PAST

mmm
hinese medicine's The past 1 0 0 0 years of indices to combinations of

C formative
reminiscent of
earlier rise of Hippocratic
period,
the Chinese medicine
specific pharmaceutical sub-
stances. For reasons unknown
and concomitant with these
medicine in ancient Europe and Paul U Unschuld developments, acupuncture lost
roughly coinciding with the much of its appeal by the
reign of the Han dynasty, lasted from the 2nd century BC middle of the second millennium, An impressive
to the 2nd century AD. Henceforth, attempts to prevent compendium of knowledge about needle piercing, the
and cure illness on the basis of an understanding of natural Zhenjiu dacheng, was published in 1601, 3 years after the
laws coexisted with older notions of health fled to beliefs in appearance of the Bencao gang mu, a comprehensive
ancestors or the supernatural and a rich tradition of drug " pharmaceutical encyclopaedia. Yet, it was not uncommon
lore. The theories of systematic correspondences between for medical authors to note, as t~e eminent physician and
phenomena, known as the yin-yang and writer Xu Dachun did in 1754, the
five-phases doctrines, were applied demise of the acupuncture tradition.
almost exclusively to map the human With the rise to power of the Ming
body, to explicate its normal and dynasty in the 15th century, nationalists
pathological functions, to pulse diagnosis, began to wonder what had gone wrong in
and to guide needle treatment Chinese intellectual history. So when the
(acupuncture). Ming dynasty was overthrown in 1648 by
Beginning only in the l lth century their northern Manchu neighbours who
AD, eminent physician-authors system- subsequently set up the Qing dynasty, a
atically explored the application of drugs movement gained momentum in the
guided by correlative thought, thereby 17th and 18th centuries that advocated a
creating a pharmacology of systematic return to ever more distant layers of the
correspondence. These developments past to uncover the sources of former
were part of a far-reaching neo- Chinese independence and glory.
Confucian re-orientation of the Chinese Medicine was no exception. While some
elite, that is, of an adoption of concepts schools continued to adhere to the
by Confucians that previously had theoretical models of health and disease
belonged within the purview of Daoism, construed between the 12th and 15th
and of a development of new concepts centuries, an increasing number of
that were directly opposed to comparable authors sought to regain a presumed
ideas within Buddhism. These develop- advantage of antiquity when empirical
ments also reflect reactions by some A western trader presents a Chinese knowledge was not marred by theoretical
physician-intellectuals to a policy by the with ainaxiang leaves (Blumea speculation. They focused on philological
state to curb the influence of professional balsamifera DC) reconstructions of the medical and
healers. Neo-Confucian moralists asked From a Chinese manuscript of AD 1505. pharmaceutical texts of antiquity or tried
the educated to acquire sufficient medical to grasp the spirit of old wisdom and
knowledge to treat their kin themselves, rather than turn to portray it as the mould into which more recent knowledge
those who practised medicine as an occupation. In the 12th was to be poured. Others probed new paths altogether. For
century, the government sponsored the publication of a few physicians even a glimpse at folk healing or a careful
prescriptions, encouraging people to identify suitable and systematic inspection of human anatomy proved
recipes for their illnesses and purchase these medications in rewarding; both these realms had been mostly out of reach
government-operated apothecaries without having to see a of the gentleman physician in previous centuries. A title like
physician first. Authors the Chuanya, compiled by the scholar-physician Zhao
began to point out that each Xuemin from the notes of an itinerant healer at the close of
illness is a unique event that the 18th century, offers a rare view of the most common
requires an individualised medications and medical techniques.
diagnosis. When western medicine was introduced to China in the
Subsequently, Chinese 19th century, it confronted a heterogeneous array of ideas
medicine took the form of a and practices that encompassed both onfic and holistic
stream flowing into an perspectives. Ontic theories traced illness to an intrusion of
increasing number of the body by pathogenic agents, whereas holistic ideas
separate and sometimes portrayed disease as a departure from a harmonious state
criss-crossing river beds. The guaranteed by a lifestyle that accorded with the basic laws
most well-known authors governing the universe. The 20th century has brought the
between the 13th and 15th further development of Chinese medicine within the
centuries offered explanatory confines of its traditional theoretical foundations to a
models of the basic causes of complete halt. As the ancient doctrines of yin-yang and the
human illness. Increasingly five phases lose their importance in everyday life, every new
elaborate theoretical struc- generation in China is increasingly alienated from the world
tures were published that view of systematic correspondence. Nonetheless, over the
linked a patient's status by past decades an empirical and scientific basis has been built
means of intricate diagnostic to justify the application of Chinese medicine in the future.

SlV9 The Lancet • 2000 ° 354 • December ° 1999