{ "meta": { "dataset": "theory", "title": "Theory, diagnosis, therapies and patterns / 理论·诊法·治法·证候", "source": "Meridian Bridge — TCM Knowledge Base", "homepage": "https://lieke-ai.com/mb/", "page": "https://lieke-ai.com/mb/data/theory.html", "license": "CC BY 4.0", "license_url": "https://creativecommons.org/licenses/by/4.0/", "citation": "Meridian Bridge. TCM Knowledge Base — Theory, diagnosis, therapies and patterns / 理论·诊法·治法·证候 [data set]. https://lieke-ai.com/mb/data/theory.html (accessed 2026-10-18).", "generated": "2026-10-18T16:31:07Z", "note": "Long-form entries with both the English and the Chinese text, and the classical source each one is drawn from.", "disclaimer": "Educational and cultural reference only. Not medical advice: no diagnosis, no prescription, no dosing, no recommendation of specific medicines." }, "count": 114, "items": [ { "slug": "yin-yang", "section": "fundamentals", "title_en": "Yin and Yang", "title_zh": "阴阳", "pinyin": "yīn yáng", "body_en": "Yin and Yang are not good versus evil, and not two separate things. They are two complementary aspects of one phenomenon. Yin is the cooler, quieter, interior, resting, material side; Yang is the warmer, more active, exterior, moving, functional side.\nHealth in this model is their relative balance — and, more importantly, their ability to keep turning into one another. Every other TCM concept (cold and heat, excess and deficiency, interior and exterior) is built on this pair.", "body_zh": "阴阳不是\"好与坏\"，也不是两个彼此独立的东西，而是同一事物相互对待、相互转化的两个方面。阴偏于寒凉、安静、内在、收藏、物质；阳偏于温热、活动、外在、升发、功能。\n传统理论认为，健康在于二者的相对平衡，更在于它们能正常地互相转化。中医里的寒热、虚实、表里等一切概念，都建立在这一对关系之上。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "qi-concept", "section": "fundamentals", "title_en": "Qi", "title_zh": "气", "pinyin": "qì", "body_en": "\"Vital energy\" is a misleading translation. In TCM theory Qi is closer to functional activity — the capacity to transform, move, warm, hold and protect. It is not a substance measured like a vitamin, and no physical correlate has been identified.\nClassical texts distinguish functional types: Yuan Qi (source), Zong Qi (gathering, tied to breath and the heart), Ying Qi (nutritive, moving with Blood) and Wei Qi (defensive, at the surface). Read it as a working model, not a measurable thing.", "body_zh": "\"生命能量\"是个容易误导的译法。在中医理论中，气更接近\"功能活动\"——转化、推动、温煦、固摄、防御的能力，而不是一种能像维生素那样被测量的物质，目前也没有找到对应的实体。\n经典文献区分出元气、宗气、营气、卫气等功能类型。应把它理解为一种工作模型，而不是可测量的东西。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "five-phases", "section": "fundamentals", "title_en": "Five Phases", "title_zh": "五行", "pinyin": "wǔ xíng", "body_en": "Wood, Fire, Earth, Metal and Water are five patterns of change, not five kinds of matter. Each is tied to a direction of movement (Wood expands, Metal contracts, Water descends and stores, Fire rises, Earth stabilises the centre), plus an organ pair, a season, a colour, an emotion and a flavour.\nPractitioners reason with two relations — generating (Wood feeds Fire) and controlling (Water controls Fire). It is a relational framework for thinking about how systems influence each other.", "body_zh": "木火土金水是五种\"变化方式\"，不是五种物质。每一行对应一种运动趋向（木升发、金收敛、水下行而藏、火炎上、土居中运化），并对应一对脏腑、一个季节、一种颜色、一种情志、一种味道。\n中医用\"相生\"（木生火）与\"相克\"（水克火）来推理系统之间如何互相影响。它是一个用来思考系统关系的关系型框架。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "zang-fu-concept", "section": "fundamentals", "title_en": "Zang and Fu — the \"organ\" systems", "title_zh": "脏腑", "pinyin": "zàng fǔ", "body_en": "The Zang are not the anatomical organs of modern medicine. Each Zang — Heart, Liver, Spleen, Lung, Kidney, plus Pericardium — names a functional system that also carries a mental-emotional aspect, a tissue, a sense organ, a fluid and a season.\nThe Fu (Gallbladder, Stomach, Small Intestine, Large Intestine, Bladder, San Jiao) are described as hollow and associated with receiving, transforming and transmitting. TCM \"Kidney\", for instance, covers part of what modern medicine assigns to adrenal, endocrine, reproductive and skeletal function. Reading these words as anatomy is the single most common misunderstanding of TCM.", "body_zh": "中医的\"脏\"并不等同于现代医学的解剖器官。每一个脏——心、肝、脾、肺、肾，加心包——命名的是一套功能系统，同时带有情志、组织、官窍、体液与季节的对应。\n六腑（胆、胃、小肠、大肠、膀胱、三焦）被描述为\"中空\"，与受纳、传化、排泄相关。例如中医的\"肾\"，覆盖了现代医学中肾上腺、内分泌、生殖与骨骼的部分功能。把脏腑当解剖器官来读，是理解中医最常见的误区。", "source": "Classical theory · Huangdi Neijing, Nanjing", "note": "" }, { "slug": "blood-fluids", "section": "fundamentals", "title_en": "Blood and body fluids", "title_zh": "气血津液", "pinyin": "qì xuè jīn yè", "body_en": "Xue (Blood) and Jin Ye (fluids) are described as the material, nourishing side of the body, paired with Qi as the moving, warming side. The phrasing is almost always relational: \"Qi moves Blood, Blood carries Qi.\"\nThin fluids are said to moisten skin and muscle; thicker fluids nourish joints, marrow and the sense organs. In TCM reasoning these categories explain dryness, swelling and poor circulation patterns — again as a model, not as laboratory findings.", "body_zh": "血与津液被描述为身体\"物质、滋养\"的一面，与\"气\"的推动、温煦一面相对。经典中的表述几乎总是关系式的：\"气行血，血载气\"。\n清稀的津液润养肌肤肌肉，稠厚的液则滋养关节、骨髓与官窍。中医用这些范畴来解释干燥、肿胀、运行不畅等证候——同样是一种模型，而非实验室发现。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "jing-essence", "section": "fundamentals", "title_en": "Essence (Jing)", "title_zh": "精", "pinyin": "jīng", "body_en": "Essence is the constitutional, store-able, slow-changing aspect — associated with the Kidney system, growth, reproduction and ageing. Roughly \"what you were born with, plus what you have drawn from food and rest\".\nIt is the part of the model that most resembles a reserve, which is why the classical literature on longevity is full of warnings about dissipating it.", "body_zh": "精是本质的、可储藏、变化缓慢的一面——与肾系、生长、生殖、衰老相关。大致相当于\"先天所禀，加上后天从饮食与休息中所得\"。\n在这个模型里，它最接近\"储备\"的概念，因此经典中关于养生的论述里充满\"勿妄耗\"的告诫。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "shen-spirit", "section": "fundamentals", "title_en": "Spirit (Shen)", "title_zh": "神", "pinyin": "shén", "body_en": "Shen is consciousness, awareness and emotional presence, associated above all with the Heart system. In the four examinations a practitioner reads Shen in the eyes and the overall bearing.\nIt is said to be the single most prognostic sign — which is worth noting, because \"this person looks well\" is something any experienced clinician recognises, in any tradition.", "body_zh": "神是神志、意识与精神状态，首先与心系相关。四诊中望神主要看目光与整体气度。\n它被认为是判断预后最重要的征象——这一点值得注意，因为\"这个人看起来精神尚好\"是任何传统的资深医者都熟悉的判断。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "wei-and-ying", "section": "fundamentals", "title_en": "Defensive and nutritive Qi", "title_zh": "卫气与营气", "pinyin": "wèi qì · yíng qì", "body_en": "Wei Qi is described as circulating at the surface, between skin and muscle, resisting external influences. Ying Qi is described as moving with the Blood and nourishing internally. They are two functions of one model, not two substances.\nThe nearest modern analogue people reach for is immune surveillance, but the mapping is loose and should be treated as a metaphor rather than an equivalence.", "body_zh": "卫气分布于体表、皮肤与肌肉之间，被认为能抗御外邪；营气与血同行偏于内养。它们是同一个模型的两项功能，不是两种物质。\n人们常拿\"免疫监视\"来类比卫气，但这种对应是松散的，宜作比喻而非等同。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "qi-movement", "section": "fundamentals", "title_en": "The four movements of Qi", "title_zh": "气机升降出入", "pinyin": "qì jī shēng jiàng chū rù", "body_en": "Qi is described as having four directions of movement: rising, descending, exiting and entering. Health is said to depend on these four keeping their proper direction; illness is described as them going the wrong way.\nThis is the origin of phrases like \"stomach Qi rebelling upward\" for nausea, or \"sinking Qi\" for prolapse. It is a directional vocabulary, and much of TCM symptom language depends on it.", "body_zh": "气被描述为有四个运动方向：升、降、出、入。传统认为健康取决于四者方向各得其常，而疾病则被描述为方向失常。\n这正是\"胃气上逆\"（形容恶心）、\"中气下陷\"（形容下垂）这类说法的来源。它是一套方向性的词汇，中医症状语言很大一部分依赖于此。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "six-influences", "section": "fundamentals", "title_en": "The six influences", "title_zh": "六淫", "pinyin": "liù yín", "body_en": "Wind, Cold, Summer-heat, Damp, Dryness and Fire are six descriptions of how external conditions are said to interact with the body. Wind is the most abstract: it describes signs that move around or come on suddenly.\nRead them as descriptions of patterns, not as weather-based causes in a modern sense. Damp, for instance, describes heaviness and sluggishness — a set of features, not humidity itself.", "body_zh": "风、寒、暑、湿、燥、火是六种描述外界条件如何与身体相互作用的说法。其中\"风\"最抽象，用于描述游走不定或突然出现的一类征象。\n应把它们读作证候的描述语言，而不是现代意义上的气象致病原因。例如\"湿\"，描述的是沉重、黏滞的一组特征，而不是湿度本身。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "seven-emotions", "section": "fundamentals", "title_en": "The seven emotions", "title_zh": "七情", "pinyin": "qī qíng", "body_en": "Joy, anger, worry, pensiveness, grief, fear and fright are described as affecting the organ systems — anger the Liver, pensiveness the Spleen, fear the Kidney, and so on.\nThis is one of the parts of TCM that modern readers find easiest to take seriously, because the observation that emotional states affect physical health is not controversial. What is specific to TCM is the mapping and the vocabulary.", "body_zh": "喜、怒、忧、思、悲、恐、惊被描述为会影响脏腑系统——怒伤肝、思伤脾、恐伤肾等。\n这是现代读者最容易接受的部分之一，因为\"情绪影响身体\"本身并无争议。中医的特殊之处在于它的对应关系与术语体系。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "pattern-vs-disease", "section": "fundamentals", "title_en": "Pattern versus disease", "title_zh": "证与病", "pinyin": "zhèng yǔ bìng", "body_en": "A Western diagnosis names a disease; a TCM pattern (证) names a configuration of signs in one person at one time. Two patients with the same disease may be given different patterns; one patient with different diseases may share a pattern.\nThis is why TCM and modern medicine are not simply rival answers to the same question. They are answering different questions with different instruments.", "body_zh": "西医的诊断给出的是\"病名\"；中医的\"证\"给出的是某个人在某一时刻的一组征象配置。同为一种病，两人可能辨为不同的证；不同的病，也可能共有同一个证。\n这就是为什么中医与现代医学并不只是\"对同一问题的两个竞争答案\"——它们用不同的工具回答不同的问题。", "source": "Classical method", "note": "" }, { "slug": "body-clock", "section": "fundamentals", "title_en": "The meridian clock", "title_zh": "子午流注", "pinyin": "zǐ wǔ liú zhù", "body_en": "A classical scheme in which each of the twelve primary meridians is assigned a two-hour period of the day, with Qi said to be most active in that meridian at that time.\nIt is used as a memory aid and as a framework for some classical timing rules. It should not be read as a claims about measurable physiology; the value is organisational.", "body_zh": "一种经典的时间配属方案：十二条正经各对应一日中的两个时辰，认为此时经气在该经最盛。\n它被用作记忆工具，也是一部分经典择时法则的框架。不应把它读作关于可测量生理学的结论；它的价值在于组织信息。", "source": "Classical theory", "note": "" }, { "slug": "san-jiao-question", "section": "fundamentals", "title_en": "Why the San Jiao has no organ", "title_zh": "三焦为何无实体", "pinyin": "sān jiāo", "body_en": "The San Jiao is the only Fu with no anatomical counterpart at all. Classical texts describe it as dividing the torso into upper, middle and lower regions for reasoning about the movement of Qi and fluids.\nIts lack of physical basis is not hidden by the tradition — it is a well-known topic in TCM theory. It is a useful example of how the system is willing to include openly abstract categories.", "body_zh": "三焦是六腑中唯一完全没有解剖器官对应者。经典把它作为把躯干分为上、中、下三段的划分，用于推理气与水的运行。\n传统本身并不隐讳它缺少实体对应——这在中医理论中是常被讨论的题目。它很好地说明了这个体系愿意容纳明显抽象的范畴。", "source": "Classical theory", "note": "" }, { "slug": "terminology-problem", "section": "fundamentals", "title_en": "Why TCM writing is hard to read", "title_zh": "为什么中医文字难读", "pinyin": "shù yǔ", "body_en": "The single biggest obstacle for learners is terminology. The same Chinese word is translated differently by different authors: 气 appears as qi, chi and \"vital energy\"; 脾 as spleen, \"the spleen system\" and \"the digestive centre\".\nA second obstacle is that many terms are borrowed words — \"liver\" and \"spleen\" in TCM are not the organs. Our recommendation: always learn the Chinese character with the English term, and treat English translations as labels rather than definitions.", "body_zh": "学习者最大的障碍是术语。同一个中文词被不同作者译得五花八门：气有 qi、chi、\"vital energy\" 等写法；脾有 spleen、\"the spleen system\"、\"the digestive centre\" 等译法。