Theoretical Foundations and Treatment
The most impressive mode of treatment recorded in detail in the Ma-wang-tui scripts is drug therapy. More than 200 active drugs and neutral carrier substances were described, as was a highly developed pharmaceutical technology.
Other therapies included massage, minor surgery, hot baths, sexual practices, dietetics, and moxa cauterization, in addition to various magical interventions. Acupuncture was not yet referred to and appeared first in the already mentioned biography of the semilegendary physician Pien Ch’io compiled by Ssu-ma Ch’ien in 90 B.C. Because no earlier documentation of needling exists in China, the origins of acupuncture, possibly the most recent mode of therapy in the history of Chinese medicine, remain unknown.For about 1,200 years after the emergence of Chinese medicine, until the end of the Song dynasty in the thirteenth century, a dichotomy prevailed between two major currents. One was the so-called medicine of systematic correspondence; the other was pragmatic drug therapy.
The ideology of systematic correspondence appeared almost simultaneously in China and ancient Greece (possibly stimulated by a common origin, the location of which is unknown) around the sixth century B.C., when it became the theoretical underpinning of the functional approach to an understanding of health and illness.
The (most likely older) ontological understanding of illness is based on a recognition of struggle, attack, and defense as normal modes of interaction in nature. Both human behavior and the daily observation of attack and defense among other animals and plants supported this worldview.
In contrast — and this is to be regarded as one of the outstanding cultural achievements of humankind - the ideology of systematic correspondence is based on the concept of harmony as normal, and of a loss of harmony as abnormal, states of existence.
Like the ontological notion, the notion of systematic correspondence drew on sufficient environmental and social evidence to be plausible; it gained legitimacy from its emphasis on the regularity of countless natural processes, a regularity that was guaranteed by the appropriate behavior and location of each perceivable phenomenon in a complex network of interrelatedness. It holds that inappropriate behavior jeopardizes this regularity, or harmony, and leads to crisis. This crisis may occur in nature, in the affairs of state, or in the life of an individual, in the last case leading to illness. Hence, this ideology is holistic in that it views both the individual physical/ mental organism and the sociopolitical organism as corresponding to identical principles, and “health” is a notion transcending them.The ideology of systematic correspondence assumes (as this designation by contemporary scholars implies) a relationship of correspondence among virtually all tangible and abstract phenomena in the universe. Phenomena of identical quality are grouped within a category, and two or more categories are linked with one another and interact with one another according to certain natural laws. Various schools emerged within the framework of systematic correspondence, advocating the existence of two (yin and yang) or five (five-phases) categories of all phenomena.
The yin-yang school was based on a perception of the unity of two antagonistic categories of all existence. Day and night are opposites, and yet they form a unity. The same applies to male and female, heaven and earth, summer and winter, above and below, dominating and submitting, and so forth. Beginning in the fourth century B.C., day, male, heaven, summer, above, and dominating were identified as qualitatively identical and were categorized as yang, their opposites as yin. The Huang-ti nei- ching contains more sophisticated groupings into four and six yin-yang subcategorizations, which may have developed in the meantime.
The second school, the five-phases school, recognized five categories of qualitatively identical phenomena, symbolized by five essential environmental elements: metal, wood, water, fire, and soil. These five categories represented phases in the succession, and hierarchical stages in the interaction, of certain phenomena. For example, the liver was associated with the phase of wood, and the spleen was associated with the phase of soil. Wood - for instance, as a wood spade — could move soil; hence, a specific relationship between liver and spleen could be explained as resulting from a potential of the liver to subdue the functions of the spleen.
The Huang-ti nei-ching and the Nan-ching linked these notions of systematic correspondence with physiology, etiology, and therapy. As a result, the human organism was described as a microcosm of interrelated functional units associated with the more encompassing categories of all being, and hence with the social and physical environment. Not surprisingly, the reasons for maintaining individual health, or for the emergence of illness, closely paralleled the reasons for social and environmental harmony and crisis. The only therapeutic mode within this system of ideas was acupuncture (and to a certain degree dietary means and moxa cauterization).
The Shen-nung pen-ts’ao ching contained virtually no references to the concepts of systematic correspondence. Pharmaceutics developed along its own lines from a description of 365 substances in Shen- nung’s herbal of the first century, to 850 substances in the first government-sponsored materia medica in 659, to more than 1,700 drug descriptions in the great herbals of the northern Song published from 960 to 1126.
One reason for this dichotomy may be seen in a basic antagonism between Confucian-Legalist thinking and the Taoist worldview. Confucian-Legalist social ideology has dominated Chinese society - with varying intensity - since the early Han dynasty. One of its conceptual foundations is the belief in social order, a social order maintained by the government through law enforcement and education, both of which encourage appropriate legal and moral behavior.
The medicine of systematic correspondence was built on identical tenets; health was promised to individuals if they followed a specific life-style congruent with Confucian-Legalist ethics. Needling, moxa, and dietetics were not meant to rescue the fatally ill, but were seen as stimuli to correct aberrations from a proper path.By contrast, drug lore promised to rescue individuals from illness regardless of whether they adhered to morality and human rites. From the Han through the T’ang dynasty, the development of pharmaceutics was closely tied to persons affiliated with Taoism. This phenomenon was obviously related not only to the Taoist quest for elixirs and drugs of immortality, but also to the value of drug lore for contradicting the Confucian-Legalist linking of social and individual well-being with an adherence to a morally legitimated life-style and to government-proclaimed laws. Taoists claimed such rites and laws to be the origins of social and individual crisis. Thus, it was only between the thirteenth and fifteenth centuries, in the aftermath of Song Neo-Confucianism, that certain Confucian-Legalist and Taoist tenets were united for a few centuries and that attempts were made to construct a pharmacology of systematic correspondence.