Section I Prevention
Prevention refers to the measures adopted to keep diseases from occurrence and development, and the actions taken to keep diseases from spreading among people. Prevention belongs to the field of preventive medicine and health preservation.
Prevention first is one of the four main principles in medical works in China. Medical workers should realize the deep significance of this principle for improvement of patients' health, and should place the prevention of diseases first in their practice. The ancient Chinese not only accumulated a wealth of experience of treatment, but also acquired much knowledge about disease prevention and health preservation in their daily life and longterm productive practice. In the Internal Classic, the treatment of "pre-disease" was advocated, and an emphasis was placed on preventing potential problems.
It is directed in Chapter 2 in Plain Questions that medical practitioners are "to treat pre-disease, not to treat diseases that already happened; to take preventive measuresa gainst possible trouble, not to take action against those already existing It will be to late to treat diseases when they have already developed, or to deal with troubles when they have already become serious. This is Just like digging a well when thirsty, or casting a weapon when battle has already begun. " It is also said in Huainanzi that the "best doctots usually treat potential diseases, then no diseases develop; wise men usually prevent troubles, then no troubles occur. " It is thus clear that traditional Chinese medicine has
paid great attention to the prevention of diseases from very earliest times. This is a concept which was called "to repair a house before it rains. " According to this concept, prevention is much more important than treatment of diseases. Today, this concept still has realistic significance and guiding value in clinical practice.
The principle of treating "pre-diseases" consists of two parts, preventing the occurrence of diseases, and preventing the progress of diseases.
I. Prevention of the Occurrence of Diseases
This phrase implies that many preventive measures are taken to avoid disease before it occurs. Traditional Chinese medicine accumulated a wealth of experiences and methods of prevention in its long-term fight against diseases.
Traditional Chinese medicine holds that the occurrence of disease involves two aspects, the genuine-qi and evil-qi The genuine-qi refers to human body's vital activities and its resistance to diseases. Traditional Chinese medicine has attached much importance to the genuine-qi in the courses of diseases. It is emphasized in traditional Chinese medicine that "a human body full of the genuine-qi cannot be invaded by the evils; and in those invaded by evils, the genuine-qi is certainly insufficient. " This means that if the genume-qi of a human body is sufficient, the patient's constitution must be tonic, the body's physiological activities must be active, and the resistance to diseases must be forceful. Under this condition, the body will not be ill even if invaded by evils; or the illness will be mild and its prognosis will be better in case a disease occurs. So in order to prevent the occurrence of a disease, one should first strengthen the genuine-qi and the constitutions, and improve the body's resistance to diseases.
1. Taking Physical Exercises and Building up a Good Physique
Life depends upon movements, and health depends upon exercise. It is noted in biology that life is the most superior mode of motion of matter; and the body's health is a reflection of normal life movement. It has been proven that plentiful energy is embodied in strong bodies, and strong bodies usually come from suitable and continuous physical exercise and training. Therefore, physical exercise is an important way to strengthen the constitution of the human body and to prevent or decrease the occurrence of diseases.
Huatuo, a famous doctor of Han Dynasty, guided by the theory of "Running water
is never stale and a wooden door-hinge never gets worm-eaten," created a series of exercises which are called "Five mimic-animals exercises. " These include : "Mimic-tiger exercise" to build up body strength by its forceful movement,"Mimic-deer Exercise" to relax the body by its calming, relaxing and combination of force and flexibility; "Mimic-bear Exercise" characterized by steady steps to relieve superior-excess and inferior-deficiency syndrome; "Mimic-monkey Exercise" to train people to be as nimble as an ape; and Mimic-crane Exercise" in which people imitate the crane's action of spreading the wings to activate the pulmonary respiratory function, to regulate the blood and qi, and to imrove the circulation of the meridians and collaterals. From these we can see that by suitable physical exercises, people can actively improve the circulation of blood, make jointsimble, and make the body's physiological functions active. This can actively strengthen the body's resistance to diseases, improve health, and prevent diseases. Suitable physical exercises have, at the same time, certain curative effects in certain cases of disease. Most of the recently created health-improving exercises such as Taijiquan, Baduanjin, and Yi-jinjing, are based upon the "Five-animals exercises. "
2. Taking Care of the Body, Avoiding Over-Exertion
Taking care of the body is an important measure to improve one's health, strengthen its resistance to diseases, and reduce the occurrence of diseases. It is said in Chapter 1 in Plain Questions that: "Those who understood the nature laws follow the principles of yin and yang, grasp the health-preserving methods, take diet properly, live regular lives and avoid over-exertion. So they can maintain the health of their bodies and brains, and enjoy the maximum life span. " This means that in order to maintain health of the body, remain energetic and prolong life expectancy, one should understand the natural laws, adapt one self to environmental changes, take a moderate diet, keep regular daily lives, and do appropriate works. Only by this can one keep the genuine-qi abundant and prevent diseases from happening. If one's daily life is irregular, and diet is improper, his health may be impaired, and his body's resistance to illness may be decreased. It is also said in Chapter
1 in Plain Questions: "Those who drink alcohol too much just like they drink fruit juice,live an improper life just like a habit, and have sexual intercourse when they are drunk,exhaust the essences and genuine energies of their bodies. Those who are careless in their daily lives and are not good at tranquilizing their brain, who live an irregular daily life, and only want to be joyful but not realize the real meaning of joy of life, will age in middle age.