\n第二个障碍是许多词是\"借用词\"——中医的\"肝\"\"脾\"并不是那些器官。我们的建议是：学英文术语时永远连汉字一起记，并把英文译名当作标签，而不是定义。", "source": "Editorial overview", "note": "" }, { "slug": "evidence-honest", "section": "fundamentals", "title_en": "What the research actually shows", "title_zh": "研究到底说了什么", "pinyin": "zhèng jù", "body_en": "Being honest about the evidence is part of understanding TCM. The picture is uneven: it is not \"all disproven\", and it is not \"all proven\".\nSome areas have a substantial trial literature with mixed results — acupuncture for chronic pain and for chemotherapy-related nausea are the two most studied. Others have very little. Risk of bias, blinding difficulties and publication bias are recurring problems in the field, and a single positive trial is not enough to change practice in any branch of medicine.", "body_zh": "如实看待证据，是理解中医的一部分。实际情况并不均匀：既不是\"全被推翻\"，也不是\"全部证实\"。\n有些领域已有相当数量的试验而结果不一——针灸用于慢性疼痛、以及用于化疗相关恶心，是研究最多的两项。另一些领域则证据极少。偏倚风险、盲法困难与发表偏倚是该领域反复出现的问题；在医学的任何分支里，单个阳性试验都不足以改变临床实践。", "source": "Critical reading", "note": "This is a general statement about literature quality, not advice about your own treatment." }, { "slug": "who-standard", "section": "fundamentals", "title_en": "The WHO point standard", "title_zh": "WHO 腧穴标准", "pinyin": "wèi shēng zǔ zhī", "body_en": "In 2008 the WHO published Standard Acupuncture Point Locations in the Western Pacific Region, giving internationally agreed locations for 361 points. It is the reason a practitioner in Germany and one in Korea can point to the same spot and mean the same thing.\nThis matters for more than tidiness: it is the precondition for comparing research results across countries.", "body_zh": "2008 年世界卫生组织发布《标准针灸穴名定位（西太平洋地区）》，为 361 个腧穴给出国际一致的定位。正因为如此，德国与韩国的执业者指向同一点时说的才是同一件事。\n这不仅是整齐与否的问题：它是跨国比较研究结果的前提。", "source": "WHO 2008", "note": "" }, { "slug": "licensing-world", "section": "fundamentals", "title_en": "Licensing differs enormously", "title_zh": "各国监管差异极大", "pinyin": "zhí yè zī gé", "body_en": "There is no single global rule. In the United States most states license acupuncturists and the title is protected; national bodies administer examinations. In Australia, practitioners are registered under a national scheme. In the United Kingdom there is no single statutory regulator, and several voluntary registers operate.\nThe practical consequence: before booking, check your local health authority for how to verify credentials, and ask about needle hygiene, single-use needles and what training the practitioner holds.", "body_zh": "全球没有统一规则。美国多数州对针灸师实行执照管理，该称谓受法律保护；澳大利亚将其纳入全国注册体系；英国没有单一法定监管机构，而是由数个自愿注册机构运作。\n实际含义是：就诊前请查阅当地卫生主管部门如何核验资质，并询问针具卫生、是否使用一次性针具，以及执业者的受训背景。", "source": "Editorial overview", "note": "Rules change; verify with your local authority." }, { "slug": "first-session", "section": "fundamentals", "title_en": "What a first session is like", "title_zh": "初次就诊是什么样", "pinyin": "chū zhěn", "body_en": "A first consultation typically takes longer than follow-ups. Expect a long history — sleep, appetite, digestion, temperature preference, pain, emotions, menstrual history — plus tongue and pulse examination.\nThen treatment may include acupuncture, moxibustion, cupping, tuina, or a herbal prescription to take home. You should leave knowing what was found, what was given, and when to come back. If a practitioner tells you to stop taking prescribed medicine, that is a serious warning sign — get a second opinion.", "body_zh": "初诊通常比复诊时间长。会有一次很长的问诊——睡眠、饮食、消化、寒热喜恶、疼痛、情志、月经史——加上舌诊与脉诊。\n随后治疗可能包括针刺、艾灸、拔罐、推拿，或带回家服用的中药。离开时你应当知道自己被辨为什么、给了什么、何时复诊。如果执业者让你停用正在服用的处方药，这是严重的警示信号——请另找医生评估。", "source": "Practical guide", "note": "Not medical advice." }, { "slug": "granules-vs-decoction", "section": "fundamentals", "title_en": "Decoction, granules, pills", "title_zh": "汤剂、颗粒、丸剂", "pinyin": "jì xíng", "body_en": "Classically, herbs were boiled together and the liquid drunk. Most overseas clinics now use concentrated granules dissolved in hot water, or pills, because they are portable, standardised and taste far more tolerable.\nConvenience has a cost: the practitioner has less control over exactly what is in the mixture, and powders are easier to adulterate. Reputable suppliers test for heavy metals and pesticides — it is reasonable to ask.", "body_zh": "经典做法是数味药同煎、服用煎液。海外多数诊所现在改用热水冲服的浓缩颗粒或丸剂，因为便于携带、标准化程度高，而且味道远为可口。\n便利也有代价：从业者对配比的控制变弱，而粉剂更易掺伪。正规供应商会做重金属与农残检测——询问这一点是合理的。", "source": "Practical guide", "note": "" }, { "slug": "drug-interaction", "section": "fundamentals", "title_en": "Herbs and drug interactions", "title_zh": "中药与西药相互作用", "pinyin": "xiāng hù zuò yòng", "body_en": "This is the part of TCM with the highest stakes and the least public awareness. Herbs are pharmacologically active; some interact with prescription medicines in ways that are documented and clinically significant.\nExamples that appear repeatedly in the literature include ginseng, dong quai, goji and salvia with anticoagulants; licorice with blood-pressure and diuretic medicines; hawthorn with cardiac medicines; coptis (berberine) across a broad range.\nCommon sense rule: tell both your physician and your TCM practitioner everything you take, including supplements.", "body_zh": "这是中医里安全权重最高、而公众意识最低的部分。中药具有药理活性，其中一些与处方药的相互作用有明确记载且具有临床意义。\n文献中反复出现的例子包括：人参、当归、枸杞、丹参与抗凝药；甘草与降压药、利尿剂；山楂与心脏药物；黄连（小檗碱）的作用范围很广。\n一条常识性做法：把你服用的所有东西——包括保健品——同时告知你的医生与中医师。", "source": "Safety literature", "note": "General information, not a substitute for advice from a pharmacist or physician." }, { "slug": "pregnancy-caution", "section": "fundamentals", "title_en": "Pregnancy and traditional cautions", "title_zh": "孕期与传统注意事项", "pinyin": "yùn qī", "body_en": "Classical literature names a set of points and herbs described as contraindicated or to be used with caution during pregnancy — SP6, LI4, GB21, BL60 and CV4 among points; dong quai, safflower, motherwort and coix among herbs.\nWe list these as part of describing the tradition. The practical point is simpler: pregnancy is a situation where any treatment decision belongs with a licensed practitioner who knows your obstetric history, and where self-treatment is not appropriate.", "body_zh": "经典文献列出了一批孕期禁用或慎用的腧穴与药物——腧穴如 SP6、LI4、GB21、BL60、CV4；药物如当归、红花、益母草、薏苡仁。\n我们列出这些，是作为描述这一传统的内容。实际的做法更简单：孕期任何治疗决定都应由了解你产科史的持牌执业者来做，自行处理并不合适。", "source": "Traditional caution", "note": "Not a self-treatment guide. Consult a licensed practitioner." }, { "slug": "tcm-global", "section": "fundamentals", "title_en": "How TCM travelled", "title_zh": "中医如何走出去", "pinyin": "chuán bō", "body_en": "TCM is practised today in more than 180 countries and regions, with tens of thousands of clinics outside China. Acupuncture arrived in Europe and North America well before the herbal tradition did, carried by diplomats, émigré practitioners and, later, by research interest.\nThe result is a patchwork: in one country acupuncture sits inside hospitals and insurance schemes, in another it is a spa service. That patchwork is why this knowledge base gives the tradition rather than a set of instructions — the local rules matter more than any general advice.", "body_zh": "如今中医在 180 多个国家和地区被实践，中国境外有数万家诊所。针灸传入欧美远早于中药，早期由外交人员、移民执业者带动，后来则与科研兴趣有关。\n结果是一幅拼图：在一个国家里针灸进入医院与保险体系，在另一个国家里它只是水疗服务的一部分。正因为如此，这个知识库提供的是传统本身而不是一套操作指南——当地规则比任何通用建议都重要。", "source": "Editorial overview", "note": "" }, { "slug": "critical-reading", "section": "fundamentals", "title_en": "How to evaluate a TCM claim", "title_zh": "如何判断一个中医说法", "pinyin": "pàn duàn", "body_en": "Five questions cut through most marketing: What exactly is being claimed — a feeling, a mechanism, or a cure? Who says so, and do they sell the thing they are praising? Is there a source you can open, or only a testimonial? Does the claim involve a diagnosis of your condition? Are they promising a result that no treatment can guarantee?\nBeing sceptical about claims is not the same as dismissing a tradition. It is how you tell a careful practitioner from a salesperson.", "body_zh": "五个问题能穿透大部分宣传：他到底在声明什么——一种感受、一个机制，还是\"治愈\"？是谁说的，他是否在卖他夸的那个东西？有没有你能打开核对的来源，还是只有\"好评\"？这个声明是否包含对你病情的诊断？他是否承诺了任何治疗都无法保证的结果？\n对说法保持怀疑，不等于否定整个传统。这只是区分\"谨慎的执业者\"与\"推销者\"的方法。", "source": "Editorial overview", "note": "" }, { "slug": "four-examinations", "section": "diagnostics", "title_en": "The four examinations", "title_zh": "四诊", "pinyin": "sì zhěn", "body_en": "- Wang 望 — looking: complexion, body shape, movement, and above all the tongue.\n- Wen 闻 — listening and smelling: voice quality, breathing, cough and odour.\n- Wen 问 — asking: a long structured history — sleep, appetite, digestion, temperature preference, pain, emotions, menstrual history.\n- Qie 切 — palpating: the pulse at three positions on each wrist, plus the abdomen and channels.\nA practitioner is trained to combine all four into one pattern. Any single sign taken alone misleads.", "body_zh": "- 望：神色形态，尤重舌象。\n- 闻：语声、呼吸、咳嗽与气味。\n- 问：结构化长问诊——睡眠、饮食、消化、寒热喜恶、疼痛、情志、月经史等。\n- 切：两手寸口三部脉，兼及腹诊与经络触诊。\n受训的医者会把四者合为一个\"证\"。单独取任何一项都会失真。", "source": "Classical method", "note": "We describe the method; we do not teach self-diagnosis." }, { "slug": "tongue-diagnosis", "section": "diagnostics", "title_en": "Tongue diagnosis", "title_zh": "舌诊", "pinyin": "shé zhěn", "body_en": "The practitioner notes the tongue body (colour, shape, moisture, movement) and the coating (colour, thickness, distribution). In the model, body colour is read as reflecting deeper, longer-standing states and the coating as reflecting more recent digestive and fluid conditions.\nLighting, medication, coffee, smoking and even toothpaste change what is seen — which is why practitioners view the tongue as one input among four, never a verdict.", "body_zh": "医者观察舌质（颜色、形态、润燥、动态）与舌苔（颜色、厚薄、分布）。在模型中，舌质反映较深、较久的状况，舌苔反映较近的消化与津液状况。\n光线、用药、咖啡、吸烟乃至牙膏都会改变所见，因此舌象只是四诊之一，从不单独作为结论。", "source": "Classical method", "note": "Tongue appearance is affected by many non-TCM factors." }, { "slug": "pulse-diagnosis", "section": "diagnostics", "title_en": "Pulse diagnosis", "title_zh": "脉诊", "pinyin": "mài zhěn", "body_en": "Three positions on each wrist are felt at three depths, giving twenty-eight classical pulse qualities — floating, deep, slippery, wiry and so on.\nIt is the most skill-dependent part of the tradition, and studies of agreement between practitioners have generally found lower consistency than the classical literature implies. Modern medicine reads the pulse for rate and rhythm; the TCM reading is a different, interpretive exercise.", "body_zh": "两手寸口各有三部，每部分浮中沉三候，共二十八种经典脉象——浮、沉、滑、弦等。\n这是传统中最依赖个人功力的部分，而不同医者之间判断一致性的研究，结果普遍低于经典文献所暗示的程度。现代医学的脉搏主要看频率与节律，中医的脉诊是另一种解释性工作。", "source": "Classical method", "note": "Inter-practitioner reliability is a known limitation." }, { "slug": "eight-principles", "section": "diagnostics", "title_en": "The eight principles", "title_zh": "八纲", "pinyin": "bā gāng", "body_en": "A four-pair framework for organising everything gathered in the examination: Interior / Exterior (where), Cold / Heat (which direction), Deficiency / Excess (how much reserve), Yin / Yang (the summary pair).\nIt is a way of sorting, not a diagnosis. Its value is that it forces the practitioner to state assumptions — which is exactly what modern clinical reasoning also demands.", "body_zh": "用四对概念整理四诊所得：表里（病位）、寒热（趋向）、虚实（正邪多少）、阴阳（总纲）。\n它是一种分类方法，不是诊断结论。它的价值在于迫使医者把判断前提说出来——这一点与现代临床推理的要求其实一致。", "source": "Classical pattern framework", "note": "" }, { "slug": "pattern-differentiation", "section": "diagnostics", "title_en": "Pattern differentiation", "title_zh": "辨证论治", "pinyin": "biàn zhèng lùn zhì", "body_en": "The core reasoning step of TCM: convert what was gathered at the examination into a pattern, then choose a strategy to match that pattern. The classical phrase adds 论治 — treatment follows the pattern.\nTwo patients with the same Western diagnosis may be given different TCM patterns and therefore different treatments. That difference is the whole basis of TCM treatment design, and also the reason it is hard to test in a standard trial format.", "body_zh": "中医的核心推理步骤：把四诊所得归纳为一个\"证\"，再据证确定治法。经典表述加上\"论治\"——治法随证而定。\n两位西医学诊断相同的病人，可能在中医里辨为不同的证，因而治法不同。