Medicine In China: A History Of Ideas

In the first comprehensive and analytical study of therapeutic concepts and practices in China, Paul Unschuld traced the history of documented health care from its earliest extant records to present developments. This edition is updated with a new preface which details the immense ideological intersections between Chinese and European medicines in the past 25 years.

Acknowledgments xi
Introduction 1

1. Illness and Healing in Shang Culture 17
1.1. Shang Culture and Society 17
1.2. Responses to Illness 19
1.3. Harmony between the Living and the Dead
1.4. Illness as an Indication of Crisis 24
1.5. Illness as the Result of "Natural" Influences
1.6. Shang Healers 25
1.7. Concluding Remarks 26

2. The Chou Period and Demonic Medicine 29
2.1. Historical Background 29
2.2. Concepts of Demonological Therapy 34
2.3. The Practice of Demonological Therapy
2.4. The Concept of Ku 46

3. Unification of the Empire, Confucianism, and the Medicine of Systematic Correspondence 51
3.1. The Paradigm of Correspondences 52
3.1.1. Magic Correspondence 52
3.1.2. Systematic Correspondence 54
3.1.2.1. The Yinyang Doctrine and the Issue of Syncretism 55
3.1.2.2. The Doctrine of the Five Phases 58
3.2. Aspects of Confucian Political and Social Doctrine
3.3. Fundamental Principles of the Medicine of Systematic Correspondence 67
3.3.1. The Concepts of Wind and Ch'i 67
3.3.2. Structure and Function of the Organism 73
3.3.3. Diagnostic Principles of Systematic Correspondence 83
3.3.4. Classic Acupuncture: Origins and Therapeutic Principles 92
3.3.5. Concluding Remarks 99

4. Taoism and Pragmatic Drug Therapy: From Antifeudal Social Theory to Individualistic Practices of Longevity 101

4.1. Social Theory of Early Taoism 101
4.2. Early Taoism and the Question of Life and Death 104
4.3. The Influence of Taoism on the Huang-ti nei-ching 106
4.4. Taoist Macrobiotics and,the Liberation of the Individual 108
4.5. The Origins and Early Development of Pragmatic Drug Therapy 111

5. Religious Healing: The Foundation of Theocratic Rule 117
5.1. Social Conditions during the Later Han 118
5.2. T'ai-p'ing Ideology and the Yellow Turban Revolt 120
5.3. Physical Existence: Tensions between Daily Life and the Ethos of Nature 122
5.4. The Five-Pecks-of-Rice Movement and the State of Chang Lu 127

6. Buddhism and Indian Medicine 132
6.1. Early Buddhism in China 132
6.2. Indian Medicine and the Buddhist Literature of China 137
6.3. Indian Cataract Surgery in China 144
6.4. The Chinese Reception of Indian Buddhist Medicine 148

7. Sung Neo-Confucianism and Medical Thought: Progress with an Eye to the Past 154
7.1. A Survey of Political and Intellectual Developments between the Sixth and Thirteenth Centuries 155
7.1.1. The Sui and T'ang Epochs 155
7.1.2. The Sung Epoch 161
7.2. Cultural and Social Trends as Reflected in Medical Thought 166
7.2.1. Reductionism and the Narrowing of Categories 168
7.2.1.1. Chang Chi and the Adoption of Restricted Etiology 168
7.2.1.2. The Cosmobiological Concepts Wu-yun liu-ch'i 170
7.2.2. Individual Contributions to Contemporary Trends 172
7.2.2.1. Liu Wan-su 172
7.2.2.2. Chang Ts'ung-cheng 174
7.2.2.3. Ch'en Yen 175
7.2.2.4. Li Kao 177
7.2.3. The Pharmacology of Systematic Correspondence 179
7.2.3.1. The Fourfold Categorization of Drug Qualities 181
7.2.3.2. The Sixfold Categorization of Drug Qualities 182
7.2.3.3. The Fivefold Categorization of Drug Qualities 185
7.2.3.4. The Determination of Primary Qualities 186

8. Medical Thought during the Ming and Ch'ing Epochs: The Individual in Search of Reality 189
8.1. Political and Intellectual Developments 189
8.1.1. The Ming Epoch (1368-1636) 189
8.1.2. The Ch'ing Epoch (1636-1912) 192
8.2. Medical Thought 194
8.2.1. The Intellectual Environment 194
8.2.2. The Spectrum of Conceptual Approaches 197
8.2.2.1. Searching the Interior 197
8.2.2.2. Searching the Exterior 204
8.2.2.3. Searching the Past 208
8.2.2.4. Searching Down Below 21()
8.2.2.5. Searching Far Ahead 212
8.2.3. Demonology, "Psychiatry," and "Psychoanalysis" 215
8.3. The Heterogeneity of Chinese Medicine during the Decline of the Empire 223

