History of Chinese Medicine

Introduction 

Over time, Complementary and Alternative Medicine (CAM) has gained immense precedence among practicing physicians all over the world. While their effectiveness and usage remain a debate among people, different forms of complementary alternative medicines have come up including the most famous option: The Traditional Chinese Medicine (TCM). Considered the most widely accepted alternative medicine among westerners, TCM continues to influence western medicine; especially, the prevalence of procedures such as acupuncture. Through extensive literature reviews, writings concerning the methods of traditional Chinese medicine among them the historical backgrounds, education, development, acupuncture and herbal medicine continue to surface shedding more light on ancient Chinese medical procedures. As such, this paper takes an in-depth look at the development of traditional Chinese medicine. Through commencing with a review of the texts in which Chinese medicine is based, the paper delves deeper into describing the branches in which Chinese medicine is based and finally its history. Overall, having a strong bearing on the journey of the evolution of Chinese medicine, this paper conveys the phenomenon of Chinese medicine.

Section 1

Book One: Huang Di Nei Jung (Huang Ti Nei Ching) 

The title of this book translates to The Yellow Emperor’s Classic of Medicine. As the title suggests, this is an ancient treatise written concerning both disease and health by the Chinese emperor Huangdi prior to the year 2600 BC (Curran, 2008). Inasmuch as most historians agree to this premise, Huangdi is thought to be a mystical figure, and many ancient enthusiasts predate this record. Whatever origin this masterpiece assumes, its influential nature as a work of reference for practitioners in the field of Chinese medicine continues to make strides even in the modern era. This record takes the form of discussions between Huangdi and his doctor, whereby, Huangdi incessant inquiries concern the nature of his disease, treatment, and health. Among the major ideas of the book is the Taoist philosophy that declares that the key to a life that is long and full of life is through following the way of the Tao, or the universe’s way, which is the natural way. This book also stipulates that illnesses and the abundance of health are typically caused by the imbalance of this two fundamental processes; the yin and yang; and the influence of the five elements on the body organs. These elements include earth, metal, wood, fire, water. Other ideologies spread by the group also included the interconnectivity of body organs. Such interdependence and interconnections included strange facts presented in the book such as the fact that the spleen “ruled” over the lungs; the lungs were connected with the skin; and the interconnected nature of the heart and body pulse.

Book Two: The Mei Jing (Mo Ching) 

This book surfaced around the same time as Huang Di Nei Jing. While still following the Taoist way of spiritual and health enlightenment, this record gave birth to diagnosis, as we know it today. Intricate details in these records denote the process of carrying out diagnosis through pulse taking. Pulse taking is a complex process that involves taking into account various factors such as season, time of the day, and sex of the patient. The book also denotes treatments such as the taking of drugs, acupuncture, diet, and enlightening the patient towards an understanding of Taoist principles. While numerous ideas concerning the physiology and anatomy of the human body may sound outdated and primitive among contemporary readers, these were advances in medicine at their time. Such comprehension brought to various light methods of treating the human body. Throughout time Mei Jing, principles have reverberated throughout the medical world resulting in cures where westernized medicine has failed. This reliance has given Chinese medicine and in particular this record, immense strength and widespread influence

Presently, the Mei Jing is not only a source of reference for those interested in traditional Chinese medicine, but it also presents fundamental ideas that appeal to those interested in comprehending relations concerning the practice and customs of medicine. The Mei Jing has full recognition of the fact that for all individuals, the body processes follow certain precise natural rules. Moreover, another rule states that the natural processes of aging, as well as the influence of various environments subsequently, follow health and disease. In Mei Jing, all these versatilities of health and well-being need to be understood to come up with accurate diagnostics, and specific treatments for conditions. The record is written in a style that is straightforward with minimal explanatory footnotes. More recently, readable versions have become available; and these embody the true spirit of traditional Chinese medicine.

Book Three: Nan Jing 

The Nan Jing also referred to as the Classic of Difficult issues or the Huangdi Bashiyi Nanjing, translated as the Yellow Emperor’s Classic of Eighty-one Difficult Issues, is a book of equal reverence among traditional Chinese medicine practitioners. In reference to the medical tradition that commenced from the Shiji in 91 BC, this book is accredited to the work of Bien Que, an astute physician who flourished between the sixth and third centuries. Through his works, the fountain of knowledge from the Nan Jing was added to the traditions of the Yellow Emperor himself. Through the inclusion of the Nan Jing on the Emperor’s traditions, these records received notoriety as official medical accounts dictating pertinent medical traditions of the Chinese. Until in recent times, the Nan Jing had always had the interpretation of being a commentary to the Huangdi Neijing, elaborating pertinent obscure practices, issues and passages from it. However, although having apparent similarity, the difficult issues are not found in the Huangdi Neijing. Actually, in numerous cases, the prevalent difficult issues cannot be obtained entirely reason being that the Nanjing elaborated medical practice and theories much more clearly and lucidly compared to the Huangdi Neijing and its precursor (Galambos, 2017).

