An overview of Chinese medicine
 
 The Chinese system of medicine is of great antiquity and is
independent of any recorded external influences. According to
legend, Emperor Huang Ti (the Yellow Emperor) wrote the canon of
internal medicine called the Nei ching in the 3rd millennium BC;
but there is some evidence that in its present form it dates
from no earlier than the 3rd century BC. Most of the Chinese
medical literature is founded on the Nei ching, and it is still
regarded as a great authority. Other famous works are the Mo
ching (known in the West as the "Pulse Classic"), composed about
AD 300; and the Golden Mirror, a compilation, made about AD
1700, of medical writings of the Han dynasty (202 BC-AD 220).
European medicine began to obtain a footing in China early in
the 19th century, but the native system is still widely
practiced.
 
 Basic to traditional Chinese medicine is the dualistic cosmic
theory of the yin and the yang. The yang, the male principle, is
active and light and is represented by the heavens; the yin, the
female principle, is passive and dark and is represented by the
earth. The human body, like matter in general, is made up of
five elements: wood, fire, earth, metal, and water. With these
are associated other groups of five, such as the five planets,
the five conditions of the atmosphere, the five colours, and the
five tones. Health, character, and the success of all political
and private ventures are determined by the preponderance, at the
time, of the yin or the yang; and the great aim of ancient
Chinese medicine is to control their proportions in the body.
 
 The teachings of the religious sects forbade the mutilation of
the dead human body; hence traditional anatomy rests on no sure
scientific foundation. One of the most important writers on
anatomy, Wang Ch'ing-jen, gained his knowledge from the
inspection of dog-torn children who had died in a plague
epidemic in AD 1798. Traditional Chinese anatomy is based on the
cosmic system, which postulates the presence of such
hypothetical structures as the 12 channels and the three
so-called burning spaces. The body contains five organs (heart,
lungs, liver, spleen, and kidneys), which store up but do not
eliminate; and five viscera (such as the stomach, intestines,
gallbladder, and bladder), which eliminate but do not store up.
Each organ is associated with one of the planets, colours,
tones, smells, and tastes. There are 365 bones and 365 joints in
the body.
 
 According to the physiology of traditional Chinese medicine, the
blood vessels contain blood and air, in proportions varying with
those of the yin and the yang. These two cosmic principles
circulate in the 12 channels and control the blood vessels and
hence the pulse. The Nei ching says that "the blood current
flows continuously in a circle and never stops. It may be
compared to a circle without beginning or end." On this
insubstantial evidence it has been claimed that the Chinese
anticipated Harvey's discovery of the circulation of the blood.
Traditional Chinese pathology is also dependent on the theory of
the yin and the yang; this led to an elaborate classification of
diseases in which most of the types listed are without
scientific foundation.
 
 In diagnosis, detailed questions are asked about the history of
the illness and about such things as the patient's taste, smell,
and dreams. Conclusions are drawn from the quality of the voice,
and note is made of the colour of the face and of the tongue.
The most important part of the investigation, however, is the
examination of the pulse. Wang Shu-ho, who wrote the "Pulse
Classic," lived in the 3rd century BC, and innumerable
commentaries were written on his work. The pulse is examined in
several places, at different times, and with varying degrees of
pressure. The operation may take as long as three hours. It is
often the only examination made, and it is used both for
diagnosis and for prognosis. Not only are the diseased organs
ascertained but the time of death or recovery may be foretold.
 
 The Chinese materia medica has always been extensive and
consists of vegetable, animal (including human), and mineral
remedies. There were famous herbals from ancient times; but all
these, to the number of about 1,000, were embodied by Li
Shih-chen in the compilation of Pen-ts'ao kang-mu (the "Great
Pharmacopoeia") in the 16th century AD. This work, in 52
volumes, has been frequently revised and reprinted and is still
authoritative. The use of drugs is mainly to restore the harmony
of the yin and the yang and is also related to such matters as
the five organs, the five planets, and the five colours. The art
of prescribing is therefore complex.
 
 Among the drugs taken over by Western medicine from the Chinese
are rhubarb, iron (for anemia), castor oil, kaolin, aconite,
camphor, and Cannabis sativa (Indian hemp). Chaulmoogra oil was
used by the Chinese for leprosy from at least the 14th century,
and about a century ago it began to be used for this purpose by
Western physicians. The herb mahuang (Ephedra vulgaris) has been
used in China for at least 4,000 years, and the isolation of the
alkaloid ephedrine from it has greatly improved the Western
treatment of asthma and similar conditions.
 
 The most famous and expensive of Chinese remedies is ginseng.
Western analysis has shown that it has diuretic and other
properties but is of doubtful value. In recent years RESERPINE,
the active principle of the Chinese plant Rauwolfia, has been
isolated; it is now effectively used in the treatment of high
blood pressure and some emotional and mental conditions.
 
 Hydrotherapy is probably of Chinese origin, since cold baths
were used for fevers as early as 180 BC. The inoculation of
smallpox matter, in order to produce a mild but immunizing
attack of the disease, was practiced in China from ancient times
and came to Europe about 1720. Another treatment is moxibustion,
which consists in making a small, moistened cone (moxa) of
powdered leaves of mugwort, or wormwood (Artemisia species),
applying it to the skin, igniting it, and then crushing it into
the blister so formed. Other substances are also used for the
moxa. Dozens of these are sometimes applied at one sitting. The
practice is often associated with acupuncture.
 
 Acupuncture consists of the insertion into the skin and
underlying tissues of a metal needle, either hot or cold. The
theory is that the needle affects the distribution of the yin
and the yang in the hypothetical channels and burning spaces of
the body. The site of the insertion is chosen to affect a
particular organ or organs. The practice of acupuncture dates
from before 2500 BC and is peculiarly Chinese. Little of
practical importance has been added since that date, although
there have been many well-known treatises on the subject.
 
 A bronze model, c. AD 860, shows the hundreds of specified
points for the insertion of the needle; this was the forerunner
of countless later models and diagrams. The needles used are
three to 24 centimetres (about one to nine inches) in length.
They are often inserted with considerable force and after
insertion may be agitated or screwed to the left or right.
Acupuncture, often combined with moxibustion, is still widely
used for many diseases, including fractures.
 
 Recently people in the Western world have turned to
acupuncturists for relief from pain and other symptoms. There is
some speculation that the treatment may trigger the brain to
release morphinelike substances called endorphins, which
presumably reduce the feeling of pain and its concomitant
emotions.
 
 
John Cottingham                     "KNOWLEDGE is of two kinds: we know
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