这个差异正是中医治疗设计的全部基础，也是它难以套用标准试验格式的原因。", "source": "Classical method", "note": "" }, { "slug": "why-single-signs-mislead", "section": "diagnostics", "title_en": "Why one sign is never enough", "title_zh": "为什么不能只看一个征象", "pinyin": "dān zhēng", "body_en": "A red tongue, a wiry pulse or a dislike of cold can each point in several directions. In the classical method they are weighed together, and the pattern is chosen from the combination.\nThis is also why \"I read that a red tongue means X\" is a poor way to use any TCM material — including this one. The tradition itself insists on the combination; that insistence is one of its more defensible features.", "body_zh": "舌红、脉弦或恶寒，单独任何一项都可能指向好几个方向。在经典方法中它们被合并权衡，证从组合中得出。\n这也是为什么\"我看网上说舌红就是某某\"是使用任何中医资料（包括本知识库）的错误方式。传统本身坚持合参，而这份坚持是它比较站得住脚的一点。", "source": "Classical method", "note": "" }, { "slug": "what-to-expect-consult", "section": "diagnostics", "title_en": "What is being assessed in a consultation", "title_zh": "就诊时在评估什么", "pinyin": "píng gū", "body_en": "Beyond tongue and pulse, a practitioner is assessing: how you respond to temperature, when symptoms appear and worsen, what improves them, sleep and appetite, bowel and urinary patterns, energy across the day, and emotional tone.\nThe value of asking all of this is not mysterious — it is a thorough history. Much of what is called TCM diagnosis is simply the kind of careful questioning that is good practice in any system.", "body_zh": "除舌脉之外，医者还会评估：你对寒热的反应、症状何时出现与加重、什么能缓解、睡眠与食欲、二便情况、一天中的精力变化、以及情绪状态。\n问这么多问题的价值并不神秘——它就是一一份详尽的病史。被称为\"中医诊断\"的很大一部分，其实只是任何体系里都算好做法的细致问诊。", "source": "Practical guide", "note": "" }, { "slug": "consultation-red-flags", "section": "diagnostics", "title_en": "Red flags that end the consultation", "title_zh": "必须立刻结束问诊的红旗", "pinyin": "hóng qí", "body_en": "Certain findings mean you should be in emergency or urgent care, not in a TCM consultation: chest pain or pressure, difficulty breathing, one-sided weakness or numbness, facial drooping, slurred speech, sudden severe headache, uncontrolled bleeding, high fever with confusion or stiff neck, severe abdominal pain, thoughts of self-harm, significant injury, pregnancy complications, or illness in an infant.\nNo tradition, and no practitioner, should keep treating something that belongs in an emergency department.", "body_zh": "有些表现意味着你应该在急诊或紧急救治，而不是在中医问诊里：胸痛或胸部压迫感、呼吸困难、单侧无力或麻木、面部歪斜、言语不清、突发剧烈头痛、无法控制的出血、高热伴意识模糊或颈项强直、剧烈腹痛、自伤念头、明显外伤、妊娠并发症、婴幼儿患病。\n任何传统、任何执业者，都不应继续处理本该去急诊的问题。", "source": "Safety checklist", "note": "Call your local emergency number. In the United States, 911." }, { "slug": "acupuncture", "section": "therapies", "title_en": "Acupuncture", "title_zh": "针刺", "pinyin": "zhēn cì", "body_en": "Fine, single-use sterile needles are inserted through the skin at selected points and usually retained for 15-30 minutes. Sensation is typically a dull ache, heaviness or a spreading warmth rather than sharp pain.\nSerious adverse events are rare but not zero — the main risks are pneumothorax from needling the chest wall, and infection when sterile technique is not followed. Regulation varies enormously; in the United States most states require a licence and in many countries the title is protected.", "body_zh": "使用一次性无菌毫针刺入皮肤特定穴位，通常留针 15–30 分钟。感觉多为酸、沉、胀或传导感，而非锐痛。\n严重不良事件罕见但并非为零——主要风险包括胸部操作导致的气胸，以及未遵守无菌规范引起的感染。各国监管差异极大：美国多数州要求执照，许多国家该称谓受法律保护。", "source": "Descriptive only", "note": "We do not teach technique or advise on personal use." }, { "slug": "moxibustion", "section": "therapies", "title_en": "Moxibustion", "title_zh": "艾灸", "pinyin": "ài jiǔ", "body_en": "Dried mugwort (Artemisia argyi) is burned near or on a point to deliver gentle heat — as a stick held above the skin, as cones, or on a needle handle. It is central to the classical treatment of \"cold\" patterns.\nBecause it produces smoke and heat it carries real risks: burns, especially in people with reduced sensation such as diabetic neuropathy, and airway irritation. Many clinics now use smokeless or infrared alternatives.", "body_zh": "将干燥艾叶（艾绒）点燃后靠近或置于穴位施以温热刺激——可用艾条悬灸、艾炷或温针灸。它是传统\"寒证\"处理的核心方法之一。\n由于有烟与明火，确有风险：烫伤（尤其对感觉减退者，如糖尿病神经病变者）与呼吸道刺激。现在不少诊所改用无烟艾或红外替代。", "source": "Descriptive only", "note": "Burn risk is a documented concern." }, { "slug": "cupping", "section": "therapies", "title_en": "Cupping", "title_zh": "拔罐", "pinyin": "bá guàn", "body_en": "Glass, bamboo or plastic cups are held to the skin by suction — classically created with a flame, now often with a hand pump — creating a local pull on tissue. Sessions last five to fifteen minutes and typically leave circular marks that fade over three to ten days.\nThe marks are the most-asked-about part: they come from capillaries under suction, not from \"toxins being drawn out\". Wet cupping, which involves small skin incisions and blood, carries higher infection risk and requires proper hygiene and training.", "body_zh": "用玻璃、竹或塑料罐以负压吸附于皮肤——传统用火，现在多用抽气泵——形成局部牵拉。留罐约 5–15 分钟，常留下圆形罐印，3–10 天消退。\n罐印是问得最多的一点：它来自负压下的毛细血管变化，而不是\"把毒素拔出来了\"。刺络拔罐需切开皮肤并出血，感染风险更高，需要严格的卫生条件与训练。", "source": "Descriptive only", "note": "The \"detox\" framing is folk explanation, not a measured effect." }, { "slug": "gua-sha", "section": "therapies", "title_en": "Gua sha", "title_zh": "刮痧", "pinyin": "guā shā", "body_en": "A smooth tool is pressed and stroked along the surface of the skin with oil, producing red or purple petechiae that fade in a few days. In the classical description this releases \"stagnation\" at the surface; practically, the visible marks are small capillary changes.\nIt should not be performed over broken skin, bruises, varicose veins or areas of poor circulation.", "body_zh": "用光滑器具蘸介质在皮肤表面反复刮拭，出现红紫瘀点，数日消退。传统描述认为可\"解表散滞\"；就实际所见而言，这些痕迹是小血管的变化。\n破损皮肤、瘀斑、静脉曲张部位及循环不良处不宜操作。", "source": "Descriptive only", "note": "Contraindication notes are standard safety information." }, { "slug": "tuina", "section": "therapies", "title_en": "Tuina", "title_zh": "推拿", "pinyin": "tuī ná", "body_en": "A structured bodywork tradition using pressing, rolling, kneading, vibration and joint mobilisation, often along meridian lines. Related traditions include shiatsu in Japan and acupressure in English-language books — all working on points without needles.\nAnything involving forceful manipulation of the neck is worth special caution; that is a general statement about manual therapy, not only about TCM.", "body_zh": "一套结构化的手法体系，包含按、滚、揉、振颤与关节活动，常沿经络操作。相近的传统有日本的指压，以及英文读物里的 acupressure，都是不用针的点穴操作。\n凡涉及颈部的强力手法都值得格外谨慎——这是一般手法治疗的普遍提醒，不限于中医。", "source": "Descriptive only", "note": "" }, { "slug": "herbal-decoction", "section": "therapies", "title_en": "Herbal decoction", "title_zh": "汤剂", "pinyin": "tāng jì", "body_en": "Classically, several herbs are boiled together and the liquid is drunk — a formula, not a single plant. The reasoning operates at the level of the formula: individual herbs are combined with roles such as chief, deputy, assistant and envoy.\nThis is the one part of TCM where safety stakes are highest, because herbs have pharmacological activity and interactions with prescription drugs are real.", "body_zh": "经典做法是数味药同煎、服用煎液——用的是\"方\"，不是单味药。其配伍有君臣佐使的角色分工。\n这是中医里安全权重最高的部分，因为中药具有药理活性，与西药的相互作用是真实存在的。", "source": "Descriptive only", "note": "We never give formulas, dosages or herb-drug combinations." }, { "slug": "granules", "section": "therapies", "title_en": "Concentrated granules", "title_zh": "配方颗粒", "pinyin": "pèi fāng kē lì", "body_en": "The modern default in most overseas clinics: single herbs extracted, dried into granules, and dispensed as a measured mixture to dissolve in hot water. It removed the need to boil herbs at home, which was the single biggest practical barrier for patients.\nThe trade-offs are that granular products vary between manufacturers, and quality-control failures — heavy metals, pesticides, adulteration — have been documented across the supply chain. Ask suppliers about testing.", "body_zh": "海外多数诊所的现代默认做法：将单味药提取、干燥成颗粒，按方计量配给，热水冲服。它消除了在家煎药这一最大的实际障碍。\n代价是不同厂家的颗粒产品存在差异，而且供应链中确实出现过重金属、农残与掺伪等质量控制问题。可以向供应商询问检测情况。", "source": "Practical guide", "note": "" }, { "slug": "qigong-taiji", "section": "therapies", "title_en": "Qigong and taiji", "title_zh": "气功与太极", "pinyin": "qì gōng · tài jí", "body_en": "Movement, breath and attention practised together — either for health maintenance or as a martial art. In English-language research it is usually studied as a gentle physical activity; trials most often look at balance, fall prevention in older adults, and quality of life.\nThat framing is a normal exercise-science one and does not require any claim about Qi. It is generally low-risk and adaptable — a large part of why it travels well across cultures.", "body_zh": "把动作、呼吸与意念合起来练习——既可作养生，也可作武术。在英语研究中，它通常被当作一种缓和的身体活动来研究，试验多关注平衡能力、老年人跌倒预防与生活质量。\n这一研究取向属于运动科学的常规框架，并不依赖任何关于\"气\"的主张。它总体风险低、易调整——这也是它能跨文化传播的重要原因。", "source": "Descriptive only", "note": "" }, { "slug": "session-safety", "section": "therapies", "title_en": "Safety questions worth asking", "title_zh": "值得问的安全问题", "pinyin": "ān quán", "body_en": "Before any treatment: Are needles single-use and disposed of properly? What is the practitioner's qualification and registration? What are the risks of this specific treatment for my specific situation? What medicines and supplements should I mention?\nAnd the one that matters most: what would make you tell me to go see a doctor instead? A practitioner who has a clear answer to that is a practitioner worth keeping.", "body_zh": "任何治疗之前：针具是否一次性使用并规范处置？执业者的资质与注册情况如何？对\"我这种具体情况\"，这个治疗的风险是什么？我应当主动告知哪些药物与保健品？\n以及最关键的一个：在什么情况下你会让我去看医生？能清楚回答这个问题的执业者，是值得长期合作的执业者。", "source": "Safety checklist", "note": "" }, { "slug": "integrative-reality", "section": "therapies", "title_en": "Where TCM sits in modern care", "title_zh": "现代医疗中的位置", "pinyin": "jié hé", "body_en": "In practice, most people use TCM alongside modern medicine rather than instead of it. Insurance coverage has expanded in some places — in the United States more than eighty commercial plans have been reported to include acupuncture, and Medicare has covered it for chronic low back pain since 2020.\nThe workable pattern is straightforward: keep your physicians informed, do not stop prescribed treatment without medical advice, and treat complementary care as complementary.", "body_zh": "实际上，多数人是把中医与现代医学并用，而不是取而代之。部分地区保险覆盖有所扩大——据报道美国有八十多个商业保险计划包含针灸，Medicare 自 2020 年起覆盖慢性腰痛。\n可行的做法很直接：让你的医生知情，不要在没有医嘱的情况下停用处方的治疗，并把\"补充疗法\"就当作补充。", "source": "Editorial overview", "note": "Coverage rules change; verify locally." }, { "slug": "qi-deficiency", "section": "patterns", "title_en": "Qi deficiency", "title_zh": "气虚", "pinyin": "qì xū", "body_en": "Described as tiredness, shortness of breath on exertion, a weak voice, spontaneous sweating and a tendency to catch colds.", "body_zh": "表现为疲乏、活动后气短、语声低微、自汗、容易感冒。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "blood-deficiency", "section": "patterns", "title_en": "Blood deficiency", "title_zh": "血虚", "pinyin": "xuè xū", "body_en": "Described as pallor, dizziness, palpitations, dry skin, poor sleep and, in the TCM model, sparse menstruation.", "body_zh": "表现为面色淡白、头晕、心悸、皮肤干燥、睡眠不佳，在中医模型中可见月经量少。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "yin-deficiency", "section": "patterns", "title_en": "Yin deficiency", "title_zh": "阴虚", "pinyin": "yīn xū", "body_en": "Described as a feeling of heat in the afternoon or evening, night sweats, a dry mouth and throat, and restlessness.", "body_zh": "表现为午后或夜间发热感、盗汗、口咽干燥、心烦。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "yang-deficiency", "section": "patterns", "title_en": "Yang deficiency", "title_zh": "阳虚", "pinyin": "yáng xū", "body_en": "Described as a persistent cold feeling, cold limbs, low energy, a pale complexion and a preference for warm drinks.", "body_zh": "表现为持续畏寒、四肢不温、精神不振、面色淡白、喜热饮。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "qi-stagnation", "section": "patterns", "title_en": "Qi stagnation", "title_zh": "气滞", "pinyin": "qì zhì", "body_en": "Described as distension, discomfort that moves around, sighing, and symptoms that worsen with emotional stress.", "body_zh": "表现为胀满、走窜不适、喜叹息，并随情绪紧张而加重。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "blood-stasis", "section": "patterns", "title_en": "Blood stasis", "title_zh": "血瘀", "pinyin": "xuè yū", "body_en": "Described as fixed stabbing pain, a dark complexion, dark lips and, in the classical model, masses.", "body_zh": "表现为固定刺痛、面色晦暗、唇色暗，在经典模型中可见有形积块。