[More 100 Days of Arts and Sciences, featuring “Manuscripts as sources in the history of Chinese Medicine,” by Unschuld and Zheng, in Medieval Chinese Medicine.]
Two medical manuscripts dating from the Han Dynasty were found in Zhangjiashan grave number 247, in Jiangling, Hubei province, i, n 1983. These are the Maishu (脈書, Book of the Mai [vessels/channels]) and the Yinshu (引書, Pulling Book).
The Maishu was composed no later than the middle of the 2nd century BCE (there was a surge in medical development at the end of the 3rd century BCE). The Maishu consists of 6 texts, which were named by Donald Harper as follows:
Five Signs of Death
Care of the Body
Vessels and Vapour
The content is a mix of pre-medical healing techniques and the foundations for medical practice. The same connection between human physiology and natural structures is present here, especially in the Six Constituents.
The Yinshu contains a three-part text regarding macrobiotic techniques intended to pull qi (vapor) in and through the body. This is accomplished via gymnastic exercises, seasonal regimens, daily hygiene, and sexual practices.
Leo’s book is primarily concerned with the 1st century BCE-1st century CE text, Suwen(素問, Basic Questions), which is dedicated to the Yellow Emperor. The text is considered part of Chinese medical canonical thought, and was annotated and amended over the course of 500 years.
The Suwen connects human physiology with natural forms and structures, using the same word (mai) used for river systems as for circulatory systems. This is indicative of the larger framework that guided Chinese thought: “[the] human being as a par of nature means that, by means of intelligence, humanity is capable of co-operating with the productive cycle of heaven and earth” (x).
Schilling also mentions Stephen Owen’s “Reproduction in the Shijing (Classics of Poetry)” and how human fertility and reproduction were presented there as being aligned with agricultural cycles of sowing and harvesting. More pearl-growing for me!
Understanding Chinese views of human sexuality shine a much brighter light on pregnancy and obstetrics, as well as Chinese culture. For example, because sexuality and reproduction were seen as life-sustaining forces, the separation of the sexes in Chinese society was not a way to diminish sexuality but rather used to “control and guide human sexual behavior in certain ways believed to be consistent with the dualistic scheme of nature” (x).
The physical body was seen as an ancestral gift, and fertility an extension of that. There was a “deep concern” (ix) exhibited in Chinese literature for childbearing and fertility, as it was a way to honor one’s family and clan by continuing the ancestral line.
A few weeks ago, I decided to undertake the A&S Century, or 100 Days of A&S, that has been sweeping through the SCA as of late. The challenge was first proposed by Baroness Ameline of Rowany, and is similar to the armored combatant century drill (100 days, 100 blows). Except instead of hitting people/getting hit, you spend at least 10 minutes a day working on an A&S project.
Inspired by Wu daren at the Royal University of Meridies this summer, and prompted by Mistress Catelin’s challenge to research period maternity clothing, I decided to embark on a research focused A&S Century. My topic? Pregnancy and obstetrics in Early-Middle Imperial China (221 BCE – 1234 CE). This covers the Qin through the Song Dynasties, but I will likely focus more on Middle than Early Imperial China, due to available sources.
This is technically a restart, since my start a few weeks ago had gaps between research periods, and the idea of the challenge is to do it every day. So for the reboot, I moved to the interlibrary loan title that I had to give back the soonest – Medieval Chinese medicine: The Dunhuang medical manuscripts, edited by Vivienne Lo and Christopher Cullen, published by Routledge (Taylor and Francis), in 2005.
This book has 16 essays on a variety of topics pertaining to the medical manuscripts found in the Dunhuang caves. My initial plan of attack for this title was to look up “pregnancy” in the index and go to all the listed pages and see what was mentioned. Three of those four essays (at least in part) are the subject of this post. Other essays of note, which I’ll have to look at before I turn this book in, include:
“Love charms among the Dunhuang manuscripts,” by Liu Lexian
“Tiandi yinyang jiaohuang dalefu and the art of the bedchamber,” by Sumiyo Umekawa
The first essay I looked at was “Manuscripts as sources in the history of Chinese medicine,” by Paul U. Unschuld and Zheng Jingsheng, translated from German by Mitch Cohen. Pregnancy pops up in this essay in the discussion of “medication lists” (yaomu, 藥目) as a type of medical manuscript, though one that is absent from the Dunhuang collection. Unschuld and Zheng have other writings regarding such lists in the Berlin collection of manuscripts (yay pearl-growing!). Medication lists are lists of prepared medicines, usually pills but sometimes powders, salves, or boli, that were sold in pharmacies. The medications were designed for specific diseases, and the lists only name things that could be inventoried and sold. The lists are almost always well organized, either by disease/symptom or with medications numbered and indexed in a table of contents.
There are two kinds of medication lists – printed for publication and, often handwritten, confidential lists. Published lists were used to promote pharmacies by advertising what products were available, offer guarantees of success, and build trust. They sometimes listed the component ingredients to medications, but never the amounts, so as to keep recipes secret. Conversely, confidential lists were handwritten, and had to be copied meticulously since accuracy was key to the pharmacy’s success. These lists were only accessible by those working at the pharmacy, and were more often organized by the amounts of various components, preparation methods, form of medication, or preservation methods. Some items had prices for individual components, others only a price for the whole medication. Since these lists were “trade secrets,” they did not become available to collectors and other interested parties until after 1949, when private pharmacies were banned and either closed or nationalized. Most lists were comprehensive in terms of the areas of medicine they covered (internal, external, gynecology, orthopedics, pediatrics, treating smallpox, ophthalmology, ears/nose/throat) while others were specialized (gynecology, pediatrics, orthopedics).
The second essay I looked at was “From prognosis to diagnosis of illness in Tang China: Comparison of the Dunhaung manuscript P. 3390 and medical sources,” by Catherine Despeux. Manuscript P. 3390 is held by the Bibliothèque Nationale in Paris, and is digitized as part of the International Dunhuang Project.
The manuscript has two listed dates, 945 CE and 950 CE, making the reasonable compilation of the manuscript 950 CE. The fragment that describes how to examine the face to divine events and diagnose disease is missing the beginning and end. It consists of 11 illustrations of the face, captioned and annotated, and additional instructional text (columns 50-83). The diagrams of the faces are annotated to show:
the relationship between the parts of the face and the 12 earthly branches;
the relationship between the parts of the face and the 9 regions of China; and,
the relationship between the parts of the face, from top to bottom, and the 12 months of the year.
Coloring of the complexion was interpreted as a release of qi. Using these defined regions and various colors, the practioner made their prediction and/or diagnosis. Of the 80 legible signs, the majority are about auspicious or inauspicious events, such as accident, illness, death, or promotion, prosperity, and legacy. 3 are medical, and one has to do with predicting the gender of an unborn child.
The right side of the face corresponded to Yin, or the feminine, and the left to the Yang, or masculine. If the pregnant woman had yellow coloration under her right eye, she would have a girl – under the left, a boy.
Lastly, I looked at “The Dunhuang manuscripts and pharmacology in medieval China,” by Wang Shumin, translated by Christopher Cullen. Wang talks briefly about the earliest extant work on dietetics, the treatment of diseases through diet – the Shiliao Bencao (食療本草, Materia Dietetica). Meng Sheng’s 934 compilation of over 200 edible items is lost, but a fragment survived in Dunhuang, and it is quoted in later sources.
The Dunhuang fragment, housed by the British Library and digitized as part of the International Dunhuang Project, consists of 139 columns of text, with 82 entries regarding 23 medical foods. The text goes into considerable detail on the dietary needs of children and pregnant women.