This singular people possess works on medical science which they trace as far back as three thousand years, and chiefly written by two of their emperors, Chin-nong and Hoang-ti. It has been asserted that they received the early elements of the science from the Egyptians, but it is more probable that they derived their information from their constant intercourse with the Bactrians, whose arts and sciences were flourishing at the period of Alexander’s conquests, and the Chinese historians in support of this probability, state that several learned physicians came from Samarcand to establish themselves amongst them. Moreover, the doctrines of Erasistratus bear much resemblance to those of the Chinese.

The superstitious regard shown to the bodies of the departed, must naturally have materially retarded the progress of anatomical pursuits, although this people assure us that 2706 years before our era they possessed a work on this subject, entitled Nim Kin. Howbeit it seems probable, from their extreme ignorance of the structure of the human body, that this important branch of the science of medicine has remained stationary ever since the publication of the aforesaid treatise.

The Chinese physicians divide the body into a right and left portion, and three regions. The upper one, comprising the head and the chest, a middle one, extending from the lower part of the thorax to the umbilicus, and an inferior region, comprising the hypogaster and lower extremities. They admit twelve viscera as the sources of life, but they do not appear to have any distinct notion of the division, uses and conformation of the muscles, nerves, vessels, and the various tissues of the human economy. Their ignorance equally extends to the construction of animals.

They consider that man is influenced by two principles, heat and humidity, the harmony of which constitutes life, which ceases when their equilibrious state is destroyed. Vital moisture resides in the heart, lungs, liver, spleen, and kidneys, while vital heat pervades the intestines, the stomach, the pericardium, the gall-bladder and the ureters. These two principles are transmitted through the medium of the vital spirits and the blood by twelve canals, one of which carries a fecundating moisture from the head to the hands; another from the liver to the feet; a third from the kidneys to the left side of the body; and a fourth from the lungs to the right division.

In addition to these channels of vital transmission, they imagine that the state of our internal organs can be ascertained by the appearance of various parts of the head, which they consider as indicative sympathies of the action of the internal viscera. For instance, the head corresponds with the tongue, the lungs with the nostrils, the spleen with the mouth, the kidneys influence the ear, the liver acts upon the eyes, and thus they consider that they can form a correct idea of the nature of internal maladies by the complexion, the state of the eyes, the sound of the voice, the taste, and the smell of the patient.

The Chinese physiologists also consider the human body as a harmonic instrument, of which the muscles, tendons, nerves, arteries, &c. are vibrating chords, producing various sounds and modulations, and the pulse their chief guide in ascertaining the nature of disease, is but the result of a modification of these sounds as the chords are more or less extended or relaxed.In addition to these singular views of the human economy, they imagine that the body is influenced by five elementary agents, earth, minerals, water, air, and fire.

Fire prevails in the heart and the thoracic viscera, which bear an astronomic relation with the south.

The liver and the gall-bladder are under the influence of air, which is in relation with the east, whence the winds arise, and it is towards spring that these organs are generally affected.

The kidneys and ureters are ruled by water, astronomically associated with the north—hence winter is the usual season of the maladies in these parts.

The stomach and spleen are regulated by earth, and are placed in connexion with the centre of the firmament, between the five cardinal points, and affections of these parts are observed in the third month of each quarter.

Diseases are distinguished by their vicinity to or their distance from the central part of the body, the heart and lungs, and are usually occasioned by vicissitudes in the atmospheric constitution—varying with cold, heat, and moisture.

The minuteness of their division of maladies is as great as the mechanical precision which all their labours exhibit: for instance, they admit no less than forty-two varieties of the smallpox; according to the shape, colour, situation of the pustules, which they compare to the cocoons of the silkworm—to strings of beads—chaplets of pearls—and lay equal stress on their being flat or round—black, red, or violet. This disease has, indeed, been described by them with much accuracy and judgment, as regards its benign or its confluent character; and there is no doubt that inoculation was practised among them from time immemorial, as I have already shown in the article on that head. Equally accurate have they been in detailing the various symptoms of gout, scurvy, elephantiasis, and syphilis, which also scourges the “Celestial empire.”

