PAST

The past 1000 years of

C
hinese medicine's indices to combinations of
specific pharmaceutical sub-

formative period,
Chinese medicine stances. For reasons unknown
and concomitant with these
reminiscent of the Paul U Unschuld developments, acupuncture lost
earlier rise of Hippocratic much of its appeal by the
medicine in ancient Europe and middle of the second millennium. An impressive
roughly coinciding with the compendium of knowledge about needle piercing, the
reign of the Han dynasty, lasted from the 2nd century BC Zhenjiu dacheng, was published in 1601, 3 years after the
to the 2nd century AD. Henceforth, attempts to prevent appearance of the Bencao gang mu, a comprehensive
and cure illness on the basis of an understanding of natural pharmaceutical encyclopaedia. Yet, it was not uncommon
laws coexisted with older notions of health tied to beliefs in for medical authors to note, as the eminent physician and
ancestors or the supernatural and a rich tradition of drug writer Xu Dachun did in 1754, the
lore. The theories of systematic correspondences between demise of the acupuncture tradition.
phenomena, known as the yin-yang and
With the rise to power of the Ming
five-phases doctrines, were applied
-4 Lir^__' J dynasty in the 15th century, nationalists
almost exclusively to map the human
began to wonder what had gone wrong in
body, to explicate its normal and
Chinese intellectual history. So when the
pathological functions, to pulse diagnosis,
Ming dynasty was overthrown in 1648 by
and to guide needle treatment
their northern Manchu neighbours who
(acupuncture).
subsequently set up the Qing dynasty, a
Beginning only in the 11th century
movement gained momentum in the
AD, eminent physician-authors system-
17th and 18th centuries that advocated a
atically explored the application of drugs -^ •* -J.
return to ever more distant layers of the
guided by correlative thought, thereby
past to uncover the sources of former
creating a pharmacology of systematic
Chinese independence and glory.
correspondence. These developments
Medicine was no exception. While some
were part of a far-reaching neo-
schools continued to adhere to the
Confiician re-orientation of the Chinese
theoretical models of health and disease
elite, that is, of an adoption of concepts
construed between the 12th and 15th
by Cotrfucians that previously had
centuries, an increasing number of
belonged within the purview of Daoism,
authors sought to regain a presumed
and of a development of new concepts
advantage of antiquity when empirical
that were directly opposed to comparable ^ ^ S'K
knowledge was not marred by theoretical
ideas within Buddhism. These develop- ,.i«
speculation. They focused on philological
ments also reflect reactions by (B/u,r,ea
""**' reconstructions of the medical and
physician-intellectuals to a policy by the
pharmaceutical texts of antiquity or tried
state to curb the influence of professional
to grasp the spirit of old wisdom and
healers. Neo-Confuaan moralists asked ^ ^^, , .,~.C/M;
portray it as the mould into which more recent knowledge
, , , . _ . ,. , From a Chinese manuscript of AD 1505
was to be poured. Others probed new paths altogether. For
the educated to acquire suffiaent medical
a few physicians even a glimpse at folk healing or a careful
knowledge to treat their kin themselves, rather than tum to
and systematic inspection of human anatomy proved
those who practised medicine as an occupation. In the 12th
rewarding; both these realms had been mostly out of reach
century, the government sponsored the publication of
of the gentleman physician in previous centuries. A title like
prescriptions, encouraging people to identify suitable
physician first. Authors the Chuanya, compiled by the scholar-physician Zhao
recipes for their illnesses and purchase these medications in
Paid U Urachukl is director of beganwithout
to pointhaving
out that each Xuemin boia the notes of an itinerant healer at the close of
government-operated
,^ ^
apothecaries
the Institute of
to see a
illness is a unique event that the 18th century, ofFers a rare view of the most common
History of medications and medical techniques.
requires an individualised
Medicine at
the i;nii«re«y
diagnosis. When western medicine was introduced to China in the
of Munich, Subsequently, Chinese 19th century, it confronted a heterogeneous array of ideas
Germany. His medicine took the form of a and practices that encompassed both ontic and holistic
latest book is stream flowing into an perspectives. Ontic theories traced illness to an intrusion of
Medicine in China: Historicai increasing number of the body by pathogenic agents, whereas holistic ideas
Artefacts and images, separate and sometimes portrayed disease as a departure from a harmonious state
published by Prestel. criss-crossing river beds. The guaranteed by a lifestyle that accorded with the basic laws
Instttut fur Seachlclito dar most well-known authors governing the universe. The 20th centiuy has brought the
Madlzbi, Laulncitr 2, between the 13th and 15th further development of Chinese medicine within the
D40336, Munehan, centuries offered explanatory confines of its traditional theoretical foundations to a
Qeimany models of the basic causes of complete halt. As the ancient doctrines of yin-yang and the
(Prof P U Unschuid MPH) human illness. Increasingly five phases lose their importance in everyday life, every new
unschuid@lrz.unl- elaborate theoretical struc- generation in China is increasingly alienated from the world
muenchen,de 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.

srv9 The Lancet • 2000 • 354 • December • 1999