## 1. Introduction: Shared Intellectual Contexts




Before addressing connections between Chinese philosophy and Chinese
medicine it is necessary to make two clarifications on the meaning of
the term Chinese medicine. Chinese medicine could in principle
refer to: (1) the full range of medical systems used in contemporary
China, including Western biomedicine; (2) the traditional indigenous
Chinese medicine that is conventionally referred to as Traditional
Chinese Medicine (TCM); and (3) other indigenous medical systems,
distinct from but TCM, practiced by non-Chinese or minorities who live
in areas that historically were part of China or are now part of the
Peoples Republic of China, for example, Korean and Tibetan
medicine. For purposes of this essay I use the term Chinese
medicine only to refer to TCM, but including issues of the integration
of TCM and Western medicine. Second, Chinese medicine, in the
sense of TCM just discussed, includes a wider range of practices than
does Western medicine. In particular it includes: (1)
"medicine" in its conventional sense of practices that cure
or prevent disease, treat disease and injury and assist in childbirth,
etc.; (2) a range of practice to prevent disease in the broadest sense
by maintaining health, including practices associated with the martial
arts such as Taijiquan (also known as T'ai chi); and (3) a range of
practices that extend health by seeking longevity. In particular,
a clear account of Chinese medicine cannot confine itself to the first
of these only.




Within a Chinese historical context, medicine (*yi* Yi )
was one of several qualitative sciences. It included
"nurturing life" (*yang sheng* Yang Sheng ), a
broad category that comprised a wide range of self-cultivation
techniques. In later periods, medicine also included materia
medica (*bencao* Ben Cao ) and internal (*nei
dan* Nei Dan ) and external (*wai dan*
Wai Dan ) alchemy. The early Chinese qualitative and
quantitative sciences were specific, with no unified notion of science
(Sivin 1982 and 1990).




Secondly, medical works, like other scientific works, were classified
as technical specialties, distinct from generalist works, including
the "Masters" texts associated with Chinese philosophy
(Raphals 2008-2009, forthcoming). Medicine and its related disciplines
appear in the last section of the Bibliographic Treatise (chapter 30)
of the Standard History of the Han Dynasty (*Han shu*). This
Treatise consists of six sections. The first two ("Six
Classics" and "Masters") contain philosophical
works. The last two are technical: "Numbers and
Techniques" (S*hu shu* Shu Shu ), and
"Recipes and Methods" (F*ang ji* Fang Ji ).
The latter includes works on medicine and longevity, including the
categories of medical classics (*yi jing* Yi Jing ),
classical recipes (*jing fang* Jing Fang ), sexual arts
(*fang zhong* Fang Zhong , also referred to as "arts
of the bedchamber"), and immortality practices (*shen
xian* Shen Xian ). These chapters reflect the concerns and
expertise of the technical and ritual specialists closely associated
with the "Recipe Masters" (*fang shi*
Fang Shi ) associated with the Han court. But their concerns
also appear in early philosophical texts to such an extent that any
separation of their philosophical from their religious and technical
content is arbitrary and artificial (Harper 1998 and 1999; Kalinowski
2004).




Nonetheless, Chinese philosophy and Chinese medicine shared important
intellectual contexts in their early development. The origins of
science in China seem to lie in an amalgam of ideas from both
philosophers and technical specialists, including physicians.
According to Sivin (1988 and 1990) the basic Chinese sciences were
established some time between the first century BCE and the first
century CE through what he describes as a combination of Ru
("Confucian") ideas and ideas from technical specialists,
especially experts in yin-yang, Five Agents (*wu xing*)
Wu Xing , henceforward *wuxing* and technical expertise
traditions associated with "Numbers and Techniques"
(*Shu shu*) and "Recipes and Methods" (*Fang
ji,* mentioned above).




Key to this amalgam were several concepts shared by both groups but
deployed in very different ways. Early medical - and
cosmological - thinking depicts a cosmos ultimately composed of
*qi* Qi  (the energy that constitutes and organizes matter
and causes growth and change) in processes of constant change, based on
the interactions of *yin* and *yang* Yin Yang  and
the "Five Agents" or "Five Powers"
(*wuxing*. 
See Graham 1986, Raphals 1998 and 2013).




Philosophers deployed these ideas in (1) the yin-yang cosmology of
the *Book of Changes* or *Yi jing*, (2) theories of
correlative correspondence between heaven, earth and humanity as a
shared representation of cosmic order, and (3) the idea of a
"classic" or "canon" as the founding text of a
textual lineage. The authors of the first medical classic, the
*Yellow Emperor's Classic of Internal Medicine* (*Huang Di
neijing*), also deployed these concepts, in particular in models of
the human body as a yin-yang and Five Agent microcosm of the
cosmos.




