TCM OBGYN History and Development: Acupuncture CEU Course 2018-08-27T17:19:51-08:00

Integrative Women’s Health Program | Acupuncture CEU Course

TCM OBGYN History and Development

A one hour CEU Video course. This course is the first in a series of TCM and Integrative Women’s Health.

The field of Traditional Chinese Reproductive Medicine has a rich history of development spanning the last 2,000 years and much of the focus has been centered around conception, pregnancy, and postpartum care. From the essential beginnings to modern day, this course presents an overview of classic works and their authors.  By understanding some of the original classical works in TCM obstetrics and gynecology such as Fu Ren Liang Fang and Jin Gui Yao Lue, we can begin to appreciate the clinical significance and effectiveness of herbal therapy and acupuncture treatments that have been time tested for the treatment of OB GYN issues.

On completion of this class the participant will:
• Gain a summary framework for understanding the TCM approach to OB Gyn, including reference sources describing clinical treatment methods.
• Become familiar with the TCM treatises that present herbal formulations widely used to address pregnancy, labor and postpartum issues.
• Gain an introduction to the standards of diagnosis and treatments used to address fertility issues in TCM.

With: Dr. Daoshing Ni, Yo San University chair of Doctoral program in Women’s Health and Reproductive Medicine
1 ½ Units/PDA      
$15      Includes .pdf notes, online quiz and certificate of completion (free to watch this video)

First Time User?

Approved for CEU/PDA by:
NCCAOM Details: Core Competencies: AOM/Biomedicine: 1 ½ PDA
California Details: California Category 1: 1 ½ CEU

Course Outline:

  1. Study Approach to the History and Development of TCM OBGYN
  2. Shan Shui Jing 山水經 Book of Mountains and Seas
  3. Huang Di Nei Jing Su Wen: Yellow Emperor’s Classic of Internal Medicine – Simple Questions
  4. Shi Ji Historical Annals
  5. Han Shu: Book of Han
  6. Hou Han Shu: Book of the Later Han
  7. Tai Chan Shu: The Book of Pregnancy, Labor and Postpartum
  8. Shen Nong Ben Cao Jing: The Classics of Herbal Medicine
  9. Jin Kui Yao Lue Fang Lun: Discussion of Prescriptions of the Golden Chest
  10. Mai Jing: Pulse Classic
  11. Zhu Bing Yuan Hou Zong Lun: General Treatise on The Symptomatology and Etiology of Disease
  12. Qian Jin Yao Fang: Thousand Golden Ducat Prescriptions
  13. Bei Ji Qian Jin Yao Fang: Prescriptions Worth a Thousand in Gold for Every Emergency
  14. Wai Tai Bi Yao: Medical Secrets of an Official
  15. Jing Xiao Chan Bao: Treasure of Obstetrics
  16. Shi Chan Lun: Discussion of Ten Labors
  17. Wei Shen Jia Bao Chan Ke Bei Yao
  18. Nv Ke Bai Wen: Hundred Questions in OBGYN
  19. Fu Ren Liang Fang Da Quan: Great Treatise of Useful Prescriptions for Women
  20. Liu Wan Su
  21. Zhang, Cong Zheng
  22. Zheng Zhi Zhun Sheng: Standards of Diagnosis and Treatments
  23. Nu Ke Zuo Yao: Summary of Gynecology and Obstetrics
  24. Guang Si Ji Yao: Summary of Fertility
  25. Ji Yin Gang Mu: Compendium of Therapy of Women’s Diseases
  26. Jing Yue Quan Shu: Complete Works of Jing Yue
  27. Fu Qing Zhu’s Gynecology
  28. Yi Zong Jin Jian: Golden Mirror of Medicine
  29. Da Sheng Bian: Treatise on Obstetrics
  30. Yi Lin Gai Cuo: Correcting the Errors in the Forest of Medicine
  31. Xue Zheng Lun: Discussion on Blood Syndromes
  32. Yi Xue Zhong Zhong Can Xi Lu: Records of Combined Chinese and Western Medicine
  33. Major Texts of TCM Universities and Colleges
  34. Zhong Yi Fu Chan Ke Xue: “TCM Science of OBGYN”

Transcript:
TCM OBGYN History and Development: The Classical Literature

  Today I’m here to share a my experience and learning in TCM OBGYN.

In the area of historical development I firmly believe to be a good practitioner

Of integrated Women’s Health Care  we must really understand  the fundamentals of TCM.

And part of it is to relocate a history look at how we’ve developed look at some of the important Classics that support our work today.

  And as you know TCM OBGYN has been around for quite a while

It has a rich history that spans  around two thousand years.

And much of a focus has been on pregnancy trying to help someone pregnant a couple pregnant conception.

