The History of TCM Specialization: Two Thousand Years of the Six Great Branches
Formularies · Pulse Studies · Acupuncture · Pediatrics · Gynecology · Surgery — From a Single Tree to a Whole Forest
“In ancient times, those who studied always had a teacher. The teacher is one who transmits the Way, hands on the learning, and resolves doubts.
So it is with medicine.」」 (「古之学者必有师。师者，所以传道受业解惑也。医者，亦然。」)— Tang · Hán Yù (韩愈), On the Teacher (《师说》) (applied to the transmission of the medical Way)
In its three thousand years, Chinese medicine — is not “an undifferentiated mass of traditional medicine” — but “a tree of disciplines with spreading branches and abundant leaves” — with root, with trunk, with branches, with leaves.
This tree’s “root” — is the theory of the Huangdi Neijing (《黄帝内经》), the pattern identification of the Shanghan Lun (《伤寒论》), and the medicinal substances of the Shennong Bencao Jing (《神农本草经》).
This tree’s “trunk” — is the four pillars of “principle, method, formula, and medicine (理、法、方、药)” — principle in the Neijing — method in the Shanghan — formulas in the formula books — medicines in the materia medica.
This tree’s “branches” — are the six great specialties:
- Chinese Medical Formula Studies (方剂学) —
- Pulse Diagnosis (脉学) —
- Acupuncture (针灸学) —
- TCM Pediatrics (中医儿科) —
- TCM Gynecology (中医妇科) —
- TCM External Medicine (中医外科).
This tree’s “leaves” — are the thousands upon thousands of formulas, medicinals, acupoints, disease patterns, and case records — myriad upon myriad — ever-renewing, never-ceasing.
At Qihuang Library, today we take you, with “the specialty” as our outline, along the six great trunks of “formularies — pulse texts — acupuncture — pediatrics — gynecology — surgery” — to enter the “inner structure” of Chinese medicine — to see how this “tree of disciplines” — has gone from “a single tree” to “a whole forest.”
I. Overview: The Origins and Flow of TCM Specialization
“The sage governs by dividing into specialties, each fully employing its own ability.」」
1. The Three Stages of TCM Specialization
🌱 Stage One: Qin and Han — The Embryo
The Zhou Li · Tianguan (《周礼·天官》, late Warring States) — already divided medical officials into four specialties: “Dietary Physician, Disease Physician, Ulcer Physician, and Veterinarian” — “Dietary Physician” (营养医生) — “Disease Physician” (内科) — “Ulcer Physician” (外科、骨伤) — “Veterinarian” (兽医) — the earliest recorded specialization in Chinese medicine.
🌿 Stage Two: Tang and Song — Institutionalization
The Táng Imperial Medical Academy (太医署, 624 CE) divided medicine into four departments: medicine, acupuncture, massage, and incantation-prohibition — the medicine department was further divided into five specialties: body-treatment (internal medicine), ulcer-and-swelling (external medicine), young-and-small (pediatrics), ears-eyes-mouth-teeth (five sense organs), and horn-method (external treatment) — the Northern Sòng’s Imperial Medical Bureau (太医局) with the “Three Lodges and Promotion Tribute System” divided into nine specialties: great-vessel-pulse, small-vessel-pulse, wind, eye, ulcer-and-swelling-and-fracture, obstetrics, mouth-teeth-throat, acupuncture, and metal-and-arrow — TCM specialization moved toward completeness.
🌳 Stage Three: Ming and Qing — Refinement
Míng and Qīng TCM specialization was further refined — internal medicine was further divided into external contraction, internal injury, gynecology, pediatrics, acupuncture, bone-setting, eye, throat, dermatology, hemorrhoids-fistulas, massage, tuina, qigong, and so on — to this day the specialty division in the teaching of universities of Chinese medicine — still basically follows this framework.
