Medicine: Chinese Herb Doctor

The busiest doctor in Chungking last week was Chang Chien-tsai, a spidery, parchment-skinned man of 64 who never studied anatomy, dissected a cadaver or saw a microbe. He is one of the 800,000 herb doctors who still provide most of China’s medical care. (At the highest estimate, there are only 12,000 Western-trained physicians in China.)

A stream of patients keeps Dr. Chang busy in his office from noon until nearly midnight. After that he visits his private patients. What amazes Westerners in Chungking is not the number of his patients but their prominence: he attends such august personages as the Generalissimo and Madame Chiang, Cabinet Ministers T. V. Soong, H. H. Kung, Chen Cheng and police head Tai Li.

In keeping with Chinese medical ethics (as written by Sun Ssu-miao in the 7th Century A.D.), which are much like those outlined in the Western world’s Hippocratic oath, Dr. Chang treats poor patients as carefully as the rich, charges them nothing. His middle-class patients pay about $100,000 Chinese ($200 American) a day. His upper-crust patients pay in largesse of the realm—fine furs and such succulent delicacies as sharks’ fins and bears’ paws.

Like other well-trained herbalists, Dr. Chang follows old texts going back to the foundation of Chinese medicine more than 4,000 years ago. Besides a thousand & one herbs, he uses concoctions of such weird ingredients as the gallstones of horses, rats’ foetuses pickled in oil, powdered snakes, powdered horns, musk.

The Vapors. While Dr. Chang does not deny the existence of microbes, he operates on the basis of chi (vapors)—spring, summer, autumn and winter vapors which may enter the body and produce changes. A stomachache is often merely too much chi in the belly. For this Dr. Chang occasionally prescribes sneezing powder which releases the pressure pain from the stomach. The theory is the same as lifting the lid of a spouting tea kettle to release steam. After Western laxatives had failed to relieve a certain Cabinet member, Dr. Chang prescribed a herb to “heat the vapor of the spleen.” The statesman was cured overnight.

Dr. Chang’s successes (and perhaps also the shortage of Western drugs) has provoked a press campaign in Chungking urging support of the oldtime doctors. Even Westerners agree that there is a lot of common sense in Dr. Chang’s methods—he is a good doctor who knows symptoms, takes pulses, fits the medicine to the patient’s needs. And some Chinese medicines have panned out by Western standards (e.g., “ma-huang,” known in America as ephedrine, a drug which constricts blood vessels). But Dr. Chang is an exception: in the hands of most village practitioners, the native craft has degenerated into superstitious mumbo jumbo.