Fragmented Essays 2 - Gender and Chinese Medicine

This is a fragmented messy essay that I was lucky enough to find thanks to my computer's recovery system - it's very messy, jumbled, and incoherent - and this is only a draft of the lost finished version - but I decided to post it in order to be able to revisit the ideas. - - Once again, it is very messy, incomplete, and not very good.

Gender and the Yellow Emperor’s Inner Canon

Gender in traditional Chinese medicine is a multifaceted question of theory and time. Certainly, one must remember that the academics and medical practitioners who produced classical medical theories and texts viewed the human body and its functions differently than today’s Western biomedical models. But, when it comes to gender and sex-specific medicine, people often search for simple answers of Yes or No to the question of whether or not such notions existed in early China. Examining the works of Raphals and Furth, I found that early Chinese medicine had no notion of sex-specific medicine, like gynecology as it is known today in the West, but it did, in its own way, acknowledge gender. However, a realization of gender does not imply a bodily difference between the sexes, excepting the reproductive organs. The reproductive organs of women were very difficult to understand because the uterus is internal and human dissection was frowned upon.[1] However, in extreme cases like pregnancy, sex-specific remedies were utilized but not classified as a different or unique field of medicine.[2] The basis of differentiation in medicine based on gender would be inspired by the theory of a woman’s major vital fluid being blood, especially because of visible examples like menstruation.[3] However, these developments would not be utilized until the development of Fuke with the Song Dynasty.[4] I believe it is misleading to think that the Chinese had no notions of gender, for one would have to be isolated from others to not notice differences between males and females. I believe that the Chinese were more sophisticated and egalitarian in early physiological and anatomical thought than Western scholars have shown them to be. In the West, where gender is an important and differentiating aspect of a person’s individual identity, the Chinese saw gender as the manifestation of a single androgynous human body, as theorized in the Yellow Emperor’s Inner Canon, which interprets yin-yang energy in order to express gender.[5] However, even the early notions of gender take time to develop, and it should be noted that it was not until the 2nd century BC that yin and yang began to embody “female” and “male” as genders in their meanings.[6] The terms may not have created an explicit separation between the sexes before the finalization of their meanings. However, they certainly were terms that denoted opposites with a focus on gender.