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "phlegm-damp", "section": "patterns", "title_en": "Phlegm-damp", "title_zh": "痰湿", "pinyin": "tán shī", "body_en": "Described as heaviness, a muzzy head, a sensation of fullness in the chest, a sticky taste and easy weight gain.", "body_zh": "表现为身体沉重、头目不清、胸脘满闷、口中黏腻、容易发胖。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "damp-heat", "section": "patterns", "title_en": "Damp-heat", "title_zh": "湿热", "pinyin": "shī rè", "body_en": "Described as a heavy, hot, sticky feeling, a bitter taste, a yellow coating on the tongue and irritability.", "body_zh": "表现为身重而热、黏滞不爽、口苦、舌苔黄腻、烦躁。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "cold-damp", "section": "patterns", "title_en": "Cold-damp", "title_zh": "寒湿", "pinyin": "hán shī", "body_en": "Described as cold with heaviness, joints that ache and feel worse in damp weather, and a dislike of cold drinks.", "body_zh": "表现为寒与沉重并见、关节酸痛且阴雨天加重、不喜冷饮。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "wind-heat", "section": "patterns", "title_en": "Wind-heat", "title_zh": "风热", "pinyin": "fēng rè", "body_en": "Described as a sore throat, slight fever, a yellow nasal discharge and a dislike of wind — the classical \"common cold, hot type\".", "body_zh": "表现为咽痛、发热、鼻涕黄稠、恶风——即经典中的\"风热感冒\"。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "wind-cold", "section": "patterns", "title_en": "Wind-cold", "title_zh": "风寒", "pinyin": "fēng hán", "body_en": "Described as a marked aversion to cold, an absence of sweating, a clear nasal discharge and aching limbs.", "body_zh": "表现为明显恶寒、无汗、鼻涕清稀、肢体酸痛。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "liver-qi-stagnation", "section": "patterns", "title_en": "Liver Qi stagnation", "title_zh": "肝气郁结", "pinyin": "gān qì yù jié", "body_en": "Described as irritability or low mood, a lump-in-the-throat feeling, distension in the sides of the chest, and premenstrual worsening.", "body_zh": "表现为烦躁或情绪低落、咽中如有物阻、胸胁胀满，以及经前加重。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "liver-yang-rising", "section": "patterns", "title_en": "Liver Yang rising", "title_zh": "肝阳上亢", "pinyin": "gān yáng shàng kàng", "body_en": "Described as headache, dizziness, ringing in the ears, a red face and a short temper.", "body_zh": "表现为头痛、眩晕、耳鸣、面红、急躁易怒。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "spleen-deficiency", "section": "patterns", "title_en": "Spleen deficiency", "title_zh": "脾虚", "pinyin": "pí xū", "body_en": "Described as poor appetite, loose stools, a bloated feeling after eating, tiredness and a sallow complexion.", "body_zh": "表现为食欲不振、大便偏稀、食后腹胀、乏力、面色萎黄。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "kidney-yin-deficiency", "section": "patterns", "title_en": "Kidney Yin deficiency", "title_zh": "肾阴虚", "pinyin": "shèn yīn xū", "body_en": "Described as lower-back soreness with a feeling of heat, night sweats, ringing in the ears and dry mouth at night.", "body_zh": "表现为腰膝酸软伴热感、盗汗、耳鸣、夜间口干。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "kidney-yang-deficiency", "section": "patterns", "title_en": "Kidney Yang deficiency", "title_zh": "肾阳虚", "pinyin": "shèn yáng xū", "body_en": "Described as a cold lower back, cold limbs, frequent night urination and a general sense of coldness.", "body_zh": "表现为腰冷、四肢不温、夜尿频多、整体畏寒。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "heart-fire", "section": "patterns", "title_en": "Heart fire", "title_zh": "心火", "pinyin": "xīn huǒ", "body_en": "Described as restlessness, insomnia, a red tongue tip, mouth ulcers (in TCM reasoning) and a feeling of heat in the chest.", "body_zh": "表现为心烦、失眠、舌尖红、口舌生疮（属中医推理），以及胸中烦热。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "heart-shen-disturbed", "section": "patterns", "title_en": "Disturbed Shen", "title_zh": "心神不宁", "pinyin": "xīn shén bù níng", "body_en": "Described as palpitations, anxiety, broken sleep and a sense of not feeling settled — broadly the emotional vocabulary of the Heart system.", "body_zh": "表现为心悸、易惊、睡眠易醒、心神不安——大致是心系的情志词汇。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "lung-qi-deficiency", "section": "patterns", "title_en": "Lung Qi deficiency", "title_zh": "肺气虚", "pinyin": "fèi qì xū", "body_en": "Described as a weak cough, shortness of breath on exertion, a low voice and easy sweating.", "body_zh": "表现为咳声无力、动则气短、语声低微、容易出汗。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "lung-heat", "section": "patterns", "title_en": "Lung heat", "title_zh": "肺热", "pinyin": "fèi rè", "body_en": "Described as a dry or productive cough with yellow phlegm, thirst, a sore throat and a feeling of heat.", "body_zh": "表现为干咳或咳黄痰、口渴、咽痛、身热，是传统上对肺系热象的归类。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "stomach-heat", "section": "patterns", "title_en": "Stomach heat", "title_zh": "胃热", "pinyin": "wèi rè", "body_en": "Described as a big appetite with a burning sensation, bad breath, thirst and a preference for cold drinks.", "body_zh": "表现为食欲亢进伴灼热感、口气重、口渴、喜冷饮。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "stomach-rebellion", "section": "patterns", "title_en": "Stomach Qi rebelling", "title_zh": "胃气上逆", "pinyin": "wèi qì shàng nì", "body_en": "Described as nausea, belching, hiccups and a rising sensation after eating — the directional vocabulary of Qi movement made concrete.", "body_zh": "表现为恶心、嗳气、呃逆、食后上冲感——是\"气机方向\"这套词汇的具体化。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "spleen-stomach-disharmony", "section": "patterns", "title_en": "Spleen-Stomach disharmony", "title_zh": "脾胃不和", "pinyin": "pí wèi bù hé", "body_en": "Described as alternating appetite and poor digestion, a bloated abdomen, irregular stool and fatigue after meals.", "body_zh": "表现为食欲时好时差、腹胀、大便不调、食后倦怠。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "liver-gallbladder-damp-heat", "section": "patterns", "title_en": "Liver-Gallbladder damp-heat", "title_zh": "肝胆湿热", "pinyin": "gān dǎn shī rè", "body_en": "Described as a bitter taste, a sensation of fullness under the ribs, a yellow tongue coating and irritability.", "body_zh": "表现为口苦、胁肋胀满、舌苔黄腻、烦躁，传统上归为湿热蕴结于肝胆。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "heart-spleen-deficiency", "section": "patterns", "title_en": "Heart and Spleen deficiency", "title_zh": "心脾两虚", "pinyin": "xīn pí liǎng xū", "body_en": "Described as palpititations, poor memory, broken sleep, tiredness and poor appetite together — a combined pattern.", "body_zh": "表现为心悸、健忘、睡眠易醒、疲乏与食欲不振并见——属复合证候。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "upper-heat-lower-cold", "section": "patterns", "title_en": "Heat above, cold below", "title_zh": "上热下寒", "pinyin": "shàng rè xià hán", "body_en": "Described as heat symptoms in the upper body together with cold symptoms below — notably, this pattern exists precisely because TCM does not assume one uniform state.", "body_zh": "表现为上部热象与下部寒象同时存在——值得注意的是，这个证之所以存在，恰恰因为中医并不假设全身状态一致。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "yin-yang-both-deficiency", "section": "patterns", "title_en": "Deficiency of both Yin and Yang", "title_zh": "阴阳两虚", "pinyin": "yīn yáng liǎng xū", "body_en": "Described as cold signs and heat signs appearing together in a person who is generally depleted — a chronic picture.", "body_zh": "表现为寒象与热象同时出现于整体虚衰的人身上——属慢性情况。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "exterior-deficiency", "section": "patterns", "title_en": "Exterior deficiency", "title_zh": "表虚", "pinyin": "biǎo xū", "body_en": "Described as a weak surface defence: easy sweating, sensitivity to wind and a tendency to catch colds easily.", "body_zh": "表现为卫外不固：容易出汗、怕风、容易感冒。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "interior-excess", "section": "patterns", "title_en": "Interior excess", "title_zh": "里实", "pinyin": "lǐ shí", "body_en": "Described as constipation, abdominal fullness with pain that worsens on pressure, and a thick tongue coating.", "body_zh": "表现为便秘、腹满疼痛且拒按、舌苔厚，是八纲中「里」与「实」的组合。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "qi-blood-both-deficiency", "section": "patterns", "title_en": "Deficiency of both Qi and Blood", "title_zh": "气血两虚", "pinyin": "qì xuè liǎng xū", "body_en": "Described as tiredness with pallor, dizziness, palpitations and a weak pulse — the two deficiencies together, common after illness or childbirth.", "body_zh": "表现为疲乏伴面色淡白、头晕、心悸、脉弱——两种虚证并见，常见于病后或产后。", "source": "Classical pattern framework", "note": "Descriptions only. We do not diagnose." }, { "slug": "spleen-kidney-yang-deficiency", "section": "patterns", "title_en": "Spleen and Kidney Yang Deficiency", "title_zh": "脾肾阳虚", "pinyin": "pí shèn yáng xū", "body_en": "What it describes: a pattern combining a weak Spleen with a weak Kidney, so the warming and transforming functions are described as depleted. Classically recorded: cold limbs, loose stools or early-morning diarrhoea, oedema, a cold lower back, a deep weak pulse.\nHow it is read: as a pattern, not a disease. Conventional medicine has no equivalent category - the same symptoms would first be investigated for thyroid, kidney, gut and other causes.\nWhat this is not: something you can diagnose from a symptom list, and not a reason to self-prescribe warming herbs.", "body_zh": "它描述的是什么：脾与肾同时偏弱的证候，传统认为温煦与运化功能不足。文献记载可见：四肢不温、便溏或晨起腹泻、水肿、腰部冷感、脉沉弱。\n怎么理解：它是一种“证”，不是一种病。现代医学没有对应分类——出现这些症状，应先排查甲状腺、肾脏、肠道等原因。\n它不是什么：不是照症状清单能自行判断的结论，也不是自行服用温补类中药的理由。", "source": "Classical theory · Jingyue Quanshu", "note": "" }, { "slug": "liver-kidney-yin-deficiency", "section": "patterns", "title_en": "Liver and Kidney Yin Deficiency", "title_zh": "肝肾阴虚", "pinyin": "gān shèn yīn xū", "body_en": "What it describes: depletion of the yin aspect of the Liver and Kidney systems - described as dryness, heat at night, dizziness, ringing in the ears, weakness in the lower back, and a thin rapid pulse.\nHow it is read: as a pattern that groups several symptoms the practitioner takes together, rather than one by one. It is not a disease and does not by itself tell you what you have.\nWhat this is not: a self-diagnosis. Most of these symptoms have treatable medical causes and should be checked first.", "body_zh": "它描述的是什么：肝与肾的阴液不足，传统描述为干燥、夜间发热感、头晕、耳鸣、腰膝酸软、脉细数。\n怎么理解：它是一种把若干症状合起来看的“证”，而不是逐个症状的对应。它不是疾病名称，本身不能告诉你得了什么。\n它不是什么：不是可以自行判断的结论。这些症状中的大多数都有可治疗的医学原因，应先检查。", "source": "Classical theory · Yizong Jinjian", "note": "" }, { "slug": "phlegm-dampness", "section": "patterns", "title_en": "Phlegm-Dampness Obstructing", "title_zh": "痰湿内阻", "pinyin": "tán shī nèi zǔ", "body_en": "What it describes: heaviness, a muzzy or foggy head, a feeling of fullness, a sticky taste in the mouth, loose or sluggish stools - grouped as phlegm and dampness obstructing the interior.\nNote this carefully: the word phlegm here is a theoretical category, not sputum you can see. This is one of the most common sources of confusion for English readers, and one of the most common claims in health advertising.\nHow it is read: as a pattern of several symptoms taken together. Claims such as 'removes dampness' by themselves carry no measurable meaning and should not be treated as a diagnosis.", "body_zh": "它描述的是什么：身体沉重、头昏如裹、脘腹胀满、口中黏腻、大便溏而不爽，归为痰湿阻滞于内。\n请特别注意：这里的“痰”是理论上的分类，不是能咳出来的痰。这是英文读者最容易误解之处，也是保健广告最常借用的话术。\n怎么理解：它是把若干症状合起来看的“证”。“祛湿”这类说法本身没有可测量的含义，不应被当成诊断。", "source": "Classical theory · Danxi Xinfa", "note": "" }, { "slug": "qigong-daoyin", "section": "therapies", "title_en": "Daoyin and Qigong", "title_zh": "导引与气功", "pinyin": "dǎo yǐn", "body_en": "Daoyin is the classical term for guided movement and breath practice; qigong is the modern umbrella term for the same family. What it involves: slow coordinated movement, attention to the breath, and a relaxed but held posture. Nothing is punctured and nothing is swallowed.\nWhat the evidence shows: trials exist for balance, fall prevention and quality of life in older adults, with modest effects. It is not a substitute for treating acute illness.\nWhat to watch for: avoid forceful breath-holding. If you have uncontrolled blood pressure, a recent injury or surgery, or you are pregnant, get medical advice before starting.", "body_zh": "导引是古代对呼吸与动作配合锻炼的称呼，气功是现代对这一类练习的统称。它的内容是：缓慢配合的动作、对呼吸的注意、放松而保持的姿态。不刺破皮肤，也不服用任何东西。\n证据方面：老年人平衡能力、跌倒预防与生活质量方面有临床试验，效果温和。它不能替代对急性疾病的治疗。\n需注意：不要用力屏气。若有未控制的高血压、近期外伤或手术、或处于孕期，开始前请先咨询医生。