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TRADITIONAL CHINESE VETERINARY MEDICINE
Volume 1
Fundamental Principles
TRADITIONAL CHINESE VETERINARY MEDICINE

Volume 1: Fundamental Principles
Huisheng Xie, DVM, PhD

Vanessa Preast, DVM
Copyright 2002 by Jing Tang
Book design:
Illustration, Page layout:
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Printer:
Huisheng Xie and Vanessa Preast

Vanessa Preast
Stewart J. Thomas
Beijing University of Aeronautics &
Astronautics Printing House
Xie, Huisheng
Traditional Chinese Veterinary Medicine, Volume 1: Fundamental Principles
Jing Tang, 2002
First Edition
Includes appendices, indexes, and bibliographical references
ISBN: 0-9720045-0-5
Jing Tang
9708 West Hwy 318
Reddick, Florida 32686
USA
All rights reserved. This book is protected by copyright. No part of this publication may be reproduced
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information storage and retrieval system without written permission from the copyright owner.
The publisher, editor, and authors are not responsible (as a matter of product liability, negligence, or
otherwise) for any injury resulting from any material contained herein. This publication contains
information relating to general principles of medical care which should not be construed as specific
instructions for individual patients. Manufacturers product information and package inserts should be
reviewed for current information, including contraindications, dosages, and precautions.
Printed in Beijing, China

First printing, November 2002
TRADITIONAL
CHINESE VETERINARY MEDICINE
Volume 1
Fundamental Principles
Huisheng Xie, DVM, PhD, MS

Vanessa Preast, DVM
PREFACE
This volume, Fundamental Principles, is the first of four books which comprise the
textbook Traditional Chinese Veterinary Medicine. As a collaborative work, it has
developed into an update and expansion of the text Traditional Chinese Veterinary
Medicine published in 1994 by Dr. Huisheng Xie. This volume intends to clarify the basic
principles of Traditional Chinese Veterinary Medicine.
We have created this text for several reasons. First, Traditional Chinese Veterinary
Medicine has been used to treat animals for thousands of years in China. Only in recent
history have practices such as acupuncture and herbal therapy come into use in the
Western world. The majority of the literature about these traditional techniques is written
in Chinese and is inaccessible to most Westerners. Because of the paucity of texts in the
English language regarding these techniques, we hope this text will fill some gaps in the
current knowledge. This is especially true of the basic philosophies and principles of
traditional medicine for which English-language information is quite deficient. For this
reason, we dedicate the entire first volume to the underlying principles of Traditional
Chinese Veterinary Medicine.
Second, we wish to create a book which would be a relevant, functional resource for
veterinarians and students who wish to apply these principles. For this reason, we intend
to present the material in a practical manner and to illustrate these principles with case
examples and questions at the end of the chapters. In addition, the final chapter of this
book consists of numerous, lengthy case studies with descriptions and explanations of
all the findings and treatments. It is our hope that this will promote understanding of how
one may apply these principles to clinical cases.
Third, creating a new edition of Traditional Chinese Veterinary Medicine provided us an
opportunity to clarify the text, to add additional detail, and to alter the appearance of the
book. We hope that the diagrams and illustrations in this text will further enhance
readers understanding. Much of the new information in this book had not been available
in the original edition. Readers familiar with the first edition will also note that we avoided
detailed discussions of herbal formulas and acupuncture techniques in this book. These
topics will be discussed in subsequent volumes.
We sincerely appreciate the efforts of all who have helped to make this book possible.
Special thanks to Drs. Robert Spiegel and Bruce Ferguson for proofreading the
manuscript and to Mr. Li Hongfan for coordinating with the press. Thanks also to family
and friends for their patience, encouragement and support.
HUISHENG XIE
VANESSA PREAST
ABOUT THE AUTHORS
Huisheng Xie received his Doctor of Veterinary Medicine at the Sichuan College of
Animal Science and Veterinary Medicine in Sichuan, China in 1983. Dr. Xie became an
assistant and staff veterinarian in the College of Veterinary Medicine of the Beijing
Agricultural University from 1983 to 1987. In 1988, he received his Master of Veterinary
Science in Veterinary Acupuncture. From 1988 to 1994, he was an Assistant and
Associate Professor in the Beijing Agricultural University College of Veterinary Medicine.
In 1992, he also received advanced training in human acupuncture at the Beijing College
of Traditional Chinese Medicine and the National Academy of Traditional Chinese
Medicine. In 1999, he received his Ph.D. from the University of Florida for his
investigation of the mechanisms of pain control in horses using acupuncture. Currently,
he serves as the Complementary and Alternative Veterinary Medicine Clinician in the
Veterinary Medical Teaching Hospital at the University of Florida. In 1998, Dr. Xie
founded the Chi Institute in Reddick, Florida to train veterinarians in Chinese
acupuncture and herbal medicine.
Dr. Xies academic accomplishments in China include Achievement Awards from the
Ministry of Agriculture, the National Science and Technology Committee and the Beijing
Agricultural University. He has been invited to talk about veterinary acupuncture and
herbal medicine all over the United States, Japan, Mexico and Europe. He is also the
author of eight books and 35 scientific papers. His English-language textbook,
Traditional Chinese Veterinary Medicine, was published in 1994 and has been used for
TCVM training programs in China, Europe and the United States.
Vanessa Preast received her Doctor of Veterinary Medicine from the University of
Florida. As a graduate of the Chi Institute, she has become certified in small animal
acupuncture. She practiced integrative medicine in small animal practice.
NOTICE
This book is written for use by veterinarians who practice Traditional Chinese Veterinary
Medicine (TCVM). It is a guide to the general principles behind this medical system, and
it is not intended to be a substitute for sound medical education. Veterinarians are
strongly advised to seek a comprehensive TCVM training program before using
acupuncture or herbal medicine. There are several certification programs in the United
States that are available to veterinarians. Nonveterinarians are cautioned against
practicing medicine on animals, unless permitted by law. Untrained or inadequatelytrained individuals are unable to accurately assess a patients health status and make
appropriate recommendations.
Traditional Chinese Veterinary Medicine, as with any other medical system, is an everchanging field. In addition, much of the information in this book is based on clinical
observations, as opposed to controlled studies. The publisher, editor, and authors make
no warrant as to results of acupuncture or other treatments described in this book.
Medical practitioners should be aware of the standard safety precautions and make
appropriate changes in therapies as new research becomes available and as clinical
experience grows. Any person administering medical therapy is responsible for using his
or her professional skill and experience to determine the best treatment for the patient
and to assure that the benefits of this treatment justifies the associated risk. Thus, the
information within this book should not be construed as specific instructions for individual
patients, and readers should use clinical judgment in deciding when and if the
acupuncture procedures described should be applied. The authors cannot be
responsible for misuse or misapplication of the material in this work.
While every effort has been made to ensure the accuracy of information contained
herein, the publisher, editor, and authors are not legally responsible for errors or
omissions. Readers are advised to check the product information currently provided by
the manufacturer of each drug or formula to be administered to be certain that changes
have not been made in the recommended dose or in the contraindications for
administration.
TABLE OF CONTENTS
Preface ..............................................................................................................................i
About the Authors..........................................................................................................iii
Notice ...............................................................................................................................v
Introduction ...................................................................................................................xv
CHAPTER ONE
Yin and Yang ...................................................................................................................1
The Concept of Yin-Yang......................................................................................................... 1
Five Principles of Yin-Yang ...................................................................................................... 6
Clinical Application of the Yin-Yang Theory ............................................................................. 9
Physiological Aspects............................................................................................................................9
Pathological Aspects ...........................................................................................................................10
Herbological Aspects...........................................................................................................................15
Yin-Yang as a Guide to Clinical Diagnosis and Treatment .................................................................15
Yin-Yang as a Guide to Prevention .....................................................................................................17
Case Examples ...................................................................................................................... 18

Self Test ................................................................................................................................. 25
CHAPTER TWO
Five Element Theory .....................................................................................................27
Two Physiological Cycles of the Five Elements..................................................................... 29
The Inter-promoting Cycle: Sheng Cycle ............................................................................................31
The Inter-restraining Cycle: Ke Cycle..................................................................................................31
The Sheng and Ke Cycles keeping the Body in Balance....................................................................31
The Sheng and Ke Cycles forming a network within the body............................................................33
Four Pathological Cycles of the Five Elements...................................................................... 35

The Mother Element (organ) affects the Son Element (organ) ...........................................................35
The Son Element affects the Mother Element.....................................................................................36
The Overwhelming Cycle: Cheng Cycle..............................................................................................36
The Insulting Cycle: Ru Cycle .............................................................................................................37
The Five Constitutional Types of Animals.............................................................................. 38

Wood Type ..........................................................................................................................................38
Fire Type..............................................................................................................................................39
Earth Type ...........................................................................................................................................40
Metal Type ...........................................................................................................................................42
Water type ...........................................................................................................................................43
The Five Elements in Diagnosis............................................................................................. 44

Color of the Mouth or Tongue..............................................................................................................44
Tissues ................................................................................................................................................44
Sense Organs......................................................................................................................................44
Three Treatment Strategies of the Five Element Theory....................................................... 45

Tonify (Bu) the Mother for Deficiency..................................................................................................45
Clear (Xie) the Son for Excess ............................................................................................................45
viii CONTENTS
Strengthen the Grandchild Element for Prevention.......................................................................... 45
Conclusions............................................................................................................................ 46
Case Examples ...................................................................................................................... 52
Self Test ................................................................................................................................. 63
CHAPTER THREE
Qi, Shen, Jing, Blood and Body Fluid......................................................................... 69
Qi............................................................................................................................................ 70
Classifications of Qi............................................................................................................................. 70
Functions of Qi .................................................................................................................................... 74
Qi Pathology........................................................................................................................................ 76
Shen....................................................................................................................................... 80
Shen Pathology................................................................................................................................... 80
Jing......................................................................................................................................... 81
Jing Pathology..................................................................................................................................... 81
Blood ...................................................................................................................................... 83
Source and Formation ........................................................................................................................ 83
Circulation of Blood ............................................................................................................................. 84
Functions of Blood .............................................................................................................................. 84
Blood Pathology .................................................................................................................................. 85
Body Fluid (Jin Ye)................................................................................................................. 87

Formation and Distribution.................................................................................................................. 87
Functions of Body Fluid ...................................................................................................................... 89
Body Fluid Pathology .......................................................................................................................... 89
Case Examples ...................................................................................................................... 91

Self Test ............................................................................................................................... 101
CHAPTER FOUR
Zang-Fu Physiology.................................................................................................... 105
The Zang Organs ................................................................................................................. 106
The Heart .......................................................................................................................................... 106
The Pericardium................................................................................................................................ 108
The Lung ........................................................................................................................................... 108
The Spleen........................................................................................................................................ 110
The Liver ........................................................................................................................................... 112
The Kidney ........................................................................................................................................ 114
Relationships among the Five Zang Organs........................................................................ 123

Heart and Lung ................................................................................................................................. 123
Heart and Spleen .............................................................................................................................. 123
Heart and Liver.................................................................................................................................. 124
Heart and Kidney .............................................................................................................................. 124
Lung and Spleen ............................................................................................................................... 125
Lung and Liver .................................................................................................................................. 125
Lung and Kidney ............................................................................................................................... 126
Liver and Spleen ............................................................................................................................... 126
Liver and Kidney ............................................................................................................................... 127
Spleen and Kidney ............................................................................................................................ 127
The Fu Organs ..................................................................................................................... 129

The Gall Bladder ............................................................................................................................... 129
The Stomach..................................................................................................................................... 129
The Small Intestine ........................................................................................................................... 130
The Large Intestine ........................................................................................................................... 130
CONTENTS ix
The Bladder .......................................................................................................................................130

The Sanjiao........................................................................................................................................131
The Extraordinary Fu Organs............................................................................................... 131

The Brain ...........................................................................................................................................131
The Marrow........................................................................................................................................132
The Bone ...........................................................................................................................................132
The Vessels .......................................................................................................................................132
The Gall Bladder................................................................................................................................132
The Uterus .........................................................................................................................................132
Case Examples .................................................................................................................... 133

Self Test ............................................................................................................................... 145
CHAPTER FIVE
The Meridians ..............................................................................................................149
Nomenclature of the Twelve Regular Channels .................................................................. 150
The General Pathways of the Twelve Regular Channels .................................................... 151
Lung Channel ....................................................................................................................................159
Large Intestine Channel ....................................................................................................................162
Stomach Channel ..............................................................................................................................165
Spleen Channel .................................................................................................................................168
Heart Channel ...................................................................................................................................171
Small Intestine Channel.....................................................................................................................173
Urinary Bladder Channel ...................................................................................................................176
Kidney Channel .................................................................................................................................180
Pericardium Channel .........................................................................................................................183
Triple Heater Channel .......................................................................................................................185
Gall Bladder Channel ........................................................................................................................188
Liver Channel ....................................................................................................................................191
The Eight Extraordinary Channels ....................................................................................... 194

Du Channel........................................................................................................................................195
Ren Channel......................................................................................................................................197
Chong Channel..................................................................................................................................199
Dai Channel .......................................................................................................................................199
Yang-Qiao Channel ...........................................................................................................................200
Yin-Qiao Channel ..............................................................................................................................200
Yang-Wei Channel ............................................................................................................................201
Yin-Wei Channel................................................................................................................................201
Fourteen Regular Channels ................................................................................................. 202

Functions of the Jing Luo ..................................................................................................... 202
The Physiological Aspects.................................................................................................................203
The Pathological Aspects ..................................................................................................................203
The Therapeutic Aspects...................................................................................................................204
Self Test ............................................................................................................................... 205
CHAPTER SIX
Etiology and Pathology ..............................................................................................209
Exogenous Etiologic Factors................................................................................................ 210
The Six Excessive Qi.........................................................................................................................210
The Noxious Epidemic Qi ..................................................................................................................217
Internal Etiologic Factors...................................................................................................... 218

Emotional Factors..............................................................................................................................218
Dietary Factors or Feeding Program .................................................................................................220
Daily Activity ......................................................................................................................................222
x CONTENTS
Secondary Etiologic Factors ................................................................................................ 224

Phlegm and Retained Liquid............................................................................................................. 225
Stagnant Blood.................................................................................................................................. 226
Lithiasis ............................................................................................................................................. 227
Food Stasis ....................................................................................................................................... 227
Other Etiologic Factors......................................................................................................... 227

Traumatic Injury ................................................................................................................................ 227
Parasites ........................................................................................................................................... 228
Poisoning .......................................................................................................................................... 228
Iatrogenic Factors ............................................................................................................................. 228
Congenital Factors ............................................................................................................................ 228
Pathology ............................................................................................................................. 229

Conflict Between the Zheng Qi and the Xie Qi ................................................................................. 229
The Immune System and Zheng Qi .................................................................................................. 233
Disharmony of Yin and Yang ............................................................................................................ 236
Abnormal Ascending and Descending.............................................................................................. 236
Case Examples .................................................................................................................... 241

Self Test ............................................................................................................................... 246
CHAPTER SEVEN
Diagnostic Methods.................................................................................................... 249
Inspection............................................................................................................................. 250
Shen .................................................................................................................................................. 250
Tongue .............................................................................................................................................. 251
Body Appearance.............................................................................................................................. 257
Skin and Hair..................................................................................................................................... 257
Movement and Posture ..................................................................................................................... 257
Drinking and eating ........................................................................................................................... 259
Feces and Urination .......................................................................................................................... 260
Eyes .................................................................................................................................................. 262
Ears ................................................................................................................................................... 265
Nose .................................................................................................................................................. 265
Lips.................................................................................................................................................... 266
Limbs................................................................................................................................................. 267
Hearing and Smelling........................................................................................................... 267

