During the Tang dynasty in the mid 8th century, a military leader named Li Baozhen was frustrated with his aging body. He had achieved much military glory and material wealth in his life, but he was aging and facing the fact that death was approaching. But he had also had dreams that he was riding triumphantly through the sky on a crane. Surely this was an omen! At the same time, Li Baozhen met Sun Jichang, who was a fangshi – a word that can be translated as alchemist, wizard, magician, and also doctor or physician. Sun Jichang offered Li Baozhen a concoction that he promised would allow him to “transcend” death. Inspired by his dreams of slipping away from earth on the back of a crane, Li Baozhen took the elixir – only to become incredibly sick. Li Baozhen’s experience captures something of the complexity of Chinese medicine: competing ideas of how to heal, the use of various powerful medicines in careful (and not so careful) doses, the intermingling of spiritual and medicial philosophies, and the quest for health and power, even immortality. For this installment in our series on the five C’s of historical thinking, we’re contemplating the historical concept of complexity through an exploration of Chinese medicine.

Transcript for Chinese Medicine: The Complex Balance of Individual, State, and Cosmos

Written and researched by Sarah Handley-Cousins, PhD

Recorded by Sarah Handley-Cousins, PhD and Elizabeth Garner Masarik, PhD

Sarah: During the Tang dynasty in the mid 8th century, a military leader named Li Baozhen was frustrated with his aging body. He had achieved much military glory and material wealth in his life, but he was aging and facing the fact that death was approaching. But he had also had dreams that he was riding triumphantly through the sky on a crane. Surely this was an omen! At the same time, Li Baozhen met Sun Jichang, who was a fangshi – a word that can be translated as alchemist, wizard, magician, and also doctor or physician. Sun Jichang offered Li Baozhen a concoction that he promised would allow him to “transcend” death.

Elizabeth: Inspired by his dreams of slipping away from earth on the back of a crane, Li Baozhen took the elixir – only to become incredibly sick. Another doctor, this one a Taoist practitioner, attended to Li Baozhen and brought him back to health. But when Li Baozhen met Sun Jichang again, the fangshi asked why he had given up and gotten help from another doctor – after all, he assured him, Li Baozhen was so close to transcendence! Reassured, Li Baozhen took even more of the elixir, but this time, when he sickened and slipped into unconsciousness, he did not send for another healer – he died.[1]

Sarah: Li Baozhen’s experience captures something of the complexity of Chinese medicine: competing ideas of how to heal, the use of various powerful medicines in careful (and not so careful) doses, the intermingling of spiritual and medicial philosophies, and the quest for health and power, even immortality.

For this installment in our series on the five C’s of historical thinking, we’re contemplating the historical concept of complexity through an exploration of Chinese medicine. Chinese medicine is a vast subject, and there’s only so much we can cover in one little podcast episode, so think of this as a little introduction, rather than a thorough excavation, of the topic. But I think you’ll find that it’s about as complex as it gets.

I’m Sarah

And I’m Elizabeth

And we are your historians for this episode of DIG

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Sarah: Complexity can be deceptively simple as a historical thinking skill – it means things are complicated, right? But for many folks, I think complexity is actually scary, because thinking with complexity means accepting that things are not necessarily as clean, straightforward, and often, praise-worthy as we might like. Complexity requires that we let go of certain simplistic, and comfortable, narratives that we might very attached to. I love the way that historians Thomas Andrews and Flannery Burke begin their description of complexity: “Re-enacting battles and remembering names and dates require effort but not necessarily analytical rigor. Making sens of a messy world that we cannot know directly, in contrast, is more confounding but also more rewarding.” 

Elizabeth: Chinese medicine is a good way to think about complexity because it was never one, easily definable thing. As Vivienne Lo and Michael Stanley-Baker argue, “From a discussion of its mythic origins, through the coalescence of many theories about astro-physiology in early China to the medieval heyday of religious healing pluralism, it charts the changing emphases in what was always a plural healing environment. Indeed, the ethnic and cultural boundaries of China itself are contested.”[2]

Sarah: Let’s start at the beginning. As Elizabeth just read in that quote, Chinese medicine has mythic origins. In 221 BCE, the Qin dynasty, under the military might of Qinshi Haungdi, first unified a number of warring feudal kingdoms into one imperial entity which eventually would come to be called China. After Qinshi Huangdi’s death, the Han dynasty came to power. While they benefited from the Qin dynasty’s tough control over those feudal kingdoms, they also wanted to create for themselves a new identity, one that was distanced from the powerful and unpopular Qinshi Huangdi. Part of that process was creating a mythic history that told of a long-ago golden age after which the Han had modeled itself, thus linking their power to something grander, more ancient, and more authentic.

Elizabeth: According to the mythology, earth was a chaotic place until the five Sage Emperors arrived, domesticated it. The five emperors corresponded to the five directions: north, south, east , west, and center. The Yellow Emperor and Red Emperor, who was also known as the Divine Farmer, were also associated with medicine and healing. While both were important in the foundations of Chinese medicine, the Divine Farmer played a particular role in establishing the importance of experimentation and data collection in the healing tradition. The Divine Farmer raised humans from being savage and uncivilized by teaching them agriculture. Further, through careful study and trial and error, the Divine Farmer classified all the plants, determining by tasting them which ones were safe, which were healing, and which were poisons.

