If
you read Volume I of Fung Yu-Lan’s A
History of Chinese Thought, which I mentioned in my last post, you will
find that much of Chinese philosophy developed during the end of the Zhou
Dynasty in the Spring-Autumn Period (770-476 BCE) and the Warring States Period
(476-221 BCE). Another spurt of philosophical development came during the Han
Dynasty (206 BCE-220 CE). During these times, Chinese philosophers developed
the Yin-Yang Theory, which I discussed in earlier posts with respect to its
influence on gender roles and women. They also developed the Five Elements or
Five Phases Theory (五行,wu xing) that categorizes natural phenomenon into the five
elements of wood, fire, earth, metal, and water. These five elements or phases move
according to the cycle of the seasons. Paul Unschuld’s Medicine in China shows how these theories gave rise to the
theories of systematic correspondence that form the basis for TCM today.
Unschuld prefers the term Five Phases for wu
xing because the Chinese term implies process or motion. These five notions
are not static materials as the word “element” might suggest.
Unschuld also
traces the development of the concept of meridians along which the qi or vapor of life flows. In medical
texts found in the Ma-huang-dui, there are eleven disconnected meridians, and
it seems that acupuncture and moxibustion are recommended for aiding the flow
of qi. Later, in the Huang-di-nei-jing (Yellow Emperor’s
Inner Classic), the eleven meridians have been augmented into a system of
twelve meridians which connect the various organs of the body. These organs are
divided into two groups, the depots and the palaces, and it seems that the
entire economy of a healthy body is characterized by the metaphor of a healthy
united empire with canals and roads for transporting food, with storage depots
for holding supplies, and with factories for processing metals and making salt. There is a hierarchy among the organs, similar to the hierarchy of
officials in the empire. The heart is considered to be the ruler or jun. Grains are eaten and are processed
in the stomach to become qi. This qi nourishes the blood, which
circulates, and the qi itself also
circulates to all parts of the body. The various parts of the body absorb
whatever elements of the qi they need
for their functions, and the dregs are moved to the lower parts of the body
from which they are eliminated. The qi going
up to supply the body is called pure qi,
and the depleted qi going down for
elimination is called turbid qi.
Herbs, food, life-style, acupuncture, and moxibustion are all recommended to
help maintain the proper balance and functioning of the organism.
In addition to
these theories, Unschuld describes how the religious Daoists contributed
greatly to the knowledge of herbal properties, as they conducted alchemical
experiments in their pursuit of immortality. They, too, became a school of
medical practice in Chinese antiquity.
The following are
three of the early Chinese medical texts with Paul Unschuld’s translations from
his Chinese Life Sciences: Introductory
Readings in Classical Chinese Medicine (Paradigm Publishers, 2005). I have
chosen three that I think give a basic overview without getting into too much
detail. They are a few of my favorite texts in the book.
黃帝內經,素問2
四氣調神大論
從陰陽則生。逆之則死。從之則治。逆之則亂。反順為逆。是謂內格。是故聖人不治以病治未病。不治已亂治未亂。此之謂也。夫病以成而後藥之。譬如渴而穿井。鬪而鑄錐。不亦晚乎。 (Unschuld 2005, p. 10)
Huang Di Nei Jing, Su Wen 2
Comprehensive
Treatise on the Regulation of the Spirit in Accord with the Four Seasons
If one follows yin
and yang, then life results; if one opposes them, then death results. If one
follows them, then order results; if one opposes them, then disorder results.
To act contrary to what is appropriate, this is opposition. This is called
inner obstruction. Hence, [when it was said] “the sages did not treat those
already ill, but treated those not yet ill; they did not regulate what was
already in disorder, but regulated what was not yet in disorder,” then this
expresses the meaning of that [what was said above]. Now, when drugs are
employed for therapy only after disease has become fully developed, when
[attempts at] restoring order are initiated only after disorder has fully
developed, this is as if a well were dug when one is thirsty, and as if weapons
were cast when the fight is on. Would this not be too late, too? (Unschuld
2005, p. 12)
黃帝內經,素問77
疏五過論
聖人之治病也。必知天地陰陽。四時經紀。五藏六府。雌雄表裏。刺灸砭石,毒藥所主。從容人事。以明經道。貴賤貧富。各異品理。問年少長勇怯之理。審於分部。知病本始。八正九候。診必副矣。(Unschuld 2005, p. 16)
Huang Di Nei Jing, Su Wen 77
On the Five Errors
When the sages
treated a disease, they certainly knew the yin and yang [qi] of heaven and
earth and the invariable rules followed by the four seasons; the five depots
and six palaces (1), female and male, exterior and interior, [as well as]
piercing, cauterization, pointed stones, and toxic drugs with all [the
diseases] they master. Their approach to the human affairs was natural, thereby
understanding the Way laid down in the classics. The noble and the common, the
poor and the wealthy, they all [represent] a structure of different ranks, [and
the sages] inquired [from the parents] whether they [belonged to] the order of
youth or adulthood, of courage or timidity. They investigated [all the] parts
and sections [of the human body] and they knew the root and the beginning of
the diseases [to be treated]. As for the eight cardinal [turning points] (2)
and the nine indicators, in their examinations they were of definite help
[too].
(1) The
acknowledgement of the yinyang dualism as one of the pervasive structuring
principles of all existence required the identification of two types of organs.
