Premedical Health Care

A concern with illness has been documented in China for three millennia; the earliest written evidence extant today on the theoretical and practical consequences of this concern dates from approximately the eleventh century B.C. At that time, and for centuries to come, it was assumed that the well-being of the living - be it related to success on the battlefield, to an abundant harvest, or to physical health - depended to a considerable extent on their interactions with the nonliving members of the community (i.e., with their ancestors). An adherence to specific norms was thought to guarantee social and individual health; transgressions were known to cause the wrath of the dead, who then had to be propitiated with sacrifices. The communication between the living and the nonliving that was necessary to establish the cause of an affliction and to identify an appropriate remedy was recorded on bones and turtle shells, many of which were found in the soil, especially in the province of Henan, earlier this century. Whether the belief in ancestral intervention was supplemented by a pragmatic application of drugs or other empirically valuable means of therapy was not documented in written form at this early time.

Political changes during the first millennium B.C., when the Chou dynasty fell into a period of turmoil with several centuries of civil war, may have been responsible for the rise of a new worldview. Even though a belief in the effect of ancestral curses or blessings on the health of the living has survived in Chinese culture well into the twentieth century, especially among some rural strata of the population, Chou sources indicate a change in emphasis. The physical health and illness of the individual (and, in the case of epidemics, of society) were thought of at this time predominantly as an outcome of successful protection against the possibility or manifestation of an onslaught of not only visible but also invisible enemies (i.e., demons).

In contrast to ancestors, demons, who were not related to specific living persons as deceased relatives, were not believed to desist from harming humans even if they adhered to certain moral principles. Moreover, demons could not be propitiated through sacrifice. Rather, they had to be prevented from entering and harming a human body by means of signs and symbols demonstrating an alliance with superior metaphysical powers, and they had to be removed from the body either through the casting of oral or written spells or with the help of substances designed to kill or chase away (for instance, through their odor) unwanted intruders. Several clues suggest that among the origins of acupuncture may have been attempts to pierce, with symbolic swords and lancets, afflicted, aching body regions thought to be invaded by some outside evil.

Ancestral and demonological notions of health and illness are mentioned here for two reasons. First, they have survived in Chinese culture until the present time as important aspects of the overall system of conceptualized and practical health care, particularly in the treatment of mental and children's illnesses. Second, Chinese medicine, documented since the second century B.C. and developed as a system of ideas and practices based on insights into the laws of nature rather than on metaphysics, still embodies some of the fundamental tenets of these earlier approaches to understanding health and healing, namely an emphasis on cause—effect relationships and a localistic-ontological notion of disease.

Traditional Chinese Medicine

Traditional Chinese Medicine

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