Old Diseases

It is very difficult to trace precisely the historical development of particular epidemic diseases in China. First, traditional Chinese medical terminology is based on a system hardly translatable into modern Western terms. Second, not only the concepts of disease, but the diseases themselves have changed, so much so that it is impossible to determine whether an ancient classical term meant the same thing when used in premodern texts, or to find the exact modern counterpart of a disease discussed in old texts.

Only during the second half of the nineteenth century did diseases in China begin to be scrutinized by Western medical practitioners, and as late as the early twentieth century, it was difficult to construct a complete picture because “there were classes of disease that were rarely brought for treatment to modern doctors” (Polunin 1976).

One principal feature of the traditional Chinese medical system (a system that achieved classical form by the second century) that makes it difficult to identify individual epidemic diseases in premodern China is the ancient categorization of both epidemic and endemic diseases along with other afflictions into a large group labeled shanghan (“affection by cold,” although today it is the modern term for typhoid fever). Ge Hong, one of China’s most important early medical thinkers, specified in the early fourth century A.D. that the Shanghan diseases included not only those caused by winter cold but also those caused by spring warmth and by seasonal liqi (epidemic “breath”). However, he conceded that differences among the origins of the three types of diseases were slight and they should therefore be grouped into a single category.