception can result in hereditary organ weaknesses affecting specific head locations. For example, a hereditary Spleen weakness in children manifests as forehead headaches related to food intake, poor muscle tone, and digestive problems.

Dizziness, termed Xuan Yun, ranges from slight unsteadiness to severe vertigo. Pathologically, it divides into Deficiency types involving insufficient Qi, Blood, or Kidney-Essence, and Excess types driven by Liver-Yang, Phlegm, or Fire.

A 70-year-old man suffering from vertigo for several years with raised blood pressure and dry skin was diagnosed with Liver-Yang rising and underlying Liver-Yin deficiency, successfully treated with acupuncture and Jiang Ya Wan.

Breathlessness, known as Chuan, is caused by the failure of Lung-Qi to descend. Excess types feature loud breathing with a Full pulse, while Deficiency types involve short breathing with a Weak pulse.

A 48-year-old woman suffering from breathlessness for 10 years following bronchopneumonia experienced fluid retention in the abdomen and ankles, constipation, and cold legs; she improved steadily when treated with acupuncture and a variation of Su Zi Jiang Qi Tang.

Acute conditions respond rapidly to treatment, whereas chronic breathlessness requires long-term care and strict dietary avoidance of Phlegm-producing foods.

To prevent recurrence, you must follow specific protective and dietary rules:

• Abstain from eating dairy foods including milk, cheese, butter, cream, yoghurt, and ice cream.
• Keep greasy and fried foods to a minimum.
• Avoid eating excessive fresh fruit and raw vegetables.
• Protect the upper back and chest adequately from wind and cold.
• Apply indirect moxibustion with garlic in the summertime at 10-day intervals on specific point groups.
• Grind Bai Jie Zi, Xi Xin, Gan Sui, She Xiang, and Yan Hu Suo into a powder, mix with ginger juice and honey, shape into tiny pieces, place on a plaster, stick on acupuncture points for no longer than 2 hours.

3. Asthma, Rhinitis, and Sinusitis

Respiratory conditions like allergic asthma, rhinitis, and sinusitis involve hidden wind and Defensive-Qi deficiencies, requiring treatment strategies that balance root tonification with manifestation dispersal.

Allergic Asthma and Eczema

Traditional Chinese medicine separates Wheezing from Breathlessness. Wheezing features hidden phlegm stored in the lungs, while Breathlessness allows full expulsion of pathogens. Early-onset allergic asthma requires a new theory focused on chronic Chest Wind lodging in the bronchi. You trace this vulnerability to a congenital deficiency of the Lung and Kidney Defensive-Qi systems. This deficiency often stems from prenatal essence, birth trauma, or early immunizations.

A 58-year-old man used an inhaler, spray, and oral corticosteroids for 6 years before receiving acupuncture. Treatment allowed him to gradually reduce and discontinue oral corticosteroids after 3 months. Atopic eczema shares this identical allergic root and Defensive-Qi deficiency through the Lungs and Kidneys. Suppressing eczema with cortisone creams drives the pathology inward and leads to asthma.

To treat acute asthma attacks and eczema, you must apply specific protocols:

• During an actual attack: treat the Manifestation only, i.e. expel Wind and restore the descending of Lung-Qi.
• In a period of time when attacks are frequent: treat primarily the Manifestation, i.e. expel Wind and restore the descending of Lung-Qi but treat also the Root, i.e. tonify the Lung and Kidney's Defensive-Qi systems.
• In a period of time when attacks are infrequent: treat primarily the Root, i.e. tonify the Lung and Kidney's Defensive-Qi systems but, as a secondary aim, also expel Wind and restore the descending of Lung-Qi.
• For Wind-Heat eczema: apply reducing method on T.B.-6, G.B.-31, BL-12, L.I.-11, L.I.-4, Du-14, SP-10, SP-6, LIV-2, HE-8, HE-7, and Zhiyangxue, with reinforcing method on LU-7 and KI-6 for women or LU-9 and KI-3 for men.
• For Damp-Heat eczema: apply reducing method on L.I.-11, SP-9, SP-6, Du-14, SP-10, and Sifeng, with reinforcing method on Ren-12, BL-20, LU-7, and KI-6 for women or LU-9 and KI-3 for men.

