Leslie:Asian Medical Systems

Introduction Pp.1-12

Page 1:

1. Most health practices and concepts worldwide continue ancient traditions particularly ideas about how body processes can go off balance.

2.That body equilibrium can be thrown off ---first seen in humoral theories thousands of years ago. But such ideas still held by many Asian
European and African cultures

3. All folk cultures practice humoral medicine

4. In some countries like India, China and Srilanka we find an institutional adaption of these indigenous medical traditions---so these are taught –
in the form of Ayurveda ,Unani and Chinese medicine systems in these countries

5. These coexist alongside cosmopolitan medicine ( remember Baer ---ethno medicine and biomedicine coexisting)

6. Physicians and folk practitioners together provide health care

7. These medical systems according to Leslie, reflect a union of ancient scientific practices and ways of thinking and enable an analysis of how
these are related to modern cosmopolitan medicine

Page 2:

1. Three medical traditions that have been central to world societies and arose in the period called ‘Oikumene’ of old world civilization --- are
the Mediterranean or Unani,South Asian or the Ayurveda and the Chinese

2.Leslie calls these three “great traditions” of medicine, borrowing on Robert Redfield’s idea

3.He identifies certain features of these:

a) Though in contact they maintained their identities--Each had a separate integrity of tradition that was not lost
b) The three share general features of social organization that are generic and create a body of knowledge that can be compared to
cosmopolitan medicine

4.The Mediterranean system, formulated by Galen,in 2nd century -- continued in the same way and eventually coming to Asia with the spread of
Islam-- was called Unani tibbia in Arabic and continues to be called this and practiced as this in South Asia Pakistan and India today

5. Similarly we find the Chinese and the South Asian medical systems spread across the world

Page3:

1.As mentioned the three systems were independent but evolved in similar ways:

a) All three became professional branches of medical learning between 5 th century BC and 5th century AD
b) All three had significant scholars defining the systems namely Charaka, Galen and Nei Ching
c) Different texts carried knowledge and methods of treatment and knowledge of these gave status to individuals
d) Their high status was reflected also in their dress and appearance. They also followed ethical codes
e) Women were not a part of the systems and the texts were masculine
f) The practitioners gained knowledge by studying the texts and training but there were also those who followed simplified
understanding of the methods and practiced
g) Thus healers and practitioners coexisted ---bonesetters shamans etc
h) The texts made a clear distinction between—learned and humble, full time and part time practitioners, generalists and specialists,
clearly to separate the quacks and the learned

Page 4.

1.In all these societies the armies needed medical help and so the services were patronized by rulesrs and many engaged in philanthropic activity
to promote the medical institutions and knowledge
2. Besides similarities in their organization of practice, Leslie says that the three systems were formulated from “generic physiological and
cosmological concepts”

a) All were humoral theories--4 in the Unani/3 in the Ayurveda /and 6 in the Chinese
b) These humors represented pairs of opposed qualities and their equilibrium was necessary for health and balance
c) This equilibrium depended upon age, sex, season, food etc
d) Diagnosis depended on practitioner’s skill and an understanding of the patient’s environment
e) Therapy involved manipulations modifications of diet and medications---medications were prepred and were often esoteric such has
containing saffron and gold

3.The three traditions also believed that the human anatomy and physiology were bound physical systems

4The body was a microcosm of the larger universe---and a balance of elements was related to a balanced universe

5This belief also meant that attention was give to the relation of men to their environment and preventive ad curative medicine sought to also
maintain a cosmic balance

Page 5

1. Towards the end of the 14th century developments began in Europe that eventually led to the rise of a universal cosmopolitan medicine even
though up to the 19th century humoral theories dominated

2. The scientific theories and organization of cosmopolitan medicine took time to grow and expanded with rise of modern science and the
industrial revolution

3. During the period of Renaissance and Reformation (between 12th and 17th century), new scientific work emerged often questioning ancient medical
ideas and authorities

4. A greater regulation of medical services arose and teaching and research expanded

5. It was only in the 19th century that the main achievements of cosmopolitan medicine were reached such as germ theory, new surgical
techniques

6. Such advances not only led to refinement of medical services and knowledge but also increased their role in social welfare greater
professionalization also arose along with a bureaucratization of medical services ,role of the Sate to regulate and license medical practices

7. Most important the “preeminence” or the medical knowledge of illness and it treatment under cosmopolitan medicine was now recognized

Page 6

1.In all societies today there is respect for cosmopolitan medicine and its ability to cure and the role of the State in enabling its growth ( we are
seeing this right now with the Corona virus)

2. In almost all social classes in contemporary society , the doctors play a critical role in different life events of birth illness and death.Th
ethrories of medical knowledge define the standards of health and abnormality and shape how people think about what is normal

3 People from different cultures and classes are open to adopting the techniques and medications of cosmopolitan medicine

4. However there is also a bias seen I the way in which rural plpulations are treated by health care workers and doctors

5. In such situations the role of the local and indigenous practitioner becomes important and he uses different elements of cosmopolitan medicine
to treat patients ( this is what we saw in Nichter)
6.People go to the cosmopolitan practitioners only in emergency situations ( as seen with Gould study of smallpox)

Page 7

1.Leslie point sout that in our understanding of medical systems we must be clear that when we compare the idea of cosmopolitan medicine with
traditional/folk medicine we also find, that there is a change taking place in the world of medical understanding.

2.Rather than there being an opposition between the two medical systems of the folk and modern we find folk practitioners open to using modern
medicine and learning about it just as cosmopolitan medicine uses folk or traditional methods. For example in China the coexistence of modern
medicine and traditional medicine is a way of life.
3. Often the term scientific or modern is used to denote cosmopolitan medicine but these terms overemphasis the scientific or modern elements
and ignore that these can and do coexist with the traditional

4.Even within the scientific many elements are unscientific.Such an argument also assumes wrongly that all medicine that is not modern or
scientific is traditional or unscientific.Leslie highlights how infact, Chinese Ayurveda nad Unani are scientific systems

Page 8

1. He also argues that the term western medicine is equally misleading because he says the social organization of all medicine is professional and
not all medicine systems are Western

2. For comparative purposes he believes the term cosmopolitan medicine is most suited and therefore uses it.

3.Leslie says that today cosmopolitan medicine dominates institutions and treatment in all societies but people continue to use the humoral
systems as well as seen in large parts of Asia and China,where the folk practitioners alsoprovide medical care.

4.Thus he says great and little medical traditions coexist in many nations such as India and China and we need to study both to understand what
is best for the human condition an equilibrium.

Page 9 --ignore

Page 10

1.We need to recognize that in Asian medical systems ,folk the humoral and cosmopolitan medicine coexist and there is pluralistic approach to
medicine

Read page 11 and 12