The History of Chinese Medicine
Chinese Herbal Medicine is the oldest practiced medicine which goes back more than 5,000 years. The discovery of herbal medicine is ascribed to the legendary emperor Shen Nong (3494 BC). He introduced agriculture to his people and became enchanted by the medicinal properties of various plants. The discoveries of the Shen Nong era were passed from generation to generation by word of mouth, since there were no written records at this time. Myths and facts are therefore hard to distinguish.
It took approximately 2,000 years until the discoveries of Shen Nong and his followers were committed to writing. Many remedies and concepts could stand the test of time and their effectiveness has been proven by modern science as well.
Medicine as an element of philosophy
About 500 BC the science of herbal medicine had become an integral part and key element of Chinese philosophy and spiritualism. It is therefore much more than just medicine: on the foundations of its discoveries and ideas of the well-being of the body and the soul that became the core of Chinese philosophy it can as well be seen as an attempt to define the meaning of life.
Shen Nong "wrested from Nature a knowledge of her opposing principles". They have been established as the opposing and yet complementary and reciprocal "yin" and "yang" forces of nature and of all matter.
Chinese observed the natural world and life determined by mutually dependent and constantly interacting forces of energy. Confucius (551-479 BC) established a code of ethics on the postulate that there is a right order and harmony to the universe, based upon the balance of yin and yang - the fundamental doctrine of two opposing but equal natural life forces. It also underlies all Chinese philosophy, art and science.
Lao Zi, the founder of Taoism (Tao = way, reason), embraced the Confucian postulate of universal order and taught that man himself can only reach personal harmony by bowing to its natural and predestined fact and following a course of passiveness, declaring interfering senseless. According to his teaching the successful conclusion will be reached without effort.
The neo-Confucian thinker Dong Zhongshu (100 BC) developed this philosophy further by including the inner reaches of man himself, establishing man as the universe on a smaller scale. The same locked cycle of yin and yang at work in the universe is at work in man himself. In Chinese medicine, illness and treatment are viewed as the universal striving for harmony.
The evolution of Chinese Medicine
Chinese medicine became a profession more than 2,000 years ago at the time of the Han dynasty (206 BC - AD 220). It is also in this period of time that the first steps were taken to record the remedies of herbal medicine. Long before these records, however, (around 3,500 BC) herbal medicine was already playing an important role in the cycle of Chinese tribal life. At this time it was the domain of tribal shamans and mountain recluses. The mountain recluses turned their backs on community life in order to retreat deep into the hills to practice the "Way of Long Life". It included practicing and developing herbal diet and medicine, therapeutic breathing techniques and kung-fu exercises. In this way they contributed to Chinese medicine not only by gathering wild plants and herbs, but also by setting up a link between medicine and martial arts which is still intact today.
In the Yin dynasty (around 1,500 BC) the knowledge gathered by these mountain recluses had made its way back into the market place, leaving the isolation of the mountains. It was the time of the legendary emperor Shen Nong and his own herbal experiments, followed by the Zhou dynasty (1,122 BC) which is referred to as the Spring and Autumn and Warring States period - a period of great turmoil and instability. Many learned men left society and its dangers for the safety and isolation of the mountains. There they were searching for much more than just a secure and healthy everyday life: it was rather a quest for immortality which became the the prime driving force behind the development of herbal medicine. The Chinese aristocracy became obsessed by this search as well, making emperors and feudal barons sponsor herbal research projects.
After the Qin dynasty that lasted only 15 years but set up a stable, centralized bureaucracy, forming the foundations of the future Chinese empire, the Han dynasty lasted almost four and a half centuries. In this period of time arts, sciences, and philosophy flourished. It was the era of Confucius and the era that laid the foundations for Taoism. The Taoist considered frequent sexual intercourse as one of the paths to strength and longevity, forming a close association of medicine and sex. According to the opposing principles of yin and yang, men were yang and women yin. In the sexual union it is considered crucial that the male must retain his vital and limited yang while absorbing as much as he could of the females unlimited supplies of yin essence. It is written that "if one regards sperm as precious and does not ejaculate, then life will never be exhausting." Longevity could be attained by absorbing the female "semen" when she reached orgasm, and at the same time retaining and recycling the male sperm. There are many references to men who had mastered this technique and lived up to 150 years or more.
