Traditional Chinese Medicine (TCM) boasts four canonical masterpieces: Huangdi Neijing (The Yellow Emperor’s Internal Classic), Nanjing (The Classic of Difficult Issues), Shanghan Zabing Lun (Treatise on Cold Damage and Miscellaneous Diseases), and Shennong Bencao Jing (Shennong’s Classic of Materia Medica).
Among them, The Yellow Emperor’s Internal Classic was compiled earliest and contains the most extensive content, establishing it as an iconic cornerstone of China’s medical heritage.
Treatise on Cold Damage, the abbreviated title of Shanghan Zabing Lun, was composed based on Tangye Jing Fa (Classic of Decoction Prescriptions), a work traditionally attributed to Yi Yin, the prime minister of the Shang Dynasty.
Traditional Chinese Medicine takes Yin-Yang and the Five Elements as its theoretical foundation. It regards the human body as an integrated unity of Qi, physical form and spirit.
Through the combined application of the four diagnostic methods—inspection, listening and smelling, inquiry, and palpation—TCM identifies the cause, nature and location of imbalances, analyzes mechanisms as well as changes in the zang-fu organs, meridians, joints, Qi, blood and body fluids within the human body, and judges the waxing and waning of stressors and vitality.
It further determines patterns and summarizes syndrome presentations. Following the principle of personalized approach based on syndrome differentiation, TCM formulates supportive methods including diaphoresis, emesis, purgation, harmonization, warming, heat-clearing, tonification and resolution.
A wide range of supportive interventions are adopted, such as Chinese herbal medicine, acupuncture, tuina massage, cupping therapy, qigong and medicinal food therapy, so as to restore the balance of Yin and Yang in the human body and facilitate wellness.
The History of Traditional Chinese Medicine Development
Traditional Chinese medicine and herbal medicine have been practiced on the ancient land of China for thousands of years. Thousands of years of clinical practice have proven that TCM and Chinese herbal medicines are undeniably effective and reliable for supporting wellness, maintaining health, and health preservation.
Before Western medicine was introduced to China, generations of our ancestors relied on TCM and herbal remedies to promote wellness, saving countless lives. TCM supports health from a macroscopic and holistic perspective.
The term “Traditional Chinese Medicine” came into being as a counterpart to Western medicine. Prior to the introduction of Western medical practices into China, it was rarely referred to by this name; instead, it bore unique titles with profound connotations of its own.
The formation period of Traditional Chinese Medicine (TCM)
In remote antiquity, the ancestors of the Chinese nation discovered that certain plants and animals could support comfort, accumulating a body of knowledge on medicinal substances. As humanity evolved, people began to purposefully search for herbs and practices to support health and wellness. The well-known tales of “Shennong Tasting Hundreds of Herbs” and “Medicine and Food Share the Same Origin” faithfully depict this era.
The invention of wine in the Xia Dynasty (c. 2070–1600 BCE) and herbal decoctions in the Shang Dynasty (c. 1600–1046 BCE) greatly helped enhance the benefits of herbal practices. By the Western Zhou Dynasty (1046–771 BCE), medical practitioners were divided into four specialized categories: physicians for dietary nourishment, internal medicine physicians, surgeons for skin and wound support, and veterinary physicians.
During the Spring and Autumn and Warring States Periods, the theoretical system of Traditional Chinese Medicine basically took shape. Anatomy and specialized divisions emerged, and the Four Diagnostic Methods were widely adopted. Supportive approaches included stone needle therapy, acupuncture, herbal decoctions, moxibustion, daoyin energy exercises, qi emission therapy, and zhuyou spiritual healing.
Huangdi Neijing (The Yellow Emperor’s Internal Classic) ranks among the four canonical masterpieces of traditional Chinese medicine, and is the earliest medical text preserved in China’s treasure trove of medical literature. It is an authoritative monumental work covering human physiology, pathology, diagnostics, principles and materia medica.
The book established core theoretical frameworks of TCM, including the Yin-Yang and Five Elements theory, pulse diagnosis theory, visceral manifestation theory, meridian theory, etiology, pathogenesis, manifestation, diagnostic techniques, wellness planning, health cultivation theory, and five movements and six qi theory. Later generations of TCM practitioners and health preservation scholars interpreted human physiological activities based on Yin-Yang and the Five Elements. Medical craftsmen, golden acupuncture needles, bronze diagnostic probes and other tools also appeared in this period.
TCM primarily refers to the traditional medicine created by the Han ethnic group in China. It is an academic discipline dedicated to the study of human physiology, pathology, as well as the support and maintenance of health.
Development Period of Traditional Chinese Medicine
Huangdi Neijing (The Yellow Emperor’s Internal Classic), a TCM classic compiled during the Qin and Han dynasties, systematically elaborates on human physiology, pathology, wellness, the principle of “supporting wellness before imbalances arise”, as well as principles and modalities. It established the fundamental thinking paradigm of Traditional Chinese Medicine, marking a transition from simple accumulation of clinical experience to systematic theoretical summarization, and laid the structural framework of the theoretical system of Chinese medicine and materia medica.
In the Eastern Han Dynasty, Zhang Zhongjing authored Shanghan Zabing Lun (Treatise on Cold Damage and Miscellaneous Diseases). The work put forward diagnostic and supportive principles for externally contracted febrile conditions (including infectious challenges such as pestilence), and expounded the syndrome differentiation rules covering etiology, manifestations, diagnostic methods, support and maintenance of internal balance. It founded the complete theoretical and methodological system of personalized wellness based on syndrome differentiation.
