The
archeological discoveries of the last few decades reveal that during the two
centuries of the Western Han dynasty (206 BC – 23 AD), Chinese medical thought
underwent a process of comprehensive standardization and systematization. This
newly emerging image is in contrast with the views of the Chinese medical
tradition tracing the origins of their primary medical canons to pre-Qin times.
The medical manuscripts excavated in 1973 from Tomb #3 at Mawangdui show that
the early medical classics, especially the Huangdi
neijing (The Yellow Emperor's Inner Classic),
which is revered as the oldest writings of its kind,
had not only been compiled much later than it is commonly believed in the
Chinese tradition but even the views represented in them could not have
developed before the Han. Thus the standard view of medical tradition of the
last fifteen-seventeen hundred years in China contradicts to the reality
manifested in the Mawangdui manuscripts. Based on the manuscript texts, one can
determine that at the time of Qin (221 BC – 206 BC) and the beginning of
Western Han most of the typical features of the Chinese healing art had not been
formed yet. One must also point out here the significance of the Nanjing (Classic of Difficult Issues)
and its role in establishing a new direction towards a standardized and
systematic body of knowledge.
The
tradition
Traditional
Chinese medicine has been practically unknown in the West until very recently. The
pioneers in this subject were the Jesuit missionaries traveling and living in
China starting from the 17th century;
this was also the time when Western medicine was introduced to China for the
first time. In later centuries, as political and cultural connections between
East and West grew stronger and became more frequent, most aspects of Chinese
culture, including traditional medicine and pharmacology, came to be an object
of increasing curiosity in the Western world.
Despite the
growing interest, even in our times, and despite the fact that the major works
of ancient European medical science have been translated into Western languages
with dependable philological and medical annotations,
the ancient Chinese medical writings, with a very few exceptions, are still not
available in any of the main European languages.
Thus the range of specialists who could make serious and reliable research in
comparing medical systems of different cultures, when it comes to Chinese
medicine, is limited to those few people who are able to read the original
texts.
As is the case
with many other aspects of Chinese culture, the authorship of medical classics
has been assigned to mythical personages and pushed back to times of remote
antiquity. In traditional thought, the beginning of healing art had been
associated with Huangdi, the Yellow Emperor or Yellow Sovereign and the
knowledge of pharmacology with Shennong, the Divine Husbandman; they hand down
their wisdom in the Huangdi neijing,
or the Yellow Emperor’s Inner Classic and the Shennong bencao, the Materia Medica of the Divine Husbandry,
respectively. Huangdi was the one who
taught people the knowledge of raising silk-worms, riding boats and carriages,
also he was the one who invented writing, music and medicine. Chinese
historical records date the reign period of Huangdi and, consequently, the Huangdi
neijing to 2698 B.C., a time which by no means can be regarded historically
reliable. The Huangdi neijing is one
of the first, and undoubtedly the most important, classic in the history of
Chinese medicine, which had an enormous influence on the medical thought in
later centuries. The book records the dialogs between the Yellow Emperor and
some of his sage physicians on medical issues; the emperor’s questions
encompass every possible aspect of diagnostics, pathology, acupuncture, and
moxibution, including both theory and practice, and the sage teachers give
detailed explanation on each topic.
Another
important classic is the Nanjing, or
Classic of Difficult Issues which is also referred to as Huangdi bashiyi nanjing, or the Yellow Emperor’s Classic of the
Eighty-one Difficult Issues. According to the medical tradition starting from
the Shiji (91 BC), this book is a work of Bien Que, a physician who is
supposed to have flourished sometime between the sixth and third centuries B.C.
Later, the Nanjing was added to the
Yellow Emperor tradition and was assigned to the Yellow Emperor himself.
Until very recently, the Nanjing was
thought to be a commentary to the Huangdi
neijing, elaborating on certain obscure passages and issues from it. The
difficult issues, however, despite their apparent similarity, cannot be found
in the Huangdi neijing; in many cases
they in fact do shed light on obscure parts of the Huangdi neijing, but this is due to the fact that the Nanjing explains medical theory and
practice in a much more clear and lucid way than the Huangdi neijing.