By way of trade with India and the Persian Gulf other herbs and medicines entered the Chinese pharmacopoeia. It was during the Han reign, as well, that the theories of the Yellow Emperor were written down in Huang Di Nei Jing, The Internal Book of Huang Di and that the physician Hua Tuo (141-208 AD) performed the first treatment in history using anesthetics. He as well developed a series of therapeutic kung-fu exercises based on the movements of five animals and prescribed them to patients.
After the Han dynasty most of the elements of Chinese medicine were in place and with processes of consolidation during the Tang, Song and Ming dynasties still govern the science of today. The founding emperor of the Tang dynasty established China's first school of medicine 629 AD and concentrated all medical knowledge throughout the empire in the capital. This was the first time that science could start to sift out quacks who had been dishonoring the profession by defrauding the sick with fake medical advice and prescriptions.
Dr. Sun Simiao specialized in the field of nutrition and diet as a medical therapy - proved accurate by Western research some 1,000-1,300 years after his time.
In 1790 Chinese medical herbs made their way into European pharmacology through a Dutch botanist who went to Japan to study oriental plants. He took many of the plants originated from China back to grow and experiment with in Holland.
With Western military and missionary in China Chinese herbal medicine came under pressure from Western medicine. Western and Chinese herbal medicine coexisted alongside each other for some time until a final confrontation in 1929: Chinese doctors who had studied Western medicine returned home demanding the ban of traditional herbal medicine. However, their demand didn't win the governments support because of vehement opposition throughout all classes of Chinese society.
Chinese medicine was given an academic boost in the West in 1931: the wealthy American businessman G. M. Gest was cured from an eye disease by a Chinese physician after all other efforts had failed. He was so grateful that he collected 75,000 books about Chinese medicine and established the Gest Oriental Library at Princeton University. Much of the science of Chinese herbal medicine has been confirmed by Western research since then.
Yin and Yang
Yin and Yang are central to both Taoist philosophy and Chinese medicine and both regard the balance of these opposing forces as the key factor in all life processes and natural phenomena.
Yin symbolizes the negative, passive force. Its nature is female, dark, low-lying, contractive, descending, and it is symbolized by water.
Yang represents the positive, active force. It is male in nature, bright, high-flying, expansive, ascending, and is represented by fire.
The nature of the symbolizing elements fire and water clearly exemplify the nature of yin and yang: fire flares up quickly with great power, but it is extinguished easily by water. Water, on the other hand, is indestructible, fills everything, and wears down even the hardest rock. It can absorb and retain the powerful but short-living yang energy for a long time (water keeps the heat of fire).
The Yin and Yang forces depend on each other, one cannot exist without the other. In order to maintain health a harmonious balance is the ideal state for both nature and man. When yang is in excess, yin tends to recede. When yin overflows, yang tends to retreat. The net total, however, is always the same. Both yin and yang contain the germ of their own opposite within themselves, as symbolized by the white and black dots. Everything depends on the relative balance of yin and yang.
All vital parts of the body, every plant, all phenomena in the universe are divided into yin and yang (for instance, the moon is yin, the sun is yang; the sun is very powerful and active but lives in short day periods, the moon in monthly cycles). The body is balancing yin and yang automatically within certain limits, making medication necessary only if the imbalances should reach critical levels. However, this can be avoided with preventive care such as proper diet and exercise combined with careful attention to changes in season, weather, and geography (all these factors mentioned belong to either yin or yang thus influencing the human bodies yin-yang balance). Imbalances of yin and yang are redressed with foods and herbal medicines by supplementing components from the category of the deficient element.
Qi and the other three bodily humors
In the view of the Chinese all the forms of live are spirited by an essential life-force or vital energy called qi (it also means "air" and "breath"). Qi is invisible, tasteless, formless and odorless, and it permeates the entire universe. It is transferable and transmutable, digestion extracts qi from food and drink, breathing extracts it from the air. When meeting in the bloodstream these two forms of qi transmute to form human-qi. This is the vital energy which circulates throughout the body through the vital connections of meridians. Health and the span of life are determined by the quality, quantity, and balance of the qi.
Evil-qi which causes disease and the pure-qi of mountain mists which promotes health and prolongs life are the two extremes of many kinds of qi.
A natural and harmonious balance among the vital energies within the body on one hand and between the body and the external environment on the other is the key to maintaining optimum health. Thus the seasons are important as well and must be considered in the diet and medication - in winter for example the body needs extra heat-inducing foods to balance the excess cold outside.