Contemporary with it, Shennong Bencao Jing (Shennong’s Classic of Materia Medica) generalized core theories of herbal compatibility and properties, including the monarch-minister-assistant-guide formula structure and seven modes of herbal compatibility, four natures and five flavors of medicinal herbs. It provides vital guidance for rational formulation, safe usage and enhanced supportive effects, laying a solid foundation for the formation and evolution of the theoretical system of Chinese materia medica.
At the end of the Eastern Han Dynasty, Hua Tuo developed Mafeisan, an herbal preparation, pioneering the use of supportive aids in procedures.
In the late Qin and Han periods, as transportation networks gradually improved, medicinal materials from ethnic minority regions such as rhinoceros horn, amber, antelope horn and musk, as well as longan and lychee seeds from the South China Sea, were gradually adopted by physicians in inland China. Herbal medicines from Southeast Asia and other regions were also continuously imported into the country.
The golden age of Traditional Chinese Medicine
In the Tang Dynasty, Sun Simiao put forward the tenet of “Sincerity and Proficiency of the Great Physician”. It embodies TCM practitioners’ pursuit of profound expertise, sincere compassion, and prudent words and deeds. Concentrating the noble moral sentiments and outstanding civilizational wisdom of the Chinese nation within traditional Chinese medicine, it stands as the core value of TCM culture.
Devoting his entire life to research, Sun Simiao authored Essential Prescriptions Worth a Thousand Gold Pieces for Emergencies and Supplement to the Essential Prescriptions Worth a Thousand Gold Pieces. The former consists of 30 volumes containing 5,300 formulas and treatises, while the latter also spans 30 volumes with a collection of 2,571 recipes. These two classics elaborate on clinical specialties, acupuncture and moxibustion, medicinal diet, disease prevention, health preservation and more, representing the culmination of all formula books compiled prior to the Tang Dynasty.
The Song Dynasty witnessed a golden age in the development of traditional Chinese medicine. The imperial court attached great importance to TCM education and established the Imperial Medical Bureau as the supreme institution for training TCM practitioners. Teaching methods also underwent remarkable innovations. For instance, Wang Weiyi, an official physician specializing in acupuncture, cast two bronze acupuncture statues meticulously engraved with the twelve regular meridians and 354 acupoints for acupuncture teaching and physician examinations. As the earliest medical teaching models, they featured an intuitive, vivid and lifelike presentation, marking a groundbreaking innovation in the history of Chinese medical education.
The Song government also founded the Medical Book Collation Bureau, which spent more than a decade systematically collecting, sorting, researching, verifying and revising major medical texts from past dynasties. Numerous canonical TCM works circulated down through generations after being revised and printed at that time, including Plain Questions, Treatise on Cold Damage Diseases, Synopsis of Prescriptions of the Golden Chamber, A-B Classic of Acupuncture and Moxibustion, Treatise on the Etiology and Manifestations of Diseases, Essential Prescriptions Worth a Thousand Gold Pieces for Emergencies, Supplement to the Essential Prescriptions Worth a Thousand Gold Pieces and Secret Prescriptions of an Outer Chamber.
Innovation and Integration of Traditional Chinese Medicine
In the Ming Dynasty, Li Shizhen compiled Compendium of Materia Medica. For the first time worldwide, it carried out scientific classification of medicinal plants, innovated and advanced the theories and clinical practice of Chinese materia medica, and stands as a monumental masterpiece covering pharmaceutics and natural history.
In the Qing Dynasty, Ye Tianshi wrote Treatise on Warm Heat Diseases, which put forward the support principles and approaches for warm conditions and seasonal challenges, establishing a complete theoretical and practical system of TCM for epidemic and health challenges.
Wang Qingren, a Qing-dynasty physician, authored Corrections on the Errors of Medical Works based on human cadaver dissection and clinical experience. He rectified several anatomical mistakes recorded in ancient medical texts, stressed the essential value of anatomical knowledge for practitioners, and further developed the theory and supportive methods for blood circulation support.
Since the mid-Qing Dynasty, especially during the Republic of China period, Western medicine was introduced into China. A number of scholars began to explore the integration and convergence of traditional Chinese medicine and Western medicine.
Since the SARS outbreak in 2003, classical formula-based traditional Chinese medicine has shown signs of revival.
In modern times, TCM remains one of the commonly used supportive approaches for health maintenance in China. Internationally, acupuncture has aroused immense interest among medical communities. Acupuncture has been shown to be supportive with minimal side effects in promoting comfort during recovery, pregnancy, certain health challenges, and dental discomfort. Nevertheless, clinical data regarding chronic discomfort, back discomfort and headaches remain ambiguous or controversial.
The World Health Organization (WHO) holds that the supportive effects of acupuncture and certain herbal medicines are strongly backed by scientific double-blind trials. Further research is still required for other traditional practices, and the safety risks and potential hazards of understudied traditional interventions cannot be overlooked.
On May 26, 2002, the WHO released the Global Strategy for Traditional Medicine 2002–2005, calling on more than 180 countries worldwide to incorporate complementary and alternative medicine into their national healthcare policies.
The original innovation and theoretical revolution in the basic theories of modern Traditional Chinese Medicine, initiated in the 1990s, established a new philosophical paradigm for TCM.
TCM boasts three core philosophical perspectives: the holistic perspective, the syndrome differentiation perspective, and a newly excavated third philosophical perspective of TCM — the similarity perspective, namely fractal theory.
On October 1, 2018, the World Health Organization (WHO) incorporated Traditional Chinese Medicine (TCM) for the first time into its globally influential medical classification framework — the International Statistical Classification of Diseases and Related Health Problems (ICD).
The newly added contents concerning TCM and traditional medicine are included in Chapter 26 of the 11th Revision of the International Classification of Diseases (ICD-11). This supplementary chapter elaborates the classification system for traditional medical conditions, and it was scheduled to be implemented across all WHO Member States in 2022.