Figure 2: Oracle shell with inscriptions. The status of individuals in ancient China was determined by the perceived degree of his or her association with the supernatural. In ancient China, supernatural capabilities were common to virtually all Chinese medical doctors.
They all had supernatural capabilities that were all documented in medical texts. However, in most cases those abilities were not given prominent attention by most researchers. Shang dynasty?? There is clear evidence of a shamanic culture existing in early Asian civilization, and many shamanistic practices are believed to lie at the foundation of Chinese Medicine. By the sixth century B.
Shamanism dates back thousand years and is considered as oldest spiritual and healing practice known to humankind. Virtually all cultures around the world evolved from shamanic cultures Figure 3. Figure 3: Oracle bones pit at Yin. Most shamans begin their spiritual paths during a life-threatening illness, having a spiritual journey and communicate with the spirits and ancestors that become the source of their powers.
After recovering from the illness, they go through a ceremonial practice of cleansing. Archaeological excavations have found records of the shamanistic use of divination dating from the time of Shang dynasty. Invention of acupuncture and moxibustion originated during clan commune period of the primitive society. The activities of human beings appeared in China about 1,, years ago.
It was about , years ago that China entered the clan commune period which lasted till 4, years ago. In the ancient literature there were many legends about the origin of acupuncture and moxibustion such as Fu Xi's?? Yellow Emperor invention of acupuncture and moxibustion. However those two legends actually represent the clan commune of primitive society effort to explain acupuncture and moxibustion and to rise it on cultural pedestal [2]. Originally shamans had two ways to communicate with divine ancestors: in mystical practice, involving dances and trances; and the second is the method of the oracle bones, a rational way.
It is clear that the origins of Chinese Medicine extend far into the past and lie firmly rooted somewhere in the midst of their shamanistic beliefs and practices [3].
Archaeological evidence testifies to the ancient use of acupuncture. Excavations from the Stone Age reveal that cattle bones - and, later, turtle shells - were used for medical practice as well. Medical advice was among the more prominent requests made of diviners. During the Shang dynasty the Chinese pictographic writing system is invented. Early character writing has developed out of the need to diagnose sickness and disease Figure 4.
Figure 4: The Daoyintu. Oracle bones are pieces of bone and turtle shells that were used to divine the future for members of the royal household. It is known as scapulimancy, and it had purpose for the ruling class to seek spiritual guidance in affairs of house and the state [4]. Method of using of oracle bones: a question was carved into the oracle bone and then bone was heated via the insertion of hot metal rods into holes carved in the back of it.
Result of this action produced a series of cracks on the bone. Finally cracks would be interpreted by the shaman in order to answer to the question at hand. These oracles were used as an attempt to determine the outcome of illnesses and the sacrifices necessary to bring about recovery.
Sacrifice was believed to be a way of sharing divine powers and ensuring longevity. Many of the pictographs and ideographs represent disease names and symptoms. Other characters indicate early classifications of diseases by their location on the body Figure 5. Analysis of the cracks allowed the shaman to diagnose and treat the disease. Figure 5: Ideograms of wu? Toothache, headache, bloated abdomen and leg pains were only different symptoms of the same disease.
The shaman was often called upon by the community to perform a psychodrama, make sacrifices to Shang Di?? The story of A. In other words, scientists are innovating CHM using scientific concepts and techniques, which provide us with a new understanding on this traditional health practice.
Such techniques can be analytical chemistry Jiang et al. When studying CHM, researchers usually argue if CHM is a science or can we apply scientific methods in the investigation. As a mixture of Chinese philosophy, culture, ritual and medical practices, CHM demands a comprehensive understanding which is not restricted to science.
In order to gain a contemporary understanding of CHM, we either seek the assistance of science or adopt a novel narrative approach which will be discussed in the last section. Science bears its value in an unbiased standard that may fulfill CHM in the global setting just like artemisinin, which is no longer considered as herbal medicine but a universal antimalaria therapy acknowledged in and out of Chinese communities.
Another essential question: is it necessary for the scientific research of CHM to be guided by the records in medical classics? In the Chinese communities, we hear voices like the traditional narratives of herbs are still valid in the context of science; therefore, we need to make efforts to embody the ancient wisdom with scientific findings, as what Youyou Tu achieved in discovering artemisinin.
For example, although artemisinin was originally discovered as an antimalarial drug, recent studies show it also demonstrates anti-inflammatory, immunoregulatory, and anticancer functions which were not documented in any medical classics Nakase et al.
Neither do men put new wine into old bottles. Basically speaking, drug discovery in CHM is totally different from the knowledge in medical classics. In those classics, there is no modern concept of drug — molecules that can cure diseases.
Furthermore, the concept of disease in the ancient Chinese context also bears a different notion far from what we understand in orthodox medicine. In the scientific study of the herbs, researchers can simply treat them as plants without any prior knowledge of healing potential because such narratives were not evaluated in any rigorous experiments and can be guiding and misleading at the same time.
