Research Methodology for the History of Traditional Asian Medicine
HOKARI Hiroyuki

It was after reading Vandana Shiva's Biopiracy, the Plunder of Nature and Knowledge that I became conscious of the intricate connection between modern civilization and the natural environment. This book is a clarion call, warning that the advanced nations are using, in the name of globalization, the acquisition of patents and genetic engineering as new weapons, enclosing indigenous and local knowledge and even life itself in a new version of colonialization.

It may be somewhat of an overstatement to describe this movement in terms of the history of colonization by western nations from the time of Columbus, but there is no doubt that, as Shiva has pointed out, that a vital key to the expansion of modern western civilization has been the consistent search for "life", be it in the form of plants and animals, bacteria or genes. Social and economic changes, the reorganization of learning, particularly the systematization and institutionalization of science and scientists on a global scale in the modern era, have been mobilized to make this possible. How has this "global strategy" to exploit the world's resources come about? It can be said that the interest in the history of western science and imperial medicine lies.

In counterpoint to the exploitation of resources by western countries, there is a movement within non-western nations to protect various types of "specialized local knowledge" as ethnic property, as part of an effort to maintain national self-identity. Such knowledge spans cultural forms, such as music and design, but if we extend this to the bio-sciences, to seeds and genes from which even greater profits might be anticipated, there is a danger that any part of traditional knowledge that has been judged to have a use potential might become "enclosed" by patents.

In the nineteenth century, when traditional Asian medicine was overshadowed by modern science, traditional knowledge and technology in the field of medicine survived at a folk level though it was judged to be "superstition". This was because on the one hand medicine is an empirical science, and on the other, it was preserved by means of nationalism. By the end of the twentieth century, however, traditional medicine had drawn the world's gaze as an alternative medicine that supplemented the weaknesses of modern medicine. This can be contributed to a rise in the social standing
of traditional medicine, but also to the strengthening of control, in terms of the standardization of concepts, theories and doctors' qualifications. In the course of one century, then, the knowledge possessed by traditional medicine has become a resource to be utilized and the subject of "enclosure" by states and multinational companies. How should we understand this historically? For example, in China, is it not because the experience of senior physicians (laozhongyi), though considered old-fashioned, that the scientific understanding of traditional medicine has advanced, so that patients can be treated safely by being prescribed remedies used in traditional Chinese medicine based on numerical analyses derived from examinations. Can we therefore say that traditional medicine is itself becoming "scientific" and "modern"?

The problem is that modern scientific medicine is not a single construct based on many different systems, but the yardstick by which other medical systems are evaluated. Based on western history and culture, scientific medicine occupies an unassailable position as the peak of achievement in history. Thus, if we construct a developmental theory of the history of medicine, all its diverse strands somehow have to be merged into scientific medicine. This is the difficulty we face when writing the history of traditional medicine from non-western countries.

However, this is an argument belonging to the advanced nations, a values system belonging to a culture which situates life as the subject of development. It is important to study this type of cultural history but there is something fruitless here when it comes to acknowledging actual conditions (China gives the impression of aiming at such a culture). There are many things that fall into the catch-all of "old" as defined by modern science. We need to save them from obscurity.

England is one country which mobilized science systematically to serve imperialism. At the same time (or perhaps as a result), it has a rich research history on this topic. When we visit the Kew Gardens, the mecca of plant hunters, and the Eden Project, a new way of applying nature, we can understand the way in which the English relate to nature. The Eden Project, for example, stresses the importance of coexistence with nature, yet all mystery has been excluded for the sake of scientific understanding, and it presents nature rather like a dramatic performance. At the Science Museum in London, there is an exhibition reflecting on the scientific achievements of twenty or thirty years ago. This too implies that modern scientific developments should be understand in historical terms.

The Wellcome Library in London is a world centre for the study of the history of medical treatment. Its parent body, the Wellcome Trust, is a charity which funds research to raise health standards all over the world, and it has provided the funding to set up research centres at London University and the University of Oxford. The Wellcome Library possesses an enormous collection of books and manuscripts on the history of medicine and it works to encourage research into that history by providing various services and by constructing a data base. Its rich collection of books is basically stored in open stacks and researchers can use them freely. Archives and manuscripts can be consulted in the reading room and advice is available. What is particularly useful is that the historical materials are catalogued according to theme, such as "Malaria",
" Tropical Medicine", "Public Health", "East Asia", "Birth Management", "Race and Ethnicity", "Health Education", "Religion" and "Pressure Groups". Here we can see a multi-faceted approach to science and medicine from the broad perspective of social history, like the Science-Technology-Society position of recent years, rather than a narrow specialist stance. However, a large number of the materials concern medical missions and the practice of imperial medicine. For example, in the category "East Asia" under the sub-heading "The Royal Society of Tropical Medicine and Hygiene" we find recorded books by Patrick Manson (1844-1922) from the time he was in Hong Kong and Amoy (this information can also be downloaded from an on-line data-base). These can be used to trace the practice of imperial medicine in Asia by Manson.