Allergic Rhinitis and Sinusitis

Allergic rhinitis corresponds to Bi Qiu rather than Bi Yuan, which describes sinusitis. Sinusitis features a thick, yellow nasal discharge and corresponds to Bi Yuan. You treat perennial allergic rhinitis and sinusitis by clearing Wind, opening orifices, and tonifying the Governing Vessel.

For effective intervention, you should use these exact procedures:

• BL-12 Fengmen, BL-13 Feishu, LU-7 Lieque, L.I.-20 Yingxiang, Bitong, Du-23 Shangxing, G.B.-20 Fengchi, Yintang.
• Reducing or even method.
• Cupping is applicable on BL-12 and BL-13.
• Use Shi Chang Pu Rhizoma Acori tatarinowii as the main herb for opening the orifices.
• Utilize auxiliary orifice-opening herbs: Bai Zhi, Xin Yi Hua, Cang Er Zi, Xi Xin, and Cong Bai.
• Needle local acupuncture points: ST-8 Touwei, Du-23 Shangxing, BL-2 Zanzhu, Yintang, Bitong, and L.I.-20 Yingxiang.
• Needle distal acupuncture points: LU-7 Lieque, L.I.-4 Hegu, and ST-44 Neiting.

4. The Psyche and Mental-Emotional Problems

The term Shen has two primary meanings in classical Chinese medicine: the Mind residing in the Heart, and the comprehensive Spirit representing all five mental-spiritual aspects. The Mind derives its biological foundation and nourishment from the Prenatal Essence stored in the Kidneys and the Postnatal Essence produced by the Lungs, Stomach, and Spleen.

Mental-emotional disorders stem from organ dysfunctions, emotional stress, and pathological Minister Fire, requiring precise differentiation of the Mind as Obstructed, Unsettled, or Weakened.

The Heart serves as the residence of the Mind and governs thinking, memory, consciousness, insight, and emotional life, acting as the emperor of all organs. The five Yin organs house the five mental-spiritual aspects that together form the Spirit or Five Shen.

Emotions are internal causes of disease that injure the internal organs directly when they are long-lasting or very intense. There is a reciprocal relationship between emotions and internal organs: emotional stress injures internal organs, while organ disharmonies cause emotional imbalances.

A 33-year-old woman with skin eruptions, breathlessness, and premenstrual tension was treated by a Western therapist who suggested repressed anger from teenage sexual abuse; however, Maciocia diagnosed Lung-Qi deficiency and sadness based on a weak, soft pulse and pale complexion.

A 40-year-old woman suffering from sadness and a lack of direction after a divorce was successfully treated using Yin Linking Vessel points along with BL-23, BL-52, and BL-47.

You can observe specific diagnostic signs for these disorders:

• Check the shen of the complexion for lustre and brightness to determine prognosis.
• Compare complexion changes with pulse changes to determine whether a problem is recent or long-standing.
• Observe the lustre of the eyes as the first step when a patient sits down.
• Assess whether the eyes have lustre or lack it, and whether they are controlled or uncontrolled.
• Integrate pulse, tongue, and complexion closely to diagnose mental-emotional problems.
• Examine peripheral positions around the Heart pulse to differentiate emotional issues from actual Western heart problems.
• Inspect the tongue tip for Heart-Heat derived from emotional stress.
• Evaluate the depth of the Heart crack and changes in body color to gauge emotional severity.
• Check for a sticky, rough, yellow coating inside a combined Stomach and Heart crack to identify Phlegm clouding the Mind.

You can apply these exact clinical interventions:

