Humanistic Spirit of Traditional Chinese Medicine (Key Concepts in Chinese Thought and Culture) 9819942721, 9789819942725

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Humanistic Spirit of Traditional Chinese Medicine Genhai Luo

Humanistic Spirit of Traditional Chinese Medicine

Genhai Luo

Humanistic Spirit of Traditional Chinese Medicine

Translated by Jiajun Chu

Genhai Luo Tianjin University of Traditional Chinese Medicine Tianjin, China

ISBN 978-981-99-4272-5 ISBN 978-981-99-4273-2 (eBook) https://doi.org/10.1007/978-981-99-4273-2 Jointly published with Foreign Language Teaching and Research Publishing Co., Ltd The print edition is not for sale in China (Mainland). Customers from China (Mainland) please order the print book from: Foreign Language Teaching and Research Publishing Co., Ltd. © Foreign Language Teaching and Research Publishing Co., Ltd 2023 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publishers, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publishers nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publishers remain neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Palgrave Macmillan imprint is published by the registered company Springer Nature Singapore Pte Ltd. The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore Paper in this product is recyclable.

Medicine should be invested with profound cultural foundation and warmth. To Traditional Chinese Medicine

Foreword: Towards a New Realm for TCM in the Twenty-First Century

The nature of Traditional Chinese Medicine (TCM) has always been fairly controversial. TCM is generally seen as a medical science discipline in ancient China with profound cultural foundation. A few years ago, some argued that “we should strip off the robe of philosophy with which TCM covers itself.” How wrong they are! It is the unique ancient Chinese culture that gave birth to the cultural symbol of TCM. Some 5000 or 6000 years ago, the Chinese civilization was evolving fast. A range of fields, such as philosophy, astronomy, geography, agronomy, literature, medicine, architecture, and military were emerging, developing, and subdividing. Disciplines complemented, collided, and mixed one another. Over the long course of development, they had evolved into respective disciplinary systems. I Ching (The Book of Changes ), Shi Jing (The Book of Songs ), Huang Di Nei Jing (Huangdi’s Classic on Medicine) and Shen Nong Ben Cao Jing (Shennong’s Herbal Classic), and Sun Zi Bing Fa (The Art of War) are recognized as representative works of philosophy, literature, medicine, and military affairs. These disciplines laid a solid foundation for ancient Chinese civilization and underpinned ideological and scientific support for social development. TCM is an integral part of ancient science. It contains valuable lessons that emanate from centuries of experience and wisdom, and incorporates the knowledge of other disciplines. It had established a theoretical system. In constant practices, the theories were unceasingly developed and gradually became perfected through revisions, supplements, and innovations.

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After prolonged development, TCM had developed its own features and advantages, and matured into a medical discipline with Chinese characteristics. As a treasured icon of Chinese civilization and the key to ancient civilization, TCM played an important role for the Chinese people to survive over generations in the land and stay healthy. To this day, other ancient medical systems in the world have faded out, and ancient Chinese technology has passed into history. TCM, which has lasted for thousands of years, is still overflowing with inexhaustible charms. It plays an irreplaceable role in medical treatment, hygiene, and health care. As the spectrum of disease changes and given the aging population across the world, tremendous changes are observed in people’s concepts of health and the medical model. TCM honors the ideologies and methods of harmony between heaven and nature, seeing vitality as visceral manifestation, preventive treatment of diseases, health preservation, treatment based on syndrome differentiation, and the prescription of drugs based on seven emotions. These ancient traditions have not fallen into oblivion. Instead, they represent the trend of modern medicine development. TCM, with a distinct advantage, plays a crucial role in China’s healthcare reform. As Chen Zhu, Vice Chairman of the Standing Committee of the National People’s Congress, said, “With the deepening of healthcare reform, new opportunities arise for TCM. The development of TCM provides momentum for healthcare reform.” The outbreak of COVID-19 pandemic has inflicted severe damages to the economy and social development of countries across the world. The health of their people is endangered. Under the leadership of the Party Central Committee, the Chinese people stand united in an effort to fight the pandemic, and they have chalked up a big victory. TCM, with early intervention and full engagement, is playing an important role at all stages. The Chinese solution to the pandemic is highlighted by the combination and conjunction of TCM and Western medicine. It has a significant impact both at home and abroad. The Covid-19 pandemic is a major public health emergency human beings have not been through. In the absence of vaccines and a specific drug, the Chinese people started to look into TCM, which has a history of several thousand years. With profound cultural foundation and good treatment compliance, it features safeness, effectiveness, and syndrome differentiation. The accessibility of TCM is a significant strategic advantage and the whole system is working well. China has implemented laws aimed at ensuring the rights of people

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to be informed of TCM and take part in relevant practices. They set out the line of defense against COVID-19. TCM has its spring in the new era. The Communist Party of China Central Committee and the State Council frame TCM as a priority for the renaissance of the Chinese nation. Policies and regulations are implemented, and vast sums of money have been earmarked to subsidize TCM for inheritance and innovation. By building hospitals, disseminating knowledge, promoting research, nurturing talents, and industrializing, TCM is expected to contribute more to the health of the Chinese people. Besides, the internationalization of TCM is gathering pace. People in all countries are getting used to and even embracing the theories and therapies of TCM. The reality is that Chinese acupuncture has expanded to 190 countries and regions. TCM is made into dietary supplements, health products, and drugs, which are being used on a huge scale in nearly one hundred countries. TCM is celebrated as another great contribution of the Chinese nation to human civilization. In the late twentieth century, Edward O. Wilson, Member of the National Academy of Sciences, published an article on Science offering his vision of scientific development in the new century. He noted that human beings were not only biological species, but also cultural species. We needed to consolidate natural science with humane studies to explore life. In 2014, Mr. Li Shenming of Chinese Academy of Social Sciences advanced the idea that life sciences didn’t fall under the category of natural science or social science. It should be a scientific category in juxtaposition with natural and social sciences. TCM fully demonstrates the combination of natural and social sciences. As Academician Wang Yongyan said, “TCM is an ancient medical science with biology as the basis and combining physics, chemistry and mathematics.” The theoretical system and clinical mindset of TCM reflect the profound cultural foundation of China. In diagnosis, it takes the four diagnostic methods (inspection, auscultation and olfaction, inquiry, and pulse-taking and palpation) as its principal techniques. By proceeding from the outside to the inside, inferring the interior from the exterior, analogizing and deducing with logical, philosophical thinking, TCM physicians master the overall conditions and changes of human body. By judging the yin-yang disharmony and the excess or deficiency of zangfu viscera, they develop specialized therapies combining acupuncture and moxibustion, medicine, massage, diet therapy, and qigong. By obtaining the balance of human body and the equilibrium of yin-yang, the patients

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return to bodily health. The understanding and grasp of human health, and diagnose and coordination to restore the balance, are a unique mode and mindset to stay healthy. Riding the wave of modern technology, modern medicine, under the directions of analytic reductionism, made dramatic advances, and genomics, proteomics, and molecular biology made fair progress. But in the process, reductive analytical science faced difficult challenges, which gradually produced systems biology. The partial and whole relations, and the microscopic and macroscopic combination, have opened a new frontier in life sciences and become a main trend. A few years ago, I said that the philosophy of TCM should combine with the technology of modern medicine. That’s definitely where medical science is going and would break new grounds in contemporary medicine. Tang Zhaoyou, Academician of Fudan University, noted, “The combination of the law of TCM and the technique of western medicine will bring about new prospects. We are convinced that it’ll help moving medicine forward and bring benefit to the people around the world.” Academician Chen Zhu emphasized, “Scientists should break up the barrier between TCM and western medicine, and combine the philosophies of the two. The new medicine of the twenty first century should absorb the merits of TCM and western medicine, and compensate for their weaknesses. It is a career worth working for.” TCM is deep but by no means mysterious. If we work hard at it, the discipline is entirely understandable. Many foreign students in our school work through the process of learning and have a good command of the underlying theories and therapies of TCM. These students practice medicine in their home country. TCM achieves effect on the treatment of many diseases and is popular among the locals. Students are expected to study hard on TCM. Some overseas students complain that the reciting and understanding are so difficult, and I would confess. To do well in TCM study, we need to really understand the Chinese culture, particularly the ancient Chinese culture. When we get to know thoroughly the characteristics of Chinese culture and its modes of thought, we may understand it all. Then many problems would be solved. As the poem reads, “How can it be so clear and cool? For water fresh comes from its source.” Humanistic Spirit of Traditional Chinese Medicine by Professor Luo Genhai is the companion volume of Cultural Background of TCM . From a Chinese cultural perspective, it explains the links between TCM and Chinese culture. Prof. Luo emphasized, “The Chinese culture features

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diversity and richness, and TCM is but one. My chief object in writing the book is to present TCM to people from all over the world who like Chinese culture.” The book features “TCM Culture vs. Master TCM Practitioners,” “The Cultural Versatility of TCM Doctors,” and “Cultural Dialogue between Chinese and Western Medicines.” In the selection of interesting articles, the profound TCM culture is introduced. They give an annotation to the “law” and “technique” of TCM, and the sophisticated philosophical, ethical, and humanistic connotations within. They also stress the prevention and preventive treatment of disease, the active preventive medical thought of life nurturing, and the advantages of innocuity and non-drug diagnosis and treatment. The profundity of TCM is achieved with breathtaking lightness for professionals and laymen alike. With fresh subject, rich contents, and plain language, it is a classic work for refined and popular tastes. As the author of the book, Prof. Luo has a solid foundation of traditional Chinese culture and a keen grasp of the secrets of TCM. Luo Genhai is a famous professor at Tianjin University of Traditional Chinese Medicine. Over the past 40 years, he has been studying and teaching classical literatures and culture of TCM. A dozen years ago, he pioneered the “Humanities Lecture Hall” of TCM which has been well-received by his students. Mr. Luo is a teacher with high moral character. He never seeks credit for himself, but is always ready to take on arduous tasks. He has made great contributions to the language discipline construction of the university, thereby laying a foundation for the establishment of School of Language and Culture and Traditional Chinese Medicine Media Center. Humanistic Spirit of Traditional Chinese Medicine is going to press, and I’m glad to be its first reader. I learnt a lot from the book and would like to commend it to you. This preface is written to show proper respect to the author. Guangdong, Tianjin, China

Zhang Boli Academician of Chinese Academy of Engineering, Honorary President of Tianjin University of TCM, Honorary President of China Academy of Chinese Medical Sciences

Author’s Preface---TCM as a Cherished Healing Art

In cherishing TCM as a healing art,1 we should show our respect to TCM, its practitioners, and medical staff in the battle against COVID19. This is the deepest tribute to all those fighting the disease and saving lives across the world. Their shining images are engraved on our minds. At the end of 2019 and at the start of 2020, the COVID-19 outbreak hit China. One day ahead of Lunar New Year’s Eve, Wuhan was “locked down.” Measures were implemented across the country for pandemic control. In order to control the pandemic, everyone was required to stay at home. This in fact presented a favorable opportunity for me to create. A beautiful piece of real-life “Anti Pandemic Hero Scroll,” which is composed of health workers going in harm’s way, Academician Zhang Boli, an elderly working in the frontline to combat this pandemic, the deliverymen and food delivery workers who have stood fast in their positions, and the volunteers with bravery and dedication in the face of the pandemic, is unfolding. They’re the major spiritual drivers for my creation. In the course of the national fight against the pandemic, the

1 See: Ban Gu of Eastern Han Dynasty: Han Shu· Bibliographical Treatise· TCM : “TCM

is the instrument to preserve life. It is a duty of the officials of the Son of Heaven.” Yi Zhuan· Xi Ci Vol.1: “Yi is to perpetuate the species.” Shang Shu· Main Law by Kong Yingda of Tang Dynasty: “Sheng sheng means living without end. With the change of yin and yang, the latter succeeds the former. Everything lives in eternity. This is what Yi implies.”

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composition and publication of this book are all about timing. And I hope that it can do what little could be done to assist this fight. “The sages are concerned about the matters of national significance. They think that nothing means more than life.” (Master Lü’s Spring and Autumn Annals· Invaluable Life). The most classic phrase on life is found in Invaluable Prescriptions for Ready Reference · Preface by Sun Simiao of the Tang Dynasty, which ran thus: “Life matters more than a thousand pieces of gold. Saving life is the most benevolent act a TCM physician ever performed.” Sun Simiao gave a concise and brilliant summarization of the connections between “life” and “gold,” and “gold” and the “moral character of TCM physician.” Referring to the topic of life nurturing, he said that people must, first and foremost, be “discreet.” Such behavior should be based on the “reverence” toward the world. Just like, when a scholar loses reverence, he would be blind to all forms of human decency; When a peasant loses reverence, his farm work would be left behind; When a craftsman loses reverence, he would forget the rules; When a merchant loses reverence, he would miss out the market; When the children lose reverence, they would neglect their filial duties; When the parents lose reverence, they would be despoiled of love…And lastly, we must show concern and reverence to life. It’s only in that way we are not in bondage to or offending any people. And we can put our own position in perspective.2 A consistent thread running through the worldview of a TCM physician is: valuing life, revering life, preserving life, and having the interests of patients at heart. Here’s what Compendium of Materia Medica· Preface to the Reprinted Version by Li Shizhen of Ming Dynasty says, “The ancient sages either serve as court officials or divinatory doctors. These are both noble undertakings.” The foreign sages were no exception. Now, let’s reel back to the time of Hippocrates. A man living in ancient Greece, Hippocrates was a famous physician who argued that all medical practitioners must

2 See: Xin Tang Shu· Biography of Sun Simiao: “To temper the mind, one must observe discretion, which is based on reverence. When a scholar loses reverence, he would be blind to all forms of human decency; When a peasant loses reverence, his farm work would be left behind; When a craftsman loses reverence, he would forget the rules; When a merchant loses reverence, he would miss out the market; When the children lose reverence, they would neglect their filial duties; When the parents lose reverence, they would be despoiled of love…And lastly, we must show concern and reverence to life. It’s only in that way we are not in bondage to or offending any people…”

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swear with most solemn oaths. To him, “Medicine is the most beautiful and noblest of all technologies” (Complete Works of Hippocrates · On the Laws ). “Doctors, simultaneously philosophers, are like gods. Medicine and philosophy are essentially the same, for doctors are credited with the same generosity of spirit of philosophers: lofty altruism, eagerness, and modesty…” (Complete Works of Hippocrates· On the Valuable Conducts ). This might be the most explicit argumentation to the relationship between philosophy and medicine, and between philosophers and doctors, ever. Both Sun Simiao of China and Hippocrates of Greece were symbols of “moral endowments and longevity.” The penetrations and emotional charges in the two models of doctors aroused a feeling of respect in the modern people! Working to keep on their heels, “we feel a continually increasing warmth and are stimulated”3 (Dai Liang of Yuan Dynasty: Lodges Built in Jiuling Mountain· Vol.10). If history tells us one thing, it is that the outbreak of the pandemic may, under peculiar conditions, lead the way for human beings. The Chinese people are fighting against the pandemic. This is a test of human nature, and an experience that matures us. It sets us thinking about the meaning of life, the shortcomings of our past mode of life, and the nature overburdened by our obsession with material. It is for us to work out how to live in harmony with nature. Anyhow, if we don’t learn the lesson from the pandemic, how are we ever to face those who give up everything in the battle against COVID-19? Currently, China is fighting against the pandemic. The Chinese solution is highlighted by deep TCM intervention in every stage. The book, titled Humanistic Spirit of Traditional Chinese Medicine, is designed to demystify the underlying cultural code of TCM in ideology and mode of thinking. We strive to improve the level of knowledge on TCM. I’d like to consider it as the companion volume of Cultural Background of TCM , my work published before, for your taste. I expect the moment of “attaining to the wisdom level of the medical sages in ancient times”4 to come along. To achieve what we set out to, I want to be original in approaching TCM. I’d like to forge a new path in the existent books on the culture 3 Translation: Working to keep on their heels, “we feel a continually increasing warmth and are stimulated. “激厉” equals “stimulated.” 4 See: Classified Classic· Preface by Zhang Jiebin of Ming Dynasty. It means “attaining to the wisdom level of the medical sages in ancient times.”

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of TCM. I change the stylistic rules and layout, so that the contents are closer to what Chinese culture actually is. While revealing history as it is, a fair amount of artistic modification has been taken, so that readers of different tastes can acquire new perspectives on TCM. The emphasis is to convey profound meanings through witty language. Gu Yanwu was a thinker living in late Ming and early Qing Dynasties. Addressing the topic of the methodology of cultural history, he argued that “when citing historical materials, scholars are supposed to have ‘qi shi’.” According to Mr. Zhang Kaizhi, “qi shi” is “the self-consciousness of the author on humanistic morality.”5 Creativity is the life and soul of a book. It is supposed to have a stand, which makes it expressive with marked traits. In describing things, the book tries to convey a sense of immediacy with language. The sentences are beautifully written, soaring with literary grace featuring “tiger head,” “leopard tail,” and “pork tripe,” to add to its readability. To convey a historical sense and express the need to belong, the book is written from three perspectives: “TCM Culture vs. Master TCM Practitioners,” “The Cultural Versatility of TCM Doctors,” and the “Cultural Dialogue between Chinese and Western Medicines.” It features humanistic, visual, and profound stories in the history of medical culture. Each chapter begins with a guidance to reading to deepen appreciation of readers and their engagement. Mr. Jianmin Li is currently working in Academia Sinica, Institute of History and Language, in Taiwan, China. In Life and Medical Treatment· Introduction, he noted, “I have always set my mind to the history of ‘canon’ of ancient medicine. Canon is the model text of a discipline.” With that in mind, I would follow through on the wise research experience. Each chapter features carefully selected “model texts.” Second creations are made to give a panoramic introduction to TCM, and the wisdom, history, and text-based medical system within. I believe that the key to success is the determination of model based on the purposes of research and writing. Referring to the ways of reading, the ancient sages said: “classics are the longitude, and history is the latitude.” “A scholar must know classics and history, which are useful knowledge” (Jing Yuan Jin Yu, by Shen Hanguang of Qing Dynasty). Following in the footsteps of ancient sages,

5 Zhang Kaizhi, Gu Yanwu, Beijing: Zhong Hua Book Company, 1982.

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I make an effort to combine classics with history to add to the readability of the book. This is what I set out to do. To make the book more informative, the special column “TCM Concept” is featured at the end of each article. I want it to be a way to introduce terms related to the culture of TCM. In writing the culture of Chinese witch doctor, I took notice of The Golden Bough, a classic work of anthropology written by Englishman J. G. Frazer (1854–1941). I was fascinated by a few rows of commentary words written on the title page of the book.6 Isn’t that the popular and shared goal of I and the leaders and editors of FLTRP? “The Golden Bough, elegantly written, talks at length about the customs around the world. The opinions and comments are so intriguing that the book is emitting the flame of wisdom. The contents are by no means cliched or tired. Readers would develop a genuine affection for the interesting book.” “An old dragon still calls the rain. An old tree still blooms in spring” (Gu Yanwu: Ode to Virtuous Fu Shan 2). Such intelligence is beyond me, but I should have the courage to emulate, especially when the purpose and requirements of writing are so clearly defined. During the period of epidemic control, I’m shut up in my house where I do my creation. All is well and good, with many people bearing the burden. We must participate actively in fighting the disease, which is our top priority. Writing this book is a toil, but a happy one. It seems to illuminate the way for me to carry out this great ideal. The poems of Yuan Mei are the manifestation of “emotion,” “learning,” and “spirit.” The famous scholar in the Qing Dynasty argued that “We can’t live without the ancient people for one moment; and there could not be ancient people in our writings. We can draw experiences in our lives with them and be creative in our writings without them” (Criticism of Poetry from the Garden of Leisure Vol.10). Wish things would turn out like this, for ancient and modern to borrow from each other. Let the “Master TCM Practitioners,” “TCM Doctors,” and the “Pioneers Blending Western Medicine and TCM” go beyond time and space and appear before us together. We are going to put on a lively show of TCM. Tianjin, China April 2020, Jiayi Apartment

Genhai Luo

6 The version I read is published in 2006 by the New World Press. Translators: Xu Yuxin, Wang Peiji, and Zhang Zeshi.

Acknowledgments

I’m extremely grateful to FLTRP for her trust, support, and encouragement when I wrote the book. In the fight against the COVID-19 pandemic, health workers and volunteers bore the heavy burden of ensuring the health of people. They allowed the space for me to create and spark off the illumination in my mind. My sincere appreciation to the members of my family, Gu Xiujun, Luo Meng, and Cao Qingguo, whose efforts in manuscript printing, revision, and data verification made possible this work. I’d like to thank Mr. Zhang Boli, Academician of Chinese Academy of Engineering, and Honorary President of Tianjin University of TCM, for making time in the midst of his busy schedule to pen the preface for the book.

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Prologue: The Amazing Culture of TCM

China is an oriental great civilization with five thousand years’ history and long-standing culture. It is put at the top of the rankings for UNESCO World Heritage Site of material cultural heritage and intangible cultural heritage. A variety of academic thoughts on different levels have shaped the culture of China. TCM culture, as an important part and a major branch of the Chinese culture, possesses rich cultural implications. It is a treasure chest to be excavated and enjoyed by us, and we’re bound in duty to embrace and rekindle TCM for the well-being of people. TCM is in the sense of both “law” and “technique.” As an institutional culture, it had been the duty of court officials. The acupuncture and moxibustion therapy and the science of processing Chinese materia medica are inscribed on the List of the Intangible Cultural Heritage. TCM is the native wisdom of China for well-being, and a treasured icon of the country. Inclusion, practicability, speculation, comprehensiveness, and artistry are the most salient humanistic features of TCM culture. To gain an insight into the humanistic implications of TCM, we must trace its root. First, we need to figure out the formation, evolution, and development of Chinese culture. In the preface to Records of Han-learning Masters , Mr. Zhou Yutong, an expert in the history of Confucian classics, put forward that the evolution of Chinese culture could be split into three periods. The first period, which lasted from the remote antiquity to the Spring and Autumn Period and the end of the Warring States Period (early third century BC), can

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be characterized as the period of the origin and emergence of indigenous Chinese culture. The second period, which lasted from the Qin Dynasty to the late years of Ming Dynasty (mid-seventeenth century), can be characterized as the period of cultural mixing between China and India. The third period, which continues through the late years of Ming Dynasty to this day, can be characterized as the period of China’s embracing the cultures of the west.1 Huangdi’s Classic on Medicine (aka the Inner Canon), “was basically created in the Warring States Period. Some parts of the book consist the contents of the Han Dynasty. We can tell that it was not written by the same people.”2 Mr. Ren Yingqiu, a famous contemporary medical history philologist, compared Huangdi’s Classic on Medicine with Rites of the Zhou Dynasty, a pre-Qin classic, and drew one conclusion: “It appears that Rites of the Zhou Dynasty talks only briefly, while Plain Questions talks at great length. After all, the former is not a medical book, while the latter is. Although the focuses of the two books are different, their theoretical bases are consistent.”3 So, there is little dispute that Rites of the Zhou Dynasty and Plain Questions are classics of the Warring States Period. Huangdi’s Classic on Medicine focuses on a broad range of topics, such as ancient philosophy, astronomy, ethics, life nurturing, and biology. With literary references to 21 ancient medical literatures, Mr. Ren Yingqiu tracked the date of its composition. He revealed a clear evidence that the book was nurtured by the splendid Chinese culture, because the famous doctors in ancient times were mostly cultured people. “Huangdi’s Classic on Medicine has cited many ancient documents. Notably, Plain Questions, the bulk of which is lost in the mists of antiquity, is an honorable

1 See: Records of Han-learning Masters , written by Jiang Fan and annotated by Zhou Yutong, Commercial Press, All-Encompassing Library version, 1933, pp. 1–2. 2 Ren Yingqiu and Liu Changlin: Research Treatise of the Inner Canon· Ten Lectures on the Study of Huangdi’s Classic on Medicine, Hubei People’s Press, 1982: 19. 3 Ibid., p. 11.

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estate.”4 It follows from this that the theoretical system of TCM represented by Huangdi’s Classic on Medicine was formed and established in the interim period between the first and second phases in the evolution of Chinese culture. It was built on the foundation of the brilliant traditional Chinese culture, and tended to coincide in timing. Therefore, the traditional Chinese culture is inherited like blood and genes by the TCM theory and nourishing the latter. They share the same context. Mr. Zhou Yutong believed that “For more than 2000 years from the Western Han and Eastern Han Dynasties to the late years of Qing Dynasty, the ‘Han learning’ and the ‘Song learning’ had been placed firmly in the mainstream of academic circles.” “Besides, the ‘Han learning’ and the ‘Song learning’ had been characterized by classical study and ontological study.”5 ’The publication of Huangdi’s Classic on Medicine represents the establishment of the integrated theoretical system of TCM. In the course of development, TCM had accumulated a rich store of experiences and became popular. Medical classics were churned out. TCM at this time was consistent with Han-learning in the mainstream, which was characterized by classical study. With the rise of Song-learning, a variety of TCM schools were derived. The emphases of these schools were different, such as clearing away fire, purgation, invigorating the spleen and stomach, and nourishing yin, but they never strayed far from the central “law.” We should never underestimate the influence and penetration of social culture and life on medicine in this period. For instance, Zhu Zhenheng, a figure of the yin-nourishing school, had studied the theories of morality and destiny with Xu Qian in his earlier life. Xu Qian was the fourth-generation disciple of Zhu Xi (styled Yizhi), representative of the inductive school of Song-learning. As his mother suffered from spleen disease later, Zhu Zhenheng abandoned his studies for the Imperial Examination and took

4 Ibid., p. 26. 5 See: Records of Han-learning Masters , written by Jiang Fan and annotated by Zhou

Yutong, Commercial Press, All-Encompassing Library version, 1933, pp. 6–9.

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up medicine. We would have to say that Zhu Zhenheng’s solid background of Song-learning had spurred him to shape his personality and foster a creative spirit in his carrier as a doctor. The third period features the collision and merging of Chinese and Western civilizations. With improved transport links across the world, the processes of “Western learning spreading to the East” and “East learning spreading to the West” were growing in frequency. The western missionaries, to cater to the emotions of the Chinese people, combined missionary work with curing diseases. They vigorously promoted Western culture through medicine. In the meantime, TCM was widely disseminated in the world, changing the old stereotypes of the westerners toward the technique. In the cultural exchanges between China and the west, some wise men pioneered the innovation of TCM to demonstrate the inclusiveness of the technique. The kind of culture a nation has determines the kind of medicine it’ll get. Culture is the inward factor in medicine. There are several features of TCM culture. 1. TCM is the cultural attribute combining “law” and “technique.” What is “law”? In the early stage of Chinese civilization, the “law and technique” theory was first propounded. Our ancestors believed that “law” fell into the category of philosophy. “Law” was universal and it asserted dominance over “technique.” “Law transcends the physical form, while technique goes under the physical form” (The Book of Changes · Xi Ci 1). “Of all techniques, medicine is most important” (Wang Ang6 of Qing Dynasty: Medical Formulas Gathered and Explained· Preface). Among the Three Oldest Books in the remote antiquity, “Huangdi’s Classic on Medicine is in a sense holy” (Yuan Mei of the Qing Dynasty: A Letter to Xue Shouyu). Here’s what Invaluable Prescriptions for Ready Reference Vol.1 by Sun Simiao of the Tang Dynasty says, “We should convey the philosophy of TCM to those who are meticulous.” “The practitioners of 6 Wang Ang (1615–1695), a physician in the late Ming and early Qing Dynasties.

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‘law’ are supposed to understand the ways of the heavens, the logic of the earth, and what’s happening in the world” (Huangdi’s Classic on Medicine· Plain Questions· On Qi Alternation 69). The philosophical contemplations of TCM and the disciplines it deals with prove a point: “Law” is no simple thing for technique to fulfill. It would not be a stretch to say that law is “extensive and profound.” Simply going into the “techniques” of TCM—the most superficial of TCM culture, is obviously not enough. 2. TCM embodies the development and good practice of medical industry in China. The benevolent mind and the sentiment of humanistic care of TCM doctors are found in the details throughout the curing process: from diagnosis to treatment, from preventive treatment to life nurturing, and from “finding and treating the root cause of an illness,” “treating the same disease with different therapies” and “treating different disease with the same therapy,” to the pharmacological theories—principal (jun), adjuvant (chen), assistant (zuo), and guide (shi). With its own unique humanistic features, TCM is one of the earliest, longest-standing, vastest, and most comprehensive national medicine systems in the world. Without TCM, the Chinese people couldn’t have survived for thousands of years in the land. 3. TCM is an important part of modern medicine, embodying the ideology of human civilization. The lack of TCM is going to disintegrate modern medicine. According to The Uses of Cultural Studies by Angela McRobbie, professor at Goldsmiths, University of London, “The contemporary value of cultural studies lies in helping us to better understand the world around us.”7 Studying TCM culture is the easiest approach to give us an insight into the “harmony in diversity” between Western medicine, TCM, and ethnic medicine, and the roles they play in protecting the health of people around the world.

7 The Uses of Cultural Studies · Translator’s Preface, written by (British) Angela McRobbie, translated by Li Qingben, Peking University Press, 2007, p. 2.

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Admittedly, TCM is the product of agricultural civilization deeply rooted in China. As social productivity in those days was undeveloped, “the Chinese people relied heavily on their instincts to understand the secrets of nature and human body.”8 In light of this, the results of modern science development have to be incorporated into TCM. The new findings of “law” at the philosophical level have fueled the development of TCM, like what had happened to the latter in the ancient times. Just as we’re not going to criticize our ancestors for cladding in robes and crown suits because we’re wearing modern clothes. But such dressing should have aesthetic value and the significance to be passed down. Looking at history in isolation is an unscientific idiocy. As an inexorable law, everything is unceasingly developed and gradually perfected. In its nascent stage, TCM had been negated. Take the TCM appellation for example, TCM had been through the course of “negation of negation”, by which the trajectory of its evolution and development were indicated. Medicine originally fell under the category of “arithmetic” in the “six arts.” Arithmetic, aka technique, incorporates the philosophy of the promotion, restriction, and transformation of yin and yang, and the five elements. When it first became the duty of the officials of the Son of Heaven, medicine was called “fang ji,” which fell into the category of “technique.” In the Han Dynasty, “technique” was separated from “art” and had been synonymous with medicine. By the Sui and Tang Dynasties, TCM had evolved into an integrated theoretical system of doctor, medicine, prescription, and pulse. The art and the technique of TCM went their separate way, and the former was no longer in the mainstream of medicine. TCM doctors began to address medicine9 as the “art of healing” or the “physician’s skill,” and non-medicine was stripped out of the medical system. Having received much cultural nurturing, TCM was “purified.” I consider that such “self-purification” will carry on. We have

8 See: The Chinese, written by Lin Yutang, translated by Hao Zhidong and Shen Yihong, Xue Lin Publishing House, 1st edition in December 1994, p. 101. 9 See: Essential Secrets from Outside the Metropolis · Preface, Beijing, People’s Medical Publishing House, 1955.

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laid a good foundation and have the confidence to keep TCM culture alive. When he evaluated the qualities of “writing” and “researching,” Yuan Mei of the Qing Dynasty noted, “Composition of books began with the six classics in the three dynasties, while textual research began with commentaries in Han and Tang Dynasties. The date of the classics was investigated and their quality was identified. Books are like streams merging together into rivers and seas, while textual research is like fire, and we’ve to put the firewood on it. ‘The authors are known as the saints’ because of their texts; ‘Narrators are known as the enlighteners’ because of their textual research.”10 Mr. Zhang Shunhui living in the modern times believed that “For thousands of years, there have been very successful textual research works of the same weight as the original works”.11 Zhang’s argument is well founded from a historical perspective. The Bloomsbury Companion to Contemporary Philosophy of Medicine, published in 2017 by Bloomsbury Publishing PLC, carries profound implications for medical philosophy research and education in Europe and America. James Marcum, editor in chief of the book, noted in “Part I Introduction” that “modern medicine and its practices are essentially defined by pluralism. The book is designed to reflect this pluralism.”12 We may suitably regard pluralism as a trend of research in this field across the world and pay our attention to it, and incorporate China’s research related to this field. After all, the research methods of medical philosophy go beyond national boundaries. As Zhu Xi of Song Dynasty says in his Comment on Books, “How can it be so clear and cool? For water comes fresh from the source.” Drawing on 10 Notes on Poetries Composed in Suiyuan Garden (Full Translation) ·Vol. 6, by Yuan Mei

of the Qing Dynasty, translated by Tong Fengchang, Xining: Qinghai People’s Publishing House, 2004: 95. 11 Zhang Shunhui: Proofreading Methods of Ancient Chinese Historical Records · Chapter II , Shanghai: Shanghai Classics Publishing House, 1980: 199–200. 12 See:

Towards Diversification and Integration: Comments on The Bloomsbury Companion to Contemporary Philosophy of Medicine, Medicine and Philosophy, Vol. 40, Issue 1, 2019 (Total Issue 612), pp. 17–20.

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Fig. 1 Diagram of Cinnabar Processing

the age-old Chinese wisdom, TCM is making steady progress to take the leap from experience-based medicine to modern medicine. In the prevention and treatment of COVID-19, much is accomplished by TCM, which enables us to see the first glimmer of hope for overcoming the pandemic (Fig. 1).

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March 2020 References: [1] Angela McRobbie: The Uses of Cultural Studies [M]. Translated by: Li Qingben. Beijing: Peking University Press, 2007. [2] Jiang Fan: Records of Han-learning Masters 1 [M]. Annotated by: Zhou Yutong, “All-Encompassing Library” version. Beijing: Commercial Press, 1933. [3] Jiang Fan: Records of Han-learning Masters 2 [M]. Annotated by: Zhou Yutong, “All-Encompassing Library” version. Beijing: Commercial Press, 1933.

Contents

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TCM Culture vs. Master TCM Practitioners Reader’s Guide Balance Orientation: The Golden Mean in TCM Context Tips TCM Concept: Five Operations and Six Vital Energies: The Yin and Yang of Heaven and Earth Disentanglement from Witchcraft: Contributions of Bian Que Context Tips TCM Concept: The Small Universe in Life Master TCM Doctors Inspired by Filial Piety Context Tips TCM Concept: Hanging A Gourd to Heal the Mankind Human Orientation: The “Medical Pattern” of TCM Context Tips TCM Concept: The Germination of TCM—The Age-Old Chinese Wisdom for Health The Cultural Versatility of TCM Doctors Reader’s Guide Medicine and Music: The Life Regimen of Guqin Players Context Tips TCM Concept: Authentic Herbs, the Extracts of TCM The Common Pursuit for Excellence: Literati and TCM Doctors

1 1 5 5 22 24 24 35 37 37 47 49 49 63 65 65 67 67 78 80 xxxi

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CONTENTS

Context Tips TCM Concept: Differentiated Treatment by Stage: Repaying Debts of Gratitude by “Weaving Grass” Master TCM Doctors: Therapeutic and Calligraphic Prowess Context Tips TCM Concept: Medical Prescription: A Unique World of Calligraphy TCM as a Compassionate Medicine Context Tips TCM Concept: Bell Doctor, the Doctor of People 3

Cultural Dialogue Between Chinese and Western Medicines Reader’s Guide An Adventure beyond Classic Teaching Emboldened by Kindness Context Tips TCM Concept: Confucianism and TCM Doctors Relay Run in Transnational Prevention of Smallpox Context Tips TCM Concept: Intervention before the Onset of Symptoms Vital Energy in the Genetic Perspective Context Tips TCM Concept: Terminal Diseases The Revival of Acupuncture and Its Spread to the West Context Tips TCM Concept: The Practice of Acupuncture

Index

80 89 90 90 104 106 106 115 119 119 123 123 131 132 132 141 143 143 156 157 157 169 171

List of Figures

Fig. 1.1 Fig. Fig. Fig. Fig. Fig.

1.2 1.3 1.4 1.5 2.1

Fig. 2.2 Fig. 2.3 Fig. 3.1 Fig. 3.2 Fig. 3.3

The restoration of the Guide Map unearthed in Mawangdui Han Tomb The Golden Mean annotated by Zhu Xi Illustration of Tai Chi by Zhou Dunyi Gourd, the utensil containing medicine in ancient China Pattern of Huangdi’s Classic on Medicine Photocopy of illustrated manual of acupuncture points of the bronze figure Mozi’s Book of Songs (part), the calligraphy work of Fu Shan A corner of TCM pharmacy Uomo Vitruviano, Da Vinci’s work on human proportion Xu Lingtai Medical Treatise Six Books written by Xu Dachun The medicinal properties of herbs identified by the ancient people

3 10 11 48 55 93 101 117 129 146 154

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Reader’s Guide Ever since Emperor Wu of the Han Dynasty took the advice of Dong Zhongshu of “paying supreme tribute to Confucianism while rejecting all other schools of thought,” Confucianism became the dominant thought of governance and evolved into the Confucius thought. As a matter of fact, Confucianism and Taoism were inseparable on many occasions. When metaphysics acquired ascendancy in the Wei-Jin period (220–420), “Taoism was incorporated into Confucianism,” with “Confucianism and Taoism complementing each other.” The Book of Changes , Laozi, and Zhuangzi—the “three profound studies,” took the place of Confucianism, and social thoughts were diversified. In the Wei-Jin and Southern and Northern Dynasties, Buddhism rose in popularity in China, and Zen was the most Sinicized Buddhist sect. Characterized by “Inner Transcendence,”1 Zen was gradually integrated with the Confucian and Taoist cultures and had been embraced by the Chinese intellectuals. By the Tang Dynasty, the integration of Confucianism, Taoism, and Buddhism gained momentum, which had a profound influence on the spiritual pursuit of the intellectuals and the social culture of China.

1 See: Yin Shun: History of Zen Buddhism in China · Preface, Jiangxi People’s Publishing House, 1999: 2.

© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023 G. Luo, Humanistic Spirit of Traditional Chinese Medicine, https://doi.org/10.1007/978-981-99-4273-2_1

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When it comes to the combination of Confucianism, Taoism, and Buddhism cultures, Sun Simiao, a formula expert of the Tang Dynasty with high medical ethics, is most noteworthy. As a great scholar-physician, Sun Simiao held the principle of the Confucianists—a benevolent mind and heart. He objected to the showing off of feats and talents, an approach that he believed was such a dramatic break from the concepts of “loyalty” and “forbearance.” He despised the TCM doctors who prescribed rare medicine to wealthy patients and kept them going from place to place in search of the medicine. Sun Simiao baked the philosophies of the Taoist school, such as the way of Karma, into medical practice, and advised doctors to build professional ethics. In respect of Buddhism, Sun Simiao maintained that doctors were supposed to “show profoundest compassion and kindness” toward patients. They must strive to relieve the suffering of patients. They must treat all patients equally and look upon them as family, disregarding their fortune, age, appearance, relationship, nationality, and intelligence. Sun never used living creatures for medical purpose. He didn’t even use eggs except when he was compelled to do so. As a great doctor, Sun Simiao brought about the humanization of TCM with his people-centered philosophy.2 The evolution of TCM suggests that: TCM, which is deep rooted in the traditional Chinese culture and the Sinicized foreign cultures, is an aboriginal, special form of culture. Cultures of all sources appeared just the same to TCM, but for their difference in scope, breadth, origin, and extensibility. TCM doctors, or more accurately, scholar-physicians, are characterized by “law” manifested in the forms of Confucianism and Taoism. “The Confucianists possess the power of communicating with heaven, earth and man. The technicians possess the power of communicating with heaven and earth. The medical technicians have been actually dealing with the affairs of the Confucianists” (Li Yi of Song Dynasty: Rectified Version of Huangdi’s ABC Classic of Acupuncture and Moxibustion · Preface). In the context of traditional Chinese culture, the “Law” of Confucianism, as the conduct of life and to be a man, should never be

2 See: Invaluable Prescriptions for Ready Reference· Vol. 1 by Sun Simiao of the Tang Dynasty, photocopy of the Song version by People’s Health Publishing House, 1955.

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passed unnoticed. On the other hand, the “Law” of Taoism is essential for practicing medicine. “Law” is both a prerequisite to transform from a Confucianist to a scholar-physician, and the reflection of TCM characteristics on scholar-physicians (Fig. 1.1). Celebrated TCM doctors who honored the “Law” had been trained in Confucianism. For instance, Chun Yuyi was called “Saint Confucianist”—Confucian scholar honorning the way of the saints, by his teacher Gongsun Guang. Hua Tuo “made a study tour to the land of Xu, and he mastered many classics.” They included the Confucian classics. “Study tour” was a way for the Confucianists to seek after the “Law.” Huangfu Mi “acquired through extensive reading the knowledge of a hundred schools.” As an avid reader, he argued that “If a man in the morning hears the right way, he may die in the evening without regret.” As the “lecturer of the princes,” Tao Hongjing “read an awful lot, and he had a knowledge of guqin, chess, and calligraphy.” Nurtured by the ideology of Confucianism, these people had cultivated various attainments. For instance, Chunyu Yi was a master of divination (Historical Records · Collected Biographies of Bian Que and Chunyu Yi) and medicine. Hua Tuo was “a master of the technique of spirit nurturing” (Chen Shou of Western Jin Dynasty: Three Kingdoms Annals· Wei Shu· On Medical Technique), and he preferred the art of medicine. Huangfu Mi thought

Fig. 1.1 The restoration of the Guide Map unearthed in Mawangdui Han Tomb

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that “Without knowing medicine, one hasn’t lived” (Huangfu Mi of Jin Dynasty: The A-B Classic · Preface). “When he was ten, Tao Hongjing chanced to read The Tales of Immortals by Ge Hong…and he aspired to go into life nurturing” (Li Yanshou of Tang Dynasty: The History of Southern Dynasties · Biography of Tao Hongjing ). TCM doctors, who were also great scholars, were hardly alone. They had some common features in their medical career. Medical model, medical science, doctor, and medical skill, the four essential ingredients of medicine, are interconnected and inseparable, with a mutual influence between them. With or without physical form, they would all be displayed in the medical procedure and be judged by everyone including the implementer. It is the culture by which the medicine is nurtured that supports the latter. The doctors heal the patients and they are the nearest to benevolence. Bringing people back to health, back to life are the most benevolent acts they ever performed. Their merits are equal to those of nature that creates and nurtures all life, and beyond the emperor who plots great achievements of all things.3 All in all, they wield the skills4 to make life healthy and sustainable. Based on the belief, this chapter begins with an exploration of the development model of TCM, premiering the sentiment of humanistic care in medicine. Afterward, it comes to the reflections on the theoretical characteristics of TCM, which shall serve as the main line to open the window of TCM humanism. Speeches of leading figures in the history of TCM are quoted to elaborate from multiple perspectives the great wisdom and cultural implications of “recuperate and exercise by observing the correct healthcare methods,” “fixing yang outside to keep yin inside,” “conserving energy and nurturing essence” “balance of the five tastes” as well as “harmony of body and spirit,” with the purpose of guiding all “medical enthusiasts” into the TCM cultural hall. At the end of this

3 See: New Materia Medica · Preface by Kong Zhiyue of the Tang Dynasty: “Bringing people back to health, back to life are the most benevolent acts they ever performed. Their merits are equal to those of nature that creates and nurtures all life, and beyond the emperor who plots great achievements of all things.” See: photocopy of Anhui Science and Technology Press, 1981. 4 See: Han History · Bibliographical Treatise · The Technique of Medicine by Ban Gu of the Eastern Han Dynasty, corrected version, Zhong Hua Book Company, 1959.

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chapter, two essays are devoted to the origin and development of ancient witchcraft and to the characteristics of filial piety as the Chinese healer. “From gui and ju, we are reminded of Lu Ban; From arrow, we are reminded of Hou Yi.”5 To tell the Chinese story, we should trace the origin of our country. April 14, 2020

Balance Orientation: The Golden Mean in TCM Context Tips “Going too much genders disaster,” “going too much genders harm”— lessons of history; Review of the theory of the “Four Great Masters” in Jin and Yuan Dynasties by TCM doctors of Qing Dynasty based on the balance of yin and yang; The rich cultural implications of the “Golden Mean”; Yin-yang and five elements in Taiji Creation Theory; The difference of “Yi” manifestation and “poetic” manifestation in the “manifestation” thinking; The “Five Operations and Six Vital Energies” and “19 mechanisms of pathological changes”; The concept of “harmony”; “Balance medicine.” Golden mean, the great cause of heaven and earth. Harmony, the great path of heaven and earth. —The Golden Mean · Chapter 1

By studying, observing, and experiencing, people find that TCM falls under the category of the “Golden Mean Medicine” and “Balance Medicine.” TCM embodies the philosophy of “neutralization” from the causes of disease, the mechanism of pathological changes, treatment, and life nurturing. In the field of theory, master TCM doctors had admonished before and after the publication of Huangdi’s Classic on Medicine that “going too much genders disaster,” and “going too much genders 5 See: Classified Medical Records of Distinguished Physicians · Author’s Preface by Jiang Guan of Ming Dynasty. Ban refers to Lu Ban, an ancient craftsman who was supposed to be the inventor of carpentry tools such as the bevel gauge. Hou Yi was rumored to be the leader of Youqiong clan of Dongyi ethnic group in the Xia Dynasty. He was a master shooter.

