The need for medicine in every culture around the world has arisen whenever a people recognized imbalanced lifestyles. Sophisticated methods of dealing with ailments came to prominence with time and experience. The Chinese began dealing with medical concepts during the Shang dynasty (1751-1128 B.C.) and refined them during the Zhou dynasty (roughly 1128-221 B.C.). The Shang believed that their ancestors were “directly associated with God, and therefore could be used as mediators to ask for favors from God.” Unlike the Shang, the Zhou believed in human virtue, or de, moral deeds, and “personal effort.” They were also the first dynasty to establish the idea that tian, or “sky/heaven,” represented “the ultimate spiritual reality.” The Zhou not only made the state religion more sophisticated and practical, but they also refined-and drastically improved-the practice of medicine. The Shang are famous for their divinations via oracle bones (tortoise shells and animal bones), but the Zhou created a meritocracy that was rooted in virtue and the overarching principle of tian.Perhaps the greatest achievement of the Zhou dynasty lay in their early conception of homeostasis: “even a slight impairment in blood flow restricts the distribution of nutrients, defensive substances, vitality substances, and vital air.” During the Zhou dynasty, the Chinese people experienced the greatest sense of achievement through progress in medicine.
This essay will endeavor to explicate the need for medicine in both ancient China and Greece, particularly dealing with wound trauma (a redundant phrase, as we shall see shortly) and the methods of healing. China developed a symbiotic, flowing, and specifically internal way of dealing with wounds and diseases whereas the Greeks developed an external and static medicinal curriculum. The Chinese and Greeks did not always, however, develop these methodologies as contemporaries, but in comparing them we will discover that though they did not know of each other’s existence, they shared more than may meet the eye. Greece and China were medical contemporaries during the 6th and 5th centuries B.C. since China’s scientific and medical knowledge reached its height from 600-300 B.C. Interestingly enough, Greece’s maps did not yet have China on them; not even Alexander would reach China, though he would get to India.
So what is meant when it is said that Chinese medicine was symbiotic, constantly in flux, and internal? The Chinese primarily developed methods of approaching wounds and disease from an internal point of view, as with ch’i and acupuncture. Needles were placed at specific meridians which corresponded with different organs of the body so that they could be healed. The main principles were in fact xie (“to drain off”) and bu (“to mend”). Indeed, “the complexities of determining the cause of the problem: which internal organ is affected; the possible impairment of blood, nutrients, immune substances, vital air, or biologically active substances, or whether the problem is due to impaired functional activity.” Perhaps this symbiotic-connected-, internal approach existed because of the Zhou’s belief in moral goodness and virtue-themselves innate qualities. In fact one of the principal works of Chinese medicine was entitled Yellow Emperor’s Internal Classic, which was compiled “sometime between 600-300 B.C.” This work was thought to be written in some sort of verse, which tells us that it was passed down orally, much like Homer’s Iliad. On the other side of the world, the Greeks were developing a “hands on,” intimate approach to medicine.
When it was said that the Greeks focused on external remedies, that was meant to invoke the actual ancient Greek word cheirurgein, or “to work with one’s hands.” This is understandable considering the world the Greeks inhabited; their country was consistently divided and at war with themselves as much as they were at war with the Persians. Their realities were deep arrow-wounds, spear-thrusts to the gut, severe hemorrhages from the thigh, and boxer blows to the head. Indeed, this was a war-like culture, albeit one obsessed with arête, time, and philosophia (“excellence, honor, and love of wisdom”). But the Greek conception of moral goodness was connected to one’s polis, the city-state and precursor of the modern city. It was called a city-state for a reason, for one’s polis was self-contained and was indeed its own entity. Unlike the Chinese, who were at least united by an emperor, the Greeks had no hegemon-at least until Philip II and his son Alexander came along in the 4th century. So this essay will work to compare the different healing methods of the Chinese and the Greeks. Specifically, we will be looking at a case-study of the famous arrow wound which Alexander received in 325 B.C. in India-both from the Greek approach and the Chinese approach. One commonality that the different healers will share is their Indian influence, since both the Greeks and the Chinese came into contact with Indians, but not each other! We shall observe how a Chinese yang I and a Greek iatros (both healers or anachronistically called “physicians”) approach the wound, and how they intend to heal it. Ultimately, we should come away with an understanding of these two culture’s need for medicine (or healing), method of approaching wounds, and a better appreciation of our modern medicine. First a short introduction of the yang I and iatros is in order, then we shall set the scene of the injury, then we will begin our study with the Chinese.