Voice ................................................................................................................................................. 267
Breathing........................................................................................................................................... 268
Cough................................................................................................................................................ 268
Chewing ............................................................................................................................................ 269
Intestinal Sounds............................................................................................................................... 270
Odor of the Mouth ............................................................................................................................. 270
Odor of the Nose............................................................................................................................... 271
Pus .................................................................................................................................................... 271
Feces ................................................................................................................................................ 272
Urine.................................................................................................................................................. 272
Inquiring ............................................................................................................................... 273

Current Condition and Previous Treatments .................................................................................... 273
Dietary Programs .............................................................................................................................. 274
Management ..................................................................................................................................... 274
Origin of the Patient .......................................................................................................................... 274
Medical History.................................................................................................................................. 275
Breeding and Pregnancy .................................................................................................................. 275
Palpating .............................................................................................................................. 275

Feeling the Pulse (Pulse Diagnosis) ................................................................................................. 275
Palpation of the Meridians and Acupoints ........................................................................................ 290
CONTENTS xi
Palpation of Body Regions ................................................................................................................292
Application of TCVM Diagnostics in Practice ....................................................................... 294

Self Test ............................................................................................................................... 302
CHAPTER EIGHT
Diagnostic Systems and Pattern Differentiation ......................................................305
Eight Principles .................................................................................................................... 308
Zang-Fu Patterns ................................................................................................................. 315
Patterns of the Heart and Small Intestine..........................................................................................317
Patterns of Lung and Large Intestine ................................................................................................331
Patterns of Spleen and Stomach.......................................................................................................346
Patterns of the Liver and Gallbladder................................................................................................361
Patterns of Kidney and Bladder.........................................................................................................371
Six Channels Patterns.......................................................................................................... 380

Tai-Yang Pattern ...............................................................................................................................381
Shao-Yang Pattern ............................................................................................................................382
Yang-Ming Pattern.............................................................................................................................383
Tai-Yin Pattern...................................................................................................................................384
Shao-Yin Pattern ...............................................................................................................................384
Jue-Yin Pattern ..................................................................................................................................385
Four Stages.......................................................................................................................... 390

Wei Stage ..........................................................................................................................................391
Qi Stage.............................................................................................................................................392
Ying Stage .........................................................................................................................................394
Blood Stage .......................................................................................................................................395
San Jiao Patterns................................................................................................................. 398

Upper Jiao Patterns...........................................................................................................................399
Middle Jiao Patterns ..........................................................................................................................403
Lower Jiao Patterns...........................................................................................................................406
Pathogen Patterns ............................................................................................................... 409

Six Pathogens Patterns .....................................................................................................................409
Seven Emotional Patterns .................................................................................................................420
Disorders of Feeding and Management Programs ...........................................................................426
Qi, Blood and Body Fluid Patterns ....................................................................................... 430

Qi Patterns.........................................................................................................................................431
Blood Patterns ...................................................................................................................................436
Dual Patterns of Qi and Blood ...........................................................................................................441
Body Fluid Patterns ...........................................................................................................................445
Channel Patterns ................................................................................................................. 451

Lung Channel Pattern........................................................................................................................452
Large Intestine Channel Pattern........................................................................................................452
Stomach Channel Pattern .................................................................................................................453
Spleen Channel Pattern ....................................................................................................................453
Heart Channel Pattern.......................................................................................................................454
Small Intestine Channel Pattern ........................................................................................................455
Bladder Channel Pattern ...................................................................................................................455
Kidney Channel Pattern.....................................................................................................................456
Pericardium Channel Pattern ............................................................................................................456
Triple Heater Channel Pattern...........................................................................................................457
Gall Bladder Channel Pattern............................................................................................................457
Liver Channel Pattern........................................................................................................................458
Governing Vessel Channel................................................................................................................458
Conception Vessel Channel ..............................................................................................................459
Chong (Penetrating) Channel............................................................................................................459
xii CONTENTS
Dai (Girdle) Channel ......................................................................................................................... 460

Yin-Qiao Channel.............................................................................................................................. 460
Yang-Qiao Channel........................................................................................................................... 461
Yin-Wei Channel ............................................................................................................................... 461
Yang-Wei Channel ............................................................................................................................ 462
Self Test ............................................................................................................................... 463
CHAPTER NINE
Prevention and Treatment Strategies ....................................................................... 469
Four Principles of Life .......................................................................................................... 469
Prevention Strategies........................................................................................................... 470
Preventing the Occurrence of Illness ................................................................................................ 471
Preventing Aggravation of the Disease Progress ............................................................................. 472
Treatment Strategies............................................................................................................ 473

Treating the Root and Treating the Manifestation ............................................................................ 473
Tonifying the Zheng Qi and Eliminating the Xie Qi ........................................................................... 474
Straight Treatment and Paradoxical Treatment................................................................................ 475
Comparative Treatments for the Same and Different Diseases ....................................................... 475
Eight Treatment Methods..................................................................................................... 476

Diaphoresis ....................................................................................................................................... 476
Emesis .............................................................................................................................................. 477
Purgation........................................................................................................................................... 477
Harmonizing Method ......................................................................................................................... 478
Warming Method............................................................................................................................... 479
Clearing Method................................................................................................................................ 480
Tonification........................................................................................................................................ 480
Dissipation......................................................................................................................................... 481
External Therapy with Herbal Medicines.............................................................................. 481

Self Test ............................................................................................................................... 483
CHAPTER TEN
Clinical Case Analysis................................................................................................ 485
Case One: Jet the Quarter Horse Gelding ........................................................................... 485
Case Two: Markie the Warm Blood Gelding ........................................................................ 493
Case Three: Mr. Flopp the Lop Eared Rabbit ...................................................................... 500
Case Four: Galahad the Doberman Pinscher ...................................................................... 505
Case Five: Lady Bird the Greyhound ................................................................................... 510
Case Six: Roxa the Great Dane........................................................................................... 514
Case Seven: Doc the Labrador Retriever ............................................................................ 519
Case Eight: Red the Quarter Horse Thoroughbred Mix....................................................... 523
Case Nine: Rosie the Quarter Horse ................................................................................... 531
Self Test ............................................................................................................................... 537
CONTENTS xiii
APPENDIX A
Self Test Answer Key..................................................................................................541
APPENDIX B
History of Traditional Chinese Medicine...................................................................543
APPENDIX C
Diagrams......................................................................................................................551
APPENDIX D
Acupuncture Point Locations ....................................................................................559
APPENDIX E
Herbal Formulas..........................................................................................................583
APPENDIX F
References...................................................................................................................625
Index.............................................................................................................................629
INTRODUCTION
Knowing others is wisdom;

Knowing the self is enlightenment.
Mastering others requires force;
Mastering the self needs strength.
He who knows he has enough is rich.
Perseverance is a sign of will power.
He who stays where he is endures.
To die but not to perish is to be eternally present.
Lao Tsu, Thirty-Three of Tao Te Ching
Traditional Chinese Veterinary Medicine (TCVM), although relatively new to the Western
world, is a medical system that has been used to treat animals in China for thousands of
years. This system developed as prehistoric people tried to understand domestic animal
disease and each subsequent generation has added their knowledge and discoveries to
those of the previous generation up through present day. As such, TCVM continues to
change and grow as new information is incorporated into the system. Thus, even though
many of the therapeutic techniques were developed through the trials and observations
of ancient Chinese people, TCVM is not immune to adaptations from other cultures and
to advances in technology. For example, ancient Chinese techniques are combined with
modern medical practice through the use of sterile, single-use filiform acupuncture
needles, hypodermic needles with syringes, electrical current or laser-light to stimulate
acupoints. The scientific research of recent history has also added to the ever-growing
understanding of this medical system.
Today, the practice of TCVM in the Western world differs from its Chinese origins. First,
most of the acupoints and Meridian lines used by Western veterinarians are transposed
from humans. The ancient texts describing many of the classical Meridian lines and
charts were lost long ago; however, some ancient books describing the acupoint
locations were preserved and are still used today. This has inspired some discussion
about the actual location of the Meridian lines and points in species with fewer digits or
more ribs than humans. The energetic significance of some of these points is also called
into question when one considers a human biped compared to a quadruped animal that
has all four limbs touching the ground. Second, veterinary acupuncture in China was
primarily used for agriculturally important species such as cattle, pigs and horses. In
Western society, dogs, cats and birds have great significance as companions, so the
understanding of acupuncture in these species has grown greatly in recent history.
Third, many of the ancient techniques have been modified to fit Western perceptions and
medical practice. For example, the needles commonly used today are very thin, solid
and sterile. The traditional tools were large, non-sterile needles of various shapes and
sizes. Last, Western practitioners may combine TCVM with a variety of other medical
techniques such as chiropractics, Western herbal medicine and homeopathy. These
modifications are not inherently good or bad but are merely part of the systems
continued development.
xvi INTRODUCTION
Traditional Chinese Veterinary Medicine may initially be quite foreign to Western-trained

minds. To some, it may seem that the principles of TCVM and Western Veterinary
Medicine (WVM) are separated by a great abyss. Bridging that gulf is largely an
individual mental process, but readers of this text have already made the first steps
towards understanding through their interest and willingness to accept new ideas.
These medical systems are not mutually exclusive. Each has aspects that place them on
opposite ends of the spectrum, but there is a large area of overlap between them. This
common ground provides some familiarity for those new to TCVM concepts. It does,
however, make accurate simplification and categorization of the systems difficult for
teaching purposes. Bearing this in mind, realize that the complexities of medical systems
are learned through experience, and this text provides only a framework to build upon.
Learning TCVM requires a shift in perspective. In general, Western medicine believes in
control while traditional Chinese medicine believes in balance; WVM is more
mechanistic while TCVM is more energetic. Western medical practitioners are very
familiar with analyzing a disease process to discover its specific, fundamental, physical
cause whether this is an infectious agent, an enzymatic defect or a toxic insult. By fully
understanding the functions of the physical body all the way down to a cellular or
molecular level, one can target the abnormality and better control the disease process.
On the other hand, TCVM practitioners recognize disease as an imbalance in the body.
They understand that the body is an integrated, energetic structure, and that disturbance
of energy flow creates disease in the whole organism. When a disease Pattern is
identified, one can restore balance and health by helping the body regulate itself.
Both systems rely on medical history and physical examination to make a diagnosis or
identify a Pattern. Western medicine adds in diagnostic tests such as bloodwork or
radiographs. The diagnostic tests of TCVM include palpation of the pulse and the shu
points. In both cases, an experienced clinician interprets the findings and chooses an
appropriate therapeutic regimen. A Western veterinarian may recommend surgery or
reach for antibiotics, steroids or other pharmaceuticals. A TCVM practitioner may
recommend herbs, acupuncture or special management practices as therapy.
Generally, the goals of TCVM and WVM are the same; both hope to promote health and
to prevent disease. They are merely two different ways of viewing the world, and each
system has its own strengths and weaknesses. Western medicine deals well with acute
diseases and has advanced surgical techniques. TCVM can be beneficial for chronic
diseases, especially those that Western medicine can only control but not cure. Due to
the more individual nature of TCVM, Western medicine can better handle herd health
problems. Although Western veterinarians promote disease prevention through yearly
physical exams and vaccines, TCVM is very beneficial for identification of potential
problems and preventing disease through dietary modification or preventative therapies.
In addition, when veterinarians practice traditional Chinese medical techniques such as
Tai Qi Quan or Qi Gong, they are able to remain centered and to better assist their
patients. The therapeutics of TCVM can avoid some of the deleterious side effects of the
Western drugs, but the Western drugs act much more quickly. Thus, through integration
of the two systems, one may take advantage of the strengths of each while minimizing
the weaknesses. Practitioners who are able to bridge the mental gap between Eastern
and Western medicine may find that this combination brings better results than either
one alone.
CHAPTER ONE
YIN AND YANG

Under heaven all can see beauty as beauty only
because there is ugliness.
All can know good as good only because there is evil.
Therefore having and not having arise together.
Difficult and easy complement each other.
Long and short contrast each other;
High and low rest upon each other;
Voice and sound harmonize each other;
Front and back follow one another.
Lao Tsu, Two of Tao Te Ching
Yin-Yang and the Five Elements are two philosophical views originating in ancient
China. These were initially developed in order to understand and interpret natural
phenomena. These principles were applied in the field of Chinese Medicine some time
between the Spring and Autumn Period (722-481 B.C.) and the Warring States Period
(403-221 B.C.). Yin-Yang and the Five Elements promoted the development of two
theoretical systems: Traditional Chinese Medicine (TCM) and Traditional Chinese
Veterinary Medicine (TCVM). Yin-Yang and Five Elements represent the conceptual
foundation of each system and have guided clinical work up to the present.
The Concept of Yin-Yang

The earliest reference to Yin and Yang is probably in Yi Jing (Book of Changes) which
dates back to about 700 B.C. In this book, Yin and Yang are respectively represented by
a broken line ( ) and an unbroken line ( ). By combining the broken and
unbroken lines into pairs, four diagrams are formed. These represent utmost Yin, utmost
Yang, Yang within Yin and Yin within Yang (Figure 1.1). The addition of another broken
or unbroken line to these four diagrams forms the eight trigrams. In this case, various
combinations of the three lines form eight different characters (Figure 1.2). These
trigrams can also be paired to compose the sixty-four hexagrams (Figure 1.3). The
hexagrams symbolize all possible phenomena in the universe.
For example, each of the three example hexagrams illustrated in Figure 1.3 has a
different meaning. 1) The Tai diagram represents the harmony between Yin and Yang.
Yin lies in the upper part and Yang lies in the lower part. Yin descends to nourish Yang,
and Yang rises to support Yin. 2) The Weiji diagram represents the disconnection
between Water (Kidney) and Fire (Heart). The Fire goes up while Water descends, thus
Fire and Water fail to connect and support each other. 3) The Xiaoguo diagram
represents Cold or Yang Deficiency. Yang is surrounded by too much Yin (Cold).
2 CHAPTER ONE
Yin
Utmost
Yin
Utmost
Yang
Yang
Yang within
Yin
Yin within
Yang
Figure 1.1: Yin and Yang diagrams
Qian
Heaven
Kan
Water
Yin
Yang
Kun
Earth
Zhen
Thunder
Xun
Wind
Li
Fire
Gen
Mountain
Dui
Pond
Figure 1.2: The Eight Trigrams
Yin
Tai
Health
Yang
Weiji
Disconnection
Xiaoguo
Cold
Figure 1.3: An example of three hexagrams
YIN YANG THEORY 3
The Yin-Yang principles are derived, in part, from observation of the cyclical alternation
between day and night. Day belongs to Yang and night belongs to Yin. Similarly, light
and activity relate to Yang, as darkness and rest relate to Yin. The continuous
interchange between two alternate poles observed for every circumstance can be
described in terms of Yin and Yang. Light, Sun, Brightness, Activity, Heat, and Strength
correspond to Yang while Darkness, Moon, Dimness, Rest, Cold, Weakness correspond
to Yin. From this perspective, Yin and Yang are two stages of a cyclical movement or
phenomenon; thus, Yin and Yang are representative names for dual opposites and
interdependent aspects of everything in the universe. Chapter five of the book Su Wen
(Plain Questions) pointed out that "Yin and Yang are the laws of heaven and earth, the
great framework of everything, the parents of change, the root and beginning of life and
death." According to Su Wen, all natural events and states of being are rooted in Yin and
Yang, and they can be analyzed by the theory of Yin and Yang.
Tai Ji
The symbol above is traditionally used to represent the interrelationship of Yin
and Yang. One can think of Yin and Yang as a way of trying to understand the
events of the universe by organizing phenomena into distinct categories. It is
at once extremely simple and staggeringly complex.
Basically, all conceivable entities or events are broken down into two opposite
aspects. Many concepts may even lose their meaning without a comparison
to their opposites. For example, what is heat without cold? How do we
recognize dark without light? Yin and Yang are opposite sides of the same
coin; they are inseparable. Like a bar magnet, no matter how it is divided,
there will always be a North and South pole, a Yang and a Yin. Keep cutting
and you get smaller and smaller pieces, each with a North and South pole.
Any Yin or Yang aspect can be further broken down into other Yin and Yang
qualities. Our world is full of endless shades of grey. Summer may be
considered Yang, but there is still nighttime (Yin) as well as daytime (Yang)
throughout the summer months. What about a cool summer day compared to
a hot summer day? What about an eclipse of the Sun? Similarly, Yin becomes
Yang and Yang becomes Yin in an endless cycle of transformation and
generation. Day turns to night and back to day again.
The circle can represent the universe divided equally into Yin (black) and
Yang (white). The division is not straight; but rather, Yin and Yang merge and
continuously cycle with each other. Each controls and transforms into the
other while carefully maintaining balance. The small circles within Yin and
Yang represent the seeds of Yang within Yin and Yin within Yang. Yin and
Yang compose and divide all things; yet, they cycle unceasingly in a state of
eternal transformation.
4 CHAPTER ONE
The theory of Yin and Yang is a conceptual framework. It is a means to generalize any
two opposite principles, which may be observed in all related phenomena within the
natural world. In this way, Yin-Yang may be used to explain animal physiology and
pathology and to guide clinical diagnosis and treatment. Yin and Yang represent not only
two separate phenomena with opposing natures, but also two different and opposite
aspects within the same phenomenon. Generally speaking, one may compare the
different properties of everything in the universe, as shown in Table 1.1 and Figure 1.4.
Figure 1.4: A Pictorial view of the Yin-Yang aspects of Phenomenon
The Yin-Yang nature of a phenomenon or event is not absolute; it is relative. This

