Papers on Chinese medical history published in _New History_[Hsin shih-hs¸eh], (Taipei)

Chin Shih-ch'i (Graduate Institute of History, National Taiwan University)

"A Study of Medical Doctors in Ancient China with Special Reference to Their Social Positions" _New History_ Vol. VI No. 1.

Since the beginning of the twentieth century, historical research on traditional Chinese medicine has grown into a field of its own. However, research on traditional physicians has either focused on the lives and works of individual doctors, or on the changes in medical institutions over different periods. Questions about the special features of traditional Chinese medicine and its cultural implications can only be answered once we succeed in forming a clear and integral idea about the changes in the role and status of traditional doctors as a social group.

This article discusses the activities of doctors, as a social group, in ancient China from a socio-political perspective. The author attempts to draw a picture of the doctor's active role, through an investigation into the nature of his profession, the group of patients treated, possible influence on the pattern of medical practice in general, value-judgments conferred upon him by society, and self-evaluation by the doctor himself. It is the aim of this study to put forward a new standpoint for exploring the way traditional medicine developed in early China.

Ch'iu Chung-lin (Dept. of History, Tamkang University)

"A Socio-historical Study of the Phenomenon of 'Cutting Flesh to Heal Parents' from the T'ang Dynasty to Modern China." _New History_ Vol. VI No. 1

Since the pre-Ch'in epoch, it is widely believed that the preservation of body integrity is essential in the practice of filial piety. However, after the T'ang dynasty, there arose a contradictory phenomenon: the utilization of one's flesh as medication for parents. The self-injured medication, as a cultural phenomenon, is practiced in various forms, such as the cutting of flesh from the thigh, arm, chest, heart or liver. They are informed by medical texts, medical advice, hearsay, and family tradition.

Orthodox Confucianism prohibited self-injury because the practice may hurt the parents' feelings. Cutting one's flesh definitely contradicts this teaching. Since the T'ang Dynasty, the question of whether the ends justifies the means in using one's flesh as medication was a controversial subject among Confucian thinkers. During the T'ang and Sung dynasties, most people viewed it as a tolerable behavior. At the end of Ming Dynasty, the majority began to appreciate the purpose of parent-saving, and no longer viewed it as inappropriate behavior. The reason of this attitude-shift is possibly related to the justification from the educated class, for since the Ming Dynasty there is a trend of such self-injury practices among the members of educated families.

The official attitude toward this kind of extreme behavior was not always the same. This behavior was valued during the T'ang and Sung Dynasties, but not so during the Five Dynasties, Yuan, Ming and Ch'ing. Regardless of the imperial policy, however, local authorities often saw it differently. A great number of local officials valued it in order to show that they were caring officials. This attitude seems to result from the demand for justification from the public, and the increase of the practice among the educated.

Wang Daw-hwan (Institute of History and Philology, Academia Sinica)

"Wang Ch'ing-jen on Human Anatomy" _New History_ Vol. VI No. 1

_Yilin Kaitsuo_ (Correcting Mistakes in Traditional Medical Wisdom), published in 1830, is one of the best known works among Chinese medical writings in the 19th century. With the lapse of time, it has achieved a measure of either notoriety or fame for its relentless attacks on the traditional descriptions of human anatomy. According to its author, Wang Ch'ing-jen (1768-1831), who practiced medicine in Peiking but remained an obscure character in contemporary medical circles, medical students before him seldom bothered to present themselves beside cadavers to carefully observe human viscera. As a result their topographical and functional descriptions of the _wutsan liufu_ (viscera) were plagued with errors, inconsistencies and contradictions. He forcefully proposed to correct those mistakes and set the record straight with his own observations.

For modern scholars who are convinced that studying the fabric of the human body through dissection as the foundation of scientific medicine, Wang Ch'ing-jen represents an avant-garde of the scientific spirit by which the aged Chinese medicine systems should have been rejuvenated and then been capable of competing with Western ones. However, as I argue in this paper, Wang Ch'ing-jen's inquiries were in fact conducted on traditional terms, both methodologically and ideologically speaking. There is no comparison between his achievements and western human anatomy. The pursuit of human anatomy in the West has never been confined to medical circles since Aristotle launched his research programmes in biology in the fourth century B.C. Comparative anatomy was an integral part of Aristotle's biology. It was this heritage of merging human anatomy with biology that earned Galen (129-99 B.C.), who had never dissected human bodies during his lifetime, his fame as a great master in human anatomy from the Middle Ages to the Renaissance.

Bred in a different heritage, Wang Ch'ing-jen's inquisitive mind was framed with little light shed from other sources than medical ones, which Manfred Pokert characterizes as antithesis to the practice of dissecting human bodies. While Wang Ch'ing-jen felt compelled to examine for himself more than 30 human cadavers of plague victims, he did it at the risk of his life. Despite his good faith in observing _wu-tsang liu-fu_ on his own instead of relying on ancient texts, Wang Ch'ing-jen's eyes failed to register nuances that might have interested Galen. In short, Wang observed with a Chinese mind and was not disposed to see Western fabrics.

