Changing Role of Traditional Chinese Medicine During the Qing Dynasty

This is a map of China as it was during the Qing Dynasty: 1644-1912. Image by Louis le Grand, courtesy of History and Commercial Atlas of China, Albert Herrmann, Harvard University Press, 1935.

The Qing dynasty (1644-1912) was the second dynasty founded and maintained by foreign rulers-in this case, the Manchus.

During their reign, the Manchus tripled the size of the territory that their predecessors (the Ming dynasty) held, expanding Chinese territory to cover the largest area ever controlled by a Chinese dynasty.

This meant the absorption of many minority groups and their (often unwilling) assimilation to Chinese culture. Along with this, the population grew from about 150 million to 450 million. But perhaps the most significant fact about the Qing dynasty is that it was China’s last dynastic empire.

The Qing dynasty ended in 1912 with the takeover of Sun Yat-sen. During those eventful 250 years, both China and the world around it underwent enormous and far-reaching changes, not the least of which we see in the changing role of Traditional Chinese Medicine (TCM).

TCM at the Beginning of the Qing Dynasty

The 1700s witnessed a publishing boom in encyclopedias in China, including numerous medical books throughout the 1700s. One of these, the Gujin Tushu Jicheng (Collection of Ancient and Modern Works), appeared in print in 1726. 520 of its 10,000 chapters deal with medicine.

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For centuries, epidemics of febrile diseases (i.e.- diseases caused by fever, called wenbing in Chinese) plagued China. During the Ming dynasty, practitioners developed TCM treatmetns for fevers and, at the beginning of the Qing dynasty, TCM continued to develop this aspect of medicine.

This is the flag of the Qing Dynasty rulers.

This is the Qing dynasty flag. Image by Hoshie.

Famous Doctors of the Qing Dynasty

Many TCM doctors devoted their careers to refining treatments for febrile illnesses. Ye Gui (1667-1746) believed that patients contracted febrile illnesses through the respiratory organs (lungs and pericardium), and as they progressed from the superficial to the deeper levels of the body, they increased in their severity.

Xue Xue (1681-1770) claimed that febrile disease is related to climatic factors, which he called exogenous pathogens. His book Shire Tiaobian (Illnesses Associated with Heat and Dampness) outlined the causes, development, diagnosis and treatment of what he termed “heat and dampness” diseases.

Wu Tang (1758-1836) specified nine different types of fevers, and concluded that only one of them was contagious. He described the progression of febrile illnesses through the various organs, and claimed that therapy must constantly be readjusted to address the organs involved in the disease.

Other doctors of the Qing dynasty also dealt with febrile illnesses. Wang Mengying (1808-66) wrote the Wenre Jingwe about fever-caused diseases. Liu Baoyi (1842-1901) wrote Wenre Fengyuan (The Source of Fevers). Lei Feng published his book on seasonal illnesses (Shibinglun) in 1882.

During the first half of the Qing dynasty, publishers reprinted many traditional medical works and TCM continued to serve as the mainstream approach to health and illness in China until the mid- to late 1800s.

The Decline of the Qing Empire

After the death of the Emperor Qianlong (1799), the Qing emperors became isolationist, limiting China’s contact with the Western world. During the Industrial Revolution, technology developed rapidly in the Western nations.

In sharp contrast, China’s economy remained primarily based on agriculture. Beset by foreign invasions and internal rebellions, as well as famines, earthquakes, floods and the Bubonic Plague (1910-1912), the Qing dynasty gradually declined.

During the 1800s, Christian missionaries converted tens of thousands of Chinese commoners to Christianity. One of these converts was Sun Yat-sen, who sought to overthrow the Qing dynasty and found a democratic government in China. Interestingly, Sun Yat-sen was also a medical doctor, educated in the West.

This is a photo of Sun Yat-sen at the beginning of his career. Image by Itsmine.

The Influence of Western Medicine on TCM

Christian missionaries and doctors associated with the church were the major disseminators of Western medicine in China during the late Qing dynasty.

They introduced Chinese doctors to Western medical practices and translated Western medical texts into Chinese. These missionaries and doctors also helped establish medical schools throughout China. The Chinese ran these schools, or sometimes Western and Chinese doctors ran them together.

The debate about the merits of TCM versus Western medicine raged throughout the late Qing dynasty, and there was no consensus.

Dr. Sun Yat-sen received his medical training in Hawaii and at a Christian college in Hong Kong, and was eager to introduce what he perceived as the wonders of the West to the Chinese people: democracy, Christianity, and Western medicine.

The Chinese saw all three of these ‘wonders’ as aspects of modernization, which they were eager to embrace.

The Qing dynasty thus ended with the status of TCM in question. This question would be resolved in the 20th century by the implementation of integrated (Chinese and Western) medicine throughout China.