Chinese medical traditions

Chinese medicine is one of the oldest continuous healing traditions in the world. In a tomb at Mawangdui, sealed in 168 BCE, archaeologists found silk manuscripts with recipes against fifty-two ailments. They show how old the knowledge already was.

The classical foundation lies in a few great works. The Huangdi Neijing, the “Inner Classic of the Yellow Emperor”, took shape in the last centuries BCE. The Shennong Bencao Jing, the herbal classic of the mythical farmer-emperor Shennong, describes 365 remedies. Around 200 CE Zhang Zhongjing wrote the Shanghan Lun, on febrile diseases, with formulas still in use today.

Over the centuries the knowledge kept growing. In 1578 Li Shizhen completed the Bencao Gangmu, a huge encyclopaedia with almost two thousand remedies. In the twentieth century the tradition was reformed and standardised in China into what the West now calls “traditional Chinese medicine”.

Chinese medicine sees the body as a coherent whole, connected with nature and the seasons. Central are yin and yang, two opposing but complementary forces, such as cold and warm, rest and movement. Health is their balance.

Qi is the life energy that flows through the body, along pathways called meridians. The five phases, wood, fire, earth, metal and water, describe how organs, seasons, tastes and emotions influence one another.

A physician diagnoses not only a disease, but above all a pattern: a picture of what is out of balance in the whole body. To do so he looks at the tongue, feels the pulse and asks many questions. Two people with the same complaint can thus receive very different treatment.

For a long time knowledge was passed on within families or from teacher to pupil. Physicians studied the classics, wrote commentaries and collected their own recipes.

There were also imperial medical institutes, from the Tang dynasty onwards, with examinations and training. Alongside the learned physicians there was broad folk knowledge of herbs, as well as itinerant healers and herb sellers.

Today universities of Chinese medicine in China train physicians in a programme of five years or longer, with Western medicine also on the curriculum.

The Huangdi Neijing and the Bencao Gangmu have been on UNESCO’s Memory of the World register since 2011. The Shennong Bencao Jing and the Shanghan Lun are the other great classics.

A remarkable story belongs to a fourth-century book by the scholar Ge Hong. He described how to soak sweet wormwood in cold water against fever. In the 1970s the Chinese researcher Tu Youyou read that text and so discovered artemisinin, a drug against malaria. In 2015 she received the Nobel Prize for it.

In 2010 UNESCO recognised acupuncture and moxibustion as intangible heritage.

In China traditional medicine works alongside Western medicine, with its own hospitals, pharmacies and training. It is also important in Taiwan, Hong Kong and Singapore, and there are practitioners worldwide.

Since 2019 the WHO’s International Classification of Diseases, ICD-11, has had a separate chapter with diagnoses from the traditional medicine of China, Japan and Korea.

The scientific support differs greatly by use. Some remedies are well researched; for many others evidence is lacking.

Chinese remedies are almost always combined in formulas. Every formula has a principal remedy and helpers. Well-known herbs are ginseng, astragalus, dang gui, liquorice, which brings many formulas into balance, ginger, cinnamon and Chinese dates.

Goji, rehmannia, peony root and the mushroom poria also belong to the basics.

According to the tradition every remedy has its own nature (warm or cold), a taste and a direction in the body. Besides plants, minerals and animal products are also used.

Some Chinese remedies can be harmful. Herbs containing aristolochic acid caused serious kidney damage in Belgium in the 1990s among users of a slimming regimen. Ephedra can strain the heart. Buy only controlled products and consult a doctor.

Do not use remedies from endangered animals, such as the pangolin or the tiger. That trade threatens these species with extinction.