Doctors’ Dilemma in Auspicious Pulse Diagnosis Represented in the Ming-Qing Fiction

Abstract

Pregnancy diagnosis in traditional Chinese medicine involves such issues as medical skills, narrative skills, family decency, and ethics. It is an excellent case for the exploration of ethical dilemmas in traditional Chinese medical practice. The early classical medical texts such as Su Wen (Basic Questions) and Ling Shu Jing (Spiritual Pivot Canon) provide a principle-based ethical guide for doctor-patient communication, while popular fiction such as Hong Lou Meng (A Dream of Red Mansions), Yu Mu Xing Xin Bian (Stories: Entertain to Enlighten) and Feng Yue Meng (Courtesans and Opium) in the Ming and Qing dynasties present literary examples for solving ethical dilemmas. This article will analyze these texts from three perspectives. First, the doctors in the text were subject to gender order and other delicate etiquette and customs, therefore were unable to make the diagnosis without embarrassing the patients and jeopardizing family decency. Second, the narrator tends to attribute pregnancy misdiagnosis to three reasons: incomplete patient information, doctors’ poor narrative competence, and doctors’ corrupted medical ethics. Finally, the Ming-Qing fiction proposes three methods to solve this moral dilemma: clear pulse reading, tactful speech, and taboo challenging. This discussion of moral dilemmas in pregnancy diagnosis in traditional Chinese medical practice can be used as a reference for the localization of narrative medicine.