Literature and Specialties
Before the decline of the last of the imperial dynasties at the end of the nineteenth century, Chinese medicine developed on many levels and in many directions. Even though new insights and data were being accumulated virtually all the time, it maintained its original theoretical foundations; perhaps a peculiarity of Chinese medical history is that the concept of obsolescence remained almost entirely alien to it.
Indeed, before modern Western thought made an impact, no theory or practice was ever relegated to oblivion as outdated (only in pharmaceutics do some herbals list “drugs no longer in use”). The notion of a dialectic advancement of knowledge or of “scientific revolutions” does not apply to Chinese medicine. In fact, one should speak of an expansion rather than of a progression of knowledge, because the etymology of progress implies that something is left behind.More than 12,000 titles of premodern Chinese medical literature from a period of about 2,000 years ειre available in libraries in China and other countries today, but not even a handful of these texts have been translated into modem languages in a philologically serious way. Hence, only some very basic historical tenets of traditional Chinese medicine are known in the West, and it is imperative that access to many sources be provided so that comparisons can be made with the history of medicine in other cultures. In this connection, it is important to note that Chinese medicine developed the same specialties as did traditional European medicine. Separate sections in the often very voluminous prescription works and individual monographs were devoted to such problems as children’s diseases, the diseases of women, skin problems, eye complaints, and throat ailments. The following provide a few examples: The earliest extant title concerned with the diseases of children is the Lu-hsin ching (Classic of the Fontanel), of unknown authorship and compiled around A.D.
907, which was presumably based on sources of the fourth century or even earlier. The oldest available text today on women’s diseases and obstetrics is the Fu-jen Iiang fang (Good prescriptions for females) of 1237 by Ch’en Tzu-ming. A text, lost now, possibly dating back to T’ang times and indicating the Indian origins of Chinese ophthalmology, is the Lungshu p’u-sa yen Iun (Bodhisattva Nagarjuna’s discourse on the eyes), and a first monograph on leprosy was published by Hsiieh Chi in 1529 under the title Li-yang chi-yao (Essentials of the Ii- Iesions). On ailments affecting the throat, the oldest text extant is the Yen-hou mai cheng t’ung Iun (Comprehensive discourse on vessel [movements] indicating [the condition of] the throat), of unknown authorship and dating from approximately 1278.Although, as has been stressed, Chinese medicine emphasized an ontological perspective and was quite familiar with Iocalistic notions of illness, only a few dissections were recorded during the imperial age, and surgery was never developed much beyond the knowledge needed for performing castrations. Cataract surgery was introduced from India as early as the T’ang dynasty, but was never really integrated into Chinese medicine or further developed, despite the great number of patients who could have benefited from such operations.
The reasons for such reluctance to explore human anatomy and develop surgery are unclear; also unclear is the reason for the failure to expand certain knowledge that reached an impressive stage at some early time but went no further. An example is the world’s first treatise on forensic medicine, the Hsi yuan Iu (The washing away of wrongs) of 1247 by Sung Tz’u. Although it preceded comparable Western knowledge by several centuries, it remained a solitary achievement, for no author is known to have built upon and improved this work. In contrast, pharmaceutical literature was continuously expanded and amended throughout Chinese history.