The designations chosen were metaphors borrowed from the realm of social
institutions, i.e. fu 府 in the sense of a storage unit where items are
kept only temporarily before being emitted again, and zang 藏 in the sense of
an inner-most storage unit where items are kept for a long time, if not
forever. The former, including small and large intestines, urinary bladder,
gallbladder, stomach, and heart enclosure (pericardium), were identified as
yang, signifying notions such as “outer” and “passage”; the latter, including
lung, heart, spleen, liver, and kidneys, were identified as yin, signifying
notions such as “interior” and “tranquility”. However, a second metaphorical
usage of fu 府 identified small and large intestines, urinary
bladder, gallbladder, stomach, and heart enclosure (pericardium) as “palaces”
housing the zhu 主, “rulers”, lung, heart, spleen, liver, and kidneys, respectively. Thus,
in ancient Chinese medical literature, the term fu 府 is encountered in
two different kinds of social metaphorical contents. In my translations of the
terms zang 藏 and fu 府, I render the former as “depot”, thereby referring
to the storage unit metaphor, and the latter as “palace”, thereby referring to
the ruler-palace metaphor. A clear identification of each usage of the term fu 府 as either “palace” or “short-term storage unit”
appears impracticable.
(2) A reference to
the qi at “the eight seasonal turning points”, i.e. the two solstices, the two
equinoxes, and the four first days of the four seasons. These are critical
terms in the course of each year. (Unschuld 2005, pp. 18-19)
黃帝內經,太素 2
調食
黃帝曰: 願聞穀氣有五味。其入五藏。分別奈何。伯高曰。胃者。五藏六府之海也。水穀皆入於胃。五藏六府皆高於胃。胃受水穀。變化以滋五藏六府。五味各走其所喜。穀味酸。先走肝。穀味苦。先走心。穀味甘。先走脾。穀味辛。先走肺。穀味鹹。先走腎。穀氣津液已行。營衛大通。乃化糟粕。以次傳下。(水穀化為津液。清氣猶如霧露。名營衛。行脈內外。無所滯礙。故曰大通。其沉濁者。名為糟粕。泌別汁入於膀胱。故曰以次傳下也。) 黃帝曰。營衛之行奈何。伯高曰。穀始入於胃。其精微者。先出於胃之兩焦。以即五藏。別出兩行於營衛之道。(精微。津液也。津液資五藏已。衛氣出胃上口。營氣出於中焦之後。故曰兩行道也。) 其大氣之搏而不行者。積於胸中。命曰氣海。出於肺。循喉嚨。故呼則出。吸則入。(搏。聚也。穀化為氣。計有四道。精微營衛。以為二道。化為糟粕及濁氣并尿。其於精下傳。復為一道。搏而不行。積於胸中。名氣海。以為呼吸。復為一道。合為四道也。) (Unschuld 2005, p. 55)
Huang Di Nei Jing, Tai Su 2
To Balance
Nourishment
Huang Di: I should
like to hear [about the following]. The qi of the grains have five flavors.
When they enter the five depots—according to what [kind of criteria] are they
separated?
Bo Gao: The
stomach is the sea for the five depots and six palaces. All the water and
grains [that man consumes] enter the stomach. The five depots and six palaces
receive all their supplies from the stomach. (The stomach receives the water
and the grains; it transforms them to nourish the five depots and six palaces.)
The five flavors move each to [the one depot] which they prefer. The sour
flavor of the grains moves first into the liver. The bitter flavor of the
grains moves first into the heart. The sweet flavor of the grains moves first
into the spleen. The acrid flavor of the grains moves first into the lungs. The
salty flavor of the grains moves first into the kidneys. As soon as the qi of
the grains and all the liquids have begun their passage [through the organism],
and when the camp and guardian [qi] penetrate the entire body, dregs result
from transformation and are transmitted downward step by step. (The water and
the grains are transformed into liquids. There are clear qi resembling mist and
dew; they are called camp and guardian [qi], and they proceed inside and outside
the vessels. There is nothing that could obstruct [their flow]. Hence, [the
text] states “penetrate the entire [body].” Those that sink down and are turbid
are called dregs. They gush, as separate juices, into the urinary bladder.
Hence, [the text] states: “are transmitted downward step by step.”)
Huang Di: How do
the camp and guardian [qi] move [through the body]?
Bo Gao: The grains
first enter the stomach. Their essential and subtle components leave the
stomach first through two of its burners [before] they nourish the five depots.
They leave [the stomach through two] separate [openings], and proceed through
the two paths of the camp and guardian [qi, respectively]. (The essential and
subtle [components] are the liquids. After the liquids have nourished the five
depots, the guardian qi leave through the upper opening of the stomach; the
camp qi leave from behind the central burner. Hence, the text states “proceed
through two paths.”) Those major [portions of] the qi which are seized and do
not move on, they are collected in the chest, and this is called the “sea of
qi”; its outlet is through the lungs, via the windpipe. Hence, to exhale
[causes the qi] to leave; to inhale [causes them] to enter [the body]. (“Are
seized” stands for “are accumulated.” The grains are transformed into qi.
Altogether there are four paths [for the qi to enter and leave the body, and
pass through it]. The essential and subtle [components, i.e. the] camp and
guardian [qi] occupy two paths. The transformation into dregs and turbid qi,
and also urine, and the passage downward together with the semen, that
constitutes yet another path. [Those qi that are] seized and do not move on,
and which accumulate in the chest, they are called the “sea of qi”. From this
originates inhalation and exhalation, which constitutes yet another path.
Together these are four paths.) (Unschuld 2005, pp. 58-59)