tcm

The origin of the theory behind Traditional Chinese Medicine (TCM) is lost in prehistory before the invention of writing. The written language emerged in China during the Shang Dynasty around 1766 BCE. What has been written about medicine during this time has a history of more than two thousand years. The ancient works referred to in prehistoric times are now lost and considered 'legendary'.

A current theory on how acupuncture points were discovered can be traced back to the Stone Age. It is believed that stone knives and sharp tools were used to relieve pain and illnesses. Often these were used only for primitive surgeries, but it is conceivable that patients may have noticed sensations or changes in other parts of the body after treatment with these "needles". Later, these needles were replaced with bone or bamboo.

Other interesting theories:

Warriors in battle were struck by arrows and noticed, guided by pain in other parts of the body, and spontaneous remission of pain elsewhere. Spots on the body became soft/discolored when the disease was present. Constipation was common due to the primitive Stone Age diet, but people found that certain points were soft when constipated and that manipulating them with pressure or puncturing them led to relief. Relief of pain was discovered when heat was applied (after the discovery of fire). This treatment became more specific in certain areas as results were noted. Monks noticed energy moving in specific areas when performing meditation techniques. Over centuries, these energy movements were carefully noted, and the channel system was gradually developed. Regardless of the exact origin, acupuncture is not exclusive to China, but it was only in the East that it was so highly developed. This occurred due to observations by ancient Chinese over hundreds and even thousands of years. It was noted that:

A single point could affect many different symptoms. Symptoms could be treated that were close and distal from the actual point, including internal organ pathology. It was therefore natural to assume that points with common symptomatology could be somehow related. Therapeutic potential extending over a significant distance in the body. This was confirmed by the transmission of needle sensation along specific pathways. A therapeutic property could be achieved through a number of different points. From this evidence, it was concluded that there are channels and the flow of Qi along them. As locations and therapeutic properties of points were gradually discovered, they were named.

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{slider Philosophical Roots}

TCM is deeply rooted in traditional Eastern philosophy. The philosophy was not singular and did not originate from just one era of Chinese history but was built upon, added to, and modified throughout history. This is very typical of the Chinese, who are a very pragmatic people. They have no problem accepting a variety of philosophies into their culture and do not see any conflict between them. An example would be The Three Teachings: Taoism, Confucianism, and Buddhism, which coexisted harmoniously in China: we can see them together in paintings, with Lao Tzu, Confucius, and Buddha all depicted together.

{slider Shamanistic Medicine}

• Shang Dynasty (1766-1122 BC)
• Chou Dynasty (1122-403 BC)

The beginning of the Bronze Age, the first civilization. They had developed writing and had religion: their god was called Shang Ti, who resided in the celestial imperial court populated with deceased ancestors. Ancestor worship was very important (and is actually still) in China. Rituals with ancestors in bronze were performed. Shang had already high-tech bronze casting: bronzes cast with incredible animal forms. Animals were greatly respected for their power, as evidenced in the art. Shang believed that disease was a result of:

• Upsetting an ancestor and being subject to a curse.
• The "evil" of a demon entering the body, curing involved appeasing the ancestors through appropriate rituals or seeking their aid to expel the demon. Shamans were intermediaries who spoke with the ancestors, who in turn spoke with Shang Ti. Questions were asked by writing them on "oracle bones", usually scapulae or turtle shells, which were then heated and the cracks "divined", in other words, read by a shaman to find an answer. Questions ranged from "Will it rain?" to "Will the king die?"

A problem with history is that it relies on archaeological finds and writings, but what was written about this epoch has been found on ritual bronzes and shells, the richest owners (bronze was very expensive).

Throughout early history, we, therefore, have the problem of not knowing about the common people's medicine, as those who wrote were educated and wealthy.

As late as the 6th century BC, physicians were still associated with shamanism. Demonology and shamanism continued through the next dynasty (Chou: 1122-403).

Even today, the "Six Evils" or six kinds of "deviating energy" persist in TCM theory, except that they are now environmental energies, i.e., wind, cold, moisture, heat, summer heat, and dryness.

In some areas in the East, shamanistic medicine survived almost intact, e.g., in parts of Vietnam and especially in Tibet.