Finally, physicians and philosophers created textual lineages and
accounts of textual authority. The most important medical works
of this kind are the *Yellow Emperor's Classic of Internal
Medicine* and the *Materia Medica of Shen
Nong* (*Shen Nong bencao*), ascribed to the "Divine
Husbandmen" Shen Nong, who, according to legend, tested hundred
of herbs and plants to ascertain their curative properties. By
contrast, the evidence of recently excavated texts indicates that the
*Huang Di neijing* derived from prior textual traditions that
were subsequently lost (Harper 1998) and that the extant version is a
composite of several earlier texts (Keegan 1988, Unschuld 2003,
Unschuld and Tessenow 2011, Yamada 1979).


### 1.1 *Yin-yang*, *Qi* and *Wuxing*




Theories of *qi* and *yin* and *yang* also are
importantly pursued in early philosophical works. Several Warring
States texts contain references to the nature of *qi*,
*yin* and *yang*, and their relation to health and
longevity. The *Zhuangzi* clearly identifies qi as the
basis of the physical constitution of the body: "Human birth is
caused by the gathering together of *qi*" (22, 733,
misleadingly translated by Watson (2013, 180) as "purity").
The *Zhuangzi* also describes harmonizing or taking charge of
the six *qi*.



> 
> 
> The *qi* of heaven is not in harmony, the *qi* of
> earth is tangled and snarled. The six *qi* are maladjusted, the
> four seasons are disordered. *Now I want to harmonize the essences
> of the six qi in order to nurture life* (Zhuangzi 11, 386, emphasis
> added, cf. Watson 2013, 80).




Similarly, the *Springs and Autumns of Master Lu*
(*Lushi chunqiu*) describes sages as making their numinous
essences (*jing shen* Jing Shen ) tranquil, and preserving
and increasing their longevity (3.2, pp. 3b-4a, trans. Knoblock and
Riegel 2000, 3/2.1, 99).




In all these texts a sage or numinous person achieves that status
through both meta-physical and physical means. This is the focus of
Daoist "Nurturing Life" techniques (discussed in section
2).




We find a different account of these concepts in technical
works. The apocryphal "founder" of scientific thought
in China was Zou Yan Zou Yan  (305-240 BCE), who is credited
with combining and systematizing *yin-yang* and *wuxing*
theory. No works attributed to him survive. Sima Qian's
biography in *Shi ji* 76 describes him as a member of the Jixia
Ji Xia  Academy, originally from the state of Qi in present
day Shandong (Needham 1956: 231-34). By contrast, the *Han
shu* describes him as a Recipe Master (*fang shi*). 
This is important because of the connection between *fang shi*
and medicine.



*Fang shi* practiced medicine and divination and claimed to
possess secret texts and formulae. They gained great influence during
the earlier part of the Han dynasty, though their influence waned by
the later Han. The fang shi used yin-yang and Five Agents cosmology.
They seem to have originated from the Shandong peninsula, and were
particularly associated with the mantic arts, including the use of the
sexagenary cycle of stems and branches, the *Yi jing*, and
divination by stars, dreams, physiognomy, the winds, and by the use of
pitch pipes (Ngo 1976).


### 1.2 Body, State and Cosmos




It is almost impossible to separate Chinese ideas of body, state,
cosmos from concepts of "nature," though, as Nathan Sivin
points out, there is no indigenous Chinese term for
"nature" before the nineteenth century. Over the course of
the last three centuries BCE, Chinese understandings of the physical
world developed to reflect, and mirror, political consolidation (Sivin
1995, 2007). These new ideas of cosmic order--correspondence
between microcosm (the body) and macrocosm (the cosmos)--appeared
in new representations of the body, the state, and the cosmos that were
based on systematic applications and correlations of the ideas of
*yin-yang* and *wuxing*. They are prominent in Warring
States politico-philosophical writings such as the *Springs and
Autumns of Master Lu* (*Lu Shi chunqiu*) of
Lu Buwei (291?-235 BCE) and the *Luxuriant Dew of the Springs
and Autumns* (*Chunqiu fanlu*), attributed to Dong
Zhongshu (179-104 BCE).




Theories of *qi*, *yin-yang* and *wuxing* also
inform medical works. New systematic medical theories based on
these ideas were systematized in a cosmological framework in the
*Huang Di neijing*, a complex and multi-layered text, probably
compiled in the first century BCE (Keegan 1988, Unschuld 2003, Yamada
1979). It presents a systematic cosmology that analogizes the
body, the state, and the cosmos in systems of "correlative
cosmology" (Graham 1986b, Sivin 1995, Lloyd and Sivin 2002). It
describes relations and analogies between the body (including the
emotions), the state and the cosmos in terms of *yin-yang* and
*wuxing*. For example, the *Huang Di neijing* describes
correspondence between the articulations of the body and the cosmos,
specifically between heaven and earth and the upper and lower parts of
the body:



