Marginalisation, Reduction and Omission: An Examination of Historical Approaches to the Disease Category Shàn and the Impact of its Reduced Status in Modern Traditional East Asian Medical Practice

Shàn (疝) is a disease category (bìng 病) that broadly refers to various diseases characterised by pain and/or swelling of the abdomen or scrotum. Its inclusion and definition in modern academic materials in both the Chinese and the English language is highly variable. Furthermore, a 2012 study by the author of this article revealed low awareness and understanding of the term by current Traditional East Asian Medicine (TEAM) practitioners in the UK. This is in contrast to the place it occupied in the pre-20th Century TEAM corpus, where it featured in all the major canonical texts of the Hàn dynasty and was widely discussed by many later notable TEAM figures. This article summarises the research above and outlines the primary characteristics of shàn that have been emphasised and debated by TEAM authors throughout history. This is followed by an examination and evaluation of both Chinese and English language terms associated with shàn and a discussion of factors that may have contributed to the current low awareness of the term. Finally, there is a discussion of the clinical implications of the loss of this term and recommendations for future research.