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{slider Confucius (K'ung Fu-tzu) (551-479 BC)}

Born towards the end of the Eastern Chou period and the beginning of the Warring States. We know of him from the "Analects", a series of passages written by his disciples.

Brief Biography Confucius' Ideas Influence on Chinese Medicine

How Confucian ideology influenced Chinese medicine

• Passage written by Hsun-Tzu, a famous disciple of Confucius: "The true ruler begins to arrange his state while order still prevails; he does not wait until uprisings have already broken out."
• Passage in Nei Ching (Chinese medical classic): "Sages do not treat those who have already fallen ill but rather those who are not yet ill. They do not arrange their state only when uprisings are occurring but before an uprising occurs."
• The Confucian idea of moderation also appeared in the Nei Jing in several passages; in other words, health would be maintained through moderation in lifestyle.
• The five relationships also influenced medicine: Example: imbalance between husband and wife (which is where the pulses at one wrist are too strong and at the other wrist too weak): Some techniques are also called Mother-Son and Father-Son techniques.
• Zang Fu (organs) are given the names of "officials". The liver, for example, is the "commander" of the armed forces. The heart is the highest ruler, the stomach is the official responsible for public grain. The court (the organ) functions well when all the officials (organs) work together harmoniously. Of utmost importance is the highest ruler or emperor (the heart). If the emperor is disturbed, the entire court (all other organs) will suffer. This reflects the Confucian way of thinking; the highest ruler must remain in perfect balance and regulate by example. Even today, many believe that the heart should be treated first if affected (e.g., in emotional disturbance, the heart is always affected).

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{slider Taoism}

Taoism is not a religion, but more a philosophy based on the concept of Tao. Sometimes said to mean "the way" or something like the unknowable, unimaginable source of all phenomena. Before Tao, there was chaos, then suddenly Tao manifested as the universe (comparable to the modern "big bang" theory). Tao expresses itself through the duality of Yin-Yang. Tao is like the eternal primeval law of nature.

The best-known ancient Taoist philosopher was Lao Tzu (Lao Tzu = "Old Master"). He wrote the Tao Te Ching: a mystical Taoist work, full of poetic allusions, riddles, etc., to expand consciousness, promote love of nature and simplicity, and reject worldly ambition. The Tao Te Ching is a composite text, probably dating from the 3rd century BC (the same time that the major medical classic, the Nei Jing, was officially written down), but Lao Tzu has had his traditional dates fixed to make him slightly senior to Confucius (i.e., 6th century BC). It is impossible to know the exact birth date.

The best introduction to Taoism is to read some Taoist literature. The way the ancient Taoists would teach would be via observation of nature, in the hopes of obtaining a direct grasp of the truth. Most mystical or inner-directed spiritual paths concur with this.

In Chapter 1 of the Tao Te Ching, Lao Tzu wrote:

The tao that can be told is not the eternal Tao The name that can be named is not the eternal Name. The nameless is the beginning of heaven and earth. The named is the mother of ten thousand things. Ever desireless, one can see the mystery. Ever desiring, one can see the manifestations. These two spring from the same source but differ in name; this appears as darkness. Darkness within darkness. The gate to all mystery. Taoists advocated "wu-wei," which means non-doing or non-intentional action. To be without plans, to go with the flow. Not surprisingly, Taoism was a popular philosophy mainly among the aristocracy! Seeking learning, daily pains. Seeking Tao, daily losses until one reaches Wu-Wei Doing nothing, yet there is nothing that is not done. To win the world, one must care for nothing. When one cares, nothing is left undone.

An example of working with the Tao is given in a traditional tale of Prince Wen Hui and his cook. Prince Wen-Hui was visiting his kitchen one day when he happened to pause and observe his cook slicing through joints of meat. He remarked upon the deft and smooth way his cook worked, the blade hardly seeming to touch the bone as it cut. His cook explained that he simply relaxed and non-purposefully allowed the knife to do its work. In this way, he became one with his knife, which slid through the spaces between the joints, never touching the bone. He explained that he had used the same knife for many years and it had never needed sharpening. The prince was astounded at his cook's story and exclaimed that although he was an avowed Taoist, he had truly learned something fundamental about the philosophy from his cook.

Taoists advocated simplicity, living according to the Tao, according to the laws of nature.

