History of Medicine: Traditional Chinese Medicine

In 1975, the Huangdi Neijing (The Inner Canon of the Yellow Emperor) was found in an ancient tomb that was closed in 164 BCE. Written 50 to 100 years earlier before it was sealed, this book is the most famous Chinese medical text. Before the Han dynasty (260 BCE to 220 CE), Chinese medicine was more into magical thinking, but this book stated that illness was not caused by evil demons, but by events and experiences that occur in the world. Watts says this better:

“The revolutionary breakthrough first exemplified in the oldest essays in the Inner Classic is that the health or illness situation of individual men is not caused by malevolent demons or ancestors. Instead, it is caused by happenings in the world which can be studied and comprehend by mankind, using human reason.”

HUANGDI NEIJING

Thes essential pillars of tradtional Chinese medicine (TCM) were refined within the Huangdi Neijing. The book is named after the Yellow Emperor, or Huangdi, an early and highly venerated ruler. The book compiles centuries worth of philosophy, and was most likely completed by Han dynasty (206 BCE to 25 BCE). The book is divided into two sections, Suwen (Plain Questions) and Lingshu (Effivacious Pivot). Suwen is organized as a dialogue between Huangdi and his advisers, who are contemplating questions ranging from anatomy and physiology, to geography and astronomy. Lingshu concentrated on acupuncture, which is the practice of using needles at particular points in the body to either replenish it, or remove a blockage within channels of chi/qi (vital internal energy) (Hoizey and Hoizey). Huangdi Neijing also mentions four methods of diagnosis: visual observation, questioning about case history, auditory symptoms, and taking the pulse (Croizier).

Like Ayurvedic medicine, TCM had its own spiritual foundation. The Five Phases (Wuxing) refers to the five materials: water, fire, earth, wood, and metal. These were the makeup of the universe and of life itself, including the body. In nature, these elements reacted with one another, through creation and destruction. For example, wood (from trees) is created by water and metal, but wood itself creates fire and breaks earth (Hoizey and Hoizey). The elements were tied to bodily processes and the functioning of organs. For instance, fire was the element of the heart, and through the heart, brought joy and laughter (Croizier; Hoizey and Hoizey). By connecting the spiritual functions of each organ, an image of a whole body can be synthesized; The Huangdi Neijing has written “The east gives rise to wind, wind produces wood, wood gives birth to acid, acid nourished the liver, the liver supports the muscles, and the muscles sustain the heart” (Hoizey and Hoizey).

Interestingly, wind (feng) was the disease agent (or at least carried the agent). Body parts also had yin yang components. For example, the heart and kidneys were yin, while the stomach and intestines were yang (yang is light, yin is dark) (Watts).

 The Han dynasty had brought the obscure Confucius to the highest pedestal, making him the nation’s greatest philosopher. Medicine followed the ways of Confucianism – live a moderate, balanced life, control temper, and act respectful. If one was sick, it was because one did not live according to the correct morals and the order of the universe (Watts).

The Chinese created a vast encyclopedia of herbal medicines, or a pharmacopoeia, which contained 365 drugs. Such medicines were classified ranging from “superior,” which were non-toxic, to “inferior,” or toxic drugs used for severe ailments. Two thirds of the medicines were of vegetable origin, the rest being made from animals and minerals. By the late 16th century, the famous pharmacologist Li Shi-Chen compiled all pharmacopeias into a single text, known as the Pen-tsao (Croizier).

DIAGNOSIS AND TREATMENT

The main issue when a person becomes ill is that there must be an imbalance with chi flow, while healthy person’s chi is in balance (Watts).

The pulse was a very important part of Chinese medicine. There were at least 51 kinds of them. Just by the categorization of the specific pulse would the doctor be able to diagnose the disease (Pollack).

In acupuncture, thin needles are put into the body, with 338 points where they could be inserted, depending on symptoms. The idea is that there are channels in the body which move qi. The needles allow for good energy to come in, and bad ones come out, thus balance can be reached. Another big treatment is moxibustion, in which dried plants called “moxa” are burned near the surface of the skin. It is supposed to stimulate the body (Pollack).

Acupuncture

Moxibustion

STATUS OF PHYSICIANS

The most famous Chinese physician was Pien Ch’io (6th or 5th century BCE). He wrote Nan-ching (Concerning Difficult Problem). But he was murdered by a physician who was jealous of his success. Another famous one included Huan T’uo, the greatest Chinese surgeon. Surgery though didn’t really advance. Dissection was forbidden, so there was a lack of anatomical knowledge (Pollack). An abstract on pubmed states:

“Despite the fact that anesthetic agents in major surgery were employed during the third century, Chinese surgery is conspicuous by its stagnation. Reverence for the dead, filial piety, abhorrence of shedding blood and other conservative attitudes make it impossible for any accurate knowledge of the human anatomy and physiology, without which surgery cannot progress.”(http://www.ncbi.nlm.nih.gov/pubmed/20002988)

While medicine itself was praised, the actual medicine men were not so upheld. Doctors were viewed as tradesmen, and many were men who did not pass their civil service exam. Because doctoring was considered a special art that was potentially profitable, doctors were competitive with one another and only passed down their knowledge to their sons. People thought that doctors should work altruistically, and so should not take payment. But if this was a man’s livelihood, he was forced to take payment, degrading his status in the process  (Croizier). Other physicians, especially those serving the courts and other high classmen, were esteemed (Medicine and Society in China). Community doctors had no formal education, and learned by experience (Pollack).

CRACKS IN THE SYSTEM

By the Ming dynasty (1368-1644), the medical system was broken into different groups. The mandarins also upheld the respect of old texts and banned any new takes on old writings, at the cost of innovation. By the Manchu dynasty (1644-1911), traditional Chinese medicine was at a standstill, as the Europeans finally reached shore with their new brand of medicine (Pollack).

Since then Chinese medicine had come under attack. Younger, pro-Western Chinese found their old medicine backward. The traditionalists believed modernists to be naive, lacking the ability to understand. By the end of the 20th century, both camps, traditional and western, were at odds (Croizier). Under the Communist government, traditional medicine was given its legitimacy. The field became standardized and scientific research began on effectiveness of treatments (Taylor).

Traditional Chinese Medicine has been in practice for thousands of years and continues to play a role in healthcare today. Though it has suffered from its lack of scientific basis, it has proved effective in relieving illnesses (especially with acupuncture, which is used as an alternative to anesthesia during surgery). For many people, Chinese medicine’s emphasis on the spirit and unseen elements allows for people to also care for their own inner well being, not just their physical bodies. Despite its lack of recognition over the years, traditional medicine has survived due to the Communist government’s belief that as an ancient practice, it still has a place in Chinese society.

SOURCES:

Disease and Medicine in World History by Sheldon Watts

The Healers by Kurt Pollack

Traditional Medicine in Modern China by Croizier, R. C.

A History of Chinese Medicine by Hoizey, D., & Hoizey, M-J.

Medicine and Society in China edited by Bowers, J. Z. & Purcell E.

Chinese Medicine in Early Communist China, 1945-63 by Kim Taylor

 

 

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