Apparatus XY

25The relatedness of women and depression in early China was viewed very differently than in the traditional period and begins with overall ideas on emotions. The first medical treatise in China, the Yellow Emperor's Classic of Internal Medicine (or Huangti neijing suwen), demonstrated the existence of an etiology and etymology of depression early in the history of China. Written before the Han Dynasty (206 BCE-220 CE), the book revolves around the Yellow Emperor's dialogue with the physician Chi Po. The chapters are based in a question and answer format, where the Yellow Emperor learns, among other topics, that the mind and body are always connected. The four seasons, the five elements, and other factors such as yin and yang energies, affected the human systems of blood, viscera and emotions. As the four seasons and five elements change in nature, they also affect the human body as seen in the five viscera and five emotions (wu qing). The five emotions are xi (joy), nu (anger), you (sympathy), bei (grief) and kong (fear). (Two others were added during the Ming namely those of jing (surprise) and si (pensiveness). Medical historians have called this multi-layered system the Correspondence Theory, according to which each element correlates with and affects a part of the human body. The Yellow Emperor was the first known summary of traditional medicine to discuss this system (Unschuld 51-99). The basic theory of this system, with adaptations, has continued through to the modern day system of Traditional Chinese Medicine (TCM).

26In this system, depression was never a separate emotion or concept, but part of a symptomology of emotions, where emotional imbalances lead to physical and mental illness. The Yellow Emperor's Classic has the five emotions corresponding to a specific organ and in balance: "[W]hen all is well: joy comes from the heart, pity from the lungs, grief from the liver, anxiety from the spleen, fears from the kidneys" (207). However, explosions or outbursts of these emotions was seen as unhealthy, because they trap the vital air (qi), and excess of any emotion meant illness ensued in the appropriate organ. In reverse, imbalance in the organs or other systems of the body could also create emotional symptoms. Depression was part of this physiological discussion not as an emotion, but as a symptom. For example, kuang, meaning "insanity with excitation," and dian, "insanity without excitation" or epileptic fits, are two insanity illnesses detailed in the Yellow Emperor, as both were seen as being from the same root causes of wind (T'ien 70). Both shared the same pathology of depression as part of the illness's symptoms: that the patient for no "obvious" reason exhibited grief, fear, anger, or odd behavior according to the standards of the Yellow Emperor indicated a deep sadness. These indicators of sadness seem to reflect modern ideas of depression and what it means to be depressed, as previously outlined in section one of this paper.

27These notions of illness illustrate two things. First, depression was not viewed as a separated disorder. It was embedded in the overall symptomology of health and illness, where discussions of balance and imbalance were central, and that imbalance created both mental and physical illness. Second, mental illness and emotions in the Yellow Emperor were discussed in non-gender specific ways, because the human body was seen as a homologous structure. In this concept the human body's set up was the same for every person with the person's mind included therein. It was believed that overwhelming elements of yin created a female and yang created a male (208). However, a female body and a male body were not so dissimilar to warrant separate entomologies. Discussions on dian, kuang, and the five emotions not gendered, as men and women were both subject to the changes in yin and yang. Either gender could exhibit the outward manifestations of imbalances. The differences in men and women existed only in procreation systems in the Yellow Emperor, such as sexual health and pregnancy. It could then be said, that depression was also not gender specific, and women as well as men suffered from such this condition.

28Sun Simiao makes some important comments here about women, emotions and control. Compared to men, women were more emotional, prone to illness because of it, and could not control themselves emotionally. We unfortunately have no case studies available on his treatment of depression in women specifically, but it seems from this information that emotions, including depression, were very gender-specific in Sun Simiao's eyes.

29Sun Simiao's ideas on female illness were expanded upon by many physicians, including the physician Wang Ji (1463-1539 CE). In his Stone Mountain Medical Case Histories, Wang Ji does not use the word depression but more of an overall aetiology of emotions. Wang's overall discussion of medicine seems not to delineate between the sexes, except when speaking about emotions. He believed that women were unable to control their emotions and had a high risk of illness "normally" because of the excess of the seven emotions: "Women's temperament is to hold on to the emotions […]. They are not able to release them and are more often damaged by the seven emotions..." (Grant 137). The reason, Wang believes, is the mechanism of "excessive emotionalism" in women that naturally occurred due to blood levels and qi depletion in their system. These excessive emotions damaged their bodies stemming from "pensiveness or sorrow" (Grant 141-142). (Men, he thought, were more in control of their emotions, but suffered from disorders related to anger and anxiety.) With these ideas, Wang Ji echoes what Sun Simiao said one thousand years earlier: women were prone to physical illness because their emotions were naturally excessive. In a note of sympathy, he states that women were unable to release them. The reason why seems to be attributed to a natural state of women as their lives are to be in the service of others.