Nursing College of Pingdingshan University, China.
*Corresponding author: Xia Xichao
Nursing College of Pingdingshan University, Pingdingshan 467000, Henan
Province, China.
Email ID: masuli.001@163.com
Received: Jan 04, 2025
Accepted: Feb 05, 2025
Published Online: Feb 12, 2025
Journal: Annals of Traditional Chinese Medicine
Copyright: Xichao X et al. © All rights are reserved
Citation: Suli M, Xichao X, Yujing Z. A application of theroy in the Traditional Chinese Medicine nursing: Theory of benevolence art. Ann Tradit Chin Med. 2025; 2(1): 1007.
The current study is designed to explore the application of Theory of Benevolence Art in the Traditional Chinese Medicine (TCM) nursing. In the TCM nursing, philosophy of people orientation, benevolence for saving lives and putting oneself in others’ shoes are composed of framework of Theory of Benevolence Art. In the Theory of Benevolence Art, it not only requires doctors to master the skills of saving the dying and helping the wounded, and foster the scientific attitude of seeking truth from facts, but also requires them to enjoy the humanistic spirit of respecting life, loving life, and caring for life. Medical practitioner should fulfill the people orientation, that contribute to promote patient’s physical and mental health and improve their quality of life.
Keywords: Theory of Benevolence Art; Traditional Chinese medicine nursing; People-orientation; Benevolence for saving lives; Putting oneself in others’ shoes.
In the ancient times of China, due to the producing conditions, living and survival environment, various kinds of internal and surgical diseases occurred frequently. The earliest medical treatment system and medical care ideas of Traditional Chinese Medicine (TCM) were born under such environmental conditions. With the advancement and development of age, the disease treatment theories and thought systems of traditional medicine have been gradually established and perfected. During this process, TCM nursing philosophy has been fully integrated into traditional medical theory. One theory of traditional medicine named Three and Seven Theory is widely accepted in the treatment of diseases, in which care play 70% role that and disease treatment play 30% role [1]. A series of medical works are invested into special emphasis on the role of care and nursing in the treatment of disease, such as Huang Di Nei Jing, Treatise on Cold Damage and Miscellaneous Diseases (Shanghan Zabing Lun) written by Zhang Zhongjing in the Western Han Dynasty, Qianjin Yi Fang written by Sun Simiao, Compendium of Materia Medica (Bencao Gangmu) written by Li Shizhen. In these books, 70% care is advocated in the treatment process. With perspective of care and nursing, many important philosophies of TCM nursing have been established, among of which Theory of Benevolence Art is one important TCM nursing theory [2-4].
Benevolence is a moral category with an extremely wide range of meanings in traditional Chinese culture. It mainly refers to the mutual care and harmonious co-existence among people and has become a traditional virtue in China, which has become a main line from ancient times to the present through Chinese culture. The concept of benevolence has already appeared in Shangshu book, has also been mentioned for many times in Zhoushu book. By the Spring and Autumn Period, the thought of benevolence had developed greatly. Confucius, as the master of the doctrine of benevolence, established benevolence as the highest principle of Confucian moral norms. Therefore, benevolence has been regarded as the basic norm of personal morality by later generations [5].
The term of benevolence art was first seen in Mencius book. But, benevolence art was used in medicine and have an association after the Northern Song Dynasty. The ideological system of Traditional Chinese Medicine (TCM) is deeply rooted in the core values of universal love and cure the sickness to save the patient. These concepts are composed of framework of benevolence in Confucian culture. With the development of Confucianism, it further strengthened the ethical and moral status of benevolence and promoted the widespread of the thought of benevolence in various fields of society. Under this cultural background, it was given an honorary title of benevolence art in the medicine because of its important role in practicing benevolence saving the dying and helping the wounded. Afterward, Theory of Benevolence Art is appeared in the medicine characterized by a comprehensive summary and basic quality requirement for the moral conduct of medical care work in ancient times. Meanwhile, it is also the core of traditional Chinese medicine culture. In the TCM, Theory of Benevolence Art not only requires doctors to master the skills of saving the dying and helping the wounded, and foster the scientific attitude of seeking truth from facts, but also requires them to enjoy the humanistic spirit of respecting life, loving life, and caring for life. Theory of Benevolence Art of medical practice has experienced a process of gradually deepening, developing, and perfecting, in which the relationship between doctors and the universe, doctors and life, doctors and relatives, doctors and themselves, and doctors and patients is established and gradually enrichment. In the TCM nursing, philosophy of people-orientation, benevolence for saving lives and putting oneself in others’ shoes are composed of framework of Theory of Benevolence Art. As a result, the research mode of TCM nursing talents is built.
