Qing Dynasty (1644 ∼ 1911AD)
About Qing Dynasty
Emperor Kangxi (1662-1722) Much weakened by long wars with the Mongols and harassment by Japan, the Ming dynasty was brought to a close in 1644 by the Manchu chieftains. To prevent internal conflict, the Qing pursued in certain circumstances a policy of giving rewards of land for cultivation and reducing or exempting taxes. The early Qing emperors, especially Kangxi (1662∼1722 ), Yongzheng (1723∼35) and Qianlong (1736∼96), not only resolved the long conflict between nomads and peasants which had plagued China throughout its history, but also undertook a series of measures to develop the economy, culture and transportation in the frontier areas. As a result, they consolidated national unification and laid the foundation for modern China's territorial boundaries.
In spite of these noticeable achievements, the Qing rulers were autocratic and despotic. The nation was still agriculturally based and dominated by feudal ethics and rites. Worse still, the Qing empire in its relationship with foreign countries was isolationist, conservative and arrogant. It paled in comparison with the newly industrialized West and was left behind in world development. The gap between China and the West gradually widened.
During the mid-Qing dynasty, social conflict began to surface. Many revolts took place and that of the White Lotus Sect put an end to the Qing's golden age. The Opium War of 1840 and increasing foreign aggression resulted in many unequal treaties being signed between the Qing and Western imperialist powers. All these treaties demanded that China cede territories, pay indemnities and/or open trading ports. Eventually, China became a semi-feudal and semi-colonized country. With its corrupt politics and conservatism, the Qing dynasty rapidly declined. The dynasty was finally overthrown by the Revolution of 1911 led by Sun Yatsen.
Further Development on Febrile Diseases
In the Ming dynasty, Wu Youxing's Treatise On Pestilence exerted considerable influence on what is known as the "school of febrile disease" (wen bing). The kind of diseases derived from "wen bing" were associated with heat, which today remains one of the disease causing agents of Chinese Medicine. Through clinical practice and further study, physicians in the Qing dynasty gave new prominence to the study of wen bing. The most significant representatives of this school included Ye Gui, Xue Xue and Wu Tang. Wang Shixiong (1808∼66) devoted an entire work to related diseases, the Compendium of Epidemic Febrile Diseases (wen re jing wei). The Source of Febrile Diseases (wen re feng yuan) by Liu Baoyi (1842∼1901) and Treatise on Seasonal Diseases (shi bing lun) by Lei Feng in 1882 also exerted a lasting influence in this area.
Confronted by the challenge of Western medicine, the practice of Chinese medicine was buttressed by its long-held traditions and continued unabated in the later-Qing period. Its survival was assured by the adherents to the Treatise on Cold-induced Diseases, "school of cooling" by Liu Wansu, Shen Nong’s Classic of Herbal Medicine and other champions of Chinese medicine.
New Anatomy
Chinese anatomy continued to rely essentially on the information provided in the Yellow Emperor’s Classic of Internal Medicine. Little had been added to this work since its completion because surgery had not been looked upon favorably over the centuries.
Although it was not the first documentation of proper anatomy, Wang Qingren (1768∼1831) published his Correction of Errors in the Medical Circles (yi lin gai cuo) in 1830. In this, he dispelled certain long-held beliefs, such as the claim that urine originated from excrement and that the lungs had 24 holes. His observations from corpses abandoned in public cemeteries and execution grounds led him to discover organs and structures previously unmentioned in medical books. These included the abdominal aorta, bile duct, pancreas and diaphragm. He also showed that it was the brain and not the heart, as was previously thought, that was the seat of thought and memory.
Use of the Smallpox Virus to Combat Smallpox
Prevention measures for variola (smallpox) had been used in China as early as the sixteenth century, during the time of Ming Dynasty. According to Yu Maokun, whose Golden Mirror of Smallpox and Commentaries (dou ke jin jing fu ji jie) was published in 1727, variolation (inoculation against smallpox) had been practiced since the years 1567∼72. The method involved extracting the dry scabs caused by the disease, reducing them to a fine powder and then having the healthy individuals inhale the powder through the nose with the aid of a silver tube, so as to get the immunity against the disease. Despite the imperfection of such a method, it is undeniable that variolation as practiced in China played a significant role in the prevention of smallpox. It was the earliest vaccination method in the world. Knowledge of the process quickly spread to Europe.
Supplement to the Compendium of Materia Medica and Plant Therapy
Zhao Xuemin (1719∼1805) bequeathed to Chinese medicine and pharmacy a supplement text to the Compendium of Materia Medica, called Supplement to Compendium of Materia Medica (ben cao gang mu shi yi). A total of 921 drugs were listed under the categories of water, fire, earth, metals, stones, herbs, trees, creeping plants, flowers, fruit, seeds, vegetables, utensils, birds, quadrupeds, creatures with scales or shells, and insects. Among them, 716 drugs were newly added that not well described or not found in Li Shizhen's book.
