History of Chinese Medicine: From the Classics to the Present
Chinese medicine took shape over more than two thousand years. Its theoretical foundations were set down in texts such as the Huangdi Neijing, around the Han dynasty, and expanded with works such as Zhang Zhongjing's Shanghan Lun and Li Shizhen's Bencao Gangmu. In the 20th century it was institutionalized in China and spread around the world.
Key points
- The theoretical foundations of Chinese medicine are set out in the Huangdi Neijing, a text compiled roughly between the 3rd and 1st centuries BCE.
- At the end of the Han dynasty, Zhang Zhongjing wrote the Shanghan Zabing Lun, the basis of treatment with herbal formulas.
- Li Shizhen completed the Bencao Gangmu in 1578, the great encyclopedia of materia medica of imperial China.
- In the 20th century Chinese medicine survived attempts to ban it and was institutionalized in the People's Republic of China.
- Recent milestones include the 2015 Nobel Prize awarded to Tu Youyou for artemisinin and the inclusion of traditional medicine in the WHO's ICD-11 in 2019.
The history of Chinese medicine is that of a tradition built up over more than two thousand years, from clinical observations, philosophical ideas and texts that each generation of physicians commented on, corrected and expanded. Knowing it helps you understand why Chinese medicine speaks of Qi, of Yin and Yang or of five elements, and also helps separate verifiable historical facts from the legends that often accompany it.
Timeline of Chinese medicine: the major milestones
This table summarizes some well-documented milestones. The dates of the ancient texts are approximate, because many works were compiled over several generations.
| Period | Milestone |
|---|---|
| 3rd-1st centuries BCE (Warring States and Han) | Compilation of the Huangdi Neijing (黄帝内经), the fundamental theoretical classic |
| 168 BCE | Date the Mawangdui tomb was sealed; its medical manuscripts were discovered in 1973 |
| Eastern Han dynasty (1st-2nd centuries) | Compilation of the Shennong Bencao Jing, the oldest surviving materia medica, with 365 substances |
| Around the year 200 | Zhang Zhongjing writes the Shanghan Zabing Lun, the origin of the Shanghan Lun |
| 3rd century | Wang Shuhe writes the Maijing (pulse classic) and Huangfu Mi the Zhenjiu Jiayi Jing, on acupuncture |
| 7th century (Tang dynasty) | Sun Simiao writes the Qianjin Yaofang, which includes reflections on medical ethics |
| 1027 (Song dynasty) | Bronze figures marked with the acupuncture points, the work of Wang Weiyi, are cast for teaching |
| 1578 (Ming dynasty) | Li Shizhen completes the Bencao Gangmu, published after his death |
| 17th-18th centuries (Qing dynasty) | Development of the school of warm diseases (wen bing) |
| 1929 | Protests in China against a Nationalist government proposal to abolish Chinese medicine |
| 1956 | Founding of the first universities of Chinese medicine in Beijing, Shanghai, Guangzhou and Chengdu |
| 1971 | James Reston's article in The New York Times sparks interest in acupuncture in the West |
| 1972 | Tu Youyou's team isolates artemisinin from Artemisia annua |
| 2004 | The US FDA bans ephedra (ma huang) supplements |
| 2015 | Tu Youyou receives the Nobel Prize in Medicine for the discovery of artemisinin |
| 2019 | The WHO includes a chapter on traditional medicine (chapter 26) in ICD-11 |
The origins: from divination to the first medical texts
The earliest traces of ideas about illness in China appear in the oracle bone inscriptions of the Shang dynasty, in which illness was often linked to the influence of ancestors. Over time, and especially during the Warring States period, those explanations gradually gave way to a naturalistic view: health depended on the body's balance with the seasons, the climate and habits.
The manuscripts found at Mawangdui (in Hunan province) offer a privileged window into that stage. Among them are collections of remedies and texts on the body's channels that predate the classical form of the meridians, which shows that the theory was built in stages.
The Huangdi Neijing and the formation of classical theory
The Huangdi Neijing, or Inner Classic of the Yellow Emperor, is the great theoretical work of Chinese medicine. It is divided into two parts, the Suwen (basic questions) and the Lingshu (spiritual pivot), and takes the form of dialogues between the legendary emperor and his physicians.
