Yin and Yang: The Physical and modified in Chinese society. By analyzing the Symbolic in Chinese Medical the transformation of Chinese medicine over Practices time, it is possible to witness changes in Chinese beliefs and values, which creates a connection between the physical and the Shilo H McBurney symbolic within a culture that medical anthropology is useful for investigating. Introduction Anthropology has struggled to find a The Value of Medicine in Anthropology correlation between the physical and As seen when studying Chinese symbolic aspects of cultures for many years health care systems, the medical practices of now. There has even been a division a society allow for a dual-perspective where between sociocultural anthropologists, who both the beliefs and physical aspects of a mainly study the beliefs and structures of culture can be examined. Studying medicine cultures, and bioarchaeological anthrop- provides a view of intangible cultural ologists, who are primarily concerned with processes, such as a group’s comprehension the physical and material aspects of cultures. of the world, which are rooted in the visible The relatively new discipline of medical structure of the body. Medical practices are anthropology may find common ground functional, providing care for the physical between the two. It is valuable to study the being of a person, while they also reinforce health practices of present and past cultures, the beliefs and values of a culture. For this in part because they mark a point where the reason, medicine is an important area of physical and the symbolic meet. Health research for anthropology, as it connects the practices serve a functional role by caring symbolic and the physical. for the physical body, but they can also Medical anthropology, as a relatively display the unique beliefs of a specific new discipline, is involved with studying culture. The history of recognizing the value how illnesses are spread across the world medicine has in understanding thought and what social and economic processes processes within a culture reaches back to transform disease from one culture to anthropologists such as Claude Levi-Strauss, another (Dressler 2001). As globalization with his myth versus science arguments, and increases, with rural groups migrating into E. E. Evans-Pritchard, who studied Zande urban centres and elevated amounts of beliefs that were rooted in the body (Evans- chronic diseases, medical anthropology is Pritchard 1965; Levi-Strauss 1962). This becoming more important as an area of paper focuses on how particular aspects of examination. It employs a two-tiered Chinese medicine have changed over time in approach of studying how the environment order to attempt to examine how Chinese and beliefs of a culture come together to society has correspondingly transformed its affect the body; both the physical and values and beliefs. However, the symbolic symbolic need to be studied holistically to importance of studying health practices attempt to properly comprehend disease. within a culture is first discussed by Elevated amounts of chronic disease are employing Levi-Strauss’ (1962) and Evans- connected to social stresses and cultural Pritchard’s (1965) theories. Early Chinese change. Thus to resolve issues of disease, health practices and respective beliefs are anthropology is attempting to connect then investigated, which includes a behaviour, the physical body, and cultural discussion of how they have changed to constructs (Dressler 2001). Anthropology observe why and how key values have been has struggled in this area for a long time, as Witchcraft was noted as a fundamental part all of these aspects form society and are very of Zande society, as this form of health- difficult to separate. Health practices related ritual displayed the underlying consequently must be examined collectively values and beliefs of Zande culture (Evans- and through individuals. Although Pritchard 1965). individuals usually reflect the group Levi-Strauss (1962) focused on mentality, they can share personal scientific perspectives of cultures as a experiences that create a more holistic and whole, rather than specific medical detailed understanding of medical practices, practices. He recognized that myths and which are a link between the body and rituals were of equivalent value to science in culture (Dressler 2001). collecting information about the world. He Long before medical anthropology considered magic its own system that was was considered a discipline, well-known distinct from science, not simply an anthropologists such as E. E. Evans- inadequate form of science (Levi-Strauss Pritchard and Claude Levi-Strauss were 1962). Science and magic are two parallel studying the different medical and scientific methods for understanding and categorizing practices of cultures in attempts to examine the world, and in different situations either unique modes of thought. Evans-Pritchard can be more valuable. Both display the (1965) studied Zande witchcraft, which was mental processes of a particular culture. The considered to be the source, or control differences in the techniques and achieved mechanism, for diseases; witchcraft was outcomes of a ritual or scientific process used to structure Zande culture. Acute reflect the variation between cultures. Ritual illnesses were attributed to sorcery, while is used to structure patterns within cultures, chronic illnesses were caused by witchcraft whereas science primarily employs structure as the witch slowly consumed the ‘soul of (Levi-Strauss 1962). Levi-Strauss (1962) the organ’ (Evans-Pritchard 1965). recognized that Western science is not the Locations of bodily pain were areas believed ultimate form of logical understanding of the to have been shot by witches, while witch world, and that each culture’s modes of doctors were relied on to resolve these thought have value and rationality in their physical issues. How witchcraft was passed own right. This reflects on medical practices on from one generation to the next displayed too, as a form of science, as Western Zande beliefs of procreation and biology: medicine is not always the best solution in witchcraft is inherited, passing from father every health situation. Various cultural to son or mother to daughter. Azande practices are extremely valuable medically believe that if the father’s soul is more even if they are not considered as ‘scientific’ powerful, the child will be a boy, and if the or as ‘technological’ as Western practices. mother’s soul is more powerful, the child China recognizes this, and maintains will be a girl (Evans-Pritchard 1965). traditional medicinal practices along with Consequently, if the parent with a stronger integrating Western medicine into the health soul is a witch, the child will unavoidably care system. also be a witch. Witchcraft was further used Anthropologists need to attempt to to structure gender relationships: men were step outside of their own culture and usually affected by male witches, while scientific notions to properly understand women were typically only affected by medicine in other cultures. To adequately female witches, keeping both genders study health practices they need to be seen distinct in issues of health and disease. as a system of community, information, and identity (Zhan 2001). Medical systems (Beinfield and Korngold 1991). Tao was represent complex global interactions, thus defined as the continuous whole entity of the they are constantly shifting and changing as universe, which people formed a small part new ideas are integrated (Zhan 2001). of; a constant interaction occurred between Studying medicine from an anthropological humans and the environment around them perspective can make people aware of (Beinfield and Korngold 1991). Ch’i was the different modes of comprehension and essential life force found in the body which rationality found within other cultures, while was balanced through the opposite forces of showing that each has equal value. Aside Yin and Yang (Anderson 1992). When a from finding common ground between the person disrupted this balance, they became physical and symbolic aspects of cultures, ill. Yin diseases were due to particular foods this is where the value of medical and habits, while Yang diseases were caused anthropology lies. by evil winds, rain, cold, and heat (Anderson 1992). Everything in Chinese medicine was Ancient and Contemporary Chinese based on this fundamental relationship Medicine and Beliefs between the opposing notions of Yin and Yang and treatment was concerned with The Beginning recreating harmony and balance within a Chinese medicine is considered to person (Jingfeng and Zhen 2003). have begun around 2700 BC when The Chinese believed that everything Shennong, an emperor of legend, was in in the world was controlled by the five power (Ho and Lisowski 1997). He is famed elements of wood, fire, earth, metal, and for initiating the Chinese medicinal practices water. Each of these elements was tied to a of acupuncture and herbs. Shennong is now certain bodily organ, sense, and season and understood to have been the period when thus, in addition to Yin and Yang, they also medicine appeared and not an actual person played an important role in diagnosing and (Ho and Lisowski 1997). While ancient treating diseases (Jingfeng and Zhen 2003). inscriptions were found on bones in China This notion of the five elements also which displayed knowledge of various reinforced the deep connection the Chinese illnesses, the first actual text on classical believed a person had with nature. In health Chinese medicine was Huang Di’s Inner practices, this meant that the relationship of Canon of Medicine (Jingfeng and Zhen an individual to their environment, including 2003). Medicine, or yi in Chinese, meant ‘a the season, was always considered. Disease man who treats disease,’ while liquor was was believed to be an imbalance between a defined as ‘cures disorders,’ and in the past person’s inner and outer world, where it was thought to be the most useful external poisons could invade due to internal medicine (Jingfeng and Zhen 2003). The disharmony. There were eight guiding Inner Canon of Medicine was comprised of principles given to study the imbalances in a two sections that articulated the key patient’s energy that were rooted in principles of Chinese traditional medicine: opposites: Yin and Yang, cold and heat, Su Wen speaks of Yin and Yang, the five deficiency and excess, and interior and evolutionary phases and medical care; Ling exterior. These principles were employed Shu provides information about acupuncture with the four diagnostic notions of and moxibustion (Jingfeng and Zhen 2003). inspection, interrogation, listening, and In ancient China, a human was palpation to diagnose the disease (Jingfeng believed to be a small model of the universe and Zhen 2003). Herbal medicine has a very long responsibility taken by the shaman was history of practice in China, with early therapeutic concerning the internal stress of pharmacology employing 730 categorized the individual (Gallin 1978). medicines (Jingfeng and Zhen 