Brief History of TCM
As an acupuncturist, you may not need to
know in detail the history of the Traditional Chinese Medicine
(TCM), but if you claim that you are a TCM doctor, you must know
it. The history of the TCM, we mean here, is not as you are
taught that the TCM is developed through the natural life of old
Chinese, or it is the summary of the Chinese through random
experience in the heeling….
What we mean the TCM history that you must
know is: you should know which book is the TCM bible and which
book is the clinic guide that work before, now and in future
too. What you learned from the textbook TCM is not at all a good
summery of the TCM. It is not enough to allow you have enough
knowledge to handle daily clinic work. If you practice TCM based
mostly on whatever you learned from the textbook TCM, you are
still a beginner of TCM. Current TCM textbook, no matter it is
published in China
or published out of
in English, omits and neglects very important knowledge part of
the TCM. There could be many reasons for this. One of the
important facts is: the editor and the teacher them selves are
not skillful enough to apply the TCM bible in their own clinic.
The TCM bible – Huang Di Nei Jing
In brief, the bible of TCM, we call it TCM
bible, is the book named “Huang Di Nei Jing”. The exact author
of the book is unclear actually, but it is known that it is
written about 2000 years ago and may authors worked for the
writing. This book tells the reasons for a disease and the
principles for the treatment of diseases. It tells the structure
and the function of the organs in the body and how the organs
work. It tells how to prevent disease and how to match the
nature to keep healthy. It also tells how to predict the disease
and how a doctor should prepare to prevent it. The principle
told in the book is well admitted by many famous TCM doctors in
the history to be true. It is still the principle used by many
famous TCM doctors nowadays. However, the weakness of this book
is that it does not tell in detail how to use herb exactly for
the treatment. It has been said that there is another sister
book to tell more in detail, but it is missing though we know
So, did you learn this book when you are in
Shang Han Lun
The second most important TCM book is named
“Shang Han Lun”. It is written by Dr. Zhang Zhong-Jing 2000
years ago. It is a summery of clinic experience of many doctors
before that time. It is the earliest systematic summery of
clinic treatment in TCM history. It tells exactly how to make a
diagnosis, how to monitor the progress of a disease and how to
use herbs for the treatment. It tells in which condition a
disease it is cured and in which condition it is hardly be
cured. This book is so important that we call it
the practical bible of
TCM. Doctors who practice clinic using mostly the herbal formula
of this book are called “Jing Fang Pai”. Jing means bible in
Chinese; Fang means formula, and Pai means group.
The contribution of Dr. Zhang Zhong-Jing is
the introduction of diagnosis principle: Liu Jing Bian Zheng.
Liu means six; Jing means meridian, or stage of the diseases;
Bian Zheng means diagnosis. This is the earliest TCM book that
separate the stages of a disease into 6. It tells that if a
disease-causing factor comes into the body, it can attack the
surface of the body then deeper into the organs; it can also
come into the body directly affecting the organs. It also gives
the herbal formula to use in each stage (each Jing), and tells
how to use and to modify the formula, according to the clinic
situation. It is known that the kinds of the herbs introduced by
Dr. Zhang Zhong-Jing in each formula is less, but the dose is
more, than used by later doctors in their own formula. I suspect
that, just because the clinic effect of the later doctor’s
formula is not so good when they use low dose of herbs, so that
they have to use more kinds of herbs in each formula.
In my clinic, I use mostly the herbal
formula of this Shang Han Pai. I like it very much and believe
what it is touched that, once the diagnosis is correct and
following the introduction by this group of doctor, the clinic
effectiveness is very high.
The Liu Jing Bian Zheng system has been
modified or abstracted into the later Ba Gang Bian Zheng in
textbook. Ba Gang Bian Zheng. Ba means eight, Gang means
principle, and Bian Zheng means diagnosis. The eight principles
is: Ying, Yang, Biao (surface), Li (inner), Xu (deficiency), Shi
(extra condition), Han (cold) and Re (hot). In this diagnosis,
the Yin and Yang is easy to tell. Biao, Shi and Re belong to
Yang and Li, Xu and Han belong to Yin. The Yin and Yang becomes
a concept rather than a clinic useful guide. This is one of the
biggest mistakes by the textbook TCM. We have an article to
discuss this mistake in detail.
Wen Bin Pai
Later on there is a new TCM group called
Wen Bin Pai. The master of this group is Dr. Zhang Jing-Yue. At
his time, there comes a big epidemiologic disease, called Wen
Bin in TCM. When doctors use the herbs introduced by the Shang
Han Pai above, it seems not work well. Dr. Zhang Jing-Yue
developed a new diagnosis system, called Wei, Qi, Ying Xue Bian
Zheng system. He also introduced to use herbs that belongs to
Cold in herbal nature for the treatment. It works well.
