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The History of Chinese Medicine
Writtenby Amy Moll, special thanks to Martin Kidwell
The following is an account of Chinese history as it pertains to the development of Chinese Medicine (CM). It focuses on 1) major shifts and changes in the practice of CM, 2) important landmark texts and books, 3) the cultural influence and interactions with CM and 4) the spread of CM to other countries. Information is arranged primarily by the historical periods in which they occurred.
First I would like to introduce some of the terminology used in this account. I have used the term Chinese medicine when speaking directly of medical and therapeutic practices originating in China. Traditional Chinese Medicine is the term used to describe the style of Chinese medicine that developed in the 1950's and is most commonly seen in the U.S. today. The term traditional Japanese medicines refer to those medicines traditional to Japan that include Japan's adaptations of Chinese medicine. Oriental medicine is a term that describes any traditional medicine from East Asia.
It has been widely stated that Chinese medicine and acupuncture date back several thousands of years. While this has not been proven incorrect, good evidence documenting the existence of an organized system of medicine in China only dates back to the time period between -200 and -100.
Chinese Medicine began to distinguish itself as an independent system apart from religious practices in the middle Zhou (-772 to -480). This was aided by the arrival of Confucianism. Confucianism affected medicine by ascribing a link between human action and subsequent outcomes. The behaviors of eating and drinking combined with lifestyle habits became recognized as important factors in one's health and longevity.
Daoism, the second of three philosophies (Confucianism, Daoism, and Buddhism) that influenced Chinese medicine arose in the late Zhou (-480 to -221). Daoism, unlike Confucianism, was more concerned with how humanity could best emulate nature in its many forms. Part of Daoism's influence on medicine was the search for longevity elixirs and practices of deep breathing.
The Han (-206 to 220) was a time when civilization and trade flourished. During this time the five phase theory was established by Zou Yan (-350 to -270). The theory of wind invasion as a cause of illness was elaborated. The great classic, the Nan Jing (Classic of Difficult Issues), author unknown, was written during this period and explained the coursing of qi through the body via a system of channels, similar to the watercourse that exemplified the latest technology of the time. It described the twelve main channels, front and back midline channels, and pulses.
Two other important texts were written at this time. The first, the Ma Wang-dui, was discovered in the burial of the Lord of Dai buried in -168. The second is the Huang Di Nei Jing (Yellow Emperor's Cannon of Internal Medicine) text that presents itself as a series of conversations between Huang Di, the Yellow Emperor, and Qi Bo, his minister. This text continues to be studied by students and scholars of CM to date.
Zhang Zhong-Jing wrote the Shan Han Lun (A Discourse on Cold Induced Disorders) in 198. He described the six levels of disease progression in externally contracted illnesses and associated herbal formulas. Amazingly, his work was not utilized nor studied in China for another thousand years. Today, it is considered one of the most important herbal and theoretical texts of CM.
Buddhism was thought to have come to China during the 1st century. Its influence on Chinese medicine included meditation, martial arts, and an emphasis on mental health.
In 282 Huang-fu Mi wrote the Zhen Jiu Jia Yi Jing (The Systematic Classic of Acupuncture and Moxibustion). This contained information on acupuncture point location, depth of insertion, point function, moxibustion and disease prevention.
In the 500's Chinese medicine was exported to Japan and became rapidly integrated. Zhi Cong, a Buddhist monk is known to have had the largest influence on Japan regarding the assimilation of Chinese medicine. He brought 164 Chinese medicine texts to Japan in 562. Japan established the first Imperial medical school in 702 by the emperor Monmu. This school had programs in acupuncture, moxibustion, massage and herbal studies.
Sun Si-miao (581-682) lived during the Sui period (590 to 617) and is considered the most famous medicine practitioner of the period. He is believed to be the creator of the cun measurement system of locating acupuncture points that is still used today. He discusses ashi points (likened to modern trigger points), extra points, and is known for his contributions to Chinese dietary therapy.