relative nature of Yin-Yang includes two meanings. First, under certain conditions, Yang
may change into Yin. For instance, the day (Yang) turns into night (Yin), and vice versa.
Second, any phenomenon or thing can be infinitely divided into its Yin and Yang aspects
thus reflecting its own inner relationship, which may be Yang within Yin or Yin within
Yang. For example, day is Yang, while night is Yin. Each day and night, however, can be
further classified as follows: morning is Yang within Yang, afternoon Yin within Yang, the
first half of night Yin within Yin, and the second half of the night Yang within Yin. In an
animal, the back belongs to Yang, but the thorax and abdomen belong to Yin. The front
half of back is Yang within Yang while the second half is Yin within Yang. The thorax is
Yang within Yin while the abdomen is Yin within Yin. The front limb is Yang while the
rear limb belongs to Yin. The body surface (the Exterior) belongs to Yang, but the
internal organs (the Interior) are Yin.
Yin-Yang theory maintains that everything is essentially composed of two opposing, yet
complementary pairs of opposites. Yin-Yang theory can extend to TCVM physiology,
pathology, pharmaceutics, diagnosis and treatment with acupuncture or herbs.
YIN YANG THEORY 5
Table 1.1: Comparison of Yin and Yang
Parameter
Time of Day
Heavenly Body
Light
Position
Temperature
Season
Color
Weight
Catalyst
Speed
Elements
Building
Vibration
Gender
Biological
Food
Nerve
Birth/death
Physical Condition
Attitude
Tendency
Direction
Structure
Fitness
Space
Shape
Compass Direction
Body
Qi / Blood
Taste
Organs
Yang
Day
Sun
Brightness
Movement / Activity
Heat
Summer
Red (Light)
Light
Fire
Fast
O, K, P
Outside / Roof
Short wave
Male
Vegetable
Salad
Sympathetic
Birth
Health
Active / Positive / Excited
Expansion
Ascend / Forward / Outward
Time
Strength
Heaven
Round
East / South
Back
Qi
Pungent / Bitter
Fu Organs
Large Intestine, LI
Bladder, BL
Gall Bladder, GB
Stomach, ST
Small Intestine, SI
Triple Heater, TH
Yin
Night
Moon
Dimness
Stillness / Rest
Cold
Winter
Blue (Dark)
Heavy
Water
Slow
Na, Ca
Inside / Bottom
Long Wave
Female
Animal
Cereals
Parasympathetic
Death
Illness
Gentle / Negative / Depressed
Contraction
Descent / Backward / Inward
Space
Weakness
Earth
Flat
West / North
Abdomen
Blood
Salty / Sweet
Zang Organs
Lung, LU
Kidney, KID
Liver, LIV
Spleen, SP
Heart, HT
Pericardium, PC
6 CHAPTER ONE
YANG
YIN
Energy goes out from a center
Energy comes into a center
Figure 1.5: The Energy relationship with Yin and Yang
In summary, anything that relates to activity, brightness or function and whose direction
goes or tends to go upwards and outwards belongs to Yang. On the other hand,
anything that relates to inactivity, darkness or structure and whose direction goes or
tends to go downwards and inwards belongs to Yin.
Five Principles of Yin-Yang

1. Everything in the universe has two opposite aspects: Yin and Yang
Male
Warm
Morning
Left
Female
Cold
Afternoon
Right
2. Any Yin-Yang division can be further divided into Yin and Yang aspects.
Yin within Yang
Yang within Yin
YIN YANG THEORY 7
Day (Yang):
Morning (Yang)
Afternoon (Yin)
Night (Yin):
1st half of night

o Yin within Yin
nd
2 half of the night o Yang within Yin
Back (Yang):
Upper back
Lower back
Abdomen (Yin): Upper abdomen

Lower abdomen
o Yang within Yang

o Yin within Yang
o Yang within Yang

o Yin within Yang
o Yin within yang
o Yin within Yin
3. Yin and Yang control each other

Everything in the universe has two opposite aspects, Yin and Yang, which struggle with
and control each other. For example, Heat (Yang) and Cold (Yin) are two opposite
aspects. Heat may dispel Cold, but Cold may lower a high temperature (Heat). Thus, the
Yin or Yang aspect within any phenomenon will restrict the other through opposition.
Under normal conditions in the animal body, a relative physiological balance is
maintained through the mutual opposition of Yin and Yang.
YIN
Cold
Control
YANG
Heat
Heat
YANG
Control
Cold
YIN
However, the opposition of Yin and Yang is relative, not absolute. Nothing is totally Yin
or completely Yang. Everything contains the seed of its opposite aspect. Because
everything that is associated with Yin or Yang is relative to something else, the
opposition of Yin-Yang must be relative as well. Therefore, strictly speaking, it is wrong
to say that something is always Yang or always Yin. For instance, activity pertains to
Yang insofar as stillness pertains to Yin.
4. Yin and Yang mutually create each other

Although Yin and Yang oppose each other, they are also interdependent. The existence
of one of the two opposites, Yin or Yang, depends upon the existence of the other.
Neither of them can exist in isolation. There is no Yang without Yin, and there is no Yin
without Yang. There is no meaning of Heat (Yang) without Cold (Yin). There is no
meaning of upward movement (Yang) without downward movement (Yin). The existence
of either Yin or Yang is mandatory for the other's existence.
8 CHAPTER ONE
Neither of Yin and Yang can exist without the other. Moreover, they support each other.
For instance, nutrient substances of the animal body correspond to Yin while the
functional activities correspond to Yang. Therefore, the production of Yin needs the
activities of Yang and vice versa.
Yin and Yang co-exist in a constant and dynamic state in which one rises while the other
declines. Yin and Yang are not fixed. Instead, they exist in a state of continuous mutual
consumption and support. For example, the production of various functional activities
(Yang) of the animal body will necessarily consume a certain amount of nutrient
substances (Yin). This process is called "consumption of Yin leads to gaining of Yang".
On the other hand, the production of various nutrient substances (Yin) will necessarily
consume a certain amount of energy (Yang). This process is called the "consumption of
Yang leads to the gaining of Yin".
The mutual creation of Yin and Yang is also called the Ebb-Rise relation. Under normal
conditions, the Ebb-Rise relation of Yin and Yang is in a state of relative balance. This
balance is maintained by continuous adjustment of the relative Yin and Yang levels.
However, if this relationship goes beyond normal physiological limits, the relative
balance of Yin and Yang will not be maintained. This results in a Deficiency or Excess of
either Yin or Yang as well as the development of disease.
Consumption of Yin leads to growth of Yang
Consumption of nutrients (Yin)
Functional activities (Yang)

In this case, nutrients or Yin is used to provide the supplies needed for the activities or
Yang Functions of the body. The Yin is consumed to produce Yang. For example, an
animals body uses the stored glycogen to provide energy for running.
"Consumption of Yang leads to growth of Yin"
Consumption of energy (Yang)
Nutrient substances (Yin)

In this case, energy or Yang is expended to form nutrients or Yin. The Yang is
consumed to produce Yin. For example, it requires energy for the body to create and
store the glycogen.
Because Yin and Yang are related in this manner, deficiency or excess of one can lead
to an imbalance in the other.
Yang Deficiency
Yin Deficiency
Yin Deficiency
Yang Deficiency
YIN YANG THEORY 9
5. Yin and Yang may transform into each other in certain circumstances
Summer
(Yang)
Winter
(Yin)
Day
(Yang)
Night
(Yin)
Heat
(Yang)
Cold
(Yin)
Yin and Yang transform into each other as the seasons, with their temperature changes,
flow into one another. Each transition from day to night is a transformation from Yang to
Yin and back again.
Yin and Yang are not static. Under certain circumstances, they may mutually transform
into each other. Yin may change into Yang and vice versa. This change does not
happen at random; instead, it occurs only at a certain stage of development. Summer
changes into winter, day changes into night, heat changes into cold. If the Ebb-Rise of
Yin and Yang is a process of quantitative change; then, inter-transformation is a process
of qualitative change.
For example, a patient with an acute febrile disease has a high fever, a rapid respiratory
rate, a red tongue and a fast pulse, which is considered Yang (Excess Heat). Long-term
Excess Heat tends to consume body fluids and damage Qi, leading to Cold signs (Yin).
After a persistent high fever, severe Cold symptoms may appear. This is a process of
Yang transforming into Yin. If proper emergency treatment is given in time, the Yang Qi
will be resuscitated and the Cold symptoms may disappear. This process is the
transformation of Yang from Yin.
Clinical Application of the Yin-Yang Theory

PHYSIOLOGICAL ASPECTS
Within the theory of Yin-Yang, the various physiological functional activities of the animal
body belong to Yang, while the various nutrient substances correspond to Yin. The
functional activities depend on the support of the nutrient substances, and these
activities act concurrently as the motive force for the production of nutrient substances.
In this circumstance, Yin and Yang within the animal body are mutually supportive. They
perform together protecting the body from invasion by pathogenic factors including
bacteria and viruses, and they maintain a relative balance within the body thus resulting
in disease prevention. The goal of the TCVM practitioner, when providing animal health
care, is to achieve and maintain the balanced state.
10 CHAPTER ONE
Range of Equilibrium
Balance of Yin and Yang (Harmony)

When there is Balance, there is Health and Homeostasis.
YIN
YANG
Figure 1.6: Illustration of Yin and Yang in the Normal (Balanced) state
This harmony or balanced state of an animal depends on three pairs of forces. The first
is the balance between the universe and the animal itself. The second is the balance
between the individual animal and the other animals in the environment, including the
humans of the household. The third is the balance between the various organ systems
within the animal body. For example, a castrated male Himalayan cat named Newton
lives together with his human guardian, Mary, and three other cats in a South Florida
home. Newtons health depends upon his status at the three different levels:
x
How well Newton self-adjusts to the hot, humid weather or how Mary helps Newton
to adjust.
How well Newton gets along with Mary and the other three cats. Do the individuals
live in peace and harmony or do they fight with each other?
Whether or not Newtons own body systems are in balance.
Thus, it is on three levels that a body must maintain balance in order to remain healthy.
There is balance between the body and the external elements or the environmental
forces. There is emotional or social balance between individuals in contact with each
other. There is balance within the body itself among the internal processes.
PATHOLOGICAL ASPECTS
The theory of Yin-Yang is also applied to explain pathological changes. According to
Traditional Chinese Veterinary Medicine, no disease occurs if Yin and Yang maintain a
relative balance. Disease occurs when there is loss of the balance between Yin and
Yang, as with the excess or deficiency of either Yin or Yang due to pathogenic factors.
The pathogenic factors can be also classified into two types: Yin and Yang. There are
four possible states of imbalance between Yin and Yang: Excess of Yin, Excess of
Yang, Weakness of Yin and Weakness of Yang.
YIN YANG THEORY 11
Imbalance of Yin and Yang (Disharmony)

When there is not balance, there is illness and disease.
1. Yang Excess (Excess Heat)
YIN
YANG
Harmony
Balance
YIN
YANG
Disharmony
Yang Excess
Figure 1.7: An unbalanced stateExcess Heat (Yang Excess)
In this unbalanced state, Yang is greater than normal. The cooling properties of Yin are
unable to counteract the warming properties of Yang, so an Excess Heat condition
appears. The treatment principle is to clear the Heat or sedate the Yang.
TCVM Diagnosis:
Excess Heat or Yang Excess
Treatment Principle:
Clear Heat (Sedate Yang)
Treatment:
Herb: Coptis Huang Lian

Acupoint: GV-14
12 CHAPTER ONE
2. Yin Excess (Excess Cold)
YANG
YIN
Harmony
Balance
YIN
YANG
Disharmony
Yin Excess
Figure 1.8: An unbalanced stateExcess Cold (Yin Excess)
In this unbalanced state, Yin is greater than normal. The cooling properties of Yin
overwhelm the warming properties of Yang, so an Excess Cold condition appears. The
treatment principle is to clear the Cold or sedate the Yin.
TCVM Diagnosis:
Excess Cold or Yin Excess
Clear Cold (Sedate Yin)
Treatment:
Herb: Cinnamon Rou Gui

Acupoint: GV-4
YIN YANG THEORY 13
3. Yang Deficiency (Deficient Cold)
YIN
YANG
Harmony
Balance
YIN
YANG
Disharmony
Yang Deficiency
Figure 1.9: An unbalanced stateDeficient Cold (Yang Deficiency)
In this unbalanced state, Yin is at the normal level, but Yang is lower than normal. The
warming properties of Yang are insufficient to equalize the cooling properties of Yin, so a
cold condition appears. However, the coldness is caused by the Deficiency of Yang. In
order to treat this condition, it is necessary to tonify Yang.
TCVM Diagnosis:
Yang Deficiency or Deficient Cold
Tonify Yang
Treatment:
Herb: Morinda Ba Ji Tian

Acupoint: Moxa at Bai Hui
14 CHAPTER ONE
4. Yin Deficiency (Deficient Heat)
YANG
YIN
YIN
Harmony
Balance
YANG
Disharmony
Yin Deficiency
Figure 1.10: An unbalanced stateDeficient Heat (Yin Deficiency)
In this unbalanced state, Yang is at the normal level, but Yin is lower than normal. The
cooling properties of Yin are insufficient to equalize the warming properties of Yang, so a
Heat condition appears. The Heat is caused by the weakness of Yin. Because Yin is
deficient, it is necessary to focus on the nourishment of Yin.
TCVM Diagnosis:
Yin Deficiency or Deficient Heat
Nourish Yin
Treatment:
Herb: Rehmannia Shu Di Huang