The homogenous structure of the Nan Jing confirms that it is not a thought and idea collection, as was the norm for cases that present early Chinese literary texts. In addition, while various individuals revealing an esoteric and self-inflicted cosmology wrote other texts such as the Huangdi Neijing, over spans of centuries, one individual wrote the Nan-Jing over a specific time. In the texts of the Nan Jing, a critical moment in the history of Chinese medicine takes place. This moment presents itself in the link between medicinal procedures that are archaic and the contemporary standardized concepts that dominated the next two millennia of traditional Chinese medicine. This linkage systematically covered various aspects of medical thought including pathology, the use of needles, medical theories, diagnosis and many more. Through the evolution of information conveyance to patients, this period saw the development of descriptive classification and the clarification of inconstancies.

Book Four: Shang Han Lun 

This book was written by a physician who was regarded as being the greatest physician of all time during the Han Dynasty of 206 BC to 220 AD, Zhang Zhongjing. Many scholars regard the period of the Han Dynasty as the most revered and glorious period of Chinese history of medicine. After the Huangdi Neijing, the Shang Han Lun, meaning the Treatise on Colds and Fevers, has the consideration of being the most significant classic on medicine. Many people refer to Zhang Jiang Zhongjing as the Hippocrates of China. In the medical systems of the Chinese people, the employment of herbal medicine is normally done using intricate formulas. Such formulas need formal follow-ups, and these follow-ups were the basis of the book Shang Han Lun, later divided into two categories of works: Shang Han Lun, translated to the Treatise on Colds and Fevers and the Jin Gui Yao Lue, translated to the Prescriptions of the Golden Cabinet. In spite of the fact that the historical figure behind these texts was a mere human, his enlightenment and in particular, formulas, have gained distinguished notoriety as being of a divine nature. Borrowing from a Catholic perspective, the description of Zhang is that of a Patron Saint of formulas for herbal medicine. For years, Chinese and other physicians practicing alternative medicine have studied Zhang’s work, and gradually, it has become one of the foundations of traditional Chinese medicine.

Book Five: Ben Cao Gang Mu 

Known as the Compendium of Materia Medica, or the Romanization of Ben Cao Gang Mu, these records present Chinese materia medica compiled by Li Shizhen during the Ming Dynasty. The work epitomizes most of the medical materials available in those times. Presently, this record is regarded as the most complete and all-inclusive medical book written concerning the history of traditional Chinese medicine. In this book, all plants, minerals and even animals believed to have properties that are medicinal are listed and explained exhaustively. As such, the text has 1892 entries, with each entry having its name referred to as a Gang, while the Mu in the title refers to each name’s synonym. Most historians recognize this text as a ground breaking medical document. Even the British historian Joseph Needham calls the author “the uncrowned king of naturalists, among the people of China.” Other notable remarks on the Ben Cao Gang Mu include its reference as the greatest scientific achievement of the Ming Dynasty. The book is highly comprehensive with the table of contents alone depicting more than a thousand hand drawn diagrams that serve as illustrations. It contains 53 volumes of which it details intricate lists of herbs for almost all ailments. The main content has close to 2000 herbs of which roughly 400 were included by Li himself. Furthermore, there are more than 11,000 prescriptions for common illnesses most compiled by Li. Overall, the value of this book remains as the foundational basis of traditional Chinese medicine.

Section 2 

The Eight Branches of Chinese Medicine 

Acupuncture and Moxibustion 

As an integral part of Traditional Chinese Medicine, moxibustion is a highly integral aspect of healing. Methods of moxibustion achieved greater levels of recognition and more generalized applications in ancient times than in contemporary life. As vital historical records and sources indicate, ancient literature unearthed revealed that Chinese medicinal practice and patterns of social life within the Qin and Han dynasties relied heavily on the use of moxibustion as a medical alternative. Furthermore, relics such as silk and bamboo documents excavated from the tombs of Mawangdui and Hantanpo also show that in ancient times, large texts relevant to Chinese practices of moxibustion permeated the medicinal world. Moreover, the workings and strategies of moxibustion entail various modalities exploited to form various indications and contra-indications. Over the years, hints have emerged to show and provide support to various hypotheses indicating the influence of moxibustion in the discovery of the discipline known as the meridian. By definition, moxibustion entails an external therapeutic procedure that uses the burning of the moxa stick or cone, producing a warm sensation and moxa smoke on intrinsic acupoints (Huang et al., 2017).

