It goes without saying that medical treatment is needed throughout the life style, and is closely related to psychosomatic health. Therefore, the origins and development of the medical system were closely connected with living and production environments. Intelligence and spirit pursuits in different times and areas also had a tremendous impact on medicine. In ancient times the Chinese civilization emphasized life, health, genetics and heredity, prevention and treatment of diseases, which are also the foundation of traditional Chinese medicine. Undoubtedly, oriental wisdom is rooted in these concepts and behaviors.

There are records in the oracle-bone inscriptions about regular face and hand washing, as well as baths. In 1953, the relics excavated from archaeological sites dated to the Shang Dynasty （16 ^th century-11 ^th century B.C.） included a whole set of toiletries, such as kettles, jars, ladles, plates, pottery, scrubbing boards and combs.

In the Western Zhou Dynasty （11 ^th century-221 B.C.） there was a variety of foods and culinary arts made important advances. People paid more attention to food hygiene and therapy, for example, different meats were recommended to be eaten in different seasons along with appropriate seasonings. Food and dishes should be combined in harmonious ways.

An imperial official was especially assigned to manage “ice affairs”, and icehouses were constructed to store ice.

“Roten rancid, or foul-smelling meat or fsh should not be eaten.” （ The Analects ofConfucius, Lún Yŭ, 论语）

Chinese people attached great importance to maintaining a peaceful and cheerful mind, which can be seen from the ancient cultural relics such as gem clusters, inscriptions on pottery, pieces of bones, and other adornments. Spiritual and cultural life was also seen in the activities of divination, pray-healing, worship ceremony, songs and dances.

Folk beliefs and customs handed down through the generations had significant influence on the original concept of “body and spirit factors” in traditional Chinese medicine. In a sense, we can say that “psychosomatic treatment” grew out of these folk traditions.

Ancient classics point out that the occurrence of diseases is often connected with mental factors. People at that time knew “rage triggers diseases”, “sorrow makes one fall ill” and “critical illness leads to death”.

Ancient Chinese attached great importance to their living environments and drinking water hygiene. They preferred to live in higher, dry places near rivers and build their dwellings so that they faced south. They thought that disease was also caused by irregular lifestyle or imbalance of work and rest. It seems that ancient people understood disease was caused by both internal and external factors, which has significant influence on the theory of disease causation.

According to legend, in the era of Huang Di water wells appeared. Sludge in wells and ditches made water murky and impure, so people often dredged wells and cleaned out ditches. A large number of well lids and fences were unearthed in archeological excavations. Dredge pipes from the Shang Dynasty （16 ^th century-11 ^th century B.C.） were discovered in Yin Ruins near Zhengzhou, Henan Province.

The word “pigpen” appeared in the oracle-bone inscriptions, indicating that people and livestock lived separately, and there were also records of separate sources for indoor and outdoor water, as well as the cleaning and killing of insects.

The Book of Songs recommends several methods to get rid of insects and vermin, including spreading plasters on walls, stopping up holes, fumigating, spraying lime, and routine general house-cleaning. It also suggests blocking-up north-facing windows and wooden doors with mud to keep out the cold.

According to the Rites of Zhou officials in charge of environmental health were appointed at that time.

In ancient times, male and female cohabitation was common and people frequently changed partners. There were no restrictions on sexual relationships and no rigid concepts of marriage and family.

After matriarchal society and free sexual relationships were no longer common, communal marriage based on blood ties emerged. Family communal marriage meant that brothers and sisters could get married. In the ancient myth of Fu Xi and Nü Wa, these two were husband and wife as well as brother and sister, reflecting the fact that family communal marriage existed in ancient times.

Later, people found that descendants of different blood lines were far healthy and stronger than those born from communal marriage. The system of family communal marriage gradually transformed into non-family communal marriage, which was the advanced stage of communal marriage.

Legend has it that Shun of the Xia Dynasty （21 ^st century-16 ^th century B.C.） took E Huang and Nü Ying, Yao’s two daughters, as his wives. His brother plotted to murder him in order to take the two women as his wives. This kind of marriage in which two brothers married two sisters from another clan indicates that in the Shun’s times communal marriage was still prevalent but in a more advanced form.

