Dr. Unschuld is the author of several of the West’s most influential books on
Chinese medicine, including “Medicine in China: A History of Ideas,” “What Is
Medicine? Western and Eastern Approaches to Healing” and “The Fall and
Rise of China: Healing the Trauma of History.” In an interview, he discussed
Tu Youyou’s Nobel Prize and how Chinese officials view their country’s
medical heritage.
Q.
In “The Fall and Rise of China” you write: “From the very start (of the
reform movement in the early 20th century), Chinese medicine was at
the center of criticism. That is hardly surprising. Nowhere within a
culture are fears and optimism expressed as swiftly and existentially
as in the attitudes toward one’s own illness.”
A.
The Chinese Empire was subject to a series of humiliations beginning
with the First Opium War, 1839-42. The sovereignty of China over its
territory appeared to have reached its lowest point exactly 100 years
ago, in 1915, when Japan made its 21 Demands [extending its control
in China]. These exceeded anything the Western powers had ever
demanded from China and marked the beginning of decades of
Japanese annexation efforts, a large-scale invasion, including the
most appalling war crimes against the Chinese people.
Many Chinese intellectuals saw their country as ill, and writers like
Ba Jin and Lu Xun identified Chinese medicine as a symbol of
China’s illness. Reformers and revolutionaries were in complete
agreement that it should have no future. Naturally, conservatives
raised their voice, too, warning against elimination of such a
central element of Chinese culture, but, in general, ideas like
yin and yang or the Five Phases [the interaction among the
five elements: wood, earth, water, fire and metal] were denounced
as obsolete.
Q.
And eventually the government shifted on Western medicine?
A.
The turning point was the Manchurian plague of 1910-11. The
population burned vinegar and set off fireworks to drive out demons,
but such traditional measures didn’t stop the plague. Finally, the
authorities turned to an ethnic Chinese from Malaysia, Wu Lien-teh,
a Western-trained microbiologist. He quickly brought the plague
under control with basic public health policies unknown before
in Chinese medicine. This was a big signal to the Chinese
government: We have to get closer to Western medicine, or we’re
finished.
Q.
And China did move quickly.
A.
Once the superiority of such public health measures had been
recognized, a very rational attitude towards Western science and
medicine was adopted that may be characteristic of China. A victim
needs to look at himself to realize why he was put down. If the
West can do this to us, they must have something we don’t have.
We’ll get it, and in the next round we shall see.
There’s an old saying: “Wo ming zai wo, bu zai tian.” My fate is in my
hands, not heaven’s. This principle has been applied in China both
in politics and in health care for the past 2,000 years.
Q.
In terms of Chinese medicine, do you see this continuing today?
A.
Certainly. In 2007, the government invited politicians and experts from 50
countries to draft the Beijing Declaration on Traditional Chinese Medicine
and declared T.C.M. to be part of biomedicine. The future of T.C.M. was
seen in molecular biological legitimation. I was the German delegate, and
one high-ranking Chinese politician voiced amazement to me that some
Westerners, exposed to modern science for centuries, believe in the Five
Phases theory. You see, political decision makers in China can’t understand
this because the Five Phases doctrine won’t make your mobile phone work.
It won’t shoot a rocket to the moon. The government is not interested in
promoting yin and yang and the Five Phases because it is convinced that
people who believe in that are lost for the strengthening of China vis-à-vis
the West. And we do see that young Chinese people are less and less open
to these ideas. T.C.M. colleges in China have problems finding competent
students.
Q.
What about the Nobel Prize and Chinese medicine?
A.
I met Prof. Tu Youyou in the 1970s. She was a modern pharmacological
researcher, working on harnessing certain herbs. She’s a perfect example
for the successful modernization of Chinese medicine. Her successes are
unrelated to yin and yang or the Five Phases. She had a great education
in Western science, and she and her team searched through ancient literature
for medications recommended to cure malaria. She used modern science to
analyze Artemisia annua, figured out the active ingredient of the plant and
modified it until it exerted an antimalaria effect never achieved in China before.
That is what Mao Zedong had asked for: the unification of historical Chinese
and modern Western medicine.
