Chapter 2 Section 2 Overview of the Development of Traditional Chinese Medicine
The development of Chinese medicine, like other disciplines, is closely related to the development of productive forces and social changes in various historical stages.Although it is constantly improving, it is not all smooth sailing.This starts with the first dynasty in the history of our country - the Xia Dynasty.
The Xia and Shang dynasties were the era when my country's slavery system emerged and developed, and made outstanding achievements in agriculture, animal husbandry and handicraft production.In particular, the bronze culture that originated in the late Xia and flourished in the Shang and Zhou dynasties, and the oracle bone inscriptions that have matured in Shang and Zhou dynasties, mark the high level of ancient civilization in our country.Naturally, there will be some progress in medicine.From the oracle bone inscriptions unearthed from the Yin Ruins, it is found that people at that time had a clear classification of diseases, and the scope involved has included today's internal medicine, gynecology, pediatrics, external diseases, facial features and other diseases, with more than 20 names of diseases.The invention of some disease names is very meaningful in the history of medicine.For example, the record of dental caries is the earliest record of the disease in the world.At that time, there was a saying of "disease year", referring to the year of many illnesses, which was the earliest record of epidemics.There is also some experience accumulated in the drugs and methods for treating diseases.However, the development of medicine in Xia and Shang was relatively slow, which was extremely disproportionate to the outstanding achievements in production and culture.The direct reason is that medical activities in the Xia and Shang dynasties were controlled by wizards.Witchcraft originated in the late stage of primitive society and reached its peak in Shang Dynasty.They are considered as the media between gods and humans, they can participate in all social affairs including state affairs, and they have a pivotal social status.In the era when witches are turned to for help in everything, the "witch doctor" who combines witches and doctors naturally came into being.The reason why witch doctors can win people's trust is that they also perform medical treatment under the cover of witchcraft.There are records about wizards often collecting medicine in Lingshan and "fucking the medicine of immortality".It can be seen that the reason why witch doctors can "bless people's blessings and cure people's diseases" is not that they do not rely heavily on medicine.Therefore, in the era of the integration of witches and doctors, medicine served witches, and the sad situation that witches controlled medicine was formed.Therefore, in the Xia and Shang dynasties, medicine was still under the heavy shackles of theocracy, and it was impossible to have a breakthrough development, which delayed the emergence of medical theories for a long time.
From the Western Zhou Dynasty to the Spring and Autumn Period, the slave system went from prosperity to decline, and the feudal states in the Warring States Period completed the transition to the feudal system one after another.The Qin Dynasty established the first unified feudal empire in history.At the beginning of the week, due to the further development of productivity, the social division of labor tends to be more specialized. The government agency set up in "Zhou Li" has clearly separated the responsibilities of wizards and doctors: doctors (medical officials) belong to Tianguan Zhongzai; wizards belong to. "The government decree of doctors in charge of medicine, gathering poisons to share (for) medical services." "The government decree of witches and witches. If there is a severe drought in the country, the witches will be led to dance yuyu; if the country has a catastrophe, the witches will be led Made..." shows that doctors and witches were separated at that time, and there was already a legal medical administration organization.Some relevant records in some books of the Zhou Dynasty reflect that medicine has accumulated rich experience.For example, "Zhou Li" records medical divisions, rough diagnosis of diseases, and general principles of internal and external treatment; The emergence of the medical theory emphasized the scientific nature and independence of medicine itself, and laid the foundation for the formation of the medical theory system from the Warring States Period to the Qin and Han Dynasties.Even so, due to the long-standing influence of witch doctors, there is still a choice between "believe in witches" or "believe in doctors" in society.For this reason, doctors have never stopped their resolute struggle against witchcraft.For example, the "Nei Jing" emphasizes: "Those who are bound by ghosts and gods should not speak of virtue (referring to medical theories)." It also warns: "It is the fault of doctors to make miscellaneous tricks and make false words the way."And the doctor's most powerful critical weapon is the medical effect that witchcraft cannot produce. "Historical Records" contains a typical example. During the Eastern Zhou Dynasty, the prince of Guo (Guo State) was critically ill. He stopped all activities in order to "cure the disease" (prayer activities), but to no avail. He was saved by the superb medical skills of the Qinyue people. .After recalling this historical fact, Sima Qian concluded that there are "six incurable diseases", one of which is "believe in witches but not doctors".The separation of medicine and witchcraft has brought the development of medicine into a scientific track, and the struggle between medicine and witchcraft has ensured the healthy development of medicine.
