Understanding menstruation and menopause from the perspective of gender history
Menstruation and menopause are important life courses for women. People rarely discuss it from the perspective of gender history, but they always accompany each other. How do women after 50 treat and define when menstruation no longer comes? How does medical treatment interfere with women's bodies? What is the body view behind it? An interview with Jen-der Lee, a researcher at the Institute of History and Language, Academia Sinica, examines the historical context of ancient people facing menopause, and provides some thoughts on medical care for mature women.
When did the word "menopause" come into use? Is this word also used in ancient medicine?
The word "menopause" appeared in Taiwan Province Province during the Japanese occupation period, which originated from the Japanese translation of the western word "menopause" at the end of 19. In European tradition, menopause originally refers to the life cycle of men and women, but after Japanese translation, it has added a new meaning. The "menopause" corresponding to menopause also includes the physical and mental conditions of women before and after menopause. 18 16 years, a French doctor coined the word "menopause", which specifically refers to female menopause.
Now we usually say "menopause", which is often a mixture of menopause and menopause. It implies both physical aging and psychological aging. It refers to the biological phenomenon that the ovary stops producing follicles and menstruation no longer comes.
However, if we look back at China's classical medical literature, there is no such thing as menopause. Doctors refer to the permanent menopause of women by "menopause" and "menstrual period".
The word menopause is a Japanese translation of western concepts. If traced back to China's classical medical literature, doctors call permanent menopause for women "menopause" and "menstrual period".
How did ancient medicine in China understand the relationship between menstruation and women?
"There are three kinds of unfilial, childless is the greatest", and bearing children is a heavy responsibility, so the care of women's bodies in ancient medicine began with "bearing children".
Huangdi Neijing has already mentioned "twenty-seven days of decadence" and "seventy-seven days of decadence", and decadence means water. Decadence, as a substance to promote fertility, manifests itself in the form of menstruation when girls 14 years old. Female 14 years after menarche, which means that the body is mature and can give birth; 49 years old, lack of days, "authentic" is menopause, no longer giving birth.
Since the pre-Qin and Han dynasties, ancient medicine has described and observed the life cycle of women through the beginning and ending of menstruation.
Was there any special medical care for menopausal women in the Middle Ages?
In costume dramas, you will hear the saying that women come to drink water. In fact, according to Huangdi Neijing, there are both men and women, but men will reach the age of 16, which means "returning to water in 28 days". Tiangui means that women "menstruate" and men "master", which means that they are mature and can have children. The specific fertility of a woman is that she can get pregnant and give birth, so doctors first focus on preventing pregnancy and childbirth.
In ancient times, there were no so-called "gynecological drugs" for women's bodies except providing more prescriptions to ensure the safety of fetal delivery. Postmenopausal middle-aged and elderly women no longer bear the heavy responsibility of childbearing, just as the task of life has been "unlocked", medical books in the pre-Middle Ages paid relatively little attention.
For example, in the Jin Dynasty, a 50-year-old woman stopped menstruating and came back for more than two or three days. The doctor was indifferent after the consultation: "My wife is 49 years old and should stop menstruating, but she still continues to menstruate, which leads to weakness." then what No, then.
Although doctors tend to "stop menstruation when the time comes", if menstruation comes again after July 7, it will be even more virtual, but doctors seem to think that this is not a serious problem. Some health books even claim that if they are properly maintained and practiced, they can continue to have children after the age of 49!
When did China establish "Gynecological Medicine" and begin to care about the physical changes of mature women?
Since the 5th century, with the emphasis on fetal delivery, ancient medicine has gradually expanded its understanding of women. Pushing forward from childbirth and pregnancy, more and more people began to pay attention to menstruation that shows fertility, and gradually developed a set of views: women's bodies are special and different from men's.
As a result, there has been a "female prescription" for women.
5? Between 65438 and the 3rd century, these prescriptions tailored for women became more and more complete. In the Song Dynasty, China's first female prescription monograph "Female Prescription" appeared. The author Chen emphasized in the book:
"Women are blood-oriented, men are qi-oriented", which clearly shows the gendered body view and lays the foundation of gynecological medicine in China.
It was also at this time that medical books appeared as prescriptions for postmenopausal women. The "women's prescription" contains the conditioning prescription for elderly women and provides an ancient health care method. For example, women after the age of 50 can take Danggui Powder and Cornus Pills to regulate qi and blood; Siwu decoction can treat the problem of leucorrhea secretion in elderly women.
Menstruation was very important for the establishment of gynecology in ancient times. Did the doctor also construct the "menstrual theory"?
Of course, ancient physicians noticed menstruation very early, but they theorized menstruation at 5? /kloc-slowly formed in the 0/3rd century.
For example, Sun Simiao, a great doctor in the Tang Dynasty who was known as the King of Medicine, asked why women should be independent. His argument is that it is too dangerous to have children, so in order to ensure safety and reduce harm, we must pay attention to the daily nourishment of women from the source. What state is suitable for pregnancy? How to recuperate to make the body better? Step by step, related to menstruation.
Physicians' exposition has developed to "women's all-round prescription" From the arrangement of chapters, we can see the important foundation of China's exposition on gynecological medicine:
The textual order of a woman's complete prescription is "menstruation, leucorrhea, pregnancy, childbirth", and an orderly cognitive system is constructed with menstruation as the leading factor. It is emphasized that as long as women are treated, they must first deal with the matter of asking for a month, starting with menstruation.
