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All lessons   Module 7: Treatment   Lesson 1

Module 7   Lesson 1   Zhi Ben

Treatment principles: Root and Manifestation

What do you treat first when someone has more than one thing wrong, and how do you defend that order?

After this lesson you can place the principle between pattern and points, you know the four meanings of Root and Manifestation, you can apply the three rules with the two exceptions from Su Wen 65, and you can write a principle in one sentence that names branch and root together.

Pattern what is there Root and branch what first Principle in one sentence Points or formula the means root light or recent root deep or chronic branch urgent intense, acute branch not urgent mild, stable Branch first often that is the end of it severe: one thing at a time Branch first, then root the focus shifts once acute is over stop early, the branch returns Both together branch and root in one plan mild: together The root the branch follows, often both slower, but it stays away The Middle fills up always branch first Su Wen 65 Urine and stools stuck always branch first Su Wen 65 The branch is an alarm doctor first, before any pattern general medicine
Schematic. The grid is a textbook summary of the rules in step 4; "severe: one thing at a time" and "mild: together" paraphrase Su Wen 65. The red boxes are the exceptions and the red flag.

Know by heart

  • Root and Manifestation. The book translates ben 本 as the Root and biao 标 as the Manifestation; in plain words, the root and the branch. A pair, not fixed boxes. mnemonic: 本 is a tree 木 with a stroke at its foot.
  • Four meanings. Zheng qi versus xie qi; cause versus symptom; earlier versus later disease; interior (organ) versus exterior (skin, channel). mnemonic: FOCI; the root lies with First, Own strength (zheng qi), Cause, Inside.
  • Three rules. Acute: the branch first (急则治标); chronic: the root (缓则治本); often both (标本兼治). Su Wen 65: if the disease is mild, both together; if it is severe, one thing at a time.
  • Two exceptions, Su Wen 65. If the Middle fills up, or urine and stools are stuck, treat the branch first, whatever the root. mnemonic: bloated or blocked, branch before.
  • Principle in one sentence. Verb plus object, branch and root together, the most urgent first: "subdue Liver-Yang, nourish Kidney-Yin".
  • Principle, method, means. The principle (zhi ze 治则) chooses order and direction; the method (zhi fa 治法) is the verb; points and formula are the means (textbook knowledge).
  • Against the nature, or along with it (Su Wen 74). Warming Cold and cooling Heat is zheng zhi; with a false picture you treat the true nature and seem to go along with the false one: fan zhi. mnemonic: against the current, or with it to the source.

The rest of this lesson is reference.

Treatment principles: Root and Manifestation: What do you treat first when someone has more than one thing wrong, and how do you defend that order?
The chart as an image, to save or share

Three practice questions from this lesson

How does the book translate ben and biao?
  1. As the Root and the Manifestation
  2. As the Yin and the Yang
  3. As the Excess and the Deficiency

Answer: As the Root and the Manifestation. Ch. 69 from p. 1173: the Root (ben, the root) and the Manifestation (biao, the branch).

Which pair does not belong to the four meanings of root and branch?
  1. Earlier and later disease
  2. Zheng qi and xie qi
  3. Heat and Cold
  4. Interior and exterior

Answer: Heat and Cold. FOCI: first, own strength (zheng qi), cause, inside. Heat and Cold is an axis of the Eight Principles, not a pair of root and branch.

Case. Woman, 44, Spleen-Qi deficiency for years. Since yesterday a fever of 38.6 °C, sore throat, thirst; tongue with a red tip, pulse floating and rapid. What first?
  1. Release and tonify together, in one plan
  2. Release the Exterior and clear Heat, then the Spleen
  3. First tonify the Spleen, because that is the root

Answer: Release the Exterior and clear Heat, then the Spleen. Acute: the branch first. Wind-Heat (pattern 17) is exterior, later and xie qi. Then the root. Tonifying the Spleen first or alongside is the pitfall: tonifying while the Wind is still there. Rule out first: drowsiness, neck stiffness, breathlessness, a fever that stays high for days.

The rest of this lesson

In the course you get the step-by-step explanation, 23 case-based practice questions, 16 spaced-repetition flashcards, the pitfalls and the bridge to physiology with evidence grades. This lesson belongs to module 7: Treatment.

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