The Chinese offer to our observation the unique spectacle, in the records of the human race, of a people who have preserved, for more than four thousand years, their manners, laws, religion, literature, language, name, and territory. This remarkable phenomenon is certainly related to a concourse of extraordinary circumstances, well worthy the attention of the philosopher and statesman ; but we can not dwell on this subject especially, as we do not possess the documents necessary thereto.
We simply remark, that in all time, the sovereigns of China have taken extraordinary care to prevent all contact or exchange of ideas between their subjects and foreigners (But a new era commences; the barriers which, have excluded all strangers from entering this empire, have just been broken down by British cannon. The day is not far distant when the learned curiosity of Europeans may be gratified by the study of Chinese monuments). Police regulations, customs, superstitions, and national prejudice, have all united to isolate the Chinese from the rest of the world. The language and writing of the mandarins and savans are so difficult, that it requires nearly an entire life to learn them. It is only by force of perseverance in surmounting a thousand obstacles, and braving a thousand dangers, that the intrepid missionaries have been enabled to lift a corner of the vail with which the science and history of this country are enveloped. We owe to their apostolic zeal, the little we have to say on these subjects (The description and history of China, by Father Du Halde ; the fragments of Chinese medicine, translated into Latin, by Father Michael Boym, and published by Cleyer, have furnished the materials of nearly all that has been written up to this time on that country).
The antiquity of the Chinese, as that of every nation, is mingled with traditions more or less uncertain and fabulous. But from the year 2357, before Jesus Christ, their chronology, says Father Du Halde, is perfectly well arranged ; their tables exhibiting the names of their emperors, the duration and principal events of their reigns, the revolutions, and interregnums ; and the whole is narrated in a simple manner, without any admixture of supernatural statements. This chronology is supported, beside, by the observations of eclipses, whose dates coin- cide exactly with the calculations of the most eminent astronomers of Europe. In fine, Confucius, the greatest Chinese philosopher, a sage whose opinion is of great weight, on account of his worth and probity, has never questioned its correctness.
They attribute the invention of Medicine to one of their emperors, named Hoâm-ti, who was the third of the first dynasty. He is said to have reigned 2687 years before the Christian era, which goes back many ages before the universal deluge, to an epoch of which their history does not treat in the same authentic manner as is referred to above. He is regarded as the author of a work entitled Nuy' Kim' which still serves as a guide for medical practice. In this work is found a theory of the pulse, extremely minute, which clearly reminds us of the sphygmics of the successors of Erasistratus. For this reason, it has been supposed, and not without probability, that the disciples of this physician, who were established in Bactriana, after the invasion of Alexander the Great, communicated to the Chinese doctors their ideas on this subject. The chronicles of the mandarins confirm this conjecture, for they state that at that epoch the savans of Samarcand fixed their residence among them. It is, then, very reasonable that Nuy'Kim' is an Apocryphal book, or rather a collection of fragments belonging to various authors of different eras. This is made probable by the following resume extracted from the articles edited by Cleyer (Cleyer, " Specimen Medico: Siniae." Francofurti, anno 1682. See, especially, the fragment No. 2, entitled, " Tractatus de Pulsibus.").
There are set forth in it two radical hidden principles, heat and moisture, which give life and movement to all things. The spirits are the vehicles of heat, just as the blood is the vehicle of moisture. The harmony or disunion of these two principles, their excess or their deficiency, in a word, their combinations and their various proportions, produce that infinite variety of phenomena that are seen in the world. They produce, also, the good and the bad constitution, health and disease, life and death.
An immoderate degree of heat causes cold, and vice versa, just as autumn succeeds summer, and spring succeeds winter.
Heat naturally ascends and occupies the highest places. It is in perpetual agitation by diffusion, expansion, rarefaction, and penetration. Moisture, on the contrary, tends downward, and seeks repose ; it becomes condensed and viscid, and stops the pores.
As in the universe, we see three chief objects, the heavens above, the earth beneath, and man, who, placed between these two, participates in the celestial as well as terrestrial nature ; so we distinguish in the human body, three principal regions, namely: the superior, extending from the head to the epigastrium, which contains the heart, the pericardium and the lungs, which are all above the diaphragm ; the middle, which is bounded below by the umbilicus, and incloses the stomach with its annexes, the spleen, the liver and its gall-bladder, and the diaphragm ; lastly, the inferior, which comprehends the kidneys the bladder, the intestines, and the abdominal members.
