Hello, every one. Last class we have discussed the benevolent basis of the Chinese Medicine ethics then this class I will talk about the moderate ideology (zhizhonghe)of traditional Chinese medicine in the review of Confucianism we once talked about that "neutralization and mean" is one of the core ideas so what is "neutralization"? it is called "zhong" when people do not express his feelings, while called "he" when express out his feelings but control it let us read the definition in the Book of Rites·Mean Zhong is the root of all human He is the universal rules followed by people when reached Zhong and He, everything will develop properly what is it mean? Zhong is the foundation of social stability He is the methods of interaction with others when reaches Zhong and He everything will in its proper place and develop naturally therefore, it is a very good state an ideal state when understanding this thought the mistake that people always made is to pursue absolute neutralization but in fact it should be harmonious as a whole and unification of diversity from social angle the development with absolute mean and without difference is lack of motivation from human himself, even the healthy person yin and yang in the body(briefly understood as substance,energy etc. in western medicine) are constantly changing if you do not quite understand yin and yang I can say some index of modern medicine for your understanding such as blood sugar, blood fat, blood pressure and so on are all in the dynamic change I once made an electrocardiogram named 24 hours it is very interesting I found my heart rate is constantly changing it is probably around seven clock, the heart rate changes most rapidly and it is most slowly at three or four clock at night many people may not image how frequent it is just over twenty times that is to say these index are changing dynamically in one day however in fact, he is a healthy man at that time so it is a dynamic balance from the perspective of nature there are the change of four seasons, temperatures and the movement of sun and moon they are all changing in a certain range therefore, Zhi Zhong He is a kind of dynamic trend and stability in time and space the idea of Zhi Zhong He has already permeated in many areas of traditional Chinese medicine and pharmacy then let us see the first effect of Zhi Zhong He on TCM Etiology let's see the unbalance of emotions Chinese Medicine considers that,seven human emotions are happy, anger, worry, love,sorrow, fear,and hate happy comes from heart,anger from liver, love from lungs, fear from kidney in the normal condition, the change of seven emotions is normal and will not bring disease over the degree will hurt the body, namely when spirit boost is too intensively or lasts too long beyond the ability of self-control these parameters I just said is changing everyday but it has a certain range for example, your blood pressure cannot over 160 it is generally considered that over 150、160 is hypertension and your diastolic pressure can not over 90 it has a limit when beyond the ability of human self-control it will cause the imbalance of human system and affect human health the imbalance of seven emotions will lead to the air loss and disorder of five organs I just said seven emotions are related to the function of five organs so," diseases are all from pneuma, it is caused by anger, smoothed by joy and removed by sorrow down by fear, chaotic by surprise and heal by love it is referred in Huangdi Nei jing·plain questions the up, down, removed, smooth, chaotic and heal discussed here is referred to the disorder of pneuma caused by over emotions the doctor of tradition Chinese medicine thinks qi movement is important it is an manifestation of normal human body function so it is said joy and surprise make heart-broken when said this, can you think about in Chinese ancient stories is there a story in which some character has this condition joy、surprise make heart-broken maybe many people think of immediately oh, it is Fanjin the story is about Fanjin whose family members are all poor common people, but he, surprisingly passed the provincial civil service examination this was the biggest good news for his whole family 82 however,he was over joyful,and became sick joy, surprise damage heart then how to understand anger impairing liver you maybe see many people get angry do you ever notice their action when they fly into a rage someone may cover the lower right rib after their anger because they feel the liver uncomfortable and contemplation hurts spleen is also the crucial reason nowadays many people like thinking contemplation hurts spleen also causes disease dose anyone can recall in the Chinese history is there any character in the novel having spleen hurt by contemplation you may think about the Dream in Red Mansions there is a character named Lin Daiyu she got lovesickness she felt sorrow when she heard Jia Baoyu would engage soon then she got sick at last she pined away for eating nothing Lin is very slim, right? It has something to