“Traditional Chinese Medicine,” or TCM, is a modern label. Historian Volker Scheid uses it for the version of Chinese medicine set out in national textbooks that China’s Ministry of Health began producing in the late 1950s (Scheid 2007). The books behind those textbooks are far older, and they did not treat “the mind” as a separate compartment. The Huangdi neijing (Yellow Emperor’s Inner Classic), assembled from writings of the last centuries BCE, calls the heart the body’s ruler and the source of shen, often translated “spirit.” It says anger, joy, sorrow, and fear push the body’s qi (vital breath) in particular directions, and that unchecked feelings can make a person ill. Later physicians, including Zhang Ji around 200 CE and Li Gao (1180–1251), built on those ideas. These are medical classics, not guides to an afterlife.
What does “Traditional Chinese Medicine” actually name?
Scheid defines TCM as the picture of Chinese medicine presented in contemporary Chinese textbooks. In 1959 the Ministry of Health decided to produce national teaching texts, with the explicit goal of making Chinese medicine look more like biomedicine. A revised edition in 1964 set a framework that, in Scheid’s words, “has been exported around the world as TCM” (Scheid 2007, section “The invention of menopause as a medical problem in TCM”).
“Traditional” doesn’t mean frozen. Scheid argues that East Asian medicines changed deeply over centuries, and that China, Japan, and Korea all drew on the same early Chinese medical texts (Scheid 2013a).
Think of TCM as a 20th-century textbook built from a very old library. (That’s an analogy, not evidence.)
What is the Yellow Emperor’s Inner Classic?
The Neijing is written as conversations: the legendary Yellow Emperor asks, and advisers such as Qibo answer. It has two parts, the Suwen (Basic Questions) and the Lingshu (Divine Pivot).
When was it written? Nobody knows exactly (Disputed). Lisa Raphals writes that it was “probably compiled in the first century BCE” (Raphals, SEP §1.2). Scheid gives the 4th to 2nd centuries BCE (Scheid 2013b). Jen-der Lee reports that most scholars see the Suwen as material from different periods, mostly Warring States and Western Han, edited by many hands (Lee, n. 3). Raphals and Lee both describe a layered text.
The Suwen we read today also passed through a Tang-dynasty editor, Wang Bing. His preface, dated to the first year of the Baoying reign (762 CE), says he spent twelve years on it. He filled gaps, moved passages, and added words where the meaning seemed unclear, writing every added character in red ink so old and new wouldn’t blur (Wang Bing, preface). So some words of “the ancient Neijing” came to us through a medieval editor’s hands.
Where did thinking and feeling live?
Mostly in the heart, but not the heart as a pump. Suwen chapter 8 describes the organs as officials in a government. The heart is the ruler, and “spirit brightness” (shen ming) comes from it. The liver is the general, where plans come from; the gallbladder makes decisions. If the ruler sees clearly, everyone below is at peace. If not, all twelve officials are in danger (Suwen 8).
Chapter 23 gives each of five organs something to store: the heart stores shen, the lungs po, the liver hun, the spleen yi (intention), and the kidneys zhi (will) (Suwen 23). Translations vary: one English version gives hun as “soul” and po as “vigor” (Lee, p. 28). In this list, all five are things organs hold.
Chapter 8 of the Lingshu lays out a chain: the heart takes charge of things; what it recalls becomes intention; intention that holds firm becomes will; and on through thinking, planning, and wisdom. The same chapter says wise people nourish life by following the seasons and keeping joy and anger in balance (Lingshu 8).
This isn’t a modern theory of where thinking happens. Scheid notes that when the physician Miao Xiyong (1546–1627) wrote of “Heart disorder,” the term drew on older views of the heart as governing emotions, covering what we might now call cognitive and emotional problems together (Scheid 2013b, “Making Constraint Emotional”).
Can a feeling move your body?
In this system, yes. Suwen 39 says that all illnesses arise from qi, then lists what feelings do: anger makes qi rise, joy makes it slacken, sorrow makes it dissolve, fear makes it sink, fright throws it into disorder, and brooding ties it in knots (Suwen 39).
Suwen 5 pairs each organ with a feeling: liver with anger, heart with joy, spleen with brooding, lungs with worry, kidneys with fear. It adds a twist: each feeling can be checked by another. Anger harms the liver, but sorrow overcomes anger (Suwen 5).
Joy is on the danger list too. Jen-der Lee’s study of “laughing disorders” found that these medical writers treated every emotion, joy included, as potentially harmful. The Lingshu links too much heart qi with laughter that won’t stop (Lee, abstract and §2.1).
Centuries later, “one feeling overcomes another” became a kind of emotional counter-therapy. In 1584 the physician Wu Kun called such techniques “immaterial medicines” (Scheid 2013b, n. 16).
What were dian and kuang?
They are two named conditions in Lingshu chapter 22. Dian begins with unhappiness, a heavy, aching head, and restlessness. Kuang has several forms. One starts with sorrow, forgetfulness, anger, and fearfulness, and is said to come from worry and hunger. In another, the person sleeps little, isn’t hungry, calls themselves wise and noble, and curses day and night. Another involves seeing ghosts and spirits and laughing, and is said to follow great joy (Lingshu 22).
