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History of Chinese Medical Theory - Vocabulary Flashcards

Legends and Myths

  • Timeline context: Ancient Chinese medical practice is largely obscure before around 200 ext{ BC}; earliest legends link medical origins to a trio of legendary figures.

  • a) Fu Xi (伏羲) (~{ extbf{ca.} ext} 2953 ext{ BC})

    • Father of Chinese medicine; credited with creating the Ba Gua (八卦), eight trigrams used as the basis for the I Ching (Yi Jing) or Book of Changes.
    • Bagua concept connected to cosmology and divination; used to express the underlying structure of the universe.
    • Bagua arrangement (simplified): Kun 坤, Gen 艮, Qian 乾, Zhen 震, Li 離, Dui 兌, Kan 坎, Xun 巽, with associated elements and cyclical interactions (extinctions and generations) as depicted on charts.
    • Related imagery: Dragon-horse symbol; He Tu (Yellow River Map) as a contributing cosmological map.

  • Fu Xi’s Bagua is the forerunner to the later 64 hexagrams of the I Ching; foundational to Chinese cosmology and later medical theory.

  • b) Shen Nong (神农) – Divine Husbandman or Fire Emperor (≈ 2838 ext{ BC}–2698 ext{ BC})

    • Founder of agriculture and originator of herbal medicine in China.
    • Taught plant cultivation, livestock management, and empirically learned therapeutic properties of herbs by observing their effects.
    • The legend of Shen Nong’s herbal testing includes hundreds of plants tested via tasting and observation; the herbal tradition is rooted in direct trial and experience.
    • Early texts associate Shen Nong with the foundational role of materia medica and herbal pharmacology.
    • The legend emphasizes systematic experimentation with plants for healing.

  • The Legend of Shen Nong’s Herbal Classic emphasizes: earliest Chinese herbal textbook and the founder’s dual role in agriculture and medicine.

  • c) Huang Di – Yellow Emperor (黄帝) (≈ 2698 ext{ BC}–2598 ext{ BC})

    • Traditionally regarded as the originator of Chinese medicine and the Father of the Chinese Nation.
    • Allegedly taught skills essential to civilization: building wooden houses, silk weaving, boats, carts, bows and arrows, ceramics, writing.
    • The modern form of TCM is first expressed in his work, the Yellow Emperor’s Inner Classic (Huangdi Neijing), divided into two books.
    • Significance: establishes the cultural and philosophical basis for medical theory (e.g., Yin–Yang, Five Phases, and clinical principles).
    • Huangdi is credited with spreading technological and cultural innovations; many noble lineages trace their roots to his sons and to the broader narrative of Xia/Shang/Zhou.

  • Illustrative notes:

    • Huangdi and the Yellow Emperor Mausoleum are iconic symbols of ancient Chinese heritage (e.g., Huangdi Mausoleum, Huangdi stone trees, and related inscriptions).
    • The Yellow Emperor’s outer legends connect the origin of surnames to geographic settlements established by his offspring.

Xia, Shang, Zhou Dynasties (2100 BC–771 BC)

  • Role of shamans: acted as intermediaries between the living and the dead; participated in ritual courts, weather activities, and combatting illness-causing demons.
  • Acupuncture may have emerged from shamanic practice aimed at driving out evil spirits with ritual tools such as spears; early medical interventions were intertwined with ritual and cosmology.
  • Key geographic and cultural nodes mentioned: Anyang, Luoyang, Shang/Huang maps, Mawangdui, Sanxingdui, Yangtze and Yellow Rivers, East/West China, South China Sea, etc., illustrating the geographic breadth of early Chinese medicine.
  • Wu-Witch healers noted as historical reference to early healing practices.

Spring-Autumn Period, Warring States Period, Qin and Han Dynasties (722 BC–AD 220)

  • Philosophical awakening shaped medical ethics and cosmology:
    • Confucianism and Daoism influenced medical ethics, social order, and cosmological views.
    • Early Yin–Yang concepts and the Five Elements began to influence health theory and disease classification.
  • Medical practice in Spring-Autumn: healing remained intertwined with ritual and shamanic traditions; emphasis on harmony between humans and nature.
  • Yi He (伊和) and the Theory of Six Climatic Factors (六气学说): explains the causes of diseases through climatic influences.
  • Warring States to Han: numerous philosophers and schools contributed to CM theory; major strands include Taoist, Confucian, and Yin–Yang thought; foundational theoretical system established.
  • Four CM Classics written/published in this period:
    • a) The Yellow Emperor’s Inner Classic (Huang Di Nei Jing)
    • b) The Classic of Difficult Issues (Nan Jing)
    • c) Treatise on Cold Damage and Miscellaneous Diseases (Shang Han Lun)
    • d) Classic of Shen Nong’s Materia Medica (Shen Nong Ben Cao Jing)

The Four Classics of CM (foundational texts)