In 1973, a large number of medical books on bamboo slips and silk were unearthed in Changsha Mawangdui Tomb No. 3, with a total of 14 kinds and more than 30,000 characters.In the book, knowledge about meridians, pulse methods, medical prescriptions, health preservation, and birth and birth are all involved.According to textual research, these medical books were written in various periods from the Spring and Autumn Period to the Qin and Han Dynasties.Among them, "Moxibustion Classic of Eleven Vessels of Foot and Arm" and "Moxibustion Classic of Eleven Vessels of Yin and Yang" are the earliest documents about meridians discovered so far.
According to the records of "Hanshu Yiwenzhi", there are seven Chinese medical classics in the early Han Dynasty that can still be seen in the pre-Qin period, with a total of 216 volumes.However, there is only one "Huangdi Neijing" in later generations, with 18 volumes.These are the "Lingshu" and "Suwen", which are still regarded as canons of medical schools, with nine volumes each. "Huangdi Neijing" proves that the medical theory system in our country has been formed.For more than two thousand years, although the basic theories of Chinese medicine have been continuously enriched and developed, they have not deviated from the "Nei Jing". "Nei Jing" comprehensively discusses human physiology, pathology, diagnosis, treatment principles, methods of treatment and the relationship between man and nature.The theories of yin and yang, five elements, viscera, meridians, etiology, and pathogenesis of TCM are all derived from these medical classics.It reflects the overall and macroscopic academic characteristics of TCM, and is the theoretical basis for TCM syndrome differentiation and treatment. "Huangdi Neijing" has a very complete academic ideological system, so it can neither be produced in isolation, nor can it be the first monograph on medical theory in history. A lot of ancient medical documents are quoted in the "Nei Jing", among which there are more than 20 kinds with clear titles.This is an important clue to the lost pre-Qin medical records.Scholars of the past dynasties have great disagreements about the date when the "Nei Jing" was written. The more objective opinion is that the "Nei Jing" came out around the Warring States period, and then it was synthesized and enriched by Qin and Han doctors in the process of continuous copying.
Another influential medical classic is the "Eighty-one Difficulties of the Yellow Emperor", or "Nanjing" for short. "Old Tang Book·Jing Ji Zhi" said that this book was written by Qinyue people.However, most scholars have been against this statement through textual research.Zhang Zhongjing's "Treatise on Febrile and Miscellaneous Diseases" referred to this book, which shows that "Nan Jing" was popular in the world at the latest in the Eastern Han Dynasty.Judging from its content, it is obviously based on the theory of "Nei Jing". In some aspects, especially issues such as Mingmen, Sanjiao, and Qijing, there are more in-depth discussions. Obviously, this book was written after "Huangdi Neijing" , but not later than the Han Dynasty.
The earliest surviving monograph on pharmacology in my country, like the "Nei Jing", was not written by one person at a time, but was probably the crystallization of the experience of many doctors since the Qin and Han Dynasties, and was finally written in the Eastern Han Dynasty.It summarizes the achievements of pharmacology in the pre-Qin and Han Dynasties, and the herbal works of subsequent dynasties are all expanded on the basis of it.