It is first essential to understand that the Chinese and Greeks both regarded healing very highly. Both the Chinese and the Greeks had an understanding of how the natural world and its elements affected individual’s homeostasis and constitution. The Chinese developed the Wu-Sheng, or the “Five Phases,” as a perpetually changing and moving concept of how the five elements affected the human body. There was metal, water, wood, fire, and earth, and there existed both a “mutual generation” and “mutual conquest” effect between them. The large intestine, skin and hair, nose, smell, and mucus (one of the Greek’s Four Humors) all belonged to the element of metal whereas the small intestine, vessels, tongue, speech, ear, and sweat corresponded with the element of fire. Furthermore, two of the five principal viscera-the heart and the lungs-belonged to the elements of fire and metal respectively. Between these two viscera and various bodily functions and appendages, there existed an “insulting (conquest) mode” and a “victory (generation) mode” through which one element affected the other, the lungs insulted-or counteracted-the heart and the heart acted upon the lungs, and the large intestine counteracted the small intestine. The Greek’s four humors did not come close to this sort of layered, constantly changing concept. For the Greeks, the four humors’ “success suggests that it was perfectly suited to the needs of mankind. Its fourfold symmetry had the appeal of an order that could also embrace the whole of nature: the four seasons, four tastes, four temperaments.” The four humors were blood, yellow bile, black bile, and phlegm, and “any pain or lump could be explained as a ‘distemper’ or disharmony of the blend.” Here we have more similarities between the Chinese and the Greeks. We see that the Greeks’ love of static order-embodied in their Doric, Ionic, and Corinthian architectural columns-and their belief that any disruption of these four humors was a disharmony is in line with the Chinese wu-sheng. One organ could act upon or counteract another just as one humor out of whack could mean that another humor was “low,” for example. The Greek treatment of this disharmony was as follows: Bleed, to get rid of bad humors, starve, to prevent new ones from forming, purge, to get rid of the rest, ‘from above and from below,’ or from any other exit. The Greek iatros and the Chinese yang I both had to be very familiar with these concepts in order to address the wound or disease of a patient. So who were the Greek iatroi?
The Greek iatroi were healers who managed healing houses called iatreion. They were well-versed in the concept of the four humors and had a versatile knowledge of wine’s antiseptic properties, healing herbs and vegetables such as the onion and celery root, and knew a wound when they saw one. They were men who also knew how to bind wounds in such a way that anticipated modern styptics. For a severe hemorrhage, the iatros would raise a wounded appendage, wrap the wound with a cold linen cloth very loosely, then wrap a warm cloth around the patient’s head to draw the blood to the heated area, then apply a plug of wool dipped in fig sap over which a clean white linen drenched in red wine would be applied “with an adroit play of both hands.” The fig juice was believed-erroneously-to coagulate blood, and the red wine-in great, great quantities-served as an antiseptic for the gaping wound. This was the iatroi way! An iatros had to be very hands-on, dexterous, and efficient to deal with a rapidly hemorrhaging wound. What of the Chinese yang i? This word yi actually means medicine, not physician, and this character is an amalgam of very intriguing symbols.
