"Avoiding pathogenic influences and damaging winds in due season" is a concise yet inclusive scripture in Huangdi Neijing that not only focuses on avoiding pathogenic qi in the four seasons but is also explained from the two perspectives of "three deficiencies" and "eight cardinal directions." First, in terms of "three deficiencies," in the year of overrestraint, we should avoid the conquest of abnormal changes of climate from the first to third qi, and avoid the retaliation of abnormal changes of climate from the fourth qi to last; second, on the first day of each lunar month and one to two days before and after, the human body is in a weak state under the influence of the moon; therefore, deficient nature pathogens should be avoided. Third, when the solar terms are exchanged, climate changes should be observed to anticipate them. In terms of "eight cardinal directions," we should prevent abnormal wind and rain, which come early or late around the eight solar terms (Beginning of Spring, the Spring Equinox, the Beginning of Summer, the Summer Solstice, the Beginning of Autumn, the Autumn Equinox, the Beginning of Winter, and the Winter Solstice). In contrast, especially on the day of the eight solar terms, the wind coming from the opposite direction of the corresponding solar terms should be paid attention to, as this wind is violent and easily opens the pores to cause disease. Therefore, it is necessary to stay indoors on such days. Additionally, the wind, coming from the rest of the six directions in addition to the direction and the opposite direction of the corresponding solar terms, on the first day of the first month of the lunar calendar, is regarded as the basis for predicting the prevalence of diseases of the coming year, which also needs special attention. Therefore, "avoiding pathogenic influences and damaging winds in due season" must be deeply interpreted to fully use the Huangdi Neijing to prevent and treat diseases.
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Open Access
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Open Access
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In traditional Chinese medicine theory, the skin is one of the five body constituents, and its connotations are described through multiple interpretations and expressions in Huangdi Neijing. The concept of the skin encompasses fine hair, striae and interstices (couli), and superficial collaterals, reflecting diverse medical perspectives and understandings of the skin. The functions of the skin are also reflected through its associated structures. With the development of the theories of meridians and visceral systems, the skin, as a bodily tissue, became integrated with these systems, forming various correlation patterns. The qi and blood of the entire body nourish the skin and fine hair, and their condition serves as an external indicator of the abundance or deficiency of qi and blood. As the lung governs qi and regulates respiration, providing the dynamic force for the circulation of qi and blood, the concept of "lung governs the skin and hair" emerged. The notion that "taiyang governs the exterior" originated from the integration of meridian theory with the skin, muscles, and bones. It represents an early diagnostic approach that combined bodily tissue differentiation with meridian differentiation for febrile diseases caused by external pathogens. "Heart governs the exterior" is closely associated with early bloodletting therapies. The superficial collaterals on the body surface are considered extensions of the function of the heart governing blood circulation. Bloodletting method was believed to promote blood circulation, purge heart fire, and regulate mental activity. This paper investigates the concept and connotation of skin and the construction of its relevant theoretical framework, aiming to address the current gaps in the understanding of skin theory and contribute to the enrichment and refinement of the theory of bodily constituents in Huangdi Neijing.
Open Access
Original Article
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To evaluate whether the traditional Chinese medicine (TCM) theory of five circuits and six qi (FCSQ) is beneficial in terms of improving clinical effectiveness.
Randomized controlled trials (RCTs) evaluating the clinical value of FCSQ theory were reviewed. Multiple databases (China Network Knowledge Infrastructure, Chinese Scientific Journals Database, Wanfang Data, SinoMed, Cochrane Library, PubMed, and Embase) were systematically searched from inception to June 12, 2018. Two authors independently extracted the data and performed a methodological quality assessment of the RCTs. RevMan 5.3 software was used for the data analysis. The effect sizes for the primary outcome measures were expressed as relative risks or mean differences with 95% confidence intervals.