do with lovesickness which hearts the spleen. She doesn't want to eat. surely, besides the lovesickness, her sadness also hurts the lungs. she is in a depression for a long period. of course there is another saying that may be she has the phthisis. all in all, her body degenerated in the end. you may have some other thinking while mentioning sadness hurts the lungs. when someone is in great sadness or depression he may behave some manner unconsciously i don't know whether you have noticed what the behaviour is alas, he sighed then why he sighed? because his sadness has hurt his lungs and the sigh made him feel smooth and comfortable then he will feel relax what's more, fear hurts kidney perhaps you have seen some cases like in some spy TV series, when the betrayers were caught, they might too frighten to pee in their trousers that means fear hurts kidney kidney controls the water in our body, that makes sense too many emotional fluctuation will hurt the heart therefore, one that good at preserving his health would keep a balance between one's happiness and sadness this is the highest realm so anyone who knows this knows how to keep his health in a good state besides the influence of emotion, some diseases may caused by losing control such as the abnormal of air, the failure of controlling diets, the imbalance of rest and tired these are all embodies of losing control it means the changes of seasons and climates go beyond people's ability of adjusting the huge decrease of temperature and so on or the lack of self regulation makes people couldn't adapt to the climate changes, thus to arouse sickness secondly, let's take a look at the influence of attaining a state of harmony to our health as mentioned in the book "Su Wen Tiao Jing Lun" then yin and yang are balanced, the body becomes robust, the nine indicators of the body's pulses will also be concert. this occurs in a normal, healthy person. the normal, healthy person means a person has a balanced yin and yang a professor said in a funny way that a person without yin and yang means a person with a balanced yin and yang "Su Wen Sheng Qi Tong Tian Lun" says, the most importance of yin and yang is the gather of yang if the relationship between yin and yang are messed, then people's body will be messed too therefore the balance between them is the ideal realm what does the ideal realm mean here? it means the golden mean, the saints' realm then what does "five kinds of impairments caused by overstrained" in Huangdi Neijing mean? it means that use your eyes overtime hurts your blood. today many of us may stare at the computer screen for a whole day then it will hurt our blood lie in the bed for long time may hurt our qi if a healthy person always lies in bed, he will be sick in the long run what is qi? it is our body function in Chinese medicine his body function is losing sit to much hurts our body if a person always sit there without doing some exercise, finally it will hurt the body shape standing too much hurts the bone if one always stand, his bone may hurts of course, modern medicine tells us people couldn't always stand out skeletal system may bear much pressure walking too much hurts our tendon always running and walking outside may hurts our tendon then what about balance on diet food may benefit people at the same time hurt people in normal cases food benefits people but when you take it wrongly, it hurts. hence, the mean is catch the balance and take control confucianism emphasizes not eating too much modern medicine proves that a low energy intake is good for health but besides not eating too much, we also emphasizes not eating too little, but to have a good balance surely, today's many diseases are caused by food Huangdi Neijing Plain Questions says, eating twice as usual hurts the intestines and stomach you may know that many Chinese are suffering from intestines and stomach diseases especially after the reform and opening up policy, people's living condition improved more people suffered from this kind of disease that is because people eat too much, not too little in the old poor days, people don't have enough to eat, and thus suffering from malnutrition as Sun Simiao says,"if one eat all the five flavors, then he must has a control of not eating too much." that means one could not eat without control, the same knowledge therefore, "a person good at keeping healthy eats while hungry and drink while thirsty" that means you eat when you feel hungry this is mentioned in Qianjin Fangyao Chinese medicine says eating five flavors may nourish our five organs but when one tends to one particular flavor, which means the partial eclipse that hurts five organs too partial eclipse is normal in us too that means you could't tend to one particular flavor you need to keep a balance modern medicine also requires the balance of nutrition one must eat vegetables, fruits, staple food and so on thirdly, let's take a look at the thought of golden mean's influence to Pharmacology of traditional Chinese medicine here i take two examples in the