The food and drink we consume and the air we breathe are the most important factors concerning qi. This is the reason why Taoists emphasize the great importance of diet and breathing exercises in their system of health and longevity. The condition of the vital organs which absorb qi influences the quality and quantity of qi .
Combinations of proper diet, exercise, breathing, and hygiene can usually correct qi-deficient ailments. The Chinese physician applies curative herbal medications only when a problem has become so serious that it impairs the functions of vital organs. Those organs and glands are stimulated more directly and more powerfully by these herbal medications since the qi extracted from them goes straight to the organ it has been prescribed for. There it acts to restore the natural functions of diseased organ, by redressing the imbalances of vital energy.
The functions of the vital organs can be influenced by breathing and kung-fu exercises, diet and herbal medicine which increase the quantity and improve the quality of qi. The qi extracted from food and the qi extracted from the air convert to human-qi, which takes the two forms of nourishing-qi and protecting-qi. These naturalistic views of the Chinese medicine some 2,000 years ago correspond to the observations of Western medicine of the 19th and early 20th century regarding bacteriology and the body's resistance as well as the circulation.
Besides qi - the most important bodily humor - there are three others: blood (xue), vital essence (jing) and fluid (jin). Blood and nourishing-qi are formed together from the most refined products of digestion. They nourish the body by circulating through the system. Qi controls the movement of blood and can itself be controlled with breathing exercises.
All the bodily humors are closely linked and deficiencies and imbalances in one have adverse effects on the others. Qi is the most vital and only one that is not entirely depended on food and drink since the lungs extract it from the air. Because the other humors entirely depend on the quality of the food and drink we consume, it is not hard to understand why the proper diet is so important to the Chinese.
The Five Elements
The Chinese world is divided into five symbolic elements: Wood, Fire, Earth, Metal, and Water. Depending on its nature everything on earth is associated to one of these elements, and all change and activity in nature is determined by the constant interplay of these elements as well as yin and yang.
The Five Elements represent the primeval forces and have a generative and a subjugative influence on one other force and are subjugated or generated by an other one.
Subjugative relationships:
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Wood subjugates Earth (by braking up the soil and depleting its nutrition)
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Earth subjugates Water (by containing it in one place and soiling its clarity)
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Water subjugates Fire (by extinguishing it)
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Fire subjugates Metal (by melting it)
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Metal subjugates Wood (by cutting it)
Generative relationships:
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Wood generates Fire (by burning)
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Fire generates Earth (by generating ashes)
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Earth generates Metal (it can be mined from the ground)
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Metal generates Water (when heated it is molten)
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Water generates Wood (by promoting the growth of plants)
These subjugative-generative relationships of the Five Elements form mother-son and victor-vanquished relationships. The interactions of these symbolic representations of the fundamental forces of nature are what matters most in Chinese Medicine. They provide the tools for balancing yin and yang: each vital organ belongs to one of the Five Elements. By prescribing certain herbs, which are associated with one of the Five Elements like everything on earth, Chinese doctors can put their natural relationships at work for adjusting energy imbalances in the body (to restore the equilibrium the deficient energy is provided).
The Vital Organs
For diagnosis and treatment of disease the functional relationships among the vital organs are the key factors. The vital organs are referred to as the five "solid" (wu zang) and the six "hollow" (liu fu) and correspond with the exception of the "triple-warmer" (the openings to the stomach, small intestine, and bladder) to the organs distinguished by the Western anatomy. The pericardium (sack which surrounds the heart) was added later as the sixth "solid" organ in order to balance the system. It corresponds to the triple-warmer. Besides the two organs mentioned the vital organs consist of the heart, lungs, liver, kidney and spleen as the five "solid" yin organs and the small intestine, large intestine, gall bladder, bladder, and stomach as the five "hollow" yang organs.
Each of the organs has a corresponding organ from the opposite classification (yin and yang) with which it forms a pair that is dominated by one of the the Five Elements. The condition and activities of the vital organs determine all other parts of the body. For the cure of ailments of a certain part of the body the corresponding organs are treated according to the relationships of the Five Elements.
The yin organs are considered to be more vital than the yang organs: they "store but do not transmit" whereas the later "transform but do not retain."
