Huang Di Nei Jing Su Wen: Nature, Knowledge, Imagery in an Ancient Chinese Medical Text

532 Pages·2003·2.85 MB·English

by  Paul U. Unschuld

Unschuld,Huang Di nei jing 12/2/02 1:34 PM Page iii
Huang Di nei jing su wen
Nature, Knowledge, Imagery
in an Ancient Chinese Medical Text
Paul U. Unschuld
with an appendix
The Doctrine of the Five Periods and Six Qi
in the Huang Di nei jing su wen
UNIVERSITY OF CALIFORNIA PRESS
Berkeley Los Angeles London
Unschuld,Huang Di nei jing 12/2/02 1:34 PM Page iv
University of California Press
Berkeley and Los Angeles, California
University of California Press, Ltd.
London, England
© 2003 by the Regents of the University of California
Library of Congress Cataloging-in-Publication Data
Unschuld, Paul U. (Paul Ulrich), 1943–
Huang Di nei jing su wen :nature, knowledge, imagery in an
ancient Chinese medical text, with an appendix, The doctrine
of the five periods and six qi in the Huang Di nei jing su wen /
Paul U. Unschuld.
p. cm.
Includes bibliographical references and index.
isbn0-520-23322-0 (alk. paper)
1. Su wen. 2. Medicine, Chinese—Early works to 1800.
I. Title. [dnlm: 1. Su wen. 2. Medicine, Chinese Traditional.
wz294 s938u2003]
r127.1.s93u57 2003
610'.951—dc21 2002027170
Manufactured in the United States of America
12 11 10 09 08 07 06 05 04 03
10 9 8 7 6 5 4 3 2
The paper used in this publication is both acid-free and totally
chlorine-free (TCF). It meets the minimum requirements of
ansi/niso z39.48-1992 (r1997) (Permanence of Paper).
Unschuld,Huang Di nei jing 12/2/02 1:34 PM Page v
contents
prefatory remarks / ix
i. bibliographic history of the su wen
1. Some Scholarly Views on the Origin of the Su wen / 1
2. References to Huang Di nei jingand Su wenin Early Bibliographic
Sources / 3
ii. the meaning of the title huang di nei jing su wen
1. Huang Di / 8
2. Nei / 14
3. Jing / 16
4. Su wen / 18
iii. early su wen texts and commentaries before the
eleventh century
1. Huangfu Mi and the Jia yi jing / 22
2. Quan Yuanqi and the Su wen xun jie / 24
3. Yang Shangshan and the Huang Di nei jing tai su / 26
3.1. History and Reconstruction of a TaisuText in Japan / 26
3.2. The Issue of the Chinese Master Copies of theTaisu / 27
3.3. Yang Shangshan’s Commentaries / 33
4. Wang Bing’s Su wenEdition of a.d.762 / 39
4.1. Wang Bing, His Intentions and His Preface / 39
4.2. Structural Characteristics of the Wang Bing Edition / 44
4.3. Discourses 66 through 74 in Today’s Suwen / 46
Unschuld,Huang Di nei jing 12/2/02 1:34 PM Page vi
4.4. The Influence of Wang Bing’s Worldview on His Su wenEdition / 48
4.5. Scope and Structure of Wang Bing’s Commentaries / 51
iv. origin and tradition of the textus receptus of the
su wen
1. The Imperial Editorial Office of 1057 / 59
2. The Scope of the Revision by Gao Baoheng et al. / 62
3. The Major Commentated Su wenVersions Subsequent to Gao Baoheng
et al. / 66
3.1. Ma Shi’s Huang Di nei jing su wen zhu zheng fa wei / 66
3.2. Wu Kun’s Huang Di nei jing su wen zhu / 66
3.3. Zhang Jiebin’s Lei jing / 68
3.4. Zhang Zhicong’s Huang Di nei jing su wen ji zhu / 69
3.5. Gao Shishi’s Huang Di su wen zhi jie / 70
3.6. Zhang Qi’s Su wen shi yi / 71
3.7. Hu Shu’s Huang Di nei jing su wen jiao yi / 72
3.8. Yu Yue’s Nei jing bian yan / 73
4. Two Japanese Commentated Su wenVersions of the Edo Period / 74
4.1. Tamba Genkan’s Su wen shi / 74
4.2. Tamba Genken’s Su wen shao shi / 75
v. a survey of the contents of the su wen
1. The Literary Setting / 76
2. The Yin-Yang Doctrine / 83
2.1. The Discovery of Dualism / 83
2.2. The Fourfold Subcategorization / 89
2.3. The Sixfold Subcategorization / 92
2.4. An Eightfold or Tenfold Subcategorization? / 94
2.5. Yin-Yang Physiology, Pathology, and Diagnosis / 96
3. The Five-Agents Doctrine / 99
3.1. General Remarks / 99
3.2. Early References to Pentic Categorizations / 100
3.3. Early Notions of Correspondences among Phenomena / 102
3.4. Early Patterns of Correspondences / 105
3.5. The Status Quo of the Five-Agents Doctrine in theSu wen / 106
3.6. The Significance of the Five-Agents Doctrine in the Su wen / 110
4. The Body and Its Organs / 124
4.1. Su wenMorphology / 124
4.2. Chest and Abdomen / 124
