Introduction: Historical Background
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Tony Reid’s Principles of TCM Online Course: INTRODUCTION Introduction: Historical Background Traditional Chinese Medicine (TCM) has continued in an unbroken recorded tradition for at least the past 2,000 years. Some authorities speculate that TCM had its origins over 5,000 years ago, based on the findings of quasi therapeutic inscriptions on pieces of bone that were intended to placate ghosts, demons or disgruntled ancestors. However, it is unlikely that the traditional medicine of this period would have been anything like contemporary TCM. What we do know with certainty is that the records from the Warring States periodi show a medical system that, although crude by contemporary standards was already quite well developed by around the second century BCE. Contrary to popular notions, traditional Chinese medicine has not been handed down to us as a complete system that was perfected in ancient times by sages and mystics. Equally untrue is the misconception that the rapid development TCM has undergone in the latter part of the 20th century is an unusual feature of a system of medicine that was relatively stable and generally resistant to large-scale change. In fact, during most of its recorded history, TCM has been subject to periods of intensive development and revision along with the usual multi-faceted debate that accompanies such activities. These misconceptions arise in part because of the confusion caused by the fact that the underlying principles upon which TCM is based (which also underlie most other aspects of classical Chinese culture), i.e. Yin-Yang, the five Elements (or ‘five Phases’) and Qi, were well developed and articulated long before the early works on traditional medicine were recorded. However, these essential concepts really belong to the culture as a whole – not solely to the medicine that arose out of that culture. The general consensus is that traditional Chinese medicine, as it has been practiced during the past 2,000 years, is an unique and relatively consistent system, while the form of medicine that was practiced before this time was sufficiently different not to warrant inclusion under the umbrella of TCM. The oldest and most highly respected medical classic extant in China is the Huang Di Nei Jing (also referred to simply as the ‘Nei Jing’). This work was ascribed to a legendary sage-king, the Huang Di, who ruled over the central region of China in ancient timesii. The text, in the form of a dialogue between the ruler and his chief minister, Qi Bo, was, in fact, the product of various unknown authors, mostly written and compiled during the Warring States period (475 – 221 BCE), and finally completed in the early part of the Han Dynastic period. It has been a common scholastic tradition in China to lend weight and authority to one’s views by ascribing them to an ancient (and often mythological) famous figureiii. In this way, the theories and practical techniques of some of the best physicians in ancient China were compiled together as the work of the Huang Di in this renowned medical text. The Nei Jing outlines all of the essential theories and practices of traditional Chinese medicine and has provided a well-spring of inspiration and deep insights into the nature of health, disease, and therapeutic methods for Chinese physicians throughout the centuries up to the present day. This includes rudimentary concepts concerning the circulation of the blood as well as the nature of infectious diseases; quite remarkable, considering that it was not until the 17th century that Western scientists made significant progress in these areas. 1. Available at www.ChineseMedicineEducation.com Tony Reid’s Principles of TCM Online Course: INTRODUCTION Similarly, Shen Nong’s Materia Medicaiv (shen nong ben cao jing) was attributed to the legendary ancient monarch, Shen Nong (the ‘Divine Farmer’). He is credited with inventing the wooden plow, teaching the arts of agriculture and animal husbandry, and developing herbal medicine by experimenting with various plants, minerals, and other substances to determine their properties. The text attributed to him was most likely compiled during the 1st century BCE and lists 365 different medicinal substances with detailed actions and indications for each. Reputed to be able to observe the functioning of his own internal organs to determine the physiological effects of various substances, the Shen Nong tested each of them on his own body. It is said that he often poisoned himself in the course of his investigations and, as an effective general antidote, he discovered the virtues of the world’s most popular beverage: tea (the leaf of Camellia sinensis). The Warring States period, in which the Nei Jing was begun, represents several centuries of instability, marked by the struggle of one kingdom to conquer and rule over all of the others. Seven main kingdoms – Qin, Wei, Hann, Zhao, Yan, Qi and Chu – fought in ever changing coalitions against each other. Along with