About Traditional Chinese Medicine
A Heritage of Two Millennia
Encompassing thousands of years of history, Traditional Chinese Medicine (TCM) is a summary of the accomplishments that comprise an important cultural component within China’s cultural mosaic. TCM has flourished under the influence and guidance of its ancient materialism and dialectics to evolve into the major medical theoretical system it is today. Succeeding in numerous clinical tests, it has had remarkable contributions to healthcare and the prosperity of the Chinese nation.
Bursting with youthful vigour, TCM has drawn increasing attention and interest from medical circles worldwide. The fundamental reason is that TCM has a track record of successfully solving practical problems and is wrought with valuable clinical experience bearing marked curative effects. Grounded solidly in scientific ideology, and in accord with the objective laws of physics, TCM is a subject of interdisciplinary study encompassing a wide range of scientific theories.
I.
How Traditional Chinese Medicine Works
TCM is a subject that deals with physiology and pathology, as well as the diagnosis, prevention, and treatment of disease. TCM considers the body of a person and the natural world as an inseparable whole. Using the method of synthetic analysis, TCM from the macroscopic point of view studies the dynamic intrinsic relationships of the body and the relationship between interior and exterior environments, and then makes clear basic physiology to serve medical practice.
After long-term medical practice and revision — as well as thousands of years of clinical tests and improvements — TCM has evolved into a unique medical system with very special ways of diagnosis, theory, and medication.
TCM is based on laws, concepts, and theories that encompass a widespread theoretical system, including the Yin and Yang theory, the theory of the Five Elements, Zang-Fu organs, the meridian theory, pathogenesis of diseases, pathology, diagnostics, syndrome differentiation, disease prevention, and therapeutic principles. It is these basic theories that provide the theoretical basis upon which to build a deep understanding of medicine, and the tools necessary to probe into the theoretical systems of TCM.
II.
The History
Spring & Autumn · Warring States · Shang
The development of TCM theory dates back to the Spring and Autumn Period and the Warring States in Chinese history. This period was a time of separation between the kingdoms, resulting in the remarkable development of politics, economy, science, and culture. Great academic thoughts emerged — due to the relaxing of totalitarianism, the drastic social change, and the academic ideology of the materialist dialectical ideology of Yin and Yang, as well as the Five Elements theories that became public. During this time, favourable conditions were met for the formation of the theories of TCM.
This provides the practical foundation for the development of the theories of TCM. Its origins lie in the very beginning of human activities; since the 21st century B.C., there has been a deepening in the understanding of diseases.
Slowly, the study of the art of Chinese medicine has progressed. The first use of technical words was added during the Shang Dynasty, resulting from an interpretation made using inscriptions found on tortoiseshell. Some examples of technical words are abdominal mass, scabies, tympanitis, dental caries, and so on. Some terminology was derived from symptoms such as tinnitus, diarrhoea, and insomnia. However, most of the diseases were named after affected parts — head, eye, ear, nose, and skin diseases. According to Mr. Hu Houxuan, “man in the Shang Dynasty named sixteen kinds of diseases.”
During the Western Zhou Dynasty, Spring and Autumn Period, and the Warring States, humankind had more understanding of the nature of diseases. The Mountain and Sea Classic recorded 38 types of diseases, out of which 23 were given technical terms such as jaundice, blockage, abdominal masses, scabies, rabies, epidemic diseases — and 12 were named after symptoms and signs (abdominal pain, sore throat, vomiting, deafness, and the like). Discovered in the excavation of the No. 3 Han Tomb at Mawangdui, Changsha, Prescriptions for 52 Kinds of Diseases listed a total of 103 disease names, signs, and symptoms. According to incomplete figures, The Book of Changes, The Book of History, The Book of Odes, and others of the thirteen classics recorded over 180 kinds of diseases and symptoms. The above-mentioned works show the depth at which humankind’s understanding of disease has grown.
III.