English translators have used “withdrawal” and “mania” for these terms (Lee, n. 5). This page keeps the Chinese words. Whether any modern diagnosis fits these signs is Unknown; calling them “schizophrenia” or “bipolar disorder” reads today’s categories into a very different text. The chapter doesn’t tell us how often anyone was treated for these conditions, and no patient speaks in it.
Where does Zhang Ji’s fever book fit?
Zhang Ji, also called Zhang Zhongjing, is traditionally dated 150–219 CE (Plausible; Scheid 2013b; Lee §2.3). A preface attributed to him says his clan once numbered more than 200 people. Within ten years of the start of the Jian’an reign period, near the end of the Han dynasty, two-thirds had died, seven in ten of them from shanghan, “cold damage,” a class of feverish illness. Grieving those early deaths, he writes, he gathered older texts, including the Suwen, into a sixteen-scroll book (Shanghan lun, preface).
The same preface scolds people who neglect medicine. Once the body dies, it says, the “spirit brightness” is snuffed out, the person lies deep in the earth, and the living can only weep. That’s a warning, not a description of a happy afterlife.
Most of the Shanghan lun is about fevers; the mind appears as signs. “Delirious speech” (zhanyu) turns up 34 times in the edition we checked. Clause 106 describes a patient who is “as if kuang” when heat is “bound in the bladder” (Shanghan lun, clause 106). Scheid notes that Zhang’s larger work also describes clearly emotion-related disorders with herbal formulas, in language rooted in older accounts of spirit possession, to which women were seen as especially prone (Scheid 2013b, “Chen Yan”).
What did Li Gao add, a thousand years later?
Li Gao (1180–1251), also known as Li Dongyuan, is labeled in his book as “Li Gao of Zhending,” of the Jin dynasty (Piwei lun; dates also in Scheid 2013b, n. 15). His Piwei lun (Treatise on the Spleen and Stomach) argues that irregular eating, cold and heat, and “joy, anger, worry, and fear” wear down a person’s “original qi” and feed a harmful “heart fire” (juan 1).
A section titled, roughly, “Calming and nourishing the heart-spirit to treat the spleen and stomach” (juan 2) quotes the Suwen’s heart-as-ruler line, then says anger, resentment, sorrow, brooding, and fear all drain original qi. The passage connects bodily organs, emotions and everyday circumstances within Li’s account of illness. Its advice and claimed results are omitted here.
Did doctors stop believing in spirits?
Not in any clean way. Divination records buried with a Chu official named Shao Tuo, dated 318–316 BCE, note an ailment near his heart and abdomen with shortness of breath, alongside diviners’ forecasts and sacrifices to gods and ancestors (Raphals 2005, pp. 80, 83–84). In the 12th century, the physician Chen Yan (1131–1189) still wrote of emotional diseases “as if produced by spirits” (Scheid 2013b, “Chen Yan”). Historian Miranda Brown traces the popular story of a clean break, with superstitious healers giving way to secular doctors, back to at least a 1919 History of Chinese Medicine by Chen Bangxian, written under the secular ideals of the May Fourth Movement (Brown 2012).
How we know
- What survives: Mostly received texts, copied and re-edited for centuries. A few excavated manuscripts, like Shao Tuo’s divination slips, come straight from tombs, but elite tombs.
- Whose voices are missing: Patients. People described as dian or kuang never speak in these chapters. Shao Tuo appears only through his diviners. In the texts on this page, no woman is a named author or speaker; women appear only as others describe them. Scheid shows that later ideas tying “constraint” to emotion were worked out among elite physicians and patients in southeast China (Scheid 2013a).
- How power shaped the record: Song state endorsements from the 10th century lifted Zhang Ji’s book (Scheid 2013b). State textbook projects in 1959–64 shaped what counts as “TCM” (Scheid 2007). A 1919 “superstition to science” history still shapes the popular story (Brown 2012).
- Translation: English versions of Chinese passages here are our plain paraphrases unless a translator is named.
Then vs. now
Then. Feeling, thinking, and willing belonged to a body run like a state, with the heart as ruler. Feelings moved qi; too much of any feeling, even joy, could cause illness; one feeling could check another. Care could include needling and bloodletting (Lingshu 22), herbal formulas (Scheid 2013b), and, in some settings, divination and sacrifice (Raphals 2005).
Now. Current medicine says the brain is responsible for thoughts, emotions, memories, and behavior (MedlinePlus). We found no current evidence that the specific pairings, such as anger with the liver, describe how bodies work (Unknown).
Modern TCM isn’t a time capsule either. Scheid reports that “Liver qi constraint” is one of TCM’s most common diagnoses and is often blurred with depression, anxiety, or stress. His research traces how “constraint” gradually became an emotional disorder from the 11th century on, not 2,000 years ago (Scheid 2013b, abstract). Scheid argues that equating these older categories with today’s diagnosis of depression is a late-20th-century development (Scheid 2013a).