The close relationship between menstruation and women has been theorized, and blood has become the foundation of women's body, and it transcends fertility, even without pregnancy and childbirth, which affects women's health all their lives.
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Because women's bodies are understood as "celestial exhaustion" and "celestial exhaustion", women's menarche and menopause are more concerned than ancient and medieval doctors. However, the focus of attention is not to delay the exhaustion of heaven, but to gradually regard "27" and "77" as the standard clocks of women's bodies.
14 years old menarche, 49 years old should be menopausal. Take a 49-year-old woman who menstruates as an example. After the diagnosis, the doctors in the Jin Dynasty only pointed out the reason for her weakness. If you were a doctor in the Song Dynasty, you would prescribe Danggui powder or something. In the Ming Dynasty, the doctor further demonstrated that since the number of laurel days had been exhausted on July 7, menstruation should be stopped. Li Shizhen, the most famous TCM doctor, even advocated "Septicemia of Fifty Meridians"!
Generally speaking, it seems that the more I feel "disturbed" by it, the less I can see that China ancient medicine wanted to use drugs to prolong menstrual cramps.
Long-term hormone supplementation for female menopause is very popular in Europe and America. What is the difference between this view and China's classical medicine?
Hormone replacement therapy (HRT) has been controversial. Why it became popular in the second half of the 20th century is a very interesting topic. Judith Houck, a western historian of gender medicine, has made a long-term historical investigation on the situation in the United States.
Hormone replacement therapy appeared in the 1930 s, initially as a short-term symptom treatment of female menopause, and it was not promoted until the 1960 s, advocating long-term use by women. A key figure who added fuel to the flames was American gynecologist Wilson. In his book Forever Woman, he vigorously advocated the miraculous effect of female hormones on rejuvenation. Middle-aged women after menopause are described as haggard, lacking sexual interest and unattractive, and can only regain their feminine charm by supplementing estrogen.
Without estrogen, women are like withered flowers, "no longer women"!
Hormone therapy is very popular, like a panacea to save youth and marriage. This can also correspond to the gender environment at that time. Women are emphasized to maintain feminine charm and femininity, so feminists jump out to challenge: what is a woman?
Compared with the West, the theoretical basis of traditional medicine in China since the Song Dynasty is "women take blood as the foundation". "Blood" is not only menstrual blood, but a concept that doctors describe women's physical characteristics.
Menstruation certainly shows that women have reproductive ability, but after menopause, the blood-based female body still exists, and women are still women.
Why do eastern and western medicine have such different attitudes towards menstruation?
Classical Chinese medicine is worried that menopause is coming and menstruation will continue; Western medicine pays special attention to the problem after menstruation no longer comes. This difference is very interesting. Why?
To tell the truth, there is no good answer to this question. Although scholars of medical anthropology, medical sociology and feminist health movement did a lot of research on hormone replacement therapy in the 20th century, there were few consistent and long-term studies on menopause or menopause by medical historians in both the East and the West.
And Kuriyama Shigehisa, a Japanese scholar, compares the attitudes of ancient China and Greek medicine towards "blood", which may provide an opportunity for further thinking.
Since the ancient Greek era, westerners thought that blood accumulated in the body would be inflamed, so in the Middle Ages, pricking blood and "bloodletting" was an important treatment. Women can keep healthy by regularly removing waste blood from menstrual blood; Once menopause, the body can't "detoxify" regularly, and it may be weak and aging.
Compared with ancient Greece, China emphasized the body view of Qi in ancient times. Although there is acupuncture therapy, it has developed from bloodletting to acupuncture to "invigorating qi, discouraging and regulating qi"
Do the different attitudes of Chinese and western medical traditions towards menopause also come from this different view of blood and body? Maybe we can continue to explore later.
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Why study the medical history of menopause? What are your observations and feelings about the actual social culture?
In the past 30 to 40 years, historical research on gender and health care has been quite active. However, most of them focus on the related topics of childbearing, and pay little attention to the health history of women after childbearing age. The argument about hormone theory in Europe and America has attracted many anthropologists, sociologists and feminists to study, but there is not much long-term historical analysis.
How did human society face the health problems of the elderly in the past? What are the gender differences? How to influence our current habits and mentality? We lack understanding of these problems. The situation in the Chinese world is similar.
But look at Taiwan Province Province, we have entered a highly aging society, but we are quite lacking in imagination and understanding of the body of the elderly, especially middle-aged and elderly women.
But in our social structure, elderly women are often the weak among the weak. They have been in the position of "caregivers" for many years, and their understanding of their bodies is far away, lacking sufficient discussion to support them. It is often difficult for them to jump out of their fixed roles and fall into a state of fatigue and aphasia.
Research is the basis of discussion, and discussion is the link to promote improvement.
Without enough research and discussion, it is easy to exclude the understanding and care of elderly women from health design.
These are all important issues behind the study of medical history from a gender perspective. I hope that when we spend a long time in-depth understanding of the cultural situation of elderly women, we may be able to break the existing social thinking mode and produce more considerate behaviors and more effective health care strategies.
The research authorization reprinted the original source "Postmenopausal, Woman or Woman?" This is how the ancients viewed menstruation and menopause.