The history of Traditional Chinese Medicine Spans over more than 5000 years of human history. The Yellow Emperor’s Classic of Internal Medicine, recorded by Qi Bo is the earliest known recording of TCM, and is dated sometime between the 3rd-1st centuries BC (2016, Huangidi Neijing), and is the foundation of all Chinese Medicine that followed.
It wasn’t until Zhang Zhongjing (150-219 AD) that the first major school of thought – the Shang Han school – was introduced to Chinese Medicine. Zhang Zhongjing was the earliest doctor to describe pathology form external pathogenic factors systematically, in which he focused primarily on invasions of Wind-Cold and their consequences, and formulated the theory of the Six Stages (Maciocia, 1989 p. 270). He wrote Discussion on Cold Induced Diseases. This school of thought led Chinese medicine for 15 centuries (Maciocia, 1989 p. 270), and spawned the development of the Four Schools of Jin-Yuan, and the development of the Wen Ben school. And, in fact, is still used and taught in modern practice (Jin-Huai, 2013).
The Cooling School, led by Liu Wansu (1120-1200), was the first of the Jin-Yuan schools, and was centered around the understanding that the Suwen – or Six Pathogenic Factors: Wind, Cold, Summer Heat, Damp, Dry, and Fire – as the source of disease, would all ultimately manifest as pathogenic Fire. Even Cold would either turn into Fire, or undergo a process of assimilation and manifest with Fire-type patterns. Therefore, Liu Wansu’s primary key to treatment was to lower Heart Fire and Tonify Kidney Water, especially using cool and cold-natured herbs. It’s also important to note that Wansu advocated treatment according to time and place, stating that the Suwen varied in a cyclical manner according to the Five Elements, as well as the patient’s constitution, and characteristics of the disease including recognition of the underlying Fire. This method of treatment was only suited to those with a strong constitution (Dharmananda, 2001).
The Purgation School, led by Zhang Congzheng (1156-1228), believed that most diseases resulted from evils invading the body. External pathogenic factors were divided into two groups; the original Suwen, considered to be of Heaven, and the Pathogens of Earth: Fog, Dew, Rain, Hail, Ice, and Mud. And alternative cause of disease was improper food intake, particularly when in excess of one or more of the five tastes. The primary treatment goal was to remove the evils and dispel the food excesses. Congzheng accomplished this by expanding on the traditional three methods of purging – Sweating, Emesis, and Purgation. This was considered very risky due to the fact that failure of the treatment to eradicate the disease left the patient too weak to survive. Congzheng also advocated a change in formula in accordance with local conditions, and believed that Tonification should be accomplished through food over herbs due to the dangers of potency. Neither of the first two Jin-Yuan schools put much support behind internally generated diseases (Dharmananda, 2001).
The Spleen/Stomach School, led by Li Gao (1180-1251), followed the syndrome discrimination patters of Zangfu established by Zhang Yuansu, but believed that diseases were mainly derived from damage to the Spleen and Stomach, which is the foundation of the body’s Qi. In “Treatise of Spleen and Stomach,” Gao explains the source of damage to three factors: Improper Food Intake (especially an excess of cold, raw, fatty, or unclean foods), Overstrain that leads to exhaustion and need for rest in the middle of the day, and Mental Irritation caused by excessive emotions agitating the Heart Fire. The primary pattern from this point of view was the sinking of Qi, and so treatments included the raising of Qi, especially via herbal remedies, transitioning the school to become known as the “school of Warm Tonification.” This school persisted through the centuries, and Ye Gui (1667-1746) eventually identified the missing element as the Nourishing of Stomach Yin, and introduced an emphasis on aromatic orifice opening agents for specific febrile diseases (Dharmananda, 2001).