Acupuncture is similar to moxibustion in its therapeutic significance. In acupuncture, instead of using cigars made of moxa to heat the skin, thin needles are employed to bring about healing effects in vital body organs. While theories and practices of acupuncture are considered a form of pseudoscience, their relevance in influencing the medical world cannot be understated. Therefore, as a form of alternative medicine, acupuncture stimulates various areas of the body through the insertion of needles through the skin. This technique yields numerous benefits on the body such as the providence of a drug-free approach to healing; the building of the immunity; improvement of blood circulation; and many more. Besides, when combined with different techniques of moxibustion, the two seamlessly complement each other resulting in benefits such as an increased ability that enables the body to fight off harmful diseases at a quick pace, and the providence of energy to the body.

Exercise (Qigong or Qi) 

As a branch of traditional Chinese medicine, exercise is of great significance. Within the traditions of Chinese medicine, a large emphasis is placed on the implications of self-help in keeping healthy and in effecting recovery from various kinds of illnesses. In traditional Chinese medicine dictates, while the practitioner uses intervening methods such as herbal medicine and acupuncture, sole conscientiousness lies in the hands of the client, their work being to uphold lifestyle issues that have a sound basis on the advice given by physicians and practitioners. In this respect, the practice of Qigong or exercise has been accepted widely as a health care system that integrates breathing techniques, physical postures, and the intentions of a focused mind. Numerous traditional Chinese medicine practitioners consider the incorporation of Qigong as a highly effective treatment form for innumerable conditions within the body. In the East, this form of body treatment has been recognized as a central method of preventing ailments and the prolongation of a healthy life span.

Under traditional Chinese medicine teachings, the employment of exercise as a treatment regime focuses on the cultivation or management of the energy behind the life force. This life force is referred to as Qi. Its management takes place using special techniques of breathing and the combination of both mental concentration and the performance of continuous concentration exercises and still postures that are coordinated and slow in essence. Through the constant performance of these exercises, the blood flow and pressure are kept healthy, and the coordination of physical movements in various body parts becomes efficient. Furthermore, exercise as a form of alternative medicine assures improvements in the efficiency of oxygen delivery as well as the overall equilibrium of the nervous, digestive, hormonal and immune systems. Therefore, exercise remains a fundamental traditional Chinese medication method.

Massage or Tuina 

In the East, especially in China, the practice of massage applications and Tuina is among the most common modalities in the wholesome practice of traditional Chinese medicine. Currently practiced the world over, Tuina continues to gain dominance in many forms. Nonetheless, numerous countries have not yet developed formalized training or legislations for the proper practice of Tunia. This has led various individuals to purport claims to provide professional Tunia while in essence; they do not have full or complete Tuina training. Moreover, the rapid growth and development of Tuina among practitioners and clients alike require proper qualifications. By definition, Tuina refers to a manual technique that aims at augmenting the health of individuals suffering from various clinical conditions. Using techniques such as grasping or Na, and pushing or Tui of the soft tissue, Tuina or massage achieves a state of well-being and overall wholesomeness. In China, the use of these techniques began some 2000 years ago. In ancient times, during the Ming Dynasty, Tuina was formulated empirically, with its developments and achievements being documented in large classical texts such as the Yellow Emperor’s Internal Classic, the Huang Di Nei Jing of 475 to 221 BC (World Health Organization, 2010).

Consistent with the intricate philosophies of traditional Chinese medicine, the medical practice of Tuina is directed through fundamental principles such as the five elements, yin and yang, the identification of patterns and syndromes, and the principle of blood and body fluids. The practice of massage or Tuina incorporates a range of conformist methods of diagnostics such as neurological and orthopedic assessments, laboratory tests, and imaging. Also, under patient management, the inclusion of manual techniques such as patient education, the use of rehabilitative exercises among other therapeutic advice results in the proper address of the needs of Tuina as a traditional Chinese therapeutic procedure. Treatment using this method aims at alleviating particular pertinent medical conditions such as the unblocking of the meridians, the promotion of a proper and adequate circulation of the life force, regulation of functions within body organs, and the augmentation of the body’s resistance to pathogens. This resistance is achieved through manual techniques at specific points within the body or on its surface. In addition, as supplementary therapies, patients undergoing Tuina are asked to perform exercises resulting in the relief of ailments

