As a TCM learner, one should be familiar with the history of TCM in the development of basic theories. During the period from the Warring Sates to the Eastern Han Dynasty, The Yellow Emperor’s Canon of Medicine (Huang Di Nei Jing, 黄帝内经）and Nan Jing (Canon of Difficult Issue, 难经) came into existence. These two books indicate that TCM has devel- oped from the phase of pristine experiential accumulation to the phase of systematic theoretical summarization, thus providing theoretical guidance and foundation for the development of TCM. Shang Han Za Bing Lun (Treatise on Damage Cold and Miscellaneous Disease, 伤寒杂病论), written by Zhang Zhongjing, put forth the principle of treatment accord- ing to syndrome differentiation encompassing principle, method, pre- scription and medicine. It also discussed the diagnostics and therapeutics of cold-induced diseases and miscellaneous diseases. For these reasons, the book is considered an indelible milestone in the development of Chinese clinical medicine. Shen Nong Ben Cao Jing (Shen Nong’s Classic
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of the Materia Medica, 神农本草经) is a systematic monograph on mate-
ria medica, thus laying a theoretical foundation for the development of Chinese Materia Medica.
During the Wei Dynasty, Jin Dynasty, and Southern-Northern Dynasties, the medical theories were systematically compiled. Wang Shu He wrote
Mai Jing (The Pulse Classic, 脉经), the earliest comprehensive mono-
graph on pulse-taking. Huang Fumi in the Jin Dynasty complied Zhen Jiu
Jia Yi Jing (A-B Classics of Acupuncture and Moxibustion, 针灸甲乙经),
the earliest monograph on acupuncture and moxibustion. In Ben Cao Jing
Ji Zhu (Collective Commentaries on the Classic of Materia Medica, 本草
经集注), Tao Hongjing further elucidated the theories on Chinese materia medica. Lei Gong Pao Zhi Lun (Master Lei’s Discourse on Medicinal
Processing, 雷公炮炙论) complied by Lei Xiao, dealt exclusively with
the theories and methods of preparation and decoction of Chinese medicinals.
During the Sui Dynasty, Dang Dynasty, and the Five Dynasties, the theoretical system of TCM continued to evolve owing to the rich medical practice. Huang Di Nei Jing Tai Su (Grand Simplicity of Yellow Emperor’
Canon of Medicine, 黄帝内经太素) complied by Yang Shangshan is the
earliest annotation edition. And in Bu Zhu Huang Di Nei Jing Su Wen (Supplementary Commentaries on Plain Conversation of Yellow Emperor’
Canon of Medicine, 补注黄帝内经素问), Wang Bing expounded and
developed some theories in Nei Jing. He also supplemented seven chapters about five movements and six climates, in which the theory of Yun Qi was rooted. Zhu Bing Yuan Hou Lun (Treatise on Causes and
Manifestations of Various Diseases, 诸病源候论), the earliest mono-
graph on etiology and symptomatology, was compiled by Chao Yuanfang. Moreover, Sun Simaio devoted all his life to the writing of two great books: Qian Jin Yao Fang (Valuable Prescriptions, 千金要方) and Qian
Jin Yi Fang (Supplement to Valuable Prescription, 千金翼方). The two
books played an important role in the medical history of China in that they cover a relatively comprehensive discussion on various medical fields from basic theories to clinical subjects.
The Song, Jin and Yuan Dynasties witnessed tremendous development in the theoretical system of TCM. In the Song Dynasty, Chen Wuze wrote
San Yin Ji Yi Bing Zheng Fang Lun (Treatise on Diseases, Patterns and
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Formulas Related to the Unification of the Three Etiologies, 三因极一病
证方论), which further improved the theory of etiology in TCM. Zhang Yuansu summed up the essentials of many previous physicians and came- up with a comparatively systematic theory on visceral syndrome differen- tiation. He also proposed the theories of medicinal tropism and medicinal guide. In the Jin and Yuan Dynasties, there came forth four great medical schools represented by Liu Wansu, Zhang Congzheng, Li Gao and Zhu Zhenheng. Their achievements provided significant impetus to the devel- opment of basic theories in TCM. For example, Liu Wansu advocated the theory of “fire-heat.” Zhang Congzheng proposed the method of “purging the pathogenic factors.” Li Gao suggested “warming and invigorating the spleen and the stomach.” Zhu Zhenheng believed that “yang is usually redundant while yin is frequently deficient,” which is based on the theory of “ministerial fire (kidney fire).”
