SOCH111 History of Healing · 960 –1279 CE Song and Southern Song Dynasty 1279 –1368 CE Yuan...

SOCH111 – History of Healing

www.endeavour.edu.au

Session 9

Chinese Medicine

Department of Social

Sciences

© Endeavour College of Natural Health www.endeavour.edu.au 2

Session Aims

o To explore the third of the earliest

documented whole medical systems still

in practice today

o To contextualize the development of

Chinese Medicine within a changing

political and global landscape

o To define the key concepts and

philosophies in the system of Chinese

Medicine


Chinese Medicine o Chinese Medicine (CM)

has had a very long and

ultimately successful

history of development

and use in China and

abroad

o Core principles were

initially based on the laws

of nature, applied from

both a ‘vitalistic’ and

‘physiomedical’

perspectivePublic Domain,

https://commons.wikimedia.org/

w/index.php?curid=9382281

https://commons.wikimedia.org/w/index.php?curid=9382281


o Original Ayurvedic texts are

500-1000 years older than

original CM texts

o No evidence of significant

migration of information to imply

that CM grew out of Ayurveda

o Theory underlying traditional

acupuncture may date as far

back as 4000-5000 years

o Earliest acupuncture type

“needles” date back to the

Stone Age

CM vs Ayurveda

By U.S. National Park Service, Public Domain,

https://commons.wikimedia.org/w/index.php?cu

rid=964040



History of China

1523 – 1027 BCE Shang Dynasty

1027 – 450 BCE Western and Eastern Zhou Dynasty

450 – 220 BCE Warring States Period

220 – 206 BCE Qin Dynasty

206 BCE – 220 CE Han Dynasty

220 – 620 CE Six Dynasties & Three Kingdoms

620 – 900 CE Tang Dynasty

900 – 960 CE Five Dynasties & Ten Kingdoms

960 – 1279 CE Song and Southern Song Dynasty

1279 – 1368 CE Yuan Dynasty

1368 – 1662 CE Ming Dynasty

1662 – 1912 CE Qing Dynasty

1912 – 1949 CE Republic of China

1949 – Present People’s Republic of China


o Earliest medical texts: Ma Wang Dui, date uncertain, but likely sometime between 1500 – 200 BCE

o Identified 11 of 12 acupuncture channels, though not specific points

o Listed medical theories related to the channels’ physiology associated with repletion, vacuity, and undesirable movement

o No identification of needling, however, moxa and bian stone practice were likely

History of Chinese Medicine

By Unknown - Mawangdui Silk

Manuscript Public Domain,

https://commons.wikimedia.org/w

/index.php?curid=19264100



Han Dynasty (206 BCE – 220 CE)

o Golden age of CM

development

o Many key classic texts written

during this time

o Still used today:

• Huang Di Nei Jing

• Nan Jing

• Shang Hun Lun

o Key medical texts also formed

the basis of other traditional

medical practices

subsequently established in

Japan, Korea, Vietnam and the

world in more recent times

By unknown

(这个版本为王冰所编)

[Public

domain], via

Wikimedia

Commons


Huang Di Nei JingThe Yellow Emperors Internal Cannon

o Written between 206BCE – 50CE

o Detailed the use of key acupuncture points in

management of specific diseases, with 12 regular

meridians and 295 acupuncture points identified

o Presented 12 herbal medicine formulae, as well as

procedures for bloodletting and moxibustion

o Two major components:

• Su Wen (Fundamental Questions): collection of medical

questions and considerations

• Ling Shu (Spiritual Axis): Yin/Yang & five phase theories

included, 11 organs identified, internal & external causes of

disease defined


o Evidence of a shift from

matrilineal to patrilineal

culture in 4th – 3rd

millennium BCE

o Society bonded by strong

ties of obligation at all

levels to family, community

and king, worship of

ancestors

o Numerous sub-groups of

people and sub-cultures

Historical Chinese Society

By User Kowloonese on en.wikipedia - (Oracle Shell), CC BY-SA

3.0, https://commons.wikimedia.org/w/index.php?curid=789808



o Feudal state system

prevailed in the period

before CM developed

o Period of monarchy,

urbanisation and

assimilation of scattered

nomadic people followed

the Warring States period

o Confucianism and Taoism

developed during this

period as well

Historical Chinese Society

By Mountshang (talk) (Uploads) - Own work, CC BY-SA

3.0, https://en.wikipedia.org/w/index.php?curid=3386260

https://en.wikipedia.org/w/index.php?curid=3386260


o More closely connected to

ancient shamanistic

traditions and imagery

from ancient mystics

o Central text: Tao Te Ching

o Written by Lao Tzu ~3rd

century BCE

o The Tao is translated as

“the way”, meaning path or

road

Taoism

By 申威隆 - Own work, CC BY-SA 3.0,

https://commons.wikimedia.org/w/index.

php?curid=28550451



Taoist Cosmology

o More magical/alchemical

than materialistic or

animistic

o Macrocosm-microcosm:

Universe viewed as a

hierarchically organised

phenomenon in which

each sub-part mirrors the

whole

o Yin and Yang

o Five Phases

By Benoît Stella alias

BenduKiwi, CC BY-SA 3.0,

https://commons.wikimedia.or

g/w/index.php?curid=1206741



Yin and Yang

By Gregory Maxwell - From

Image:Yin_yang.png Public Domain,

https://commons.wikimedia.org/w/inde

x.php?curid=364239

o Everything in the

universe is composed of

a combination of Yin and

Yang

o They are in opposition

o They are interdependent

o Each consumes and is

transformed into the

other



Yin and YangYin Yang

Earth Heaven

Moon Sun

Dark Light

Wet Dry

Cold Hot

Stillness Movement

Nourishing Protecting

Receptive Creative

Night Day

Internal External

Feminine Masculine


o Yin and Yang must be equal

and in harmony in order to

create health

o Achieving balance is the core

underpinning principle of health

o The further out of balance

these principles become, the

greater the risk of developing

disease

o CM treatment focuses on

balancing these properties

Philosophy of Healing

By Leandro Inocencio - Own

work, CC BY-SA 3.0,

https://commons.wikimedia.org

/w/index.php?curid=22166102



Revision Questions

o What role does Taoist philosophy play in Chinese

Medicine?

o List 5 qualities each of Yin and Yang.

Other food for thought:o What are the similarities and differences between

the concept of Yin and Yang in CM and the concept

of the three doshas in Ayurveda?


Unifying Principle of Life: Qi

o Conceptually translated as

“vital energy”

o Not measurable, hard to

define, it is perceived

functionally by what it does

o Considered to be both yin

and yang in quality

o Transformative force, thus

its smooth flow ensures

smooth transformation of yin

into yang and yang into yinBy Photography by Wikipedia

User:MrX, CC BY-SA 3.0,





Qi arises . . .

o From parents at

conception (Original/Yuan

Qi)

o From eating and drinking

(Grain/Gu Qi)

o From breathing (Air/Kong

Qi)

o These three forms of Qi

intermingle to produce the

different types of Qi that

permeate the entire bodyBy Keith Weller, USDA ARS - Public Domain,

https://commons.wikimedia.org/w/index.php?c

urid=25115238



Chinese Five Phases/Elements

o Five elements make up all of nature, including the human organism:

• Wood

• Fire

• Earth

• Metal

• Water

o Each element corresponds to certain organs/functions in the body

Wood (Liver,

Gallbladder)

Spring

Fire (Heart, Small

Intestine,

Pericardium,

Triple Warmer)

Summer

Earth (Stomach,

Spleen/Pancreas)

Late Summer

Metal (Lung,

Large Intestine)

Autumn

Water (Kidney,

Bladder)