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harm.” Originally a statecraft, the idea was applied to the whole process of treatment of disease. In the Spring and Autumn period, Duke Ping of Jin was afflicted with the diseases of body and mind and he turned to the Qin state for help. Duke Jing of Qin sent a famous doctor named “Yi He” to give diagnosis and treatment. After inspection, auscultation and olfaction, inquiry, pulsetaking and palpation, Yi He said that the disease was not attributable to evil spirits or a poor diet. It was caused by the infatuation with women. The patient was bewitched and lost consciousness. He was beyond cure, even by the mandate of heaven. Duke Ping asked doubtfully, “Couldn’t I have sex with women?” Yi He replied, “It will be alright, but everything has to be done in moderation. Just as, the late emperor created music to moderate things. When the rhythm attained to harmony, the piece was done. If the performer didn’t stop it, the notes would become disjointed and left people dispirited. The obscene noise filling the ears would confuse the senses and disturb the mind, and the high-principled people were not going to listen to it. Music is like everything else, to which there must be a limit. If excesses are avoided, diseases would be deprived of the breeding ground. The high-principled people regulate their desire for women with etiquette, so that they would not be disturbed by the latter. Excess would result in disaster. To give another example, there are cloudy, sunny, windy, rainy, gloomy, and bright weathers in nature. If either sort of weather goes overly, people would fall sick. Excess cloud would cause cold syndrome; excess sun would cause heat syndrome; excess wind would cause limb diseases; excess rain would cause abdomen diseases; excess night activities would cause confusion diseases; and overwork and too much thinking in the day would cause heart disease. All in all, these are the harms of the excess of six qi.” Similarly, overindulgence would also cause diseases. Here’s an example of Liu Yuxi, a great poet of the Tang Dynasty. Liu was not a doctor, but he recorded a story which served as a warning for people: when being treated or taking medicine, patients should avoid “excess,” lest the diseases should relapse. Liu told the story of a gentleman by the name of Liu. When resigned from the post, he was stuck at home all day and didn’t exercise. The result was poor circulation of qi and blood, loss of appetite, and scorching pain in the body. A man referred a doctor with remarkable medical skill to Liu. After diagnosis, the doctor thought that the symptoms were caused by disordered life and improper diet and clothing. The doctor took out

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a case of pills and gave it to Mr. Liu, saying that the syndrome of stagnation would disappear and the healthy qi would be restored soon after taking the pills. Given the toxicity of the pills, the patient should stop taking them when he has recovered. Otherwise, the yin-yang balance of the body would be upset. Just as the doctor said, Mr. Liu had favorable prognosis after taking the pills. The symptoms disappeared very soon and he returned to health. One day, a person came to congratulate and he urged, “The medicine works! Why don’t you keep taking it to consolidate the effect?” Mr. Liu was bewildered and he mistook the liar for an expert. The obsession with curative effect and the distrust of the compassionate doctor misled him into taking another five days’ dosage. The consequence was, he was afflicted by the toxicity of medicine. Suddenly, Liu remembered the medical advice and he went to the doctor again. When he learned what happened, the doctor scolded Liu heavily, “That is as I have supposed.” He immediately concocted a dosage of antidote and let him take it. Mr. Liu had learnt a painful lesson from this error and he fully realized the implication of “soothing the nerves with harmony.” As Zhu Xi said, “Scholars should make new discoveries and break fresh ground over time. This is the way to make a success” (Analects of Zhu Xi). In the Qing Dynasty, the theories of the “Four Great Physicians” of the Jin and Yuan period were judged by the “Equilibrium Between Yin and Yang” in Huangdi’s Classic on Medicine. Liu Wansu of Hejian School argued in favor of the “heat and fire”; Zhang Zhongjing of the Classical Remedies School argued in favor of the “wind-cold pathogens”; Zhu Zhenheng of the Nourishing Yin School argued in favor of deficiency of yin; and Li Gao of the “Invigorating Spleen and Stomach School” argued in favor of deficiency of yang. The Qing people believed that these arguments were relative. They were designed to make up for the inadequacies of former theories without bias. People of later generations argued that Liu Wansu and Zhu Zhenheng had a preference for cold medicine to redress overly warm supplementation. Medicine must be prescribed within tolerable limits, or we’ll go to the extreme of intense warm supplementation. Therefore, the ancient people advised “hiding the heart in the abyss to harbor the linggen.”6 6 See The Book of Taixuan by Yang Xiong of the Western Han Dynasty. The original meaning of the sentence is “to live a refined life and have high moral sense.” Luo Mei, a famous doctor of the Qing Dynasty, used this phrase in Treatise on the Prescriptions of Famous Doctors in Ancient and Modern Times Vol. 4 (lithographic printing version of

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In fact, these analyses of cause of illness and methods of treatment have their roots in the age-old Chinese philosophical wisdom: “the golden mean.” Confucius said, “The golden mean should be the highest moral character! But there is a perpetual lack of such character in the common people” (The Analects of Confucius· Yong Ye). We can tell that the “golden mean,” which is at the center of the Confucianism philosophy, is the latter’s code of ethics and ideology. What is the “golden mean”? “Golden” means neither too much nor too little. It is the way of even-handedness and the right path of the world; “Mean” means application,7 the theorem of the world. The golden mean implies that people should be impartial in words and deeds, and conform to the principle of moderation. In the remote antiquity, when Yao abdicated, Shun succeeded him on the throne; when Shun abdicated, Yu succeeded him on the throne. This philosophy of country governance8 is the earliest manifestation of the golden mean. As a sage with great wisdom, Shun was ready to listen to people’s views. He repressed the bad and popularized the good. As to the extreme talk, he steered a middle course and took something of value from it. This is Confucius’ understanding of Shun.9 Obviously, Shun was an early sage strictly adhering to the “golden mean.” This idea was valued, followed, and inherited by Confucius, an ancient sage and the successor of the golden mean we can read about in history books. Once, Confucius’ student Zi Gong asked, “Who is better, Zi Zhang or Zi Xia?” Confucius replied, “Zi Zhang is going too far, and Zi Xia couldn’t keep up with the pace.” Zi Gong said, Jigeng Study, Ningbo, in the 3rd year of Xuantong of the Qing Dynasty [1911]), as a metaphor for warming yang from yin to flame up the vital gate fire. Linggen, originally meant the root and seedling of plant, is an allegorical way of expressing the source of the production and transformation (life gate fire). 7 “庸” and “用” are homophones with the same meaning. 8 See: Translation and Annotation of the Analects of Confucius · The Words of Yao 20 by

Yang Bojun: “Yao clicked his tongue and said, ‘Shun, you have the mandate of heaven! And demonstrate you’re worthy to rule. If your people are caught in an abyss of suffering, your position will be withdrawn by heaven forever.’ Shun said the same to Yu,” Zhong Hua Book Company, 1980, Second edition, p. 207. 9 See: Commentaries on the Four Books · The Golden Mean· Chapter VI by Zhu Xi of

Song Dynasty: Confucius said: “Shun was certainly a sage man! He often went straight to people with questions, and was clever in analyzing what lied behind the simple words. He never thought ill of anybody, and always mentioned other people with great commendation. He listened to praises and criticisms, and found the middle way for the people. This is what makes Shun a sage!’” Shanghai Gonghe Bookstore, 1910, p. 4.

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“Do you mean that Zi Zhang is better than Zi Xia?” Confucius replied, “Lagging behind is out of the question, but going too far is nearly as bad.”10 We can tell that Confucius’ principle of life is moderation and justness (Fig. 1.2). Generally speaking, there are three levels of meaning in the “golden mean.” First, as Confucianists’ attitude to life, the “golden mean” upholds the middle course without going too much or too little. “In neutralization, the heaven and earth will return to their positions, and everything will grow” (The Golden Mean · Chapter 1). Second, the “golden mean,” as a code of ethics, was tied in with human nature and morality by Zi Si, Confucius’ grandson. He considered that: “‘Middle’ is the fundamental law of the world; ‘harmony’ is the rule abided by everyone” (The Golden Mean · Chapter 1). By placing heaven, earth and everything where they are, the “harmony between human and nature” can be attained. What is the “universal path”? Zi Si considered that it was the combination of “learning, benevolence and the courage to admit error.” In the ethnic standard of the “golden mean,” honesty is the highest principle of humanity.11 Third, the “golden mean” is the way to think and act. As a highly applicable ideology, the “golden mean” is omnipresent and used widely. The “golden mean” has many connotations. To understand it and develop an insight into its metaphysical meaning, we are required to develop the unity of knowing and doing. The process requires constant practice. That’s the only way to master the “golden mean” and steer the right course. As an instrument for country governance, the “golden mean” was transformed into a TCM philosophy for “healing.” How did it manage to do that? And how was it transformed? To answer, we need to understand the cultural background of TCM and the similarities between the two disciplines.

10 See: Translation and Annotation of the Analects of Confucius · Advanced Learning 11 by Yang Bojun: “Zi Gong asked, ‘Who is the better, Zhuansun Shi (i.e. Zi Zhang) or Bu Shang (i.e. Zi Xia)?’ Confucius said, ‘the former is overreaching, while the latter fails to keep up.’ Zi Gong said, “So Zhuansun Shi is better, isn’t he?” Confucius said: ‘Overreaching is as bad as failing to keep up,’” Zhong Hua Book Company, 1980, Second edition, p. 114. 11 See: The Golden Mean· Chapter XX : “Sincerity is the principle of heaven, and pursuing sincerity is the principle of life.”

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Fig. 1.2 The Golden Mean annotated by Zhu Xi

1. In traditional Chinese culture, Tai Chi was the creator of everything. It was considered as the origin of the universe and the life science of TCM. Zhou Dunyi (1017–1073), founder of the Confucian school of idealist philosophy of the Song Dynasty, was a great thinker in illustrating the ancient Tai Chi philosophy. His expression on Tai Chi, which appeared later than Huangdi’s Classic on Medicine, supplemented what the book lacked. Zhou believed that

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“With the movement of Tai Chi yang is born. Extreme movement produces quiescence. With quiescence yin is born. Extreme yin produces movement. Movement and quiescence interact as both cause and effect. Yin and yang are the two polarities.” As to the five elements, Zhou believed that “The changes of yin and yang produce water, fire, wood, metal and soil. The qi of the five elements is distributed between heaven and earth according to the law of mutual generation in the four seasons. Five elements are the yin and yang; Yin and yang are the Tai Chi; Tai Chi had originally no polarity. The five elements are born according to their nature…The interaction of the two qi gives birth to all things on earth, which survive through the land in various forms. Humans are the pinnacle of existence with inseparable body and mind. The nature of the five elements (Qi) in the human body gradually interacts with the external environment, and is affected and changed by the external world, so the acquired concept of good and evil comes into being. Since then, all kinds of things in human society occurred (Fig. 1.3).” Zhu Xi made a philosophical analysis on Zhou Dunyi’s Illustration of Tai Chi and the “birth of all things.” He explained that yin and yang, the essence of Tai Chi, were the roots of each other. The system where the five elements contend and supplement each other is exactly the same as the one of yin and yang. Human beings are

Fig. 1.3 Illustration of Tai Chi by Zhou Dunyi

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born out of the qi on heaven, earth, and nature. The essence of yin and yang and the unity of ultimate source is Tai Chi.12 2. The transformation of Tai Chi’s creation from philosophical sense to life sense depended on the mode of thinking. The basis of thinking of TCM derived from The Book of Changes , the oldest book on Tai Chi philosophy. Imaginal thought, the basic mode of thought of TCM, also derived from the book. “The Book of Changes is on the image of things; and the image represents the imagery.”13 Xiang is the imagery; imagery is the figurative meaning of things. The whole idea of The Book of Changes is “using imagery for analogy.” What is the essence of “imagery”? It is a mode of thinking, and the process of simplifying and generalizing complex things into symbols and truth. For example, the emergence of Chinese characters is the specific application of this way of thinking, because the earliest Chinese characters were based on natural images; the yin-yang and five elements theories are the display of this mode of thinking in traditional Chinese medicine. “So, the heaven has essential qi, and the earth has forms. The heaven has eight solar terms, and the earth has five directions. Thus, the heaven and earth are eligible to be parents of everything.” This theory of “harmony between human and nature” was derived from nature.14 “If a man can adapt to the changes of the four seasons, everything in the nature will become the source of his life.” So, “heaven and earth are parents.” TCM has taken the mode of thinking of The Book of Changes and become part of it. In relative terms, The Book of Changes has its own originalities, because it is a way of understanding the world with universal relevance predating TCM, and not reserved for TCM. The imaginal thought of TCM is just the adoption of the theories of the book. To understand the mode of thinking of TCM, we have to trace its

12 See Zhu Xi of Song Dynasty: Collective Works of Zhou Lianxi, Vol. 1 & 4. 13 See: The Book of Changes · Xi Ci 2, Zhong Hua Book Company, “Commentaries to

the thirteen classics” version. 14 Taoists believe that heaven is the big universe and man is the small universe. The

thought of “harmony between man and nature” was first expounded by Zhuang Zi. See: Huangdi’s Classic on Medicine· Plain Questions· On the Six Vital Energies 68: “The upper and lower parts interact with each other on Qi alternation, which is the place where human beings live.” It means heaven, earth, and man are distributed in different areas, and the place of Qi alternation is where human beings live.

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root. It’s only in that way we can gain valuable insights into the very essence and the profoundness of TCM. Mr. Qian Zhongshu had given his view about the imaginal thought”: there are imagery of “change” and imagery of “poem,” which are apt to be confused. This is a chronic problem of the traditional academic circles.15 The biggest difference between them is: the imagery of “change” is detachable from the law. “When the spirit is taken, the imagery is ignored…Not obsessing with imagery, spirit can be achieved; not obsessing with language, imagery can be achieved.”16 For instance, two yin and one yang is water—the imagery of natural “change,” and the way of nature; two yin and one yang is kidney—the imagery of medical “change,” which comprises the medical law and medical science. It is the abstraction of the concept of natural yin and yang to human body. The imagery and law of poems are inseparable, otherwise the figurative meaning will disappear. 3. The focus of TCM is on the impact of “Five Operations and Six Vital Energies” on the human body. On the basis of the promotion, restriction, inhibition, and transformation of yin and yang and the five elements, Five Operations and Six Vital Energies was originally a discipline designed to get a better look at the law of natural changes. “The five operations and the yin and yang are the general law of natural changes, the general outline of all things in nature, the basis for the development and change of things, the root of growth and destruction, and the universe in an endless cycle of changes” (Huangdi’s Classic on Medicine · Plain Questions · The Art of Ancient Chinese Algebra 66). It is closely related to the health and life of people. Five Operations and Six Vital Energies are the yin and yang of nature, but we can figure out by analogy the yin and yang of human body, which is in some way the same as the yin and yang of nature.17 This is the medical thinking featuring “harmony between 15 See: Reflection on and Research of Prose of Pre-qin Period in the 20th Century by

Chang Sen, Peking University Press, 2002, pp. 116—117. 16 See: Guan Zhui Bian by Qian Zhongshu, in the words of A Brief Example of Zhou Yi· Definite Divine Manifestation by Wang Bi. 17 See: Huangdi’s Classic on Medicine· Plain Questions· On Five Operations 67: “Five Operations and Six Vital Energies” are the yin and yang of heaven and earth. You can count the yin and yang in the human body. As to the consistency with the yin and yang

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human and nature.” The ancient sages creating Huangdi’s Classic on Medicine were intensely aware of this, and they devoted seven chapters to illustrate. TCM doctors need to know that “the excess of qi would inevitably be suppressed by an opposite force,”18 and grasp the theory of the “alternation of excess and suppression.” It is more important than anything else to understand the relationship between the five operations, the alternation of excess and suppression of six vital energies, and disease19 —the basis on which the diagnosis and treatment of doctors are founded. If we see it the other way, it also serves to show the humanistic basis in the core of TCM. A doctor must explore the basis of medicine, in order to understand its law and become a great doctor. 4. The “harmony” in the golden mean and the “harmony” in TCM are a bond in which the knowledges in two distinct systems are firmly tied. It follows from this that the concept of “harmony” is very important. In the perspective of golden mean, “harmony” is “in diversity”,20 a state in which discordant views coexist peacefully. The “golden mean” is, in a sense, the “mean of neutralization.” Literally, neutralization means the middle course; but there is a deeper meaning in it—the state of harmony and order. So, “neutralization” is the ultimate goal for the golden mean. It is only by “neutralization” that the zenith of perfection of “universal path” can be attained. When the bounds of “middle” is pushed to “harmony,”

of heaven and earth, it can be calculated by analogy. This also refers to the “harmony between man and nature.” 18 See: Huangdi’s Classic on Medicine· Plain Questions· On the Main Points of Truth 47 . In Huangdi’s Classic on Medicine· Plain Questions, seven chapters are devoted to the “theory of five operations and six vital energies,” including: On the Fundamental Laws of the Five Operations and Six Vital Energies, On Five Operations , On Six Vital Energies, On Qi Alternation, On Five Constants, On the Source of Six Climate Changes, and On the Main Points of Truth. They account for about one third of the total length of Plain Questions. Zhang Jiebin of the Ming Dynasty says: “The six vital energies wax and wane. They are restricting and being restricted.” See: Classified Classic· Five Operations and six Vital Energies. 19 See: Huangdi’s Classic on Medicine· Plain Questions· On the Main Points of Truth 74: “The five operations interact, and excess and deficiency alternate.” 20 See: The Analects of Confucius· Zi Lu: “Confucius said: ‘A gentleman seeks harmony but not uniformity; a little man seeks uniformity but not harmony.’”

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which goes further to “neutralization,” the harmony of nature and people can be achieved. “All things grow together without harming each other, and the paths are parallel without conflict. Small virtues flow like rivers, while great virtues pour on the world boundless benevolence.”21 The way of life also lies in “harmony.” “The balance of yin and yang is the norm.”22 To “achieve harmony,”23 we must have proper diet so that the host qi and the guest qi are composed with moderate temperature. If human beings can be congruent with the four seasons, nature will become the source of life. Therefore, the profoundness of TCM lies in “harmony”; and TCM is in a sense a discipline about “harmony.” First, “harmony” should be established in the light of yin and yang, to conform with the “highest standard”.24 To do this, we must adapt our body to the four seasons, stay uninfluenced by the outside world, concentrate essence and spirit, and roam freely in the world. We’re not physically exhausted, and our hearts are unburdened. We spend the days of freedom, with no love or hatred. This is the way to increase longevity.”25

21 To the effect that: small virtue is like a river flowing endlessly; great virtue is honest and sincere nourishing everything. See: The Golden Mean· Chapter 30. 22 曰和: “和” (harmony) should be “味” (flavor). Yang Shangshan said: “The root of harmony is the five flavors.” See: Guo Aichun: Proofreading of Huangdi’s Classic on Medicine· Plain Questions· On Yin and Yang 7 Note 4, Tianjin Science and Technology Press, 1981: 52. 23 See: Huangdi’s Classic on Medicine· Plain Questions· On the Main Points of Truth 74: “Adjust the diet to pacify the host qi and guest qi, and adapt to the cold and warm…”. 24 See: Huangdi’s Classic on Medicine· Plain Questions· The Union of Heaven and Human Beings 3: “So, to harmonize the yin and yang is the policy of sages.” The policy of sages: the rules of sages for health preservation. 25 See: Huangdi’s Classic on Medicine· Plain Questions· Ancient Ideas on How to Preserve Natural Health Energy 1: “They adapted themselves to changes of the yin, yang and four seasons. Staying above the secular world, they accumulated the essences and protected the spirits. Their thoughts roamed between the heaven and earth…Their bodies were not fatigued by matters outside. Their minds were not perturbed inside. They kept tranquil, optimistic and self-contented…Their life-span could also reach a hundred years.” “Tian yu” means a casual life without love and hatred. Writings of Prince Huainan· Spiritual Training says: “Living casually through a lifetime.” See: Guo Aichun: Proofreading of Huangdi’s Classic on Medicine· Plain Questions· Ancient Ideas on How to Preserve Natural Health Energy 1, Note 3, Tianjin Science and Technology Press, 1981, p. 6.

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Second, “harmony” should be established in the light of numerology. What is “numerology”? It is a way to speculate on the “fortune” of nature, society, and incidents with the promotion, restriction, inhibition, and transformation of yin-yang and five elements. In the remote antiquity, numerology was a form of ritual and the duty performed by the divinators”.26 In its narrow sense, harmony is to regulate the body and mind with correct health care methods, such as balanced psychology, regulated life, balanced diet, and proper exercise. Specially, it refers to the way to recuperate spirit, such as breathing exercise and massage.27 To achieve numerological “harmony,” people are required to live an undemanding life with peace of mind. This is the way to retain the genuine qi and find spiritual peace.28 The idea of “harmony first” was being incorporated into TCM. TCM is a discipline brimming with philosophical wisdom. From the perspective of the golden mean, it is also a discipline on balance. The ideology of balance stands at the core of TCM theory and is omnipresent. The first is the balance between man and nature. “Conforming to the changes of heaven and earth”29 is the basic theory of TCM. Built on the age-old idea that human beings are closely connected with nature, TCM is about the fundamentals of life.30 In other words, birth, old age, sickness, and death are nature laws. Therefore, one who is good at talking about the heavenly laws must know the corresponding rules of the human race. 26 From Han History· Bibliographical Treatise· Divination by Ban Gu of Eastern Han Dynasty. Annotation by Yan Shigu of the Tang Dynasty is attached, Zhong Hua Book Company, Proof Reading Version. 27 Pronounced qiao, which means massage and physical and breathing exercise. 28 Spiritual peace: If you can regulate your qi, you will transfer essence to qi, and qi to

spirit. When both spirit and qi are transferred, spirit can be preserved. This is the origin of spiritual peace. See: Guo Aichun: Proofreading of Huangdi’s Classic on Medicine· Plain Questions· Ancient Ideas on How to Preserve Natural Health Energy 1 Note 3, Tianjin Science and Technology Press, 1981, p. 6. 29 See: Huangdi’s Classic on Medicine· Plain Questions· Ancient Ideas on How to Preserve Natural Health Energy 1: “followed the rules of the heaven and earth, acted in accordance with the running of the sun and moon, and ascertained the changes of the stars…” See: Guo Aichun: Proofreading of Huangdi’s Classic on Medicine· Plain Questions, Tianjin Science and Technology Press, p. 7. 30 See: Huangdi’s Classic on Medicine· Plain Questions· The Union of Heaven and Human Beings 3: “Since ancient times, weather has been the foundation of life…” See: Guo Aichun: Proofreading of Huangdi’s Classic on Medicine· Plain Questions, Tianjin Science and Technology Press, 1981, p. 14.

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In the calendar of nature, there are twelve months in a year. Correspondingly, there are twelve channels in the human body. The earth takes about 365 days to make a circuit of the sun. Correspondingly, there are 365 acupuncture points in the human body.31 Therefore, the way of heaven is the way of human beings. The wise thing is to conform with, preserve, develop a sense of awe toward, and live in harmony with nature. This falls in line with the principle of balance and coexistence. The essential point of Yin-yang balance is to “fix yang outside to keep yin inside” (Huangdi’s Classic on Medicine · Grand Simplicity). The equilibrium of yin and yang makes the vitality well-conserved; the divorce of yin and yang makes essence qi exhausted. The ancient medical sages told us that it was very important to conform with the “wane and wax between yin and yang.”32 “Yin and yang alternate between normality and abnormality, and diseases are divided into favorable and unfavorable prognoses.” When we grasp the fact, we’ll put more emphasis on the law of yin and yang: Accumulations of the yang constitute the heaven, and accumulations of the yin constitute the earth. The yin is tranquil, and the yang is restless. As the yang is generated, the yin grows. As the yang is harsh, the yin is blockaded. Extreme cold generates heat, and extreme heat generates cold.33 How can we achieve the balance of yin and yang? “The purpose is to achieve balance. Treat the positive disease with positive

31 See: New Cast Bronze Man Acupuncture and Moxibustion Manual· Preface by Xia

Song of Song Dynasty. Engraved version of Liu’s Yuhai Hall in Guichi in the first year of Xuantong in the Qing Dynasty (1909). 32 Ni Cong Yin Yang: Ni: reverse. Cong, conform. Yang dominates ascent and yin dominates death; yang dominates expansion and yin dominates contraction; yang dominates ascending and yin dominates descending; The number of ascending is in clockwise order, and the number of descending is in counterclockwise order. The waxing and waning must be distinguished, so the wise men used routine treatment and contrary treatment respectively. See: Guo Aichun: Proofreading of Huangdi’s Classic on Medicine· Plain Questions· Ancient Ideas on How to Preserve Natural Health Energy 1, Note 1, in the words of Zhang Jiebin. Tianjin Science and Technology Press, 1981, p. 7. 33 Above see Guo Aichun: Proofreading of Huangdi’s Classic on Medicine· Plain Questions· The Art of Yin-Yang Manifestation 5 and note 5. The root must be sought in treatment: in the words of Chang: “Yin and yang are the root cause of everything and every change. The mechanism of pathological changes. In determining the medicinal property and pulse, we should take this into consideration. The root might lie in the yin or the yang. The good treatment is based on the cause of illness,” Tianjin Science and Technology Press, 1981, p. 21.

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methods; treat the adverse disease with adverse methods.” What is “positive disease” and “negative disease”? According to Wang Bing, a great doctor of Tang Dynasty who made great effort to organize and annotate Huangdi’s Classic on Medicine · Plain Questions, “Positive disease is yin disease without yang disease, or yang disease without yin disease. The right treatment is to cure heat with cold, or cure cold with heat. Negative disease features yang pulse in the yin position, or yin pulse in the yang position. The right treatment is to cure cold with cold, or cure heat with heat.”34 This is what “carefully observe the location of yin and yang diseases to adjust and achieve balance” means. Source qi gives birth to all things in the universe. Yin and yang, transformed from source qi, spread into the five elements and manifest themselves in the form of four seasons. Everything takes its form from the source qi. Third, the balance of body and mind. In TCM, the imbalance of body and mind will lead to functional diseases induced by emotion and organic lesion. For example, anger injures the liver; joy injures the heart; grief and melancholy injure the lung; worry injures the spleen; and fear and fright injure the kidney.35 Therefore, we should attach great importance to the interrelationship between mental activities and the coordination of zang-fu organs, and the normal function of qi and blood activity. TCM believes that the heart governs all the other zang-fu organs and, therefore, is a “monarch organ.” Heart is the pathway for intelligence and mental activities, and the fundamental for life. In contrast, the consequences of “deranged spirit” will be dire. The sufferer might even exhibit symptoms of spirit and qi disorder, failing to keep clothing and covers on, and giving abusive remark without regard to his relatives.36 Today, people often talk about “depression,” which is a psychological and spiritual disease. According to historical records, mental diseases were treated 34 Above see Guo Aichun: Proofreading of Huangdi’s Classic on Medicine· Plain Questions· On the Main Points of Truth 74 and Note 4: The positive diseases are treated routinely; the negative diseases are treated with special methods, Tianjin Science and Technology Press, 1981, p. 454. 35 See Guo Aichun: Proofreading of Huangdi’s Classic on Medicine· Plain Questions· On the Five Zang-organs 11, Note 7 : “Observe the mental state of the patient”, in the words of Wu Kun. Tianjin Science and Technology Press, 1981, p. 73. 36 See Huangdi’s Classic on Medicine· Plain Questions· On the Profundity of Pulse Taking 17 : “Failure to keep clothing and covers on, and abusive remark without regard to his relatives, are due to deranged spirit.”

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by “Yi Jing Bian Qi” in remote antiquity. What does it mean? It means transferring the idea and spirit of the patient to sever the origin of the disease. When the TCM theories were established, “Yi Jing Bian Qi” went out of fashion. Diseases were treated with herbals and acupuncture, although they carried no guarantee for cure. At that time, the biggest success of medicine had come in the etiological cognition, which held that the changes in living environment, such as the load of anxiety, exhaustion of physical build, and violation of the four seasons and the alternation of cold and heat, were the cause of physical and mental diseases.37 Therefore, it was essential to achieve the balance of human and the external environment, and the balance between body and mind, to keep the spirit in good shape. As the Chinese saying goes: “He who maintains spirit prospers; he who loses spirit perishes.” Obviously, it is very important to maintain the balance of body and mind and preserve spirit. Fourth, the balance of nutrition intake. What is the proper intake of nutrition? It is the diversity and balance of food selection. The rationale of modern people is that a person should eat 25 kinds of food every week. In other words, all food can be eaten, but not too much, lest one should be deficient or redundant in “spirit, qi, blood, form and mind” and decline in immunity. The needs of human body are diverse. “The heart favors bitterness; the lung favors acridness; the liver favors sourness; the spleen favors sweetness; and the kidney favors saltiness”.38 The offering of food should be various. Besides, the five flavors have their respective efficacies. “Acridness disperses; sourness contracts; sweetness moderates; bitterness hardens; and saltiness softens.” Therefore, the ancient people supplemented their diet with the five grains (polished rice, adzuki bean wheat, soybean, and millet) as nutritious food, the five fruits (jujube, plum, chestnut, apricot, and peach) as accessory food, the five domestic animals (cattle, dog, pig, sheep, and chicken) as tonics, and the five vegetables (mallow, leek, patchouli, allium macrostemon, and scallion) 37 See: Huangdi’s Classic on Medicine· Plain Questions· On Removing Essence and Transforming Qi 13: “I heard that in ancient times, patients were treated by transferring their idea and spirit…Today, diseases are treated with herbals and acupuncture. But that carried no guarantee for cure. Why? Qi Bo answered…Today’s people have changed because of the load of anxiety, exhaustion of physical build, the violation of the four seasons and the alternation of cold and heat…” 38 See: Huangdi’s Classic on Medicine· Plain Questions· On the Generation of Five Zangorgans 10. 欲: like.

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as nourishment. They were able to meet the demand for “replenishing essence and qi.” “By dispersing or contracting, moderating or speeding, and hardening or softening, the treatment works well” (Wang Bing: Chong Guang’s Supplementary Note of Huangdi’s Classic on Medicine· Plain Questions· Storing Essence According to the Four Seasons ). Therefore, the author wouldn’t advise taking special nourishments at ordinary times so as not to build up imbalance of nutrients in the body. As you know, “if a person is in a healthy state, all he needs is grain and meat.” “Grain, meat, fruit, and vegetable are sufficient to feed people.” When a person falls ill, he needs medicine to offense, but he is compelled to do so. As the saying goes, “medicine is not as good as dietetic therapy.” In the process of dietetic therapy, the patient should beware not to go too far. He doesn’t have to dine on abalones and lobsters every day, or he is predisposed toward illness. This is because “When one eats too much salty food, his blood would have difficulty coursing through the veins and change color; when on eats too much bitter food, his skin would become dry-looking and the hairs would shed themselves; when one eats too much acrid food, he would have spasmodic contracting of the tendons and channels and dry fingernails; when one eats too much sour food, his muscles would go harsh and his lips would become charred; when one eats too much sweet food, he would suffer osteodynia and lose hair.”39 “Therefore, too much sourness injures the spleen; too much bitterness injures the lung; too much acridness injures the liver; too much saltiness injures the heart; and incongruence of five flavors injures the kidney.”40 It is only when the five flavors are balanced can the five zang-organs are peaceful. Fifth, the balance of health preservation. When health preservation is mentioned, the first thing that rises to the mind of ordinary people is improving living conditions, especially in diet. They would eat nutritious food, do physical exercise, and have regular lifestyle. This is indeed a dogmatic understanding of health preservation. Although it is essential, it is not nearly such a balance as needed by health preservation. In TCM, the balance of health preservation chiefly refers to the balance of body and mind. The body and mind are supposed to be in good shape, in a way 39 Bei Tang Shu Chao, Vol. 143, Wine and Food, taking “weep” for “blood.” 胝 is pronounced “zhi”; and 騶 is pronounced “zhu.” 40 See: Research on the History of Taoism and the History of Science and Technology· Ji Yan, by Ge Hong of Jin Dynasty, 1986, Zhong Hua Book Company, p. 245.

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that can achieve full health preservation. TCM champions comprehensive health preservation featuring “healthy qi without any signs of senility, with the form and qi defending each other”41 and the “inseparability of the body and mind.”42 It models itself on the “sages” and “saints” from ancient times through to the mediaeval age. As the pace of life in the society speeds up and the living environment changes, people get into bad habits. As the cause of many diseases, they pose enormous threat to the health of human beings. The ancient people warned us: “Prolonged seeing injures blood; prolonged lying injures qi, prolonged sitting injures flesh; prolonged standing injures bone; and prolonged walking injures tendon.”43 There are limits to everything we do. To have a healthy life and preserve health, abstinence should be accorded topmost priority, and we have to triumph over the bad desires. “Moderation” in normal desires, such as eating desire, sports desire, social desire, travel desire, and sexual desire, is required so that they are coordinated and balanced. This is the wisdom of the ancient people.44 Here’s what Huangdi’s Classic on Medicine· Plain Questions· Visceral Manifestation Theory 9 says: “If the weather comes before the season, it is called tai guo,” or “climatic disorder”; “If the weather comes before the qi, it is called bu ji,” or “abnormal weather.” In both cases people would hurt themselves bodily. More than 2200 years ago (219 BC), Qin Shihuang sent people in search of the elixir of life, but the dream died. The people being sent (such as Xu Fu) disappeared. It was said that “Xu went down to a fertile region and became the self-appointed king.” In the end, Qin Shihuang died of disease on his fifth tour. He was 49. He didn’t realize that the key to health and longevity was in the hands of himself.

41 Ibid., p. 244. 42 See: Huangdi’s Classic on Medicine· Plain Questions· Ancient Ideas on How to Preserve

Natural Health Energy 1: “They maintained well-being of body and mind; thus, it is not surprising that they lived over one hundred years…” 43 See: Huangdi’s Classic on Medicine· Plain Questions· On the Five Vital Energies 23. 44 “With desire, life doesn’t go right. So, the sages must moderate their desire.” “The

whole life means that the six desires are balanced.” “The sages cultivate the right feelings to restrain disire, so they do not indulge their senses too much.” See: Explanation of Master Lü’s Spring and Autumn Annals by Chen Qiyou, Xuelin Publishing House, 1984, pp. 33, 74, & 84.

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Written again on April 12, 2020 References: [1] He Mengyao. Yi Bian [M]. Beijing: People’s Medical Publishing House, 1994. [2] Kong Yingda. Interpretation of the Book of Changes: 1[M]. Annotations to the Thirteen Classics. Beijing: Zhong Hua Book Company, 1980. [3] Liu Yuxi. Collected Works of Liu Binke [M]. Shanghai: Commercial Press, 1937. [4] Yu Jincheng. The Theory of Five Operations and Six Vital Energies [M]. Taipei, China: Hualian International Press, 1986. [5] Zhou Dunyi. Illustration of Tai Chi[M]. Second edition. Taipei, China: Chinese Confucian Academy, 1976.

TCM Concept: Five Operations and Six Vital Energies: The Yin and Yang of Heaven and Earth The principle of “harmony between human and nature” is the basic theory of TCM. Since ancient times, master TCM doctors had attached great importance to the law of meteorological movements and its effect on the health of people. They thought that the two were closely related. According to Huangdi’s Classic on Medicine· The Theory of the Preciousness of Life and the Wholeness of Form 25, “Between heaven and earth, everything is ready, and nothing is more precious than human beings. People rely on the atmosphere of heaven and earth and the essence of water and valley to survive, and live with the laws of generation, growth, bloom, harvest and storage in the four seasons.” In ancient times, a TCM doctor was expected to have a good command of astronomy, which was a basic skill and the theoretical basis of “Five Operations and Six Vital Energies.” The theory of five operations and six vital energies is a huge, wideranging knowledge system encompassing calendar, astronomy, and climatology. Some experts even equate it with the medical meteorology in ancient times”.45 Such esoteric theories must be very difficult for the 45 See: Theory of Five Operations and Six Vital Energies by Yu Jincheng, Taipei, China: Hualian International Press, 1986, p. 13.

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ancient people, aren’t they? In fact, “In the Xia, Shang and Zhou Dynasties, everyone was proficient in astronomy. ‘Wildfire in the Seventh Lunar Month’ were the words of peasants; ‘Three Stars in the Sky’ was what the women said; ‘The moon going away from the Hyades’ was what the garrison soldiers said; ‘The tail laying in the intersection of the sun and moon’ was in the ditty of children. When asked about these contents, some literati of later dates had no idea. As to calendar, the ancient people are not as proficient as the modern people.”46 Things are changing, and the circumstances are not at all the same as before. What is “Five Operations and Six Vital Energies”? Five operations are designed to work with the law of pathological changes in the five seasons of the year (including the long-summer).47 In other words, the basic meteorological properties of five seasons in a year, which are characterized by “warm spring, hot summer, damp long-summer, dry autumn, and cold winter,” are illustrated with the five elements. Its importance lies in that the five operations and yin and yang are the laws between heaven and earth, the guiding principle of everything, the origin of myriads of changes, the fundamental for life and death, and the anchor of mental activities. It is essential to have a knowledge of them, isn’t it?48 Six vital energies, based on the characteristics of the climatic zones in different regions, is designed to work out various climatic laws. They are grouped into the categories of “wind, heat, damp, fire, dryness, and cold.” “Pathological factor is gendered if a person is not in his place; healthy qi is gendered if a person is in his place.”49 If the six vital energies don’t come at the right time, they are a pathological factor. If the essence is in accordance with the four seasons, it is the normal six vital energies in 46 See: Collected Explanations of Ri Zhi Lu Vol. 30 by Gu Yanwu of the Qing Dynasty,

explained by Huang Rucheng, Changsha: Yuelu Press, 1994, p. 1049. 47 Long-summer: Refers to the turn of summer and autumn in the sixth lunar month. 长 is pronounced “chang.” 48 See: Huangdi’s Classic on Medicine· Plain Questions· The Art of Ancient Chinese Algebra 66: “The five operations and the yin and yang are the general law of natural changes, the general outline of all things in nature, the basis for the development and change of things, the root of growth and destruction, and the universe in an endless cycle of changes. How can we not understand them?” See: Proofreading of Huangdi’s Classic on Medicine· Plain Questions by Guo Aichun, Tianjin Science and Technology Press, 1981, p. 364. 49 See: Proofreading of Huangdi’s Classic on Medicine· Plain Questions· On Five Operations 67 by Guo Aichun, Tianjin Science and Technology Press, 1981, p. 375.

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nature. According to the doctrine of five operations and six vital energies, the latter is designed to be used in conjunction with the twelve earthly branches (Zi, Chou, Yin, Mao, Chen, Si, Wu, Wei, Shen, You, Xu, Hai) to calculate the things to do and to avoid in each shi chen (two-hour period). Thus, the five operations and six vital energies form a comprehensive principle through which the meteorological law is understood. To sum up, five operations and six vital energies are the yin and yang of heaven and earth. Going too much is out of the question, but going too little is nearly as bad. The theory of five operations and six vital energies has a lot to do with etiology and treatment based on syndrome differentiation and philosophies of TCM. Only when their changes and relationship of generation and restriction are understood, can we take the initiative in treating and preventing diseases and make the process more apposite. July 13, 2020

Disentanglement from Witchcraft: Contributions of Bian Que Context Tips Witchcraft was the “childhood” of human beings; using witchcraft as a curative was popular in the remote antiquity; Biography of Bian Que, an encyclopedia of Chinese witch doctor culture; Bian Que, the inheritor of pulse science disentangling from witchcraft; The witch-historian in The Classic of Mountains and Rivers and The Golden Bough; Historical contemplation on “medicine originates from saint”; Gong Dingchen, who was not a doctor, was the representative of “saving life.” Foolishness and wisdom are human nature incarnated. Witches and doctors have their respective crafts. Meditation is practiced for one night. Enlightenment is gained after three years. —Southern Song Dynasty· Liu Kezhuang Ten Pieces of Five-word Miscellaneous Notes

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There’s almost nobody who hasn’t heard of Bian Que of the Spring and Autumn period. He has long been a miracle doctor and the symbol of TCM in the minds of the Chinese people. But our acquaintance with this personage is largely based on Bian Que’s Meeting Duke Huan of Cai State, which fully reveals his consummate medical skill. He has left behind consequential legacies. “No talk of pulse taking ever ended without mentioning Bian Que.” In fact, Bian Que was also a trailblazer of the new TCM. He disentangled the discipline from witchcraft and witch doctors, for the former to embrace the profound culture. “Believing in witchcraft and not believing in medicine” was among the “Six Incurable Diseases.” This represented the vow of Bian that he would disentangle TCM from witchcraft, and marked the end of the witch doctor. Referring to witch doctor, we need an understanding of the history of witch. From the formation of the character “巫”, we can tell that witch was considered as the person capable of communicating with heaven, earth, ghosts and gods. The male witch was called “Xi,” and the female witch was called “Wu.” In its heyday, witchcraft was the exclusive preserve of the aristocracy society, and witches were the equivalent of “experts.” Witchcraft was the “childhood” of human beings. In the ancient times, there were many mysteries of the world incomprehensible to human beings. In light of this, witchcraft was born. The civilization in different parts of the world had not evolved in lockstep. In some undeveloped and uncivilized countries and peoples, witchcraft still prevails. We’re enjoying the modern technology and civilization, which prove such a boon to all people. But we won’t mock at our ancestors for their savage ignorance. Witchcraft is, after all, the product in the evolution of human history. It is essentially to cause something to take place in the soul in a way that people are approached.”50 Scholars agreed that witchcraft was in full bloom in China during the Yin and Shang dynasty. At that time anybody could be a witch and communicate with ghosts and gods. Witchcraft was a must-do thing in daily life, and we could imagine that the witches at that time were kept busy forever. Take the oracle inscriptions on tortoise shells as an example: “The Shang dynasty people had sufficient confidence in this

50 See: Totem & Taboo by Sigmund Freud, translated by Yang Yongyi, China Folk Literature and Art Publishing House, 1986, p. 4.

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approach. Before expedition, fishing and hunting, marriage and sacrificial rite, they must perform divination with the tortoise shells.”51 Here’s what Miscellaneous Notes on the History of States says: “we couldn’t think of a scene in which human and gods are mixed together. When psychic worship evolved to ancestor worship, the patrilineal ancestors were spiritualized.”52 The mixing of human and gods is generally thought to be the characteristics of witchcraft in the early stage. In a sense, we cannot fully understand the Chinese history without knowing the history of “witchcraft.” Sacrifice (Zhao Shi Gu Er) is a Chinese movie telling the tale of justice and revenge. It follows the Zhao Clan of the Jin state being exterminated by a treacherous official Tu’an Gu in the Spring and Autumn and the Warring States Period, and Zhao Shuo’s wife returning to the palace as the princess and delivering a posthumous child. For the survival of this family’s bloodline, Cheng Ying and Gongsun Chubai, domestic men of the Zhao Clan, risked their lives breaking into the palace and saving the orphan—Zhao Wu. When Zhao Wu grew up, he formed an allied power with Wei Jiang, the border general, and killed Tu’an Gu. His father’s murder was finally avenged. Once, Duke Jing of Jin state who was in power dreamed of Zhao Dun, an elderly of the Zhao Clan, becoming a ferocious ghost. With loose hair draping over the ground, the ghost pounded his chest and jumped up. “You have slaughtered my offspring. It’s cruel! I’ve asked god’s permission to avenge.” With these words he burst the palace gate open and rushed in. Duke Jing was so frightened he retreated to the inner chamber, and the ghost busted in. Just then the duke awoke from his dream. The next day, the witches from Sangtian were summoned to the palace to explain the dream. It follows from this that whenever a big event happened, witches would be called for. Afterward, witches were empowered to act as doctors, although no one knew when it happened. “Witches took the place of doctors, and

51 See: Reproduced Civilization: Unearthed Chinese Documents and Traditional Academics by Zhu Yuanqing, East China Normal University Press, 2001, p. 48. 52 See: Miscellaneous Notes on the History of States· Chu 2. “Bu ke fang wu”: unimaginable. “Fang wu”: the consonant-transformation of “fang fu,” means “imagination.” Also see: Master Zuo’s Spring and Autumn Annals· The Tenth Year of Duke Cheng.

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they were called witch doctors”.53 “County witch doctors had a collection of all medicines in case of necessity” (The Book of Zhou· Accumulated Syndrome). For example, Wu Xian54 and Wu Peng55 were celebrated witch doctors. “The major function of witches was to receive deities and dispel evil spirits, while the major function of doctors was to cure diseases.” In other words, witch doctors could couple the communication with ghosts and gods with curing diseases by divination. They were more capable than common witches and possessed the knowledge of medicine and herbal plants. Witches cured diseases mainly through prayer and miscast magic. The stage of development was phenomenally popular for all nationalities in the world in the remote antiquity. The richness and diversity of witchcraft was typically characterized as “applied witchcraft” and “imitative witchcraft” (James George Frazer. Golden Bough). According to historical records, in the late Babylonian period, diseases were cured by magics and spells. Under the shelter of Marduk, the Babylonian god of medicine, these knowledges were taught. In those days, fortune prophesied by symbols dominated the life of Babylonians. Imhotep living in the Third Dynasty of Egypt had great medical skill. His name implied “the people bringing immense peace.” According to ancient Egyptian literature, he was the first god of medicine. According to his biography written by someone, Imhotep was the prime minister. He had also been an architect, a priest, a wise man, a scholar, an astrologer, and a magic doctor. In short, Imhotep was the first god of medicine with the aspect of a man. The ancient Greek culture featured a rich diversity of gods with distinctive functions: Zeus, the god of heaven, Athena, the goddess of wisdom, Aphrodite, the god of love, and Apollo, the god of sun. In the meanwhile, medicine and philosophy were inseparable in early Greek culture. This

53 See: Medical System in Ancient and Modern Times by Xu Chunfu of the Ming Dynasty: “Witch doctor implies witches in the place of doctor, hence its name.” 54 See: Tai Ping Yu Lan· Fang Shu 2· Medicine, in the words of Ancient Genealogy: “Wu Xian, an official of Rao. He had supreme medical skill.” 55 See: Master Lü’s Spring and Autumn Annals· Religious Philosophy 5· Things not to Enter Into: “Wu Peng served as the doctor.” Also see: Notes on the Origin of Chinese Characters by Duan Yucai of the Qing Dynasty: “When Wu Peng first became a doctor in ancient times.”

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intimacy was closer than the relationship between medicine and philosophy in other nations. In ancient Greek mythology, Chiron, a centaur, was the founder and master of Greek medicine. Asclepius, his disciple who was the son of Apollo, was the god of medicine. In ancient Greek literature, Asclepios was called a doctor, healer, and rescuer. He often assumed the form of a snake, which was the symbol of god and his authority in healing in ancient Greek culture. Sometimes, he was represented in the Omphalos, a dog, a goat, a bleeding cup, a medicine bowl, a book, or a stick. The Chinese medicine was developing in lockstep with the rest of the world before the second century B.C., when it was in a period of witch mixing with doctor. At that time, the character “doctor” (医) was written as “鐾”. According to etymologists, “In the ancient times, the witches and doctors were to treat and cure. Therefore, the character ‘doctor’ (醫) was written as ‘鐾’” (Notes on the Origin of Chinese Characters by Zhang Shunhui). In other words, the character “鐾” is consisted of “doctor” ( 医) and “witch” (巫). At the same time, alcohol and herbs were used to fight the diseases, and a rich store of experiences were accumulated. As the power of medicine grew, the strength of witchcraft waned. This is in conformity with the laws of medical development. Literature chronicled how Miao Fu, a witch doctor in the remote antiquity, treated the patients. In medical practice, he would make a straw dog and paint it. Then he would face north and ask blessing. This was the way to cut off the cause of disease. Whether the patient was assisted or carried into the ward, he would be cured of the disease.56 Now let’s turn to the Biography of Bian Que excerpted from Historical Records· Biography of Bian Que and Chunyu Yi by Sima Qian, a great historian. As an important work on the history of early Chinese witch doctor, it is not so much the biography of Bian Que than the summary of ancient witch doctors. The author thought that the book, which told of five witch doctors in the remote antiquity, was arguably an encyclopedia of “witch” culture in ancient China. The Biography, with Bian Que as the hero, tells of three medical cases: (1) The medical case of Prince Guo;

56 See: Shuo Yuan · Identification of Objects by Liu Xiang of Han Dynasty: “I heard that Miao Fu was a witch doctor in the remote antiquity. When he treated diseases, he was put the straw on the floor as the mat and fashion a dog out of the hay. Then he would face north and ask blessing. Whether the patient was assisted or carried into the ward, he would be cured of the disease.”

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(2) The medical case of Zhao Jianzi; (3) The medical of Duke Huan of Qi. The timing of the three cases straddled hundreds of years, and Bian Que, Qin Yueren by name, lived between 407 and 311 BC. Apparently, Bian Que couldn’t have treated the diseases of the three people. Scholars generally agree that Bian Que was not the same man in these cases. According to the order of appearance in the article, the first witch doctor should be Chang Sangjun, the teacher of Bian Que, Qin Yueren by name. This is how the biography describes the venerable master of witch doctor: “Chang Sangjun knew that Bian Que was no ordinary person. They were an acquaintance for a decade or more. Once, Chang said in private to Bian: ‘I have a secret recipe. I’m old and would like to pass it on to you. You must keep it a secret.’ ‘I know,’ replied Bian Que in a deferential way. Chang took the recipe out of the pocket, which reads: ‘decoct the medicine with water in the tree hole and take it for thirty days, and you’re supposed to possess the power.’ Chang gave all the recipes and books to Bian and vanished into thin air. He was probably no ordinary person.”57 Sima Qian marveled at the superpower of Chang Sangjun and said that he was probably no ordinary person! Who was he? The subtext is: “He was a witch doctor.” The second witch doctor, Bian Que, Qin Yueren by name, made his entrance with Chang Sangjun. He prepared the medicine as Chang ordered, and took it for thirty days. Then, he could see right through the walls. With the superpower, Bian Que was able to check out the issues of the five viscera with naked eyes. He still took the pulse of the patients, but it was just a perfunctory move for the sake of appearance. From historical and realistic perspectives, if a doctor who had a magic touch with the patients was not a witch doctor, what else could he be? The third witch doctor was Zhong Shuzi of Guo state, an administrator and lecturer of the art of medicine. With a particular interest in the discipline, he was a big fan of witch doctor. We can tell by his dialogue with Bian Que about treating Prince Guo and his familiarity with the history of witch doctor that Zhong Shuzi was, if nothing else, a quasi-witch doctor in history. Guo was a small state where witchcraft was fashionable. Once, Prince Guo suddenly felt dizzy and toppled over in a faint. Led by the witches, 57 “Dang zhi wu yi”: He must see something strange. Collation of Historical Records by Sima Zhen of Tang Dynasty: “He must see the ghostly things.” Ghostly things: evil spirits.