Under such circumstances a child’s mother had several sexual partners, and it was difficult to confirm the identity of the biological father.

Our ancestors realized that changing the marriage system from communal marriage to a single, fixed spouse, and forbidding marriage between family members could prevent genetic diseases. “The age for marriage should be about 30 for men and 20 for women” and “marriage between people with the same surname is not allowed”were listed in The Book of Rites. We can say that this was a great leap forward in the history of Chinese civilization, and was beneficial for the evolution of the human physique, eugenics, healthy birthing and healthy child rearing.

In the ancient oracle-bones, we find records of diseases being caused by “worms”or “parasites”. This is an example of a concrete, specific disease cause. However, other, non-tangible factors, such as natural environment and climate, diet and residence were also emphasized. Afterwards, Yi He （600 B.C.）, the famous physician in the Spring and Autumn Period （770-476 B.C.）, put forward the “theory of the six qi or climatic factors, which would lead to various illness”. These are considered generalized disease causes. In later ages, people found “an agent that triggers consumptive disease”, “tapeworm” and “chigger mites”, but ultimately the concept of “agent-induced diseases” was replaced by the theory of the six adverse environmental conditions—wind, cold, dryness, dampness, fire and summerheat. The agent-induced disease causes can be verified by empirical approaches, while the generalized disease causes are difficult to verify by using scientific approaches.

The generalized disease causes originated from Chinese traditional ontology based on “original qi”, which also led to the exclusion of agent-induced disease causes from the theoretical system of traditional Chinese medicine. However, the illogical theory of generalized disease causes was accepted. Although there were records from thousands of years ago showing the concept of diseases caused by substantial agents, these were not adopted. The concept of treatment based on syndrome differentiation using categories of yin and yang, exterior and interior, cold and heat and deficiency and excess had inadequate logical connections to the agent-induced disease causes.

Therefore, when traditional Chinese and Western medicine are integrated in clinical practice, no matter how accurate the Western medicine diagnosis may be, if traditional Chinese medicine is suggested as a treatment, syndrome analysis must be done on the basis of the “six pathogenic factors” and “seven emotions”, in order to reach a conclusion.

“Nipping it in the bud” ^[11] is a Chinese old maxim. In the face of suffering from disease, people longed for effective prevention and “prevention first” became the goal of medicine.

At first, ancient people were afraid of diseases because they could not comprehend them. But gradually they began to understand that climatic and environment changes were related to disease. They attempted to control climatic changes and defend themselves against diseases.

In early times, people asked for blessings from the gods in order to get rid of diseases, bad omens and evils. Later on, they had a vague awareness of prevention. They knew using different types of wood for fuel could prevent epidemic diseases.

People used breath regulation exercises and imitated the movements of birds and animals to tone up and prolong life.

Killing rabid dogs

There are records about killing rabid dogs in The Commentary of Zuo, which suggests that people knew the harm of rabies and it could not be cured, making it morally acceptable to kill them.

Taking medicinal herbs to prevent disease

About 60 kinds of medicinal herbs are recorded in The Classic of Mountains andSeas: 8 for legendary venomous worms, 8 for epidemic diseases, 25 tonics, 8 for sense organ disorders, 8 for skin and external disorders, 4 for internal organs, 2 for contraception, and 1 for animal bites. This indicates that in the Spring and Autumn Period （770-476 B.C.） people began to know that some medicinal herbs were effective in the prevention of diseases.

In addition, rites were held during the Dragon Boat Festival, Double Ninth Festival and on New Year’s Eve to prevent seasonal diseases. For example, people drank realgar liquor, mugwort leaf liquor, burned atractylodes rhizome and angelica root as fumigation, took sweetflag rhizome and mugwort leaf baths, and covered their foreheads with realgar during the Dragon Boat Festival. They also drank cornus liquor, winter-made wine, and pricklyash wine in the Double Ninth Festival, and drank pricklyash-arborvitae leaf liquor, spiced sake, peach soup, and burning cloves or honeylocust on New Year’s Eve to expel epidemic diseases.