The most important medical achievement in the Eastern Han Dynasty was the publication of Zhang Zhongjing's Treatise on Febrile Diseases and Miscellaneous Diseases.On the basis of previous medical theories and practices, he created a thought model of diagnosis and treatment of typhoid fever (exogenous febrile disease system) based on "syndrome differentiation of the six meridians" and treatment of miscellaneous diseases based on "syndrome differentiation of viscera". Syndrome differentiation and treatment system closely linked with prescriptions and medicines. Treatise on Febrile Diseases and Miscellaneous Diseases is a medical classic that physicians of all dynasties must study.In addition, Hua Tuo, another famous doctor in the Eastern Han Dynasty, performed anesthesia and laparotomy, which was a miracle in the history of world medicine and made outstanding contributions to medicine.
From Wei, Jin to Tang, medicine has developed in an all-round way, and clinical medicine is paid special attention to.The development of acupuncture and pulse science in the Jin Dynasty was more prominent.Wang Shuhe collected the expositions of pulse diagnosis methods from previous generations of physicians, combined with his personal clinical experience, and wrote 10 volumes of "Mai Jing", which summarized pulse conditions into 24 types, clarified the methods of pulse detection and diagnosis, and made researches on pulse science in later generations more effective. in accordance with."The Yellow Emperor's Three Acupuncture and Moxibustion A and B Classics" (referred to as "A and B Classics") written by Huangfu Mi (mi Mi) is the earliest existing monograph on acupuncture and moxibustion.Since the book aims to be practical and easy to grasp, it has contributed to the popularization and development of acupuncture and moxibustion. "Jia B Jing" was later spread abroad and had a certain influence in the world.
Physicians in the Sui Dynasty attached great importance to the study of etiology and syndrome."On the Origin and Symptoms of Various Diseases" written by Chao Yuanfang and others has high academic value.The whole book discusses more than 1,700 kinds of diseases and symptoms, which has become the model for the study of disease names in later generations.For example, obstetrics and gynecology diseases are divided into five categories: women's miscellaneous diseases, pregnancy diseases, labor diseases, dystocia diseases, and postpartum diseases, which include almost all diseases of TCM gynecology.He has a certain understanding of epidemic infectious diseases, parasitic diseases, and even some allergic diseases.For diabetes (diabetes), beriberi, leprosy, etc., the description has been very detailed and ranks among the top in the world.The content of the book also reflects that at that time, it was possible to perform operations such as induced abortion (pregnancy desire to remove the fetus), intestinal anastomosis (golden sore and broken intestine), tooth extraction (tooth extraction and pulse damage).Among them, the method, main points, steps and postoperative care of intestinal anastomosis are introduced in detail and reasonably, which are consistent with Hua Tuo's treatment method roughly recorded in historical books, and make up for some of the shortcomings of Hua Tuo's surgical treatment method that has been lost.
Since the Eastern Han Dynasty, prescription scripts have been prevalent, and many doctors have left valuable experience in medical medicine, and their academic influence will shine on later generations."Saving the Soldiers Behind the Elbow" written by Ge Hong in the Jin Dynasty is one of the best.Not only is it practical, but some of the content is a world first.For example, the description of scrub typhus and smallpox, and the use of rabies brains to prevent and treat rabies, etc., occupy an important position in the history of medicine.During the Southern and Northern Dynasties, two very important prescription books came out, namely Chen Yanzhi's "Small Prescriptions" and Yao Sengtan's (one as Sengyuan) "Ji Yan Fang".In the Tang Dynasty, "Small Prescriptions" was listed as a must-read book for doctors.It is a pity that the second book was lost in the Northern Song Dynasty, but in the Tang and Song Dynasties, it was believed that "the ancient ones such as Zhang Zhongjing, "Ji Yan" and "Xiao Pin Fang" are the most famous." The two masterpieces of "Yao" are masterpieces of clinical prescriptions since the Eastern Han Dynasty, marking the high academic level of clinical medicine before Tang Dynasty.
