Briefly describe the struggle that occurred during the Tang and Sung dynasties between the "family lineage" trained practitioners and the imperially training practitioner of Chinese medicine. What was the end result of this struggle? What do you think about this and how it may have influenced the practice of Chinese medicine today?
The Tang dynasty (618 – 906 AD) proved to be a landmark period for the future of Chinese medicine. During this period classic medical texts, (such as the Shang Han Lun, Nei Jing, and Nan Jing) were re-written, compiled, or completed. Without this re-examination of foundational texts, modern Chinese medicine would look very different. The Tang Dynasty period also began the institutionalization of medicine under the guidance/governance of Confucian scholars.
Confucian scholars and newly appointed Imperial Physicians argued that by not protecting and institutionalizing the practice of medicine and it’s appropriate application there may be potential for amoral acts along with inappropriate application of medicine. By making this stance, imperial officials were attempting to help keep the uneducated general public away from unethical opportunists selling false medicine. However, I would imagine that the main reason for this shift toward educational requirements was for generating governmental income, upholding standards of medicine, and creating a hierarchy of medical institutions/practitioners.
Sun Si Miao (581 – 682 AD) was a physician living during Tang Dynasty who was highly regarded, yet NOT affiliated with the Imperial Physicians. While Sun Si Miao had numerous texts on philosophy and treatment of disease, he also focused on ethics in medicine. His reasoning may not have been completely aligned with imperial officials, but he too insisted that opportunists taking advantage of people by selling false medicine needed to be stopped.
Imperial officials of the Sung Dynasty (960 – 1279 AD) built upon the institutionalization started by the Tang Dynasty. However, schools for training physicians may have been shifting their core values because non-aristocratic members of society were being considered for matriculation. With a wider pool of applicants for medical schools apprentice based education, while still practiced, starting to wane. Like all novel governmental programs, there needed to be an incentive for aspiring physicians to apply for imperial training. If physicians chose the antiquated apprentice based/fold medicine route there would be limited or no access to herbs from government operated herb farms started during the Sui Dynasty (589 – 618 AD).
This trend of institutionalizing and specializing within a hierarchical medical structure has perpetuated itself. Most models that I’m aware of focus primarily on curriculum developed by agencies and organizations that watch over the practice and education of herbalism. I can’t speak to if the desire for apprentice based learning had fallen out of fashion during periods after the Sung Dynasty up until now, but I personally feel like the value of working one on one with a teacher/practitioner (master?) is priceless. I’ve attempted to work under a few practitioners AFTER graduating acupuncture school and it seemed to me like our society (or at least the culture in Lancaster PA) is not set up to facilitate or manage successful apprenticeship. Could this be a product of the open market or because of a practice developed during he Sung Dynasty???