The History of Chinese Medicine is very long, with its beginnings dating to well before the life of Christ. Here in 21st century Canada, it is difficult and perhaps even impossible for us to fully grasp the nature of such a time scale of development. The earliest archaeological evidence of acupuncture indicates beginnings over 2000 years before Sir John A. Macdonald was born! Chinese Medicine was not developed at one point in time or by one person. It has been developed by an entire civilisation over centuries of revision, refinement and adjustment to different social, cultural, political and scientific trends . Many physicians and clinicians have contributed to the full body of knowledge known today as Chinese Medicine. This synopsis gives a brief overview of some of the more seminal moments in the history of this Medicine, running chronologically through each era of Chinese history.
The Periods of Chinese History
Much of premodern China is demarcated historically as a series of dynasties. The major dynasties and modern eras are listed below.
- Xia – 2100-1523 BC
- Shang – 1523-1027 BC
- Zhou Dynasty – 1027-221 BC
- Qin Dynasty – 221-206 BC
- Han Dynasty – 206 BC – 220 AD
- 6 Dynasties – 220-589
- Sui Dynasty – 590-617
- Tang Dynasty – 618-906
- 5 Dynasties – 907-960
- Song Dynasty – 960-1264
- Yuan Dynasty – 1264-1368
- Ming Dynasty – 1368-1643
- Qing Dynasty – 1644-1911
- Republic of China – 1911
- People’s Republic of China – 1949
The eminent sinologist, Paul Unschuld has noted a distinct difference between how we handle knowledge in modern Western societies and how traditional Chinese society handled knowledge. The evolution of ideas in Western cultures is characterised by Replacement. That is, if a previously held idea is inconsistent with the prevailing paradigm or worldview, it is rejected/discarded. The evolution of ideas in Traditional Chinese culture is characterised byAccumulation (syncretism). The Chinese are traditionally a highly practical people. If an idea works, it will continue to be used even if it is inconsistent with newer models of reality. So the full body of Chinese Medicine is characterised by many different theories, ideas and principles which often contradict one another but which remain in use due to their clinical effectiveness and profound insights.
Shang Dynasty (1523 BC – 1027 BC)
- Dominated by themes of shamanic and ancestral Medicine
- Community consisted of all the Living and Dead.
- Health was perceived to depend on harmony between the Living
- and the Dead
- The only recognised ‘natural’ cause of illness was Wind
Zhou Dynasty (1027 BC – 221 BC)
- Confucianism arose in the middle Zhou Dynasty.
- Key Confucian themes included
- – Impacts of Human Behaviour on Social Outcomes
- – Importance of Moderation in Lifestyle
- – Shifted thinking away from demonic illness causation to human action
- Taoism arose in the late Zhou. A key Taoist theme was the notion that the
- Laws of Nature were ultimately beyond Human Comprehension
Qin Dynasty (221 BC – 206 BC)
- All books except those on Medicine, Agriculture, Oracles were burnt
- Standardisation of weights, measures, road width.
Han Dynasty (206 BC – 220 AD)
This was such a productive and creative period that even today, the Chinese people are sometimes referred to as ‘People of the Han’ This period saw the complete development of a Medicine of Systematic Correspondence (the basis of much of Chinese Medicine) over its full 400 year period
- Ma Wang Dui Texts
- Written in the late -3 to -2 Century, these texts were excavated by
- archaeologists in 1973 from the tomb of a Han Dynasty Prince in Hunan
- Province. They had been buried in 168 BC.
- They are now considered to represent a reasonable boundary for the
- point in time at which Medicine became distinct from Religion.
- These texts contain descriptions of 11 of the 12 Separate Acupuncture
- Channels (Pericardium channel is missing).
- Each Channel is associated with specific symptoms
- Some channels are even named after their symptomatic focus.
- For example, the Large Intestine Meridian is called ‘the tooth
- These texts contain medical theories describing the idea that channels
- are subject to repletion, vacuity, and undesirable movement. These
- ideas remain central to acupuncture practice today.
- No mention of points are found, indicating that the concept of channels
- predates the concept of acupuncture points.
- No mention of needles, only moxibustion; indicating that moxibustion
- predated needling as a therapy.
- No mention of the idea of Qi circulation
- No disease theory
- Huang Di Nei Jing (Yellow Emperor’s Canon of Internal Medicine)
- Written in -2 to -1 Century.
- This text is arguably the single most important text in the
- canon of Chinese Medicine. In legend, it is dated to -2700 to -2600, the
- time of the Yellow Emperor. The text is written as Dialogue between
- Huang Di and Minister Qi Bo.
- The Nei Jing, as it is known, has 2 parts, each with 81 Chapters.
- Nei Jing Su Wen (Fundamental Questions)
- contains medical theory.
- Nei Jing Ling Shu (Spiritual Axis)
- is an acupuncture manual.
- Yin Yang theory and 5 Phase theory are present in the Nei Jing.
