history of traditional chinese medicine powerpoint

J O A N W A L T O N

History of Traditional Chinese Medicine

Several Perspectives

History based on ancient mythology of Chinese Medicine deducted from the study of ancient texts and records

Archaeological evidence and textual materials produced extravagant interpretations which sought to establish the ancient character of certain Chinese medical practices

The birth of medicine attributed to the legendary emperors Fu Xi, Shen Nong and Huang Di

Legendary and Semi-Mythical Origins

Mythically linked to 3 emperors

Fu Xi-Ox Tamer (ca. 2953 BC)- Taught people how to domesticate animals and divined the Ba Gua which are eight symbols that became the basis for the I Ching (Yi Jing) or Book of Changes

Shen Nong- Divine Husbandman or Fire Emperor (2838-2698 BC)- considered the founder of agriculture and the originator of herbal medicine in China, taught plant cultivation, livestock raising and learned the therapeutic properties of herbs and substances through taste

Legendary and Semi-Mythical Origins

Huang Di- Yellow Emperor (2698-2598 BC)-considered the Traditional Chinese Medicine originator and the Father of the Chinese Nation, taught the Chinese how to make wooden houses, silk cloth, boats, carts, the bow and arrow, ceramics and introduced the art of writing. According to legend, he attained these skills through visitations with immortals. Today’s version of TCM is 1st expressed in his work “ Yellow Emperors Inner Classic” which is divided into 2 books

The Yellow Emperor’s Inner Classic

First compiled around 200-100 BC and is critical to Chinese medicine legend and practice

Consisted of 2 books:

Simple Questions (Su Wen)- concerned with medical Theory such as Ying Yang principles, the 5 phases and the effects of seasons

Spiritual Axis (Ling Shu)- deals mostly with acupuncture and moxibustion

Texts are mostly dialogue between the emperor and his ministers. Qi Bo was the most famous minister for his role in curing sickness, testing drugs and writing books on medicine and therapeutics.

Qi Bo Explains the Orderly Life of Times Past

Ancient Medicine: 2205-206 BC- little known about Chinese medical practice before 200 BC

Shang dynasty (1766-1121 BC) 1st dynasty having clear archaeological evidence documented by the succeeding dynasty showing some form of therapeutic activity in response to illness

Developed the 1st scripts

Defined social relationships such as the king, his nobility and the people who were no longer nomadic

Developed central Chinese culture ideas such as the relationship between the living and the dead, the ritualized reverence of ancestors and oracle bone use to consult ancestors for advice on many issues including illness treatment

Zhou Dynasty

Became one of the longest dynasties Caused by political conflict with Chinese speaking descendants of

the Shang Established a pattern of governance that would characterize Chinese

society-a central government working in relation to smaller principalities

Continued the tortoise shell oracle practices of the Shang rulers with the aid of the wu (shaman)

Shaman acted as an intermediary between the living and the dead, participated in ritual court activities, weather activities and combated illness causing demons

The emergence of acupuncture may have been the result of the shaman practice of chasing evil spirits out of towns and homes with spears in addition to the 5th century AD needling techniques of the physician Bian Qu

The Warring States Period

Became at the end of the Zhou dynasty

Marked by political strife and social upheaval

Two philosophers emerged during this time

Kong Fu Zi (Confucius)

Lao Zi (Lao Tzu)

Their ideas concerning social and natural order have had a lasting impact on Chinese culture

Medicine began to view the human body as no longer a subject to the whims of spirits and demons but as a part of nature and subject to recognizable natural relationships

The Flowering of Chinese Medicine (206 BC-AD 907)

The Han empire established (206 BC-AD 220)

Created a stable aristocratic social order, expanded geographically and economically

Chinese political influence spread throughout Vietnam and Korea.

Chinese people began to refer to themselves as the Han

Great development occurred including the integration of the Confucian doctrine, elements of yin and yang and the five-phase theory


Early texts of this period recovered dating to 168 BC

Discussed magical and demonological concepts, ideas about yin and yang in relation to the body and channels in the body.

