Course:
Class:
Foundations of TCM – I
1
Date:
Winter 2007
Stuff you need to memorize for tests is highlighed like so.
The History of Chinese Medicine (or “How’d we get here?”)
Chinese civilization has existed in written record for about 5000 years; oriental
medicine for about 4500 years. The Yellow Emperor is the legendary ancestor
the chinese civilization, probably not a single person and probably didn’t write
all that was attributed to him.
The most important book in Chinese Medicine, laying out the fundamentals of
the discipline and the definitive text is the Huang Di Nei Jing or the Yellow
Emperor’s Internal Classics. This is a compilation of herbalists over several
decades (Spring and Autumn or 770-476BC to the Warring states or 475221BC Dynasties). The work is broken into 2 parts: 1) the fundamentals of
oriental medicine philosophy called Plain (or Simple) Questions or Su wen,
and 2) Ling Shu or Miraculous/Spiritual Pivot which details the channels,
point locations, etc.
Cat’s Note: You’ll be studying this book in several classes while you’re here. You’ll get it in
Advanced Needling and again in Classics at a bare minimum.
Hua Tuo (current era 110-207) is the first famous surgeon in Chinese medicine. The first recorded
development and use of anesthesia is credited to Hua Tuo. He also the Chinese knowledge of anatomy.
Hua Tuo preferred simple methods of acupuncture and herbs, using a small number of acupoints and
formulas with only a few herbs. As an illustrative from Dr. Wu’s notes:
One day a patient came to see Hua Tuo. Hua Tuo diagnosed the patient with ulcerative colitis
(bleeding ulcer in the large intestine). He decided that surgery was needed. He gave the patient
“anesthetic powder.” When the patient lost feeling, he cut the abdomen, located the ulcer in the
intestine and probably resected the bowel. After sewing the patient back together he applied
“Spirits Lotion.” One month later the patient was completely recovered.
Hua Tuo practiced Qigong and invented/taught a style called Frolic of the Five Animals or Five Animal
Qigong which is still in use today. Five Animal Qigong is based on the movements and behaviors of the
Tiger, Deer, Bear, Ape, and Crane. It is a powerful technique for cancer patients, as cancer cells tend to
shrink and recede with regular practice of this qigong.
Hua Tuo invented the Jiaji points, 34 bilateral points along the erector spinae muscles of the back
located from T1  L5. These points are used for central nervous system dysfunctions (all other
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Disclaimer: This is not an official AOMA document, is intended for reference only and is not a replacement for your own class notes. This document is
available for your use As Is and may contain errors and omissions. Cat Calhoun retains full copyright ownership, rights and protection in all material
contained herein. You may use this document for your own purposes and distribute it to other people provided you 1) do not charge for it and 2) attribute it
as having been generated by Cat Calhoun and disclose that it available free of charge on CatsTCMNotes.com. © 2010 Catherine (Cat) Calhoun
acupoints treat the peripheral nervous system) such as para- and quadraplegia. There is a possiblity of
regaining function with the use of these points.
Hua Tuo died at the age of 97, not from old age, but because a general named Zao Cao ordered his
death. Zao Cao had contracted an illness called “Tou Feng” or head wind. The general came to see Hua
Tuo and was advised to have an operation. Suspecting Hua Tuo wanted to harm him, the general had
him executed.
Zhang ZhongJing (also called Zhang Ji – AD 412-220), the most
famous of China’s ancient herbal doctors, was originally a provincial
governor who resigned his position in order to pursue the study and
practice of medicine. When he was approximately 50 years old there was
a very grave plague in China. Over 2/3 of his family members died as a
result of this plague. With sadness, Zhang Zhongjing decided to dedicate
himself to finding a solution to this problem. After several decades he
finished his work, titled Shang Han Lun or Shang Han Za Bing Lun
which translates to Treatise on Febrile Diseases. (You’ll also see this
referred to a “Cold Injured Diseases.” More on this in later classes.) The
Shang Han Lun contains over 100 effective formulas, many still in use,
and provides a theoretical framework that led to hundreds of books
analyzing, explaining, and refining his theories. It contains 397 articles and 112 prescriptions and is
considered to be a cornerstone in TCM history.
