The medical texts excavated from Mawangdui and Zhangjiashan have transformed our understanding of the early development of Chinese medical ideas. This talk will confront excavated material with the earliest stratum of the received textual tradition to reconstruct some crucial issues in the evolution of Chinese thinking about the human body and the processes it undergoes in health, sickness and death.
Starting from the debates about the physical possibility of living for ever that are reported in Galen's short treatise 'Peri Marasmou', this paper will explore a wider set of ideas about death and dying that are articulated in the surviving medical texts of ancient Greece and Rome.
In pre-modern societies, lacking knowledge of discovery of bacteria and viruses, it was generally believed that illness is caused by external forces that transcend human understanding. In such societies, when someone fell ill, it was deemed essential first to determine the type of being that was causing the illness in order to implement effective treatment.
In Heian (9th-12th cent.) period-Japan, mononoke were a prime example of beings that cause illness. Mononoke were ghosts or evil spirits who had been filled with resentment and the desire for vengeance at the time they separated from their physical bodies. The mononoke would then enter into the bodies of the people who were the direct object of their malice, as well as people related to them, causing physical suffering and mental anguish.
When it was determined that the cause of diseases was a mononoke, the methods of response were either kaji (mudras and invocations) or chobuku (esoteric Buddhist rites) conducted by Buddhist priests. Both sought to invoke the power of the Buddha in order to overwhelm and drive out the mononoke that had taken possession of the afflicted person.
In Heian Japan, the traditional deities or kami were also considered a potential cause of illness. In contrast with mononoke, which possess individuals and cause suffering limited to specific persons, the kami were thought to cause disasters that could involve large numbers of people, such as infectious diseases that impact an entire population. The kami that causes such diseases were often referred to as ekishin or plague gods.
Because illnesses caused by kami have their origin in sacred beings, the power of the Buddha was not invoked to overpower them. Rather, the kami in question was venerated in order to placate its anger and to entreat it to retire to some distant place.
In this way, entirely different responses were employed according to the type of being causing the illness. Thus, when a person fell ill, the services of a religious practitioner called an onmyooji were enlisted to accurately divine the cause of sickness to determine the appropriate treatment.
While mononoke were considered the principal cause of illness in the Heian period, in the preceding Nara period (8th cent.) it was the exclusively the role of the kami to cause disease and disaster. In the Nara and earlier eras, all kami would inflict tatari (curses) in this way spreading disease. Even Amaterasu Oomikami, the ancestral goddess of the Imperial Family who stood at the head of the hierarchy of kami, would on occasion inflict violent tatari, causing great suffering.
In contrast, the Heian period plague gods whose function it was to inflict tatari and cause illness were clearly distinguished from the other kami and it came to be thought that only these kami caused illness. The other kami, who no longer inflicted tatari or caused disease, were attributed a more rational character and positioned as protective deities of the state and society. With the splitting of the plague gods came the division of the Japanese pantheon into good and evil kami: those who cause prosperity and those who bring disaster.
The change in the conceptualization of kami that occurred in the Heian period demonstrates the need to clarify concretely the transfiguration of the kami over different historical periods. This effort represents a fundamental challenge to traditional research that at times has treated the kami as era-transcending form of religiosity unique to Japan and ahistorically bound up with the Japanese national identity and character.
"Nourishing life" (yangsheng 養生), a method of keeping healthy distinctive of China, developed its theoretical aspects during the five hundred or so years from the Warring States period to the late Han, incorporating as it did so the widespread desire to "become an immortal" (dengxian 登仙). Thereafter, as the safety of practices for "nourishing life" gradually improved, it became popular among Chinese literati as a routine method for keeping healthy, and it caught on in a big way in the second half of the Ming dynasty, especially during the Wanli 萬暦 era. This popularity was heightened on account of the desire to become an immortal that permeated much of literati society in Jiangnan at this time.