4.3. The Head / 126
4.4. The Extremities / 127
4.5. General Structural Elements and Mobile Agents / 127
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4.6. Toward a Hierarchy of Human Organs / 129
4.7. Depots, Palaces, Containers, and Officers / 136
4.8. Links between Organs and Orifices / 141
4.9. The Organism as a System of Morphological Entities and Their
Functions / 143
5. Blood and Qi / 144
5.1. Blood / 146
5.2. Qi / 149
5.3. Camp Qi and Protective Qi / 163
6. The Vessels / 167
6.1. Vessel Theory in the Mawangdui Manuscripts / 167
6.2. Vessel Morphology in the Su wen / 169
6.3. Vessel Pathology / 171
6.4. The Contents of the Vessels / 174
6.5. Vessel Flow / 175
7. Pathogenic Agents / 180
7.1. From Bugs and Demons to Natural Environmental Factors / 180
7.2. Wind Etiology and Pathology / 183
7.3. Wind Etiology and Leprosy / 189
7.4. Wind Etiology and Malaria / 191
7.5. Dampness, Cold, Heat, and Dryness / 194
8. Diseases / 198
8.1. Lifestyle and Prevention / 198
8.2. Ontological and Functional Views / 200
8.3. Disease Terminology / 201
8.4. Malaria / 206
8.5. Cough / 209
8.6. Lower Back Pain / 211
8.7. Limpness / 212
8.8. Block / 217
8.9. Recession / 222
8.10. Somatopsychic Diseases / 227
8.11. Beyond Conceptualization / 234
9. Examination / 241
9.1. General Principles / 241
9.2. Inspection / 247
9.3. Inquiries / 251
9.4. Three Sections and Nine Indicators / 252
9.5. Empirical and Conceptualized Prognosis / 255
9.6. Vessel Diagnosis of Disease / 260
9.7. Conclusion / 264
10. Invasive Therapies / 265
10.1. The Concept of Invasive Intervention / 266
10.2. Bloodletting / 268
Unschuld,Huang Di nei jing 12/2/02 1:34 PM Page viii
10.3. Bloodletting to Treat Qi / 271
10.4. Misleading Piercing and Grand Piercing / 274
10.5. Genuine Qi Manipulation / 278
10.6. Morphological Piercing / 281
10.7. The Technique of Piercing / 282
11. Substance Therapies / 284
11.1. From Materia Medica to Pharmacology / 284
11.2. Pharmacotherapy in the Main Text of the Su wen / 289
11.3. Drug Qualities and Dietary Therapy / 294
11.4. The Dawn of Pharmacology in the “Seven Comprehensive Discourses” / 301
12. Heat Therapies / 313
12.1. Conceptual Levels prior to Vessel Theory / 313
12.2. Cauterization and Vessel Theory / 315
vi. epilogue: toward a comparative historical
anthropology of medical thought
1. The Su wen:Document of a New Style of Thought / 319
2. Social Facts, Worldviews, and Medical Ideas: Parallel Structures / 325
3. Philosophical Key Terms in a Medical Context / 338
4. Conclusion / 348
notes / 351
Appendix / 385
the doctrine of the five periods and six qi in the
huang di nei jing su wen
bibliography / 495
index / 503
Unschuld,Huang Di nei jing 12/2/02 1:34 PM Page ix
prefatory remarks
This book is a study of the Huang Di nei jing su wen¿“∫g¿›(Su wen),
an ancient text that, together with its sister text, the Huang Di nei jing ling
shu ¿“∫gFœ (Ling shu), plays a role in Chinese medical history com-
parable to that of the Hippocratic writings in ancient Europe. Progress and
significant paradigm changes have reduced Hippocrates to the honored origi-
nator of a tradition that has become obsolete. In contrast, many practitioners
of Chinese medicine still consider the Su wena valuable source of theoreti-
cal inspiration and practical knowledge in modern clinical settings.
Available evidence suggests that at the basis of the Su wenis a layer of texts
written beginning in the second or first century b.c., with some of its con-
ceptual contents possibly dating from the third century b.c.Presumably in
the first or second century a.d., several compilers or teams of authors, all
unknown to us today, set out to bring together disparate texts of previous
decades, thereby generating a second textual layer, to which were added
further layers in subsequent centuries. The outcomes of these more or less
contemporary efforts to combine a selection of statements and texts from
an identical pool of writings by numerous previous authors in one author-
itative compilation have come down to us in four major works: in addition
to the Su wenand the Ling shu,the Nan jingand the Huang Di nei jing tai su
(Tai su).