Q.
These views contradict how many in the West see Chinese medicine.
A.
Professor Tu’s discovery had nothing to do with what most Westerners
define as traditional Chinese medicine, except that the substance she
examined is described in ancient pharmaceutical literature. The Chinese
authorities are trying to strip historical Chinese medicine of superstition
and nonsense. What is left can exist with molecular biology.
That disappoints those in the West who see T.C.M. as an alternative to
biomedicine. These people don’t understand why the Chinese authorities
act like this. The trauma of the 19th- and early-20th-century humiliation is
still present. For 100 years, China has been struggling on many fronts to
catch up with the West. Professor Tu’s Nobel Prize is proof of the success
of this policy.
Q.
And yet many people in China opt for traditional medicine.
A.
Western medicine can’t achieve miracles, and there are many everyday
health problems it cannot solve. Many Chinese — and Westerners — know
that there are recipes in Chinese medicine that work, regardless of whether
there is scientific evidence. It is a characteristic common to all societies
with a coexistence of modern and traditional health care options. Patients
are aware of the strengths and weaknesses of the alternatives and oscillate
between modernity and tradition accordingly.
Follow Ian Johnson on Twitter@iandenisjohnson.
An Interview With Dr. Paul Unschuld
Acupuncture Today
July, 2004, Vol. 05, Issue 07
By Matthew Bauer, LAc
http://www.acupuncturetoday.com/archives2004/jul/07bauerunschuld.html
The field of acupuncture/Oriental medicine has seen a tremendous amount of
growth since first bursting on the scene in the West some 30 years ago.
Understandably, much of the growth in this field has centered around
establishing training and licensing programs, as well as forming a basic
infrastructure of regulators, professional organizations, and
suppliers of both materials and information.
As this initial "big bang" has begun to wane, the AOM field seems to be
entering a phase of reflection as leaders seek to re-evaluate and refine
current positions on such areas as training standards and the operation
of key organizations. Many involved in the AOM field have begun
trying to better understand the history of Oriental medicine, as
re-evaluating training and practice standards often involve opinions
regarding faithfulness to the "true" or "original" theories/practices of the
founders of this healing art. Even those not interested in re-evaluating
current policies tend to find the subject of the history of Oriental
medicine fascinating on its own accord.
During the time AOM began making a name for itself in the West, a
handful of scholars began undertaking a systematic study of Chinese
medical classics and other sources of information relating to the history
of Oriental medicine. One such scholar is Dr. Paul U. Unschuld. As
director of the Institute for the History of Medicine at the University of
Munich (with degrees in Chinese studies, pharmacology, public
health, and political sciences), he has distinguished himself as
one of the world's leading authorities on the history of Chinese
medicine. Author of several highly regarded books, his most recently
published work, Huang Di Nei Jing Su Wen, Nature, Knowledge,
Imagery in an Ancient Chinese Medical Text, is the world's most
detailed and in-depth analysis of the multiple factors that lead to
that most famous of Chinese medical classics. Anyone desiring to
understand the roots of Chinese medicine would benefit from
studying this work. His actual translation of the Su Wen is scheduled
to be published sometime next year.
I was honored to have the opportunity to ask Dr. Unschuld a few
questions regarding more than 30 years studying various aspects
of Chinese medicine history.
Matthew Bauer (MB): Could you tell us how you became interested
in the study of the history Chinese medicine?
Paul Unschuld (PU): In the 1960s, while I studied at the Munich
University School of Pharmacy, I was quite interested in international
relations. With the Cold War tensions easing a bit in Europe, the
fighting between China and the Soviet Union caught our attention.
As I was quite fluent in Russian, I thought I should study Chinese
to be able to read information from their side, too, so I enrolled
in Chinese language courses. After graduation, in 1968, my wife and
I applied for a grant to visit Taiwan (the only part of China accessible
to a West German at the time) to improve our spoken Chinese.
