Huangdi Neijing

Kong, Y.C.

Published by The Chinese University of Hong Kong Press

Kong, Y.C.
Huangdi Neijing: A Synopsis with Commentaries.
The Chinese University of Hong Kong Press, 2010.
Project MUSE.muse.jhu.edu/book/24634.

For additional information about this book

https://muse.jhu.edu/book/24634

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 Introduction
A Short History of Neijing Studies and
Li Zhong-zi’s Neijing zhiyao

There is every reason to believe that the first authors of Neijing were among
the archive clerks at the service of the imperial court prior to the Qin dynasty
(221–206 bc). These clerks could gain access to the precious library, which
must have included books of medical knowledge that were later spared
destruction by the tyrannical first emperor, the Qin Shihuangdi 秦 始 皇 帝.
Many passages of Neijing can be found almost verbatim in Zuozhuan 左 傳
and other classics of pre-Qin time.1 Of all the famous pre-Qin scholars (zhuzi
baijia 諸子百家), from Laozi in the Spring and Autumn period (ca. 580 bc) to
the late Western Han dynasty when Neijing was presumably taking shape (ca.
50 bc), the present work quotes frequently Zhuangzi.2 If medical knowledge
was the prerogative of the Daoists, Zhuangzi did not fail us by providing many
allegories, parables and quotations in a medical context (yuyan 寓 言, chong-
yan 重 言, zhiyan 巵 言). It is also due to their consummate literary skills that
Zhuangzi and his school could relate the complexity of life to social ethics, the
laws of nature and the universe. Other scholars were keen to promote their
socio-political views to feudal lords in their peripatetic journeys round the
fiefdoms.3 Zhuangzi mocked Confucius for peddling his goodwill through
singing mournfully unaccompanied in spite of dire poverty.4
As a resident petty official (qiyuanli 漆 園 吏, superintendent of the
lacquer tree grove), no one other than Zhuangzi would have time to ponder
on matters of health and disease.5 Zhang Can-jia gives an exhaustive review of

1
See Zuozhuan: Year One in the reign of the Duke of Zhao, a case of Doctor He
explaining the cause of the Duke of Jin’s problem, sexual indulgence.
2
For a reference on Zhuangzi, see for example Zhong Tai 鍾 泰, Zhuangzi fawei 莊
子 發 微 (Elaborating on the Finer Points of Zhuangzi) (Shanghai: Shanghai guji
chubanshe, 2002).
3
《史 記．老 莊 申 韓 列 傳》 ：「屬 書 離 辭，指 事 類 情。」(zhu shu li ci, zhi shi lei
qing).
4
《莊子．天地》 ：「獨弦哀歌，賣聲名於天下。」(du xian ai ge, mai sheng ming
yu tian xia).
5
《莊 子．人 間 世》 ：「醫 門 多 疾。」(yi men do ji, “a doctor confronts all kinds of
diseases”).

Neijing.indb 33 2010/2/26 6:57:36 PM

 xxxiv | Introduction

pre-Neijing medical references as well as similar passages from previous

literary sources found in Suwen and Lingshu (ref. 29, Chapter 4). An in-depth
study of the medical thinking in the pre-Qin period might give some hints as
to the origin of Neijing. There were passages in Neijing that appeared verbatim
in Suwen as well as in Lingshu (e.g. on the pulse pattern of pregnancy,
malaria). If they were not from the same authors, the anonymous editors of
Neijing might have gleaned them from a pool of medical writings, guarded
jealously by individuals or schools of professionals under the oath of secrecy
(see ref. 44). Given the constraints on publication (or transcription) before the
advent of printing, only the writings of intellectuals affiliated to the imperial
court, most likely the clerks for historic archives, could have had a chance to
survive.
Chun-Yu Yi 淳 于 意 was probably the most famous ancient doctor on
record, so much so that Si-Ma Qian dedicated a biography (liezhuan 列 傳) to
him and Bianque 扁 鵲.6 While the life and medical practice of Bianque (Qin
Yue-ren 秦 越 人) might be the summation of several personalities stretching
over a period of time, Chun-Yu held the official position of superintendent of
the government granary in the Dukedom of Qi (present day Shandong prov-
ince) in the early Western Han dynasty. He learned his craft from Lord Yang
Qing (公乘陽慶) who passed on to him a number of medical classics from his
private collection. Among this list, there were several titles later quoted in
Neijing, but there was no Neijing as such. It can be fairly concluded that
Neijing as an independent medical text could not have pre-dated the Western
Han dynasty. Chun-Yu invoked the displeasure of Emperor Han Wendi in 176
bc. He also left twenty-five records of medical cases, the earliest such material
available to us. Both facts attest to the fact that Chun-Yu was a real person and
he had not read Neijing. Nor had Si-Ma Qian, before he was incarcerated in
99 bc. Neijing appeared later.
In 26 bc, the Han emperor Chengdi commissioned Liu Xiang 劉 向, a
court official, to compile a bibliography for the imperial library. As editor-in-
chief, Liu Xiang was assisted by his son Xin 歆 and a team of editors. This
result was later dovetailed into Qilüe 七 略 (The Seven Summaries) in 5 bc. As
the title implies, there were seven sections, of which the section on skills and
crafts, including medicine, was edited by Li Zhu-guo 李 柱 國, physician in
attendance at the imperial court. Qilüe was lost in the Tang dynasty but its
contents were cited in the Hanshu: Yiwenzi 漢 書．藝 文 志 (Bibliography of

