The Rise, Fall and Renaissance of Traditional Chinese Medicine
By Willie Mao, PhD, LAc
The Early Rise
The development of traditional Chinese medicine (TCM) follows the course of Chinese civilization. Acupuncture, acupressure and moxibustion all date to the Stone Age.
In the late 1920s, the Peking Man, an extinct cave man who lived 300,000 to 500,000 years ago, was excavated in Zhou Kou Dien, just north of Beijing. Polished flint-stones, bone needles and bamboo shafts, which are believed to be acupuncture and acupressure tools, were unearthed at the site.
Herbal medicine can be traced to a man named Shen Nung, or the "Divine Husbandman," circa 3494 B.C. He is one of three legendary ancestors of the Chinese people. The other two are Fu Xi, who started animal husbandry, and Shui Ren, who discovered fire. Shen Nung experimented on himself, trying numerous herbs to study their healing effects. Legend has it that he died of herb intoxication. His most ancient portrait and records are now kept at Johns Hopkins University Hospital.
The well-known Yellow Emperor's Classic of Medicine (Hung Di Nei Jing) is the work of the Warring States Period which occurred from 475 B.C. to 221 B.C. Bian Chueh, also known as Ching Yueh Ren, compiled the Difficult Classic (Nan Jing) to supplement the deficiencies in the Hung Di Nei Jing. Bian was the first accomplished acupuncturist on record to bring a patient out of a coma. Another monumental work in this period is the Classic of Mountain and Sea, which described 270 plant, animal and mineral substances with some medicinal applications.
The First Great Leap Forward
TCM made a great leap forward during the Han dynasty, which lasted from 202 B.C. to 220 A.D. - one of the strongest and most prosperous periods in China's history. Shen Nung Materia Medica was compiled, which collected 364 botanical, animal and mineral substances and their medicinal properties. Zhang Zong Jing (150-219 A.D.) wrote two instrumental books that are still used today: Summaries of Common Diseases (Jing Kuei Yao Lueh) and Discussion of Cold-Induced Disorders (Shang Han Lun). Because of the many accomplishments that occurred during the Han dynasty, TCM is often referred to as "Han medicine" in both Japan and Korea. Zhang has been dubbed "the father of traditional Chinese medicine"; the oldest copy of his book is kept in a museum in Japan.
Hua Tao was another accomplished surgeon and TCM practitioner of the Han dynasty. He prescribed ma for san for anesthesia during operation. He also invented the "five-animal exercise routine" by studying the movement of different animals. This is an early form of wu shu.
A well-preserved female corpse buried in 168 B.C. was recovered from the Ma Wang Dui Han Tomb in 1972. It is the earliest "wet" corpse ever recovered. The most important TCM discovery in the tomb was a manuscript titled, Prescription for Fifty-Two Ailments, composed before 300 B.C. It describes 250 medicinal substances and discusses diet, exercise and moxibustion.
Classic of Acupuncture and Moxibustion is the earliest treatise of its kind, written by Huang Pu Mih of the Jing dynasty in 286 A.D. Another text, Classic of Pulse Diagnosis, which classifies 24 pulses, was written by Wang Shu Ho circa 201-280 A.D. Revised Shen Nung Materia Medica was written by Tao Hung Jing in 450 A.D. It catalogs 730 medicinal substances and comprises seven volumes.
The Second Great Leap Forward
TCM reached a new height in the Tang dynasty (618 to 907 A.D.), another prosperous era in Chinese history. The royal government established the Imperial Medical College to take charge of TCM in 624 A.D., more than 200 years before the first Western medical college was established in Italy.
Sun Sze Miao (590-682 A.D.) was one of the most accomplished scholars in this period. He wrote Thousand Precious Formulas and Thousand Precious Supplemental Formulas, detailing herbal prescriptions and acupuncture meridians. He proposed the idea of "tender spots" or ah shi points.
In 659 A.D., the Tang government commissioned Su Jing and his colleagues to revise the New Materia Medica. It was the first official pharmacopoeia in the world.
Diet therapy was advanced by Meng Shen in his book, Diet Therapy of Herbs (Shih Liao Ben Tsao) in 686 A.D. The oldest copy of this book is in the archives of the British Museum.
TCM was introduced to Korea and Japan in the Tang dynasty. Korea established the first doctorate degree of acupuncture and moxibustion in 693 A.D. Classic of Acupuncture and Moxibustion and Ming Tang Acupuncture Meridian Chart were brought to Japan by Tze Tsong, a Buddhist monk from China, in 562 A.D.
The Blossom of a Thousand Flowers
The progress of TCM during the Sung (962-1279), Yuan (1215-1368), Ming (1368-1644) and Ching (1644-1911) dynasties is unprecedented. Movable typesetting invented by Bi Shen during the Sung dynasty played a major role in disseminating information, and publications and numerous schools of thoughts flourished. For example, Wang Wei Yi wrote Illustrated Manual of Acupuncture and Moxibustion Points on the Bronze Figure in 1026. He cast two life-size bronze figures to standardize 675 acupuncture points on the figure. One figure was lost during a war; the other was seized by Japan as a trophy.