The organs and their functions in detail:
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Heart (called "Chief of the Vital Organs", regulates the other organs by controlling circulation of blood; the heart activity is reflected on the color of the face and the tongue)
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Liver (stores blood, houses the human soul, which is said to enter the fetus at the moment of birth)
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Spleen (controls the "moving and transforming" of vital essence extracted by the stomach from food and drink; it houses the mind)
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Lungs (control vital energy (qi) by extracting it from the air and transferring it to the blood; they house the animal-soul, which is said to enter the embryo at the moment of conception)
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Kidneys (control water, receive the vital essence of the vital organs and store it, both life-essence and semen-essence; together with the surrounding glands they control all sexual functions)
The vital connections
Both Chinese and Western medicine agree upon the circulatory, lymphatic, and nervous systems and their functions of carrying blood, fluids, and messages through the body. An additional connecting system of meridians (jing luo), however, is only distinguished by the Chinese. It is considered to circulate the body's most vital substance - qi, the essential energy of life - and is therefore the most important of all.
The meridians - just like qi - don't manifest themselves physically but functionally. There are fourteen main meridians which branch out a total of fifty-nine meridians.
Twelve of the main meridians are centered around one of the twelve vital organs and represent a biological energy system. The remaining two are located in the front and in the back of the body (spinal cord).
Qi - the vital energy - flows from one meridian to the other thus covering the whole body. The main meridians meet in the fingers, toes, and head. To influence certain vital organs and through them the entire system the corresponding meridians are stimulated with acupuncture, acupressure, and herbs.
The meaning of food and disease in Chinese Medicine
Physical health became an integral part of the whole Chinese spiritual and social life with the Taoist principles of balance and correlation of forces applying as well to diet and medicine. Food is taken not just for survival but also to constantly balance and tune up both physical and mental health. Foods are categorized according to their therapeutic value into "cold" foods (such as fruits and vegetables) that were used to reduce "heat" in the body, "hot" foods (such as fatty and spiced foods) used to heat up the body with a "heat" deficiency. "Supplementary" foods (internal organs of animals) were taken to strengthen the corresponding organ in the human body. Diet and medicine can't be separated and form powerful medical diets. The balancing of the opposing forces yin and yang within the metabolism is the paramount concern. To avoid disease the equilibrium of yin and yang has to be maintained. Imbalances are corrected by applying the opposing food, when any of them is in excess or deficiency. For correcting imbalances the proper diet is always the first step. Herbal medicine is prescribed only if diet fails to balance the body.
This clearly exemplifies the nature of Chinese Herbal Medicine that focuses on preventive care. A physician that had to wait for the onset of obvious signs and symptoms of disease before treating the problem was considered inferior. Interesting are the parallels Chinese Medicine drew from observations made on the political system.
Preventive care as the paramount goal
The famous Internal Book of Huang Di (The Yellow Emperor of internal medicine) states:
"To administer medicines to diseases which have already developed and to suppress revolts which have already developed is comparable to the behavior of those persons who begin to dig a well after they have become thirsty, and of those who begin to make their weapons after they have already engaged in a battle."
The story of the famous physician of the Zhou dynasty Bian Que shows this approach to preventive care: he visited the nobleman Huan Qi on a audience and realized immediately that he needed to be treated. Huan Qi replied that he was feeling well and rejected Bian Que's advice. After Bian Que had left Huan Qi said that all the physicians are interested in is making profits. However, Bian Que returned twice warning Huan Qi more urgently each time. At his fourth audience he just saw Huan Qi from the distance and left immediately. When asked for the reason by a servant sent by Huan Qi he replied that on his first audience the disease was just in the pores of the skin and that it could have been cured with hot compresses. When it reached the blood circulation it could have been cured with bloodletting/acupuncture. When it reached the stomach it could have been cured with herbal wines. Now it has reached the bones and there is no help for that. Five days after the servant delivered this observation Huan Qi got ill and died shortly after.
Chinese physician reject the idea of instant remedies, considering most illness to be the result of deep-rooted problems that can only be cured with continuous long-range treatment focussing on the root of the problem. Without treating the disease at the root it will simply manifest itself again and again in different parts of the body. This approach of total treatment and preventive care is becoming more and more influential in Western medicine. Chinese science and technology including medical science had been 1,000 years ahead of developments in the West well into the Ming dynasty (1600). Many drugs now "discovered" by Western medicine have been applied over centuries by Chinese herbal physicians. The curative properties of more than 100 of the 700 drugs of Chinese herbal medicine tested so far by modern science have been confirmed.