6
See Si-Ma Qian, Shiji: Bianque Cang-gong liezhuan 史 記．扁 鵲 倉 公 列 傳
(Historical Record: Biography of Bianque and Cang-gong).

Neijing.indb 34 2010/2/26 6:57:37 PM

 Introduction | xxxv

Han Dynasty) by Ban Gu 班 固 (32–92), who spent over thirty years of his life
writing the first dynastic annals, Hanshu 漢 書, in Chinese history. Since Qilüe
became apocryphal, this bibliography, abbreviated to Hanzhi 漢 志, is the
earliest official bibliography extant today. It was here that the current title
Huangdi Neijing first appeared, in 18 volumes (juan 卷), as one of the seven
works of medical literature recorded. This is presumably the earliest verifiable
source of reference for Huangdi Neijing as a book. However, it is hard to prove
that the content of this Neijing was similar to what we know today.
Zhang Zhong-jing 張 仲 景 (ca. 150–219), a contemporary of Hua To 華
佗 (141–208) in the Three Kingdoms period, in his preface to Shanghanlun 傷
寒 論 (Treatise on Febrile Diseases) admonished his readers that all medical
practitioners should read ancient scriptures and consult widely various
standing prescriptions so that they would be able to perceive the cause of
diseases, even if they might not be able to cure all of them. First among the list
of references was Suwen, followed by Lingshu (written as Jiujuan 九 卷 [The
Nine Volumes]) and Nanjing 難 經 (written as Bashiyi nan 八 十 一 難 [The
Eighty-one Difficult Issues]). The three together have constituted the theoret-
ical framework of Chinese medicine ever since Zhang’s announcement.
Knowing that Shanghanlun was the first, and up to this day the most impor-
tant, single title on clinical Chinese medicine, and that Zhang Zhong-jing
valued Suwen as the primary reference for practising Chinese medicine, it is
not hard to argue for the bedrock status of Neijing and its congener titles for
the two millennia of Chinese medicine that have followed.
Tao Hong-jing 陶 弘 景 (456–536) edited and updated Shen-nong bencao
jing 神 農 本 草 經 (The Divine Ploughman’s Herbal), the prototype of a long
history of “bencaolore” (studies in medicinal plants and natural products).7 In
his elaborate preface, which might also serve as a concise treatise on pharma-
cology, he accorded Suwen the same status as Shen-nong bencao jing without
further elaboration.
Later, Sun Si-miao 孫 思 邈 (581–682) was venerated as the lord of drugs
(yaowang 藥 王, or yaoshi 藥 師, one of the three Buddhas worshipped in a
Buddhist temple) by virtue of his colossal work on drugs and prescriptions,
the Qianjinfang 千 金 方 (A Thousand Gold Prescriptions). Both Tao and Sun
were veteran adepts of Daoism and declined the offer of official positions, true
to their upbringing. Whilst Zhang Zhong-jing recommended some three
hundred prescriptions without explaining the properties of the drugs he

7
P. S. Kwan and Y. C. Kong, Bencao yanjiu rumen 本草研究入門 (An Introduction
to Bencao Study) (Hong Kong: The Chinese University Press, 1999).