The chief guide, however, in their diagnosis and prognosis, is the state of the pulse, and a very curious work, called “The Secrets of the Pulse,” and said to have been written two centuries before our era, by Ouang-chou-hÓ or Vam-xo-ho. The pulse is divided into the external, the middle, and the deep—producing nine different pulsations called Heon, and the arterial beats were formerly sought for in the joint of the big toe; this custom is now abandoned, but they still follow the strange practice of taking up the right wrist in women and the left in men.The external pulse, called Piao, is subdivided into several varieties.

1. The superficial P. in FÉou, which yields to the slightest pressure.

2. The hollow P. Kong, which announces that the artery is empty when pressed upon.

3. The slippery P. Hang, which slides under the fingers, like the beads of a necklace.

4. The full P. ChÉ, striking against the fingers with a full caliber of blood.

5. The tremulous P. Hien, vibrating like the chord of a musical instrument.

6. The intermittent P. Kin, vibrating by starts, like the instrument called Kin.

7. The regurgitating P. Hong, the strong pulsation of a full and distended vessel.

These seven characters are considered much more favourable than the eight which follow, and which, arising from a deeper action, require a more forcible pressure.

1. The deep P. Tehin, only discovered by a firm pressure.

2. The filiform P. Ouei, a threadlike pulsation.

3. The moderate P. Ouan, slow and languid.

4. The sharp P. Soe, producing the sensation of a cutting or sawing instrument.

5. The slow P. Tehis, when the pulsations follow each other with languid intervals.

6. The sinking P. Fou, when the pulse, although pressed hard, sinks under the finger.

7. The soft P. Sin, which feels like a drop of water one might press upon.

8. The weak P. Yo, which yields the sensation of feeling like a worn-out texture, and ceases to be observed when pressed upon for any time.

To these are added nine other varieties, called Tao.

1. The long P. Tehang, full, smooth—feeling like a full tube.

2. The short P. Toan, presenting a pointed surface, that seems indivisible.

3. The empty P. Hin, insensible under moderate pressure.

4. The tight P. Tsou, which the finger feels with difficulty.

5. The embarrassed P. KiÉ, languid and occasionally stopping.

6. The intermittent P. Tai, when several pulsations appear to be missing.7. The slender P. SiÉ, so slow and weak, that it feels like a hair.

8. The moving P. Tong, that one might compare to stones under water.

9. The tense P. KÉ, feeling like a distended drum-head.

But as many Chinese doctors were not satisfied with this confusion in the classification of pulses, and, like practitioners in other countries, sought to render darkness still more visible—they sought to strike out a new career by increasing the multiplication, and introduced the following addenda:

1. The strong pulse, Ta, filling the vessel, yet yielding to pressure.

2. The precipitate P. Son, in which the pulsation was rapid in succession.

3. The scattered P. San, soft, slow, and non-resisting.

4. The stray P. Li-king, strong—not pulsating three times in each inspiration.

5. The firm P. Tun, consistent and resisting.

6. The lively P. Ki, pulsation rapid in succession.

7. The skipping P. Teng, pulsation unequal, sudden, and frequent.

In this minute attention to the many variations of the pulses, the Chinese aided their study, by attending to age, sex, stature, constitution, the seasons, the passions, and the comparative state of health and disease.

In a person of high stature, the pulse was full—concentrated in diminished individuals—deep and embarrassed in fat subjects—long and superficial in the meager—soft in the phlegmatic temperament—tremulous in the lively and the active—slower in man than in woman, excepting when threatened with disease—full and firm in the adult—slow and feeble in old age—soft and vivacious in infancy.

The rhythm of the pulse was affected by the passions, though chiefly in a transient manner:—moderately slow, in joy—short, in grief—deep, under the impression of fear—precipitate and regurgitating, in anger. In the spring, they maintained that the pulsation was tremulous—replete, in summer—spare and superficial, in autumn—dry and deep, in winter. Much mysterious ceremony was observed by the Chinese physicians in this investigation; they felt the pulse with four fingers, which they alternately raised or dropped on the vessel, as if playing on a musical instrument.

In this profound study, they attributed to every disease a peculiar state of the pulse by which it could be recognised and ascertained, and at the same time it enabled them to form a favourable or unfavourable prognostic. Some of these rules are curious. If the pulses stop before fifty pulsations have been counted, disease is at hand; when an interruption in the course of the circulation takes place after forty pulsations, the patient has not more than four years to live; when an interruption takes place after the third pulsation, three or four days are the probable term of existence; but the patient may linger on for six or seven days more, when the interruption only succeeds the fourth pulsation.