Because the herbs used in this group is
much less in dose, so it is believed much safe (and cheaper)
than the herbs used by Shang Han Pai. This fact affected much
more later doctors who tend to apply this Wen Bin Pai herbs and
less herbs introduced by Shang Han Pai.
It is now believed by some doctors that the
Wen Bing Pai is actually developed from one major Jing in the
Shang Han Pai. It means that the major herbs used is to treat
the epidemiologic disease that belongs to one of the Jing in the
Shang Han Pai, e.g. Yang Ming Jing. It does not mean that the
Wen Bin Pai is complete different Pai from the Shang Han Pai.
However, the new diagnosis system and the way to use herbs in
the Wen Bin Pai make the influence of the Shang Hai Pai much
less to the later doctors.
Now we also know that when applied to the
treatment of most other diseases, the herbs used in the Wen Bin
Pai works much less effective than the Shang Han Pai. It needs
much more kinds of herbs in a formula and needs longer time for
the treatment. The cure rate for most diseases, is also low. If
you know how a pain killer works for your pain, you would know
how the Wen Bin Pai herbs works for most ordinary diseases. Even
though, many doctors nowadays use the herbs of Wen Bin Pai much
more than that of Shang Han Pai.
Other TCM groups (Pai)
In the history of TCM, there are different
other TCM group more or less different from above Shang Han Pai
and Wen Bin Pai, such as Huo Sheng Pai, Wen Yang Pai, and Pi Wei
pai. All of these TCM groups have their own clinic advantage and
disadvantage. For us as TCM beginner, we should learn their
difference and learn when to use each of them in our own clinic.
Strictly, the textbook TCM is not a group.
It is not as any of above groups which are developed from clinic
work and has their own styles in diagnosis and herbal therapy.
The textbook TCM means an introduction of TCM with its own
modifications. For instance, it introduce Ba Gang Bian Zhen, but
the diagnosis of Yin and Yang becomes more theory and a concept,
rather than a clinic obligation (though it claims it is very
It focuses more as Five Element diagnosis
combined with the Wei, Qi, Yin and Xue diagnosis. It lists
mostly a symptom as a TCM “disease”, rather than a clinic
syndrome as used in
Shang Han Lun. For example, it uses Cough as a “disease”, then
diagnose subgroup of the cough as “Fen Han Xiu Fei”, or “Fen Re
Fan Fei”, or “Zao Xie Shang Fei”, or “Yin Xue Huo Wang”… the
question in clinic is that many times a patient does not show
such typical clinic picture to allow a diagnosis. Secondly, even
if the diagnosis is clear, if the herbs introduced does not
work, students do not learn what should be the next. In the
textbook TCM, the diagnosis seems easy, since to link the
disorder to one or two of the Five Element, so to the organs, is
easy. However, in clinic, such diagnosis seems less useful
compared with the Liu Jing Bian Zhen system above. This is my
own experience at least. I believe I am not the only one with
In all, the textbook TCM is a scattered
information that being picked up from various TCM groups in TCM
history. It seems a summery, seems better than ever. But it is
not. It broken the consistence of TCM system, and broken each
TCM style too. The common phenomenon is: when in TCM school, a
student feels very confidence to practice TCM. In his heart, it
seems no disease that cannot be diagnosed or treated. However
after graduate for two to three years, he feel hard to treat any
diseases. Why? Why
should we ask if it is due to the misleading by the textbook TCM
What we believed so important books, such
as Huang Di Nei Jing and Shang Han Lun is no longer teach in the
TCM school as obligation courses. They are turned into an option
now. Check your TCM school lecture list, see if they teach you
these two books, or they leave them to you to learn by your
willingness? What you need urgent from your TCM teacher is to
let them tell you how to understand and to apply the knowledge
in these two books.
What you should do
Certainly, if you have learned TCM in a TCM
school, you are only a beginner. You need to learn the TCM bible
and the Shang Han Lun, since they are not touch in TCM schools.
It is a tough task for everyone, even for us who speak Chinese.
Speak Chinese does not mean that you can really understand the
meaning in the books or to use them in your clinic, even if you
can read every word in it. IT NEEDS YOUR WHOLE LIFE TO LEARN.
To really understand the meaning of the two
books, you need to read books by other authors telling their own
experience in using the two books. This is another way to learn.
You may realize that you have to learn Chinese first, since most
of the books are not in Chinese.
 The word “syndrome” here in TCM is
not exactly the one used by conventional medicine.
 So that the TCM doctor (now he is
a doctor) tends to use the chemical drugs for the
treatment, as every doctor in the conventional medicine.