On previous posts we talk about extinct archaic cultures, such as the Assyrian-Babylonian and the Egyptian, in this opportunity we will talk about another archaic culture, which, although it arose in history at the same time that those, it has managed to survive to this day, even when it has decayed and suffered a process of "westernization". Today we are going to talk about the Medicine of ancient China.
To understand the ancient Chinese medicine we must know that its doctors used the doctrine of cosmology as a foundation, with its concept of absolute unity called Tao. Taoism establishes the existence of two complementary and opposite principles that are in unstable equilibrium: the Yin (darkness, earth, cold, passive / subtle force, feminine, humid) and Yang (light, sky, heat, active/concrete force, masculine, dry); the Tao is the superior force that contains them. Some natural processes will depend on the relationship between these principles.
In addition, Yin and Yang are able to modify the 5 constituent elements of the universe and matter in general: water, earth, fire, wood and metal.
Medicine had its foundation in this idea of the 5 "cosmic elements", the human body is formed by these elements and human life and disease is based on their interrelation and the rupture of their harmony. The main objective of ancient Chinese medicine is to control the proportion of Yin and Yang in the body.
The most important medical text (still studied) was the Nei Ching or Neijing, whose author was Huang Di, called the yellow emperor (it is said to have been written in collaboration with his doctor Qi Bó). It dates from around 2,600 B.C. and represents one of the fundamental pillars of traditional Chinese medicine.
Some historians consider that it was compiled more than 2,000 years later.
Anatomy, physiology and pathophysiology in ancient Chinese medicine
Anatomical knowledge of ancient China was scarce and not very scientific, since dissection was prohibited by religion, hence its surgical technique was rudimentary.
As in cosmology with its five elements, the anatomo-physiological knowledge of ancient China is based on the cosmic system. Five Yin organs (heart, lungs, kidneys, liver and spleen) and five Yang organs (stomach, small intestine, large intestine, gallbladder and bladder) are mentioned. The relationship between these organs can be of friendship or enmity; for example, the heart (fire) is an enemy of the kidney (water) but friend of the liver (wood), hence, it is of poor prognosis in a patient with heart disease the change of the color of the tongue from red (predominance of fire) to dark grey (predominance of water).
In relation to circulatory physiology, it’s proposed that blood vessels contain blood and air and that the proportions vary with those of Yin and Yang. These two principles circulate through 12 channels and thus control the pulse.
Pathophysiologically speaking, the development of the disease depends on the rupture of the harmony between Yin and Yang plus the imbalance of the five elements. The clinical picture will depend on the effect of both alterations on the affected organ.
Diagnosis
Chinese doctors made a detailed medical history about the evolution of the disease. It was also very important the physical examination of the patient where the evaluation of the tongue was included (they found 37 different varieties of tongue colors), of the color of the face and of the quality of the voice. The examination of the pulse is considered one of the most important parts of the physical examination.
For Chinese doctors, the examination of the pulse was very important (even when they didn’t know the principles of circulation). It was taken at eleven different points, with three different degrees of pressure. Through pulsology it is determined if there is a lack or excessive energy in any of the points. The pulse was taken at different times and its study could take up to 3 hours. The examination of the pulse is used for both diagnosis and prognosis (it allows predicting the time of recovery or death).
Therapy
In the ancient pharmacological chinese texts no less than two thousand vegetables, minerals and animals (mixture of their organs and excretions) are described, used in the treatment of various pathologies. The mechanism of action of them was also based on cosmology, trying to recover the balance between the two great cosmic principles (Yin and Yang) and the five elements. Rhubarb, aconite, iron, castor oil, kaolin, camphor, Indian hemp, arsenic and sulfur were very used, but perhaps the most famous are opium and ginseng.
The creation of the world's first anesthetic is due to Chinese medicine, this product is Ma Fei San, which is of herbal origin. It was invented by Dr. Hua Tou, who lived in the second century A.C. He was an expert in several fields (acupuncture, gynecology, pediatrics and surgery). Thanks to the use of this anesthetic he managed to perform the first abdominal surgery with anesthesia registered.
Special mention deserves acupuncture, ancient practice (dating from 2,500 B.C), which is still used today. It was executed with very fine needles of silver, gold or iron, which could be hot or cold and whose length varied from 3 to 24 cm (1 to 9 inches). Its purpose is to revitalize the balance of Chi or vital energy. The chi flows continuously through the body through channels or meridians.
Some texts mention up to 600 points of puncture (that unite the 12 channels). The point is chosen to exert an effect on a particular organ. Its practice required a long training in special mannequins.
In the West it’s currently used to relieve pain, since it stimulates the central and peripheral nervous system with the consequent release of neurotransmitters that modulate pain.
Moxibustion was sometimes associated with acupuncture. This technique consists of the cauterization with a hot moxa of the points in which the needles are inserted. Moxa is a kind of cigar, made with dried, powdered leaves of the Artemisia vulgaris plant. Its purpose is to stimulate blood flow (through heat) at the puncture sites.
As a curiosity I should mention that the doctors of ancient China practiced preventive variolation, as they pulverized the dry scab of a chickenpox pustule and the resulting powder was introduced into the nose (they inoculated the virus to produce a mild clinical picture that produce immunity against the disease).
After the Ming Dynasty (1368-1644) Chinese doctors explore new territories, increase the influences of the West and its technical advances, until , around the nineteenth century, European medicine began to be established in China. However, certain precepts of ancient Chinese medicine are still widely practiced.
Until a next post
References:
- http://www.cervantesvirtual.com/obra/historia-de-la-medicina/
- https://www.britannica.com/topic/history-of-medicine
- http://www.monografias.com/trabajos63/historia-medicina/historia-medicina2.shtml
- https://es.wikipedia.org/wiki/Historia_de_la_medicina
- http://www.cardenashistoriamedicina.net/
- https://books.google.co.ve/books?id=lgcSCAAAQBAJ&printsec=frontcover&hl=es#v=onepage&q&f=false
Previous posts:
History of Medicine: medicine of the extinct archaic cultures. Medicine in Mesopotamia
History of Medicine: medicine of the extinct archaic cultures. Medicine of ancient Egypt