Chinese Medicine and Culture

REVIEW ARTICLE
Year
: 2019  |  Volume : 2  |  Issue : 1  |  Page : 21--25

Traditional vietnamese medicine between chinese heritage and national tradition


Anita Bui 
 Department of Medicine, Evaluation and Treatment of Pain Centre at Hotel-Dieu and Cochin Hospitals; Doctor of Medicine, Anesthesiologist-Acupuncturist at the Faculty of Medicine, University of Paris, Lecturer at the University of Paris-René Descartes, Paris, France

Correspondence Address:
Dr. Anita Bui
Paris Hospitals, Faculty of Medicine, Paris V René Descartes, Paris VI Pierre and Marie Curie
France

Abstract

The influence of Chinese medical theory and practice on traditional Viet Nam medicine in the past is undeniable. We can discuss about a Chinese heritage. This Chinese School of Traditional Medicine has trained a large number of Vietnamese doctors. There is, however, throughout the history of medicine in Viet Nam and along with the native genius, the birth of a Vietnamese specificity. What is the part of the heritage in this tradition, what is its own distinctiveness? Hence the title of this article.



How to cite this article:
Bui A. Traditional vietnamese medicine between chinese heritage and national tradition.Chin Med Cult 2019;2:21-25


How to cite this URL:
Bui A. Traditional vietnamese medicine between chinese heritage and national tradition. Chin Med Cult [serial online] 2019 [cited 2019 Jul 21 ];2:21-25
Available from: http://www.cmaconweb.org/text.asp?2019/2/1/21/254376


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 Chinese Heritage



The history of traditional medicine in Viet Nam has often been considered as just a heritage of China's long annexation. For Northern Viet Nam, the heritage is explained by several factors: the geographical proximity, a common history of more than a thousand years of Chinese annexation, and a common language and writing. For Southern Vietnam, it is more influenced by India. It is in fact the reason for the name Indochina.

A common history

North Viet Nam is annexed by China, from the reign of Hàn Wǔdì (汉武帝) until the end of the reign of the Tang Dynasty (唐代) (141 B.C.-907 A.D.). Then again annexed by the Yuan-Ming dynasties between 1420 until 1427.

Compliance with the Chinese model exists not only in the organization of the medical profession but also in the administration and culture.

Based on the model of China, the Vietnamese Dynasties settled in Huê. This town became the capital for the imperial court. In 1802, Gia-Long (嘉隆帝) [Figure 1], the first king of the Nguyen dynasty, created in Huê a medical corpus which gradually became hierarchical and assimilated to Mandarins. A medical institution, the Thai-y vien (越南阮朝), raised from there. Vietnamese doctors are recruited and sent throughout the country. However, this form of institutionalization of medicine remains marginal. An apprenticeship from father to son or teacher to student provides the largest number of physicians who claim to be inspired by the Chinese tradition.[1]{Figure 1}

Another lasting model is the technique of flooded rice. We still see this technique throughout Viet Nam.

A common language

The current Vietnamese language, spoken by more than 80% of the population of Viet Nam, is a mixture close to an amalgam of the Thái, Khmer, Chinese, and Vietnamese elements, but the Chinese are clearly dominant.

In contact with China, the Vietnamese people incorporate Chinese elements into their culture. On the other hand, Chinese words are going to be tinted with Vietnamese. Both Chinese and Vietnamese languages give birth to the Sino-Vietnamese language.

A common writing

The first writing used in Viet Nam was Chinese writing.

Chinese writing Chu Nho or “Writing of the Literates” (儒字) was the official writing. The classical medical texts are studied in Chinese by high-ranking families, i.e., Mandarins, a legacy often from father to son. It was necessary to wait until the beginning of the 20th century for these texts to be translated into Vietnamese writing.

Sino-Vietnamese writing Chu Nôm or “South writing” (字喃) is essentially based on a transcription system of the Vietnamese words combined with Chinese characters, according to the sound of a Vietnamese word or the meaning of a Vietnamese word. Used from the 13th century onward for literary works, it was however never the official writing. Not standardized, this writing whose handling required the knowledge of the Chinese remained the prerogative of an elite.

There are two ways of transcription:

Direct transcription 官, guān in Chinese and quan in Sino-VietnameseA character is a combination of its semantic value and of its phonetic value.

mouth peace eat

zh:kou zh:an vn: an

口 安 咹

Finally, the important event occurred in the 17th century with the French Jesuit Alexander de Rhodes (法国耶稣会传教士罗德) [Figure 2] who invented the national writing Quôc Ngu (国语字). He used the Latin alphabet to create Vietnamese writing; there are no longer Chinese characters. The consequences of this event are very significant. Vietnamese writing becomes accessible to the entire population without elitism, thus enabling the unification of the country. This writing is practiced until now.{Figure 2}

The evolution of writing has a great importance in the transmission of Chinese heritage in traditional Vietnamese medicine (TVM). Despite the advent of the national writing brought by Alexander de Rhodes, Viet Nam continued to practice Chinese writing by various ruling dynasties until 1945, at the end of the Nguyen dynasty with Bao-Dai, the last Vietnamese king.

