What we learned from TCM history

Returning to the classics: An important approach for the ongoing development of traditional Chinese medicine

1. History and Inheritance of Traditional Chinese Medicine

As we all know, Chinese medicine has a long history. If we count from the Fuxi era, Chinese medicine has a history of 8,000 years. The earliest works on Chinese medicine discovered so far were written 3,500 years ago. Today, we will learn about the history and inheritance of traditional Chinese medicine from the development of historical works. The quantity and quality of work can be divided into the following four stages.

• The first stage: From the Shang Dynasty to the Spring and Autumn Period and the Warring States Period (about 1600 BC to 202 BC), Chinese medicine became independent from shamanistic practices and formed a separate discipline. At this stage, the theory of traditional Chinese medicine is complete, and the technology is comprehensive. It has formed a whole system of health preservation and treatment with Qi as the core, yin and yang as the theoretical basis, face complexion and pulse as the diagnostic basis, acupuncture, moxibustion, herbal medicine, and bian-stone therapy as the therapeutic method, and Qi regulation as the purpose. During this period, there were only a few classic works. The recorded books include “Tangye Jing,” “Huangdi Neijing,” “Nanjing,” and “Yin Yang Ying Xiang Da Lun.” Still, the only existing books now are the “Huangdi Neijing” (Yellow emperor interior canon) and the “Nan Jing” (the classic of Difficulties).

• The second stage: Han Dynasty to Tang Dynasty (202 BC to AD 907). This epoch sees the development and perfection of traditional Chinese medicine to its peak. The main works are “Shen Nong’s Materia Medica,” Zhang Zhongjing’s ” Shanghan Lun “(Treatise on Cold Pathogenic Diseases), Hua Tuo’s “Zhong Zang Jing,” Wang Shuhe’s “Mai jing” (Pulse Classic), Huangfu Mi’s “Acupuncture and Moxibustion Jiayi Jing,” Tao Hongjing’s “Shen Nong’s Materia Medica,” Yang Shangshan’s “Huangdi Neijing Taisu,” Sun Simiao’s “Qian Jin Yao Fang” (thousand essential prescriptions), Wang Tao’s “Wai Tai Mi Yao,” and Wang Bing’s “Supplementary Notes to Huangdi Neijing Su Wen” (which is the current version of Huang Di Nei Jing). At this stage, the classics of traditional Chinese medicine and the theoretical system are complete. The essential diagnosis of the complexion and pulse expands to include the symptom system. During this period, TCM also spread to Japan, Korea, India, Vietnam, Southeast Asia, and the Arab region.

• In the third stage, from the Five Dynasties and Ten Kingdoms to the Qing Dynasty (AD 907-1912), due to the invasion of the northern peoples, the inheritance of Chinese culture was ruined. This era saw the development of competing doctrines, divergent theories, and alternate schools of thought. During this period, there were more than 500 TCM works recorded. Including books aimed at interpreting the classics, collections of medical experiences, and books promoting their schools of thought, such as the Hanliang (Cold and Cool) School, the Gongxia School, the Yishui School, the Warming Nourish School, the Nourishing Yin School, and the Warming Disease School. From the names of these schools, it can be recognized that at this time, the treatment principles of traditional Chinese medicine have deviated from the theoretical basis of “no need for questions about the disease, focus only on regulating and balancing the Qi.” The selective use and purposeful modification of theoretical parts by these competing theories and schools led to incompleteness and errors in the inheritance of TCM theories, as well as the weakening and modification of the unity of Qi. Therefore, in the Qing Dynasty, Zhang Zhicong concluded that “Even though the scriptures were passed down, the true meaning of the scriptures vanished.”

• In the fourth stage, from the Republic of China to the present (1912-present). Due to the introduction of scientific ideas, the concept of Qi in TCM cannot be understood and explained. As a result, the PRC TCM schools decided to modify their educational system to account for the scientific theories of the times. Although the concept of qi remained in specific medical practice, the idea of ​​qi has been wholly abandoned, thus directly destroying the theoretical basis of traditional Chinese medicine with Qi as the core. Abandoning Qi as the central foundation results in the fragmentation of the theory of traditional Chinese medicine and the loss of integrity. More than 10,000 Chinese medicine books were published in this era, covering various approaches and styles. The modified TCM model produced a type of Chinese medical practice less connected to the essential core of Chinese medicine. The outcome is the current version of TCM based on selected fragments and modified parts of the founding principles practiced with various acupuncture techniques and prescriptions. Due to the narrowness of scientific cognition and the fragmentation of traditional Chinese medicine theory, the efficacy of traditional Chinese medicine has been degraded. These changes create an educational system that produces graduates and practitioners capable of working with the parts and pieces while missing the functional wholeness of the complete system. Working clinic without a whole system may not achieve the best outcomes for patients compared to results obtained by practitioners using the whole system. Greater understanding and utilization of the founding principles will result in a complete application of the medicine with significant potential to improve patient outcomes. Fortunately, in the past ten years, science is realizing that there are still many unknown fields in science, which has also caused science to reconsider the concept of qi.