Acupoint: KID-3
YIN YANG THEORY 15
HERBOLOGICAL ASPECTS
The theory of Yin-Yang can be applied to the properties and tastes of herbs. If the herb
has traits of warmth and Heat, it is associated with Yang. The Yang herbs are designed
to treat coldness (Yin diseases). For example, dry Ginger Gan Jiang is hot and is
considered a Yang herbal medicine. It is commonly used for coldness of the stomach
(abdominal pain, vomiting, and abdominal discomfort).
Cooling herbs, however, are associated with Yin. The Yin herbal medicines are used for
the treatment of Heat (Yang diseases). For example, Coptis Huang Lian is very cold and
is considered a Yin herbal medicine. It is commonly used for Large Intestine Heat
conditions (bloody diarrhea or inflammatory bowel disease).
Type of Herb
Nature / Property
Indication
Yang Herb
Hot / Warm
Yin Excess, Cold
Yin Herb
Cold / Cool
Yang Excess, Heat
YIN-YANG AS A GUIDE TO CLINICAL DIAGNOSIS AND TREATMENT

Imbalance between Yin and Yang is the root cause for disease occurrence and
development. If the Pattern of Yin and the Pattern of Yang are grasped, the correct
diagnosis can be made regardless of how complicated or changeable the clinical signs
of an animal disease may appear. Yin-Yang is the basis for the Pattern Identification
according to the Eight Principles (Yin, Yang, Interior, Exterior, Cold, Heat, Deficiency
and Excess). For this diagnostic system, Yin is associated with Interior, Cold and
Deficiency Patterns, and Yang is associated with Exterior, Heat and Excess Patterns.
Because a disease occurs due to excessive or inadequate amounts of Yin or Yang, the
basic treatment principles are to dispel the Excess and to tonify the Deficiency. In this
way, one adjusts the Yin-Yang and allows Yin and Yang to maintain balance once again.
For instance, herbs with Cold properties should be used for an Excessive Heat Pattern.
Herbs that enhance Yin should be used for a Deficient Yin Pattern.
16 CHAPTER ONE
Table 1.2: Clinical Signs and Treatment of Yin and Yang Patterns
Patterns
Yang
Excess Heat
(Yang Excess)
Deficiency Heat
(Yin Deficiency)
Yin
Excess Cold
(Yin Excess)
Deficiency Cold
(Yang Deficient)
Signs
x
x
x
x
x
x
x
x
Acute onset
Short course
Young age
No general weakness
Hyperactive
High fever
Red or purple tongue
Strong, fast pulse
x
x
x
x
x
x
x
x
x
x
Chronic onset
Long course
Older animal
General weakness
Thirsty
Lower degree of fever
Restless or anxiety
Prefers cool
Red and dry tongue
Thready and fast pulse
x
x
x
x
x
x
x
x
x
Acute onset
Short course
Young age
No general weakness
Pain
Swelling or edema
Loose stool
Pale or purple tongue
Strong and slow pulse
x
x
x
x
x
x
x
x
x
x
x
Chronic onset
Long course
Older animal
Coldness at extremities
Edema, Loose stool,
Urinary incontinence
Chronic back pain/weakness
Weakness of the rear limbs
Infertility
Pale tongue
Weak and deep pulse
Treatment
Clear Heat
Sedate Yang
GV-14, LI-4, LI-11
Coptis Huang Lian
Nourish Yin
Clear Heat
KID-3
Rehmannia Shu Di Huang
Clear Cold
Moxa at GV-4
Dry Ginger Gan Jiang
Warm and tonify Yang

Moxa at Bai Hui
Morinda Ba Ji Tian
YIN YANG THEORY 17
YIN-YANG AS A GUIDE TO PREVENTION

The best medical care for animals is disease prevention. In TCVM, disease is prevented
by maintaining the Yin-Yang balance or by making adjustments to the body based upon
the animals constitution. In general, the active, outgoing, younger animals are Yang.
Yang animals tend to have Yang disease including Excess Heat (Yang Excess) or False
Heat (Yin Deficiency). In order to keep the Yin-Yang balance for Yang animals, provide a
cool environment during Yang weather (summer) and give foods that are cooler in
nature, such as fish or bananas.
The quiet, shy and elder animals are Yin. These Yin animals tend to have Yin disease
including Excess Cold (Yin Excess) or False Cold (Yang Deficiency). Providing a warmer
environment in Yin weather (winter) and feeding warm foods such as chicken, ginger,
and garlic can help keep the Yin animal in balance.
Individual
Traits
IDENTIFICATION
Activity Level:
Personality:
Preferred Climate:
Age:
Environment
MODIFICATION
Climate adjustment:
Yin Animals
Hyperactive
Outgoing
Cool
Younger
Quiet
Shy
Heat
Older
Yang Animals
Yin Animals
Cooling place
Warming place
Shade
Air Conditioning
Northern climate
Fans and misting
Dietary adjustment:
Cooler diets
Fish
Turkey
Banana
Tofu
Brown rice
Wheat
Duck
Egg
Celery
Kelp
Spinach
Broccoli
Small Animal
Diet
Equine
Diet
Yang Animals
Dietary adjustment:
Cooler diets
Buckwheat
Barley
Wheat Bran
Sunbathing
Heaters
Southern climate
Blankets
Warmer diets
Mutton
Deer Meat
Chicken
White rice
Oats
Citrus
Ginger
Garlic
Pepper
Chicken Liver
Squash
Pumpkin
Warmer diets
Oats
Ginger
Garlic
Onion
18 CHAPTER ONE
Case Examples
Case 1.1
Signalment: A six year old Thoroughbred gelding
Primary Complaint: Photic headshaking unresponsive to conventional therapy
History and Exam:
He is a show hunter for an amateur rider and is a nice, graceful horse. He is fairly sturdy
in body type for a thoroughbred. He is active and friendly; he likes attention and loves
treats.
The problem is triggered by sunlight. He is fine while in a barn, but he headshakes
severely when outdoors in the daylight. At these times, he displays the typical photic
type of head flip. When he is turned out at night, he acts normally. No physical problems
were noted (including eye problems) other than the photic headshaking. There appears
to be little paraesthesia associated with this problem. According to the owner, he will
sometimes rub the end of his nose on things when he is in the sunlight. The nonpigmented snip end of his nose will get a little pink (vasodilatation).
His tongue appears red, and the pulse is forceful. His coat is glossy, and his appetite is
good. All else is within normal limits.
Case 1.1 Assessment:
This is a Yang horse because he is active, likes attention, and looks strong. It is a Yang
disease or Excess Heat Condition because the major clinical signs (headshaking
triggered by sunlight, forceful pulse and red tongue) are characteristics of Yang.
The treatment strategy is to balance Yin and Yang by clearing the Excess Yang (Excess
Heat). The acupuncture points LI-4 and GV-14 (to clear general Heat) and the Chinese
herb Coptis Huang Lian (to clear Excess Heat) can be used.
YIN YANG THEORY 19
Case 1.2
Signalment: A seventeen year old, white Andalusian gelding
Primary Complaint: Cough and Phlegm when beginning work
History and Exam:
He is a tall, quiet and independent horse. He prefers to stay alone and likes warm
weather. He caught several respiratory infections with a high fever and cough over the
past three years. Now, he has recovered from the infection, but he has an occasional
cough and gags up phlegm when he starts work. He continues to have this problem with
mucus in his throat. He coughs when he starts to work then seems better. Overall, he
does not like work (exercise intolerance).
His tongue is pale, very moist with white foam. He has a white, thin nasal discharge. His
pulses are deficient.
This is a Yin disease*, specifically a Yang Deficiency Pattern, as evidenced by the
chronic cough (three year duration), wet tongue, weak pulse, exercise intolerance, and
old age (17 years). The treatment strategy is to balance Yin and Yang by enhancing
Yang. The acupuncture points GV-4 and CV-17 and herbal medicine Bu Fei San (Lung
Tonic Powder) are recommended for this case.
* There are two types of Yin diseases: 1) Yin Excess (Excess Cold) and 2) Deficiency
Cold (caused by Yang Deficiency).
20 CHAPTER ONE
Case 1.3
Signalment: A seven year old, female spayed Labrador Retriever
Primary Complaint: Separation anxiety
History and Physical Findings:
From a Western perspective, the dog has all the signs of separation anxiety.
Acupuncture treatment did not help much. She has also been on the herbal formula
Long Dan Xie Gan Wan for signs of Liver Stagnation.
Her tongue is slightly red and dry and her gums are tacky. Her eyes are red. Her pulses
are thready and fast.
This is a Yin Deficiency Pattern (Deficient Heat), specifically a Heart Yin Deficiency
pattern. The Yin Deficiency can be determined from the red, dry tongue (Heat signs) and
the thready and fast pulse. The association with the Heart is based on the major
complaint of separation anxiety because this is due to a Shen (Spirit or Mind)
disturbance. Of the five Yin organs, the Heart is the one that houses the Shen.
Separation anxiety and other behavior problems are mostly related to the Heart. The
treatment strategy is to balance Yin and Yang by enhancing Yin. The acupuncture points
An Shen, HT-7, Da Feng Men, and KID-3 as well as the herbal formula Shen Calmer
(Modified Tian Wan Bu Xin Dan) are recommended for this case.
YIN YANG THEORY 21
Case 1.4
Signalment: A thirteen year old female spayed American Eskimo dog
Problem List:
1. Cushings disease which has been treated with Mitotane for the past four years
2. Seizures which began last month and clustered about once a week.
3. Hypothyroidism
4. Generalized stiffness with weak hind end. There is no limping, but the dogs gait is
very stiff. The dog takes three to four steps then huffs and puffs and lies down.
5. Generalized lethargy, weakness, lack of energy.
Physical Findings:
x
Pulse is thin and fast
Rose colored thin ocular discharge
Ravenous appetite and thirst
Stool dark brown and foul smelling
Bilateral cataracts
Chronic urinary incontinence, all day, all the time
Deafness
Draining pressure sore on left hip
Panting constantly
Pot-bellied with muscle wasting
Poor teeth and gums
Tongue is pink with thin coating

This can be considered a Deficient Heat (Yin Deficiency) condition with a Qi Deficiency
and Internal Wind. The old age, weakness, urinary incontinence and lethargy indicate Qi
Deficiency. The fast pulse, thirst, ravenous appetite, constant panting and foul smelling
stool can indicate Heat. Seizures are caused by Internal Wind.
The treatment strategy is to use acupuncture to balance Yin and Yang by enhancing Yin
and clearing the Wind. In addition, acupuncture can be used for the stiffness while using
Chinese Herbal medicine for the internal organ problems. Acupuncture points such as
GB-20, LIV-3 and GV-20 may be beneficial for the seizures (Wind). The points KID-3
and SP-6 may be beneficial for Yin. Two herbal formulas may be beneficial: Tian Ma
Gou Teng Yin for Internal Wind and Suo Quan Wan for incontinence and Kidney Qi
Deficiency.
22 CHAPTER ONE
Case 1.5
Signalment: An eight year old, male Labrador Retriever dog
Primary Complaint: Crying at night
This dog has a history of severe hip dysplasia and arthritis; however, the owner does not
notice any lameness or stiffness. The owners main concern is the dogs tendency to cry
during the night. This has been occurring for two years and typically happens at 1:00 to
3:00 in the morning. The dog will go back to sleep if the owner gets up and sits with him.
The dogs tongue is purple-pink with very fine central cracks. The pulses are stronger on
left than right, and they are thready or wiry. The dog is sensitive at BL-18 to BL-21.
The TCVM pattern is Heart/Liver Yin Deficiency with Kidney Yang Deficiency. Because
the crying occurs at night, this is associated with Yin. The crying itself indicates a
disturbance of the dogs Shen (consciousness or Mind) which often relates to the Heart.
The time (1 am to 3 am) and the sensitivity at BL-18 and BL-19 are associated with the
Liver. The very fine centrally located cracks on the tongue indicate a Yin Deficiency as
well. The weaker pulse on the right side and the purple tongue indicate a Yang
Deficiency. Because the Kidney is associated with bone, the hip dysplasia in this dog
indicates a Kidney problem.
Initially, the treatment should focus on the Heart and Liver Yin Deficiency as the major
complaints are crying at night. The usual treatment strategy is to treat the major
complaint(s) first and then treat other underlying deficiencies. The treatment period for
Heart Yin Deficiency may last one to four months. The acupuncture points HT-7, PC-6,
BL-15, BL-18, BL-23, KID-3, and An Shen may be beneficial. In addition, Yi Guan Jian
and Shen Calmer (Modified Tian Wan Bu Xin Dan) are two recommended herbal
medicines which nourish Yin and calm the Mind.
Subsequent treatment should focus on the Kidney Yang Deficiency. This treatment may
require two to five months. Depending upon the character and appearance of the pulse
and tongue, Loranthus Powder (to tonify Yang) and Sang Zhi San (to resolve Bi
syndrome including hip dysplasia and arthritis) are the herbal medications that may be
used. Loranthus Powder is the modified Ba Ji San. The acupuncture points GV-3, GV-4
and Bai Hui may be used as well.
YIN YANG THEORY 23
Case 1.6
Signalment: An eight year old, neutered male Bichon Frise
Primary Complaint: Acute cardiovascular collapse
The dog presented with acute cardiovascular collapse following a dog attack by two Jack
Russell Terriers. The patient suffered multiple deep and superficial bite wounds on the
face, neck and caudal extremities. There were many wounds on the inner and outer
thighs of both hind legs as well as some bruises on the caudal abdomen. There were no
penetrating wounds to the abdomen.
The patient was hypothermic with a temperature of 99.4 F. Initially, he was stabilized
with oxygen and intravenous fluids. In addition, he received Solu-Delta-Cortef, Baytril,
and Penicillin. His wounds were flushed with copious amounts of saline solution, and he
was given Torbugesic for pain management. He improved slowly with treatment, but
temperature regulation was still a problem. He continued to remain hypothermic.
Bloodwork revealed azotemia, low glucose, elevated alanine aminotransferase (ALT)
levels and an elevated packed cell volume. Radiographs showed no chest involvement;
however, soft tissue trauma of the neck muscles was evident. In addition, a large,
radioopaque bladder stone was observed.
Yang is warm. When Yang is deficient in the body, it almost always results in signs of
coldness or hypothermia. The two most important organs to keep the body warm are
Kidney and Heart. Thus, the TCVM pattern of this case is a Heart and Kidney Yang
Deficiency. Traditional Chinese Veterinary Medicine can be used in combination with the
conventional Western treatments to assist the patients recovery. The herbal medication
Si Ni Tang may be beneficial; however, it should not be used for longer than two weeks.
Also, the acupoints Bai Hui, GV-4, and Shen Shu may be used to tonify Yang.
Moxibustion techniques can help provide some extra warming effect as well.
24 CHAPTER ONE
Case 1.7
Signalment: A thirteen year old female cat
Primary Complaint: Constipation
This cat frequently experiences severe constipation. She occasionally becomes
extremely painful, and she requires emergency care to manually evacuate the feces.
Her medications include daily Cisapride and every other day Laxatone. Her feces are
very dry and without mucus. She has some halitosis. Her thirst, urination, and
temperature preferences do not differ from that of the other household cats. Her tongue
is red and dry, and her pulse is fast and thready.
The major function of Large Intestine (LI) is to excrete feces. Difficulty in defecation can
be due to either a Yin Deficiency (fails to moisten the LI and leads to constipation) or a
Qi Deficiency (LI Qi is too weak to excrete feces). Very dry feces, a dry, red tongue and
a fast, thready pulse indicate Yin Deficiency. Painful defecation, constipation and
halitosis indicate Qi Stagnation. The TCVM pattern is Large Intestine Yin Deficiency and
Qi Stagnation.
In her case, several recommendations may be helpful. Her diet should be high in fiber.
The herbal medication Ma Zi Ren Wan may be given for one to three months to moisten
the Large Intestine and to move the Stagnation. The suggested acupuncture points
include ST-37, ST-25, GV-1, and BL-21. In addition, the owner can massage the
acupoints CV-12 and CV-8 for ten minutes twice daily.
YIN YANG THEORY 25
Self Test
Of the following pairs, choose which one belongs to Yang.
Question 1.1:
Question 1.2:
Question 1.3:
Question 1.4:
Question 1.5:
Fire (a) or Water (b)

10 a.m. (a) or 10 p.m. (b)
Mare (a) or Stallion (b)
Winter (a) or Summer (b)
East (a) or West (b)
Of the following pairs, choose which one belongs to Yin.