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "acupuncture-session", "section": "therapies", "title_en": "What Happens in an Acupuncture Session", "title_zh": "一次针刺治疗的过程", "pinyin": "zhēn cì guò chéng", "body_en": "What happens: a consultation first, then points are selected. Needles are single-use, sterile and hair-thin. You may feel a dull ache or a spreading sensation - this is described as deqi. Needles usually stay in place for fifteen to thirty minutes.\nWhat it should not involve: advice to stop prescribed medication, a diagnosis of serious disease made by someone who is not a physician, or any promise of a cure.\nWhat to watch for: serious adverse events are rare but reported - pneumothorax from deep needling over the chest, and infection where sterile technique is not followed. Choose a licensed practitioner in your own jurisdiction.", "body_zh": "过程是：先问诊，再选穴。针具为一次性无菌针，细如发丝。可能有酸胀或向周围扩散的感觉，这被称为“得气”。针一般留十五到三十分钟。\n不应当出现的事：让你停用医生开的药、由非医师给出重大疾病的诊断、或任何治愈的承诺。\n需注意：严重不良事件少见但有报告——胸部深刺可致气胸，不遵守无菌操作可致感染。请选择所在地区持牌执业者。", "source": "Classical method · Zhenjiu Jiayijing", "note": "" }, { "slug": "herbal-process", "section": "therapies", "title_en": "How a Herbal Formula Is Actually Built", "title_zh": "中药方剂是怎么开的", "pinyin": "fāng jì kāi jù", "body_en": "How a formula is built: the practitioner differentiates a pattern first, then chooses a classical formula and modifies it for that individual. The doses and the combination are set by the practitioner - they do not come from a book, a website or this knowledge base.\nWhy this matters: herbs are pharmacologically active. Interactions with anticoagulants, antihypertensives, antidiabetics and immunosuppressants are documented. Some herbs are restricted or banned in certain countries.\nWhat to watch for: tell your doctor about every herb you take, buy from regulated suppliers, and treat any product with undeclared ingredients as a serious risk.", "body_zh": "方剂是怎么组成的：先辨证，再选用一个经典方，并根据个体情况加减。用量与配伍由医师确定，不来自书本、网站，也不来自本站。\n为什么这很重要：中药具有药理活性。与抗凝药、降压药、降糖药、免疫抑制剂的相互作用有文献记录。部分药材在有些国家被限制或禁用。\n需注意：把你在吃的所有中药告知你的医生；从受监管的渠道购买；含未标明成分的产品应当视为严重风险。", "source": "Classical theory · Shanghan Lun", "note": "" }, { "slug": "food-therapy", "section": "therapies", "title_en": "Food Therapy", "title_zh": "食疗", "pinyin": "shí liáo", "body_en": "What it means: choosing ordinary foods by their traditional warming, cooling, moistening or drying nature, as a daily habit rather than a treatment.\nWhat the evidence shows: broad dietary patterns - more vegetables, less processed food - have strong evidence behind them. The specific warming and cooling classification does not have measurable evidence, and should be understood as a traditional framework.\nWhat to watch for: food does not treat a serious condition. If a food or supplement is being sold to you as a replacement for medical treatment, treat that as a warning sign.", "body_zh": "它的意思是：按传统的温、凉、润、燥性质来挑选日常食物，属于日常习惯，而不是治疗手段。\n证据方面：多吃蔬菜、少吃加工食品这类总体膳食模式有充分证据。而具体的寒热温凉分类没有可测量的证据，应当理解为一种传统框架。\n需注意：食物不能治疗重大疾病。如果有人把某种食品或保健品当作医疗的替代品卖给你，应当视为警示信号。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "ten-questions", "section": "diagnostics", "title_en": "The ten questions", "title_zh": "十问", "pinyin": "shí wèn", "body_en": "The classical interview is organised into ten lines, remembered as a mnemonic. In outline they cover: cold and heat, sweating, the head and body, stool and urine, diet and appetite, the chest and abdomen, hearing, thirst, past illness, and the cause and course of the present complaint.\nIts value is that it works as a checklist. A practitioner who runs through it will not forget sleep, appetite or bowel habit, which are exactly the everyday details patients rarely volunteer and which often carry the most information.", "body_zh": "传统问诊把提问编成便于记诵的十句口诀，大意涵盖：寒热、汗、头身、二便、饮食、胸腹、耳聋、口渴、旧病，以及病因与病程。\n它的价值在于是一张清单。逐条问过，就不会漏掉睡眠、食欲、二便——这些恰是患者很少主动说、却往往信息量最大的日常细节。", "source": "Jingyue Quanshu", "note": "" }, { "slug": "facial-colour", "section": "diagnostics", "title_en": "The five colours of the face", "title_zh": "面色五色", "pinyin": "miàn sè wǔ sè", "body_en": "Five colours are described as appearing on the face, each paired with a pattern and a system: blue-green with Liver and with cold or pain, red with Heat, yellow with Spleen and damp, white with Lung and with deficiency or cold, and dark or black with Kidney.\nTwo cautions apply. In classical practice a colour is always read together with the pulse and the interview, never alone. And several of these appearances, such as a yellow tinge or a grey pallor, are also signs that modern medicine treats as reasons to seek assessment.", "body_zh": "面部出现的五种颜色各有对应：青与肝、主寒或痛；赤与心、主热；黄与脾、主湿；白与肺、主虚或寒；黑与肾。\n两点提醒：古籍中面色须与脉象、问诊合参，不可单凭一色下判断；而其中若干表现，如发黄或灰白晦暗，现代医学同样视为需要就医评估的信号。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "listening-smelling", "section": "diagnostics", "title_en": "Listening and smelling", "title_zh": "闻诊", "pinyin": "wén zhěn", "body_en": "The second of the four examinations covers what a practitioner hears and smells: the strength and tone of the voice, whether speech is low or forceful, breathing, coughing, sighing, and unusual odours of the body or breath.\nThe vocabulary is qualitative rather than measured: a low, weak voice is read as deficiency and a loud, coarse voice as excess. Modern readers should note that some findings in this category, notably an unusual breath odour, are also clinical signs that warrant proper medical assessment.", "body_zh": "四诊之二，包括听与嗅：语声的高低强弱、言语的低微或洪亮、呼吸、咳嗽、叹息，以及身体与口气的异常气味。\n其词汇是定性的而非测量的：语声低微读作虚，声高气粗读作实。现代读者应注意：这一类中的某些发现，尤其是口气异常，现代医学同样视为需要正规评估的临床征象。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "abdominal-examination", "section": "diagnostics", "title_en": "Abdominal examination in classical practice", "title_zh": "腹诊", "pinyin": "fù zhěn", "body_en": "Classical texts describe palpating the abdomen: its overall tension, the location of tenderness, whether pressure relieves or worsens discomfort, and whether there are palpable masses or a sense of shifting fluid.\nThis overlaps with what any clinician does during an abdominal examination, and the dividing line matters. Anything new, severe, or accompanied by fever, bleeding or weight loss calls for medical assessment rather than pattern reasoning.", "body_zh": "古籍描述按腹的方法：腹部整体的紧张度、压痛的部位、按压后缓解还是加重，以及有无可触及的包块或振水感。\n这与现代临床的腹部检查有重合，而且这条界线很重要：凡新出现、程度剧烈，或伴发热、出血、消瘦者，应先就医评估，而非按证候推理。", "source": "Classical method · Shanghan Lun", "note": "" }, { "slug": "constitution-types", "section": "fundamentals", "title_en": "Constitutional types", "title_zh": "中医体质学说", "pinyin": "tǐ zhì xué shuō", "body_en": "Classical and modern Chinese literature describes people as falling into broad constitutional types: the balanced type, and types described as qi-deficient, yang-deficient, yin-deficient, phlegm-damp, damp-heat, blood-stasis, qi-stagnant and allergic-constitution. The most widely used modern scheme in China lists nine such types.\nThe useful part of the idea is that the same complaint can behave differently in different bodies, which is why two people with the same symptom may be discussed quite differently. The caution matters just as much: a constitutional type is a description of tendency, not a diagnosis, and it should not be used on its own to decide what to do.", "body_zh": "中医文献把人分为若干体质类型：平和质，以及气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质。目前国内使用最广的现代分类共列九种。\n这一说法的价值在于：同一个主诉在不同体质的人身上表现可能不同，因此同样症状的两个人，讨论方式可能差别很大。提醒同样重要：体质只是对倾向的描述，不是诊断，不能单凭体质决定怎么做。", "source": "Classical theory · Huangdi Neijing; modern nine-type scheme from the China Association of Chinese Medicine", "note": "" }, { "slug": "jin-ye-metabolism", "section": "fundamentals", "title_en": "Fluid metabolism", "title_zh": "津液代谢", "pinyin": "jīn yè dài xiè", "body_en": "Jin Ye is the collective term for the body's normal fluids. Classical writing divides them into thinner fluids said to moisten skin and muscle, and thicker fluids said to nourish joints, marrow and the sense organs.\nTheir movement is described as a loop: intake and transformation by the Spleen and Stomach, distribution by the Lung, transport by the Spleen, and excretion through the Kidney and Bladder, with the San Jiao named as the pathway that connects them. Where the loop is said to fail, the result is described as dryness, swelling or phlegm. Read this as a working model of fluid handling, not as a description of kidney physiology.", "body_zh": "津液是体内各种正常水液的总称。古籍把清稀者称津，润养肌肤肌肉；稠厚者称液，滋养关节、骨髓与官窍。\n其运行被描述为一个循环：脾胃受纳运化，肺主宣发肃降，脾主转输，肾与膀胱主排泄，三焦被认为是贯通上下的通道。循环失常，则表现为燥、肿或痰。这是水液运行的一套工作模型，不是现代肾脏生理的描述。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "five-zang-relations", "section": "fundamentals", "title_en": "How the five Zang relate", "title_zh": "五脏相关论", "pinyin": "wǔ zàng xiāng guān lùn", "body_en": "The five Zang are not treated as independent units. Classical reasoning links them in two ways: through the generating and controlling relations of the five phases, and through direct physiological pairings such as Heart and Lung jointly governing qi and Blood, or Liver and Spleen jointly affecting digestion.\nA practical consequence is that a complaint in one system is often discussed in terms of another. Irritable bowel-type presentations, for instance, are described as Liver overacting on the Spleen. This is why a TCM consultation so often ranges across symptoms that appear unrelated to the original complaint.", "body_zh": "中医不把五脏当作各自独立的单位。传统推理有两条联系路径：五行相生相克的关系，以及直接的生理配对，如心肺共主气血、肝脾共同影响消化。\n一个实际后果是：某一系统的问题常被用另一个系统来解释。例如易激类肠道表现，被描述为肝木乘脾。这也是中医问诊常会延伸到看似无关症状的原因。", "source": "Classical theory · Huangdi Neijing", "note": "" }, { "slug": "six-channel-intro", "section": "patterns", "title_en": "The six channels — an introduction", "title_zh": "六经辨证入门", "pinyin": "liù jīng biàn zhèng", "body_en": "The six-channel framework from the Shanghan Lun sorts illness into six stages: Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin and Jueyin. Taiyang is the exterior and the earliest stage, Yangming is interior heat, and Shaoyang is the half-exterior half-interior stage between them.\nIts importance is historical as much as clinical. It is the earliest systematic attempt in Chinese medicine to describe illness as a process that moves over time, rather than a fixed label, and modern discussion of cold damage still uses its vocabulary.", "body_zh": "六经出自《伤寒论》，把外感病分为六个阶段：太阳、阳明、少阳、太阴、少阴、厥阴。太阳属表、为初起；阳明属里热；少阳为居于两者之间的半表半里。\n它的重要性既是临床的，也是历史的：这是中医最早把疾病描述为随时间推移的过程、而非固定标签的系统尝试。今天讨论伤寒仍沿用这套词汇。", "source": "Shanghan Lun", "note": "" }, { "slug": "four-levels", "section": "patterns", "title_en": "The four levels (wei, qi, ying, xue)", "title_zh": "卫气营血辨证", "pinyin": "wèi qì yíng xuè", "body_en": "A framework from the warm-disease school that describes the depth of an acute febrile illness in four levels: wei (defence, at the surface), qi (the active stage with marked fever), ying (nutritive, with deeper disturbance), and xue (Blood, the deepest, with bleeding or rash).\nIt is essentially a severity ladder, and it was built to reason about epidemics. That is why it reads more like a staging system than the static patterns used elsewhere in TCM.", "body_zh": "出自温病学派，把急性发热性疾病的深浅分为四层：卫（在表）、气（高热的活动期）、营（扰动较深）、血（最深，可见出血或疹）。\n本质上是一把轻重程度的梯子，为推论疫病而设，所以读起来更像分期系统，而不像中医别处的静态证型。", "source": "Wenbing Tiaobian", "note": "" }, { "slug": "san-jiao-pattern", "section": "patterns", "title_en": "The three burners as a pattern framework", "title_zh": "三焦辨证", "pinyin": "sān jiāo biàn zhèng", "body_en": "A second warm-disease framework, dividing illness by the three burners: upper (Lung and Heart), middle (Spleen and Stomach) and lower (Liver and Kidney). Its logic is depth from above downward, and it is usually used alongside the four levels rather than instead of them.\nFor a reader new to TCM it is a useful reminder that Chinese medicine has no single unified diagnostic system. Different schools built different maps for different problems, and knowing which map is being used is part of reading the literature honestly.", "body_zh": "温病学的第二套框架，按三焦划分：上焦（心肺）、中焦（脾胃）、下焦（肝肾）。其逻辑是由上而下的深浅，通常与卫气营血四层合用，而非互相替代。\n对初学者来说，它提醒：中医并没有唯一统一的辨证体系。不同学派针对不同问题画了不同的地图，弄清对方在用哪张地图，是把文献读诚实的前提。", "source": "Wenbing Tiaobian", "note": "" }, { "slug": "exterior-cold-interior-heat", "section": "patterns", "title_en": "Exterior cold with interior heat", "title_zh": "表寒里热", "pinyin": "biǎo hán lǐ rè", "body_en": "A mixed pattern in which signs described as exterior cold, such as chills, absence of sweating and body aches, appear together with signs described as interior heat, such as thirst, a red tongue or a rapid pulse.