With our pharmaceutical background, we thought it would be most
appropriate to research the situation of medical care and pharmaceutical
supplies in Taiwan. We knew little of Chinese traditional medicine
when we arrived, but met a scholar, Dr. Na Qi, who introduced us
to the history of Chinese pharmaceutical literature and the current
status of Chinese traditional pharmacy on Taiwan. He also informed
me of the works of the eminent Japanese researcher of Chinese
traditional medical and pharmaceutical literature, Dr. Okanishi
Tameto, who I had a chance to meet in Kyoto a few years later,
shortly prior to his passing away.
It soon became evident that to understand the presence of Chinese
traditional medicine, one needs to understand the past. During our
one-year field research on Taiwan (1969-1970), I interviewed more
than a hundred physicians and pharmacists of Chinese traditional
medicine. Many conflicting interpretations of past developments and
of the essence of Chinese medicine came to my attention. Also,
structural peculiarities, such as the doctor-patient relationship in
Chinese traditional medicine, and the fact that physicians often
are employees of pharmacies, raised our interest and led us to
devote more time to historical research. My wife used the time
in Taiwan to study the beginnings of the Chinese pharmacology
of systematic correspondences during the Song, Jin and Yuan
dynasties. A Yuan dynasty materia medica, Wang Haogu's Tangye
Bencao, was the focus of her dissertation. I concentrated my
research on the current situation of Chinese traditional medicine
in Taiwan, and it was only after our return to Germany that I took
the lead, outlined in my wife's dissertation (namely to trace
fundamental conceptual changes in Chinese medicine to similarly
fundamental changes in the sociopolitical environment), to examine
larger time sections of Chinese medical history. This eventually
led to my Medicine in China: A History of Ideas. If I had played
with the thought of becoming a specialist in Sino-Soviet
relations before we went to Taiwan, being back in Munich,
a future devoted to the history of medicine in China appeared
much more fascinating.
MB: A central theme of your work is the importance of considering
the cultural environment in which medical theories develop, also
known as the "external history" of medicine. Could you elaborate on
this?
PU: Medical practitioners may decide what they want to be: mechanics
or intellectuals. The mechanic views the body as a machine that,
every now and then, requires repair. He does not need to know
much about the mental condition of his patients, and he does not
bother much why he does this or that. He has learned that
one intervention will be able to deal with problem "A," and another
intervention will successfully cure problem "B."
The intellectual healer follows a different course. He wants to know
why biomedicine has arrived at its current notions of the origin and
nature of disease, and at therapeutic interventions derived from them.
He wants to know what the essential difference is between different
health care traditions, and he wishes to have arguments (and be able
to voice these arguments) as to why he prefers one approach over
another. The intellectual healer may realize that one type of health
care is good for a certain portion of his clientele, while the mental
set-up of another portion of his clientele requires a different
therapeutic approach.
To be able to understand the paths Western and Chinese traditions
of health care have taken, it is essential to study the cultural environments
in which they have developed. Medicine cannot be understood without
its external history.
Anybody who criticizes biomedicine for whatever shortcomings or
deficits it has - and it has many - and wishes to change things or
create a better medicine, will end up as a Don Quixote if he does
not take the cultural environment, or external history, of medicine
into account. An awareness of the close links between the conceptual
foundations of health care traditions and their cultural environment
makes one understand, first, that medicine cannot change without
changes in the world view and/or existential experiences of a given
population, and, second, that certain patients cannot be successfully
treated by means of therapies legitimated by a world view that is not
their own. What it comes down to is the following: to study the cultural
history of human reactions to existential threats such as illness and
the danger of early death means to study the essence of the human
condition. To reach an understanding of the human condition and assist
one's patients to overcome episodes of disease, or to prevent
disease - that is the difference between an intellectual physician and
a mechanic.
MB: Could you expand on why you focus much of your work on comparing
the history of Western and Chinese medicine and how important you believe
it is for advocates of Chinese medicine in the West to understand these
subjects?