Regardless of
their high esteem in Chinese tradition, almost everything about these classics
is uncertain, especially their authorship and date. “It must be taken for
granted that our present versions of all important medical classics (including,
of course, the Huangdi neijing) are
vitiated by interpolations, lacunae, and corruptions ignored by Chinese
commentators. The transmission of the principal medical texts (including the Neijing) is submerged in utter darkness
from the end of the Han well into the Sui period, that is, for a span of ten
generations.”
The homogeneous
structure and content of the Nanjing confirms
that it is not a collection of thoughts and ideas, as it is often the case with
early texts in Chinese literature, but was written by one author and,
therefore, belongs to one time period. Most of the Western scholars date the
book anywhere from the first to third century AD; in general, their
calculations are based on the dating of the Shanghan
lun, written by Zhang Ji (142-220?), which has been influenced by the Nanjing.
As I mentioned above, the Nanjing is
also referred to as Huangdi bashiyi
nanjing. The Shiji quotes a book called Bashiyi
nan fourteen times and all of the quotes can be identified in the present
version of the Nanjing; therefore, we
have a clear evidence that at the time of the compilation of the Shiji, i.e. around 90 B.C., the Nanjing was already extant. On the other
hand, the Mawangdui texts, as I will
attempt to prove below, demonstrate that the Nanjing was composed after the burial date (168 B.C.).
Unlike the Nanjing, the Huangdi neijing is a text that was put together over a span of several
centuries by a number of individuals; one can finds esoteric and
self-cultivating cosmology next to Confucian discussions on ethical
considerations; there are highly rational and scientific arguments a few pages
after appraisal of physiological alchemy; certain parts of the book may go back
to pre-Qin times and other parts are from the Tang dynasty. There has been an
extensive debate over the last few decades regarding the authorship and dating
of this book, yet, to present day, no generally accepted and solidly based
theory exists. Since it is a compilation, it is extremely hard to label it with
a particular date. The title first appears in the "Yiwenzhi" chapter of the Hanshu, among the bibliography of medical classics. Of course,
there is no way of knowing, whether that title referred to the same content
and, similarly, other titles could have included parts of the present text. The
name Huangdi neijing is generally
prefixed to the titles of four books, Suwen,
Lingshu, Taisu, and Mingtang. We
do not have a Han copy of any of the texts and all of the extant texts have
undergone further editing and revision after the Han. There are also two other
texts, the Jiayijing (256 – 282) and the Maijing (ca. 280) which were strongly influenced by the original version
of the text.
This shows that the Huangdi neijing
was already present at least during the Latter Han, however, it is very hard to
establish to what extent was this original text damaged by later revisions. A
detailed analysis of the various time layers in the Huangdi neijing and the dating of these text fragments is a task
far beyond the scope of this paper.
Before the Nanjing and Huangdi neijing, we do not see comprehensive works on medical
theory; there are only practical manuals and reference books, entirely focusing
on the practical applications of treatment. Even the Nanjing follows this tradition, closely concentrating on medical
questions. The Huangdi neijing is
probably the first medical book which aims to interweave medical experience
with the wider cosmogonic ideology into a coherent system.
Medical theory
has always been traced back to the Nanjing
and Huangdi neijing which served
as an absolute standard for all works after the Han; this kind of continuous
authority, produced as a result of the well-known traditionalism of Chinese
scholarship, resulted in an unusually homogenous and coherent conceptual
structure. On this part of the world, just like in other ancient societies, the
idea of evolution worked seemingly backwards, the original settings were the
best and ever since the times of antiquity everything has been deteriorating.
While in the modern, “scientific” West it is customary to think that the newer
a thing is the better, in traditional Chinese thought this appears to be just
the opposite; a new thing could be justified and accepted if one could prove
that it has been already mentioned and thought of in ancient times.
As a result of this traditionalistic approach, medicine in China has been
regarded as a body of knowledge which has undergone very little, if any,
changes through the span of history.
This
conservative attitude was largely shaken by the archeological discovery of
medical documents dating back to early Han or pre-Han times.