And on post post partum care. and a wealth of experience

and information has passed down to us via some of  these Classics that we will be looking at.

  The essential beginning with u starter in around 216 A.D. when dr. Zhang Zhong Jin

has basically written the book of Shang Han Lun and also the Jin Gui Yao Lue which is the essential prescriptions of the golden cabinet.

In that book The three chapters 20 chapter 21 chapter 22.

On the pulse pants and treatments of diseases in pregnancy post partum disease and miscellaneous gynecological diseases.

  This is such a seminal work even today a lot of formulas that existed on that book are still widely used.

  And from this point to now

we have a great now called the TCM science of Ob-Gyn or Zhong Yi Fu Chan Ke Xue.

The first edition was publishing 2001.

And the second edition was published in 2011 by The People’s medical Publishing House in China.

The editors are reputable famous physician today in their own right. dr. Liu Min Ru and dr. Tan, Wan Xin

And they were helped and written by over 73 well-known TCM OB-GYN doctors.

  This is the most comprehensive text today in the most widely used for TCM and integrative OBGYN.

  When we study we need to approach on how to study TCM OBGYN because there’s just so much information.

What event is to actually study the background the history.

The classics the people that’s involved in this field to formation by understanding that nothing for suffering work.

So since most information in clinical medicine has been preserved and documented in the classical books therefore our approach is to gain understanding.

And try to appreciate these Classics through a time shall we say a chronological process There are countless books.

What we call Classic for the truth is not old books create impact.

So I’m going to do today is look at some of these Classics that have created impact and we can look at some of the things that happen if they have contributed to this field.

So we will focus on the ones that have the greatest impact on the development of TCM OBGYN.

The very first book is Shan Shui Jing.

This book is what we called the book of mountains and seas.

We don’t know who wrote it,  multiple authors and the author’s existed there around approximately 476 – 221 BC during the warring States era.

It contains descriptions of geological features locations medicine and animals you can almost say that this is like a Farmer’s Almanac.

  Encompasses everything and this is the earliest text that actually documents and describe medicine

that has been used to treat infertility I will say this is probably one of the earliest documents of any kind of healthcare or any kind of treatment for woman’s health.

And the next book would be Huang Di Nei Jing as you know has two parts of it Su Wen is a theoretical Foundation Ling Shu is mostly focus on acupuncture so we are looking at a Su Wen  mostly.

In the simple questions we call Yellow Emperor’s classic of internal medicine in the simple question section

we don’t really know who wrote these two sections but we do know

it’s probably not Huang Di. Now we do know its probably numerous unknown author’s compiling putting things together and this book probably is around written around 99 to 26 BC.

Again in the warring states era to the Han Dynasty era. It was written

in a way that it’s about discussions between Huang Di and his ministers such as Qi Bo or Lei Gong Yu Fu

and such as Shao Shi, Gui Yu Qu and it’s mostly health issues and and questions.

So meaning have references to OBGYN and really this book is considered to be the first fundamentals of OBGYN in TCM.

  So if we look at Su Wen, Su Wen has given a lot of different contributions the first is on the anatomy.

Is the First to mention the female womb or Nv Zi Bao,

which basically is uterus it talk about Bao Mai which is the womb Meridian its the meridian and vessels that runs into the uterus and it talks about Bao Luo is the womb collateral.

Nv Zi Bao it acts like a Zang Fu  and he acts like a drum when you can transform Jing, Qi and blood to nourish the fetus,

and creates menstrual flow and it also acts like a Fu,

at the same time because you can store and discharge Essence Chi and blood so therefore

this is kind of like the first organ that we consider this as an extraordinary Fu organ we call that Qi Heng Zi Fu.

Continuing onward Su Wen talks about about the Bao Mai

Bao Mai belongs to the heart and connects to the Bao connects to the uterus and connects to the house that houses the fetus.

Bao Luo belongs to the kidney and connects to the uterus so Bao Mai and Bao Luo it’s a connection between heart to the uterus and kidney to the uterus so that’s the contribution of Su Wen on the anatomy.

  And if we look at Su Wen on physiology

it describes the 7 x 7 order and 8 x 8 reproductive physiology for both women and men.

It first describes the function,

of these points we call the Tian Kui we could I have the water Chong and Ren channel as well as Kidney Chi.

In the reproductive function in reproduction it also describes the unique female physiology of menstruation pregnancy labor and breastfeeding.

In pathology Su Wen pointed out that women tend to have excessive Qi.

But always somewhat lacking in blood so this paved the foundation for a lot of blood nourishing methods of treatment it also describes pathology underlying abnormal uterine bleeding, amenorrhea abnormal vaginal discharge conditions of infertility Zheng Jia which is pelvic Mass conditions things like today like ovarian cyst issues dermoid cyst issues or uterine fibroid issues and adenomyosis issues dysphonia during pregnancy and other conditions.