first example, there is a kind of soup, called the soup of neutralization it is made by Rhizoma Atractylodis Macrocephalae,orange peel, ginseng,liquorice,Poria cocos and Mangnolia officinalis it could adjust our yin and yang, benefits our spleen and stomach, increasing our appetite so each medicine in the soup benefit our spleen and stomach in a balanced way, not too little nor too much then reach the aim of the golden mean it has the medicine of repair our qi it also has medicine to excreting dampness and promoting the circulation of qi that is a nutritional supplement without an overtake as to the influence of the medicine Xu Dachun in Qing dynasty once said a funny sentence saints made the prescription for him to nurse one's health it may useful to one particular disease, or all kinds of problems, it may coordinate with each other, or opposite, or control each other. so a prescription not only can preserve each medicine's function, but also lose them making prescription is tricky. you have to be careful, or it will lose all their respect functions if done it properly, it will have the combined function of all the medicines Cheng Jiamo said we should also pay attention to the balance of the medicines. the key is mean, less is useless, more the medicine will backfire. pay attention, if you go home to brew medicines usually, stems should be heated for a longer time this way it can perform its functions as for the leafy medicines such as those for curing flu, you should not brew them too long. or they will lose their functions they are all of the same reason during the process of prescription we just mentioned the need for cooperation Chinese traditional medicine is quite tricky take ephedra decoction for example ephedra decoction is made up of four medicines including ephedra, Cassia twig, apricot and liquorice its function is to induce perspiration and relieve asthma such as to treat common cold i believe many of you have been caught up with the flu that is the result of sudden temperature drop or the decrease of body resistance so what are the symptoms of the flu? aversion to cold with fever aversion to cold means the patient will be extremely sensitive to cold which means even covered with two blankets, he will still feel cold but according to his temperature, he is actually burning up. This is aversion to cold with fever. ache all over the body, including the limbs the patient will have trouble breathing, but unable to sweat. but once ephedra decoction successfully induce the perspiration, these symptoms will disappear gradually in this prescrption, ephedra serves as the main medicine to induce perspiration like the king ruling the world in the old times he is the main medicine in this prescription and Cassia twig mainly serves to help ephedra to perform its function adding apricot is because apricot could help ephedra to relieve asthma it tackles the lesser symptom of asthma it is helpful in that way lilquorice is also very important. it was called conductant drug, serves to balance the medicines. monarch drug is the main element while ministerial drug serves to help and limit its functions namely prevent it inducing too much perspiration to create a balanced state and conductant drug is the backup to finish what's been missed by monarch drug and ministerial drug or balance the two this is a reflection of traditional Chinese thought. Fourth, the idea of mean's influence on treatment principle Chinese traditional medicine believes too much Yin and too much yang are both excessive too little yin and yang are both insufficient both excessiveness and insufficiency will cause trouble to our body, as we have mentioned the so-called yin and yang in equilibrium is not too excessive or too insufficient the book concise exposition on febrile disease says typhoid fever on the surface will appear as sweat typhoid fever on the inside will be dealt by the body. those not on the outside or in the inside are not too easy to induce perspiration or be relieved from the body, in this circumstance, a balanced way is recommanded. so what is their suggestion, when the problem is not in the body or on the surface, but in between? deal with it properly. both perspiration or diarrhoea aim to create the state of balance. to adopt this kind of treatment is the result of the idea to attain a state of harmony in medicine field attaining a state of harmony equals the perfect state of yin and yang in a state of equilibrium when not, it's called discord which will lead to sub-health, even serious symptoms. prevention, treatment, prescription and making are all permeated with this thought besides personal health, the relationship between man and nature, man and society and interpersonal relationships are all the same no woner 75 nobel prize winners since 1988 made their co-speech in Paris that if man were to live in the 21st century, we must back to 2500 years ago and seek wisdom from Confucius, that's the same reason that's all for this class next time we will talk humanistic care in Confucianism thought.