A woodcut of the Yellow Emperor | Public Domain / Wikimedia Commons

Sarah: The Yellow Emperor, on the other hand, looked to the sky for understanding of health and healing. He identified the ways that the human body relates to cosmic powers, cycles, and calendars. Health was associated with numerical codes, and thus his knowledge, recorded in a text called the Daybook, includes divinations that guided the most healthful  times for human activity.

Elizabeth: China’s empire was bureaucratic, filled with educated civil servants who created vast written records of every aspect of the empire. Similarly, to be a physician in China required mastery of previously written medical texts. Because of all this, Chinese medicine has always been textual, meaning that knowledge has been passed through written records, such as The Divine Farmer’s materia medica or the Yellow Emperor’s Daybook. (A materia medica is a compendium of therapeutic properties of pharmaceutical substances.) Several texts, all credited to the Yellow Emperor, make up the ‘canon’ of Chinese medicine (to quote Lo and Stanley-Baker) “the human body as a microcosm, the origins of disease, and some therapies, principally acupuncture and moxibustion and a few drug treatements.” There’s debate about when the text was first written, but there is consensus that it originated in the Han Dynasty, which stretched from 202 BCE to 9 CE though the earliest text that scholars have been able to find came from printed in the 12th century CE.

(Moxibustion is a traditional healing practice similar to acupuncture, except instead of piercing the skin with a needle, you place a pile or little ball of mugwort leaves on particular spots on the body and burn them like incense, heating the point rather than poking it.)

Sarah: The Yellow Emperor’s Canon of Medicine (sometimes translated as the Yellow Emperon’s classic of medicine) is very similar to an ancient Greek philosophy text because it’s presented in the form of a dialogue between Huang Di (the Yellow Emperor) and his learned minsters, including his physician, Qi Bo. Through their conversations, Huang Di learns about the universe, the workings of the human body, and the art of healing. In the first discourse, Haung Di asks his ministers, “I’ve head that in the days of old everyone lived one hundred years without showing the usual signs of aging. In our time, however, people age prematurely, living only fifty years. Is this due to a change in the environment, or is it because people have lost the correct way of life?”

Elizabeth: Qi Bo responded: “In the past, people practiced the Tao, the Way of Life. They understood the principle of balance, of yin and yang, as represented by the transformation of the energies in the universe. Thus, they formulated practices such as Dao-in, an exercise combining stretching, massaging, and breathing to promote energy flow, and medication to help maintain and harmonize themselves with the universe. They ate a balanced diet at regular times, arose and retired at regular hours, avoided overstressing their bodies and minds, and refrained from overindulgence of all kinds. They maintained well-being of body and mind; thus it is not surprising that they lived over one hundred years.” Qi Bo then goes on to explain that by “seeking emotional excitement and momentary pleasures,” which disregards the natural rhythm and order of the universe. Because of this, they age prematurely and die younger than their ancestors.[3] This discourse gives us an introduction to the “universal truth” of health within Chinese medical theory: living in moderation and in balance with the universe.

Sarah: The Yellow Emperor’s Canon also describes qi, the fundamental stuff of all life in the universe. Qi moves around and through the body, analogous to how many Western cultures think about energy. When moving through the body, qi moved through mo or mai, which means something like ‘channels,’ ‘vessels,’ or ‘pulse.’[4] These channels traveled along throughout the body. If you’ve ever seen an acupuncture chart, you likely have an idea of what we mean. Imagine lines that run from the top of your head to your toes, then several additional lines that go around your body such as at your waist. Each meridian is associated with an organ – the lung meridian, the heart meridian, kidney meridian, etc. Along these meridians, there are “points,” which correspond to to certain disorders, areas of pain, or aspects of health. By piercing those points with very thin, fine needles, practitioners could manipulate or unblock the qi to bring about pain relief or healing. For instance, by piercing Stomach Meridian 36, which is located just below the knee on the shin, you can treat digestive disorders, immune deficiency, fatigue, and may also experience emotional grounding. Liver Meridian 3, which is on the top of the foot between the first and second toes, treats headaches, regulates menstruation, and reduces high blod pressure. The Yellow Emperor’s Canon described ways to read the pulse of the qi, which surfaced on certain points of the body, in order to make a diagnosis.