The
Mawangdui documents
In 1973, a large
number of silk and a smaller number of bamboo slip documents were excavated
from Tomb Three of the Mawangdui site at Changsha, Hunan. The burial is dated
to 168 B.C., providing us with an absolute date for the latest time span of all
the manuscripts in the tomb. The total of 130,000 characters included the
copies of the Yijing, the Laozi, Chunqiu shiyu, as well as other manuscripts on history, geography,
military science, philosophy, astronomy, divination, and medicine.
The medical texts, representing every aspect of healing art in ancient China,
amount to more than 23,000 characters,
constituting one sixth of all the writings; the 14 individual medical
documents, following the arrangement of the bibliographic catalogue in the Hanshu,
can be grouped into four main categories:
A. Classics of Medicine (yijing):
1. Zubi shiyi mai jiu jing
(Canon of Cauterization for the Eleven Ducts of the Legs and Arms).
2. Yin-yang shiyi mai jiu
jing (Canon of Cauterization for the Eleven Yin
and Yang Ducts, ed. 1 and 2).
3. Maifa (Model of the Ducts).
4. Yin-yang mai sihou (Fatal
Symptoms of the Yin and Yang Ducts).
B. Collection of Prescriptions (jingfang):
1. Wushier bingfang (Recipes for Fifty-two Ailments).
C. Treatises on the Bedroom (fangzhong):
1. Yangsheng fang (Recipes for Nurturing Life).
2. Za liao fang (Recipes for Various Cures).
3. Shi wen (Ten Questions).
4. Tianxia zhidao tan (Lecture on the Culminant Way in Under Heaven).
5. He Yin-yang (Joining the Yin and Yang).
D. Methods and Prescriptions for Immortality (shenxian)
1. Qugu-shiqi (Rejection of Grains and Consumption of Vapor).
2. Daoyin tu (Illustration of Guiding and Conducting).
3. Taichan shu (Book of the Generation of the Fetus).
4. Za jin fang (Recipes for
Various Charms).
It is fortunate
that all of the four categories in the Hanshu
are represented among the excavated materials. “The diversity of texts included
in the Mawangdui medical corpus gives
us an unusually complete picture of the state of medical literature in the
Warring States and Qin-Han periods.”
Despite the wide variety of documents, the Mawangdui
corpus presents us with an essentially consistent ideology; this is an
important evidence that the texts are part of a larger tradition and not just
individual fragments.
What makes these
documents so rare and valuable is that the exact date of the burial and the way
name-taboo characters are used or omitted give us a solid chronological basis
so unusual in this field. Furthermore, since these manuscripts have been out of
circulation during the centuries of changes, they allow us to lift up the veil
covering the earliest phase of development of medical thought during the
Eastern Han dynasty.
The Mawangdui documents present us an
ideology remarkably different from the conventionally accustomed view of
medical theory which, in its earliest form, is represented by the Nanjing and Huangdi neijing. The more “primitive” and unstructured doctrines of
the excavated material remind us of the grand process of standardization that
took place sometime during the Latter Han. If we compare the Mawangdui medical corpus with the
classics, a number of striking distinctions confirm the gap in time and
ideology.
The manuscripts
within group A, categorized under the title “Classics of Medicine,” are the ones
immediately concerned with medical theory and ideology and in my study I would
like to concentrate on these texts. Below are descriptions of the main
distinctions in the Mawangdui medical
corpus as opposed to the extant medical classics.
1. Acupuncture points
None of the
documents mentions names or even the existence of acupuncture points (xue).
The later classics discuss a
large number of different types of acu-points, most of which are located along
the ducts; the Huangdi neijing states
that there are 360 acu-points in the body which corresponds to the number of
days in a year. In traditional Chinese medical thought the needling of
acu-points has been regarded as definitely the most important kind of treatment
along with herbal therapy; consequently, the classics elaborate in detail on
the name, location, category, and function of individual points, as well as the
technique of piercing, including the depth, angle, body position, time
interval, time of the day etc. Evidently, the theory of acu-points was
altogether a later development.
