MEDICAL PRACTICE IN MODERN CHINA

11 May

When the People’s Republic  of China  was founded  in 1949, Chairman Mao  Zedong  (1893–1976) declared  that  traditional Chinese  medicine and pharmacology constituted a great treasure-house that must be explored  and improved.  Mao’s call for the use of both  traditional and Western-trained doctors  was a pragmatic  response to China’s desperate need to  expand  the  pool  of health  care  workers  to  serve 540 million people,  typically  living  in  impoverished,   rural  areas  without   public health,  sanitary,  or  medical  facilities.  Circumstances   impelled  China into  a unique  experiment  in the integration of past  and  present,  East and  West.  The  revival of traditional medicine was launched  with  the Great  Leap  Forward (1958–1960), gained  momentum during  the Cul- tural Revolution (1966–1969), and peaked in the aftermath of this ideo- logical frenzy.

China’s health care system was dedicated to dealing with common and recurrent  diseases, public health work, and the eradication of major endemic disorders.  The motto  adopted  by the Chinese medical system was: ‘‘Eradicate the four pests!’’ The official four pests were rats,  flies, mosquitoes,   and  sparrows.   Cockroaches,  fleas,  lice,  bedbugs,  snails, and  mice were  also  targeted  for  eradication, but  listing  all  of  them would have ruined  a good motto.

By the 1980s, China  had  established  a health  care system that  is generally conceded to be a model for other developing countries.  Sensi- tive measures  of health  in Shanghai  in 1980, such as infant  mortality and life expectancy at birth,  compared  favorably  with New York  City. Western visitors were impressed by Chinese experiments in medical edu- cation  and  the  restructuring of medical  practice,  which obligated  the physician  to  share  diagnostic  and  therapeutic responsibilities  with  a newly empowered  array  of lay and  paramedical  personnel.  Preventive medicine  and  basic  primary  health  care  were provided  by legions  of ‘‘barefoot doctors,’’ midwives, and nurses. The use of herbal remedies, acupuncture, and moxibustion  remains the core of medical practice, but traditional doctors  also study microbiology and pharmacology. China’s colleges of Western medicine include training  in traditional medicine.

The  development  of  acupuncture anesthesia  has  been  hailed  in China as another  great leap forward.  Inspired by the thoughts  of Chair- man Mao, hospital workers began to wonder whether the pain-relieving effects of needling  that  had  been  exploited  in the  treatment of post- surgical distress might be used in place of chemical anesthetics  during surgery.  Even  in  China,  the  prospect  of  acupuncture anesthesia  was greeted with some skepticism, but in the 1960s acupuncture anesthesia was being used in about sixty percent of all surgical operations. Modern acupuncturists argue that,  in contrast  to chemical anesthesia,  needling allows the body to mobilize all its defense mechanisms, while maintain- ing normal  physiological functions.

The revival of interest in acupuncture and herbalism  has not been accompanied   by  commensurate attention  to  the  theoretical   basis  of traditional medicine. Separated  from its theoretical  framework,  Chinese medicine  could  become  merely a hodge-podge  of empirical  remedies, rather  than  a sophisticated philosophical  system capable  of providing guidance  and  inspiration  for  both  patients  and  practitioners. Chinese philosophy   and   medicine   have,   however,   always   demonstrated a remarkable capacity  for  syncretism  and  adaptation. China  is a living civilization,  in which the traditional arts  are intimately  linked to their modern  counterparts. Perhaps  the  thoughts   of  both  Huang   Ti  and Chairman Mao  will be subsumed  and integrated  into a new synthesis, still reflecting the goals of the Three Celestial Emperors  for the perfec- tion of Chinese medicine as a source of peace of mind, health, strength, and long life.

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