- The Nei Jing is not rigorously structured or systematic.
- It has clearly been written by many authours.
- 12 regular channels identified.
- 295 acupuncture points identified (670 presently).
- An internal anatomy composed of 11 organs (5 Zang and 6 Fu) is
- Therapy discussed in the Nei Jing includes Bloodletting, Needle
- Insertion, and Moxibustion at specific points; all tending to be quite
- Beyond Wind, the Nei Jing recognises other Internal and External
- causes of disease, including climatic factors and emotions.
- Treatment is allopathic
- Terminology used in the Nei Jing reflects political, social and
- engineering structures of the day.
- is an acupuncture manual.
- Nan Jing (Classic of Difficulties)
- Written in the 1st century, the Nan Jing has 81 Chapters.
- It contains a mature development of Medicine of Systematic
- Correspondence. The Nan Jing integrates all aspects of health care
- into Yin-Yang and 5 Phase doctrines. All Channels connected in one
- circuit of Qi circulation. The Nan Jing contains a highly formal
- development of positional pulse diagnosis at the wrist, with
- 3 identified depths at each of 3 positions on each wrist for a total
- of 18 wrist locations where pulse quality has interpretable significance.
- Demonology and Magic are entirely absent in the Nan Jing.
- The choice of Acupoints is based on systematic understanding of Qi
- circulation. The goal of treatment in the Nan Jing is not so much to
- treat a disease or symptom but to adjust Qi to an ideal state.
- Shang Han Lun (Discourse on Cold-Induced Disorders)
- Written around 198 by Chinese physician, Zhang Zhong-Jing
- This is the 1st major text of Herbal Medicine.
- Details progression of epidemic acute febrile disease through 6 levels.
- The Shang Han Lun is a major foundation of modern day Traditional Chinese Herbal Medicine
- Hua Tuo – Hua Tuo was a famous physician, surgeon, and diagnostician.
- He developed a physical exercise known as the 5 Animal Frolics.
Six Dynasties (220 – 589)
Zhen Jiu Jia Yi Jing (The Systematic Classic of Acupuncture and Moxibustion)
This text was written by Chinese physician, Huang Fu Mi in 282.
It is a complete technical book on Acupuncture and Moxibustion.
This text was the first to focus on Acupuncture for Disease prevention
(the idea that the superior physician treats disease before it arises).
It establishes a modern text book format (each channel, points on the
channel, locations, needling specifics, actions and effects)
Mai Jing (Pulse Classic)
Written by Chinese physician, Wang Shu He, in 280, the Mai Jing
established 24 pulse qualities
First Export of Medical Practices to Neighbouring Countries
Korea, Japan, Vietnam
Tang Dynasty (618 – 906)
Qian-jin Yao fang (Thousand Ducat Prescriptions) 652
Qian-jin Yi fang (Supplement to Thousand Ducat) 682
Written by famous Chinese physician, Sun Si Miao
These are mostly Herbal Texts with many new formulae for febrile
diseases and Women’s diseases. Sun Si Miao developed the format
for Acupuncture Charts still in use (front, side, back views) today.
He systematised the Body Inch (cun) Acupoint location system
Sun Si Miao developed the use of Ashi points (an early trigger
He described 13 ‘ghost points’ with specific applications for
Search for Immortal Elixirs was the focus of much Herbal work
7 of 22 Tang rulers died from formulas intended to impart immortality
Four specialised types of Doctor recognised during the Tang Dynasty.
Physician (herb doctor), Acupuncturist, Masseur, Exorcist
Korea and Japan formalised Medical education with establishment of
Medical Colleges during this time period.
Nei Jing, Nan Jing, Zhen Jiu Jia Yi Jing were core of curriculum
Practice of Acupuncture was, for first time, related to seasonal and
other cycles of Chinese Calendar (The Tang dynasty edition of the
Nei Jing Su Wen contained chronobiological concepts).
Song Dynasty (960 – 1264)
This famous life size model was constructed in 1026, after the Emperor
ordered life size bronze statue with holes. During the qualifying
examination for physicians, it was filled with water and covered in wax.
When the correct point locations were needled, it would leak.
Zhen Jing Zhi Nan (Compass Bearings for Acupuncture and Moxibustion)
Written by Chinese physician, Dou Han Jing in 1241.
Contains an elaboration on Diurnal, Monthly, Seasonal, Annual cycles
of Qi according to which Acupuncture is performed
Zi Wu Liu Zhu Zhen Jing
Written by Chinese physician, He Rou Yu
Contains specific Biorhythmic treatments
The Four Schools
Cold and Cooling School
Led by Liu Wan Su (1120 – 1200)
Led by Zhang Zhe (1156 – 1228)
Dominated by the theme that we are sick because of toxins.
This school advocated that tonics were overused.
Therapies promoted sweat to cool and expel toxins, induced vomitting
to expel poison and promoted bowel movements to expel toxins.