Around Wanli 10 (1582) there spread among the literati of Jiangnan a prophecy referred to as longsha babai 龍沙八百. According to this prophecy, a total of eight hundred immortals would appear by Wanli 41 (1613) at the latest, and many contemporary literati supported this prophecy with the expectation that they themselves would be included among these immortals. There was, moreover, proof to back up their belief in the trustworthiness of the prophecy, for in Wanli 8 (1580) Tanyang 曇陽, the second daughter of Wang Xijue 王錫爵, died in an unusual manner recognized as that in which immortals die. She had also worked many miracles while alive, and as a result several hundred contemporary prominent figures, including Wang Shizhen 王世貞 and Tu Long 屠隆, revered her as an object of worship. After her death she appeared in dreams to Wang Shizhen and other disciples and promised that those who continued to perform practices for reducing their desires would become immortals in five years' time.
In conjunction with the spread of the cult surrounding Tanyang, there was an increasing tendency among literati in Jiangnan to look upon practices for maintaining physical and mental health as a precondition for becoming an immortal on the basis of the longsha babai prophecy. Tu Long was not only a fervent practitioner, but also a thinker who reflected on the content of his practice. In the course of his practice he was confronted with the difficulty of eradicating the roots of desire, and on the basis of this experience he reached the conclusion that in order to attain sudden, or supratemporal, enlightenment (dunwu 頓悟), even someone with the most outstanding natural qualities needed to engage in gradual cultivation (jianxiu 漸修). But he also considered it necessary to have repeated experiences of awakening (jiewu 解悟) during the course of this gradual cultivation. The term jiewu refers to the supratemporal awakening experienced momentarily by someone engaged in gradual cultivation, and at the same time it also signifies the motive force that awakens the practitioner to his own shortcomings and drives him on to further practice.
The actual content of gradual cultivation as understood by Tu Long may be summarized in terms of the practice of inner alchemy (neidan 内丹). However, he also considered that such cultivation had no effect unless the consciousness seeking to objectify external objects was eradicated at each stage of practice. But he realized that, in order to engage in gradual cultivation, it was also necessary to rely, if only provisionally, on one's physical body. While aspiring to transcendence of not only his body, but all objects, he also recognized that in reality this was a state that could be reached only after a long period of practice, and for this reason he also paid attention to daily methods of "nourishing life" in order to keep the physical functions in optimum condition.
But it is also a fact that Tu Long and many other literati at this time had a strong expectation that they would become immortals. Although this expectation and the experience of jiewu could lead to self-contradiction, those possessed by the desire to become immortals were convinced that the practice of "nourishing life" was the sole precondition for becoming an immortal. And on the one hand they became avid readers of books on "nourishing life" that were being published one after another during this period, while on the other they became the driving force behind the popularity of "nourishing life."
There are more than ten portraits of Hippocrates extant, and doctors of Western-style medicine appreciated them by putting up the scrolls in the room. Why did they choose specifically Hippocrates? We may count the two reasons:
(1) Custom. Doctors of Chinese-style medicine (so-called kanpo 漢方）had customarily put up portraits of Chinese god of medicine, i.e. shen nong （神農）on the winter solstice or the first day of the year. Some put up the scrolls of Japanese god of medicine, i.e. sukuna-hikona-no-kami （少彦名神）, instead. To identify their specialty in medicine of Western style, doctors of Western-style medicine adopted this custom by deliberately choosing the portrait of the great "teacher" of Western medicine.
(2) Idea. Although the original portrait has been lost, the inscription by Ohtsuki Gentaku （大槻玄沢, 1757-1827) in the oldest portrait says, "the characteristics of a human body is that it has a natural excellent way....A human body, once in sickness, has an action ready to heal by itself. This shows that a human body is a good medical doctor." Gentaku's inscription apparently refers to Hippocratean idea of vis medicatrix naturae. The idea of natural healing was transmitted to Edo Japan through Dutch sources such as H. Boerhaave's Aphorisms (1709) and L. Heister's Practical Handbook of Medicine (1761). Natural healing power came to be, thus, translated as "shizen ryono （自然良能）lit. the good capability of nature." The idea of shizen ryono appealed to the minds of doctors of Western-style medicine to such an extent that Sugita Genpaku (1733-1817), a great pioneer in the introduction of Western medicine, wrote a dictum "Nothing is better than nature in medicine" in the last year of his life.