Medicine in East Asia

HI 176: Lecture 5Dr. Howard Chiang

Historical Context

Periodization of East Asian History- China: Ming (1368-1644), Qing (1644-1911),

Republican (1911-49), PRC (1949-present)- Japan: Edo/Tokugawa (1603-1868), Japanese

Empire (1868-1945), Showa (1926-89), Hesei (1989-present)

- Korea: Choson (1392-1897), Korean Empire (1897-1910), Japanese Colony (1910-45), 2 Koreas (1945-)

Qing:- Manchu preserved basic social/political frameworks- Kaozheng or ‘evidential scholarship’ movement- Opium War (1839-42); Taiping Rebellion (1851-64)- ‘Self-Strengthening’ (1861-95); Sino-Jap War (1894-

5)

First Opium War

Fuzhou Shipyard

Partitioning of China- Queen Victoria

- William II (Germany)- Nicholas II (Russia)- French Marianne

- Meiji Emperor

Medical Systems: East Asia

Until rather recently:- All healers and medical systems operated within a

common set of limits: none had any route of direct access to the internal workings of the body

- inferred from a narrow range of indirect evidence- Human body is a microcosm of the universe- Disease is a state of body imbalance

Chinese/East Asian Medical System:- Five ‘elements’/‘phases’ theory (wuyuan) –

metal (the lungs), wood (the liver), water (the kidneys), fire (the heart), and earth (the spleen)

Body as microcosmof the universe

Medical Systems: East Asia

Chinese/East Asian Medical System:- Yin (‘feminine’) and Yang (‘masculine’)

- dark/light, wet/dry, cold/warm- Does not impose a rigid duality

- within each predominantly yin or yang entity, characteristics associated with its opposite occur

- Huangdi Neijing or the Inner Canon of the Yellow Emperor: the earliest surviving medical text (200BCE)

- major channels known as jing and mai, through each of these channels flows a fluid substance called qi

- Healthy body depends on free circulation of qi- qi is polysemic: literal breath, wind in the meteorological sense, vital principle, life force

Hua Shou (1341) v. Vesalius (1543)

Social, Cultural, Intellectual Trends

- Qing period – fluid boundaries between multiple realms of curative and health-promoting activities

- No regulations controlled who could provide healing services – the ability to attract patients was the ‘practical’ requirement to become a healer

- Everyday knowledge exchange among friends, relatives, and neighbors

- ‘daily use encyclopedias’- ‘protecting life’ (weisheng) and ‘nourishing life’

(yangsheng) – former becomes ‘hygiene’ in 20th c.- Internal (neidan) vs. external alchemy (waidan)- People consult & compare multiple practitioners- Everyone could be his/her own doctor

Daoist Alchemy

Gentrification of Medicine

- 1772: Qianlong Emperor’s Complete Books of the Four Treasuries (Siku quanshu) – literary purge?

- ‘evidential research’ – to recover the original form and meaning of Han Dynasty works, which was allegedly distorted by Song-era commentaries- challenge Song-era Neo-Confucianism- close relationship to literate medicine in Qing

- Gentrification of medicine:- ‘medical legitimacy’ – from ‘3 generations of medicine’ (hereditary physicians, shiyi) to mastery of ‘3 canonical texts’ (scholarly physicians, ruyi)

- Qing: qualification & authority constructed on cultural terms rather than legal regulations

Complete Books of Four Treasuries

Global Medical Exchange

- The materia medica Bencao gangmu (1578) by Li Shizhen (1518-1593) could be purchased in Korea, Japan, Vietnam, and communities in Southeast Asia

- Tribute system – structured China’s relations with other kingdoms and conduit for medical exchange

- New in Qing: between China and the West- founding the Society of Jesus in 1540

- 18th century: - European interest in acupuncture and moxibustion- European interest in Chinese drugs: e.g., ginseng, ‘China root’, rhubarb, and tea

- 19th century: opium

Li shizhen’s Bencao Gangmu

Acupuncture / Moxibustion

Ginseng, Rhubarb, Tea

Western Medicine & Self-Strengthening

- Treaty ports – e.g., Shanghai & Tianjin- ‘cultural imperialism’ – Western medicine to E Asia- Tokugawa Japan – Dutch East India Company- 17th & 18th c. China – Jesuit Missionaries

- 1693, French Dominique Parennin, Manchu Anatomy

- 19th c. China – Protestant Missionaries- British Benjamin Hobson, Outline of Anatomy and Physiology (1851) – first systematic translation- Tongwen Guan in Beijing – translators’ school- Scottish John Dudgeon, Gray’s Anatomy (1886)- American John Kerr, Refuge for the Insane (1898)

Manchu Anatomy (1693)

Benjamin Hobson (1851)

Kerr Refuge for the Insane

20th Century Transformations

- In the 20th century, the cacophonous medical marketplace was eventually harmonized into a single medical system in which modern biomedicine became the model against which acceptable versions of Chinese medicine were measured

- 1928 – Ministry of Health in China- Yu Yunxiu (1879-1954) led the movement to

‘abolish old-style medicine’- Chinese medicine made appear more ‘scientific’

- edited new textbooks- founded new schools of Chinese medicine- National Studies movement – ‘national medicine’- embodied experience, what Western med. lacked

20th Century Transformations

Chinese medicine in the PRC (1949-present):- 1949-53 – subsumed under biomedicine- 1954-65 – creation of ‘traditional Chinese

medicine’- 1966-77 – led by ideological simplification- 1976-89 – exploded into myriad

options/possibilities- 1989-present – integration into global health care

Globalization:- Actively supported by WHO, promoted by the

Chinese state, dispersed by Chinese physicians, studied by conventional and alternative practitioners throughout the world, sought after by international clientele of patients

Chinese medicine- cultural imperialism?