Its pages systematize ideas that remain central today: Yin and Yang, the five elements, the organs, the meridians and the importance of prevention. One of its best-known sayings compares treating a disease once it has already set in to digging a well when you are already thirsty.
Zhang Zhongjing and formula-based medicine
At the end of the Han dynasty, Zhang Zhongjing wrote the Shanghan Zabing Lun (treatise on cold damage and miscellaneous diseases). Over time the work was handed down divided into two texts: the Shanghan Lun and the Jingui Yaolüe. His great contribution was to unite theory with clinical practice: he describes how diseases progress in stages and matches each presentation to specific formulas. Many of those formulas are still used in Chinese herbal medicine today, and Zhang Zhongjing is revered as the "sage of medicine."
From the Tang and Song dynasties to the Bencao Gangmu
During the Tang dynasty, medicine was organized as an official discipline, with institutions to train physicians. Sun Simiao left encyclopedic works and a text on the sincerity of the great physician that is still cited as an ethical reference.
The Song dynasty promoted the printing of medical texts and the teaching of acupuncture, for which bronze figures with the points marked on them were cast.
In the Ming dynasty, Li Shizhen completed the Bencao Gangmu in 1578, after almost three decades of work. This encyclopedia describes nearly two thousand medicinal substances and corrects errors in earlier works, which also makes it a text of great value for the history of botany.
The 19th and 20th centuries: crisis, survival and institutionalization
The arrival of Western medicine in China in the 19th century opened up an intense debate. Many reformers saw traditional medicine as an obstacle to modernization, and in 1929 a Nationalist government proposal to abolish it triggered a strong mobilization by its practitioners, which ended up stopping it.
After 1949, the People's Republic of China decided to integrate traditional medicine into its health system. Universities, hospitals and research programs were created, and the content was standardized in textbooks. Much of what is taught today as "traditional Chinese medicine" comes from that 20th-century systematization, which selected and unified elements from different historical schools.
Chinese medicine in today's world
Since the 1970s, acupuncture and other therapies have spread across Europe and the Americas. Scientific research has produced significant results, such as artemisinin, and has also documented risks, such as aristolochic acid nephropathy associated with certain herbal preparations.
The inclusion in 2019 of a chapter on traditional medicine in the WHO's ICD-11 allows its diagnoses to be recorded for statistical purposes, although it does not amount to an endorsement of the effectiveness of each treatment. The history of Chinese medicine is still being written, today in dialogue, and sometimes in tension, with biomedical science.
Frequently asked questions
How old is Chinese medicine?
Healing practices in China are very old, but Chinese medicine as a theoretical system took shape about two thousand years ago, around the Han dynasty, when texts such as the Huangdi Neijing were compiled. The figures of five thousand years that are sometimes cited mix legend and tradition and are not supported by medical documents of that age.
Who wrote the Huangdi Neijing?
Tradition attributes it to the Yellow Emperor, Huangdi, a legendary figure. Historians consider it a collective work, compiled from texts by different authors and periods, probably between the Warring States period and the Han dynasty. It is organized as dialogues between the emperor and his medical advisers.
When did acupuncture reach the West?
There were reports of acupuncture in Europe from the 17th century onward thanks to travelers and physicians who had been to Asia, and in the 20th century it gained some popularity in France. The big leap in popularity in the West came in the 1970s, after journalist James Reston's 1971 article in The New York Times about his experience in a Beijing hospital.
Who was Li Shizhen?
Li Shizhen was a Chinese physician and naturalist of the Ming dynasty who lived in the 16th century. He devoted decades to reviewing ancient texts and studying plants, minerals and animals used in medicine. His work, the Bencao Gangmu, completed in 1578, is the great encyclopedia of materia medica of imperial China and is still cited today.
Health notice. This content is educational and describes concepts of Traditional Chinese Medicine together with the available scientific evidence. It does not replace diagnosis or treatment by a healthcare professional. If symptoms are persistent or severe, consult your doctor. Safety guide.