> 
> Heaven is round, earth is square; people's heads are round,
> their feet are square and thereby correspond to them. Heaven has the
> sun and moon, people have two eyes; Earth has nine regions, people have
> nine orifices. Heaven has wind and rain, people have joy and anger;
> Heaven has thunder and lightning, people have the notes and sounds.
> Heaven has four seasons, people have four limbs. Heaven has five tones,
> people have the five depots; Heaven has six pitches, people have six
> palaces. Heaven has winter and summer, people have cold and hot
> [ailments]. Heaven has ten days, people have the hands' ten
> fingers ... Heaven has yin and yang; people have man and wife. The
> year has 365 days; the body has 360 joints (*Huang Di neijing ling
> shu* 71.2, 446, cf. Wong Ming 1987, 336-338 (French). There
> is no good English translation of this text.).




Theories of *yin-yang, qi* and *wuxing* also inform
Warring States and Han astrocalendrics, observational astronomy and the
study of astronomical portents, and in the so-called "correlative
cosmologies" of many Han dynasty texts.


## 2. Nurturing Life (*yang sheng*)




Several Warring States texts express the need to preserve
one's person, self, or essential nature:



> 
> 
> Therefore the sage puts his person last and it comes first, Treats
> it as extraneous and it is preserved. (*Daode jing*, chap.
> 7)




One way to do this was to maintain health by nurturing life
(*yang sheng*), an area of common ground for speculative
thinkers and practitioners of traditional medical arts. The term
*yang sheng* first appears in the *Zhuangzi* and
then throughout a range of second (BCE) century medical literature.




The third chapter of the *Zhuangzi* is titled "The Lord
of Nurturing Life" (*Yang sheng zhu*
Yang Sheng Zhu ). In it, the expert butcher Pao Ding
instructs Duke Hui of Liang. Pao Ding describes the process of
mastering his skill. His method is initially analytic; he begins by
studying oxen as wholes, next as parts, and finally with faculties
beyond ordinary vision. This discourse is presented as an instruction
to the Lord Wenhui, who ends by saying that: "Pao Ding has taught
me how to nurture life" (*yang sheng*, *Zhuangzi*
3, 124, cf. Watson 2013, 20).




Another passage in the Outer Chapters refers to some of these
exercises. It contrasts "real sages" who follow the way of
heaven and earth with (among others) practitioners of "nurturing
life" traditions who:



> 
> 
> blow out, breathe in, old out, new in, dormant like the bear,
> neck-stretched like the bird, their only care for longevity; these are
> the practitioners of "guide-and-pull" [*dao yin*
> Dao Yin ] and "nourishing the body" [*yang
> xing* Yang Xing ] who desire the longevity of Pengzu
> (*Zhuangzi* 15, 535, cf. Watson 2013, 119).




The passage continues. Real sages:



> 
> 
> cultivate [their persons] without benevolence and righteousness,
> govern without merit or fame, are at ease without needing rivers and
> seas, attain longevity without "guiding and pulling,"
> forget everything but lack for nothing, placid without limit, things of
> value follow upon them (ch. 15, 537, cf. Graham 1986a, 265;
> Watson 2013, 119).




Since the whole point of the *Zhuangzi* passage is to oppose
"guiding and pulling" and other longevity techniques to
true sagehood, it does not dwell on their details. We can get a better
idea of what he might have been talking about from other sources. Some
of these ideas are elaborated in a chapter of the *Guanzi*
titled "Inner Cultivation" (*Nei ye*), which
describes the cultivation of qi, as well as vital essence
(*jing*), and spirit (*shen*). It describes Dao as
literally pervading the body or the person of a sage:



> 
> 
> So long as the wellspring is not exhausted,   
> 
> The passages of the nine apertures will remain clear.  
> 
> Thus it is possible to explore the limits of Heaven and Earth, and
> cover the four seas. (*Guanzi* 16.3a8-3b1; trans. Rickett
> 1998, 48).




The *Zhuangzi* and other texts refer to the figure of the
spirit person or *shen ren* Shen Ren  as someone who has
effectively transformed the physical body and the *qi* that
constitutes it. The *Zhuangzi* describes spirit person of Guye,
who concentrates his spirit (*shen*), avoids the five grains,
rides the clouds, and, through the concentration of his *shen*
protects others against sicknesses and epidemics and makes the harvest
ripen (*Zhuangzi* 1, 28; cf. Graham, 1986a, 46). This passage
suggests that a sage can have a nurturing effect on the world by acting
at a distance, possibly as an unintended by-product of self-cultivation
practices.




Other passages in the *Zhuangzi* extol the abilities of
specialized craftsmen who possess highly technical skills. These
stories liken mastery of the Way to mastery of a craft. They also
emphasize the technical skills of commoners. Commoners, rather than
rulers, are presented as sage-like figures. These technical experts
include arrow makers, bell-stand carvers, boatmen, butchers, cicada
catchers, potters, sword makers, and wheelwrights (Raphals 2005). It is
curious that these passages never include physicians. 