\nMixed patterns are the norm rather than the exception in real consultations, and this is why formulas are so often modified: a single label rarely fits the whole person. Presentation of this kind should still be medically assessed, since chills with fever of unclear cause is not something to manage at home.", "body_zh": "一种复合证候：表寒的征象（恶寒、无汗、身痛）与里热的征象（口渴、舌红、脉数）同时出现。\n实际门诊中复合证候是常态而非例外，这也是方剂常需加减的原因——单一证型很少能覆盖一个人。此类表现仍应就医评估，因为原因不明的寒热不宜在家中按证候处理。", "source": "Classical pattern framework", "note": "" }, { "slug": "tongue-zones", "section": "diagnostics", "title_en": "Tongue Zones: Tip, Middle and Root", "title_zh": "舌象分区", "pinyin": "shé xiàng fēn qū", "body_en": "Classical tongue reading divides the surface into regions and reads each against a part of the body: the tip is associated with the Heart and Lung, the middle with the Spleen and Stomach, the sides with the Liver and Gallbladder, and the root with the Kidney.\n\nThe logic is a mapping, not a measurement. It tells you where to look, not what a finding means. Two practitioners looking at the same tongue can describe it identically and still weigh it differently.\n\nPractical cautions apply to observation itself: strong coffee, tea, coloured sweets and cigarettes alter the coating within minutes, and some medications and mouthwashes change it more durably. A tongue is read in a standard light, and the observation is only one contribution to the whole assessment.", "body_zh": "传统舌诊把舌面划为区域，各自对应身体的一部分：舌尖与心肺相关，舌中与脾胃相关，舌两侧与肝胆相关，舌根与肾相关。\n\n这层逻辑是定位，不是测量。它告诉你往哪里看，不告诉你看到的东西代表什么。同一个舌象，两位医师可以描述得完全一致，权重却不同。\n\n观察本身也有实际限制：浓咖啡、茶、带色糖果与吸烟会在几分钟内改变舌苔；某些药物与漱口水的影响更持久。看舌需要在标准光线下进行，而且只是整体评估中的一项。", "source": "Classical method", "note": "与「舌诊」总论配合阅读。" }, { "slug": "paediatric-inspection", "section": "diagnostics", "title_en": "Paediatric Inspection and the Finger Vein", "title_zh": "小儿望诊与指纹", "pinyin": "xiǎo ér wàng zhěn yǔ zhǐ wén", "body_en": "Examining young children required its own classical method, because a child cannot describe symptoms reliably and will not sit still for a long pulse reading. Inspection therefore carries more weight, and specific attention is paid to the index finger.\n\nThe so-called finger vein is the small superficial vessel on the radial side of a young child index finger. Classical texts describe it in three passes and use its colour and position as one of several observations. It is a traditional marker, not a laboratory value, and its reliability is debated even within the tradition.\n\nFor parents, the useful message is the opposite of a technique: an infant or toddler who is unusually drowsy, breathing fast, feeding poorly, or running a high fever needs medical assessment, and no observation replaces that. Children deteriorate faster than adults, which is why fever in a small child is a clinical matter rather than a pattern question.", "body_zh": "诊察幼儿需要专门的方法：孩子无法可靠地描述症状，也不会安静配合长时间的脉诊。因此望诊的分量更重，并会特别关注食指。\n\n所谓「指纹」，是幼儿食指桡侧的浅表小血管。古籍把它分为三关，用颜色与位置作为若干观察之一。它属传统标志，不是检验数值，而且即便在传统内部，对其可靠性的讨论也一直存在。\n\n对家长而言，有用的信息恰好与技术无关：婴幼儿若异常嗜睡、呼吸急促、吃奶差或高热，都需要就医评估，任何观察都不能替代这一步。儿童病情变化比成人快，这也是为什么幼儿发热属于临床问题，而不是一个证候判断题。", "source": "Classical method", "note": "本条只描述传统做法，不提供任何自查判断。" }, { "slug": "combining-the-four", "section": "diagnostics", "title_en": "Combining the Four Examinations", "title_zh": "四诊合参", "pinyin": "sì zhěn hé cān", "body_en": "The four examinations - looking, listening and smelling, asking, and palpating - are not four separate diagnostic routes. The tradition treats them as one process, each correcting the others.\n\nThis is the answer to a question beginners ask often: why not read one strong sign and act on it? Because classical texts explicitly warn against it. A shiny red face and a fast pulse may look like heat until the asking reveals the person feels cold and wants to be covered. The signs are the same; the reading changes.\n\nThe practical consequence is that a self-check built on any single sign is unreliable by design. The tradition itself says so, which is a relief for a library that refuses to diagnose: the refusal is not caution layered on top of the method, it is what the method asks for.", "body_zh": "望、闻、问、切并非四条独立的诊断路线。传统把它们视为一个过程，彼此校正。\n\n这恰好回答初学者常问的问题：为什么不抓住一个明显征象就下判断？因为古籍对此有明确告诫。面红、脉数看起来像热，但一问之下，患者自觉怕冷、想盖被，读法就变了。征象相同，判读不同。\n\n由此得出一个实际结论：只凭任何单一征象建立的自测，从设计上就不可靠。这是传统本身的态度，对本库也有意义——我们不做诊断，并不只是在方法之外加一层谨慎，而是这套方法本身就要求如此。", "source": "Classical method", "note": "与「为什么不能只看一个征象」互为呼应。" }, { "slug": "san-jiao-and-mingmen", "section": "fundamentals", "title_en": "San Jiao and Ming Men in the Literature", "title_zh": "三焦与命门的文献记载", "pinyin": "sān jiāo yǔ mìng mén", "body_en": "Two concepts that classical texts describe extensively and define inconsistently. The San Jiao has a function list - it is the passage for fluids and the route by which yuan qi is distributed - but no agreed anatomical seat. Ming Men, the Gate of Life, is placed between the kidneys by most texts and described as the source of original yang; whether it is a separate organ or a function of the Kidney is argued in the literature.\n\nLater authors did not settle the question, they elaborated it. Ming dynasty writing made Ming Men central to a whole school of tonifying practice, which is why the term is still common in clinical conversation even though it maps onto nothing in modern anatomy.\n\nHow to read this: the disagreement is not a defect to be corrected. It is what a tradition working from observation and long use, rather than from dissection, looks like. Knowing that a term is contested is more useful than being told a tidy answer.", "body_zh": "有两个概念，古籍论述很多，定义却并不统一。三焦有一份功能清单——是水液通行的道路，也是元气布散的途径——但没有公认的解剖位置。命门则被多数文献定在两肾之间，被描述为元阳之本；它究竟是一个独立脏器，还是肾的功能之一，文献中一直有争论。\n\n后世医家并没有解决这个问题，而是把它展开了。明代医著把命门放到补益法体系的核心，这也是它至今仍常出现在临床话语中，却对应不上任何现代解剖结构的原因。\n\n怎么读这类内容：这种分歧不是一个待修正的缺陷，而是一门依靠观察与长期使用、而非依靠解剖建立的传统本来的样子。知道一个术语有争议，比被告知一个整齐的答案更有用。", "source": "Classical theory", "note": "与「三焦为何无实体」互为补充。" }, { "slug": "time-medicine", "section": "fundamentals", "title_en": "Time in Chinese Medicine", "title_zh": "中医时间医学", "pinyin": "zhōng yī shí jiān yī xué", "body_en": "Classical medicine treats time as a variable rather than a background. The best-known scheme assigns each of the twelve channels a two-hour period across the day, so that a symptom recurring at a fixed hour is read against the channel associated with it.\n\nThere are further layers: seasonal advice about rest and activity, and the observation that some patterns are described as worse at particular times of day. The reasoning is cyclical and astronomical in origin, tied to the sun and the seasons rather than to clock time as an abstract quantity.\n\nWhat to keep and what to drop: as a description of how a tradition organised its observations, it is coherent and worth knowing. As a way to decide what is wrong with you from the hour you woke up, it does not hold. Someone waking at the same time every night in distress should be assessed medically - that pattern has ordinary medical explanations and deserves to be checked.", "body_zh": "传统医学把时间当作变量，而不是背景。最著名的一套方案把十二经脉各对应一天中的两个小时，因此固定在某个时辰反复出现的症状，会被放在对应的经脉上考量。\n\n还有更外层的结构：依季节调整作息与活动，以及「某些证候在特定时段加重」这类记载。这套推演的来源是循环与天象，与太阳和季节绑定，而不是把钟表时间当作抽象量。\n\n哪些该留、哪些该放：作为「一门传统如何组织它的观察」的描述，它是自洽的，也值得了解；但要据此从「几点醒来」推断自己哪里出了问题，就不成立了。若有人每晚固定时间醒来且明显不适，应当就医——这类表现有寻常的医学解释，值得去查。", "source": "Classical theory", "note": "写给对「子午流注」感兴趣的读者，重点是边界。" }, { "slug": "constitution-and-pattern", "section": "fundamentals", "title_en": "Constitution and Pattern", "title_zh": "体质与证候的关系", "pinyin": "tǐ zhì yǔ zhèng hòu", "body_en": "Constitution and pattern are different scales of description, and mixing them up causes a lot of confusion. Constitution is the longer-term tendency a person carries - how they generally react, what they tolerate, what they drift towards. A pattern is a current state, which can change in days.\n\nThe relationship is usually described as one of predisposition: a given constitution makes certain patterns more likely, without determining them. Two people with the same constitution can be in different patterns, and the same pattern looks different in different constitutions - which changes how it is approached.\n\nThis is also why a questionnaire that sorts you into one of a fixed number of body types is not the same thing as a diagnosis. Naming a tendency is describing a background. It does not tell you what is happening now, and it is not a reason to start taking anything.", "body_zh": "体质与证候是两个不同尺度的描述，混为一谈会造成很多混乱。体质是人长期带有的倾向——通常如何反应、能耐受什么、容易偏向哪边。证候则是当下的状态，可以在几天内变化。\n\n两者的关系通常被描述为「易感」：某种体质使某些证候更容易出现，但并不决定它一定出现。体质相同的人可以处在不同证候中；而同一种证候在不同体质上表现也不同——这会改变处理方式。\n\n这也是为什么「把你归入若干固定类型之一」的问卷，与诊断不是一回事。给倾向命名，是在描述背景；它既不说明你现在正在发生什么，也不能作为开始服用任何东西的理由。", "source": "Classical theory", "note": "与「中医体质学说」一条配读，本条讲关系与边界。" }, { "slug": "root-branch-priority", "section": "fundamentals", "title_en": "Root and Branch: What to Address First", "title_zh": "标本缓急", "pinyin": "biāo běn huǎn jí", "body_en": "Classical texts insist that deciding what to treat first is itself a clinical judgement, and one of the harder ones. Root and branch describe cause and manifestation; acute and chronic describe urgency. The four combinations give four different orders of work.\n\nThe rule that comes out of it is stated plainly in the tradition: in sudden, severe situations address the branch first, and in slow, long-standing ones address the root. The reason is not philosophical. If someone is in acute distress, the acute problem is what threatens them now, whatever its origin.\n\nThis principle has a direct modern reading. Sudden severe chest pain, difficulty breathing, weakness on one side of the body, or heavy bleeding are branch emergencies. Nothing about long-term constitutional work changes that, and no constitutional theory should be allowed to delay emergency care.", "body_zh": "古籍坚持认为，先处理什么是临床判断本身，而且是较难的判断之一。标本说的是本因与表象，缓急说的是紧迫程度。四个组合给出四种不同的先后次序。\n\n由此得出的规则，传统里说得很直白：卒病、急症先治其标，久病、缓症治其本。理由并不是玄学。一个人正处在急性痛苦中，无论根源是什么，眼下威胁他的就是那个急的问题。\n\n这条原则有一个直接的现代读法：突发剧烈胸痛、呼吸困难、身体一侧无力、或大量出血，都属于「标」的急症。任何长期的调养计划都不改变这一点，也不应让任何理论延误急诊。", "source": "Classical theory", "note": "把传统治则与就医边界写在一起，避免被误用为拖延的理由。" }, { "slug": "mixed-cold-heat", "section": "patterns", "title_en": "Mixed Cold and Heat", "title_zh": "寒热错杂", "pinyin": "hán rè cuò zá", "body_en": "In this framework cold and heat signs are not opposites that exclude each other - they can appear together in the same person, and often in different parts of the body.\n\nClassical descriptions include heat above with cold below, cold in the interior with heat on the surface, and intermingled cold and heat in the middle. The reason it matters is practical: treating it as if it were simply hot, or simply cold, tends to make part of the picture worse.\n\nWhat it is not: a diagnosis, and not something to sort out alone. Cold and heat here are pattern descriptions, not temperatures. Persistent or worsening symptoms belong with a clinician.", "body_zh": "在这一框架里，寒象与热象不是互相排斥的对立，可以同时出现在同一个人身上，而且常分布在不同部位。\n\n经典描述包括上热下寒、里寒表热、寒热错杂于中焦等。之所以要单独提出，是因为很实际：把它当成单纯的热或单纯的寒来处理，往往会让其中一部分表现更糟。\n\n需要说清的边界：这不是诊断，也不适合自己判断。这里的寒热是证候描述，不是体温。症状持续或加重，应交由医师。", "source": "Classical pattern framework", "note": "与虚实的夹杂一同构成临床上更贴近实际的辨证图景。" }, { "slug": "true-false-cold-heat", "section": "patterns", "title_en": "True and False Cold or Heat", "title_zh": "寒热真假", "pinyin": "hán rè zhēn jiǎ", "body_en": "A classical caution about appearances: a picture that looks like heat can in fact be cold at root, and the reverse also occurs. The tradition uses this to argue that the most obvious sign is not always the decisive one.\n\nCriteria proposed in the classical literature include whether the person wants to be covered or uncovered, whether they want cold drinks, the character of the pulse, and how the tongue looks. None of these is decisive alone.\n\nThis is the clearest example of why the library does not do diagnosis. What looks like one thing and is another is exactly the situation where self-assessment is most likely to be wrong. If someone is very unwell, the answer is medical care, not pattern analysis.", "body_zh": "传统对表象的一层警觉：看起来像热的表现，其根本可能是寒；反过来也一样。