• Use points HE-5 Tongli and BL-15 Xinshu to stimulate thinking function.
• Use point HE-7 Shenmen when the Heart is affected by emotional stress.
• Use G.B.-40 Qiuxu together with BL-47 Hunmen to stimulate the coming and going of the Ethereal Soul.
• Use LIV-8 Ququan, Ren-4 Guanyuan, and SP-6 Sanyinjiao with reinforcing method to nourish Liver-Blood and anchor the Ethereal Soul.
• Use G.B.-37 Guangming, LIV-2 Xingjian, and BL-18 Ganshu to influence sight and the Ethereal Soul.
• Add Tu Si Zi Semen Cuscutae and Mai Men Dong Radix Ophiopogonis to formulas to tonify the Kidneys and Lungs, supporting Essence and the Corporeal Soul in conditions like eczema.
• Reinforce BL-23 Shenshu and BL-52 Zhishi to tonify the Kidneys and strengthen Will-Power in cases of depression.
• Treat fear by unblocking Qi in the Upper Burner using HE-5 Tongli and LU-7 Lieque alongside lifting Qi.
• Tonify Original Qi with Ren-4 Guanyuan.
• Lift Qi using Du-20 Baihui and Ren-6 Qihai.
• Clear upper body heat using P-8 Laogong, P-7 Daling, L.I.-4 Hegu, LU-7 Lieque, and Ren-15 Jiuwei.
• Calm the Mind with Du-24 Shenting, Du-19 Houding, and HE-5 Tongli.
• Regulate the Triple Burner using T.B.-6 Zhigou and T.B.-5 Waiguan.
• Use P-6 Neiguan to stimulate the coming and going of the Ethereal Soul, lift mood, treat depression, and provide a synergistic effect on prescriptions.
• Use P-7 Daling to restrain and settle the Ethereal Soul, calm the Mind, and settle anxiety.
• Use P-5 Jianshi to resolve Phlegm from the Pericardium and treat mental confusion.
• Divide a person's life into the womb period, childhood up to 18, and adulthood to form an idea of the origin of the problem.
• Live a quiet life with few desires to preserve Qi and guard the Mind.
• Avoid excessive thinking, excessive craving, and distracting thoughts.
• Not thinking too much to nourish the Heart.
• Restraining anger to nourish the Liver.
• Restraining sexual desire to nourish the Kidneys.
• Careful talking to nourish the Lungs.
• Regulating diet to nourish the Spleen.

5. Depression, Anxiety, and Insomnia

Depression, anxiety, and insomnia involve disturbances of the Ethereal Soul, Will-Power, and Heart-Blood, treated through specialized acupuncture points and organ-specific herbal formulas.

Depression accounts for 35-40% of all psychiatric illnesses and is twice as common in women as in men, with a maximum onset in the 55-60 age group. Western medicine views depression as a fixed mood change lasting days to years, while Chinese medicine attributes it to stagnation termed yu. Zhu Dan Xi formulated Yue Ju Wan for six stagnations in 1347, and Zhang Jing Yue outlined six emotional stagnations in his 1624 Jing Yue Quan Shu. Mental depression reflects poor integration between the Heart Mind and Liver Ethereal Soul, alongside a weakening of Kidney Will-Power. Lilium Syndrome described in the 220 AD Essential Prescriptions of the Golden Chest features restlessness and trance-like states treated by Bai He Zhi Mu Tang.

You treat depression and anxiety by differentiating underlying patterns and applying precise interventions:

• Tonify the Kidneys in depression to address lack of drive and will-power.
• Use points BL-23 Shenshu and BL-52 Zhishi to tonify the will-power and drive deriving from the Kidneys.
• Add Bai He and Zhi Mu to formulas when treating depression against a background of Lung and Heart syndrome, Qi and Yin deficiency, or Heart-Heat, especially for sadness and grief.
• Use reducing or even method on acupuncture points P-6 Neiguan, LIV-3 Taichong, G.B.-34 Yanglingquan, T.B.-3 Zhongzhu, G.B.-13 Benshen, and BL-47 Hunmen, and reinforce Du-20 Baihui.
• Select Yue Ju Wan when the pulse is Full and Wiry in every position.
• Select Xiao Yao San when stagnation occurs against a background of Liver-Blood and Spleen-Qi deficiency.
• Needle HE-5 Tongli, HE-7 Shenmen, P-6 Neiguan, Ren-15 Jiuwei, Ren-17 Shanzhong, LU-7 Lieque, ST-40 Fenglong, and L.I.-4 Hegu using the even method.
• Administer Mu Xiang Liu Qi Yin or Ban Xia Hou Po Tang to move Qi in the chest and relieve depression.
• Reinforce Ren-12 Zhongwan and BL-20 Pishu, and apply reducing or even method on ST-40 Fenglong, SP-9 Yinlingquan, SP-6 Sanyinjiao, P-5 Jianshi, P-7 Daling, ST-8 Touwei, Du-24 Shenting, G.B.-13 Benshen, G.B.-17 Zhengying, G.B.-18 Chengling, and Du-20 Baihui.
• Modify Wen Dan Tang with the addition of Yuan Zhi and Suan Zao Ren for Phlegm-Heat depression.
• Apply reinforcing method and moxa on KI-7 Fuliu, KI-3 Taixi, Ren-4 Guanyuan, Du-4 Mingmen, BL-23 Shenshu, BL-52 Zhishi, BL-47 Hunmen, and Du-20 Baihui.
• Prescribe You Gui Wan or Jin Gui Shen Qi Wan to tonify Kidney-Yang.

