Medicine in East Asia
HI 176: Lecture 6
Dr. 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 (18971910), 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 microcosm
of 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 (206BC-220 AD) works,
which was allegedly distorted by Song-era (960-1279)
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 & SelfStrengthening
-
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?