In the Han dynasty, "nurturing life" techniques became a
major concern of the Recipe Masters *(fang shi)* of the Han
court (Ngo 1976). Texts on nurturing life include methods for absorbing
and circulating qi in the body--for example, breathing and
meditation exercises, diet, drugs and sexual techniques.




Medical and mantic texts excavated from tombs make it clear that a
wide range of longevity techniques had been developed before the Han
dynasty (Harper 1998, 33). Most important is a corpus of medical
manuscripts excavated from Mawangdui Ma Wang Dui 
(Changsha, Hubei), dated to 169 BCE. This tomb is best known for its
two versions of the *Daode jing*, but it is meaningful to locate
those texts among other texts of a scientific provenance found in the
tomb (Harper 1998 and 2000, Ma Jixing 1992, Zhou Yimou 1994, Zhou 
Yimou and Xiao Zuotai 1987).




Six of the medical manuscripts are concerned with nurturing life in
various ways. "Harmonizing Yin and Yang" (*He yin
yang* He Yin Yang ) and "Discussion of the
Realized Way of All Under Heaven" (*Tianxia zhi dao tan*
Tian Xia Zhi Dao Tan ) are concerned with sexual
cultivation. They refer to the movements and postures of animals as
whole-body metaphors for sexual techniques. An example is the
description of ten postures in "Harmonizing Yin and
Yang":



> 
> 
> The ten postures: the first is "tiger roving"; the second
> is "cicada clinging"; the third is "measuring
> worm"; the fourth is "river deer butting"; the fifth
> is "locust splayed"; the sixth is "gibbon
> grabbing"; the seventh is "toad"; the eighth is
> "rabbit bolting"; the ninth is "dragonfly";
> the tenth is "fish gobbling." (Harper 1998,
> 418)




These texts emphasize that sexual activity is a natural process, but
one that must be regulated. As the "Realized Way of All Under
Heaven" puts it, people know by nature how to breathe and how to
eat, but everything else is a matter of learning and habit. "What
assists life is eating; what injures life is lust. Therefore the sage
when conjoining male and female invariably possesses a model"
(Zhou and Xiao 1989, 431; Harper 1998, 432).




"Recipes for Nurturing Life" (*Yang sheng fang*
Yang Sheng Fang ) consists of eighty-seven recipes, including
food, drugs, and beverages, along with several sexual cultivation
exercises. "Eliminating Grain and Eating Vapor" (*Que gu
shi qi* Que Gu Shi Qi ) specifies diet and
breathing exercises to be performed in the morning and evening, and a
seasonal regimen of breath cultivation through consuming six qi and
avoiding another five (Harper 1998, 25-30). Another text, the
"Ten Questions" (*Shi wen* Shi Wen ) gives
advice on techniques for nurturing life (Harper 1998, 22-30), for
example:



> 
> 
> Yao asked Shun: "In Under-heaven what is most
> valuable?"
> 
> 
> 
> Shun replied: "Life is most valuable."
> 
> 
> 
> Yao said: "How can life be cultivated?" Shun said:
> "Investigate yin and yang." (Zhou Yimou and Xiao Zuotao
> 1989, 379; Harper 1998, 399)
> 
> 
> 




Finally, the "Drawings of Guiding and Pulling"
(*Daoyin tu* Dao Yin Tu ) is a series of forty-four
drawings of human figures performing exercises, some with captions.
Some are described in another excavated text from tomb no. 247,
Zhangjiashan Zhang Jia Shan  (Jiangling, Hubei). The
"Pulling Book" (*Yin shu* Yin Shu ) from
Zhangjiashan describes exercises that refer to or are named after
animals, including inchworms, snakes, mantises, wild ducks, owls,
tigers, chickens, bears, frogs, deer, and dragons. Both exemplify a
tradition of exercise for both therapy and health known as
*daoyin* (pulling and guiding).




The "*yang sheng* culture" of these texts
emphasized control over physiological and mental processes, both
understood as self-cultivation, through the transformation of qi.
"Self-cultivation" in this context included moral
excellence, health, and longevity (V. Lo 2001).