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“zhi rang,” a prayer service to Heaven to avert misfortune, was launched across the nation and other events had to give way. Zhong Shuzi had great influence as the director of “zhi rang,” which was performed on an epic scale. We can tell that he was a very experienced witch with access to the witch scepter. He briefed Bian Que on the cause for Princess Guo’s illness, saying that the circulation of qi and blood was irregular. They crossed each other and couldn’t dredge and regulate. Damage was done to the internal organs, and the healthy qi was not able to suppress the pathogenic qi. With the depletion of essence qi and the exuberance of yin pathogen, qi counterflow and the prince toppled over in a faint. The technical terms in his talk suggested that Zhong Shuzi possessed profound medical knowledge. He was just the witch doctor needed by Guo state. The fourth witch doctor, Yu Fu living in the remote antiquity,58 remained in the memory of Zhong Shuzi. He was cited by Zhong as an example for Bian Que. From Zhong Shuzi’s description, Yu Fu matched exactly the standard of a witch doctor. For example, he utilized no alcohol, acupuncture and moxibustion, or massage, but employed the approaches called “vital essence training and shape changing,” “removing essence and changing qi,” and “incantation and psychology.” We may look at the record of “burning the nine orifices of the body to pacify the channels”59 for proof. Literature in various periods had different opinions, but there is no getting around the fact that Yu Fu lived before the time of Bian Que. This is the only way to confirm his identity. The fifth witch doctor was Bian Que who was summoned to treat Prince Guo. There had been questions about him, although he was already close to a regular doctor. He promised to perform witchcraft in treating the disease—the one condition Zhong Shuzi had attached, to ease his misgivings. It was a good thing in itself. However, in the treatment program he offered, the four methods (inspection, auscultation and olfaction, inquiry, pulse-taking and palpation) in diagnosis were abandoned. Like guessing a riddle, he gave a description of the symptoms of Prince Guo’s disease, and determined the cause of the disease. His skills in the art of witchcraft were positively occult. By using the herbs and acupuncture, Bian Que was actually showing off, but mostly it seemed

58 Yu Fu: A famous doctor in the remote antiquity with many records in literature. He is also known as “俞拊”, “俞拊”, and “臾跗”. 59 See: Shuo Yuan· Identification of Objects by Liu Xiang of Han Dynasty.

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like he came prepared. If he was not a witch doctor, what else could he be? So then, he was a mystical witch doctor in disguise. Yet who could the Bian Que disentangling from witchcraft be? The author believed that he should be the one who inherited the pulse science, and the one “everyone mentioned when the subject of pulse taking came up.” He shouldn’t be Qin Yueren “who made the perfunctory move of pulse taking.” So, what’s the difference between witch doctor and experience-based doctor appearing later in time in treating diseases? Among the bamboo and silk medical literatures unearthed, there are many materials specifying how witch doctors performed medical procedures. Take eliminating verruca for example, experienced-based doctors would twist the broken cattail mat into a rope, perform moxibustion at the lateral aspects of the verruca, and tear out the verruca. Witch doctors acted quite differently. They would let the patient carry some straw and have someone ask loudly: “Are you verruca?” The patient with verruca would answer: “I’m verruca.” Then he set down the straw and left without so much as a backward glance. It was believed that the verruca would be left there.60 We feel that this was something of mere a child’s game. In treating verruca, the discrepancy between witch and doctor was enormous and appalling. Huangdi’s Classic on Medicine sums up the most important means by which witch doctors treated patients: transferring the spirit and changing the movement of qi. That is, to cure disease by changing the mind and spirit of the patient. Their etiological hypothesis that diseases were caused by ghosts and gods playing tricks on people was absurd. Generally speaking, etiological hypothesis can best reflect the level and stage of medical development. The kind of etiological hypothesis determines the level of medicine. In terms of TCM, it went through the “Four Ends” etiological hypothesis in the witch doctor period, and the etiological hypotheses of “Three Causes” and “Furious Qi” after the

60 See General Theory of Bamboo and Silk Literature· Mawangdui: Recipes for Fifty-two Ailments by Zhang Xiancheng: “(doctors would) twist the broken cattail mat into a rope, perform moxibustion at the lateral aspects of the verruca, and tear out the verruca.” “(Witch doctors would) let the patient carry some straw and have someone ask loudly: ‘Are you verruca?’ The patient with verruca would answer: ‘I’m verruca’. Then he set down the straw and left without so much as a backward glance,” Zhong Hua Book Company, 2006, pp. 417–418. “broken cattail mat,” aka “gupuxi” or “baipuxi” in Mingyi Bielu by Tao Hongjing, was used to “cure swelling veins and ulcers.”

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establishment of a complete TCM system. Here’s what “Four Ends” etiological hypothesis says: (1) The Emperor of Heaven brought diseases to the world; (2) The ghosts and gods played tricks on people and made them sick; (3) Diseases were caused by the evil spirits; (4) Diseases were caused by the six qi in heaven—yin, yang, wind, rain, gloom, and bright. As the most valuable theory of etiology in the early stage of TCM, “six qi causing disease” laid a preliminary foundation for the theoretical formation of the etiology of TCM. When the etiological hypothesis of “Three Causes”—internal cause, external cause, and injury, was brought up, “witchcraft” stepped down from the stage of history. TCM was put on the right track of development. As people began to understand infectious diseases, the pathogenic theory of “Furious Qi” emerged. Breakthroughs were spurred in etiological theory, which powered the development of related disciplines such as diagnostics and therapeutics and boosted the holistic development of medical science. The Classic of Mountains and Rivers and Golden Bough are must-reads for anyone interested in witchcraft and its culture. As a classical work in ancient China, The Classic of Mountains and Rivers devoted several chapters to introducing the witch doctors in ancient China. For example, The Great Wilderness in the Northwest introduces Wu Xian, Wu Peng, and the other eight witch doctors. The folklores in the book reflected the boundary of people’s knowledge at the time and they were of practical use. Golden Bough was the masterpiece of James George Frazer, a renowned British anthropologist and folklorist. The book was honored by the journal Nature as “one of the greatest books of human beings,” and “a book of authority on the origins of witchcraft and origin.” Frazer believed that witchcraft, as a long and crucial stage in the annals of cultural history, was the mother of system, religion, and science. Why is witchcraft the mother of science? Basically, science is a rational choice of human beings to coordinate with the living environment. Witchcraft, religion, and art are ways to coordinate the natural or social environments. This highlights the long-lasting vitality of science. Witchcraft is the mother of science, that is to say, there are some common features between the two. What was the connection between them? We know that witchcraft professed an attitude of oppression and coercion toward the gods. By divination, dream interpretation and astrology, it contrived to predict how things would go in future, and to find out the gods who were behind all this. By exorcism, incantation, and

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contamination, it contrived to control or change the growth and development of things. If we put aside the factor of gods and the concrete applications, witchcraft and science had essentially the same position on principle of “the betterment of mankind.” Moreover, the two believed that “the succession of events is completely regular and definite” (James George Frazer. Golden Bough). However, the pursuits of witchcraft and science were different. “The major shortcoming of witchcraft isn’t in its general assumption of an event or process determined by objective laws, but in its gross misconception of the nature of the special laws governing this process.”61 Witchcraft had departed from where it had been going, so it would never reach the designated destination. At last, it was denied by its long-accumulated experience. With the rise of natural philosophy, the importance of divinity began to take a back seat, and science-based medicine was established. Frazer said, “If witchcraft can be proved real and effective, it is no longer witchcraft, but science.” If witches could really subjugate the evil spirits that caused diseases, that would make them doctors. On the other hand, the extensive experiences accumulated over the years might shed light on the real cause that lay behind diseases. Gradually, medicine was stripped out of witchcraft. The dialogue between the Yellow Emperor and Qi Bo in Huangdi’s Classic on Medicine · Plain Questions ·Theory of Essence Transfer and Transformation 13 had given a vivid description of the trajectory of the gradual change. “Witchcraft” is a stage many countries must pass through in their development of medicine. These countries shared similar circumstances in the origin of the craft. Besides “witchcraft,” there was the expression that “doctors are the descendants of sages” in China where the custom of worshiping ancestors was prevalent. Fuxi, Shennong, and the Yellow Emperor were famous for their medical contribution. They were regarded as the founding fathers of the Chinese civilization and the common ancestors of the Chinese people. They were credited with establishing the TCM, which gave more prominence to their authority and sacredness. Historians believed that the saying “medicine was originated from sages” was fabricated by the scholars in the Warring States period and Qin and

61 1. See: [English] Golden Bough, by James George Frazer, translated by Xu Yuxin, Wang Peiji, and Zhang Zeshi, Beijing: New World Press, 2006, p. 52.

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Han dynasties”.62 It mirrored the ideology of the Chinese people of “ancestor worship.” “Changing the classics at pleasure,” however, will sometimes be the excuses for the slowdown in medical development. This was the apprehension of Zhang Jiebin, a famous physician and representative of the warm tonification school in the Ming Dynasty, when he organized the Huangdi’s Classic on Medicine and compiled the Classified Classic. In allusion to this phenomenon, Professor Li Jingwei, an expert in medical history, gave an expression to his opinion. He concluded that: “records of scholars in ancient times on the creation of medical science, pharmaceutical science, and health care by Suiren (who devised the method of drilling wood to make fire), Fuxi and Shennong didn’t mean to be taken literally. But they are still commendable for their valuing the experiences in labor, production and life. It is very possible that these historical facts were in line with the origin of medicine and health care in the primitive society of China.”63 Unlike superstition, which is all bad, witchcraft is a form of culture in the early days of human society. Things were changing, and medical science was developing vigorously. In the Spring and Autumn period, Bian Que called for the disentanglement of medicine from witchcraft. After that, Gong Dingchen of the Northern Song Dynasty shone out in history. He had the deepest sympathies to the wretchedness of the natives of Bachu. “They believed in the witches but not in the doctors, which cost them their lives.” “The sick men groaned alone in the house.” “They didn’t seem to realize that without treatment, they would almost certainly die.” Gong hoped in this way to guide people to understand medical ethics aright, and to figure out that medicine was “to expel pathogens with healthy qi, and to expel frenetic with sincerity, as the treatment of disease.” People should grasp the fact that “believing in medicine is better than worshipping the unorthodox gods.” In order to prevent people from “backsliding,” he carved the words on the wood to broadcast the principle to people. As the trailblazer of science-based medicine and the spreader of TCM, Gong Dingchen was thoughtful and farsighted.

62 See: Compendium of General History of China, Part I (revised edition) by Fan Wenlan, People’s Publishing House, 1965, p. 90. 63 See: Brief History of Ancient Chinese Medicine by Li Jingwei and Li Zhidong, Hebei Science and Technology Press, 1990, p. 26.

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Gong Dingchen was not a doctor, and he had no medical experience. But he defended the purity of medicine and gave a rallying cry for the cause. He bore the historical responsibility of a scholar.64 From the Spring and Autumn period when witches were mixed with doctors, to the dawn of modern medicine, and to the Song dynasty when “medical books were of paramount importance”; from Bian Que who vowed to disentangle TCM from witchcraft to the intellectuals’ self-reflection and resistance to witchcraft, there is a consistent thread running through the process: TCM was constantly breaking away from the past and developing new things. In maintaining the uniqueness, scientific nature, openness, and purity of TCM, we will face the interference and challenge from all directions. This process is a never-ending struggle. From the course of TCM history, we can tell that the discipline has a primary motive force of purification and development. March 23, 2020 References: [1] Sima Qian. Historical Records [M]. Proofreading version. Beijing: Zhong Hua Book Company, 2014. [2] Castiglioni. History of Medicine: 1 [M]. Translated by Cheng Zhifan. Guilin: Guangxi Normal University Press, 2003. [3] James George Frazer. Golden Bough [M]. Translated by Xu Yuxin, Wang Peiji, and Zhang Zeshi. Beijing: New World Press, 2009. [4] Zhou Bida. Imperial Document [M].“Si Bu Cong Kan” version.

TCM Concept: The Small Universe in Life In Han History· Bibliographical Treatise by Ban Gu, a historian of the Eastern Han Dynasty, the ideas of Separated Records and Seven Summaries by Liu Xiang and Liu Xin, the father and son, were being incorporated. TCM was fit into the category of Seven Summaries, called “fang ji.” At that time, “fang ji was classified in four categories”: medical classics, prescriptions, divination, and immortals. Zhang Xuecheng, a “great 64 See: Song History· Biography of Gong Dingchen: “Gong Dingchen has been remonstrating in the official position for several years. He never minds small things, but has no scruples about big things.”

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historian”65 of the Qing Dynasty, raised questions about the classification. He said that “The books of fang ji are classified in four categories: channels, vessels, formulas and Medicinals…The four categories reviewed by Li Zhuguo are in fact channels and formulas, missing the vessels and Medicinals. Divination and immortals are Taoist magic arts. They are not authentic fang ji. Those books on fang ji are still ignorant of the meaning of the four categories.”66 Afterward, the compiler of General Catalogue of the Complete Library in the Four Branches of Literature· Master TCM Doctor was sensible that immortals were not authentic medicine. “They were all canceled due to indeterminate origin.” It is not so much Li Zhuguo was ignorant of the meaning of the four categories, that his category had the relics of Taoism. There are doubts that “divination” was the predecessor to the “technique of medicine.” The divinations listed in Han History· Bibliographical Treatise fall into the categories of astronomy, calendar, five elements, yarrow turtle, miscellaneous divination, and xing fa. Historical Records · Biography of Bian Que and Chunyu Yi tells of “Zhong Shuzi, an enthusiast of the technique of medicine,” who held a sacrifice in the capital to protect against disasters. Obviously, the favorite of Zhong Shuzi was “divination,” not the “technique of medicine.” According to historical documents, “divination” and the “technique of medicine” had recent origins. “Divination appeared after the Qin and Han Dynasties. It was about the promotion, restriction, inhibition and transformation of Yin-Yang and Five Elements.” (General Catalogue of the Complete Library in the Four Branches of Literature· Divination). “The technique of fang ji” originally included medicine, divination, astrology, and physiognomy. As the “Five Elements Summaries” and “Divination Summaries” were listed separately in Han History· Bibliographical Treatise, fang ji was purified, remaining the contents of medicine only. We can know from this that “medicine, with widespread uses, was for the benefit of people, so the ancient people attached importance to it. During the reigns of Qin Shihuang, books were burned and the literati were buried in pits. But the medical books did not extinguish, and the essence of 65 See: Compilation of Anecdotes of the Qing Dynasty· Zhang Shizhai the Great Historian. Zhang Xuecheng, styled Shizhai. 66 See: Annotation of the General Meaning of Literature and History (Part 2), by Zhang Xuecheng of the Qing Dynasty, proofreader: Ye Ying, Beijing: Zhong Hua Book Company, 1985, p. 1083.

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medicine was passed on” (Explanation of Han History· Bibliographical Treatise by Zhang Shunhui). The “origins” of “divination” and “fang ji” were related to The Book of Changes. Divination was “in fact a branch of The Book of Changes coupled with miscellaneous teachings” (General Catalogue of the Complete Library in the Four Branches of Literature· Divination). Fang ji is “the instrument for life preservation. It is a duty of the officials of the Son of Heaven” (Han History· The Technique of Medicine). “Life preservation is the equivalent of change,” so “divination” and “fang ji” have the same origin and many intersections. The Book of Change is about the science of life and survival. Only by following the laws of heaven and harmonizing the way of heaven with humanity, astronomy, and humanity, can human beings have a healthy life. July 17, 2020

Master TCM Doctors Inspired by Filial Piety Context Tips Historical master TCM doctors and their filial piety; master TCM doctors inspired by filial piety (Huangfu Mi, Zhang Zhongjing, Xu Shuwei, Li Gao, Zhu Zhenheng, Zhang Congzheng, Liu Wansu etc.); The Book of Filial Piety and Confucius’ thought of filial piety. Alas! In the Qi and Liang periods of the Southern Dynasty, people without medicine knowledge could not be a filial son. –Essential Secrets from Outside the Metropolis by Wang Tao of Tang Dynasty

In Chinese history, many Confucianists were inspired by filial piety, and they branched into the world of TCM. When they became doctors, these people wrote works to unlock the mysteries of medicine. They blazed a trail for others to follow and brought blessings to the common people. Without Treatise on Typhoid and Miscellaneous Diseases and Differentiation on Endogenous, we might never have known Zhang Zhongjing, Li Dongyuan, and other master TCM doctors.

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This special medical tradition began with Huangfu Mi. To know about it, we must touch on the subject of the Chinese acupuncture and moxibustion and Huangdi’s Three Acupuncture and Moxibustion Classics A and B (The ABC Classic) worshiped by latter generations. Acupuncture and moxibustion are skills unique to TCM by using the stone needle. Classic works include Acupuncture and Moxibustion Chart , Bronze Man Acupuncture and Moxibustion Manual, and The ABC Classic. Significantly, The ABC Classic, as an icon of TCM, has gone beyond China to Japan, and finally reached the world. In this process, the contribution of Huangfu Mi (styled Shian, 215–282), who got down the ancient acupuncture and moxibustion technique on paper, was essential. At first, Huangfu Mi was a Confucian scholar “devoted to writing poetries and elegies.” “Inflicted by diseases” and encouraged by the elders, he became a doctor later. Huangfu Mi came from an official family. As a young man, he would not learn and had no sense of purpose, but his filial feelings toward the elders had never wavered. Once, he paid respects to his aunt with melons and fruits. The lady was sensible and she said to Huangfu Mi in the words of The Book of Filial Piety that one was not really a dutiful son, even if he paid respect to his parents with cattle, sheep, and pigs every day. “You’re in your twenties, but you don’t take study seriously enough and are not aware of its importance. I’ll have no solace even if you send me food every day. I’m weeping bitter tears,” said the lady. Huangfu Mi kept his aunt’s words with him. In the life-changing moment, he had a revelation: “The body is a gift from the ancestors, and one would be a hollow existence if he has no knowledge of medicine! One may be filial and kind, but if he doesn’t master the ethic of medicine, it would be impossible to help when his parents are in danger.” This sharpened his resolution to leave literature and take up medicine. Zhang Zhongjing (named Ji, c. 150~154—c. 215~219) was the “medical sage” in Chinese history and the founder of clinical TCM. He was the prefecture chief of Changsha, hence the name Zhang Changsha. According to historical documents, Zhang Zhongjing lived in the times of plague and war. As the beneficiary of the ancestry system, he was appointed prefecture chief of Changsha, but he was a rebel against his class. During his office, he attended to the locals openly, setting a precedent of master TCM doctor receiving patients. It’s only that the patients were received in the official court, not the herbal medicine store. After decades of struggle, he created Treatise on Typhoid and Miscellaneous Diseases , a clinical medicine classic. The dynamics of his creation was that

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Zhang Zhongjing witness the death of his relatives in a plague. In Jian’an period of the Han Dynasty, Zhang’s populous clan was hit by a plague, and two-thirds of the relatives died. The once prosperous clan declined, and Zhang grieved at his clan members who received no treatment and died. Seeing that the country was ravaged by wars and plagues, Zhang was struck by feelings of obligation to rescue people from their plight. He was unceasingly at work studying the teachings of the ancient people and collecting medical prescriptions. Zhang Zhongjing was credited with converting the TCM theories into clinical medicine. There were many well-known figures who changed the current of life because their parents died from having an ignorant doctor. They included Xu Shuwei (1079– 1154), an academician of Southern Song Dynasty and a “master TCM doctor”; Li Gao (1180–1251), founder of the “school of reinforcing the earth” (spleen and stomach), who was ranked among the four great physicians of the Jin and Yuan period, and Zhu Zhenheng (1281–1358), founder of the “school of nourishing yin.” The domestic circumstance of Xu Shuwei was most melancholy. As the son of a senior martial official, Xu and his family were well provided. When Xu Shuwei was 11 years old, his father was struck by plague and very dangerously ill. As the levels of doctors were quite modest then, the patient was no better but rather grew worse after taking the medicine they prescribed. At last, he died of illness. After his father’s death, the young Xu Shuwei attached himself for life to his mother. Two months later, Xu’s mother, who had been grieving and overworking, slumped to the ground unconscious, with teeth set and saliva in fluids. Xu Shuwei hastened to go to a doctor nearby, who diagnosed the lady’s condition as apoplexy. He prescribed three Datong pills for purgation. The pills caused diarrhea due to which she lost her focus and became delirious. Before long, she was gone. Within a hundred days, Xu Shuwei had lost his father before his mother and been orphaned. “Very much distressed at the lack of an abled doctor, which caused his parents to await their deaths,” he swore he would become a doctor and bring people back to health and life. In searching for the TCM books later, he “focused on the books on the technique of medicine and vowed to save the life of people.” As a person of the Song Dynasty, Xu Shuwei was an “authority” well versed in the Treatise on Typhoid and Miscellaneous Diseases written by Zhang Zhongjing. The book was recommended by the Qing people as the equivalent of The Great Learning and The Golden Mean in Confucianism. It was written with opaque language and impenetrable. Since its

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publication, Xu Shuwei was the only one who could fully make sense of it. Dozens of medical cases were inventions with contemporary relevance.”67 Xu Shuwei lost his parents when he was a boy, but he remained true to his original aspiration and became a master TCM doctor. Li Gao (known by the literary name Dongyuan Old Man in his later years) was ranked among the four great physicians of the Jin and Yuan periods. Born into a family of affluence, he had spent a lot of money on medical study. His family was the richest in the two districts. In his boyhood, Li Gao had acquired the orthodox Confucian-learning education. He had a reverence for the Confucian rites and customs. As a person of fealty and good faith, he was ethically aware and charitable. However, a sudden storm of calamity had blown up out of nowhere. When Li was twenty years old, his mother Wang fell sick. The family turned from one doctor to another.68 They advanced many theories, but couldn’t reach a conclusion of the complaint of Wang. The lady had taken many medicines, but the illness was delayed. She did not live to discover what she suffered from. Self-loathing rose inside the young Li Gao. He said after a lot of soul-searching that if he met a skillful doctor, he would study medicine from him to make atonement for failing to rescue his mother. When he heard of Zhang Yuansu (styled Jiegu), a master TCM doctor, he went with a lot of money and learnt TCM from him. Thanks to the special tutoring of the teacher and his own efforts, Li Gao accomplished his study and presented the theory that “internal impairment of spleen and stomach would bring about various diseases.” This represented the enlightenment, sublimation, and innovation of TCM theory. We attribute it to internal and external causes, and Li Gao’s good command of Confucian learning. Li Gao was a competent doctor with good character. Mr. Xu Heng, a famous scholar devoted to the study of Confucianism and educator in the Jin and Yuan Dynasties, said, “Dongyuan was the leader of TCM doctors. People aspired to a medical career must read his books, and he can talk

67 Medical Cases in Ancient and Modern Times by Yu Zhen of the Qing Dynasty, in the collection of Li Lingshou, a native of Wujiang, in 1883 during the years of Guangxu in Qing Dynasty. 68 Essential Readings for Medical Professionals · Vol. 1 by Li Zhongzi of the Ming Dynasty: “Some doctors and patients are not acquainted. During the differentiation of syndromes, the patients turned from one doctor to another. Afraid of making mistakes, the doctors could only prescribe ordinary drugs such as Scutellaria baicalensis and platycodon root.” See the edition of the 10th year of Chongzhen in the Ming Dynasty (1637).

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about medicine in future.”69 Xu spoke very apropos. As a teacher, Li Gao was commendable for his efforts in giving lessons, imparting knowledge, and solving problems. According to Biography of Dongyuan Old Man, Luo Tianyi wished to study under Li Gao, and the first thing Li asked was, “What do you study medicine for? Making money or inheriting the ethic of medicine?” Satisfied with the answer of Luo Tianyi, Li Gao took him on as an apprentice. Luo was properly housed and fed, enjoying the privilege of “full scholarship.” When Luo completed his apprenticeship, Li Gao awarded him twenty taels of silver for his meticulous scholarship. Luo wouldn’t accept the money, and Li explained, “I’ve passed on all the knowledges to you, will I begrudge the small money?” Li Gao’s nobleness in educating people was certificated. Even today, many people couldn’t seem to figure all this out. In fact, the hardest thing for a teacher to do is not imparting knowledge, but finding the right person. Li Gao kept a low public profile in his life. During his period of office as the tax commissioner in He’nan, an epidemic called head infection struck the place. The local doctors never found reference to this disease in TCM books, and their views were so different. They prescribed the wrong medication which had been quite without effect and even caused the death of many sufferers. These doctors didn’t admit error, and the patients’ relatives didn’t sense anything wrong. The epidemic continued to ravage the place and the local people were wild with torture. Li Gao sympathized with the innocent people and he avidly exploited the pathogenesis and spreading of the epidemic. He saw through the appearance to perceive the source of the epidemic, and made the prescription which worked out well. Li Gao proceeded to carve the prescription on a board and placed it in public. Thinking that it was a message conveyed by the immortals, people inscribed the words on a dome headstone. The stone was mounted on the ground to bring blessings to the common people. Here’s another example: Zhu Zhenheng, founder of the school of nourishing yin who acquired accomplishments in both “academy” and “medicine.” Just as other intellectuals in ancient times, Zhu Zhenheng initially took the path of “academy.” He hoped through the imperial examination to obtain an employment in the imperial court. In the beginning, he’d 69 Xu Heng (1209–1281) styled Zhongping, also known by his literary name Lu Zhai, was a Neo-Confucianist and educator in the Jin and Yuan Dynasties.

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planned to study Confucian classics. But he heard, afterward, that Xu Qian, the fourth disciple of Zhu Xi, was living secluded in Mount Bahua where he lectured on the study of mind and nature. Many people took lessons from him and Zhu Zhenheng was attracted. The speech of Xu Qian that “exploring the secret of life was the Mandate of Heaven and the highest state of governance” was particularly touching to him. Thinking that Xu’s theory was compact and sound, Zhu decided to take lessons from the master. If things worked out like that, Zhu Zhenheng would be quite capable of climbing up the official ladder. But fate evidently had something else in mind. The prospect of “shooting to fame overnight” was a dream shared by many people, as well as a dilemma worthy of nightmares. Zhu Zhenheng’s father and wife “died from taking the wrong medicine,”70 and his heart was broken by the fact. After the pain passed, he decided to give up his study and dream to become an official. Besides, his master Xu Qian suffered limb illness and was bedridden.”71 He encouraged Zhu to “become a doctor.” Under the influence of internal and external factors, Zhu Zhenheng asked himself: “I’m poor and can only maintain my own welfare. Still, I aspire to bring blessings to the people, and I think the only way is to become a doctor” (Literature of TCM History of Mr. Zhu Danxi by Song Lian of Yuan Dynasty). Zhu Zhenheng had a real interest in the welfare of people! Xu Qian was seen by Zhu Zhenheng as the “incarnation of sage.” When he first heard the lecture of Xu, Zhu, in much agitation, regretted his hollow, dissipated72 lifestyle, and sighed over the lack of a teacher. Indeed, Xu Qian had no aspiration for fame or gain. He was a Confucian scholar “catering for all abilities,” and he had got his reasons in encouraging Zhu Zhenheng to become a doctor. As the direct inheritor

70 See: Further Treatises on the Properties of Things · Preface by Zhu Zhenheng of Yuan Dynasty. 71 According to The Sequel of Classified Medical Records of Distinguished Physicians Vol. 16, the limb disease of Xu Qian was caused by phlegm accumulation and cold-dampness pattern. He suffered stasis pattern of meridians qi and blood, fluid blockage, phlegm and fluid infusing into osteomere. He had been confined to bed, unable to sit or walk for more than ten years. Eventually, Zhu Zhenheng cured him of the disease. 72 Shenming Dianji: Shenming: fooling around; Dianji: dissipation. 隋: pronounced ji.

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of Confucianism, he “inherited all the learnings passed on by Zhu Xi, aka Kaoting.”73 When Zhu Zhenheng was thirty years old, his mother suffered from spleen ache and her illness resisted the efforts of all medical professionals. Fearing a repeat of his father’s tragedy, Zhu read Plain Questions and taught himself the medical knowledge. Three years later, he began to get the hang of TCM. Five years later, he put his lessons into practice. He personally prescribed the remedy for his mother, successfully curing the lady of disease. The incident fortified Zhu’s determination to study medicine. The five years’ experience of self-study proved to be a solid foundation of his formal study from Luo Zhiti in future. But all was not well in the process. When Zhu paid his respect to Luo, the latter was insolent in bearing and manner. He wouldn’t meet Zhu although the latter had paid him several visits. At last, Luo was touched by the sincerity of Zhu and took him on as a disciple. Influenced by Xu Qian, Zhu Zhenheng was oriented by Confucianism and medicine all through his lifetime. He had a reputation for pragmatism over ideology, and argued that life “has to be experienced.” In medical practice, he fostered a creative spirit and argued against “treating today’s disease with yesterday’s formula.” For the revitalization of medicine, people were supposed to break away from the traditional laws, rules, and criteria. Zhu Zhenheng had raised many crucial ideas on medicine, which were in large part due to his solid background of traditional Chinese culture and philosophy. The most outstanding example is his redefining and skilled use of “decoction for invigorating spleen and replenishing qi” invented by Li Gao. Zhu Zhenheng thought that the landscape of China was higher in the west and lower in the east. Therefore, the yang qi of the northwestern people tended to descend, while the yin-fire of the southeastern people tended to ascend. In light of this, the decoction was suitable for the southeastern people and unsuitable for the northwestern people. Zhu Zhenheng learned from the three master TCM doctors Liu Wansu, Zhang Congzheng, and Li Gao. He referred to ancient people’s

73 Stone Classic in Memory of Mr. Zhu Danxi by Song Lian. Kaoting, Kaoting Village in the southwest of Jianyang District, Nanping, Fujian Province, had been the place where Zhu Xi gave lectures and lived in his later years. In memory of Zhu Xi, Emperor Lizong of the Song Dynasty gave the name “Kaoting Academy” in the fourth year of Chunyou (1244). Zhu Xi was known by later generations as “Kaoting.”

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theory that “Tai Chi” was the origin of everything in the world, and the philosophies in The Book of Changes , The Book of Rites, Almanac,74 and Correcting Ignorance.75 He combined the medical theories of “fire,” “sthenia and asthenia of yang path and yin path,” the movement of Tai Chi generates yang, and the five natures generate movement, with the thought of nourishing yin in The Book of Rites. He propounded the “ministerial fire theory” and the “yang is usually redundant, while yin is frequently deficient,” which stunned the medical world. Patients from everywhere “beat a path to his door.” Zhu Zhenheng was a famous Confucianist. “When he saw a talkative man, Zhu would persuade him by saying, ‘The sages live up to their ideals through their lifetime.’ They dispensed with the flashy language which was often to the detriment of good government.”76 He was a pure great doctor, believing that “doctor and Confucianist are divergent paths achieving the same ends.” Zhu was a worthy representative of Confucianists and doctors. He was a very responsible scholar-physician. Zhang Congzheng (styled Zihe, 1156–1228), who belonged to the school of purgation, was ranked among the four great physicians of the Jin and Yuan period. He had never experienced the loss of the loved ones, but was well aware of the importance of doctor. Zhang Congzheng was the author of Confucians’ Duties to Their Parents , which includes his academic thoughts. The book sums up the central idea of “becoming a doctor to perform filial duties.” The point is that “A man ought to study Confucianism to be sensible, and he ought to study medicine to perform filial duties.”77 People of latter generations put it more straightforwardly: “This book written by Zhang Zi he is dedicated to those wishing to perform filial duties.” As its name implies, the book illustrates the “basis for master TCM doctor.” The vision is a bit small, but it sheds light on the way of TCM and conveys the message that “to be a filial son, one is supposed to study medicine.”78 74 Almanac: Almanac of Zhou Zi by Zhou Dunyi. 75 Correcting Ignorance by Zhang Zai of Northern Song Dynasty. The book believes

that everything in the universe originated from Qi. 76 See: Stone Classic in Memory of Mr. Zhu Danxi by Song Lian of Yuan Dynasty. 77 See: General Catalogue of the Complete Library in the Four Branches of Literature·

Sub-catalog· Master TCM Doctor 2. 78 See: Reprinted Confucians’ Duties to Their Parents · Preface by Shao Fu of the Ming Dynasty.

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Zhang Congzheng’s idea that “to be a filial son, one is supposed to study medicine” was the reflection of the medical experience of his teacher Liu Wansu (styled Shouzhen, 1120–1200). Liu was living in straitened circumstances. His mother could not afford the medical expenses and died of illness. Liu was hit by his mother’s death and he felt remorse at the lack of medical knowledge. Aspiring to be a doctor, he embarked on the road of medical study. Inspired by filial piety, many people became master TCM doctors. Besides, there were numerous common TCM doctors who were filial sons. At the heart of Confucian thought is “kindness and love.” What will it take to achieve this? Confucius believed that fundamental to kindness and love was filial piety to parents and affection to siblings. Here, Confucius propounded the concept of “filial piety.” Scholars of later generations raised questions over the sentence, arguing that “if filial piety was fundamental to kindness, then kindness would be the purpose of filial piety.” In Commentaries on the Four Books , Zhu Xi, a great scholar of the Song Dynasty, replaced “kindness” with “human.” In other words, filial piety was fundamental to the life of humans. It was rational and made sense. This is the original meaning of “filial piety,” which focuses on the natural attributes of people. “A filial son is an everlasting example. A man with kindness is the lifeblood of a nation.” This is the original meaning of “filial piety.” Throughout history, there had been several periods when “filial piety” was advocated. In the Confucian school, “filial piety” was more social than natural. The first period was when The Book of Filial Piety was published. The overarching question is: who is the author of the book? There are two theories in history books. First, according to Historical Records· House of Confucius by Sima Qian of Han Dynasty, Zeng Shen had been commissioned by Confucius to create The Book of Filial Piety. Second, “Confucius lectured his disciple Zeng Shen on filial piety”79 and created The Book of Filial Piety. The Book of Filial Piety is a work on filial piety, filial rule, and patriarchal ideology. At modest length, the Confucian classics was very influential. 79 See: Han History· Bibliographical Treatise: Confucius lectured his disciple Zeng Shen on filial piety. It’s only right and proper that people should perform filial piety. The book deals with a grand topic, hence its name The Book of Filial Piety.”

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Afterward, there was an equivalence between “filial piety” and “loyalty to the emperor,” and rulers throughout history held remarkable regard to The Book of Filial Piety. Based on the contents, filial piety was divided into five categories, namely, “serving the emperor,” “serving the elderly,” and “caring the parents.”80 In the feudal society, doctor was considered an insignificant profession as humble as the “scholar” or the “commoner.” They were supposed to “stay loyal to the emperor and stay filial to their parents. This is the strategy for staying employed and keeping the family line going.” Besides, they were supposed to “live meanly and take care of their parents.” In the Qin Dynasty, The Book of Filial Piety was popular. In the Han Dynasty, Emperor Wen installed a learned scholar to lecture on The Book of Filial Piety. Emperor Wu issued an imperial edict to elect a filial official and a clean official every year. The second period was the Wei, Jin, Southern, and Northern Dynasties, when “filial piety,” the moral standard for “national governance,” had penetrated various fields. The promotion of “filial piety” was meant to encourage people to stay loyal to the emperor. In Seven Summaries written by Liu Xin of Han Dynasty, The Book of Changes was placed at the top of the six arts. Wang Jian, a bibliographer of the Northern and Southern Dynasties, placed The Book of Filial Piety at the top in Qi Zhi. He considered that “Filial piety should be number one in all conducts.” This provides us with a glimpse into the current thought of the society. Some “celebrities” used “filial piety” as an excuse to stay away from the official court. Li Mi of Jin Dynasty argued that “filial piety is fundamental to the governance.” He said, “Without the care of my grandmother, I wouldn’t be where I am today; Without me, my grandmother couldn’t live out the remainder of her life.”81 He also cited “crows feeding their aged parents”82 as an example, to beg for resignation.

80 See: The Book of Filial Piety: filial piety was divided into five categories: category two for the emperor, category three for the princes, category four for the officials, category 5 for the scholars, and category 6 for the commoners. 81 See: Chen Qing Biao by Li Mi of Jin Dynasty: “Filial piety is fundamental to the governance of Jin Dynasty.” See: Selected Works of Zhao Ming. 82 The affection of crow: It was rumored that the baby crows were in the habit of feeding their aged parents. It is often used to describe filial piety. Final care: care until the end.

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The third period was the Song and Yuan Dynasties, when neoConfucianism acquired ascendancy. Neo-Confucianism was in favor of retrieving the doctrines of saints to understand the meaning of life. In light of this, Guo Juye of the Yuan Dynasty compiled the story collection of Twenty Four Filial Pieties (Full name: Collection of Poems on the Twenty Four Filial Piety) based on The Book of Filial Piety. The book was typical and written in plain language to spread the message of “filial piety” among people. However, blind devotion to parents and the emperor was blended into the book and promoted as “filial conduct.” “Filial piety” proved to be double-edged. It transformed a Confucian scholar into a master TCM doctor so that the elderly were properly looked after at home. It turned a heartless person into a man of true sentiment who cared for others. Meanwhile, it was an obstacle that stymied the traditional Chinese anatomical medicine.83 For thousands of years, The Book of Filial Piety had been affecting the custom, lifestyle, and behavior of the Chinese people. We should look at it dialectically, taking the nourishment and expelling the waste. Right now, the filial piety culture is coming through the test of times. We should take a critical look at it and inherit between variants and invariants. March 29, 2020

TCM Concept: Hanging A Gourd to Heal the Mankind “Hanging gourd” is generally known as the symbol of TCM. As an icon, it is synonymous with the medical practice of TCM doctors. “Healing the mankind” identifies the values of TCM. The conception of “hanging a gourd to heal the mankind” is attributed to a fantastic story about the “Elderly Gourd” in the Han Dynasty (Fig. 1.4). Legend has it that there was a man by the name of Fei Changfang in Shangcai, Henan, who was a market administrator. One day, an old man came to the market to sell medicine, and he hung a gourd as a sign. When the market-day nearly ended, the old man jumped into the gourd. No one in the market seemed to take notice. Fei Changfang, who was staying upstairs, saw all this, and he marveled at the scene. The next day, 83 Zeng Zi said, “A filial son is supposed to keep the body of his parents intact.” Anatomy will inevitably dismember the body, so anatomic medicine was slow to take off.

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Fig. 1.4 Gourd, the utensil containing medicine in ancient China

Fei Changfang went to greet the old man with wine and dried meat. The old man knew what he was there for and he said to Fei, “You may come here again tomorrow.” The third day, Fei Changfang arrived duly, and the old man took him to jump into the gourd. It was a place as solemn and magnificent as a palace, with notable wine and delicacies all over the table. The meal was over and the two people jumped out together. The old man said that Meng was not to tell anyone. “I’m a fairy. I have done wrong and am sentenced to selling medicine here. Now, I am leaving. Would you like to follow me?” Fei Changfang would like to go to the mountain and study medicine from the old man. He readily agreed. Impressed by his perfect

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sincerity, the old man passed on to him all the medical knowledge. Later, Fei Changfang became a master TCM doctor and saved many lives.84 The Chinese characters “壶” and “葫” shared a similar pronunciation, meaning gourd. The shape of gourd is similar to the streamline of Tai Chi Diagram, conveying auspicious meanings in Taoism. Taoist culture is closely related to TCM. Master TCM doctors such as Hua Tuo, Ge Hong, Tao Hongjing, and Sun Simiao were very attached to Taoism. So, gourd became the signboard of herbal medicine stores. March 16, 2020 References: [1] Dai Liang. Jiuling Mountain House Collection [M]. “Four major categories series”, Preliminary edition in reduced size. [2] Fang Xuanling, etc. The History of the Jin Dynasty [M]. Proof reading version. Beijing: Zhong Hua Book Company, 1959. [3] Li Lian. Medical History [M]. Handwritten copy of Tianyi Library. [4] Xu Shuwei. Effective Prescriptions for Universal Relief [M]. Aki Yasarao version, 1735. [5] Zhang Ji. Treatise on Febrile Diseases [M]. Zhao Kaimei version of Ming Dynasty. Formula Rhyme of TCM Acupuncture Points.

Human Orientation: The “Medical Pattern” of TCM Context Tips The “Warmth” of Medicine; The Medical Model of “Spiritualism”; The Medical Model of “Natural Philosophy”; Psychological and Social Factors Embedded in TCM; Human Orientation of TCM; Sun Simiao, A Great Doctor Empathizing with the Patients; TCM Culture for the Welfare of People; Li Zhongzi, a physician doubled as a sociologist, folklorist, and psychologist.

84 See: The Book of Later Han Dynasty· Biography of the Art of Medicine· Fei Changfang by Fan Ye, Zhong Hua Book Company, 1965 edition.

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A doctor is bound in duty to save the lives of people. The contribution is comparable to heaven that gives birth to life. —Wang Haogu of Yuan Dynasty: Medical Treatise · Preface

The attitude of doctors toward patients and diseases may give us an insight into the “warmth” of the hospital, not altogether the “warmth” of medical science. There’s scarcely anyone who never goes to the hospital or takes medicine in his life. It would be impossible for a person to avoid going to the hospital. Doctors are supposed to take a humane approach toward patients. There’s no need to use idle words such as patients are the “God.” If doctors can treat patients the way they treat their close relatives, that is sufficient. The humane approach of doctors is derived from the medical model, including the understanding of what medical science really is, the social attributes of diseases, and the remedies of healing and their applications. The kind of medical model we have determines the level and pattern of medical service we’ll get. At various stages of history, the scientific level is different. In common perception, medicine has been through several periods in human society: spiritualism, natural philosophy, mechanism, biomedicine, and the biological-psychological-social model. Looking around the world, we’ll find that different types of medical science have different requirements, standards, and approaches to protect health and treat diseases, and they’re not in lockstep. Some medical models power ahead, while others make the move in stages. But fast or slow, integrated or unintegrated, the philosophical thought in the dominant position is playing a decisive role. It gives birth to social humanities, concentrates on medical science the humanistic feelings, nurtures doctors on the humanity qualities, and raises the humanistic level of medical science. TCM is different from the medical models of other countries and people in the world. The characteristic of its development is as follows: 1. TCM itself had been through the so-called “Deism” model. It was only that the deity it worshiped was not the same as those worshiped by other medical sciences. In the remote antiquity, TCM had experienced a time of witches mixing with doctors. As the theoretical basis for Chinese medical science, Huangdi’s Classic on Medicine details the scenario of patients being treated by witches in the early stage

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of Chinese civilization. In a gorgeous talk between Huangdi and Qi Bo,85 the former said, “I’m told that in ancient times, diseases were cured by merely changing the thought and spirit of the patients, which was the way to cut off the cause of diseases.” Since the history in the remote antiquity is very difficult to check, we couldn’t possibly tell how to operate? In a document, Liu Xiang of Han Dynasty gave a detailed account of the whole process. There’s a great deal of imagination in his words, and a fair amount of artistic license has been taken. Also recorded in the document is the discussion between Bian Que and Zhong Shuzi, an enthusiast of the art of medicine, on the treatment program for Prince Guo. To question the viability of Bian’s proposal, Zhong narrated an event about the witch doctor buried deep inside his mind. Here’s what he said, “I’m informed that there was a witch doctor in the remote antiquity called Miao Fu. In medical practice, he would spread out a straw mat on the floor, make a straw dog and paint it. Then he would face north and ask blessing.”86 This is the way to cut off the cause of disease. The treatment process, by “removing essence and transforming qi,” or “incantation and psychology,” required neither acupuncture nor medicine. It looks more like theatrical performance. With the development of society, the internal and external environments indispensable to man’s survival were altered. And there were better ways for people to make sense of the world. “Removing essence and transforming qi” or “incantation and psychology” must be given away, and people had to find new ways to protect health. Huangdi and his officials were aware of this too. In Huangdi’s Classic on Medicine, Huangdi asked Qi Bo, “Nowadays, toxin87 is

85 See: Huangdi’s Classic on Medicine · Plain Questions ·Theory of Essence Transfer and Transformation 13. Zhu You: “Zhu” means “eradicate,” and “Zhu You” means “eradicating the cause of disease.” The ancient interpretation that Zhu You was a god in the south was faulty. Proofreading of Huangdi’s Classic on Medicine · Plain Questions by Guo Aichun, Tianjin Science and Technology Press, 1981, p. 77. 86 See: Shuo Yuan · Identification of Objects by Liu Xiang of Han Dynasty: Han Wei Series · Shuo Yuan by Cheng Rong of Ming Dynasty, Jilin University Press, Photocopy based on the Xin’an Cheng’s version published in Wanli period of Ming Dynasty, 1992, p. 455. 87 Generally refers to various medicines for curing diseases. Drugs are also called toxins because they are biased, with both curing property and toxicity.

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applied to treat the internal diseases, and acupuncture and moxibustion therapy is applied to treat the external diseases. But I don’t know why a successful cure still couldn’t be guaranteed.” Qi Bo replied, in the old days, people used to live in the caves where beasts were on the prowl in the surrounding wilderness. People moved their bodies to keep warm, and they lived in the shady places in the middle of the heat. They had no aspiration and were free of care and anxiety. In such an environment, the human body was less prone to exogenous pathogens. There was not any medicine or acupuncture and moxibustion therapy required. People just changed the thought to cut off the cause of disease. Things are changing. Today, people’s lives are beset with anxieties of one kind or another. They overwork themselves and are hurt bodily. They do things that appear to break the rules of seasons and the alternation of cold and heat. If they are invaded by Zeifeng (Thief-wind) and Xuxie (Deficiency-Evil), problems would occasionally arise in the internal five viscera and marrow, and the external openings. Ailments would develop into extreme illnesses, and people in extreme illnesses are in danger of dying. It is impossible to cure a disease by changing the thought. Over time, TCM’s view of witch doctor and “incantation and psychology” had altered—it treasured life and reflected the main problems in the treatment of diseases. To adapt to the changes of internal, external, macro, and micro environments, TCM began to change the mindset of treating diseases. With the wisdom of Chinese philosophy and profound cultural accumulation, it was making steady progress. 2. After the Spring and Autumn Period and Warring States Period, restructuring of TCM mode, which was signaled by the publication of Huangdi’s Classic on Medicine, took place. TCM solemnly declared that “It is not worthwhile to talk the esoteric healing theories to those believing in ghosts and spirits”.88 This illustrates the disentanglement of medical science from witch doctors and the medical model of spiritualism. That, coupled with medical classics such as Shennong’s Classic of Materia Medica and Classic of Questioning, prepared TCM to enter a new period with natural

88 See: Huangdi’s Classic on Medicine · Plain Questions ·Theory of the Five Viscera 11. “Highest technique” refers to medical theory.

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philosophy as the leading idea and featured by experience and practicality. The philosophical idea of the “unity of man and nature” was absolutely fundamental. It argued in favor of “conforming to the heaven qi,89 and preserving health in four seasons,” and “roaming the heaven and earth, and keeping the eyes and ears open.” Conforming to natural laws was the secret of maintaining health. What is Huangdi’s Classic on Medicine? Numerous people throughout history, including famous scholars, had tried to make a definition of it. Zheng Qiao, a man of the Song Dynasty, summed up in plain terms: “Huangdi studied the Five Operations and Six Vital Energies, and he asked Qi Bo some questions. This is the origin of the Inner Canon” (General Chronicle · The Three Emperors ). Zhang Jiebin, a famous doctor in the Ming Dynasty, spoke very apropos, “‘Inner’ refers to the law of life, while ‘Canon’ is the container of law, hence the name Inner Canon.” The book tells of the profound medical knowledge so broad, delicate, and deep. It explores the ways of the heaven, the logic of the earth, and what’s happening in the world…What an extensive and profound work it is! It blazed a trail for later generations to follow and unlocked the secret of longevity. The magnitude of its contribution is comparable to heaven and earth and still shines through like the sun.90 Books have a “soul.” The “soul” of Huangdi’s Classic on Medicine is the traditional Chinese philosophy of yin-yang and five elements. The yin-yang concept in philosophical, metaphysical, and abstract senses could be found in the description of many Pre-Qin classics:

89 As to “conforming to the heaven qi,” see Huangdi’s Classic on Medicine · Plain

Questions · The Union of Heaven and Human Beings : “When the heaven qi is pure, the human spirit will be smooth and peaceful. Complying with the change of qi, and the yang will be tonified. The human body wouldn’t be harmed by the deficiency-evil and the thief-wind.” 90 See: Classified Classic · Preface by Zhang Jiebin of Ming Dynasty: As a great work, Huangdi’s Classic on Medicine “deals with the ways of the heavens, the logic of the earth, and what’s happening in the world. So epic in scope, it gives a detailed account of the changes of yin and yang, the ecology of plants and insects, the origin of tonality and divination figures, and the functions of viscera and fu-organs.” The book has an everlasting significance which is comparable with heaven, earth, sun, and moon…Photocopy of People’s Medical Publishing House.