It can be seen from the above four epochs that in the first and second stages, there are few works. The four major and other classics of traditional Chinese medicine were completed during this period. In the third and fourth stages, the number of works has increased exponentially, but not one of them can be called a classic. Therefore, from the perspective of traditional Chinese medicine works, we can see that a large number does not necessarily equate to high quality. These works not only fail to improve the theoretical system of traditional Chinese medicine, but on the contrary, due to the large number of them, the basic theoretical system of traditional Chinese medicine has been differentiated, reduced or even disappeared.

2. The necessity and importance of theoretical support

Any discipline, any research, needs to have its specific theoretical basis. Based on this theoretical basis, we can guide practice and form a closed-loop system of theory-practice-theory-practice, that is, the law of scientific development. At the same time, various disciplines are striving to pursue the integrity and broad applicability of the theory, that is, to use a set of big theories to unify all the current theories. For example, people also try to use a theory to explain the formation and development of the universe, such as the Big Bang Theory. Physics also explores using a force theory to unify the four fundamental forces.

Using theory to guide practice makes our exploration directional and verifies the rationality of our practical results.

For example, people have been exploring the invention of perpetual motion machines throughout history. However, the emergence of energy conservation theory (energy is neither created nor destroyed) an empirical law, tells us that perpetual motion machines are impossible to achieve from a theoretical level.

For another example, after the discovery of Uranus, astronomers observed the orbit of Uranus and, according to the gravitational theory, pointed out that the deviation of Uranus’ orbit must be caused by the existence of another planet acting on it. This use of gravitational principles led to the discovery of Neptune.

For another example, in modern competitive sports, we have been applying various theories to guide the training of various technical movements. For example, in figure skating, obeying the conservation of angular momentum theory, the skater spins faster by folding in their arms. In swimming, as long as you find ways to reduce the resistance of the water, it is also possible to swim faster. It can be said that in any project, some fundamental theories guide the technical development of coaches and athletes.

Therefore, practice with theoretical support is a purposeful exploration, and practice without theoretical support is a blind guess.

Going back to Chinese medicine, the original and root theory of Chinese medicine is the unification of Qi. Regardless of the etiology, pathogenesis, symptoms, pulse, weather changes, etc. They are all manifestations of Qi. The yin and yang of Qi, the attributes of the five elements, and the movement and transformation of Qi are the core of Chinese medicine theory. If this theory does not guide the practice, it is equivalent to practicing without theoretical support, and unpredictable results can be expected.

3. The origin and development of TCM theory

Like most disciplines, the origin of TCM theory comes from the observation and summary of nature.

In the Fuxi era (about 8000 BC), Fuxi created the “Book of Changes” (I Ching) and the innate Eight trigram system through his observation of the natural world. The Book of Changes is based on yin and yang lines, and since then, the theory of yin and yang has become one of the fundamental theories of traditional Chinese medicine.

The He Tu is an abstract form of the sky map. The emergence of the He Tu has completed the theory of yin and yang and five elements.

Hetu, Luoshu, and Taijitu are the two-dimensional models of Chinese medicine theory, and the double spiral field is the three-dimensional model of Chinese medicine theory. These models not only reflect the general laws of the universe but also cover the yin and yang of Qi in the field of Chinese medicine, the five elements, as well as movement and changes. From this, it is determined that traditional Chinese medicine takes Qi regulation as the treatment principle and acupuncture, moxibustion, Bian-stone therapy and herb medicine as the treatment methods.

Therefore, we will say that the theory of traditional Chinese medicine comes from astronomy because it comes from the observation of the universe, and it is applied to the human body according to the principle that human beings are a part of the universe and follow the general laws of the universe. To this day, the scientific exploration of the universe has not denied the double spiral model of the universe’s yin-yang and five elements and has instead verified the double-spiral theory.

Current TCM has many theories, including yin and yang, the five elements, the Zang Fu organs, the meridians, etiology, pathogenesis, syndrome differentiation, and Five Yun and Six Qi theory. There have been many problems, such as contradictions in some places and unreliable curative effects. However, if we return to the classical perspective, from the perspective of Qi, these theories can be unified under the theory of Qi. Yin and yang and the five elements are the attributes and restraints of Qi. The complexion and pulse are the windows of Qi. The Zang-fu organs are the yin and yang of the human body and Qi of the five elements. The meridians are the channels through which the human body operates, the etiology is because of the imbalance of Qi, the pathogenesis is an imbalance in the root of Qi, and the symptoms are the external manifestations of Qi. The diagnosis is to judge what is the Qi movement problem and at which position. The treatment is to regulate the Qi. The Five Yun and Six Qi theory is about the changes in the Qi of heaven and earth and their impact on the human body.

Therefore, we can draw the following conclusions: the current TCM theory is fragmented, and the unified theory of Qi is a complete theoretical system of TCM. Therefore, at the theoretical level, we need to return to the classics and use the whole TCM theory to guide practice, to realize the revival of traditional Chinese medicine, and to serve human health better.