Early Texts of Traditional Chinese Medicine – An Ancient and Sophisticated Medical System

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This manuscript, found in a Han era tomb, gives prescriptions for 52 kinds of disease remedies.

This manuscript, found in a Han era tomb, gives prescriptions for 52 kinds of disease remedies. Image courtesy of Professor Ying Li, Shanghai Institute of Materia Medica, Chinese Academy of Science, Shanghai, China.

The earliest written records of Chinese medicine date back about 5000 years, and include the Huang-Di Nei-Jing, possibly the oldest medical text in the world. These records had great significance for the development of traditional Chinese medicine (TCM), and even for Western medicine.

Chinese Medicine and Oral Tradition

Today, people take writing for granted, and we expect knowledge in every field to be documented in writing. Writing is a relatively recent invention however: for most of human history, knowledge passed down from generation to generation via oral tradition – often in the form of songs and stories. People used a variety of mnemonic devices to help them remember details.

Approximately 5000 years ago, the Chinese established a formal written language, writing with ink on silk. That was the culmination of centuries of experimentation with writing. But archaeologists claim that the roots of written Chinese go back much further, to about seven thousand years ago.

Thanks to archaeological research, we know that by the time the first written records of Chinese medicine appeared, the knowledge that they imparted had been in use for many centuries.

Chinese Medicine in the Archaeological Record

Archaeologists have found some of the best information about the early use of Chinese medicine at grave sites. For example, two graves from the Han Dynasty (c. 202 BCE to c. 220 CE) contained ancient silk scrolls with references to 247 herbal substances used for medicinal purposes.

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At the grave site of a doctor from the Later Han era (c. 25 to c. 220 CE), archaeologists found 92 wooden bamboo slips with pharmaceutical data which included a list of thirty prescriptions, referring to a hundred herbal medicines. These are believed to be the oldest written medical records in existence.

Zhou Dynasty Medical Documents

Medical records from the Zhou Dynasty (c. 1100 BCE – c. 250 BCE) reveal that doctors were divided into four areas of specialization: diet, internal medicine (called “disease”), external medicine (called “sores”), and veterinary medicine. Senior doctors were in charge of the administration and evaluation of junior professionals. Interestingly, the dietary physician had the highest status; therapeutic diet has continued to be a central element in TCM throughout its evolution.

This ancient grave is found on "China Hill" in Melaka

This ancient grave is found on “China Hill” in Melaka. Image courtesy of Rudolph A. Furtado.

The Classic of Mountains and Rivers (c. 200 BCE) gives information on diseases and the plants, minerals and animal materials that may be used to treat them.

The Huang-Di Nei-Jing (Yellow Emperor’s Cannon of Internal Medicine) may be the oldest medical textbook in the world, dating back to somewhere between 300 BCE and 200 BCE. The book is named for Huang Di, The Yellow Emperor, who lived between 2700 BCE and 2600 BCE. It is supposedly a record of the emperor’s conversations with his distinguished doctor, Qi Bo.

The Huang-Di Nei-Jing Document

The Huang-Di Nei-Jing consists of 162 articles and is divided into two sections: theory and practice. The theoretical section discusses the interactions between the internal organs, the sense organs, and brain waves. It deals extensively with the concept of yin and yang, as applied to medicine.

The yin-yang principle states that the organs of the body are interdependent, and support each other in a harmonious state when the individual is healthy. Disease is thus defined as loss of the natural harmony within and between the organs. Therefore, the goal of treatment in traditional Chinese medicine is to restore the body’s natural harmony.

Another theory discussed in the book is the concept of the five elements: metal, wood, water, fire and earth.

The second section of the Huang-Di Nei Jing is a detailed manual on the practice of acupuncture, revealing how it had evolved to include much of the knowledge that forms the basis of modern acupuncture.

Researchers believe that the Huang-Di Nei Jing was written by an anonymous group of doctors, rather than one author. Significantly, the book continues to be used as a reference work by contemporary TCM practitioners.***

The acupuncture points  developed over two thousand years ago are still considered accurate by today's standards.

The acupuncture points developed over two thousand years ago are still considered accurate by today’s standards. Image courtesy of Hegu. CC BY-SA 3.0.

Shang Han Lun from the Han Dynasty

Zhang Zhong Jing (150-219 CE) wrote the Treatise on Febrile Diseases (Shang Han Lun) during the Eastern Han Dynasty (25 BC – 220 CE). In the work, febrile diseases are defined as infectious illnesses caused by external pathogens. The Shang Han Lun introduced the classification of febrile diseases into six “channels,” which represent the developmental stages of a disease.

The Shang Han Lun describes each stage of the illness and suggests specific treatments, based on the progression of the illness. These treatments include acupuncture, herbal medicine and the use of moxibustion – all of which remain basic to TCM.

Zhang Zhong Jing’s work also dealt with internal illnesses and surgery. It remains an important reference work today.

Traditional Chinese Medicine:The Spread of TCM

Until the Renaissance, Asian medicine was considered the most advanced in the world. Every new generation of Chinese doctors tested and retested the knowledge passed down both orally and via written documents. The knowledge also spread to physicians from other regions via trade routes. The dissemination of medical knowledge from China to other countries contributed to the advancement of many medical systems, including Western medicine.

Dating of Chinese Dynasties

It is difficult to give the exact dates of the Chinese dynasties because they overlapped. China covers a vast expanse of territory, and different areas were under the control of different ruling families at different times. The ruling families were often at war with each other, and thus exercised sporadic control over various regions. Thus, one region might be under the control of the Zhou Dynasty while the Shang Dynasty controlled another.

In “Timeline of Chinese History and Dynasties,” the internet site Asia for Educators provides a clear timeline.


Asia for Educators. Timeline of Chinese History and Dynasties. Accessed Aug 5, 2013.

Calhoun, Cat. Six Channel Theory. Accessed Aug 1, 2013.

China Internet Information Center. Formation of the Chinese Civilization: Medicine. Accessed Aug. 1, 2013.

Encyclopedia Britannica. Zhou Dynasty. (2008). Accessed Aug 1, 2013.

Ho, P.Y. and Lisowski, F.P. A Brief History of Chinese Medicine (2nd Ed.). (1997). Accessed August 4th, 2013.

Jingfeng, Cai. A Historical Overview of Traditional Chinese Medicine and Ancient Chinese Medical Ethics. Accessed Aug 1, 2013.

Jin-Huai, Wang. Understanding the Past: A Historical Timeline of Chinese Medicine. Accessed Aug. 1, 2013.

Li, L., Yau, T. et al. What Is the Origin of Acupoint? (2012). Journal of Acupuncture and Tuina Science. 10:2. Accessed Aug 5, 2013.

Wei Li. The Literature of Chinese Medicine: Classic Works of Internal and External Medicine. Accessed Aug 1, 2013.

Yu, Lang. The Zhou Dynasty. Accessed Aug. 1, 2013.

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© Copyright 2013 Leslie Cohen, All rights Reserved. Written For: Decoded Past

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