Dao yin is an ancient form of exercise to keep fit, and evolved from primitive dancing. Primitive dancing was also the origin of tui na/massage and other physical exercise therapies.

In primitive society, dancing was performed after hunting or taking revenge for blood relatives, having a good harvest, after the birth of infants and for social events in order to express their happiness, allay fatigue, consolidate clan unity and express hope for a good future life. Based on the movements of dancing, dao yin exercises developed.

According to legend, in the era of Yao and Shun there were many floods. The cold and wet weather caused people to be disgruntled. They suffered from swollen legs and feet and tight muscles. To alleviate these conditions, people began to create some movements similar to dancing in order to exercise the joints, dredge blocked qi and blood, and remove dampness.

Dao yin and tui na were developed from ancient dancing according to The YellowEmperor’s Inner Classic. “Dao yin” was considered an important form of health care in ancient times.

In terms of nurturing life, The Yellow Emperor’s Inner Classic clearly points out that people should “avoid attacks by seasonal prevailing evils. When one is indifferent to fame and gain, and enters the state of emptiness, original qi can be replenished and preserved. Keep a sound mind, and disease will never occur.” ^[12] All of the above shows it was considered important to conform to nature and seasonal changes. Exercise and rest are necessary but too much of either is harmful. Ancient Greek physical fitness focused on seeking extraordinary physical strength and endurance, which was quite different from what the Chinese pursued. Various forms of nurturing life, whether for prevention of diseases or prolonging of life, developed in later ages. All followed the principle of conforming to nature.

There are records of using animals as medicine in The Classic of Mountains andSeas. It says “eating river fish may cure carbuncles, and a bird, named Qing Geng, is effective against epidemic diseases.” ^[13]

Along with the development of mining and smelting, people began to understand the properties of minerals and their effects on diseases. For example, sulfur had yang invigorating properties and mercury had insecticidal actions. When they boiled the salt off the water, they found salt water could improve vision and mirabilite was a purgative.

There are no records of medicinal substances in the oracle-bone inscriptions, but in the pre-Qin period （21 ^st century-221 B.C.）, medicinal substances were recorded in Rites of Zhou, The Book of Songs and The Classic of Mountains and Seas.

There are records about the medicinal use of animals and plants with brief descriptions of their actions including 50-odd. medicinal herbs in The Book of Songs. Some of them are still in use today, such as ài yè （Folium Artemisiae Argyi）, bèi mŭ （Bulbus Fritillariae）, chē qián zĭ （Semen Plantaginis）, cāng ĕr zĭ （Fructus Xanthii）, gŏu qĭzĭ （Fructus Lycii）, zé xiè （Rhizoma Alismatis）, sāng jì shēng （Herba Taxilli）, tù sī zĭ （Semen Cuscutae）, qīng hāo （Herba Artemisiae Annuae）, huáng qín （Radix Scutellariae）, sháoyào （Radix Paeoniae Alba seu Rubra）, bái máo gēn （Rhizoma Imperatae）, qiàn căo （Radix et Rhizoma Rubiae）, nǚ zhēn zĭ （Fructus Ligustri Lucidi）, gé gēn （Radix Puerariae Lobatae）, guā lóu （Fructus Trichosanthis）, xiāng fù （Rhizoma Cyperi）, bái zhĭ （Radix Angelicae Dahuricae）, chuān wū （Radix Aconiti）, căo wū （Radix Aconiti Kusnezoffii）, táo rén （Semen Persicae）, sāng yè （Folium Mori） and dà zăo （Fructus Jujubae）.

The Classic of Mountains and Seas is a geographic book on Chinese well-known mountains and rivers, in which 126 medicinal substances are listed, including 67 animal medicinal substances, 52 herbs, 3 mineral ones, 1 watery kind, and 3 from unknown sources.

In terms of their actions, they are classified into tonics, agents for growing seeds, contraception, prevention of diseases, killing vermins, resuscitation, treatments for livestock diseases, poisons, and antidotes to poisons.