Nutrition 

At the very foundation of traditional Chinese medicine is nutrition. Through emphasizing on nutritional value in the achievement of health, there is the achievement of harmony between one’s own external and internal environment. The Chinese value of nutrition stems from the very fact that the earliest forms of medicine were food from flora and fauna of their immediate surroundings and sometimes in exotic places such as the mountains, forests, and valleys. In the Chinese culture, fruit vegetables, plants, minerals, and wildlife from various regions were each studied and implemented to provide medicines resulting in the prevention of illnesses due to weather conditions, infections and physical labor. Based on the interaction of food with the uniqueness of people’s constitutions, the use of food on individuals can be therapeutic. The ultimate goal of nutrition in traditional Chinese medicine remains to be the inherent balance of yin and yang and the equilibrium of the flow of Qi throughout the body. While external phenomena such as the occurrence of weather conditions impact our bodies, proper nutrition creates balance within this interaction.

The Chinese believe that specific foods are needed for each season to strengthen and protect the body. On the other hand, one should avoid certain foods so as not to cause disharmony. A good example here is the consumption of cooling and raw vegetables in the summer, which is recommended as an effective strategy in dealing with quite a number of complications. Another example is the contraindication of hot and spicy foods during summer seasons due to their attributes of raising body temperatures and the depletion of body fluids. According to the traditional Chinese medicine dictates, the combination of nutrition with lifestyle habits such as mental and physical activities creates a foundational basis for disease prevention and vitality enhancement. In nearly all Eastern medicine schools, nutrition is taught as a core subject, and it is also emphasized in highly Oriental medical procedures such as Chinese herbal medicine and acupuncture. Practitioners often work to deliver dietary recommendations that align to other branches of traditional Chinese medicine.

Astrology 

The occurrence of both Chinese and Western medicine has always had contentions. While there are numerous common points between traditional western medicine and Chinese medicine, distinct differences separate them. Such differences are innately pronounced in the long-standing concepts of elements. In the Chinese perspective, there are five elements, which are wood, fire, earth, water, and metal. While these five elements contradict the westernized notion of the four elemental principles, that is earth, air, water and fire, the underlying reality is that both the east and the west present elements of astrology in their healing processes. Another astrological perspective is the difference of cultural standpoints on correspondences that are based out of emotions. While the West equates certain emotions to psychological and physiological progress such as the expression of joy, the Chinese, on the other hand, interpret emotion as a source of disharmony if not expressed in the right manner at the right instances. As such, astrology being the study of human eventuality, the control of emotion in treatment processes is of vital importance to the clients and practitioners alike.

In the traditional Chinese medicine, the yin-yang balance is of vital importance. Fundamentally, Chinese medicine is based on Taoism, which is a philosophical approach that is organic and is derived from having a keen inclination to the observance of nature’s patterns. The Chinese believe that the Tao is the true divine way or path through the flow of the universe. Therefore, through the Tao, one has an acute sense of the opposing nature of the yin and yang. Having this comprehension, an individual becomes acquainted with the balance of these interdependent cosmic forces which eventually result in well-being. Through this embodiment of balance between the yin and yang, astrology within the practice of traditional Chinese medicine becomes embodied within all aspects of treatment.

Geomancy and Feng Shui 

Both Feng Shui and Chinese medicine are intertwined since they both originate from ancient Chinese roots. In fact, they are believed to have a root of influence and acute development in the practices of Taoism. Although their eradication was instigated during the times of communism, numerous believers remain staunch practitioners of both these health practices seeking regular services and benefits of each. When translated, Feng Shui means wind and water. Since the meaning of this branch translates to mean the surroundings within a person’s environment, it is the only branch of traditional Chinese medicine which does not involve the body but its surroundings. As an ancient form of geomancy, its practice is related to the earth and is in the form of metaphysical, spiritual or pseudoscientific occurrences. In simpler terms, Feng Shui combines the laws of astronomy, heaven and the earth to come up with newfound positivity for all individuals, an indication of holistic health. Overall, Feng Shui aids in availing to people a model for the arrangement of their environment to a setting that encourages happiness, peace, prosperity, success and health for all. Through the careful analysis of the natural environment, immediate surroundings, and structures that are fabricated, Feng Shui extrapolates the corollaries of these environmental variables. Above all, Feng Shui ensures that one is on par with his or her environment and is not working against it.