Three visual angles are explored in the understanding of life. In the theoretical system of TCM nursing, the principle of people-centered is first emphasized. In this principle, life of people is precious because it occurs only once, thus life should be respected by everyone. Human beings, as high-spiritual life form in nature, not only have a physical existence but also pursue lofty ideals and values. Therefore, when facing life and dealing with diseases, medical practitioner should show friendly for every patient as well as others, including patients, relatives, friends, and themselves. At the same time, TCM nursing also pay attention to the importance of benevolence. Every living being of nature has own’s value and function. The existence of every life brings about a diversity on nature, that contributes to the operation of the entire universe. Therefore, medical practitioner should keep a broad-minded sense of benevolence and a benevolent heart for loving and caring for every life, that contribute to stay away from pain and recover health. Finally, in the TCM nursing, it advocates the concept of empathy in which putting oneself in others’ shoes. During the process of disease treatment and care, medical practitioner should put themselves in the patient’s position and consider their feelings and preferences. If certain treatment and nursing measures are unacceptable to the medical practitioner themselves, they should not be imposed on the patients, thereby reducing the possible pain suffered by the patients. In summary, TCM nursing combines the Confucian thought of benevolence with medical techniques to build up a comprehensive theoretical system of Theory of Benevolence Art. This theory not only requires medical practitioner to constantly improve their technical skills, but also demands deep-rooted humanistic care morally [6]. The combination achieves comprehensive and meticulous care for patients. Through this people-centered nursing practice, TCM nursing aims to promote patients’ physical and mental health, and improve their quality of life.
People-orientation and respect for life are the most important ideological foundations of TCM nursing. Physicians of past dynasties highly valued the life value of human beings and regarded saving the dying and helping the wounded as the essential and basic professional ethics criterion for medical practice. Sun Simiao proposed that human life is more precious than gold in the Qian Jin Yao Fang, and curing diseases and saving lives is the top priority of medicine. As a professional responsibility, this view is deeply rooted in the medical practitioner. Meanwhile, saving and maintaining life should be regarded as the highest criterion in medical practice. In the Huang Di Nei Jing, it is holding that numerous animals and plants with life characteristics are appeared in the nature, but human life is the most precious in the earth. Nothing is more precious than human beings between heaven and earth [7]. Once one’s life is lost and death occurs, it cannot be retrieved in the Huang Di Nei Jing. It is proposed that human beings have the highest spirituality in nature, and life is the most important thing for human beings in Quanyi Lun written by Xiao Gang. It is also proposed that when doctors treat patients, they hold the power of life and death in Lei Jing Tu Yi written by Zhang Jingyue. Therefore, doctors should master excellent professional qualities and professional ethics. On another hand, doctors must avoid the occurrence of negligent, the phenomena of deliberately mystify as well as that pretend to know what they don’t in order to avoid missing the best opportunity for disease treatment and causing irreparable harm to patients.
In number of ancient books, it is repeatedly emphasized that the respect and cherishing for life is one of the most importance works. As to medical practitioners, it is known that human life is of crucial importance and the responsibility. In the Huang Di Nei Jing, philosophy of respecting life is also spread in diversity of patients. It is points out that doctors should respect the customs and habits of different countries and ethnic groups in the process of treating diseases and saving lives, and keep the privacy of patients’ family environments and family members confidential. Doctors show respect and courtesy to patients’ families and relatives, and respect the wishes and requirements of the patients themselves. During the verbal communication between medical practitioner and patients, the tone of medical practitioner should be soft and warm, enjoy an equal relationship with patients. The arrogance or a superior attitude towards patients is forbidden in the medical practitioner. The commercial activities or action of against professional ethics are also banned. Full respect for patients should be welcome behaviour in the treatment. Therefore, the nursing philosophy of peopleorientation is provided in the Theory of Benevolence Art.