Another section is best known for some of the formulas such as the gynecological remedy Tang-Kuei
and Peony Formula (called Danggui Shaoyao San, known in English as “Free and Easy Wanderer”)
which is still used for infertility, disorders during pregnancy, prevention of miscarriage, and post-partum
weakness. It’s also frequently used for PMS and menstrual dysfunction.
This great work could have been lost to history, but for the efforts of Wang ShuHe. Wang ShuHe
recovered the book, reworked it a bit and split it into 2 parts, The Treatise on Febrile Diseases (Shang
Han Lun) which discusses the invasion of the body by externally introduced pathogens and The Golden
Chamber (Jing Kui Yao Lue) which covers internal disease, diet, stress, etc.
Huangfu Mi (214-282 AD) lived to see the end of the later Han Dynasty. He is
famous for his skills in acupuncture therapy. He composed many literary works
and was very influential during his time. He studied Chinese medicine
thoroughly and by the end of his life had compiled one of the prominent
acupuncture works in history, Huang Di Zhenjiu Jia Yi Jing or The Yellow
Emperors Acupuncture A and B. This classic, often nicknamed Jia Yi Jing,
consists of 12 scrolls and 128 chapters. It not only summarized the entire
knowledge of acupuncture at the time, but added a sizeable amount of new
information. Later generations of acupuncturists needed only to learn Huangfu
Mi’s book to understand the secrets of the art. This classic influenced the art of
acupuncture in China as well as countries around the world such as France,
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Disclaimer: This is not an official AOMA document, is intended for reference only and is not a replacement for your own class notes. This document is
available for your use As Is and may contain errors and omissions. Cat Calhoun retains full copyright ownership, rights and protection in all material
contained herein. You may use this document for your own purposes and distribute it to other people provided you 1) do not charge for it and 2) attribute it
as having been generated by Cat Calhoun and disclose that it available free of charge on CatsTCMNotes.com. © 2010 Catherine (Cat) Calhoun
Korea, and Japan.
Wang Shuhe, who you might remember from the discussion about Zhang Zhongjing
above, lived from AD 210 – 285 during the Western Jin dynasty and is the great pulse
diagnosis expert in Chinese medical history. He wrote Mai Jing or The Pulse Classics
(which you might also see titled “The Classic of Pulses”) detailing 24 pulses. The 10
scrolls of this work describe the pulse positions and methods for reading the pulse.
We use this as the basis for our current pulse diagnosis, though we now learn 28.
Sun Simiao is the “King of Herbs.” Sun Simiao (AD 590-682) was a
famous doctor during the Tang dynasty. Sun Simiao is famous not only for
his herbal knowledge, but also for his medical ethics and desire to help the
poor. He may be the first guy in recorded history to practice the community
acupuncture model, charging fees on a sliding scale and recommending food
therapy as a simple remedy to illness. He recommended seaweed to people
living in the mountains who suffered from goiter and recommended the liver
of oxen and sheep for people suffering from night blindness. (Later you will
learn that the Liver “opens” to the eyes and when unbalanced can resolve
certain eye problems.)
A Daoist practitioner, Sun Simiao understood the virtue of medicine. “Human life is worth a thousand
gold bars, with a virtue of one prescription you can fix it” is a quote from Sun Simiao. In 652 he
compiled the famous Qian Jin Yi Fang, also called Prescriptions Worth a Thousand Gold for
Emergencies, 30 scrolls worth of herbal scripts. Later he composed a second work of 30 scrolls, Qian
Jin Yi Fang (no idea what the translation is, sorry). He also sought demon dispelling remedies, including
spells, herbal formulas and toxic alchemical preparations.
Note: This is some of the magical aspect of Chinese Medicine that gets somewhat swept under
the rug in western TCM schools…not very palatable to the current western mindset as we strive
for acceptance in the biomedical world and in the academic realms. Nevertheless, this is a
powerful aspect of Chinese medicine. Please explore Qigong to get a small taste of this magic
and energy. You might also check a few books in the library on this subject. There’s definitely
something missing in the way Chinese medicine is presented in this culture.
