GEOGRAPHICAL APPROACH TO AN ENDEMIC DISEASE “CHANG-LI” IN SOUTH CHINA

Abstract

Chang-li, an endemic disease which emits superheat, broke out most recently in the first half of this century in the south-western parts of China. It appeared early in history books and literature in the Han Dynasty, for instance in Han-Shu. And after that, Sui-shu and some of the literature or poets of the Tang Dynasty ref eyed to it. Purpose and Method of this Study The first purpose of this paper is to understand what Chang-li's medical substance was and what influences were given to the expansion of the Celestial Empire. The secondary and last purpose is to explain the reason why the area of distribution of that disease diminished in the Chin Dynasty. The thesis or working hypothesis advanced here is the following import. The tertian fever or ordinary malaria of the Far East and tropical malignant malaria were implied by the term Chang-li in old Chinese. It would, of course, be preferable to test this hypothesis in China, but as the international atmosphere does not allow field rsearch, I have used the methods of Historical geography : Old documents, medical and ecological informations. Geographical Agency of the Disease In historical process, the force of Celestial Empire, especially military forces who went on some expeditions to Annan, Thai and Burma, often suffered from Chang-li so seriously that folks and policies or the cultural independency there escaped from being absorbed throughly into the Empire. For example, in the Yuan Dynasty, which established a world-wide Empire, the second Emperor of Yuan sent twenty thousand men to conquer a small native state of Yunnan, which was known as the state of eight hundred mistresses. In the southern part of Yunnan, Chang-li caught the army and the porters of food supply. Then, bodies of hundred thousands of people were abandoned on the way and the subjugation failed in. We can present some other examples in China's history and local events. With due regard to the historical circumstances, we must be concluded that the political autonomy of peoples in South-east Asia was saved from the conquest of Celestial Empire owing to Chang-li. Furthermore, the disease lingered in the bottom of ravines to check the migration of Chinese peasants who economically oppress the traditional lives of Natives. Because the Chinese peasants generally immigrated to the bottom of ravine or valley where paddy cultivation was available. On the contrary, the cultivated land and villages of the natives were often situated near the tops of mountains or in the vast plain where Chang-liscarcely broke out. In passing reference, some habits and customs related to Chang-li may be pointed out. For instance, chewing betel-nut together with relishes was heavily employed to avoid the lack of appetite by malaria. The custom of drinking green tea is also taken to have originated in order to avoid this disease. Symptoms and Environmental Conditions of Chang-li In ancient times it was believed that patients were infected with Chang-li by the rising miasma from mountain forests or valley swamps in the muggy South where savage natives lived. Outbreaks of Chang-li were reported in Fukin, Canton, Kwangsi, Southern parts of Hunan, Kweichow, Szechwan and Yunnan. Some books had described the violence of Chang-li at the time of an outbreak as being so extreme that “ten houses have nine patients” in those Provinces. Chang-li broke out every year between early spring and the beginning of winter in the southernmost regions of Canton, but the season is shorter in the regions near the northern boundary of this Province. For instance, there were four or five waves of outbreak in one season in the west parts of Canton and Kwangsi, but the northern uplands of these Provinces had only two waves of outbreak between late spring and mid-autumn. In Taiwan also there were two waves in a season.