Neijing.indb 35 2010/2/26 6:57:37 PM

 xxxvi | Introduction

prescribed, Sun provided information on how to use the various drugs to treat
major symptoms with a multitude of prescriptions. Tao kept to the realm of
pharmacognosy and primitive pharmacology and did not touch upon clinical
practice, while Sun also produced an appendix to his work which was closer to
the context of Tao’s specialty, pharmacognosy, indicating that he truly knew
the drugs he used or cultivated/collected.8
What is relevant to Neijing lies in the opening section of Chapter 1 in
Qianjinfang. This short section defined the curriculum for a course of study to
become a serious, or competent, doctor. It said: “All those who want to become
competent doctors must be conversant with Suwen, Jiayi Huangdi zhenjing 甲
乙黃帝針經 (i.e. Jiayi jing 甲乙經) etc. including the works of Zhang Zhong-
jing.” After quoting some disciplines in divination and similar faculties, Sun
also gave a list of collateral readings, which were necessary to complete the
education of a competent doctor. Among these he quoted a certain “Neijing”
內 經. Since the context of this work entitled “Neijing” actually involved
compassion and abnegation, it is more likely that Sun was talking about a
particular Buddhist scripture rather than the medical Neijing. This list shows
that between the time of Zhang Zhong-jing and that of Sun Si-miao, Neijing
was circulating as Suwen among congener titles like Jiujuan. Neither Zhang
nor Sun left the slightest clue as to the content and chapter titles of Suwen. We
have to leave open the possibility that there were several concurrent editions
of Suwen, which differed from each other according to their provenance and
state of integrity.
Today, it is widely accepted that different authors contributed to different
passages in Neijing at various times (from the Warring States period to the
Eastern Han dynasty, a span of 700 years). The present arrangement is the
result of much editorial work accumulated down the ages. Although some
passages discuss the same topic, they more likely than not originated from
different authors; it is not right to lump them together as if they were drawn
from the same source. Unschuld (ref. 51) and Zhang Can-jia (ref. 29) have
both given a concise view of the “layering” of the sources of the Neijing text.9
The latter concluded succinctly that Neijing “drew its original information
from pre-Qin sources, which were compiled in the Western Han and supple-
mented in the Eastern Han, with more supplements added in Tang and Song”.
The definitive edition of Neijing saw the light of day thanks to the

8
Sun Si-miao 孫 思 邈, Qianjin yifang 千 金 翼 方 (An Appendix to the Thousand
Gold Prescriptions).
9
See for example Section 8.22 on Dong Zhong-shu 董仲舒.

Neijing.indb 36 2010/2/26 6:57:37 PM

 Introduction | xxxvii

personal effort of Wang Bing 王 冰 (710–805) (refs. 6–11). Before Wang Bing,
the attempts of Quan Yuan-qi 全元起 (5th–6th century) to edit Neijing left us
only fragments. Later Yang Shang-shan 楊上善 (ca. 575–670) took the trouble
to arrange Suwen and Lingshu under different clinical categories (the first time
this had been done), but his work, the Taisu edition (太素本), was soon lost in
the early Tang dynasty. However, a copy was found in Japan, in the third year
of the Ninna reign period (887) (corresponding to the third year of the
Guangqi reign period in Tang dynasty), hidden in the Ninna monastery.
Apparently a transcript of what remained of Yang’s work, this copy, known as
the “Renhe si edition” (仁 和 本) was brought back to China a century ago and
is now widely available in its modern format (ref. 16). Where there is discrep-
ancy between the text of Neijing and that of Taisu, the latter was considered
correct by annotators due to its ancient lineage.
The most important contribution from Wang Bing, besides his editing of
the text, was that he arranged the chapter sequence for Suwen that we have
adopted unchanged today. This is the so-called “cizhu edition” ( 次 注 本,
sequenced and annotated edition). The sequence was decided by Wang Bing
when he edited the contents of Neijing to give its present structure. It is only
apparent that Wang Bing gave much careful thought to the sequence of chap-
ters (pian 篇) in order to emphasise their close relationship; the grouping of
several chapters into a volume (juan 卷) was of less didactic significance, often
decided by the length of the chapter. For example, the seven chapters on
climatic cycles added (or reconstituted) by Wang Bing were scattered between
volumes 19–22, with two apocryphal chapters in between. In his own preface
(written in 762), Wang Bing declared that he spent 12 years composing and
annotating (zhuan zhu 撰 注) this edited version so that it could be left to
perpetuity (yong zhuan bu xiu 用 傳 不 朽). Thus when Gao Bao-heng 高 保 衡
and Lin Yi 林 億 and their team of officials expanded and enriched Wang’s
version with further annotations (chong guang bu zhu 重 廣 補 注) during the
Jia-you reign period (1056–1063), they declared in their preface that Wang
Bing “annotated and put the chapters in sequence” (ci zhu 次 注). Henceforth,
Wang Bing’s unique contribution was described as “ci zhu”. This became
known as Suwen Wang zhu 素問王注 (Wang’s Annotation of Neijing Suwen).
Few alterations were made to Neijing after Wang Bing until the Northern
Song dynasty, when the imperial court established the official Bureau for
Annotation and Emendation of Medical Classics (Jiaozheng yishu ju 校 正 醫
書 局), which was then commissioned to edit Neijing and a dozen other titles.
Since this was an official assignment and the fruit of teamwork, the editors,
headed by Gao Bao-heng and Lin Yi, gingerly made a thousand amendments
but no substantial changes. This is the famous “newly emended edition”