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Law is composed of yin and yang (The Book of Changes· Xi Ci 1). All things bear the Yin on their backs and the Yang in their arms; By the blending of Yin and Yang, equilibrium comes to the world (The Classic of the Virtue of the Tao · Chapter 42). Yin and yang produce all living things in the world (The Book of Rites· Sacrificial Ox). …

The earliest reference to the five elements theory comes from Shang Shu · Hong Fan. Ji Zi, the advisor to King Zhou of Shang, told the story of Gun. To tame the deluge, Gun had tried the way of blocking, but ended up disturbing the normal flow of the five elements. He learned a lesson from this failure and put forward the theory of the five elements, which referred to wood, fire, earth, metal, and water. He pointed out, “Water is characterized by moistening and downward flowing; Fire is characterized by flaming up; Wood is characterized by growing freely and peripherally; Metal is characterized by change; and earth is characterized by cultivation and reaping. They are salty, bitter, sour, spicy, and sweet.” The words illustrate that the five elements have their respective characteristics. Zhang Congzheng (Zihe), a famous doctor of the Jin Dynasty, put a case in a medical article for the sake of illustrating the use of five elements theory in medical diagnosis and treatment. According to him, patients dominated by pathogenic factors with manifestation of symptoms must not be treated by the reinforcing therapy. Without knowledge of the five elements, it’d be like taming the deluge by way of blocking (Confucians’ Duties to Their Parents Vol. 2) (Fig. 1.5). In Huangdi’s Classic on Medicine, the ancient sages and medical scientists applied the philosophic yin-yang and five elements theories to the understanding of the life phenomena. 1. The relationship between yin and yang and the existence of people. According to Huangdi’s Classic on Medicine, “A person’s life is closely related to nature.” “Life has its own form, which cannot be separated from the changes of yin and yang” (Huangdi’s Classic on Medicine · Plain Questions · On the Holomorph Life 25). “Yin and yang are the general laws of the universe and the discipline of all

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Fig. 1.5 Pattern of Huangdi’s Classic on Medicine

things. There is great reason to care about the origin of all things’ changes and the root of their growth and destruction” (Huangdi’s Classic on Medicine · Plain Questions · On the Correspondence of Yin and Yang 5). To sum up, human body is an ensemble of yin and yang, which are omnipresent and interdependent. If the superficial is yang, the internal is yin. On the superficial aspects of the body, the back is yang and the abdomen is yin; On the internal aspects of the body, the six fu-organs—the gallbladder, the stomach, the large intestine, the small intestine, the urinary bladder, and the triple energizer, are yang, while the five zang-organs—the heart, lungs, spleen, liver and kidneys, are yin. Even the same organ can be divided into yin and yang. For instance, the kidney is divided into kidney-yin and kidney-yang. In the philosophical perspective, yin and yang are not physical matters in the universe, but the properties of matters. TCM believes that yin governs tranquility, and it represents the material basis of the human body; Yang governs activity, and it represents the movement of human body. In various chapters of Huangdi’s Classic on Medicine, the theory of yin-yang is highlighted or briefly outlined. 2. The argumentation on the relationship of yin and yang and the medical value of the theory. In respect of the causes of disease, Huangdi’s Classic on Medicine argues that “If one is disobedient to this, disasters will ensue; if one is obedient to this, diseases will not

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arise” (Huangdi’s Classic on Medicine · Plain Questions · The Art of Life Through the Four Seasons 2). “To stay healthy and revived, the equilibrium between yin and yang is required” (Huangdi’s Classic on Medicine · Plain Questions · The Union of Heaven and Human Beings 3). In diagnosis, TCM doctors should learn from the evolution of all natural phenomena. This is because “The yin being overwhelming, the yang becomes ill. The yang being overwhelming, the yin becomes ill. When the yang prevails, there is heat. When the yin prevails, there is cold. Double cold leads to heat, and double heat leads to cold” (Huangdi’s Classic on Medicine · Plain Questions· The Art of Yin-Yang Manifestation 5). “A doctor versed in diagnosis first distinguishes the yin from yang.” “Treat the yin for yang diseases, and treat the yang for yin diseases.” “The root must be sought in treatment” (Huangdi’s Classic on Medicine · Plain Questions · The Art of Yin-Yang Manifestation 5). What is root? “From ancient times, people who knew the heavenly law realized that the basis of life is rooted in the yin and yang ” (Huangdi’s Classic on Medicine · Plain Questions ·The Union of Heaven and Human Beings 3). The process of TCM, from the cause of illness to treatment, all bespeak the principles of differentiation thinking according to yin and yang. The five elements correspond to the five viscera according to their nature and characteristic, which forms a mutual generation and restriction relationship. According to Huangdi’s Classic on Medicine, “The east produces wind. The wind promotes the wood qi. The wood qi generates sour flavor…liver in the zang-organs.” “The south produces heat. The heat promotes the fire qi. The fire qi generates bitter flavor…heart in the zang-organs.” “The center produces dampness. The dampness promotes the soil qi. The soil qi generates sweet flavor…spleen in the zang-organs.” “The west produces dryness. The dryness promotes the metal qi. The metal qi generates acrid flavor…. lungs in the zang-organs.” “The north produces cold. The cold promotes the water qi. The water qi generates salty flavor…kidneys in the zang-organs” (Huangdi’s Classic on Medicine · Plain Questions· The Art of Five Circuits 67 ). Correspondingly, “The heaven has the four seasons and the five elements…A man has five zangorgans to generate the qi of the five zang-organs.” With the waxing and waning of yin and yang, life is sustained. Thus, the etiology, pathogenesis, and therapeutic principle of TCM were formed.

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According to historical documents, relevant psychological and social factors had been incorporated into the development model of TCM before the emergence of biomedical model. Over a fairly long period of time, TCM was not a pure or typical medical science. Comparing it with other medical models in the world, we may find the features in common and the differences. In the broader context of social culture of “Heaven remains unchanged, so does law,” the features of TCM were evident. According to some researchers, Huangdi’s Classic on Medicine “was basically created in the Warring States Period. Some parts of the book consist the contents of the Han Dynasty.”91 In the Eastern Han Dynasty, Fu Weng, Cheng Gao and Guo Yu, TCM doctors with master-apprentice relationship who were renowned for acupuncture and moxibustion, were active in the medical field. “The lesser hermit lives in seclusion in the country, while the greater hermit does so in the court.”92 Seclusion was the lifestyle of men of letters in ancient China. Fu Weng and Cheng Gao lived in seclusion as TCM doctors in good practice. Guo Yu, who was well-rounded with a lot more experiences, served as the Imperial Medical Officer during the reign of Emperor He of Han Dynasty, with authority over the medical affairs. According to The Book of Later Han Dynasty by Fan Ye, Guo Yu had a benevolent mind and heart. He appeared casual and never lost the common touch. He treated all patients equally and devoted his best efforts to them, disregarding their background, social status, and fortune. In the feudal society with an entrenched caste system, the way Guo Yu valued the life and health of patients was indeed something rare and deserving of praise. He gained the respect of people and built a solid reputation.

91 Research Treatise of the Inner Canon by Ren Yingqiu and Liu Changlin, Hubei People’s Press, 1982, p. 19. See: Ten Topics on the Study of Huangdi’s Classic on Medicine · The Time of the Completion of the Inner Canon. 92 There are many versions of ancient scholars’ view of seclusion, such as “The greater hermit lives in seclusion in the court (city, world); and the lesser hermit lives in the wilderness (mountain, pharmacy).” Many doctors were used to the lifestyle. “The ancient sages either serve as court officials or doctors.” Chunyu Yi, Hua Tuo, Huangfu Mi, and Tao Hongjing became doctors as another way to show their “benevolence.” Bai Juyi of the Tang Dynasty said in his poem Medium Hermit, “We cannot have all things to please us in life. The conditions of the lowly are tough; The rich are always bothered by troubles. Only a hermit can live a peaceful life.”

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In the long medical practice, Guo Yu discovered something strange: The wealthy people were hard to be cured. But when they wore old clothes and moved to another place, their diseases would soon be cured. At first, Guo was confounded: Would there be a “link” between the curative effect and the fortune of the patients? Thankfully, he knew the minds of patients and doctors very well. He believed that there was some sort of psychological interaction between doctors and patients due to the differences in social status. The patients of superior social status were wayward, and they doubted the ability and competence of doctors. They used to live a life of ease and comfort, with freewheeling lifestyle. They paid no attention to life nurturing and their physique was weak. It would be a difficult thing for the doctors to attend the noble persons. There were just too many variables to consider, such as the inhibitions of the timing of acupuncture and moxibustion application. The sense of fear would make the doctors very cautious and deprive them of all power of attention. They would perform below their potential. Worse, some noble persons would assume a patronizing air and instruct the doctors on their work. Terrorized by them, the doctors would break the basic rules of treatment. As we know, the doctors must give undivided attention and determination to the needle. Only in this way could diseases be cured. These demonstrated the depth of Guo’s sensibility derived from his medical practice. He considered that doctors must take into consideration the social status of patients while performing medical procedures. Only in this way could they offer a comprehensive and targeted treatment program which proved effective. And so, Guo Yu said to Emperor He, “A doctor must be meticulous.”93 He believed that the doctor must think thoroughly over every situation that might arise during the treatment process. That was because the tissues of the human body are very delicate, and the doctor must be closely attentive when treating them. The application of needle must follow the pattern of circulation of qi and blood. “Doctors should take initiative to comprehend the philosophy of medicine.” Evidently, in medical practices, there was also the consideration of the complex psychological activities between doctors and patients,

93 Huangdi’s Classic on Medicine · Plain Questions ·The Manifestation of Tip and Root Cause of Disease 65: “Doctors should inspect the jian and shen meticulously, and adjust the root and tip carefully.” Jian means slightness; Shen means seriousness. See: Proofreading of Huangdi’s Classic on Medicine · Plain Questions by Guo Aichun, Tianjin Science and Technology Press, 1981, p. 360.

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and social factors. It was the duty of doctors and they would follow it to the end. TCM doctors of later date interpreted the sentence in different ways, which made medical science more complete and promoted the development of medical model. Time goes on. In the Tang Dynasty, Sun Simiao, a great doctor blending Confucianism, Taoism, and Buddhism, came onstage. He was the author of The Good Faith of Doctors , a medical work which was considered the Chinese equivalent of The Hippocratic Oath and the enhanced version of the Chinese Doctors’ Oath. Sun believed that “Life matters more than a thousand pieces of gold. Saving life is the most benevolent act a TCM physician ever performed” (Invaluable Prescriptions for Ready Reference · Preface). Sun Simiao advised against the aspiration for fame or gain. He thought that doctors must, first and foremost, have sympathy for the patients. They must strive to cure the patients of their diseases, and treat all patients equally, disregarding their fortune, age, appearance, relationship, nationality, and intelligence. They must overcome all sorts of difficulties—the rough road, the darkness of the night, the heat and the cold, and hunger, fatigue, and thirst. None of these is meant to serve as an excuse. A qualified doctor should always be composed and generous; he looks inward and is meticulous about his work; and he treats all patients alike, with neither humbleness nor haughtiness. When summoned to the house of the patient, he must not look round the room or be joyful; he must not eat or drink, or show self-complacency; he must not make noise or criticize the patient; he must not speak ill of other doctors to promote himself…The words give a comprehensive and detailed account of the norms and code of ethics of medical practice. This enhanced version of the Chinese Doctors’ Oath provides a glimpse of Sun Simiao’s vision of medical practice. It deals with the psychological problems, social ethics, and moral character of doctors, which have realistic significance. To properly handle the doctor-patient relationship, doctors should show sympathy for patients and put themselves in the position of patients. What a doctor says and does are associated with the spirit of medicine, and the wellbeing of the patients. A “great doctor” should have superb medical skills and high moral character. The theory of “great doctor” was first propounded by Sun Simiao, who himself was a great doctor. Sun believed that “great doctor” was comparable to the “sage” noted by Zhuang Zi in

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Free and Easy Wondering , and the “sage”94 with high moral character in the antiquity noted in Plain Questions. Sun Simiao assimilated the essence of Confucianism, Taoism, and Buddhism, and he studied hard even in his old age. He “unraveled the mystery of law” with superb medical skill and high moral character. In Confucianism, he was warm and affectionate; in Taoism, he did good ungrudgingly; in Buddhism, he took pity on people. After more than a thousand years, he is still a role model for the Chinese people. TCM is under the influence of traditional Chinese culture. TCM doctors should “improve the lot of mankind with no aspiration for fame or gain.”95 They must not “use their expertise to enrich themselves.” It has become a redline that TCM doctors could not step over. TCM doctors throughout history strictly followed an unchanging rule: every detail in the process of treatment must be tended to, and medical practice shouldn’t be done on a for-profit basis. It is a well-known fact TCM is also called “apricot grove.” Tracing the source of the term, we would find that it is a symbol of medical ethics and incorruptibility. According to The Tales of Immortals Vol. 10 by Ge Hong of Jin Dynasty, the origin can be traced back to the Three Kingdoms Period. Dong Feng was a famous doctor of Wu kingdom (222–280) who was good at dealing with all baffling symptoms. Once he practiced medicine in Jiaozhou where there was an official who was dangerously ill. The local doctors were absolutely at a loss what to do, and they sought out Dong Feng’s help. Dong fed the patient with three pills and the latter came back to life. After further treatment, the patient gradually recovered. The story of Dong Feng spread throughout Jiaozhou, and the number of patients coming through his doors had risen. Dong Feng put in a rule: if the patients were cured of illness, they didn’t have to pay, but were required to plant an apricot tree around his house. For those with extreme illness, they should plant five trees when they had recovered. A few years later, Dong Feng’s house was shut in by apricot trees. 94 See: Huangdi’s Classic on Medicine · Plain Questions · The Universal Truth 1: “There were supreme men in the middle ancient times who possessed up-right virtues and skilled health care. They adapted themselves to changes of the yin, yang and four seasons. Wang Bing noted: “This is the supreme way, hence the men were called the sage. With matchless ease, they always knew the way.” 95 See Internal Treatments of Folk Medicine · Introduction by Zhao Xuemin of Qing Dynasty: “Doctors must strive to cure the patients of their diseases, with no aspiration for fame or gain.”

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“A vernal tint freshens the apricot grove. It is the most delicious retreat that the imagination of man could conceive.”96 When the apricots were ripening, the trees were dripping with golden fruit. Dong Feng made a strange condition: people can fetch the apricots without paying. They only needed to exchange with the same weight of millet. Many people were confused, and they asked Dong, “You don’t have a big family, and there’s no need of so much millet. Are you using it to make medicine?” Dong Feng did not answer, but built a large barn near the apricot grove to store the millet. Before long, the barn was filled with millet. Dong Feng told the villagers that the millet was to help people in their difficulties. The hungry mass could fetch millet here without paying. People finally understood his purpose of helping the poor, and credited him for his kindness and benevolence. Afterward, when people saw the apricot grove, they thought of Dong Feng, a skillful doctor with high moral character. “Apricot grove,” the alias for TCM, was dedicated to the memory of Dong Feng. It has been synonymous with the good practice of the trade. TCM has been going on for more than 2000 years. In this process, the noble spirit was embraced and rekindled. The benevolence and unselfishness of TCM doctors were manifested even in the trivialities of medical procedure. Sun Zhihong, a medical doctor of the late Ming Dynasty, wrote the Concise Medical Work. He put it this way, “Syndromes are divided into cold, heat, deficiency and excess natures, which must not be confused. The doctors should prescribe carefully. If they are uncertain, prescribe a small dose first and gradually increase the dosage. When the disease is cured, stop taking the medicine. Powerful drugs must not be taken in excess.” The medical advice reflects the affection of doctors to patients. Li Zhongzi (styled Shicai, 1588–1655), a famous folk doctor in the late Ming and early Qing Dynasties, was very conscious of the social, psychological, and humanistic factors of medical science. His view of “never be unsophisticated,” a brilliant epigram in Huangdi’s Classic on Medicine, was original. In the long medical practice, he gained a keen understanding of the epigram. He made his own experience into a general rule, which could be reduced to the “psychology of patient,” the “psychology of outsider,” and the “psychology of doctor.” The interaction of the three 96 Tang Shunmin of Yuan Dynasty: To the Rhyme of Nan Lü A Flower and Spring Memory.

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kinds of people, and the complex psychological activities and demands of people of various qualities, cultures, experiences, and ages in the medical process, were perceptively written. Li Zhongzhi was more than a doctor. He was a sociologist, folklorist, and psychologist. To qualify as a doctor, one must know humanity. To him, it was very difficult to understand the three kinds of people and handle their relationship properly. If we couldn’t put these psychological activities in the objective perspective, the discussions would be one-sided. In case of pandemics, rumors would fly around due to the lack and asymmetries of information. In the Song Dynasty, TCM was put through the process of modernization and on the track for productive development. Building on its past glory, it was well positioned to stage a comeback and contribute to the betterment of society. However, the interaction of Chinese and western cultures and the changes of international outlook put a stop to the development of TCM. Happily, in the broader context of “Chinese learning as the essence and Western learning for its utility,” TCM entered the transition phase. With the emergence of the sect of epidemic febrile diseases and the convergence of Chinese and Western medicine, we can see the first glimpse of hope for the modernization of TCM and ethnic medicine. First draft: February 5, 2020 Revised draft: July 25, 2020 References: [1] Fan Ye, The Book of Later Han Dynasty [M]. Beijing: Zhong Hua Book Company, 1965. [2] Li Zhongzi, Essential Readings for Medical Professionals [M]. 1637 (the 10th year of Chongzhen). [3] Sun Simiao, Invaluable Prescriptions for Ready Reference [M]. Photocopy of the Song Version. Beijing: People’s Medical Publishing House, 1955.

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TCM Concept: The Germination of TCM---The Age-Old Chinese Wisdom for Health TCM is also called “Qi Huang Zhi Shu” (Chinese herbal medical science). Initially, the term was synonymous with Huangdi’s Classic on Medicine, the theoretical basis for TCM. So, Qi Huang Zhi Shu was also synonymous with TCM. Some scholars believed that97 Huangdi’s Classic on Medicine articulated in a questions-and-answers way between Huangdi and his six officials—Qi Bo, Wei Rongou, Bo Gao, Shao Shi, Shao Yu, and Lei Gong, the profound knowledge, hence its name Qi Huang Zhi Shu. The book was not written by a single person in the same period, but written between the Warring States Period and the Eastern Han Dynasty. As a great work displaying many aspects of ancient Chinese science and culture, such as astronomy, biology, anthropology, psychology, logic, and philosophy, Huangdi’s Classic on Medicine “deals with the ways of the heavens, the logic of the earth, and what’s happening in the world. So epic in scope, it gives a detailed account of the changes of yin and yang, the ecology of plants and insects, the origin of tonality and divination figures, and the functions of viscera and fu-organs.”98 The TCM theory is a comprehensive one containing the very essence of natural science and humanities in ancient China. Standing at its center, Qi Huang Zhi Shu is an important part of traditional Chinese culture. “Inner, the way of life” (Classified Classic by Zhang Jiebin of Ming Dynasty). “Canon, the constancy, the law, the way, and the cause” (The Annotation of Classics by Lu Deming of Tang Dynasty). Huangdi’s Classic on Medicine is among the earliest ancient classics of China. There is a great theoretical and practical significance in it. Since its publication, Huangdi’s Classic on Medicine has been the subject of study throughout history. In Proofreading of Huangdi’s Classic on Medicine · Plain Questions written by Professor Guo Aichun, a famous 97 Ren Yingqiu and Liu Changlin: Research Treatise of the Inner Canon, Hubei People’s Press, 1982. 98 See Classified Classic· Preface by Zhang Jiebin of Ming Dynasty, photocopy by People’s Health Publishing House, 1956. The Inner Canon is among the sanfen…The book has an everlasting significance.” Fendian, the books of Fuxi, Shennong and Huangdi, is known as “sanfen” (earliest ancient classics of China). They give an account of the great truths. The books of Shao Hao, Zhuan Xu, Gao Xin, Tang Yao and Yu Shun, which is known as “five classics,” give an account of the common laws. (Zuozhuan · The 12th Year of Zhao Gong ).

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literature expert of contemporary medical history, “the source of the book is traced.” “Huangdi’s Classic on Medicine has an origin lost in the mists of antiquity. There are many errors in the book” (Supplementary Note on Huangdi’s Classic on Medicine · Plain Questions· On Channels by Wang Bing of Tang Dynasty). The note, as a collation of Huangdi’s Classic on Medicine, enunciates the principle of the book. As a classical and featured textbook of universities, it is a representative work on the study of Huangdi’s Classic on Medicine with contemporary values. March 17, 2020

CHAPTER 2

The Cultural Versatility of TCM Doctors

Reader’s Guide If lyre-playing, chess, calligraphy, and painting are the four fancies of men of letters, then TCM must be the fifth one for some literati, in particular some cultural gurus and elites. This is because TCM is also a discipline requiring profound cultural accumulation. Meanwhile, it is a way to maintain health, to “save oneself from imminent disasters”,1 and to contribute to a life of elegance. Early master TCM Doctors in China were mostly cultural elites of the “Confucian school.” They provided TCM with plenty of cultural nourishments and invested it with the sentiment of humanistic care. By demonstrating humanism which is intrinsic to TCM, such as human kindness and love, ethical awareness, equality, and treatment based on syndrome differentiation, they managed to humanize the profession. In ancient times, it was also a very fashionable thing for cultural gurus and elites to dabble in TCM beyond their own specialty. These people fell under three categories. 1. Cultural elites leaving the literary circle and taking up medicine for some reason. As trailblazers in certain realms of TCM, these highly 1 Bao Pu Zi· Miscellaneous Essays by Ge Hong of Jin Dynasty: “People beginning to study Tao would also study medicine, to save himself from imminent disasters.” Jinhuo: Imminent disasters.

© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023 G. Luo, Humanistic Spirit of Traditional Chinese Medicine, https://doi.org/10.1007/978-981-99-4273-2_2

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educated people had impressive medical attainments and carved out a niche in the profession. They included Huangfu Mi, a man of the Three Kingdoms and Western Jin Dynasty displaying many aspects of talents in acupuncture and moxibustion, and Wang Tao, a medical literature scholar of the Tang Dynasty. 2. Famous historical figures taking up the virtuous course. They dabbled in TCM during lulls in the busy schedule, and shone out in the history of Chinese medicine. These people included Shen Kuo,2 an expert in the history of natural science, and Su Shi, a literary giant. In the Ming and Qing Dynasties, the society was under the influence of the thoughts that “if one could not serve the imperial court, he should become a doctor in good practice.” Many talented scholars dabbled in TCM. The works of Yu Zhengxie and Yu Yue, textual research masters, as well as their prefaces and postscripts, are still deemed to be masterpieces of TCM culture. Here’s what Good Recipe Vol. 15 by Shen Kuo says: “The effect of a good recipe must be seen before we put it down on paper. We can take no hearsay at face value”.3 Shen Kuo was noted for his meticulous scholarship. As eminent role models, Su and Shen were as good as doctors themselves, or only better. Additions were made by later generations to Su Shi’s miscellaneous medical works and proven prescriptions, which was called Proven Prescriptions of Su and Shen. When the book came out, it was highly esteemed by people. 3. The age-old Chinese culture served as a strong bond for the cultural gurus and elites, and the master TCM doctors. They formed a close-knit companionship and went together, despite the difference in profession. The unique life experience of the cultural elites represented a major new trend of Chinese culture marked by the characteristics of “harmony in diversity.” The most prominent examples are Wang Shizhen, a litterateur of the Ming Dynasty, leader of the “Later Seven Litterateurs,” and a friend of Li Shizhen, and Yuan Mei, a litterateur of the Qing Dynasty, leader of the “Spirit School,” and a friend of Xue Xue. 2 Shen Kuo (1031–1095), his later literary name Dream Pool Oldster, was a scientist of the Northern Song dynasty. Dream Pool Essays , his masterpiece, summarizes the scientific achievements in ancient China, especially the Northern Song Dynasty. 3 See: Good Recipe, author’s preface by Shen Kuo, excerpted from Rectification of Dream Pool Essays Vol. 9, 1957, Classic Literature Publishing House edition.

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Cultural elites, master TCM doctors and their friends, and TCM practitioners had followed divergent paths, but they worked together to build a thoroughfare traversing TCM and culture. With traditional Chinese culture building the bridge between art and medicine, TCM became a part of culture and culture became a part of TCM. In this section, the author collected several episodes on the friendship of five cultural gurus and elites with medical experts, including Ji Kang (Shuye) who was fond of living without unrestraint in the Jin dynasty, Yuan Mei (Zicai) who was an outstanding poet in the Qing dynasty, Fu Shan (Qingzhu) who was an artistic master at the turn of the Ming and Qing dynasties, Gu Yanwu (Tinglin) who was a founding Confucian in the Qing dynasty, and Liu Zongyuan (Zihou)4 who was a profoundly elegant man of letters in the Tang dynasty. The author is about to favor the readers with descriptions of their contributions to TCM culture. In this way, we will learn about the implication of Chinese classics, such as paradigm of health preservation, the divine science of medicine, TCM as a refined art of healing, human kindness and love, and the discernment of gossip, so as to pass down the immortal benevolence of TCM. It’s all well and good if enthusiasts of Chinese studies can gain valuable insights into the age-old profession5 ! February 2, 2020, after the snow Revision: February 29, 2020

Medicine and Music: The Life Regimen of Guqin Players Context Tips Ji Kang’s thought of “Taoist philosophy”; The philosophical and cultural implications of “shu”; The origin of Lao-Zhuang philosophy and TCM; The first man in history to propose the holistic life regimen idea; How

4 See: Essay Collection of Liu Zongyuan Preface by Liu Yuxi of the Tang dynasty: “Han Changli (styled Tuizhi), wrote the epitaph and sent a letter for morning: ‘Alas, his life was given over to lesser men! His articles are reckoned to be as good as the ones of Sima Qian, making the works of Cui Yin and Cai Yong insignificant.’” 5 He Xing Ru Zhi: Nothing is as fortunate as this. See: Classified Classic· Preface by Zhang Jiebin.

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guqin promoted the life regimen idea of Ji Kang; Xiang Xiu’s idea of natural life regimen and Ji Kang’s idea of holistic life regimen. The bronze camel stands amidst the overgrown bushes at night. My breast overflows with love for the smart and wise. For a century in south capital elegant music is unheard. But the voices of Guangling are still ringing in my ears. —Versifying History 2· Ji Kang by Chen Pu of Song Dynasty

Ji Kang (styled Shuye, 224–263) was famous because he was ranked among the Seven Sages of the Bamboo Grove. A Music from Guangling, his swansong in the posthumous work On Life regimen, suggests that he was a life regimen specialist and a guqin player of great acquirements. The combination of medicine and guqin lends a legendary prowess to his life. As the fancy of Ji Kang, guqin was a factor to be reckoned with in his life, and it made him who he was. The science of life regimen of TCM was closely related to his “adoring the books of Lao Zi and Zhuang Zi, clear mind and temperate spirit, and love of life regimen potions.”6 In China, Lao-Zhuang philosophy was known as the “Taoist Philosophy,” which was actually the combination of the Wuming school and the Qiwu school in Taoism. The theories and propositions of Wuming school had produced the largest impact to latter generations.7 At the center of Taoism is “naturalism,” which believes that “‘Tao’ is the underlying principle behind the creation of the everything.” What does the term “Tao” mean? As the Chinese proverb says: “Human follows land, land follows sky, sky follows Tao, and Tao follows nature.” “Tao” is 6 See: Selected Works of Zhaoming On Life Regimen, in the words of Biography of Ji Kang by Ji Xi. 7 See: Students’ Q&A on Chinese Studies, Part 4, Philosophy, Chapter 2, Philosophy of Zhou and Qin philosophers: “Taoist philosophy can be divided into three schools: (a) Nameless school represented by Lao Zi; (b) Egoism school represented by Yang Zi; (c) Equality school represented by Zhuang Zi. The three schools of thought, in the final analysis, advocate ‘naturalism’. The one with profoundest thoughts and greatest influence was Nameless school represented by Lao Zi.” Commercial Press, the twenty-third year of the Republic of China (1934).

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“nature.” Lao Zi said: “Tao begets one, one begets two, two begets three, three begets all things. All things bear the shade on their backs, and the sun in their arms; By the blending of breath, from the sun and the shade, equilibrium comes to the world.” With “tripartition,” the intermediate state of things is established. There are three explanations in the academic circle for “tripartition.” First, it is a state of harmony where yin and yang are in balance. Second, it is “harmonized qi” formed by the combination of yin and yang. Third, it is the homeostasis achieved by the interactions of yin qi and yang qi from which the new harmonious bodies are born and whence all things emerge.8 What “Three begets all things” actually implies is that “shu begets all things.”9 As a philosophical and cultural concept, “shu” symbolizes the tendencies of myth and religion. In TCM, “three” has special meaning and significance. For example, based on the places where pectoral qi, nutrient qi, and defense qi are produced and the outlet of water passage, “the interiors of human body” (Canon of Classification) can be divided into the upper, middle, and lower energizers—the triple energizers. Diseases are caused by the endogenous pathogenic factors, exogenous pathogenic factors, and non-endo-non-exogenous factors; Inch (cun), bar (guan), and cubit (chi) are places for pulse-taking. The nature of disease can be divided into cold, heat, and cold-heat complex pattern, as well as deficiency, excess, and deficiency-excess complex pattern. In fact, “three” is an intriguing factor in TCM. Wandering in Absolute Freedom, the magnum opus of Zhuang Zi, expounds upon the theory of “natural philosophy”; On the Equality of Things expounds upon the theory of “knowledge philosophy”; and Nourishing the Lord of Life expounds upon the theory of “life philosophy.” The three works are representative of the doctrines and thoughts of Zhuang Zi.10 Zhuang Zi, his “doctrines” and “techniques” predating the integral system of TCM theory, was the pioneer and trailblazer of TCM. In other words, the relation between the Lao-Zhuang philosophy and TCM can be traced back a long time ago. Zhuang Zi, who said that witchcraft was

8 See: Footnotes and Comment on Lao Zi by Chen Guying, Zhong Hua Book Company, 1984, p. 233. 9 See: The Secrets of Numerology· Author’s Preface, Peking University Press, 1999. 10 Ibid.

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dubious (see: Zhuang Zi· In Response to the Emperor), first propounded the TCM theory. For example, he believed that diseases were caused by the confusion and disharmony of yin qi and yang qi. Excessive joy damages yang, and excessive anger damages yin. The damages of yin qi and yang qi, together with the disorder of four seasons, cold and heat, would hurt people bodily (see: Zhuang Zi· Zai You). Zhuang Zi thought that “tranquility serves as a recuperation of disease, and massage can prevent aging” (see: Zhuang Zi· External Things ). These medical principles have passed down over generations. In addition, Zhuang Zi was the recorder and disseminator of medical names, disease names, and drug names. The first recorded mention of six climatic factors (yin, yang, wind, rain, dimness, and brightness) was found in Zhuang Zi· Free and Easy Wondering ; and the first recorded mention of six zangorgans (the heart, lungs, spleen, liver, and kidneys. The kidneys consist two zang-organs: shen on the left and vital gate on the right) was found in Zhuang Zi· On the Equality of Things . In Zhuang Zi· Webbed Toes and Zhuang Zi· Lie Yukou, disease names such as “fu zhui xian you” and “po yong kui cuo” were recorded. Kui and cuo refer to fleshy tumors, while yong and cuo refer to yang carbuncle and yin carbuncle. In Zhuang Zi· Xu Wugui, drug names such as “shi jin” (aconite poisoning), “platycodon root,” “ji yong ” (aconitum kusnezoffii), and “jia ling ” (polyporus) were recorded. Zhuang Zi thought that these drugs had a curative effect, but they were not panacea. He was aware of one truth: “people will die without drug, and they will also die after taking the wrong drug.” Ji Kang used to live without unrestraint, playing guqin and reciting verses all day. Under the influence of the thought of Lao Zi and Zhuang Zi, he had a complete severance from all his old life. He was well-read and widely knowledgeable. Unbound by the rules and etiquettes of Confucianism, he let his personality shine through. As a man with intriguing and unusual ideas, he put more emphasis on the interaction between body and mind, and spiritual cultivation. He was bold in moving into the realm of life regimen and blazing new trails. Finally, he turned out to be a life regimen expert with “unworldly quality.” As the proverb says: “Disease arises from the heart, and physical form is governed by the heart.” When the heart is nourished, one will appear good and have a vivid expression. Mr. Yu Yingshi believed that “scholarbureaucrats of Han dynasty valued life regimen and they were practiced in the techniques of the Yellow Emperor and Lao Zi.” “The idea of Lao Zi and Zhuang Zi and life regimen were the ultimate fulfillment of

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scholar-bureaucrats in Han and Jin Dynasties.”11 Ji Kang was a model of ideological trend of the time. “Spirit is to the human body what monarch is to a country” (On Life Regimen). “What Ji Kang meant to express was that spirit was more precious than the physical form, or the interiors outweighed the exteriors” (Scholars and Chinese Culture). The expressions of Ji Kang give us an idea why the scholar-bureaucrats valued life regimen and spiritual cultivation. In fact, the tradition of life regimen predated Ji Kang’s proposing the idea. It was only that the expressions were scattershot and the focus was on material desire.12 Zhuang Zi said that “putting too much importance on material objects and one overtaxes himself. If he persists in this folly, that would be tragic!”13 It was not until the Eastern Han Dynasty that the great thinker Wang Chong again brought up the subject of the vital role of spirit in people’s health.14 Over time, abundance of health theory had gradually settled down before Ji Kang proposed the theory of holistic life regimen featuring the “unity of form and spirit” and the “nurturing of form and spirit.” On Life Regimen by Ji Kang was a masterpiece of life regimen idea. In the book, a wealth of examples of the ordinary life of people are given. Written in plain language, it gives a vivid description of the interdependence and mutual influence between form and spirit. Ji Kang was methodical and he talked so brilliantly. By presenting facts and reasoning things out, he allowed readers to reach his conclusions. For example, he said that taking drugs did not guarantee a sweating, but the sense of shame would work up a sweat. If one took no breakfast in the morning, he would feel starved with an empty stomach. But that was not always the case. When Confucius’ disciple Zeng Shen was in deep affliction for the loss of his loved one, he hadn’t eaten for seven days but 11 See: Scholars and Chinese Culture· New Consciousness and New Thought in the Han and Jin Dynasties by Yu Yingshi, Shanghai People’s Publishing House, 2003, p. 287. 12 For example, discussion on diet, see: The Analects of Confucius· Fellow Villagers: “Grain is not supposed to be fine, and fish is not supposed to be delicate.” For another, discussion on the dwelling, see: Master Lü’s Spring and Autumn Annals· Valuing Life: “When the room is large, it will be shady; when the terrace is high it will be sunny. Too much yin depresses people, and too much yang flares deficient fire up.” 13 See: Zhuang Zi·Xu Wugui: “The unbridled use of form and heart, and the obsession in worldly things are pathetic!” 14 See: On Balance· Asthenia by Wang Chong of Han dynasty: “Maintain spirit and cherish vitality. Spirit is essential for longevity. If it is unhurt, people would live a long live.”

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wasn’t hungry at all. If one didn’t go to sleep at midnight, he would suffer from a headache and feel very faint and drowsy. But when something was bothering him, he would not sleep the whole night. A good comb smoothed the hair; and wine with thick and strong flavor made the cheeks flushed. But when a vigorous man was irritated, his whole complexion would be set in a blaze and his hair would stand on end. Spirit is at work in these life experiences. These cases were highly appropriate and convincing. Ji Kang said that spirit was to the human body what monarch was to a country. If a person was in spiritual turmoil, his physical form would be impaired. It would be like if the monarch was depraved, the fellow citizens would rise in rebellion. What should the monarch do? The answer of Ji Kang was: “cultivating temperament as a means of spiritual health care, and soothing the mind as a means of body preservation.” Spiritual health care implied that emotions such as love, hatred, joy, and sorrow shouldn’t be kept in the heart forever; Body preservation implied that the impure air should be expelled to rebuild the health. The ultimate goal was to achieve the unity of form and spirit, and unblock the exterior and interior. With a life regimen like that, it was only natural that one would live a long life. Ji Kang was well aware that these were two sides of the same coin, and the effects of food proved to be double-edged. He warned against “eating too much,” which was believed to be “detrimental to health.” For example, black soya bean when eaten to excess would cause the stagnation of the body. The stimulating garlic when eaten to excess would damage the eyes. Jujube when eaten to excess would make the teeth yellow. The male musk deer eat a lot of cypress leaves and produce musk. From these examples, we would see the impact food has on the body. We can tell from these life experiences that the diversity of diet therapy, the balance of nutrition, and the compatibility of principal (jun), adjuvant (chen), assistant (zuo), and guide (shi) could fortify ourselves against diseases. These scientific approaches were of practical use. Ji Kang noted that it was important to get over short-termism and proceed slowly. The ambitious people who hoped to see a fast return tended to conceal their sentiments, forbid their desires, or even give up their aspirations. The world was filled with the seductiveness of lust, but it took years or even decades for the benefits of life regimen to show. In the face of temptation, curative effect would be sidelined. So much to gain, so much to lose. To achieve the long-range goal, one must abandon the present. Life regimen and seductiveness were exclusive, and one couldn’t

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have them together. In the position of uncertainty, of indecision, people would be divided between two feelings, and the seductiveness of lust had always been. It could only end up with the failure of life regimen. Ji Kang’s analysis into the faults of ordinary people and warning are of practical use. It had alerted people of later generations. Ji Kang’s life regimen idea embodied the materialist conception of history based on the objective laws. He scorned the false reasonings, such as “one can become an immortal through study,” or “one can achieve immortality through efforts.” When it comes to the life regimen idea of Ji Kang, we must mention the guqin with which he played A Music from Guangling, his swansong, and going away with him. For the first time in history, a man awaiting execution asked to be untied and played a piece of music. The executioner agreed to his request. In fact, Ji Kang’s life regimen idea was “played out” by guqin. He was playing a musical piece of life combining medicine and guqin. China was among the first countries in the world to place a high importance on music cultivation. The ancient sages believed that “Listening to the music, and one can be informed of the folk customs; Knowing the folk customs, and one can be informed of people’s cultivation.” The literary allusion of “music mate” is so often talked about by people. It has been synonymous with the most intimate friend. Music contributes to the peace of mind. When one is calm, he can do the rational approach. People wish for longevity and do not want to die prematurely. They crave for safety, honor, and comfort, and detest danger, humiliation, and fatigue. When the desires are satisfied and the detestations are clear away, people would be in a pleasant, moderate mood.15 Guqin, the musical instrument of choice in ancient China, revealed the heart full and eager to overflow. It captured the mood of the performer more than anything could. It was recognized by the ancient Chinese literati, which in turn developed the guqin culture. Guqin performance has been regarded as a measure of temperament, mentality, Zen, and refinement. Why was a guqin player tied up with the

15 See: Explanation of Master Lü’s Spring and Autumn Annals· Midsummer 5 by Chen

Qiyou, “So, music is to calm the mind for proper behavior…Craving for long life and hating premature death, craving for safety and hating danger, craving for honor and hating shame, and craving for comfort and hating tiredness are the nature to human beings. When they get what they crave and cast off what they hate, they will enjoy a blissful kind of calmness,” Xue Lin Publishing House, 1984, p. 272.

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wisdom of life regimen? In God’s Will, Zhuang Zi had dedicated a chapter to the dialogue between the Yellow Emperor and his minister Beimen Cheng. This article described how music excited horror, relaxed the mind, and made people confused and disoriented. It focused on the universal relevance of Tao. To Ji Kang, life regimen and guqin were merely his skills. The central idea running through The Prose of Guqin and On Life Regimen was “going beyond the Confucian ethics to embrace nature.” With a grasp of the secret of “Tao,” one would always keep his mind even. Without a care in the world, he took the sky for the car cover, the earth for the carriage, the four seasons for the galloping horse, and the yin and yang for the driver. He sprang into the air and became one with “Tao,” rhythmically flying away into the Land of Illusion with peace of mind.16 Managing to achieve this, one would be a sensible person. He could take things for what they are, enjoy the peaceful, quiet happiness, and be permanently secured from disturbance. This is the approach taken by the sensible persons in life regimen!17 The art of medicine and the art of guqin were divergent paths, but they arrived at the same spiritual destination. “There is pleasure in keeping the mind even, which makes us feel inwardly at ease and happy” (The Songs of Chu· Outings ). The words captured the secret of Taoist regimen— a happy mood, and self-satisfied complacency. How can we avoid mental confusion, relieve ourselves of emotional and moral burdens, and clear the hurdle in the way of Tao? According to Zhuang Zi, “Nobility, richness, prominence, prestige, reputation and profit are the six evils that undermine your ambition; Manners, gestures, complexions, talents, expressions, and intentions are the six evils that haunt your heart; Hatred, love, joy, anger, sadness and happiness are the six evils that taint your temperament; and avoidance, accommodation, entrepreneurship, charity, wisdom, and bravado are the six evils that block your cultivation” (Zhuang Zi· Geng 16 See: Writings of Prince Huainan· Original Way Training: “Therefore, a true man would always keep his mind even. Without a care in the world, he took the sky for the car cover, the earth for the carriage, the four seasons for the galloping horse, and the yin and yang for the driver. He sprang into the air and became one with “Tao”, rhythmically flying away into the Land of Illusion with peace of mind.” 17 See: Proofreading of Huangdi’s Classic on Medicine · Plain Questions ·The Art of YinYang Manifestation 5: “Therefore, the sages lead placid, austere and optimistic lives, and they can live to a great age. This is how the sages build their bodies.” Tianjin Science and Technology Press, 1981, p. 37. Also see Guo’s connotation “之守”: Hu Shu said, “‘ 守’ should be ‘宇’. It is a form error. Literary Expositor: ‘Yu means dwelling’.”

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Sangchu). If we purge the heart of evils, we’ll have peace of mind amidst seeming chaos, and recover our senses. As long as people observe the law of nature and have inward tranquility, they would definitely live a long life. Ji Kang always lived up to his ideals of a holistic life regimen. If we have a run-through of his life, we’ll find that he had incorporated guqin, poems, articles, friends, talking, drinking, and administering elixir into his life regimen philosophy. Ji Kang’s life regimen theory was diverse, which added new dimensions and vibrancy to his life. As is said in his masterpiece On Life Regimen, one must not get the idea that it’s not a problem to get angry or sorrowful once in a while. It’s bad for the body. Some people tonify the body by the ounce and consume it by the pound. That’s undesirable and unsustainable. We must pay attention to life regimen in every part of life, which is the only way for harmonized qi to accumulate. Xiang Xiu, Ji Kang’s dearest friend who was also ranked among the Seven Sages of the Bamboo Grove, supplemented On Life Regimen and gave it a nice touch. His article Criticism on Ji Kang’s On Life Regimen was peculiar and beautifully written. Apparently, Xiang Xiu was lashing out against Ji Kang and his On Life Regimen. In fact, he had said a great deal about natural life regimen in the article, and the bellicose tone was designed to entertain readers. We may read about intriguing topics in the book, such as “the natural course of life, humanity, human feelings and desires.” That produced the desired effect, and, as expected, Ji Kang struck back with a long article In Response to Criticism on Ji Kang’s On Life Regimen, which was in fact the continuation of On Life Regimen. In the article, Ji Kang introduced his life regimen idea in entirety. Contemplating it for some time, we’ll find that the two people, rather than debating, were in a relay run. They left behind valuable spirit heritages for literary historians of later dates. The purpose of Xiang Xiu’s article was by no means to refute the ideas of Ji Kang in On Life Regimen. Xiang came straight to the question of “abstaining from the five cereals, suppressing the worldly desires, and renouncing fortune,” and “voiced his disagreement.” At the same time, he advocated the natural attributes of lust, taste, sensual desire, and wealth. He said, “In the natural course of things, life is accompanied by emotion.” “Desire, honor, shame, and the craving for comfort and the repulsion to labor are only natural.” “The boundless beneficence of nature lies in creating the environment for human beings to live on; The greatest

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treasure of saints is their hold on power. The loftiest things are power and wealth, but they are the laws of the world.” Xiang Xiu added that: “Everyone craves for fortune and power, but they should be gained in a legal and proper way.”18 In his natural life regimen approach, Xiang Xiu called for “moderating desire” and following the natural order of things. Perhaps this was a vestige of Master Lü’s Spring and Autumn Annals, which holds that “The behavior of saints deviates from the commoners because they keep emotions within bounds.”19 The life regimen concepts of Ji Kang were based on the natural philosophy that the “laws of Nature govern all things,” but their focuses and implications were different. Here’s what Jin History· Biography of Xiang Xiu says: “(Xiang Xiu) argued with Ji Kang about life regimen, but neither could convince the other. In fact, Xiang was intended to champion Ji’s idea.” Historians thought that the two people were not likely to have a debate over the question of life regimen. Xiang Xiu was not calculated to criticize Ji Kang, but to take his On Life Regimen to a new level. Xiang Xiu was a famous metaphysician of the time, and his mission was to examine the philosophy of things. “The learnings of Lao Zi and Zhuang Zi have been a fancy with Xiang, who wrote dozens of articles to interpret them. The novelty of interpretations had generated a renewed fascination with metaphysics. The readers read avidly and had a revelation” (Jin History· Biography of Xiang Xiu). Xiang Xiu was fond of wild life. He liked to wear exotic clothes, with a careless appearance. He was often seen leaning by the tree, with bare arms and feet, and a meditative demeanor as if flying away into the immortal realm. Among the Seven Sages of the Bamboo Grove, the relationship between Xiang Xiu and Ji Kang was the closest. They frequently had a drink by themselves. Ji Kang was introduced to Xiang Xiu by Shan Tao. The two people shared a common interest in forging iron. Xiang Xiu’s father was a blacksmith. In the atmosphere, he had developed a fondness of hammering and had been working in the bellows since childhood. When he met Ji Kang, a master craftsman, the two people became bosom friends. Drinking and chatting while hammering rhythmically had been the greatest happiness

18 Above see Criticism on Ji Kang’s On Life Regimen by Xiang Xiu. 19 See: Explanation of Master Lü’s Spring and Autumn Annals·Midspring 2 by Chen

Qiyou, Shanghai: Xuelin Publishing House, 1984, p. 84.

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for them. Drinking and hammering were seemingly irrelevant, but they amused and “spiced up” the lives of the two people. It was rumored that once the two people struck iron together, and, as if by agreement, Ji Kang wielded the clamp and Xiang Xiu hammered the iron. They worked with absorption and pleasure, oblivious of anything else around them. A moment afterward, General Zhong Hui came for a visit, but they took no notice, still engaging in their work. The two people, whose interests and views on life coincided, were not going to go their separate ways merely because they differed over life regimens. Some believed that it was the combination of On Life Regimen and Criticism on Ji Kang’s On Life Regimen that completed the life regimen idea of Ji Kang. They stood as a symbol of life regimen genius of the time. In short, Ji Kang’s holistic life regimen concept and Zhuang Zi’s life regimen idea were born of the same roots. Zhuang Zi proposed that people should comply with the laws of heaven and earth, or the Laws of Nature, in life regimen. Besides, they should “get the things for nurturing physical form ready and must not let the thoughts run wild” (see: Zhuang Zi· Geng Sangchu), for the nourishment of body and spirit. In Zhuang Zi’s opinion, people were supposed to stay true to themselves all through the lifetime. The most sorrowful was that, when people got elderly, their spirit was bounded by the form and eventually vanished.20 The fragmented life regimen idea of Zhuang Zi was found in his works and it was often ignored by people. The sage was famous for his philosophy ideas, not his medical ideas which included life regimen. His theoretical knowledge of and contributions to TCM were rarely brought up. Ji Kang was the first man who was exclusively concerned with the nourishment of body and spirit and the holistic life regimen. The life experience written in colloquial language was intelligible to all. Ji Kang defined the paradigm of traditional Chinese life regimen, pioneering the nourishment of body and spirit in the discipline. His theory on life regimen was a milestone. A Music from Guangling was his swansong, but the repercussions of On Life Regimen continued to reverberate. Several centuries later, Su Shi of Song dynasty wrote: “I began to realize the importance of Ji Kang’s On Life Regimen on treating diseases. So, I copy it out and present one copy to Taoist Deng in Mount Luofu” (Postscript on Ji Kang’s On Life 20 See: Zhuang Zi On the Equality of Things : “When life takes form, the only thing waiting for it is death.” “The body tends to dissolve, so does the mind. It is a great sorrow, isn’t it?”.