2. Metal Needles
Apparently as a
direct consequence of the absence of the concept of acupuncture points, none of
the texts in the Mawangdui corpus
mentions the use of acupuncture needles. Instead, as in B2, we find that stone
probes were used to open up boils and abscesses, just as documented in writings
from the Warring States period. In Chinese medical tradition acupuncture treatment
with metal needles plays an extremely important role and even in the age of the
Huangdi neijing there were already
nine different needles in use with a specific name assigned to each of them.
This is a clear proof that needling technique was unknown before 168 B.C. and
that stone probe technique, which completely disappeared in the following one
or two centuries, was still in use. In B1 we read, “pierce the side of the
buttocks with a stone probe.”
While the Nanjing, devoted to new
classification, does not speak about stone probes, the Huangdi neijing occasionally refers to them as a treatment against
boils and abscesses.
3. System of Ducts
The documents only list eleven ducts none of which is connected to
specific organs, as opposed to the usual twelve ducts being ascribed to twelve
organs. Although most of the ducts can be identified, their names mostly do not
match those of the present model. Some scholars have related the descriptions
of ducts in the Mawangdui documents
to the Jingmai chapter in the Taisu part of the Huangdi neijing. According to their conclusions, A1 and the two
editions of A2 could be regarded as the archetypes for certain chapters of the
early Huangdi neijing;
although many of the ducts can be identified with each other, in the Huangdi neijing, and consequently in all
of the later medical tradition, their names have been altered. Interestingly,
the names for the same ducts within the individual documents of the Mawangdui corpus, such as A1 and A2, can
be different too, while after the new names took their final form in the Huangdi neijing, they remained unchanged
for the next two millennium up to the present day. This is a further evidence
that at that time when the excavated Han documents were written, Chinese
medical terminology had not become standardized.
4. Theory of Five Phases
Manuscripts of
group A and B1 employ the theory of five phases. A4 lists the qi, blood, bones, flesh, and muscles
(tendons) in relation to the symptoms of death; according the five phase
theory, the tendons, flesh, blood, and bones can correspond to wood, earth,
fire, and water, respectively, but the qi
cannot be associated with any of the presently known five elements. This
suggests that at the time of the compilation of the text, the theory of five
phases, being already fully developed and accepted in Chinese philosophy and
literature, had not been fully incorporated into medical theory. On the other
hand, D3 lists six phases or elements with the addition of shi (stone) which is not part of the standard classification;
the C3 manuscript already mentions the five sounds, five tastes, five voices,
confirming the presence of five phase theory at the time, or place, of this
manuscript’s compilation.
5. Organs
In the documents
we rarely find the names of the zang and
fu organs. While in later times these
organs play a vitally important role and are related to the ducts, the Mawangdui scripts do not use them in
this way. Also, their meaning does not always correspond to the customary ones.
For example, in B1 the word shen (kidney)
does in fact refer to the testes and in this sense is very different from the
concept of kidneys; also in B1 the character fu (hollow organ, palace) means the bladder and not all six of the
hollow organs (gall bladder, stomach, large intestine, small intestine, middle
burner, and bladder).
Furthermore, the organs were not connected physically with the ducts, nor pathogenetically with the individual
diseases. This evidence suggests that the theory of organs had been also in the
process of development.
6. Yin and Yang
In B1 Yin and
Yang are also mentioned in their more primitive form as mu (male animal) and pin
(female animal), a distinction that cannot be found in the classical medical
texts. The existence of the theory of Yin and Yang is extensively documented in
the philosophic and military literature since the Warring States period and a
usage of the mu and pin forms can only mean that medicine
was a practical matter which did not always and completely accord with the
philosophic ideology and in many cases was using its own terminology.
7. Mai and Jing
While later
tradition, especially the Nanjing,
distinguishes between mai and jing,
in A1 the ducts are exclusively referred to as mai. The term jing
customarily is the term for the twelve main ducts in the body ascribed to the
twelve inner organs and mai plays a
multiple function naming the eight extra channels, the blood vessels, and the
pulse. Besides, A1 uses the character wen
(warmth) to write mai, a practice
previously unrecorded.