2. The Modern Map of TCM Specialization
The “Categories of TCM Clinical Practice” published by the National Administration of Traditional Chinese Medicine in 2017 — divided into 12 major departments and more than 130 specialties — the modern grand inventory of traditional TCM specialization.
| Major Department | Main Specialties |
|---|---|
| Internal Medicine | Heart disease, lung disease, spleen-stomach disease, liver-gallbladder disease, kidney disease, brain disease, oncology, geriatrics, infectious diseases |
| External Medicine | General surgery, anal-intestinal, dermatology, ulcer-and-sore |
| Gynecology | Gynecology, obstetrics |
| Pediatrics | Pediatrics, neonatology |
| Orthopedics and Traumatology | Bone-setting, tendon injury, bone disease |
| Acupuncture | Acupuncture, tuina, rehabilitation |
| Eye Medicine | Eye medicine |
| Ear-Nose-Throat Medicine | Ear-nose-throat |
| Stomatology | Stomatology |
| Emergency Medicine | Emergency care |
| Critical-Care Medicine | Critical care |
| Preventive-Treatment Medicine (治未病科) | Health cultivation, rehabilitation |
Source: Dèng Tiětāo, ed., General History of Chinese Medicine · Ancient Volume; National Administration of Traditional Chinese Medicine, Categories of TCM Clinical Practice (2017).
II. Chinese Medical Formula Studies: From the Wushier Bingfang to the Yifang Jijie
“A formula is a fixed method; a method is a not-yet-fixed formula.」」
1. Overview of the Sources and Flow
Chinese Medical Formula Studies is the most important “practical discipline” of Chinese medicine — moving from “one formula for one pattern” to “organizing formulas by method” — in a transformation spanning more than 2,000 years — it can be roughly divided into five stages: “Germination — Classical Formulas — Contemporary Formulas — Synthesis — Cumulative Synthesis.”
2. The Five Stages
📜 Stage One · Germination (Warring States to Western Han)
The Mawangdui Han tomb silk manuscript Wushier Bingfang (《五十二病方》) (c. 3rd century BCE) — recording 283 formulas — classified by 52 disease names (the “fifty-two diseases”) — the earliest extant “formula book” — even more ancient than the Huangdi Neijing.
📜 Stage Two · Classical Formulas (Eastern Han to Tang)
Zhāng Zhòngjǐng’s Shanghan Zabing Lun (《伤寒杂病论》) (219 CE) — recording 269 formulas — using 241 medicinals — the founding of the “classical formulas (经方)” — “classical formulas” remain to this day the core of Chinese clinical practice — “Guìzhī Tāng, Máhuáng Tāng, Xiǎo Cháihú Tāng, Wǔlíng Sǎn, Shènqì Wán” — still in use today.
Other classical formularies:
- Eastern Jìn · Gě Hóng, Zhouhou Beiji Fang
- Eastern Jìn · Fàn Wāng, Fan Wang Fang
- Northern and Southern Dynasties · Chén Yánzhī, Xiaopin Fang
- Suí · Cháo Yuánfāng, Zhubing Yuanhou Lun
- Tang · Sūn Sīmǐao, Qianjin Fang
- Tang · Wáng Tāo, Waitai Miyao (recording more than 6,000 formulas)
- Tang · Zǎn Yīn, Jingxiao Chanbao
This is the “classical age” of Chinese Medical Formula Studies.
📜 Stage Three · Contemporary Formulas (Song, Jin, Yuan)
Song-dynasty official formularies — Wáng Huáiyǐn’s Taiping Shenghui Fang (《太平圣惠方》), 100 scrolls, 16,834 formulas — Chén Shīwén’s Taiping Huimin Heji Jufang (《太平惠民和剂局方》), 10 scrolls, 788 formulas — Emperor Huīzōng’s commissioned Shengji Zonglu (《圣济总录》), 200 scrolls — Xǔ Shūwēi’s Benshi Fang — Yán Yònghé’s Jisheng Fang — the four masters of the Jīn and Yuán’s formularies — “contemporary formulas (时方)” arose — “contemporary formulas” and “classical formulas” stood side by side — the tradition of “read the classics, do clinical work” — continues to this day.
📜 Stage Four · Synthesis (Ming and Qing)
Ming · Wáng Kěntáng, Zhengzhi Zhunsheng (《证治准绳》), 44 scrolls — Ming · Zhāng Jǐngyuè, Jingyue Quanshu (《景岳全书》), 64 scrolls — Qīng · Wú Qiān, Yizong Jinjian (《医宗金鉴》), 90 scrolls — Qīng · Xú Dàchūn, Yixue Yuanliu Lun (《医学源流论》) — Qīng · Wāng Áng, Yifang Jijie (《医方集解》), 3 scrolls — Qīng · Chén Xiūyuán, Shifang Miaoyong (《时方妙用》) — this is the “synthesizing age” of Chinese Medical Formula Studies — the theory of “organizing formulas by method” — at last complete.