  • a) The Yellow Emperor’s Inner Classic (Huang Di Nei Jing)
    • First compiled around 200 ext{ BC}–100 ext{ BC}; critical to legend and practice.
    • Two books:
    • Simple Questions (Su Wen): medical theory (Yin–Yang, Five Phases, seasonal effects).
    • Spiritual Axis (Ling Shu): acupuncture and moxibustion; largely dialogue-driven between Huangdi and ministers (e.g., Qi Bo).
    • Key historical figures: Qi Bo (famous minister) for curing sickness, testing drugs, and contributing to medical writings.
    • Modern connections: the Neijing forms the core of classical CM theory and remains a reference for theory and practice.
    • References: linked lecture/YouTube materials illustrate the Neijing’s content and historical context.
  • b) The Classic of Difficult Issues (Nan Jing)
    • Compiled in the 1st–2nd century AD; attributed to the legendary physician Bian Que (407–310 BC).
    • Introduced the four diagnostic techniques: inspection, listening/smelling, inquiry, and palpation.
    • Organized theory and practice of acupuncture in terms of body structure and diagnosis; emphasizes systematic thinking rather than magical elements.
    • Influenced CM practice and its transmission to Japan; serves as a commentary on the Inner Classic.
    • Notable lines include the emphasis on pulse and other diagnostic cues (e.g., a translation excerpt: “The twelve meridians all have arteries, only the pulse is taken”).
  • c) Treatise on Cold Damage and Miscellaneous Diseases (Shang Han Lun)
    • Zhang Zhongjing (张仲景), the “Sage of Medicine,” Eastern Han dynasty (circa 150 ext{–}219 ext{ AD}).
    • Clinical foundation: first comprehensive text to systematically apply diagnosis and treatment based on symptom differentiation (辩证论治, Bian Zheng Lun Zhi).
    • Six Stages Theory (six stages of febrile disease): Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin.
    • Formula mastery: includes over 260 herbal prescriptions; some remain in use today (e.g., Gui Zhi Tang, Ma Huang Tang).
    • Impact: laid groundwork for internal and external disease treatment, guiding centuries of clinical reasoning.
  • d) Classic of Shen Nong’s Materia Medica (Shen Nong Ben Cao Jing)
    • First systematic summary of medicinal herbs; 365 substances described for healing.
    • Core pharmacological concepts introduced:
    • Si Qi: four properties of drugs — cold, hot, warm, and cool.
    • Wu Wei: five flavors — sour, bitter, sweet, acrid, and salty.
    • Jun, Chen, Zuo, Shi: monarch, minister, assistant, and guide roles in prescriptions.
    • Qi Qing He He: seven conditions in constructing prescriptions (individualized herb-dietary adjustments).

Wei, Jin, Sui, Tang Dynasties (AD 265–907)

  • 1) The Pulse Classic (Maijing) by Wang Shuhe (晋, Jin dynasty)
    • First dedicated monograph on pulse diagnostics in China; classified 24 pulse types; refined tactile diagnosis.
  • 2) On Etiology and Syndromes of Diseases (Zhu Bing Yuan Hou Lun) by Chao Yuanfang (楚元方, Sui dynasty)
    • Systematic text on disease origin and symptom patterns; documented hundreds of syndromes; provided a blueprint for pattern differentiation.
  • 3) Systematic Classic of Acupuncture and Moxibustion (Zhen Jiu Jia Yi Jing) by Huangfu Mi (黄甫谧; AD 215–286)
    • First comprehensive text organizing acupuncture points, techniques, and indications.
  • 4) Prescriptions Worth a Thousand Gold for Emergencies (Bei Ji Qian Jin Yao Fang) by Sun Simiao (孙思邈; Tang dynasty)
    • Covers internal medicine, pediatrics, gynecology, emergencies; emphasizes physicians’ moral responsibility; earliest articulation of medical ethics in CM.
  • 5) A Supplement to the Essential Prescriptions Worth a Thousand Gold (Bu Ji Jin Yian Fang) [additional supplement]

Song, Jin and Yuan Dynasties (AD 960–1230)

  • Three Categories of Causes of Diseases and Formulas (San Yin Ji Yi Bing Zheng Fang Lun)
    • Chen Wuze (Chen Yan) of the Song dynasty introduced a tripartite classification for disease causes: external, internal, miscellaneous.
    • Notable mythic elements: two life-size bronze figures created in 1057; symbolic of medical knowledge and ritual.
  • Wang Weiyi and standardization
    • Wang Weiyi (Song dynasty) established Bureau for Correcting Medical Books and contributed to standardizing medical texts.
  • Academic landscape: prominent schools of thought and cross-pollination that influenced clinical practice and education.

Four Great Physicians of Jin–Yuan Dynasties (academic arguments and schools)

  • Liu Wan-su (Liu Wansu) – School of Cold and Cool
    • Observed high fever and inflammation in serious diseases; advocated cooling/clearing herbs for these conditions.
    • Influenced later concepts of wen bing (epidemic febrile diseases) and connected with Nei Jing Su Wen etiology.
  • Chang Tzu-Ho (Zhang Zihe) – School of Attacking (Eliminating)
    • Developed the attacking school, emphasizing diaphoretics, emetics, and purgatives to expel pathogens; revival of Han-era techniques of driving out demons.
  • Li Tung-yun (Li Dongyuan) – School of Supplementing Earth
    • Argued many diseases stem from injury to the stomach/spleen due to overindulgence, overwork, and emotional strain; emphasized the importance of digestive system health.
    • Famous work Pi Wei Lun (Treatise on the Spleen and Stomach); popular formula: Buzhong Yiqi Tang (Ginseng and Astragalus Combination) to tonify and support the middle burner.
  • Chu Tan-Chi (Zhu Danxi / Zhu Zhenheng) – School of Enriching Yin
    • Argued chronic disease often results from yin deficiency due to overindulgence; recommended temperance and tonic formulas, focusing on kidney and liver nourishment.