Stomach and Spleen School
Led by Li Gao a.k.a. Li Dong Yuan (1180 – 1251)
Dominated by the theme that most illness was from damage to Spleen
and Stomach systems. Formulas developed are still used today for
digestive troubles, allergies, and chronic fatigue.
Nourish Yin School
Led by Zhu Zhen Zhen (1281 – 1358)
Dominated by the theme that protecting Yin should be the priority.
Yin is easy to lose and difficult to replace while Yang is easy to build.
Ming Dynasty (1368 – 1643)
Zhen Jiu Da Quan
Written in 1439 by Xu Feng
This was the first text to systematically describe 8 Extraordinary
Vessels (originally mentioned in Nei Jing)
Zhen Jia Ju Ying
Written in 1529 by Gao Wu
This text promoted the use of Supplementation and Drainage Points.
Zhen Jiu Da Cheng (Great Compendium of Acupuncture and Moxibustion)
Written in 1601 by Yang Ji Zhou
Ben Cao Gang Mu (The Great Pharmacopia)
Written in 1578 by Li Shi Zhen
1892 herbs, 1000 formulae
Bin Hu Mai Xue (Pulse Studies of the Lakeside Master)
Written in 1564 by Li Shi Zhen
27 Pulse Qualities
Written by Korean monk, Sa-Am
system of 5 phase treatment which forms the basis of modern
day Korean constitutional acupuncture.
Mubunryu School – Japan
Developed by Japanese physician, Isai Misonou.
Hara (abdominal) based diagnosis system was developed which still
forms the basis of many Japanese palpatory styles of acupuncture
in practice today.
Qing Dynasty (1644 – 1911)
Increasing infiltration of Western thought
Small pox vaccine (1805), first missionary surgeon (1835), Translation of
Western Medical Texts (1850’s), China’s First Western Medical
In Vietnam, Lan Ong wrote Y Ton Tam Linh in 1700’s which became basis
for eventual development of French Vietnamese Acupuncture
In Korea, Lee Jaema developed 4 constitution medicine in late 1800’s
In Japan, Waichi Sugiyama (a blind practitioner) invented Shinkan
(the insertion tube) in late 1600’s. This enabled thinner needles,
painless insertion and freed the left hand for palpation (a highly revered
approach in many modern-day classically based Japanese acupuncture
styles. Sugiymama established the first acupuncture school for the Blind
(now 40% of classically-based practitioners in Japan).
In Japan, shonishin (pediatric) developed in 1700’s as are unique Japanese
Republic of China (1911 – 1949)
This period witnessed a severe decline in all TCM approaches.
By 1912 much of Traditional Medicine had been abandoned.
In 1914, the Minister of Education declared an intention to abolish Chinese
Traditional Medicine altogether.
‘Modern Acupuncturists’ were criticized by Xu Da Chun (an avid proponent
of classical styles and leader of Han Xue movement) for incorrect channel and
point location, over reliance on formula acupuncture, ignorance of 5 phase
points, loss of supplementation and drainage theory and technique and
ignorance of seasonal correspondences.
Georges Soulie de Morant, a French diplomat in China began a very
comprehensive transmission of Classical Acupuncture to France, a critical
point in the Westward transmission of acupuncture.
Public Health Officials authoured “A Case for the Abolishment of Old
Medicine to Thoroughly Eliminate Public Health Obstacles”, in which it was
stated “the theories of yin and yang, the five elemental phases, the six
atmospheric influences, the zang fu systems, and the acupuncture channels
are all illusions that have no basis in reality”, “old medicine is still conning the
people with its charlatan, shamanic and geomancing ways”.
This proposal was not implemented due to widespread protest by doctors
By 1930’s, there was only one acupuncturist in all of Canton
People’s Republic of China (1949 +)
While pre-revolutionary Mao Zedong wrote about Traditional Medicine as
being backward, once in power, he reversed these earlier views.
Mao Zedong saw Chinese Medicine as serving his political ambitions since it
was ‘self-reliant’, ‘among the people’, ‘native’ and ‘patriotic’.
The mid 1950’s saw the establishment of 4 major Colleges of Chinese
Medicine; Chengdu, Beijing, Shanghai and Guangzhou, followed by Nanjing.
In 1958, Mao Zedong issued a vision of Chinese – Western medicine
integration. He advocated the elimination of what he felt were the ‘feudal
elements’ of Chinese Medicine. A program was implemented to train
thousands of Western medical doctors in highly abbreviated and simplistic
Chinese Medicine. These doctors became the main administrators of TCM
The late 1960’s and early 1970’s were dominated by the Barefoot Doctor
Movement, a program which saw thousands of individuals trained in a sort of
first aid acupuncture and disseminated to all corners of China to serve as
primary health care providers in factories and fields.
For details of this period, see ‘Chinese Medicine in Crisis’ by H. Fruehauf