Neijing.indb 37 2010/2/26 6:57:38 PM

 xxxviii | Introduction

(xinjiaozheng 新校正) that became the textus receptus of Suwen available to us

today (see ref. 15 for a meticulously annotated new printing). In their preface,
Gao and Lin recapitulated the landmark events in the evolution of Neijing as
outlined above.
What happened to Lingshu followed soon, albeit in a modest manner. The
definitive version of Lingshu did not appear until 1155, at the hand of Shi
Song 史 崧 from Chengdu. Many scholars are of the view that Lingshu was
actually circulating concurrently with Suwen; it was only due to its practical
nature that it was neglected by annotators until much later.
During the chaotic interregnum of the Jin-Yuan period, when China was
overrun by barbaric hordes from the north, not much had happened to the
edition of Neijing. The rapid change in disease patterns called for a new clin-
ical approach that prompted the emergence of the four great Jin-Yuan clinical
masters (all of whom used herbal medicines), headed by Liu Wan-su 劉 完 素
(ca. 1120–1200). He expanded the famous “19 items of disease mechanism”10
into a monograph entitled Suwen xuanji yuanbingshi 素 問 玄 機 原 病 式 (The
Profound Meaning of Suwen regarding Primary Disease Patterns). Another
great clinical master, this time in acupuncture, appeared later, in the four-
teenth century. His name was Hua Shou 滑壽 and his two monumental works,
Du Suwen chao 讀 素 問 鈔 (Notes on Suwen) and Nanjing benyi 難 經 本 義
(Original Meaning of Nanjing) remain desk references today.
The Ming dynasty saw a resurgence of Neijing study. Most relevant to our
concern is the publication of what is known as the “Gu edition” (顧 氏 本) of
Suwen in 1550, notably based on a rare copy dating back to the Song dynasty.
It was found in the private collection of Gu Cong-de’s 顧 從 德 father, who
served in the imperial pharmacy; he took pains to proofread it meticulously
before re-publication. This is the most ancient and authentic edition of
Neijing known to us. There are many copies deriving from this source, one
particularly worthy of note is the annotated and newly carved edition by Qian
Xi-zuo 錢 熙 祚 in 1852, the so-called “Shoushange edition” ( 守 山 閣 本)
(named after its publisher).
During the 267 years of the Qing dynasty, nearly every clinician or scholar
worth his salt wrote something on Neijing. The escape to antiquity, using
hermeneutics (xungu 訓 詁) as the principal tool of research, the so-called
“minor study” (xiaoxue 小 學), was a safe way to remain productive and
creative without provoking the ire of the Manchu rulers. If we are to cite only

