The Qing Dynasty: the last emperors and the struggle for the soul of TCM

The Qing Dynasty (1644-1912) was the last imperial dynasty of China — and one of the most dramatic. Founded by the Manchu, a people from the northeast who brought down the divided Ming Dynasty, the Qing ruled for almost three centuries over the largest Chinese empire ever. But the nineteenth century brought a series of crises that gradually undermined the Qing regime: foreign invasions, humiliating treaties, domestic uprisings, and confrontation with European modernity. For Traditional Chinese Medicine, the Qing period was a time of both refinement and existential threat.

Manchu rule over a Chinese empire

The early Qing emperors — Shunzhi, Kangxi, Yongzheng and Qianlong — were remarkably capable rulers who greatly respected and adopted Chinese culture and tradition. Under Qianlong, the Qing Empire reached its greatest territorial extent, including Tibet, Xinjiang and Mongolia. The Chinese population grew explosively, from about 150 million at the beginning of the Qing to more than 400 million by the end of the eighteenth century.

For TCM, the early Qing was a period of consolidation and codification. Great medical encyclopedias were compiled by order of the imperial courts. The Yizong Jinjian (Golden Mirror of the Medical Tradition), compiled in 1742 by order of Emperor Qianlong, is a monumental compilation of all TCM knowledge up to that point — a work of eighty volumes that would serve as a standard handbook for generations of physicians.

The nineteenth century: crisis and confrontation

The nineteenth century was disastrous for the Qing Dynasty. The Opium Wars (1839-1842 and 1856-1860), initiated by the British to force the lucrative opium trade on China, resulted in humiliating treaties and the cession of Hong Kong. The Taiping Rebellion (1850-1871) — one of the bloodiest civil wars in world history, with tens of millions of deaths — devastated large parts of southern China. The Boxer Rebellion (1899-1901), an anti-Western popular movement that received support from the Qing empress dowager Cixi, ended in military intervention by an alliance of eight Western powers and the occupation of Beijing.

In this climate of national humiliation and the drive for modernization, TCM was seriously called into question for the first time. Western medicine — with its anatomy, microbiology and surgery — entered China through mission hospitals and foreign doctors. Chinese reformers, searching for the causes of China's weakness, also denounced traditional medicine as outdated and unscientific. The first attempts to ban TCM already date from the late Qing period.

The end of the empire

In 1911, the Xinhai Revolution broke out under the leadership of Sun Yat-Sen. In 1912, the last Qing emperor, the young Puyi, abdicated the throne. Two thousand years of imperial China had come to an end — and with the empire, the institutional structure that had protected and financed TCM also disappeared. The Republic of China that followed would subject TCM to one of its harshest ordeals.