In the Ming Dynasty, Zhao Xianke put forth the theory of mingmen (gate life), which further enriched the theory of visceral manifestation in TCM. Besides, Li Zhongzi held that the kidney is the prenatal foundation while the spleen is the postnatal foundation. Even today, this remark is still widely used to guide clinical practice. In the late Ming Dynasty, Wu Youxing revealed the causes of pestilence and warm disease as well as their routes of transmission, which is a major theoretical breakthrough. In the Qing Dynasty, Ye Tianshi and Wu Jutong established the theories and methods for treatment of warm disease based on syndrome differentiation and centered on “wei, qi, ying and blood” and the “triple energizer,” gen- eralizing the knowledge on warm-diseases into a systematic theory. Moreover, Wang Qingren wrote Yi Li Gai Cuo (Corrections no Medical
Errors, 医林改错). In this book, he developed the theory of pathogenic
blood stasis, which is of great clinical significance.
The theoretical system of TCM is essentially characterized by the con- cept of holism and treatment based on syndrome differentiation. Concept of holism views everything as holistic and integral objects, and deems the connection among them as inseparable. In light of this concept, the human body is regarded in TCM as an organic whole of which the constituent parts are inseparable in structure, interdependent in physiology, and inter- affected in pathology. The human body is composed of five zang-organs, six fu-organs, five body constituents (the skin, vessels, muscles, tendons
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and bones) and seven orifices (the eyes, nose, ears, mouth, tongue, exter- nal genitalia and anus). Though different in physiological functions, they are interconnected through the meridians rather than isolated. The unity between the body and its external environment is also emphasized in TCM. It is just through the process of actively adapting to and remolding the natural environment that human beings maintain their normal life activities. For this reason, the concept of holism is highly valued in TCM, and is widely used in various branches of TCM such as physiology, pathology, diagnostics, syndrome differentiation and therapeutics.
Treatment based on syndrome differentiation is a basic principle in TCM for diagnosing and treating diseases. Differentiation of syndrome implies that the patient’s symptoms and signs collected through the four diagnostic methods (inspecting, smelling-listening, inquiring and pulse- taking) are analyzed so as to identify the etiology, nature and location of a disease, and the relation between healthy qi and pathogenic factors, thereby generalizing them into a certain syndrome. Treatment refers to the selection of the corresponding therapy according to the result of syndrome differentiation. The course of treatment based on syndrome differentiation is actually a process of understanding the nature of disease, as well as treating the disease. It is one of the basic characteristics of TCM.
The theory of essence, qi and spirit, an ancient philosophical thought, has tremendous influence on TCM and is widely applied in various areas of TCM. In TCM, it is believed that essence is the basic substance consti- tuting the human body and maintaining its life activities. Essence in a broad sense and essence in a narrow sense refer to deferent substances. According to its origin, essence can also be divided into prenatal essence and postnatal essence. The functions of essence are to reproduce, to nour- ish, and to promote growth and development. Qi is not only the basic substance for the constitution of the human body, but also the main sub- stance for the maintenance of life activities. The movements of qi inside the body have four forms: ascending, descending, entering and exiting. Under normal circumstances, ascending and descending, as well as enter- ing and exiting, should maintain a relative balance. Such a balance, if destroyed, may lead to morbid conditions. Spirit is the concentrated reflection and dominator of the mind, consciousness, perception and motion of the human body. The spirit inside the body is most closely
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connected with the five zang-organs. Although they are different in names, ethereal soul, corporeal soul, ideation and will, as a matter of fact, all pertain to spirit. TCM holds that the body and spirit are inseparable, and with or without spirit is the decisive factor for life and death. The co- existence of spirit and body is a major sign of life.
In TCM, essence, qi and spirit are called the “triple treasures” which, although being separate entities, are closely associated. Essence may transform into qi, and qi may transform into essence, so they are inter- transformed. Essence and qi can generate and nourish spirit which, in turn, can control essence and qi. In TCM, it is considered that spirit is the most important one among the three factors because it is the dominator of essence, qi, and all the life activities.
Daily Exercises
1. Understand the general information on the development of the basic theories of TCM.
2. Master the basic characteristics of the basic theories of TCM.
3. Master the application of the theory of essence, qi and spirit in TCM.
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