Traditional Chinese Medicine. History. Principles of TCM. Chinese Herbs

Traditional Chinese medicine (TCM) is an ancient healing system that originated in China but is used today to treat millions of people all around the world. TCM applies treatments including acupuncture and herbs according to a highly developed, holistic philosophy of health and disease. Treatment is based on balancing and regulating the flow of qi (pronounced “chee”) — the body’s life energy or vital force. Japan, Korea, and Vietnam have all developed traditional medicine systems of their own, based on concepts and practices begun in China at least 3,000 years ago.


Traditional Chinese medicine (TCM) has very deep historical roots. Sometime between 2700 and 2600 BCE, the emperor Shen-Nung reputedly created the first Chinese written pharmacopoeia, called the Pen-ts’ao (Herbal). It was followed by the Huang-ti Nei ching (The Yellow Emperor’s Classic of Internal Medicine), allegedly written by the legendary Emperor Huang Ti (2697–2597 BCE). Near the end of the Han dynasty, a physician named Chang Chung-ching wrote the Shang Han Lun (or Treatise on Colds and Fevers), which eventually became the theoretical framework for all herbal prescriptions in TCM. It contained more than 100 formulas, many of which are used today.

In 1590, the herbalist Li Shih-Chen (1518–1593) published the Bencao Gangmu (Compendium of Materia Medica). It contained 11,000 prescriptions and formulas, analyzed 1,094 plant substances, filled 53 volumes, and took nearly 27 years to write. It became the first major Chinese work to be translated into Western languages, and its publication coincided with a dramatic rise in Chinese global exportation of herbs and spices.

In the early 20th century, interest in traditional herbal medicine waned for a time. China’s scientists were instructed to examine native plants using Western scientific methods, which resulted in many important discoveries, such as the isolation of the drug ephedrine from the Chinese ephedra (Ephedra sinica) plant. Ephedrine quickly became one of the world’s most effective decongestants and asthma treatments, and China became its principal supplier. The country also constructed modern hospitals and clinics and began using more advanced instruments and synthetic drugs.

After the People’s Republic of China was established in 1949, China’s leaders recognized that the most effective health-care system for the populous nation was a combination of Western and traditional methods. Colleges were established to train doctors in both disciplines, and an army of “barefoot doctors” was created to serve the rural population. As the demand for herbs increased, the Chinese government established a program of medicinal plant cultivation, setting aside thousands of acres solely for the production of medicinal herbs. Today, of the 35,000 species of plants growing in China’s various habitats, some 5,000 are used in TCM and provide 40 percent of all China’s pharmaceuticals.

These pages from the 1740 classic text of traditional Chinese medicine, Hu, Tsung-wen Shen-nung pen ts’ao pei yao i fang ho pien, or Herbal and Prescriptions, illustrate plants used medicinally.

These pages from the 1740 classic text of traditional Chinese medicine, Hu, Tsung-wen Shen-nung pen ts’ao pei yao i fang ho pien, or Herbal and Prescriptions, illustrate plants used medicinally.

Principles of TCM

The principles of traditional Chinese medicine are deeply rooted in the Chinese philosophy and way of seeing the universe. Some Westerners have difficulty fully understanding the concepts of TCM, which do not conform to conventional (Western) ideas about science and medicine. Traditional Chinese healers believe that human beings are subject to the same laws that govern nature and that disease results from imbalances or lack of harmony in forces that influence the workings of the body.

The five elements of traditional chinese medicine and their associations

The Five Elements represent fundamental relationships among the forces and cycles of nature and their effects upon the human body. Each element is associated with specific organs and emotions.

Wood Spring Sour Anger Liver, tendons gallbladder, eyes
Fire Summer Bitter Joy Heart, tongue, small blood intestine, vessels
Earth Indian summer Sweet Worry Spleen, mouth, stomach, muscles
Metal Fall Pungent Grief Lungs, nose, skin large intestine
Water Winter Salty Fear Kidneys, bones bladder, ears

The Practice of TCM

A TCM practitioner’s first step is to pinpoint imbalances that have resulted in a person’s physical problems. In TCM, all disease is viewed as the result of energetic imbalances (excess or deficiency) caused by a person’s way of life and relationship with the universe. The six external causes of disease are wind, cold, heat, dampness, dryness, and summer heat. The seven internal causes, or emotions, that contribute to physical manifestations of disharmony are joy, anger, sadness, pensiveness, grief, fear, and fright. So, for example, a TCM practitioner might conclude that a patient’s disease is caused by excessive “wind” in the body, too much “heat” in a specific organ, or by “qi deficiency” or “deficient spleen yang.”

A traditional Chinese physician uses a unique array of diagnostic techniques. In addition to carefully questioning a patient about his health, lifestyle, and behavior, the doctor examines his tongue for signs of illness, observes all aspects of his appearance, palpates his abdomen, and analyzes his pulse. Chinese pulse diagnosis is a highly refined art that takes many years to master.