Ming and Qing Dynasties (AD 1368–1911)

  • School of Wen Bing (Warm Diseases)
    • Acute febrile diseases caused by exogenous factors (epidemic smallpox and plague);
    • Clinically characterized by acute onset, strong heat signs, rapid progression, and tendency to damage yin;
    • Recognized warmth diseases as distinct from earlier cold-induced illnesses (e.g., Shang Han Lun influences).
  • Grand Materia Medica (Ben Cao Gang Mu, 本草纲目) by Li Shizhen (李时珍; 1518–1593)
    • Classified 1,892 medicinal substances; represents a cultural peak for acupuncture and moxibustion practice.

Dark Years of CM and Modern Transformations

  • Western-educated reform movement and regulation (early 20th century)
    • Between 1914 and 1936, clashes occurred regarding the regulation, establishment, or elimination of Chinese medical practice; traditional CM was challenged and sometimes displaced by Western medicine (WM).
    • The term “Chinese medicine” ( Zhong yi, 中医) emerged as a distinction from Western medicine (WM).

Modern Times (PRC era)

  • 1949: Founding of the People’s Republic of China
    • Widespread healthcare and educational reforms; modernization of CM.
    • CM and WM integration: traditional Chinese medicine was systematically integrated with Western medicine in clinical practice and education.
  • Unified training and professionalization
    • Medical practitioners trained in both CM and WM; dual-skilled workforce for hospitals and research centers.
  • Academic and institutional advancements
    • Standardized CM textbooks to support learning and clinical consistency.
    • Establishment of CM schools and colleges nationwide; formal licensing required to prescribe Western drugs in hospitals alongside traditional treatments.

Key Concepts, Techniques, and Ethical Foundations Across Eras

  • Shamanic to philosophical transition
    • Early CM used shamanic and ritual-based techniques; over time, emphasis shifted to cosmology (Yin–Yang, Five Elements), pattern differentiation, and evidence-based herbology.
  • Core theoretical pillars recurrent across eras
    • Yin–Yang dynamics, Five Elements, Qi (vital energy) and their circulation in the body.
  • Diagnostic innovations
    • Four diagnostic methods formalized in Nan Jing: inspection, listening/smelling, inquiry, palpation (and pulse diagnosis in Maijing).
  • Pattern differentiation and treatment principles (辩证论治)
    • Centric to Zhang Zhongjing and later physicians: match therapeutic strategy to the patient’s unique presentation.
  • Ethical dimensions
    • Sun Simiao’s emphasis on physician ethics as foundational to medical practice in CM (moral responsibilities of physicians).

Numerical and Terminological Highlights (selected references)

  • Bagua consists of 8 trigrams with the 64-hexagram system developed later from the Ba Gua structure.
  • The early herbal canon Shen Nong Ben Cao Jing describes 365 herbs/substances for healing.
  • The Grand Materia Medica classifies 1892 medicinal substances.
  • The major classic periods span roughly:
    • Ancient legends: up to 200 ext{ BC}
    • Classical canon formation: 200 ext{ BC} ext{ to } AD ext{ ~}
    • Jin–Yuan debates: 10 ext{th} ext{–} 13 ext{th} ext{ centuries}
  • The Six Stages of febrile disease in Shang Han Lun: Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin
  • The Four Diagnostic Techniques: inspection, listening/smelling, inquiry, palpation

Connections and Real-World Relevance

  • Continuous thread from mythic origins (Fu Xi, Shen Nong, Huang Di) to formal clinical practice (Neijing, Jing, and later treatises) shows a steady evolution from cosmology to systematized clinical reasoning.
  • The shift from ritual-dominated healing to pattern-based, diagnostic-driven care mirrors broader shifts in science from metaphorical frameworks to reproducible methods.
  • The modern integration of CM with WM in China demonstrates a pragmatic approach to healthcare: multi-modal training, cross-disciplinary licensing, and joint clinical practice.
  • The ethical emphasis from Sun Simiao foreshadows contemporary medical ethics discussions on patient-centered care, consent, and professional responsibility.

Notes on sources and context: The content above consolidates slide-derived material, including references to classic texts (Huang Di Nei Jing Su Wen and Ling Shu; Nan Jing; Shang Han Lun; Shen Nong Ben Cao Jing), physician biographies (Liu Wansu, Zhang Zihe, Li Dongyuan, Zhu Danxi), and historical shifts through the Ming, Qing, and modern eras. Illustrative links to external videos and mausoleums are included in the slides for supplementary context.