It is very significant that it records 31 medicinal substances which are effective in the treatment of internal, external, women’s, eye and skin disorders. Usually one ingredient is indicated for one disorder, but some are put together into “formulas”, such as a 6-herb formula for wind disorders, a 7-herb formula for eye disorders and a 5-herb formula for skin disorders. It also clarifies that one ingredient can be effective for treating a few different disorders, so, for example, herbs for hemorrhoids also treat sores, and herbs for contraception also kill vermin. At that time, the principles of herbal compatibility still in use today appeared in an embryotic form. The basic principles behind herbal medicine had already been evident. Namely that single ingredients are often unable to cure diseases, and that herbs should be combined in compatible ways to achieve optimal results. These are the main features of Chinese herbal medicine today.

Medicinal herbs were either orally administered or taken as food. The external treatments included wearing certain objects, siting or lying on certain things, bathing with herbs, and applying compresses and salves.

From the Western Zhou Dynasty to the Spring and Autumn Period （11 ^th century-476 B.C.）, people began to acquire knowledge of poisons such as wū tóu （Radix Aconiti Kusnezofi, Radix Aconiti）, máng căo （Illicium lanceolatum A.C. Smith）, yuán huā （Flos Genkwa） and bái fán （Alumen）. Their experiences with medicinal substances accumulated over time and laid the foundation for the compiling of the Shen Nong’sClassic of the Materia Medica （Shén Nóng Bĕn Căo Jīng, 神农本草经）, the first Chinese monograph on medicinal substances.

The Book of Rites warns people “only seek the services of doctors that have medical experience handed down from their great grandparents” ^[14], which indicates that people attached importance to medical inheritance and experience.

In primitive society, man and animals lived together and human beings were easily harmed by animals. In addition, the working conditions were so bad that injuries from falls, fractures, concussions and strains, as well as from fights between tribes, were frequently seen. On these occasions, people used clay, ashes, lichen and grass blade to stop bleeding and reduce pain. They also utilized bandages, removed pus and rubbed muscles and joints to reduce pain. Repeated use of these practices gave birth to external treatments. Primitive instinctive massage was applied to relieve general pain due to cold and abdominal fullness due to improper diet, which became the basis for present-day tui na.

When human hygiene became a social issue, it was necessary to establish relevant regulations and management. In the middle and late period of the slave society, the social divisions of labor were further expanded and greater professionalization developed. Medicine gradually cast off the yoke of witchcraft and developed independently.

A strict, comprehensive examination system was established in the Zhou Dynasty （11 ^th century-221 B.C.）, which, no doubt, promoted independent development of the medical system.

According to Rites of Zhou, imperial court physicians were divided into four categories, namely, dietitians, physicians of internal medicine, surgeons, and veterinarians. Dietitians were in charge of the imperial family’s nutrition and healthy diet, and imperial court physicians not only gave service to the imperial family, but also took care of common people’s health. The appearance of branches of medicine represented a great advance in medicine.

In the Zhou Dynasty （11 ^th century-221 B.C.） medical staff had different official positions. Chief physicians were in charge of government medical decrees （policy）and prevention and treatment of diseases for the imperial family. They were also in charge of carrying out annual assessments of physicians. Based on the results of their medical practice, their rank and salary would be determined for the following year. Physicians shouldered responsibility for giving medical service. Imperial medication supplies, medical equipment and accounting services were taken care of by medical managers. Medical archivists managed documents and medical records. There were also nurses and orderlies.

In the Zhou Dynasty （11 ^th century-221 B.C.）, there was a system for case and death reports. Rites of Zhou says, “when they fall ill, people are treated by physicians of different medical branches. The result of treatment is recorded as experience. When one dies, the cause must be made clear.” ^[15] It means that case reports are beneficial to drawing lessons from the past and for public administration. Reporting the cause of death was a significant contribution to human history.

In the Zhou Dynasty （11 ^th century-221 B.C.）, the position of prime minister was set up and there were officials in charge of ice storage and supply for the imperial family. Imperial maids took care of the hygiene of the bedrooms and other facilities. Imperial dietetic hygiene was managed by special staff. Local officials were sent to inspect the disaster areas when pestilence occurred. Special local officials were appointed to be in charge of environmental health and prevention of epidemics.