Apparatus XY

35While not discussing the etiology of depression, Miss Tan relates how her patients expressed their emotional problems to her, including what appears to be depression. Miss Tan related many cases where women suffered damage from negative emotions because of the toll exacted by the need to remain strong. She tells stories of suffering linked to hard labor, repressed resentment, grief and damage (Furth 295). As an outlet for these emotions, women saw in Miss Tan a sympathetic listener who would understand her patients' emotional needs, female to female. This was probably one reason why they came to her for treatment. However, she couches her prognosis in terms of body connected language, and not on identifying depressive illnesses per se. She talks about two women who miscarried because their anger was hidden. The "fire" brought on from these repressed emotions destabilized the fetus. In another case, a middle aged woman comes to Miss Tan explaining that her daughter died and then her husband, citing that she suffered from damage caused by so much crying (Furth 294). Miss Tan, while not using a terminology of depression, seems to be citing emotional damage as a cause of illness. The treatment for this damage was focused on metabolic function of the digestive system, and using moxibustion and aromatic herbs to restore and warm qi. While Miss Tan emphasized women conveying emotional problems, her solutions emphasized body-based treatments.

36It is interesting that Tan Yuxian suggests that many women who come to her for treatment prefer a female instead of a male, which may indicate that a male doctor was not necessarily a desirable option or used as a last resort for women suffering with depression. A statistical analysis of multiple medical documentation of the gender of patients in history has not been done; however, one author looked at one specific medical casebook of Wang Ji, where the overall sex ratio of 109 cases was 1.7 male to 1 female. When the reproductive cases were excluded, the ratio was 2.5 male to 1 female. Grant concluded that Chinese women were most likely first to seek female healers rather than male healers, and only sought male physicians as a last resort (Grant 106-7). This desire to seek female healers over male doctors also had a practical reason: women could not speak openly to men about their physical conditions. It seems that for a great deal of time in traditional China, women needed to have a male relative.

37However, male physicians and their treatments seem to be the third and last solution for women with depression. Male physicians' treatments originated from the belief that the root causes of depression were unsatisfied desires, repressed anger and pent up feelings, as evident in real cases. One treatment focused on appealing to female feelings: the counter-emotional therapy, which relied on the correspondence system of healing (T'ien 73). Taken originally from the Yellow Emperor's Classic, each emotion was connected to a corresponding colour, element, organ or metabolic system. Each emotion also had its opposite which could counter its effects. Joy could be displaced by anger, sorrow by joy, and so on (Sivin 4). This was in effect a therapeutic manipulation of emotions to lead to a desirable outcome. This therapy was created by physician Han Shilang in the Han Dynasty, as reported by Zhu Zhenheng in his twelfth century case histories, indicating that he believed and used Han's ideas. Han was called to the house of a woman who was suffering from depression brought on by her mother's death. Her husband summoned the physician and reported that she was lethargic, out of sorts, and stayed in bed all the time. Han believed that using other emotions to counter the depression could cure her. After gaining permission, Han and one of the maids "summoned" the dead mother, who had become a vengeful spirit wanting revenge upon her daughter for blotting out her life. The daughter became angry, and stopped grieving for her mother. Han reported that the anger canceled out the depression, and the woman got out of bed (Ng 41-2).

38Another case, however, places depression and emotional imbalance as being more about the correction of emotions to further physical and social health. One case where a woman could not bear children due to depression, jealousy and anger is related in a text on women's disorders by Fu Shan (1607-1684). Here he states clearly that his first concern is that fact she cannot get pregnant and attributes it to her blockage of qi in her cardiac circulation due to releasing her emotions (Sivin 2-3). His prescription then is to use seven ingredients commonly used to promote fertility. He states that once the area is unblocked, the qi of happiness will fill her belly and it will be possible for her feelings to change. She and her husband will then be on better terms (2). Fu's focus is not the countering of emotions in therapy but in paying attention to the emotional issues being raised in the marriage, and which he can address within the confines of his medical beliefs by prescribing remedies.

39This treatment is similar to what other physicians including Wang Ji address where women and their emotional upheavals including depression are treatable through the body itself. Wang Ji used drug therapies as his primary treatment plan overall for his patients, both women and men, for all types of illness. However, his treatments for what seems to be depression indicate an emphasis on the body over the mind. For example, in one case his patient, a mother, has been mourning for her son for fifteen years and in so doing "an excessive amount and subsequent melancholy and pensiveness harmed the Spleen and weeping harmed her qi" (Grant 137). It seems by reading the symptoms as a unit this woman could be viewed as suffering from a long term depression, triggered by bereavement. This seems not to have been a concern of Wang's. In this and other cases, he emphasizes treating the physical ailments created by the depression, and not the depression itself.