"These appearances, which bewilder you, are merely electrical phenomena not uncommon—or it may be that they have their ghastly origin in the rank miasma of the tarn."
- The Fall of the House of Usher, Edgar Allan Poe (1809~1849)
In the sentence above, Poe juxtaposes two intriguing terms: electrical phenomena, a scientific term, and miasma, a term that would soon disappear from history after the publication of this novel. Miasma theory fell like the house of Usher, replaced by the germ theory. What a fascinating time, age of magic and science.
Historically, the miasma theory was a widely accepted explanation for the spread of disease in Western medicine. The term "miasma" dates back to ancient times and describes an unhealthy vapor or fog that was thought to carry diseases. This theory posited that diseases, such as cholera and malaria, were caused by inhaling contaminated air from decaying organic matter.
In traditional Chinese medicine (TCM), the concept of Zang Qi (瘴氣) aligns with the miasma theory. According to the World Health Organization's International Standard Terminologies on Traditional Medicine in the Western Pacific Region (2007), Zhang Qi is translated into "miasmic toxin." Zang Qi theory is a relatively recent addition to TCM, originating in the Qing Dynasty. This theory emerged during the Qing Dynasty to explain epidemics that were prevalent at the time. Traditional six external pathogens could not explain why all people in a town had the same ailment, as based on the six pathogen (six evil qi) theory, only those exposed to a specific climate would be affected. However, epidemics contaminated all people in the same region, and Zang Qi theory could explain this phenomenon.
As scientific knowledge advanced, the miasma theory was gradually replaced by the germ theory of disease in Western medicine. Interestingly, while the miasma theory was abandoned in the West, the concept of Zang Qi and similar concept like Li Qi(戾气) has not been entirely discarded in TCM. It is still used today to explain epidemics and certain illnesses in TCM.
A comparison between the Zang Qi theory and the miasma theory offers a fascinating perspective into the evolution of medical understanding across different cultures, as well as the various factors that influence the adoption or rejection of specific theories. This leads us to inquire:
What historical factors led TCM doctors to replace the traditional six climate pathogen theory with the Zang Qi theory? Furthermore, why do TCM practitioners continue to embrace the Zang Qi theory, even as Western culture has dismissed the miasma theory?
In my humble opinion, let me share some thoughts on this matter. Both the Zang Qi theory in traditional Chinese medicine and the miasma theory, as well as germ theory, are theoretical systems used to explain certain natural phenomena. Some explanatory frameworks are better than others. Indeed, germ theory proved to be a more effective framework for understanding and treating infectious diseases. Similarly, the Zang Qi theory offered a better explanation for infectious diseases compared to the six climate pathogen theory. However, is germ theory the ultimate and perfect explanatory framework for infectious diseases? Not necessarily, as it tends to neglect the role of the host (human) in disease development and progression, which in turn necessitates new explanations. The ongoing development of better theories and treatments in both traditional Chinese medicine and Western medicine, as natural sciences, is what truly matters. We are living in an era of magic and science, like Edgar A. Poe, and we also need to build theories and verify them through experience.
The enduring influence of the Zang Qi theory in TCM can be attributed to various factors, such as cultural elements, distinct philosophical foundations, or limitations in the development of the theory itself. Investigating these factors will enable us to gain a deeper understanding of the progression of medical thought and practice across diverse cultures.
Recommended Reading for further discussion;
MAGIC AND SCIENCE IN EARLY MODERN EUROPE – ARE THEY REALLY SO DIFFERENT?