Liu Wansu (1120-1200) lived during the Jing Dynasty. He observed the high
incidence of fever and inflammation in serious disease and promoted the idea of
using cool nature herbs to treat and balance these conditions. This was counter to
many of his predecessors, who focused on using warming herbs. Liu Wansu’s
work heavily influenced the later concept of “wen bing” or epidemic febrile
diseases. This concept corresponds to and yet precedes the western concept of
contagious disease. Liu Wansu also undertook a detailed study of the Nei Jing Su
Wen or Plain Questions of the Yellow Emperor’s Internal Classic, describing the
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Disclaimer: This is not an official AOMA document, is intended for reference only and is not a replacement for your own class notes. This document is
available for your use As Is and may contain errors and omissions. Cat Calhoun retains full copyright ownership, rights and protection in all material
contained herein. You may use this document for your own purposes and distribute it to other people provided you 1) do not charge for it and 2) attribute it
as having been generated by Cat Calhoun and disclose that it available free of charge on CatsTCMNotes.com. © 2010 Catherine (Cat) Calhoun
etiology (origin or cause) of disease in relation to the teachings of this famous text.
Zhang Zihe (1156-1228AD) is known as the developer of the ‘Attacking School’
of Chinese medicine. This philosophy emphasized the use of diaphoretics, emetics,
and purgatives to attack pathogens and drive them out of the body. (This is a revival
of the early Han Dynasty techniques of driving out demons.) Pathogens are an
excess and these techniques eliminate that excess by dispelling or removing them.
You will often see this referred to as “sedating” the excess, which is a kind way of
saying you’re going to kick it to the curb. “Sedate excesses, tonify deficiencies” is a
common theme in TCM.
Li Dongyuan (aka, Li Gao) lived from 1180-1252AD and is best known for his
thesis that most diseases were due to injury to the Stomach/Spleen system as the
result of intemperance in eating and drinking, overwork, and the seven emotions.
This philosophy is still employed: too much cold and sedative herbs or foods or
medications lead to disease and obesity. Digestion is the key to health. Li Gao
detailed this philosophy, practice, and many herbal scripts still widely used in Pi
Wei Lun or Treatise on the Stomach and Spleen. One of his famous scripts and
one of the most used is Bu Zhong Yi Qi Tang (ginseng and astragalus) which treats muscle atrophy,
prolapse of internal organs, fatigue, and fibromyalgia as well as boosting immunity.
Things you need to know for your first test:
Four Great Classics of Oriental Medicine
Know the names of these books and who wrote each
1. Yellow Emperor’s Internal Classic
2. Treatise on Febrile Diseases
3. Golden Chamber
4. Warm Diseases
Four Great Doctors in the Jing Dynasty
Know their names and contributions to chinese medicine
1. Liu Wansu – cold herbs for hot diseases
2. Zhang Zihe – the “Attacking School”
3. Li Dongyuan – Treatise on Stomach and Spleen
4. Zhu Danxi – disease comes from overindulgence
Zhu Danxi is also known as Zhu Zhenheng (1280-1358AD). He believed that people suffered from
chronic disease mainly due to overindulgences in pleasurable things and activities
which results in debility of the Yin Essence. He recommended temperance and the
use of tonic formulas, especially those nourishing the Kidney and Liver.
Dr. Wu says 80-85% of disease is lifestyle related, including high blood pressure,
high blood sugar, and high cholesterol. This results from Yin deficiency/Yang
excess. To nourish Yin, nourish the Kidney and Liver while reducing your desires.