7. Pathologic Names
In the Mawangdui documents we find a large
number of previously unrecorded names of diseases,
some of which were presumably part of the local dialect around Changsha. In
later tradition, the names of ailments, were also standardized and categorized
according to their cause and nature.
8. Magic
In the Mawangdui corpus magic plays a
considerably larger role than in later tradition. B1 contains thirty-eight
recipes including magical formulas which reveal their significance in early Han
healing practice. In his research on B1, Harper comes to the conclusion that “the
inclusion of magical recipes in the repertoire of medical treatments
represented in Fifty-two Ailments is
clear evidence of the shamanistic heritage which continued to form part of the
medical practice of the physician during the Han period. These recipes, which
reveal the precise wording of incantations to be used against demonic forces
and detail a variety of excorcistic rituals, constitute yet another body of
secret knowledge in Fifty-two Aliments.”
We find traces of magical healing even in the early passages of the Huangdi neijing, although in later parts
it expresses a much more “modern” attitude towards magical healing, saying that
believing in demons cannot be agreeable with medicine.
Chapter 50 of the Suwen tells us
about a kind of divination called zhuyou which
was used in antiquity.
I
have heard that in ancient times, when the sages treated, all they had to do
was to employ methods to guide and change the emotional and spiritual state of
a person and redirect the energy flow. The sages utilized a method called zhuyou, prayer, ceremony, and shamanism,
which healed all conditions. Today, however, when doctors treat a patient, they
use herbs to treat the internal aspect and acupuncture
to treat the exterior.
This is a description of the
evolution of Chinese medicine. Originally people were treated with exorcism and
other ‘primitive’ healing technique, later they treated them with stone blades,
metal needles, and herbs. The Nanjing,
on the contrary, being a major step in the process of rationalization, does not
talk about magic at all.
A
new standard: the Nanjing
In the Nanjing we are able to witness a very
important moment in the history of Chinese medicine. It is the link between the
archaic medicine and the standardized new concept which will dominate the next
two millennia. It systematically covers all aspects of medical thought,
including diagnosis, needling technique, pathology, and, especially, theory.
The main concern
and the aim of the book is classification and standardization. The questions
are not the inquires of a person ignorant in the field but questions of an
expert on the contradictions, inconstancies, and illogical concepts in
contemporary medicine.
With regard to
its effort of guide medical thought into new directions, it applies two
distinctive methods to convey information to the reader.
1. Descriptive classification
This is a
category where the question does not directly refer to any kind of argument or
contradiction, it is simply asking for information. An example for this is the Twenty-third issue which details the
length and starting and ending point of every conduit.
The
twenty-third difficult issue: Can one be instructed on the measurements of the
three yin and three yang vessels of the hands and feet?
It
is like this. The vessels of the three hand-yang [conduits] extend from the
hands to the head. They are five feet long. Five [feet] times six amounts to
three zhang....
The Thirty-fourth issue asks about the
correspondence of the five sounds, colors, odors, tastes, and body fluids to
the five depots. This is a classification of body organs and functions
according to the five phases theory.
The
thirty-fourth difficult issue: Each of the five depots has a [specific] sound,
complexion, odor, and taste. Can they be known?
It
is like this. The ‘Ten Transformations’ states: The color of the liver is
virid; its odor is fetid; its taste is sour; its sound is the shout; its liquid
is the tears. The color of the heart is red; its smell is burned; its taste is
bitter...
2. Clarification of inconstancies
Another approach
is revealed when the “disciple” points out an inconstancy within the existent
ideology and asks the “teacher” to solve the contradiction. The Twenty-fifth issue inquires why is it
that while every conduit is assigned to an organ, there are twelve conduits and
only eleven organs (five depots and six palaces).
The
twenty-fifth difficult issue: There are twelve conduits, but the [body’s] five
depots and six palaces [add up to only] eleven. Of what nature is the missing
conduit?
The Thirty-sixth issue asks why all the
depots have a single entity, except the kidneys which have a double entity.
The thirty-sixth difficult issue: Each of the
depots is a single [entity], except for the kidneys which represent a twin
[entity]. Why is that so?