We can get a broader notion of what these techniques were like if we
turn to the list of titles from the "Recipes and Methods"
section of the *Han shu* Bibliographic Treatise, mentioned
above. One of the few extant texts it lists is the *Huang Di
neijing*, along with the titles of lost medical works on nurturing
life, health, and longevity. The "Classical Recipes"
(*jing fang*) section includes titles such as "Recipes for
Married Women and Infants" (*Furen ying er fang*
Fu Ren Ying Er Fang ) and "Food Prohibitions
of Shen Nong and Huang Di" (*Shen Nong Huang Di shi jin*
Shen Nong Huang Di Shi Jin ). The sexual arts
section includes "Recipes of Huang Di and the Three Sage-Kings
for Nurturing Yang" (*Huang Di san wang yang yang fang*
Huang Di San Wang Yang Yang Fang ) and
"Inner Chamber Recipes of the Three Schools for Having
Children" (*San jia nei ju you zi fang*
San Jia Nei Fang You Zi Fang ). Other
sections describe physical exercises and therapeutic techniques, such
as the "Stepping and Pulling Book of Huang Di and Other Masters"
(*Huang Di za zi bu yin*
Huang Di Za Zi Bu Yin  (*Han shu* 30,
1778-79).




Another medical text from Mawangdui is a recipe (*fang*
Fang ) manual titled *Recipes for Fifty-Two Ailments*
(*Wushier bing fang* Wu Shi Er Bing Fang ,
translated and discussed in Harper 1998). Recipe texts also have been
excavated from Zhangjiashan (Li Ling 1993 and 2000). In addition, the
Mawangdui tombs also contained hexagram divination texts and charts and
diagrams on cloud divination and physiognomy, including the oldest
known representation of a comet (Li Ling 1993).




In summary, most of these texts can be described as part of a
*yang sheng* culture, which offered and emphasized control over
physiological processes of the body and mind that were understood as
transformations of *qi*. What is the relation of these detailed
technical texts to philosophy? These technical arts form a continuum
with philosophy because their transformations were understood as
self-cultivation in the coterminous senses of moral excellence, health,
and longevity (rather than medical pathology), and physiological
transformation through the manipulation of *qi* (V. Lo
2001).




Mark Csikszentmihalyi (2004) describes them as part of an
"embodied virtue" tradition of self-cultivation practices.
They structured much of early Daoist philosophy and medical theory, and
also had profound effects on early Chinese ethics and metaphysics (V.
Lo 2005). Such "material virtue" traditions held that the
body-mind was constructed of *qi* and that embodied
self-cultivation practices could transform *qi*. These views
informed Warring States accounts of dietary practices, exercise
regimens, breath meditation, sexual cultivation techniques, and other
technical traditions associated with *fang shi*. Material virtue
traditions also had important links with Daoist texts, southern
schools, and the "moralization" of health in traditions
that culminated in the *Huang Di neijing*. Accounts of these
practices appear in passing in the texts of the received tradition.
Many more come from texts excavated from tombs.


## 3. Daoist Medical Traditions and Physicians


### 3.1 Ge Hong




Ge Hong Ge Hong  (283-343 or 363 CE, a physician and Daoist
from of the Eastern Jin (317-420 CE), was the first of several
explicitly Daoist physicians to write about the practice of
alchemy. He was the author of the *Teachings of the Master Who
Embraces Simplicity* (*Baopuzi*
Bao Pu Zi ). The *Baopuzi* consists of
seventy chapters (*pian* Pian ): twenty "Inner
Chapters" (*Baopuzi* *neipian*
Bao Pu Zi Nei Pian ) and fifty "Outer
Chapters" (*Baopuzi* *waipi**an*
Bao Pu Zi Wai Pian ). The two were
effectively different books that were not combined under one title
until a thousand years after Ge Hong's time (Sivin1969, 389. For
a partial translation of the *waipian* see Sailey 1978). Ge Hong
was also the author of the *Collected Life Stories of Immortals*
(*Shen xian zhuan* Shen Xian Chuan , trans. Campany
2002) and *Biographies of Recluses* (*Yin yi zhuan*
Yin Yi Chuan ). 




According to his autobiography (*Baopuzi waipian*, ch. 50;
Sailey 1978, 242-272; Ware (1966, 6-21), in his youth he studied the
Confucian classics, but at the same time, became interested in
quasi-medical techniques for nourishing the body with the goal of
achieving immortality. He became a student of the alchemical
master Zheng Yin Zheng Yin  (c.215-c.302 CE), and remained his
disciple for some fifteen years. After brief success, he abandoned a
military career to go to the capital at Luoyang to search for books on
immortals. After difficulties during the political unrest in the south,
Ge Hong entirely gave up political life and devoted himself to
immortality practices. In 316 he returned to the north and was
named a marquis by the Eastern Jin court and took up an administrative
post. On learning that cinnabar had been discovered in the south
(in present day North Vietnam), he secured a position as magistrate in
the south in Guangxi, where he settled at Mt. Luofu
Luo Fu  and began the study of alchemy, remaining there until
his death (Sailey 1978, 277-78; Ware 1981; Wells 2003).