a generalized negative impact on cultural development, the ongoing development of the Chinese medical tradition was also hindered under these unfavorable social conditions. Eventually the state of Qin emerged victorious. King Ying Zheng of Qinv conquered one state after the other and proclaimed himself the ‘First Emperor’ in 221 BCE, having unified the whole territory of ancient China. He reigned under the title of Qin Shi Huang Di (‘First August Emperor of the Qin Dynasty’)vi. He established his authority over the whole of China, standardizing Chinese writing, weights and coinage. He was also responsible for two of China's best known archaeological treasures: the Great Wall and the Terracotta Warriors guarding his tomb in Xi-an. During this time Chinese cultural development suffered another major set-back, with the great book burning in 213 BCE. This was part of the new emperor’s plans to consolidate the Qin dynasty and maintain stability in the recently unified empire. By establishing intellectual conformity and actively persecuting free speech, Qin Shi Huang Di hoped to prevent any criticism of imperial rule which could lead to revolution. We have no way of knowing how many great works were lost during this critical period and, although medical books were spared, the suppression of free thought doubtless had a negative impact on the newly emergingvii traditional medicine. Qin Shi Huang Di's autocratic rule and the draconian methods he employed ensured that the newly established Qin Dynasty did not long survive his own death. In 206 BCE, with the empire in revolt, his son, the Second Emperor (Er Shi) committed suicide. In the same year, Liu Bang, prince of Han, defeated the Qin army in the Wei valley. This marks the beginning of the Han Dynasty. The ban on books, however, was not lifted until fifteen years later, in 191 BCE. The recorded history of Chinese medicine begins with the Han Dynasty (206 BCE to 220 CE). The Han Dynastic period was a time of relative stability and cultural development. Much of what we now regard as essential Chinese culture developed and was formally recorded during this time. Many of the early herbal formulas from this period are still highly respected by traditional Chinese physicians and are commonly used in clinical practice to this day. The most famous book of Chinese herbal formulas was written at the end of the Han period and represents the culmination of 400 years of experience in this stable cultural setting. The original text 2. Available at www.ChineseMedicineEducation.com Tony Reid’s Principles of TCM Online Course: INTRODUCTION was subsequently divided into two volumes: The Treatise on Cold-induced Diseasesviii (shang han lun), and the Synopsis of Prescriptions of the Golden Cabinetix (jin gui yao lue fang lun). The former text is the earliest attempt at describing, categorizing and outlining the treatment protocols for infectious diseases. The medical theories elaborated in this text, along with the herbal formulations that the author describes, represent an essential part of TCM practice. During the early Han period, the Nei Jing in the form that has been handed down to us today was completed. Being the work of several different authors, over so long a period, it is not surprising that there are many inconsistencies as well as discrepancies throughout the work. From a modern perspective, the Nei Jing contains the rudiments of Chinese medical doctrine, which have been clarified, organized, made more consistent and ‘fleshed out’ by succeeding generations. In fact, this process is still continuing, especially with the importation of Western medicine into China and the exportation of Chinese medicine to the West. One of the first attempts to reconcile the incongruities of the Nei Jing was the Classic of Difficult Issues (nan jing)x. This appeared sometime in the second century CE, authorship unknown, and spawned several commentarial works over subsequent centuries, the most influential being the ‘Genuine Meaning of the Classic of Difficult Issues (nan jing ben yi) published in 1336 by Hua Shou. The translation by Unschuldxi, in addition to the text, contains a selection of commentaries by various Chinese and Japanese authors from the past seventeen centuries. These annotations and commentaries, remarkable in their scope, provide a profound insight into the sort of debate and discussion that has characterized the literary tradition of TCM throughout its recorded history. The earliest documents describing prepared Chinese herbal formulations were discovered in a recently excavated burial site, Ma Wang Dui, in Hunan province. The find has been dated at 168 BCE, which makes them over 2,000 years old, from the early part of the Han dynasty. Among the many relics unearthed were a set of silk scrolls describing the medical system of that time, including herbal therapies for the treatment of 52 diseases, with 170 different medicinal prescriptions, utilizing a total of 247 medicinal substancesxii (mostly herbs, as well as minerals and materials of animal origin).