📜 Stage Five · Modernization (Late Qing to the Present)
- Late Qīng and Republican era — TCM schools established the specialized subject of “Chinese Medical Formula Studies” —
- 1950s — TCM colleges established the “Teaching and Research Section of Chinese Medical Formula Studies” —
- 1980s — Xǔ Jìqún, Wáng Miánzhī, and others compiled the standardized textbook Chinese Medical Formula Studies —
- Contemporary era — Chinese Medical Formula Studies has become a “core course” in universities of Chinese medicine — along with “Chinese Materia Medica” and “Internal Medicine of Chinese Medicine”, it is called the “three great clinical foundations” of Chinese medicine.
3. The “Four Beams and Eight Pillars” of Chinese Medical Formula Studies
| Beam/Pillar | Representative |
|---|---|
| Theory | “Chief, deputy, assistant, envoy” / “Seven Relations” / “Ascending, descending, floating, sinking” |
| Representative Formulas | Guìzhī Tāng, Sì Jūnzǐ Tāng, Liù Wèi Dìhuáng Wán, Bǔ Zhōng Yì Qì Tāng |
| Contemporary Formulas | Huò Xiāng Zhèng Qì Sǎn, Xiāo Yáo Sǎn, Lóng Dǎn Xiè Gān Tāng |
| Modern Textbook | Chinese Medical Formula Studies (standardized textbook) |
Source: Dèng Zhōngjiǎ, Chinese Medical Formula Studies, China Press of Chinese Medicine, 2003; People’s Medical Publishing House, Chinese Medical Formula Studies (10th edition).
III. Pulse Diagnosis: From the Mai Jing to the Bihu Maixue
“The principles of pulse diagnosis are subtle and minute; their forms are hard to distinguish. Wiry, tight, floating, hollow — they shift and resemble one another.」」
1. Overview of the Sources and Flow
Pulse Diagnosis is the core of TCM diagnostics — from the Neijing’s “three positions and nine indicators” — to the Nan Jing’s “taking only the cunkou” — to the Mai Jing’s “twenty-four pulses” — to the Bihu Maixue’s “twenty-seven pulses” — to the modern “pulse-diagnostic instruments” — spanning more than 2,000 years — it is the “trunk” of Chinese “diagnostic method.”
2. Five Milestones
📜 Milestone One · The Huangdi Neijing
The Neijing first established the “three positions and nine indicators” pulse-taking method — the whole body was divided into upper, middle, and lower three positions — each position was further divided into heaven, earth, and man three indicators — nine indicators in all — diagnosing the whole body — this is the original form of pulse studies.
📜 Milestone Two · The Nan Jing
The Nan Jing · The First Difficulty — “All twelve channels have their arterial pulsations; yet, taking only the cunkou, one decides the life, death, fortune, or misfortune of the five zang and six fu” — originated the “taking only the cunkou” pulse-taking method — using only the “cun, guan, and chi” six positions of both hands — to survey the whole body — greatly simplifying pulse taking — still used today.
📜 Milestone Three · The Mai Jing
Western Jìn · Wáng Shūhé, Mai Jing (《脉经》), 10 scrolls — fixed the twenty-four pulse types — fú, chén, chí, shuò, huá, sè, xū, shí, cháng, duǎn, hóng, wēi, jǐn, huǎn, xián, kōu, gé, láo, rú, ruò, sǎn, xì, fú, dòng — defined each pulse image — the “three positions and nine indicators of the cunkou” — at last complete — transmitted to the Arab world and to Japan — Avicenna’s Canon of Medicine was influenced by it.
📜 Milestone Four · The Maijue
Northern Song · Gāo Yángshēng (高阳生, pseudonymously attributed to Wáng Shūhé), Wáng Shūhé Maijue (《王叔和脉诀》) — in the seven-character verse form — simplified pulse studies — “floating, sinking, slow, rapid, slippery, choppy, deficient, replete” and “long, short, surging, faint, tight, moderate, wiry, hollow” — though there are academic disputes about it — it is still required reading for the introduction to Chinese medicine.