2003). Ben The ancient Chinese health care cao was the name for ancient Chinese herbal system was based on these shamans, who medicine, which was a very complex practiced both medicine and magic, which practice that required a great deal of were inseparable. Eventually the position of knowledge, preparation, and use. Creating court physician was created, but ‘physicians’ drug forms was considered an actual art, as were considered very distinct from combining various herbs, of which plants, ‘shamans,’ introducing a dual-approach animals, and minerals are included, could medical system (Ho and Lisowski 1997). have a potentially dangerous outcome However, unlike shamans, these physicians (Jingfeng and Zhen 2003). By 2000 years were traditionally of low-importance and ago, the healing techniques of both status (Jingfeng and Zhen 2003). Shamans acupuncture and moxibustion were a well- continued to provide ritual healing, called established art form. Acupuncture described sacred medicine, where a lapse in morality is the process of employing needles, herbs, and found and resolved. It was at this time that force at ‘acupoints’-particular places that the opposition of secular and sacred responded to disease, and where Ch’i was medicine was introduced into Chinese health transported to the surface of the body. care (Gallin 1978). Various needle lengths and shapes were utilized for different treatments (Jingfeng The Present and Zhen 2003). Moxibustion involved Traditional Chinese medicine applying burning moxa floss or other continues to have a fundamental role in the materials at acupoints or the source of structure of Chinese culture, representing a illness. Both techniques were meant to fix a long past of dealing with illnesses and disruption in the system of movement within working to improve health. However, a person, which was considered the cause of information has increased with the disease. Moxibustion and acupuncture globalization, resulting in the introduction of were used to restore an individual’s internal many medical advances into China, while balance and harmony (Jingfeng and Zhen aspects of Chinese health care have in turn 2003). spread across the world (Jingfeng and Zhen From a Chinese perspective, disease 2003). The sciences and the arts never was often rooted in anxiety about a lapse in separated in China, as they both function morals, such as neglecting responsibilities to under the same main principles, such as Yin one’s ancestors. This idea originated in the and Yang (Ho and Lisowski 1997). “Mandate of Heaven,” a fundamental law of Consequently, many healing techniques are Chinese society that dictated that rulers must still considered to be art forms as well as abide by moral rules, or destruction would scientific processes (Beinfeld and Korngold befall China. The notion of morality was 1991). Chinese medicine continues to be integral to Chinese culture, which in turn rooted in the notion of inclusive opposition: carried over to medicinal practices (Gallin as diffusion occurred between the ‘West’ 1978). Shamans, traditional Chinese healers, and the ‘East,’ China began to employ employed ritualistic medicine to deal with Western techniques alongside traditional lapses in morality. The healing process techniques. The idea of the ‘physical’ and addressed the physical issue, while the technological advances became important to Chinese health care, but the notion of the Chinese medical practices within their ‘unseen’ and interconnected harmony was historical context to attempt to achieve a not abandoned (Beinfield and Korngold proper understanding of Chinese beliefs 1991). Yin and Yang, the five elements, the (Gallin 1978). Treatment often functions as eight principles, and the four diagnostic a sort of social therapy or release for the notions are still fundamentally used as the patient, as all of the responsibility is placed basis for Chinese medicine (Jingfeng and on the healer. There is also a focus on the Zhen 2003). patient, instead of the disease, which holds Herbal medicine still plays a large true for all Chinese medicine, which creates role in Chinese healing, with the variation in a sense of support and community in drugs initially increasing through trade with Chinese society (Gallin 1978). other cultures (Jingfeng and Zhen 2003). It Despite this, as the Chinese health is occasionally used along with Western care system attempts to combine traditional forms of medical treatment, such as to medicine with large populations, political strengthen the body during radiation or systems, and Western medicine, changes surgery due to cancer (Beinfield and have occurred. There have been increases in Korngold 1991). Acupuncture and moxi- private hospitals and health insurance, along bustion are still very popularly utilized for with a struggle to integrate large rural all sorts of healing purposes (Jingfeng and populations into the overall health care Zhen 2003). This specific area of traditional structure. These rural areas are the main Chinese medicine also displays the proponents of traditional therapeutic combining of modern technology with techniques, as these practices are easily ancient techniques, as new procedures such affordable in regions with higher poverty as electro-acupuncture have been created rates (Anderson 1992). ‘Barefoot doctors,’ (Jingfeng and Zhen 2003). Acupuncture and peasants who are given minimal medical moxibustion are some of the more well- education, have been created in these large known Chinese medicinal procedures scale rural regions as part of a ‘cultural