traditional chinese medicine traditional chinese medicine traditional chinese medicine (tcm) is an alternative medical practice drawn from traditional medicine in china. it has been described as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of action. "chinese medicine" redirects here. for the practice of medicine in modern china, see medicine in china. traditional chinese medicineyinyang, a theory of traditional chinese medicinechinese namesimplified chinese中医traditional chinese中醫literal meaning"chinese medicine"transcriptionsstandard mandarinhanyu pinyinzhōngyīwade–gileschung1-i1ipayue: cantoneseyale romanizationjūng yījyutpingzung1 ji1southern minhokkien pojtiong-itâi-lôtiong-ivietnamese namevietnamesey học cổ truyền trung quốc đông y thuốc bắc thuốc tàuhán-nôm醫學古傳中國東醫 𧆄北 𧆄艚korean namehangul중의학hanja中醫學transcriptionsrevised romanizationjung'uihakjapanese namekanji中国医学kanaちゅうごくいがくtranscriptionsromanizationchūgoku igaku this article is part of a series onalternative medicine general information alternative medicine history terminology alternative veterinary medicine quackery (health fraud) rise of modern medicine pseudoscience antiscience skepticism scientific therapeutic nihilism fringe medicine and science acupressure acupuncture 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benzhuism bimoism bon dongbaism miao folk religion vietnamese folk religion qiang folk religion yao folk religion zhuang folk religion religion portal medicine in traditional china encompassed a range of sometimes competing health and healing practices, folk beliefs, literati theory and confucian philosophy, herbal remedies, food, diet, exercise, medical specializations, and schools of thought. in the early twentieth century, chinese cultural and political modernizers worked to eliminate traditional practices as backward and unscientific. traditional practitioners then selected elements of philosophy and practice and organized them into what they called "chinese medicine" (zhongyi). in the 1950s, the chinese government sponsored the integration of chinese and western medicine, and in the great proletarian cultural revolution of the 1960s, promoted chinese medicine as inexpensive and popular. after the opening of relations between the united states and china after 1972, there was great interest in the west for what is now called traditional chinese medicine (tcm). tcm is said to be based on such texts as huangdi neijing (the inner canon of the yellow emperor), and compendium of materia medica, a sixteenth-century encyclopedic work, and includes various forms of herbal medicine, acupuncture, cupping therapy, gua sha, massage (tui na), bonesetter (die-da), exercise (qigong), and dietary therapy. tcm is widely used in the sinosphere. one of the basic tenets is that the body's vital energy (ch'i or qi) is circulating through channels called meridians having branches connected to bodily organs and functions. the concept of vital energy is pseudoscientific. concepts of the body and of disease used in tcm reflect its ancient origins and its emphasis on dynamic processes over material structure, similar to the humoral theory of ancient greece and ancient rome. the demand for traditional medicines in china has been a major generator of illegal wildlife smuggling, linked to the killing and smuggling of endangered animals. history the compendium of materia medica is a pharmaceutical text written by li shizhen (1518–1593 ce) during the ming dynasty of china. this edition was published in 1593. acupuncture chart from hua shou (fl. 1340s, yuan dynasty). this image from shi si jing fa hui (expression of the fourteen meridians). (tokyo: suharaya heisuke kanko, kyoho gan 1716). scholars in the history of medicine in china distinguish its doctrines and practice from those of present-day tcm. as ian johnson notes, the term "traditional chinese medicine" was coined by "party propagandists" and first appeared in english in 1955. nathan sivin criticizes attempts to treat medicine and medical practices in traditional china as if they were a single system. instead, he says, there were 2,000 years of "medical system in turmoil" and speaks of a "myth of an unchanging medical tradition." he urges that "traditional medicine translated purely into terms of modern medicine becomes partly nonsensical, partly irrelevant, and partly mistaken; that is also true the other way around, a point easily overlooked." tj hinrichs observes that people in modern western societies divide healing practices into biomedicine for the body, psychology for the mind, and religion for the spirit, but these distinctions are inadequate to describe medical concepts among chinese historically and to a considerable degree today. the medical anthropologist charles leslie writes that chinese, greco-arabic, and indian traditional medicines were all grounded in systems of correspondence that aligned the organization of society, the universe, and the human body and other forms of life into an "all-embracing order of things." each of these traditional systems was organized with such qualities as heat and cold, wet and dry, light and darkness, qualities that also align the seasons, compass directions, and the human cycle of birth, growth, and death. they provided, leslie continued, a "comprehensive way of conceiving patterns that ran through all of nature," and they "served as a classificatory and mnemonic device to observe health problems and to reflect upon, store, and recover empirical knowledge," but they were also "subject to stultifying theoretical elaboration, self-deception, and dogmatism." the doctrines of chinese medicine are rooted in books such as the yellow emperor's inner canon and the treatise on cold damage, as well as in cosmological notions such as yin–yang and the five phases. the "documentation of chinese materia medica" (cmm) dates back to around 1,100 bce when only a few dozen drugs were described. by the end of the 16th century, the number of drugs documented had reached close to 1,900. and by the end of the last century, published records of cmm had reached 12,800 drugs." starting in the 1950s, these precepts were standardized in the people's republic of china, including attempts to integrate them with modern notions of anatomy and pathology. in the 1950s, the chinese government promoted a systematized form of tcm. shang dynasty traces of therapeutic activities in china date from the shang dynasty (14th–11th centuries bce). though the shang did not have a concept of "medicine" as distinct from other health practices, their oracular inscriptions on bones and tortoise shells refer to illnesses that affected the shang royal family: eye disorders, toothaches, bloated abdomen, and such. shang elites usually attributed them to curses sent by their ancestors. there is currently no evidence that the shang nobility used herbal remedies. stone and bone needles found in ancient tombs led joseph needham to speculate that acupuncture might have been carried out in the shang dynasty. this being said, most historians now make a distinction between medical lancing (or bloodletting) and acupuncture in the narrower sense of using metal needles to attempt to treat illnesses by stimulating points along circulation channels ("meridians") in accordance with beliefs related to the circulation of "qi". the earliest evidence for acupuncture in this sense dates to the second or first century bce. han dynasty the yellow emperor's inner canon (huangdi nei jing), the oldest received work of chinese medical theory, was compiled during the han dynasty around the first century bce on the basis of shorter texts from different medical lineages. written in the form of dialogues between the legendary yellow emperor and his ministers, it offers explanations on the relation between humans, their environment, and the cosmos, on the contents of the body, on human vitality and pathology, on the symptoms of illness, and on how to make diagnostic and therapeutic decisions in light of all these factors. unlike earlier texts like recipes for fifty-two ailments, which was excavated in the 1970s from the mawangdui tomb that had been sealed in 168 bce, the inner canon rejected the influence of spirits and the use of magic. it was also one of the first books in which the cosmological doctrines of yinyang and the five phases were brought to a mature synthesis. the treatise on cold damage disorders and miscellaneous illnesses (shang han lun) was collated by zhang zhongjing sometime between 196 and 220 ce; at the end of the han dynasty. focusing on drug prescriptions rather than acupuncture, it was the first medical work to combine yinyang and the five phases with drug therapy. this formulary was also the earliest public chinese medical text to group symptoms into clinically useful "patterns" (zheng 證) that could serve as targets for therapy. having gone through numerous changes over time, the formulary now circulates as two distinct books: the treatise on cold damage disorders and the essential prescriptions of the golden casket, which were edited separately in the eleventh century, under the song dynasty. nanjing or "classic of difficult issues," originally called "the yellow emperor eighty-one nan jing", ascribed to bian que in the eastern han dynasty. this book was compiled in the form of question-and-answer explanations. a total of 81 questions have been discussed. therefore, it is also called "eighty-one nan". the book is based on basic theory and has also analyzed some disease certificates. questions one to twenty-two is about pulse study, questions twenty-three to twenty-nine is about meridian study, questions thirty to forty-seven is related to urgent illnesses, questions forty-eight to sixty-one is related to serious diseases, questions sixty-two to sixty-eight is related to acupuncture points, and questions sixty-nine to eighty-one is related to the needlepoint methods. the book is credited as developing its own path, while also inheriting the theories from huangdi neijing. the content includes physiology, pathology, diagnosis, treatment contents, and a more essential and specific discussion of pulse diagnosis. it has become one of the four classics for chinese medicine practitioners to learn from and has impacted the medical development in china. shennong ben cao jing is one of the earliest written medical books in china. written during the eastern han dynasty between 200 and 250 ce, it was the combined effort of practitioners in the qin and han dynasties who summarized, collected and compiled the