📜 Milestone Five · The Bihu Maixue
Ming · Lǐ Shízhēn, Bihu Maixue (《濒湖脉学》), 1 scroll — in seven-character verse — recording 27 pulses — “floating, sinking, slow, rapid, slippery, choppy, deficient, replete” — 8 types — “long, short, surging, faint, tight, moderate, wiry, hollow, drum-skin, firm, soggy, weak, scattered, thin, hidden, moving, abrupt, knotted, intermittent” — 19 types — concise, accurate, easy to remember — the “golden textbook” for the introduction to Chinese pulse diagnosis — still required reading in Chinese clinical medicine.
3. Modern Pulse Studies
Contemporary pulse studies — combined with modern science — the “pulse-diagnostic instrument” has arisen as the times demand — in Shanghai, Beijing, Taiwan, Japan, and elsewhere — research on the pulse-diagnostic instrument — attempts to digitize traditional pulse studies — this is one of the explorations of the modernization of Chinese medicine.
Source: Jìn · Wáng Shūhé, Mai Jing (original), People’s Medical Publishing House punctuation-and-collation edition, 1956; Míng · Lǐ Shízhēn, Bihu Maixue (China Press of Chinese Medicine punctuation-and-collation edition, 1996).
IV. Acupuncture: From the Jiayi Jing to the Zhenjiu Dacheng
“First needling, second moxibustion, third medicine,
The meridians decide life and death, treat all diseases.」」
1. Overview of the Sources and Flow
Acupuncture — the most distinctive “physical-therapy” discipline of Chinese medicine — from the Lingshu to the Zhenjiu Jiayijing — from the Song-dynasty “Wáng Wéiyī Bronze Figures” — to the Ming-dynasty Zhenjiu Dacheng — spanning more than 2,000 years — it is the core of Chinese “external treatment.”
2. Four Milestones
🩺 Milestone One · The Lingshu
The Lingshu is also known as the “Needling Classic (针经)” — recording meridians, acupoints, needling methods, and manipulations — the “source” of acupuncture studies — “The meridians are what determine life and death, treat all diseases, and regulate deficiency and excess — they must not be left unstudied” — the “fundamental great principle” of acupuncture studies.
🩺 Milestone Two · The Zhenjiu Jiayijing
Western Jìn · Huángfǔ Mì, Zhenjiu Jiayijing (《针灸甲乙经》), 12 scrolls — gathered the three books of the Suwen, the Lingshu, and the Mingtang Kongxue Zhenjiu Zhiyao — “pruning their superfluous words, eliminating their repetitions, and distilling their essentials” — defining 349 acupoints — originating the “arrange by bodily region” method — standardizing acupuncture manipulation — still today the “core textbook” of acupuncture.
🩺 Milestone Three · The Song-dynasty Bronze Figures
Northern Song · Wáng Wéiyī (王惟一, c. 987–1067 CE) — Tongren Shuxue Zhenjiu Tujing (《铜人腧穴针灸图经》), 3 scrolls — cast two “acupuncture bronze figures” — “with the viscera and bowels within, the valleys and streams along the sides, the well, spring, stream, and confluence points marked, so that depth and shallowness can be measured” — the world’s earliest “acupuncture model” — a milestone in the teaching of acupuncture.
Cast in 1027 CE — one was preserved in the Song Imperial Medical Academy — one was preserved in the Bianjing Great Xiangguo Temple — after the Disaster of the Jingkang Reign — one was lost — today the Palace Museum, Shanghai University of Chinese Medicine, and the Tokyo National Museum — all have various replica bronze figures.
🩺 Milestone Four · The Zhenjiu Dacheng
Ming · Yáng Jìzhōu, Zhenjiu Dacheng (《针灸大成》), 10 scrolls — the cumulative synthesis of acupuncture studies before the Ming — recording 359 acupoints — collecting the needling methods and verse-formulas of the previous masters — the “encyclopedia” of acupuncture — still today the core textbook of acupuncture — an important reference for the WHO acupuncture standards.
3. Modern Acupuncture
Contemporary acupuncture — combined with modern neuroscience, immunology, and molecular biology — “acupuncture anesthesia” (first successfully used at Shanghai First People’s Hospital in 1958) — “auricular acupuncture,” “scalp acupuncture,” “electroacupuncture,” “laser acupuncture” — in use in 183 countries and regions worldwide — the “homeland of acupuncture” — China — has made acupuncture “the foremost calling card of Chinese medicine abroad.”