传统借此说明：最显眼的那一项，不一定是决定性的那一项。\n\n古籍提出的判断线索包括：患者喜不喜欢盖被、是否想喝冷饮、脉象的性状、舌象如何。这些线索没有一条可以单独作准。\n\n这也最能说明本库为什么不做诊断。表象与本质相反的情形，恰恰是自行判断最可能出错的地方。如果人已经明显不舒服，答案就是就医，而不是分析证候。", "source": "Classical pattern framework", "note": "与寒热错杂互为对照：一个讲同时存在，一个讲表里不一。" }, { "slug": "mixed-deficiency-excess", "section": "patterns", "title_en": "Mixed Deficiency and Excess", "title_zh": "虚实夹杂", "pinyin": "xū shí jiā zá", "body_en": "Classical writing treats deficiency and excess as a pair that frequently coexists rather than as a strict either-or. A person may be depleted while also carrying something that needs to be cleared.\n\nThe practical consequence is a well-known classical warning: tonifying too early can strengthen the wrong thing, and draining too hard can leave the person weaker than before. This is why the order of approach is discussed at length in the texts.\n\nWhat it is not: a self-check list. Deciding which is dominant, and in what order to work, is precisely the judgement that requires training and a full examination.", "body_zh": "传统论述里，虚与实常是并存的一对，而不是非此即彼。人可以在已经虚损的同时，又带着需要清除的东西。\n\n由此引出一条著名的传统告诫：补得太早，可能补错了对象；攻得太狠，又会让人比之前更虚。古籍中反复讨论处理的先后次序，原因就在这里。\n\n需要说清的边界：这不是一份自测清单。判断以哪一边为主、按什么次序处理，正是需要系统训练与完整诊察才能做的判断。", "source": "Classical pattern framework", "note": "与八纲中的虚实两纲配套阅读。" }, { "slug": "herbal-bath", "section": "therapies", "title_en": "Herbal Baths and Foot Soaks", "title_zh": "中药药浴与足浴", "pinyin": "zhōng yào yào yù yǔ zú yù", "body_en": "Soaking in water infused with herbs is an old external method, recorded in classical texts on external treatment. Foot soaking in particular became a routine household practice rather than a clinical procedure.\n\nThe usual classical reasoning is that warmth opens the pores and moves the surface, and that the feet are where several channels begin or end. What the practice is not is a way to treat internal disease through the skin.\n\nReal risks are simple and worth stating plainly: water hot enough to burn, especially where sensation in the feet is reduced; skin that is broken, infected or freshly injured; and allergic reaction to a herb you have not used before. Diabetes with reduced foot sensation is the clearest case where this is not a casual activity.", "body_zh": "以药液浸浴是传统外治法的记载之一，足浴后来更成为家庭日常习惯而非临床操作。\n\n传统解释大致是：温能开泄皮毛、通行肌表，而足部是多条经脉的起止之处。需要说清的是，它并不是「通过皮肤治内脏」的手段。\n\n真实的风险很朴素：水温高到会烫伤——足部感觉减退者尤其危险；皮肤破损、感染或新伤处；以及对从未用过的药物过敏。糖尿病伴足部感觉减退，是最明确不适合随意尝试的情形。", "source": "Descriptive only", "note": "本条只描述是什么与风险，不含任何操作步骤。" }, { "slug": "auricular-therapy", "section": "therapies", "title_en": "Auricular Therapy", "title_zh": "耳穴疗法", "pinyin": "ěr xué liáo fǎ", "body_en": "Treating the ear as a map of the whole body, with points on the auricle corresponding to organs and regions. A nomenclature for auricular points was standardised internationally under WHO auspices, which is why the same point names are now used across countries.\n\nIn practice it appears as pressure with seeds or pellets, fine needles, or electrical stimulation. Practitioners of acupuncture treat it as one technique among several rather than as a stand-alone system.\n\nRisks centre on the ear itself: the cartilage of the auricle has poor blood supply, so infection there can become serious and is hard to treat. Unsterile needles or prolonged pressure dressings are the main avoidable causes. Evidence for benefit in specific conditions varies widely between reviews.", "body_zh": "把耳朵看作全身的缩影，耳廓上的穴位与脏腑和身体部位相对应。耳穴名称曾由世界卫生组织主持制定国际标准化方案，这也是各国使用同一套穴名的原因。\n\n实际应用中表现为贴压、揿针或电刺激等形式。针灸从业者一般把它视为多种技术中的一种，而非独立体系。\n\n风险集中在耳朵本身：耳廓软骨血供差，此处感染容易变重且难处理。器械不洁与长时间贴压是主要的可避免原因。对具体病症的效果，各研究结论差异很大。", "source": "Descriptive only", "note": "只描述是什么与风险，不含操作指导。" }, { "slug": "paediatric-tuina", "section": "therapies", "title_en": "Paediatric Tuina (Infant Massage)", "title_zh": "小儿推拿", "pinyin": "xiǎo ér tuī ná", "body_en": "A distinct branch of manual therapy for infants and young children, described in dedicated classical texts. It uses light, fast techniques on the hands, forearms, abdomen and back, and its point locations differ from those used in adults.\n\nParents often meet it as a home routine for a restless or colicky baby. That is a different thing from a practitioner treating a sick child: in classical practice the technique is one part of an assessment.\n\nThe safety boundary is sharp. Any infant with fever, poor feeding, lethargy, breathing difficulty or an unexplained rash needs medical assessment first, not massage. Infant bones and joints are easily injured by force. Parents should be cautious of anyone offering to treat a serious childhood illness by massage alone.", "body_zh": "针对婴幼儿的独立手法分支，有专门古籍记载。多用轻快手法作用于手部、前臂、腹部与背部，其穴位定位与成人不同。\n\n家长接触到它，通常是作为婴儿烦躁或肠绞痛时的家庭安抚手段。这和「由医师处理生病的孩子」不是一回事：传统实践中，手法只是评估的一部分。\n\n安全边界很硬：婴儿出现发热、吃奶差、精神萎靡、呼吸费力或不明皮疹，都应先就医，而不是推拿。婴幼儿骨骼关节受力不当容易受伤。若有人宣称单靠推拿能治小儿重症，家长应当警惕。", "source": "Descriptive only", "note": "只描述是什么与风险，不含手法教学。" }, { "slug": "moxibustion-research", "section": "therapies", "title_en": "Moxibustion: What the Modern Research Shows", "title_zh": "艾灸的现代研究", "pinyin": "ài jiǔ de xiàn dài yán jiū", "body_en": "Modern research on moxibustion is a genuine but modest body of work. Systematic reviews in this area repeatedly note the same limitations: small sample sizes, difficulty blinding participants and practitioners, and wide variation in how moxibustion is applied and for how long.\n\nThat combination means results are hard to pool, and reviews often conclude that evidence is insufficient rather than that moxibustion works or does not work. Where benefits are reported, they are typically described as short-term, with few studies following people for long periods.\n\nThere is also a safety literature. Moxa smoke is a combustion product and irritates the airway; burns and blistering are reported, particularly where sensation is reduced or where the person cannot report pain. Anyone with asthma or lung disease should treat smoke exposure as a real consideration.", "body_zh": "关于艾灸的现代研究确实存在，但体量有限。该领域的系统评价反复指出同样的局限：样本量小、对受试者与操作者都难以设盲，以及艾灸的做法与时长差异很大。\n\n这些因素叠加，导致结果难以合并，评价的常见结论是「证据不足」，而不是「有效」或「无效」。在报告有获益的研究中，通常也只是短期效果，长期随访的研究很少。\n\n另有一批安全文献：艾烟属燃烧产物，刺激气道；也有烧伤与水疱的报告，尤其见于感觉减退或无法表达疼痛的人。哮喘或肺部疾病者，应把烟雾暴露当作真实需要考虑的问题。", "source": "Systematic review", "note": "本条只综述研究现状与局限，不引用具体疗效数字。" }, { "slug": "cupping-safety", "section": "therapies", "title_en": "Cupping: The Safety Literature", "title_zh": "拔罐的安全文献", "pinyin": "bá guàn de ān quán wén xiàn", "body_en": "Cupping has a documented adverse-event literature, and it is worth knowing before deciding to try it. The common, expected effect is a circular bruise from broken capillaries - it looks dramatic but is usually harmless and fades.\n\nThe more serious reports are burns from the flame method, blisters and subsequent infection, and scars. Severe events requiring hospital care have been published, though they are uncommon. Risk rises sharply when the person doing it is untrained, when the same equipment is reused without proper cleaning, or when cupping is applied over broken or inflamed skin.\n\nCupping is not appropriate over varicose veins, on anyone taking anticoagulants, in pregnancy over the abdomen and lower back, or on skin that is already damaged. Marked bruising in someone on blood thinners is a reason to seek advice rather than to continue.", "body_zh": "拔罐有可查的不良事件文献，决定尝试前值得了解。最常见、也属预期内的是毛细血管破裂形成的圆形瘀斑——看上去夸张，但通常无害，会自行消退。\n\n较严重的报告包括火罐造成的烧伤、水疱及继发感染与瘢痕。已有需要住院处理的严重事件发表，但并非常见。风险明显升高的情况包括：操作者未受训、器具重复使用且未规范清洁，以及在破损或发炎的皮肤上操作。\n\n静脉曲张处、正在服用抗凝药者、孕期腹部与腰骶部、以及已有皮肤损伤的部位，都不适合拔罐。服用抗凝药者出现明显瘀斑，应咨询专业人士而不是继续做。", "source": "Safety literature", "note": "本条站在「有什么风险」的角度写，不含操作指导。" }, { "slug": "pulse-diagnosis-research", "section": "diagnostics", "title_en": "Pulse Diagnosis: What Has and Has Not Been Shown", "title_zh": "脉诊：已被证实与尚未证实的部分", "pinyin": "mài zhěn", "body_en": "Pulse diagnosis is the most technically demanding part of the classical examination. Traditional texts describe dozens of pulse qualities, each with a name, a felt character and an associated pattern, and the skill is transmitted by feeling many pulses alongside a teacher.\n\nThat is also why it is hard to study. The measuring instrument is a practitioner's fingers, and studies repeatedly find only modest agreement between practitioners examining the same person - better than chance in some settings, less impressive in others. Reproducibility, not the existence of a pulse, is the open question.\n\nInstrumented approaches exist: pressure sensors, Doppler ultrasound and smartphone-based systems have all been used to try to capture a pulse objectively. These produce numbers, but the classical categories were not defined numerically, so mapping one to the other is not straightforward.\n\nWhat can be said fairly: the pulse carries real information. Rate, rhythm and the character of the arterial wall are clinically meaningful and are used in conventional medicine too. What has not been shown is that the specific classical categories can be assigned reliably and repeatably by different practitioners, or that they map onto particular conditions in the way the tradition claims. A practitioner who treats pulse findings as one input among several is being straightforward; one who treats the pulse alone as decisive is not.", "body_zh": "脉诊是古典诊法中对技术要求最高的一环。传统文献列出数十种脉象，每种有名称、有指下的手感、有对应的证候，这门技术靠跟着老师摸大量脉象来传授。\n\n这也正是它难以研究的原因：测量工具是操作者的手指。多项研究反复发现，不同操作者诊察同一个人时，一致性只是中等——有些场景下高于随机，另一些场景下并不突出。真正悬而未决的是「可重复性」，而不是「脉象是否存在」。\n\n仪器化的路径确实存在：压力传感器、多普勒超声、基于智能手机的系统都被用来尝试客观记录脉象。这些方法能产生数字，但古典脉象并非按数字定义的，两者之间的对应并不直接。\n\n可以公允地说：脉象确实承载信息——脉率、节律、动脉壁的性状在临床上有意义，现代医学同样在使用。尚未被证实的是：那些具体的古典脉象类别，能否由不同操作者稳定、可重复地判定；以及它们是否如传统所言，对应到特定的证候。把脉象当作多项依据之一的实践者是诚实的；把脉象单独当成决定性依据的，则不是。", "source": "Critical reading", "note": "本条只讨论可重复性与证据形态，不评价任何具体脉象的临床价值。" }, { "slug": "electroacupuncture", "section": "therapies", "title_en": "Electroacupuncture: What It Is and What the Evidence Shows", "title_zh": "电针：它是什么，证据如何", "pinyin": "diàn zhēn", "body_en": "Electroacupuncture is needling with a small electrical current passed between pairs of inserted needles. It is a twentieth-century development rather than a classical technique: the needles are classical, the current is not. Textbooks describe it as a way of standardising stimulation that would otherwise depend on how long and how vigorously a practitioner manipulates each needle by hand.\n\nFrequency is the main variable clinicians discuss. Low and high frequencies are described as producing different effects in laboratory and animal work, and different devices offer different waveforms. This matters for reading the research: two studies that both say \"electroacupuncture\" may not have applied anything like the same stimulus.\n\nThe evidence base has the same shape as the rest of this field - small trials, difficulty blinding, and heterogeneous protocols. Systematic reviews tend to describe possible short-term effects and call for larger, better-controlled work rather than declaring the question settled.\n\nSafety deserves the most attention. Electroacupuncture is not appropriate for anyone with a pacemaker or another implanted electronic device, and it is used with real caution in pregnancy and in people with epilepsy. Before starting, a practitioner should be able to explain why a particular current and placement is safe for the person in front of them.", "body_zh": "电针是在刺入的针之间通以小电流的做法。它属于二十世纪的产物，而非古典技术：针是古典的，电流不是。教材一般把它描述为一种把刺激量标准化的方式——否则刺激量取决于操作者用手法行针的时长与力度。\n\n频率是临床讨论中最主要的变量。低频与高频在实验室与动物研究中被描述为产生不同效应，不同设备的波形也各不相同。这一点直接影响如何解读文献：两项都写着「电针」的研究，施加的刺激可能完全不同。\n\n证据的面貌与本领域其他部分一致——样本小、难以设盲、方案异质。系统评价通常只能说「可能有短期效应」，并呼吁更大规模、控制更好的研究，而不是宣布问题已有定论。\n\n最需要留意的是安全：装有心脏起搏器或其他植入式电子设备者不适合电针；孕期与癫痫患者需格外谨慎。开始之前，操作者应当能够说明，为什么某个电流与放置方式对眼前这个人是安全的。", "source": "Modern research", "note": "本条只综述技术、证据形态与安全边界，不引用具体疗效数字。" }, { "slug": "seven-combinations", "section": "fundamentals", "title_en": "The Seven Combinations of Herbs (Qi Qing)", "title_zh": "中药配伍七情", "pinyin": "pèi wǔ qī qíng", "body_en": "The 'seven feelings' (qi qing) — more accurately translated as seven kinds of combination — is the classical vocabulary for how two herbs behave when used together. The list comes from the preface of the Shennong Bencao Jing (Divine Farmer's Classic of Materia Medica, compiled roughly in the Han dynasty), which names them: single action (dan xing), mutual reinforcement (xiang xu), mutual assistance (xiang shi), mutual restraint (xiang wei), mutual aversion (xiang wu), mutual antagonism (xiang fan), and mutual counteraction (xiang sha).