Early Chinese Medical Literature
Donald Harper in his impressive monograph 'Early Chinese Medical Literature. The Mawangdui Medical Manuscripts Translation and Study' analyses the silk manuscripts that were found in a tomb at Mawangdui in 1973. Anyone with an interest in the origins of Chinese medicine, science, magic, and culture will not want to miss it.
By WOLFGANG BEHR
According to a recent survey of the World Health Organization (WHO), there are few countries in the world where Traditional Chinese Medicine (TCM) has not been enjoying a massive growth spurt during the last two decades. TCM herbal preparations are currently sold to at least 130 countries, including many developing regions in Southeast Asia and Africa, and reached an export volume of some 500 million US $ in 1998. They account for 30-50 % of the total medical consumption in China, but the per capita consumption in absolute figures is even higher in Japan. Increased Western interest in TCM is reflected by the fact that the WHO has now set up seven TCM co-operation centres in China, and that the number of foreign students of TCM at Chinese universities outranks those in all other subjects within the natural sciences.Wherever TCM is sold, references to the venerability of a seemingly monolithic medical 'tradition', reaching back 'several millennia' into China's dim and distant prehistory, are sure to fill the marketing blurbs. Athough there have been a few brave attempts by Chinese paleographers to cull the references to ailments, drug-names, and shamanistic treatments scattered throughout oracle bone and pre-Qin bronze inscriptions, the customary starting point for any standard history of Chinese medicine is still the Inner Canon of the Yellow Emperor (Huangdi Neijing), the oldest layers of which probably stem from the late second or first century BC. Until very recently, this fairly heterogenous corpus of texts, which survived in three divergent medieval recensions, was considered to be the sum and substance of the earliest Chinese medical system. It is primarily concerned with an elaborate theory of physiology and pathology, focusing on the interplay between 'vapour' (qi), blood (xue) and the vessels (mai), as well as the healing of 'disruptions' between these units by means of acupuncture, moxibustion, herbal prescriptions, and other treatments. Yet the late Bronze Age origins of this already quite complex system, still considered to underlie all later practices of TCM, are rather poorly understood, as are the early history of its transmission and socio-cultural backgrounds. While most modern practitioners of Chinese medicine are perfectly happy to live with such lurking uncertainties, the 'sudden' appearance of the Huangdi Neijing was always a sort of an epistemological nuisance to historians of science in China.
This disquieting situation was dramatically changed by the famous discovery of thirty silk manuscripts in a lacquer box in 1973. They were found in a tomb at Mawangdui (Changsha, Hunan province), and only three of them (Laozi, Zhouyi, Xici zhuan) have counterparts in the received literature. Some eighteen percent of the forty-five texts included in the manuscripts were found to have medical contents, predating the Inner Canon by at least a century. Supplemented by several other Warring States' manuscripts excavated during the last few decades (Zhangjiashan, Fuyang, Yunmeng, Wuwei, Baoshan), which are more or less directly related to medical issues and subsumed under the conveniently broad-meshed header of fang or 'recipe-literature', these texts and their intellectual backgrounds form the topic of Donald Harper's impressive monograph.
