Medical Practice In Modern China

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When the People's Republic of China was founded in 1949, Chairman Mao Zedong (1893-1976) declared that traditional Chinese medicine and pharmacology constituted a great treasure-house that must be explored and improved. Mao's call for the use of both traditional and Western-trained doctors was a pragmatic response to China's desperate need to expand the pool of health care workers to serve 540 million people, typically living in impoverished, rural areas without public health, sanitary, or medical facilities. Circumstances impelled China into a unique experiment in the integration of past and present, East and West. The revival of traditional medicine was launched with the Great Leap Forward (1958-1960), gained momentum during the Cultural Revolution (1966-1969), and peaked in the aftermath of this ideological frenzy.

China's health care system was dedicated to dealing with common and recurrent diseases, public health work, and the eradication of major endemic disorders. The motto adopted by the Chinese medical system was: ''Eradicate the four pests!'' The official four pests were rats, flies, mosquitoes, and sparrows. Cockroaches, fleas, lice, bedbugs, snails, and mice were also targeted for eradication, but listing all of them would have ruined a good motto.

By the 1980s, China had established a health care system that is generally conceded to be a model for other developing countries. Sensitive measures of health in Shanghai in 1980, such as infant mortality and life expectancy at birth, compared favorably with New York City. Western visitors were impressed by Chinese experiments in medical education and the restructuring of medical practice, which obligated the physician to share diagnostic and therapeutic responsibilities with a newly empowered array of lay and paramedical personnel. Preventive medicine and basic primary health care were provided by legions of ''barefoot doctors,'' midwives, and nurses. The use of herbal remedies, acupuncture, and moxibustion remains the core of medical practice, but traditional doctors also study microbiology and pharmacology. China's colleges of Western medicine include training in traditional medicine.

The development of acupuncture anesthesia has been hailed in China as another great leap forward. Inspired by the thoughts of Chairman Mao, hospital workers began to wonder whether the pain-relieving effects of needling that had been exploited in the treatment of post-surgical distress might be used in place of chemical anesthetics during surgery. Even in China, the prospect of acupuncture anesthesia was greeted with some skepticism, but in the 1960s acupuncture anesthesia was being used in about sixty percent of all surgical operations. Modern acupuncturists argue that, in contrast to chemical anesthesia, needling allows the body to mobilize all its defense mechanisms, while maintaining normal physiological functions.

The revival of interest in acupuncture and herbalism has not been accompanied by commensurate attention to the theoretical basis of traditional medicine. Separated from its theoretical framework, Chinese medicine could become merely a hodge-podge of empirical remedies, rather than a sophisticated philosophical system capable of providing guidance and inspiration for both patients and practitioners. Chinese philosophy and medicine have, however, always demonstrated a remarkable capacity for syncretism and adaptation. China is a living civilization, in which the traditional arts are intimately linked to their modern counterparts. Perhaps the thoughts of both Huang Ti and Chairman Mao will be subsumed and integrated into a new synthesis, still reflecting the goals of the Three Celestial Emperors for the perfection of Chinese medicine as a source of peace of mind, health, strength, and long life.

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