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Regimen). To show reverence to Ji Kang and his life regimen idea, Zhao Gou, Emperor Gaozong of the Song dynasty, made a banner imprinted with On Life Regimen written in regular script and cursive script. Ge Hong, a medicinal chemist of the Jin dynasty, Tao Hongjing, a pharmacist of the Southern dynasty, and Sun Simiao, a formula study expert in the Tang Dynasty, inherited the holistic life regimen philosophy of Ji Kang and discussed the details on life regimen, rounding out the science of life regimen of TCM. Some of their expressions were incredibly similar to the ones in On Life Regimen. “Green leaves twine round the pines; the branches of aged trees are pliant. The glow of sunset is more beautiful than the bright red sunrise.” With proper cultivation and care of life regimen experts for two millennia, the tree of Chinese life regimen would grow to an enormous size for the betterment of mankind. January 9, 2020 Revision: March 3, 2020 References: [1] Chen Guying. Modern Annotation and Translation of Zhuang Zi: 1 [M]. Beijing: Commercial Press, 2007. [2] Chen Guying. Modern Annotation and Translation of Zhuang Zi: 2 [M]. Beijing: Commercial Press, 2007. [3] Chen Qiyou. Collation Notes of Master Lü’s Spring and Autumn Annals [M]. Shanghai: Xue Lin Publishing House, 1984. [4] Ji Kang. Collected Works of Ji Kang [M]. Photocopy of the Huang Xingzeng version. 1525 (The fourth year of Jiajing of Ming dynasty). [5] Liu An. Writings of Prince Huainan [M]. Beijing: Zhong Hua Book Company, 1954.

TCM Concept: Authentic Herbs, the Extracts of TCM In recent years, Radix Notoginseng has been revered for its universal tonic effects and gained in popularity. As a medicinal material capable of preventing and treating stroke, a serious threat to human health, it can also activate and stop the flow of blood. As the public awareness of

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health preservation and health literacy is improved, we’re seeing the hope dawning upon our nation. Most important of all, we need to choose the authentic Radix Notoginseng. A few years ago, there were reports of liver necrosis as the patients had taken the false “Radix Notoginseng.” We must always be mindful of this. What are authentic herbs? In broad terms, they are quality medicinal materials with high credibility which are recognized by TCM through clinical practice. They have particular germplasm, area, and wellestablished production and processing techniques. The whole process from planting to processing is traceable, which ensures the quality and effect of medicinal materials. Some medicinal materials are prefixed by the traditional places of origin, to be distinguished from the ones in non-traditional planting areas. The names of some medicinal materials, such as Sichuan bulb of fritillary, Zhejiang bulb of fritillary, Tibetan saffron, Hangzhou white chrysanthemum, and Yunnan radix notoginseng are suggestive of their places of origin. In Dream Pool Essays · Discussion on Medicine, Shen Kuo, a man of Song Dynasty, wrote about the many factors affecting the growth of medicinal materials, such as the lay of land, nature of medicine, climate, and cultivation method, as well as the advantages of authentic herbs. All through his lifetime, Confucius approached fasting, war, and disease with caution.21 How the infirm was treated was a huge issue, which had to be considered carefully. As the proverb says: “Medicine is more or less toxic.” There may be “homogeny of drug and food,” but the two are after all different. TCM doctors cautioned people against taking drugs when they were not sick. When they fall sick, they need medicine to fight the diseases. After the sickness passes, they have grain and meat for needed nutrition and trace elements. Drug can’t be your staple or tonic.22 These words are the best advice master TCM doctors ever gave us, unlike the promotions of some dishonest drug makers against conscience! We must devote major efforts to the growing and production of authentic herbs, so that the quality of medicinal materials can be improved. This is the path that TCM has to take in the future. 21 See: Translation and Annotation of the Analects of Confucius · Shu Er 7 : “All through his lifetime, Confucius approached fasting, war, and disease with caution,” Beijing: Zhong Hua Book Company, 1980, p. 69. 22 Confucians’ Duties to Their Parents Curing Diseases with Sweating, Lowering and Vomiting Methods by Zhang Congzheng of Jin Dynasty.

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July 15, 2020

The Common Pursuit for Excellence: Literati and TCM Doctors Context Tips Medicine and poem, technique and art, are the “common pursuit for excellence”; The origins of Sweeping Leave Study and Stamping Snow Study; The friendship of Xue Xue and Yuan Mei; The realistic and practical significances of TCM; “A ladle” of “tender water”—the source and flow of Chinese culture. A doctor is supposed to have wide knowledge, be able to communicate with human and nature, be marvelously talented, and be unfailingly compassionate like a Buddha. If he fails to do so, he might as well be a plougher or a spinner. He must not be a doctor, which is a sacred profession. —On Doctor· Preface by Pei Yizhong of Ming Dynasty

In late Ming and early Qing dynasties, China experienced a period of intellectual vigor when people reminisced the past and outlined the future, and great changes took place. TCM was in a period of transition marked by the sect of epidemic febrile diseases and the convergence between Chinese and Western medical science. In this period, two cultural figures stepped onstage and were lively in the society. They were Xue Xue (styled Shengbai, was also known by his literary name Ladle, 1681– 1770), a famous seasonal febrile diseases expert “marked by his originality in medicine,”23 and Yuan Mei (styled Zicai, 1716–1797), a representative figure of the “Spirit School” in the poetic circle who was extolled for his unworldliness and “polished, bourgeois tastes.”24 Working in different fields with different dispositions, they “demonstrated great resiliency in spiritual pursuit.” They shared common principles of life, medical and artistic pursuits, straightforward nature, and honest attitude. They were 23 See: Draft History of Qing· Biography of Xue Xue. Also see: Tenor of Medical Classics· Preface, Xue Xue called himself “Leaf Sweeper.” 24 See: Yang Jie’s article “Literati of the Qing Dynasty”, China Youth Daily, May 9, 2018.

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the emotional bonds that held the two people and their simple friendship together. Xue Xue was fond of the poems of Yuan Mei, while Yuan Mei thought highly of the medical skills of Xue Xue. This was the thing they had in common in their “spiritual pursuit.” Although their professions were different, their thoughts were in accord. They let their personalities shine through and left legacies in their respective fields. Once when Yuan Mei was staying in Suzhou, Wang Xiaoyu, his neighbor who was a butcher, was laid up with extreme illness for many days and dying. When Xue Xue was called in at night, he lit a candle and examined the patient. “He looks dreadfully ill, but I would try to cure him,” said Xue. He took out a herbal pill, smashed it, and squeezed grass-leaved sweetflag juice into it. He asked the strong sedan-chair bearer to pry open the patient’s teeth with an iron chopstick, and then he poured the medicine into the patient’s mouth. Then he added: “Don’t worry. Keep an eye upon the patient and he will wake up at cock-crow.” Things had been going as expected, and, after taking some more doses of medicine, the patient recovered. Again, there was a chef in Suzhou by the name of Zhang Qing who was afflicted with insanity. He often mistook sunlight as snow, and had a thumping abdominal pain whenever he ate. The doctors had given many treatments, but they didn’t work. When Xue Xue was called in, he took the hand of the patient and examined his face. “He is struck by rubella and the scrapping therapy would work out well. I needn’t take his pulse.” The patient was treated as guided, and a scarring the size of a man’s palm was formed on his body. Soon, other symptoms disappeared. Yuan Mei witnessed the entire process and he marveled at the great skills of Xue Xue. After all, it was a rare condition from which the patient was suffering! Since that time, Yuan Mei had held him in great esteem. Once, Yuan Mei went to Xue Xue for medical needs and he composed Thanks to Xue Ladle during My Sickness: “He bended over to help me up in front of the bed. Then he measured out a dose of papaya and brew it. After taking the medicine, I fell asleep. When I woke up, my eyes were clear.” Xue Xue said: “My medical practice is like your poem, which is purely spiritual. As people used to say, they live in the house, while I go beyond

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the sky. I felt distinguished, for being a different person. And my skills in the art of medicine are positively occult.”25 Xue Xue was best at the study and treating of warm heat disease. He was ranked among the “Four Great Physicians of Warm Heat Disease” with Ye Tianshi (literally Ye Gui), Wu Tang (literally Wu Jutong), and Wang Shixiong (literally Wang Mengying). He had a natural sort of “quiet distinction,” and an aloof pride. To him, benefit was never a benchmark against which friendship was measured. Sometimes, he would refuse to give medical attendance to high officials, but he would promptly appear whenever his friend Yuan Mei was sick. Like many other famous doctors, Xue Xue was “knowledgeable,” and his opinions on TCM were original. He’d prescribed odd-ingredient medicines to patients which were very effective, and rarely misdiagnosed. Xue Xue and Ye Tianshi (alias Ye Gui, 1667–1746), another warm heat disease expert, were contemporaries, but the two people were in discord. According to Draft History of Qing, Ye Tianshi was widely known for his great medical skill. Here’s what it says: “Ye Gui was the greatest TCM doctor in the north and the south. He had numerous visiting disciples26 over the last century.” Ye Tianshi had “gained great fame and he caused himself to be talked about in society. There were even some nonsensical gossips about him”27 which bordered on fables. Xue Xue was the second biggest name in TCM of the same period, after Ye Gui. Ye and Xue were in discord, either from jealousy or conceit, but we don’t know which. And we don’t know who had caused the discord. It was rumored that a night watchman had a bad edema and he sought the medical attention of Xue Xue. Without an idea that the disease was caused by the smoke of mosquito-repellent incense, Xue said that it was incurable. Afterward, the watchman went to Ye Tianshi, who wrote out a prescription and asked him not to worry. After taking a few doses, the watchman got better. When Xue Xue was informed of this, he thought that Ye Tianshi was meant to embarrass him, and he renamed his study to Sweeping Leave in a fit of rage. Ye Tianshi knew that Xue Xue’s move

25 See: Notes on Poetries from Garden of Leisure Vol. 5 by Yuan Mei of Qing Dynasty, Xining: Qinghai People’s Publishing House, 2004, p. 67. 26 Si Shu: Disciples who failed to receive inhouse instruction. 27 See: History of the Qing Dynasty· Biography of Art: “Ye Gui, styled Tian…had gained

great fame…”

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was against him, and he renamed his study to Stamping Snow. By “sweeping” and “stamping,” the two people had abandoned all proper manners. Afterward, Ye Tianshi’s mother came down with cold pathogenic disease. When Xue Xue knew that, he told somebody that the lady had fever with cold pattern, and the strong dose “baihu decoction” was most effective. Ye dared not use it because the patient was his mother. When the talk reached the ears of Ye Tianshi, he thought that Xue had a point. After taking the “baihu decoction,” his mother felt better very soon. Ye Tianshi had a revelation: a famous doctor was supposed to be generous. Impressed by the compassion and medical skills of Xue Xue, Ye pondered his mistakes and asked Xue’s advice. Xue Xue put past grievances behind and the stand-off between the two people was ended. He would show his approval of Ye’s prescriptions with “high fives.” The two people in discord at first partnered with each other and combated diseases. They worked in a joint effort for the betterment of people, which became a beautiful story. As a representative of the “Spirit School,” Yuan Mei held that poem was “an outpouring of the poet’s overflowing heart” (Notes on Poets from the Garden of Leisure, Vol. 1). He argued that the poets should express the true feelings of people in a natural and gentle way. They must be innovative and let imagination fly. Yuan Mei was a poet with a casual sort of attitude toward fame and gain. He knew about lifestyle and was fond of living without unrestraint. He lived in a style of elegance and retrospection. From high official to street peddler, everyone in the country knew him well. His reputation even spread beyond China. There were people coming from as far afield as Ryukyu, just to get his work. According to his friends, “Yuan Mei was not particularly brilliant in the imperial court, but he enjoyed the freedom of nature and wrote brilliant articles. Over the past century, he was unmatched in this respect.”28 “When the host is cultured, guests frequent his house.” Yuan Mei loved the company of friends in his life, and “traces of him could be found across the country. When visiting the magnificent sceneries in the southeast and south, he would write poetries to show his admiration.” Yuan Mei had a large circle of acquaintances. “He lavished praise on good writings.” “His dwelling was quiet and beautiful, with garden, 28 Annotation to Selected Works of Tongcheng School· Yao Nai: Preface to the epitaph of Yuan Suiyuan, by Qi Xubang and Wang Kaifu, Hefei: Anhui People’s Publishing House, 1984, p. 201.

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hall, plants, and decorative stones. The panes, railings and utensils were exquisite for the entertainment of guests. His hospitality was incredible, and he knew no weariness in the presence of his friends.”29 Yuan Mei had formed close relationships with some master TCM doctors. He praised and protected them, presenting himself in a new, unworldly spiritual aspect. Over the past thousands of years, “Confucian scholars had been engaging in Confucianism studies, but they hadn’t made a study of medicine…The contemporaries, to cultivate lofty sentiments, modelled themselves on the ancient sages. They would devote themselves to the studies of poems and verses, and turned away from medical classics in disdain” (Master Zuo’s Spring and Autumn Annals· Supplementary Notes to the Biography of Qin He by Zhang Ji). Obviously, disdain of medical skills was in the manners of ancient society. It’s a foolish old fashion that’s kept up still. It took Yuan Mei a lot of courage to hold on to the medical faith in a worldly point of view. With a reputation for pragmatism over empty talk, Yuan Mei set a precedence for people to follow. This was a matching with the ideological mood in the Late Ming and Early Qing dynasty, when “idle study” was denounced and pragmatic study was advocated. Gu Yanwu, Huang Zongxi, and Wang Fuzhi were pragmatic masters focusing on the realistic and practical significances of ancient Chinese culture. The Yanli school of thought represented by Yan Yuan and Li Gong was praiseworthy too. They formed a rising tide of “pragmatism” that would never be reversed. They opposed empty talks and adhered to the principle of “making study serve the practical purpose.” Yan Yuan mocked at the Confucian scholars behaving in a pedantic way, saying that “the more they read, the more confused they become. They had no merit whatever, unable to size up the situation or enliven the economy.” He maintained that the society should devote more efforts to the training of “men of real ability and virtue.” A doctor all his life, Yan Yuan despised those people who “read extensively on medical works and felt as if they could do anything. They underestimate pulse-taking, drug-making, acupuncture and moxibustion, and stone needle massage, and thought them unworthy of learning.” The thoughts of variance and invariance were always fighting, and the warm heat disease school emerged against this background. Guided by

29 Ibid.

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the innovative ideas such as “ancient prescriptions are not applicable to present diseases,” “following ancient methods isn’t going anywhere,”30 and “giving opinions never offered previously,”31 it went against convention and proposed the new idea of treating diseases caused by the six climatic factors. Wu Tang proposed the syndrome differentiation of sanjiao theory, while Ye Tianshi proposed the syndrome differentiation of nutrient and defense of qi and blood, in treating infectious diseases or heat diseases. Practice had shown that they had opened up a whole new vista, like “a lamp in the dark room and a pillar in the middle stream.”32 Their achievements were beyond their predecessors. Based on the altered disease spectrum, pioneers of warm heat disease school had been grinding and exploring. They “worked out strategies for diseases and the heart, and, after ten years, they get to where they are.”33 They pioneered their way through every difficulty, and Xue Xue was a great fighter among them. After Xue Xue’s death, Xue Shouyu sent the epitaph of his grandfather to Yuan Mei. To Yuan’s surprise, there was not a word about Xue’s life as a doctor. It was all about the lectures of Mr. Chen Wengong, a Neo-Confucian, and his excellence. Yuan Mei was very angry with Xue Shouyu’s despising medicine and worshiping Neo-Confucian almost to idolatry. He knew that if he didn’t interfere with the affair, Xue Xue would disappear forever, and his name would be artificially “blotted out.”34 Yuan Mei was shocked by the epitaph of Xue Xue, which also called forth his sorrow. But what infuriated him was the folly of Xue Shouyu. “Xue Xue was born a great man, but his reputation was ruined by his grandson.” To Yuan Mei, the most annoying thing was that Xue Shouyu 30 In the words of Wu Youxing (styled Youke, 1582–1652) of Ming Dynasty. There are other versions as to the date of birth and death of Wu Youxing, but there is no literary foundation to them. See: Wu Youxing compiled by Zhen Xueyan. 31 See: Detailed Analysis of Epidemic Warm Diseases by Wu Tang. This is Wu Tang’s acclaim on On the Epidemic by Wu Youxing of the Qing Dynasty. 32 The words in Detailed Analysis of Epidemic Warm Diseases · Preface by Wang Tingzhen of the Qing dynasty are an acclaim of Liu Wansu of the Jin and Yuan dynasties. Based on photocopy of Liu’an Qiuwo Study version in the 9th year of Tongzhi of Qing dynasty (1870). Wu Tang’s Detailed Analysis of Epidemic Warm Diseases was a classic on the science of epidemic febrile disease. 33 See: Detailed Analysis of Epidemic Warm Diseases by Wu Tang of the Qing Dynasty. 34 See: Poetry Collection of Xiaocangshan House Vol. 19 by Yuan Mei of Qing dynasty,

based on the Four Essential Classics version.

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was under no compulsion, but on his own initiative, to “ruin his grandfather’s reputation.” Xue Xue was a well-recognized TCM doctor who might stand the test of time and be “immortalized.” In the eyes of some people, however, only Duke of Zhou and Confucius had the right to be immortalized. But Yuan Mei thought that Hou Yi, Yi Qiu, and Yu Fu, an excellent shooter, and excellent chess player, and an excellent TCM doctor, could be immortalized too. Sadly, Xue Shouyu had blotted out his grandfather’s name from the medical realm, “without mentioning a word of his life as a doctor.” If Xue Xue wasn’t really much of a doctor, how could he be immortalized? That’s why Yuan Mei cried in a tragic tone, “Alas! The reputation of Xue Ladle was ruined!”. Another folly of Xue Shouyu was his amoral approach to honor and greatness. In Yuan Mei’s opinion, the greatest man had an angelic heart, with no aspiration for fame or gain. No one would pursue another purpose other than greatness, and Xue Shouyu’s behavior was a hopeless idiocy. Yuan Mei said bluntly that an official would win a good name if everybody praised him. But it would be contemptible behavior if a commoner tried to be connected with high officials or celebrities, and gain respect. He didn’t know what a clown other people found him. Ask anyone whether Xue Xue was a famous doctor; he wouldn’t deny the claim, even if he was in a feud with Xue. No one, even the relatives of Xue Xue, would agree that he was a Neo-Confucianist. The ignorance of Xue Shouyu had fallen into incomprehensible absurdity. Yuan Mei said that Xue Shouyu was so foolish that he “willfully threw away the medical accomplishments of his grandfather and embraced the stagnant-tasting Neo-Confucianism.” There were many classic cases to the credit of Xue Xue, a doctor all his life. As the patron saint of health in the eyes of people, “he prescribed medicines that worked out well.” Yuan Mei even cited his personal experience as an example. Once, he was gravely ill and in danger of dying, but he recovered after taking several doses of medicine prescribed by Xue Xue. But now, Xue Zhouyu put Xue Xue in the list of Neo-Confucianist. We have no idea if he would be acknowledged, but it was certain that the medical world had lost a talented doctor. The shallowness of Xue Shouyu denied him the opportunity to do the thing he ought to do. Yuan Mei knew that Xue Xue must have left some miraculous remedies and classical medical cases, which had important reference value in helping the sick and prolonging life. They should

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be considered truly valuable heritages of all people, which were a thousand times better than the “debased words” of Neo-Confucianists. Sadly, they were ignored and abandoned by Xue Shouyu, “an incompetent man of no merit whatever.” What is medical science? To Yuan Mei, it was the “Learning of the Saint,” and the central point of criticism of the epitaph written by Xue Shouyu. Yuan Mei noted that: “The medical skills are not supposed to be talked briefly. Shennong created it, the Yellow Emperor glorified it, and the Duke of Zhou had the steward take charge of it. If we get a sense of it, we can transcend the mortal realm” (Poetry Collection of Xiaocangshan House· Vol. 19). TCM, beginning at the practices and explorations of ancient sages, was by no means the whim of somebody. As a way of virtue, it had opened a door into the “immortal realm.” It was an essential support of virtue, and the “paragon” of virtue, playing an important role in protecting the health of human. It is commendable for a man of letter to take medicine to the level of the “Learning of the Saint.” His mind was raised to the zenith of perfection. This also proved that the two people’s minds were naturally linked. Xue Xue and Yuan Mei, a doctor and a poet, were tied firmly with the bond of “spiritual pursuit.” They explored virtue, defended their faith in it, and were blessed by it. Skill is the embodiment of virtue. We’re not to take it at face value, otherwise we study skills for nothing. This is a painful lesson for both Yuan Mei and Xue Xue. In the biography of Xu Dachun, another famous doctor, Yuan Mei spoke of the relationship of virtue and skill. He said that “virtue comes before skill,” because “skill is the main concern of virtue. Without virtue, skill would be useless.” A person is supposed to cultivate moral sense before studying skill. Only in this way can he “handle the subject with a light touch and a magic hand.”35 If the metaphysical “Tao” is a village, “virtue,” which is seen as the “paragon” of human quality, is the richest family. “Tao” contains virtue, and “great Tao” contains great virtue. It should be noted that Ladle, the literary name of Xue Xue, had a subtle moral. The author found that “Mr. Ladle” had appeared four times in the 600-word letter written by Yuan Mei to reproach Xue Shouyu. “Your grandfather Mr. Ladle.” “Alas! The name of Mr. Ladle will be blotted out!” “Isn’t Mr. Ladle a famous doctor?” “Mr. Ladle is perhaps 35 See: Poetry Collection of Xiaocangshan House Vol. 34 by Yuan Mei of Qing dynasty, based on the Four Essential Classics version.

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a Neo-Confucianist.” The use of literary name means something. First, it expressed the close relationship between the two people; Second, Ladle, which was excerpted from The Analects of Confucius· Yong Ye, expressed the inspiration of Xue Xue. The story goes that Confucius admired the dignity and cultivation of Yan Hui. On one occasion, Confucius said, “Yan Hui is a highly cultivated man! He lives meagerly in the lane, having a bamboo basket of rice and a ladle of water every day. Other people could not bear the poverty and worry, but Yan Hui feels inwardly at ease and happy. What a cultivated man he is!” The words of Confucius brought to life the image of Yan Hui,36 a sage who could find joy in poverty. It remained open to question whether Xue Xue was going to follow Yan Hui to the realm of virtue by naming himself “Ladle.” Xue Xue was not alone. The Buddhist Scripture has the saying “Three are three thousand weak waters, but you just get one ladler. There are numerous dreams, but you just capture one.” The message of the sentence is that we’re supposed to be mild and generous. People are going to meet lots of beautiful things, but seizing one would be enough. We mustn’t compare, crave, and be restless. “Weak water” came from Shang Shu· Yu Gong. In ancient times, most rivers were shallow and fast-moving, which might cause the boats to run aground. The ancient people thought that water was too weak for the boat to stay afloat, hence its name “weak water.” In combination with the Buddhist Scripture, are we to understand that the implication of “one ladle” is for people to be assiduous, seize opportunities, and have the presence of mind? The letter to Xue Shouyu, which was written with remarkable consistency, conveyed the emotions of sadness and sympathy of Yuan Mei. He praised medicine as the greatest profession in the world “transcending the mortal realm,” and criticized “empty talk” and “empty learning.” Yuan Mei was fond of living without unrestraint, but on matters of medicine he was clear-cut in attitude. He would decidedly stand up and lay bare the hypocrisy of the “shallow scholars.” When praising medicine, Yuan Mei

36 See: Translation and Annotation of the Analects of Confucius· Yong Ye 6 by Yang

Bojun: “Confucius said, ‘Yan Hui is a highly cultivated man! He lives meagerly in the lane, having a bamboo basket of rice and a ladle of water every day. Other people could not bear the poverty and worry, but Yan Hui feels inwardly at ease and happy. What a cultivated man he is!’” 箪: pronounced dan, is a bamboo utensil for containing rice in ancient times. Beijing: Zhong Hua Book Company. 1980, p. 59.

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would highlight the idea of “Life above Everything Else,” associating it with “immortality.” “The cavern in the winding path by the pine is covered. The temple in the deepest recesses of the mountain lays hidden.”37 The lives of Yuan Mei and Xue Xue, on looking back, were bristled with poetry. They capture the imagination of people of later generations and give us a warm feeling inside. First Draft: February 19, 2020 Revision: August 1, 2020 References: [1] Yuan Mei. Poetry Collection of Xiaocangshan House [M]. Four Essential Classics version. Shanghai: Zhong Hua Book Company. [2] Zhao Erxun, etc. Draft History of Qing [M]. Beijing: Zhong Hua Book Company, 1977.

TCM Concept: Differentiated Treatment by Stage: Repaying Debts of Gratitude by “Weaving Grass” “Ji” and “bing” are often used as a word—disease, but in ancient times, they were different. In those days, “Ji” meant mild symptoms, ailments, or the early stage of diseases; “Bing” meant severe cases, illnesses, or the last stage of diseases. According to Master Zuo’s Spring and Autumn Annals· The Fifteen Year of Duke Xuan, Wei Wuzi, a high official of the Jin state of Spring and Autumn period, came down with an ailment. He said to his third son Wei Ke that after his death, his favorite concubine was allowed to remarry. In his last illness, Wei Wuzi said to Wei Ke that after his death, his favorite concubine must be buried with him. After Wei Wuzi’s death, Wei Ke let the concubine remarry. He explained that he acted as ordered by the will drawn up when his father was clear-headed. Obviously, the degrees of “ji” and “bing” were different. Afterward, when Wei Ke engaged Du Hui, a general of the state of Qin, he met an old man who grabbed a handful 37 Huagai Temple, a poem by Zhang Ruxiang of the Qing dynasty. The poem translates to: “The cavern in the winding path by the pine is covered. The temple in the deepest recesses of the mountain lays hidden.” See: Notes on Poetries from Garden of Leisure Vol. 14, Xining: Qinghai People’s Publishing House, 2004, p. 206.

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of grass from the ground and made a knot. Du Hui tripped and fell by the knot. The troops of Wei Ke took him alive and defeated the enemy. At night, Wei Ke dreamed of the old man coming to his assistance in the morning, who said to him, “I’m the father of the concubine who you allow to remarry. You executed the last request of your father when he was clear-headed, and I’m here to repay the debts of gratitude.” Ever since, “weaving grass” has been a metaphor for repaying the debts of gratitude. In the field of TCM, there are many monophonic words put together to form disyllabic words, which created a fixed, “general meaning.”38 People are apt to confuse the meanings of monophonic words and their disyllabic counterparts. For example, massage (an mo), tuina (tui na), acumox (zhen jiu), visualization (shi jian), vomiting (ou tu), asthma ( jiao chuan), and coughing (ke sou) are used as a single word. Actually, “an” and “mo,” “ou” and “tu,” and “ke” and “wou” are different. If we read ancient classics without any regard for the “differences”39 of monosyllabic words, how can we understand the elaborate sentiments of the ancient people? March 27, 2020

Master TCM Doctors: Therapeutic and Calligraphic Prowess Context Tips Medicine and art in the same “way” and of the same origin; The fine art theory of Nightingale, the “Madame Lantern”; “Jing Shi Wan Dai,” Treasures of medical art of Song Dynasty; The talent and medical skill of Fu Shan, the “medical sage.” The physician is the servant of the art. The highest responsibility of the art of treatment is to cure patients. Medical art is the most outstanding of all arts. —(Greece) Hippocrates

38 Hun Yan: An exegetical term meaning “general meaning,” as against “xi yan.” 39 Xi Yan: An exegetical term meaning “distinguishing the differences between

synonyms.”

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If all master TCM doctors are engaged in a contest or talent program, Fu Shan (1607–1684), who was honored as the Son of Art and the top TCM doctor in Shanxi, might round out the top three. As a learned, talented man, he had all the attributes of a master TCM doctor. As a master “practiced in art,” he made a noise in the country with poetry, article, calligraphy, painting, and medicine. The secret of his success lay in the habit of reading. Since ancient times, the Chinese people had attached great importance to practical skills and knowledge, especially medical science which was ranked as one of the Seven Skills.40 “Reading medical works but one might not be able to become a doctor. No one ever becomes a doctor without reading medical works” (Miraculous Pivot by Shi Song of Southern Song Dynasty). Moreover, “medicine is too difficult a job for one of little learning” (Confucians’ Duties to Their Parents · Notes to Interior-attacking, Exterior-effusing, and Cold and Heat Differentiation by Zhang Congzheng of Jin Dynasty). Since its birth, medicine had been “a profound subject encompassing astronomy.” Only when a TCM doctor possessed the knowledge of ancient astronomy, could he understand the law of “five operations and six vital energies” and the principle of “harmony between human and nature.” Besides, a TCM doctor was supposed to have a knowledge of geochronology, so that he could tell the nature of drugs, and the “five bitter and six hot tastes of herbs.” Last, a TCM doctor was supposed to “know what’s happening in the world.” He should know the psychological changes, mental state, temperament, and habits of the patients. In short, “it’s difficult to master the art of medicine!” “The origin of art can be traced back to remote antiquity.” “The sage kings used art to make judgements, tell fortunes, size up the situation, and ward off misfortune” (Jin History· Biography of Art ). Art in the old days, which focused on practicability in a utilitarian way, was widely divergent from today’s art with aesthetics as the basic value. Art and skill divorced over time and had their respective meanings. “Art

40 Liu Xin of the Han Dynasty divided all the books into seven categories. The category of medicine was one of the seven categories. Lue: category. See: Han History· Bibliographical Treatise by Ban Gu of Eastern Han dynasty, 1959, Zhong Hua Book Company proof reading version.

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means books, mathematics, archery, and carriage; skill means medicine, technique, fortune-telling, and divination.”41 Name is the implication of meaning. In Jin Dynasty, TCM had fallen into the category of art, and it was “artistically” named.42 The change of name was a sign of the remarkable advance in people’s understanding of medicine. Florence Nightingale (1820–1910), the “Madame Lantern” who was born in Florence, Italy, had many brilliant accomplishments. As a nurse well versed in mathematics, she was also a statistician. When forced to make a choice among housewife, literati, and nurse with low social status, she resolutely chose nurse as her lifelong profession. She regarded nursing as the “most delicate art” in medicine. The sentence, as Nightingale’s motto, revealed the real secret of nursing. She thought that medical workers should possess biological knowledge as well as the knowledge of humanities. This way, all sorts of patients could be attended to and return to physical and mental health in a short time. This is “the finest art” in itself.43 Nursing is a refined art like “embroidery” to be finished by the “Angel” and the “Goddess” only. Nightingale arrived at this belief and she had done that. In the seventeenth and eighteenth centuries, Europeans had accumulated a lot of knowledge in art and science, which were developing in sync with each other. In the process, the union of art and science was a major symbol of western humanism and civilization. Medicine and art were naturally bonded, whether in China or in Europe. Born of the same roots and nurtured by philosophy and culture, art and science were dedicated to conveying truth, goodness, and aesthete

41 See: The Book of Later Han Dynasty· Biography of Fu Zhan: “In the first year of Yonghe, Wu Ji and advisor Huang Jing were summoned to revise the Five Classics, the hundred schools of thought, and art.” Li Xian noted: “Art means books, mathematics, archery, and carriage; skill means medicine, technique, fortune-telling, and divination.” 42 See: Footstep Study for the Offspring · On Essays· The Inheritance and Change of Historical System: “In latter Han dynasty, they were called ‘fang shu’, in Wei dynasty, they were called ‘fang ji’, and in Jin dynasty, they were called ‘art’.” 43 See: Medicine and Art by Xiao Qinglin, Qinghai People’s Publishing House, 2002, p. 13.

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to people without their being conscious of it. They showed deep connotations and cultural background, and could be defined from the philosophical and scientific perspectives. When a person acted both as a doctor and an artist, he reached the perfection of medicine (Fig. 2.1). In the Song Dynasty, three TCM-related national treasures had been presented to the world. They were the Illustrated Manual of Acupuncture Points of the Bronze Figure (hereinafter called Illustrated Manual)

Fig. 2.1 Photocopy of illustrated manual of acupuncture points of the bronze figure

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painted by Wang Weiyi, a famous acupuncturist and Imperial Medical Officer of the Song dynasty, and the two bronze acupuncture models designed and made by him for teaching and medical officer examinations. Illustrated Manual and the bronze acupuncture models were more practical artistic and sculptural works than teaching aids of acupuncture and moxibustion. In 1026, the fourth year of Tiansheng (reign title of Song Renzong), Wang Weiyi, Imperial Medical Supervisor of Dianzhong Office, had a revelation of the truth in acupuncture and moxibustion. He drafted the figure of human from front, back, left, and right for the teaching of acupuncture and moxibustion and treatment. The routes of the circulation of meridians and collaterals were marked at the front, rear, and both sides. The location and depth of acupoints were identified. The 354 acupoints and 12 meridians of the human body became an integrated whole, and the names of the acupoints were marked for the convenience of users. The drawing of Illustrated Manual was very similar to the drawing of “Illustrated Graphic” of modern times. The additions included the experience in acupuncture and moxibustion treatment in ancient and modern times. The inhibitions of point selection time for acupuncture and moxibustion was rectified. And relevant theories were compiled.44 More accurately, Illustrated Manual was the crystallization of medicine and art. Some scholars thought that Song Renzong was the role model of “empty monarch.”45 The author believed that he ought to be “a man of

44 See: Illustrated Manual of Acupuncture Points of the Bronze Figure· Preface by Xia Song of Song dynasty: “Wang Weiyi, Imperial Medical Supervisor of Dianzhong Office, has been teaching classic medical prescriptions, and is especially good at acupuncture and moxibustion. He faithfully followed the orders of the emperor and carefully examined the miraculous principles of acupuncture and moxibustion. He demarcates the meridian route in the front, back and sides of the human body, and determines the position and size of each acupoint. He supplements the therapeutic efficacy in ancient and modern times, and corrects the deficiencies of ancient acupuncture and moxibustion acupoint selection theory. He summarizes various theories into three articles.” Gold incised photocopy of Guichi Liu’s Jade Sea Hall, the first year of Xuantong of Qing dynasty (1909). Dianzhong Office was responsible for the emperor’s catering, clothing, chariots and horses. In includes food, drug, clothing, housing, carriage, and horses bureaus. Shangyao Fengyu: the name of medical officer. 45 See: Song—The Dawn of Modern Times by Wu Gou, Guangxi Normal University Press, 2015, p. 400. “Empty monarch” refers to the emperor adhering to the typical Confucian ideal of “ruling the world by hanging clothes.”

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great wisdom who seemed slowwitted.” When receiving the finished Illustrated Manual presented by Wang Weiyi, the emperor was glad that the work was beautifully done. On the other hand, it wasn’t very satisfactory to him, because he had something else in mind. The reason he offered was: “communicating is not as good as visual sight,” and “literature is not as good as model.” Song Renzong issued another proclamation for casting the model of bronze figure. In fact, the emperor should take credit for the invention of the bronze figure for acupuncture and moxibustion. In the 10th month of the 5th year of Tiansheng (1027), the bronze figure model for acupuncture and moxibustion made by imperial order was finished too. In the making of it, Wang Weiyi had been through three failed attempts and many difficulties to improve the technique, the purity of alloyed bronze, and the overall design. The bronze figure for acupuncture and moxibustion was scientific, displaying artistry in the layout of viscera, circulation of meridians, and the accuracy of acupoints. Refined copper was cast into a figure the size and shape of a real person. “The viscera inside, the marginal muscle interspace, the junction of Jing acupoint and Ying acupoint, and the openings and holes, were visible. The title was engraved on the side.”46 The bronze figure had built-in, bronze viscera. On the surface were engraved 354 acupoints, the names of which are marked. Mercury was filled inside the acupoints, which were sealed with wax to prevent the mercury from extravasating. If the candidate for the examination manipulated the needle correctly, the mercury would extravasate. If he missed the acupoint, the needle wouldn’t pass through. The authentic model was akin to the full-scale body environment, and, when Song Renzong saw it, he expressed his approval. The emperor ordered a bronze figure be placed in the Medical Officer’s Academy for the reference of doctors, and the other bronze figure be placed in the palace for the pleasure of people. The achievement of Wang Weiyi went down in the annals of Chinese history. Illustrated Manual was “popularized across China,” and a stone was carved for people of latter generations to pay homage to it. Fu Shan living in the late Ming and early Qing dynasty, an age of social upheaval and regime change, was not as lucky as Wang Weiyi. As a young man, he was under the influence of multi-ideological culture, 46 See: Illustrated Manual of Acupuncture Points of the Bronze Figure· Preface by Xia Song of the Song dynasty. Engraved version of Liu’s Yuhai Hall in Guichi in the first year of Xuantong in the Qing Dynasty (1909).

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and opened his mind to Confucianism, Taoism, and Buddhism. With spiritual freedom, he opened himself up to the big stage of life and treated various cultures of religions and schools equally. Afterward, Fu Shan attended “Sanli Academy,” the most important educational institution in Shanxi, when its repairment was done. The companionship and mutual affection of most brilliant minds shaped the politics of Fu Shan and built an extensive network for him. As the saying goes: “he who stays near vermilion gets stained red, and he who stays near ink gets stained black.” Fu Shan was under the influence of Yuan Jixian, Teaching Officer of Shanxian who put an emphasis on writing and integrity education. When the Manchus crossed the pass and took Beijing and Taiyuan, Fu Shan’s family fell on hard times. To raise money for the secret activity of “Overturning Qing Dynasty and Reinstating Ming Dynasty,” he tried to stay alive by selling the family assets. Mr. Lu Xun shared his own story and said something profound: “I think it’s true to say that any once-comfortable family that falls on hard times sees soon enough what the world really thinks of it!”47 Since ancient times, the world had seen “too many people adding flowers to the brocade, and very few people sending charcoal in the snowy weather.” In the face of reality, Fu Shan changed his name to “Taoist Red Robe.” Wearing the Taoist robe, he swung the medicine chest over his shoulder and left home. He had traveled to Yuxian, Wuxiang, Quwo, Shouyang, Pingding, and Fenyang. Fu Shan embarked on medicine because of Taoism, and it was the best thing for him. First, he could earn money to provide for his family, particularly his old mother for whom he had been anxious. Just as what is said in his poem: “I burn the incense, not for the late emperor. I’m late for the New Year visit, because of my old mother.” Second, by traveling around the place, he could recruit more people in Shanxi for the cause of “Overturning Qing Dynasty and Reinstating Ming Dynasty.” Gu Yanwu, who shared the politics of Fu Shan, had called on him in his hometown three times. So, where did Fu Shan learn the medical knowledge? Which medical school did he follow? We can tell by the historical facts that Fu Shan had laid a solid foundation of Chinese studies when he was young. This was very important for him. Coming from a cultured family, Fu Shan was reading the “Thirteen Classics,” Confucian classics and historical books in

47 See: Crying·Preface by Lu Xun.

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his childhood. Influenced by his father, he came into contact with medical knowledge at the age of ten. Fu was born more intelligent, “capable of skimming through the book and memorizing everything inside.” Once when he was preparing for an exam, Fu Shan’s brother Fu Geng asked him to memorize 53 model texts. Ma, a colleague of Fu, wanted a challenge with him. The next day, Ma struggled to memorize 4 or 5 texts. Fu Shan began to recite after washing and combing, and, by the time breakfast was served, he had memorized all 53 texts. When Ma named a few texts, Fu memorized them without a mistake. Ma exclaimed, “I heard that Bamboo (note: the original literary name of Fu Shan) had an amazing memory. If I haven’t seen it with my own eyes today, I wouldn’t have believed it. You’ve done a great job, and I’m no match for you!” Fu Shan answered modestly: “The model texts collected by Fu Geng are fine and very memorable. If they’re lowbrow articles, even the most wonderful memory would be useless.” Everyone present nodded his praise.48 It follows from this that Fu Shan had shown great gifts from childhood. As the proverb says: “For men of letters, studying medicine is as easy as catching a caged chicken.” For Fu Shan, a man with literary gift and solid foundation, there was no difficulty in studying medicine. When he was 39, Fu Shan went to Mount Wufeng and became a Taoist priest. He learnt medicine as an apprentice to Guo Jingzhong, his religious name Huanyang Zhenren. When he first practiced medicine, Fu Shan’s main task was to copy the remedies of his master, who would pass on to him the TCM knowledge. Later, he chose andrology and gynecology as his research areas. Fu Shan always valued “practical learning,” and he got enlightenment in his medical practice. He attached importance to the basic theory of TCM, and treatment based on syndrome 48 See: To the Younger Generation by Fu Shan of Ming dynasty: “I remember when I was in my twenties, I used to recite the Selected Works and the Capital. I first identified the characters and then marked the pauses in sentences; after reading three or four times, I could recite it. After the examination paper of the Xu Chen year was published, my brother selected 53 articles for me. I compare my memory with my teacher, Mr. Ma, to see how much I can remember every day. Mr. Ma also thinks he has a high talent. He can only recite four or five articles every day. I began to read after combing my hair and washing in the morning. When breakfast was served, I had already memorized all 53 articles, and not a single word was missed. Mr. Ma was very surprised at this and marveled at me.” 栉: pronounced “zhi” means combing (the hair); 栉沐: means combing and washing. 爽: means omission or mistake. 西席: refers to colleagues or private school teachers in ancient times (when the host seat was in the east and the guest seat was in the west).

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differentiation. He didn’t overlook the features of medical practice. Fu Shan cleverly employed dialectics in treatment: “Everybody knows that the five elements: wood, fire, earth, metal and water, correspond to the heart, liver, spleen, kidneys, lungs. But the fact that generation resides in restriction and restriction resides in generation; generation and restriction are not all they appear to be; and generation fears restriction and vice versa is little known to people.” In respect of yin and yang, Fu believed that “Qi and blood are the supreme yin-yang in the human body…in that qi is usually redundant, while blood is frequently deficient. In the former case, yang waxes while yin wanes, and people is supposed to tonify blood and let qi leak; In the latter case, yin waxes while yang wanes, and people is supposed to tonify qi and let blood leak. The tonifying and leaking of yin and yang are depended on the redundancy and deficiency of qi and blood” (Secret Record of the Stone Chamber· On Qi and Blood by Chen Shiduo of Qing Dynasty). The theory, which was based on experience, was Fu Shan’s contribution to the theory of healthy qi and blood reinforcement. Fu noted that “qi is invisible while blood is visible. People think that to regulate the flow of blood, one must first regulate the flow of qi, for the invisible to be born out of the visible. But they are unaware that the process is turned upside down. The former is applicable when the patient is seriously ill, while the latter is applicable for daily regulation…Qi and blood are interdependent and they complement each other” (Secret Record of the Stone Chamber· On Qi and Blood by Chen Shiduo of Qing Dynasty). Besides, Fu Shan created therapies which achieved effect on the treatment of 13 kidney diseases, 4 liver diseases, and 7 spleen diseases, and were appreciated by the patients. He was honored as the “Medical Sage” by the local people. Even after his death, Fu Shan was still mentioned as the “Medical Fairy,” and his stories passed down through the ages. As far as we know, Fu Shan specialized in gynecology. His work Fu Qingzhu Talking about Gynecology set a precedent for TCM gynecology according to syndrome differentiation. The book was probably a symbol on which Fu’s memory and sorrow for his late wife was pinned. Fu Shan’s wife Zhang Jingjun died five years after their marriage, and the once happy family was destroyed. By the time, Fu was not yet a doctor and he was powerless to save his wife. After his wife’s death, Fu’s whole soul was filled with her memories, and he would not take a concubine even if a girl offered to. “Where’s the blessing of Buddha, now that you’ve died? Left alone in this world, I live in the suburbs with my mother. If

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you’re still alive, I’ll have you constantly by my side.”49 Dedicated to the memory of his late wife, the poem was an inquiry about the benevolence of the Buddha. We can tell the weight of Zhang Jingjun in the heart of Fu Shan, who spent the rest of his life cherishing the memory of his wife. We find this emotional attachment quite touching. Fu Shan was well versed in gynecology, and also competent in internal medicine, pediatrics, and surgery. His deeds were chronicled in various biographies. These are some excerpts: Living secluded in the remoted land, Fu Shan sometimes climbed the highland and chatted with the villagers. When the villagers complained of being out of sorts, he would prescribe a remedy that had curative effect…If they suffered intractable illnesses, Fu’s medication would put them right. He prescribed medicine in his own way, not by the medical book. One or two potions were dosed every time to see the curative effect. —Biography of Fu Shan, Liu Mufang of Qing Dynasty In between his work, Fu Shan taught himself TCM, and he later became a widely known doctor in Shanxi. He lived secluded in the remote village and helped the sick, and he got plenty of patients in the house. He worked tirelessly, treating every patient alike, whether he was noble or base. —Biography of Fu Shan, Dai Mengxiong of Qing Dynasty Zhengjun was a scholar and master TCM doctor, and his house saw a continuous stream of patients. He worked tirelessly, treating every patient alike. With a magic hand, he brought numerous patients back to health. —Facts of Fu Shan, Fu Liansu of Qing Dynasty Fu Shan was a TCM doctor with considerable medical and academic achievements. He was not limited to the theories of Wang Shuhe and Zhu Danxi. His house was always full of patients, and he treated them alike. —Biography of Fu Shan, An Imperial Scholar of Ming Dynasty, Ji Zengyun of Qing Dynasty

49 See: The Sight of Disciple of Buddha Sutra Embroidered My Wife Jingjun, by Fu Shan of Ming dynasty. This is a poem by Fu Shan devoted to the memory of his late wife after he saw a Buddhist sutra embroidered by his wife during a flee.

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The descriptions above give us an insight into the benevolent mind and heart of Fu Shan. Fu Shan was also a famous calligrapher with a solid foundation, a head start over his peers, and a sensitive consciousness. He once said, “when I was eight or nine years old, I began to imitate the works of Yuan Chang.”50 It was really something for a kid of not yet ten to imitate the work of a master calligrapher, although his imitation was “odd-looking.” Fu also imitated the works of other famous calligraphers, such as the elegant Yellow Court Classic, a piece written in xiao kai, regular script in small characters; Stele of Filial Daughter Cao E, a piece written in forceful regular script; On Yue Yi, a piece written in regular script with a blend of delicacy and force; Praise to Dongfang Shuo in the Portrait, a piece with forceful strokes like On Yue Yi; and On the Goddess of Luo River in Thirteen Lines, an elegant, cursive script piece like Orchid Pavilion Preface. From “odd-looking” to “a bit like,” and to “extraordinarily like,” Fu Shan was constantly developing his skill. “He has had a sense of what imitation is, although the skill is unsophisticated.” After imitating the Orchid Pavilion Preface, his mind was raised at an elevation.51 Fu Shan’s works were an excellent likeness of the authentic works, and his calligraphy was marked by originality. He recognized the sentiment with which medicine and art shared (Fig. 2.2). Fu Shan summarized, “The wonder of calligraphy lies in its uprightness, which is not slavish adherence, but the time-honored methods. A character is supposed to be lower in the left and higher in the right, if viewed from the front and back, but not the opposite. For a character to appear level, it should be higher in the left and lower in the right.” The sentence enunciated the key to calligraphy writing. Fu Shan also took Yellow Court Classic as an example for writing xiao kai. “The strokes are supposed to be forceful, like a golden pole stomping on the ground. If the strokes are weak, the character would be weightless and ugly.” To acquire 50 Yuan Chang: Supposedly Zhong Yao (styled Yuanchang, 151–230) a famous calligrapher in the Three Kingdoms Period. As the founder of kai shu (regular script in small characters), Zhang Yao was accomplished in calligraphy and he was honored as the “Founder of Kai Shu.” Calligraphers of later generations, such as Wang Xizhi, had assiduously studied the works of Zhong. Yu Jianwu of the Southern dynasty even honored his works as “top of the top.” In Shu Duan, Zhang Huaiguan of the Tang dynasty considered the works of Zhong Yao as “superb work.” Here’s what Orthodox of Calligraphy says: “The works of Zhong Yao are quaint, superb and unworldly.” 51 See: Family Precepts of Fu Shan for the excerpts above.