Yin is the body’s essence, fluids and blood. Yang is activity, mental effort, and
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Disclaimer: This is not an official AOMA document, is intended for reference only and is not a replacement for your own class notes. This document is
available for your use As Is and may contain errors and omissions. Cat Calhoun retains full copyright ownership, rights and protection in all material
contained herein. You may use this document for your own purposes and distribute it to other people provided you 1) do not charge for it and 2) attribute it
as having been generated by Cat Calhoun and disclose that it available free of charge on CatsTCMNotes.com. © 2010 Catherine (Cat) Calhoun
thinking. You need daylight to produce Yang and night to nourish the Yin. Too little sleep results in a
lack of Yin -- so don’t work the night shift if you can avoid it! To remedy an excess of Yang and a
deficiency of Yin, get to sleep earlier, reduce your desires and practice temperance in all things. This is
the ‘middle way’ of Buddhism. Qigong and meditation can help with the desire and temperance thang.
Zhang Jingyue (who, by the way is Dr. Wu’s favorite) lived from 1583 – 1640 A.D. during the Ming
Dynasty. He was a prolific writer and produced works on pulse diagnosis, gynecology, pediatrics,
surgery, and an analysis of the Nei Jing which is called the Lei Jing. He believed that yang qi and yin
essence are rooted in the kidney. Therefore, he advocated that life cultivation should concentrate on
enhancing the kidney with simultaneous consideration of yin and yang. And he also established a set of
tonic prescriptions with the actions of mutual tonification of yin and yang which are still in use. In
addition, he also put forward the theory of "life cultivation in the middle-aged" (which attaches
importance to life cultivation in middle-aged people). This has a positive significance for prevention of
premature aging and senile diseases.
Li Shizhen lived from 1518 – 1593. He is considered to be China’s greatest
naturalist. He was very interested in the proper classification of the components of
nature. He sifted through the vast array of herbal lore over a span of 40 years and
wrote his information into the Ben Cao Gang Mu (or in English, The Copendium of
Materia Medica), a treatise on pharmacopoeia, botany, zoology, mineralogy and
metallurgy. This book has been reprinted frequently and five of the originals still
exist. A rough translation of the herbal entries was published in English by two
British doctors who were working in China at the end of the 19th century (Porter and Smith) though
extracts of it were published in Europe since 1656. Ben Cao Gang Mu contains 1892 different herbs, is
divided into 6 sections, 52 scrolls and 60 different categories.
Two tidbits:
 There’s a very good clinical application for the iPhone/iTouch called Ben Cao that will set you back
about $30, but is well worth it. Wait and get it later when you start interning though. Something better is
likely to come along.
 For perspective, during this same time period (around 1550 AD), the Jesuits were formed, the Spanish
had recently finished killing off the Aztec empire, Nostradamus wrote his first almanac, and Altan Khan
besieged Peking/Bejing (there’s a PBS video about this regarding the Great Wall of China and how
Altan Khan broke through it and torched the ‘burbs of Peking).
Wu Youxing lived from 1582 to 1652 AD. He developed the concept that some diseases were caused by
transmissible agents which he called pestilential factors or “liqi.” His book, Wen Yi
Lun or Treatise on Acute Epidemic Febrile Diseases is regarded as the main
etiological work that introduced the concept of germs causing epidemic disease.
Ultimately, this was attributed to Westerners… Until Wu Youxing disease was
thought to be caused by one or a combination of the six evils: Wind, Cold, Damp,
Heat, Summer Heat, and Dryness. Wu Youxing’s work did not negate these six evils,
but rather added the 7th one in the list: Liqi or transmissible agents.
Foundations 1 – Winter 2007 – Class 1
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Disclaimer: This is not an official AOMA document, is intended for reference only and is not a replacement for your own class notes. This document is
available for your use As Is and may contain errors and omissions. Cat Calhoun retains full copyright ownership, rights and protection in all material
contained herein. You may use this document for your own purposes and distribute it to other people provided you 1) do not charge for it and 2) attribute it
as having been generated by Cat Calhoun and disclose that it available free of charge on CatsTCMNotes.com. © 2010 Catherine (Cat) Calhoun
Sidebar:
 Infectious diseases due to viral infection (mumps, strep, HIV, SARS, Bird flu, etc.) are
considered to be warm diseases.
 Autoimmune diseases come from inside the individual, not from outside sources like
febrile disease. These are due to an imbalance of Yin and Yang.
