Strengthening the Genuine-Qi and Eliminating the Evil-Qi, Correctly Handling the Relationship Between Them
II. Strengthening the Genuine-Qi and Eliminating the Evil-Qi, Correctly Handling the Relationship Between Them
The course of a disease, in Thea sense, is a course of contest between the genuine-qi and evil-qi The genuine-qi and evil-qi are contradictory to each other. If the evil-qi defeats the genuine-qi, disease becomes more and more serious; otherwise, disease becomes lessened. For treating a disease, one should strengthen the genuine-qi, eliminate the evil-qi, alter the state of confrontation between them, and help the body recover from the disease. So strengthening the genuine-qi and the eliminating the evil-qi is an important principle for clinical practice.
It is said that "excess syndrome occurs when evil-qi is in abundance; and deficiency syndrome occurs when the patient's vital essence and energy are severely damaged." Whether a disease is of excess or of deficiency nature depends on the relative level of the genuine-qi and evil-qi It is said that doctors are "To replenish the genuine-qi in the cases of deficiency syndrome; to purge the evil-qi in the case of excess syndrome. " So replenishing the deficiency and purging the excess are just the concrete applications of the principie of strengthening the genuine-qi and eliminating evil-qi But since the relationship between the genuine-qi and evil-qi varies with the pathological changes during the course of a disease, and does not remain constant, the principle of strengthening the genuine-qi and eliminating evil-qi is applied in the following approaches.
1. Strengthening the Genuine-Qi to Dispel the Evil-Qi
This approach refers to the fact that taking measures such as medication, dietary
regimens, and exercise therapy can strengthen the genuine-qi, and increase the body's resistance and restorative ability, so that the body can remove the evil-qi by itself and then return to health. So it is said that "the evil-qi will be removed spontaneously when the genuine-qi returns to sufficiency; and strengthening the genuine-qi is just the elimination of the evil-qi " The measure taken to strengthen the genuine-qi is to replenish the deficiency, and it is applied mainly in the cases in which the genuine-qi is insufficient, and the evil-qi is mild; or in cases in which the deficiency of genuine-qi is the primary problem, even though evils exist. According to patients' conditions, different therapeutic methods (e. g. , replenishing qi, nourishing the blood, nourishing yin, and tonifying yang) are adopted to supplement the body's essence, qi, blood, and fluid, which are fundamental substances for the functions of the viscera, meridians, and collaterals.
2. Removing the Evil-Qi to Help the Genuine-Qi
This approach refers to measures such as medication, acupuncture, moxibustion,
cupping, and operations, which remove the evil-qi, so that the genuine-qi returns to normal spontaneously when the evil-qi is eliminated. It is said that "to eliminate the evil-qi is just to strengthen the genuine-qi," and "the genuine-qi will restore spontaneously when evil-qi is removed." This approach is applied mainly when evil-qi is in abundance and genume-qi is insufficient, or when excessive evil-qi is the primary contradiction or the primary aspect of a contradiction although the genuine-qi is insufficient to some degree.
It has been proved in practice that it is essential to.eliminate the evil-qi when handling the relations between the genuine-qi and the evil-qi. According to what has been observed clinically, most of the exterior syndromes due to exogenous evils are excess syndromes, and for the treatment of these syndromes, the methods of eliminating evil-qi should be adopted. As for medication therapy, different evils respond to different purging therapies, which are much greater in quantity than that those used to strengthen genuine-qi. Relieving exterior syndrome, clearing away heat, detoxicating, purging, clearing away phlegm, resolving dampness, promoting urination, breaking blood stasis, eliminatag blood stasis, undoing lump, and destroying parasites, all are evil-eliminating methods. These are also methods used to remove the causes of diseases. In clinical practice, they can be adopted according to the concrete pathological conditions of the patient.
It must be pointed out that strengthening the genuine-qi can help in the elimination of evil-qi, and vice versa. In other word, the method of strengthening genuine-qi helps the body to resist and remove pathogenic factors ; while the elimination of evil-qi can stop them from invading into and damaging other parts of the body, prevent the genuime-di from being further impaired or consumed, and help the genuine-qi to return to its normal state.
3. Eliminating First and Then Tonifying
This is applicable to cases in which the abundant evils must be removed urgently, or cases in which the genuine-qi, although insufficient, can withstand drastic remedies. It is especially suitable in cases in which the deficiency syndrome is caused directly by evils For instance, in a febrile disease caused by exogenous evil, heat accumulates in the in testines and stomach, leading to symptoms such as distending abdominal pain and constipation; and the accumulating heat impairs the body's yin essence and consume body fluid, resulting in endogenous dryness, leading to such symptoms as reddened tongue with dry dark coating, absence of saliva, thirst, dry throat, and even delirium or coma. Purging the excess heat is urgently required, to eliminate the evil first and to replenish the genuine-qi afterward. If drastic purgatives are not administered and constipation persists the accumulation of evil-heat will become more and more serious, and the body's essence and fluid will be seriously impaired as a secondary effect. So urgent purging therapy is needed first; then drugs are given to nourish the yin-essence and body fluid, to regulat the viscera's functions. Purging therapy used for acute abdominal diseases in clinical practice reflects the principle of first administering medicine to drive out the evils and then giving tonic for recuperation.
4. Tonifying First and Then Eliminating
This is applicable mainly to cases in which genuine-qi is severely deficient, to the degree that the body's yin or yang is exhausted, and is too weak to stand elimination therapy. In this case, it is suitable to administer tonics first and to drive out the evils after wards. Once the genuine-qi returns to a sufficient state, drastic drugs are adopted to resolve the evils. In clinical practice, this principle is applied for the treatment of some cases, such as shock or heart failure.
5. Elimination and Reinforcement in Combination
This refers to the simultaneous application of both the evil-eliminating method and genuine-qi-strengthening method. It is applicable chiefly when the genuine-qi is weak and pathogens prevail. But in clinical practice, it is important to determine which is the key problem. If the abundance of evil is primary, clinicians should administer many drugs, or drugs in large quantities, to dispel the evils and only a few drugs, or drugs in smaller quantities, to strengthen the genuine-qi. However, in some chronic diseases in which the genuine-qi is extremely weak and evils that remain are mild, one should put stress on strengthening the genuine-qi, and less emphasis on dispelling pathogens. Generally speaking, this is a principle commonly used and it should be applied according to patient's concrete conditions. One should differentiate the primary from the secondary, and should not apply this principle mechanically.