10
See Section 8.1, the 19 items of disease mechanism (bing ji shi jiu tiao 病 機 十 九
條).

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 Introduction | xxxix

one example, this must be Zhang Zhi-cong 張 志 聰 (also known as Yin-an 隱

菴, ca. 1619–1674) who gathered a group of colleagues and disciples into a
seminar in a venue called Lü Shan Tang 侶 山 堂 that nestled by the beautiful
West Lake in the garden city of Hangzhou. There, they studied and annotated
Neijing among other titles and produced (in 1670) the famous Huangdi
Neijing Suwen jizhu 黃 帝 內 經 素 問 集 注 (Huangdi Neijing Suwen, Collective
Compilation of Commentaries) (refs. 12, 13); the term “jizhu” underlined the
fact that this was a collective effort. This was by far the most meticulous and
in-depth study of Neijing since Wang Bing. One of Zhang’s disciples, Gao
Shi-shi 高 世 栻 (also known as Shi-zong 士 宗, 1636–1700) found his master’s
work pedantic and unpractical. He produced a concise version called Huangdi
Suwen zhijie 黃 帝 素 問 直 解 (A Straightforward Interpretation of Huangdi
Suwen) (ref. 14); the term “zhijie”, literally “direct interpretation”, highlighted
the direct or intuitive approach to understanding the classics. However, these
two works are not mutually exclusive but complementary to each other. Before
moving on, mention should be made of the contributions of Hu Shu 胡 澍
(1825–1872) and Yu Yue 俞 樾 (1821–1907), experts in hermeneutics of their
time; their works on Neijing were short, concise and brilliant (refs. 23, 24).
This illustrates the point that up till the end of the Qing dynasty, two
millennia after the first words of Neijing were produced, there was still room
for interpretation and refinement.
The era of the Republic (from 1911) saw a new generation of Neijing
scholars. They were traditionalists with a modern mind who defended
ardently the integrity of Neijing, but at the same time, introduced new
concepts inspired by modern science and medicine. They delivered their
lectures in newly founded colleges of Chinese medicine and left us perspica-
cious and inspiring lecture notes that present day experts of Neijing study
tended to ignore. These were the expert clinicians-cum-scholars who
pioneered the teaching of Chinese medicine in educational institutions during
the early part of the last century. They were, notably, Yun Shu-jue 惲 樹 
(1875–1935), Shi Yi-ren 時 逸 人 (1896–1966), Qin Bo-wei 秦 伯 未 (1901–
1970) and Ren Ying-qiu 任 應 秋 (1914–1984); their works on Neijing can be
found in the bibliography (refs. 25–28). Contemporary scholars added minor
improvements (refs. 42, 43).

*****

Only two decades before the circulation of Neijing zhiyao 內 經 知 要 in

1642, Zhang Jie-bin 張 介 賓 (also known as Jing-yue 景 岳, 1563–1640) had
already published (in 1624) Leijing 類 經, a monumental task of re-arranging

Neijing.indb 39 2010/2/26 6:57:38 PM

 xl | Introduction

Neijing into functional categories (lei 類 , “class, category”). This was

re-working an approach to Neijing studies first introduced by Yang Shang-
shan in his Huangdi Neijing taisu 黃 帝 內 經 太 素. A modern publication of
this genre would be Liang Yun-tong 梁 運 通 (ref. 18). Li Zhong-zi must have
read the works of Zhang Jie-bin, whom he admired. Yet Li took the trouble to
prepare another hermeneutic interpretation of Neijing, i.e. Neijing zhiyao,
apparently in an effort to draw attention to this very important reference,
which is, after all, the source of all medical ideas in Chinese. Some of the
annotations by Li Zhong-zi and that of Xue Xue 薛 雪 (1681–1770),11 who
wrote the preface for the first reset edition of Neijing zhiyao in 1764, are also
incorporated into the present translation to provide a better understanding of
the excerpts. The two sources are not individually identified.
The title Neijing zhiyao was borrowed from a phrase in Lingshu Chapter 1,
in relation to the profusion of acupoints, and the same phrase appears
verbatim in Suwen Chapter 71, on the complexity of climatic cycles. It occurs
again in Suwen Chapter 74, where Qibo 岐 伯 explains the variation in pulse
patterns at the wrist in different seasons. In all three cases, the statement
emphasises the importance of grasping the essential core of Neijing, because
otherwise one would go astray in view of the profusion of information
therein.12 Neijing zhiyao lay in the shadow of Zhang Jie-bin’s Leijing when it
first appeared 18 years after the latter’s publication; it did not become popular
until Xue Xue prefaced and warmly endorsed it with a second printing in
1764, rating it superior to his own work in a similar vein.13 It was another
century before the original idea of précis-editing Neijing caught the attention
of pedagogues among the late Qing clinicians. According to the Encyclopaedia
of Chinese Medical Literature (ref. 47), there were titles with identifiable
authors like Neijing zuanyao 內 經 纂 要 (1702), Neijing jingyao 內 經 精 要 (ca.
1855), Neijing zhaiyao 內 經 摘 要 (1863), Neijing jieyao 內 經 截 要 (1875) and
Neijing cuoyao 內 經 撮 要 (1877). The effort to outdo previous publications of