From 1264 to 1368 China was controlled by the Mongols. During this time the Tai Yi Yuan (Imperial Academy of Medicine) was founded. Bronze statues of the human figure and corresponding acupuncture points and channels were made during this time. These indicated that acupuncture had reached a relatively stable state.
The Ming period (1368 to 1643) was a time of great intellectual exchange. It was during this time that CM became increasingly diversified in its theories and styles of practice. Wu Hu-xing became famous for successfully treating those affected by the epidemic that spread from 1641 to 1644. He wrote about his experience in the text Wen Yi Lun (Theory of Warm-Induced Disorders).
The Qing Period (1644 - 1911) marked the impending decline of CM, and the definitive end of the Chinese Empire. Western medicine was rapidly absorbed and captured the faith of those seeking to Westernize China. Small groups of people still held on to the traditional medicine of China and began the Han-Xue movement that sought to preserve the classical medicine.
Chinese Medicine in the Past 100 Years
The beginning of the Chinese Republic was even less favorable toward CM. The Minister of Education was determined to bring an end to CM completely. The great plagues and epidemics that killed thousands of people in the early 20th century in China was used by those against CM as an example of the medicines inability to effectively manage the ills of society. (Those looking back now understand that the intense famine, poverty, and lack of sanitation provided the perfect breeding grounds for such epidemics.) This allowed the promises of Western medicine to gain strong footholds and quickly become the new medicine of China. Japan also underwent similar circumstances as the acculturation of Western medicine took place.
Chinese Medicine's future was uncertain for the 1st half of the 20th century but thankfully saw a resurgence under the Chinese Communist Party (CCP) in the 1950's. The leader of the CCP, Mao Ze-dong was firm in his commitment to utilize and preserve CM. Also included in this plan was the aim to establish CM as a more scientific system of medicine. It was during this time that the term Traditional Chinese Medicine (TCM) was coined to describe the style of CM that included both Western training in basic sciences and classical CM approaches that now fell under scientific scrutiny. TCM is what is most commonly taught in Western Countries today.
It was after WWII that traditional Japanese medicines also regained popular approval. Practitioner Yoshiharu Shibata dedicated his life to researching acupuncture, dietary therapy, and herbal medicines that would aid in the recovery of radiation-induced health problems from the atomic bombs. His work was further extended to the treatment of cancer. The re-building of Japan after WWII was overseen by General Douglas MacArthur, who, during that time, attempted to abolish traditional Japanese medicines. It was the organized mass protest of blind acupuncturists in Tokyo that helped secure the future of traditional medicines in Japan. Today, a third of the schools in Japan for acupuncture are for blind students and over 40% of practicing acupuncturists are blind. These people are highly respected. Without relying on sense of vision, their sense of touch is often greatly enhanced - a skill that is important in acupuncture.
Oriental medicine first came to North America during the mid-1800's with Chinese immigrants who arrived in the U.S. during the Gold Rush. Until fairly recently, the practice of Oriental medicine remained confined primarily to cities with a large Asian immigrant population like San Francisco, Los Angeles, and New York.
That began to change in 1971 after James Reston, a New York Times journalist who was covering President Nixon's historic visit to China, had to have an emergency appendectomy. Reston received acupuncture for post-operative pain and witnessed numerous operations that employed acupuncture anesthesia. The articles he wrote about his experience generated great interest in this country about acupuncture and Oriental medicine, and were in part responsible for helping to legitimize the practice and study of Oriental medicine here in North America.
Acupuncture and Oriental medicine are flourishing in the United States today. There are over fifty master level training programs for acupuncture and Oriental medicine in the U.S. and several doctoral programs. Practitioners are found in every state. The National Institute of Health allocates large amounts of money to the study of acupuncture. Acupuncture and Oriental medicine continue to gain acceptance in our healthcare system as a cost-effective means to improving health and well-being.