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Fig. 2.2 Mozi’s Book of Songs (part), the calligraphy work of Fu Shan

good handwriting, Fu Shan didn’t begrudge time spent on practice. With a keen grasp of the secrets of calligraphy, he was able to make an analogy between xiao kai and the golden pole stomping on the ground. On the consummation of calligraphy writing, Fu Shan’s theory was: “I’m fully aware of the consummation of calligraphy writing… An ordinary man is supposed to expend the effort to do quality work; A gifted man goes to no effort, as the process is effortless to him. The gift is manifested in the lines and the individual character. Characters, as well as the space between

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them, embody the essence of a man’s gift. The art is all about gift. I’ve said what I’ve said, and calligraphy is, after all, not to be put into words” (Family Motto of Fu Shan). How to have beautiful handwriting? Fu Shan thought that “there is no ingenious calligraphy, but clumsy calligraphy.” “The ultimate pursuit of the fundamental yields the transcendental, as ingenuity may seem clumsy.” Here’s what Improvision in Linchi Pond by calligrapher Deng Sanmu says of Fu Shan’s calligraphy works: “The xiao kai of Fu Shan is delicate and upright, but he usually didn’t write in the script. When people sought his calligraphy works, he would generally give them pieces written in cursive script. These pieces, far from being worldly, were as bold as his soul and as tender as his appearance.” The other aspect of thing is that Fu’s cursive calligraphy works were intended to give people an act of politeness. “The gifting of calligraphy works was an age-old tradition. In the prefaces, postscripts and notes of books of late Ming dynasty, however, we are seeing more and more complaints and discussions of the social activity.”52 Bai Qianshen, a contemporary expert studying in Fu Shan, said that Fu was also dissatisfied with the fashion. He said that “calligraphy, painting, poetry and prose were the embodiment of nature. If they became self-serving, they would veer away from the original path. There would be no soul in them.”53 The words revealed the sad helplessness, nobility, and clear consciousness of Fu Shan! The upright hand makes forceful strokes. The sharp tips, bare and bold, stand alone. The forceful strokes exhibit vigor. The tender strokes resemble the willows.54

52 See: Fu Shan’s World—Evolution of Chinese Calligraphy in the 17th Century· Chapter IV Changes in Cultural Landscape and Cursive Script (Fu Shan’s Freestyle Calligraphy and Cursive Calligraphy) by Bai Qianshen (revised and enlarged Chinese version), Beijing: SDX Joint Publishing Company, 2006, p. 274. 53 See: Complete Work of Fu Shan Vol. 1, pp. 863–864. 54 See: Mount. Cangshan: Rhymed Verse of Mr. Qiao Baiyan. Zhang Xu Feng Liu:

used to praise people for their refined manners. Zhang Xu, a native of Wu County, Wu Prefecture (Suzhou) living in the Three Kingdoms Period, was famous for “asceticism in the early age.” Xiao Ze, Emperor Wu of Southern Qi, once planted a willow in front of Linghe Hall and said, “This willow is lovely, just like Zhang Xu in his youth.” It follows that Zhang Xu was handsome like a Sichuan willow in his youth. Afterwards, Zheng Gu, a poet of Tang dynasty, wrote Preface to the Letter on the Living of Official Wei Yingwu, which reads: “The gallantry hides within, just like Zhang Xu in his youth.”

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For Fu Shan, the works would have been “clumsy, ugly, wide apart and upright rather than being clever, voluptuous, sleek, and sophisticated.”55 The academic community has two different views on the “Four Rather Four Not” principle. Some said that it embodied the aesthetic thought of Taoism which argued that people should maintain their natural affections. This, however, gave rise to the Ugly Calligraphy school which “made a virtue of ugliness.” Fu Shan was even regarded as a master of “Ugly Calligraphy,” and the ancestor of “Eight Eccentrics of Yangzhou.” But the author thought that we must see the good in everything. The Beauty-Ugliness Contrasting Principle proposed by Victor Hugo, a French literature master, is a wonderful explanation of the principle of Fu. This is how it puts it: “The ugly exists beside the beautiful, the unshapely beside the graceful, the grotesque on the reverse of the sublime, evil with good, darkness with light.”56 Examining the “Four Rather Four Not” principle, we’ll find that clumsiness, ugliness, distance, and uprightness are the glories of nature, aren’t they? Others argued that the calligraphy of Fu Shan was like he himself, as adherents of the Ming dynasty used to associate character with calligraphy. Bai Qianshen believed that the “Four Rather Four Not” principle proposed by the Exhortation to Children, which was considered as the aesthetic views of Fu Shan, was often cited by calligraphers of later dates. Fu Shan mentioned in the article that when he was young, he was obsessed with the calligraphy works of Zhao Mengfu. As he grew up, he knew that the character of Zhao was questionable. As an imperial member of the Song clan, he served the Yuan emperor after the fall of the dynasty, becoming a ‘disloyal official’. Looking back upon the calligraphy works of Zhao, he found that they were ‘shallow’ and ‘spineless’. He resolutely returned to Yan Zhenqing, whose calligraphy was regarded as the model for the Fu Clan over generations.”57 No doubt, Fu Shan had his pride which was externalized by calligraphy.”58

55 See: Frost Red Niche Collection· Words for the Offspring. “Zhi li”, from Zhuang Zi· Earthly World. 56 See: (France) Victor Hugo, Cromwell Preface. 57 See: Fu Shan’s World—Evolution of Chinese Calligraphy in the 17th Century by Bai

Qianshen, Beijing: SDX Joint Publishing Company, 2006, p. 124. 58 See: Words in Conformity with Laws and Discipline Rites Vol. 5 by Yangxiong of the Han dynasty. Shu: calligraphy.

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Fu Shan’s artistic interest was admirably wide-ranging. As a thinker and artist, he was among the ranks of the “Six Masters in the Early Qing Dynasty.”59 Everybody said that “essay is inferior to poem; poem is inferior to calligraphy; calligraphy is inferior to painting, painting is inferior to doctor, and doctor is inferior to human. Fu Shan is the greatest man there could ever be.”60 His reputation as a versatile, virtuous person was well-earned. There’s an old saying: “writing is dominated by qi.” “Qi” may be variously understood, and for Fu Shan, it must be the “pride” of a person. June 21, 2020 References: [1] Bai Qianshen. Fu Shan’s World—The Evolution of Chinese Calligraphy in the 17th Century [M]. Beijing: SDX Joint Publishing Company, 2006. [2] Giorgio Bordin, Laura Polo D’Ambrosio, La Medicina [M]. Translated by Shao Chi. Beijing: Peking Union Medical College Press, 2019.

TCM Concept: Medical Prescription: A Unique World of Calligraphy Writing a prescription in a beautiful, flourishing hand, with brush or pen, and in regular or cursive script, had traditionally been the basic skill of a TCM doctor. Prescriptions kept track of the subtle consideration of master TCM doctors, and the treatment process according to syndrome differentiation. They showed the aesthetic knowledge of doctors, and some even went down in the annals of medical history. Some prescriptions were so beautiful that they got stamped and became calligraphy artworks. Fu Shan, a famous doctor in Shanxi, and He Hongfang, a famous doctor in Shanghai (1821–1889) in the Qing Dynasty, were master TCM doctors and calligraphers whose valued calligraphy pieces still survive today. Cheng Menxue, a famous doctor, wrote a poem 59 Fu Shan, Gu Yanwu, Huang Zongxi, Wang Fuzhi, Li Zhuan and Yan Yuan were called “Six Masters in the Early Qing Dynasty” by Liang Qichao. 60 See: Preliminary Edition of the Chronicle of Qing Poetry Vol. 2.

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for the Calligraphy of He Hongfang’s Chronicle Prescription: “In brilliance lies the unbridled temperament. In cursive script the prescription is written. Doctors are men of great acquirements, and their calligraphy works are handed down over generations.” A doctor’s life was highlighted by medicine and calligraphy. Throughout time, there had been numerous precious medical prescriptions prevailing among the locality. Zhu Yuesan, a painter and the disciple of Ding Ganren, who was a famous doctor in Zhejiang Province during the Republic of China period, wrote out a prescription to Ling Zuo; Lu Weizhao, a doctor and calligrapher of the Republic of China, prescribed five ingredients for Master Ke Chongwei; Shi Jinmo, who was among the ranks of the “Four Greatest Doctors in Beijing,” wrote out a prescription with brush. As precious archives for studying the history of TCM, these prescriptions showed great artistry. In 2005, the author worked with Ms. Jiang Shan on “leaving behind a few words TCM”—the issue for study. We made a medical prescription and an autobiography written with brush and pen. When we look back, many of the words we left have become “swan song.” Things have changed so much over time, and TCM prescriptions evolved into a unique calligraphy system. First, doctors wrote prescriptions to cure diseases and they were thinking about the compatibility of drugs and how to hit the target. They cared little for the calligraphic skills such as overall planning, layout, and novelty; Second, as the paper was small, the doctor was supposed to write in xiao kai rather than large characters; Third, applicability is what counts for a prescription. The ancient people advocated that “a prescription should be plainly written, so that the names of drugs could be seen clearly.”61 Unlike calligraphers, TCM doctors were constrained by many things when they wrote prescriptions. The art of prescription writing was all about gift. July 14, 2020

61 See: Pleasant Consensus of Book Prescriptions by Gu Mingzhao of the Qing dynasty: “Can you make an agreement with your peers, that a prescription should be written plainly, so that the names of drugs could be seen clearly?”.

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TCM as a Compassionate Medicine Context Tips Cultural spirit inherited by and nurturing people; Literati Liu Zongyuan giving the lie to pseudo-science and bad customs; Self-respects, fate and compassion; Compassion and love; Self-respect lying behind compassion; From taboo to refraining. Without the experience of it, one will never know that the key to governance is to engage people’s emotions and abolish bad customs. To achieve the goal, education and law are essential. —Collected Works of Gu Tinglin Vol. 4 Approaching People 9

Gu Yanwu was an expert of custom study. He believed that “custom is a huge issue for the world,” and, to “have an insight of a place, one must first investigate its custom.”62 In this way, one can understand the folk way. The formation of folk way, which features gentleness, toughness, simplicity, etc., is closely related to folk custom, etiquette, social strata, and culture. When it comes to the master devoted to studying the folk custom in the relationship between patients and doctors, we must mention Li Zhongzi, a folk physician of Gu Yanwu’s time. Based on the principle of not deviating from the feeling of the patient in Huangdi’s Classic on Medicine, he proceeded with the analysis of “emotion” from the perspectives of “patient,” “outsiders,” and “doctor.” Li told us when a doctor was supposed to take into account the “emotions” of patients, and when he must not meet them halfway. He warned people against being beset by the bad folk ways. In fact, patients, outsiders, and doctors are, somewhere in their souls, giving in to the folk ways and folk customs. As it was, Li Zhongzi had probed to the bottom of custom and seen through the selfrespect of “compassion” to perceive the essence of the two humanities

62 “Luo Zhongsu said, ‘Edification is the topmost priority of the imperial court; Decency is the virtue of the scholars; and custom is a huge issue for the world. When the court has edification, the scholars are virtuous; when the scholars are virtuous, the world has custom.’” See: Collected Explanations of Accumulated Record by Huang Rucheng of the Qing Dynasty, Changsha: Yuelu Press, 1994, p. 481.

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mentalities which TCM doctors must know.63 As Hippocrates said, “It is more important to know what sort of person has a disease than to know what sort of disease a person has.” (Complete Works of Hippocrates · On the Valuable Character). In that sense, medicine is human science. Gu Yanwu thought that “custom” covered a wide range of areas; Li Zhongzi thought that “compassion has too many implications to elaborate.” In compassion there lies custom, and compassion is controlled by custom. There are different customs and compassions. Compassion is the glue that holds custom together, while custom is the root of compassion. Etiquette, as the sublimation, or advanced state, of custom, wears the traits of national culture. Custom, the accumulation of social experience over a long period of time, is bound to be affected by nationalism and the manners of society. It is not easily changed when once formed, and that’s the reason why the “abolishment of bad customs” proves hard to realize. Custom was born out of particular social context and historical condition. It features “universal acceptance,” “prevalence,” and “wide circulation.” Folk ways and folk customs are deep rooted in culture. Throughout history, they have been nurtured and affected by several cultural factors. 1. The inheritance of Chinese culture. Rites of the Zhou Dynasty, Etiquette, and The Book of Rites are earliest records of ancient etiquette system in China. The niceties of etiquettes in clothing, dining, sheltering, traveling, marriage, and funeral are introduced in Etiquette. Famous sayings and proverbs, such as “people are not expected to live without etiquette; nothing is expected to be done without etiquette; and a county is not expected to be peaceful without etiquette” (the words of Xun Zi); “Learn extensively and discipline yourself with etiquette,” “without learning etiquette, one cannot conduct his life,” “do not see, hear, say, or move anything that goes against etiquette” (the words of Confucius); and “some etiquette wouldn’t go amiss,” are found in the book. Besides, there are idioms related to etiquette, such as “courtesy demands reciprocity,” “refined and courteous,” “respect each other like guests,” “etiquette is the manifestation of heart,” and “unnecessary and overelaborate formalities.” For a considerable period of time, China

63 See: Essential Readings for Medical Professionals Vol. 1 by Li Zhongzi of the Ming Dynasty, photocopy of the Ming version in the 10th year of Chongzhen (1637).

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had been a patriarchal society with agrarian civilization at the center. Many etiquette systems were embodied in village regulations and folk conventions. The fabric of society, which was governed by local gentries, allowed these etiquettes and rules to reach common people and shape the folk way and folk custom of the locality. White Deer Plain, the novel of Chen Zhongshi, accurately portrays the custom and folk way of the land governed by the local gentries. Chinese literati had a custom of writing family precepts, such as the Family Precepts of Yan Clan, Zhu Zi’s Family Percepts, and Standards for Students. The cautionary tales inside are enough to awaken people. To sum up, etiquette culture had extended to all aspects of life and it had been decisive in the formation of folk way and folk custom. 2. Cultural heritage with Confucianism at the center. From the “elegant” manner possessed by the Chinese scholars, some people judged that the Chinese people were followers of “Confucianism.” They were ignorant of the fact that what stood in the way of Confucian study’s becoming Confucianism was the absence of an integrated system of creed. After all, “Confucius was a realist…a positivist…and a humanist.”64 For two millennia, Confucian study had been evolving and fleshing out, to ultimately become the neo-Confucian study. Buddhist temples can be found across China, so some people affirmed that the majority of the population was Buddhists. White Horse Temple was where the founder of Buddhism lived, preached Dharma, and died. But most people just go there to “burn incense and make their wishes.” After leaving the temple, they continue to “feast and drink,” observing no religious rite and reciting no sutra. In fact, there are not many earnest Buddhist believers. “For two millennia, Confucianism, as the mainstream thought in the Chinese society, didn’t advocate the talk of anything out of the way, strong, against common sense, and supernatural.”65 On the matter, China is different from many other countries which 64 See: Chinese People by Lin Yutang and translated by Hao Zhidong and Shen Yihong, Xuelin Publishing House, December 1994, Version 1, p. 113. 65 See: New Interpretation of the Analects of Confucius·1 Shu Er 7 by Qian Mu: “Confucius did not talk about weirdness, bravery, rebellion and ghosts.” The words in modern Chinese are the translation of the author. Beijing: SDX Joint Publishing Company, 2002, p. 183.

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“see religion as the foundation of society,” and their customs are different. 3. Traditional and inclusive cultural mindset. The Chinese nation values tradition and has an all-enveloping culture. The tradition of ancestor worship has taken root in people’s minds which are opened to other cultures and confident in their culture. Therefore, the Chinese people prefer tradition, pragmatism, and realism over innovation, progressiveness, and ideals. The indulgence in nostalgia disposed people to criticize the new things. On the other hand, this tradition is highly inclusive. It evolved into an integrated philosophical system and a way of life capable of adapting to the nation and assimilating foreign cultures. In fact, there is diversity in the custom of the Chinese nation, which is the result of ethnic integration over a long period of time. The emotions of worshiping and cherishing the memory of ancestors are shown to considerable effect in the tradition festivals of China, such as the Spring Festival, the Tomb sweeping Day, and the Double Ninth Festival. They have been handed down from generation to generation and continue through this day. These festivals are the source of the Chinese culture, and the cement of a clan or even the nation. 4. The cultural tradition characterized by polytheism. In the Chinese folk custom, there are plenty of gods worshiped by people. There are professional gods, such as God of Drug, Goddess of the Sea (Matsu), and God of Comedy (the theatrical circles); There are gods in daily life, such as God of the Door, God of the Kitchen, God of Fire, and God of Land; and there are gods for different schools of thoughts, such as Confucius the Sage for the Confucian school. These gods constitute a huge divinity lineage. As far as the prehistoric period, our ancestors had already begun describing scenes of life and primitive worship and pursuit with petroglyph and cliff painting. The petroglyph discovered in Mount Yin, Inner Mongolia, is expressive of sun worship. As the reflection of people’s lives, the cliff paintings and petroglyphs covering Xinjiang are expressive of their expectation to build a stronger country. They are the earliest signs of god worship in the region, offering evidence for exploring the roots of such activity in future.

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In China, polytheism is a sign of the complex hero worship, such as the businessmen worshiping and enshrining the image of Guan Yu, the tea farmers worshiping and enshrining the image of Lu Yu, and the craftsmen worshiping and enshrining the image of Lu Ban. China is a pragmatic nation, and its people worship and enshrine what they need. The worship of Fu (happiness), Lu (wealth), and Shou (longevity) stars express the desire of people for a better life. The Chinese nation know the art of mental suggestion and the solace for the soul very well. For example, sister Xianglin, a heroin of Lu Xun, was persuaded by Aunt Liu to donate a threshold to the temple of the god of earth, in order to have relief and peace of mind. When we have an understanding of the factors above, we can unlock the mysteries of folk customs. There are lots of doubtful things in this world, and the folk sayings and customs must have been in some way erroneous, unscientific, and irrational. For example, there is a vague belief that “you are what you eat,” which has no scientific foundation but is still believed by many people. So, it follows that the cultivation of scientific literacy is a gradual process which cannot be accomplished in one move. Liu Zongyuan, a famous writer of the Tang Dynasty, gave the lie to the claim that “The stalactite in famous places is believed to be of good quality and edible.” It was an incident that happened to Cui Jian, Liu Zongyuan’s brother-in-law. At that time, many people had the habit of taking medicine for health preservation. Some thought that regular consumption of a drug known as stalactite66 could benefit qi and blood, impart a delicacy to the complexion, free the collateral vessels, engender stomach fluid, dredge intestine, harmonize the heart, and increase longevity. However, the medicine was working the wrong way on Cui Jian, who frequently felt ill. For this, he wrote to Liu Zongyuan two times. In the first letter, Cui enclosed the sample of stalactite for Liu to identify. Much surprised to see the sample, Liu immediately pointed out that the stalactite taken by Cui Jian was of poor quality. He added that the impureness and inferiority in the quality of stalactite were the 66 See: Compendium of Materia Medica (1)· Stone Part Vol. 9 by Li Shizhen of the Ming Dynasty: “Since the Tang Dynasty, there had been a state of peace in the country. The families used to eating delicacies put their faith in the alchemists who said that stone medicine with an intense scent was the elixir of life. Taking stone medicine became a cultural item in folkways, and the custom still prevails today. Alas! How miserable are those people who died of taking the strong dose!” Beijing: People’s Medical Publishing House, 1982, p. 564.

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cause of his discomfort. Liu Zongyuan said these words from a place of care for the health of Cui Jian. As a bigoted person, Cui insisted that “the stalactite in famous places is believed to be of good quality and edible.” In his second letter to Cui Jian, Liu Zongyuan addressed Cui on the properties of stalactite, and taught him how to identify its functions and qualities from the texture and density. He gave the examples of “Bamboo Arrow” and the other seven things, “Watering the Goat in the Morning” and the other four matters, and the identification of cinnabar and the other five medicines, unmercifully renouncing the expression of Cui in every aspect. The letter was written in plain language, and the lines were filled with passion.67 Liu Zongyuan had been scathing in his denunciation of Cui’s idea. Liu Zongyuan was at once so sharp-tongued and “so appealing, saying that he didn’t mean to reveal Cui’s shortcomings,” and “he didn’t wish to flaunt his medical knowledge.”68 Ignorant of the fact that “believing in groundless words is a taboo,” Cui Jian “persisted in his folly.” In the 7th year of Yuanhe (812), “he suffered an infection on body surface and his body was not like before.” At last, he died of the disease.69 This is an occasion in history of a person dying of blindly taking medicine for health preservation. The attitudes of patients of different status and social ranks tend to be different. In respect of this, Li Zhongzi wrote an article to express his opinion. This is how it says: “The rich people tend to be wayward and

67 Xiong shen ya jian: See Essay Collection of Mr. Hedong· Preface by Liu Yuxi of the Tang Dynasty: “After the death of Liu Zihou, Han Tuizhi of Changli wrote the epitaph and sent a letter in his memory. The letter reads: ‘Alas! It’s like chasing after the unsuitable title! I would say that his articles couldn’t match those of Sima Zichang, Cui Yin and Cai Yong.’” 68 “Earnest persuasion”; “I don’t mean to reveal your shortcomings with my medical knowledge”; “I don’t wish to flaunt my medical knowledge.” 69 See: Pedigree of Cui Junquan’s Clan by Liu Zongyuan of the Tang Dynasty: “baited with the five stones, he suffered an infection on body surface, and his body was not like before.” Also see: notes on Essay Collection of Mr. Hedong, photocopy of Shicai Hall version of Song Dynasty: “At first, he was a refined gentleman. Later, he was baited with the five stones and his body was disordered unlike before…He died on the 26th day of the 1st month of the 7th year of Yuanhe.” Yi: changing the original appearance. Cheng: continuing.

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disregard the taboos; the upper-class people tend to be arrogant and go against principles.”70 Who he meant was exactly Cui Jian in the past. China used to be an agricultural country featuring self-sufficient natural economy. In harmony with it there was a clan-based patriarchal society. Family was the unit of society, and kinship was the glue holding clan relationship together. Mr. Lin Yutang had said, “self-respect, fate and compassion are the Three Goddesses ruling China.” China is a highly humanized country, and compassion permeates all aspects of the society. Li Zhongzi was a meticulous, knowledgeable and responsible doctor. He proceeded to the analysis of “emotion” from the perspectives of “patient,” “outsiders,” and “doctor.” Li told us when a doctor was supposed to take into account the “emotions” of patients, and when he must not meet them halfway. It was the deepest awakening of the time to learn. So, why must a doctor show consideration to the patients? Whence came all the medical compassions listed by Li Zhongzi? To answer these questions, we need to begin with the cultural roots of TCM. Kindness is in the blood and genes of medicine, with no exception in ancient and modern, domestic and foreign. Since the ancient sages proposed the concept of “kindness,” “love the kins, the people, and everything”71 had become the order of the day. To the Confucianists, it was the ideal social structure. The ideal of kindness benefits all, and its influence was peculiarly felt in TCM. As Zhu Zhenheng said, if a scholar was versed in medical study and extended the concept of benevolence to the world, he could be considered as a successful official even if he didn’t pass the Imperial Examination.72 These words captured the mood of most TCM doctors. Guo Chang, a hero of Shen Yazhi, a writer of Tang Dynasty, was a doctor with no aspiration for gain and everything to the patients. A

70 See: Essential Readings for Medical Professionals Vol. 1 by Li Zhongzi of the Ming Dynasty, photocopy of the Ming version in the 10th year of Chongzhen (1637). 71 See: Mencius Vol. 13. See: Translation Notes on Mencius by Yang Bojun, Beijing: Zhong Hua Book Company, 1960, p. 322. 72 Essay Collections of Jiulingshan House Vol. 10 by Dai Liang of Yuan Dynasty: “After listening to Xu Wenyi, he said with emotion: ‘if a scholar was versed in medical study and extended the concept of benevolence to the world, he could be considered as a successful official even if he didn’t pass the Imperial Examination.’” See: abridged preliminary edition of Four Academic Categories.

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doctor by profession, Guo Chang was a native of Shangrao, Jiangxi. The place through which the Raohe River flew had easy water access, and it attracted numerous merchants from Persia. Once, a merchant had an urgent case and was in a critical condition. The illness resisted the efforts of several physicians, and Guo Chang was called in. Guo was promised a reward of 500,000 silver drafts if he could cure the merchant. After a month or so, the merchant’s illness was cured and he came to Guo Chang to fulfill his promise. Guo didn’t take the money, and the merchant thought that he just didn’t give him enough. As a straightforward sort of person, Guo told the merchant directly his reason for not taking the money. But other people didn’t see it that way, and they took him to task for fraud. Guo Chang took no notice of them. He thought that merchants had been trading and calculating all the year round”.73 If they were “robbed off” the money, it was bound to breed resentment in them. If they felt depressed, they would hurt themselves bodily and their life couldn’t possibly be saved. They took ill and sought my medical attendance. I must not gain the little advantage and be the death of them. This barbaric behavior will incur the wrath of Heaven! Guo Chang put himself in the place of patients, showing them utmost consideration. To sum up, kindness comes exactly from compassion, and compassion is complemented by kindness. Compassion with kindness, which is in the blood and genes of TCM, is worthy of praise. Besides, medical compassion was derived from the self-respect lying behind compassion. In folk custom, “face,” “affection,” and “scene” are the most frequent self-respects from which there is no getting away. The “emotion” from the perspectives of “patient,” “outsiders,” and “doctor” proposed by Li Zhongzi was in some way related to self-respect. “Those susceptible to lucky words are averse to the gravity of illness; The oversensitive took the comforting words as concealing the illness; The distrustful wouldn’t listen to the good advices; and the skeptical suspect words in the right.”74 Some people “were prevented from speaking truth and they hid the condition from the doctor.” Whether blaming the blunt person 73 See: Collected Works of Shen Xiaxian Vol. 4 by Shen Yazhi of Tang Dynasty, with Four Academic Categories as the master copy, titles based on the Finest Blossoms in the Garden of Literature. Xi shou que mai: stoking goods for retail sales. 榷: pronounced que, means retail sales. 74 See: Essential Readings for Medical Professionals Vol. 1 by Li Zhongzi of the Ming Dynasty, photocopy of the Ming version in the 10th year of Chongzhen (1637).

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or considering the doctor’s speaking truth as a taboo, whether taking the comforting words as concealing the illness or the unwillingness to listen to the good advices, that’s just the self-respect playing tricks. When we turn to the “emotions of outsiders” and the “emotions of doctors,” the ugly self-respect would be more self-evident. The outsiders “made up stories regardless of the principles of medical science.” “They saw nothing but what was most superficial. They reversed the course, treating the symptoms but not the diseases.” Some doctors “sought the recommendation of social superiors, and some came in uninvited.” “Some doctors were completely uncultured, but falsely claimed that their medical skills were taught by immortals or the secret of his family handed down for generations.” All of these are pure self-respect. Lying behind these “bad habits” that we must not “meet halfway,” there is “self-respect.” The etiquette culture and pantheism worship have led to some taboos, which end up being the taboo culture and the principles of feng shui. In traditional festivals or special realms, taboos and taboo culture are unspoken rules for everyone. For example, buying shoes is a taboo in the first month of the lunar year, because “shoe” shares a similar pronunciation with “misfortune” in Chinese. Mulberry is never planted in the courtyard and entrance of village, because “mulberry” shares a similar pronunciation with “death” in Chinese. There are more taboos in the medical field. There are sayings “doctors must never knock at the door; they can only enter upon invitation.” “Doctors must prescribe odd number, not even number, of drugs.” Actually, Chinese yam is a drug with most taboos and biggest changes. Originally named “shu yu,” it used to be a food ingredient which also served medicinal purposes. After the coronation of Li Yu as emperor of the Tang Dynasty, its name changed to “shu yao” to shy away from the name of the emperor. After the coronation of Zha Shu (dynastic title Yingzong) as emperor of the Song dynasty, its name changed to “shan yao” to shy away from the name of the emperor. The name of “shan yao” is still used today, while the name of “shu yu” had vanished.75 In convention, taboo culture is the rule of life and part of etiquette, and anybody wishes a “good fortune.” Therefore, we need to unveil the mystery of “medical compassion” and see the relationship between doctor and patient in the right perspective. 75 See: Compendium of Materia Medica (2)· Vegetable Part Vol. 27 by Li Shizhen of the Ming Dynasty, Beijing: People’s Medical Publishing House, 1982, p. 1676.

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Compassion is the expression of emotion, desire, and affection. It is put on a beautiful robe, and its culture is deep rooted in the commoners. First Draft: May 3, 2020 Revision: August 10, 2020 Reference: [1] Lin Yutang. My Country and My People [M]. Translated by: Huang Jiade, Xi’an: Shaanxi Normal University Press, 2006.

TCM Concept: Bell Doctor, the Doctor of People According to the patients being treated, doctors in ancient China fell into two categories: “imperial doctors” and “folk doctors,” and the latter had a majority. According to the way of practicing medicine, folk doctors also fell into two categories: “sitting doctors” and “called-in doctors.” Historical record described Qin Yueren (Bian Que), a celebrated folk doctor who practiced medicine according to the tradition, area, and various aspects of the illness.76 In today’s language, folk doctors were mostly “general practitioner.” Because of their characteristics of medical practice, they were for some time known by people as “bell doctor.” The name was given because these doctors were reliant on the bell to attract business. Holding the string bell in one hand and the signboard in the other, they used to go from village to village with a pack on their back containing drugs. The iron bell in the shape of a ringed-jar had a few metal balls placed in the hollow belly. When people heard the jingle of the bell, they knew that the doctor had come. Among “bell doctors” throughout history, there have been “famous ones.” According to Medical Theory by Zhang Gao of Southern Song Dynasty, Ouyang Xiu once came down with a serious case of diarrhea and near death. When the imperial doctors were absolutely at a loss as to what to do, a visiting doctor prescribed a remedy and cured him. On another occasion, a favorite concubine of Emperor Huizong of Song Dynasty had a fit of coughing through the night and her face swelled up. Unable to cure her, Li Fangyu, an imperial doctor, sought the help of a folk doctor. The latter prescribed a remedy and cured 76 See: Historical Records· Collected Biographies of Bian Que by Sima Qian, corrected version, Zhong Hua Book Company, 1959.

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the concubine of her coughing, and Li was able to keep his job.77 A Dream of Red Mansions, Chapter 98 chronicled Jia Baoyu’s experience of seeking the medical attendance of bell doctor. Stringed Elegance, a book written by Zhao Xuemin, a medical scientist of the Qing Dynasty, gives a full account of bell doctor. It justifies the name of folk doctor, whose medical practice was characterized by “affordability,” “effectiveness,” and “convenience.” The book has a profound influence (Fig. 2.3).78 March 5, 2020

77 See: Medical Theory Vol. 6 and 4 by Zhang Gao of Southern Song Dynasty. Also see: Stringed Elegance· Preface: “Ouyang Xiu once came down with a serious case of diarrhea and near death. They begged the visiting doctor to prescribe a remedy; Li Fangyu cured the concubine of her coughing and kept his job. The local remedies can also work miracles.” 78 See: Internal compilation of Stringed Elegance· Introduction: a visiting doctor must

keep “affordability,” “effectiveness,” and “convenience” in mind. The first means that the medicine should be inexpensive; the second means that the medicine can have instant effect; the third means that the medicine is easily accessible. Remembering the three words and one will become an excellent doctor.” Photocopy of Yuyuan Garden, the 14th year of Guangxu (1888).

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Fig. 2.3 A corner of TCM pharmacy

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CHAPTER 3

Cultural Dialogue Between Chinese and Western Medicines

Reader’s Guide In studying Chinese cultural history, Mr. Chen Yinke, a famous historian, discovered a general rule: some things “might seem different, but in effect, are complementary.” We should open our mind to the fine foreign cultures, and must not forget our own.”1 This attitude is extremely inspirational to those longing to know the history of Sino-foreign cultural exchanges since the Ming and Qing dynasties. The period saw the exchanges reaching their peak, when eastern and western cultures met and embraced each other. The cultural dialogue between Chinese and Western medicines builds up a vivid picture at a time of great change. 1. In this period, Western medicine was coming to China, and the will of incorporating Western medicine into TCM had proved strong. Many people went abroad to study medicine, at the expense of themselves or the government.2 In the 7th year of Guangxu (1881), Li Hongzhang founded the Western Medical Institution (its name 1 See: A Collection of Essays of Jinming Hall by Chen Yinke, and Review Report of the Second Volume of the History of Chinese Philosophy by Feng Youlan, SDX Joint Publishing Company, 2001, p. 282. 2 See: History of Chinese Medicine· Chapter 6 by Shi Zhongxu: “Huang Kuan of the Qing Dynasty was the first Chinese people going abroad to study medicine.” “Huang Kuan studied medicine at his own expense. In addition, there are those sent abroad by

© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023 G. Luo, Humanistic Spirit of Traditional Chinese Medicine, https://doi.org/10.1007/978-981-99-4273-2_3

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changed to “Naval Medical College” afterward) in Tianjin; In the 26th year (1900), it was closed down for some reason; In the 28th year (1902), Yuan Shikai reinstated the operation of the College and changed its name to Beiyang Military Medical College. Intended to coordinate with the Westernization Movement and the modernization of the army, these measures echoed the views of some master TCM doctors that “doctors must not stick to Huangdi’s Classic on Medicine without pressing ahead” (Wisdoms in TCM Classics by Yun Tieqiao). TCM was entering a time of mixing with Western medicine. The moves were calculated to draw on the strengths of Western medicine to compensate for our weaknesses, rather than negating TCM completely. Our ancestors strived to keep tradition alive, which is very admirable! Western medicine was brought to China together with Christianity by the missionaries. In coastal regions, Western hospitals mushroomed. They had led the push into the mixing of TCM and Western medicine. 2. This period saw the mixing of TCM and Western medicine, and the Sino-foreign cultural exchanges reaching their climax. Under the influence of the West, TCM demonstrated its resilience and all-embracing nature. A prominent example is the introduction of smallpox vaccination by Qiu Xi of the Qing Dynasty, which serves to illustrate the wisdom of “mixing” of TCM. The mixing of Western medicine and TCM was a “two-way” process in which China and the West learned from each other. In the Ming and Qing dynasties, the transport links between China and foreign countries were improved, and cultural exchanges became more frequent. Books on physiology and anatomy were the first Western medical works entering China. On the other hand, books on pulse, acupuncture and moxibustion, drugs, and TCM theory began to appear in the West in early Qing Dynasty. In the process, TCM learned from the strong points of Western medicine, while Western medicine came out from the prejudice against TCM and began to review its flaws and misunderstandings. Joseph Needham, a contemporary British scholar, said, “Today, many people are lulled into a false sense that TCM is rustic, strange, backward and utterly meaningless.” In fact, they are looking at the the government to study medicine.” Taipei, China: Cheng Chung Book Company, 1984. Also see: The Spread of Western Learning to the East by Rong Hong, and History of Chinese Medicine, “Huang Kuan” entry, by Chen Bangxian.

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profession from the wrong point of view. TCM is a great cultural product.”3 Take acupuncture and moxibustion. Dou Jie (styled Hanqing, 1196–1280), a famous acupuncturist of the Jin Dynasty, once said, “Clever use of the needle can save life, and the acupuncture and moxibustion therapy is the most effective. So, Plain Questions and other medical works begin with the mention of it. He Huan, Bian Que and Hua Tuo, the medical sages, were known for their acupuncture and moxibustion skill. When the needle is stuck into the acupoint, it works the magic and the patient would be cured. The skill set a precedent for TCM doctors.” It’s a pity that afterward, “the skill was in decline”4 and “had to be found in the folk”.5 3. The relay run in transnational prevention of smallpox was characterized by the eastern variolation and the western cowpox vaccination. It helped to build bridges of mixing and dialogue between TCM and Western medicine. With cooperation, not struggle, taking the center stage, the relay run was crucial to the creation of “new medicine.” Thanks to the mixing, the comparison between TCM and Western medicine, by which the TCM community was occupied, began. Some scholars noted that TCM “is good at revealing principle and bad at making it into general rule.” “Too dependent on principle, it borders on falsity.” Western medicine “is good at making principle into general rule and bad at revealing it.” “Too dependent on general rule, it borders on dogmatism.” TCM and Western medicine “have their merits and

3 See: Science and Civilization in China (aka History of Science and Technology in China), by [UK] Joseph Needham. 4 From: Song to Elucidate Mysteries by Dou Jie of the Jin Dynasty. See: Prescriptions for Universal Relief Vol. 409, compiled by Zhu Su, etc., of the Ming Dynasty, based on the People’s Medical Publishing House version, 1959. 5 See: Han History· Bibliographical Treatise· Zhu Zi Lue: “Confucius said, ‘The tradi-

tional etiquette was lost and had to be found in the folk’. Now the saints have gone far away. When ritual is lost, there is nowhere to seek it out. Isn’t it better to adopt the thoughts of the nine schools than to find them in the countryside? If one can master the six arts and observe the words of these nine schools, they should take the best from each and be able to understand all aspects.”

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demerits, and they should be developed in tandem.”6 “In medical practice, we should forsake miscellaneity and disorder. In ancient Chinese medicine, “和缓”7 (he huan) refers to a harmonious and moderate approach to treatment.” The comparison and judgment of TCM and Western medicine, based on many years of medical practice, are extremely apropos and condensed. In this section, the author selected physiological anatomy which embraced the early convergence between traditional Chinese and Western medicine and which was also the most basic discipline, as the entry point. The author extolled Wang Qingren, a brave and truth-seeking person who was the first to step inside the doorway of modern medicine, the western cowpox vaccination superseding the eastern variolation as a relay race and the Chinese and British medical practitioners who cooperated to fight the epidemic, the new thinking of the Yuanqi (essential qi) theory and the scientists who made the ancient acupuncture brilliant again… The term “harmony in diversity” originated from The Analects of Confucius· Zi Lu. It originally meant the gentlemanly behavior in interpersonal interaction, i.e., the hearts are in harmony while views could be diversified. It would need the breadth of mind and emotions to achieve this. With cross-cultural research going deeper and the global village becoming smaller, the idiom highlights its long-lasting vitality ever more. It is becoming more understandable and acceptable, no longer limited to interpersonal interaction. It is only through diversity that the unification of various forms can be achieved, that beauty and harmony can have a solid foundation, and that a hundred schools of thought can contend. “Old history narrates political affairs in detail and skips through culture.”8 Culture represents the virility and soft power of a nation, on

6 From: Combination of Chinese and Western Viscera Images by Zhu Peiwen of the Qing Dynasty, lithography copy of Hongwen Pavilion, The 23rd year of Guangxu of the Qing Dynasty (1897). 7 From: History of the Qing Dynasty· Biography of Art · Fei Boxiong. “He Huan” originally refers to Yi He and Yi Huan, famous doctors of the State of Qin in the Spring and Autumn Period (See: Master Zuo’s Spring and Autumn Annals· The 10th Year of Duke Cheng, Master Zuo’s Spring and Autumn Annals· The 1st Year of Duke Zhao, “Commentaries to the Thirteen Classics” version). “He Huan” is a pun, meaning “relieve.” 8 From: Academic History of China over the Past 300 Years by Liang Qichao, China Bookstore Press, 1985, p. 290.

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which the world has placed utmost importance. We face an arduous task of developing the soft power of TCM for the betterment of people. March 31, 2020

An Adventure beyond Classic Teaching Emboldened by Kindness Context Tips Innovators in medical history “striving for kindness”; Wang Qingren’s taking the graveyard as the natural laboratory for trial and error; 40 years’ research on the physiological structure of human diaphragm to embody the scientific spirit; “Western learning coming to the east and the significant contributions of Da Vinci, a master painter, to anatomy; “A bell ringing in the silent night”—stepping over the threshold of anatomy. The book’s really impressive. It reexamines the medical cases centuries ago and corrects their mistakes. As a rare and fine work of TCM, it embodies the medical genius and the benevolent mind of doctors! —Correction of Errors in Medical Classics, prefaced by Zhang Runpo

Who in the world can defy the pressure of public opinion, and examine the distribution of viscera all through his lifetime “in aberration of TCM classics”? Wang Qingren (styled Xunchen, 1768–1831), a famous anatomist and medical expert of the Qing Dynasty, had painstakingly done a commendable job. He went to so much effort to draw the diagram of viscera for TCM doctors of latter generations. “When seeing the diagram, the doctors will be self-assured and confident. They have a principle to follow, without going in the wrong direction, being confused, or misdiagnosing.” The footprint of Wang Qingren has been fairly steady. Wang Qingren was early in his thirties in the 2nd year of Jiaqing (1797). One day in late April, he traveled to today’s Daodi Town, Luanzhou, Hebei Province where there was a pandemic of plague. Many children came down with exanthema variolosum and dysentery, of which the fatality rate was eighty to ninety percent. Some impoverished households couldn’t afford the coffin, and they had to bury their children with mats. According to local custom, the corpses of juveniles must not be buried beneath mud. People assumed that when the corpses were eaten

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by the hyenas, the deceased could be reincarnated. In the end, disemboweled corpses were strewn everywhere in many cemeteries, and people passed through the cemeteries as quickly as they might, covering their noses. Wang Qingren thought that there were errors in the images of viscera and bowel, principally because the ancient people couldn’t see them. The graveyard was exactly a natural laboratory, wasn’t it. At the very idea, Wang resolved to go to the graveyard and see the distribution of viscera and bowel, thereby helping to draw the accurate diagram of viscera and bowel. Science and rationality had triumphed over disgust and fear, and the graveyard became his natural laboratory. When he came in the “laboratory” in the morning, Wang Qingren would observe, compare, and draw the images. In the appalling condition, he had observed for ten consecutive days and his findings did not fit the drawings of viscera and bowel in medical works in form and number. Wang Qingren had some difficulties observing the diaphragm between chest and abdominal cavity, and its shape, which was very important. When looking for the answers, questions such as “whether the diaphragm is placed above or below the heart,” and “whether its shape is oblique or positive,” had been buzzing around in his head. However, the thin diaphragm was easy to shatter and rarely seen in entirety. Wang couldn’t get the valuable diaphragm sample, but he never ceased to trace its position and shape. Thirty-two years later, in the 9th year of Daoguang (1829), something turned up when Wang Qingren was called in by a wealthy Heng family. In the conversation, the host mentioned his relative Heng Jing, who had been the guard of Kashghar before taking up the post of governor of Jiangning. Heng had seen plenty of corpse of prisoners who were sentenced to death, and he knew perfectly the location and shape of diaphragm. What the host meant as a casual remark interested Wang Qingren, who eagerly paid his respects to the old gentleman and sought his advice on the form of diaphragm. Heng Jing was affected by Wang Qingren who had been striving to understand the physiological shape of diaphragm for decades with determination and pragmatism. He described the physiological shape of diaphragm to Wang. With a full understand of the place and shape of all the viscera and bowel, Wang Qingren painted a picture of them, fulfilling a long-held ambition. Why, then, must Wang Qingren risk being accused of “aberration”? Why had he been undaunted as he took on this formidable task of

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repainting the diagram of viscera and bowel in hostile working conditions? Was he doing it to “show off” or “be original”? According to TCM literature, the reason for that is three-fold. First, the diagrams of viscera and bowel in the past were incorrect. “Since Han and Wei Dynasties, medical doctors had got used to the diagram,” but it differed greatly from the real anatomy of human viscera and bowel. The ancient sages didn’t take a conservative approach to the situation. Rather, they treated the legacies of predecessors with an attitude of innovation. They lived by the principle of “reading ancient classics and questioning them for revelation; Great question leads to great revelation. Unless the ancient books were questioned, they were not worth believing.” The ancient people were guided by the vision that “addressing the doubts is revelation.”9 Wang Qingren was just such a doctor who dared to overleap the obstacle of custom. He had spent his entire career and life pursuing innovation, change, and originality. With perseverance and pragmaticism, he spent his whole life in medical innovation. He daringly raised doubts about the authenticity of the diagram of viscera and bowel drawn by the ancient people. “I have some understanding of the viscera and bowel theory and the diagram painted by the ancient people. There are many discrepancies in the expounding of ideas.”10 Then he set out the characteristics of spleen, and the relationship between heart, mind, contemplation, emotions, anxiety, and wisdom. Wang Qingren felt that the old diagram was contradictory and confusing, and there were mistakes in reviewing and refuting the old diagram by latter generations. In fact, the diagram of viscera and bowel drawn by the ancient people was not one in the anatomical sense, but a functional description based on TCM theory. The two were very different in idea and motive. For example, this is how Huangdi’s Classic on Medicine describes the functions of liver, heart, spleen, lung, kidney—the five viscera: “The liver governs the sinews. The liver promotes the heart and dominates the eyes.” In other words, the liver blood nourishes the sinews. The liver pertains to fire in the five elements, and wood engenders fire. So, sinews nourish the heart, and liver-qi reaches the eyes.

9 In the words of Li Zhi of the Ming Dynasty. See: The Questions of Guanyin. 10 See: Correction of Errors in Medical Classics ·Record of Viscera by Wang Qingren of

the Qing Dynasty, Three Pagoda Hall version, first carved in 1830.

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“The heart governs the blood. The heart promotes the spleen, and dominates the tongue.” In other words, the heart promotes the production of blood, and blood nourishes spleen. Fire generates earth in the five elements, so the heart-qi reaches the tongue. “The spleen governs the muscles. The spleen promotes the lungs, and dominates the mouth.” In other words, the spleen nourishes the muscles and muscles make lung-qi sufficient. Earth generates metal in the five elements, so the spleen-qi reaches the mouth. “The lungs govern the skin and body hair. The lungs promote the kidneys, and dominate the nose.” In other words, the lung nourishes the skin and body hair, and skin and body hair generate kidney water. Metal generates water in the five elements, so the lung-qi reaches the noses. “The kidneys govern the marrow. The kidneys promote the liver, and dominate the ears.” In other words, kidney-qi nourishes the marrow, and marrow nourishes the liver. The kidney-qi reaches the ears. Above is the theory foundation of the mutual generation and restriction relationship of five elements (five viscera) in TCM. The diagram of viscera and bowel drawn under the guidance of this theory is obviously different from the modern anatomical diagram seeing the human body as an entity. They are the products under the highlight of two different theoretical objectives. Second, Wang Qingren’s reinventing the diagram of viscera and bowel should be motivated by the fashion of western learning coming to the east. Missionaries transmitted western culture by means of medicine, which impelled Wang to reexamine the ancient diagram of viscera and bowel. The thought of reinventing the diagram of viscera and bowel occurred to him. “Western science and technology were first introduced to China through missionaries of the Christian Church.” After science and technology, the Western medicine rushed into China. The missionaries understood that “the best way to win over the citizens is academic accomplishment.” The most influential missionaries were Matteo Ricci and Giulio Aleni, Italians coming to China in 1582 and 1613, Ferdinand Verbiest, a Belgian coming to China in 1659, and Adam Schall von Bell, a German coming to China in 1662. These learned people had their own domains and strengths and they were scientifically trained. They either had a good command of Chinese, or knew something about Chinese culture and customs. They were social, and able to communicate and carry knowledge into the commoners. In the realm of anatomy, Western medical works such as Outline of Western Theories of the Human Body

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and Universal Anatomy of the Human Body were translated into Chinese by Johann Adam Schall von Bell and Johann Schreck. As the earliest works on physical anatomy introduced into China, they had huge impacts in TCM. In the late seventeenth century, Atlas Danatomie Humaine written in French by Pierre Kamina was translated into Manchu language by Dominique Parrenin and entitled Complete Record of Human Bones Instituted by Authority of the Emperor. After reading these books, Wang Qingren said: “A book without mentioning viscera and bowel would be an arrogant fantasy; Attending the patients without knowing viscera and bowel would be a blind man walking at night.”11 His reflection is insightful. Instead of confining to their realms, TCM and Western medicine learned from each other. To sense its value in modern medicine, expand our horizons, and improve our minds, we have to trace the root and progression of human anatomy. We should have some knowledge of the Western “personages” who were epoch-making examples in this regard. The most accomplished and famous anatomist of any time is Mondino De’ Luzzi, an Italian. His masterpiece Anathomia Mundini, written in 1316, is the first textbook of human anatomy in the western world. The handbook gained widespread recognition and was honored as the bible of anatomy. After his death, Mondino was honored as the Sacred Teacher and deified. Views in textbooks of later generations discordant with those in the works Mondino were dismissed as fallacies. From the rules and systems of medical schools, we can tell that the anatomical textbook is already in its dozens of printings and has been in used for more than a century. Another anatomical genius of unexpectedly impressive attainments is Da Vinci, also a master painter. As Da Vinci was recognized as one of the greatest painters ever, people tend to overlook the anatomical gift he showed. His intuition and knowledge were the making of him—the pioneer of a new era in the field of anatomy, while basic medicine was the most complete display of the curiosity of the genius. It was said that Da Vinci had dissected dozens of male and female corpses of various ages. A few corpses were dissected just for studying the vein. The first person to draw the fetus in the womb and the appendix in the abdomen, Da Vinci could be called the founding father of local anatomical drawing. In

11 See: Ibid.

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the anatomical process, Da Vinci had wielded a set of sophisticated technology, such as intravenous injection and liquid wax injection, to improve the anatomical drawings, and make them clearer and more lifelike. He was the greatest anatomist there has ever been, or ever will be, in the world. From these manuscripts, we are in a position to catch a glimpse of the master. It follows that high-level textbooks of human anatomy already existed in the fourteenth century in the Western world. Afterward, these textbooks hitched a ride on the fashion of “Western learning coming to the east.” Crossing oceans, they were brought to China, influencing the local medicine with centuries of self-imposed isolation but thoroughly practical. It was a matter of serious urgency to embrace openness and bring TCM more into line with the rest of the world. In establishing the tie between TCM and Western medicine, there were some intriguing details about anatomy. In the course of his interpretation of anatomy, Mondino cited the human heart as an example. What he introduced was a matching with the question raised and planned to solve by Wang Qingren before the mapping of the new diagram of viscera and bowel. The mystery of science in history was “accidentally” solved (Fig. 3.1). In discussing the function of heart, Huangdi’s Classic on Medicine makes an analogy between the heart and the “monarch.” The meaning is that the spirit and thinking of people are issued from the heart. As the physiological function of heart, the mind is housed in the heart. The engagement of mind is “will”; the activities of “will” is “thinking”; long “thinking” is “anxiety”; and planning with “anxiety” is “wisdom.” These factors are housed in the heart. Wang Qingren raised a question: if that is the case, why does the book say that “spleen houses ideation, kidney governs skills, strategies get out of the liver, and gallbladder governs decision making”12 ? This is the narrative of Mondino: There are two holes on the right ventricle, one of which is larger and connects to the liver, because blood flows from the liver to the heart through it; The other hole is connected to the “arterial vein,” which leads to the lung. There are two holes on the 12 See: Ibid. Zhu: Dominates, associates. See: Huangdi’s Classic on Medicine· Plain Questions· On the Five Vital Energies 23: “The five organs are associated with different parts of the body: the heart is associated with the veins, the lungs with the skin, the liver with the tendons, the spleen with the muscles and the kidneys with the bones.”