He also talked about that excessive sadness depletes Bao Luo

and yang qi moves internally upward to  disturb the heart.

So the regulation of blood is impaired causing abnormal uterine bleeding.

He talks about how emotion, he talks about for the first time how emotional factors can be a disease causative factor.

In the diagnosis Su Wen pointed out the observation of color changes.

And other changes especially below the nose can be an indication of female reproductive organ issues especially the lips area as well as the philtrum area.

It also described that the more obvious movement of the hand Shao Yin Channel pulse can be an indication of pregnancy that’s basically your heart pulse.

It also describes that weakness of both kidney pulse can be an indication of amenorrhea so if that pulse  weakens dramatically then you might see in the amenorrhea  condition situation.

In herbal therapy Su Wen is not a book that has a lot of herbal formulas in fact we know it it listed approximately only 13 formulas is more of a theoretical Foundation.

But interesting enough there is one of the formula called a Si Wu Zei Gu Yi Lu Ru Wan which is a combination of Endoconchasepiae it’s the soft bone of the kettle fish and and rubia cordifolia.

In a dosage of four to one ratio and it appeared this formula appeared in one of the 13 formulas in the Huang Di Nei Jing and is used in irregular menstruation,

depletion of menstruation so it is we know that already in Huang Di Nei Jing there is already a start a starting of this  herbal therapy process.

To continue to the historical annals Shi Ji it’s a very useful book especially for Scholars of Chinese culture and history as a wonderful way to take a peek of what’s going on in the Qin and Han Dynasty.

And this book is written by Si Ma Qian the exact time is unknown when this book was written but we do know this is all about the Han Dynasty situation.

In fact it’s a description of History from the Huang Di era to the Han Dynasty so it spans about 440 years from 221 BC to about 220 AD.

It described the first specialty of an OBGYN which is Bian Que.

I think we have heard Bian Que was a very famous acupuncturist and one thing that we you may not be aware he’s also very famous OBGYN.

It also in this book documents the clinical cases of amenorrhea and lactation deficiency.

Han Shu is the book of Han basically the historical book that covers the first part of the Han Dynasty. The Han Dynasty has really two parts to it.

There is what we called the formal Han or the early Han and then the later Han. 

okay so this  book of Han really covers the early part of it fun 206 BC to 23 AD.

In this book it described the installation of female OB-GYN specialty doctors in the Imperial Court.

The famous ones are Yi Xu and Chun Yu Yan these two famous women.

In fact you could say that in documentation wise these OBGYN are female in this the  first document of a female OBGYN TCM OB-GYN physician in a Chinese history.

In the use of herbs this book also describe the use of herbs to actually cause abortion.

And also looking at and documentation of abnormal fetus are also is there. So its a wonderful book to kind of show what that early Han dynasty is all about later on.

The book of the later Han also known as the history of later Han it’s a Chinese court document that really cover the history of the Han Dynasty 6 – 189 AD. And it documents the very famous physician of Hua Tou you probably haven’t heard it since I was a little kid I always enjoy reading his history about how he’s a wonderful surgeon and was able to remove a poisonous arrow,

out of this very strong very passionate red-faced General Huang Go and Huang Go is sitting there playing chess and drinking wine and he didn’t really feel like there’s any pain and of course we know now Hua Tuo used Ma Fei San a anesthesia topical anesthesia and as you know Ma Fei San it’s it’s a wonderful formula for anesthesia at that time.

And also Shen Gao he has created ointments that helped heal the old skin to be get rid of and help the new skin to grow. In the performance of abdominal surgery you know this this this formal the book of later Han actually talk about surgery,

so you can see Chinese Medicine is not averse to surgery it was just not as fully developed. And also because of social taboo of not opening one’s body.

Therefore that’s why I think the surgery could have developed more fully but it wasn’t developed as well compared to conventional medicine today.

And also remove of dead fetus I mean this is think about is this is a very early time this is 2,000 years ago we talking about surgery. So it’s in this time that Chinese medicine is way in advancement compared to conventional medicine.

The next book is called Tai Chan Su this book which is actually discovered it okay this is called the book a pregnancy labor and postpartum.

And it was discovered in Ma Wang Dui excavation I’m sorry excavation in Tson Tsai area and it discovered almost 3000 cultural relics and one of the relics was this book.

Okay this book called Tai Chan Su was one of the 15 medical related books discovered that details in clarity the 10 months of gestation labor and post partum care in the Han Dynasty so it was very telling that the understanding of embryology is already quite advanced during this time.