Henry Wellcome (1853-1936), who founded the Wellcome Trust, was an avid collector of medical artifacts from all over the world and he established a museum to display them in. In his collection can be found a wide range of materials from Asia and Africa, from masks to dolls used for magic, and they have a certain flavour of orientalism. In terms of modern research into the history of medicine, looking at medicine as culture, Asian traditional medicine has here become objectified. However, to the extent it is evaluated as being something different from western culture, there is little possibility of it moving into the mainstream of medical history. At the research level, too, there is very little interaction and exchange between scholars of the history of traditional medicine and those of the history of modern medicine.

Wu Liande (1879-1960), well-known for his contributions to infectious disease prevention and to the spread of hygiene in modern China, published, together with Wang Jimin, the "History of Chinese Medicine" (Shanghai, 1932). This work was not concerned just with "the history of traditional medicine" or with "the history of the development of modern medicine". Rather it is a history of how medicine spread in China, from both points of view. Overall, a larger amount of space was given originally to the introduction of modern medicine, but in the second edition, the work was largely revised, centring on China and things Chinese, as a history of the development of the Chinese people. The number of chapters dealing with the history of traditional medicine increased from 21 in the first edition to 26 in the second. Incidentally, according to the publications by Wu in the Wellcome Library, he donated his collection of works on Chinese medicine to the Wellcome Museum in 1916, and in 1920 requested the Museum to accept the photographs he used in his works. Here we find illustrated a page in the history of scholarly cooperation between China and the United Kingdom.

Joseph Needham (1900-1995), a leading authority on the history of science in Asia, highly evaluated early developments in Chinese medicine but he looked at its later history in terms of a single line of development. Later, its inherent charactersitics and its varied origins were stressed from an anthropological point of view. An example of work by an anthropologist are the two volumes edited by Charles Leslie and published in the 1970s called "Asian Medical Systems" and "Paths to Asian Medical Knowledge". These positioned medicine as a cultural activity, and took the stance that it was necessary to analyse traditional Asian medicine in terms of history, culture, society and epistemology.

At the present time, traditional Asian medical practices such as Chinese medicine, Ayurveda and Tibetan medicine have spread around the world, and today, with the globalization of traditional medicine, its research can be said to have taken on a new direction. As I have mentioned already, as traditional medicine is increasingly institutionalized, research into its relationship with public health, management systems and non-governmental organizations has become vital. The International Association for the Study of Traditional Asian Medicine (IASTAM) has been formed out
of such a need. It aims at providing a forum for both scholars and practitioners and places emphasis upon a diversity of, among others, interests, methodologies and regions.The study of traditional Asian medicine is an interdisciplinary undertaking, comprising, for example, medicine, history, cultural anthropology and sociology. This is a welcome trend when we consider the breadth of the subject.

In terms of inherent characteristics in the context of traditional medicine, local geographic aspects are an important key to understanding. Human health consists of a variety of elements, including social and natural factors, as well as those associated with the individual organism. Endemic diseases are those peculiar to a particular locality, and cannot be understood without a comprehensive knowledge of that locality. Medical geography is that branch of learning which deals with medical phenomena such as epidemics, hygiene and health in association with a particular locality. Biometerorology is also attracting much attention for its multi-faceted examination of the influence that climate exerts on health. Unlike recent medicine, which has perhaps placed too much emphasis on the small scale, we can perceive a movement to
re-evaluate traditional medicine by attaching importance to the macro point of view.

Certain fields of learning have regarded the interworking between nature and human beings (as living beings) to be very important. For example, ideas of Yin and Yang and the five elements have had a great influence on traditional Chinese thought, while in Japan, modern meteorology had to surmount the influence of the Yin-Yang theory to develop. This fact in itself is worthy of socio-historical research. Early in the modern period, when science began permeating Asia, friction grew up at various levels between it and traditional science. This is shown by the fact that there were great
difficulties involved in standardizing translations and technical terms in its various fields. Rather than contrasting and comparing the various fields of traditional and modern science as the same category, it is necessary to study their indvidual historical development through a variety of approaches.


HOKARI Hiroyuki
Kawamura Gakuen Women's University