Idle as these speculations may appear, it is to be feared that while the Chinese paid such minute attention to the state of the circulation, more distinguished and learned schools do not consider this powerful indication of the strength or weakness of the vital functions with sufficient care and discrimination, and perhaps a translation of the works of Ouang-chou-ho, might not be altogether useless in the present enlightened age. I have no hesitation in saying that this important investigation is sadly neglected in medical education—so much so indeed, that the different appellations given to the varied state of the pulse, are neither well defined nor generally understood. The French physician Bordeu has given much valuable information on this subject, which occupied the ancients as much as it seems to have fixed the attention of the Chinese. We find that the Indians, in the time of Alexander, accurately studied this important point.

Notwithstanding the assertion of Sprengel, Hippocrates was a most attentive observer of the state of the pulse. Thus we find him giving the name of sf???? to that violent and spasmodic beating of the artery, which was not only sensible to the touch, but evident to the bystander’s eye—in more than forty passages of his immortal works do we find important references to the pulse, which he also declared could enable us to detect the secret workings of the passions. Many were the ancient physicians who have minutely entered into these investigations, amongst them we may name Herophilus, Erasistratus, Zeno, Alexander Philalethes, Heraclides of ErythrÆ, Heraclides of Tarentum, Aristoxenes. Several of the doctrines founded on these observations were most absurd, attributing the various conditions of the circulation to the Pneuma of the heart and arteries; such were the doctrines of Asclepiades, Agathinus, Galen, and many others; and amongst the Arabians we find Thabeth Ebn Ibrahim asserting that by the state of the pulse he could ascertain what articles of food had been taken—in more modern times Baillou, Wierns, Boerhaave, Hoffmann, have sedulously applied themselves to this most essential study, and Schelhammenn asserts that the pulse never once deceived him.

The effect of our passions on the circulation is much more powerful than is generally believed, and they are a more fertile source of our maladies than is commonly apprehended. We can readily conceive why the Spartan Chilo died through excess of joy whilst embracing his victorious son.[53]

In the treatment of disease, the Chinese, so fond of classification, divide the medicinal substances they employ into heating, cooling, refreshing, and temperate; their materia medica is contained in the work called the Pen-tsaocang-mou in fifty-two large volumes, with an atlas of plates; most of our medicines are known to them and prescribed; the mineral waters, with which their country abounds, are also much resorted to; and their emperor, Kang-Hi, has given an accurate account of several thermal springs. Fire is a great agent, and the moxa recommended in almost every ailment, while acupuncture is in general use both in China and Japan; bathing and champooing are also frequently recommended, but blood-letting is seldom resorted to.

China has also her animal magnetizers, practising the Coug fou, a mysterious manipulation taught by the bonzes, in which the adepts produce violent convulsions.

The Chinese divide their prescriptions into seven categories.

1. The great prescription.

2. The little prescription.

3. The slow prescription.

4. The prompt prescription.

5. The odd prescription.

6. The even prescription.

7. The double prescription.

Each of these receipts being applied to particular cases, and the ingredients that compose them being weighed with the most scrupulous accuracy.

Medicine was taught in the imperial colleges of Pekin; but in every district, a physician, who had studied six years, is appointed to instruct the candidate for the profession, who was afterwards allowed to practise, without any further studies or examination; and it is said, that, in general, the physician only receives his fee when the patient is cured. This assertion, however, is very doubtful, as the country abounds in quacks, who, under such restrictions as to remuneration, would scarcely earn a livelihood. Another singular, but economical practice prevails amongst them—a physician never pays a second visit to a patient unless he is sent for. Whatever may be the merits of Chinese practitioners both in medicine and surgery, or their mode of receiving remuneration, it appears that they are as much subject to animadversion as in other countries:—a missionary having observed to a Chinese, that their medical men had constantly recourse to fire in the shape of moxa, redhot iron, and burning needles; he replied, “Alas! you Europeans are carved with steel, while we are martyrized with hot iron; and I fear that in neither country will the fashion subside, since the operators do not feel the anguish they inflict, and are equally paid to torment us or to cure us!”