It also described when is the best time to begin intercourse to conceive.

It talks about that you can start 3 days after menstruation is completely clear. It also described that the 10 months of the embryology and the concept of nourishing fetus, Yang Tai.

It describes the concept and importance of Tai Jiao what we call Fetal Education.

And today a lot of Chinese families still believe very strongly that the baby when the baby is born its not zero age when baby is born its almost one year old. The baby’s learning things already when the baby is in mommy’s tummy.

So we need to actually educate and teach a child already when the baby is in mommy’s tummy so we call it fetal education for example listening to very nice music,

being able to reduce emotional stress no emotional outbursts and reading some fine intelligent books that can stimulate the brain to develop and playing piano those kind of thing can stimulate the baby’s development already when the baby’s in your tummy so you don’t have to wait until when the baby comes out of mommy’s tummy.

 And then there is the nourish fetus according to the gestational month we call it so Zhu Yue Yan Tai so for example the first month is the formation of embryo.

Second month is the formation where we call the Gei. The third month is the formation of a fetus the baby is growing. The fourth month we talked about formation of blood from the watery energy from the kidney energy. In the fifth month we talk of formation of qi from the fire energy from the heart.

And in the sixth month we talk about formation of tendon and ligament from the Metal energy of the body.

And the seventh month we talk about formation of the bones from the Wood energy.

At eight months we talked about formation skin fascia and muscles from the Earth element the Earth Energy of the body.

In the ninth month we talk about formation of hair from the Stone energy which is a collection of all the different five elemental energies of the body.

And at 10 months all the organs are formed receiving energy from Heaven and Earth.

And this is sometimes in Taoist study we say this is a time when the spiritual  its when the spiritual energy is starting to come to the fetus and it is ready to be delivered.

 The next book is Shen Nong Ben Cao Jing, the classic of herbal medicine. I think all of us have heard about this book as we study or herbology. It Was Written in the Han Dynasty and around 365 AD.

And it classified herbs into what we called premium-quality will go higher grade average grade quality, and then the lower quality and so these are different grades of herbs as well as categorizing herbs to plants to animals to minerals and just different classifications so you get the beginning of different classifications.

It included many herbs that are widely used in OBGYN.

And he also renamed Nu Zi Bao to Zi Gong during that time with that book.

He stated that the wind cold attack to the Zi Gong in a woman can cause infertility for 10 years. So basically what he is saying is that if there is infectious disease in a woman it can actually cause infertility which is quite true if the infection is severe.

 And Jin Kui Yao Lue Fang Lun, the discussion of prescriptions of the golden chest is obviously as I say  an essential beginning written by Zhang Shong Jing in 219 AD in the Han Dynasty. And later on it was edited by Wang Shu He,

and Sun Qi so a lot of time what we are looking at today the Shang Han Lun is actually an edited version of what these doctors  have done and some of them has interpreted in their own commentaries and trying to figure out what’s lost and putting some of the words in there too to make up for the loss of words.

Three volumes herbal and food therapy for various stages is also in there and they have 3 chapters on gynecology and over 30 formulas and that’s collected and described it and a lot of them are still being used today.

For example Gui Shi Fu Lung Wan that’s used for pelvic mass especially during pregnancy. Jiao Ai Tang is a form of uterine bleeding with pelvic pains including occurrences during pregnancy and after an abortion.

Dang Gui Shao Yao San is for gestational pelvic pain. And Gan Mai Da Zao Tang

for Zang Zao this is like easily almost two thousand years ago these formulas are still widely used today.

Gan Mai Da Zao Tang is used for depressive and anxiety disorders.

And Wen Jing Tang is also used for menopausal abnormal uterine bleeding so you can see some of these formulas are still used today or in variants are also widely used today.

In this book it also introduced the practice and concept of vaginal douche and suppositories.

For example a Fan Shi Wan for leukorrhea, vaginal infection amenorrhea due to stagnant blood and with clots.

She Chuang Zi San is very good for parasitic infection,

so things such as what we call yin cold type of leukorrhea and vaginal infections can be used.

And Lang Ya Tang is I’m sorry.

I’m sorry Lang Ya Tang is for the parasitic infection She Chuang Zi San is actually for itchiness very severe itching leukorrhea and vaginal infection due to yin and cold.

Lang Ya Tang used for parasitic infection such as trichomonas.

Alright so the next book is Mai Jing, the pulse classic.

This one is by Wang She He in 280 AD in the Jin dynasty.

Is the first book that created a systemic understanding of framework of Pulse diagnosis. And it also collected and synthesized earlier work such as the Nei Jing such as Nan Jing and Jin Kui in pulse diagnosis and diagnostic differentiations.