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Fig. 3.1 Uomo Vitruviano, Da Vinci’s work on human proportion

left ventricle too, one of which has three valves; The other is connected to the “arterial vein” and has two valves through which the smoke-like steam from the lungs passes. Mondino’s wonderful story about heart structure echoes the view of Wang Qingren of later generation who assiduously pursued the “truth” of anatomy. He presented a concrete picture of heart structure from the perspective of anatomy, while the highlights of TCM is on the functions of heart. Due to different medical theories, logic, methods and habits, the observations of heart might come to different conclusions. Just as, when we view the same landscape from different angles, it unfolds itself differently. Third, the publication of Wang Qingren’s Correction of Errors in Medical Classics had driven the development of TCM, and so was of significance. From the perspective of Western medicine, the real physiology began with the progress and perfection of anatomy. So, anatomy is the foundation and source of physiology, pathology, therapeutics, and even forensic medicine. Admittedly, the anatomy practice of Wang

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Qingren had broadened the horizons of TCM, which enabled the leap from “judging by listening” to “judging by seeing.” The reinvented diagram of viscera and bowel subverted the cognition of heart and blood vessels, lungs, stomach, and bile ducts connected to the duodenum. On these bases, he gained a new insight into thinking, wisdom, and qi and blood. Afterward, he concocted the “stuffy nose relieving and blood activating decoction,” “veins stasis dissipating decoction,” and “diaphragm stasis dissipating decoction.” His formulars for coronary disease and stroke sequela were marked by originality. These theories were proposed on the basis of the improved anatomy, and new acquiring of TCM therapeutics.13 Wang Qingren’s Correction of Errors in Medical Classics ascended from basic anatomy to drug prescription in TCM therapeutics. Practice has shown that it was a ground-breaking endeavor. Wang’s success marked a symbolic milestone for the development of TCM and Western medicine with great educational value. Wang Qingren conducted himself as a responsible doctor with great personality. He had changed the course of China’s history of anatomy, and he always kept the interests of other TCM doctors in mind. What worried him most was that the new diagram of viscera and bowel was “heretical,” and “TCM doctors of later generations would suffer the consequences.” And he worried also that in the absence of the diagram, TCM doctors would go in the wrong direction and be confused.14 Wang didn’t eschew blames, and he bore upon himself the accusation of “aberration.” He was a realist and innovator in Chinese medical history with a benevolent mind and never believing rumors. Wang Qingren “focused for decades on correcting the errors in medical works over the past thousands of years. Like a bell ringing in the silent night, he gave people a whack on the head. The dreamers had a rude awakening.”15 In his confession, he “laid bare” his fond hopes to TCM doctors of later generations, and his love upon the people of this land. First Draft: February 24, 2020

13 See: History of Chinese Medicine, Chapter V: The Period of Medicine Decline, by Shi Zhongxu. 14 See: Correction of Errors in Medical Classics ·Record of Viscera by Wang Qingren of the Qing Dynasty, Three Pagoda Hall version, first carved in 1830. 15 See: Ibid., prefaced by Liu Birong.

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Revision: June 1, 2020 References: [1] Guo Aichun. Proofreading of Huangdi’s Classic on Medicine · Plain Questions [M]. Tianjin: Tianjin Science and Technology Press, 1981. [2] Arturo Castiglioni. A History of Medicine [M]. Translated by Cheng Zhifan. Guilin: Guangxi Normal University Press, 2003. [3] Wang Qingren. Correction of Errors in Medical Classics [M]. Three Pagoda Hall Version, 1830. [4] Wu Guosheng. The Course of Science [M]. Changsha: Hunan Science and Technology Press, 1997.

TCM Concept: Confucianism and TCM Doctors In the remote antiquity of China, Confucianists and witches were in hot demand. The former was capable of communicating with heaven, earth, and people; and the latter was capable of communicating with heaven, earth, ghosts, and gods. Confucianist was a profession appearing early in Chinese history. In the Yin and Shang Dynasties, Confucianists served the aristocrats and were responsible for performing the sacrificial rites. Confucianists were cultured people with good verbal skills and artistic mastery. Afterward, Confucianist meant the literate persons mastering the six arts and aspiring to serve in the imperial court. Ban Gu, a famous historian of the Eastern Han Dynasty, said, “In ancient times, the Confucianists were learned and they mastered the six arts” (Han History· Biography of Confucianists ). The “six arts” generally referred to rites, music, archery, chariot driving, calligraphy, and mathematics—the six disciplines of ancient education. At last, Confucianists went down the path of communicating the “six arts” to the general public, hence their name “Confucius teacher.” In late Spring and Autumn period, Confucius founded the private academy in keeping the tradition alive. The school of thought he founded was called Confucianism. Confucianism and Confucianist physician, born of the same roots, are an indivisible whole.

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With Confucianism as the basic value, Confucianist physicians were medical practitioners following through on the Confucian theories. Benevolent doctor was the medical practitioner upholding the core value of benevolence in Confucianism. Xiao Jing, a Confucianist physician of the Ming Dynasty, said, “I have investigated the great Confucianists since Qin and Han Dynasties. With incredible versatility, they stayed in the paths of righteousness. They mastered TCM and tried to reach greatness by seeking its truth. They put their experiences down on paper for latter generations.” Obviously, Confucianist physician mastered both “Confucianism” and “medicine,” and they must pass down their medical skills for latter generations. “Without a sensible approach to medicine, a Confucianist must not write medical works” (Correction on Huangdi and Qi Bo’s Discussion by Xiao Jing of Ming Dynasty). History abounds with great men starting out as Confucianists before branching into the realm of TCM, such as Hua Tuo and Huangfu Mi, and great men starting out as doctors before branching into the realm of Confucianism or even the revolutionary cause. Sun Yat-sen was a revolutionist who studied medicine when he was young. In 1893, he established the Sino-Foreign Pharmacy in Xianji, Guangzhou to offer courtesy medical service. Lu Xun, who himself had received medical training as a youth, realized later that changing the spirit of the countrymen was more important than treating their diseases. He left the medical circle and took up literary creation. March 14, 2020

Relay Run in Transnational Prevention of Smallpox Context Tips Edward Jenner and the birth of smallpox vaccination; Lu chuang and the spread of human pox vaccination; Fubo General Ma Yuan’s “Semen Coicis Pearl” case and disease control; The birth, spread and popularization of human pox vaccination; The epidemic of smallpox in early Qing Dynasty; Smallpox vaccination being incorporated into TCM. In the first years of the dynasty, citizens feared smallpox. When I obtain the formular, our children are vaccinated for smallpox and are no longer ill.

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—Family Instruction

On May 14, 1796, Edward Jenner,16 an Englishman, administered a vaccine for a boy called James Phipps. Different from before, the vaccine came from the smallpox of a dairymaid. In 1768, Jenner talked with a dairyman in the pasture and he was informed of a virus on cows. When one was infected with the virus, he would feel a little unwell. Upon recovery, he would never be infected with smallpox any more. The words of the dairyman set Jenner thinking, as the British people were vaccinated human pox against the spread of smallpox, a method introduced from China. Jenner was an excellent physician who was clever in observing and listening. After hearing the dairyman’s introduction of cowpox, he watched the effect of cowpox upon the pasture staff and their families when treating diseases. 30 years’ study and exploration confirmed that the toxicity of cowpox (vaccine) was lower than the human pox vaccine, and it had immunization effect to the smallpox. It was only because of this that he dared to administer the cowpox vaccine for the village boy. As expected, the experiment was a success, and the boy being administered the cowpox hadn’t infected the smallpox. Jenner had observed and experimented many times, and his findings were published in 1798 in a pamphlet entitled An Inquiry into the Causes and Effects of the Variolae Vaccinate. A new method to treat patients suffering from smallpox came out! The human pox vaccination from China, however, was Jenner’s source of inspiration to prevent smallpox with cowpox, and his experiments and researches were based on it. As the most effective, convenient and lowcost way to prevent smallpox, the vaccination was favored by many and put into use in many countries. Once, M. W. Montagu, the wife of British Minister to Turkey, came down with smallpox. Her eyelash fell out and her face was badly pockmarked. In 1717, she discovered the human pox vaccination in Turkey and made up her mind to prevent the spread of smallpox with it. Before long, she asked a doctor to administer human pox for her five-year-old son. Word of the incident got back to England, and the king admired that very much. And so, human pox vaccination was gradually popularized in England. After many years, people began to look for an alternative vaccine with lower toxicity. 16 Edward Jenner, 1749–1823. This is the common translation in China. He is also known as “琴纳” or “金纳”.

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It would be hard to imagine how the findings and research results of Jenner had shocked the world after their publication. As the human pox vaccination of China had been spreading around the world, the cowpox vaccination was soon adopted by Switzerland, Italy, Germany, and the United States to prevent smallpox. So, what exactly is human pox vaccination, the predecessor to cowpox vaccination? In China, the evolution of human pox vaccination can be broadly split into two stages. The first stage is marked by the increased understanding of smallpox; and the latter stage is marked by the invention, administering, and spread of human pox vaccination across the world. In China, the first recorded mention of smallpox can be traced back to the Eastern Han Dynasty when Emperor Guangwu (dynastic title: Jianwu) was in power. In the peak of summer in the 24th year of Jianwu (48 AD), general Ma Yuan engaged a battle with an ethnic minority armed force in Hutou (today’s Yuanling County north, Hunan Province). According to historical document, “The heat is so intense that many soldiers of Ma Yuan died of disease.” The type of “disease” was not specified. There is a strong possibility that it was smallpox that produced widespread deaths. As history tells it, when he fought the battle in Cochin (today’s Northern Vietnam) in the 16th year of Jianwu (40 AD), Ma Yuan consumed “coix seed” to dispel miasma in the body. Coix seed, or the seed of Jobs tears, could strengthen the spleen, clear heat, and dispel dampness. Both drug and food, it could be cooked together with rice bean and white hyacinth bean in water to release summer heat and remove dampness. It follows that when he was in Cochin, Ma Yuan consumed “coix seed” to dispel miasma and the summer heat dampness. Here’s what Pestilence Theory·On Miscellaneous Qi, the work of Wu Youxing, a famous pestilence scientist of the Ming Dynasty, says: “Miasmic toxin and the unwholesome mists in the south, as the impure air of the land, are observable. But the miscellaneous qi of heaven and earth can take different forms.” Miasmic toxin and the unwholesome mists refer to the toxic gases in the southern mountains and forests that are pathogenic due to damp heat steaming. They have a variety of pathogens. However, historical record didn’t specify what kind of disease Cochin miasmic toxin was. But the experience of Ma Yuan gave other people a chance for talking the “semen coicis scandal.” This scandal had its origins in Cochin where Ma Yuan used semen coicis to prevent miasmic toxin. The semen coicis species originated from

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the south were plump, and Ma Yuan was going to use them for seeds. During the return of the army, he loaded the seeds onto a carriage. Some people thought that Ma was getting back the exotic or strange things from the south. The aristocrats merely stood apart and saw, because he was at the time a favorite of the emperor. Ma had attracted jealous haters. After his death, those people, among whom were Ma Wu and Hou Yu, Duke of Yuling, criticized him for bringing back treasures such as pearls and rhinoceroses. The emperor listened to the tales and was misled. After Ma’s wife and children learned the news, they felt very afraid. Not daring to bury him in the ancestors’ gravesite, they bought a few acres of land in the western part of the city and buried him quietly and quickly there. Guests and old friends were too scared to visit the bereaved family and offer comfort. Ma’s wife and children even trussed themselves up with a hemp rope and voiced their grievance directly to the emperor. They earnestly and humbly entreated his pardon for six times. At last, the emperor was impressed and Ma Yuan was allowed to be buried in the ancestors’ gravesite.17 People of later dates created a poem, which runs thus: “The dwarf has had enough and laughed at Dongfang Shuo. The jealous haters criticized Fubo General using Semen Coicis as an excuse.”18 At last, Ma Yuan was rehabilitated. The letter of accusation criticized Ma for replacing treasures with phonies, and it alluded to “wen xi,” an item that captures our imagination. “Wen xi” is a species of Asia Rhinoceros with graphic veining, the horns of which had been used for medicinal purposes (the use of rhinoceros products is banned today). In the 1950s and 1960s, the author went to the Northeast countryside where he heard of a horrible infectious disease, colloquially called “hemorrhagic fever” (actually the plague). The treatment involved the use of rhino horns, an herb cold and cool in nature which worked miraculously on infectious heat diseases. It remains open to question whether the complaints in the letter of accusation was fabricated or not. There was the possibility that Ma Yuan brought back the rhino horns due to their effects on miasmic toxin. The pity is, the truth is lost forever. 17 See: The Book of Later Han Dynasty Vol. 24, Biography of Ma Yuan, by Fan Ye. 18 See: The Author’s Feelings upon Receiving a Letter from an Official about the Situation

in Tongzhou by Bai Juyi of the Tang Dynasty. Ma Yuan was also called Ma Fubo. Fubo Jiangjun, “General who Calms the Waves,” was an official title of ancient generals. Ma Yuan, who served during Emperor Guangwu’s reign in Eastern Han Dynasty, was a famous Fubo Jiangjun in history.

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The earliest record of smallpox as an infectious disease was found in the Jin Dynasty. Prescriptions for Emergent Reference was written by Ge Hong, an infectious disease expert of the Jin Dynasty. Essential Secrets from Outside the Metropolis , written by Wang Tao, a medical philologist of the Tang Dynasty, quoted the words of the book. Here’s what it says: “In recent years, smallpox was rife. When people contracted the disease, fiery red sores with white pus would erupt all over the face and the body. When one sore disappeared, another would erupt. If not promptly treated, the mortality rate would be high. This clear and specific description was an early record of smallpox. Wang Tao outnumbered his contemporaries, even the famous doctor Sun Simiao, with regard to the notes to medical documents. This is because he had the superiority others lacked. “As supervisor of the Institute for the Advancement of Literature, he had access to thousands of volumes of medical formularies” (Complete Compendium of Medical Works, Ancient and Modern, Xu Chunfu of the Ming Dynasty). In other words, he was backed by a “national library.” Emergency Remedies to Carry behind the Elbow, written by Ge Hong, is the first Chinese clinical medicine handbook ever. When compiling the book, Ge Hong accorded topmost priority to “convenience” and “emergence.” “It provides comprehensive treatments for all kinds of emergencies and illnesses, so that people can treat themselves without needing to visit a doctor” (Baopuzi Neipian and Waipian Sections by Ge Hong of the Jin Dynasty). “Behind the elbow” means that the book was wearable for easy reference. Afterward, Tao Hongjing, a pharmacist of the Liang Dynasty who was nicknamed “Mountain Minister,” made revisions to the book.19 Emergency Remedies to Carry behind the Elbow called smallpox “lu chuang,” which was said to be brought to the Central Plains by the captives of the Western Regions in the Jianwu period of the Jin Dynasty (301 AD). It follows that “lu chuang” was an “imported” infectious disease. Judging from the demand and introduction of human pox immunization in other countries, we can tell that lu chuang had become an infectious disease in many countries at that time. Human pox vaccination as the way to prevent smallpox could be traced as far back as the Tang Dynasty. Some say that Sun Simiao, a great 19 Based on Book of Sui·Record of Classic Works, Emergency Remedies to Carry behind the Elbow, six volumes in total, by Ge Hong. Liang supplied the deficiencies in two volumes.

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doctor of the time, proposed the theory of counteracting one toxin with another. He applied the white pus of smallpox externally to the skin of the healthy people, as a way to prevent smallpox. However, medical instruments such as syringes and needles were still some way off invention. Cutting through the flesh might be painful to the patients. The early immunological thought had provided beneficial insights to people of later generations. But it has yet to prove whether the thought was influenced by the theory of “counteracting one toxin with another” proposed by Wang Chong and Ge Hong. In 1713, Conclusion of Pox, a book written by Zhu Chunjia, was published. According to the book, a child of Wang Dan, the prime minister during Emperor Zhenzong’s reign (Song dynasty), came down with sever smallpox. Later, an intelligent member, Wang Chong, was added to the family. Wang loved the child very much, but worried that he would also be infected with smallpox. At this time, a Sichuanese happened to come and see Wang. He said that there was a miraculous doctor in Mount Emei who knew the practice of pox inoculation. Whoever was inoculated would not be infected with smallpox again. Delighted to hear that, the prime minister immediately sent up for the doctor. After being inoculated, Wang Su had a fever, and the pox broke out as expected. After twelve days, the scars were healed. Yu Tianchi of the Qing Dynasty said: “I was informed that pox inoculation started during the reign of Emperor Longqing of the Ming Dynasty (1567–1572). A native of Taiping County, Ningguo Prefecture, whose name we do not know, learned the technique from an alchemist and promoted it across the country. To date, people being inoculated pox are mostly natives of Ningguo Prefecture.” (Collection and Explanation of Pox Treatment by Yu Maokun of the Qing Dynasty). Zhang Yan of the Qing Dynasty came from a medical family. His grandfather studied pox inoculation with Mr. Nie Jiuwu and was committed to popularizing the technique. He had administered vaccine for some 10,000 people. On Pox Inoculation created in his final years was an early book on pox inoculation. Here’s what it says, “The technique of pox inoculation has passed down over several generations,” “saving the lives of 8000 or 9000 people. Only 20 or 30 people died as a consequence of the disease.”20 Obviously, the technique of pox inoculation was very developed at that time. 20 See: New Book on Smallpox Vaccination by Wang Yan of the Qing Dynasty, photocopy of Jujin Hall version, the 6th year of Qianlong (1741).

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In 1682, Emperor Kangxi issued an Edict requiring pox inoculation to be carried out by the local governments, suggesting that the technique was very developed at that time. Here’s what his Family Instruction says: “In the first years of the dynasty, citizens feared smallpox. When I obtain the formular, our children are vaccinated for smallpox and are no longer ill. Now the citizens of Forty-Nine Banner beyond the border and the Karka vassals are required to be inoculated, and they are no longer infected with smallpox. I remember the old people seeing the inoculation as something strange at first. I insisted on their being inoculated, and thousands of lives were saved. This was not incidental but invariable.” It follows that pox inoculation was recognized and vigorously promoted by the monarch. Emperor Kangxi personally promoted pox inoculation, and this act was motivated by his personal experience. The House of Aisin-Gioro originated from the cold Northeast. As smallpox preferred hotness and feared coldness, it never broke out in the skin of Manchu people. Owing to the lack of immunity and experience, they were vulnerable to the disease. To the Manchu people, the most horrible enemy was not the Ming troops, but smallpox. The Qing troops crossed the Shanhai pass, and Shunzhi became the first emperor of the Qing dynasty. However, he died of smallpox. Emperor Kangxi, who was born Xuanye as the third son of Shunzhi, was also infected with smallpox. He had a narrow escape from death, but his face was badly pockmarked. It was a painful lesson to learn and the emperor dared not take this issue lightly any more. In those days, many Manchu people died of smallpox when they entered the capital. Smallpox became a nightmare to them that there was no possibility of breaking in. Written in 1742 by Wu Qian of Qing Dynasty, The Golden Mirror of Medicine is the most comprehensive work on human pox vaccination. The book gives an account of four methods of human pox vaccination. First, vaccine lymph method, that is, soak the cotton in the lymph and plug it into the nose of the recipient; Second, lymph cloth method, that is, let the children put on the clothes of their peers who had been infected with smallpox; Third, dry seedling method, that is, peel off the scab and grind it up into powder, before blowing it into the recipient’s nostrils with a small silver tube; Fourth, water seedling method, that is, peel off the scab and moisten it, soak the cotton in the liquid and plug it into the nose of the recipient. For added safety, people kept exploring and improving the quality of vaccine. At first, the vaccine being used was pox scab, or

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“time seedling.” People found out afterward that “when the time seedling is vaccinated for seven times and refined, it becomes mature seedling.” Besides, “the longer the seedling passes down, the more effective it will become. And there are more desirable traits in the process of artificial selection. When the fire toxins are eliminated, the life essence remains. This is all to the good and not at all bad.”21 Human pox vaccination was safe, convenient, effective, and affordable. Soon, it began to prevail around the world. In the seventeenth century, Russia was the first to send students to China where they studied smallpox medicine. Afterward, human pox vaccination spread from Russia to Europe by way of Türkiye. In the eighteenth century, Li Renshan, a native of Hangzhou, brought the human pox vaccination technique to Nagasaki, Japan. By the second half of the eighteenth century, the technique was used around the world. Afterward, the cowpox vaccination, which had less toxicity and was safer, was born in Britain. Compared with the human pox vaccination, it was a remarkable advance. Cowpox vaccination owed a great deal to human pox vaccination, which was its inspiration. Master medical practitioners of the two countries followed divergent paths, but they strived to achieve the same ends. They shone out in the history of epidemic prevention and treatment. People today should borrow the experiences from this international cooperation to address the pandemic. In less than six years after Jenner invented the cowpox vaccination, the method was bought to China with the aid of British businessmen and their offices in China. Actually, the transmission of cowpox vaccination in China was closely related with a business legend, as well as the joint efforts of the medical and business circles. They have contemporary relevance even today. In the early nineteenth century, Qiu Xi (1774–1851), a native of Nanhai County, Guangzhou Prefecture, traveled by ship to Macau, where he received a post in the British East India Company as the comprador. There, he made the acquaintance of Alexander Pearson (1780–1874), a surgeon of the company in Macau. A new opportunity changed the whole current of his life. In the autumn of the 10th year of Jiaqing (1805), the Peterloo merchant ship left Manila, Philippines for Macau, China. Instead of loading with cargo, the ship had children infected with cowpox on 21 Above see: Mental Cultivation Methods for Smallpox Vaccination by Zhu Yiliang of the Qing Dynasty.

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board. They were the “human” vaccine hired along the way. The mobile vaccine bank really solved a very large problem of the storage of vaccine. The vaccines were readily available for the recipients. Pearson was responsible for administering vaccine to the Chinese and foreigners in Macau and he was very busy. Qiu Xi displayed the liveliest interest in the job and he expressed a wish to experience it. He hoped to fortify his immune from smallpox, and do his bit to help Pearson. Qiu Xi had succeeded, and he recommend the method to his relatives and friends. Based on his own personal life experience, Pearson wrote in English A Marvellous Book on Vaccination Recently Coming Out of England, to introduce the technique of pox inoculation. Later, the book was translated into Chinese by Zheng Chongqian, a businessman in “Thirteen Hongs of Canton,” and published. It was the first book introducing cowpox vaccination in Chinese. Afterward, Zheng Chongqian recruited some people to study cowpox administering from Pearson, and Qiu Xi was among them. Financed by the businessmen in “Thirteen Hongs of Canton,” Qiu Xi and his friends established China’s first pox vaccination institution in Xiguan, Guangzhou, offering free pox inoculation service to the neighboring people. Qiu Xi was not a doctor, but in order to give more people an opportunity to understand and study cowpox vaccination, he published the Introduction on Cowpox Vaccination, a non-fiction medical classic, in 1817. The book gives a full and minute account of the introduction and administering of cowpox vaccine. It was written in plain language and highly practicable, catching the fancy of Chinese readers. It was a huge boost to the popularity of cowpox vaccination in China. In 1847, Pan Shicheng (1804–1873), a Cantonese merchant who had served in the Board of Punishment, asked Qiu Xi’s son Qiu Chang to popularize pox inoculation in the capital. Engaging the support of his father, Qiu Chang established a pox inoculation clinic and the technique was popularized in the capital. In the book On Vaccination Methods of Cowpox Qiu Chang, instead of taking things literally, explained cowpox vaccination from the cultural background of China under the direction of TCM theory. That’s pretty impressive. For example, he thought that cow and the spleen of human being pertained to “earth” in the five elements. Through the cowpox, the toxins in the spleen could be eliminated from the body. The cowpox was injected from the arm, which was the junction of two acupoints. So, it might easily enter the body. Qiu Chang’s expression is a bit farfetched, but we think he had done about as much as he could do. In a period of

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cultural mixing, he could take his chances when he had got them, focus on the universal relevance of eastern and western cultures, and incorporating western wisdom into TCM. His adventurous spirit was recommendable. On October 26, 1977, the last case of smallpox in the world was cured. On May 8, 1980, the 33rd World Health Assembly officially declared that “the world and its peoples have won freedom from smallpox.” From human pox vaccination to cowpox vaccination, the relay run of Chinese and British medical experts should take the credit for the elimination of smallpox. The victory represents a success of cultural mixing in the war against smallpox, a banner, an example, and a wealth of mankind. In it, there are the significant contributions of TCM and Chinese wisdom to the health of mankind, and the international collaboration for the betterment of people. This great cause will always be remembered and cherished by the world. As historical experience shows, a virus cannot be eliminated in a few years. We should proceed slowly, without forcing the issue. After all, viruses are living organisms, and mutations would take place before they are eliminated. When fighting with viruses, we should try to coexist with them, put an emphasis on self-protection, and fortify our immune system. June 21, 2020 References: [1] Imperial Examination and Approval of General Books of Past Dynasties 1 by Aisin Gioro· Hongli· Qianlong [M]. Changchun: Jilin People’s Publishing House, 1997. [2] Arturo Castiglioni. History of Medicine [M]. Guilin: Guangxi Normal University Press, 2003. [3] Qiu Xi. A Brief Introduction of Pox [M]. Photocopy of the Qing Version. 1817.

TCM Concept: Intervention before the Onset of Symptoms As a characteristic of TCM, the idea of Intervention before the Onset of Symptoms has three levels of meaning. First, prevention before infection; Second, preventing the mutation of diseases; Third, preventing the relapse of diseases. “Intervention before the Onset of Symptoms”

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integrates “before the diseases,” “during the diseases,” and “after the diseases.” It has created an interlocking network of proactive medical treatment with “prevention” standing at the center. The complete and comprehensive logic is the supreme advantage and a great special feature of TCM. It is the reason why TCM has thrived so vigorously over thousands of years and never lost its appeal at home and abroad. “Intervention before the Onset of Symptoms” is the purpose of medical study, the requirement of clinical practice, and the standard of medicine. As Xu Dachun, a famous doctor of the Qing Dynasty, said, “Illnesses, even small ones, can sap energy and large ones can be life-threatening, like a hidden enemy country.” “Preventing illness before it occurs,” and “preempting the unarrived are preventive measures in traditional Chinese medicine.” “Preventing the progression of illnesses before they become severe is like safeguarding the territory of our nation. If a person has been ill for some time due to consuming unhealthy food, we should remove the unhealthy food from his diet, like destroying the enemy’s supplies. For diseases caused by accumulated food, remove the food, just like destroying the enemy’s internal supplies…Treating each illness separately, and we can defeat many with very few. When the previous and latter could not help each other, the power of disease declines by itself. When treating multiple diseases, use combined strength to break down the toughest one, so that the scattered forces have no leader. When the disease progresses, do not attack it too much. We should maintain the original qi, and let its leader age.” When the disease is cured, the patient should act carefully. To prevent relapse, one should “strive to find the cause and attack or disturb the weak spot of disease.22 ” It follows that “Intervention before the Onset of Symptoms” requires the control in each step, so that the disease would not mutate or relapse. Underneath the philosophy of “Intervention before the Onset of Symptoms” is the wisdom of Chinese health management. Preventive medicine is an important part of both traditional and modern health management, as it focuses on preventing health problems from developing rather than treating them after they occur. This way, medicine will become the real guardian of people. Both prevention and control of diseases rely on the same principle of “prevention” to close the door 22 From: On the Origin and Development of Medicine·Vol. 1 by Xu Dachun of the Qing Dynasty, based on the Qingheyue Medical Society version in the Dingwei year of Guangxu (1907).

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on disease occurrence, development, and recurrence. The day will come when hospital will no longer be a place people couldn’t live without. “Spring sees an abundance of scattered flowers in Chang’an” (Cold Food by Han Pian of the Tang Dynasty). Human beings are on course for a future of health and longevity. In health management, Professor Ma Jun of Tianjin has made significant contributions over the past decades. He proposed valuable advice and became a banner in the field. In recent years, he shifts his focus to talent cultivation in health management, instructing, guiding students, and writing textbooks. His educational attainments are impressive. Health management is an ancient concept yet showing fresh vitality, as the future of medicine. Its value and significance are no longer on paper only, but acknowledged by more and more medical workers and patients. July 16, 2020

Vital Energy in the Genetic Perspective Context Tips Xu Dachun who didn’t play by the rules; The two distinct theories of genetics and essential qi; The origination and evolution of the essential qi theory; The transition of the essential qi theory from philosophy to medical area and its universal relevance; Chinese medical experts following the essential qi theory. When giving medical treatment to people, he could look through the skin and communicate with the lungs and spleen. The medicines he prescribed worked miracle and could cure all diseases. They captured the strategic fortress, like the troops of General Zhou Yafu diving out of the sky. All the doctors stared at him dumbfounded, highly appreciative of his medical skill. —Biography of Xu Lingtai by Yuan Mei of the Qing Dynasty

Thomas Hunt Morgan was an American biologist. In 1910, he established the chromosome theory of heredity, and more than a century has passed. Life science is a field of study that researches life phenomena and is closely related to medicine and pharmacology. It has become one of the most frequently used and well-known terms today. This is because the survival and reproduction of human beings rely on life sciences and

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the exploration of genes. Currently, many countries are deciphering the genetic code in an organized manner. The essential qi theory of TCM was systematically studied and examined by doctors during the reign of Qianlong of the Qing Dynasty. It predates the birth of the gene theory by several hundred years. Xu Dachun (styled Lingtai, 1693–1771) was the person who studied and examined the essential qi theory. Like many TCM doctors in history, Xu was a versatile man. At the beginning, he studied Confucianism and mastered classics and history. Later, he mastered astronomy, geography, music theory, military strategy and martial arts such as sword-dancing and o chess. He had a deep and comprehensive research of these subjects, and was proficient in medical skill.” He liked reading and studying. “Xu Dachun read over a thousand books and skimmed over ten thousand books in the fifty years he studied medicine” (Shen Ji Chu Yan· Introduction, by Xu Dachun of the Qing Dynasty). He had a fancy for ancient Chinese texts such as Book of Changes, Tao Te Ching, and Yin Fu Ching, which cultivated his character of intelligence and eloquence. His biggest characteristic was that he often did things unconventionally, leaving others unable to predict his actions. When he was old and weak, he was summoned to the capital to treat the eunuch favored by the emperor. He asked his son Xu Chi to carry the coffin and accompany him to the capital, knowing that he might not return alive.23 His devotion to treating the patients made a great impression on people. Xu Dachun usually relied on “strange formulas and skills” to treat patients. Once, a famous scholar named Ze Gengshi in Wujiang County came down with severe summer heat syndrome and was bedridden. “His pulse was faint and other syndromes included enuresis and delirium.” Upon diagnosis, Xu Dachun thought that they were symptoms of yang excess. Upon profuse sweating, the patient would suffer yang depletion (yang deficiency). Xu immediately prepared a dose of ginseng and fu zi (aconite) decoction. The patient took the decoction and woke up after an hour or two. His eyes were closed, but he could already speak. After taking the second dose, the patient could sit up. Xu Dachun discontinued meditation and asked the patient to have watermelon. Glad to hear that, the patient ate watermelon for several days. After taking some medicine for clearing summer heat and nourishing the stomach, he completely recovered. The 23 See: Poetry Collection of Xiaocangshan House Vol. 34 by Yuan Mei of Qing Dynasty, based on the Four Essential Classics version.

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patient expressed his gratitude, and said that he saw in a state of stupor two guys, one red and one black, tangling him up and doing mishap. Suddenly, the black guy was killed by lightning, and a while later, the red guy was taken away by a white tiger. The patient asked if there was any prophetic meaning in it. Xu Dachun smiled and said, “The lightning is the drug called Aconite Pili Powder, and the white tiger is the drug called White Tiger Decoction.” He explained that in ancient times, aconite was called pili powder; and the White Tiger Decoction was watermelon which dispelled summer heat. Ze Gengshi was cured of the severe disease by Xu Dachun, whose words affected him very much. With a rude awakening, Ze praised Xu as a miraculous doctor.24 In those days, “Xu Dachun and Ye Gui (note: Ye Tianshi) were noted for their medical accomplishments.” “Their contributions were most inspiring among TCM doctors.” The systematic discussion of the “life code” and the “essential qi theory” should start with Xu Dachun’s questions about life. Why are people falling in health as they grow older? Are they immune to death if they keep away from lust, exhaustion, and worry? When one is over 40, he might have no lust, exhaustion, and worry, but still begins to fail in health. What exactly is the cause? What is it relevant to? Xu Dachun answered these questions one by one with the knowledge accumulated through long-term exploration and practice. He uncovered the knowledge that had not been revealed before, and spoke words that ordinary people dare not say. His words represented impeccable logic, preciseness, terseness, and resoluteness (Fig. 3.2). Xu Dachun thought that when a person is born, they already have a predetermined fate. So, what is the life span of a person determined by? It is Yuanqi (essential qi). “Fixed portion refers to a person’s essential qi.” Xu Dachun’s metaphor about life suggests that life is like a fire, starting small and growing until the fuel is exhausted and the fire dies out. The length of a flame is related to the quality of the fuel, such as wood or charcoal. The metaphor is very appropriate and natural. He added that “Even for a person who never develop a disease, the depletion of “essential qi” can lead to his death. This is called enjoying the natural life span. In an era when feudal superstition was still prevalent, it required open-mindedness and fearlessness to make statements that conform to scientific laws. How important is “essential qi” to a person’s health? Based on the TCM system 24 See: Hexi Medical Case by Xu Dachun of the Qing Dynasty. Also see the note of Wang Shixiong: watermelon is also called the White Tiger Decoction.

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Fig. 3.2 Xu Lingtai Medical Treatise Six Books written by Xu Dachun

of thought, Xu Dachun argued that: First, it is the key to regulating the opening and closing of Yin and Yang; Second, it connects the airways for breathing in and out; Third, one can keep his body warm without a fire source and the five viscera can stay hydrated without water. “Essential qi” is the basis of life. Where there is the former, there is the latter. The various parts of body, five viscera, and emotions of human being are dependent on the “essential qi,” which is essential for life.25 Thomas Hunt Morgan proposed the Boveri-Sutton chromosome theory, which states that genes are the genetic units on a cell’s chromosomes that have high stability, can self-replicate and mutate, and determine life and death, diseases, physical features, blood type, talents, and more. Genes control 25 Above see: On the Origin and Development of Medicine Vol. 1 by Xu Dachun of the Qing Dynasty, based on the Yanfen Thatched Hall version in the 7th year of Xianfeng (1857). Yuan qi is also called “essential qi.”

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certain metabolic processes and express certain genetic traits and characteristics during individual development. Gene mutations make possible evolution. Therefore, it is possible to decipher genetic codes to gain an insight into an individual’s predisposition and potentially alter genes to extend life. No matter which medical field, the pursuit of benefit and avoidance of harm, and service to the health of humanity are its goals. Xu Dachun once raised the question “where the essential qi is located” and made further study of it. Based on medical classics, he boldly proposed three body parts: 1. “Dantian”,26 according to the classic Taoist text, Dao De Jing; 2. “Mingmen” or “Life Gate”,27 according to Classic on Medical Problems, a work on TCM. 3. “The seventh vertebrae located near the neck”28 mentioned in Huangdi’s Classic on Medicine. Tracing the location of “essential qi” is no less important than deciphering the genetic code, and the purpose is to protect the essence of life. On the other hand, it shows us the broadness of TCM and the refinement of western medicine. The exploration of the “essential qi theory” and the deciphering of the “genetic code” give us a keener insight into the essence of medicine. In those days, Xu Dachun proposed that medical workers should observe the law that “the mystique of god” was to “preserve essential qi,” and “keep it intact.” In the process of medical treatment, doctors should “look at the big picture and attend to the smallest details.” They should emphasize the importance of balancing cold and heat in order to protect the source of life, and prevent “essential qi” from being injured. The philosophy of

26 According to Taoism, three inches below the man’s navel is the place where the essence is hided; Three inches below the woman’s navel is the place where the woman’s uterus is located. They are collectively called Dantian. 27 According to TCM, life gate is the place where life is related, the energy of men

is preserved, and the infant is nurtured. See: Classic on Medical Problems· 36 Difficulties by Qin Yueren: “The kidneys have two parts, not both of which are kidneys. The left is the kidney and the right is the life gate. The life gate is where the gods reside and the original energy is bound.” Four Essential Classics version of Zhong Hua Book Company. 28 See: Huangdi’s Classic on Medicine· Plain Questions· Contraindication of Acupuncture and Moxibustion 52. The meaning is: “The place beside the seventh thoracic vertebra is an important part, as it houses the essence of kidney.” Proofreading Translation of Huangdi’s Classic on Medicine· Plain Questions· Contraindication of Acupuncture and Moxibustion 52 Note 7 says in the words of Yang Shangshan: “There are 21 vertebras of the spine. The kidneys are located near the seventh vertebrae of the spine.” “旁”, also “傍”. Tianjin Science and Technology Press, 1981, p. 290.

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“treating illness before it occurs” was advocated. It suggests that “prevention is better than cure,” and “one should take preventive measures before an illness becomes too severe to treat.” It advises against allowing the illness to become so advanced that it cannot be cured. Chinese medicine, which sees the preservation of “essential qi” as the goal and means, highlights the people-centered philosophy. Then, what are the advantages of genomic analysis? What changes will it bring about in the development of medicine? Obviously, it has revolutionized the field of diagnostics, offered treatments for genetic diseases, and been instrumental in advancing therapeutics. Besides, it offers a broad range of potential to the R&D of new drugs, particularly targeted drugs. To sum up, gene theory has played a prominent role in promoting research on pathogenesis and clinical diagnosis, as well as in improving the overall level of medical technology and new drug development. “Essential” implies beginning; Qi creates and constitutes everything in the universe. The “essential qi theory” is derived from an ancient and profound philosophical proposition, which was originated from the “Daoqi” theory of Taoism. In Journey to the North, Zhuang Zi proposed that “when qi (energy) is gathered, life is born; when it disperses, death occurs.” Guan Zi (Zhong) believed that “If there is qi, there is life; if there is no qi, there is death; those who are alive rely on their qi”.29 What is “qi”? According to Zhuang Zi, “qi” is both material and functional, as it can be seen from its ability to gather and disperse in relation to life and death. During the time, the theory about “qi” was still an abstract philosophical proposition. The concept of “essential qi” first appeared in the book Ying Guan Zi, which says: “Heaven and Earth are created from essential qi and everything rely on Heaven and Earth.”30 In the Eastern Han Dynasty, philosopher and thinker Wang Chong proposed the idea of “Essential Qi Naturalism,” further promoting the development of “Essential Qi Determinism” and enriching the philosophical connotations of “essential qi.” His masterpiece On Balance has high academic position and significance both in literature and medicine. Wang Chong said, “When Heaven and Earth come together, everything is created; when two people come together, the child is born” (On Balance· Nature). He 29 See: Proofreading of Guan Zi· Shu Yan 12, “Compendium of Zhu Zi” version, Beijing: Zhong Hua Book Company, 1954, p. 64. 30 From: He Guanzi· Juan Zhong· Tai Lu 11. See: Interpretation of He Guanzi by Lu Dian of Song Dynasty, Vol. 3 (Nineteen Pieces) version.

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noted that “For everything on earth, the cessation of breath means death” (On Balance· Falsity). He believed that “Essential qi unites heaven” (On Balance· Invisibility), and “Essential qi reflects the subtle changes of nature and the universe” (On Balance· Four Taboos ). Evidently, Wang Chong’s “essential qi” refers to a materialistic concept of “subtlety” which marks a major step forward in the “essential qi” theory. Wang Chong believed that the “sage is endowed with qi, so his life span will be long,” and thus placed great importance on cultivating qi. Harmony and balance should be maintained in order to achieve peace and stability. Therefore, people who live in a peaceful and harmonious society tend to have longer lifespans” (On Balance· Lost Articles ). Ji Kang was another thinker who advocated the “essential qi natural” theory in history. He emphasized that one should go beyond Confucian ethical standards and let nature take its course. This was seen as a rejection of the more traditional and orthodox “style” at the time. He explored the principles of everything, and challenged the various misconceptions of the time. Based on the Taoist thought that “the universe is composed of essential qi and all living beings are born from it” (Collection of Works of Ji Kang· Vol. 6), he believed that human beings were born out of “essential qi.” The essential qi theory, which features “the vastness of the universe, the harmony of yin and yang, the transformation of two principles, and the rise of human morality” (Collection of Works of Ji Kang· Vol. 10), was formed. People should entrust their lives to nature, so that they could last forever.31 Classic on Medical Problems (or Huangdi’s 81 Difficulties on Medical Classics or 81 Difficulties ), and Huangdi’s Classic on Medicine, introduced the concept of “essential qi” to medicine and elevated it to a medical proposition. The two works were written around the same time. Classic on Medical Problems is the first to discuss topics such as the relationship between “essential qi” and primary qi. It proposed that: “Human beings have pulse, just as a tree has its roots. Even if a tree’s branches and leaves are withered, its roots will still be alive, and similarly, a person’s pulse has a root and they have an essential energy that allows them to live.” So, where is the essential qi located? Here is what Classic on Medical Problems says: “Life gate is responsible for the storage and movement of energy and qi, 31 See: Work Collection of Ji Kang· In Response to the Criticism of Nourishing Life Theory by Ji Kang: “One should live in harmony with nature and the universe, allowing natural forces to take control of their life and destiny”.

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and the tie of essential qi.”32 Huangdi’s Classic on Medicine focuses on the study of the theories of “qi” and the “essential qi theory.” It believes that people are the result of the combination of heaven qi and earth qi. Once, Huangdi asked Uncle Qi: “What is fundamental element of human life when it begins?” Uncle Qi answered: “When a human life begins, the Kun Dao is formed with the mother as its foundation and Yang Qi for defense. Without Shen Qi, death will occur; With it, survival is possible.” Huangdi asked again: “When is Shen?” Uncle Qi answered: “a person is considered to be fully formed when their blood and qi are balanced, their rong and wei are connected, their five organs have formed, their spirit is hidden in the heart, and they possess full mental awareness.” This is the famous dialogue from the medical history: “When a person is born, qi is their foundation.”33 What is “father providing the support”? The author believes that the interpretation of Huangdi’s Classic on Medicine is most appropriate. Here is what it says: “the relationship between yang qi and people is similar to that of sun and sky. When yang qi is insufficient, people may not grow. So, the health of Heaven does not cease, all thanks to the light of the sun. The Yang Qi of human rises up and plays a role in protecting the body from external harm.34 Besides, “Yin and Yang mutually promote and grow,” “yang disperses and transforms into qi, while yin condenses and forms.” This is the reason why “yang 32 From Classic on Medical Problems·36 Difficulties by Qin Yueren. 33 From Huangdi’s Classic on Medicine· Miraculous Pivot· Natural Life Span: “The

Emperor asked: In the beginning of one’s life, what is the foundation? What is the shield? What is lost that a man will die? What is gained that a man will live?” Uncle Oi answered: “The mother is the foundation. The father is the shield. One who loses the spirit will die. One who gains the spirit will live. The Emperor asked: What is spirit? Uncle Qi answered: The gi and blood have been harmonious. The ways of the nutritive qi and defensive qi have been free. The five zang-organs have been formed. The spirit has resided in the heart. The yang soul and yin soul have been generated. Under these preconditions, a man of sound health will appear.” See: Proofreading of Huangdi’s Classic on Medicine· Miraculous Pivot· Natural Life Span 54 (2) Note 1: Ma Shi said. Guiyang: Guizhou Education Press, 2010, p. 369. 34 From Huangdi’s Classic on Medicine· Plain Questions· The Union of Heaven and Human Beings 3: “The yang qi is just like the sun in the sky. If the yang qi fails to run normally, one’s life-span will be shortened and he will not be healthy. Therefore, the motions of the celestial bodies are normal due to the sunlight. By the same mechanism, the yang qi of a man runs upward, acting as a defensive force.” See: Proofreading Translation of Huangdi’s Classic on Medicine· Plain Questions· The Union of Heaven and Human Beings 3, Note 1: Lou Ying said, by Guo Aichun. Tianjin Science and Technology Press, 1981, p. 15.

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disperses and scatters, thus transforming into qi; yin is still and congeals, thus forming into shape.”35 “Harmony between human and nature” is the essence of Chinese medicine theory. According to the theory, human body is a small universe, while the natural world is a large universe. The laws of nature are the laws of humans. The universe is filled with “Jing Qi,” and humans are filled with “essential qi.” Therefore, only those who are able to connect with heaven are considered to be the origin of life. When one’s will is peaceful and in harmony with nature, their body will be protected from harm even if evil forces are present.36 Throughout the history of Chinese medicine, practitioners have valued the concept of “essential qi” and used it as a theoretical basis for prescribing treatments. They strived to protect “essential qi,” treat the root cause of illness, and identify key medical issues. Li Gao (Dongyuan), one of the four great medical masters of the Jin and Yuan Dynasty, is known as the founder of the “Earth (Spleen and Stomach) Replenishing” school of Chinese medicine. He argued that when the spleen and stomach’s yang qi (stomach area’s yang) cannot rise, “the essential qi would not function, the stomach qi would flow downward, and the triple energy fire in the chest and the fire in the heart would rise to the lungs.” According to the “essential qi-oriented” philosophy, tonics for replenishing qi and invigorating yang are used. Herbs such as Astragalus membranaceus, Panax ginseng and Glycyrrhiza uralensis can be used to replenish the spleen and stomach’s qi energy, and clear heat and dampness; Paeoniae Alba and Angelica Sinensis can be used to nourish the yin and clear away dampness; Rhizoma and radix bupleuri can be used to “clear yang qi and raise stomach qi.” The move was considered

35 See: Proofreading Translation of Huangdi’s Classic on Medicine· Plain Questions· The Art of Yin-Yang Manifestation 5 by Guo Aichun, and Note 6: Li Zhongzi said. Tianjin Science and Technology Press, 1981, p. 29. 36 See: Huangdi’s Classic on Medicine Plain Questions· The Union of Heaven and

Human Beings 3: “From ancient times, people who knew the heavenly law realized the basis of life,” “If the heavenly qi is clear, one’s mental state will be sound. Obedience to it makes the yang qi secure. Though evils exist, they cannot poison men.” See: Proofreading Translation of Huangdi’s Classic on Medicine· Plain Questions· The Union of Heaven and Human Beings 3 by Guo Aichun, Tianjin Science and Technology Press, 1981, p. 14.