Text mention moxibustion and the use of heated stones

No mention of acupuncture or specific body points

Appearance of the first known formal presentation of individual medicinal substances called The Divine Husbandman’s Classic of the Materia Medica


The Classic of Difficult Issues (Nan Jing) was compiled sometime during the 1st and 2nd century AD

Attributed to the legendary physician Bian Qu

Influenced Chinese medicine practice and its practice in Japan

Organized theory and practice of therapeutic acupuncture systematically in terms of body structure, illness, diagnosis

Almost entirely devoid of magical elements

Known as a commentary on The Inner Classic


Zhang Zhong Jing wrote The Treatise on Cold Damage and The Survey of Important Elements from the Golden Cabinet and Jade Container (Jin Gui Yao Lue) during the 2nd century AD.

Mostly philosophical Chinese medical text Viewed disease from a clinical standpoint Emphasized physical signs, symptoms, disease course, treatment

method and the action of the substance used similar to The Classic of Difficult Issues

Placed special focus on fevers due to the common occurrence of villager deaths related to fever epidemics.

Texts remained relatively obscure until the Sung dynasty (after AD 960) during which medical thinkers realized the similarity of these concepts of diagnosis and therapy in relation to their own concerns

Largely influenced herbal medicine practice in Japan


Hua Tou (AD 110-207)-near legendary figure in Chinese medicine

Acupuncturist, herbalist and surgeon

Adaptation of animal postures is an early form of qi gong

Successfully practiced surgery through the use of plant anesthetic properties

Use of surgery faded with the departure of Hua Tou

Minor surgery for growths, hemorrhoids, castration and wound healing continued


Huang Pu Mi (AD 215-286) wrote the Systematic Classic of Acupuncture (and Moxibustion)(Zhen Jiu Jia Yi Jing)

Text had extensive influence over the acupuncture traditions of China, Korea and Japan.

Text presented and reorganized material from The Inner Classic and earlier texts.

Histories of individual physicians and text reflect the medicine of the literate elite of China excluding eighty percent of the total population which consisted of farmers, peasants and farming villages

Life for these individuals was one of bare subsistence They worked extremely hard to stay at this level and were completely

dependent on the soil and the weather Lacked exposure to formal education and were generally illiterate Little is known about what they knew or thought Their traditions were regionally oriented and full of folk superstition and

historical legend Aspirations dominated by the hope of survival.


Non-literate traditions of the Chinese people were explored by some authors of material medica- 1st

systematic publication of this material followed the Qing.

Most folk herbal and medical tradition exploration occurred under the guidance of the post revolutionary government of China

Resulted in texts such as The Barefoot Doctors Manual

The Han dynasty fell in AD 220 following 30 years of strife and religious rebellion by Daoist sects

This resulted in another long period of division in China.


For a short period in AD 589 the Sui dynasty reunited China The Sui dynasty was followed by the Tang dynasty, considered by

many to be the height of cultural development in China The Sui spread China’s influence as far as Mongolia, Vietnam,

Central Asia, Korea, and Japan. Buddhist and Daoist strongly influenced medical thought during

this time. Sun Si Mian (AD 581-682) was a famous physician, prolific author

and scholar well versed in Daoist and Buddhist practice Became known as the first medical ethicist in China following the

writing of “On the Absolute Sincerity of Great Physicians” in addition to many other works.

In this book he addresses the need for diligent scholarship, compassion towards patients and high moral standards in physicians

Academic Medicine and Systemic Therapeutics(AD 960-1368)

Medicine was more specialized by the time of the Sung dynasty and efforts were made to integrate past insights systematically

Number of texts published during this dynasty may have exceeded the number written during all the previous dynasties

1027 Wang Wei Yi oversaw the casting of 2 bronze figures he designed to illustrate acupuncture point locations one of which was used at the Imperial Medical College.