Panic disorder affects about 2.4 million adult Americans and is twice as common in women as in men. Generalized anxiety disorder requires six months of uncontrollable worry for diagnosis. Anxiety corresponds to Fear and Panic Throbbing, driven by rebellious Qi in the Penetrating Vessel and organ imbalances.

You address anxiety and insomnia through targeted point combinations:

• Combine distal channel points with head points to calm the mind and relieve anxiety.
• Use Du-24 Shenting for its downward movement to make Qi descend and subdue rebellious Yang.
• Use G.B.-13 Benshen to gather Essence to the head, clear the brain, and calm the Mind.
• Needle HE-7 Shenmen, HE-5 Tongli, BL-15 Xinshu, Ren-14 Juque, G.B.-40 Qiuxu, and ST-36 Zusanli with reinforcing method.
• Apply moxa if the tongue is Pale.
• Apply reducing method without moxa to points LIV-2, LIV-3, G.B.-44, G.B.-12, G.B.-20, SP-6, BL-18, Du-24, G.B.-13, G.B.-15, BL-47, BL-62, BL-1, and KI-6.

A 61-year-old man suffering from insomnia and grief after his wife's death experienced complete relief from night waking after 6 months of fortnightly treatments and Suan Zao Ren Tang Pian.

6. Digestive, Urinary, and Cardiovascular Disorders

Gastrointestinal, urinary, and cardiovascular disorders reflect deep organ imbalances, Dampness, and Blood stasis, requiring structured pattern differentiation and herbal management.

Stomach and intestinal disorders stem from dietary errors, emotional stress, and external pathogens. When emotional frustration causes Liver-Qi to overact on Earth, you encounter epigastric pain, nausea, and hypochondrial distress.

A 42-year-old female sales representative suffering from early-stage diabetes and Stomach- and Spleen-Yin deficiency failed to respond to herbal treatment for six weeks until her erratic eating habits of skipping breakfast, eating sandwiches while driving under stress, and consuming microwave TV-dinners late at night were addressed.

You must follow concrete dietary rules to protect the Middle Burner:

• Eat regular meals at the same time every day with similar amounts for corresponding meals.
• Eat a substantial breakfast and lunch and only a light evening meal.
• Avoid eating too fast, eating on the run, discussing work while eating, or going straight back to work after eating.

Constipation depends on whether fluids and Qi move freely through the large bowel. You can diagnose specific patterns by evaluating stool shape, moisture, and effort.

A 61-year-old woman suffering from persistent constipation for many years with non-dry stools, exhaustion after bowel movements, weariness, a pale-swollen tongue, and a deep-weak pulse was diagnosed with Kidney-Yang deficiency and successfully treated with acupuncture and a variation of Ji Chuan Jian.

Urinary Syndromes, termed Lin, involve Dampness and Heat in the Lower Burner. You categorize them into six types that range from acute Stone and Heat patterns to chronic Fatigue conditions.

A 30-year-old woman suffering from recurring cystitis after losing her father was successfully treated using acupuncture points HE-8, S.I.-2, SP-9, Ren-3, and BL-63 after antibiotics failed.

For Heat Urinary Syndrome, apply these precise techniques:

• Use reducing method without moxa on Ren-3 Zhongji, BL-28 Pangguangshu, BL-22 Sanjiaoshu, ST-28 Shuidao, SP-9 Yinlingquan, BL-66 Tonggu, BL-63 Jinmen, and L.I.-11 Quchi for Heat Urinary Syndrome.
• Administer Ba Zheng Tang as the main herbal prescription to drain Damp Heat from the Bladder.

Hypertension and chest pain require balancing root deficiencies with acute manifestation relief. You evaluate chest obstruction through pain characteristics that point to specific pathogenic factors.

• Distending pain indicates stagnation of Qi.
• Feeling of oppression or tightness of the chest indicates Phlegm.
• Burning pain indicates Heat.
• Very severe pain indicates retention of Cold in the blood vessels.
• Stabbing pain that is fixed and feels like a knife blade indicates stasis of Blood.