9. Medicine in Twentieth-Century China 229
9.1. A Survey of Intellectual Currents in the Twentieth Century 229
9.2. The Appearance and Spread of Western Medicine in China 231
9.2.1. Concepts of Modern Western Medicine 231
9.2.2. The Medical Missionaries: Objectives and Methods 235
9.2.3. Science and Scientific Medicine in Twentieth-Century China 242
9.3. Traditional Medicine in the Twentieth Century: Changes in Conceptual Legitimation 249
9.3.1. The Combination of Western and Chinese Medicine and the Emergence of a New Therapy 252
9.4. Therapeutic Plurality in Present-Day China 260

Appendix: Primary Texts in Translation 263

1. Huang-ti nei-ching t'ai-su 263
1.1. Manifestations of Winds at the Eight Seasonal Turning Points 263
1.2. The Nine Palaces and the Eight Winds 265
1.3. The Three Conditions of Depletion and The Three Conditions of Abundance 267
1.4. The Transmission of Evil 269
1.5. Longevity, Early Death, Firmness, and Softness 269
1.6. Natural Phenomena That Must Be Avoided 270
1.7. Various Statements on Winds 272
1.8. On All Types of Winds 273
1.9. On the Numerous Manifestations of Wind 275

2. Huang-ti nei-ching su-wen 276
2.1. On the [Preservation of the] True [Influences Endowed by] Heaven in High Antiquity 277
2.2. Comprehensive Treatise on the Regula~tion of the Spirit in Accord with the Four Seasons 280
2.3. Comprehensive Treatise on the Phenomena Associated with the Categories of Yin and Yang 283
2.4. Additional Treatise on the Five Depots 285
2.5. Treatise on the Various Methods of Treatment That Correspond to the Four Cardinal Points 287
2.6. Treatise on Changes in the [Assimilation of] Essence and on the Transformation of Influences 288
2.7. Treatise on the Secrets of Mr. Yu and on the True Depots 289
2.8. Treatise on Influences in the Depots as Patterned by [the Normal Progression of] the Seasons 290
2.9. Blood and Influences, Body and Mind 293
2.10. On Yao-lllnesses 294

3. Chu-ping yuan hou lun 296
3.1. Symptomatology of [the Illness] "Hit-by-Wind" 296
3.2. Symptomatology of [the Illness Caused by] Wind-Evil 298
3.3. Symptomatology of [the Illness Caused by] Malevolent Wind 298
3.4. Symptomatology of Ascending Influences 299
3.5 Symptomatology of Sudden [Abdominal-intestinal] Distress Caused by Being Hit by the Malevolent 300
3.6. Symptomatology of [the Illness] "Hit-by-the
Malevolent" 300
3.7. Symptomatology of a Demon Attack 301
3.8. Symptomatology of Evil Possession 301
3.9. Symptomatology of Nosebleeding 302
3.10. Symptomatology of Harelip 302

4. Ch'ien-chin i-fang 303
4.1. Techniques of Gesticulative Magic 303

5. Wai-t'ai pi-yao 304
5.1. Eight Prescriptions agaihst an Exchange of Yin or Yang [Influences] Following a Cold-lnduced Injury 304
5.2. Forty-Two Prescriptions against Illnesses Caused by Natural [Influences], Resulting in Sweating or Similar Symptoms 307
5.3. Four Prescriptions against Sexual Intercourse with Spirits and Demons 308
5.4. Three Techniques to Ward Off Snakes 308

6. Taisho Tripitaka 309
6.1. Sutra Containing Pronouncements of Buddha on Buddhist Medicine 309
6.2. Sutra of the Thousand-Handed, Thousand-Eyed Avalokitesvara Bodhisattva on the Treatment of Illnesses and the Preparation of Drugs 314

7. Ju-men shih-ch'in 321
7.1. Madness 321
7.2. Fetid Breath 322
7.3. Noises during Knee Bends 323
7.4. Conception of a Child following Purgative Therapy 323

8. Ku-chin i-t'ung ta-ch'uan 324
8.1. The Origins of Illnesses 324
8.2. On Injuries Caused by the Evil 325
8.3. All Injuries Caused by the Evil Originate in the
8.4. Senses 325
Integrated Treatment Using Spells and Drugs 326

9. Chang-shih lei-ching 328
9.1. Exorcism of the Causes 328

10. Shih-shih mi-lu 333
10.1. Direct Therapy 333
10.2. Reverse Therapy 335

11. Hsu Ling-ttai i-shu ch'uan-chi 337
11.1. On Illnesses Caused by Demons and Spirits 337
11.2. Illnesses Resulting from [Demon-Caused] Injuries 339
11.3. Demon-Caused Pregnancies 339

12. Tzudan pien-cheng fa 340
12.1. The Struggle for and against a Belief in Fate in the Medicine of Our Land 340
13.1. How to Recognize Illnesses of the Human Body 352
13.2. Some Insights Regarding the Use of Drugs 359

14. Wen-huipao 360
14.1. The Evaluation of Acupuncture Anaesthesia Must Seek Truth from Facts 360

Notes 367

Bibliography: Chinese Primary Sources 391
Chinese and Japanese Secondary Sources 394
Western Secondary Sources 396
List of Chinese Characters 405
General Index 415