Traditionally, a prescription of CHM is a unique formula tailored for the patient. In the formula, herbs are combined in a hierarchy of Principal, Associate, Assistant, and Coordinator. The herbs are also characterized according to their nature hot, warm, cool, and cold and flavor acrid, sweet, bitter, sour, and salty , which need careful combination in the prescription Chan, Doctors of TCM frequently advocate the philosophy of holism in medical practices as they hold firmly that everything is interconnected.
Therefore, the treatment as a prescription should also address different parts of the body. For example, a famous formula for the common cold is composed of four herbs: Coptis chinensis , Scutellaria baicalensis , Phellodendron amurense , and Gardenia florida documented by Wang Dao , while the first three are responsible for clearing the heat at heart, lung, and kidney, respectively Zeng et al.
Following the traditional practices of herbal medicine, some scientists adopt the paradigm of holism in drug discovery of CHM, as they believe this paradigm can best appreciate the ancient wisdom of herb combination Leung et al.
Ideologically speaking, holism distinguishes CHM as a unique health practice. However, while emphasizing the narrative on wholeness of herb and body, one is likely to neglect the building components of herbal medicine and their detailed mechanisms with drug targets. Based on our standpoints on the two essential questions addressed above, we suggest methodological reductionism to be adopted in drug discovery of CHM.
To be concrete, here we would like to propose a three-step roadmap. For each herb, scientists are encouraged to identify as many molecules as possible and organize the information in databases. Secondly, we are obliged to clarify the toxicity and bioactivity of the identified molecules as it lays the foundation for future pharmaceutical study of the natural products.
These two steps are also understood as reverse pharmacognosy for accelerating natural drug discovery Do and Bernard, Finally, in order to reveal the mechanisms of a herb or formula, one can test the combinatorial function of composing compounds in the biological networks with respect to human diseases Gu et al.
With that, the holistic practices in CHM can be revealed at the systemic level and engineered in a scientific manner. After a comprehensive understanding being achieved, we can further apply engineering approaches like systems biology to design tailored formulas targeting specific biological networks or diseases. However, as a double-edged sword, science also threatens CHM while fulfilling it because by the rigid scientific standards, the medical narratives of herbs are too vulnerable.
Scientists and physicians, after rigorous examination, may discover an abundance of controversies between the facts and the classical writings.
Especially during the past decades, CHM has been severely challenged on its efficacy and safety Qiu, As a result, how can we appreciate herbal medicine in tandem with orthodox medicine? If we narrate CHM in the postmodern world full of scientific quests and proofs, what else can we offer other than the medical classics and scientific research? It is actually a very difficult question to answer; yet it is vital for the next generation of Chinese to keep their medical traditions.
As we have learned from our history, narrative is powerful because it keeps the identity of an ethnic group, transcending the collective memories into belief.
Therefore, the questions on efficacy and safety raised by scientific research no longer hold back the faith in herbal medicine because CHM should not be judged only by facts, but also be appreciated by either individual or collective memories of the patients.
A good example is the placebo effect Kaptchuk, In order to construct the contemporary narratives of CHM, we suggest to alter the narrative subject from physicians to patients. Different from the orthodox medicine, CHM has a long history of practices in the homology of medicine and food.
Herbs are never pure medicine in the Chinese context — they can be tonic or simple food. When not delivered properly, acupuncture can cause serious adverse effects, including infections, punctured organs, collapsed lungs, and injury to the central nervous system. Tai chi and a similar technique called qi gong appear to be safe practices. Women who are pregnant should talk with their health care providers before beginning tai chi, qi gong, or any other exercise program. Acupuncture can ease joint pain caused by medical treatments for breast cancer.
A tai chi program can be a feasible alternative to traditional cardiac rehabilitation programs in selected people. If you have a health condition, talk with your health care provider before using TCM herbal products. Ask about the training and experience of the TCM practitioner you are considering. Most states and the District of Columbia have laws regulating acupuncture practice, and most states require certification from the National Certification Commission for Acupuncture and Oriental Medicine.
Tell all your health care providers about any complementary or integrative health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care. For More Information. Toll-free in the U. Cochrane Database of Systematic Reviews The Cochrane Database of Systematic Reviews is a collection of evidence-based reviews produced by the Cochrane Library, an international nonprofit organization. Key References. Combined DNA, toxicological and heavy metal analyses provides an auditing toolkit to improve pharmacovigilance of traditional Chinese medicine TCM.
Scientific Reports. Developing traditional Chinese medicine in the era of evidence-based medicine: current evidences and challenges. Interventions for preventing falls in older people living in the community. Cochrane Database of Systemic Reviews. Tai chi exercise for treatment of pain and disability in people with persistent low back pain: a randomized controlled trial.
Cochrane systematic reviews of Chinese herbal medicines: an overview. PLoS One. Ancient Chinese believed that humans are microcosms of the larger surrounding universe, and are interconnected with nature and subject to its forces. Balance between health and disease is a key concept. TCM treatment seeks to restore this balance through treatment specific to the individual.
It is believed that to regain balance, you must achieve the balance between the internal body organs and the external elements of earth, fire, water, wood, and metal. Acupuncture is a component of TCM commonly found in Western medicine and has received the most study of all the alternative therapies.
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