Ye Tianshi (1690-1760 AD) is famous for his thesis on febrile diseases, Wen Re Lun or Treatise on
Epidemic Fevers, published in 1746. He postulated the transmission of disease in four stages, with the
first stage affecting the body first and progressing further inward as follows:
 Wei level
The affect is on the exterior limits of the body.
 Qi level
Getting deeper, but still fairly exterior by comparison to the next
stages.
 Jing or Nutritive level
This is deeper penetration into the body’s defenses. By the time a disease gets this far it
has gotten to the storehouse of the body and is difficult to stop because now it has
resources to nourish it. Kind of like enemy troops capturing a supply line, you know?
 Xue or Blood level
This is the deepest level. Now the patient is in deep, deep trouble. No good can come
from this!
Ye Tianshi also wrote a book, even more famous than the last, called Detailed Analysis of Febrile
Diseases or Wen Bing Tiao Bian. You’ll study these Four Stages later in Diagnostics.
If you take the time to trace the history of disease, you might see that most diseases, 2000-5000 years
ago were mostly cold diseases and were treated with warm and hot herbs. Liu Wansu was on the cutting
edge of the shift in disease, noticing that diseases were becoming hot in nature and should be treated
with cooling herbs. This is still applicable today.
Foundations 1 – Winter 2007 – Class 1
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Disclaimer: This is not an official AOMA document, is intended for reference only and is not a replacement for your own class notes. This document is
available for your use As Is and may contain errors and omissions. Cat Calhoun retains full copyright ownership, rights and protection in all material
contained herein. You may use this document for your own purposes and distribute it to other people provided you 1) do not charge for it and 2) attribute it
as having been generated by Cat Calhoun and disclose that it available free of charge on CatsTCMNotes.com. © 2010 Catherine (Cat) Calhoun
The Global Development of TCM
From the 5th to the 7th Century in China, TCM was exported to Japan by Jian Zhen, a monk/doctor who
took books and herbs with him when he fled the wars in China. Shiatzu, Japanese massage, means
“acupressure” in Chinese. Chinese medicine has also found its way to Korea (check out Korean Hand
Therapy Acupuncture) where it is widely advanced and used. Acupuncturists in Korea go through a
rigorous 8 year program of study and have MD status when they are done. France has the oldest oriental
medicine (OM) program in Europe, closely followed by Germany. By contrast, OM wasn’t introduced
into North America until the early 1970’s when Richard Nixon went to China. At the time these notes
were taken in class, there were 39 accredited schools of acupuncture in the U.S.
Characteristics of TCM:
1. Application of Chinese philosophy, such as Yin/Yang and Five element theories in TCM.
Chinese medicine is based on restoring harmony and balance to the body. You are well when
Yin and Yang as well as your internal organ energies are balanced. Much, much more on this
later.
2. The concept of Wholism.
Wholism is the whole picture. Left is a copy of right. Superior is a copy of inferior. Treat the
whole body, not just the symptoms of disease. OM observes from a whole body standpoint:
pulse, nails, eyes, tongue, hair, voice, teeth and gums, posture – everything is relevant.
Sometimes in clinic I refer to TCM as “Sherlock Holmes” medicine because all of the tiny details
add up to a complete picture. No detail is insignificant and all details contain clues to the whole
picture. There’s a holographic universe in each body.
3. Advanced Channel and Point system.
Channels/meridians and acupoints allows an acupuncturist to treat internal organs from outside
the body. Energies flow through the body along the meridians from deep inside to outside and
back again. You can thus affect the energy going in by treating it when it comes to the surface.
4. Treatment of disease according to pattern diagnosis and differentiation.
So much on this later that when you graduate you’ll be amazed that there was ever a time when
you did not know this.
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Disclaimer: This is not an official AOMA document, is intended for reference only and is not a replacement for your own class notes. This document is
available for your use As Is and may contain errors and omissions. Cat Calhoun retains full copyright ownership, rights and protection in all material
contained herein. You may use this document for your own purposes and distribute it to other people provided you 1) do not charge for it and 2) attribute it
as having been generated by Cat Calhoun and disclose that it available free of charge on CatsTCMNotes.com. © 2010 Catherine (Cat) Calhoun