\n\nThe categories describe relationships, not ingredients. Two herbs with similar actions used together may reinforce each other (xiang xu); a secondary herb may assist the action of a chief herb (xiang shi); the toxicity of one may be held in check by another (xiang wei and xiang sha, which later writers read as a positive pairing); while some pairings were recorded as diminishing each other (xiang wu) or as conflicting outright (xiang fan). The last category is the root of the later 'eighteen incompatibilities and nineteen fears' (shi ba fan, shi jiu wei) lists found in later formulary literature, which tabulate pairs traditionally considered incompatible.\n\nHow to read this: the seven combinations are a descriptive grammar, not a rulebook with numbers. The classical text records how paired herbs were observed to behave; it does not and cannot certify that any particular pairing is safe for any particular person. Modern pharmacology has found that some of these traditional pairings correspond to measurable interactions and others do not, and the question is still studied. What the framework contributes today is a precise, shared language for talking about herb-to-herb interaction — and a reminder that combination, not the single herb, was always the unit of classical practice.", "body_zh": "「七情」是描述两味药同用时相互关系的传统词汇，出自《神农本草经》序录，原文列举：单行、相须、相使、相畏、相恶、相反、相杀。它说的是「关系」而不是「成分」：功效相似的同用可能互相增强（相须），辅药可助主药（相使），一味药的毒性可被另一味牵制（相畏、相杀，后世多读作良性搭配），也有记载彼此削弱（相恶）或直接冲突（相反）的配对。最后一类是后世方书「十八反、十九畏」名录的源头，用于罗列传统上认为不宜同用的药对。\n\n怎么读这一条：七情是一套描述性的语法，不是带数字的规则手册。古籍记录的是配伍被观察到的行为，它不能为任何具体的人担保任何具体搭配的安全性。现代药理研究发现其中一些传统记载与可测量的相互作用对应，另一些则不然，问题仍在研究中。这套框架今天的价值，是一套谈论「药与药相互作用」的精确公共语言——以及一个提醒：经典实践的基本单位从来是配伍，而不是单味药。", "source": "Classical theory", "note": "本草配伍理论" }, { "slug": "four-qi-division", "section": "fundamentals", "title_en": "The Four Qi and Their Divisions of Labor (Yuan, Zong, Ying, Wei)", "title_zh": "四种气的分工", "pinyin": "sì zhǒng qì de fēn gōng", "body_en": "Classical Chinese medicine describes the vital energy (qi) not as one undifferentiated substance but as a family of functional currents, each with its own origin, route and job. Four of these are singled out in the foundational texts: yuan qi (original qi), zong qi (pectoral or ancestral qi), ying qi (nutritive qi) and wei qi (defensive qi).\n\nYuan qi is the deepest layer. It is described as rooted between the two kidneys, in the region later texts call ming men (the gate of life), and is understood as the primordial endowment a person is born with, drawn from the essence (jing) of both parents. The Huangdi Neijing does not use the term yuan qi as a fixed technical label — that usage was consolidated by later authors such as the Ming physician Zhang Jingyue — but the Neijing already treats the kidney system as the storehouse of prenatal essence. Yuan qi is not spent on daily tasks; it is the baseline that warms and activates all the other qi.\n\nZong qi assembles in the chest, in the region called shang qi hai, the upper sea of qi. The Lingshu (chapter 4 among others) describes it as formed where the air taken in by the lung meets the food essence raised by the spleen and stomach. Its two documented jobs: it feeds the heart and lung to drive breathing and the beat of the pulse, and it flows down to support the voice and the rhythm of respiration.\n\nYing qi and wei qi are described together in Lingshu 50 (Ying Wei Sheng Hui) as two halves of one circulation. Both begin from food essence, both run in continuous cycles. Ying qi is the clearer, softer current: it travels inside the vessels alongside the blood, transforming into the nutritive part of the body. Wei qi is the swifter, tougher one: it runs outside the vessels, along the body surface, day and night, and its classical role is warming and guarding — regulating the opening and closing of the pores (couli) and holding the exterior against external pathogens.\n\nThe division is functional, not anatomical: one origin (food and air, resting on the prenatal base), several specializations. Later generations summarized it in one line — yuan qi roots, zong qi gathers in the chest, ying nourishes within, wei guards without. The Neijing presents these as descriptions of how the body is observed to work; whether they map onto modern physiological categories is not claimed by the classical sources themselves.", "body_zh": "中医基础理论把「气」分成各有来历、各管一段的几股，其中最常引用的是四种：元气、宗气、营气、卫气。\n\n元气是最深一层，后世表述为「根于两肾之间（命门）」，禀受于父母先天之精。《内经》虽未把「元气」固定为术语（这一定型见于明代张景岳等），但已把肾系统当作先天之精的库房。元气不直接干日常的活，它的角色是温煦与推动——其余诸气都靠它打底。\n\n宗气积于胸中（上气海）。《灵枢》多处记载它由肺吸入的清气与脾胃上输的水谷精微「相合」而成，文献明确记载的职责有两条：一是贯心脉、行呼吸——推动肺的呼吸与心的搏动节律；二是下走以支持声音与气息。\n\n营气与卫气在《灵枢·营卫生会》里被作为一对来讲：两者同源（皆出于水谷精微），都在做昼夜不停的循环。营气「清柔」，行于脉中，与血同行，化生身体所需的营养部分；卫气「悍疾」，行于脉外、循体表昼夜运行，经典记载的职能是「温分肉、充皮肤、肥腠理、司开阖」——主管毛孔腠理的开合，抵御外邪，是身体的「卫外」层。\n\n这个分工是功能性的，不是解剖性的：同一个来源（水谷与清气，垫在先天元气之上），几条不同的分工线。后世的概括是一句话——元气根于下，宗气积于胸，营行脉中以濡养，卫行脉外以固表。需要说明：这些是古人对身体运作的观察描述，经典本身并没有主张它们直接对应现代解剖或生理学的某个具体结构。", "source": "Classical theory", "note": "气血津液 · 经典气的分类" }, { "slug": "pricking-blood", "section": "therapies", "title_en": "Pricking bloodletting (Cìluò)", "title_zh": "刺络放血", "pinyin": "cì luò fàng xuè", "body_en": "A classical external method in which a sterile lancet or three-edged needle is used to make a quick, shallow prick at a selected point so that a few drops of blood emerge. The classical rationale comes from the Huangdi Neijing: where there is accumulation and stagnation, remove it through the luo vessels. It is described in the classics for conditions of \"heat\" and \"stagnation\", and it is historically distinct from the large-volume wet cupping traditions of other cultures.\nThis is a skin-breaking procedure. Infection control, single-use instruments and trained hands are not optional extras — they are the procedure. It is unsuitable over broken skin, and people on anticoagulants or with bleeding or blood-borne conditions should not receive it. Red flags such as fever, spreading redness or unexplained bruising belong with a physician, not a lancet.", "body_zh": "一种古典外治法：用一次性三棱针或采血针在选定穴位快速浅刺，令数滴血渗出。经典依据出自《黄帝内经》——\"菀陈则除之\"，即以络脉放血祛除郁滞。古籍将其归于\"热证\"\"瘀滞\"的处理思路，与其他文化中大出血量的放血传统在理念与规模上都不同。\n这是破皮操作：无菌、一次性器械与受训的手不是可选项，而是操作本身。破损皮肤上不宜施术；服用抗凝药、有出血性或血行传染性疾病者不应接受。发热、红肿扩散、不明原因瘀斑等红旗信号应交给医生，而不是交给针。", "source": "Descriptive only", "note": "Skin-breaking procedure — sterile technique is the whole game. Red flags go to a physician." }, { "slug": "herbal-steaming", "section": "therapies", "title_en": "Herbal steaming (Xūnzhēng)", "title_zh": "中药熏蒸（药蒸）", "pinyin": "zhōng yào xūn zhēng", "body_en": "A heat-plus-aroma method: a decoction of herbs is kept hot so its steam rises toward the skin, or the whole body sits in a warm herbal vapour cabinet. In the classical frame it combines warmth (to move what is \"cold and congealed\") with the herb's surface-reaching quality; it is traditionally used for sore, stiff, cold-sensitive muscles and joints. Modern practice uses controlled steam cabinets with temperature settings.\nThe physical risks are straightforward: scalding from overly hot vapour, dizziness or dehydration from prolonged heat, and aggravation for people with certain cardiovascular or skin conditions. Pregnancy, high blood pressure and open wounds are standard reasons to skip it. Any \"custom formula\" sold with the steaming session should be viewed with the same caution as any herbal product — it is a pharmacologically active decoction, not just a pleasant smell.", "body_zh": "热与药气结合的外治法：将药液保持滚烫，令蒸汽升腾熏于局部皮肤，或全身坐在药雾熏蒸舱中。传统思路是温热之力（行\"寒凝\"）加上药物走表的特性，多用于酸冷僵硬的肌肉关节。现代做法使用带温度控制的熏蒸舱。\n物理风险很直接：蒸汽过烫可致烫伤；久蒸可致头晕、脱水；部分心血管或皮肤疾患者不宜。孕妇、高血压、皮肤破溃是常规禁忌。随熏蒸搭售的\"专属药方\"应与一切内服中药同等看待——那是药理活性的煎液，不只是好闻的气味。", "source": "Descriptive only", "note": "Heat injury is the documented risk; herbal vapour is pharmacologically active, not just aroma." }, { "slug": "die-da", "section": "therapies", "title_en": "Die-da: the trauma tradition", "title_zh": "跌打损伤（跌打）", "pinyin": "diē dǎ sǔn shāng", "body_en": "\"Die-da\" (\"fall and strike\") is the Cantonese-rooted name for the tradition of managing everyday musculoskeletal injuries — sprains, bruises, strained tendons. The classical model reads a fresh injury in stages: first blood stasis and swelling (qi and blood do not move), later chronic stiffness and \"cold\" sensations in the injured tissue. External applications, liniments, tuina and gentle mobilisation are its tools; the famous \"die-da jiu\" (medicated wine) liniments belong here.\nOne honest boundary matters more than the whole tradition: the classical model cannot tell a bad sprain from a fracture. Numbness, deformity, inability to bear weight, or swelling that does not improve belongs with imaging and a physician first. The tradition itself always assumed an experienced hand reading the injury — self-treatment of an unexamined injury is the failure mode, not the method.", "body_zh": "\"跌打\"是源自粤语的叫法，指处理日常筋骨损伤——扭伤、挫伤、筋伤——的一门传统。古典模型分阶段看待新伤：初期血瘀肿胀（气血不行），后期转为慢性僵硬与伤处\"发冷\"。外敷、药酒、推拿与轻手法活动是其工具，著名的\"跌打酒\"即出于此。\n有一条诚实边界比整个传统都重要：古典模型分不清严重扭伤与骨折。麻木、畸形、无法承重、肿胀不退，应先影像检查、先看医生。传统本身一直假定有一双有经验的眼睛在判读伤情——对未经检查的伤自行处理，才是真正的失败模式。", "source": "Descriptive only", "note": "Fracture triage is outside any classical model — red flags go to imaging and a physician first." }, { "slug": "bone-setting", "section": "therapies", "title_en": "Bone-setting (Zhènggǔ)", "title_zh": "正骨", "pinyin": "zhèng gǔ", "body_en": "The manual tradition of assessing and repositioning displaced joints and misaligned bones, described in classical texts such as the Yuan-dynasty \"Yinshan Zhengyao\" lineage of orthopaedic writing and the Qing-dynasty \"Yizong Jinjian · Zhenggu Xinfayaozhi\". Its vocabulary includes \"sinew out of groove, bone wrong seam\" (筋出槽、骨错缝) — the idea that soft tissue can slip from its channel and joints can sit fractionally out of place. Diagnosis is by hands: palpation, comparison of the two sides, and listening for joint movement.\nHere the safety boundary is unusually hard: the difference between a \"fractionally out\" joint and a fracture, dislocation, ligament rupture or unstable spine is exactly what training and imaging exist for. Forceful neck and lumbar manipulation carries documented risks regardless of tradition. A responsible practice refers out anything with trauma history plus red flags, and works with — not instead of — modern orthopaedics.", "body_zh": "以手法检查并复位错动关节与移位骨骼的传统，典籍如元代危亦林《世医得效方》的脊柱悬吊复位记载、清代《医宗金鉴·正骨心法要旨》。其术语包括\"筋出槽、骨错缝\"——筋可离于槽，骨可微错于缝。诊断靠手：触诊、双侧对比、听关节活动的声响。\n安全边界在这里格外硬：「微错位」与骨折、脱位、韧带断裂、不稳定脊柱之间的差别，恰恰是训练与影像存在的理由。无论何种传统，颈腰椎的强力扳动都有记录在案的风险。负责任的做法是：外伤史加红旗信号一律转诊，与现代骨科协作而非替代。", "source": "Descriptive only", "note": "Differentiating \"slightly out\" from fracture is exactly what imaging is for — manual traditions refer out." }, { "slug": "medicated-liniment", "section": "therapies", "title_en": "External liniments (Yàojiǔ, Dieda jiu)", "title_zh": "外用药酒（跌打酒）", "pinyin": "wài yòng yào jiǔ", "body_en": "Alcohol-based herbal extracts rubbed onto unbroken skin over sore or bruised areas — a fixture of the die-da tradition and of martial-arts injury culture. The alcohol base carries the herbs and produces a warming sensation; formulas vary enormously by lineage and region.\nTwo cautions recur in the literature. First, \"external use only\" is a real instruction: several traditional liniment herbs are toxic if swallowed, and poisoned-children case reports exist. Second, broken skin, mucous membranes and bandaged heat-wrap over fresh liniment can all increase absorption — the warming that feels therapeutic is the active extract entering tissue. Keep it on intact skin, and keep it away from children.", "body_zh": "以酒为基的草药浸剂，涂抹于酸痛或瘀伤处的完整皮肤——跌打传统与武术伤科文化的标配。酒基载药并带来温热感；配方因门派与地域差异极大。\n文献中有两条反复出现的提醒。其一，\"只可外用\"是真话：多种传统药酒药材吞服有毒，儿童误服中毒的病例报告确实存在。其二，破损皮肤、黏膜、以及涂药后加盖热敷加温，都会增加吸收——那种\"治疗感\"的温热，正是活性成分进入组织的表现。只用于完整皮肤，并放到儿童拿不到的地方。", "source": "Descriptive only", "note": "External-use-only is a real safety line: several liniment herbs are toxic if swallowed." } ] }