Source: Jìn · Huángfǔ Mì, Zhenjiu Jiayijing (original); Song · Wáng Wéiyī, Tongren Shuxue Zhenjiu Tujing (original); Míng · Yáng Jìzhōu, Zhenjiu Dacheng (original), People’s Medical Publishing House punctuation-and-collation edition, 2006.
V. TCM Pediatrics: From the Key to Therapeutics of Children’s Diseases to the Modern Era
“The viscera and bowels of children are soft and weak, prone to deficiency and prone to excess, prone to cold and prone to heat.」」
1. Overview of the Sources and Flow
TCM Pediatrics — the earliest-developed and most complete specialty in TCM specialization — from Biǎn Què’s “becoming a physician of children” — to Cháo Yuánfāng’s Zhubing Yuanhou Lun — to Qián Yǐ’s Key to Therapeutics of Children’s Diseases — to Chén Fùzhèng’s You You Ji Cheng — to the modern TCM pediatrics — spanning more than 2,000 years — it is the model of “specialization” in Chinese medicine.
2. Three Milestones
👶 Milestone One · Qián Yǐ and the Key to Therapeutics of Children’s Diseases
Northern Song · Qián Yǐ (1032–1113 CE) — Key to Therapeutics of Children’s Diseases (《小儿药证直诀》), 3 scrolls — originated the “five-zang pattern-identification” pediatric system — “the heart governs fright; the liver governs wind; the spleen governs lassitude; the lung governs panting; the kidney governs deficiency” — created the “Six-Ingredient Rehmannia Pill” — the founding of TCM pediatrics — still today the “Sage of Pediatrics.”
👶 Milestone Two · Chén Wénzhōng’s Xiao’er Bingyuan Fanglun and Xiao’er Douzhen Fanglun
Southern Song · Chén Wénzhōng — Xiao’er Bingyuan Fanglun (《小儿病源方论》), 4 scrolls — Xiao’er Douzhen Fanglun (《小儿痘疹方论》), 1 scroll — specifically treating “douzhen (smallpox)” in children — an early specialized text on smallpox in China — laying the foundation for the birth of “variolation (人痘接种).
👶 Milestone Three · Chén Fùzhèng’s You You Ji Cheng
Qīng · Chén Fùzhèng (1750–1795 CE) — You You Ji Cheng (《幼幼集成》), 6 scrolls — the cumulative synthesis of TCM pediatrics before the Qīng — “the iron mirror of pediatrics” — the “encyclopedia” of TCM pediatrics — still today the core reference for TCM pediatrics.
3. Modern TCM Pediatrics
- 1950s — TCM hospitals established the “pediatrics” department —
- Modern — Beijing Children’s Hospital, the Capital Institute of Pediatrics, and so on —
- Clinical conditions — pneumonia, asthma, diarrhea, kidney disease, purpura —
- Integration of Chinese and Western medicine — TCM pattern identification + Western diagnosis — this is one of the most active areas in Chinese clinical medicine.
Source: Song · Qián Yǐ, Key to Therapeutics of Children’s Diseases (People’s Medical Publishing House punctuation-and-collation edition, 1991); Qīng · Chén Fùzhèng, You You Ji Cheng (Shanghai Science and Technology Publishing House, 1955).
VI. TCM Gynecology: From the Comprehensive Good Formulas for Women to the Fu Qingzhu Nyuke
“Women are the root of life and nature;
the physician must be all the more attentive to them.」」
1. Overview of the Sources and Flow
TCM Gynecology — “women first, then children, then the elderly” — the clinical order established by Sūn Sīmǐao — still used today. From the Jingxiao Chanbao — to the Comprehensive Good Formulas for Women — to the Fu Qingzhu Nyuke — to the modern TCM gynecology — spanning more than 1,500 years — it is a “distinctive specialty” of Chinese medicine.
2. Four Milestones
🌸 Milestone One · The Jingxiao Chanbao
Tang · Zǎn Yīn, Jingxiao Chanbao (《经效产宝》), 3 scrolls — the earliest extant monograph on obstetrics — recording many formulas — chiefly treating gestation, difficult labor, and the postpartum period — the founding of TCM obstetrics.