In the TCM nursing, it is emphasizing that medical practitioners show benevolence for every patient, in which this spirit of benevolence plays a key role in the wide application of promoting medical means as well as the process of curing diseases and saving lives. This is highly consistent with the content of Theory of Benevolence Art characterized as universal love for everyone and absolute sincerity for patient. Therefore, universal love for everyone and absolute sincerity are also summarized as the philosophy of benevolence for saving lives [8].
With respect of universal love of TCM, it is proposed that medical practitioner is required to treat all patients equally regardless of their social status, wealth, age, or hierarchy. Meanwhile, all patients should be considered as own relatives. Sun Simiao pointed out that medical practitioner should firstly exhibit a calm mind, inner purity, and peace before treating patient in Great Physicians with Sincerity. They should put heart and soul for care patients and loving patients. Even, they sincerely pray for patients with quickly recovery from danger and restoration of health through treatment. When faced seeking treatment of patients, medical practitioners cannot refuse to treat with respect of differences in wealth, age, personality, kinship, ethnicity, and living habits, should treat each patient equally. It is proposed that medical practitioners treat the patient just as their closest relatives. In the Huang Di Nei Jing, it points out that diseases can result in a dual injury on physical function and mental activity of patients. As medical practitioner, one should show a sympathy with suffered pain of patients as well as the difficulties and hardships of patients. Medical practitioner should put oneself in patients’ shoes, and not treat patients with differences of economic conditions and social status [9].
It proposes that a doctor should firstly understand and study Confucian academic thoughts in the Waike Zhengzong written by Chen Shigong, this professional foundation is regarded as the background of medical knowledge to build one’s professional ethics, and then learn relevant medical knowledge and theories. Under the nutrition of professional ethics, one doctor should actively treat patients regardless of age, family poverty or wealth. It is purposed that medical practitioner should master the classical prescriptions and superb techniques, that not only be able to treat diseases for high-ranking officials and nobles, relieve the pain of poor people, and also provide guidance in disease prevention to achieve physical health for themselves in the Treatise on Cold Damage and Miscellaneous Diseases (Shanghan Zabing Lun) written by Zhang Zhongjing. Meanwhile, Zhang Zhongjing take the philosophy into practice by setting aside two days in every month to provide free disease treatment for the common people.
Sincerity is an essential quality of medical practitioner and an important criterion for fulfilling the art of benevolence. Li Ting, a physician in the Ming Dynasty, proposed that the professional ethics of medical practitioner cannot violate their conscience. It is pointed out that doctors should abide by the principle of honesty, and treat patients and colleagues with sincerity in Yixue Rumen. In addition, medical practitioner cannot exaggerate or fabricate treatment effects in order to gain patients’ trust, show off their skills or mislead patients by being deliberately mystifying.
In the Huang Di Nei Jing, it proposes that doctors can not declare the principles of diseases without comprehensive analysis. When not shed light of knowledge about the phenomena of diseases, they should seek help from another expert. As a sincere doctor, the first principle cannot deceive patients. In the clinical treatment, it is banned to randomly combine strange prescriptions to pursue unexpected effects, or use mysterious drugs to confuse patients or others. Meanwhile, they cannot fabricate false theory against classic medical theories, pretend to understand patients’ conditions. Doctor cannot describe one common disease as monstrous one. In the last, these actions are likely associated with coveting patients’ property. In the Yixue Yuanliu Lun, it emphasizes that doctors should respect each other, learn from other’s advantages to make up for their weaknesses, and not mutual attack each other. Once facing complex diseases, doctor cannot diagnose or treat, he or she should refer patients to more suitable doctors ensure that patients receive timely and accurate treatment.