The theory of the human body as Chinese medical practitioners understood it was that of the Yellow Emperor’s Inner Canon’s design. The date of the Inner Canon’s compilation is debated among scholars, but it is undoubtedly an early text containing even earlier ideas and theories. Debates sparked by the years of the Inner Canon’s publication are heated because of the text’s multiple authors and multiple recompilations through China’s war-torn history.[7] However, it is generally agreed upon by Western scholars that the Inner Canon’s language and ideas were shaped between 400 BCE and 260 CE.[8] In addition, one must take note that the Inner Canon compilations examined today are not exact copies of versions from the Han because of the many revisions made to the anthology in the past.[9] Nonetheless, by the Inner Canon’s finalization in 260 CE, during the tremulous Six Dynasties period, there were still 700 years before the development of Fuke in the Song Dynasty.[10] The importance of the Inner Canon’s medical and cosmological theories to early thinkers and practitioners is explained by Furth:
During the centuries when the textual tradition of the Inner Canon was being formed, philosophers… were coming to imagine the world in terms of a universal system by which all phenomena of Heaven, Earth and Humanity could be categorized and their transformations known… philosophers elaborated various superstructures of symbolic correlations that patterned the relationship of a vast range of phenomena… the Inner Canon became a germinal text… because it drew upon basic features of this cosmology—qi, yin yang and Five Phase theory—to explain health and disease, firmly establishing correlative relationships between the cosmos and the microcosm of the body; (21).
Of the theories described, yin-yang theory is central to this discussion. So fundamental was this theory that “the [Inner Canon made] analogies between the body, the cosmos, and the state [were] based on the polarity between yin and yang” (Raphals 183). Raphals emphasizes that “depending on the exact analogy, the hierarchy of yin and yang may or may not be stressed” (183). Early thinkers interpreted yin-yang theory as an important aspect of their cosmos. In a sense, yin and yang represented the universe’s transformative aspects, for the early Chinese view of the universe was that it was in a constant flux that flowed naturally. The Inner Canon speaks highly of the dualistic theory, saying: “… it is the dao of heaven and earth. It is the warp that weaves together the myriad creatures, it is the father and mother of transformation and change. It is the root and origin of life and death, and it is the storehouse of deamonic brilliance.” [11] Raphals emphasizes that when the Inner Canon describes yin and yang, it “stresses their mutual interactions more then their hierarchical relations. It is not strongly evaluative in the sense that the qualities ascribed to yin and yang are not consistently negative or positive” (184). Thus, Raphals shows that the Inner Canon was not focused on whether or not men where higher in standing than women, but rather that the focus was on how yin and yang acted as opposing transformative forces.
Yin-yang theory is the first of the theoretical forces to create gender in the androgynous human body presented by the Inner Canon. As the “[Inner Canon] contains no generalized description of differences between men and women or differences in the application of yin-yang vessel theory to men and women”, one must then wonder how they function in the body as opposing forces (Raphals 187). Sexual maturation as portrayed in the Inner Canon is an excellent example of the androgynous human body interpreting these energies:
At seven years of age… a girl's Kidney qi is flourishing; her adult teeth come in and her hair grows long. At fourteen she comes into her reproductive capacities … her Conception pulse moves and her Highway pulse is abundant; her menses flow regularly and she can bear young. At twenty-one her Kidney qi is stabilized, and so her wisdom teeth come in and her growth has reached its apogee. … At eight [sui] a boy's Kidney qi is replete; his adult teeth come in and his hair grows long. At sixteen his Kidney qi is abundant, and he comes into his reproductive capacities [tiangui zhi]; his seminal essence overflows and drains; he can unite yin and yang and so beget young. At twenty-four his Kidney qi is stabilized and so his bones and sinews are strong, his wisdom teeth come in and his growth has reached an apogee.[12]
This passage is interpreted by Furth thusly:
[Sexual maturation of girls and boys is] portrayed as the work of a single human body of dynamically interpenetrating yin yang vitalities. At the same time male and female are homologous partners in generative function; their complementarity as a yin yang pair is evoked through the convention of correlative cosmology that odd numbers are yang in resonance and even numbers are yin; (45).
In the maturation process of males and females, yin and yang are not explicitly mentioned. However, they are still present in the passage, as yin and yang are evoked through the difference in years of maturation between males and females. One also notices that the differences in aging and ability to reproduce do not mention the sexual organs. This is explained by Furth:
The Yellow Emperor's body has no morphological sex, but only gender. Yin and yang do not get their meaning because they are attributes of something else, in bodies or in nature. Rather than labeling a gender which is defined on other grounds, yin and yang are the foundations on which the language of gender rests. In the language of literary theory, yin and yang are the signified, not the signifiers (Furth).
I agree with Furth on this notion. While yin and yang may not have meant female and male, that they were evoked in a passage focusing on differences in human aging concerning gender implies that they may have embodied gender without beings words specifically meaning gender. However, I also agree with Raphals that this idea would take a long time to finalize and that women would not come to explicit embody yin aspects until the end of the 2nd century BCE.
One must now question how the previously mentioned androgynous body expresses gender while remaining androgynous. As Furth stated, the Inner Canon does not detail “morphological sex”, but rather gender. This is because it was difficult for early medical practitioners to understand the female uterus. For men, there need not be a focus on their external genitals. Male sexual functions are associated with the channels that governed circulation of qi in the body.[13] For female sexuality, the womb could not be known because it was internal, and dissection was considered taboo. Any explanation of internal anatomy was often covered up with a story, or else it would be highly scrutinized. [14] Therefore, the descriptions of female internal organs in the Inner Canon were “reduced to an irrelevancy” (Furth, qtd. by Raphals 44).