Question 1.6: Function (a) or Structure (b)
Question 1.7: Fast (a) or Slow (b)
Question 1.8: Head (a) or Tail (b)
Question 1.9: Interior (a) or Exterior (b)
Question 1.10: Left eye (a) or Right eye (b)
Question 1.11: If the Yin-Yang equilibrium is destroyed by Excess Heat, what is the
proper treatment principle to restore the Yin-Yang balance?
a. Clear Excess Heat
b. Tonify Excess Heat
c. Tonify Yang
d. Clear Excess Yin
Question 1.12: If Yin is deficient, what is the treatment principle?
a. Clear Excess Yin
b. Clear Excess Heat
c. Tonify Yang
d. Tonify Yin
Question 1.13: Jumper, a 10-month old castrated male cat, is an outdoor-indoor cat. He
enjoys running, climbing trees, and jumping from high places. He is also a good hunter,
catching small creatures such as dragonflies and lizards. He likes attention, and he
always walks with his human guardian. His whole body feels hot. He drinks a lot, but he
does not have any endocrine disorders. What type of animal is Jumper?
a. Yin
b. Yang
Question 1.14: What is the best type of food for Jumper?
a. Yang
b. Yin
CHAPTER TWO
FIVE ELEMENT THEORY

When the minds of the people are closed and
wisdom is locked out they remain tied to disease. Yet
their feelings and desires should be investigated and
made known, their wishes and ideas should be
followed; and then it becomes apparent that those
who have attained spirit and energy are flourishing
and prosperous, while those perish who lose their
spirit and energy.
Huang Ti, Nei Ching Su Wen
The Five Elements, also known as Wu Xing, the five activities, or the five principles in
action, refer to the five categories in the natural world: Metal, Water, Wood, Fire and
Earth. These are the indispensable and fundamental elements that constitute the
universe. Enhancing, inhibiting and restraining relationships exist between them. Also,
these elements are in constant motion and change. In Traditional Chinese Veterinary
Medicine, the properties and the mutual relationships of the Five Elements are used to
explore and illustrate the basis of medical problems.
The Five Element theory was first formed in China around the time of the Yin and Zhou
Dynasties (16th century B.C. to 221 B.C.). Later, it was adopted into medical practice,
thus becoming a founding theory of Traditional Chinese Veterinary Medicine. The Five
Element principles can describe the nature of the Zang-Fu organs, the inter-relationships
between the organs and the relationship between the animal body and the natural world.
Thus, the theory of Five Elements, together with the theory of Yin-Yang, serves to guide
clinical diagnosis and treatment.
28 CHAPTER TWO
Table 2.1: Comparison of the Five Element characteristics
Wood
Fire
Earth
Metal
Water
Season
Spring
Summer
Late Summer
Fall
Winter
Climate
Wind
Heat
Damp
Dryness
Cold
Direction
East
South
Center
West
North
Color
Green
Red
Yellow
White
Gray / Black
Flavor
Sour
Bitter
Sweet
Pungent
Salty
Sound
Shouting
Laughter
Singing
Weeping
Groaning
Emotion
Anger
Irritation
Joy
Fright
Preoccupation
Worry
Grief
Sadness
Fear
Terror
Growth
Germination
Growth
Transformation
Reaping
Storing
Zang
Organs
Liver
Heart
Pericardium
Spleen
Lung
Kidney
Fu Organs
Gall Bladder
Small Intestine
Triple Heater
Stomach
Large
Intestine
Bladder
Orifice
Eyes
Tongue
Mouth
Nose
Ears
Sense
Vision
Speech
Taste
Smell
Hearing
Tissue
Tendons
Ligaments
Vascular
system
Muscles
Skin
Hair Coat
Bones
Functions
Purification
Circulation
Digestion
Respiration
Elimination
Exterior
Nails
Complexion
Lips
Skin Pores
Head Hair
Secretion
Tears
Sweat
Saliva
Nasal Fluid
Urine
Body
Action
Spasms
Tantrums
Mania
Depression
Spitting
Vomiting
Coughing
Wheezing
Trembling
Shivering
Body Odor
Rancid
Scorched
Fragrant
Rotten
Putrid
Weakness
Looking
Walking
Sitting
Lying
Standing
Tongue
Part
Sides
Tip
Center
Mid-tip
Rear
THE FIVE ELEMENTS 29
Figure 2.1: The characteristics of the Five Elements
Two Physiological Cycles of the Five Elements

Each of the five internal organs and sense organs pertains to one of the Five Elements.
The Five Elements properties serve as an analogy to explain some of the physiological
functions of the five Zang or five Fu organs.
There are two physiological cycles of the Five Element Theory: the inter-promoting and
the inter-inhibiting relationships. These explain the interconnections among the five Zang
organs or the five Fu organs as well as the connections between Zang and Fu. As
discussed in Chapter 4, the Zang-Fu is the collective term for internal organs, which
30 CHAPTER TWO
include five major Yin organs (Heart, Lung, Spleen Liver, Kidney) and five major Yang
organs (Small Intestines, Triple Heater, Large Intestine, Gallbladder, Bladder). For
instance, the Kidney promotes the Liver, which in turn promotes the Heart; therefore, the
Liver is the mother of the Heart and the child of the Kidney. On the other hand, each of
the five Zang organs or the five Fu organs inhibits another thus maintaining a relative
balance among the organs. For instance, the Liver inhibits the Spleen, and the Spleen
promotes the Lung, which then inhibits the Liver. The Heart Fire promotes the Spleen,
while the Kidney Water inhibits the Heart Fire. The inter-promoting and inter-inhibiting
relationships among the five Zang organs are shown in Figure 2.2.
Figure 2.2: The interactions of the Five Elements
The outer circle of arrows represents the inter-promoting relationship in which each
element supports the next. The crossing arrows in the center represent the interinhibiting relationship in which each element can restrain another.
THE INTER-PROMOTING CYCLE: SHENG CYCLE

Wood Fire Earth Metal Water Wood
This sequence of elements illustrates how each Element promotes, nurtures, or
generates another. For any element, the previous element in the series is the mother of
the element. Similarly, any element next in the series is the child or son of the
previous element.
Wood promotes Fire:
Wood is the mother of Fire

Fire is the child of Wood
Fire promotes Earth:
Fire is the mother of Earth

Earth is the child of Fire
Earth promotes Metal:
Earth is the mother of Metal

Metal is the child of Earth
Metal promotes Water:
Metal is the mother of Water

Water is the child of Metal
Water promotes Wood:
Water is the mother of Wood

Wood is the child of Water
THE INTER-RESTRAINING CYCLE: KE CYCLE

Wood Earth Water Fire Metal Wood
This sequence of elements illustrates how each Element restrains and controls another.
For any element, the previous element in this Ke Cycle series is the grandparent of
that element. Similarly, any element next in this Ke Cycle series is the grandchild of
the previous element. It is the job of the grandparent to control the grandchild. In this
way the elements keep each other in check and maintain the balance.
THE SHENG AND KE CYCLES KEEPING THE BODY IN BALANCE

Together, these cycles form a feedback system that helps to keep everything functioning
at the proper level. When one element acts upon another, whether to replenish or to
drain the next, the connection between the elements will eventually cause a reaction
upon the original element. This prevents one element from acting too severely upon
another and causing an imbalance within the system.
Wood restrains Earth (Ke cycle), but at the same time the Earth promotes the Metal
which then restrains the Wood. In this instance, the Metal makes sure that the Wood
does not restrain the Earth too excessively.
32 CHAPTER TWO
Wood
Earth
Ke cycle
Sheng cycle
Metal
Metal restrains Wood (Ke cycle) to prevent an Excess of Wood, but Wood promotes the
Fire which then restrains the Metal. Thus, the Fire restrains the Metal to make sure that
it does not restrain the Wood too much.
Metal
Wood
Ke cycle
Sheng cycle
Fire
Fire restrains Metal (Ke cycle), but Metal promotes the Water which simultaneously
restrains the Fire. In this way, the Fire is unable to restrain Metal too excessively.
Fire
Metal
Ke cycle
Sheng cycle
Water
Water restrains Fire (Ke cycle), but Fire promotes the Earth which simultaneously
restrains the Water. The Earth prevents the Water from restraining the Fire too much.
Ke cycle
Fire
Water
Sheng cycle
Earth
Earth restrains Water (Ke cycle), but Water promotes the Wood which simultaneously
restrains the Earth. The Wood prevents excessive restraint of the Water by the Earth.
Water
Earth
Ke cycle
Sheng cycle
Wood
THE SHENG AND KE CYCLES FORMING A NETWORK WITHIN THE BODY

The Sheng and Ke Cycles ensure that each element is connected with the other four
elements. Consequently, a network is established within the universe and the body. No
element is immune to the forces from the other elements.
For example, Wood restrains (Ke Cycle) the Earth and promotes (Sheng cycle) the Fire.
At the same time, the Wood is restrained by the Metal and is promoted by the Water.
Water
Ke cycle
Metal
WOOD
Fire
Earth
Sheng Cycle
34 CHAPTER TWO
Fire Restrains the Metal and promotes the Earth. Meanwhile, the Fire is restrained by
the Water and is promoted by the Wood.
Wood
Ke cycle
Water
FIRE
Metal
Sheng cycle
Earth
Earth Restrains the Water and promotes the Metal. At the same time, the Earth is
restrained by the Wood and is promoted by the Fire.
Fire
Ke cycle
Wood
EARTH
Water
Sheng cycle
Metal
Metal Restrains the Wood and promotes the Water. At the same time, the Metal is
restrained by the Fire and is promoted by the Earth.
Earth
Ke cycle
Fire
METAL
Water
Wood
Sheng cycle
Water Restrains the Fire and promotes the Wood. At the same time, the Water is
restrained by the Earth and is promoted by the Metal.
Metal
Ke cycle
Earth
WATER
Fire
Sheng cycle
Wood
Four Pathological Cycles of the Five Elements

A disease occurs as a pathological manifestation of a Zang-Fu organ and related tissue
dysfunction. This may be due to a number of factors. The animal body is an organic
whole; there are inter-promoting and inter-inhibiting relationships among the Zang-Fu
organs. Disease occurs when the Five Element inter-promoting and inter-inhibiting
relationships go out of control thus becoming excessive or deficient. There are four basic
pathological cycles: Mother Element to Child Element, Child Element to Mother Element;
Overwhelming Cycle and Insulting Cycle.
THE MOTHER ELEMENT (ORGAN) AFFECTS THE SON ELEMENT (ORGAN)

In this case, an imbalance follows along the same route of the promoting cycle; however,
the mother element transmits problems to her child instead of nourishment. For instance,
a Liver problem will transmit to the Heart. When Liver Blood is deficient, the Liver fails to
nourish the Heart. This affects the Heart Blood thus resulting in a Deficiency of Heart
Blood. Similarly, Spleen problems can transmit to the Lung. If the Spleens function of
transformation and transportation is impaired, pathogenic phlegm will be formed and will
remain in the Lung thus causing a Lung problem.
Example 1:
Liver problems transmitted to the Heart (Wood Fire)

Liver Blood Deficiency
Failure to nourish
the child
Heart Blood Deficiency
36 CHAPTER TWO
Example 2:
Spleen problems transmitted to the Lung (Earth Metal)

Spleen Qi Deficiency
Failure to transport/transform fluid
Failure to nourish the child
Production of Phlegm
Lung Qi Deficiency
THE SON ELEMENT AFFECTS THE MOTHER ELEMENT

In this case, an imbalance follows along a reverse path of the Sheng cycle; problems
with the child are transferred to the parent. For example, a Spleen problem will transmit
to the Heart. The Spleen is the original supplier of Qi and Blood, which are important for
the Heart. When the Spleen does not make enough Blood, a Deficiency of Heart Blood
may occur.
Example:
Spleen problems transmitted to the Heart (Earth Fire)

Spleen Qi Deficiency
Failure to generate Qi/Blood
Heart Blood Deficiency
THE OVERWHELMING CYCLE: CHENG CYCLE

Wood Earth Water Fire Metal Wood
In this case, an imbalance follows along the same route of the Ke cycle; each element
excessively restrains another beyond the normal extent. This usually occurs when an
element is in Excess. This is the most common pathological condition seen in practice.
Excessive Restraint on an Element
Pathological Conditions
Example 1: Excessive Wood

Cheng Cycle
Earth
Wood
(Hyperactive, Stress, Constitution)
Liver Qi
Stagnation
Spleen Problems
(Anorexia, Diarrhea, Vomiting)
Example 2: Excessive Fire
Excess
Heart Fire
Cheng Cycle
Lung Yin
Deficiency
Dry Cough
THE INSULTING CYCLE: RU CYCLE

Wood
Metal
Fire
Water
Earth
Wood
In this case, an imbalance follows along the opposite route of the Ke cycle; each
element can insult the one that normally restrains it. This reversal of the Ke cycle usually
occurs when the balance is broken, especially when one Element is insufficient.
Example 1: Excessive Metal (Lung) or Deficient Fire (Heart)
Lung Problem
Ru (Insulting Cycle)
(Cough, Phlegm)
Impaired Heart Qi
Circulation
Example 2: Excessive Wood (Liver) or Deficient Metal (Lung)

Ru Cycle
Wood
Metal
(Hyperactive, Stress, Constitution)
Liver Qi
Stagnation
Lung Problems
(Cough with flank pain)
38 CHAPTER TWO
The Five Constitutional Types of Animals

The principles of the Five Element Theory can be applied to the personal characteristics
of individuals. This is a way of categorizing the personality and disease tendencies of an
animal. By comparing an animal to its most dominant elemental personality type, a
TCVM practitioner can understand the patient as a whole and can better address the
imbalances associated with that constitutional type.
WOOD TYPE
Personal Characteristics:
x
x
x
x
x
x
x
x
x
x
Dominant behavior or attitude

Quick, fast movements
Enjoys or skilled with running or moving
Impatient
Easily becomes angry or loses temper
Alert and responds quickly to stimuli
Good at adapting to changing conditions
Good diplomat (human)
Quickly forms ideas, but then changes his/her mind
Narrow-minded and intolerant to different ideas
Physical Characteristics:
x
x
x
x
x
x
x
Thin body, either tall or short

Big eyes
Pulse: Wiry (String-taut)
Performance: Good, but variable. Sometime good; sometimes bad
Hooves and tendons are strong and healthy
Runs like the wind. Quick and nimble movement
Good type for the racetrack
Disease Predispositions:
x
x
x
x
x
x
Hypertension
Stroke
Allergy
Depression (Liver Stagnation)
Hysteria
Neurosis
Life Span:
Short (a little bit longer than the Fire type)
TCVM Health Suggestion

In TCVM, the Liver (Wood organ) is considered as Yang function and Yin body. Yang
function means that the Liver acts upward and outward and has little tolerance for
depression. Even a small amount of stress, depression or Stagnation will devastate or
strain the Liver function. Thus, foods that have harmonizing or regulating properties are
very important to Liver function. Yin body refers to the Liver Yin and the Liver Blood,
which are the major sources of nourishment for the tendons, hooves and eyes. The
herbal medicine Xiao Yao San is recommended to maintain a balanced Liver. The
recommended foods include chicken liver or pork liver, green vegetables (mustard
greens, spinach, cabbage), carrots, and citrus fruits.
FIRE TYPE
x
x
x
x
x
x
x
x
x
x
x
x
x
Easily excited
Extroverted
Love to be loved
Tends to be the center of party
Loves and is skilled at fostering a social life
Difficult to calm down
Sharp mental activities
Inventor. Suddenly conceives good ideas
Persuasive. Skilled at inspiring others
Proficient in competition or fighting
Aggressively peruses ambitions
Arrogant attitude
Exaggerates. (Making a mountain out of a molehill; blowing things out of proportion)
x
x
x
x
x
x
x
x
Strong body
Small head
Small, but bright, shining eyes
Red face (human)
Prominent blood vessels
Pulse: Fast or Full
Runs very fast, but easily fatigued
Good for short-distance racing
40 CHAPTER TWO
x
x
x
x
x
x
x
Cardiovascular Disease
Chest pain
Arteriosclerosis
Stroke
Separation anxiety
Restlessness
Sudden Death
Life Span:
Very short
TCVM Health Suggestion:

The Heart belongs to Fire. Yang is often excessive, and Yin is often deficient; the fire
(Heat) easily becomes excessive and damages Yin. A Heart Yin tonic is very important
to maintain the functions of the Heart energy system. The herbal formula Shen Calmer
(Modified Tian Wan Bu Xin Dan) is recommended to help balance the Heart. Diet
recommendations include foods such as pork heart, fish, brown rice, wheat and
vegetables such as spinach, broccoli, celery and mushrooms.
EARTH TYPE
x
x
x
x
x
x
x
x
x
x
Honest and kind

Takes care of others (A good type for a mare)
Generous and modest
Laid back
Humble
Speaks and walks neither fast nor slow
Easily satisfied
Holds oneself aloof from the world
Slow response to a stimulus
Good worker, but a little slow
x
x
x
x
x
x
Short but sturdy body

Prominent musculature
Big head
Brown hair-coat on the head (Yellow face in humans)
Thick lips and big nose
Pulse: Slow
x
x
x
Chronic gastrointestinal problems. Diarrhea. Colic.

