Ming and Qing Dynasty: Formalisation of TCM
The Ming and Qing Dynasties marked a pivotal period for expanding and formalising Traditional Chinese Medicine (TCM). TCM experienced significant growth during these dynasties, with notable contributions that enhanced its principles, publication, and dissemination.
One of the most significant developments during this time was the expansion of TCM into a systematic, scientific, and professional field encompassing theory and practice. This era witnessed a proliferation of writings and publications that deepened the understanding and spread the knowledge of TCM principles.
A notable milestone was the emergence of the "school of warm diseases" (Wen Bing), a school of thought that organised pathogenic factors into four distinct levels – wei (defensive), qi (energy), Xue (blood), and nutritional levels. This categorisation offered a more refined and systematic framework for understanding and treating diseases, contributing to the maturation of TCM as a scientific and professional discipline.
The Ming and Qing Dynasties played a vital role in shaping TCM into a comprehensive and organised field, fostering a deeper understanding of health and illness. The developments during this time continue to influence the practice of TCM today, reflecting the enduring legacy of these dynasties in the world of traditional medicine.
TCM History
The history of Traditional Chinese Medicine (TCM) is a fascinating journey encompassing the evolution of a health system and the gradual assimilation of theories and practices gleaned from ancient texts. TCM finds its roots deeply embedded in traditional Eastern philosophy, which was not a static entity but rather an ever-evolving tapestry of thought continuously built upon, enriched, and modified throughout history.
The foundational principles of TCM began to take shape during the Warring States Period (475-221 BC), and they gained momentum with the publication of the Medical Classic of the Yellow Emperor. Over time, the development and refinement of these ideas primarily unfolded in the cultural spheres of Korea, Japan, and China. Importantly, the history of TCM reflects a profound integration of these traditional concepts with the principles of Western Medicine, symbolising a dynamic interplay of ideas and practices that has continued to shape the course of healthcare.
The Shang Dynasty, situated in Northern China, holds a prominent role in the genesis of Chinese civilisation. The region's significance was profoundly shaped by the periodic flooding of the eastern Yellow River, an environmental force that enriched the land's fertility and presented challenges to its inhabitants.
During the Shang Dynasty, an early form of written communication emerged, representing a crucial step in developing Chinese script. Simultaneously, religious beliefs and ancestor worship occupied a central place in the population's daily lives. Rituals and ceremonial practices held paramount importance, contributing to the cultural and spiritual tapestry of the era.
Understanding illness during the Shang Dynasty is particularly important in the context of Traditional Chinese Medicine (TCM). Afflictions were often perceived as the result of ancestors being afflicted by malevolent forces or demons entering the body. This spiritual interpretation reflects the shamanic culture of the time, with worship centred around the deity Shang-Ti. In this cultural milieu, ancestors were honoured through rituals that included requests for assistance in expelling these malevolent influences.
This early perspective on health and disease, with its ties to ancestor worship and the expulsion of demons, laid the foundation for certain aspects of TCM. The interplay between the spiritual and the physical and the belief in maintaining balance within the body and the broader universe became fundamental principles in the development of TCM. This historical context sheds light on how ancient beliefs and practices have profoundly influenced the holistic philosophy that characterises Traditional Chinese Medicine today.
Shang Dynasty (1766-1122BC): Spiritual Roots of TCM
The Chou Dynasty was marked by considerable instability, yet it is regarded as a zenith of Chinese civilisation. Amid this era of political turbulence, a vibrant intellectual atmosphere thrived, leading to the flourishing of diverse philosophical schools and prolific literary output.
In this fertile intellectual landscape, great thinkers like Confucius, who would significantly impact the development of Chinese culture, emerged. Confucius' teachings laid the moral and ethical foundation for Chinese society and have enduring relevance.
One of the notable contributions of the Chou Dynasty to the realm of Traditional Chinese Medicine (TCM) was the creation of the "Huang Ti Nei Ching" or the "Yellow Emperor's Classic of Internal Medicine." This work is a cornerstone of TCM and a treasure trove of ancient medical wisdom. It encompasses many medical theories, concepts, and practical guidelines for maintaining health and treating illnesses.
The "Huang Ti Nei Ching" reflects the medical knowledge of its time and serves as a bridge between the ancient and modern understanding of TCM. It is a testament to the rich heritage of Chinese medicine, with its roots firmly embedded in the philosophical and intellectual milieu of the Chou Dynasty, where profound insights into the human body, health, and disease began to take shape.
As such, this period in Chinese history has left an indelible mark on the foundation of Traditional Chinese Medicine, as the "Huang Ti Nei Ching" continues to be a source of valuable knowledge and inspiration for practitioners and scholars in the field today.
Chou Dynasty (1122-403BC): Philosophical Foundations of TCM
The Warring States Period was characterised by social unrest, escalating chaos, and declining moral values. It witnessed a unique focus on health maintenance, particularly among the upper echelons of society, in contrast to the broader development of the state. This era was notable for the emergence of "The Hundred Schools" during the 3rd century BC, representing a diverse range of philosophical thoughts and teachings. Within this crucible of ideas, the foundational principles of Traditional Chinese Medicine (TCM) began to take shape.
Influenced by Taoist and Confucian philosophies, TCM was enriched by a holistic understanding of the human body, health, and the interconnectedness of nature and the universe. This period marked the genesis of critical medical theories, including the concept of Qi (vital energy), the balance of Yin and Yang, and the classification of diseases and their treatment based on these principles.
Despite its social upheaval, the Warring States Period provided fertile ground for cultivating these core TCM ideas. It laid the groundwork for a holistic approach to healthcare that would continue to evolve over the centuries, becoming a central pillar of traditional Chinese culture and medicine and influencing healthcare practices worldwide.
