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The origination, formation and development of the theoretical system of TCM

TCM originated in antiquity. Early in the primitive society, human beings began to accumulate medical knowledge. In Chinese classics there are many records concerning medicine or drugs, such as "Fuxi made nine needles" and "Shennong tasted hundreds of herbs and was poisoned seventy times in a single day". These records indicate that the Chinese ancestors made great efforts to explore medicine in their work and life.

In the Spring and Autumn Period and the Warring States, China was greatly advanced in politics, economy, science and culture. In medicine, disease was well understood and medical experience was further enriched. Rapid development in medicine made it possible to develop a new theoretical system of medicine by combining the medical knowledge passed on from the previous generations with latest theoretical ideas. The publication of Huangdi Neijing (Huangdi's Canon of Medicine), the earliest extant medical canon in China, symbolized the formation of such a new theoretical system of medicine. Huangdi Neijing appeared around the time from the Warring States to the Qin and the Han Dynasties. It collected a great quantity of materials concerning medical practice done by the previous generations, summarized and synthesized knowledge of astronomy, geography, biology and meteorology in the light of the theories of yin-yang and five elements. It systematically expounded the physiology and the pathology of human body as well as the diagnosis, treatment and prevention of disease, consequently establishing a unique theoretical system for TCM and laying a solid foundation for the theoretical and clinical development of TCM.

Ever since the publication of Huangdi Neijing, doctors of all generations have made great efforts to further enrich and improve the theory of TCM, promoting the development of medical system.

Nan Jing(Canon of Difficult Issues), another important medical classic after Huangdi Neijing, expounded the main contents of Huangdi Neijing in a style of questioning and answering and supplemented what Huangdi Neijing lacked of. As an indispensable classic in the theoretical works of TCM, Nan Jing put forward a number of important ideas, such as "taking pulse only at the area of cunkou" and "the left is the kidney and the right is mingmen (life gate)" which exerted great impact on the theoretical development of TCM.

In the last years of the East Han Dynasty, Zhang Zhongjing, based on Huangdi Neijing and Nan Jing as well as his own clinical practice, wrote Shang Han Za Bing Lun ( Treatise Exogenous Febrile Disease and Miscellaneous Diseases), the first monograph on clinical medicine. This book contributed greatly to the formation and development of syndrome differentiation and treatment in clinical medicine. Taking syndrome differentiation of the six meridians (taiyang, shaoyaug, yangming, taiyin, shaoyin and jueyin) and syndrome differentiation of the viscera as the principles for the differentiation of syndrome, Zhang formulated effective therapeutic methods and prescriptions for the diagnosis and treatment of exogenous and endogenous diseases. These methods and prescriptions are still widely used at home and abroad. Zhang himself was worshiped as the "sage of medicine" by the later generations.

The Jin, Sui and Tang Dynasties witnessed extensive summarization, enrichment and completion of the theory and clinical practice of TCM. In the Jin Dynasty, Wang Shuhe wrote Maijing ( Canon of Pulse), the first monograph on diagnostics of TCM in China; in Sui Dynasty, Chao Yuanfang compiled the first monograph on pathogenesis and symptomology; in Tang Dynasty, Wang Tao wrote Waitai Miyao (Medical Secrets of An Official) and Sun Simiao wrote Beiji Qianjin Yaofang (Valuable Prescriptions for Emergency) which thoroughly summarized the theoretical study and clinical practice before the Tang Dynasty.

From the Song Dynasty to the Jin and Yuan Dynasties, various doctrines of medicine appeared, promoting the development of TCM from different angles. Liu Wansu, Zhang Congzheng, Li Gao and Zhu Zhenheng were the representatives of these medical schools. Liu Wansu believed that "fire and heat" were the main causes of diseases and that diseases should be treated with drugs cold and cool in nature. So his theory was known as "the school of cold and cool" by the later generations; Zhang Congzheng believed that all diseases were caused by exogenous pathogenic factors and advocated that pathogenic factors should be eliminated by means of diaphoresis, emesis and purgation. Elimination of pathogenic factors ensures the restoration of the healthy qi and cure of disease, so his theory was known as the "school of purgation". Li Gao held that internal impairment of the spleen and the stomach would bring about various diseases and therefore emphasize that the most important thing in clinical treatment should be to warm and invigorate the spleen and the stomach. So he was regarded as the founder of the "school for reinforcing the earth". Zhu Zhenheng believed that "yang is usually redundant while yin is frequently deficient" and that yin-deficiency and fire-exuberance were the commonly encountered syndromes. Clinically he usually used the prescriptions for nourishing yin and reducing yang to treat diseases. So his theory was known as the "school for nourishing yin".

Though different from each other, these theories enriched TCM and promoted its development. That is why they were called "four great doctors in Jin and Yuan Dynasties" by the later generations.

In the Ming and Qing Dynasties, wenbing, a new branch of seasonal febrile disease in TCM, appeared. Wu Youke in Ming Dynasty first put forward the idea that the cause of pestilence was different from liuyin (six abnormal climatic factors). He believed it is "a special pathogenic factor in the natural world". This was a new explanation of pestilence.

In Qing Dynasty, Ye Tianshi, Xue Shengbai, Wu Jutong and Wang Mengying made extensive study on the route of infection, pathogenesis and pathological changes of seasonal febrile disease through clinical practice, gradually establishing a theoretical system of seasonal febrile disease with syndrome differentiation of wei (defensive qi), qi, ying (nutrient qi), xue (blood) and sanjiao (triple energizer) as its core. This theoretical system is now a specialty of TCM.

With rapid development of modern medicine, TCM now encounters another chance to develop. On the basis of the theoretical study and clinical practice made by the previous generations and with the adoption of modern scientific theory and technology, TCM will certainly step into a new era.