The Imperial Pharmacy was founded by the Sung Court. In 1151, Chen Shi Wen and his colleagues compiled Formulas of Imperial People's Pharmacy, a revision of Tai Ping Royal Formulas that lists over 20,000 formulas in 1,700 categories.
Hua Bo Ren, of the Yuan dynasty, wrote Discussion of Fourteen Meridians in 1341. He is regarded in Japan as the father of acupuncture. The most celebrated herbal work in Li Shi Zhen's (1518-1593) Grand Materia Medica, which was posthumously published in 1596 during the Ming dynasty. It has 52 volumes describing 1,892 substances and 8,160 formulas. Ping Hu Pulse Diagnosis is his other contribution to TCM. He is regarded as the greatest herbalist of all time. Archives of Acupuncture and Moxibustion is an important book of reference written by Yang Jih Zou in 1602. It elaborates various ancient and current theories.
The decline of TCM began when the Czar of Russia invaded China from the north in the late 18th century. The invasion continued in the 19th century, with Japan invading from the northeast and the Western imperialists from the south and southwest. A series of humiliating defeats, including the First Opium War (1839-1842), the Second Opium War or Anglo-Franco Invasion (1856-1860) and the Invasion of Eight Western Armies or Boxer Rebellion (1900-1901) brought China to its knees. China not only lost vast territories, huge indemnities and priceless national treasures, but also its confidence in many of its old values, such as the "unscientific" TCM.
Traditional Chinese medicine became a prime target of attack by pro-Western government reformists and doctors of Western medicine. The attack culminated in 1928, when the Nationalist Government proposed to phase out new TCM licensing in the subsequent five years. On March 17, 1929, nearly 300 TCM representatives from across the nation gathered in Shanghai to discuss plans to oppose the proposal. Even TCM workers in Hong Kong (a British colony at that time) donated 100 silver dollars for the cause. The meeting was organized by Chen Tsen Ren (1908-1990), a young traditional Chinese medicine practitioner. He is also noted for compiling the Encyclopedia of TCM Substances in 1935.
After the meeting, he led a five-man delegation to petition the Nanjing government to drop the proposal. The delegates were well received by Chiang Kai Shek, chairman of the Military Committee and the Minister of Public Health. The delegates argued that traditional Chinese medical treatment was effective and economical, and that there were simply not enough Western doctors to provide health care for the entire nation. The proposal was dropped a few days later. March 17, 1929 marked the end of the darkest period in TCM history and has now become a national Traditional Chinese Medicine Day.
Traditional Chinese medicine did not recover immediately because of the advances of the Japanese army during World War II. In the 1950s, the government systematically set up a number of TCM colleges nationwide. Some Western science courses have been incorporated into the curriculum. Graduates receive advanced degrees to booster their academic and social status. Western medical doctors have been encouraged to study TCM. A significant development was the introduction of TCM to major Western medical universities in China. The marriage between Eastern and Western medicine gave birth to so-called integrative medicine, and led to the first successful tonsillectomy under acupuncture anesthesia by the Shanghai Cooperative Group of Acupuncture Anesthesia in 1964. A number of research studies conducted by scientists in China in the 1960s and early 1970s provided sufficient evidence for the neurohumoral theory to explain the mechanism of acupuncture.
Credit for the renaissance should be given to Mao Tse Tung. One of his noted quotations is, "Traditional Chinese medicine is a great treasure. It must be thoroughly studied and elevated to a higher level." "Credit" should also be given to the United States, which has imposed harsh economic sanctions and embargoes against China ever since the Korean War. Without adequate Western medical supplies, China had to rely on TCM and "barefoot doctors" to provide health care to its one billion citizens.
After the Zhou-Nixon summit in 1972, TCM was reintroduced to the West. Its popularity rose quickly. One out of ten adults in the U.S. tried TCM last year, and a number of TCM colleges have been established across the nation. The number of practitioners has increased more than tenfold in the past 20 years. China has played an important role by providing scholars and clinicians to become the backbone of TCM educators and practitioners worldwide. In the U.S., the National Institutes of Health has established the National Center for Complementary and Alternative Medicine. Its annual budget is now more than $100 million. Some major medical schools have set up offices for integrative medicine. Their larger mission is to integrate Eastern and Western medicine, which China started doing 40 years ago.
To prepare for the integration, TCM curriculum should incorporate more courses of Western clinical and basic science. The length of study should be increased to accommodate the additional training. It will help the graduates to conduct scientific research to find out why and how TCM works. This is important for the advancement and acceptance of TCM, not only by the public, but also the scientific community. Education and research through science are the driving forces for the eventual integration of Eastern and Western medicine. It is possible that one day there will be only one integrative health system, where practitioners of both fields will work side-by-side.