11
Xue Xue (also known as Sheng-bai 生 白, 1681–1770): Eminent clinician who
treated “warm diseases” (viral infections) with great success. His contemporary
from the same city, Ye Gui 葉 桂 (also known as Tian-shi 天 士, 1667–1746) was
equally famous, but the two did not seem to get along with each other. Xue
disdained public acclaim and left few writings. Ye enjoyed fame and was a prolific
writer, leaving behind many titles, often penned by his disciples.
12
知其要者，一言而終；不知其要，流散無窮。 (zhi qi yao zhe, yi yan er zhong;
bu zhi qi yao, liu san wu qiong).
13
Xue Xue, Yijing yuanzi 醫 經 原 旨(Original Meaning of Medicine), published in
1754.

Neijing.indb 40 2010/2/26 6:57:39 PM

 Introduction | xli

this genre continued into the twentieth century with titles, authored or anony-
mous, such as tiyao 提要, gangyao 綱要, leiyao 類要, and jiyao 輯要. This does
not include similar titles with similar aims but which did not adopt the eye-
catching format of “Neijing X-yao”. In a word, even up to the present, there has
always been room to prepare a synopsis of Neijing with annotations and
commentary that would open a window into the source of inspiration for two
millennia of Chinese medicine. Qian Mu 錢 穆, a Titan of litterae humaniores
of our times, undertook the task of re-interpreting The Analects of Confucius
in his Lunyu xinjie 論語新解 (1988),14 fully aware of the multitudinous publi-
cations on this subject before him, because he believed that he could still make
some unique contribution.
Li Zhong-zi 李 中 梓 (also known as Shi-cai 士 材, “a talented scholar”,
1588–1655), scholar name Nian-er 念 莪 (in fond memory of mother), a
native of Huating (present day Songjiang near Shanghai), was a famous physi-
cian during the late Ming dynasty. He pursued a scholarly career in his youth
but disdained to climb the social ladder through taking government examina-
tions. He finally took up medicine after his son was wrongly treated by an
unqualified physician. He conducted a thorough study of the medical classics,
especially the studies of Neijing. His medical thinking was heavily influenced
by famous predecessors like Li Gao 李杲15 of the Jin dynasty and Xue Ji 薛己16

14
Qian Mu, Lunyu xinjie 論語新解 (A Re-interpretion of The Analects of Confucius)
(Taipei: Dongda tushu gongsi, 1988).
15
Li Gao (scholarly name Dong-yuan 東 垣, 1180–1251): One of the four great clin-
ical masters in the Jin-Yuan period. He was born into a wealthy family and
decided to devote himself to a medical career because his mother died as a result
of medical malpractice. He was a student of Zhang Yuan-su 張 元 素 (1151–1234),
an eminent clinician of his time but not ranked among the four great clinical
masters. Li was famous as the founder of the Digestive School (Bu tu pai 補 土 派)
in which he emphasised that digestion and absorption was of primary concern in
health conservation and disease management. He left a popular title, Piwei lun 脾
胃論 (On Stomach and Spleen).
16
Xue Ji (scholarly name Li-zhai 立 齋, ca. 1486–1558): An eminent clinician, he
succeeded his father in serving at the imperial court, and eventually became a
member of the Imperial Medical College (Taiyi yuan 太 醫 院). He was much
influenced by Li Gao and Zhang Yuan-su, head of the Yishui School of Clinicians
(Yishui xuepai 易 水 學 派) who influenced the emergence of the four great Jin-
Yuan clinical masters (vide supra) but was not counted as one of them. Besides
being the editor of many important medical classics, he also specialised in waike
外科 (topical treatment for surface ailments).

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 xlii | Introduction

and Zhang Jie-bin17 of the Ming dynasty. His clinical approach stressed the
equal importance of the functions of the spleen and the kidney, with emphasis
on reinforcing the yangqi 陽 氣 (metabolic function). He was skilful in the use
of warm tonics;18 very often he succeeded in saving the lives of extremely ill
patients, and eventually his name spread far and wide. His writings, among
them Neijing zhiyao 內 經 知 要 (Knowing the Essentials of Neijing), Yizhong
bidu 醫 宗 必 讀 (Compulsory Reading on the Principles of Medicine) and
Shi-cai sanshu 士 材 三 書 (Three Titles by Li Shi-cai), were popular titles for
those who wished to engage in the practice of medicine.19
According to Xie Guan 謝 觀,20 who devoted a special section to the
“School of Li Shi-cai” in his Zhongguo yixue yuanliu lun 中國醫學源流論 (On
the Source of Chinese Medicine) (ref. 40), recognised that Li stood out among
the late Ming scholars, none of them particularly distinguished. In his Encyclo-
paedia of Chinese Medicine, Xie Guan related another story testifying to the
expertise of Li Zhong-zi. Wang Ken-tang 王 肯 堂 (1549–1613), the most
successful doctor of his time, who had two encyclopaedic publications to his