Ge Hong was the first to systematically describe the history and
theory of Daoist immortality techniques such as "preserving
unity" (*shou yi* Shou Yi ), circulating energy
(*xing qi* Xing Qi ), "guiding and pulling"
(*dao yin*), and sexual longevity techniques (*fang
zhong*Fang Zhong , *Baopuzi neipian,* ch. 2; Lai
Chi-tim 1998, 203-204). But his accounts of these techniques clearly
reflect an interest in self-cultivation according to broadly Confucian
principles. For example, he considered moral self-cultivation a
precondition for the search for immortality; self-cultivation included
such Confucian virtues as benevolence (*ren*), trustworthiness
(*xin*), loyalty (*zhong*) and filiality (*xiao*).
Ge Hong criticized Daoist "pure conversation" (*qing
tan*) and emphasized the importance of both moral virtue and Daoist
study. His specifically Daoist writings emphasize the importance
of both "mystery" (*xuan* Xuan ) and
emptiness (*xu* Xu ), and all-embracing unity, which the
Daoist must actively preserve by meditation practices, techniques of
"preserving the essence" (*bao jing*
Bao Jing ) and consuming medicinal herbs (*fu yao*
Fu Yao ).




As an alchemist, Ge Hong experimented with drugs and minerals. The
"Gold Elixir" (*Jin dan* Jin Dan ) and
"Yellow and White" (*Huang bai* Huang Bai )
chapters of the *B**aopuzi* *neipian* survey the
history of alchemy and describe in detail a method for "alloying
cinnabar," quoting from ancient recipes and "cinnabar
methods." The "Immortal Herbs" (*Xian yao*
Xian Yao ) chapter gives information on medical herbs (Gao 1996,
Qing 1994, Theobald 2013).




Although Robinet (1997) insists that Ge Hong was only interested in
pharmacology as an adjunct to alchemy, the *Baopuzi* also
includes important material on medicine and pharmacology. Other
pharmacological treatises attributed to him are no longer extant:
*Prescriptions for Rescuing the Dying after the Pulse-takin*g
(*Zhou hou jiu zu Fang*
Zhou Hou Jiu Zu Fang ), *Prescriptions from the
Jade Box* (Yu Han Fang  *Yu han fang*), Herbal
Recipes from the Gold Cabinet (*Jin gui yaofang*
Jin Gui Yao Fang ), and Prescriptions for Emergencies
after Taking the Pulses (*Zhou hou bei ji fang*
Zhou Hou Bei Ji Fang ), which is said to be the
first Chinese text to mention smallpox (*tian hua bing*
Tian Hua Bing ). Thirteen texts attributed to Ge Hong are
preserved in the Daoist Canon (*Dao zang* Dao Cang ), but
most are probably later works (Robinet 1997, 78-113, Theobald
2013).




In summary, Ge Hong's writings combine interests in Confucian
ethics, Daoist self-cultivation and alchemical techniques, and the
details of medicine and pharmacology. 


### 3.2 Tao Hongjing




Tao HongjingTao Hong Jing  (456-536) was the effective
founder of Shangqing Shang Qing  (Highest Clarity) Daoism. He held
several court positions under the Liu Song and Qi dynasties. In
492 he retired to Mount Mao (Maoshan Mao Shan ), where he became
interested in the so-called Shangqing revelations to Yang Xi a
century before his time. He set himself to collect and edit
the original manuscripts connected with these revelations. The
result was the *Declarations of the Perfected* (*Zhen
gao* Zhen Gao ). When the Liang dynasty came to power
in 502, he joined the court of Emperor Wu (r. 502-549), on whom he had
considerable influence.




Tao was educated in Daoist traditions associated with the *Daode
jing, Zhuangzi,* and the works of Ge Hong; and was initiated in the
Linbao school at the age of thirty. He was also actively engaged
in mostly unsuccessful attempts to produce alchemical elixirs
(Strickman 1979, 152). 




Tao's father and grandfather were experts in medicinal drugs, and he
shared their interests in materia medica and medicine. Shortly
after compiling the *Zhen gao* he wrote a major work of
pharmacology: the *Collected Commentaries to the Canonical
Pharmacopoeia* (*Bencao jing jizhu*
Ben Cao Jing Ji Zhu ), a commentary and re-edition
of the *Shen Nong bencao*, a Han work of pharmacology attributed
to Shen Nong, the legendary inventor of materia medica. Tao
doubled the account of 365 drugs in the original and also rearranged
the material (502-557), (Predagio 2013, 968-71; Robinet 1993;
Strickman 1979).




Tao Hongjing is thus another clear case of overlapping interests
between philosophy and medicine. His interests clearly included
Daoist philosophy and practice, medicine, pharmacology and alchemy.