7. Musculoskeletal and Neurological Disorders

Musculoskeletal and neurological conditions such as Bi syndrome, fibromyalgia, Parkinson's disease, and stroke sequelae involve channel obstructions, internal Wind, and deep organ deficiencies.

Painful Obstruction Syndrome arises when external Wind, Cold, and Dampness invade the channels and joints, causing local stagnation of Qi and Blood. This invasion exploits an open space between the skin and muscles known as Cou Li.

• Use Du-26 Shuigou for facial oedema and Upper Burner transformation.
• Select Ren-9 Shuifen as a general point for fluid transformation in any oedema case.
• Apply Ren-5 Shimen and ST-28 Shuidao to promote fluid transformation and excretion in the Lower Burner.
• Select KI-7 Fuliu for Lower Burner fluid excretion in Kidney pathology.

Lower backache is one of the most common musculoskeletal complaints, heavily influenced by the Bladder and Kidney channels. At least 50 percent of people in Western industrialized countries suffer from back pain, and approximately one million patients consult their GP for back pain each year in the UK.

A 44-year-old woman with acute backache from gardening and left sacroiliac pain was successfully treated with distal points BL-62, P-7, and LIV-3, followed by local point BL-26 with cupping and extra point Tunzhong, resolving the problem in two sessions.

• Insert distal points first and manipulate them with reducing method while the patient gently flexes and turns the waist.
• Retain distal needles for about 15 minutes with intermittent manipulation.
• Have the patient lie down after removing distal needles to needle local points based on tenderness.
• Apply the clock technique of lifting and thrusting with circular movements on local points.

Fibromyalgia is characterized by chronic widespread pain, multiple tender points, fatigue, and sleep disturbances. Between 3 to 6 percent of the U.S. population has fibromyalgia, and patients require an average of 5 years to get an accurate diagnosis.

• Check for widespread pain in all four quadrants of the body lasting a minimum duration of 3 months.
• Perform a manual tender point examination to find tenderness or pain in at least 11 of the 18 specified tender points.
• Select treatment emphasis based on pulse and tongue rather than symptoms.
• Place emphasis on eliminating pathogenic factors if the pulse is Full such as Slippery or Wiry and the tongue has a thick coating.
• Place emphasis on tonifying Qi and Blood if the pulse is Empty such as Weak, Fine or Choppy and the tongue has a thin or no coating.
• Choose local points according to tenderness on palpation starting with Ah Shi points.
• Use one or more distal points below elbows and knees to open the channel and eliminate stagnation.
• Stimulate horizontal Qi flow among Greater Yang, Bright Yang, and Lesser Yang channels using adjacent points.

10 Key Ideas

1. Translating Chinese medical terminology requires navigating substance-oriented Western languages because attempting to find a single one-to-one equivalent for every character strips rich terms of their allusive range of meanings.
2. Headaches are diagnosed by localizing specific channel pathways across the head, where concentrated Yang channels are intrinsically prone to the rising of pathogenic factors like Liver-Yang.
3. Early-onset allergic asthma involves a hidden chest wind traced to a congenital deficiency of the Lung and Kidney Defensive-Qi systems stemming from prenatal essence, birth trauma, or early immunizations.
4. Mental-emotional disorders stem from organ dysfunctions, emotional stress, and pathological Minister Fire, requiring precise differentiation of the Mind as Obstructed, Unsettled, or Weakened.
5. Emotional stress acts as an internal cause of disease that injures internal organs directly when long-lasting or intense, demonstrating a reciprocal relationship where organ disharmonies cause emotional imbalances.
6. Depression and anxiety are treated by tonifying the Kidneys to address a lack of drive and will-power while modifying formulas with specific herbs like Bai He and Zhi Mu for underlying syndromes.
7. Urinary Syndromes involve Dampness and Heat in the Lower Burner, categorized into six types ranging from acute Stone and Heat patterns to chronic Fatigue conditions.
8. Painful Obstruction Syndrome arises when external Wind, Cold, and Dampness invade the skin and muscles known as Cou Li, causing local stagnation of Qi and Blood.
9. Lower back pain is heavily influenced by the Bladder and Kidney channels and is successfully treated by inserting distal points first with manipulation while the patient gently flexes the waist.
10. Fibromyalgia requires choosing treatment emphasis based on the pulse and tongue, prioritizing the elimination of pathogenic factors for full pulses or tonifying Qi and Blood for empty pulses.