The study is roughly divided into two halves, one including an extensive prolegomena (pp. 1-183), the other a copiously annotated complete translation of all fourteen manuscripts (185-438). Three subject indexes of materia medica, physiological terms, and names of ailment, as well as a short general index, round off the book, unfortunately mixing entries of English translation equivalents and their underlying Chinese originals without any clearcut organizational principle. The translation of original manuscripts, unlikely to be related in a linear fashion to the Huangdi Neijing-tradition, and which clearly predate the emergence of acupuncture and moxibustion which yet do not apply duo-pentaistic (yinyang wuxing) agent theories to physiology and generally favour recondite ontological notions of illness to more sober functional explanations, is certainly an extraordinarily daunting task. The author's undertaking aims at no less than recreating a whole world of medical practices that had been totally eclipsed by later rationalizing developments and therefore inevitably leads back into the realm of magic, occult practices, macrobiotic hygiene, natural philosophy, and a 'culture of secrecy' permeating much, if not all, of the Warring States' medical discourse. Faced with a lack of any positively guiding exegetical tradition, a translator struggling to find his way through the thickets of pre-Qin medical knowledge, is virtually required to revive pre-modern exigencies of academic pansophy, since the varied contents of the texts call for a thorough familiarity with pre-Qin history, archaeology, paleography, philosophy, botany, mythology, and macrobiotics, to name but a few of the disciplines involved. While one might quibble over some of the translations, especially of plant/drug names, Harper has in general succeeded admirably in producing a translation that is highly reliable and thoroughly readable, in many respects clearly superior to Modern Chinese and Japanese renderings of the texts. One can feel the awe-inspiring amount of work which must have gone into the book since Harper's first treatment of one of the Mawangdui medical manuscript in his dissertation almost two decades ago. I am sure that this book will be of lasting importance to anyone with an interest in the origins of Chinese medicine and pharmacology, but, perhaps more importantly, also for those working on the history of science, philosophy, society, and culture during the fourth to second centuries BC and beyond.
These backgrounds are amply dealt with in the excellent prolegomena, which I will not even try to summarize here. Much to his credit, Harper has been careful to refrain from extensive comparisons with later systems of TCM or contemporaneous Western medical traditions. More often than not, comparisons of this type have proved to be problematic in the sense that they inevitably introduce subliminal theoretical presuppositions into a subject best approached from a deliberately self-contained 'internal' perspective. Typical examples of retrospective misconceptions discussed by Harper, which have arisen from rash comparisons with later texts and traditions, include the mechanical association of macrobiotics and sexual techniques with a proto-Daoist background, the overreliance on Huangdi Neijing etiology in the translation of arcane ailment names in the manuscripts, the misinterpretation of lancing as acupuncture, of cauterization as moxibustion, or the anachronistic assignment of different texts to formal medical or philosophical 'schools'. To be sure, Harper's reconstruction of the world of medicine before the 'Yellow Thearch' texts makes ample use of an impressive range of later (as well as contemporaneous) edited sources for the identification of difficult terms and concepts, and, indeed, it documents a surprising degree of cross-fertilization between medicine and other branches of natural philosophy during the late Warring States and Early Han periods. But the book is a groundbreaking work, in the best sense of the word, in that it always gives preference to a close scrutiny of the textual relationships within the manuscript corpus itself.
One of the most exciting chapters in the prolegomena deals with the transmission and copying of the manuscript texts, and the astonishing value of books as 'objects of power' for their elite owner and readerships during the last centuries BC. In a sense, it is this culture that was indirectly responsible for the preservation of the medical 'texts in tombs' to the present day. The Warring State elites formed a fairly sophisticated readership, engaged in an informed dialogue with the physician-practitioners, and as the texts show, a clientele already much plagued by 'civilizational diseases' like haemorrhoids and the inability to sleep. Yet they were also a readership still inextricably involved with the magic and exorcism of earlier periods, for whom a haemorrhoid-cure like 'hot-pressing with vapour of a male rat boiled in urine' (MSI.E.154) presumably sounded perfectly reasonable. Prescriptions like this make the book an exhilarating read, and Harper is to be congratulated for making them accessible in a well-argued and beautifully produced volume. Anyone with an interest in Ancient Chinese medicine, science, magic, and culture will not want to miss it. *
- Donald Harper
Early Chinese Medical Literature: The Mawangdui Medical Manuscripts translation and study
London & New York: Kegan Paul International (Sir Henry Wellcome Asian Series), 1998,
ISBN 0 7103 0582-6 (hard cover), UK £75.00 / US $127.50
Dr Wolfgang Behr, Department of East Asian Studies, Ruhr Universität Bochum, Germany.
E-mail: Wolfgang.Behr@ruhr.uni-bochum.de