Winter

Image © Kate Broderick, ND, used with permission


Wood Correspondences

o Organs: liver and

gallbladder

• Ligaments,

tendons,

eyes/vision

• Kindness and

anger

• Determination,

structure,

planning, creativity Photo © Kate Broderick, ND, used with permission


Fire Correspondences

o Organs: heart, small

intestine,

pericardium, triple

warmer

• Blood vessels,

complexion, tongue

• Joy and bitterness

• Compassion,

relationships, spirit,

self-expressionPhoto © Kate Broderick, ND, used with permission


Earth Correspondences

o Organs: spleen/

pancreas and

stomach

• Muscles, mucous

membranes, mouth

• Sympathy and

obsession/neediness

• Nourishment,

support,

contentment, stabilityPhoto © Kate Broderick, ND, used with permission


Metal Correspondences

o Organs: lungs and

large intestine

• Skin, nose

• Inspiration and

grief/sadness

• Perfection, self-

worth, meaning,

respect

Photo © Kate Broderick, ND, used with permission


Water Correspondences

o Organs: kidney and

bladder

• Bones, teeth,

endocrine system

• Courage and fear

• Power, will,

wisdom, intuition

Photo © Kate Broderick, ND, used with permission


Chinese (Horary) ClockHeart Yin 11am-1pm

Small Intestine Yang 1pm-3pm

Bladder Yang 3pm-5pm

Kidney Yin 5pm-7pm

Pericardium Yin 7pm-9pm

Triple Warmer Yang 9pm-11pm

Gallbladder Yang 11pm-1am

Liver Yin 1am-3am

Lung Yin 3am-5am

Colon Yang 5am-7am

Stomach Yang 7am-9am

Spleen/Pancreas Yin 9am-11am


Chinese Medicine Substances

Internal:

o Yin and Yang

o Qi (energy)

o Xue (blood) and

Jing Ye (body fluids)

o Jing (essence)

o Shen (spirit)

External/Internal

Pathogenic Factors:

o Wind

o Cold

o Heat

o Damp


Blood (Xue)

o Blood and Qi are the Yin and

Yang of ordinary life activity

o Blood is liquid and

considered a Yin substance

relative to Qi, which is

considered a Yang

substance

o Blood nourishes Qi, and Qi

“leads” the blood; the

intermediate state between

blood and qi makes up the

body fluids


Jing (Essence)

o Fluid like substance that

underlies all organic life

o Supportive and nutritive, it is

the basis of reproduction and

development

o Jing originates form two

sources: prenatal and

postnatal

o Basis of our constitutional

strength


Shen (Spirit)

o Shen in CM is translated as

“spirit”

o Said to be an elusive concept,

and a “substance” unique to

human life

o Resides in the Heart and

corresponds to the mind

o Human consciousness therefore

indicates the presence of Shen

o Considered a Yang substance


Revision Questions

o Describe the concept of Qi.

o List the five elements and three correspondences

for each.

Other food for thought:o How do these concepts and the picture they paint

of the function of the human body/mind/spirit sit

with you coming from a Western mindset?


o Proper balance of Yin and Yang

o Smooth flow, appropriate levels and proper

transformation of Qi and Blood

o Balance of the five elements, smooth flow

of appropriate levels of energy in Sheng

and Ko cycles

o Jing sufficiently replenished and maintained

o Shen bright

Health According to CM


Causes of Imbalance & Disease

o Excessive,

suppressed or

disturbed emotional

state

o Unhealthy lifestyle,

habits or behaviours

o Climate or change

of weather,

exposureBy M from Somerville, USA - CC BY 2.0,

https://commons.wikimedia.org/w/index.ph

p?curid=4107251



o Is the illness one of excess or deficiency, or both?

o What is the level of qi, blood, yang, yin?

o Are they flowing and transforming properly, or are

they blocked or stagnant?

o What pathogenic factors are present? Did they arise

internally or externally?

o What element(s) are out of balance?

o How deep has the illness penetrated, i.e., is it

superficial/acute or deep/chronic?

