CHINESE MEDICINE: CLASSICAL, TRADITIONAL, AND MODERN

11 May

Until  recently,  Western  historians   of  science and  medicine  generally ignored China,  except for a few exotic items and inventions  that  could be rationalized  as crude precursors  of technologies  brought  to fruition in the  West,  such as gunpowder  and  printing.  Fortunately, the  work of Joseph Needham,  Nathan Sivin, Paul Unschuld,  and other  scholars has helped redefine the place of Asian studies in the global  history  of science and medicine. Scholars  have suggested that  a fundamental dif- ference between  Greek  and  Chinese  thought was the  competitiveness of early Greek  political  and  intellectual  life. In contrast, the power of autocratic rulers in China  forced scholars  toward  consensus  positions. Consequently,  while Greek thinkers  were free to criticize their mentors and rivals, Chinese scholars accepted aspects of change that Greek philosophers rejected.  Thus,  Chinese  astronomers and  Chinese  physi- cians  made  very  different  assumptions   about   the  movement   of  the heavenly bodies and the movement  of the blood.

Most elements of the ancient learned systems have essentially disappeared, or survive only in folklore  as quaint  vestiges of the past, but  supporters  of  Chinese  medicine  maintain   that  it  is  and  always has  been  a viable scientific enterprise.  Traditional Chinese  medicines and  healing  techniques  have  gained  a  significant  place  in  the  alter- native  or  integrative  medicine practiced  in the  Western  world  today. Certainly,  classical Chinese  medicine is remarkable for its persistence and  adaptability. In practice,  the system exhibits  an exceptional  level of flexibility. A patient  of Chinese medicine might receive 10 different prescriptions. Rather  than  conclude  that  most  of these  prescriptions must be useless, the patient  might find many of them satisfactory  and effective.

More than  any other culture, China has maintained its traditional medicine not  only in folk remedies,  but  also in mature  and  respected forms.  In  part,  this  unique  stability  can  be attributed to  a profound reverence  for  the  past  and  a system of writing  perhaps  six thousand years old. Although  many scholars have discounted  the earliest chapters in China’s historical  narratives,  recent archaeological  and archival dis- coveries will doubtlessly  transform much  mythology  into  history  and much  history  into  mythology.  Since the 1970s, Chinese archaeologists have experienced a golden age of discovery. Ancient tombs have yielded treasures   ranging   from   panels   of  magnificent   wall  paintings   and manuscripts  written on bamboo  or silk to well-preserved bodies, skele- tons, and hordes of life-sized terra-cotta figures of warriors complete with weapons  and  horses  from  the Ch’in Dynasty  (221–206 B.C.E.)  and  the Han Dynasty  (206 B.C.E.–220 A.D.). Archaeologists  and art scholars think that  these remarkable terra-cotta warriors,  horses, chariots,  musicians, and farm animals once served as symbolic escorts into the afterlife for members of the nobility.

Much of the China’s history is obscured by warfare and chaos until the Ch’in unification  in 221 B.C.E.  To enforce his goal of total  reorgani- zation, the Emperor  Shih Huang-ti  ordered the destruction of all surviv- ing  manuscripts   in  order  to  erase  unacceptable historical  traditions. Exceptions were made only for texts dealing with medicine, drugs, divination, agriculture,  and  forestry.  During  the  centuries  of conflict, scholars  as well as peasants  assimilated  the concepts  that  formed  the framework  of classical Chinese medicine: belief in the unity of nature, yin–yang dualism, the theory of the five phases, and a medical practice based on the theory  of systematic  correspondences.

Some elements of this system can be traced back to China’s Bronze Age, the period of the Shang Dynasty,  which was already flourishing by the fifteenth  century  B.C.E.  Scholars  once consigned  the Shang Dynasty to the realm  of legend, but  excavations  begun  in the 1930s have pro- vided  evidence that  the  Shang  era  served as the  formative  period  of Chinese culture.  So-called oracle  bones,  inscribed  with an archaic  but essentially  mature  form  of  written  Chinese,  have  provided  valuable insights into this semilegendary  era.

Oracle bones used in divination  ceremonies were made of various materials, including the shoulder blades of oxen, goats, and sheep, turtle shells, antlers,  and even human  skulls. According  to Shang beliefs, the well-being of the living was dependent on the will of the ancestral spirits that rule the world. If the ancestors were displeased, their hostility could cause disease, crop  failures,  and  military  defeats.  In  order  to  address questions  about  battles, harvests, illness, and epidemics to the ancestral spirits, appropriate bones or shells were carefully prepared  for the king and his diviners. During  the divination  ritual, pairs of antithetical ques- tions were addressed  to the spirits; for example, ‘‘Will the king recover from his illness’’ and ‘‘Will the king not recover from his illness?’’ Heat was applied  to  the  oracle  bone  with  a heated  bronze  rod,  a burning stick, or a glowing piece of charcoal. If the bones had been properly pre- pared,  heat  would  result  in the appearance of a pair  of cracks  resem- bling the written  character  ‘‘pu,’’ a vertical line joined about  midpoint from the right by a perpendicular line (). If the angle between the lines was close to the perpendicular, the answer was yes; if not,  the answer was no.

Shang writings and divination  were essentially forgotten  until the end of the nineteenth  century even though  oracle bones could be found in almost  every traditional Chinese apothecary shop. When physicians included  ‘‘dragon  bones’’ in their  prescriptions for  disorders  ranging from  lung  diseases  to  anxiety  and  nocturnal emissions,  apothecaries used bits of ancient  bones and  shells, including  many  that  had  served as ancient  oracles.  Since nineteenth  century  fossil hunters  discovered that  collections of dragon  bones often contained  valuable  fossils, hun- dreds of thousands of oracle bones have been collected. How many were pounded  into medicines over the centuries can only be imagined.

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