### 3.3 Sun Simiao




Sun Simiao Sun Si Miao  (581-682) was the author
of two major works on medical practice and a work on Daoist
longevity prescriptions. He has been worshiped as the
"Medicine Buddha," and as the "King of Medicine" (*yao
wang*). Sun is said to have taken up medicine to strengthen
his own health after childhood illnesses. He also treated
relatives and neighbors, and practiced medicine near the Tang capital
of Chang'an. He also traveled widely to learn new prescription recipes.
After completing his first book, he lived in seclusion on Mt. Wubai
(Wubai shan, later known, after him, as *Yao wang Shan*), where
he followed Daoist principles. He refused several official positions at
the Sui and Tang courts, preferring to treat ordinary people in the
countryside.




His biography (in both of the two *Standard Histories of the Tang
Dynasty*, trans. Sivin 1968, 81-144) emphasizes his interests in
philosophy, noting his particular study of the *Yi jing*,
*Daode jing*, works concerned with yin-yang theory, and *shu
shu* numerical calculations. His work reflected these
interests in *yin-yang* and *wuxing* theory and
macrocosm-microcosm correspondences between the body and cosmos. 
He is also the first Chinese physician to write extensively on medical
ethics.




Sun Simiao is the author of two major medical works.
*Prescriptions Worth a Thousand Gold* (*Qian jin fang*
Qian Jin Fang , printed in 652 CE) was a comprehensive
treatise on the practice of medicine in thirty chapters. It contained
herbal remedies and reviewed the history of medicine since the Han
Dynasty, starting with the *Huang Di neijing*.




The introduction to the *Qianjin fang* (ch. 1) describes the
characteristics of a great physician and describes inappropriate
conduct, especially the desire for wealth or reputation. 
According to Sun, a great physician should not pay attention to status,
wealth or age; he should not care whether a person is attractive, a
friend or enemy, or whether the person is (Han) Chinese or educated. He
should meet everyone on equal grounds and should always act as if he
were thinking of a
close
relative
(ch.1. For translation see Unschuld 1979, 29-33).




The *Qian jin fang* also includes chapters on diet (ch. 26),
nurturing life *(yang xing,* ch. 27), pulse diagnosis (ch. 28),
acumoxa (chs. 29-30, the combination of acupuncture and moxibustion),
massage, and exercise. His interests also included the treatment
of women (ch. 2-4) and children (ch. 5). May chapters are concerned
with herbal recipes. Sun Simiao emphasized that the effectiveness
of herbal recipes depended on correct identification and preparation,
including gathering herbs at the right time and drying them
correctly. His formulas came from both famous physicians of the
past and his own contemporaries, including minorities and foreigners.
He also edited formulas to eliminate non-essential
ingredients. 




The second book is a supplement to the first. The supplement
(*Qian jin* *yi fang* Qian Jin Yi Fang ,
printed in 682) records some thirty years of Sun's own experience with
special attention to folk remedies. It adds some eight hundred
recipes, with details on collection and preparation for two
hundred. Some are new herbs, including herbs from India. It also
refers to many mystical and magical practices, including exorcisms,
talismans, incantations and descriptions of acumoxa points effective
against demons.




Sun was also the author of several works on Daoist alchemy, which he
is believed to have practiced (he died at the age of 101). These
include the Essential Instructions from the Scripture of the Elixirs of
Great Clarity (*Taiqing Danjing Yaojue,* ca. 640), an anthology
of some thirty selected methods (Sivin 1968, 262-264). His
"Essay on Preserving and Nourishing Life" (*Sheyang
lun* She Yang Lun ) gives monthly advice on food,
sleeping habits and action of good and ill auspice (Predagio 2013,928).




In summary, Sun Simiao, like Ge Hong and Tao Honjing combines
explicit interests in Daoist philosophy, medicine, materia medica and
alchemy. These physicians were informed by the *yin-yang*
theory and cosmology of the *Yi jing* and the philosophical
concepts of the *Zhuangzi* and *Daode jing.*  But,
despite their strong philosophical interests, the major contributions
of their writings lie in the areas of medicine, pharmacology and
alchemy.


## 4. Zhang Xichun on Chinese Philosophy and Chinese Medicine




The views of the physician Zhang Xichun (1860-1933) provide an
important testimony to the complex relations between Chinese medicine
and Chinese philosophy. Zhang's life coincided with the
transition of China from the Qing dynasty to the modern era, a period
in which major Chinese intellectuals were preoccupied by questions of
the relative merits of indigenous philosophical and scientific
traditions as compared to foreign knowledge, especially of science and
medicine.




The medical context for these debates was the differences between
Chinese and Western medicine, and the best role for traditional Chinese
medicine in modern times. Zhang was a major contributor to these
debates. Zhang Xichun was trained by his father in traditional
medicine from youth, but he was also educated in the classics of
Chinese philosophy. He became a leading proponent of the
"school of converging and connecting" Chinese and Western
medicine (*hui tong xue pai*
Hui Tong Xue Pai . For the life of Zhang Xichun
see Scheid 1995, 5-6).