Tu Cheng-sheng (Institute of History and Philology, Academia Sinica)

"A Note on Medical History as Social History"_New History_ Vol. VI No. 1.

This article discusses the overlap between social history and medical history. The aim is to use the study of medical history to contribute to a better understanding of social history. Five points are discussed:

1. Understanding the body--The concept of the circulation of the chi through the living body was central to Chinese medical theory rather than the study of anatomy through dissection.
2. The relationship between those who treated the sick: Shamans, Taoists and Confucians in Chinese history--Before Western medicine was introduced into China, the social background of those who treated the sick was different at different stages of Chinese history. At the earliest stage, before the Warring States, those who treated the sick had much in common with Shamans, from the Warring States until the T'ang Dynasty doctors were usually Taoists, and from the T'ang onward, doctors generally held Confucian beliefs.
3. Sexual health, pediatrics and health care in old age as family history--These include ideas about contraception, pregnancy, ways to influence the sex of a fetus, child-rearing and maintaining health in old age. All these can be seen as aspects of family history
4. Medicine and cultural influence--In this article I concentrate on the Indian influence on Chinese medicine in the medieval period: from the Indian system China only adopted technical skill of ophthalmology and pharmacopoeia.
5. Medical treatment reflecting social mentality--I discuss the belief that supernatural beings influenced people's health and the use of methods such as exorcism in treatment.

Fan Ka-wai (Graduate Institute of History, Chinese University of Hong Kong)

"On Beriberi from the Eastern Chin Dynasty to the Sung Dynasty"_New History_ Vol. VI No. 1.

This article consists of five parts. Part One points out that traditional Chinese medical doctors believed that evil ch'i from outside attacked the body and caused the illness. In Part Two, the author points out that the medical doctors in Eastern Chin dynasty also believed that the evil ch'i invaded the feet and passed to the abdomen and heart, causing swollen feet (oedema), weakness of feet, fever, diarrhea, and finally problems in the nervous system. They mistakenly thought that it was a southern regional illness. In the T'ang Dynasty, the medical doctors had already known that this illness did not exist exclusively in the southern region, and that there were two kinds of symptoms: swollen (oedema) and non-swollen.

Part Three points out that according to modern medical knowledge, beriberi was due to the lack of Vitamin B1. Since the Eastern Chin Dynasty, the shih-ta-fu changed their diet to southern well-milled rice and tea, thus, reducing the ingredient of vitamin B1 and causing the problem. Part Four compares the understanding of beriberi between traditional and modern medical doctors. For the healing methods, the Chinese medical doctors might not know that the illness was due to the lack of vitamin B1, but they had already used those herbs that consisted of vitamin B1 as medicine for the illness. Part Five concludes that after the efforts by Chinese medical doctors, as well as medical knowledge being widely known by the public, by the Sung Dynasty, beriberi was no longer a fatal illness.

Chen Yuan-peng (Grad.Inst.of History, National Taiwan University)

"Ju-i of the Sung Dynasty with comment on Robert P. Hymes' "Doctors in Sung and Yuan"_New History_ Vol. VI No. 1.

The term "Ju-i" , describing a physician of superior healing skills, profound knowledge of medicine, and a high moral tone, appeared for the first time towards the end of the Northern Sung, and became widely used during the Southern Sung. The word had become both applicable to Ju-physicians as well as doctors of non-Ju background bringing Ju-values into practice.

The social position of doctors in traditional China has recently been studied in detail by Robert. P. Hymes. It is the aim of this paper to re-analyze previous views on the change in status of physicians, through an in-depth study of the concept of Ju-i. The author attempts to establish that the rise in status of doctors in traditional China took place during the Sung dynasty, and that this process came into being, not so much by the "gentleman becoming doctor", but rather by the growth of a new set of standards for value-judgment.

Hsiao Fan (Inst. of History and Philology, Academia Sinica)

"On a Human Parasitic Disease: Sparganosis Mansoni in Chinese History_New History"_ Vol. VI No. 2

Varieties of toads and frogs are widespread throughout China, and have been noted there since remote times. The ancient Chinese people, especially those who lived in southern China, were quite fond of eating frogs. In traditional Chinese medicine such animals were considered to be of the chilling or cooling nature and have heat-clearing and toxicity-expelling effects. Thus toads and frogs were frequently used to treat a variety of disorders caused by the toxicity of heat, such as surface wounds, sores, scabies, toothache, tooth decay, poisonous snake-bites, etc. From the third century onward the Chinese people applied the raw meat of or skin peeled from living toads or frogs to the sore spot or even ate the raw meat of the toad or frog to cure the above diseases. Therefore the Sparganum mansoni which parasitized the frogs got the opportunity to invade human bodies and consequently caused the hosts to become infected with the Sparganosis mansoni.