“The complete character conveys that the priest uses strong weapons to fight off the demons of disease,” write Guido Majno M.D., who wrote a comprehensive study of ancient medicinal practices. Another pause for a comparison between these two cultures is noteworthy. Within this character is a quiver full of arrows. Arrows-in both cultures-were seen as weapons of both destruction and healing. Apollo was both god of the plague and the god of healing, and his arrows could either “drive this killing plague from the armies” or sweep “a fatal plague through the army.” We have already seen that arrows in Chinese culture were the weapons of medicine. It is time to observe the patient in waiting; his name is Alexandros and he is the monarch of the Macedonians, the Greeks, the Egyptians, the Bactrians, the Babylonians, and many, many other cultures across most of the entire known world at the time of the middle 4th century B.C. He has just been forced to abandon his campaign further east-which might have brought him into contact with the Chinese-and he is sailing down the Indus River to subdue a rowdy tribe called the Mallians. The story is told by Quintus Curtius Rufus, a 2nd century A.D. Roman history whose account of the tale is the most detailed of all of Alexander’s historians. First our Greek iatros will observe the patient and using a combination of the new Indian medicinal practices Alexander’s armies have picked up and the homespun remedies of Greece, our healer will attempt to remove a barbed arrow from Alexander’s pierced lung and stop a severe hemorrhage. Our Chinese healer will then attempt to do the same. Let us pay close attention to the differences in the healer’s approaches, as the Chinese will have less experience in dealing with such grievous wounds, but will have more experience in returning Alexander’s body to its balanced and functional state after the arrow is removed and while he is in recovery. Here we will see the external-internal approaches and how they differ and also how they complement one another.
The story told by Quintus Curtius Rufus, who was a Roman historian of Alexander the Great, explains that the young king isolated himself from his men atop a parapet during a siege. Alexander had been forced-due to a mutiny on the Hyphasis River-to sail down the Indus River and into the Indian Ocean to return to Greece. He certainly was not pleased with this, as he wanted to push further east into the unknown lands of myth. Alexander had already suffered numerous injuries to all parts of his body; he had murdered his best friend and commander of his cavalry a few years prior; he had asked obeisance as a god-man figure from his army, and he had just been forced to return home.
Along the Indus River many tribes existed whose medicinal knowledge was great-especially when it came to arrow wounds since the tribes always fought one another. These Indian medics were called vaidya, and their lands were being invaded by an impetuous and foreign monarch. Alexander’s baggage train was great, however, and so cultural stimulation between Greeks and Indians was profound. By the this time, too, the Indians had already come into contact with the Chinese, whose Zhou dynasty was currently fighting amongst themselves. In fact, they had been fighting since 476 B.C. and would continue until 221 B.C. when a leader would unite all of China. What if Alexander had reached Chinese soil-would he have incorporated this sophisticated and experienced culture into his empire?
Alexander stopped along the coast of the Indus to subdue a tribe called the Mallians, whose Indian archers inflicted him with a most grievous wound which almost killed him. Guido Majno M.D. says that there was a special Indian style for “firing arrows with great force, noticed by the ancient Greeks and still in use in 1860…Perhaps it was a shot of this kind that pierced the breastplate of Alexander the Great, bowled him over, and almost killed him.” The arrow fired, and Arrian, another of Alexander’s historians says that bubbles of air arose from the blood which spurted after the arrow sank in-proof that a lung had been punctured. To prevent Alexander’s body from going into anemic shock, two of his closest companions fought to recover and treat his body. This is the scene for our Chinese and Greek physician to enter. It is a mythological space, if you will, but in order to illustrate the similarities and differences between Greek and Chinese medicinal practices, it is valuable to provide such a unique case-study. As we have said, the Greeks developed a very external-internal, confrontational methodology of treating wounds.
The iatros would first call an assistant or two and perhaps even demand a local healer who defected to the Greeks to help identify the foreign arrow. The assistants would ask the Indian vaidya if he thought the king was mortally injured, since the vaidya and the Chinese physicians shared a common belief that there are special meridians which are vulnerable to exogenous pathogenic influences; in the example of Indian medicine, the vaidya would examine Alexander to see if the arrow hit a fatal marma. The iatros would then wrap a cold towel around Alexander’s upper torso to help staunch the hemorrhage and a warm towel around his head to draw the blood away from the wound. If the arrow had been continuing its path through the body, then the iatros and vaidya present would have deemed the injury an anuloma wound. If the arrow needed to be pulled out, it would be a pratiloma wound. The vaidya and iatros could not retrieve the arrow from Alexander’s body, so the vaidya, who were more experienced with these type of injuries than the Greeks were, tied a branch to the shaft of the arrow and let it fly, thus ripping the arrow out pratiloma style. This is the Greek way-confrontational, external, bandages, perhaps even a little impetuous. To insure proper healing, Alexander’s gaping wound would have had a generous “scoop of honey-butter paste” bandaged on by a vaidya or a large, clean white linen cloth dipped in red wine wrapped around his upper torso by the iatros. How, then, would a Chinese physician approach this same situation? There is, in fact, an interesting folktale from the Zhou dynasty that will elucidate.