It has a very good section on OBGYN pulse description and differentiations are appearing in chapter 9 of total 10 chapters in this book.

It says that in chi position which is the kidney pulse when it is persistent when pressed

it’s considered a pregnancy pulse this woman is pregnant. Or three level pulse floating middle and deep when they are continuous you press them down you can link them up and feel them very strongly that is a pregnancy pulse.

It also discusses about Li Jing Mai this is when the post seeds up much more than you’re normal pulse this also occurs during the time of Labor so as you looking pregnant woman as you feel the pulse if it start to speed up you know that labor is pending.

It also provides a new technologies I’m sorry new terminologies Ju Jing

is menstruation that comes every 3 months that’s normal for them the period really comes every 3 months that’s called Ju Jing.

Bi Nian is somebody who gets menstruation only once a year but they can get pregnant, they are pretty healthy otherwise so their unique situation where people are like that.

And then you have someone who is another terminology that is Ji Jing somebody who gets menstruation especially at the very beginning of an early pregnancy so let’s say they’re pregnant but they are still getting some sort of menstruation so you have some bleeding there some spotting. It scares the woman quite a bit but that is normal that is nothing that creates a problem for the pregnancy so we call that Ji Jing.

 The next book is Zhu Bing Yuan Hou Zong Lun called a general Treatise on the symptomology and etiology of disease.

Chao Yuan Fang is an Imperial physician around 610 AD now the time is moving down getting closer to us but not so close  yet in the Sui Dynasty.

He did a major work on etiopathology that lays an incredible foundation is the earliest

systemized work on etiology on symptoms and signs of disease. He classified 67 diseases and 1739 syndromes.

And 283 syndromes out of that 1739 syndromes covered OBGYN so he provided a pretty strong foundation in etiopathology understanding.

For example in this book it says irregular menstruation is caused by overstraining. Because overstraining causes consuming qi and blood. This consumption with this consumption this can cause the body to be weakened.

The weakness weakened body can easily attract wind cold Invasion from the outside.

Therefore it causes blockage in interior of Bao I mean  in your uterus in the inside of uterus damaging the Chong and Ren channels, damaging the hand Tai Yang channels.

Damaging Shao Yin channels. So already a pretty good start in etiopathology description of irregular menstruation.

Let’s move on to the next classic Qian Jin Yao Fang. Qian Jin Yao Fang is known as the Thousand Golden Ducat Prescriptions.

It’s written by Sun Si Miao in 652 AD in the Tang Dynasty.

This book is a collection of 5300 herbal formulas expended on the Zang Fu theories and other fundamentals.

It’s a seminal book of doctor Sun Si Miao who was very famous Taoist physician. It describes the various TCM treatment such as acupuncture, Food therapy, massage, Dao Yin and others. In this book there are three comprehensive volumes on OBGYN.

And he also talked a lot about sanitation for example he talked about a metal, a knife that’s made from metal should never be used to cut umbilical cord.

That’s a very smart discovery because there may be bacteria and this bacteria may cause infection to both the infant as well as the mother.

So it talks very clearly around that time on sanitation and prevention.

 So we move on to this era where now we are starting to have some formation of the Imperial medical system as we know it. The emperors wanted to live long so what they do is they hire some of the best physicians in the country and bring them to Beijing or wherever the capital is so during Tang Dynasty which is about 618 – 980 AD this dynasty established the first Imperial Medical Department.

It is the first formalized educational institution to teach to train these smart doctors physicians to take care of the royal family as well as the privileged government officials.

Due to this educational influence there are now more published books on OBGYN during this period.

Notably such books as Bei Ji Qian Jin Yao Fang.

Wai Tai Bi Yao and Jing Xiao Chan Bao are all very very famous reputable classics so let’s take a look at them.

The first one is Bei Ji Qian Jin Yao Fang again its written by Sun Si Miao we  just looked at it earlier he authored in 652 AD and so frequently we just call it Qian Jin Fang .

30 chapters as I said 3 chapters on OBGYN and and it collected about 540 herbal formula in OBGYN section because the whole entire book it collected about 5300 plus herbal formulas so added 540 herbal formulas in this chapter that’s used for the OBGYN.

He pointed out for the first time that infertility can be caused by problems from both men and women not just women alone that that has infertility men can also contribute to infertility situation. He wrote extensively on antepartum, intrapartum and postpartum care. 

He expended on treatments for difficult labor and both herbal and acupuncture therapies. Seminal book and laid a lot of very good foundation for OBGYN.

The next book is Wai Tai Bi Yao it’s about this thick it’s basically written by Wang Dao. It’s called medical secrets of an official.