17
Zhang Jing-yue 張 景 岳 (scholarly name Jie-bin 介 賓, 1563–1640): An unsuc-
cessful military attaché turned clinician, he was famous for his assiduous study of
Neijing that resulted in its total re-arrangement into functional categories under
the title Leijing 類 經. Zhang stressed the importance of renal (sympathetic and
hormonal) function and advocated the use of warm tonics to this end. After Wang
Bing, Lin Yi et al., he is the most important contributor to Neijing study up to this
day.
18
warm tonics: “wen” 溫 and “bu” 補 are two of the eight clinical approaches in
Chinese medicine. See ref. 53, Section 8.2.
19
Bao Lai-fa 包 來 發 et al. (eds.), Li Zhong-zi yixue quanshu 李 中 梓 醫 學 全 書
(Complete Medical Titles of Li Zhong-zi) (Beijing: Zhongguo yiyao chubanshe,
1999).
20
Xie Guan (1880–1950): An outstanding all-round scholar, including medicine, Xie
was born into the famous Menghe 孟 河 school of Chinese medicine. He started
his career as a geography teacher, but served twice as an editor at the Commercial
Press in Shanghai. During 1914–1917, he led a team of 66 editors, in compiling
the colossal Zhongguo yixue dacidian 中國醫學大辭典 (Encyclopaedia of Chinese
Medicine) in two volumes. When he wrote the preface to the publication in 1926,
he was the principal of Shanghai University of Chinese Medicine, the first institu-
tion of its kind for teaching Chinese medicine. In his brilliant career, devoted
largely to promoting Chinese medicine, his most distinguished contribution was
his daring to oppose the proposed abolition of Chinese medicine by the then
Nationalist government. He retired to a life of full time clinical practice after 1936,
and counted amongst his famous disciples Qin Bo-wei, who was the first person
to interpret Neijing zhiyao in modern times (ref. 2).

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 Introduction | xliii

name, was wrongly medicated at the age of 80. Li saved the day by using
strong laxatives in spite of Wang’s old age. Wang was greatly impressed by this
and declared that among their contemporaries, the two of them were the best.
This story is unlikely to be true because Wang died at 64 years of age when Li
was only 25 years old. Since Li was a self-taught expert, he would not dare to
tackle the senior confrère who was precariously ill at this fragile old age.
Li published dozens of works, and Neijing zhiyao was among his five most
popular titles, along with another title, Yizhong bidu; they were easy to
comprehend and helpful to beginners. But Li considered diseases of the blood
to be consumptive diseases; that might be misleading. Although not all the
titles were written by Li himself (his disciples added to his writings and cred-
ited him with authorship), the School of Li Shi-cai showed considerable schol-
arship. In another section on sphygmology, Xie Guan claimed that the 28
representative pulse patterns were first proposed by Li.21
Tamba Gen-in, in his Zhongguo yijikao 中 國 醫 籍 考 (Bibliography of
Chinese Medical Texts) (ref. 46), quoted Jiangnan tongzhi 江 南 通 志 (General
Records of the South Bank) with regard to Neijing zhiyao: “Li Zhong-zi … was
erudite since young. He practised medicine. Whenever he was confronted with
rare cases, the outcome was always instantly successful.” Other favourable
comments can be found in the Sibu zonglu yiyaobian 四部總錄醫藥編 (Medi-
cine Section of the Comprehensive Bibliography in Four Categories).22 It
might be useful to add that Li was a compassionate and considerate person, as
he explained in the opening sentence of his Yizhong bidu: “When I read the
last sentence in ‘Fang Shengshuai Lun’ 方盛衰論 (Neijing, Chapter 80, on diag-
nosis and clinical examination), I could not help admiring how deeply the
ancient medical practitioners understood the good and bad of the inmost
human nature and never lost sight of it in their practice.” This is also an unin-
tentional avowal that he frequently consulted Neijing and was guided by its
teaching. In his preface to the same title, he modestly claimed that his book
might serve as a raft to ford the river (to guide novices in medicine to a better
understanding of the subject matter). The didactic implication of Neijing
zhiyao is evident from this statement.