It
is like this. The two kidneys are not both kidneys. The one on the left is the
kidney; the one on the right is the gate of life. The gate of life is the place
where the spirit-essence (jing)
lodges; it is the place to which the original influences are tied. Hence, in
males it stores the essence; in females it holds the womb. Hence, one knows
that there is only one kidney.
The examples
quoted above indicate that, at the time the text was written, there was a
difficult conflict present between different medical ideas and schools and the Nanjing was intended to establish,
through its clear and categorical definitions, a new standardization of
ideology and terminology.
The didactic
tone and concise definitions of the text, as well as the complete absence of
references to magic, magical spells, and incantations suggests that the goal of
the Nanjing’s author, or authors, was
to guide medical thought towards a rational and “scientific” approach. Unschuld
writes in his Nanjing monograph that
the “Nanjing should once again (as
was the case until early this millennium), be regarded as a significant and
innovative work that marks the apex, and also the conclusion, of the
developmental phase of the conceptual system known as the medicine of
systematic correspondence. The contents of the Neijing texts, in contrast, should be appreciated as a collection
of extremely valuable transitory stages in this developmental phase — valuable
because they reflect various historical steps as well as a wide range of
diverging (and even contradictory) theoretical arguments.”
By talking about
the consolidation and rationalization of medicine I am by no means suggesting
that medical theory stagnated and did not evolve anymore after the
standardization of the Han; indeed, there were other major changes in later
ages too. A significant development was the introduction of the concept of
phase energetics, the “transformation of the energy” (yunqi). Although the Suwen
part of the Huangdi neijing corpus,
which was edited and annotated in AD 762 by Wang Bing, contains a large number
of passages related to phase energetics, the other parts of the book, do not
include any of these sections; therefore, phase energetics appears to be Wang
Bing’s interpolation and a much later invention. Porkert says, “The thesis that
phase energetics constitutes a relatively late innovation is corroborated by
the fact that secondary literature on this subject does not appear before the
middle of the Song period (1099) and in notable quantity only in the Ming.”
Standardization
of Chinese thought during the Western Han
The
standardization of terminology, theory, and practical technique during the
early Han was by no means limited to the medical world; it was a much broader
process, involving many aspects of contemporary culture, including philosophy
and literature. “In sharp contrast with the Qin the Han dynasty, while
continuing the political heritage of the former, combined in its
world-conception the idea of the absolute power of the Emperor with the
recognition of the necessity of the metaphysical norms of love and duty, thus
realizing, perhaps for the first time in Chinese history, Confucius’ ancient
ideal of the Sovereign who, mandated by Heaven, carried out its will: to govern
the people by spiritual power which by its very nature is beneficent and
stimulating.”
The period of
early Han is the time of general standardization in Chinese culture; it is the
time of classification and standardization of the classics. The study of the classics
was a central issue and was promoted by the emperor himself; in 191 B.C.
emperor Hui abolished the law proscribing the possession of books, promulgated
by the Qin in 213 B.C.; in 136 B.C. emperor Wu established, advised by the
leading scholar Dong Zhongshu, the institution of the wujing boshi (erudities for the five classics), raising
Confucianism to be the only officially recognized doctrine. The reign of
emperor Wu of the Han is known in Chinese literature as the period of tongyi sixiang, or the ideological
unification; despite his affinity towards occult and esoteric teachings,
through promoting Confucianism and the study of classics, he made a big step
towards the unification and rationalization of Chinese thought. The need for
such reforms was present in the political and intellectual world, the changes
did not merely represent the literary interest or attraction of the emperor;
“the fact that two councils for the discussions of the discrepancies in the
Classics were held within comparatively so short a time, the first in the
Shiquguo in 51 B.C., the second in the Baihuguan in 79 A.D., points out the
unsettled state of affairs in the world of Classical studies during the Western
and Eastern Han Dynasties;”
even the fierce conflict between the
New Text and Old Text schools shows us how important it was considered
to have a united and consistent approach to intellectual thought.