The causes of disease
Modern Western medical science tends to isolate physical factors such as germs, bacteria and viruses as the cause of all diseases. Many of these ?causes? are viewed merely as symptoms of the disease by the Chinese physician. To them a certain organ is unable to resist outside invasion because it is already weak. Killing the germs might eliminate the immediate symptoms but doesn?t restore the right energy of the diseased organ and tissues. It therefore fails to treat the real cause of the disease and it is only a matter of time before the organ is attacked again. They stress the question why gems attack some people and don?t attack others.
According to Chinese theory the reason is that germs gather and flourish only in weakened parts of the body of patients with low resistance. The true cure is to counteract the conditions which give way for disease to develop in the first place instead of just killing the germs.
Six external cosmological causes are distinguished, which permit disease to develop when in excess. They are governed by meteorological conditions of climate and season. The excess of certain meteorological conditions tends to have negative effects on the body. If the resistance of patients is low, heat, damp, cold, and dryness, gather in weakened parts of the body.
In Chinese medical theory the major internal causes of disease are the Seven Emotions. These emotions ? anger, anxiety, concentration, fear, fright, grief, and joy ? cause disease and injury to vital organs only if they become uncontrollable and overwhelming. Harmful, however, is not the intensity but the duration of an extreme emotion.
To maintain health proper exercise is considered vital. The lack of exercise is one of the miscellaneous causes of disease, because it makes the blood flow sluggish. Excessive physical labor or fatigue, however, will also weaken the body and open doors to disease.
Chinese medical literature stresses the importance of preventive care: proper diet, exercise, breathing, regulated sex, and preventive herbal prescriptions are considered vital.
Chinese Diagnosis
Chinese doctors read basic physical signs of health and disease such as eyes, complexion, color and texture of tongue and tongue fur, pulse, and the patient?s personal habits.
Interviewing, observing, listening, and feeling are the four basis methods of diagnosis.
The interview focuses on the major symptoms of the disease and background factors which may have contributed to its development.
With methodical visual observation traditional Chinese doctors try to find visual onsets of an ailment or problem by examining the skin coloring and form, tongue color and tongue fur, eyes, secretions and excretions, as well as the patient?s mood and movements. The examination of the tongue ? its color and fur ? is the most important method of the observation-diagnosis and it requires a lot of experience.
Listening to the patient?s breathing, coughing, speech, and the sounds coming from the visceral organs are important in the listening technique.
Most important is the traditional Chinese pulse diagnosis: the physician is using three fingers with light pressure to feel three different pulses, with heavy pressure he can feel three different pulses at each wrist. The total adds up to twelve pulses, each reflecting the condition of a different vital organ. On each of the twelve pulses the skilled doctor can detect over thirty different pulse qualities. Chinese pulse diagnosis requires sensitive fingers and years of practice and experience.
How the Formulas are prepared
Many Westerners may wonder why the Chinese Herbal Medicine isn?t modernizing its ancient art of herbal healing by purifying and refining the crude herbs, by extracting and concentrating their active ingredients into capsules and ampules.
There is, however, a reason for why this hasn?t been done: Many herbs only have the desired effects in their crude state by balancing possible side-effects of the concentrated active ingredient. By mixing the crude herbs the herbalist is able to tune the net effects of the prescription carefully. He can tailor the formula for different patients differently to exactly meet their different requirements. Gentler and slower absorbing preparations can be given to weak or elderly patients, while more robust patients can be treated faster with the stronger forms.
This is the reason why the methods of preparing and mixing herbal medications are equally important as their ingredients.
Different herbs develop their effectiveness in a different state, some have to be boiled to become medically active, others are ground to powder and mixed into pills.
There are different methods of mixing herbal medications:
- Broth: The oldest and most common method of mixing and ingesting herbal prescriptions. It is the most effective method: the herbs take effect immediately because the body absorbs them quickly after ingestion.
- Pills: They are made from the ground herbal ingredients. Most pill prescriptions require the patient to take fifteen to twenty pills three or four times a day to ensure constant present of the medication in the system. They are slow-acting and gentle and are used for treating chronic ailments.
- Drops: The herbal extracts are blended from two, four, or eight oz jars into one or two oz dropper bottles. Because of the potency of these herbal extracts, proportionately lower doses are required than with tablets. Therapeutic responses can be much more rapid, patients are sometimes feeling results immediately.
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