Traditional Chinese medicine (TCM; simplified Chinese: 中医; traditional Chinese: 中醫; pinyin: Zhōngyī) is a style of traditional medicine built on a foundation of more than 2,500 years of Chinese medical practice that includes various forms of herbal medicine, acupuncture, massage (tui na), exercise (qigong), and dietary therapy, but recently also influenced by modern Western medicine. TCM is widely used in Greater China (where it has long been the standard system of medicine), and is becoming increasingly popular and recognized worldwide (where it is primarily approached as alternative medicine).
One of the basic tenets of TCM is that "the body's vital energy (ch'i or qi) circulates through channels, called meridians, that have branches connected to bodily organs and functions." 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 European humoral theory. Scientific investigation has not found histological or physiological evidence for traditional Chinese concepts such as qi, meridians, and acupuncture points. The TCM theory and practice are not based upon scientific knowledge, and there is disagreement between TCM practitioners on what diagnosis and treatments should be used for any given patient. The effectiveness of Chinese herbal medicine remains poorly researched and documented. There are concerns over a number of potentially toxic plants, animal parts, and mineral Chinese medicinals. There are also concerns over illegal trade and transport of endangered species including rhinoceroses and tigers, and the welfare of specially farmed animals including bears. A review of cost-effectiveness research for TCM found that studies had low levels of evidence, but so far have not shown benefit outcomes. Pharmaceutical research has explored the potential for creating new drugs from traditional remedies, with few successful results. A Nature editorial described TCM as "fraught with pseudoscience", and said that the most obvious reason it hasn't delivered many cures is that the majority of its treatments have no logical mechanism of action. Proponents propose that research has so far missed key features of the art of TCM, such as unknown interactions between various ingredients and complex interactive biological systems.
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. 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.
While health is perceived as the harmonious interaction of these entities and the outside world, disease is interpreted as a disharmony in interaction. TCM diagnosis aims to trace symptoms to patterns of an underlying disharmony, by measuring the pulse, inspecting the tongue, skin, and eyes, and looking at the eating and sleeping habits of the person as well as many other things.
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 fields, their oracular inscriptions on bones and tortoise shells refer to illnesses that affected the Shang royal family: eye disorders, toothaches, bloated abdomen, etc., which Shang elites usually attributed to curses sent by their ancestors. There is no evidence that the Shang nobility used herbal remedies. According to a 2006 overview, the "Documentation of Chinese materia medica (CMM) dates back to around 1,100 BCE when only dozens of drugs were first 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."
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 treat illnesses by stimulating specific points along circulation channels ("meridians") in accordance with theories related to the circulation of Qi. The earliest evidence for acupuncture in this sense dates to the second or first century BCE.
The Yellow Emperor's Inner Canon (Huang Di Nei Jing), the oldest received work of Chinese medical theory, was compiled 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 a 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.
In the centuries that followed, several shorter books tried to summarize or systematize its contents of the book Yellow Emperor's Inner Canon. The Canon of Problems (probably second century CE) tried to reconcile divergent doctrines from the Inner Canon and developed a complete medical system centered on needling therapy. The AB Canon of Acupuncture and Moxibustion (Zhenjiu jiayi jing 針灸甲乙經, compiled by Huangfu Mi sometime between 256 and 282 CE) assembled a consistent body of doctrines concerning acupuncture; whereas the Canon of the Pulse (Maijing 脈經; ca. 280) presented itself as a "comprehensive handbook of diagnostics and therapy."
In 1950, Chairman Mao Zedong made a speech in support of traditional Chinese medicine (TCM) which was influenced by political necessity. Mao believed he and the Chinese Communist Party should promote TCM but he did not personally believe in TCM and he did not use it. In 1952, the president of the Chinese Medical Association said that, "This One Medicine, will possess a basis in modern natural sciences, will have absorbed the ancient and the new, the Chinese and the foreign, all medical achievements—and will be China’s New Medicine!"