From that date on the Quoc Ngu has become the national Vietnamese writing, undoubtedly the advent of French colonization also contributed to the return of Vietnamese national writing.

The medical writings, inherited from China, are gradually translated into Vietnamese writing, accessible to everybody. They are thus enriched and become more specifically Vietnamese.

 Birth of a Tradition, the Sino-Vietnamese Traditional Medicine



Two giants of traditional medicine marked their time and gave birth to specificity of the traditional medicine of Viet Nam: Tuê Tinh Thiền su 慧静禅师(1330–1400) and Hải Thượng Lãn ™ng 海上懒翁(1724–1791) [Figure 3].{Figure 3}

Tue Tinh Thien Su was born in 1330 in Hai Duong. At 6 years old, he lost his parents. As an orphan he was raised by monks. Having past the examination of the Mandarinate, he refused to leave the monastery, became a monk, and took the name of Tuệ Tĩnh. He studied medicine at the monastery. He was a very famous doctor. In 1385, he was sent to the Chinese court under the Ming Dynasty-appointed Grand Doctor of the court. He died in China in 1400 (?).

When he was in China, he often shed tears about his fate far from his native land and hoped that one day he would return to his hometown. On his tombstone, he had a verse engraved: “To whoever goes southward: take me with thee.” In 1690, Dr. Nguyen Danh Nho travelled to China to visit the Tuê Tĩnh's tomb. Moved by the passion of the famous doctor, Dr. Nguyen Danh Nho made a drawing of his tomb. Back in Hai Duong, he built the tomb exactly as it was; since then, it becomes a place of pilgrimage for the Vietnamese. They consider him as a saint.

Tuê Tĩnh was a great precursor of traditional national medicine. He founded the Vietnamese traditional medicine. He said, “Medicine of the South heals people of the South;” these words became famous for Vietnamese people.

He made two fundamental observations to demonstrate the specificity of TVM:

1. Some effective remedies for people from the North (i.e., China) have an opposite effect for the people from the South (i.e., Viet Nam)

For example, the ginger and cinnamon used for people in the North gave a feeling of pleasant warmth; they have a harmful effect for the people of the South.

2. Climatic adaptation of the South: Tropical diseases and damp-heat. China is in a temperate zone whereas Vietnam is in a tropical zone. As a result, the two countries do not have access to the same plants. Tuê Tĩnh takes into account the Vietnamese tropical climate and prescribes small amounts of “calorific” ingredients to his compatriots. For fevers, he uses a “reconciling remedy” or Hoa Giai, composed at first times with soothing agents, then acrid agents so as to lower the temperature. He recommends the following plants for this remedy:

Acrid agents: Zingiber officinale and Allium fistulosumSoothing agents: Dolichos hirsutus, Gardenia florida, Bambusa, gypsam, Hodgsonia macrocarpa.

He made the distinction between the medication of Northern Thuoc Bac which is, in fact, Chinese traditional medicine, and the medication of Southern Thuoc nam, which is specifically Vietnamese traditional medicine.

His works:

He wrote two books of great importance:

Nam dược thần hiệu 《南方医学的神奇疗效》Miraculous Effects of Southern Medicine) [Figure 4]{Figure 4}

1761First Chinese edition by Monk Ban Lai, his disciple (Hanoi). Ten pharmacopoeia treaties1960First edition in Vietnamese by the Printing of the School of Traditional Medicine in Hanoi1972 reissued by the same publishing house

Hồng Nghĩa Giác Tư Y Thư(《红義官医书面》 Written on the medicine of the Mandarin of Hong Nghia [Figure 5] in 2 volumes. The first edition is drafted in Sino-Vietnamese (Nôm) in 1723. We have to wait until 1978 to get the translation in to national writing (Quoc ngu) by the Association of the Sino-Vietnamese, Faculty of Medicine of Hanoi.{Figure 5}

The first volume includes the Medicine of the South, the prescription of the medicine of the South, the comments of 37 treaties of the fevers (typhoid).

Volume 2 includes 13 methods of treatment and therapeutic approach by medicinal plants of the country.

However, Tuê-Tinh's doctrine of traditional VN medicine is not a separation from China; it appears to be an adaptation for the Vietnamese population. His proverb about “using southern remedies to heal the people of the south” is preceded by “Disciples of the ancient teachers must venered their doctrine.” This first verse clearly demonstrates his attachment to the doctrine of traditional Chinese medicine (TCM). He respected the TCM and did not deviate from it.