Advances made in herbal therapeutics Several herbal texts compiled with illustrations during the Sung

dynasty. Herbal tastes and properties assigned based on the yin and yang

nature. Functions assigned based on the herbs nature and its ability to treat

specific symptoms Efforts made to systematize herbal therapeutics Increasing interest in Zhang Zhong Jing writings due to his

systematic application of traditional theoretical principles in the use of herbal medicine

Treatise on Cold Damage was revived influencing medicine for the next several hundred years

Sparked the development of warm induced disease theory (wen bing xue) during the Ming dynasty


Formal physician education began

The Imperial College (trained emperor’s physicians) expanded

1076 Imperial Medical College founded (enrolled 300 students) in addition to regional schools

Jin and Yuan dynasties saw the continuation of specialized medical thought and independent inquiry

Most of current Chinese medicine comes from the Sung, Jin and Yuan dynasties

Physicians developed ideas during this period were based on the elaboration of therapeutic approaches from earlier theory

Ideas supported the application of 5 phase theory in relation to seasonal influence, supplementing the body, purging the body to eliminate evil influences and supplementing the yin

Medicine in the Ming and Qing Dynasties (AD 1368-1911)

Physicians continued to pursue lines of inquiry from previous dynasties such as the far-reaching naturalistic exploration of Li Shi Zhen (1518-1593)

His Grand Materia Medica (Ben Cao Gang Mu) included discussions of 1892 substances

Continued exploration of more precise connections between disease causation factors and therapeutics

Several medical sects emerged Towards the end of the Ming dynasty Yan Ji Zhou wrote The

Great Compendium of Acupuncture and Moxibustion (Zhen Jiu Da Cheng) which became one of the most influential acupuncture texts

Ming dynasty considered the peak of the cultural expression of acupuncture and moxibustion in China


Intellectual trends of the Ming continued into the Qing dynasty

Ye Tian Shi’s The Discussion of Warm Disease (Wen Re Lun) complemented Zhang Zhong Jing’s method of diagnosing and treating cold induced diseases using similar systematic methods to diagnose and treat those caused by heat

Political, economic and social trends during the Qing dynasty lead to western knowledge, technology and science exposure increasing the isolation of the residing Manchu rulers and broadening cultural horizons and medical inquiry

The combined effects of this exposure shook the classical underpinnings of Chinese medical thought

Lead to the 1822 elimination of acupuncture from the Imperial Medical College


At the close of the Qing dynasty in 1911, political and cultural institutions were in a state of decline

Scattered traditional Chinese medicine practitioners were increasingly under fire from the advocates of a contemporary China and its modern medicine.

Republic formation following the collapse of the Qing left traditional medicine open to the conquering influence of Western medicine which caused the elimination of the Imperial College of Physicians


Western-educated medical system reform advocates began to work towards the elimination of the traditional medicine of China replacing it with Western medicine

Resulted in a series of clashes and encounters from 1914 through 1936 concerning the regulation, establishment or elimination of practitioners of Chinese medicine.

The traditional medicine of China, or “medicine” (yi) became know as “Chinese medicine” (zhong yi)

Disliked by nationalist and Marxist reformers

So-Called Chinese Medicine

New Chinese Medicine rejects manifestly “unscientific” ideas Views yin/yang and the 5 phases as naïve and ancient

containing elementarily dialectic ideas This view resulted in the creation of zhong yi as contemporary

Traditional Chinese Medicine Chinese Marxists used aspects of zhong yi to build a strong

medical infrastructure Zhong yi exists parallel to western medicine today using

biomedical concepts along with Traditional Chinese medicine Acupuncture and herbal medicine are emphasized in

educational programs Care is delivered in large hospitals in addition to in and

outpatient services, private clinics and pharmacies.

References

Micozzi, M.S. (2011) Traditional Medicine of China, Fundamentals of Complementary and Alternative Medicine 4th Edition, p.373-380, Saunders Elsevier, St. Louis, Missouri

history of traditional chinese medicine powerpoint

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