Written language in China is said to have first appeared 3,785 years ago in 1766 BC during the Shang Dynasty. However, those early texts describe medical practices from over 2,000 years prior. So it can be argued that, in various states of sophistication, Traditional Chinese Medicine (TCM) has existed for over 5,000 years. Discover more about the people, experiences, and influences that developed the TCM we know today.
Philosophy Behind TCM
Much like the evolution of Western medicine, the philosophy behind Traditional Chinese Medicine can’t be credited to a single person. Rather than coming from a singular source, the ideas were added from many different elements of Eastern philosophy. These continued to evolve and expand as new information and experience came to light.
Many of the ideals woven into TCM are seen as being drawn from similar ideologies in the religious practices of Taoism, Confucianism, and Buddhism. Just as these religions are able to exist in harmony in China, so can they in Traditional Chinese Medicine. In addition to religious practices, there have been many TCM specialists focusing on medicinal herbs, acupuncture, and other pillars of TCM responsible for the innovation of information and technique.
Prevention Over Cures
A central theme in TCM is the idea that prevention of disease is more important than curing an existing one. It was believed that it was easier and better overall to maintain good health than it was to exist mindlessly and only address an issue when it arises. This idea of prevention is so ingrained into the Chinese culture that it was viewed as a doctor’s primary responsibility. In the older times, there was typically only one doctors in each town. Their job was to keep everyone well and avoiding illness. If sickness broke out, many times the doctor would be shamed or viewed as a failure.
The classic TCM text, Nei Jing outlines this point:
“The sages of antiquity did not treat those who were already sick, but those who were not sick. When a disease has already broken out and is only then treated, would that not be just as late as to wait for thirst before digging a well, or to wait to go into battle before casting weapons?”
This philosophy is still very present in modern practice of TCM. Practitioners take time to understand the full realm of a patient’s lifestyle and concerns in order to pinpoint diagnoses. They can make short and long-term suggestions for acupuncture, herbal remedies, and diet and lifestyle changes that are designed to keep you healthy. The biggest development is that we tend to avoid shaming our TCM practitioners when we do get sick.
Important Texts of TCM
The practice of TCM has been catalogued in several foundational texts. These books outline the basic principles of TCM along with specific details on medicinal herbs, acupuncture, tui na, cupping, dietary and lifestyle habits, and more.
Huang Ti Nei Ching
The Huang Ti Nei Ching is said to have been officially written down in the 3rd century BC. It’s designed as a catalogue of the conversations between the Yellow Emperor, Huang Ti, and his physician Chi Po. Because of this, many view the book as a cross between a historical retelling and medical guide. The Emperor Huang Ti’s source of knowledge is still surrounded in mystery. It is said that he obtained much of the knowledge in the book directly from gods and immortal beings.
This classic text contains information on the principles of yin and yang, the Five Elements, and information on the zang fu (organ systems). Information on the nine needles of acupuncture is also included, often said to be Huang Ti’s most important contribution to TCM. It’s important to note that researchers are almost positive that additional information was added to the text in later dynasties as new information unfolded. There are two key sections of the Nei Ching; the Su Wen (or Essential Questions) and the Ling Shu (Spiritual Axis).
Part one is the majority of the book and covers those foundational elements of Chinese medicine from the philosophy to the medical conditions. Part two is more supplemental in nature. The Ling Shu dives deeper into the concepts of Tao and Confucianism, covers making diagnoses and specifics on examining the pulse.
Nan Jing: The Classic of Difficult Issues
The Nan Jing: The Classic of Difficult Issues aimed to flesh out the work presented in the Huang Ti Nei Ching. It also addressed some difficult subjects that had been previously unanswered and shrouded in mystery. Specifics on acupuncture points and moxibustion are two key areas of clarification. Notes about the physiological and pathological connections and conditions relations to the eight Extra Vessels was also included.
It’s interesting to note that as years passed, slight modifications to the Nan Jing were made. In the Tang dynasty, important additions and edits were made to the Nan Jing to help make the book easier to understand. The core messaging of the piece, however, was left untouched.
Shennong Bencao Jing
The Shennong Ben Cao Jing is considered the original, legendary piece written on herbs and plants. Supposedly based on the teachings of Shennong (The Divine Farmer), who is described to this day in China with mysticism and respect. Many drawings and statues depict him as a recluse, with two horns and clothing made of leaves. It’s said that he is the reason the people gave up a meat-based diet and transitioned to more grains and vegetation.
This book is also referred to as the Divine Farmer’s Classic of Materia Medica. In it, 365 different medicinal herbs are categorized and described. They are divided between three categories. Within the “upper herbs” there are 120. There are also 120 “middle herbs”, and 125 “lower herbs”. Though this text is generally agreed to have been written around the same time that Christ was alive, later than other TCM books, Shennong is still viewed as the Father of Chinese Medicine.
Bencao Gangmu (Compendium of Materia Medica)
This TCM literature was released In 1578 by Li Shizhen. The author was a medical expert of the Ming dynasty. It took Shizhen a reported 27 years to compile the research into a completed volume. The Bencao Gangmu (Compendium of Materia Medica) contains in-depth information on 1,892 medicinal herbs and their uses. It also breaks down about 11,000 different combinations and prescriptions of these herbs to treat for specific conditions. It is often viewed as the most comprehensive book on TCM ever written.
Where Did the TCM Fundamental Ideas Come From?
Though there are several books outlining the practices of TCM, many of these were simply transcribed versions of centuries-old oral teachings. The way of Chinese medicine would be passed down from generation to generation. Because of this, the root of who discovered each of the fundamental ideas of TCM and why can seem a bit muddled. Here’s what we know about the origins of yin and yang, the zang fu, acupuncture, herbal remedies, and other philosophies of TCM.