Zhang's book contains an essay explicitly titled "Concerning
The Relation of Philosophy and Medicine." It is so central
to the topic of this essay that it is worth quoting at length. 
Zhang begins by remarking that recent (Chinese) medical journals accuse
traditional Chinese philosophy of holding back the progress of
medicine. He responds: "their authors do not understand the
use of philosophy, nor do they understand that philosophy is actually
the basis of medicine." He quotes a passage from the Book
of Songs (Shi jing) says: "he is intelligent and wise, and
protects his own person" (*Shi jing*, "Zheng
min" Zheng Min , Mao 260). The passage refers to a
certain Zhong Shanfu Zhong Shan Fu , a virtuous minister of
King Xuan of Zhou (r. 827-782 BCE). The point is that
"protecting one's person means not only protecting oneself from
attach by thieves or robbers but also protecting one's person from
being beset by disease and illness. But, Zhang continues, the
point of the quotation is that people must possess an inherent aptitude
for intelligence and wisdom. They must also make a systematic
study of wisdom and virtue, and only then can we protect our
persons. 




He next identifies the combination of inherent aptitude and
systematic study behind "being intelligent and wise and
protecting one's own person" with what the recluse-hermits of
antiquity called "the dao of nurturing life (*yang sheng zhi
dao* Yang Sheng Zhi Dao ). In his view, the
nurturing life (*yang sheng*) practices of antiquity are what we
now call philosophy.




He goes on to argue that those who had the benevolent disposition of
a junzi and themselves understood nurturing life practices wanted to
enable others to be able to nurture their own lives. 
However, for people who do not use understanding and wisdom to protect
their persons, the way of nurturing life was not sufficient, and they
themselves could not help falling ill: "therefore they
promulgated the principles of philosophy and originated the disciplines
of medicine and pharmacology (materia medica) in order to offer
assistance to those who themselves were unable to engage in nurturing
life practices." 




He then goes on to identify specific physicians with this derivation
of medicine from philosophy, including Ge Hong, Tao Hongjing and Sun
Simiao. All these great physicians, he argues, were really
philosophers who wrote important philosophical works.




He then turns to the *Huang Di neijing*, which begins with a
chapter titled "Discourse on the True [Qi Endowed by] Heaven in
High Antiquity" (Shang Gu Tian Zhen Lun). It says:
"In highest antiquity there were true men (*zhen ren*) who
upheld [the patterns of] heaven and earth and grasped yin and yang,
exhaled and inhaled essence *qi* (*jing qi*), stood alone
and guarded their spirit (*shen*), and their muscles and flesh
were like one, and thus they were able to achieve longevity in
correspondence with heaven and earth" (*Huang Di neijing*
1, trans. after Unschuld 2011, 42).




Zhang argues that, according to the *neijing*, these realized
persons were able to use these techniques to transform their
temperament and disposition and to achieved achieve an infinite life
expectancy. He thus identifies a clear link from the realized
persons of high antiquity to the great schools of Chinese philosophy
through the methods and theories attributed to the Yellow Emperor.




His point is that, although the *neijing* is an exposition of
medicine: "it necessarily begins with philosophy and takes
philosophy as the study of how to safeguard one's person. People
must first be able themselves to protect their own persons; only then
can they represent to others how to protect their persons. Taking
philosophy as the way to protect one's person, it is by means of the
principles of philosophy that we are able to preserve our bodies by
transforming our *qi*. Taking medicine is the way to
protect other people's bodies, it is by first completely
understanding the transformation of qi in one's own person that [the
physician] is able to represent to others how to adjust the
transformation of qi in their own bodies." He concludes:
"from this we understand that philosophy is the true source of
medicine, or rather that medicine is the natural outcome of philosophy.
This is why the Neijing states explicitly that the study of medicine
must start from philosophy." How, he concludes, could
philosophy obstruct medicine? (Zhang Xichun 1918-1934, 296-98).


## 5. Conclusion




In conclusion, this brief account addresses important issues in the
connections between Chinese philosophy and the development of Chinese
medicine. Philosophical texts clearly influenced medicine in
several ways. First, both are grounded in theories of *qi,
yin-yang* and *wuxing* and microcosm-macrocosm analogies
based on them. However, as in the case of science more generally,
philosophical textualists emerged as a distinct social group from the
*fang shi*, especially. Nonetheless, we can trace
philosophical concerns in several areas of medical interest, especially
the ongoing history of "nurturing life" (*yang
sheng*) practices, first described in philosophical texts but
elaborated in great and practical detail by physicians and alchemists
such as Ge Hong, Tao Hongjing and Sun Simiao. This linkage is
made explicit by one of the greatest of China's twentieth-century
physicians and medical reformers, Zhang Xichun, who unequivocally
describes philosophy as the basis of medicine.