During the Han
dynasty, Confucian thought became a great synthetic religion which, despite all
the superstition and mysticism fused into it, was a highly rationalized body of
thought. This rationalistic system, until the first decades of the Western Han,
was counter-balanced by “other, rival, doctrines, in particular Taoism and the
School of Law;” later on,
these schools lost from their influence and attraction and Confucian
rationalism became the dominant force in politics and culture. This is what
Needham calls a “Naturalist-Confucian synthesis during the Han.“
The study of the classics was further emphasized in the years of the reign of
emperor Xuan (73-49 B.C.), twelve scholars representing twelve different
schools of interpretation taught the Five Classics at the Grand School in the
New Text tradition; the Old Text versions were not recognized officially until
a little later, although many scholars of the first century knew and had
studied them.
The process of
ideological and intellectual consolidation was present in all aspects of
contemporary Chinese thought; the grand scale unification also involved the
standardization of terminology and technical vocabulary. John S. Major presents
a clear and detailed analysis on the evolution of the nomenclature of winds and
directions in this period, reaching the conclusion that “the nomenclature of
winds and directions in the early Han was still somewhat confused, but also
that the confusion was rapidly diminishing as the manifold correlations of Han
cosmology were becoming standardized.”
Major also points out the cosmological significance of Gao You’s (c. 168-212)
commentary that gives a correlation to the eight musical instruments as well.
“This may seem a trivial correlation to make until one remembers how seriously
music was taken in ancient China for its symbolic and numerological qualities.
Thus introducing musical instruments in this context opens the door for further
cosmological integration, so that the system will embrace not only time and
space, yin and yang, the Five Phases, and the eight triagrams, but the
numerology of the pentatonic and duodecatonic scales. Thus the system
approaches the all-embracing syncretic organic cosmology, containing an
appropriately detailed set of prescriptions for human conduct, that was to have
its full flowering in the works of Dong Zhongshu within a few decades of the
writing of the Huainanzi.”
One of the
spectacular manifestations of this standardization process in this period is
the compilation of Dong Zhongshu’s Chunqiu
fanlu, a work in the New Text tradition which, despite its later
interpolations, remains to
be one of the greatest examples of correlative thinking and the system of
correspondences. It is a work extends the theories of Yin-Yang and five phases
to virtually every aspect of human existence, including arts, music, food,
politics, philosophy etc., creating a consistently integrated system very much
in the tradition seen in medical literature starting from the Nanjing, Huangdi neijing, Shanghanlun and other texts during and
after the Han dynasty.
Conclusions
As the examples above suggest, the sophisticated system of correspondences
constituting the main characteristics of Chinese medical science could emerge
only after the first century B.C., possibly even later. It was certainly far
from that stage in 168 B.C., at the time of the Mawangdui burial and, considering the phase of development revealed
by the excavated documents, it might have taken several centuries to reach the
stage manifested in classics like the Nanjing.
Despite the gen%ral view of seeing the system as part of the Zhou or early Han
Jprosperity of Chinese philosophical thought, the materials found in the
Mawangdui tombs confirm that even during the early Han, Chinese medicine was
still far from that comprehensive and subtle universality which became its main
characteristics during the next millennium. The Mawangdui documents reveal a pragmatic clinical healing practice
primarily based on pharmaceutical knowledge; routine, philosophical ideology
and theoretical considerations play a much smaller role in the texts.
During the
Western Han dynasty, in the time period between the Mawangdui medical corpus and the text of earliest traditional
medical classics, especially the Nanjing,
that is during the several decades between 168 B.C. and the first century B.C., as part of a more
general process in Chinese thought, we can recognize a grand scale
standardization and systematization of Chinese medical thought and terminology;
the medical knowledge and experience of the preceding centuries was revised and
shaped into a new integrated model.
In the process
of standardization the Nanjing played
a pioneering role, outlining the new principles and eliminating the
contradictions and peculiar interpretations; with its scientifically concise
style it is a conscious effort to guide the contemporary medical thought
towards integration. Unlike the Huangdi
neijing, it was a work of one
person with a revolutionary attempt to influence and guide medicine into a new
direction. Taking into consideration the questions raised regarding the
unsettled aspects of various concepts and the intentionally methodical answers,
at the time when the Nanjing was
written, there was a great deal of confusion and uncertainty in the medical
world and the old teachings were still very much present.