Basic Theory of Traditional Chinese Medicine (TCM)

Introduction to Traditional Chinese Medicine (TCM) Theory

Traditional Chinese Medicine (TCM), in its 5000 year history of development, collected, documented and summarized the experience of the Chinese people in fighting against Disease. Although its theory is rich and complex, the treatments are effective and practical. In the presence of advanced western medicine technology, Traditional Chinese Medicine modalities are still widely used within China because of its important and amazing clinical curative effect. Today in China, many hospitals are using dual Western and Chinese Medicine to prevent and cure diseases. Many hospitals have both Chinese Medicine and Western Medicine Departments working together. When diseases that have no cures in Western medicine are encountered, Chinese Medicine is employed in treatments to help cure or to extend the quality of life of patients.

The origination, formation and development of the theoretical system of Traditional Chinese Medicine (TCM)

Traditional Chinese Medicine (TCM) originated in ancient times. In early prehistoric society, ancient Chinese people began to accumulate medical knowledge. In Chinese classics “Shennong, the Divine Farmer, tasted hundreds of herbs and was poisoned more than seventy times a day”. These records indicate that the early ancestors of the Chinese made great efforts to explore medicine in their life and work.

The Spring and Autumn Period (771-464 BC) and the Warring States (463-221 BC)

In the Spring and Autumn Period and the Warring States, medical experience was further enriched. Medical knowledge was passed on from earlier generations and expanded. “Huang Di Nei Jing”, The Yellow Emperors Internal Classic is the earliest extant medical canon in China, symbolizing the formation of a theoretical foundation to the Chinese Medicine system.

“Huang Di Nei Jing” is a written collection of medical practice records and experience passed on from previous generations. It summarized and synthesized knowledge into the theories of yin-yang and the five elements. It systematically explained the physiology and the pathology as well as the diagnosis, treatment and prevention of Disease. Subsequently, it established a unique Traditional Chinese Medicine (TCM) theoretical system and laid a solid foundation for ongoing TCM theoretical and clinical development.

Nanjing (“Canon of Difficult Issues”), another important medical classic written after Huangdi Neijing, systematically explained the main contents of Huangdi Neijing in the style of questions and answers and supplemented what were seen as inadequacies in the Huangdi Neijing. Nanjing proposed and explained a number of important ideas such as pulse taking, which further expanded the theoretical basis of TCM.

The Han Dynasty (206 BC–220 AD)

Towards the end of the East Han Dynasty, Zhang Zhongjing wrote “Shanghan Zabing Lun” (Treatise on Exogenous Febrile Disease and Miscellaneous Diseases), the first monograph on clinical medicine. He emphasized syndrome differentiation of the six meridians (taiyang, shaoyang, yangming, taiyin, shaoyin and jueyin) and syndrome differentiation of the viscera as the principles for the differentiation of syndromes. Zhang formulated therapeutic methods and prescriptions for the diagnosis and treatment of exogenous and endogenous diseases and was considered the “sage of medicine” by later generations.

The Jin (265–420) 晋朝 and Sui (581–618 AD)Dynasties (581–618 AD):

In the Jin Dynasty, Wang Shuhe wrote “Maijing” (Canon of Pulse), the first monograph on diagnostics of TCM in China.

In the Sui Dynasty, Chao Yuanfang compiled the first monograph on pathogenesis and symptomology.

The Tang (618-907), Song (960-1279), Jin (1115-1234) and Yuan (1271-1368) Dynasties

In the Tang Dynasty, Wang Tao wrote “Waitai Miyao” (Medical Secrets of An Official) and Sun Simiao wrote “Beiji Qianjin Yaofang” ( Valuable Prescriptions for Emergency) which summarized the theoretical study and clinical practice made before the Tang Dynasty.

From the Song Dynasty to the Jin and Yuan Dynasties, various schools of medicine appeared, promoting the development of TCM from different perspectives. Liu Wansu, Zhang Congzheng, Li Gao and Zhu Danxi were the best-known representatives of the four medical schools of the Jin-Yuan dynasties:

  • Liu Wansu (the school of cooling) believed that “fire and heat” were the main causes of diseases and that diseases should be treated with cold and cool nature herbs. His theory was known as “the school of cooling” by later generations;
  • Zhang Congzheng (the school of purgation) believed that all diseases were caused by exogenous pathogenic “evil” factors and advocated that pathogenic factors should be expelled by means of diaphoresis, emesis and purgation. Expelling of pathogenic factors ensures the restoration of healthy qi and the cure of disease, so his theory was known as the “school of purgation”
  • Li Gao (the school of strengthening the Spleen and Stomach / the school of reinforcing the earth) held that apart from external causes, internal impairment of the spleen and the stomach would bring about various diseases and therefore emphasized that the most important aspect of clinical treatment should be the building up and regulating of the spleen and the stomach. He was regarded as the founder of the “school for reinforcing the earth”.
  • Zhu Zhenheng / Zhu Danxi (the school of nourishing Yin) believed that “yang is usually redundant while yin is frequently deficient” and that yin deficiency and fire-exuberance were the most commonly encountered syndromes. Clinically he emphasized the principle of nourishing yin and reducing fire for treatment of diseases. His theory became known as the “school for nourishing yin”.

Though different from each other, these theories enriched Traditional Chinese Medicine (TCM) and promoted its development because they all progressed from theory to effective clinical practices. That is why they were called “the four great physicians of the four schools of the Jin-Yuan Dynasties” by later generations of TCM practitioners.

The Ming (1368-1644) and Qing (1644-1911) Dynasties

In the Ming and Qing Dynasties, Wenbing (seasonal febrile disease), a new branch in TCM theory, first appeared.

WuYou Ke at the time of the Ming Dynasty first proposed the idea that the cause of pestilence was different from “liu yin” (six pathogenic factors / evil qi). He believed it was “a special pathogenic factor in nature”. This was a new explanation of pestilential “infectious febrile disease”.

In the Qing Dynasty, Ye Tianshi, Xue Shengbai, Wu Jutong and Wang Mengying made extensive studies of the route of infection, pathogenesis and pathological changes of seasonal febrile disease through clinical practice.

Ye Tianshi and Wu Jutong futher developed the method of diagnosing and treating seasonal febrile disease by establishing the differentiation of syndromes according to the Theory on Wei (Defensive Qi), Qi (Vital energy), Ying (Nutrient Qi), Xue (blood) and the Theory of Sanjiao (triple energizer), so as to systematize the theoretical systems of aetiology, pathogenesis, pulse diagnosis, syndrome differentiation and treatment for febrile diseases.

Wang Qingren wrote “Corrections on the Errors of Medical Works”. He emphasized anatomy and he corrected anatomical errors in the medical classics. He further developed the Theory on Blood stasis as the cause of diseases and presented methods of treatment of syndromes caused by blood stagnation.

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