The Development
The development of natural sciences is always interrelated; they promote and benefit from each other. The development of TCM is inseparable from the achievements of ancient science and technology in China. The development of astronomy, the calendar, meteorology, agriculture, and mathematics laid a solid multidisciplinary foundation for the formation of the theories of TCM. For instance, Yi He, a famous ancient doctor, presented “the theory of Six Kinds of Climatic Factors,” which demonstrated that ancient people understood the inevitable effect of abnormal climatic change on health.
The formation of the theoretical system of TCM possesses a profound philosophical origin. When systematising long-term medical experience, ancient doctors purposely applied ancient materialistic dialectical viewpoints — the theory of vital essence and Qi, the Yin and Yang theory, the Five Elements theory. This application transformed scattered and fragmented medical experience into a systematic and complete system. The change was gradually done by inducing, summarising, analysing, and synthesising the experience — heightening empirical knowledge into theory.
The formation of the theoretical system of TCM is symbolised by the first publication of the Yellow Emperor’s Internal Classic. The classic summed up the medical achievements and clinical experiences of Chinese medicine during the Spring and Autumn Period and the Warring States. This text established the theoretical basis and principle of TCM, and derived many ideas from the achievements of astronomy, biology, the creation of the calendar, geography, anthropology, psychology, and ancient philosophy. This theoretical system is still guiding the clinical practice of TCM today.
IV.
The Classics
Foundational Texts of Chinese Medicine
Using the theories of vital essence and Qi, Yin and Yang, and the Five Elements as theoretical methods and holistic concepts, the Yellow Emperor’s Internal Classic explains the laws of life and the unity of the body with the natural world. It provides a systematic discussion of anatomical formation, viscera, meridians, physiology, and pathology — as well as the diagnosis, prevention, and treatment of disease. Deliberately combining natural science with philosophy, the classic provides an in-depth interdisciplinary approach to medicine. Skeletal descriptions, blood vessels, morphology of internal organs, circulation, and blood physiology are still of academic importance today. Contributions providing an understanding of the multiple functions of Zang-Fu organs are great, as is information regarding the integral relationship between physiology and pathology.
Another classic still playing an important role in present-day clinical practice is the Classic on Medical Problems, which appeared before the Han Dynasty. It expounded on and supplemented the difficult questions posed by the Yellow Emperor’s Internal Classic and was a contribution to the basic theory of TCM.
Throughout the Han Dynasty, TCM made even further progress. Using the Yellow Emperor’s Internal Classic and the Classic on Medical Problems as a foundation, an outstanding physician — Zhang Zhongjing — wrote the first clinical medicine treatise during the Eastern Han Dynasty (150–219 AD): Treatise on Cold Attacks and Miscellaneous Diseases. Within the treatise, a system of treatment based on syndrome differentiation and the principles of medical theory, therapeutic methods, prescriptions, and medication in clinical practice was established.
Arising from his methods of analysing and differentiating exogenous diseases and internal miscellaneous diseases in accordance with the six pairs of meridians and eight principles was a solid foundation for the development of clinical Chinese medicine. The treatise was subsequently rearranged by Wang Shuhe and divided into two books: The Treatise on Cold Attack and Synopsis of Prescriptions of the Golden Chamber. The former included 397 diagnostic and therapeutic methods and 113 prescriptions; the latter listed 25 volumes and 265 prescriptions.
Synopsis of Prescriptions of the Golden Chamber puts forward: “There are only three causes for all diseases: the first, exogenous, is that the evils invaded from the meridians transmit into the viscera; the second is that the evils invaded from the four limbs and nine orifices transmit into the blood vessels and result in stasis and stagnancy; the third consists of such pathogenic factors as sexual indulgence, bites by insects and beasts, and trauma.” This text further advanced the etiological theory.