The most significant feature of Zhao's work, however, was the introduction of medical substances that he had learned to recognize and use while talking with traveling physicians. His book, Treatise on Folk Medicine (chuan ya) (1759), recorded these teachings.
The popularity of such physicians, who were also known as "bell physicians" (ling yi) because they announced their presence by means of a small bell, stemmed from the fact that they prescribed medicinal plants that were accessible and thus inexpensive. Zhao Xuemin thought highly of these physicians (it might be said that the famous "barefoot doctors" of post-1949 China were their heirs), concluding that the drugs they recommended were cheap, efficient and convenient. He noted in the book that drugs need not be expensive and berated the medical quacks whose treatment skills did not match their high fees. In his opinion, such people knew how to prescribe an expensive tonic, but did not know how to recognize a medicinal plant.
Phytotherapy (plant therapy) remained the basis of Chinese medicine throughout the nineteenth century and earlier medical works of this tradition were reissued in new editions. It was the desire to revive this plant-based medicine that inspired physicians like Wu Qijun (1789∼1846), who published An Illustrated Textual Study on Plants (zhi wu ming shi tu kao) in 1848, and Fei Boxiong, who published Supplementary Notions of Medical Experience (yi chun sheng yi) in 1863. The best known dispensary of the time, the Tong Ren Tang, was located in the capital Beijing and catered especially to the imperial family.
Publishing Boom in Encyclopedias and Medical Books
Anxious to obtain the support of the scholar class, the new rulers of Qing dynasty encouraged intellectual life and gave patronage to encyclopedic projects in history, arts, medicine and science. 
The encyclopedia became very popular in the 1700s. One Chinese medicine classic that emerged during this publishing boom was ACollection of Ancient and Modern Books (gu jin tu shu ji cheng), an encyclopedia of 10,000 chapters that provides much background to the history of Chinese medicine. Published in 1723, about 520 chapters of the encyclopedia focused on medicine. Another famous work was the Golden Mirror of Medicine (yi zong jin jian), a medical series compiled by Wu Qian and other in 1742, under the commission of the Qing government and also appointed as a textbook for medical students. To this day, this remains an important reference book.
A trend also developed of authors writing personal treatises. These collections provide windows into the different thoughts of the period. For example, Zhang Lu (1617∼1700) wrote Zhang's General Medicine (zhang shi yi tong), which supported the school of warming and invigorating.
At the same time, more modest publications on medicine appeared. They tended to be introductions into Chinese medicine, such as the Medicine Comprehended (yi xue xin wu) published in 1732 by Cheng Guopend. The book discussed the four examination skills, eight diagnostic principles, eight therapeutic principles and other clinical discussions that served as the basis of medical training. Another book, Collection and Commentary on Treatment for Disharmony Patterns (zheng zhi hui bu) by Li Yongcui, which dates from 1687, is entirely devoted to internal medicine, briefing over 80 miscellaneous diseases, their symptoms and treatments.
The fascination for ancient classics re-emerged during the Qing dynasty and many were re-edited, such as the Yellow Emperor's Medicine Classic, Treatise on Cold-induced Diseases and Synopsis of the Golden Chamber. They enjoyed considerable popularity and were subject to various commentaries.
Other texts written during this period focused on topics such as gynecology, pediatrics, ophthalmology, massage and external medicine which mainly dealt with skin diseases or trauma.
Rise of Western Medicine
China's internal weaknesses made her vulnerable to Western nations hungry for economic benefit in the later nineteenth century. Christian missionaries and medical doctors associated with the church played a major role in establishing foreign influence in China at this time. This triggered growth in the number of western medical schools, clinics and even hospitals run by the Chinese, or jointly with Western doctors, and many Western medical books were translated too. Chinese doctors at this time were also introduced to Western medical practice. The first Chinese to study medicine abroad was Huang Kuan (1829∼1878), a Cantonese who went to Edinburgh University in Scotland, and then disseminated what he had learned on returning to his native Guangzhou. This brought about a new generation of doctors who saw a wealth of knowledge in Western medicine.
Integrated Traditional Chinese Medicine
In the late-Qing, this Westernization movement had a significant impact on traditional Chinese medicine. Response to the movement varied: some practitioners refused to accept Western medicine, denying its value completely; some regarded traditional Chinese medicine as non-scientific and argued that it should be banned; and others tried to learn from Western medicine and integrate this knowledge into their traditional practice. This integrated approach enjoyed little success during the Qing dynasty because of strong adherence to traditional Chinese medicine texts and skepticism about medical knowledge garnered from the West.
One of the earliest pioneers for the integration of Eastern and Western medicine was Zhu Peiwen. His A Combination of Chinese and Western Anatomy Illustration (hua yang zang xiang yue zuan) of 1892, illustrated organs according to both Chinese and Western concepts. He suggested that each tradition had its advantages and disadvantages.
In general, medical exchanges during this period are much flourishing than before, there were more frequent in related activities, more widespread in the regions and involved a wider range of knowledge too. This contributed to further development of Chinese medicine, and also influenced medical development in other countries.
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