ISO/TS 17948:2014 health information traditional chinese medicine literature metedata

Courtesy: ISO/TS 17948:2014 health information traditional chinese medicine literature metedata

Jing-luo

Acupuncture chart from the Ming dynasty (c. 1368–1644)

The meridians (经络, jīng-luò) are believed to be channels running from the zàng-fǔ in the interior (里, lǐ) of the body to the limbs and joints (“the surface” [表, biaǒ]), transporting qi and xuĕ. TCM identifies 12 “regular” and 8 “extraordinary” meridians; the Chinese terms being 十二经脉 (shí-èr jīngmài, lit. “the Twelve Vessels”) and 奇经八脉 (qí jīng bā mài) respectively. There’s also a number of less customary channels branching from the “regular” meridians.

Gender in traditional medicine

Fuke (妇科; 婦科; Fuke) is the Chinese term for women’s medicine (known as gynecology and obstetrics in modern medicine). However, there are few or no ancient works on it except for Fu Qing-zhu’s Fu Qing Zhu Nu Ke (Fu Qing-zhu’s Gynecology). In traditional China, as in many other cultures, the health and medicine of female bodies was less understood than that of male bodies. Women’s bodies were often secondary to male bodies, since women were thought of as the weaker, sicklier sex.

In clinical encounters, women and men were treated differently. Diagnosing women was not as simple as diagnosing men. First, when a woman fell ill, an appropriate adult man was to call the doctor and remain present during the examination, for the woman could not be left alone with the doctor. The physician would discuss the female’s problems and diagnosis only through the male. However, in certain cases, when a woman dealt with complications of pregnancy or birth, older women assumed the role of the formal authority. Men in these situations would not have much power to interfere. Second, women were often silent about their issues with doctors due to the societal expectation of female modesty when a male figure was in the room. Third, patriarchal society also caused doctors to call women and children patients “the anonymous category of family members (Jia Ren) or household (Ju Jia)” in their journals. This anonymity and lack of conversation between the doctor and woman patient led to the inquiry diagnosis of the Four Diagnostic Methods being the most challenging. Doctors used a medical doll known as a Doctor’s lady, on which female patients could indicate the location of their symptoms.

Cheng Maoxian (b. 1581), who practiced medicine in Yangzhou, described the difficulties doctors had with the norm of female modesty. One of his case studies was that of Fan Jisuo’s teenage daughter, who could not be diagnosed because she was unwilling to speak about her symptoms, since the illness involved discharge from her intimate areas. As Cheng describes, there were four standard methods of diagnosis – looking, asking, listening and smelling and touching (for pulse-taking). To maintain some form of modesty, women would often stay hidden behind curtains and screens. The doctor was allowed to touch enough of her body to complete his examination, often just the pulse taking. This would lead to situations where the symptoms and the doctor’s diagnosis did not agree and the doctor would have to ask to view more of the patient.

These social and cultural beliefs were often barriers to learning more about female health, with women themselves often being the most formidable barrier. Women were often uncomfortable talking about their illnesses, especially in front of the male chaperones that attended medical examinations. Women would choose to omit certain symptoms as a means of upholding their chastity and honor. One such example is the case in which a teenage girl was unable to be diagnosed because she failed to mention her symptom of vaginal discharge. Silence was their way of maintaining control in these situations, but it often came at the expense of their health and the advancement of female health and medicine. This silence and control were most obviously seen when the health problem was related to the core of Ming fuke, or the sexual body. It was often in these diagnostic settings that women would choose silence. In addition, there would be a conflict between patient and doctor on the probability of her diagnosis. For example, a woman who thought herself to be past the point of child-bearing age, might not believe a doctor who diagnoses her as pregnant. This only resulted in more conflict.