Written by Tan Ee Shuen , Year 3 (2018)
Traditional Chinese Medicine (TCM) is the crystallisation of the wisdom and efforts of our ancestors. Throughout the history of TCM, its development cannot be achieved without their continuous dedication. In a renowned Chinese mythology, Shen Nong travelled around the country and tasted all the plants he came across, in hope to discover plants with medicinal properties. He differentiated the herbs and used them to treat various illness and diseases. In his endeavour, he accidentally ingested the highly toxic Gelsemium elegans, also known as the “heartbreak grass”, that costed him his life. However, his perseverance and dedication left behind valuable knowledge that not only saved many lives during his time, but also became an important cornerstone for the progress of TCM.
There are four books that are known as classics of TCM, namely Huang Di Nei Jing (黄帝内经, “Inner Canon of the Yellow Emperor”), Huang Di Ba Shi Yi Nan Jing (黄帝八十一难经, “The Yellow Emperor’s Canon of Eighty-One Difficult Issues”), Shang Han Za Bing Lun (伤寒杂病论, “Treatise on Cold Diseases and Miscellaneous Diseases”) and Shen Nong Ben Cao Jing (神农本草经, “Divine Farmer’s Classic of Materia Medica”).
Huang Di Nei Jing, often known as Nei Jing (“Inner Canon”), is the earliest existing medical literature on TCM, and comprises of two texts – Su Wen (“Basic Questions”) and Ling Shu (“Spiritual Pivot”). There are various conjectures on when the classic was written, but it is quite likely that the materials are adapted during the Warring States and early Qin period, and the texts completed during the Han Dynasty. The classic gathered the theories and experiences of numerous practitioners, and is highly regarded as the doctrine of TCM. Much of the future works are based on its ideologies. The Huang Di Nei Jing established a firm foundation for the theories of TCM, and is an important factor that promoted the development of the medical field.
Huang Di Ba Shi Yi Nan Jing, more commonly known as Nan Jing (“Canon of Difficult Issues”), is compiled during the Eastern Han Dynasty and is believed to be authored by Qin Yue Ren (秦越人), who is also known as Bian Que (扁鹊). It supplemented the Huang Di Nei Jing and provided elaborations on its theories. An important record is the use of pulse diagnosis of the radial artery at the wrist. It deeply influenced the progress of the diagnosing methods of future practitioners.
Shang Han Za Bing Lun is written during the Eastern Han Dynasty. It is authored by Zhang Zhong Jing (张仲景), a man who is laurelled by future generations as the Medical Sage. During the Jin Dynasty, Wang Shu He (王叔和) organised the text and divided them into two books – Shang Han Lun (伤寒论, “Treatise on Exogenous Febrile Diseases”) and Jin Gui Yao Lue (金匮要略, “Essential Prescriptions from the Golden Cabinet”). It is the first literature that focuses on the unique diagnosis and treatment methods of TCM. The classic records the pathological processes, clinical symptoms, treatment methods, prognosis and rehabilitation of both exogenous diseases and internal injuries. It also provides formularies that have concise combinations as well as precise indications. Shang Han Za Bing Lun integrates basic theories with clinical practices, and is an important educational and practical reference material for the future generations.
Shen Nong Ben Cao Jing, frequently shortened to Ben Cao Jing or Ben Jing, is compiled during Eastern Han Dynasty. It is the earliest existing literature on TCM materia medica. It consists of the pharmacological knowledge of numerous practitioners and organises the herbs based on their properties. Based on the capabilities of the herbs to tonify the body, to treat illnesses as well as their toxicity, they are divided into three categories – Upper, Middle and Lower. Based on their properties, they are further classified into four natures – cold, cool, warm and hot, as well as five flavours – sour, bitter, sweet, spicy and salty. The Shen Nong Ben Cao Jing established the “four natures and five flavours” pharmacological theory of TCM, and promoted the development of herbal remedies in TCM.
Other than the four classics, the various ancient medical texts that have been passed down for generations also played important roles in the tradition, education and promotion of TCM.
An ideology of TCM is that the Qi (“Vital Energy”), blood and body fluids of the human body is always at a dynamic equilibrium. When this subtle balance is disturbed, it may cause a pathological condition. The theory of TCM also emphasises the importance of understanding how the human body interacts with the surroundings, and to consider the human body as an organic whole. Factors such as the nature, seasons, time and societal reasons can all affect the body. The internal components of the body, such as the essence, Qi, blood, body fluids, organs and meridian systems are all interconnected and can affect each other through systematic processes as well. The aim of the diagnosis and treatment in TCM, is not just to expel the causes the illnesses or diseases, but also to consider the human body as a whole and restore the balance in the human body. By strengthening the body, the intention is to keep the body healthy and to prevent future recurrences.
In clinical practices, the examination methods the TCM practitioners use to understand the condition of the patients include visual inspection, listening and smelling, questioning as well as palpation. Visual inspection is the use of the physician’s visual senses to observe the patient’s appearance such as the spirit, colour, form and bearings, as well as the tongue, and form, colour, texture and amount of excretion. Listening and smelling involves the use of the physician’s auditory and olfactory senses to identify unusual changes in the patient’s voice and smell. Questioning is a useful method to understand the pathological progression and the symptoms of the condition, as well as the previous medical history, family history and possible allergies and other factors that play a part in the resulting illness or disease. Palpation entails the use of the physician’s sense of touch to feel the patient’s pulse and to examine the body. Through the use of the four examination methods, the physicians consolidate the information, apply their knowledge and theories to identify the condition of the patients and administer a personalised treatment programme for the patients.
The theories, diagnosing and treatment methods of TCM have been continuously improved over the years through the hard work and contributions of generations of practitioners and researchers. Modern TCM practitioners not only rely on the olden ideologies, but also incorporates the use of contemporary scientific methods to advance the diagnosis and treatment techniques of illnesses and diseases. Such relentless effort shows promises in the development and progress of TCM.
