CAM presentation

1. History of Traditional Chinese
Medicine
JOAN WALTON

2. 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

3. 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

4. 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

5. 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.

6. 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

7. 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

8. 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

9. 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

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

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

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

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

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

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

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

17. 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.

18. Academic Medicine and Systemic Therapeutics
(AD 960-1368)
 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

19. Academic Medicine and Systemic Therapeutics
(AD 960-1368)
 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

20. 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

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

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

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

24. 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.

25. 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