We have already learned about four properties and five flavors of Chinese herbs Although these theories are very important they cannot precisely reflect the entire process of how disease occurs and develops If we want to focus on the disease location neither five flavors nor four properties can illustrate. So we have a specific medicinal property theory directed at the disease location meridian entry (meridian tropism) Now let's learn about location of disease and meridian entry of Chinese herbs First, meridian entry What's the concept of meridian entry Literally entry refers to where it pertains to Meridian refers not only to the meridians (of course it's related to meridians) but also to specific zang-fu organs and other related tissues as well as the pathways of meridians In a word, it reflects the disease location Meridian entry refers to the speficic position that an herb acts upon It is a concept of the functional location of herbs This theory is very important For example, same heat syndrome can be treated with cold-property herbs however, we may find the herbs work for some problems but do not work for others Obviously, this is related to whether the herbs you selected corresponds to the exact location of that heat syndrome That's why meridian entry is vital to clinical prescriptions Likewise how to determinate the meridian entry also involves two aspects One is theoretical guidance You need to first understand zang-fu organs and pathways of meridians and the relationship between zang-fu organs and tissues You need to be clear about this you also need to know pattern identification of zang-fu organs How do you conclude this problem is related to the heart or that problem is related to liver So this comes down to theoretical basis of zang-fu and meridian theory This makes the first aspect The second aspect, we have been always saying herbs are used to treat diseases You need to make pattern identification before selecting herbs As a result, as for the criteria of selectign herbs the exact disease location should be the basis to decide the meridian entry Then how do we decide it This involves three levels The first level: Pathological changes of zang-fu organs is the basis for meridian entry For instance, if a patient presents with palpitations, chest tightness, poor sleep one glance and you will know it has something to do with the heart And for sure, we choose herbs that can act upon the heart and calm the mind such as Suan Zao Ren (Semen Ziziphi Spinosae) and Zhu Sha (Cinnabar) Those herbs can relieve palpitations, improve sleep and alleviate chest tightness So we consider Suan Zao Ren and Zhu Sha enter the heart meridian We should know that the first criteria is related to zang-fu organs For another example if a patient has cough, panting and profuse phlegm we can easily tell it's related to the lung with the locatin of the lung we certainly should choose herbs that can act upon the lung such as Ma Huang (Ephedra Sinica) and Xing Ren (Semen Armeniacae Amarum) After taking Ma Huang and Xing Ren the cough and asthma were relieved and phlegm was reduced. So we assume Ma Huang and Xing Ren enter the lung meridian Vomiting and hiccough are related to the stomach. They are caused by adverse up-flow of stomach qi and can be treated with Ban Xia (Rhizoma Pinelliae) and Pi Pa Ye (Folium Eriobotryae) Since the symptoms can be eliminated by Ban Xia or Pi Pa Ye they enter the stomach meridian Thus the first basis of meridian entry is the pathological changes of meridian-related zang or fu organs This is how we determinate meridian entry That was the first level The second level of deciding meridian entry is tissues related to zang-fu organs As is known to all, traditional Chinese medicine is centered on five-zang organs that connect with all tissues and organs into an organic whole Such as nose and the lung: the lung opens into the nose eyes and the liver: the liver opens into the eyes ears and the kidney: the kidney opens into ears. Therefore, if a patient experienced deafness and tinnitus having hearing loss and hearing impairment the herbs we select must be directed at the kidney such as Gou Qi Zi (Fructus Lycii) Nv Zhen Zi (Fructus Ligustri Lucidi) and Ci Shi (Magnetitum) These herbs and mineral (rocks) can help alleviate deafness, tinnitus and hearing loss Beyond doubt, they enter the kidney meridian Likewise, if a patient has a stuffy and runny nose we can select Xin Yi Hua (Flos Magnoliae), Can Er zi (Fructus Xanthii) and Xi Xin (Herba Asari) and so on to relieve above symptoms So we think these herbs enter the lung meridian because the lung opens into the nose Similarly, if a patient presents with redness, swelling adn pain of the eyes or tears and blurred vision after using eyes for an extended period of time We can use Gou Qi Zi, Ju Hua (Flos Chrysanthemi) and and Che Qian Zi (Semen Plantaginii) to Alleviate above symptoms Then we think they enter the liver meridian because the liver opens into the eyes So this was the second level The third level is the disease-related meridians or the pathways of meridians We know that there are 12 regular meridains They travel in different parts of the body along different pathways Take headache for example the occipit is mostly closely related to the bladder meridian If a patient presents with occipital headache I can use Qiang Huo ( Rhizoma et Radix Notopterygii) to Relieve or eliminate the headache So we think Qiang Huo enters the bladder meridian The forehead and face in Chinese medicine, are mostly closely related to the stomach we can use Bai Zhi (Radix Aangelica Dahurian) to treat frontal headache and gum swelling and pain So we think Bai Zhi enters the stomach meridian We can think of it this way determining meridian entry of Chinese herbs should be based on the exact disease location. As I said we have zang-fu organs tissues, and pathways of meridains which are three levels I've mentioned that meridian entry plays a vital role in clinical prescription On one hand, it helps enhance the therapeutic effect because it is highly targeted On the other hand, it improves the accuracy of prescription So meridian entry deserves a close attention Here I'd like to clarify two points First, all herbs have their pertained meridians some has only one, such as Yu Xing Cao (Herba Houttuyniae) only enters the lung meridian and Zhu Sha (Cinnabar) only enters the heart meridian but more herbs enter two or more meridians It tells us the fewer meridians it enters, the more specified action it has whereas herbs enters mulitple meridians have more extensive indications in clinical practice This was the first point I'd like to add The second point is that We cannot limit the understanding and application of medicinal property to one single aspect Instead, we should take all aspects into consideration For example meridian entry and four properties Four properties reflect the cold/heat nature of herbs targeting cold or heat syndrome But meridian entry targets specific disease locations If a patient has hyperactivity of fire-heat the treatment principle is to treat heat with cold by using cool or cold-property herbs What herbs are you going to use You cannot pick one at random since some may work and some may not Even the same heat syndrome can occur in different locations For instance, a patient with exuberant heart fire should be treated with herbs that act upon heart fire such as Huang Lian (Rhizoma Coptidis) a patient with exuberant lung heat should be treated with herbs that clear lung heat such as Yu Xing Cao (Herba Houttuyniae) and a patient with exuberant liver fire should be treated with herbs that reduce liver fire such as Long Dan Cao (Radix Gentianae) Also, a patient with exuberant stomach fire should be treated with herbs that clear stomach fire such as Shi Gao (Gypsum) To put it another way considering from the relationship between meridian entry and four qi undoubtedly, we should pay attention to the accurate position of therapeutic action for example, if a patient has cough and asthma the first thing I can think of is the lung For sure, I should choose herbs that act upon the lung However, cough and asthma can be diagnosed as cold or heat For same symptoms if they are caused by lung heat, Huang Qin (Radix Scutellariae) shuld be used If they are caused by lung cold, Gan Jiang (dried ginger) should be used As a result, the understanding and application of medicinal properties should be taken into overall consideration rather than merely emphasizing a certain aspect So I have focused on three aspects of the theory regarding Chinese medicinal properties First, four properties directed at cold/heat syndromes Second, five flavors about actions of herbs And third, meridian entry with respect to disease location In fact, there are many more theories about meidicinal property such as tonifying and purging moistening and drying dispersing and keeping toxicity, ascending and descending Those theories will be introduced later in chapters of specific herbs or safety of herbs to you That's all for this session
