Courtesy: ISO/TS 17948:2014 Health information traditional chinese medicine literature metedata
Yin yang and gender
Yin and yang were critical to the understanding of women’s bodies, but understood only in conjunction with male bodies. Yin and yang ruled the body, the body being a microcosm of the universe and the earth. In addition, gender in the body was understood as homologous, the two genders operating in synchronization. Gender was presumed to influence the movement of energy and a well-trained physician would be expected to read the pulse and be able to identify two dozen or more energy flows. Yin and yang concepts were applied to the feminine and masculine aspects of all bodies, implying that the differences between men and women begin at the level of this energy flow. According to Bequeathed Writings of Master Chu the male’s yang pulse movement follows an ascending path in “compliance [with cosmic direction] so that the cycle of circulation in the body and the Vital Gate are felt…The female’s yin pulse movement follows a defending path against the direction of cosmic influences, so that the nadir and the Gate of Life are felt at the inch position of the left hand”. In sum, classical medicine marked yin and yang as high and low on bodies which in turn would be labeled normal or abnormal and gendered either male or female.
Bodily functions could be categorized through systems, not organs. In many drawings and diagrams, the twelve channels and their visceral systems were organized by yin and yang, an organization that was identical in female and male bodies. Female and male bodies were no different on the plane of yin and yang. Their gendered differences were not acknowledged in diagrams of the human body. Medical journals were filled with illustrations of male bodies or androgynous bodies that did not display gendered characteristics.
As in other cultures, fertility and menstruation dominate female health concerns. Since male and female bodies were governed by the same forces, traditional Chinese medicine did not recognize the womb as the place of reproduction. The abdominal cavity presented pathologies that were similar in both men and women, which included tumors, growths, hernias, and swellings of the genitals. The “master system,” as Charlotte Furth calls it, is the kidney visceral system, which governed reproductive functions. Therefore, it was not the anatomical structures that allowed for pregnancy, but the difference in processes that allowed for the condition of pregnancy to occur
Pregnancy
Traditional Chinese medicine’s dealings with pregnancy are documented from at least the seventeenth century. According to Charlotte Furth, “a pregnancy (in the seventeenth century) as a known bodily experience emerged […] out of the liminality of menstrual irregularity, as uneasy digestion, and a sense of fullness”. These symptoms were common among other illness as well, so the diagnosis of pregnancy often came late in the term. The Canon of the Pulse, which described the use of pulse in diagnosis, stated that pregnancy was “a condition marked by symptoms of the disorder in one whose pulse is normal” or “where the pulse and symptoms do not agree”. Women were often silent about suspected pregnancy, which led to many men not knowing that their wife or daughter was pregnant until complications arrived. Complications through the misdiagnosis and the woman’s reluctance to speak often led to medically induced abortions. Cheng, Furth wrote, “was unapologetic about endangering a fetus when pregnancy risked a mother’s well being”. The method of abortion was the ingestion of certain herbs and foods. Disappointment at the loss of the fetus often led to family discord
Postpartum
If the baby and mother survived the term of the pregnancy, childbirth was then the next step. The tools provided for birth were: towels to catch the blood, a container for the placenta, a pregnancy sash to support the belly, and an infant swaddling wrap. With these tools, the baby was born, cleaned, and swaddled; however, the mother was then immediately the focus of the doctor to replenish her qi. In his writings, Cheng places a large amount of emphasis on the Four Diagnostic methods to deal with postpartum issues and instructs all physicians to “not neglect any [of the four methods]”. The process of birthing was thought to deplete a woman’s blood level and qi so the most common treatments for postpartum were food (commonly garlic and ginseng), medicine, and rest. This process was followed up by a month check-in with the physician, a practice known as zuo yuezi.