The Warring States Period: TCM Ideals
Han and Tang Dynasty: Foundations of TCM Practice
Following the unification of China in the Qin Dynasty in 221 BC, a shift from slavery to a feudal system marked a temporary stability in Chinese society. This period provided a fertile ground for developing various intellectual pursuits, including studying Traditional Chinese Medicine (TCM). It brought together a diverse group of scholars, including doctors, Buddhists, Confucians, and magicians, all contributing to the rich tapestry of TCM's growth.
During this era, significant advancements in TCM were recorded. One notable contribution was "Shen Nong's Herbal Classic" (Shen Nong Ben Cao Jing), a comprehensive work cataloguing 365 kinds of herbs. This text played a pivotal role in the foundation of herbal medicine in TCM, offering a valuable resource for practitioners and scholars. Additionally, the "Shan Hun Lun" (The Treatise of Cold-Induced Diseases) emerged during this period, further expanding the understanding and treatment of various ailments in TCM.
One prominent figure who left a lasting impact on TCM during this time was Sun Simiao. He not only excelled as a physician but was also an influential philosopher. His contributions to TCM are celebrated today, as he dedicated his life to the study and practice of medicine, leaving behind a wealth of knowledge and principles that continue to shape the field.
The Han and Tang Dynasties played a crucial role in consolidating the foundations of TCM, laying the groundwork for its subsequent growth and development into a comprehensive system of medicine that has endured.
Song and Yuan Dynasties: Systematic Growth of TCM
The Song and Yuan Dynasties marked a period of profound challenges and hardships. Despite the adversities, this era witnessed significant advancements in Traditional Chinese Medicine (TCM) that would lay the foundation for its enduring legacy. During this period, there was systematic and organised development of herbal medicine. Scholars collected and meticulously studied herbal formulas, expanding the repertoire of medicinal plants and their applications in TCM. This marked a critical step in the evolution of herbal medicine and greatly enriched the pharmacopeia of TCM.
Moreover, the Song and Yuan Dynasties saw remarkable progress in acupuncture and moxibustion. Pioneering techniques like creating the 'coppery body,' understanding meridian points, and selecting specific points for distinct medical conditions emerged. These developments in acupuncture and moxibustion represented a significant leap in the practical application of TCM.
Applying medical theories to clinical practice during this period fuelled substantial theoretical innovation and development in TCM. The hardships of daily life prompted the emergence of a cohort of renowned doctors, including four distinguished experts of the Jin-Yuan Dynasty: Liu Wansu, Zhang Zihe, Li Dongyuan, and Zhu Danxi. These physicians made substantial contributions to the theoretical and practical aspects of TCM, further enhancing its systematic understanding.
Thus, the Song and Yuan Dynasties played a pivotal role in advancing the theory and principles of TCM, culminating in forming a mature and comprehensive system of traditional medicine. Despite their time's challenging circumstances, these periods heralded significant progress in TCM, contributing to its enduring legacy and global influence.
Schools of the Song and Yuan Dynasties
During the Song and Yuan dynasties (960–1368), Chinese medicine saw the rise of several influential clinical schools of thought, each offering distinct approaches to diagnosis and treatment. These schools marked a turning point in TCM, shifting from purely classical interpretation to more targeted clinical strategies that still influence practice today.
Tonifying Qi School
Liu Wansu
Regulating and nourishing qi, mind, essence and body, as well as harmonising the functional activities of qi, blood and organs
Purgation School
Zhang Zihe (1156-1228)
Eliminating evils and supporting health; preventing and treating disease by eliminating pathogenic factors instead of blindly taking tonics.
Spleen and Stomach School
Li Dongyuan
The importance of regulating qi of the spleen and stomach to protect postnatal essence
Nourish Yin School
Zhu Danxi
Nourishing the yin essence, which is hard to generate but easy to be deficient; the theory of ministerial fire
TCM in Modern and Contemporary Times
Traditional Chinese Medicine (TCM) has undergone a remarkable rejuvenation despite occasional scepticism and misunderstandings regarding its traditional practices. While the scientific community has sometimes raised concerns and scepticism about certain aspects of TCM, its enduring appeal and influence have not waned.
Over the centuries, TCM has showcased its remarkable integrational power, weaving its principles into various aspects of healthcare. This historical adaptability has been a critical factor in preserving its core principles, gradually finding explanations and acceptance from a Western perspective. We witness an increasing convergence between TCM and contemporary medical thought.
The fusion of traditional wisdom with modern research and experience has significantly contributed to developing professional knowledge within TCM. This evolution has paved the way for a more comprehensive understanding of the principles and practices of TCM, grounded in both ancient wisdom and contemporary scientific insights.
In an increasingly interconnected world, the appeal of TCM has transcended national boundaries. More individuals outside China are eager to learn and apply its principles and practices, reflecting its global impact and continued relevance in pursuing holistic health and wellness.
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1822: The Imperial Academy bans acupuncture. Late Qing Dynasty. Acupuncture was excluded from the official curriculum; it was continued only in folk practice.
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1881: First Western medical school opens in Tianjin, Qing modernisation reforms—formal introduction of Western biomedicine in state-run institutions.
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1929: Ban on TCM and acupuncture
Nationwide debate on TCM vs Western medicine. Guomindang (Nationalist Government). Attempt to replace TCM with Western medicine; sparked resistance and a major public discourse.
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1929 (continued): Nanjing Government TCM regulations:
• Exams & qualifications
• Licenses to practice
• Ethical & legal frameworks. Nanjing reforms. Partial re-legitimisation of TCM through regulation and standardised medical qualifications.
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1949: Mao reinstates and promotes TCM. Integration of classics with Western biomedicine. Founding of the People’s Republic of China. Beginning of the dual system: TCM institutionalised, merged with modern medicine in education, hospitals, and research.
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