It is a clinical Therapy book that include of 40 chapters and over 6,000 herbal formulations so he collected a lot of herbal formulation he compiled it and put it together in a very nice,

digestible book format for us and there are two chapters on OBGYN around 85 different types of conditions and 480 herbal formulas further contributed to different varieties of herbal treatments for gynecological OBGYN conditions.

Now we come to Jing Xiao Chan Bao we just call it the treasure of obstetrics this is probably the very first specialty book on obstetrics alone is written by Zan Yin 853 AD Tang dynasty. It has 41 chapters 374 formulas on pregnancy, labor and postpartum issues is again the first specialty book on TCM Obstetrics. It describes maternal care, labor and delivery care and it also describes care for for the first time probably in the world at that time identification and care for preeclampsia and eclampsia situations.

Moving forward around the Song Dynasty around 962 1279 AD we call this contemporary era of Chinese culture as well as Chinese literature as well as Chinese Medicine.

This is a time where the earliest TCM medical school for the public is now established.

The Imperial Medical College staffed by a total of 300 physicians and faculty has 9 departments, which included OBGYN department and has listed 10 obstetric physicians in a time that staff this Medical College. This is the earliest specialty education for an OBGYN probably in the world and it stimulated further refinement and development of  TCM OBGYN during this time. So during this time there are of some wonderful books that have came about due to this exploration of educational system. For example,

Shi Chan Lun which is a discussion of 10 labors written by Yang Zi Jian in about 1098 AD. It’s a book of discussion of different fetal positions that during the labor process including the footing breach, transverse breech, frank breech, umbilical cord wrapping, etc.

It also discussed the use of hand techniques on correcting such breech during labor,

as well as the intake of herbs to help out in the situation so it’s pretty quite advanced during that time with that such a wonderful description of what a doctor can do.

The next book is Wei Shen Jin Bao Chan Ke Bei Yao written by Zhu Rue Zhang in 1184 AD. It is 8 chapters total, seven chapters on labor delivery so you can say that this is almost an obstetric specialty book.

It discussed the importance of having clean environment for delivery as well as proper infant care methods.

so sanitation  is also in this book it discusses the three postpartum conditions of Chong Xin, Chong Wei and Chong Fei.

Basically these are eclampsia seizure HELLP syndrome and microangiopathic hemolytic anemia as well as cardiomyopathy. These are some of the very acute and dangerous conditions in situations just right during the labor delivery time.

And so this book has actually come out in that it describes this condition.

The next book is Nv Ke Bai Wen.

This is a book that is kind of like a question and answers or question and answer its FAQ type of frequently Asked question type of format and this is written by Qi Zhong Pu in 1220 AD. And 50 questions on Gynecology and 50 questions on obstetrics and he provided a very nice clear explanation of etiology and pathology in this book.

 And not the least we come to the bible of TCM gynecology and obstetrics it’s called the great treaitse of useful prescriptions for women.

Chen Zi Meng in 1237 AD in the southern Song Dynasty has written this wonderful book of 25 chapters, collected 1118 formularies and this is kind of like the first time it really has 48 cases so kind of quite comprehensive is not just this thing of what to do but also this the actual cases that these formulas have been effective with so this is kind of like the first Bible or comprehensive text on TCM OBGYN.

It had profound influences on the development and later on the writings of OBGYN in subsequent dynasties.

And this book is also being edited later on by Xue Ji later on by an imperial physician in the Ming Dynasty which included many of his commentaries as well as case studies.

He emphasized that liver and spleen are the sources for menstruation.

And all OBGYN disorders originate from Chong Ren Channel and Bao Gong.

Again it became a defacto textbook of OBGYN for many generations to come.

Now we come to a time where that now we are coming to a Chinese history time

where there’s a lot of barbarian invasion shall we say Mongolian invasion. This is what we call the Jin Yuan Dynasty and this is also the time it’s very fluid there was a lot of famine there’s a lot of disease and there’s a lot conquering war and famine situation so.

Chinese Medicine actually flourished during this period of time.

And the are these four what we call Jin Yuan four schools of thoughts Jin Yuan four major Physicians. Liu Wan Su Li Dong Yuan, Zhu Dong Li and Zhang Zi He . So for example Liu Wan Su is the father of fire pathology.

Li Dong Yuan is the father of earth School. Zhu Dan Xi has coined this wonderful phrase,

Yang is often excessive and yin is frequently deficient.

 And then we have Zhang Zi He who is into the sweating method purging method and emetic methods to attack pathogens. He believes that if you get rid of all the pathogens you don’t need to to treat anything else. The body will cure and heal on its own. So these are the four major schools of thought during that period of time.

So I’ll just spend a little bit time on two of them.

Lio Wan Su for example, he was around 1110 – 1200 AD. He contributed the fire heat pathology. He believed that fire heat is the main etiology of many conditions diseases so he recommends cooling and cold herbs to reduce heart fire and to benefit the kidney water.