Diseases Classified/Diagnosed


o Observation: tongue,

face, skin and gait analysis

o Listening: relates to the

patient's voice and

respiration

o Questioning: covers

subjective patient report on

aspects of illness

o Palpation: involves taking

pulses, as well as

manually examining the

abdomen or meridians

Chinese Medicine Diagnosis

Public domain:

http://wikiwel.com/wikihealing//index.

php?title=File:TCM.jpg

http://wikiwel.com/wikihealing/index.php?title=File:TCM.jpg


o General appearance,

colour and coating of the

tongue is noted

o Markings, shape, dryness/

cracks, movement, and

any deviation are also

noted

o Signs in specific locations

may indicate organ

dysfunctions

Tongue Diagnosis

By

http://wellcomeimages.org/indexplus/obf_images/d2/

bf/fd7c8b5935f3438a35c923da4bc7.jpg, CC BY 4.0,


3929660



Pulse Diagnosis

o Taken using three fingers

over the radial artery

o Six pulses on each wrist (3

deep, 3 superficial)

o Depth, speed, strength

and quality of each pulse

is noted

o Signs felt at specific

locations may indicate

organ dysfunctionsLeft Right

Lung

Radial Wrist Crease

SpleenLiver

Kidney

Yin

Heart

Kidney

Yang


Questioning

o Attributes of current

complaint, symptoms,

onset etc.

o Personal and family health

history

o Patterns of sleep, work,

exercise, elimination,

weight gain/loss, menses

o Stressors and exposures,

emotional patterns

http://2015.igem.org/Team:SCUT-China/hospitalInterview

http://2015.igem.org/Team:SCUT-China/hospitalInterview


Five Element Diagnosis


Traditionally in China, doctors were paid regularly

by their patients to help them maintain wellness,

and if the patient got sick, the doctor would provide

services without payment.

“The superior physician helps before the early

budding of disease.”

Practices of CM can be applied to daily life to

stimulate and maintain better health without waiting

for illness to arise for the system to be useful.

General Healing Approach


o To encourage smooth and harmonious flow of

Qi and Blood

o To balance Yin and Yang

o To balance Hot and Cold

o To balance Dry and Damp

o To balance the elements

o To diminish excesses and replete deficiencies

o To address causes of illness and guide patient

on how to avoid future imbalances

Chinese Medicine Healing

Principles


Revision Questions

o What are the three major causes of illness

according to CM theory?

o Describe how the patient’s condition is assessed

using tongue inspection and pulse palpation.

Other food for thought:o Consider factors in your own lifestyle and dietary

habits that might contribute to imbalances.


o Acupuncture

o Moxibustion

o Chinese Herbal Medicine

o Chinese Dietetics (Diet Therapy)

o Chinese Exercise Therapy

o Qi Gong

o Tai Chi

o Massage (Tui-Na)

o Cupping and scraping

Major Healing Practices

By Unknown -

Imagery From the

History of Medicine,

Public Domain,

https://commons.wiki

media.org/w/index.p

hp?curid=155064



o Use of fine, solid needles

therapeutically inserted into

specific points lying on meridians

within the body to affect the

movement of Qi and Blood

o 14 major meridians

o 365 major points, 1000 extra

points

o Techniques to tonify or sedate

the point

Acupuncture

Public Domain,

https://commons.wikimedia.org

/w/index.php?curid=514662



Moxibustion

By Franz Eugen Köhler, Public Domain,

https://commons.wikimedia.org/w/index.

php?curid=255280

o Originated in Mongolia, later

incorporated into CM and

Tibetan Medicine

o Stimulation of points using

burning powdered leaves of

Artemisia vulgaris (Mugwort)

o Tonify points, open them to

receive the needle, or

provide generalised warmth

and medicinal effects to an

area



o First standardised formulas

produced during Song

Dynasty (960-1234 CE)

o 1578 CE: greatest materia

medica published with 1892

species of drugs of plant,

animal and mineral origins,

8160 prescriptions

o As many as 5000 licensed

standardised formulas now

available in China

Chinese Herbal Medicine

By mailer_diablo - Self-taken

(Unmodified), CC BY-SA 3.0,

https://commons.wikimedia.or

g/w/index.php?curid=469625



o Foods, their tastes and

energetics have an

effect on levels and flow

of qi and blood and

balance of yin and yang

o Diet individualised to

constitution and health

condition, as well as

climate and season

o Focus on restoration of

strong digestion and

elimination

Chinese Dietetics

By Thagadooran - Own work, CC BY-SA 3.0,

https://commons.wikimedia.org/w/index.php?