To each of these three described regions, correspond three kinds of pulse on the hand. The supreme or celestial pulse, which is placed at the articulation of the forearm with the wrist. It is undulating, full, and prominent, and is governed by heat. That on the right arm shows the state of the heart and pericardium ; that on the left side, the state of the lungs and mediastinum. The inferior, or terrestrial pulse, situated lower down, at the articulation of the wrist with the hand, is influenced particularly by moisture ; on this account it is deep-seated. That on the right side indicates the state of the ureters, the corresponding kidney and small intestine ; that on the left side shows the condition of its corresponding kidney and the large intestine. Finally, the middle pulse, or that of man, properly speaking, is between the other two, on the middle of the carpus. It is produced by a mingling of heat and moisture, neither too high nor too low, but properly combined. On the right hand, it marks the state of the stomach and spleen ; on the left, that of the liver and diaphragm.
These three kinds of pulse are sometimes compared to a tree, of which the superior pulse constitutes the superior branches and leaves ; the middle pulse, the trunk ; and the inferior, the roots.
The examination of the pulse, not only enables the Chinese physicians to show the seat of the disease, but also to judge of its duration and gravity. They proceed to this examination after a method which appertains to them alone. They place the arm of the patient on a cushion, then they apply the index, the middle and ring-fingers on the anterior face of his wrist, in such a way that the index-finger may be nearest the arm, and the ring finger nearest the hand. They elevate and depress each finger, alternately, with more or less force, like one playing on an organ. At the same time, they observe closely the movements of respiration, being persuaded that there exists between them and the arterial pulse an intimate connection. They examine, also, during a limited number of respirations, each of the nine pulses, which are formed, according to their doctrine, on each hand, and they deduce from these their diagnosis and prognosis, which they immediately announce without any uncertainty or hesitation. They make their prescriptions on the spot, and usually administer their remedies, receive their fees, and retire, not to return unless they shall be recalled.
Independently of the two active principles of which we have spoken, the Chinese admit five elements, namely : water, wood, fire, earth, and metal. The following is the order in which they are supposed to he produced ; water, the source of all fertility, engenders wood or plants ; these, when they are dry, inflame and cause fire, or ignited spirits. The remains of the fire, or the ashes, form the earth, which in its turn produces the metals.
The Chinese physicians imagine a multitude of odd connections be- tween the viscera of the human body, the elements, the seasons of the year, the stars, colors, variations of the pulse, and numerous other objects no less dissimilar. We give but one example.
The heart, they say, is analogous to fire, to the planet Mars, to summer, to spring, and to southern climes. It comes from the liver, begets the spleen and the stomach, is antipathic with the kidney, and receives no injurious influence from its contact with the lungs.
The natural pulse of the heart is bounding, like a full swelling wave. Explored lightly with the finger, it appears large and free ; but, under a strong pressure, it becomes feeble and fugitive. It has for an antagonist, the deep-seated pulse. During the spring-time, the pulse of the heart is like a tense cord ; in summer it is more developed and becomes exuberant ; in autumn it appears as if floating ; in winter it is rather quiet.
The heart has a predominant influence on the blood, the forehead, the tongue, and the palm of the hands. It is sympathetic with odors, red colors, such as the comb of the cock, and lively, gay sounds, laughing, the exhalation of a roast, bitter taste, and sweat. Excess of joy, heat, inquietude, fixed attention, and bitters, injure the heart and the blood. A black tongue, which cannot be run out of the mouth, and swelling in the palms of the hands, are concomitant signs. Rolling the eyes back- ward, with a pulse like a floating cord, announce the destruction of that organ.
