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NAN-CHING
COMPARATIVE STUDIES OF HEALTH SYSTEMS AND
M E D I C A L CARE
General Editor
JOHN M . JANZEN
Founding Editor
CHARLES LESLIE
Editorial Board
NAN-CHING
The Classic of Difficult Issues
With commentaries by Chinese and Japanese authors
from the third through the twentieth century
U N I V E R S I T Y O F C A L I F O R N I A PRESS
Berkeley Los Angeles London
University of California Press
Berkeley and Los Angeles, California
L i b r a r y o f C o n g r e s s C a t a l o g i n g in P u b l i c a t i o n D a t a
Pien Ch'io, 5th cent. B.C.
Nan-ching—the Classic of Difficult Issues
(Comparative studies of health systems and medical
care)
Chinese text of Nan-ching with translation,
commentaries, and notes in English.
Includes index.
1. Medicine, Chinese—Early works to 1800.
2. Pien Ch'io, 5th cent. B.C. Nan-ching. I. Unschuld,
PaulU. (Paul Ulrich), 1943- . II. Title.
III. Series. [DNLM: WZ 290 P614n]
R127.1.P5413 1985 610 84-28049
ISBN 0-520-05372-9
Printed in the United States of America
1 2 3 4 5 6 7 8 9
Contents
P A R T I. PROLEGOMENA I
1. Introductory Remarks 3
2. The Historical Significance of the Nan-ching 11
3. The Contents of the Nan-ching 17
4. The Origin of the Nan-ching 29
5. The Reception of the Nan-ching in Later
Centuries 35
Notes to Part I 53
v
CONTENTS
APPENDIXES 65I
A. Survey of Commentated Nan-ching Editions
by Chinese Authors from the Third through
the Twentieth Century 653
B. Chinese Twentieth-century Essays on the
Nan-ching 662
C. Commentated Nan-ching Editions by Japanese
Authors in the Takeda and Fujikawa Libraries,
as well as Lost Titles from Past Centuries 665
viii CONTENTS
of science). One might argue that such aspirations in the West have
been fostered by an extreme sense of confidence in the perceptive
faculties of the human species; it might also be worthwhile to con-
sider whether what one might call mono-paradigmism is not somehow
linked to the Judeo-Christian emphasis on monotheism.
Traditional Chinese medicine differs from European science in
that it appears to be based on what one might call patterned knowl-
edge. Various patterns of knowledge—sometimes overlapping, some-
times antagonistic and mutually exclusive—exist side by side in the
literature and probably, in the minds of the people. There have been
Chinese authors who, for reasons about which we can only speculate,
have rejected some and accepted only a limited number of other very
specific patterns. This is true both on the level of macro-patterns (in
that some intellectuals objected to demonological knowledge while
acknowledging the paradigm of systematic correspondence) and on
the level of micro-patterns (in that some proponents of the paradigm
of systematic correspondence rejected the Five Phases concepts,
which represent one pattern of knowledge within the paradigm of
systematic correspondence, while relying solely on the yinyang doc-
trine which represents another pattern within that paradigm). In
general, however, a notion seems to have prevailed in China which
lent some justification to all patterns of human knowledge. A specific
pattern might be useful for handling a certain issue or situation suc-
cessfully, and it might be contradicted logically by another pattern of
knowledge that had also proven to be useful for handling the same (or
another) issue. Both patterns—and this seems to have been the domi-
nant attitude in Chinese history—were therefore legitimized. T h e
"either/or" approach that springs to a mind trained in the Western
tradition appears to have been posed with much less persistence in
traditional Chinese medicine. Hence authors did not find it difficult
to propose, in one and the same book, therapeutic guidelines derived
from mutually exclusive paradigms or patterns of knowledge. Such
"pragmatic" tendencies have been observed in the behavior of pa-
tients and practitioners all over the world: wherever two or more
conceptual systems of health care coexist, the population is known to
oscillate between these systems and utilize them eclectically or syn-
cretically according to its perceived needs. What appears particularly
characteristic of China is the fact that this conciliatory attitude to-
ward differing patterns of knowledge is so enormously pervasive.
