The yin, yang, and anatomy of Traditional Chinese Medicine in The Anatomical Record.
Traditional Chinese Medicine, or "TCM," is a holistic discipline that focuses on human health, preventative medicine, diagnostic techniques, and therapeutic interventions (e.g., Li et al., 2021; Zhang & Li, 2021). At its foundation, TCM is also heavily rooted in anatomical principles. As such, it is no wonder that the topic has been the subject of study in The Anatomical Record (AR) in recent years. In this Special Issue of AR, we highlight Traditional Chinese Medicine. Specifically, the volume brings together a collection of papers on topics ranging from acupuncture to traditional Chinese herbs to syndrome biomarkers. The authors delved into the molecular attributes of TCM syndromes and investigated the disease resistance mechanisms of acupuncture and Chinese herbal treatments for conditions affecting the digestive system, nervous system, and other organ systems. The issue has been skillfully edited by Professor Jicheng Li (Figure 1). Jicheng is a Professor at Zhejiang University in Hangzhou, China, and has been an International Associate Editor of AR since 2007. Jicheng is an excellent scientist who actively advances AR by tirelessly engaging in manuscript recruitment and journal promotions throughout China (Figure 1). We wish to thank Prof. Li from the outset for his excellent work on this Special Issue. The Anatomical Record's initial foray into the studies of TCM began in 2018 when the entire AR Editorial Board traveled to China for the annual Board meeting. During the trip, many AR editors, including co-author J.L. and former Editor-in-Chief Kurt Albertine, experienced acupuncture treatments firsthand! (While the closest co-author HFS has admittedly even been to TCM are her bi-weekly hot yoga sessions, she was excited to learn more from this issue's interesting submissions). Thus, AR's relationship with TCM was born! Since that time, the journal has now published three Special Issues on the topic (Albertine & Laitman, 2020; Laitman & Albertine, 2020; Zhang & Li, 2021, 2023). TCM has its origins over 3000 years ago in prefeudal China, and it has been widely used throughout China for over 2000 years (Shaw & McLennan, 2016; Xu et al., 2014; Yu et al., 2006). However, despite the longevity of the practice in Asia, TCM has only recently become broadly discussed internationally (e.g., Han et al., 2023; Lam et al., 2019; Zhang & Li, 2021). The past 10 years have seen a rapid increase in the number of TCM syndrome papers published (Liu & Li, 2023), showing a growing increased interest around the world in TCM. Similarly, the onset of the COVID-19 pandemic was also associated with a jump in TCM publications, which mainly focused on techniques and traditional herbs that may help to alleviate COVID-19 symptoms, as a supplement to treatment by allopathic medicine (e.g., Da et al., 2021; Han et al., 2023). Traditional Chinese Medicine is rooted in the Taoist philosophy of maintaining a balance between the opposing forces of yin and yang (e.g., Cai, 1988; Fazel, 1995; Hon, 2019; Tang et al., 2008; Wang et al., 2021). From an anatomical perspective, yin and yang are also linked to various anatomical regions of the body. Specifically, yin is linked to the inferior portions of the body, including the pelvis and lower extremities, while yang is associated with the superior regions of the body, such as the upper extremities, head and neck, and including the back. Therefore, the roots of TCM are strongly aligned with anatomical premises and principles. Acupuncture, the branch of TCM in which fine needles are strategically inserted into various locations on the body, was likely first developed by Han Dynasty anatomists (Shaw & Mclennan, 2016). While the precise mechanisms underlying acupuncture remain largely unknown, it is clear that its development was based on a foundation of anatomical knowledge. In fact, the ancient Chinese Mawangdui texts dating to 200–300 BCE represent some of the earliest, detailed anatomical atlases, predating those of classic Greece (Shaw et al., 2022; Yimou & Zhou, 1988). The texts detail the human body's arrangement through divisions or routes, each linked to specific disease patterns. Interestingly, these 11 pathways bear identical names as the acupuncture meridians later discussed in the Huangdi Neijing (Neijing, 2010). The Anatomical Atlas of Truth (Yang, 1106) comprises intricate depictions of the anatomy of the trunk, along with illustrations of the 12 meridians and 5 cardinal phase points. The establishment of well-marked acupuncture points also coincided with and was informed by the increase in anatomical dissection practices during the Song Dynasty (960–1279 AD; Shaw & Mclennan, 2016). A recent dissection-based study investigating the anatomy deep to each recognized acupoint revealed a correlation between acupoint location and specific anatomical features (Shaw & Mclennan, 2016). Many acupoints lie superficial to key neurovascular foramina or depressions in muscles, suggesting that each needle targets a precise anatomical location (Shaw & Mclennan, 2016). In TCM, meridians are lines through which Qi (circulating life force) flows. The meridians course throughout the body and connect acupuncture points and facilitate the flow of Qi. Early work by Dr. Bonghan Kim and others has attempted to identify the meridians as anatomical structures (Kim, 1962, 1963, 1965). It has been variously argued that the meridians may lie within the lymphatic system (Byung et al., 2005), vascular system (Baik et al., 2005), within adipose tissue (Lee et al., 2009), or even on organ surfaces (Baik et al., 2009). The Chōng meridian, also known as the Penetrating Vessel or Sea of Blood, may be an ancient description of the arterial system, because it strongly corresponds with key anatomical vascular landmarks (Shaw, 2014). Tomov et al. have argued that the more recently discovered interstium may be the anatomical foundation for some of the meridians (Tomov et al., 2019). Due to its underpinnings in Anatomy, Traditional Chinese Medicine has been used to treat a broad range of ailments and diverse sets of symptoms, in conjunction with allopathic medicine. Volatile oils have been used to treat the injuries to the hippocampus in mice (Gao et al., 2019). The traditional herb Myricetin has been argued to inhibit breast cancer tumor growth (Zhou et al., 2019). Electroacupuncture has been suggested to have antidepressive effects in mice (Li et al., 2021; Sun et al., 2021). Scalp acupuncture may help ischemic stroke patients regain functional connections between cerebral hemispheres, in combination with rehabilitation (Bao, Li, et al., 2021; Liu et al., 2021). Fu's subcutaneous needling technique may help alleviate shoulder pain (Bao, Wang, et al., 2021). TCM decoctions and herbs may help alleviate rhinitis symptoms (Feng et al., 2021). Biomarkers have been identified that may be associated with Yin deficiency syndrome, a condition said to be characterized by hot flashes and cardiovascular disturbances (Chen et al., 2020; Gan et al., 2020; Jiang & Li, 2023; Yi et al., 2020; Yu et al., 2018). All of these TCM approaches should be considered supplements to allopathic medicine to help alleviate symptoms during treatment. In all, Traditional Chinese Medicine is a diverse and fascinating approach to health and medicine, which can complement the practices of allopathic medicine. The research in this volume advances the understanding of the possible mechanisms underlying TCM's efficacy in addressing human diseases. We hope you enjoy and benefit from the collection of papers on TCM in this Special Issue. Xie-Xie ("thank you") for reading! Heather F. Smith: Conceptualization; writing – original draft; writing – review and editing; investigation; methodology; validation; visualization. Jeffrey T. Laitman: Conceptualization; writing – review and editing; validation.
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