A total of 13 RCTs were selected, involving 12 types of diseases and 4695 patients. The methodological quality of the RCTs was generally low. Five studies compared the effectiveness of TCM treatments guided by FCSQ theory with conventional TCM therapies, and the remaining eight studies compared the effectiveness of TCM treatments guided by FCSQ theory with biomedical treatments. All of the RCTs reported that the effectiveness of the treatment intervention was better than that of the intervention in the control group.
Because of many methodological problems in existing clinical studies, it remains impossible to definitively conclude that FCSQ theory can improve clinical effectiveness. It is difficult to unify the clinical application of FCSQ theory. The feasibility and repeatability of FCSQ as an intervention should be given more attention in future clinical research. Future work should also follow international norms for clinical research implementation and reporting to provide high-quality evidence for evaluating the clinical value of FCSQ theory.
Open Access
Original Article
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To analyze the impact of meteorological factors on the incidence of influenza based on the Yunqi theory in Beijing area, and to establish an effective forecast model.
Monthly data on the incidence of influenza from 1970 to 2004 and daily data on the meteorological factors (including daily averages of temperature, wind speed, relative humidity, vapor pressure, and daily total precipitation) from 1966 to 2004 were collected and processed under the traditional Chinese medicine (TCM) theory of six qi. A back-propagation artificial neural network was then performed to analyze the data.
The highest incidence of influenza occurs in the sixth qi (the period of December and January), which is characterized by dryness and coldness. Altogether six models were successfully established. Climatic data used were of the same year, one year prior, two years prior, and three years prior to the influenza data respectively. The last two models involve climatic data of the previous three years plus the current year and of the past four years plus the current year. Finally, we determined the fifth model has the highest forecast accuracy (49%).
Meteorological factors can exert an influence on the incidence of influenza, which corresponds to TCM theory that “the pestilence occurred three years after the abnormal climatic changes”. This study may generate interest among the public health community and other TCM theories can be applied so that public health measures can be taken to prevent and control influenza, particularly during the winter months.
Open Access
Original Article
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This paper aims to study the correlativity between the number of pulmonary tuberculosis (PTB) cases and seasonal meteorological factors in Beijing.
Based on theory of Human–Environmental Inter Relation in Huangdi's Internal Classics, we adopted monthly cases of PTB in Beijing from 2004 to 2011, and established a Seasonal Autoregressive Integrated Moving Average (SARIMA) model. Using the cross-correlation function (CCF), we then analyzed the correlation between meteorological factors and number of infected patients. The related meteorological factors were subsequently integrated, to establish a Seasonal Autoregressive Integrated Moving Average with explanatory variables (SARIMAX) model, which was used to estimate and verify the number of PTB cases in 2012.
In this study, a SARIMA(0,1,1) (0,1,1)12 model was established; CCF analysis was used to reveal the correlativity between PTB and precipitation with 1 lag, relative humidity with 1 lag. Then, integrated with relative humidity with 1 lag (β = 2.405, 95% confidence interval: 0.433–4.377), the SARIMAX prediction model was proved to be an accurate approach for predicting local situations of PTB occurrence.
The occurrence of PTB is correlated with seasonal meteorological factors. Combining these factors, an exact prediction model can be established, to estimate of the number of PTB infected patients.
Open Access
Original Article
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Traditional Chinese medicine (TCM) has a comprehensive and thorough understanding of biological rhythm. Biological rhythm is an inherent connotation of “harmony between human and nature”, one of the thoughts in TCM. TCM discusses emphatically circadian rhythm, syzygial rhythm and seasonal rhythm, and particularly circadian and seasonal rhythms. Theories of Yin Yang and Five Elements are the principles and methods, with which TCM understands biological rhythms. Based on theories in TCM, biological rhythm in essence is a continuous variation of the human body state synchronized with natural rhythms, and theories of Yin Yang and Five Elements are both language tools to describe this continuous variation and theoretical tools for its investigation and application. The understandings of biological rhythm in TCM can be applied to etiology, health care, disease control and treatment. Many understandings in TCM have been confirmed by modern research and clinical reports, but there are still some pending issues. TCM is distinguished for its holistic viewpoint on biological rhythms.
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