8 PROLEGOMENA
centuries B.C., these texts suggest that, concurrently with the first
unification of the Chinese empire between the third and the first
centuries B.C., ancestral and demonological concepts of health care
were supplemented by—and lost their dominant position to (at least
among most members of the literate strata in society)—a conceptual
system employing nonmetaphysical notions of natural law.10 This
new medicine appears to have been developed as a consequence of the
emergence of at least two philosophical schools (with origins trace-
able to the fifth century B.C.) that introduced paradigms of systematic
correspondence to China. The doctrines they expounded were based
on the yinyang and Five Phases paradigms. The representatives of
the two doctrines opposed each other vehemently in the beginning,
and yet—in a manner typical of subsequent developments—neither
was the contradiction between the two doctrines solved in a true
synthesis, nor did one paradigm win over the other. Rather, the two
were linked (although this proved by no means an easy task). There-
after, the rise, transformation, and disappearance of any phenomenon
in the real world or in the world of concepts could be interpreted by
referring to its correspondence to the interactive dynamics of the
yinyang categories of all existence, to the interactive dynamics of the
Five Phases of all existence, or to both—whichever appeared to be
most conclusive. A Western scientist might ask (as a few Chinese
writers did): "Are there five or six basic functional systems in the
organism?" A proponent of the pattern approach characteristic of
traditional Chinese medicine might have answered: "It depends! Five
if you wish to apply the Five Phases pattern, and six if you prefer to
apply the yinyang pattern."
Throughout its history of two thousand years, the medicine of
systematic correspondence has been transformed and expanded. It
has even been linked to originally rivaling paradigms—when the Zeit-
geist allowed for such bridges. The medicine of systematic correspon-
dence has always been the subject of probing debates among in-
tellectuals and practitioners of traditional Chinese medicine; over the
centuries, there have been countless attempts to reconcile its basic
tenets with thoughts and experiences gained by physicians in actual
clinical therapy. Yet the formative period of the medicine of systema-
tic correspondence appears to have been marked by extraordinary
dynamics within a relatively short span of time—dynamics that were
PROLEGOMENA 13
influences passing through the sections are one and the same? Hence
it should be no surprise that the Nan-ching does not mention conven-
tional circuit-needling at all, but recommends, first, the needling of
"accumulation points" on the back and front of a patient where
certain undesired influences gather and can be removed. Second, the
Nan-ching outlines what we may call "extremities needling," a
scheme previously documented in the Ling-shu. In this scheme,
twelve streams (running from hands or feet to elbows or knees, re-
spectively) are conceptualized, with five (or six) holes on each. These
streams (ching H ) are associated with the basic functional units of the
organism, but they are not seen as part of a circuit. Through inserting
needles into the holes (bearing such telling names as "well,"
"brook," "rapids," "stream," and "confluence"), it is possible, ac-
cording to the Nan-ching, to influence the organism's basic functional
units in any way desired.
The Contents of the Nan-ching
C H A P T E R ONE: T H E M O V E M E N T I N T H E VESSELS
AND ITS DIAGNOSTIC SIGNIFICANCE
C H A P T E R T H R E E : T H E D E P O T S A N D T H E PALACES
Explanation of why the liver is the only depot that has two lobes.
C H A P T E R FOUR: O N I L L N E S S E S
C H A P T E R FIVE: T R A N S P O R T A T I O N H O L E S
C H A P T E R SIX: N E E D L I N G P A T T E R N S
29
30 PROLEGOMENA
development must have taken place before Chang Chi's time because
in his preface, Chang complained:
When the text of the Nan-ching quotes the text of the Nei-ching, it does
not distinguish between Su-wen and Ling-shu but says in all instances
32 PROLEGOMENA
merely "the classic states." This is sufficient evidence not only to fully
disclose the erroneous and commonly held view that the Su-wen ap-
peared first while the Ling-shu is of later origin, but also to prove that
the Nan-ching must have been written before the Nei-ching was split
into Su-wen and Ling-shu.17
It was only in the late nineteenth century that Liao P'ing, the con-
servative author of the Nan-ching ching-shih pu-cheng (see the follow-
ing section of this Introduction and appendix A), found it difficult to
34 PROLEGOMENA
link a work that he considered to be in many respects far from the truth
conveyed by the "classic" Huang-ti nei-ching with an author who had
lived in classical antiquity. T o make his point, Liao did not shrink
from manipulating the preface of his conservative but far less rigid
predecessor Hsu Ta-ch'un, whose Nan-ching commentary entitled
Nan-ching ching-shih Liao had selected as a basis for his own com-