21
Li Zhong-zi, Zhenjia zhengyan 診家正眼 (Authentic Views in Diagnostics).
22
Ding Fu-bao 丁福保 and Zhou Qing-yun 周青雲, Sibu zonglu yiyaobian 四部總
錄 醫 藥 編 (Shangwu yinshuguan 商 務 印 書 館, 1955). This recent bibliography
complemented the medical section only in what was left out in Siku quanshu 四
庫全書 (edited 1772–1787) and its abstracts. Although this was the most compre-
hensive bibliography in history, it had also collected and then destroyed many
titles not deemed politically correct by its editors.

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 xliv | Introduction

There were many reprints of Neijing zhiyao since it caught the attention
of the public through enthusiastic promotion by Xue Xue. There were several
attempts to interpret Neijing zhiyao into colloquial Chinese but none so
important as that of Qin Bo-wei (ref. 2), and in greater detail, that of Zhang
Deng-ben (ref. 1). The present translation is mainly based on Zhang although
not in accord with every word. The arguments are presented in footnotes.
Neijing zhiyao was first published in 1642 by the son and other followers
of Li Zhong-zi in the form of Two Medical Titles from Li Shi-cai, later increased
to three titles.23 The third title Bu yisheng weilun 補頤生微論 (Supplement to
Humble Discussion on Macrobiotics) was a revised version of the first, Yisheng
weilun 頤 生 微 論 (Humble Discussion on Macrobiotics), which appeared
previously in 1618. Neijing zhiyao was much appreciated after its publication.
Zhang Lu 張 璐 (1617–1699), one of the three great masters of the early Qing
period was only 30 years his junior. In his Zhangshi yitong 張 氏 醫 通
(Comprehensive Medical Experience of Master Zhang), he quoted heavily
from Li Zhong-zi’s writings, including Neijing zhiyao. The popular edition
available today was typeset and printed by the Commercial Press in 1933
under the supervision of Xie Guan, a pioneer of Chinese medical teaching on
an institutional basis. He was the editor-in-chief of the colossal Encyclopaedia
of Chinese Medicine published in 1921 by the Commercial Press (Shanghai),
where he had for sometime been an editor. It is tantamount to the present
opus magnum with the same title Zhongyi da cidian 中 醫 大 辭 典 (Encyclo-
paedia of Chinese Medicine), published by Renmin weisheng chubanshe in
1995. This modern edition of Neijing zhiyao was typeset according to an old
edition prefaced by Xue Xue in 1764 (see for example ref. 5), who took the
trouble to reprint this book since it was out of circulation by his time. At the
time of writing, Xue was already 84. He was famous for being a critic of Ye Gui
whose professionalism was of a different kind. While Ye was a prolific author,
although not every word was penned by him personally, Xue disdained public
acclaim and declined to leave behind any writing of his own under his name.
Thus Xue’s warm appraisal of Neijing zhiyao testified much to its practical
usefulness 120 years after its first publication.
Huangdi Neijing Suwen jizhu (ref. 12) was written by Zhang Yin-an and
his colleagues in 1670; it was deemed to be the finest example of hermeneutics
relating to Neijing. In 1887, Zhong Xue-lu 仲 學 輅 wrote an epilogue which
began by stating that: “Neijing is the ladder to [scale the high ground of]

23
Li Zhong-zi, Zhengding Shi-cai sanshu 增訂士材三書 (Three Titles by Li Zhong-
zi Updated) 宏道堂梓 尤侗序 尤乘序 (1667).

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 Introduction | xlv

medicine; it is the chief of all current references. Since the Han dynasty, there
has been a plenitude of annotators of Neijing but none has seemed appro-
priate. Li Zhong-zi often made disparaging remarks about all of them.” The
Zhang Yin-an group was based in Hangzhou and Zhong Xue-lu was from the
neighbourhood. According to Zhang Yin-an, they considered themselves
nothing short of the most worthy descendants of Zhang Zhong-jing, yet they
rated Li Zhong-zi (not far away, in a Shanghai suburb) as a contemporary of
the same calibre. This is a sincere acknowledgment of Li Zhong-zi’s standing
without any professional jealousy.

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