3. Tranquilizing the Brain and Keeping Optimistic
Traditional Chinese medicine emphasizes not only the protection of the body, but all so the care of the brain. It advises people to remain optimistic and energetic, and to concentrate rather than to scatter their spirit. This is very important for reducing negative stimuli to the brain, restraining excessive emotional changes and preventing diseases. It is, therefore, said in Chapter 1 in Plain Questions: "No illness will happen when one's spirit concentrates inside the body. "
Essence, qi, blood, and body fluid are the material basis for one's mind, consciousness, and thinking, which are closely related with the functions of internal organs. one's mind has a very important influence on physiologic functions and pathologic change of the human body. Psychologists believe that mind, consciousness, and thinking hay not only positive effects, but also negative effects, on the body. Positive effects can improve the normal activities of the circulation of the blood and qi, and activate the body's functions; while negative effects may depress the physiological activities of human body For example, distress may lead to stagnation of qi and blood, interfere with the functions of the body, decrease the body's resistance to diseases, and finally result in diseases. It is, therefore, said in Chapter 66 in Spirit Pivot that "Excessive happiness or rage may impair zang-viscera, and then diseases occur from yin. " "Diseases occur from yin" means that diseases happen from inside the body.
Ancient Chinese doctors paid attention to psychological health. They advised people to temper their willpower, tranquilize emotions, and remain confident of defeating diseases. At the same time, ancient Chinese doctors also told people to be broad-minded, and to restrain their appetites; only by this, can people decrease or prevent excessive emotional stimuli, and achieve the results of preventing diseases and prolonging life expectancy. So it is said in Chapter 1 in Plain Questions:"To be relaxed and restrained, to peaceful and courageous; to do physical exercises but not to be exhausted. By this the genuine-qi circulates normally, wishes can be fulfilled, and people will be satisfied. So those who enjoy their diet and dresses, and never envy each other¡­ their appetites will not fatigue their brain, the excessive evils will not confuse their mind. Their activities are accordance with the natural laws. " To preserve psychological health, one must manage be restrained and calm. This is just like what is said in Chapter 1 in Plain Questions:"When people remain unperturbed, the genuine-qi of their bodies will be sufficient," and"No disease will happen when the genuine-qi is sufficient. "
4. Herbs Used for Medicinal Prevention
As for medicinal prevention of disease, it was noted in Chapter 72 in Plain Questions that "Xiaojindan" can be utilized to prevent infectious diseases. "Variolization," created by Chinese doctors of the sixteenth century (perhaps even earlier) was the first application of artificial immunity. Additionally, in traditional Chinese medicine, atralodes rhizome and realgar has been used through the fumigation method for sterilization. In recent years, the application of Chinese medicines in preventive medicine has progressed greatly and attracted more and more attention of medical scientists. For example, basket ferm and isatism root or isatic leaf are used to prevent influenza;oriental wormwood and kape jasmine are used to prevent hepatitis;and portulaca is used to prevent dysentery. All of these applications have achieved expected effects.
II. Prevention of the Progresses of Diseases
The most ideal purpose of prevention is to prevent diseases before they happen. But case that diseases have occurred, one should, in order to prevent possible progress and transmlsslon of diseases, determine a diagnosis and administer therapies as early as possible. It is said in Chapter 5 in Plain Questions that: "Evils invade the human body as quickly as wind blows and as rain falls. Therefore, those who are good at treating diseases treat successively the skin, muscles, tendons, and vessels, the six fu-viscera, and at tlast, the five zang-viscera. If evils reach the five zang-viscera, the prognosis will be poor." This means that when exogenous evils invade the body and the patient has not been treated in time, the pathogenic factors may gradually move from the superficial part of the body into the internal parts, and will at last injure the internal organs. As this occurs, patients' conditions become more and more complicated and serious, and treatment become more and more difficult.
So in prevention of diseases, one must grasp the rules by which diseases occur and progress, recognize the way in which diseases transmit, and then, based on the factors mentioned above, give effective treatment to control the progress. It is said in the 77th Difficult Question of the Classic on Medical Problems that "Doctors should know that liver disease has a tendency to transmit to the spleen; so when treating liver disease, you must first strengthen the spleen-qi in order to prevent the spleen from being invaded by evils in the liver. " According to the rule of disease progress and the principles of treatment and prevention, traditional medicine usually administers drugs to strengthen the spleen and regulate the stomach when treating a liver disease. This application is a concrete example which reflects the principle of preventing progress of disease when diseases have already occurred. Here is another example: Ye Tianshi, a famous doctor of the Qing Dynasty, advocated that salty-cold kidney tonics should be added to a sweet-cold recipe which was used to moisten the stomach in order to replenish the kidney-yin,since the kidney-yin is usually injured by febrile pathogenenic heat when the stomach-yin consumed in the process of disease. Ye also raised a principle: "It must be performed first to soothe the parts which have not been ill. " This is also an example of the clinical application of the principle "preventing the progress of diseases when they have already 0ccurred. "

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