Some writers have been willing to accord to the Chinese the honor of a knowledge of the circulation of the blood, but we shall see that they mean by this word a phenomenon entirely different from that to which we apply it. They think that the spirits and the blood, both vehicles of heat and vital humidity, run through all parts of the body in twenty- four hours. This diurnal circulation, they say, commences in the lungs, at three o'clock in the morning, and ceases next day at same place, and at the same instant. The knowledge of the canals through which this is effected, constitutes, in the eyes of Chinese physicians, the fullness of anatomical science. They count six canals which pass directly from above downward, and an equal number which return from below upward; eight run transversely, and fifteen obliquely. The plates that Pleyer has placed in his memoirs, suffice to give an idea of the grotesque manner in which the Chinese represent these imaginary canals, and the principal viscera of the human body.
Such is a summary of the doctrine contained in the Nuy' Kim'. The physicians regard it as an infallible guide, and when they are mistaken in their prognostics, which very frequently happens, far from suspecting. in any respect, the excellency of the precepts of the Nuy' Kim', they rather think that they have not well understood, or not properly followed them.
These physicians relate that one of their ancient emperors directed the dead bodies of criminals to be opened, that the interior arrangement of the body might be studied. This tradition is questionable, for it appears certain that, from time immemorial, the Chinese have not allowed researches on dead bodies, whether of men or animals, which explains their profound ignorance on the structure of our organs, and the long reign of a physico-pathologic system so replete with ridiculous hypotheses and glaring errors. Nevertheless, one of their emperors ordered the translation by the Jesuit Father Parrenin, of the anatomical treatise of Dionis ; but this work, though one of the best, previous to the last century, is, up to the present time, a dead letter, a light under the bushel, to the Chinese doctors (Père Dionis was Professor of Anatomy and Surgery at the Jardin du Roi in 1673).
They divide all diseases into two great classes, accordingly as they attack an organ adjoining the vital center, such as the heart, the lung, the stomach, or an organ separated from the fictitious center, as the kidneys, the bladder, the extremities on the skin. They have, also, multiplied to infinity, the nosological scale. Thus, they count forty-two kinds of variola, distinguished from each other by obscure and insignificant characteristics. They have a variola of the alae of the nose, and of the circumference of the eyes, one which is characterized by pimples, surrounded by a red circle ; others, whose pustules are acuminated or flattened, or black, or transparent, etc.
Notwithstanding the egregious errors of these pathological classifications, and the absurdity of their theories, the physicians of China must have been able to make, in the space of four thousand years, some precious observations on the march, symptoms and prognosis of diseases, and some discoveries of the means for their cure. It is, therefore, probable that there may be found, in their voluminous repositories, as some judicious writers believe, a quantity of useful material, both for the history and treatment of certain morbid affections (See the excellent "Dissertation sur la Médecine des Chinois," by M. Lepage. Paris, 1815, and the article of the Dict. des Sciences Medicates, by M. Bricheteau, sur " Médecine des Chinois."). It is known, for example, that inoculation, by the variolic virus, was generally employed by them a long time before it was known in Europe.
The Chinese appear to have cultivated, particularly, Materia Medica and Pharmacology, if we may judge by the number of works they have written on these subjects.' They possess more than forty of them, of which one alone, the most complete of all, is composed of fifty-two quarto volumes. But the extracts that have been made from them, only contain a long enumeration of substances employed in Medicine, without describing the natural characteristics by which they or their preparations might be recognized by us.
There are no apothecaries in that country. The physicians arc accustomed to prepare and administer their own remedies. Some of the most distinguished, however, simply give a formula, and leave to other? of less rank, the task of executing it. They daily retail in the markets considerable quantities of drugs, and various compositions, which are boasted to have an efficacy against a host of diseases. One of the most famous is the ginseng (See Mérat et Delens, " Dictionnaire Universel de Matière Medicale." Paris, 1831, t. Ill, p. 356.) root. Incomparable virtues are attributed to it ; among others, those of reanimating the vital forces, putting off the infirmities of age, and prolonging the life beyond the ordinary term. The people who believe in its fabulous properties, buy it, literally, with its weight of gold. Their frightful abuse of opiates is also well known.
