Published by the Students of Johns Hopkins since 1896
August 12, 2020

Visiting doctor sheds light on ancient Chinese medical textbook

By VICTOR SUN | October 3, 2019

The Program in East Asian Studies brought doctor Paul Unschuld to campus on Tuesday to provide new perspectives on an ancient Chinese medical work, the Huangdi Neijing

During his lecture, titled “The Ancient Chinese Medical Classics: Neglected Sources, Surprising Modernity, Enigmatic Origin,” Unschuld discussed the fragmentary nature of the Huangdi Neijing and how much of the methodology it prescribes was actually ignored until centuries later. 

What animates his research, Unschuld explained, is the belief that even the most basic task of medicine — observing a patient’s symptoms — can be socially conditioned.

“All thoughts in European medical history and Chinese medical history, all basic thoughts of what is disease and how do we best prevent it or cure it or mitigate it are projections of subconscious notions of chaos [and] disorder,“ he said.

Still, Unschuld argued, the deepest mystery of the Huangdi Neijing is how unannounced it appears. There are no known records of anything like it, and then it suddenly appears in the historical record with no apparent intellectual heritage. 

“This knowledge cannot have been thought out of nothing by one man or a few people sitting around a table saying, ‘Let’s think about something new.’ This is based on decades, if not centuries of patient-physician relationship and other stimuli,“ he said. “What I’m saying is beginning with the second century BCE, there was a new approach to disease — all of a sudden, without preliminary development visible.”

But at the time the Huangdi Neijing was written, it was not taken as an authoritative work, Unschuld said. 

“Look at the transmission of these texts. They found very little acceptance among the upper class of Chinese society. Apparently very few considered them worthy of discussion, of writing more about their contents,“ he said.  

So complete was this elite disregard, Unschuld explained, that the Huangdi Neijing was thought to have been lost until it reappeared in the 19th century. Instead of appearing in a Chinese archive, however, it appeared in a Japanese one. 

The Huangdi Neijing has been left behind for so long, Unschuld argued, because it resists being coopted into the major canons.

“It’s based on an idea that neither European nor Western medicine, nor Chinese medicine, can trace its basic...concepts of disease [back to],” he said.

In fact, Unschuld said, when he attempted to release a Chinese-language reprint of the Huangdi Neijing, he was told it would be better if he simply chose not to. 

“Having read them, all of them, character after character, you get a rather different understanding of what Chinese medicine was and what traditional Chinese medicine today is, rather different from what common media or common textbooks are trying to tell you,” Unschuld said. 

He explained that the Huangdi Neijing articulated a particularly innovative concept for its time. According to Unschuld, one of the main reasons for why the Huangdi Neijing was not accepted at the time was because of its revolutionary understanding of medicine. 

“There was a new promise. You have to adhere to natural laws and this will guarantee your health. You don’t have to offer sacrifices and you don’t have to pray to your ancestors, to spirits and ghosts. No — there are natural laws,” Unschuld said. “Two thousand years ago, this was a revolutionary request.” 

Unschuld explained that traditional Chinese medical concepts were inherited from Taoism and put an emphasis on spirits and demons as the causes of diseases. He argued that these notions are still visible in parts of China today. 

“Existence is a continuous fight. Existence is an eternal circle of victory, rule, distraction and revenge, and that is the simple basis of yin and yang and the five phases,” Unschuld said. 

He argued that to understand the Huangdi Neijing, people need to understand its context. 

“You may read these texts as medical text, but you may equally read them as political text, because the “Suwen” and “Lingshu” contains as much medical information and convey as many medical concepts as they convey political context,” Unschuld said. “Here comes, under a medical cover, a very strong and straightforward political message... A human body is to be ruled like a country.” 

Unschuld thinks that the unification of China in 221 BCE had an important effect on the Huangdi Neijing

“To rule a country and body in our language requires two different terms, but in these texts even until very recently, it’s only ‘zhi.’ It emphasizes that the treatment of the body and the political order of the government follow the same value. That is the basic message of these texts,” Unschuld said. 

Unschuld went on to discuss a number of other reasons for why he believed the text was revolutionary for its time, and explained why it was neglected for a thousand years. 

Junior Mathis Leblanc said in an interview with The News-Letter that he thinks that the lecture gave him a new perspective on Chinese culture. 

“I have lived in Asia and studied a little bit of Chinese and Chinese culture, so I am familiar with some of the terms that were mentioned today, but that definitely gives me a new perspective,” Leblanc said. 

Junior Ze Ou explained that the lecture provided more insight on a topic he considers to be interesting outside of the academic context.

“I planned to read the whole text of Huangdi Neijing, but I never get to do much. But this perspective is really fun and new to me, so it is very interesting,” Ou said. “Most of the time people do go to modern medicine for help, but there are some cases that modern medicine doesn’t have a solution or cure for yet that sometimes will get referred to Chinese medicine.”

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