Hải Thượng Lãn Ông 海上懒翁 alias Lê HữuTrác 黎有晫 (1724–1791)

He was born in 1720 in Hải Duong (海阳), his father was a high-ranking dignitary in the court of King Lê Du Tông (1705–1729). In 1740, when his father died, he left the capital, studied the art of the war, and enrolled in the army. Very disappointed by the violence of the army, he left it in 1746 and settled at Huong Son, a mountainous region. Specializing in medicine and he named himself “Hải Thượng Lãn ông (海上懒翁),” which means the lazy old man. In 1756, he came back to Hanoi after 10 years of in-depth study of the Chinese canonical texts and the writing of Tuê Tĩnh. He began to practice medicine and at the same time he finished his book in Chinese writing entitled, Thượng kinh ký sự, which he completed in 1785. The book was published in 1791, just after his death. It was given a new title: Hải Thượng y tông tâm lĩnh [Figure 6].{Figure 6}

Hải Thương Lan Ông used Chinese canonical texts to compose his work. His sources were essentially: Huangti Neijing suwen (《黄帝内经素问》), Nanjing 81 difficulties (《八十一难经》) and Bencao gangmu (《本草纲目》). However, as Tuê Tĩnh, Lan Ong adapted his medicine to the Vietnamese population. He used many Vietnamese plants for treatment (Volume IV, Chapter 9: South pharmacopoeia). He had his own specificity about traditional medicine. He advocated intuitive medicine (Volume XVIII: instinctive Knowledge and Memento of marvelous recipes).[2] Thus, he got away from Chinese heritage.

 Traditional Vietnamese Medicine between Western Colonization and Tradition



In 1858, the French colonization began with Emperor Gia Long. He had as private doctor, a Frenchman, who treated him for 20 years. Thus, started the influence of Western medicine.

The year 1945 is very important in the history of Viet Nam and at the same time for the evolution of the TVM. The war of Indochina took place between 1945 and 1954: Viet Nam fought against France to put an end to the colonization, which allowed the advent of the Republic and the end of dynasties. In fact, the Nguyen dynasty ended in August 1945. King Bao Dai was exiled to France. The end of dynasties means also the end of official Chinese writing. The Chinese traditional medicine was long reserved for people who practiced the Chinese language as their mother tongue; the transmission was direct, in a common language, however inaccessible to the Vulgus pecum. Because Chinese writing is no longer the official language, Vietnamese writing with the Latin alphabet becomes national writing (Quoc Ngu), Chinese canonical texts are gradually translated into Vietnamese language, they are no longer reserved for the elite, and they are now accessible to non-Sinologists.

Nguyễn Tử Siêu (Hà Nội 1887–1965), a Mandarin doctor, he was the first translator in Vietnamese writing of canonical texts [Figure 7].{Figure 7}

In 1954, he published in Vietnamese writing the most important traditional medical text: Huangti Neijing suwen《黄帝内经素问》Hoàng-đế̈ Nội-kinh Tố-vấn, Edition Hông-Khê, with the comment of Zhang Yin-an and Ma Huan-tai.[3] From this date, there are many publications of TCM such as Zhenjiu Dacheng《针灸大成》1963 Ed. Thanh Hoa HCM ville, Shanghan lun《伤寒论》 Ed. Dong Nai 1996, and Huangti Neijing lingshu《黄帝内经灵枢》 Ed. Dong Nai 1989.

 Integration of Traditional Medicine in the Health-Care System Today



In the Eastern Asia, the status of TCM is quite varied, whereas in more westernized countries, the integration of TCM into the health system is very limited. In Viet Nam as in modern China, traditional medicine is officially “”recognized by the state.

Because it is softer, less aggressive, and the TMC integrates perfectly with the health system in Viet Nam, it gradually earns its titles of nobility. Despite the western influence due to French colonization, TVM is experiencing an exceptional boom.[4] TVM becomes a state institution in big cities like Hanoi, Ho-Chi-Minh city, or Huê [Figure 8].{Figure 8}

Thus, many great Vietnamese medical practitioners stand out to form a high-level medical corpus.

Three real pioneers in TVM became national heroes:

In the South, Dr. Nguyen van Huong. His name is important to remember for the role he played in Vietnamese traditional medicine. First because he was one of the main founders of the Society of Traditional Medicine. In 1930, he was appointed Head of the Microbiology Laboratory at the Pasteur Institute in Saigon. From 1954, he participated in the building of the sanitary system. From 1968–1970, he started teaching TCM at the Ho-Chi-Minh-Ville InstituteIn the Center, Dr. Le Quy Nguu who is from Huê. A famous medical doctor both sinologist and acupuncturist, he translated numerous works and he was proclaimed as Knight Hero of Viet Nam thanks to his numerous humanitarian actions such as the founding of free care centersIn the North, Nguyen Tai Thu, he is an internationally renowned acupuncturist doctor that I had the honor of meeting at a traditional medicine Congress in Lille (France). He opened a center of treatment by acupuncture and traditional medicine for children suffering from neurological diseases.

 Conclusion



Viet Nam has played a very important role in the import of TCM into Europe and in particular into France. The Latinization of the Vietnamese language has greatly facilitated the translation of Chinese texts in French and other European languages. The French colonization of Viet Nam for nearly a century explains this early opening of France to TCM. Finally, French-speaking Vietnamese doctors also took part in the extension of this medicine in France. Among these French-speaking Vietnamese doctors, I would like to mention Dr. Nguyen Van Nghi (1909–1999) who was my mentor. I pay him tribute for his impressive work in translating Chinese canonical texts from Vietnamese into French as he had cleared a forest to make it a flower garden for future generations of acupuncturists.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

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