Chinese Medicine
Discussion of some prominent features of Chinese medicine and the traditional reaction of the people toward disease will help us understand the Chinese system and allow us to gauge its relative effectiveness from the modern point of view.
Quarantine, which was a common practice in Europe from the fifteenth century onward, was never widely practiced in China. There were, however, instances of isolation of individuals for certain diseases such as smallpox and especially leprosy.Apparently, lepers were put into “lazaretto”-type hospices as early as the Qin dynasty (221-207 B.C.), and examples of such institutions are also found in sixth-century sources (Xie 1983). Unfortunately, there is no systematic documentation relating to hospices, and there is only sporadic mention of them in later sources. In the mid-nineteenth century, for example, we know that leper hospices existed in eastern Guangdong, where interned lepers were allowed to marry only among themselves. Moreover, their offspring were freed only after the third generation, when the genetic “poison” was believed to be exhausted (Liang 1982). In the same period, leper hospices were also organized by overseas Chinese communities in Batavia (Yang 1842).
As for smallpox-quarantine measures, there is at least one instance on record. In 1645, when the Manchus had just conquered Peking, they decreed that all smallpox victims and their families be banished 40 U (about 3 miles) from the city wall. The policy was still in force in 1655 (Hopkins 1983; Leung 1987a). Yet, as noted above, these were exceptional instances, and it is difficult to understand the Chinese lack of interest in quarantine (Leung 1987a). Ethics, however, probably had something to do with it. Moralists like Zhu Xi of the twelfth century, for example, condemned the “abandoning” of one’s relatives and friends who fell victim to contagious diseases.
Rather, one should risk infection by remaining behind to care for the sick, and there existed some conviction that moral power thus manifested would somehow keep the epidemic spirit away (Huizhoufu zhi 1502). On the other hand, the concept that diseases were caused by broad environmental influences - ether or vital energy (qi), wind (feng), fire or heat (hud), and water (Xie 1983) — would also seem to have discouraged quarantine measures.Chinese medicine as a body of knowledge to fight disease never developed into a “science” as it did in Europe from the seventeenth century onward. For the scholar, medicine was a respectable field of study linked to philosophy, although the practicing physician was not accorded a high social status (Hymes 1987; Leung 1987a). Medical skills were transmitted within families and not by government-authorized institutions. The Imperial Academy OfMedicine (tai- yiyuan) trained doctors only for government service and for the imperial family, and had no obligation to standardize medical knowledge or control the medical profession. Under such circιunstances, medicine had a tendency to become “democratized,” because all educated people had access to medical literature. Popular Ming-Qing almanacs and encyclopedias must also have reinforced this trend (Leung 1987a).
As in premodem Europe, peddler-doctors, selftrained midwives, women-pharmacists and other “heterodox” healers flourished especially in the countryside. Women and children were often treated by female healers exclusively (Leung 1987a). In 1759, a book on the principles and practices of peddlerdoctors, A Collection of Proper Methods (Chuanyd), was published by the scholar-pharmaceutist Zhao Xuemin. The work was based on his interviews with a peddler-doctor and reveals a long tradition of popular healing that relied heavily on acupuncture, purging either through ding (provoked vomiting) or chuan (provoked diarrhea), and other methods (jie) that aimed at stopping symptoms instantly.
Yet healers who practiced these “violent” methods were the lowest stratum in a system that emphasized memorization of abstract theories from the medical classics, subtle diagnosis, and a long and respectable family tradition of medical practice.More often than not during epidemics, state financial aid was used for buying coffins to bury the dead (Leung 1987a), and people, high and low alike, commonly resorted to rituals and shamanistic practices when illness struck. Indeed, healing by charms and amulets (zhuyou ke), which had its roots in antiquity, was part of the curriculum of the Imperial Academy of Medicine since Tang times. Diseases and especially epidemic diseases were firmly believed to be caused by unpacified ghosts and spirits of the locality; thus rituals were essential in disease avoidance (Huangchao jingshi wenbian 1897). Individuals afflicted by illness were likely to ask help from various deities, or to correct moral faults that were believed to be the source of the physical corruption (Leung 1987a).
Such fatalistic attitudes toward illness and lack of total confidence in medicine should not be cause for surprise. To a certain extent, this behavior is still prevalent among the Chinese populace today.
Angela Ki Che Leung