The Chinese medical classics speak with reverence of sages of ancient times who knew how to live according to the Tao; hence, they lived very long lives. Whereas nowadays (3rd century BC), people had lost the ability to live in harmony with nature, did not adhere to the principles of moderation, and hence were unhealthy. One wonders what they would say about the 20th century!

Taoism eventually split into two camps: alchemical Taoism, which became a search for immortality via diet, exercise, meditation, and magical herbs, and popular Taoism, which developed a church and a whole pantheon of gods and became heavily involved with popular superstitions and demonic lore, thus losing credibility with the educated class. Earlier Taoist classics, however, continued to be read.

Taoism had a strong influence on medicine: the idea of humans being part of nature and needing to remain in harmony with nature was fundamental. "As above, so below." As an example of this, guidelines were established in the Nei Jing as to how one should conduct oneself in various seasons. In the winter time, one should go to bed early and get up late and not waste one's energy, for winter is the time of conservation and storage (a time where Yin is strongest). In the summertime, one should rise early and go to bed late and "act as if one loved everything outdoors", for Summer is the time of maximum Yang, and people naturally have more energy to expend.

Let's return to the Warring States period, the time of great social unrest where uncertainty about personal and collective existence, increasing chaos and amorality led to the search for a lasting philosophy that might change things. The time of the "hundred schools". The medicine that developed during this period of intense philosophical activity is the central part of what traditional Chinese medicine is today. It has been referred to as the medicine of systematic correspondences.

Medicine of Systematic Correspondences

The fundamental principles of this medicine arose from divergent influences, including Taoist and Confucian ideas. The Naturalist School was responsible for systematically elaborating the concepts and theories of Yin-Yang, which had been an ancient idea that was now fully developed and recorded.

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{slider Huang Ti Nei Ching Su Wen Ling Shu}

During the time of the "Hundred Schools", (3rd century BC), the famous classic of TCM, the Huang Ti Nei Ching (Yellow Emperor's Classic of Internal Medicine) was written down in its present form.

It had existed far earlier in one form or another, parts probably being handed down by word of mouth, and is thus a compilation of much earlier material, with added commentaries (commentary writing is very popular with the Chinese). The "Nei Ching" as it is called, is a mixture of ideas and philosophies, some more ancient (i.e. Taoist philosophy) and some from the time it was written (3rd century BC), such as the Yin-Yang, Five elements, and theories of the Zang Fu (Organs). It is also likely that more was added to this classic by later dynasties.

The book describes the conversations between the Yellow Emperor (Huang Ti) and his physician (Chi Po), hence it is a historical (actually legendary) account.

Huang Ti is said to have lived 2697-2595 BC, i.e. before writing existed. He was portrayed as a true Renaissance man. He designed a cart based on the big dipper, designed a series of musical notes and instruments to play them on, but his great love was medicine, which is shown in the conversations he has with his physician, during which he asks about everything imaginable.

There are 2 parts to the Nei Jing:

Su Wen (Essential Questions): This forms the core of the book; it deals with the whole realm of medical knowledge and involves aspects of all the philosophical concepts mentioned earlier. Ling Shu (Spiritual Axis): This mainly constitutes a supplement to the Su Wen. It expounds the concept of Tao and the cosmological patterns of the universe, then portrays with vivid imagery the character of the two primordial forces, Yin and Yang, and how they interact in nature and in human beings. There is then a dex-scription of the bodily organs (as "officials" - showing Confucian influences) and their functions and pathologies. The technique of pulse reading for diagnosis and the various types of pulses are discussed at length. The book describes how to live in harmony with nature and the results of not doing so (imbalance and disharmony). Therapies are based on the restoration of harmony and balance to the body. Surgery is mentioned, but only as a last resort e.g. to remove tumors. Acupuncture is mainly mentioned in the Ling Shu. Commentaries were added, both in the 3rd century BC and in later dynasties. One commentary published in the same period was the NAN JING (Difficult Classic) appeared. This filled out the Nei Jing and answered some difficult questions. Points for acupuncture and moxibustion are discussed, as well as physiological and pathological conditions of the eight Extra Vessels. Many commentaries were added in the Tang dynasty. These are important and render the work easier to read, the essential part was left intact.