And later he has been recognized as the father of He Jian Doctrine,

which is named for where he was born in He Jian province. His OBGYN contributions are several.

One for example he says when there is amenorrhea first is to reduce Heart fire. Once heart fire is reduced the menstruation will occur.

Second he talks about vaginal discharge as the condition of Ren Channel.

He  talked about how to deal with the condition of menstruation Ren Channel deals with the condition of vaginal discharge later on,

we actually corrected to talk about how vaginal discharge is actually all the channels are responsible. The Dai channel is probably a little bit more responsible than the other channels.

The third is a when there is too much damp heat in the lower Ren Channel there will be vaginal discharge,

so he connected that damp heat is the cause of excessive leucorrhea.

Number four he focused on kidneys with young woman he believed that if you going to treat disease and gynecology OBGYN most of time young woman are the ones that have more kidney issues.

The middle-aged women tend to  middle age tends to have liver issues and while the geriatric old woman tends we should focus on the spllen.

So that is also a way to take a look at how these three zang organs influence OBGYN.

Zhang Cong Zhen 1156 to 1228 AD.

He is the father of the pathogen attacking doctrine sometimes I just call it detoxification doctrine.

He says very clearly when nourishing life leave alone the sick and to just recover you should use food not medicine to help to recover to nourish life. But when your treat diseases you need to attack with medicine.

And he believed that you cannot tonify at all until pathogens are eradicated.

He focused on the use of diaphoretics, emetics and purgatives to rid of pathogens.

He is therefore, known as the father or the initiator of the attacking doctrine. And he has made a lot of contribution to OBGYN.

He, he uses emetic vomiting method and purging method to bring on menstruation mainly for excess type of patients.

He also believed that if you have deficiency type of patient you must use nourishing foods and tonification food such as lamb soup such as beef soup to nourish deficient patients and to try to help to nourish the depletion of life.

He also believed by getting rid of phlegm the menstruation will reappear establishing this phlegm congestion concept as one of the causes of amenorrhea.

Which helped to establish the phlegm damp etiology in today’s understanding of PCOS patients.

The next book is Zheng Zhi Zhun Shen what we call the standards of diagnosis and treatment.

Written in 1602 by Wang Ken Tang in the Ming Dynasty, 44 volumes divided into six specialties and OBGYN was one of the specialties.

And this is one of the most comprehensive text of the Ming Dynasty of that time.

And the next book is Nu Ke Zuo Yao the summary of gynecology and obstetrics. Xue Ji as i said earlier was a very famous Imperial physician.

In 1548 AD he had written this book.

He has a vast amount of clinical experience and this specific book the specific book is a comprehensive book on OBGYN reflecting uniquely how doctor Xue approaches women’s Health. A lot of case studies a wonderful wonderful book to study.

The next book is once Guang Si Ji Yao, the summary of fertility written by Wan Quan in 1549 AD in the Ming Dynasty.

60 chapters describe the treatment for infertility, pregnancy care, postpartum care and Pediatric Care.

He made this very clear, if you want to have a beautiful child if you want to have children that are free of abnormal genetics man – we start with men – should clear his heart

and control sexual desire to nourish the essence so that he can better prepare himself

for the sexual encounter that can help his woman become pregnant to have a wonderful healthy smart child. So it’s a very interesting and very advanced concept on infertility care.

The next book is Jin Yin Gang Mu a compendium of therapy of women’s diseases written by Wu Zhi Wang 1620 AD Ming Dynasty. It’s 5 chapters, it’s a comprehensive text that collects old works before the Ming Dynasty in the area of OBGYN. So it’s a seminal book again.

The next book is written by a very famous person who actually established this Mingmen concept, one of the co initiators it’s called Jing Yue Quan Shu this book is a continuation to complete works of Jing Yeu that’s one of his names.

So Zhang Jie Bin in 1624 AD Ming Dynasty.

He has written this 64 chapters on TCM and it is mostly his experience and is special relating to the Mingmen doctrine.

He contributed greatly to kidney tonification methods.

If you look at a lot of the fire doctrine or what we call kidney tonification methodology you have to study his work his work is brilliant in this in this area.

The next book is Fu Qing Zhu Nv Ke

Doctor Fu Qing Zhu 1607 to 1684 in the Qing dynasty this book was probably published about 1698 so it’s getting close now it’s what we should call this as modern now.

It emphasized  treatment of spleen liver and kidney in OBGYN conditions. He believed these three Zang organs are mainly the internal organs conflicting issues that create a lot of  OBGYN conditions.

He created many very simple herbal formula that don’t have a lot ingredient they’re very simple very short formulas and are very easy to use in conditions.