around the globe, and they are often revolution’ to provide health care to employed in other cultures to treat illness. communities. These doctors are a fast and The largest changes to Chinese cheap method to fulfill community health health practices have occurred in the care necessities, as they stay within their structure of the overall health care system, locale (Anderson 1992). ‘Red medical as traditional Chinese medicine has simply workers,’ housewives trained as volunteer integrated Western biomedicine as another helpers, also play a role in providing healing technique. Sacred medicine and medical aid. Patients from these rural ritual healing employed by shamans persist, communities only go to hospitals if local mainly in rural areas, which continue to health care is not sufficient. The position of reinforce societal values and norms by a physician has consequently increased in finding the root of a health issue in a lapse status through this medical hierarchy, as of Chinese morality (Gallin 1978). Morality well as through scientific and technological is still as important an issue in China today advances. Interestingly, before a patient is as when the Mandate first appeared in hospitalized, they must choose between ancient times, with shamans still existing traditional Chinese or Western health care primarily to deal with this problem. The and changing one’s decision is considered importance of morality to medicine also rude. If one type is ineffective, however, a displays the need to study contemporary patient is allowed to criticize the treatment (Anderson 1992). While physicians have an in Chinese healing, as a globalized world elevated status, traditional shamans are well encourages feelings of unison and support. trusted by the community. With such large There is also an appeal in connecting nature rural populations, traditional health care and humanity as people begin to witness continues to be the primary form of medical how their relationships with their treatment. It remains unclear as to how ecosystems have affected the environment China will completely succeed at integrating (Beinfield and Korngold 1991). traditional medicine with increasing In China, the integration of modernization and economic issues biomedicine did not create the same reaction (Anderson 1992). as it did in the ‘West’ (Ho and Lee 2007). This is partly due to trying to adapt a rather Discussion traditionally structured system to modern processes, but it is primarily argued that A Process of Change: The Transformation Chinese beliefs are the cause of this of Chinese Medicine difference. Issues of morality, especially In discussing how Chinese medicine, when dealing with the family, often affect and consequently Chinese beliefs, have health care procedures (Ho and Lee 2007). transformed over time, it is important to note Family connections are extremely important both why and how they have changed. in Chinese society, compared to often more Although Chinese health care has individualistic Western societies. This undoubtedly evolved through natural creates unique cultural and moral growth, it is arguable that diffusion from requirements, which affects medical other cultures, in particular the ‘West,’ has decisions and economics (Ho and Lee had the largest impact in creating change. 2007). A family lives in harmony when However, the diffusion is an exchange, as rituals and responsibilities are fulfilled, but Chinese medicine has consequently spread if an imbalance is created this can, in turn, all over the globe as globalization increases. affect an individual’s personal health. The Yet China has not given up faith in its family is relied upon to make all traditional medicine, which is a source of fundamental medical decisions, and the Chinese pride and identity, especially patient is simply meant to follow orders with concerning fundamental notions such as the only exception being when there is Ch’i (Anderson 1992). Health care practices internal strife within the family, in which continue to revolve around and incorporate case the individual must be considered environmental factors when diagnosing (Anderson 1992). This aspect of Chinese diseases due to the continued belief in the health care and the Chinese medical system connection between humans and nature. illustrates the value people in China place on Various social environments and natural family relationships and the certain moral conditions create a different treatment for codes that they must abide by. each individual (Anderson 1992). Ch’i Although the Chinese medical connects everything in life, meaning nothing system has undoubtedly transformed as time is static or bounded and this carries over into has passed, it has managed to maintain a medicine and health care, which are fundamental traditional structure of beliefs constantly changing. Just as the body cannot while incorporating new technology and be separated from the mind, Chinese ideas, mainly from the ‘West.’ It is medicine cannot be separated from Chinese necessary to understand Chinese modes of beliefs and society. This is part of the value thought to properly understand Chinese health practices, as key Chinese values are the notion of opposites, such as Yin and still the basis of medical practices. China has Yang or internal and external. It is arguable a very unique society, which has impacted that this opposition is the basis of the entire how its medical system has changed (Ho Chinese medical system as well: secular and and Lisowski 1997). In analyzing Chinese sacred, modern and traditional, and Western health care within its own cultural and and Eastern techniques. While providing this historical environment, cultural studies of dual-approach, the Chinese health care Chinese medicine have exceptional value in system successfully integrates both observing the process of cultural change contrasting elements together in relative (Gallin 1978). When examining how balance to provide a sense of harmony in Chinese beliefs and medical practices have Chinese society. changed over time, it is not immediately apparent that differences have occurred. Summary and Conclusion China has managed to maintain many While the medical practices within traditional aspects of health care, from this study allow a glimpse at the underlying medicinal treatments to shamans, which structure of beliefs in China, they only begin continue to be based on fundamental beliefs to touch upon the broad and intricate in Chinese society such as morality and Chinese health care system. Chinese harmony. However, China has integrated medicinal techniques, including herbal many aspects of Western medical practices remedies, acupuncture, and moxibustion, into the entire health care system which has show fundamental underlying values in resulted in wide-spread changes, such as a Chinese society, such as maintaining dichotomy between primarily traditional harmony and acknowledging nature. The practices in rural regions and mainly modern Chinese health care system displays current medicine in urban areas. Consequently, societal structures within China, as it is Chinese beliefs have been altered affected by the large rural populations and concerning the ability to accept the foreign economic processes. Both Chinese medical and unknown as plausible treatment options. practices and the overall health care system Increased value is also placed on the have transformed over time, partially due to scientific and technological within medical self-growth, and partly due to the integration practices, while there is a slight move away of new information from other cultures. from focusing on the ‘unseen’ portions of However, China manages to keep a careful medicine, including elements such as Ch’i, balance of traditional medicine and which were the basis of traditional Chinese technological advances, allowing health care. Instead, more emphasis is fundamental ancient Chinese beliefs to placed on the physical and visible, resulting retain a large role in society. With increasing in the inclusion of Western procedures globalization and scientific practices, it is which focus on treating this side of illness. unclear how Chinese health care will Due to the fundamental role of traditional proceed into the future. One can only hope medicine in Chinese society, which is seen that China can continue to maintain a as a source of cultural identity and pride, harmonious system rooted in important ancient beliefs and techniques were not beliefs which connect all Chinese society. eliminated, but rather continue to co-exist Early anthropologists such as Claude Levi- beside the newly integrated modern Strauss and E. E. Evans-Pritchard realized practices. This approach is fitting, as the importance that science and medicine Chinese beliefs are primarily structured on played in understanding different cognitive processes between cultures. As a result, with Gallin, Bernard. 1978. Comments on the creation of medical anthropology as a Contemporary Sociocultural Studies discipline, medicine is now widely of Medicine in Chinese recognized as a fundamental area of cultural Societies. In Culture and Healing in study. Chinese medical practices are Asian Societies: Anthropological, fundamental to Chinese culture, providing a Psychiatric and Public Health tie between the physical and the symbolic, Studies. Arthur Kleinman, Peter tradition and modernity, and the rural and Kunstadter, and E Russell the urban, keeping China in a constant state Alexander, eds. Pp. 173-181. of balance. Linking all of China like Ch’i Cambridge: Schenkman Publishing. connects the world, medical practices are clearly an important area of anthropological Ho, Justin, and Shui Chuen Lee. 2007. research, as they can portray the main values Medicine and the Biomedical and structures underlying a culture. Technologies in the Context of Asian Perspectives. In The Family, References Cited Medical, Decision-making and Anderson, James G. 1992. Health Care in Biotechnology: Critical Reflections the People’s Republic of China: on Asian Moral Perspectives. ABlend of Traditional and Modern. Shui Chuen Lee, ed. Pp. 1-13. Central Issues in Anthropology Dordrecht: Springer. 10:67- 75. Ho, Peng Yoke, and F. Peter Lisowski. Beinfield, Harriet, and Efrem Korngold. 1997. A Brief History of Chinese 1991. Between Heaven and Earth: A Medicine. Singapore: World Guide to Chinese Medicine. New Scientific Publishing. York: Ballantine Books. Jingfeng, Cai, and Zhen Yan. 2003. Dressler, William W. 2001. Medical Medicine in Ancient China. In Anthropology: Toward a Third Medicine Across Cultures: Moment in Social Science? History and Practice of Medicine in Medical Anthropology Quarterly Non-Western Cultures. Helaine 15:455-465. Selin, ed. Pp. 49-74. Dordrecht: Kluwer Academic Publishers. Evans-Pritchard, Edward E. 1965. Witchcraft, Oracles and Magic Levi-Strauss, Claude. 1962. The Savage Among the Azande. Oxford: Mind. Chicago: University of Clarendon Press. Chicago Press.

Zhan, Mei. 2001. Does It Take a Miracle? Negotiating Knowledges, Identities, and Communities of Traditional Chinese Medicine. Cultural Anthropology 16:453-480.