soch111 history of healing · 960 –1279 ce song and southern song dynasty 1279 –1368 ce yuan...
TRANSCRIPT
SOCH111 – History of Healing
www.endeavour.edu.au
Session 9
Chinese Medicine
Department of Social
Sciences
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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
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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,
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w/index.php?curid=9382281
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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
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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
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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,
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/index.php?curid=19264100
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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
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[Public
domain], via
Wikimedia
Commons
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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
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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
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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
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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,
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php?curid=28550451
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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,
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g/w/index.php?curid=1206741
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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
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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
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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
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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?
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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,
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w/index.php?curid=38632806
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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
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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
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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
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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
© Endeavour College of Natural Health www.endeavour.edu.au 23
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
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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
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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
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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
© Endeavour College of Natural Health www.endeavour.edu.au 27
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
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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
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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
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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
© Endeavour College of Natural Health www.endeavour.edu.au 31
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?
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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
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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,
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p?curid=4107251
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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
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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
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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,
https://commons.wikimedia.org/w/index.php?curid=3
3929660
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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
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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
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Five Element Diagnosis
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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
© Endeavour College of Natural Health www.endeavour.edu.au 41
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
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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.
© Endeavour College of Natural Health www.endeavour.edu.au 43
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
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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
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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
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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
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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
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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
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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,
https://en.wikipedia.org/w/index.php?curid=31289881
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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
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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,
https://commons.wikimedia.org/
w/index.php?curid=6727578
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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
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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
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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?
© Endeavour College of Natural Health www.endeavour.edu.au 55
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>.