ments. While Hsii had attributed the Nan-ching to a pre-Han origin,
Liao changed the line in his edition of Hsii's work so that Hsii ap-
peared to have suggested a Western Chin (265-317) origin of the
Nan-ching. In his own commentary to this line, Liao then refuted this
as too early and suggested an even later compilation date during the
era of the Six Dynasties (i.e., during the fifth or sixth century). 46
Earlier in these prolegomena, I have referred to the Nan-ching as a
work of the first or early second century A.D.; it may even have been
written a few decades before the first century A.D. I concur with the
opinion that the Shang-han lun was influenced by the Nan-ching, and
I agree with those commentators who saw a significant gap between
the language and the concepts used by the Nan-ching and those found
in the Nei-ching—a gap that signals development as well as differ-
ence. I am convinced (as shall be elucidated further in my notes to the
individual difficult issues) that the Nan-ching was compiled to over-
come the heterogeneity and unsystematic nature of the Huang-ti nei-
ching anthology of medical schools and concepts—and especially to
draw the conceptual and clinical consequences from the "discovery"
of the circulation of vapor-influences in the organism. In my opinion,
the Nei-ching texts on needling and diagnosis reveal a stage of develop-
ment that is not only later than that indicated by the texts unearthed
from the Ma-wang-tui tombs (168 B.C.) but also later than that in-
dicated in the biography of Shun-yii I (216-150?) in the Shih-chi
(compiled in 90 B . C . ) . Thus the Nei-ching texts cannot have been
compiled before the late second or first century B.C. (although some
parts of the Nei-ching—for instance, those on wind divination—
appear to be older, and some are much younger). 47 T h e Nan-ching,
then, could have been written after the appearance of the Nei-ching
texts on needling and vessel diagnosis, and before the appearance of
the Shang-han lun in the second century and of Huang-fu Mi's Ti
zvang shih-chi in the third century A.D.
The Reception of the Nan-ching in
Later Centuries
The message offered by the Nan-ching must have been quite convinc-
ing in at least one respect. Vessel diagnosis concentrating on the
wrists was adopted not only by many physicians (who were criticized
by Chang Chi—or by a later commentator to his preface—for an all
too simplistic practice both of diagnosis in general and of wrist diag-
nosis as well) but also by the leading pre-Sung authors of medical
works with sections on diagnosis that have been transmitted to us
from pre-Sung times. This applies—in addition to the Shang-han
lun—to the Chia-i ching 1 f1 J?;', and the Mai-ching IjlK 8? (both of the
third century A.D.), as well as to Sun Ssu-miao's Ch'ien-chin i
fang T" Ife % )i of the early seventh century.
The impact of and interest in the Nan-ching must have been con-
siderable in subsequent centuries: the Nan-ching provoked an endless
series of commentaries attempting to plumb the depths of its mes-
sage. The bibliographical section of the Sui History (compiled during
the seventh century) mentions a Huang-ti pa-shih-i nan ching and
adds the remark: "The Liang (Ch'i-lu) refers to a Huang-ti chung nan
ching, 1 ch., with a commentary by Lii Po-wang B tillS- [The work
is] lost." If the usual interpretation that this remark in the Sui His-
tory was indeed based on Juan Hsiao-hsii's i c ^ ( 4 7 9 - 5 3 6 ) Ch'i-lu
t i l is correct, one should assume that the first commentary on the
Nan-ching was published before the year 500, but did not survive (at
least as an independent work) until the early T'ang era. Yang Hsiian-
ts'ao, the second Nan-ching commentator, referred to his predecessor
as "Wu t'ai-i-ling Lii Kuang" tl lie- As Japanese scholars
have pointed out, several persons are known whose personal name
35
36 PROLEGOMENA
Lii Po was still young when he made himself a name with his medical
practice. He was an expert in the differentiation of illnesses on the basis
of vessel diagnosis. He wrote a lot about this. In the second year of
ch'ih-wu of the [dynasty] Wu he became Head of the Imperial
Physicians (t'ai-i'ling). He compiled the Yii-kuei chen ching and wrote
a commentary on the Pa-shih-i nan ching. [His works] became very
popular.
Language: English
HOMER
BY
AGNES M. CLERKE
LONDON
LONGMANS, GREEN, AND CO.
AND NEW YORK: 15 EAST 16th STREET
1892
Homeric archæology has, within the last few years, finally left the
groove of purely academic discussion to advance along the new
route laid down for it by practical methods of investigation. The
results are full of present interest, and of future promise. They
already imply a reconstruction of the Hellenic past; they vitalise the
Homeric world, bringing it into definite relations with what went
before, and with what came after, and transforming it from a
poetical creation into an historical reality. Excavations and
explorations in Greece, Egypt, and Asia Minor, have thus entirely
changed the aspect of the perennial Homeric problem, and afford
reasonable hope of providing it with a satisfactory solution.
CHAPTER PAGE