PU: Why do I teach medical students the history of European and Chinese
medicine? Medicine develops not only with its cultural environment, it also
develops amidst a political arena. Anybody who grew up in a Western
society and develops an interest in Chinese traditional medicine is
confronted with an import from a foreign culture. How does he or she know
whether the product taught by his teacher, whether Chinese or Western,
is genuine? How does he or she know whether the literature offered
reflects true Chinese medicine, or the views of some more or less
ill-informed writer? It is a fact that more than 95 percent of all literature
published in Western languages on Chinese medicine reflect Western
expectations rather than Chinese historical reality. Bestsellers are
usually written by those who know no Chinese, have no access to
Chinese medical history, and have never - or at best for short periods -
been to China.
There is, I wish to emphasize, nothing wrong with these books, as they were
informed by visions of an ideal health care presumably developed in China.
As such, these books tell us something about what is lacking in Western
biomedicine, and what is expected by many as a remedy to cure an ailing
Western health care system. This way, these books fulfill an important function.
They suggest ways to improve or circumvent biomedicine, and offer ideas
and strategies that may be helpful for many. Nevertheless, while they reflect
Western yearnings, they fail to reflect the historical truth of Chinese medicine.
Chinese medical history is, indeed, a huge treasure box, and given that TCM
has selected only parts of its contents, serious historical research may turn
up many more.
MB: (Laughing) The publisher of my forthcoming book will be happy to hear
that I meet two and perhaps all three of your criteria for a bestseller. Seriously
though - what advice would you have for individual practitioners who wish to
learn more about the history of Chinese medicine and for acupuncture/
Oriental Medicine schools who want to include that subject in their curriculum,
especially at the level of the recently established Doctoral degree program?
PU: Unfortunately, there is very little available in Western languages on the
history of Chinese medicine. No research institute exists in the West where
the history of Chinese medicine is researched systematically over an
extended period of time. Nevertheless, the body of scholarly works on the
history of Chinese health care traditions is steadily growing. Don Harper's
profusely annotated translation and analysis of the Mawangdui manuscripts
is indispensable for an understanding of the pre-conditions of the
subsequent emergence of Chinese medicine in the Han era. Kim
Taylor's bookChinese Medicine in Early Communist China is required
reading if one wishes to understand the politics behind the formation of
TCM. Paul Buell has published a dietary work from the Mongol dynasty,
A Soup for the Qan with most informative annotations, and Nigel
Wiseman has contributed the most reliable translation available
of Zhang Ji's Shanghan Lun of the late Han dynasty.
I myself have conducted my own research partly to meet the interests
of my students, some of whom attend medical school; others are in
Chinese studies. Thus, I have offered initial studies of the history of
Chinese pharmaceutical literature, of the history of ideas in Chinese
medicine, and of several seminal texts, such as the Nanjing of the 1st
century AD, Xu Dachun's "On the Origin and Further Development of
Medicine" of the 18th century, the ophthalmological treatise "Essentials
on the Silver Sea" of perhaps the 15th/16th century (together with J.
Kovacs), and together with H. Tessenow and J.S. Zheng the
introductory volume to the Huang Di Nei Jing Su Wen translation
project. This book (Huang Di Nei Jing Su Wen: Nature, Knowledge,
Imagery in an Ancient Chinese Medical Text), together with the
Nanjing translation, may be my most important contribution to the
emerging picture of the beginnings of Chinese medicine in the
Han era. Anybody who is interested in knowing the true historical
origins of Chinese medicine should read this introductory volume
to the Huang Di Nei Jing Su Wen project. It is only with this
background in mind that one is able to reach an informed judgment
on what early Chinese medicine may contribute to our health
care needs today.
Also, I have shown, in Chinese Medicine in Historical Objects and
Images, the value of material objects as sources for a more
comprehensive understanding of Chinese medical history. It should
be hoped that more will be published. For the time being, however,
readings from these books will be very helpful to learn more about
the history of Chinese medicine.
At present, I am working on a revised edition of Introductory Readings in
Classical Chinese Medicine. This reader offers a wide selection of most
informative texts from two millennia of Chinese health care traditions.
法律申明|用户条约|隐私声明|小黑屋|手机版|联系我们|www.kwcg.ca
GMT-5, 2024-7-3 22:42 , Processed in 0.016669 second(s), 17 queries .
Powered by Discuz! X3.4
© 2001-2021 Comsenz Inc.