🌸 Milestone Two · The Comprehensive Good Formulas for Women
Southern Song · Chén Zìmíng, Comprehensive Good Formulas for Women (《妇人大全良方》), 24 scrolls — the cumulative synthesis of TCM gynecology before the Song — originated the seven major categories of “menstruation, leukorrhea, seeking offspring, fetal education, pregnancy, difficult labor, and the postpartum period” — the disciplinary framework of TCM gynecology — still today the “fundamental great principle” of TCM gynecology.
🌸 Milestone Three · The Fu Qingzhu Nyuke
Míng–Qīng · Fù Shān, Fu Qingzhu Nyuke (《傅青主女科》), 2 scrolls — taking “liver depression” as the core — created “Dìng Jīng Tāng” and “Xuān Yù Tōng Jīng Tāng” — still today the core formulas of TCM gynecological clinic — “the Fù family alone, the sage of gynecology.”
🌸 Milestone Four · The Nüke Zhengzong
Qīng · Xiāo Gēngliù (萧赓六), Nüke Zhengzong (《女科正宗》) — along with Chén Zìmíng and Fù Shān jointly known as the “Three Great Masters of TCM Gynecology” — emphasizing the three great principles of “regulating menstruation, seeding offspring, and protecting the fetus” — the “comprehensive summary” of TCM gynecology.
3. Modern TCM Gynecology
- 1950s — TCM hospitals established the “gynecology” department —
- Modern — the advantageous clinical conditions of TCM gynecology — menstrual disorders, infertility, uterine fibroids, ovarian cysts, perimenopausal syndrome —
- Integration of Chinese and Western medicine — TCM cycle regulation + Western assisted reproduction — TCM gynecology is a “brilliant calling card” of Chinese cultural export.
Source: Tang · Zǎn Yīn, Jingxiao Chanbao (Zhongyi Guji Chubanshe punctuation-and-collation edition); Southern Song · Chén Zìmíng, Comprehensive Good Formulas for Women (People’s Medical Publishing House punctuation-and-collation edition, 1992); Qīng · Fù Shān, Fu Qingzhu Nyuke (Shanghai Science and Technology Publishing House, 1959).
VII. TCM External Medicine: From the Liu Juanzi Gui Yi Fang to the Waike Zhengzong
“The difficulty of external medicine is the difficulty of pattern identification;
The essence of external medicine is the integration of internal and external treatment.」」
1. Overview of the Sources and Flow
TCM External Medicine — the discipline of Chinese medicine with the most distinctive “craft” character — from the Zhou Li · Tianguan’s “Ulcer Physician” — to the Liu Juanzi Gui Yi Fang — to Chén Shígōng’s Waike Zhengzong — to Wáng Hóngxù’s Waike Zhengzhi Quansheng Ji — to the modern TCM external medicine — spanning more than 2,000 years — it is the “root” of Chinese “surgery.”
2. Five Milestones
🔪 Milestone One · Huà Tuó and the Mafei Powder
Eastern Han · Huà Tuó — the invention of “Mafei Powder” — “to cut open the abdomen and back, and to extract and excise the masses” — the founding of TCM surgical operations — still today the “ancestor” of TCM external medicine.
🔪 Milestone Two · The Liu Juanzi Gui Yi Fang
Liúsòng of the Southern Dynasties · Liú Juānzǐ (collated by Gōng Qìngxuān) — Liu Juanzi Gui Yi Fang (《刘涓子鬼遗方》), 5 scrolls — the earliest extant monograph on TCM external medicine — recording more than 140 formulas — the “dual-track” system of “internal + external” treatment — the disciplinary framework of TCM external medicine — still today the “fundamental great principle” of TCM external medicine.
🔪 Milestone Three · The Waike Jingyao
Southern Song · Chén Zìmíng, Waike Jingyao (《外科精要》), 3 scrolls — for the first time elevating external medicine from “experience” to “theory” — “The difficulty of external medicine is the difficulty of pattern identification” — laying the foundation for the “disciplinarization” of TCM external medicine.
🔪 Milestone Four · The Waike Zhengzong
Ming · Chén Shígōng, Waike Zhengzong (《外科正宗》), 4 scrolls — the ancestor of the “Orthodox School of External Medicine” — recording more than 40 external-medicine surgical procedures — “nasal polyp removal,” “oral mucous cyst excision,” “tracheal suturing” — the “clinical standard” of TCM external medicine — still today the core reference of TCM external-medicine clinic.