Edema
Obesity
Life Span:
Long

The Spleen belongs to the Earth. The Spleen is the dominant organ system for Earth
type animals. Like the Earths characteristics, the Spleen consistently works very hard.
There are no complaints until a big problem develops. The Spleen deserves special
attention and careful medication because the Spleen, as the source of energy, muscular
strength, and defending force, is important to the whole body.
The major natural challenge to the Spleen is Damp. Damp may originate from food,
drink, weather changes and the environment. In addition, the collection of damaged
cells/tissues or abnormal (mutated) cells within the body is considered Damp or Yin
production. The Spleen Qi and Wei Qi are associated with the body's ability to identify
abnormal tissue. If the function of the Spleen diminishes, the Damp will not be identified.
Damp is thick, sticky and difficult to move. If it is allowed to remain in place for long
periods of time, cancerous growths may develop.
According to TCVM herbal theory, plants with dryness properties, such as Atractylodes
Cang Zhu, will support the Spleen because that herb can dry up the Damp. In addition,
the Spleen (Earth) requires Fire because Fire is the mother of Earth. Therefore, all herbs
supporting the Spleen should also have the property of Fire; they should be warm or
hot herbs. This is probably why those who live in humid areas (Damp) prefer hot, spicy
foods (Fire).
It is also important to understand that the Spleen is located in the middle-jiao (MiddleBurner) where it dominates the Qi flow (Qi-Ji). The two major directions of Qi flow are
upward and downward. All the beneficial substances, nutrients and energy, should be
transported upward to the Lung, then to the whole body. All the useless materials
(metabolic by-products) and the harmful substances (toxins) should go downward to
large intestines for excretion from the body. Thus, a good herbal prescription for Spleen
should contain ingredients that maintain this up-down relationship of Qi flow. The Herbal
formula Ping Wei San may be used. The recommended foods include rumen, lamb,
chicken, ginger, garlic, and sweet potato.
42 CHAPTER TWO
METAL TYPE
x
x
x
x
x
x
x
x
x
Foresight and sagacity (good vision)

Broad-minded
Good organizer
A leader in a group
Always follow the rules
Righteous
Holds oneself aloof
Confident and consistent
Haughty or vain
x
x
x
x
Broad forehead
Big and wide nose
Broad chest
Good hair coat
x
x
x
Respiratory problems. Cough. Asthma. Nasal congestion

Diabetes
Constipation
Life-span:
Long

In TCVM, the Lung (Metal organ) functions primarily to control breathing and to regulate
the respiratory system. The Lung is a delicate organ. Dryness and Heat can easily
damage the Lung Yin, which holds and supports the Lung Qi. Lung Yin damage (Lung
Yin Deficiency) causes malfunction of respiratory activities (Lung Qi) and results in
asthma or cough.
The Lung is located at the top of the Three-Burner (Sanjiao, Triple Heaters). It distributes
Ying-Qi (nutrients) down to the entire body. This inspiratory direction (descending) of the
Lung Qi flow should be downward as well. The expiratory direction (ascending) of the
Lung Qi should be upwards. This is the reason why the Lung dominates the ascending
and descending Qi flow. In the case of dyspnea or asthma, it is caused by damage of
the Lung Qis descending or ascending direction. The TCVM treatment strategy for the
Lung is as follows: 1) use a Yin tonic herb to moisten and nourish the Lung Yin, 2)
restore the downward direction of the Lungs Qi flow. The herbal medicine Bai He Gu Jin
Tang may be used. The recommended foods include eggs, duck, barley, tofu and rice.
WATER TYPE
x
x
x
x
x
x
x
x
x
x
Introverted
Terrified or fearful about everything
Quiet, but a good observer
Skilled at planning and scheming
Good advisor or supervisor
Prefers deep thought
Willing to live alone
Very consistent, but slow when doing something
Sinister or insidious if evil
Fear biter
x
x
x
x
x
x
Thin, middle sized body

Black hair on the head
Deep, big eyes and big ears
Cold intolerance. Prefers to stay in a warm area
Pulse: Deep
Not a favorable type for a stallion
x
x
x
x
x
x
Edema
Infertility
Back pain
Urinary infections
Diarrhea at dawn
Depression
Life Span:
Very long

The Kidney (Water organ) dominates reproduction and supplies vital force (Ming-Men
Fire, or Kidney Yang). Coldness is the natural enemy of the Kidney. Herbs with warm or
hot properties, which eliminate coldness, can help the Kidney.
The Kidney stores the Essence (Jing), which influences the animals growth,
development and reproduction. Therapy for the Kidney should maintain the balance
between Kidney Yang (Ming-Men Fire) and Kidney Jing. The herbal formula Epimedium
Powder (Sheng Jing San) is recommended. The food recommendation includes pork
kidney, eggs, duck, mussels, sweet potato, and black beans.
44 CHAPTER TWO
The Five Elements in Diagnosis

The Five Element Theory may be used with the Four Diagnostic Techniques to examine
the clinical findings and to elucidate the Patterns of disease according to the nature of
the Five Elements.
COLOR OF THE MOUTH OR TONGUE

One of the most important diagnostic parameters is the color of an animals tongue or
mouth. There are five abnormal colors that may indicate an imbalance in the associated
Element and its organs.
x
A purple, blue, or lavender indicates an imbalance in Wood, which may be

due to Stagnation of Liver-Qi.
A red color indicates an imbalance in Fire, which may be due to an Excess of

Heart-Fire.
A yellow color may indicate an imbalance in Earth, which may be due to a

Deficiency of Spleen-Qi.
A white color may indicate an imbalance in Metal, which may be due to a

Deficiency of Lung-Qi.
A dark color may indicate an imbalance in Water, which may be due to a

Deficiency of Kidney Yin.
However, the above diagnostic method is just one possible indication. Because a
disease is complex, every symptom should be systematically analyzed before
determining the diagnosis.
TISSUES
Pathological changes of the tissues can be used as a diagnostic tool. These changes
may indicate an imbalance of a certain organ according to the Five Element
associations.
Tendon, ligament disorders may indicate a Liver Yin Deficiency. A problem with blood
vessels may indicate a Heart disharmony. Muscle atrophy may indicate a Spleen Qi
Deficiency. Dry hair and skin may indicate a Lung Yin Deficiency. Degenerative bone
diseases may indicate a Kidney Qi or Kidney Yin Deficiency.
SENSE ORGANS
A problem with one of the five sense organs may reflect an imbalance of the associated
internal organ. For example, red and painful eyes often reflect a Liver problem. A tongue
problem may indicate a Heart imbalance. A mouth and lip problem may be related to the
Spleen. If the nose is troubled by heat, dryness or sneezing, there may be a Lung
problem. Deafness may be related to a Deficiency of the Kidney.
Three Treatment Strategies of the Five Element Theory

TONIFY (BU) THE MOTHER FOR DEFICIENCY
If an organ is deficient, its mother organ should be tonified. In a case with a Deficiency of
Lung Qi, the treatment should involve tonification of Spleen Qi. Because the mother
element nourishes the child element, stimulation of the mother will provide more support
for a weak child.
CLEAR (XIE) THE SON FOR EXCESS

This method is called Xie in Chinese. Xie can be also translated as clear, reduce or
sedate. If an organ is in Excess, the child organ should be sedated. In a case with a
Liver Fire Flaring-Up Pattern, the treatment principle may be to reduce the Heart and to
eliminate the Fire. By stimulating the child organ, the child organ can draw some of the
Excess away from the parent.
An Organ in Excess
Clear the
Child Organ
Liver Fire Flaring-Up

(Eye inflammation)
Clear Heart and

Clear Fire
STRENGTHEN THE GRANDCHILD ELEMENT FOR PREVENTION

It is a common clinical practice to determine the principle of treatment according to the
pathological influence among the Zang-Fu organs in the Five Element cycle. When there
is disharmony between the Liver and Spleen, the principle of treatment should include
methods that promote the Spleen and clear the Liver because Stagnation of Liver Qi
over-acts on the Spleen.
If one organ is in Excess, it is beneficial to strengthen its grandchild organ (the element
that directly follows the child element). An excessive element can over-act (Cheng) upon
its grandchild organ, thus strengthening the grandchild organ in the Cheng cycle will
provide a protective function for that organ.
x
If the Liver has problems, strengthen the Spleen for prevention.
If the Spleen has problems, strengthen the Kidney.
If there are Heart problems, strengthen the Lung.
If the Lung has problems, strengthen the Liver.
If there are Kidney problems, strengthen the Heart.
46 CHAPTER TWO
Heart
Liver
Excess
Spleen
Tendency to overcontrol the Spleen
Strengthening the Spleen
before Spleen signs occur
can prevent disease
When Liver is Excessive, it tends to over-control (Cheng) Spleen. For prevention, Spleen
should be reinforced before the signs of Spleen Deficiency occur.
Conclusions
The Yin-Yang and Five Element Theories form the foundation of Traditional Chinese
Veterinary Medicine (TCVM). These two theories are used to explain physiological
activities and pathological changes and to provide a basic guideline for clinical practice.
They are interdependent and cannot be entirely separated during clinical evaluation. For
a horse with high fever, the Yin-Yang Theory should be used to determine if it is an
Excess Pattern (Yang) or Deficient Pattern (Yin), and the Five Element Theory should be
used to determine which organs are affected. Both theories, however, are limited by the
historical development of ancient Chinese society. They may be incomplete and need to
be complemented with modern, advanced scientific research and clinical experience.
Summary of Normal Five Element Physiology
Inter-Promoting Relationship
Sheng Cycle
Fire
Wood
Earth
Water
It is possible to imagine this sequence in nature with

one element promoting and flowing into the next. The
river Water nourishes a young seedling, which
becomes a great Wood tree. A forest Fire burns the
tree and the ash nourishes the Earths soil. This Earth
is mined for Metal ore. Metal tools are used to
discover and collect Water; and the Water flows into
the river that nourishes the tree.
Metal
Inter-Inhibiting Relationship
Ke Cycle
Fire
Wood
Water
This cycle is the normal generative cycle found in the

five-element system. It is a parent-child relationship
in which one element nourishes the following element.
Fire promotes Earth, which promotes Metal, which
promotes Water, which promotes Wood, which
promotes Fire. In other words, Fire is the mother of
Earth but is also the son of Wood. In this way, each
element serves as both a parent and a child to the
surrounding elements in the cycle.
Earth
Metal
This cycle is the normal control cycle found in the fiveelement system. It is a restraining relationship
between the elements. The elements involved can be
called the grandparent and the grandchild. The
grandparent is the element that is one ahead of the
parent element, and it is involved in controlling the
activity of the grandchild element. Water inhibits
Fire; Fire inhibits Metal; Metal inhibits Wood; Wood
inhibits Earth; and Earth inhibits Water.
Once again an analogy can be used to illustrate the
restraining effects that each element can have on
another. Fire melts Metal ore and allows it to be
shaped. A Metal saw is used to harvest trees for
Wood. The Wood is used to mold the Earth into a
dam. The dam restrains the flow of Water in a
reservoir. The Water collected is used to extinguish
the Fire.
48 CHAPTER TWO
Normal Five Element Interactions

Fire
Wood
Earth
Water
Metal
Together these two cycles create balance among the

elements. When the elements are cooperating
normally through this system of inhibition and
promotion, there should be no Excess or Deficiency.
When there is Excess or Deficiency of any of the
elements, there is an abnormality within one or both
of the cycles. In a normal situation, the cycle would
work to feed back upon the original element and
maintain it at its balanced state. For example, Water
inhibits Fire, but then Fire promotes Earth, which
inhibits Water.
Summary of Abnormal Five Element Physiology

Over-Acting Relationship
Cheng Cycle
Fire
Wood
Earth
Water
Metal
Inter-Insulting Relationship
Ru Cycle
Fire
Wood
Water
This cycle occurs as a pathologic form of the Ke

cycle when the balance of the normal Ke cycle is
broken due to an excess of one element. The
grandparent element goes beyond the normal
amount of control of the grandchild element so that
it results in disease. This can be seen when one
element is in excess and exerts too much restraint
upon another element. For example, the OverActing Relationship would be occurring if Wood was
so excessive that Metal cannot inhibit it. In this case
Wood excessively inhibits Earth and causes a
pathologic condition.
Earth
Metal
This cycle occurs as a pathologic form of the Ke

cycle when the balance of the normal Ke cycle is
broken due to an insufficiency of one element. In this
case, the Ke cycle is reversed. The grandparent
element is weak, thus unable to exert a normal
amount of control over the grandchild element. The
flow of control is reversed and grandchild element
restrains the grandparent element. For example,
the Insulting Relationship can occur if Metal was
weak or if there was an excess of Wood. In this
case, the Wood will exert restraint upon Metal.
Son Element affects the Mother Element

Fire
Wood
Earth
Water
This cycle occurs as a pathologic form of the Sheng

cycle. In this case, the Sheng cycle is reversed. If the
Child Element has a problem, it can transfer
problems to the Mother Element. For example, if the
Spleen is deficient, it may lead to a deficiency of the
Heart.
One way of thinking about this is to imagine a sick
child. The mother spends all her time and energy
helping her sick child until she becomes ill herself.
Metal
Mother Element affects the Son Element