Yin and Yang
It’s believed that the teachings of Taoism shine a light on many of the specifics surrounding yin and yang. One of the inherent lessons of Taoism is that humans are part of nature and need to create a harmonious relationship with it in order to maintain health. Since nature changes throughout the year, reflected by the four seasons, so must we as humans adapt to maintain harmony.
This idea is reflected in the TCM book, Nei Ching. It provides guidelines for the best way to orient your lifestyle in each season for optimal health. Winter is marked as the time of year when yin energy is most strong, and summer when yang is highly powerful. Because of this, it’s important to create a balance with your choices of either yin or yang to offset the extremes of the seasons.
For example, in the summer, it’s advised to wake up early and go to bed late. Because people have the most energy during this season, they should spend as much time outdoors and active as possible. Fresh fruits and vegetables, and chilled food options containing yin can be eaten during this time. In the winter, however, the Nei Ching advises going to sleep early and wake up late. The teachings suggest that you should conserve your energy as it’s more easily drained in the winter. Food should be eaten warmed or slow cooked to help boost yang.
The Zang Fu
The zang fu is the Chinese name for organ systems. In TCM, it’s believed that the organs work together in pairings to establish internal balance. There are 10 primary organs, half of which are yin and the other yang. They are matched up according to function and used as clues for TCM practitioners when making a diagnosis. These zang fu organs include:
- Spleen and Stomach
- Lung and Large intestine
- Kidney and Bladder
- Liver and Gallbladder
- Heart and Small intestine
The way in which the organ systems are described are said to be heavily influenced by the teachings of Confucius. This school of thought is known to center on station and order. Many of the teachings use many military terms and titles when describing function and orientation of the world we live in and what it should look like. In the same way, the zang fu are described by militant titles as well.
The Heart is viewed as the “Supreme Ruler” or “Emperor”, while the Liver is viewed as the “commander”. The Stomach is sometimes said to be the “official in charge of public granaries”. The entire body, in fact, is referenced as the “court”. If the Heart, or Emperor, becomes imbalanced, the entire body, or court, will be threatened. This is in reference to the monarchy and their courts. If the king or emperor had an issue, then everyone had an issue. Similarly, the Heart’s connections to the other organs means that it is often one of the first areas to be examined.
Acupuncture is one of the key treatment options available under Traditional Chinese Medicine. Today, it’s practiced using very long and thin needles that are strategically placed in the skin. After making their diagnosis of a person’s condition, the acupuncturist or TCM practitioner will put together a series of points along the meridian channels that need to be stimulated. Every needle that is inserted in the body is said to help reestablish a balanced flow of qi, or energy. After the needles are placed, they’ll remain in place for anywhere from 15 to 45 minutes before being removed.
Though the practice today is structured and regulated, it’s believed that the first acupuncture was practiced in a much wilder time; the Stone Age. Some believe that sharp stone tools and knives were used to fix disease and pains. While it’s likely that these folks were only practicing primitive surgery, some think that they might have also felt changes and unusual feeling in other parts of the body as well.
Though an integral part of TCM, acupuncture is not said to be exclusively a Chinese practice. In fact, acupuncture has traces linked to many different Asian countries. However, the Chinese were the group who committed the most energy and effort into tracking research and new innovations of acupuncture. Over many years of trial and error, it was discovered that the acupuncture points could be used to treat issues directly nearby or deep within an internal organ. It was also discovered that the effects of needling along certain meridian pathways resulted in therapeutic stress-relief.
Herbal Remedies of TCM
Another pillar of treatment in TCM, herbal remedies can be prescribed by a TCM practitioner as part of a treatment plan. The medicinal herbs can be taken in many different ways; as a tea, in a supplement capsule, a topical mixture, tincture, or directly with food. As noted above, there have been thousands of medicinal plants, herbs, and animals studied and catalogued over several thousand years.
The origins of these herbs in Chinese medical understanding is similar to that of other ancient societies. In the early days of nomadic peoples and early settlements, trial and error was the name of the game. As people tried different plants, likely as part of a meal, they began to notice certain effects and changes in their bodies. This developed into an understanding of the physical reactions to the herbs. Over time, specialist healers became keepers of this knowledge, treating others and passing on their knowledge to successors.
This information and experience was eventually written down into several books on TCM as listed above. While some of these books make mention of the many shamans and healers who passed down the knowledge, others reference information coming from deities and higher powers speaking through a human. In modern times, many Western medical doctors and researchers have studied the herbs listed in these volumes, to various degrees of success.
The Spread of TCM to the West
So how did TCM find its way across the globe? Despite its long history in the East, use of Chinese medicine was slow to spread. It wasn’t until the 19th century California Gold Rush that large numbers of Chinese people began to migrate to the United States looking for work opportunities. While they brought their practice of TCM with them, it didn’t catch on within the United States.
It wasn’t until the 1970’s that Traditional Chinese Medicine began to come onto the Western world’s radar. The practice was first written about in national media by James Reston of the New York Times. In 1971, he had been traveling in China with another reporter, Henry Kissinger, and fell ill with acute appendicitis. While he had emergency surgery, his postoperative treatments included acupuncture. He was impressed with the results and documented his experience for the Times.
Since then, TCM has become better understood and more widely used in the United States and Europe. The practice of Chinese medicine itself has also continued to evolve, transitioning from local healers passing down their knowledge to accredited higher education degrees being required for practitioners. Today, there are over 50 masters-level programs and more than 3 doctoral-level programs for TCM practitioner training.