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to be a unique and creative approach by medical practitioners at the time. It involves using innovate thinking to diagnose and treat diseases.37 Wang Ji, a famous TCM doctor of the Ming Dynasty in Qimen, Anhui, valued the legacies of Qi (Bo), Huang (Di), Cang (Gong), and Bian (Que). He explored their ideas on how to cultivate and nurture the body.38 He advocated for treating diseases by regulating qi and nourishing the root cause. He avoided cold and acrid remedies and used milder treatments, to protect the Yang energy. The theory most closely associated with Xu Dachun’s treatment of illness is that of Xiao Jing, a renowned physician from the Lingnan region of the Ming Dynasty. As a great TCM doctor, Xiao Jing returned to the basics and constantly absorbed himself in medical classics. Throughout his life, he had been focusing on medical classics. He said that one must not hide or obscure the principles of spiritual essence; focus on his own family and not worry about others; cling to a certain path or method, even if it is not the most efficient one; forget the origin and follow the standard; or abandon complexity and pursue simplicity. He “lamented their ignorance and urgently called for a return.” In medical practice, Xiao Jing was a proponent of the theory of essential qi. The relationship between life and death is determined by “essential qi,” which was not taken into account when diagnosing illnesses. Xiao 37 See: Collection of Jiulingshan House Vol. 10 by Dai Liang of the Yuan Dynasty: “According to the ‘Pi Wei Lun’ (脾胃论) of Li Dongyuan, internal damage to the spleen and stomach caused by overindulgence in food and drink or exhaustion can lead to a deficiency of Yang energy in the stomach area. The heart and lungs are affected, and one is overwhelmed by emotions or stress. Remedies should be used to restore balance and benefit Qi. This is an innovative, unprecedent move,” based on the Four Academic Categories version. Wei wan zhi yang: Stomach qi. Here’s what Li Gao’s On Differentiation of Internal and External Injuries· Differentiation of Yin and Yang Diseases says: “the essential qi, valley qi, flourishing qi, defensive qi, and the qi raising yang up, are obtained through diet. The valley qi that goes up is the same as the stomach qi.” Li Gao thought that “when food enters the stomach, its nutrients are sent up to the lungs and heart, where they are used to nourish the body.” “When the essential qi is stagnant, the stomach qi will flow downward, and the fire of triple energizer in the chest and heart will ascend to the lungs.” “Weakness of the spleen, stomach and qi would cause the stomach qi to flow to the spleen. Then, the yin fire would prevail.” “乘”: 行。. 38 See: Gazetteers of Qimen County: “Wang Ji, from a young age, was devoted to the medical needs of the people. When his mother fell ill, he devoted himself to the study of medicine. He studied assiduously the works of Qi Bo, Huangdi, Wang Shuhe and Bian Que, and absorbed the knowledge inside.” 肯綮, originally referring to the junction of tendon and leg, implied the key of a matter.

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criticized the approach, arguing that “a physician should first understand the meaning of the four examinations, then observe the patient’s condition, then consider the properties of medicine, and finally examine the disease and its treatment methods. Changes in temperature and other symptoms are caused by an imbalance in pulse. The deficiency and excess of pulse are determined by qi, while the deficiency and excess of qi are determined by essential qi. Essential qi is the source of life and death.” Xiao Jing was the author of “Life Gate Water and Fire Diagram” and the “Five Qi Diagram.” Scholars have studied the theories of Yin and Yang, Water and Fire, Reality and Illusion, and Truth and Falsehood in order to understand the source of chaos and illness. What a beautiful cave, unique in its beauty.”39 Xiao Jing thought that when people encountered difficulties when diagnosing and treating diseases, “the understanding of the root cause of illness should come from a spiritual perspective.” Fundamentally, it is the process of seeking “essential qi,” “the source of life.” Xiao proposed a theory linking qi and the spleen and kidney. When giving diagnosis, he saw “strengthening the spleen and kidney and tonifying essential qi” as the basis of treatment, prescription and medication. The purpose was to preserve the “essential qi” in the body (Fig. 3.3). The ancient people say, studying medicine could help governing the country, and diagnosing could give an insight into the national affairs.40 This is because cultivating the body and governing the country are similar in principle. Xu Dachun made an analogy between the prescription of medicine by doctors and leading soldiers into battle. He said, “Therefore, the use of military force is to eliminate violence, and it must be resorted to only when necessary; Similarly, medicine should be used to attack

39 See: Xuanqi’s Theory of Saving· General Examples by Xiao Jing of the Ming Dynasty, Beijing: Traditional Chinese Medicine Classics Press, 1983, p. 6. 洞垣: knowing the people on the other side of the low wall. The allusion is found in Historical Records· Collected Biographies of Bian Que: “Bian Que followed his advice and took the medicine for thirty days. Then, he could see the person on the other side of the wall. The diagnosis of five viscera diseases was based on this approach, and pulse taking was just a token gesture.” 40 See: Han History· Bibliographical Treatise·The Technique of Medicine by Ban Gu of the Eastern Han Dynasty: “discussing diseases and the state, diagnosing in order to understand national governance.” 1959, Zhong Hua Book Company proof reading version.

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Fig. 3.3 The medicinal properties of herbs identified by the ancient people

illnesses, but only when necessary.”41 He went further to argue that “the methods of treating illnesses were listed in the thirteen chapters of Sun Wu’s Art of War, an ancient military work.”42 In other words, doctors might diagnose, prescribe medicine, and treat the patients drawing on 41 See: On the Origin and Development of Medicine Vol. 1 by Xu Dachun of the Qing Dynasty, based on the Qingheyue Medical Society version in the Dingwei year of Guangxu (1907). 42 Ibid.

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the experience of military men. Isn’t it the great wisdom of TCM? Xu Dachun was a master TCM doctor in medical history, and a great figure with profound knowledge in national governance. Yuan Mei, a renowned literary figure of the Qing Dynasty, had a “mud-playing friendship”43 with Xu Dachun. Here’s what his work says of Yuan: In the second year of the Yongzheng Emperor’s reign (1724), local authorities began to dig reservoirs for water storage. In the beginning, the plan was to take soil from the embankment on both sides of the pond. When he learned this, Xu Dachun said that it would be costly to dig a deep pond. The soil on the shore might easily fall, endangering the whole embankment. The authorities agreed with the premise and decided to shorten the river channel and take soil from a place one zhang and eight chi away from the embankment. Thus, the human effort was reduced, and the embankment was preserved. Two goals were achieved with one action. In the 27th year of Qianlong’s reign (1762), Jiangsu and Zhejiang were flooded. Zhuang Yougong, the provincial governor of Jiangsu, planned to merge the 72 small tributaries in Zhenze Town, Wujiang County, and relieve the flood from the lower reaches of Taihu Lake. Xu Dachun judged it altogether inappropriate. He argued that the 72 tributaries were not located at the downstream of Taihu Lake. The dozen river courses near the county seat, which were flowing to the river, should be dredged. The other more than 50 river courses had a total length of over 200 li, and many people lived and had tombs on both sides of the rivers. The excessive costs of excavating these rivers and the infringement on the immediate interests of the people were major concerns. Besides, the sediments in the river would be backwashed, and siltation would occur while dredging. It was the responsibility of local communities, not the government, to dredge the tributaries. Besides, the citizens would not be pleased with the outcome, even if the government took the pain to do the job. Enlightened by Xu Dachun’s words, Zhuang Yougong adjusted the plan and submitted it to the imperial court, which gave its approval. Before long, the project was completed without interfering the citizens, and everyone rejoiced at the result.

43 Fu chen zhi hao: A Chinese proverb that original means children’s games such as gathering sand. Friendship since childhood refers to old acquaintance. Below see: Poetry Collection of Xiaocangshan House Vol. 34 by Yuan Mei of the Qing Dynasty, based on the Four Essential Classics version.

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Doctors save lives and relieve suffering. With a magic hand, they are the treasure of the nation. This is the fact of Xu Dachun’s life, isn’t it? May 20, 2020 References: [1] Yuan Mei. Poetry Collection of Xiaocangshan House [M]. “Four Essential Classics” version. Shanghai: Zhong Hua Book Company. [2] Zhao Erxun, etc. Draft History of Qing [M]. Beijing: Zhong Hua Book Company, 1977.

TCM Concept: Terminal Diseases The Chinese idiom “bing ru gao huang” means that the patient is critically ill. Then, what does “gao huang” mean? Here’s what Zuo’s Spring and Autumn Annals· The Thirteenth Year of Duke Cheng’s Reign says: In the Spring and Autumn and Warring States Period, Duke Jing of Jin killed the entire family of Zhao Tong and Zhao Kuo. After that, he lived in fear and trembling in the day, and was tormented by the terrible dream of the ghost coming after him. Before long, he lay ill and turned to Qin state for help because its medical level was the highest. Duke Huan of Qin sent a famous doctor called Yi Huan to give medical attention to Duke Jing of Jin. By tradition, a person’s name was generally preceded by his professional title. For example, the chess player was named Yi (or chess) Qiu, the doctor was named Yi (or doctor) Huan…Before the arrival of Yi Huan, Duke Jing of Jin dreamed a queer dream—the illness became two little children. One of them said, “I heard that Yi Huan is a wise doctor. When he comes, he would hurt me. Where is it safe to hide?” The other child replied: “Let’s hide above the cardio part and under the diaphragmatic part, then Yi Huan could do nothing with us.” When Yi Huan arrived, he examined Duke Jing of Jin and said, “Your illness is beyond cure. The focus of infection is above the cardio part and under the diaphragmatic part. Moxibustion treatment does not work. Acupuncture treatment and drug treatment cannot reach that part.” Duke Jing of Jin marveled at the diagnosis of Yi Yuan, which was fully in line with his dream. He commended him for being a good doctor, and rewarded him with gifts of great value. According to TCM theory, gao was the fat on

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the tip of the heart, and huang was the space between the heart and the diaphragm. Based on the medical technology available at the time, it was difficult to reach the two parts. Therefore, the ancient Chinese people used “bing ru gao huang” to describe a person who was gravely ill. March 15, 2020

The Revival of Acupuncture and Its Spread to the West Context Tips The historical acupuncture technique; The global spread of acupuncture; Chinese acupuncture in Ukraine; The ABC Classic of Acupuncture—A Milestone of TCM; National treasure of acupuncture in the Song Dynasty and the contribution of Bureau for Revising Medical Books in history; Experimental acupuncture—the new century project, and the new era of acupuncture. Ji Leigong asked the way. Maude Gwynne sat in the Mingtang and taught the technique of acupuncture. This is why it is referred to as the Mingtang by people of later generations. It is believed that this technique was divinely inspired and highly skilled. –Illustrated Manual of Acupuncture Points of the Bronze Figure· Preface by Xia Song

Acupuncture is a time-honored technique. It is surprising to modern people that the technique used to be a means of recovery and the quickest treatment strategy in the Jin and Yuan Dynasties. It’s a pity the old tradition was irretrievably lost afterward.44 In the Daoguang era of the Qing Dynasty, the acupuncture department was removed from the Imperial Medical Institute. Why was this happening? As early as the Jin Dynasty, Dou Jie, an acupuncture expert, had stated the reason for its decline. Some people, unable to grasp the essence of the discipline, eased off study. Others made mistakes due to violation of taboos of the practice. 44 From: Song to Elucidate Mysteries by Dou Jie of the Jin Dynasty: “A skilled doctor can cure a patient with just one needle. In modern times, this technique has almost been lost. What a pity!” See: Prescriptions for Universal Relief Vol. 409, compiled by Zhu Su, etc. of the Ming Dynasty, based on the People’s Medical Publishing House version, 1959.

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It is difficult for those with shallow intelligence and mediocre understanding to comprehend the profound theory; There were only a few people who could capture the spirit and profundity of acupuncture, as it is a complex and deep practice.45 To sum up, the medical technique is theoretically complex, difficult to operate, yet highly practical. Xu Dachun, a renowned medical doctor of the Qing Dynasty, put it straightforwardly that Miraculous Pivot and Plain Questions were the most important works on acupuncture. The books gave an extensive and minute description of diseases of the viscera and meridians. They say that seven or eight out of ten cases were treated using acupuncture, and two or three cases were treated using herbs. Acupuncture was highly valued in ancient times, but difficult to practice; while herbs were more appealing to patients. Therefore, people of later dates preferred medicine over acupuncture.”46 According to the research of the author, the Spiritual Pivot section of Huangdi’s Classic on Medicine, besides a dozen articles, are all about acupuncture. This is the reason why it was called the Acupuncture Classic by people of later dates. The Plain Questions section of Huangdi’s Classic on Medicine discusses the causes and mechanisms of disease. It devotes 17 chapters to acupuncture, covering topics such as acupuncture theories, clinical acupuncture techniques, the “insertion of needle,” the “depth of needle,” the “principle of nine needles,” and the “way of virtual and real.” The book is all-encompassing, reaching the zenith of perfection. About 20 percent of the 81 chapters in Plain Questions are related to acupuncture, and there are other chapters referring to the topic.47 As Zhang Congzheng, a representative of Purgation School of TCM, said, “Huangdi’s Classic on Medicine emphasizes acupuncture over herbal medicine, because the sages wished to understand the meridians. They 45 See: Song to Elucidate Mysteries by Dou Jie of the Jin Dynasty: “Some people failed to get the essence of acupuncture and moxibustion and abandoned study; Some people were killed because of their superb technique, arrogance and evil nature. The stupid people were mediocre, and it was unable to impart them with the mysterious theory of acupuncture and moxibustion! The theory of acupuncture and moxibustion is extremely profound, and few very people could understand it.” Yi: The essence of acupuncture and moxibustion. San: Abandon. 知: “智”. 46 See: On the Origin and Development of Medicine On the Loss of Acupuncture and Moxibustion Technique, by Xu Dachun of the Qing Dynasty. 47 Huangdi’s Classic on Medicine · Plain Questions, chapters 26, 27, 28, 36, 50, 51, 52, 53, 54, 55, 58, 59, 60, 61, 63, 64 and 65, are devoted to acupuncture and moxibustion technique.

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didn’t realize that the principles of acupuncture are equivalent to the principles of medicine.”48 Acupuncture is an important part of TCM and was a mainstream treatment method in the past. With unique therapeutic methods and deeply rooted in Chinese culture, acupuncture has become an icon of TCM in its endeavor to go global. During the Three Kingdoms and Jin Dynasties period, Huangfu Mi laid the foundation for the academic study of acupuncture. Combining theory with practice, he created the A-B Classic of Acu-moxibustion (called Huangdi’s A-B Classic of Acu-moxibustion in the Sui Dynasty, and Huangdi’s Three A-B Classic of Acu-moxibustion in the Song Dynasty). The book assimilates all the extracts of Plain Questions, Miraculous Pivot , and Mingtang Acupoint Acupuncture Treatment. “From divergent opinions, they explore the fundamentals of the technique.” The books were credited with introducing acupuncture across China. In the 3rd year of the reign of Emperor Wen of the Southern Chen Dynasty (dynastic title Tianjia, 562), a monk by the name of Zhi Cong brought the book to Japan. Very soon, it was listed as a required textbook for Japanese medical education. During the Ming Dynasty, Japan sent a doctor named Kanemochi Shigehiro to China to specifically study acupuncture. Traditional Chinese medicine had a significant influence in Japan, as evidenced by the number of ancient Chinese medical texts collected from Japan. Acupuncture had been widely spread in the East and it had been introduced to the West gradually since the seventeenth century. Dutchman Busschof H. was the first to translate a manuscript on Chinese acupuncture into English and publish it in London. William Ten Rhyne, a Dutch doctor, introduced Chinese acupuncture to Europe. Afterward, Germany, France, Italy, Sweden, Czech Republic, and Russia began to introduce the technique of acupuncture. France, in particular, placed great emphasis on the technique. In October 1994, the author traveled to Kiev, Ukraine with a delegation from Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine, to communicate and cooperate on acupuncture. The locals loved Chinese culture, and acupuncture was popular among them. 48 See: Confucians’ Duties to Their Parents ·Vol. 2 by Zhang Congzheng of the Jin Dynasty, based on the Stepped Moon House version in Xinchou Year of Jiajing of the Ming Dynasty (1541), proofread against the Shanghai Qianqing Hall version in Gengxu Year of Xuantong of the Qing Dynasty (1910).

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They had a strong desire to study and explore the technique. In 1956, two Soviet delegations were sent to Beijing to studied acupuncture techniques. In 1959, the health department of Soviet Union issued the Regulations on the Application of Acupuncture, and experimental and research institutions were established in Petrograd, Moscow, and Kazan. They explained the principle of acupuncture with the mechanism of nerve reflex, and believed that acupuncture was a kind of “acupoint reflex therapy.” They called the acupoints “functional points” and the meridians “functional lines.” In the late 1980s and early 1990s, there were over 15,000 practitioners of acupuncture in Ukraine who had obtained diplomas. In 1994, more than 10,000 Ukrainians were employed in the field, with more than 2000 practitioners in Kyiv alone. At the time, Ukraine’s population was less than 50 million, and 10,000 acupuncturists was not a low proportion. The Ukrainians had different lifestyle and their understanding of acupuncture mechanisms was divergent from ours. Besides, AIDS had become a global health threat at that time. So, instead of using gold needle for acupuncture, they irritated the specific acupoints with the light from laser instrument, based on TCM acupoint selection. Manufacturers were making laser therapy devices of various models and specifications. One day, we were invited to the house of the host in a small village in the suburbs of Kiev. There, we detected the rumbling of machines next to the house. The host told us that it was a small workshop manufacturing laser therapeutic apparatus. We were amazed by the popularity and demand for acupuncture among the Ukrainians. The Ukrainian acupuncturists had a deep understanding of Western medicine theory. In contrast, their knowledge of acupuncture, which was acquired from Japanese and Korean acupuncturists, as well as Chinese doctors living in Europe, was fragmented. They were unable to build a framework of the discipline, and their level of skill was quite modest. They were eager to have a Chinese doctor, who could directly pass on acupuncture. Dr. Ivgenia Leonibovna Maˇceklet, Chairman of the European Laser Therapy Association and Head of the Kyiv National University, Neurology and Reflection Medicine Doctoral Studies Department, was noted for the clarity of vision. She graduated from Ukraine State National Medical University in 1955. She obtained the Candidate of Sciences degree in 1964, and the Doctor of Sciences degree in 1971. In 1976, she was appointed professor of neurosurgery at the Kyiv Medical University. In 1978 she became head of the department of

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neurosurgery and acupuncture of the university. She had been engaged in teaching, medical practice, and research in neurosurgery and acupuncture for a long time. She is part of a research institution that has become a center for research and educational training in neurology and acupuncture in Ukraine. In 1977, Professor Maˇceklet organized the European Acupuncture Center to teach courses on acupuncture to students from Bulgaria, France, Germany, and her own country. All the textbooks used by the students were written by her. The students, mostly clinical doctors, participated in the training course lasting around three months. In 1991, Professor Maˇceklet came to Beijing where she conducted a research into the development of acupuncture in China. Dr. Maˇceklet believes that the primary reason Ukrainian acupuncturists have not progressed quickly over the years is because they have not learned the genuine Chinese acupuncture. In this condition, she proposed the establishment of a two-year Chinese medical education center in Kiev. The center should use Chinese-written textbooks, employ Chinese doctors, and follow the outline of International Professional Level Examination for TCM Professionals issued by China. The exam is supervised by the Chinese side and those who pass would receive a joint diploma issued by both sides. This measure is intended to establish a high requirement for TCM that Ukrainian acupuncturists have to fall in line with. She has proposed measures to ensure the standards of Chinese acupuncture are met. Maˇceklet has been praised for her foresight and carefully planned out schemes. Represented by Dr. Maˇceklet, Ukrainian acupuncturists have contributed to the spread of knowledge and treatments of acupuncture in their home country and across Europe. Presently, many public hospitals in Germany, France, and other countries have acupuncture departments. Through academic exchanges, they gain a deeper understanding of Chinese culture. Maˇceklet hoped we would visit Ukraine in summer, but our visit was delayed to October. Fascinated by the traditional Chinese culture, she regretted to have made our acquaintance so late. In several occasions, she made time for us in the midst of her busy schedule, and organized academic lectures and exchanges on Chinese acupuncture. She said, “You’re like God’s provision in times when we’re in direst need you.” The Chinese culture is deep and long-standing, and it is seen as the

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“God” in which we should become “angels.” I’m convinced that Chinese traditional medicine will bring health and peace to the world.49 Chinese acupuncture has progressed from theory to clinical treatment and from tradition to innovation. To gain an insight into it, we need to study the TCM classics such as Plain Questions, Miraculous Pivot , and Acupuncture Meridian. Besides, we need to have some knowledge of the most crucial and influential stages in the development of acupuncture. Their value lies not only in working out how TCM began and was popularized, but in representing a leap forward. Huangfu Mi’s A-B Classic of Acu-moxibustion is considered to be a milestone, as it advanced the theories proposed in Acupuncture Meridian, and was closest in time to the latter. Its significance in the history of TCM is comparable to that of Zhang Zhongjing, the medical sage who made the theory of TCM applicable to medical clinic. “There is no greater wisdom than to not make subjective assumptions when faced with difficulties, and no greater action than to not regret it afterwards.”50 Huangfu Mi’s creation began with the shortcomings of Huangdi’s Classic on Medicine in acupuncture, especially in the operational level. He thought that the discussions in Huangdi’s Classic on Medicine were profound and insightful. The narrative theories were abundant, but the clinical operations were scarce and disorganized. Plain Questions focuses on diagnosing diseases in detail, while Miraculous Pivot investigates the source of meridians with deep connotations. Huangfu Mi noted that Mingtang Acupuncture Point Treatments should be added to the list of acupuncture classics, along with Plain Questions and Miraculous Pivot . The three works have the same principle, and there is more than one repetition. Together, they affect the spread and application of acupuncture.51 In the 49 What is the status quo of acupuncture and moxibustion in Ukraine? How about Professor Maˇceklet, head of neurosurgery and acupuncture and moxibustion in Ukraine, who planned to build an acupuncture and moxibustion treatment team? To know more, see Luo Genhai: Chinese Acupuncture and Moxibustion in Ukraine, Journal of Tianjin College of Traditional Chinese Medicine, 1994, Issue 4, and Familiarity and Strangeness— A Glimpse of Ukraine (II), Tianjin United Front, 1995, Issue 8. 50 From Shuo Yuan· Shuo Cong by Liu Xiang of the Western Han Dynasty. See: Han Wei Series· Shuo Yuan, Jilin University Press, published based on Cheng’s edition of Xin’an school during the reign of Wanli in the Ming Dynasty, 1992, p. 445. 51 See: A-B Classic of Acupuncture and Moxibustion· Preface by Huangfu Mi: “The words are far-reaching, but they have little realistic relevance. And the things he did had no order.” “The learnings were originated from Plain Questions, which helps diagnosing

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face of the choice between seeking wealth and fame, and studying assiduously and concerning about the well-being of people, he reflected a great deal upon it. At last, he decided to capture the high ground of life and morality, and chose the latter option. In his opinion, the most precious thing is life and nature protects the physical body. The topmost priority is to protect life and health against diseases.52 As Lie Zi said, “Impoverishment is a common sight among scholars, and death is the end of all people. When one’s fate is fulfilled, why worry?”53 And so, Huangfu Mi compiled the A-B Classic of Acu-moxibustion to integrate the three books. He “grouped the similar topics together, deleted superfluous descriptions, removed repetitions, and extracted the essentials.”54 He issued a call for learning from wise sages and saving the parents and the emperor from illness. When writing the A-B Classic of Acu-moxibustion, Huangfu Mi was guided by an important principle: “Observe what it has gathered, and you will detect the temperament of Heaven and Earth” (The Book of Changes· The 45th Hexagram). The Book of Changes says that when things converge, they inevitably reflect the mutual compatibility of temperament and character. It is intended to generalize and praise the main meaning of the “Cui” hexagram. Huangfu Mi incorporated it into the A-B Classic of Acu-moxibustion for the purpose of theoretical elaboration and extension. The idea of the book is consistent with “knowing the essentials and ending with one word”55 mentioned in Huangdi’s Classic on Medicine.

diseases accurately. The Nine Chapters deals with the meridians. Its meaning is profound and not easily understandable. Mingtang Acupoint Acupuncture and Moxibustion is about the selected dialogues between Huangdi and Uncle Qi. The three books are essentially the same.” See: A-B classic of Acupuncture and Moxibustion, based on the photocopy carved version of the Ming Dynasty, People’s Medical Publishing House, 1956. 52 See: Jin History· Biography of Huangfu Mi: “Huangfu Mi says: ‘That which is most cherished by people is life; What must be preserved in life is the physical form; and if physical form is preserved, diseases couldn’t attack it.’” 53 From: Lie Zi·Heaven Luck. Dang: still. Collected interpretations of Yang Bojun: “ 当” has the same pronunciation as “尚”. 54 From: A-B Classic of Acupuncture and Moxibustion· Preface by Huangfu Mi of the Wei and Jin Dynasties, based on the photocopy carved version of the Ming Dynasty, People’s Medical Publishing House, 1956. 55 From: Huangdi’s Classic on Medicine · Plain Questions· On the Source of Six Climate Changes 71: “Those who understand the essentials of a subject can explain it in one sentence, while those who don’t understand it will ramble endlessly.”

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“Convergence” is the main theme and outline of Huangfu Mi’s work. He argued that innovation required creative thinking, and creative thinking must first conform to comprehensive reasoning logic. The use of logical analysis must be supported by deep philosophical thinking. It follows that ancient Chinese philosophy has an important role to play in driving medical innovation and should not be underestimated. In writing A-B Classic of Acu-moxibustion, Huangfu Mi followed the “essential qi” philosophy, which had been present since the pre-Qin period. He said in the words of Huangdi’s Classic on Medicine that: “The heaven bestows its virtue on people; and the earth bestows its benevolence on people. The virtue of the heaven descends, and the benevolence of the earth ascends so that people may live.” By seeing qi as the material basis of the universe and the source of life, his materialistic spirit comes to life. Huangfu Mi once said, “if one wishes to understand the text in detail, he should wait until they have free time and then compose a commentary on it.”56 Sure enough, after the Sui and Tang dynasties, his long-cherished wish came true. A-B Classic of Acu-moxibustion had become a popular teaching material of acupuncture in foreign countries. Governments of countries and regions, such as China in the Sui and Tang Dynasties (see: Six Law Codes of Tang Dynasty), Japan (see: History of Japanese Medicine), and Silla (see: The Histories of Three Korean Kingdoms ) established it as a compulsory course for medical students.”57 During the Tang Dynasty, the medical office established a department for acupuncture and made the book A-B Classic of Acu-moxibustion a required teaching material. Here’s what New Tang History· Official Records says: “The Doctor of Medicine…was responsible for teaching students. Doctors at the time would divide their profession according to Compendium of Materia Medica, A-B Classic of Acu-moxibustion, and The Pulse Canon.” During the Tang Dynasty, some medical experts called for doctors to pay more attention to studying the A-B Classic of Acu-moxibustion and some even quoted its contents in their works.

56 See: A-B Classic of Acupuncture and Moxibustion· Preface by Huangfu Mi of the Wei and Jin Dynasties. The meaning is: when one has the time, they should carefully compile and verify the material to make a textbook. Zhuan He: Compiling and verifying. 57 See: Literature of Traditional Chinese Medicine, Part 2: The Origin and Development of TCM Literature by Ma Jixing, Shanghai Science and Technology Press, 1990, p. 90.

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Many people had referenced and built upon the A-B Classic of Acumoxibustion, but none had been able to surpass its scope. For example, Sun Simiao, the great doctor, advocated that “if one wishes to be a great doctor, he must be familiar with the Plain Questions, A-B Classic of Acumoxibustion, Huangdi’s Acupuncture Meridian, Mingtang Liuzhu…and more.” Invaluable Prescriptions for Ready Reference, Vol. 29 & 30, and Supplement of Invaluable Prescriptions for Ready Reference, Vol. 26~28, are devoted to the method of acupuncture based on A-B Classic of Acu-moxibustion. Wang Tao, another master of classics and prescriptions in the Tang Dynasty comparable to Sun Simiao, was unusually observant. He said that the A-B Classic of Acu-moxibustion “is a secret treasure of doctors recommended for use by later scholars.” In short, the Tang Dynasty was one of the most influential periods for A-B Classic of Acu-moxibustion. It is not incidental that the two artifacts—the three volumes of Illustrated Manual of Acupuncture Points of the Bronze Figure compiled by Wang Weiyi under imperial instruction, and the two acupuncture bronze figure models headed by him, were produced in the Song Dynasty. They represented the other milestone in the history of acupuncture development and were closely related to the cultural environment of the time. From the perspective of poetry creation, Mr. Jiang Xun, a famous scholar, said: “The Song emperors had a strong literary temperament, from Zhenzong and Renzong to Shenzong and Huizong. These rulers were often compared to literati due to their appreciation of literature and art…They were renowned for their artistic talents, including writing calligraphy, creating poems, and painting.”58 With people like them ruling the country, it is certain that cultural construction would not be neglected. Take movable type printing as an example, “books published and printed in the Song Dynasty are famous all over the world today…The invention of movable type printing in the Song Dynasty was widespread and was credited with sparking the Renaissance in the West”.59 During the Song Dynasty, there was a flourishing of culture and achievements, including traditional Chinese medicine. This period was characterized by a sense of confidence, composure, and security among the literati. In the 2nd

58 See: Jiang Xun’s Commentary on Song Ci· Lecture Two by Jiang Xun, China CITIC Press, 2012, p. 059. 59 See: Ibid., p. 167.

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year of Jiayou (1057), Emperor Renzong of the Song Dynasty accepted Han Qi’s proposal of establishing the Bureau for Revising Medical Books at the Compilation Institute. Medical experts such as Zhang Yuxi, Lin Yi, Su Song, Gao Baoheng, and Sun Qi were appointed to revise and supplement the medical classics. The bureau preserved and organized a large number of precious ancient medical books, playing an important role in the inheritance of Chinese medicine, and benefiting the health of the people with immeasurable value. According to historical documents, during the Jiayou period of the Song Dynasty (1060), Emperor Renzong organized a team of medical experts, including Zhang Yuxi, Lin Yi, and Su Song, to revise the Kaibao Materia Medica which was compiled during the early Song Dynasty. The revised version was named (Jiayou) Supplement of Shennong’s Herbal Classic and contained 1,082 medicinal herbs. The original Kaibao Materia Medica is lost, so we can only get a glimpse of its former glory from (Jiayou) Supplement of Shennong’s Herbal Classic. Based on Kaibao Materia Medica, 94 medicines, including 82 new supplementary medicines and 12 newly defined medicines, were added to the (Jiayou) Supplement of Shennong’s Herbal Classic. Together with the Turen Acupuncture Chart, it was generally known as Jiayou Materia Medica. Later, Tang Shenwei, a folk doctor in Chengdu, compiled the Classic and Historical Materia Medica for Emergency Preparedness (referred to as Herba Medica for Syndrome). The book includes the information about herbal medicine in medical works, and Confucian classics, historical works, works from the Hundred Schools of Thought in pre-Qin China, and literary anthologies. With 1,746 drugs, it is called “an encyclopedic gathering of medicine.”60 Before the publication of Li Shizhen’s Compendium of Materia Medica, the book was regarded as the most comprehensive work on materia medica for over 400 years. (Jiayou) Supplement of Shennong’s Herbal Classic mentioned before served as the basis for Classified Materia Medica. Joseph Needham, a British science and technology historian, pointed out in his book History of Chinese Science and Technology that Classified Materia Medica was

60 See: A Collection of Essays of White Thatch Vol. 38 by Gu Jingxing of the Qing Dynasty: “Emperor Renzong ordered the supplementation of notes and the addition of one hundred medicines. Tang Shenwei compiled the Classification of Symptoms and revised all the editions, which was known as an encyclopedia.” Based on the photocopy in the years of Qianlong.

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more sophisticated than the botanical works from early fifteenth- and sixteenth-century Europe. Now, let’s discuss the background of the two national treasures produced in the Song Dynasty. Documentary records suggest that acupuncture was not well understood in the past, leading to inaccurate information being passed down and perpetuated by unskilled practitioners. To respond to the situation, officials were ordered by Emperor Renzong to issue various orders to the medical professionals, who were required to accurately organize the medical works, and reflect on the acupuncture treatments. Besides, they were required to put medical science among the duties of the officials of the Son of Heaven. Emperor Renzong believed that medicine was a matter of life and death, and that its drawbacks must be eliminated in order to help people forever.61 The progress of medicine in the Song Dynasty is not accidental, but closely related to the attention of the upper class. Besides, Wang Weiyi’s Turen Acupuncture Chart was significantly influenced by Zhen Quan’s Mingtang Illustration Depicting the Human Body in the Tang Dynasty. The trajectory of medical heritage passed down through generations is clearly visible. The glories of A-B Classic of Acu-moxibustion and Turen Acupuncture Chart have overshadowed Miraculous Pivot , and people in those days didn’t attach importance to the study of the latter. Shi Song, a person of the Southern Song Dynasty, saw through this, and he said in the preface to Miraculous Pivot: “But it is a pity that the medical knowledge contained in Miraculous Pivot has not been preserved and passed down over time.”62 This is the factor contributing to the decline of acupuncture in later times, the dismay of master acupuncturist Dou Jie in the Jin Dynasty, and the surprise of modern people. “The sudden arrival of spring with the snowfall creates a vivid and romantic image.” In 1989, Tianjin College of Traditional Chinese Medicine (now Tianjin University of Traditional Chinese Medicine) 61 See: Bronze Figure Acupoint Acupuncture and Moxibustion Diagram· Preface by Xia Song of the Song Dynasty: “The engineering officers were ordered to amend the government decree. The great doctors were ordered to explore the technique of acupuncture and moxibustion. In the past, they were among the ranks of imperial officials. Medicine is about the lives of people and should be accorded priority for their wellbeing.” Based on the engraved version of Liu’s Yuhai Hall in Guichi in the first year of Xuantong of the Qing Dynasty (1909). 62 From: Miraculous Pivot·Xu.

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ended the decline in acupuncture studies since the mid-Qing Dynasty. The “experimental discipline construction for acupuncture” team led by Professors Tang Denan and Xu Tangping won the “National Teaching Achievement Award of Excellence,” issued by the Ministry of Education. This honor opened the door to a new era of revitalizing Chinese acupuncture research. The combination of the ancient acupuncture with modern neuroscience has ended the old models and methods of acupuncture research, creating a path to combine traditional clinical practice with modern experimental methods. This has led to interdisciplinary and comprehensive research in acupuncture, exploring new paths and directions. Acupuncture has caused a stir in the industry and related academic circles abroad; Afterward, two consecutive training courses were held for acupuncturists, spreading the “spring breeze” of acupuncture research and innovation to schools, hospitals, and research institutions across the country. There have been various detailed studies related to meridians, such as chemical research, cupping and bloodletting research, and chronobiology research. These studies are unprecedented in the history of Chinese medicine and are also cutting-edge researches today. “Experimental acupuncture is a new branch and important component of acupuncture.”63 It reveals the principles and laws of how acupuncture can treat diseases, providing insight into why it is effective. This is in contrast to traditional acupuncture which focuses on the way to “treat” diseases. The research assessment team consisted of top domestic experts in this field. It was headed by Professor Wang Xuetai, Secretary-General of the World Federation of Acupuncture-Moxibustion Societies and Vice President of the Chinese Acupuncture Society, with Professor Wu Xianzhong, Vice President of the Chinese Association for Integrative Medicine, as Deputy Leader.64 This advanced research project has left a historical mark with its rigorous research design, professional background, reasonable age structure of the research team, and excellent expert review team. We are proud to see that the age-old tradition is thriving again in our generation.

63 See: Introduction to Experimental Acupuncture and Moxibustion· Preface, edited by Guo Yi and Fang Jianqiao, China Press of Traditional Chinese Medicine, 2012, p. 8. 64 See: Commemorating the 90th Anniversary of the birth of Mr. Xu Tang (I) Past Events, a WeChat video edited by Zhuang Caiwei and reviewed by Chen Bo. The video script is based on Wang Guangjun’s “West Wind Withering the Green Trees—Notes of Mr. Xu Tang.” See: Traditional Chinese Medical Culture, 2009, 4 (03), pp. 4–7.

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Science is an endless pursuit. On February 17, 2016, Professor Guo Yi’s team from Tianjin University of Traditional Chinese Medicine worked with Professor Wang Jiang’s team from Tianjin University, and first proposed the concept of “Computational Acupuncture” and have since organized seminars and written monographs on the subject. The article “On Computational Acupuncture” published by World Chinese Medicine Magazine on April 22, 2020 covers the concept, research content, methods, and prospects of the topic. The new research has combined recent developments in biology, computer science, and big data to pave the way for further research into the ancient practice of acupuncture. This has allowed acupuncture to once again stand at the forefront of Chinese medicine development. July 10, 2020 References: [1] Shi Zhongxu. History of Chinese Medicine [M]. Taipei, China: Cheng Chung Book Company, 1984. [2] General Catalogue of the Complete Library in the Four Branches of Literature: Zi Bu.

TCM Concept: The Practice of Acupuncture According to Huangdi’s Classic on Medicine· Miraculous Pivot , there are nine types of gold needles. This is likely surprising to many, as when we enter an acupuncture clinic and see the gold needles of various lengths, we would not expect such a variety. “Nine Needles” is a collective term for nine types of acupuncture needles used in TCM. Why are there so many types of acupuncture needles? This is because “each type of needle has its own purpose and size. It is important to choose the right needle for the situation, as using an inappropriate one will not be effective in treating the illness.” (Huang Di’s Classic on Medicine· Miraculous Pivot· Selection of Needles 7 ). Corresponding to the nine different types of acupuncture needles, there are nine methods of application to treat different illnesses. Clinical use of “hair needle” is widespread, and there are many different sizes and thicknesses available. “Hair needle” ranks seventh among the “nine needles.” Its tip as delicate as the mouth of a mosquito, the needle

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is used to treat illnesses caused by external pathogens invading the meridians and hiding in the channel (Huangdi’s Classic on Medicine· Miraculous Pivot· Nine Needles 78). The needle is designed for treating “cold and heat arthralgia.” According to Records of the Three Kingdoms· Book of Wei· Biography of Hua Tuo, when Hua Tuo performed acupuncture, he would tell the patients that if they felt a certain sensation, they should say “arrived” and he would then remove the needles. This technique was said to be effective in treating illnesses.”65 This is a dialogue about the process of acupuncture “de qi.” “Dang yin mou xu” is a phrase used in the acupuncture process to describe the sensation of qi (energy) traveling along the meridians and arriving at a certain point. What Hua Tuo meant was that if the needle sense was transmitted to a certain part, told him. When he heard the patient say “arrived,” he would immediately pull out the golden needle, and the disease would be cured. In acupuncture, “de qi,” which was called “qi zhi” in ancient times and “zhen gan” in modern times, refers to the local numbness the patient may experience in acupuncture and the heavy and tight sensation the doctor may experience under the needle. “De qi” (qi arriving) is the sensation of “travelling qi” obtained after the needle is inserted into an acupoint to a certain depth and manipulated with techniques such as lifting, thrusting, or twirling. It is the key to producing a therapeutic effect from acupuncture. It is said that “for acupuncture, qi must arrive for it to be effective” (Huangdi’s Classic on Medicine· Miraculous Pivot· Nine Needles and Twelve Origins 1). The medical case of Hua Tuo demonstrates the effectiveness of acupuncture in treating stroke, as it shows that “treatment is more effective when applied sooner rather than later.”66 July 10, 2020

65 应: Immediately; 行: At once; 差: The same as “痉”, means recovery. 66 See: Book of Acupuncture and Moxibustion, Volume V, Golden Needle by Xu Feng of

the Ming Dynasty.

Index

A Acupuncture and Moxibustion Chart , 38 Acupuncture Meridian, 162, 165 Advanced Learning , 9 All-Encompassing Library, xxii, xxiii Almanac, 44 Analects of Zhu Xi, 7 Analytic reductionism, x Ancient medical science, ix Ancient sage, xiv, xvi, 8, 14, 54, 57, 73, 84, 87, 112, 125 Annotation, xi, 18, 83 Apricot grove, 60, 61 Art of Life Through the Four Seasons, The, 56 Art of medicine, The, 3, 29, 51, 74, 82, 91 Art of Yin-Yang Manifestation, The, 17, 56, 74, 151

B Battle against COVID-19, xiii, xv Bei Tang Shu Chao, 20

Benevolence, 4, 9, 15, 57, 61, 67, 99, 112, 132, 164 Bian Que, 24, 25, 28–31, 34, 35, 51, 115, 121, 152, 153 Bibliographical Treatise, 4, 16, 35–37, 45, 91, 121, 153 Book of Changes, The, xxiv, 1, 12, 37, 44, 46, 54, 163 Book of Filial Piety, The, 37, 38, 45–47 Book of Taixuan, The, 7 Book of Zhou·Accumulated Syndrome, The, 27 C Canon, xvi, 53, 63 Chinese acupuncture, ix, 38, 157, 159, 161, 162, 168 Chinese learning as the essence and Western learning for its utility, 62 Chinese people are fighting against the pandemic, xv Classical Remedies School, 7 Classic of the Virtue of the Tao, The, 54

© Foreign Language Teaching and Research Publishing Co., Ltd 2023 G. Luo, Humanistic Spirit of Traditional Chinese Medicine, https://doi.org/10.1007/978-981-99-4273-2

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INDEX

Classified Classic, xv, 34, 53, 63 Classified Medical Records of Distinguished Physicians , 5, 42 Clinical mindset, ix Collection and Explanation of Pox Treatment , 137 Combination of Chinese and Western Medicine, viii Commentaries on the Four Books , 8, 45 Commentaries to the Thirteen Classics, 12, 122 Common pursuit for excellence: Literati and TCM Doctors, 80 Compendium of Materia Medica, xiv, 110, 114, 164, 166 Complete Works of Hippocrates , xv, 107 Confucianism, 1–3, 8, 39, 40, 43, 44, 60, 70, 84, 96, 108, 131, 132, 144 Confucians’ Duties to Their Parents , 44, 54, 79, 91, 159 Confucian school of idealist philosophy of the Song Dynasty, 10 Contemporary medicine, x Context tips, 5, 24, 37, 49, 67, 80, 90, 106, 123, 132, 143, 157 Correcting Ignorance, 44 Correction of Errors in Medical Classics , 123, 125, 127–130 Cultural history, xvi, 32, 119

D Detailed Analysis of Epidemic Warm Diseases , 85 Dialogue between TCM and Western Medicine Cultures, 121 Dietary supplements, ix Diet therapy, ix, 72 Diseases of body and mind, 6

Divination, 3, 26, 27, 32, 35–37, 53, 63 Dream Pool Essays , 66, 79 E Emergency Remedies to Carry behind the Elbow, 136 Empty monarch, 94 Essential Readings for Medical Professionals , 40, 107, 112, 113 Essential Secrets from Outside the Metropolis , xxvi, 37, 136 Exorcism, 32 F Family Instruction, 133, 138 Family Precepts of Fu Shan, 100 Footstep Study for the Offspring , 92 Four Ends, 31, 32 Four Essential Classics , 85, 87, 144, 147, 155 “Four Great Physicians” of the Jin and Yuan period, 7 Free and Easy Wondering , 60, 70 Furious Qi, 31, 32 Further Treatises on the Properties of Things , 42 G Going too much genders disaster, 5 Going too much genders harm, 5, 6 Good Faith of Doctors, The, 59 Good recipe, 66 Great doctor blending Confucianism, Taoism, and Buddhism, 59 Great Learning, The, 39 H Hanging a gourd to heal the mankind, 47

INDEX

Han-learning, xxiii Harmony between human and nature, 9, 12, 14, 22, 91, 151 Healthcare reform, viii Hejian School, 7 Historical contemplation, 24 Humane studies, ix Humanities Lecture Hall, xi Humanity qualities, 50 Human orientation of TCM, 49

I I Ching (The Book of Changes), vii Illustration of Tai Chi, 11 Imagery, 12, 13 Imaginal thought, 12, 13 Imperial Medical Supervisor of Dianzhong Office, 94 Incantation and psychology, 30, 51, 52 Inner Transcendence, 1 In Response to Criticism on Ji Kang’s On Life Regimen, 75 Institute for the Advancement of Literature, 136 Instrument for life preservation, 37 Internal Treatments of Folk Medicine, 60 Invaluable Prescriptions for Ready Reference, xiv, xxiv, 2, 59, 165

L “Law and technique” theory, xxiv Life regimen concept, 76, 77 Life sciences, ix, x, 143 Long-summer, 23

M Madame Lantern, 90, 92

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Master TCM doctors, 5, 22, 37–40, 43, 45, 47, 49, 65–67, 79, 84, 91, 99, 104, 120, 155 McRobbie, Angela, xxv 19 mechanisms of pathological changes, 5 Medical discipline, viii Medical ethics, 2, 34, 60 Medical Formulas Gathered and Explained, xxiv Medical model, viii, 4, 50, 52, 57, 59 Medical Model of “Natural Philosophy,” The, 49 Medical Model of “Spiritualism”, 49 Medical Theory, 115, 116 Medical thinking, 13 Medicinal materials, 79 Medicine originates from saint, 24 Medicine, technique, fortune-telling, and divination, 92 Metaphysics, 1, 76 Microscopic and macroscopic combination, x Miracle doctor, 25 Miraculous Pivot , 91, 158, 159, 162, 167, 169 Miscellaneous Essays , 65 Mode of thinking, xv, 12 Modern medicine, viii, x, xxv, xxvii, xxviii, 35, 122, 127

N Negative disease, 18 Neo-Confucianism, 47, 86 New Materia Medica, 4 Notes on Poetries from Garden of Leisure, 82, 89 Nourishing the Lord of Life, 69 Nourishing Yin School, 7 Nourishment of body and spirit, 77 Numerology, 16

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O On Five Operations, 13, 14, 23 On Life regimen, 68, 71, 74–78 On the Epidemic, 85 On the Equality of Things , 69, 70, 77 On the Five Vital Energies , 21, 128 On the Generation of Five Zang-organs , 19 On the Profundity of Pulse Taking , 18 Outings , 74

P Partial and whole relations, x Patient/treatment compliance, viii People’s Medical Publishing House, xxvi, 53, 110, 114, 121, 157, 163 Photocopy of the Song version, 2 Positive disease, 17, 18 Pox scab, 138 Preventive treatment of diseases, viii, xi Profound cultural foundation of China, ix Proofreading of Huangdi’s Classic on Medicine · Plain Questions , 51, 58, 63, 74 proof reading version, 16, 91 Prose of Guqin, The, 74

R Realistic and practical significances of TCM, The realistic and practical significances of TCM, 80 Records of Han-learning Masters, xxi–xxiii Reductive analytical science, x Removing essence and transforming qi, 19, 51

S Scholar-physician, 2, 3, 44 Scholars are supposed to have ‘qi shi’, xvi Shen Nong Ben Cao Jing (Shennong’s Herbal Classic), vii Skill and virtue, 87 Song-learning, xxiii, xxiv Spectrum of disease, viii Spirit School, 66, 80, 83 Symptom of diseases, 30, 89, 114 Systems biology, x T Tales of Immortals, The, 4, 60 TCM Culture for the Welfare of People, 49 Tenor of Medical Classics· Preface, 80 Textual research, xxvii, 66 Theories of morality and destiny, xxiii Theory of five operations and six vital energies , 14, 22, 24 Theory of yin-yang, 55 Three Causes, 31, 32 Three profound studies, 1 Time seedling, 139 Translation and Annotation of the Analects of Confucius , 8, 9, 79, 88 Treatise on Typhoid and Miscellaneous Diseases , 37–39 U Union of Heaven and Human Beings, The, 53, 56, 150, 151 Universal path, 9, 14 Uses of Cultural Studies, The, xxv W Ways of the world, The, xxv, 53, 63 Wisdoms in TCM Classics , 120

INDEX

Witch doctor, xvii, 24, 25, 27–32, 51, 52 Witch mixing with doctor, 28 X Xi Ci 1, xxiv, 54

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Y Yin and yang produce all living things in the world, 54