I. Ascending, Descending, Floating, and Sinking of Traditional Chinese Medicine:
The "ascending, descending, floating, and sinking" properties of traditional Chinese medicine (TCM) reflect the functional characteristics of medicinal herbs, indicating their directional effects within the human body. Diseases, in terms of pathogenesis and clinical manifestations, can exhibit tendencies such as upward movement (e.g., vomiting, coughing, and wheezing), downward movement (e.g., diarrhea, abnormal uterine bleeding, and organ prolapse), outward movement (e.g., spontaneous sweating and night sweats), or inward movement (e.g., external contraction with blocked exterior). Consequently, medicinal substances that can alleviate or eliminate these pathological conditions are relatively endowed with the properties of "ascending, descending, floating, and sinking." The definitions of these medicinal properties are derived from long-term clinical observations.
Similar to the four natures and five flavors of traditional Chinese medicine, the concepts of ascending, descending, floating, and sinking are also relative. Ascending and descending are relative, as are floating and sinking. Ascending refers to the property of rising, descending refers to the property of sinking, floating refers to the property of dispersing, and sinking refers to the property of purging.
According to the definition of efficacy: drugs that generally have the effects of raising yang and promoting exterior release, dispelling wind and dispersing cold, inducing vomiting, and opening the orifices can all ascend and move outward, and their medicinal properties are ascending and floating; whereas drugs with effects such as purging downward, clearing heat, promoting urination and draining dampness, calming the mind with heavy substances, suppressing yang and extinguishing wind, dispersing food stagnation, descending counterflow, astringing, and relieving cough and asthma can all descend and move inward, and their medicinal properties are descending and sinking.
However, not every traditional Chinese medicine has only one directional property; some special herbs can exhibit bidirectional effects. For example, Ephedra can both induce sweating and relieve asthma and promote diuresis; Chuanxiong can both "ascend to the head and eyes" and "descend to the sea of blood"; Cinnamon twig can both induce sweating and relieve exterior syndromes, as well as calm rebellious qi and lower adverse flow. The marvel of traditional Chinese medicine is evident here.
The ascending, descending, floating, and sinking properties of Chinese medicine are directly related to the four natures and five flavors. For instance, ascending and floating herbs mostly possess a pungent flavor and warm or hot nature; descending and sinking herbs mostly have sour, bitter, salty, or astringent flavors and a cold or cool nature. Therefore, Li Shizhen stated, "Sour and salty flavors do not ascend; pungent and sweet flavors do not descend; cold nature does not float; hot nature does not sink." Of course, this is only a general rule and should not be taken as absolute.
In addition, the ascending, descending, floating, and sinking properties of traditional Chinese medicine can also be altered through artificial processing. For example, stir-frying with wine enhances ascending properties, stir-frying with ginger juice promotes dispersion, stir-frying with vinegar facilitates astringency, and stir-frying with salt water promotes descending. Furthermore, in the formulation of prescriptions, the effects of other herbs can be used to moderate the specific properties of a particular herb. For instance, to prevent excessive lifting by Astragalus, Fructus Aurantii and Malt can be added as counteragents; to mitigate the overly strong qi-suppressing effect of Hematite, Ginseng and Licorice can be used as counteragents.
II. Channel Tropism of Traditional Chinese Medicine:
The meridian tropism of traditional Chinese medicine refers to the fact that drugs are adept at treating diseases in a specific part of the human body or in a particular meridian (in terms of the six-meridian syndrome differentiation), which is relatively similar to the so-called targeted therapy in modern medicine. For example, Platycodon grandiflorus and almonds are good at treating chest tightness, cough, and asthma, so they belong to the lung meridian; scorpions are good at treating convulsions, so they belong to the liver meridian; cinnabar can calm the mind, so it belongs to the heart meridian, and so on.
However, the channel tropism of traditional Chinese medicine is only a broad definition of its medicinal properties and cannot specifically reflect the efficacy characteristics of the drugs, such as cold, hot, warm, cool, ascending, descending, floating, and sinking. Therefore, when prescribing medication for clinical symptoms, various characteristic factors of traditional Chinese medicine must be comprehensively considered.