Another text — A B Classic of Acupuncture and Moxibustion — was written by Huang Fumi, a famous physician in the Jin Dynasty, who also offered a deeper understanding of the meridian theory. The Pulse Classic is a text by Wang Shuhe and summarises the 24 kinds of pulse conditions and their related principal diseases — a contribution to the development of Chinese traditional sphygmology. The General Treatise on the Causes and Symptoms of Diseases, compiled by Chao Yuanfang during the Sui Dynasty, is the first treatise of TCM on pathology. The Key to Therapeutics of Children’s Diseases, compiled by Qian Yi, was another pioneer in the development of treatment for diseases of the Zang-Fu viscera based on symptom and syndrome differentiation. Chen Yan’s Prescriptions Assigned to Three Categories of Pathogenic Factors of Diseases classified causes into the impairment of the seven emotions, the six climatic evils, and the non-endo exogenous — a new development in TCM etiology.
V.
The Schools
Each generation of doctors continues to study the past medical experiences found in books such as the ones mentioned above. Each generation builds upon past information, creating richer and more developed theoretical ideas while gradually forming various schools of TCM.
Influenced by the theory of the Five Elements and the six kinds of climatic factors, the eminent physician Liu Heijian, during the Jin and Yuan Dynasties, emphasised the theory that diseases caused by the six climatic factors could become heat-fire evils in the body. Zhang Congzheng advocated that diseases were caused by exogenous evils which should be expelled using the methods of diaphoresis, emesis, and purgation. Li Dongyuan held that diseases were mainly brought about by internal injury of the spleen and stomach, explaining the theory of ascending and descending of the spleen and stomach. Zhu Zhenheng advocated the theory that Yang is always in excess while Yin is always deficient, further developing the theory of the ministerial fire.
In addition, there was Zhang Yuansu’s theory of the pathological mechanism of viscera and Zhang Jingyue’s explanation of Yin Yang, the kidney, and the vital gate. All of the above theories have enriched and developed the theoretical system of TCM.
The theory of febrile diseases deals with the pathology, diagnosis, and therapy of febrile diseases. In the period of the Ming and Qing Dynasties, the School of Febrile Diseases was developed. This symbolised the understanding of febrile diseases reaching a new level. Wu Youke, a physician in the Ming Dynasty, wrote Treatise on Pestilence and offered the theory of pestilence evil — the first systematic exploration of the etiology and therapeutics of febrile diseases.
During the Qing Dynasty, many books regarding febrile diseases were compiled — Treatise on Tropic Febrile Diseases by Ye Tianshi, The Treatise on Differentiation and Treatment of Febrile Diseases by Wu Jutong, The Treatise on Damp-Heat Diseases by Xue Shengbai, and A Compendium on Febrile Diseases by Wang Mengying. The authors systematically summarised the pathogenic laws of exogenous febrile diseases — making a breakthrough in the traditional understanding that “all febrile diseases belong to cold attacks” — and created the principles of differential diagnosis and treatment of febrile diseases on the basis of the theories of Wei, Qi, Ying, and Xue, as well as the triple jiao.
The theories of both cold attacks and febrile diseases are two major schools that supplement each other and play an important guiding role in the clinical practice and studies of TCM.
VI.
Modern-Day TCM
Great progress has been made in the development of TCM within the last sixty years. There has been an enhancement in the systematisation and research of the basic theories of TCM. The application of modern science and technology towards the understanding of the essence of Chinese medical theories has displayed remarkable achievements in such areas as the nature of Yin deficiency and Yang deficiency, the essence of cold and heat, the essence of kidney and spleen, and the meridians.
Great interest has been aroused in medical circles worldwide. Through the advancement of its fundamental theories, the area of TCM study as a whole continuously develops and modernises its concepts.
At Huatuo Clinic
The whole of this inheritance — the Yellow Emperor, Zhang Zhongjing, the febrile-disease masters of the Qing — is what we draw upon in every consultation. We translate that tradition into a contemporary clinical setting: a careful interview, palpation and pulse, and a treatment built from acupuncture, herbal medicine, moxibustion, and dietary guidance refined visit by visit.