The Evolution of Modern Medicine, by William Osler is part of HackerNoon’s Book Blog Post series. You can jump to any chapter in this book here.
CHINESE AND JAPANESE MEDICINE
CHINESE medicine illustrates the condition at which a highly intellectual people may arrive, among whom thought and speculation were restricted by religious prohibitions. Perhaps the chief interest in its study lies in the fact that we may see today the persistence of views about disease similar to those which prevailed in ancient Egypt and Babylonia. The Chinese believe in a universal animism, all parts being animated by gods and spectres, and devils swarm everywhere in numbers incalculable. The universe was spontaneously created by the operation of its Tao, "composed of two souls, the Yang and the Yin; the Yang represents light, warmth, production, and life, as also the celestial sphere from which all those blessings emanate; the Yin is darkness, cold, death, and the earth, which, unless animated by the Yang or heaven, is dark, cold, dead. The Yang and the Yin are divided into an infinite number of spirits respectively good and bad, called shen and kwei; every man and every living being contains a shen and a kwei, infused at birth, and departing at death, to return to the Yang and the Yin. Thus man with his dualistic soul is a microcosmos, born from the Macrocosmos spontaneously. Even every object is animated, as well as the Universe of which it is a part."(26)
In the animistic religion of China, the Wu represented a group of persons of both sexes, who wielded, with respect to the world of spirits, capacities and powers not possessed by the rest of men. Many practitioners of Wu were physicians who, in addition to charms and enchantments, used death-banishing medicinal herbs. Of great antiquity, Wu-ism has changed in some ways its outward aspect, but has not altered its fundamental characters. The Wu, as exorcising physicians and practitioners of the medical art, may be traced in classical literature to the time of Confucius. In addition to charms and spells, there were certain famous poems which were repeated, one of which, by Han Yu, of the T'ang epoch, had an extraordinary vogue. De Groot says that the "Ling," or magical power of this poem must have been enormous, seeing that its author was a powerful mandarin, and also one of the loftiest intellects China has produced. This poetic febrifuge is translated in full by de Groot (VI, 1054-1055), and the demon of fever, potent chiefly in the autumn, is admonished to begone to the clear and limpid waters of the deep river.In the High Medical College at Court, in the T'ang Dynasty, there were four classes of Masters, attached to its two High Medical Chiefs: Masters of Medicine, of Acupuncture, of Manipulation, and two Masters for Frustration by means of Spells.Soothsaying and exorcism may be traced far back to the fifth and sixth centuries B.C.In times of epidemic the specialists of Wu-ism, who act as seers, soothsayers and exorcists, engage in processions, stripped to the waist, dancing in a frantic, delirious state, covering themselves with blood by means of prick-balls, or with needles thrust through their tongues, or sitting or stretching themselves on nail points or rows of sword edges. In this way they frighten the spectres of disease. They are nearly all young, and are spoken of as "divining youths," and they use an exorcising magic based on the principle that legions of spectres prone to evil live in the machine of the world. (De Groot, VI, 983-985.)The Chinese believe that it is the Tao, or "Order of the Universe," which affords immunity from evil, and according to whether or no the birth occurred in a beneficent year, dominated by four double cyclical characters, the horoscope is "heavy" or "light." Those with light horoscopes are specially prone to incurable complaints, but much harm can be averted if such an individual be surrounded with exorcising objects, if he be given proper amulets to wear and proper medicines to swallow, and by selecting for him auspicious days and hours.Two or three special points may be referred to. The doctrine of the pulse reached such extraordinary development that the whole practice of the art centred round its different characters. There were scores of varieties, which in complication and detail put to confusion the complicated system of some of the old Graeco-Roman writers. The basic idea seems to have been that each part and organ had its own proper pulse, and just as in a stringed instrument each chord has its own tone, so in the human body, if the pulses were in harmony, it meant health; if there was discord, it meant disease. These Chinese views reached Europe in the seventeenth and eighteenth centuries, and there is a very elaborate description of them in Floyer's well-known book.(27) And the idea of harmony in the pulse is met with into the eighteenth century.
Organotherapy was as extensively practiced in China as in Egypt. Parts of organs, various secretions and excretions are very commonly used. One useful method of practice reached a remarkable development, viz., the art of acupuncture—the thrusting of fine needles more or less deeply into the affected part. There are some 388 spots on the body in which acupuncture could be performed, and so well had long experience taught them as to the points of danger, that the course of the arteries may be traced by the tracts that are avoided. The Chinese practiced inoculation for smallpox as early as the eleventh century.Even the briefest sketch of the condition of Chinese medicine leaves the impression of the appalling stagnation and sterility that may afflict a really intelligent people for thousands of years. It is doubtful if they are today in a very much more advanced condition than were the Egyptians at the time when the Ebers Papyrus was written. From one point of view it is an interesting experiment, as illustrating the state in which a people may remain who have no knowledge of anatomy, physiology or pathology.Early Japanese medicine has not much to distinguish it from the Chinese. At first purely theurgic, the practice was later characterized by acupuncture and a refined study of the pulse. It has an extensive literature, largely based upon the Chinese, and extending as far back as the beginning of the Christian era. European medicine was introduced by the Portuguese and the Dutch, whose "factory" or "company" physicians were not without influence upon practice. An extraordinary stimulus was given to the belief in European medicine by a dissection made by Mayeno in 1771 demonstrating the position of the organs as shown in the European anatomical tables, and proving the Chinese figures to be incorrect. The next day a translation into Japanese of the anatomical work of Kulmus was begun, and from its appearance in 1773 may be dated the commencement of reforms in medicine. In 1793, the work of de Gorter on internal medicine was translated, and it is interesting to know that before the so-called "opening of Japan" many European works on medicine had been published. In 1857, a Dutch medical school was started in Yedo. Since the political upheaval in 1868, Japan has made rapid progress in scientific medicine, and its institutions and teachers are now among the best known in the world.(28)
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Osler, William. 2006. The Evolution of Modern Medicine. Urbana, Illinois: Project Gutenberg. Retrieved April 2022 from
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