In the Song Dynasty, because the imperial court attached great importance to medicine, it set up a correctional medical bookstore. In addition, it became a fashion for scribes to study medicine, and the invention of letterpress printing provided good conditions for the revision and publication of ancient medical books. Therefore, the collation of ancient medical books was the most successful. Many ancient medical books rely on this to be handed down to future generations.At that time, prescription books and herbal works were also published in large quantities.For example, the earliest influential monographs on gynecology "Women's Encyclopedia of Good Prescriptions", pediatrics monograph "Pediatric Medicine Syndrome Straight Jue", surgery monograph "Liu Juanzi Guiyi Prescription", ophthalmology monograph "Yinhai Jingwei" were all published in the Song Dynasty."Washing Injustice Collection" written by Song Ci Song, is the first forensic monograph in the world, and has always been highly valued by international forensic scholars.The Song Dynasty systematically sorted out ancient medical literature, and made outstanding achievements in clinical specialty treatment, which laid a good foundation for the theoretical achievements of various schools of medicine in the Jin and Yuan Dynasties.
In the Jin and Yuan Dynasties, society was in turmoil and many diseases abounded.Physicians often have the feeling that "ancient prescriptions are difficult to cure today's diseases", so starting from clinical practice, they have repeatedly innovated medical theories.Different people have different opinions, so there are different schools of medicine. Their most outstanding leaders are called "Four Masters of Jin and Yuan": Liu Wansu, Zhang Congzheng, Li Gao, and Zhu Zhenheng each have their own style. ", "Spleen and Stomach", "Xianghuo" and other theories, broke the dull atmosphere of reverence and persistence in the medical circle of the Song Dynasty, and promoted the development of medicine in later generations.In addition, the Department of Orthopedics and Traumatology in the Yuan Dynasty had a high level, which is not unrelated to the fact that the Mongolians who were good at riding and hunting came to dominate the Central Plains.In Li Zhongnan's "Yong Lei Qian Prescription" and Wei Yilin's "Shi Yi De Xiao Fang", there are detailed elaborations on orthopedic diseases. Traumatology achievements.The implementation of anesthesia is described in detail.It is the first in the world to treat vertebral fractures with suspension reduction.
Medicine in the Ming Dynasty was deeply influenced by the academics of the Jin and Yuan Dynasties, but most of them had no sectarian views, so the academic atmosphere was active and many achievements were made.Among them, Xue Ji, Sun Yikui, Zhang Jiebin, Li Zhongzi, etc. are all great doctors with rich experience.Aiming at the disadvantages of using medicine since the Jin and Yuan Dynasties, they established the warming and tonic school, which pays attention to the care of the human body's righteousness and yang.In the Ming Dynasty, the achievements in Materia Medica have been outstanding, and Li Shizhen's work has attracted worldwide attention.At the end of the Ming Dynasty, the plague was prevalent many times, and many people died of mistreatment. Therefore, Wu Youxing studied the source of the plague carefully, wrote "On Epidemic Diseases", and put forward the theory of "disease caused by miscellaneous qi", which opened a new era for the emergence of the theory of febrile diseases. train of thought.In the Qing Dynasty, Ye Gui, Wu Tang and others established "Wei Qi Ying Xue Syndrome Differentiation" and "Sanjiao Syndrome Differentiation" to treat warm-heat and damp-heat diseases.It filled the gap in the treatment of epidemic infectious fever in theory and practice, so far the febrile disease theory has been formed.Smallpox was introduced to my country around the beginning of the Eastern Han Dynasty in the 1st century A.D., causing great harm and a high mortality rate.As early as the Ming Dynasty, the preventive method of "human pox vaccination" was invented in my country, but it was not popularized until the Qing Dynasty and spread overseas. This is a major contribution to the world's preventive medicine. After it was introduced to England in the 18th century, it was improved into the safer "vaccinia vaccination method" used today.
In the Ming and Qing dynasties, due to their closed-door policy, they seldom accepted the rapid progress of natural scientific achievements in the West in order to stimulate the development of Chinese medicine itself. Classic retro situation.This is also an important reason why my country's medical science disease originated first, but has not kept up with the pace of the times and has been fully developed.
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