The next book is Yi Zong Jin Jian the golden mirror of medicine.

Wu Qian written by Wu Qian 1742 AD Qing Dynasty. 90 chapters as a summary collection of TCM..

It was directed by the emperor so you can say this is an imperial sanctioned work and written by an Imperial physician. It is very easy to read to understand,

and with simplified volumes. in fact a lot of the the modern TCM physicians before their schooling where you have to go to all the different classes,

this is the book they start to learn  with in fact when I was when I was doing my OBGYN

I start to learn the section on OBGYN from this book.

The next book is Da Sheng Bian it’s called the treatise on obstetrics and is written by,

Ji Zhai Ju Shi which we don’t really know,

who he is this is kind of like an anonymous writer it’s a pen name. Publication in 1715 AD in the Qing dynasty.

And incorporating more scientific information in the approach to obstectrics.

He is very clear and concise it’s a more modern favorite book to obstetrics then some of the old ones.

And Yi Lin Gai Cuo,  now we are coming to the modern era now we’re talking about 1800’s 1900’s and coming into the 2000s.

One of the one of my favorite book for the modern era is Yi Lin Gai Cuo it is called correcting the errors in the forest of Medicine.

In 1830 Dr Wang Qing Ren has written this book after he reviewed and examined cadavers. He realizes that the TCM anatomy is way way behind.

And the reason is very much that there are taboos on opening the body so he was only able to see maybe the body of a prisoner and one that’s been executed or people that have famine dying on the street side where you can actually see what’s going on in the internal organs.

So he examined the cadavers and he was very clear that we need to change and this is the time conventional medicine is coming in.

He believes it is very important for a TCM physician and he’s a fundamentalist that means is that he’s really into the true fundamentals of TCM. But he also said that you must must know anatomy as well. Okay even for TCM physicians. He shared his deep insight, the second contribution, is on stagnation of blood conditions and using activating blood relieving stagnation method to treat it.

So his famous series of Zhu Yu Tang has been widely used it’s used for blood stagnation conditions to throughout the body,

for example Solitaire down and sure who to return is probably two of the most commonly used today and continuing to enjoy a tremendous popularity.

Xue Zheng Lun is another book called discussion on blood syndrome and this is written by Tang Zhong Hai about 1885 AD Qing Dynasty. It’s a unique publication that describes and discusses blood pathology in its relationship with Qi.

He says this: “old blood that does not discharge is stagnant blood talking about so if you have retained blood in your uterus that’s a stagnancy of blood.

And to allow the new blood to come and you have to get rid of it okay and that’s how you can regulate blood.

So he believed that blood flow is regulated by Chong, Ren and Dai Channels.

Therefore Chong Ren Dai channels are regulated by liver therefore tonifying blood is related to tonifying the liver Zang organ. 

The next book is Yi Xue Zhong Zhong Can Xi Lu.

Ii is records of combined  Chinese and Western medicine. Zhang Xi Chun 1918 AD now Chin Dynasty. 30 chapters combines both Chinese medicine Western medicine perspective with formularies herbs theories discussion and cases you can say this is really the first book that is on integrative Medicine integrating TCM and Western medicine so it’s the first major attempt to bridge the Gap to help bring together the Chinese and Western medicine.

His contribution is great he created An Chong Tang and Gu Chong Tang for excessive menstrual flow and or abnormal uterine bleeding.

He also came up with Li Chong Tang as well as for amenorrhea and Zheng Jia conditions.

And not the  least is the most widely used formulation today Shou Tai Wan used for prevention, treatments for recurrent pregnancy loss in the prevention of miscarriages by tonifying kidney.

So for example that is so why to use today in a lot of it OB-GYN conditions now.

Coming to 1986 1984 Luo Yuan Kai one of the very reputable physician in Guangzhou college that time its called Guangzhou College of TCM.

In the southern part of China.

He is a wonderful physician here in like what we call the third and the 4th edition of TCM Gynecology for the colleges and University of of Chinese Medicine and we called.

This is a major text at time and a lot of people my age studied that book as the foundation. 

And not the least now the latest most comprehensive book is quite thick and is well written and is called the TCM science of OBGYN. As I said earlier in the first few slides the first edition is published in 2001, and a second edition publishing in 2011 by people’s medical publishing house its a big book.

The editors are dr. Liu Min Ru and dr. Tan Wan Xin and it is written by over by 73 well-known Physicians. Most comprehensive and a lot of my lectures will be really using the purpose as a reference material as well, and has a lot of very good information for people who love TCM OBGYN and love to learn that and really integrated into  the conventional medicine scene.

So thank you very much for listening to me today and and have a wonderful day.