Fire
Wood
Earth
Water
Metal
This cycle occurs as a pathologic form of the Sheng

cycle. In this case there is an imbalance in which
the elements pass problems from Mother to Child.
The mother element, which is ailing, is unable to
maintain the proper balance within the cycle.
Instead of supporting and nourishing the following
element, the mother transmits problems to the child.
For example a deficiency of Liver may eventually
lead to a deficiency of the Heart, because the Liver
is unable to properly nourish the Heart.
One could imagine an overworked, stressed parent
who does not feel good. This parent comes home
and does not want to interact with the child. This
causes the child to become upset.
Example of Excessive Wood:
Example of Deficient Wood:
Fire
Wood
Cheng
Fire
Earth
Wood
Ru
Water
Ru
Earth
Cheng
Metal
Water
Metal
50 CHAPTER TWO
Identifying Small Animal Constitution Types

in the Exam Room
Wood
x
x
x
x
x
x
Confident
Irritable, Crabby
Active, Energetic, Athletic
Aggressive, Angry
Bites with little provocation
Impatient
Fire
x
x
x
x
x
Earth
x
x
x
x
x
Friendly
Enjoys sleeping or relaxing
Eager to please
Slow walker
Laid back
Friendly
Greets strangers warmly
Noisy, Barking
Excited, Hyper-excitable
Difficult to keep still
Metal
x
x
x
x
x
x
Clean hair coat

Quiet
Confident
Disciplined
Follows the owners commands
Organized, Knows what to do
next or knows what to expect
Water
x
x
x
x
x
x
Hiding behind owner or under the exam table

Fear biter
Not confident
Watches what the veterinarian is doing
Urine leakage
Owner calls to cancel appointment because
the cat is hiding under the bed.
Identifying Constitution Types

of Horses in the Barn
Wood
x
x
x
x
x
x
x
x
Confident
Irritable, Crabby
Active, Energetic, Athletic
Ears back
Aggressive, Angry
Kicks, Stomps, or Strikes
Impatient
Bites
Fire
x
x
x
x
x
x
Earth
x
x
x
x
x
Friendly
Enjoys relaxing
Easy going, mellow
Eager to please
Moves slow or walks
Friendly
Noisy, Vociferous
Loves to be touched or petted
Excited, Hyper-excitable
Difficult to keep still
Very Sensitive
Metal
x
x
x
x
x
x
x
Clean hair coat

Quiet
Organized
Prepared for what happens next
Confident
Disciplined
Follows the rules
Water
x
x
x
x
x
x
Hides or runs away

Kicks when afraid
Not confident
Watches the veterinarian
Nervous when being examined
May present rump and threaten to kick
when examined
52 CHAPTER TWO
Case Examples
Case 2.1
Signalment: An eleven-year male, castrated Domestic Long Hair cat.
He is a very tolerant and friendly cat. He likes to dominate animals of equal strength, but
he lets very young or very old animals dominate him. Although he likes to be petted, he
hates to be groomed. He only wants attention on his own terms, when he wants it. He
loves to be around people, but does not like to be the center of the party. He purrs both
when happy and angry.
He prefers the support of furniture, shoes or folded rugs. He loves to sleep in the
morning. He eats only when the owner eats or when the owner offers food, rarely eating
when the owner is not home. When he was young, he was very fast and agile, catching
birds and lizards; but, now he will not even catch a moth. He used to eat only what he
caught; now he wont kill anything.
Recently he sleeps a lot and is sluggish. There is decreased muscle tone in both hind
limbs. He used to breathe clearly, now his nose is congested chronically. Sometimes the
nasal congestion is so bad that he has to use his mouth to breathe. His nasal discharge
is clear and is worse on the right side. He coughs a lot recently, but it seems worse in
the daytime.
His tongue is pale, and his pulse is deep and weak. Because of nasal discharge and
congestion, he was given antibiotics and anti-histamines for the past month. The
medications did not seem to help.
This cats tolerant, friendly attitude and his tendency to please others mark him as a
typical Earth type cat. It is not uncommon for an Earth constitution cat to tend towards a
deficient Spleen or Stomach. Deficient Earth might lead to deficient Metal (the Mother
element affects the Child element). The chronic clear nasal discharge and congestion,
the pale tongue, and the weak pulse indicate Lung Deficiency.
The treatment strategy is to tonify the Lung and Spleen. It is important to tonify the
Spleen because the Spleen is the mother of the Lung. The acupuncture points LU-9 (the
Earth point on the Lung Meridian) and BL-13 (the Lung association point) are
recommended. Herbal formulas Si Jun Zi Tang (to tonify Spleen) and Bai He Gu Jin
Tang (to tonify Lung) are recommended.
Case 2.2
Signalment: A thirteen year old Quarter Horse mare
She is always angry, irritable and crabby. When the veterinarian examines her, she
often has her ears pinned. The mare stomps her feet even tries to bite and kick the
veterinarian.
Her tongue is red, purple and swollen. Her pulse is wiry and forceful. Her eyes are large,
red, and watery.
This is a typical Wood type mare. She has Liver Qi Stagnation and Liver Fire. The anger,
irritability, aggressive behavior, purple tongue and wiry pulse are indications of Liver Qi
Stagnation. A red and swollen tongue, red and swollen eyes, and a forceful pulse
indicate Liver Fire. The treatment plan is to soothe the Liver Qi and clear Fire.
Treatment with the acupuncture points LIV-1, LIV-3, HT-9 and HT-8 are recommended.
The herbal formula Long Dan Xie Gan Tang is also recommended to clear the Liver and
to clear Fire.
54 CHAPTER TWO
Case 2.3
Signalment: An eight-year-old Paint gelding
He loves to run and to compete, but he has some anger problems. He is easily irritated
and hyperactive. His tongue is purple. He is reactive on the entire Stomach Meridian of
his neck, BL-20 (Spleen associate point), BL-21 (Stomach associate point), and Dan
Tian (the stifle point). He is also very reactive at PC-1. His pulses are fast and wiry. His
eyes are red. He had several episodes of laminitis. He also had history of colic and
diarrhea. Recently his front feet seem to bother him.
This gelding is a wood type of horse. He has liver Qi Stagnation (Liver Excess). The
treatment strategy includes clearing the Liver Qi Stagnation and strengthening the
Spleen.
The Wood (Liver) over-acts (Cheng) on the Earth (Spleen). This explains the sensitivity
of the Stomach Meridian (the husband of the Spleen Meridian), of BL-20 (Spleen
association point) and of BL-21 (Stomach association point). The stifle soreness is also
considered a sign of a Stomach Meridian disorder.
The acupoints LIV-3, ST-45, GB-44, BL-20, BL-21, PC-9, and TH-1 are recommended.
The herbal formula Xiao Yao San may also be beneficial.
The previous two cases have a core of similarity with slightly different clinical
presentations. The root is the same: a Wood horse with Liver Qi Stagnation. The first
case had secondary signs of Liver Fire, which were caused by the Liver Qi Stagnation
because any long-term Stagnation may transform into Fire. The Liver Fire is a Yang
factor which tends to flare upwards. Red and swollen eyes occur as a consequence
because the eyes are the orifice of the Liver.
The second case also had Liver Qi Stagnation (Liver Excess). The Excessive Liver
tends to affect the Stomach/Spleen (the Wood over-acts/cheng on the Earth), leading to
sensitivity of the Stomach Meridian.
Since both cases have the same root (Liver Qi Stagnation), the primary treatment is the
same: the acupoint LIV-3 and the herbal medication Xiao Yao San. However, since their
secondary clinical presentation is different, the secondary treatment is different. For the
first case, HT-8, HT-9 and the herbal formula Long Dan Xie Gan Tang are used to clear
Liver Fire. For the second case, BL-20 and BL-21 are used to strengthen the Spleen and
Stomach. PC-9 and TH-1 are used for the local foot soreness.
Case 2.4
Signalment: A thirteen year old, neutered, male cat
The cat had a history of fibrosarcoma. The tumor was surgically removed only to have it
removed again when it reappeared many months later. Following the second surgery,
the owner wanted to try holistic therapy.
The cat was bright and responsive. He was overweight and his coat was shiny. The cat
was afraid of thunderstorms, loud noises, and strangers. However, the cat was very
independent, stubborn and loud when he became hungry. He preferred to lie in the sun.
The cats pulses were rapid and superficial. The upper and lower pulses were strong,
and the middle pulses were slightly less strong. The tongue is pink with a normal
coating. There was no pain on palpation of the alarm points. The mass was removed
from the area around BL-20/21.
The treatment so far included diet modification and supplementation. He was given a
natural diet that included fish, and he received omega-3 fatty acid supplements and
antioxidants.
This cat has a Water type personality. If the Water energy is deficient, a Water type of
animal is prone to arthritis, intervertebral disc disease, and renal failure. If the water is
excessive, the animal may develop problems due to counter-control (Ru Cycle) of the
Earth, over-control (Cheng Cycle) of the Fire, or both. When the water is excessive, the
result may be Spleen Qi Deficiency (gastrointestinal complaints or tumor) or Heart
Deficiency (heart murmur or insomnia). The cat in this case is thirteen years old, but he
is still bright and has a pink tongue, a strong pulse at the Kidney level, and a shiny coat.
For these reasons, his condition is associated with a strong Water element.
Water over-controls Earth (Spleen) resulting in Spleen Qi Deficiency. The Spleen Qi
Deficiency results in failure to produce enough Qi, including Wei-Qi. (Wei-Qi arises from
Spleen Qi or food Qi.) When Wei Qi is insufficient, the T-cells fail to check the tissues for
mutations and abnormal cells (Yin substances). Thus the body fails to move the Yin
substances, and these substances accumulate eventually forming tumors or cancer.
The current therapy is intended as prevention. Thus, the focus of treatment should be on
Spleen Qi Deficiency. Acupuncture points such as ST-36, SP-6, and BL-20/21 may be
beneficial. Wei Qi Booster (Modified Si Jun Zi Tang), an herbal formula that assists
Spleen Qi and Wei Qi, is also recommended.
56 CHAPTER TWO
Case 2.5
Signalment: A nine year old, spayed female mix breed dog
Primary Complaint: Urinary Incontinence
This dog has had urinary incontinence that is under control using Phenylpropanolamine.
The owners would like to get her off the drug if possible. She is also on Thyroxine.
Her tongue is lavender and her pulses are weakest on the left. The pulses show
weakness at Heart and Pericardium. She pants at night. She is a very excitable girl,
wiggling and barking all the time. It is hard to keep needles in her. Her diet is a turkey
and rice Purina food. She eats much and is over-weight. She prefers to lie on cool, hard
surfaces.
This dog has a Fire type constitution. The lavender indicates either cold or Yang
Deficiency (Fire Deficiency). When the Heart Fire (emperor Fire) is deficient, it can lead
to Ming-Men Fire (Minister Fire) weakness. Ming-Men Fire weakness is Kidney Yang
Deficiency. The major complaint of urinary incontinence indicates Kidney Qi or Kidney
Yang Deficiency. One of the major functions of the Kidney is to control urination.
The panting at night indicates Yin Deficiency. In this case it is a Heart Yin Deficiency.
Since the dog is a Fire-type, the dog is prone to Heart Yin Deficiency by the nature of its
constitution. (Fire consumes the body fluid easily and leads to Yin Deficiency).
Thus the TCVM diagnosis for this dog is both Yang Deficiency (Kidney) and Yin
Deficiency (Heart). The recommended herbal formulas include Suo Quan Wan and Jin
Suo Gu Jin Wan to tonify Kidney Qi and Kidney Yang. The acupuncture points including
BL-28, BL-39, Shen Shu and CV-6 are recommended. After the Kidney Yang becomes
stronger (normal urination), Yin tonification (HT-7, KID-3 and BL-23) can be used.
Case 2.6
Signalment: A five year old, neutered, male cat
As a kitten this cat had a portal shunt that was surgically repaired. For a while afterwards
the cat did well, except for a couple of episodes of cystitis. Then the cat began acting
strangely and was drooling intermittently.
On physical exam no dental problems were identified. There was no jaundice noted. The
cat exhibited signs such as blindness, diminished hearing, seizures, poor appetite and
occasional vomiting. The complete blood count and biochemical values were normal. An
ultrasound of the liver was unremarkable, but the serum bile acids, both pre- and
post-prandial, were grossly elevated. The cat was thought to have microvascular
abnormalities resulting in diversion of portal blood flow from the normal detoxification
path through the liver, but this was not confirmed by a liver biopsy. The tongue was pink
to red and slightly dry. The pulses were very weak and difficult to palpate.
The cats treatment included lactulose, metronidazole, and a low protein diet.
This cat has a Liver Yin Deficiency pattern with Spleen Qi Deficiency. The red and dry
tongue, blindness, seizure and elevated serum bile acids indicate Liver Yin Deficiency.
Poor appetite, occasional vomiting and weak pulse indicate Spleen Qi Deficiency.
Spleen Qi Deficiency can be secondarily caused by Liver Yang Rising due to Liver Yin
Deficiency (the Wood over-acts the Earth).
The Liver Yin Deficiency may have resulted from Kidney Jing Deficiency. The cat had a
severe developmental problem as a kitten, thus he was likely born with weak Kidney
Jing. The Kidney (Water) is the mother of the Liver (Wood). If the mother is weak, she
fails to nourish the child.
The treatment should focus primarily on the Liver and secondarily on the Spleen. After
the Liver and Spleen problems are fixed, the treatment should include the Kidney. The
acupoints BL-18, BL-20, KID-3 and SP-6 are recommended treatments. In addition, the
herbal formulas Yi Guan Jian (to nourish Liver Yin) and Xiang Sha Liu Jun Wan (to tonify
Spleen Qi) may be used. Afterwards, Epimedium Powder (Sheng Jing San) may be
used to treat the Kidney.
58 CHAPTER TWO
Case 2.7
Signalment: A six year old, male, Arab-Trakehner cross-breed
This horse has previously been treated with acupuncture for allergies. He is allergic to
molds and experiences intense pruritis. The horse will even self-mutilate his chest and
ventral abdomen.
He seems to have a very "Yang" personality, as he is a bit hyperactive. The allergy
problem tends to appear in the Spring.
Where there is itching, there must be Wind. Both Wind and springtime are associated
with the Wood element. In addition, a hyperactive, Yang personality may be consistent
with a Wood type of animal.
The TCVM diagnosis is Wind Heat with Liver Yang Rising. Some suggested
acupuncture points to help dispel the Wind and to sooth the Liver include GB-20, LIV-3,
LIV-4, BL-10, LI-10, LI-11, and LI-4. Xiao Yao San is an herbal medication that can be
used before spring to soothe Liver Qi and to prevent Liver Yang rising. When it is close
to springtime, Fang Feng Tang can help to clear Wind Heat.
Case 2.8
Signalment: An eleven year old, Quarter Horse gelding
This horse has had chronic front foot soreness. He has not been completely sound for
three years. Radiographs of his right front foot revealed multiple problems. There are
some changes in the navicular bone of his right foot. It is also a slightly "clubbed" foot,
and there is an angle problem in the pastern.
This horse was very fearful for a long time. He was difficult to catch and he would
tremble when caught. He became calm and less fearful with the herbal medication, Shen
Calmer (Modified Tian Wang Bu Xin Dan).
He was fat in the crest of the neck, and his eyes were red and draining. The gelding
appeared to have Cushings disease; however, he did not have colic, laminitis, or long
hair. His tongue is red, dry and darker on the edges. His pulses are weaker on his left
side.
The TCVM diagnosis is Liver Heat with Kidney Yin Deficiency. The sore foot, the red
eyes and the darker edges of the tongue indicate Liver Heat. Navicular bone changes,
fear and a weak pulse on the left side indicate Kidney Yin Deficiency. Liver Heat can be
caused by Yin Deficiency. Liver Heat can lead to Blood Stagnation and result in the sore
foot.
The oral herbal medication, Long Dan Xie Gan Tang, may be beneficial in this case. If
the foot is very painful (Blood Stagnation), Four Herbs Salve (Si Sheng Gao) may be
added topically for two to three weeks. This herbal medication works very well for
navicular disease and other severe sore foot problems.
60 CHAPTER TWO
Case 2.9
Signalment: A five year old, female, spayed Sheltie
She is scared and panics during thunderstorms or loud noises. She is very outgoing and
sweet with strangers.
She has had a two-year history of reoccurring interdigital cysts. The red, firm, swollen,
and painful areas are located on the left rear and right front paws. A change to
hypoallergenic diet resolved the redness on the bottom of her paws, but the cysts
continued. Examination by specialists, several surgical procedures, and medications did
not resolve the problem.
Her diet is supplemented with Vitamins E and C and fatty acids. The dog has normal
feces, normal thirst, normal urination, and no gastrointestinal complaints. She seeks cold
floors to sleep on; however, she is not restless at night nor does she pant excessively.
Her skin and hair coat are normal. She has a large scar on her left lumbar area from a
bite wound three years ago. (The scar is lateral to the area of BL-24/25.) She has been
healthy other than the interdigital cysts. The areas on the two paws where the cysts
were removed are just slightly swollen, red, and cracked with a little clear, red, odorless
discharge.
She was not sensitive at any alarm points. Her tongue was pink to red, a little dry, and
had faint cracks. Pulses were normal to a little deep. The pulses may have been a little
weak, especially in the Heart and Lung positions.
Her personality is Fire. The problems with the paws may be considered part of the Wood
element. The red and swollen cysts indicate Heat. Firm and painful cysts indicate Blood
Stagnation.
Her TCVM pattern may be considered Liver Heat with Blood Stagnation. The
recommended herbal medications are Long Dan Xie Gan Tang and Max Formula
(Modified Nei Xiao San). The acupuncture points LIV-3, LIV-2, SP-10, LI-11, and LI-4
are recommended in this case to help sooth the Liver, nourish Blood, and eliminate
Heat.
Case 2.10
Signalment: A ten year old, neutered, male Golden Retriever and Shepherd crossbreed
Twelve days previously, this dog was in a raccoon fight and he received bite wounds on
his face. Eleven days after the fight, the owners noticed significant stiffness in the hind
legs. He also developed orange, watery diarrhea.
He is very attached to the owner and becomes anxious and panics when she is not
around. He tolerates other people and dogs well, but he only makes efforts to please his
female owner (as opposed to her husband). He does not seem aggressive, but when
there is something going on he wants to be part of it. For this reason, gets bitten first
when chasing raccoons. Overall, he tends to be fairly high strung, but he will settle down
especially if the owner gives him a massage.
He prefers soft surfaces such as a dog bed instead of hard ones such as a rug on the
floor. The dog shows no preference for sun or shade. His thirst and urination are normal,
but he will pant a lot. This dog always has a great appetite and would overeat if allowed.
He is not an overly vocal dog, but he will always bark at any noise outside. This dog
shares the house with another dog and a cat with which he has no difficulties. He loves
to roll in rotten animals and to get dirty.
Lately, he has been very healthy with normal feces, urination, and hair coat and with no
recent history of medical problems. However, three years ago, he fought with a raccoon
and suffered bite wounds all over his lips. He subsequently developed coonhound
paralysis ten days after the incident. During the illness, the dog had a weak to absent
bark. Three days after the onset of clinical signs (stiffness), he suffered from flaccid
paralysis. He seemed to make a complete recovery, although it was 75 days before he
was able to stand up on his own. There appears to be a residual trembling of his hind
legs since that time.
At the current presentation, the dogs vaccine status was noted to be current for Rabies
and Distemper-Hepatitis-Leptospirosis-Parainfluenza-Parvovirus (DA2LPP). The dog
was panting and nervous. His tongue was pink/red without a coating. The pulse was
normal to slow and very strong, almost bounding. He was weak in the hind end, and the
neurological examination was consistent with lower motor neuron disease in the hind
end. No problems were noted in the front end. The cranial nerve function appeared
normal.
The next day, the dog was worse, but he could still get up and walk. His front legs were
involved, and there was a dramatic bowing out at the elbows. There were lower motor
neuron signs in the front end as well.
62 CHAPTER TWO

