Anatomy, it appears, has never played other than a very insignificant part in the Chinese system of medicine. This is not to be wondered at when we remember that their religion makes the dissection of a human body a sin worthy of punishment. No mutilated person, the Chinese believed, would be permitted, upon reaching the domain of the dead, to rejoin his ancestors. About the year 1700 A. D. the Emperor Kang-Hi made the attempt to incorporate anatomy as a part of the regular study of medicine in the Chinese Empire; his first step being the authorization of P. Perennin, a Jesuit Father, to translate Dionis’ work on anatomy into the Chinese. His efforts were, however, unsuccessful, owing to the strong opposition offered by the native physicians. And the attempts made during more recent times to accomplish the desired reform by introducing copies of European anatomical illustrations do not appear, as yet, to have produced any appreciable impression. In very recent years, however, the medical missionaries, sent out, if I am rightly informed, from the United States, are giving excellent instruction in anatomy.
Physiology, as taught by the Chinese, is something beyond the comprehension of modern Europeans. Neuburger explains their views in the following manner: “The cosmos is the product of the combined action of two dissimilar forces—the male (Yâng) and the female (Yin). When these forces work in harmony a state of equilibrium results.... Matter consists of five elements, viz., wood, fire, earth, metal, and water; and all things are composed of these elements. In sympathetic relationship with these five elements stand the five planets (Jupiter, Mars, Saturn, Venus, Mercury), the five different kinds of air (wind, heat, moisture, dryness, cold), the five quarters of the globe (east, south, west, north and the equator), the five periods of the year (in addition to the four which we recognize, the Chinese make a fifth period out of the last eighteen days of spring, summer, autumn and winter), the five times of day, the five colors (green or blue, red, yellow, white and black), the five musical tones, etc.... As in the cosmos, so in man the two primeval forces—Yâng and Yin—underlie all his vital processes. Thus, his body is made up of the five elements of which all matter is composed, and health depends upon the maintenance of a state of equilibrium between the male and the female forces, etc.” After this brief exposition it seems unnecessary to devote any further space to the consideration of the physiological doctrines of the Chinese.
With respect to the questions of diagnosis and prognosis it may be stated that the Chinese attach great importance to the necessity of making a most careful objective examination of the entire body; but, when one investigates the precise manner in which this examination is to be carried out, it soon appears that most of the details relate to matters of a purely fanciful or mystical nature. The only steps of real importance, according to them, are the examination of the patient’s pulse and the inspection of his eyesight and his tongue. From the examination of the pulse alone they believe it possible to diagnose the nature and seat of the disease. To examine the pulse properly is a complicated affair and can scarcely be carried out in actual practice in less time than ten minutes; indeed, in certain cases the physician may find it necessary to devote two or three hours to the business. According to the Chinese scheme there are many different kinds of pulse, and there are no less than thirty-seven different types of condition presented by the tongue, each bearing its own special pathological significance.
Disease, so reads the Chinese doctrine, is a discord, a disturbance of equilibrium, caused by the preponderance of one or the other of the primeval forces (the male or the female). It manifests itself in some disorder of the circulation of the vital air and the blood, and eventually involves the organs of the body. Wind, cold, dryness, moisture, the emotions and passions, poisons, and also evil spirits and imaginary beasts are the causes of disease.
No other nation, says Neuburger, has at its command such a large number of remedial drugs; and it is also a fact, he adds, that the department of therapeutics is that in which Chinese medicine has reached its highest development. The steadfast belief that in nature there exists a remedy for every human ill led the physicians of that country to search diligently in all possible directions for vegetable and animal and also, to some extent, mineral substances which might possess remedial virtues. Although this search necessarily brought to notice a lot of useless drugs, it cannot be denied that eventually it added a considerable number of remedies which have proved useful to the medical profession of the entire world. In this category belong the following: rhubarb, pomegranate root as a cure for worms, camphor, aconite, cannabis, iron (for the relief of anaemia), arsenic (for malarial and skin diseases), sulphur and mercury (both of these for affections of the skin), sodium sulphate, copper sulphate (as an emetic), alum, sal ammoniac and musk (for nervous affections). Toward the middle of the sixteenth century A. D. there was published, under the title “Pen-Tsao-Kang-Mu,” a monumental work (fifty-two volumes) in which are very fully described no fewer than 1800 remedies, mostly of a vegetable nature. Prophylactic Inoculation with the pus from a small-pox pustule was practised by the Chinese as long ago as during the eleventh century A. D., “thus constituting a forerunner of our modern serum therapy.” (Neuburger.) Vaccination was not introduced into China until during the nineteenth century of the present era. It is a curious fact that, in the choice of a remedy, the Chinese physicians attach a certain degree of importance to the form and color of the drug, as symbols indicative of the effect which they may be expected to produce. Thus, the red blossoms of the hibiscus plant are believed to be more efficacious than the white as an emmenagogue; saffron, being of a yellow color, possesses the power to relieve jaundice; beans that have the shape of a kidney should be prescribed in cases of renal disease; glow-worms should form a part of all eye-washes, etc.