“The Chinese approach to pain is epitomized in the traditional story of the surgeon Hua T’o operating on General Kuan Yu, whose arm had been pierced by a poisoned arrow. While the knife went hsi, hsi, scraping the bone, the general played chess-and drank cups of wine.” Indeed, this story illustrate that the Chinese did not approach wounds in the same fashion as the Greeks or even their vaidya neighbors did. The general is imbibing wine, but not using it as an antiseptic like the Greeks did. There are no cloth bandages, no butter substances, no cheirurgein (“hand-work” in ancient Greek)-just an attitude to grin and bear the wound sustained. Why is that? Because the Chinese approached the human body from the inside first, preferring methods such as acupuncture, moxa, or prescription diets instead of hand-wrapped bandages. The following comes from the Nei Ching (“inside manual”), and describes the job of the physician in China: “The superior physician helps before the early budding of the disease. He must first examine the three regions of the body and define the atmosphere of the nine subdivisions so that they are entirely in harmony…therefore he is called the superior physician.” It goes on to say that the inferior physician only begins to help once the disease has set in, and because of this, he is labeled ignorant. Already we can clearly see how far set apart these cultures are in the way they approach wounds. The Chinese physician would not know, it appears, how to deal with such a grievous arrow-wound. His services would instead need to come after the injury so that he could advise Alexander on how to rest: “The Emperor asked: ‘When the body is worn out and the blood is exhausted, is it still possible to achieve good results?’ Chi’ Po replied: ‘No, because there is no more energy left…that is the way of acupuncture: if man’s vitality and energy do not propel his own will, his disease cannot be cured.'” So the patient’s getting better actually depends on his will to survive and also the way he manages his energy. It is ignorant to say that Alexander died two years later (he received the arrow injury in 325 B.C. and died in 323 B.C.) because he lacked such knowledge or physicians, but it is worthwhile to pose the question: Could Alexander have lived on if he had not been so reckless, if he had not utterly spent all of his energy, if he had known also how to manipulate the internal factors of the human body? Well, that is why we can say these two cultures are different. But perhaps the Indian vaidya’s methodswere a meeting of the ways for these two medicinally opposite cultures?
To come full circle, the conclusion to this short comparative essay is this: that the Greeks and Chinese were, as reflected in their divine geographical placement and socio-political circumstances, very different in the way they approached the human body. This study should be pursued more actively in academia since it may be possible to find commonalities in the meeting ground that is India-China’s neighbor and Greece’s land of myth. Following studies should aim to produce evidence that these two cultures actually shared more in common (medicinally) than was shown in this short essay. But comparative studies are valuable because they impel the reader to think critically and actively search for a common, humanistic meaning.
 Donald Edward Kendall. The Dao of Chinese Medicine. Oxford University Press, August 2002.
 Guido Majno, M.D. The Healing Hand: Man and Wound in the Ancient World. Harvard University Press, 1991.
 Homer. The Iliad, translated by Robert Fagles. Penguin Books, 1998.
 Kendall, 18.
 Mongolian culture in the 12th and 13th centuries also believed in a great sky, and believed that Burkhan Khaldun, their sacred mountain was the conduit to this astounding power-and a meditative sanctuary.
 Kendall, 19.
 Kendall, 25.
 Kendall, 25. From now on, this work will be referred to as the Neijing.
 Majno, 150.
 Majno, 232.
 Majno, 178.
 Majno, 179.
 Majno, 179-180.
 Majno, 150.
Iliad Book 1 Lines 543-544 and Lines 10-11 of Robert Fagles’ translation.
 Majno, 268. The archer would fire an arrow with his left foot applying pressure to the bow shaft while his right arm would pull the bowstring itself taught; all this was down sitting “Indian Style.”
 Majno, 271. Marma’s are similar to the Chinese conception of the meridian lines; they are various points located throughout the body which are vulnerable to injury and/or healing.
 Majno, 251.
 Majno, 242.
 Majno, 243.