🔪 Milestone Five · The Waike Zhengzhi Quansheng Ji
Qīng · Wáng Hóngxù, Waike Zhengzhi Quansheng Ji (《外科证治全生集》), 4 scrolls — the ancestor of the “School of Complete Life in External Medicine” — emphasizing the treatment of “yin-type abscesses” — created “Yáng Hé Tāng (阳和汤, Yang-Activating Decoction)” — still today a commonly used formula in Chinese clinical medicine.
3. The “Three Great Schools” of TCM External Medicine
| School | Representative Work | Core Doctrine |
|---|---|---|
| “Orthodox School (正宗派)” | Waike Zhengzong | “Resolving (消), expressing (托), supplementing (补)” three methods; equal emphasis on internal and external treatment |
| “Complete-Life School (全生派)” | Waike Zhengzhi Quansheng Ji | “Distinguishing yin-type and yang-type abscesses”; “the preciousness of resolution” |
| “Personal-Insight School (心得派)” | Waike Xinde Ji | “Three-burner pattern identification” applied to external medicine |
Source: Ming · Chén Shígōng, Waike Zhengzong (original), Shanghai Science and Technology Publishing House, 1989; Qīng · Wáng Hóngxù, Waike Zhengzhi Quansheng Ji (original); Qīng · Gāo Bǐngjūn, Waike Xinde Ji (original).
4. Modern TCM External Medicine
- 1950s — TCM hospitals established the “external medicine” department —
- Modern — the advantages of TCM external medicine — anal-intestinal (hemorrhoids, fistulas), dermatology (eczema, psoriasis), ulcers and sores (diabetic foot), bone-setting (cervical and lumbar vertebra disease) —
- Integration of Chinese and Western medicine — TCM pattern identification + Western surgery — TCM external medicine is the manifestation of Chinese medicine’s “distinctive features.”
VIII. Comparison Table of the Six Great Branches of Chinese Medicine
“The six branches share the same root, each with its own strengths.」」
| Discipline | Founding Work | Founding Father | Cumulative Work | Modern Status |
|---|---|---|---|---|
| Chinese Medical Formula Studies | Wushier Bingfang | (Anonymous) | Yifang Jijie | Core course |
| Pulse Diagnosis | Huangdi Neijing | (Qí Bó · Huángdì) | Bihu Maixue | Diagnostic foundation |
| Acupuncture | Lingshu (Needling Classic) | Qí Bó · Huángdì | Zhenjiu Dacheng | International calling card |
| TCM Pediatrics | Key to Therapeutics of Children’s Diseases | Qián Yǐ | You You Ji Cheng | Clinical advantage |
| TCM Gynecology | Jingxiao Chanbao | Zǎn Yīn | Fu Qingzhu Nyuke | Distinctive specialty |
| TCM External Medicine | Liu Juanzi Gui Yi Fang | Liú Juānzǐ | Waike Zhengzong | Distinctive specialty |
IX. The “Three Great Characteristics” of TCM Specialization
1. Premature Maturity
The Zhou Li · Tianguan already had the specialization into “Dietary Physician, Disease Physician, Ulcer Physician, and Veterinarian” — hundreds of years earlier than the specialization of ancient Greek medicine in Europe — the pioneer in the history of world medical specialization.
2. Systematic
From the Warring States to the late Qīng — spanning more than 2,000 years — each branch went through a complete process of “founding — development — contention — cumulative synthesis” — the model of the development of traditional Chinese disciplines.
3. Mutual Rooting
The six great branches — take the theory of the Neijing as the root — the pattern identification of the Shanghan as the method — the medicinal substances of the Bencao as the materials — divided, they are six trees — united, they are a whole forest — between division and union — the “holistic view” of Chinese medicine is manifest before one’s eyes.
X. Echoes in the Modern World
🏥 TCM Specialization and Modern TCM Hospitals
In 2024 — there are 4,662 TCM hospitals nationwide — with departments for “TCM Internal Medicine, TCM External Medicine, TCM Gynecology, TCM Pediatrics, Acupuncture, Tuina, Orthopedics and Traumatology, Eye Medicine, Ear-Nose-Throat, Dermatology, Anal-Intestinal, Preventive-Treatment” and others — in direct continuity with the traditional TCM specialties.