The Nourishing Yin School, led by Zhu Danxi (1281-1358), was the final one to take root during the Jin-Yuan period. Danxi developed this school as a response to the other three, believing they were inaccurate. Based on the Neijing and other texts, he felt Minister Fire, which is the motive force behind the body’s physiological activities, has a tendency to flare up and cause serious diseases. This was especially so when desires became excessive and impaired the Yin Fluids, causing Fire patterns. This was primarily corrected and controlled by nourishing the Kidney Yin, which has a tendency of being adversely influenced into deficiency. Kidney Yin is especially negatively impacted by excessive sexual desire and activity, and in indulgence in flavorful foods. Danxi viewed the Spleen and Stomach as a key source of Yin-Nourishment. This School gained popularity toward the end of the Ming Dynasty (Dharmananda, 2001).
While the Jin-Yuan schools significantly added to the breadth of knowledge of Chinese Medicine, all shared the flaw of having too much of a single-approach to diseases. As such, all advocated for the consideration of the specific circumstances surrounding each individual patient and the presenting disease. As such, there was a general return to understandings introduced by Zhang Zhongjing, and led to the rise of a new school.
The Wen Bing school (Warm Diseases) was led by Wu You Ke (1592-1672), Ye Tian Shi (1667-1746), and Wu Ju Tong (1758-1836). “This school concentrated on the pathology and treatment of febrile diseases caused by exterior Wind-Heat.” These diseases are characterized by fever, Wind-Heat that penetrates through the nose or mouth, have a tendency to rapidly turn into interior Heat, quickly changing, and injuring the Yin, and are particularly virulent (Maciocia, 1989). This school introduced many innovations to Chinese Medical theory, including The Four Levels (Ye Tian Shi), and the Theory of the SanJiao (Wu Ju Tong), and still plays a role in modern practice of TCM.
It wasn’t much later that the Opium War (1840) signaled the 100 Year Decline of Chinese Medicine. The Northern Warlords enacted the “Abandon Chinese Medicine” Statement (1914), and followed closely by the Nationalists (1928) who enacted the Resolution to “Abolish Chinese Medicine in Order to Remove Obstacles to the Cause of Medicine and Hygiene.” And in 1949, the Peoples Republic of China enforced a ban against, and outlawed the use of, TCM. Fortunately, an official in 1953 became aware of the risk of losing an amazing medical system and rich piece of Chinese cultural history, and saved it from total extinction (Jin-Huai, 2013).
More recently in the West we have seen a resurgence of Chinese Medicine. Initially spurred by an article in National Geographic in the 1970’s, TCM has grown into a respected and valued practice in the United States. As in the past, there are several schools of thought at play today that broadly breakdown into four main categories, and several adjunct categories.
Of course, Acupuncture spread outside of China into neighboring regions including Japan, Korea, Vietnam, and Taiwan. Japan was introduced to the practice about 1,500 years ago, and is very similar to Chinese systems. Minor differences include finer needles, more regular use of Moxibution, and a gentler & more superficial stimulation with little concern for De Qi. Japan is also the source of the “Guide Tube Insertion Method” commonly practiced worldwide today (Tanaka, 2003).
Acupuncture Styles. (n.d.). AltMD. Retrieved January 24, 2016, from http://www.altmd.com/Articles/Acupuncture-Styles
Dharmananda, S. (2001). The Jin-Yuan Medical Reforms. Institute for Traditional Medicine. Retrieved February 27, 2016, from http://www.itmonline.org/arts/jinyuan.htm
Huangdi Neijing. (2016, February 19). Retrieved February 27, 2016, from https://en.wikipedia.org/wiki/Huangdi_Neijing
Jin-Huai, W., PhD. (2013). Historical Timeline of Chinese Medicine (R. W. Jacques, Trans.; A. Nugent-Head, Ed.). Association for Traditional Studies. Retrieved February 27, 2016, from http://www.traditionalstudies.org/historical-timeline-of-chinese-medicine/
Maciocia, G. (1989). The foundations of Chinese medicine: A comprehensive text for acupuncturists and herbalists (3rd ed.). Edinburgh: Churchill Livingstone.
Tanaka, T. H., PhD. (2003). Acupuncture Styles and Techniques. Acupuncture Treatment. Retrieved January 24, 2016, from http://www.acupuncture-treatment.com/acupuncture-styles/
Woodley, S. (2009). Modern Styles of Chinese Medicine. Retrieved January 24, 2016, from http://www.steve-woodley.co.uk/?content=styles