Acupuncture and herbs, often used in combination, are the two most important components of TCM practice. Other treatments include nutritional therapies, restorative physical exercises such as qigong or tai chi, meditation, and massage.

Acupuncture, which originated in China at least 2,000 years ago, remains one of the most commonly used medical procedures in the world. Acupuncture involves the insertion of tiny needles in specific places along the body’s meridians — pathways that serve as channels for the flow of qi. There are 12 major meridians and more than 1,000 acupuncture points along the meridians.

Through the precise placement of needles on these points, the skilled acupuncturist manipulates the flow of qi to reduce excess, counteract deficiency, or otherwise correct underlying energetic imbalances to treat disease. Modern clinical studies conducted in China and in the West indicate that acupuncture can be an effective treatment or supportive therapy for health problems including addictions, asthma, carpal tunnel syndrome, fibromyalgia, headache, low-back pain, menstrual cramps, osteoarthritis pain, postoperative dental pain, postoperative and chemotherapy-related nausea and vomiting, and stroke rehabilitation.

Important herbs in traditional chinese medicine

These are only a few examples of the many thousands of different herbs that are important in traditional Chinese medicine (TCM). As in many traditional medical systems, combinations of herbs are also an integral part of the pharmacopoeia.

ASTRAGALUS (Astragalus membranaceus)

Astragalus membranaceus

Astragalus root, called huang qi in Chinese, is an important qi tonic that is considered slightly warming and sweet. It is used to treat conditions characterized by deficient qi. These include frequent colds, general weakness and fatigue, weak digestion and lack of appetite, and chronic weakness of the lungs with shortness of breath. For use as a daily tonic, pieces of astragalus root can be cooked into soups or other foods. Healers often prescribe a combination of astragalus and ginseng roots (called bu zhong yi qi tang) for debility This formula contains dong quai, and fatigue.

DONG QUAI (Angelica sinensis)

Dong Quai

Practitioners of TCM consider dong quai root (also called dang gui, or Chinese angelica) warm, sweet, acrid, and bitter. It is the most important “blood tonic” in traditional Chinese medicine, and healers use it to invigorate blood and relieve blood stagnation. Dong quai is often called the female ginseng because in TCM, women’s health relates closely to blood. Practitioners prescribe it widely in combination with other herbs to treat women’s health conditions, such as irregular menstruation, menopausal symptoms, and postpartum debility (weakness after giving birth). Four Things Soup, a classical Chinese formula, is a women’s tonic widely prescribed throughout China. Chinese peony (Paeonia lactiflora), rehmannia (Rehmannia glutinosa), and ligusticum (Ligusticum sinense) in equal parts, prepared by simmering the herbs.

GINSENG (Panax ginseng)


TCM classifies ginseng root, known as ren shen in Chinese, as a “superior” herb, or one of the most useful and safest remedies available. An important qi tonic, it is considered warming, sweet, and slightly bitter. Traditional healers use ginseng to treat extreme fatigue, debility caused by illness or old age, and heart and blood pressure problems. They generally prescribe it only for people over the age of 45 or 50 and treat young people with it only if they have severe qi deficiency.

Chinese Herbal Formulary

TCM classifies herbs according to four energies (cold, cool, warm, and hot) and five flavors (spicy, sweet, sour, bitter, and salty). Healers might prescribe cooling herbs to relieve conditions caused by excess heat in the body, for example, or sweet herbs to tonify qi and nourish the blood. TCM practitioners rarely use herbs singly; instead, they compound herbs into formulas. A single herb can have many different effects, so practitioners carefully choose and combine them with other herbs in a prescription designed to address myriad health issues at the same time.

TCM practitioners can choose from nearly 6,000 herbs to create an herbal formula that could contain 20 or more herbs. The traditional Chinese pharmacopoeia lists hundreds of different formulas for specific patterns of disharmony. The practitioner adjusts these formulas, which usually contain at least 10 different herbs, to suit the unique characteristics and needs of the patient.

Chinese practitioners often prescribe a formula as a decoction (a tea made by simmering dried herbs) to be brewed and consumed several times a day. Patients can also take an herbal formula as a powder, pill, or alcohol-based tincture, or they can add the roots, leaves, or other parts of the plant to a soup, porridge, or other food. Some classic Chinese formulas are mass-produced as ready-to-use “patent remedies” made according to a specific formula. These are usually sold in pill form.

An external herbal treatment called moxibustion is often used in combination with acupuncture. To perform moxibustion, the practitioner applies heat to acupuncture points by burning moxa (a dried herb, usually Artemesia vulgaris, or mugwort) near or on the skin. The heat is believed to penetrate into the meridians to influence qi and blood flow. Moxa is available in a variety of forms — including loose powder, cones, and sticks — for different applications. Moxa cones can be burned directly on the skin, but moxa is often applied indirectly, such as by wrapping a ball of the herb around the end of an acupuncture needle before lighting it.