He is not an Earth type because he does not seem to be laid back. Also, he is highstrung and is nervous/pants during the physical exam. Because he is not relaxed and
laid-back, he is NOT typical of Earth.
He is not a Wood type because he is NOT the boss or the dominant dog. The Wood dog
loves or tends to boss around the other dogs or cats. This dog, however, seems
untroubled with other animals, and he leaves them alone.
He is NOT a Metal type because he is not clean and aloof.
He is NOT Water because he not afraid of other creatures; he is the first to fight with the
raccoon. Being the first one to go to the action, such as fighting, is definitely NOT a
Water trait.
Most likely, this is a Fire dog. A Fire dog tends to become excitable or anxious and will
panic. For the fire dog, it is very important to be part of any event including barking,
playing and even fighting.
The raccoons saliva is considered a Toxin in TCVM. The toxin invades the body and
then it consumes or damages the Qi or Yin. Consequently, a Qi or Yin Deficiency
occurs. Weakness in the hind limbs and diarrhea indicate Qi Deficiency. Panting or
nervousness in the exam room and a red tongue indicate Yin Deficiency.
The TCVM treatment strategies are to dispel the toxins, to tonify Qi, to strengthen the
rear weakness, and to nourish Yin. Acupuncture points at the tip of the tail and the ears
can be used to dispel toxins in acute cases. Additional useful acupuncture points include
LI-4, ST-40, ST-36, Bai Hui, Shen Shu, KID-1, GB-34, GV-1, Liu Feng, KID-3, and SP-6.
Electroacupuncture and aquapuncture may also be beneficial. The herbal formula Bu
Yang Huan Wu Tang may be useful to tonify Qi and strengthen the rear weakness in this
case.
Self Test
Question 2.1: Which is the correct order for the Sheng (promoting) Cycle?
a. Wood J Fire J Metal J Water J Earth
b. Wood J Metal J Water J Fire J Earth
c. Wood J Fire J Earth J Metal J Water
d. Wood J Earth J Water J Fire J Metal
e. Wood J Fire J Water J Metal J Earth
Question 2.2: Which is the correct order for the Cheng (over-control) Cycle?
a. Wood J Fire J Metal J Water J Earth
b. Wood J Metal J Fire J Water J Earth
c. Wood J Fire J Earth J Metal J Water
d. Wood J Earth J Water J Fire J Metal
e. Wood J Earth J Metal J Water J Fire
Question 2.3: The Season Spring belongs to which element?

a. Wood
b. Earth
c. Fire
d. Water
e. Metal
Question 2.4: The Climate Damp belongs to which element?

a. Wood
b. Earth
c. Fire
d. Water
e. Metal
Question 2.5: The color red belongs to which element?

a. Wood
b. Earth
c. Fire
d. Water
e. Metal
64 CHAPTER TWO
Question 2.6: The fearful emotion belongs to which element?

a. Wood
b. Earth
c. Fire
d. Water
e. Metal
Question 2.7: The direction West belongs to which element?

a. Wood
b. Earth
c. Fire
d. Water
e. Metal
Question 2.8: The nose belongs to which element?

a. Wood
b. Earth
c. Fire
d. Water
e. Metal
Question 2.9: The Fu organ Bladder belongs to which element?

a. Wood
b. Earth
c. Fire
d. Water
e. Metal
Question 2.10: The bodily secretion saliva belongs to which element?

a. Wood
b. Earth
c. Fire
d. Water
e. Metal
Question 2.11: A dog has a history of chronic ocular discharge and a hyperactive
personality. According to the Five Element theory, which organ is most important?
a. Spleen
b. Lung
c. Kidney
d. Liver
e. Heart
Question 2.12: According to the Five Elements, which organ should be tonified when the
Lung is deficient?
a. Heart
b. Kidney
c. Liver
d. Spleen
e. Bladder
Question 2.13: According to the Five Elements, which organ should be cleared (sedated)
when the Heart is in excess?
a. Liver
b. Kidney
c. Spleen
d. Lung
e. Bladder
Questions 2.14 and 2.15 are based on the following case.

Pete is a ten year old male Labrador Retriever who has a history of weakness and back
pain for several years. Three weeks ago, Pete fell down several times. After prednisone
therapy, the acute paresis seemed under control; however, he would no longer get up to
urinate and would occasionally fall down. He was also very thirsty, but ice cubes seemed
to help. A veterinary neurologist examined him and diagnosed chronic multifocal
intervertebral disc disease (spondylosis deformans at C7-T1, T13-L1, L1-L3, and L7-S1).
The owner does not want to pursue the surgical treatment approach.
Pete is a very friendly and excitable dog. He has been with the current owner since he
was a puppy. He never acted aggressively towards humans or animals except for one
instance when the owner returned home very late at night. According to the owner, he
prefers cool or cold conditions. He wags his tail and is nice to everybody. During a
TCVM examination, he fell down four times, rested for a short while, got up again, and
walked across the slippery floor from the front room to the exam room (the whole
distance is about 20 meters). Pete is overweight. He panted a lot while in the exam
room, and he tried to avoid the acupuncture needling several times. The tongue is red
and dry. The pulse is fast, thready and very deep/weak. The TCVM Diagnosis is Bony Bi
syndrome due to Yin Deficiency.
66 CHAPTER TWO
Question 2.14: What is Petes constitutional type?

a. Wood
b. Earth
c. Fire
d. Metal
e. Water
Question 2.15: If Pete is an Earth dog, why does he show panting and restlessness
during the examination?
a. He has Excess Cold
b. He is Deficient Cold
c. He has Yang Deficiency
d. He has Yang Excess
e. He has Yin Deficiency
Question 2.16 and 2.17 are based on the following case.

Chief is a nine year old, male, castrated Japanese Chin dog with a history of chronic
congestive heart failure and bronchitis. He was hospitalized due to lethargy, weakness
and anorexia. Diagnostics revealed azotemia due to chronic renal failure (BUN: 88;
Creatinine: 6.9). He was also diagnosed with mild pancreatitis and cervical disc disease.
Chief is a very confident and dominant dog. He does not fear anything, not big or small
dogs, strangers, or thunderstorms. He loves to be in charge. He was very cooperative
during the examination and acupuncture procedure. His nose was dry with a little crack
line. His tongue is deep red and dry and his pulse is thready and thin. Chief prefers cool
environments. His Shen is subdued. He eats well but is not thirsty. Chief also always
holds his neck, back and hind limbs as if he feels pain or feels unhappy. He is reluctant
to lower his head to eat or drink so the owner must lift the bowl to his mouth.
Question 2.16: What is Chiefs constitutional type?
a. Wood
b. Fire
c. Earth
d. Metal
e. Water
Question 2.17: What is the TCVM Diagnosis for him?
a. Yang Excess
b. Yin Deficiency
c. Excess Cold
d. Excess Heat
e. Deficiency Cold
Question 2.18 is based on the following case.

Fireman is a 17 year old Quarter Horse-Thoroughbred cross gelding. He was diagnosed
with navicular disease of the left front limb. Fireman is a friendly, sensitive and smart
horse. He loves to be petted and touched but he becomes irritable and shows
restlessness as soon as he realizes you will needle him. He is sensitive to acupuncture
needling as well as the regular injections.
Fireman used to be the submissive to another horse (a 20 year old gelding who was the
only other horse to share the pasture) until the old gelding died. The old gelding was
always his boss. One year later, Fireman had a little pony to share the same pasture. He
started to boss him around. He kicked and controlled the little pony. When the little pony
left, a mare about his same age shared his pasture. He started to boss her around. The
owner is very close with Fireman as she owned him since he was born. She often gives
him treats. She rides him for pleasure about once or twice a week. He loves to run and
play, but will let the mare go first if there is something unfamiliar ahead.
His left front lameness was grade 2 to 3. His tongue was purple and pulse was fast. The
sensitive points on palpation using a needle cap include LI-18, LI-15, LI-16, BL-18 and
19, PC-1, BL-13 (worse at left side). The TCVM diagnosis is Qi and Blood Stagnation of
the front foot (front foot lameness).
The horse was responding well after each treatment (3 to 5 weeks apart). He became
completely sound after the 3rd acupuncture treatment. He had two episodes of mild left
forefoot soreness six months and one year later, which resolved with acupuncture and
herbal medicine.
Question 2.18: What is Firemans personality?
a. Wood
b. Fire
c. Earth
d. Metal
e. Water

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What is the constitutional type of Pete?

What is the constitutional type of Pete?

Why does Pete show panting and restlessness during the examination if he is an 'Earth' dog?

Why does Pete show panting and restlessness during the examination if he is an 'Earth' dog?

TRADITIONAL CHINESE VETERINARY MEDICINE

TRADITIONAL CHINESE VETERINARY MEDICINE

Huisheng Xie, DVM, PhD

Copyright 2002 by Jing Tang

Huisheng Xie and Vanessa Preast

Printed in Beijing, China

Huisheng Xie, DVM, PhD, MS

ABOUT THE AUTHORS

Case Examples ...................................................................................................................... 18

Four Pathological Cycles of the Five Elements...................................................................... 35

The Five Constitutional Types of Animals.............................................................................. 38

The Five Elements in Diagnosis............................................................................................. 44

Three Treatment Strategies of the Five Element Theory....................................................... 45

Strengthen the Grandchild Element for Prevention.......................................................................... 45

Body Fluid (Jin Ye)................................................................................................................. 87

Case Examples ...................................................................................................................... 91

Relationships among the Five Zang Organs........................................................................ 123

The Fu Organs ..................................................................................................................... 129

The Bladder .......................................................................................................................................130

The Extraordinary Fu Organs............................................................................................... 131

Case Examples .................................................................................................................... 133

The Eight Extraordinary Channels ....................................................................................... 194

Fourteen Regular Channels ................................................................................................. 202

Self Test ............................................................................................................................... 205

Internal Etiologic Factors...................................................................................................... 218

Secondary Etiologic Factors ................................................................................................ 224

Other Etiologic Factors......................................................................................................... 227

Pathology ............................................................................................................................. 229

Case Examples .................................................................................................................... 241

Hearing and Smelling........................................................................................................... 267

Inquiring ............................................................................................................................... 273

Palpating .............................................................................................................................. 275

Palpation of Body Regions ................................................................................................................292

Application of TCVM Diagnostics in Practice ....................................................................... 294

Six Channels Patterns.......................................................................................................... 380

Four Stages.......................................................................................................................... 390

San Jiao Patterns................................................................................................................. 398

Pathogen Patterns ............................................................................................................... 409

Qi, Blood and Body Fluid Patterns ....................................................................................... 430

Channel Patterns ................................................................................................................. 451

Dai (Girdle) Channel ......................................................................................................................... 460

Self Test ............................................................................................................................... 463

Treatment Strategies............................................................................................................ 473

Eight Treatment Methods..................................................................................................... 476

External Therapy with Herbal Medicines.............................................................................. 481

Knowing others is wisdom;

Traditional Chinese Veterinary Medicine may initially be quite foreign to Western-trained

YIN AND YANG

The Concept of Yin-Yang

Figure 1.1: Yin and Yang diagrams

Figure 1.2: The Eight Trigrams

Figure 1.3: An example of three hexagrams

YIN YANG THEORY 3

Figure 1.4: A Pictorial view of the Yin-Yang aspects of Phenomenon

The Yin-Yang nature of a phenomenon or event is not absolute; it is relative. This

YIN YANG THEORY 5