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2. Historical development of the pain concept
It is widely known throughout the world that both Chinese herbal medicine and acupuncture can be used to treat pain. According to popular legend, about 2000 years ago an outstanding doctor named Hua Tuo had already started to use herbs and acupuncture for different kinds of pain (Hua Tuo c. ad 180). For instance, he used acupuncture successfully to treat an emperor who suffered from severe Toufeng (severe migraine headache). Dr Hua was also very skilful in using Chinese herbs that produced anaesthesia, and once opened the skull of a patient, drained some infected blood and a damaged skull fragment and finally successfully sewed up the wound. Another legend concerns a Mr Bian Que, a famous doctor of 5th Century bc. He also successfully healed a son of the then emperor by opening his abdomen and removing a damaged section of the intestines.
The earliest relative systematic discussion on pain can be found in the Neijing or Yellow Emperor’s Classic of Internal Medicine written about 2000 years ago. In this book there is a chapter devoted to the aetiology, pathology and symptoms of pain. For the first time, Qi and Blood stagnation were considered to be the major causes of pain. The terms used in this book to describe Qi and Blood stagnation included ‘retardation of Blood circulation’, ‘retardation of circulation in the Blood vessels’, ‘disorder of Qi and Blood’, ‘fullness of the Blood vessels’, ‘failure of Blood to circulate’ and ‘blockage of the Blood vessels’, amongst others. Its theory is still applicable to clinical practice. In addition, the Neijing distinguished 13 kinds of pain; however, most of these were considered to be caused by Cold, and only one kind by Heat. Moreover, this book emphasised only the External factors as causes, so the book’s treatment was incomplete or only partially correct, because there are many kinds of causative factors, both External and Internal, in addition to Cold and Heat – for instance, Deficiency may also cause pain. Nevertheless, the theory of Qi and Blood stagnation as the main cause for the pain formed in this book has been proven accurate and practical, which has been widely accepted by most of the TCM practitioners in the last 2000 years. Based upon this theory, various kinds of pain were successfully treated and new theories gradually formulated and completed.