In a work by Wang Qingren, Correcting Errors in Medical Literature, he witnesses an execution of a woman via dismemberment:
“… since she was not a man, it would be unbefitting for me to go up to the front [to get a close look]. When they had been cut out, the executioner lifted up the heart together with the liver. The lungs had already been removed from the front, and I [was able to] examine them carefully against [my memory of] those I had previously seen [e.g. the organs of men], and I saw that they were the same; (qtd. in Raphals 192)
Raphals’text Sharing the Light, where she focuses on women from 8th to 1st century BCE emphasizes the importance of such dating. She concludes that while there was yin essence that was feminine in nature in early cosmological thought, it was not until the end of the 2nd century BC that women came to embody yin and its aspects. However, her graph “Yin-Yang in Warring States Texts”, mentions two interpretations of dualistic thought comparable to yin-yang theory. They are nonanalogous, and they are not variations of yin-yang theory as applied in the Inner Canon, but an interesting note must be made about them: the Mohist Canon’s yin-yang nan-nv, and the Boshu’s Cock and hen mode. It is not what these theories represent, but rather the titles they bear that interest me in furthering my argument.
“In both the body and the state the regulation of offices or functions and the control of disorder are of the utmost importance.” (Raphals 183)
“Both the theoretical discussions of the [Inner Canon] and the actual diagnoses of the Shi ji are consistent in that the same diagnostic techniques, particular remedies, and explanations of disease are used for both women and men” (Raphals 193).
Raphals insists that the Inner Canon’s medical prescriptions for ailments are considered for ren, a genderless word for “person”, and recipes are not specified as different for men or women. Raphals work focuses on 8th to 1st century BCE. While there was yin essence that was feminine in nature, it wasn’t until the end of the 2nd c. BC that women came to embody yin. Raphals believes that the Inner Canon is technically genderless because of how the majority of illnesses maintain that they are not gender-specific. She mentions that there are 26 references to women in the Yellow Emperor’s Inner Canon, with more than half of those referring to the differences between the sexes. She then goes on to discuss how maturation occurs in different time stages between men and women. She also mentions how pulses occur on opposites sides of the body between the sexes. Raphals work focuses on 8th to 1st century BCE. While there was yin essence that was feminine in nature, it wasn’t until the end of the 2nd c. bce that women came to embody yin. In ancient medical texts, yin was not linked to women, although it was negative. The Han and Warring states period did not hold these seperations, but then the song and ming did. This could be linked to the publishing boom of the ming dynasty, were books could be made, and images imprinted in the texts.
However, Furth claims that females and males are yin and yang energies respectfully cultivated differently in each body. yin-yang cosmology. Furth’s has created a rather dense text that examines Chinese medicine between the Song and Ming periods as a feminist, using a historical and cultural perspective. “With this as background we can turn to the Inner Canon's classic account of the sexual growth and development of boys and girls. They are portrayed as the work of a single human body of dynamically interpenetrating yin yang vitalities ... In this way the two sexes develop parallel and equivalent bodies and capacities.” (Furth 45) Furth focuses on the 700 years of the Song, Yuan, and Ming focuses on the development of Fuke. But, while Fuke is existant now, the question is: was it always around in China? The Huangdineijing does not agree. The “Yellow Emperor’s Body” and Furth describes it, is largely androgynous. Written between the 1st and 7th c. bce, it was written by medical practitioners and scholars of the Warring States and Han. The song dynasty brings about a formalized fuke, or gynecology, but this was nonexistent in earlier times. The Yellow Emperor’s body represents an androgynous idealization for both sexes with a balancing of yin and yang energy. This body is abstract. It is ascribed a male-gendered social and medical understanding. Visceral functions were based on a non-hierarchical model of yin-yang complimentarily, but sexual functions of blood and essence were nested in a hierarchy of yin and yang pairs were yin is encompassed by yang. (raphals, furth 28, 28) However, Furth’s focus is not on gender in the Inner Canon, but rather on Fuke as a late imperial invention.
Neither the Fifty-two Ailments, the [Inner Canon] nor later texts that explicitly claim to be based on it make a distinction of essential difference between men and women… [Raphals found that] over and over again the assertion [in medical texts] that men and women are medically identical, with few and specified exceptions involving sexuality and childbirth; (Raphals 192).
“…in the medical theories of the second century, the influence of yin, is, overall, negative. However, negativity is not linked to gender or attached to a negative view of women” (Raphals 192).
Raphals mentions two separate scholars who take note that women and men do not differ in body. Xu Dachun notes in his work, Forgotten Traditions of Ancient Chinese Medicine: “There is no difference between the illnesses affecting females and those affecting males, except for illnesses related to the monthly period, to pregnancy, and delivery” (qtd. in Raphals 191).
While the bodies of females and males are similar, they are nonetheless gendered. Though what female organs did remained seemingly an untouched facet of the female body, because the male reproductive organs are easier to see, while the female organs involve dissection to truly study.
While the later imperial dynasties utilized a specific field of medicine for women, known as Fuke[15], this was not until the Song Dynasty in the late 10th century CE. However, earlier dynasties had no similar notion of a specified field of medicine for women. This is because
“In the Song period physicians said—using their favored medical idiom, political action—"In women. Blood is the leader" (Furen yi xue wei zhu)” (Furth 26)

[1] In Raphals’ summary of Wang Qingren’s account of examining an executed woman’s internal organs, she implies that his description is lengthy and might be “disingenuous”, suggesting he might have been covering up an autopsy by falsifying the execution story.
[2] Raphals 187
[3] Furth 26, 60
[4] Furth 60
[5] Furth
[6] Consult Raphals Appendix Six “Yin-Yang In Warring States”, 291-292.
[7] Unschuld, 1
[8] Unschuld
[9] David Keegan as quoted by Unschuld, Paul U. (2003). Huang Di nei jing su wen: Nature, Knowledge, Imagery in an Ancient Chinese Medical Text. Berkeley and Los Angeles: University of California Press. Pg. 2-3
[10] Furth
[11] HDNJ, SW qtd in Raphals sharing the light
[12] Su wen 1.3:8–9.
[13] Raphals
[14] See footnote 1
[15] Often translated as “Gynecology” (Furth).

Works Cited not included for this essay

Written for Prof. Raphals' AST 132 - March 9, 2010

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