Although the Su wen corpus has so far escaped all attempts at recon-
struction, scholars agree that it was subjected to significant rearrangements,
emendations, and additions in post-Han centuries, culminating in the con-
tributions by Wang Bing in the eighth century. The Imperial Editorial Of-
fice of the eleventh century decided to introduce only minor editorial
changes, so that the corpus available today essentially reflects the text that
existed twelve hundred years ago.
ix
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x prefatory remarks
Hence the importance of the Su wen as a source of ancient Chinese in-
tellectual history lies in its formative period of about one thousand years; it
offers invaluable data on cognitive dynamics in ancient Chinese medicine
and knowledge of nature. Reading the Su wen not only increases our un-
derstanding of the roots of Chinese medicine as an integral aspect of Chi-
nese civilization. It also provides a much needed starting point for serious
and well-informed discussions on differences and parallels between Euro-
pean and Chinese approaches to existential threats such as illness and the
risk of early death. Such discussions are essential to an appreciation of the
cultural construct of illness and health in Chinese intellectual traditions; they
appear necessary in view of current political attempts to structure the co-
existence of Chinese and Western medicine either as competing or as com-
plementary paths in the unending quest for human health.
Nature, Knowledge, Imagery in an Ancient Chinese Medical Textis the first in
a multivolume publication of the results of the Su wenproject, which was car-
ried out with international cooperation at the Institute for the History of
Medicine of Munich University. The scope of the project was broad. It aimed
at preparing the first complete, philologically sound English translation of
the Su wentogether with a research apparatus that will be of help for future
work on this text.
I prepared a preliminary version of the translation to serve as a starting
point for an extensive collaboration with Hermann Tessenow. His philolog-
ical expertise contributed decisively to the result achieved, which will be pub-
lished separately in three volumes. In addition, Tessenow has conducted a
detailed analysis of the approximately three hundred fifty separate segments
constituting the historical and structural layers of the Su wen.The outcome
of this study also will be published in several volumes.
Because we have spent so much time with the Su wen,we have come to
realize the enormous complexity of its contents. There is no doubt that
just as we have adjusted our interpretation of many passages to an ever-
progressing understanding of the text, knowledgable readers will take issue
with the result and discover errors that we overlooked. Nevertheless, we be-
lieve that this translation represents a level of understanding that may be
considered a substantial contribution to a well-informed discussion of the
Su wenas one of the seminal documents of ancient Chinese culture.
In my attempts to penetrate the Chinese text and its historical context, I
have greatly benefited from Chinese and Japanese scholarship of previous
decades and centuries. The publication of annotated bibliographies of more
than three thousand articles by Chinese authors of the twentieth century, as
well as of more than six hundred monographs by Chinese and Japanese au-
thors of past centuries, will document the secondary sources I have used.
While our interpretation of the original is reflected in the English version,
Unschuld,Huang Di nei jing 12/2/02 1:34 PM Page xi
prefatory remarks xi
I have taken great care to quote as many consenting and dissenting Chinese
and Japanese views as was feasible.
Zheng Jinsheng of the Research Institute of Medical History and Medical
Literature of the China Academy of Traditional Chinese Medicine has
stayed with us in Munich several times for extended periods. He was of in-
valuable help in the compilation of the annotated bibliographies and of the
survey of the doctrine of the five periods and six qi, published as an appen-
dix to this volume. He also discussed with me the translation of discourses
66 through 74 and offered welcome comments.
In the early phase of the project, when PCs and electronic word process-
ing had just begun to play a role in our work, Rupprecht Mayer supplied us
with electronic versions of the Su wen, Ling shu,and Tai suand, in addition
to writing several search programs, designed the software required to com-
pile the concordances also to be published as part of this project.
Over the years, we received valuable support and technical assistance from
the following colleagues whose cooperation is gratefully acknowledged: Cui
Zhenhua, Donald Harper, Ursula Holler, Christine Hu, Frieder Kleemann,
Alexander Kossarev, Jürgen Kovacs, Franz-Josef Maaßen, Bernhard Sander,
Christian Schütz, Reinhard Vonthein, Yü Hong, and Zhang Tongjun.
The views I express in this volume are based on the translation of the Su
wenand on its structural content analysis. Its first, main part is an introduc-
tion to the meaning of the classical treatises of the Su wenas it was transmitted
before the Tang era, that is, treatises Su wen1 through 65 and treatises 75
through 81 in the textus receptus. I have surveyed and examined the his-
tory of this corpus, its reception throughout Chinese medical history, its view
of the normal and abnormal states of the human body, and the diagnostic
and therapeutic approaches advocated, and I offer a preliminary assessment
of the theoretical foundations on which these parts of the Su wenwere built.
An appendix to this first part introduces the doctrine of the five periods and
six qi (wu yun liu qi≠Bª) as it appears in Su wendiscourses 66 through
71 and 74, which were added to the original corpus by Wang Bing in the
eighth century.
All quotations from the Su wenin this volume are part of the translation
of the full text to be published in three subsequent volumes. For the most
part, the ample annotations on the meaning of individual characters and
entire passages accompanying the translation have not been repeated here.
Phrases in the quotations denoted by brackets [ ] are inserts required in En-
glish for syntactic reasons or to complete a statement from the source text
too concise to reveal its meaning in the target language without such inserts.
Parentheses ( ) indicate explanatory notes added by me. Curly brackets { }
denote statements in the Su wen tentatively identified as ancient commen-
taries on an older layer of the text. Double curly brackets {{ }} denote a sec-