Having no anatomical knowledge, surgery is uncultivated, so that it may be said that in China this branch of medical science has never passed its infancy. No one dare attempt a bloody operation, however slight. The reduction of hernia is unknown, and a cataract is regarded as beyond the resources of Art ; even blood-letting is wholly unpracticed. On the other hand, they frequently employ cups and acupuncture, which they execute with needles of gold or silver ; fomentations, plasters of all kinds, lotions, and baths. They make much use of fire, by means of moxas, or red-hot buttons. They have even their magnetizers, whom the author of the " Chinese Letters " compares to the convulsionists of Saint Medard. In a word, their therapeutics, whether internal or external, recalls that of tlie Europeans during the darkest period of feudal times.
Formerly, there existed, at Pekin, imperial schools of Medicine, and no one could then practice Medicine without having served an apprenticeship, and given proof of his capacity. Beside, it is said, there was, for each district of six leagues square, a physician chosen to instruct those who were required to serve the inhabitants of the country. At this time, there is no such organization, every one has the right of selling, prescribing, and administering remedies, without any examination, authorization, or restraint.
How inconceivable is the stupid indifference of a government which requires no guarantee of knowledge or morality on the part of individuals who are every moment the arbiters of the health and the life of their fellows, whose profession renders them the depositories of the most sacred family secrets, by giving them easy access to persons of all sexes, ages, and conditions. It is said that physicians in China are, generally, but little respected, nor do they deserve more consideration, excepting those in whom the profession is hereditary. This deep discredit into which the Art of Healing is fallen, or rather of those who cultivate it, need not astonish us ; it is the natural result of the absence of all law regulating the practice of Medicine. The same is true among all nations under analogous circumstances, as this history will prove. We might refer the reader, by anticipation, to the picture that Galen has drawn of the deplorable effects of the medical anarchy which reigned at Kome in his time ; we might also refer to the low state of Medicine during the first ages of the feudal period, before the establishment of universities. But, without searching so far back into the annals of the race, it will suffice to place before the eyes of the reader the reflections which such a state of things suggested to the author of the Medical Law of the 19th of March, 1803.
"Men united in society," says Thouret, "have, in all times, been subject to evils growing out of their intercourse, which have often caused philosophers to think that this intercourse itself was more injurious than useful to humanity. The utility of this consolatory Art has been felt among all nations and in all ages. There exists no government which does not render it a favorable support, and which is not interested, more or less, in its progress. Anarchy only, which respects no institution, could ignore the importance of the Healing Art; it belongs to every reformative government to restore to this branch of instruction its ancient splendor and advantageous results. Profoundly penetrated with the necessity of re-establishing order in the exercise of a profession which interests essentially the security of the lives of citizens, the government presents to you a project of a law, having for its object the regulation of the practice of this salutary Art.
" Since the decree of the 18th of August, 1792, which suppressed the universities, faculties, and learned corporations, there is no longer any regulation for the privilege of practice of Medicine or Surgery. The most complete anarchy has taken the place of the former organizations. Those who have studied the Art find themselves confounded with those who have not the least notion of it. The lives of citizens are in the hands of greedy and ignorant men ; the most dangerous empiricism, and shameless charlatanism impose, everywhere, upon credulity and good faith. No proof of knowledge and skill is required ; the country and cities are equally infested with quacks, who deal out poison and death with an audacity that our present laws can not repress (These remarks are very applicable to most of our state governments). The most murderous practices have usurped the place of the principles of the Art of Midwifery. Impudent barbers and bonesetters assume the title of " health officers," to cover their ignorance and greediness. Never has the list of secret remedies, always dangerous, been so extensive as since the suppression of the faculty of Medicine. The evils are so grave and so multiplied, that many mayors have sought a means of remedying them, by establishing a kind of jury, charged with power to examine the men who wish to practice Medicine in the departments. But these local institutions, independently of the variety of tests of qualification that they have adopted, open the door to new abuses, arising from the superficial nature of the examinations, and sometimes from a still more impure source. The Minister of the Interior has been compelled to annul the permits of several mayors, from the abuses and irregularities they connived at. It is, then, urgent to destroy all these evils at once, and to organize a uniform and regular mode of examination and reception for those who wish to devote themselves to the cure of the sick."( "Jurisprudence de la Médecine, de la Chirurgie et de la Pharmacie en France," by Adolphus Trebuchet. Paris, 1834, page 408, etc.)
from Histoy of medicine by P. V. Renouard.