The philosophy of putting oneself in others’ shoes can be explained from two aspects, including of internal-driven force and external-driven force. On the internal-driven force, it emphasizes that medical practitioner should cultivate the ability to concern others’ perspectives. In clinical practices, doctor is needed to consider the patient’s view and understand patients’ feelings and needs [10]. Li Ting, a medical scientist in the Ming Dynasty, pointed out that medical practitioners are engaged in clinical treatment, they should treat patients as their parents. Fei Boxiong, a famous medical scientist in the Qing Dynasty, further supplement that when ourselves become patients, we also hope that doctors can treat ourselves with the care and respect like relative. Therefore, when ourselves become doctors, we should also regard patients as our parents. In this process, doctors should put saving lives as first task, and interests and reputation as second. Yu Chang, a medical scientist in the Qing Dynasty, proposed medical practitioner should experience patients’ pain and difficulties as if they were feeling personally in Yimen Falv. Medical practitioner cannot treat patients with a differentiation because of clothing and appearances of patient. Zhu Zhenheng, a medical scientist in the Yuan Dynasty, proposed that when patients come from faraway place to seek medical treatment, medical practitioner should immediately start treatment and not miss opportunity. If patients are unable to come to the hospital for treatment due to old age or difficulty in walking, medical practitioner should initiatively to arrive in the patients’ residences and provide careful treatment. Even existence of snowy or rainy weather and long distances, they should not be afraid of this objective condition, but immediately go to the patients’ residences for treatment. At the same time, it is also reminded that every day patients experienced is a torturing process, so assistants cannot delay treatment when they receive the help come from patients. As medical practitioners, they should always practice the patient-centered philosophy, perform the transformed perspective between patient and doctor, treat patients with kindness, and always strictly abide the professional ethics.
In the training mode of TCM nursing talents, it is emphasized the cultivation of external-driven professional qualities. In the external-driven force, it is recommended that medical practitioner transform their inner benevolence and professional ethics into daily behaviors and work practices. It is a tendency to apply the Theory of Benevolence Art from the inside to outside. In this phase, it not only demands that medical practitioner shows noble moral sentiments, but also includes what they show care and sense of responsibility for patients in specific medical behaviors [11]. In the Xiaoer Weisheng Zongweilun Fang, it is pointed out that one doctor must firstly correct one’s conduct and take patients as center. This suggestion is not only reflected in the doctor’s attitude but also in the doctor’s systematic thinking perspective and professional qualities. Medical practitioners should understand life stage with a more comprehensive perspective and analyze the causes of disease and possible developments in the future with systematical pattern. In the last, medical practitioner should determine the most suitable treatment plan for patients. This kind of nursing philosophy with a focus on the overall situation is the core manifestation of external-driven It not only reflects doctors’ benevolence but also exhibit their outstanding professional skills. In the practice of external-driven force, it is proposed medical practitioner be able to quickly and accurately judge the patient’s condition, and take action when facing various complex condition and treatment scenarios. Based on proficient skills of medical practitioner, it is ensured that patients receive efficient and pain-free treatment. Regardless of poor or special needs, medical practitioner should always treat every patient with the same standard and put their well-being as first interest.
In the current study, the professional ethics of medical practitioner is emphasized. Medical practitioner should firstly be engaged in self-learning and self-cultivation, fulfill excellent professional ethics, and help patients recover health with a benevolent and superb skills. Regardless of the severity and urgency of the illness as well as the complexity of treatment, Medical practitioners should choose the most suitable drugs and treatment plans by objective analysis. They should not only pursue the best treatment effect but also take into account of the minimum expenditure and humanity of the treatment. The external-driven force plays a key role in achieving the goal of Theory of Benevolence Art and fulfill the purpose of saving the dying and helping the wounded. It is not easy seen that being patient-centered function as a player in achieving the unity of the benevolent spirit from inside to outside and proficient skills.
In summary, the traditional Chinese nursing concept is deeply rooted in the history of medical development, emphasizing the importance of nursing in disease treatment and advocating core ideas such as “medicine as a benevolent art,” “prevention before illness,” and “unity of heaven and man.” These concepts require medical staff not only to possess professional skills but also to emphasize respect for life, a heart of benevolence, and the ability to put oneself in others’ shoes. The theoretical system of traditional Chinese nursing integrates Confucian “benevolence” and medical “skills,” demanding that medical staff strive for excellence in technology and have a profound humanistic care in morality, in order to achieve comprehensive and meticulous nursing for patients, promote their physical and mental health, and improve the quality of life.
Funding: This research was funded by the National Natural Science Foundation of Henan (No. 242102310556) and Educational Foundation of Henan (2024YB0221).