Meditation 

In the most basic sense, meditation simply refers to the practice of mindfulness (Shiatsu, 2013). Being mindful requires the conscious effort of being aware of oneself, one’s patterns of breathing and thoughts. Once an individual has achieved this state, a meditative nature that is good for the mind and body ensues. On any given moment or day, people are constantly bombarded with streams of information be it on the television, billboards, the internet, twitter feeds and other numerous distractions. While these distractions and many others are unavoidable and unstoppable, the constant and committed practice of meditation aids in relieving such stressors. In some settings, meditation is normally considered as the initial step one takes in creating worthwhile health. This branch of traditional Chinese medicine takes the form whereby one closes their eyes and focuses on the happenings of the moment. In this process, the mind tends to drift to future events hoped for and past experiences. While one may be tempted to dwell on these thoughts, the proper way of meditation according to traditional Chinese medicine is through shutting down digressing thoughts and the focusing of one’s mind on present thoughts. While there are no general stipulations and practices on correct medication, keeping to the basic rules ensures better health results.

In recent scientific interests, the impact of meditation on the health of various persons has been discussed extensively. First, meditation has profound implications for the reduction of stress, blood pressure, the prevention of psychosomatic disorders, as well as other cardiovascular ailments. Other studies indicate that proper and consistent meditation results in a reduction of chronic pain and other musculoskeletal disorders, dermatological disorders and respiratory diseases. More studies suggest the benefits of meditation on the immune system and the symptomatic treatment of detrimental diseases such as cancer (Marciniak et al., 2017). With all these benefits, meditation remains to be pivotal in the fundamental teachings of traditional Chinese medicine.

Herbology 

Herbology is highly essential in traditional Chinese medicine. As depicted in this form of alternative medicine, the twelve meridians present directional pathways in which the energy flow of Qi channels through the body. As such, the meridians are present and are named according to the organs they correspond to. For example, there are three arms meridians of yin and three arms meridians of yang, which include the heart, the lung, and the large and small intestines. In all these, the primary goal of herbal therapy is to open the energy flow within the 12 meridians fully and to release any stagnancy, subsequently, enhancing health. According to the Chinese, the use of herbs is part of their medical culture and works through internal and external absorption. Their applications are formed and work on the use of various mediums such as powders, teas, pills or even the topical forms. Since Chinese herbs have innumerable properties, functions, and natures, and because they enter the body through various channels, they affect the body in different ways thereby influencing the Qi and the body’s natural balance; consequently, bringing about effects of well-being.

Section 3 

History of Chinese Medicine 

Traditional Chinese Medicine is the oldest form of medicine with only the Egyptian and Babylonian medicine predating it. Its significance and usage even in the contemporary society is a testament to its value and importance. The fact that ancient China was mainly a feudalistic society made up of many states ruled by dynasties meant that the development of TCM was not as a result of a sequential build-up of knowledge. Indeed, the practice of TCM by the Chinese people was mainly influenced by the teacher’s perception. Traditional Chinese Medicine, therefore, plays a critical role in the history of medicine. In fact, the understanding of TCM through the study of its history gives insight into this form of medication and affirms its validity and value as a form of healthcare.

In the last few decades, archaeological discoveries have revealed that during the two centuries of the Han Dynasty, which ran from 206 BC to 23 AD, Chinese medical thought went through a process of drastic change. Such drastic changed included their systematization and standardization. According to the book called the Yellow Emperor’s Classic on Medicine, the first medical compilations surfaced around the first century BC. In reference also to a document aptly named the “Documentation of Chinese “materia medica,” which dates back to around 1100 BC, only a number of drugs had adequate descriptions. By the end of the 16th century, there was the documentation of quite a number of drugs that reached close to 2,000, and by the end of this last century, the records of Chinese Materia Medica (CMM) reached a staggering 12,800 patented drugs. This shows the evolution of the traditional Chinese medicine as it gained precedence among royalties and commoners alike.

Over the years, Chinese medicine has brought about various explanations on the relationship between the environment, humans and the cosmos. Moreover, not only has TCM brought to light this pertinent knowledge, but it has also enabled physicians and practitioners all over the world to understand the intricate dependence of this knowledge in relation to the human body, its pathology, and vitality. These explanations have been possible through the evolution of Chinese medicine, cultivated through the excavation of significant texts such as the aforementioned classics on Nan Jing, Shang Huan Lun among others. In addition, Indian medicine fostered Chinese medical traditions through its emergence and penetration into the Chinese world in the 4th and 8th centuries. Notable influences such as Ayurveda continue to echo in the history books as major Indian influences of Chinese medicine while other texts indicate that acupuncture may have originated from India. Overall, historical physicians such as Li Shizen, Zhang Zhongjing, Tao Hongjing and many more, who existed in the times of the Ming and Han dynasties, continue to indicate the origins and periods of traditional Chinese medicine.

References

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