11 May

History yields to mythology in accounts of the Three Celestial Emperors, who are revered as the founders  of Chinese civilization. Fu Hsi, who is said  to  have  reigned  about   2000 B.C.E.,  is  the  legendary  founder  of China’s first dynasty.  His most important inventions  included writing, painting,  music,  the  original  eight  mystic trigrams,  and  the  yin–yang concept. The I Ching or Canon of Changes, honored  as the most ancient of Chinese books,  is ascribed to Fu Hsi.

The  invention  of the  fundamental techniques  of agriculture  and animal  husbandry are  attributed to  Shen  Nung,  the  second  Celestial Emperor.   When  the  Emperor,   who  was  also  known  as  the  Divine Peasant,  saw his people suffering from illness and poisoning,  he taught them  to  sow the  five kinds  of grain  and  he personally  investigated  a thousand herbs so that  the people would know which were therapeutic and  which were toxic. In his experiments  with poisons  and  antidotes, Shen Nung  is said to have taken  as many as seventy different  poisons in one day.  Having  collected many  remedies in the first great  treatise on  herbal  medicine  while setting  a  magnificent  example  of  unselfish devotion to medical research, Shen Nung died after an unsuccessful experiment.

During his hundred-year reign, Huang  Ti, the last of the legendary Celestial  Emperors,  gave his people  the  wheel, the  magnet,  an  astro- nomical  observatory, the calendar,  the art  of pulse measurement, and the Huang-ti Nei Ching (The Inner Canon of the Yellow Emperor), a text that  has  inspired  and  guided  Chinese  medical  thought for over 2,500 years.  Like  many  ancient  texts,  the  Nei  Ching  has  been  corrupted over the centuries by additions,  excisions, and misprints.  Scholars agree that  the existing text is very ancient,  perhaps  dating  back  to  the first century  B.C.E.,  but  the  time  of its composition   is controversial. Most historians  believe that  the text in existence today  was compiled  at the beginning  of the  T’ang Dynasty  (618–907). Other  medical  texts  have sometimes overshadowed  it, but  most of the classics of Chinese medi- cine may be considered interpretations, commentaries,  and supplements to the Yellow Emperor’s  Canon.

Although  The Inner Canon is revered as one of the oldest and most influential of the classical Chinese medical texts, studies of medical manuscripts  that  were buried  with  their  owner,  probably  during  the second  century  B.C.E.,  and  recovered  in  Mawangdui, Hunan,  in  the 1970s, have provided  new insights into early Chinese medical thought. As newly recovered texts are analyzed, scholars are beginning to illumi- nate the philosophical  foundations of Chinese medicine and the ways in which the learned  physicians of the fourth  to first centuries B.C.E.  were able to separate  themselves from  shamans  and  other  popular  healers. Physicians  apparently were still exploring  approaches to  physiology, pathology,   and  therapy  that  differed  from  those  found  in  the  Inner Canon.   Therapeutics  in  the   older   texts   included   medicinal   drugs, exorcism,  magical  and  religious  techniques,  and  surgical  operations, but  acupuncture, the major  therapeutic technique  in the Inner Canon, was not discussed in the Mawangdui manuscripts.

As  it  exists  today,  the  Nei  Ching  is a  collection  of  sometimes contradictory ideas and  interpretations forced  into  a supposedly  inte- grated  conceptual  system.  The  Inner  Canon  is cast  in  the  form  of  a dialogue  between  Huang  Ti and  Ch’i Po,  his Minister  of Health  and Healing. Together, Emperor  and Minister explore a medical philosophy based on the balance of yang and yin, the five phases (also called the five elements), and the correlations found among them and almost every conceivable  entity  impinging  on human  life, from  family and  food  to climate  and  geography.  The  terms  yin and  yang  are  generally  taken to represent  all the pairs  of opposites  that  express the dualism  of the cosmos. Thus,  whereas yin is characterized as female, dark,  cold, soft, earth,   night,   and   empty,  yang  represents   male,  light,  warm,   firm, heaven,  day,  full,  and  so  forth.  Yang  and  yin,  however,  should  be understood as ‘‘relational  concepts,’’ that  is, not  firm  or  soft  per  se, but only in comparison  to other  states or entities.

The  original  meanings  of  the  characters   for  yin  and  yang  are obscure,  but  light  and  shade  appear  to  be fundamental aspects.  The original characters  might have represented  the banks  of a river, one in the shade and the other in the sun, or the shady side and the sunny side of a hill. Applying  these  concepts  to  the  human  body,  the  outside  is relatively yang, the inside is relatively yin, and specific internal  organs are associated  with yang or yin.

Huang  Ti  taught  that  the  principle  of  yin–yang  is the  basis  of everything  in creation,  the cause of all transformations, and the origin

A History of Medicine

The five phases. As individual names or labels for the finer ramifications  of yin and yang, the five phases represent aspects in the cycle of changes. The five phases are linked by relationships of generation and destruction. Patterns  of destruction may be summarized as follows: water puts out fire; fire melts metal; a metal ax cuts wood; a wooden plow turns up the earth; an earthen dam stops the flow of water.  The cycle of generation  proceeds as water  produces the wood of trees; wood produces fire; fire creates ash, or earth; earth is the source of metals; when metals are heated, they flow like water.

of life and  death.  Yin and  yang  generate  the  five phases:  wood,  fire, earth,  metal, and water. Because the terms yang and yin are essentially untranslatable, they have been directly  adopted  into  many  languages. But the same lack of meaningful correspondence applies to the wu-hsing, a term that was usually translated as ‘‘five elements,’’ because of a false analogy with the four elements of the ancient Greeks. The Chinese term actually implies passage, transition, or phase, rather  than stable, homo- geneous chemical constituents. In recent years, scholars  have invented new  terms  such  as  ‘‘five conventional  values’’  and  ‘‘five evolutive phases’’ to convey a more precise meaning.  For  the sake of simplicity, we shall use the term ‘‘five phases.’’ Chinese philosophers and  scientists created  an elaborate  system to rationalize  the relationships  of the five phases to almost  everything  else. Thus, the sequences of creation and destruction among the five phases pro- vided a foundation for classical concepts of human  physiology.

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