About Traditional Chinese Medicine
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.
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.
The History of Traditional Chinese Medicine
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, and 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, etc. Some terminology was derived from symptoms such as tinnitus, diarrhea, and insomnia. However, most of the diseases were named after affected parts such as head, eye, ear, nose, and skin diseases. According to Mr. Hu Houxuan, “man in Shang Dynasty named 16 kinds of diseases.” For example, the diseases of the head, eye, nose, ear, mouth, teeth, throat, abdomen, foot, and toe, as well as urinary, obstetric, gynecologic, pediatric, and infectious diseases, that cover almost all aspects of internal and surgical medicine today, including diseases of the brain, ophthalmology, ear, nose and throat diseases, dentistry, urology, obstetrics and gynecology, pediatrics, infectious diseases, etc.
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, diseases due to pathogenic wind, abdominal masses, scabies, rabies, epidemic diseases, etc.; 12 were named after symptoms and signs such as 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 13 classics, recorded over 180 kinds of diseases and symptoms. The above-mentioned works show the depth at which humankind’s understanding of the disease has grown, as well as the medical practical experience, thus providing a foundation for the formalization of medical law and the formation of its theoretical system.
The Development of Traditional Chinese Medicine
The development of natural sciences is always interrelated since they promote and benefit from each other. Therefore, the development of TCM is inseparable from the achievements of ancient science and technology in China. The development of astronomy, the calendar, meteorology, agriculture, mathematics, and other disciplines, 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 changes in climate on health.
The formation of the theoretical system of TCM possesses a profound philosophical origin. When systematizing long-term medical experience, ancient doctors purposely applied ancient materialistic dialectical viewpoints, such as the theory of vital essence and Qi, the Yin and Yang theory, the Five Elements Theory, and so forth. This application transformed scattered and fragmented medical experience into a systematic and complete system. This change was gradually done by inducing, summarizing, analyzing, and synthesizing the experience, which resulted in heightening the empirical knowledge into theories.
The formation of the theoretical system of TCM is symbolized 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 Periods and the Warring States Period. 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.
The Classics of Traditional 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 providing the diagnosis, prevention, and treatment of disease. Deliberately combining natural science with philosophy, the classic provides an in-depth interdisciplinary approach to medicine. The classic was considerably advanced for its time and contributed greatly to the world of medicine. Skeletal descriptions, as well as those of the blood vessels, the 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 in physiology are great, as is information regarding the integral relationship between physiology and pathology.
Another classic still plays 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 A.D.) Treatise on Cold Attacks and Miscellaneous Diseases, and he further expounded upon the medical achievements of his forefathers while integrating his own clinical experience. 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 analyzing 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 and future abundance of clinical Chinese medicine. The Treatise on Cold Attack and Miscellaneous Diseases 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.
The Synopsis of Prescriptions of the Golden Chamber puts forward: “There are only three causes for all diseases: the first, exogenous cause, 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 a sexual indulgence, bites by insects and beasts, and trauma,” This text further advanced the etiological theory in the Yellow Emperor’s Internal Classic by analyzing the symptoms and signs according to the pathological mechanism and theory of Zang-Fu organs. 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 summarizes the 24 kinds of pulse conditions and their related principal diseases, which made 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. It details the causes and symptoms of numerous diseases and is an important source for reference. The Key to Therapeutics of Children’s Diseases, compiled by Qian Yi, was another pioneer in the development of the treatment for diseases of the Zang-Fu viscera, being based on symptom and syndrome differentiation. A more concrete summary of the causes of diseases was displayed in Chen Yan’s Prescriptions Assigned to Three Categories of Pathogenic Factors of Diseases. It focuses on internal factors of the disease: the impairment caused by the seven emotions, as well as external factors: the impairment induced by the six climatic evils in excess, or of untimely occupancy. It also focused on the non-endo exogenous: impairment due to improper diet, epidemics, bites by insects and beasts, poisoning, trauma, etc. This type of classification corresponds more with clinical reality and has become a new development in TCM etiology.
The Schools of TCM
Each generation of doctors continues to study the past medical experiences found in books such as the ones mentioned above. And each generation builds upon past information, creating richer and more developed theoretical ideas while gradually forming various types of schools of TCM. For example, influenced by the theory of the five elements and six kinds of climatic factors, the eminent physician Liu Heiian, during the Jin and Yuan Dynasties, emphasized the theory that the diseases caused by the six kinds of climatic factors could become heat-fire evils in the body. He also believed that the heat and fire of the six kinds of climatic factors were the most important pathogenic factors thus explaining the pathological mechanism of heat-fire evils.
Zhang Congzheng advocated that the 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 the internal injury of the spleen and stomach, thus explaining the theory of the ascending and descending of the spleen and stomach and creating the theory of relieving high fever with drugs consisting of sweet flavour and warm nature. Zhu Zhenheng advocated the theory that Yang is always in excess while Yin is always deficient. This further developed the theory of ministerial fire and enriched the theoretical system of TCM. In addition, there was Zhang Yuansu’s theory of the pathological mechanism of viscera and Zhang Jing Yue’s explanation of Yin Yang, the kidney and vital gate, etc. 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 symbolized the understanding and study of febrile diseases reaching a new level. Wu Youke, a physician in the Ming Dynasty, wrote the Treatise on Pestilence and offered the theory of pestilence evil, which was the first systematic exploration of the etiology and therapeutics of febrile diseases. This laid the foundation for the development of the theory of febrile diseases. During the Qing Dynasty, many books regarding febrile diseases were compiled, some of which are the Treatise on Tropic Febrile Diseases written by Ye Tianshi; The Treatise on Differentiation and Treatment of Febrile Diseases written by Wu Jutong; The Treatise on Damp-Heat Diseases authored by Xue Shengbai, and A Compendium on Febrile Diseases completed by Wang MengYing.
Within the books listed above, the authors have systematically summarized the pathogenic laws of exogenous febrile diseases during the Ming and Qing Dynasties, making a breakthrough in the traditional understanding that “all febrile diseases belong to cold attacks”, thereby creating 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 triple jiao. This completed the theoretical system in such aspects as pathogenesis, pathology, pulse diagnosis, treatment, etc. A great contribution to the enrichment and development of the theoretical system of TCM was made. It is necessary to point out that 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.
Modern-Day Traditional Chinese Medicine
Great progress has been made in the development of TCM within the last 60 years. There has been an enhancement in the systematization 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, meridians, etc. 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 modernizes its concepts.