The most interesting part of the Chinese culture described in the text is the partially social nature of the illness. While not described directly as such, a direct relationship between the social aspect of life and physical condition can be established. For instance, it is said that the existence of the dead was an established and agreed-upon part of the world (Unschuld 18). Even more importantly, the possibility of interaction between the deceased individuals with their still-living relatives was perceived as common knowledge. Because the dead were, according to the belief system, dependent on the living regarding their resources, it becomes clear that at least on some occasions the onset of the disease was interpreted as a result of their dissatisfaction. In other words, certain symptoms (or symptom categories) were perceived as a sign of wrath or mischief of the dead and required communication means to settle the misunderstanding as well as reconciliation with the help of material offerings (Unschuld 18). Admittedly, such an approach is not unique to Shang culture and can be seen in many cultures (Helman 171). Nevertheless, the consistency with which they differentiate between the physical injury and the diseases with less clear observable causes can be considered an early attempt of a systematic approach to medicine.
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Shang Ideas for Disease
According to the author, the definitions of illness and disease in Shang culture bear distinctively different meanings. This can be derived from the analysis of inscription characters. The pictogram used for illness suggests the need for an injury or other physical influence originating from an external party and resulting in the necessity to “remain in bed beyond the time necessary for rest” (Unschuld 20). While it can be used in a broader context (e.g. a toothache does not require an external injury but is considered illness), it is still discernable from the concept of disease – a social concept connected to the curse from a displeased ancestor. In Shang culture, these curses were the dominant cause of declining health conditions. Two minor origins are pointed out by researchers – natural spirits and the concept closely resembling black magic. However, the former was mostly responsible for natural disasters and the latter was rarely considered a cause (Unschuld 25).
The prevention techniques were based on the described belief system. Specifically, the funeral services were usually accompanied by the rituals and gifts to the deceased aimed at pleasing them and thus ensuring that no malevolent action is expected from them in the future. Next, during the first symptoms of any disease, the oracle was consulted to determine the reason for the illness: if the oracle suggested that the curse is not yet set, the attempt was made to persuade the dead to reconsider. If it was ruled out that the cure was already in place, attempts were made to amend the situation by offerings (Unschuld 21). Herbal remedies are also mentioned as a treatment but only as a ritual offering rather than within a “consciously therapeutic context” (Unschuld 22). Overall, the Shang treatment practices were not directed towards the patient and instead aligned with the ideological and psychological premise of ancestral worship.
Helman, Cecil. Culture, Health and Illness: An Introduction for Health Professionals. Wright, 2014.
Unschuld, Paul Ulrich. Medicine in China: A History of Ideas. University of California Press, 1986.