🎓 TCM Specialization and the Curriculum of Universities of Chinese Medicine
Contemporary universities of Chinese medicine — have set up “Foundations of Chinese Medical Theory, TCM Diagnostics, Chinese Materia Medica, Chinese Medical Formula Studies, Internal Medicine of Chinese Medicine, External Medicine of Chinese Medicine, Gynecology of Chinese Medicine, Pediatrics of Chinese Medicine, Acupuncture, Tuina, Orthopedics and Traumatology of Chinese Medicine” and others — these disciplines — can all be traced back to the “history of the six great branches” of this essay.
🌍 TCM Specialization and World Medicine
The WHO in 2002 issued the International Standard of Acupuncture Point Locations (361 points) — directly derived from the 349 points of the Jiayi Jing + the 359 points of the Zhenjiu Dacheng — “specialization” has made it easier for Chinese medicine to go out into the world.
XI. Coda: Why Specialization Matters
“Without division, there is no discipline;
without union, there is no system.」」
Three Great Reasons
1. Clinical Need
In Chinese clinical practice — internal, external, gynecology, pediatrics, acupuncture, bone-setting, eye, throat, dermatology — specialization allows the physician to “specialize” — excellent in one branch — this is the modern “subspecialty” of medicine — TCM’s specialization — was hundreds of years earlier than Western medicine’s.
2. Academic Need
Specialization — allows Chinese medicine’s scholarship to be “transmittable, inheritable, researchable, and deepenable” — the foundation of the disciplinarization of Chinese medicine.
3. The Need for Internationalization
Specialization — allows Chinese medicine to dialogue with the world — acupuncture, gynecology, orthopedics and traumatology — these specialties — are the “door-openers” for Chinese medicine to go out into the world.
🪶 A One-Line Summary
“One tree does not make a forest; the six branches have made a thousand years;
The greatness of Chinese medicine lies not only in the depth of its theory,
but also in the completeness of its disciplines.」
XII. A Word from Qihuang Library
“From the Wushier Bingfang to the Yifang Jijie, it is the long river of Chinese Medical Formula Studies;
From the Mai Jing to the Bihu Maixue, it is the staircase of pulse diagnosis;
From the Jiayi Jing to the Zhenjiu Dacheng, it is the summit of acupuncture studies;
From the Key to Therapeutics of Children’s Diseases to the You You Ji Cheng, it is the depth of pediatrics;
From the Comprehensive Good Formulas for Women to the Fu Qingzhu Nyuke, it is the subtlety of gynecology;
From the Liu Juanzi Gui Yi Fang to the Waike Zhengzong, it is the practice of external medicine.
The six great branches together form Chinese medicine’s “forest of disciplines.”」
Today, when we write a prescription — we use the wisdom of “Chinese Medical Formula Studies”; when we take the pulse — we use the subtlety of “Pulse Diagnosis”; when we insert a needle — we use the standard of “Acupuncture Studies”; when we treat a child’s illness — we use the tradition of “Pediatrics”; when we regulate a woman’s menstruation — we use the depth of “Gynecology”; when we treat an external-medicine condition — we use the practice of “External Medicine.”
These six great branches — are not “isolated” — they “share a root” — rooted together in the Neijing — rooted together in the Shanghan — rooted together in the “holistic view” and “pattern identification and treatment” — rooted together in three thousand years of clinical practice and reflection.
“Ten thousand formulas and subtle pulse texts, the 361 acupoints of acupuncture;
Pediatrics, gynecology, surgery all complete, the six branches sharing one root is Chinese medicine.」
Qihuang Library — together with you — has walked through the “past” of Chinese medicine — from the ancient past to the Ming and Qing — from canonical texts to specialization — from the ten great physicians to the six great branches — has walked through the “present” of Chinese medicine — has entered the “age of great physicians” — has entered the “contention of schools” — has entered the “cumulative synthesis and new heaven” — has entered the “voyage abroad and rebirth” — has seen clearly the “future” of Chinese medicine — “inherit the essence, guard the foundations, and innovate” — this is the path of Chinese medicine — and this is our path.
📜 Three thousand years of Qihuang, ten thousand scrolls of six branches;
The torch passes from hand to hand, ever-renewing, never-ceasing.