curid=18541739



o Qigong: meditative

movement/energy/

breathing therapy for

regulating and balancing

the flow of qi

o Tai chi: gentle martial art

involving relaxed and

regulated movements to

balance yin and yang and

encourage strength and

suppleness in the body

Exercise Therapies

By Craig Nagy from Vancouver,

Canada - Tai Chi, CC BY-SA 2.0,

https://commons.wikimedia.org/w/i

ndex.php?curid=2627857



o Chinese massage

o A component of CM for

at least 2000 years

o Similar aims to

acupuncture through

manual stimulation of

specific points on the

body with different

massage techniques

Tui Na

GFDL,




o Cupping: use of

special glass or plastic

adhered by suction to

the skin to draw blood

to the surface

o Scraping (gua sha):

use of a metal or stone

implement to scrape

the skin to bring heat

from the core to the

surface of the body

Cupping and Scraping

By Anna Frodesiak - Own work, CC0,

https://commons.wikimedia.org/w/inde

x.php?curid=26339526



Modern History in ChinaRepublic of China (1911-1949)

o Arrival of Western medicine isolated CM into rural and remote areas

o By 1912 much CM had been abandoned

o 1928: Council passed resolution to abolish traditional CM

o Resulted in major uprising of traditional practitioners and citizens, and the resolution was never enforced

By Sodacan - Own work, CC

BY-SA 3.0,





Modern History in China

People’s Republic of China

(1949 to present)

o Mid-50’s: 4 major colleges of

Traditional Chinese Medicine

established

o 1958: Mao Zedong issued a

vision of Chinese-Western

Medicine integration

o Late 60’s/early 70’s – Barefoot

Doctor Movement, program

which saw many individuals

trained in first-aid acupuncture

By 澳门特别行政区立法会 / Public Domain,

https://commons.wikimedia.org/w/index.ph

p?curid=4408769



o 1683: earliest reliably documented report of

acupuncture in the West

o Widely practiced in France in late 18th century

o First western practitioner of acupuncture was a

Parisian doctor in the early 19th century

o TCM in its re-developed form beginning in the

1950’s has spread worldwide and is hugely popular

and successful

o A more Westernised form, Five Element

Acupuncture, was also developed in England from

the 1950’s, and is popular in Europe and the US

Global Development


Revision Questions

o What are the major therapies used in traditional

Chinese Medicine?

o What were the major modern historical events that

influenced the TCM that we know today?

Other food for thought:o What are some reasons why acupuncture might

have been less used in ancient China and more

used in modern times?


References

o Beinfield, H, & Korngold, E 1991, Between Heaven and Earth, Ballantine Books, New York.

o Encyclopedia Britannica Online, China, viewed 22 June 2016 <http://www.britannica.com/place/China>.

o Encyclopedia Britannica Online, Daoism, viewed 22 June 2016 <http://www.britannica.com/topic/Daoism>.

o Grossinger, R 1995, Planet medicine, North Atlantic Books, Berkeley.

o Kayne, SB 2010, Traditional medicine: a global perspective, Pharmaceutical Press, London.

o Lehmann, H 2013, ‘Acupuncture in ancient China: how important was it really?’, Journal of Integrative Medicine, vol.11, no. 1, pp.45-53. viewed 23 June 2016 <http://www.jcimjournal.com/articles/publishArticles/pdf/jintegrmed2013008.pdf>.

http://www.britannica.com/place/China

http://www.britannica.com/topic/Daoism

http://www.jcimjournal.com/articles/publishArticles/pdf/jintegrmed2013008.pdf

SOCH111 History of Healing · 960 –1279 CE Song and Southern Song Dynasty 1279 –1368 CE Yuan...

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