The doses prescribed are very large, and the medicines are often put up in an attractive form, with labels on which such descriptive titles as these are written: “Powders of the Three very wise Men,” or “Powders recommended by Five Distinguished Physicians”—titles which are calculated to work upon the imagination of the patient.
There are two methods of treatment which the Chinese physicians are very fond of employing for the relief of a great variety of diseases—viz., acupuncture and cauterization of the skin over the seat of the malady by means of what are termed “moxae”—moxibustion. Moxae are prepared by kneading together into a cone-shaped, tinder-like mass the leaves of the artemisia vulgaris, then drying it thoroughly. Such a mass is attached to the skin at the affected spot by simply moistening the base of the cone, after which the apex is ignited. Some physicians prefer to interpose a thin sheet of metal between the skin and the base of the moxa. The manner in which these contrivances should be used in the different diseases and the proper number to employ are matters subject to fixed rules. In a strong individual, for example, as many as fifty moxae may be used at a time. In affections of the chest they were applied to the patient’s back, in diseases of the stomach to the shoulders, and in venereal affections over the spinal column. In acupuncture, which is a procedure invented by the Chinese, slender needles of gold, silver or highly tempered steel, from 5 to 22 centimetres (2 in.-8¼ in.) in length, were forced through the stretched skin to different depths (1¼ in.-1½ in.) and then driven farther inward in a rotary direction by means of a small hammer. The needles, after being allowed to remain in situ for a few minutes, were withdrawn, and pressure was made with the hand over the small wounds, or a moxa was burned over the spot. There are in all 388 places where acupuncture may be performed, and a chart of the body, showing where these places are located, has been prepared for the guidance of the Chinese physicians. Neuburger calls attention to the fact that the latter dislike the sight of blood, and that this is one of the reasons why acupuncture and the use of moxae have grown to be such popular remedies. Bloodletting is rarely employed by them; but dry cupping, on the contrary, is a favorite procedure in certain maladies. Massage is generally performed by old or blind women, and much attention is devoted to the “movement cure,” which is said to have been invented about 2500 B. C.
As may readily be imagined, the Chinese—owing to their dislike for the sight of blood and also by reason of their ignorance of anatomy—have not advanced, in surgery, beyond the most primitive state of that art.
The science of public health is quite unknown in China. In a Chinese treatise entitled “Long Life,” the following advice is given: “Always rise early in the morning, take some breakfast before you leave your residence, drink a little tea before eating, at the mid-day meal partake of well-cooked but not too highly salted food, eat slowly, take a nap of two hours after the meal, eat lightly at night, and, before going to bed, rinse your mouth with tea and have the soles of your feet rubbed until they are warm.” (Neuburger.)
Up to the latter part of the nineteenth century of the present era, Japan, so far as medical matters are concerned, differed in no material respect from China. During the last fifty or sixty years, however,—that is, since the visit of Commodore Perry, of the United States Navy, to that country,—wonderful changes have taken place; and now Japan, as a result of her determination to adopt the methods of education, of utilizing steam and electric power, etc., has already taken a leading place in the council of nations. The physicians, many of whom received their training in the best schools of Europe and the United States, are contributing to-day their full share toward advancing the science of medicine. That China is following in the footsteps of Japan is already plainly evident, and no intelligent observer entertains the slightest doubt of her ultimately—probably at no distant day—possessing a corps of medical men as well educated, as efficient in the treatment of disease, and as practical in public hygiene as their European and American confrères. During thousands of years China has suffered severely from the blighting tyranny of superstition, priestcraft and selfish bureaucracy, and, now that the sunlight of truth and genuine liberty is beginning to search every nook and cranny of that great country, we who have had the advantage of this beneficent influence for so many scores of years truly rejoice over the change that is taking place in China.