Prod 2: Along with the concept of qi, the Yellow Emperor’s Canon described the body a microcosm of the universe’s macrocosm. (You’ll notice lots of associations between things here, like elements, energies, seasons, etc – we’ll explain that in more depth soon.) Haung Di explained this concept this way: “In nature, we have the four seasons and the five energetic transformations of wood, fire, earth, metal, and water. Their changes and transformations produce cold, summer heat, dampness, dryness, and wind. The weather, in turn, affects every living creature in the natural world and forms the foundation for birth, growth, maturation, and death. In the human body, there are the zang organs of the liver, heart, spleen, lung, and kidneys. The qi of the five zang organs forms the five spirits and gives rise to the five emotions. The spirit of the heart is known as the shen, which rules mental and creative functions. The spirit of the liver, the hun, rules the nervous system and gives rise to extrasensory perception. The spirit of the spleen, of yi, rules logic and reasoning power The spirit of the lungs, or po, rules the animalistic instincts, physical strength and stamina. The spirit of the kidneys, the zhi, rules the will, drive, ambition, and survival instinct.”[5]

Sarah: He went on to explain that any “overindulgence” in emotions – say, getting really angry or depressed, creates imbalances, which damages the body’s qi. Huang Di wrote: “Failing to regulate one’s emotions can be likened to summer and winter failing to regulate each other, threatening life itself.” In the exact same way, if there were imbalances in weather or nature, there could be outbreaks of disease. To quote Huang Di again, “If there is a cold invasion in the winter, febrile disease will develop in the spring. An invasion by wind in the spring can result in digestive disturbances, food retention, and diarrhea in the summer. If there is an attack of summer heat during the summer, in the autumn there may be malaria. If dampness invades in the autumn, there will be coughing attacks in the winter.”[6] The health and functioning of the body and the world around it were interconnected. For instance, Huang Di explains that in the spring, as the weather becomes warmer and the plants begin to grow, putting forth unripe, sour fruit. This sourness strengthens the liver, which in turn nourishes the tendons. We’re going to quote here, because Huang Di’s summary really captures just how ~complex~ the theoretical basis of Chinese medicine was:

Elizabeth: “During the spring the subtlety and vastness of the universe, the intelligence and intuition of the human being, the ability of the earth to produce ten thousand things, the natural movement of the wind, and the upward motion of all plants, collectively produce the movement of the tendons, the color green, the shouting of voice, the spasms and convulsions, the eyes, the sour taste, and the angry emotions. These are all associated with the liver, since the liver is responsible for maintaining the patency of the flow of energy, and its nature is movement and expansion.”

Sarah: The Yellow Emperor’s Canon (or Classic, depending on how you’re feeling) really shows how intricate Chinese medicine is: health and illness weren’t individual, but tied to the season, the climate, certain colors and flavors, particular behaviors and emotions, and even the subtlety of the universe. That quote suggests the existence of two concepts central to Chinese theories of health and medicine. The first is the concept of the yin and yang. Unlike qi, the yin and yang aren’t forces or even substances, but instead referred to, in the words of Vivienne Lo and Michael Stanley-Baker, “relational categories that organize …‘myriad things’ in ‘complementary opposition.’”[7] Yin and yang were often opposites that go together, such as back/frton, inner/outer, or day/night. According to Huang Dis dialogue with Qi Bo, yin and yang is the carefully balanced interconnection of everything: “Heaven and earth, the masculine and the feminine principles, the qi and the blood, all reflect the interplay of yin and yang. Water has the property of coldness, fire the property of heat. The interdependence of yin and yang is reflected in all things in the universe and cannot be separated.”[8]

Elizabeth: When Huang Di asked how this applied to healing, Qi Bo replied by explaining how when those careful balances was disrupted, it affected the health. If there was too much yang qi, you could develop a “fever, rapid breathing, tremors, shaking, dry throat and mouth, irritability, and abdominal distension.” With an excess of yin qi, you would “feel cold,” with “clammy sweating, shivering, and convulsive spasms of the hands and feet.”  As people aged, their yin naturally decreased, leading to vision and hearing deterioration, organs losing function. The yin and yang worked in conjunction with the wuxing, translated as the Five Agents or Five Phases. (We’ll refer to them here as the Five Agents.) The Five Agents is a theory of interconnecting groupings of five important ‘agents.’ There were five major planets – in English, Jupiter, Saturn, Mercury, Mars, Venus which each ruled a certain force. Each of the five is also associated with a series of other things – elements, colors, tastes, seasons, directions, days of the week, etc.

Sarah: Take for example the Wood element. First, it’s important to note that it’s overly simplistic to think of the Wood element as just being like, a log or a chunk of wood. Instead, it referred more to the spirit or essence of wood. Wood evoked strength and flexibility, like a bamboo plant. Wood also evoked the springtime, new growth, sensuality and fertility. Each element of the wuxing had a list of things that is possessed or evoked – each was associated with one of the five zang organs that we mentioned above. Wood, for instance, was associated with the zang organ, the liver, and with the fu organ, the gallbladder, as well as with the eyes and tendons. (Zang organs were considered yin, and fu were associated with the yang.) The element was also associated with a body fluid – in the case of wood, it was associated with tears – as well as a finger – in this case, the index or pointer finger. Wood was also associated with the virtue of benevolence, the emotions of anger and kindness, sour flavor and  rancid smells, and the childhood phase of life. In contrast, Water was associated with the planet Mercury, the kidneys, bladder, ears, bones, and pinky finger. It was also understood as connected to wisdom, resourcefulness, salty flavors, putrid scents, and both old age and conception, and the winter months.

Elizabeth: The wuxing wasn’t just a list of five different things with different traits, but an interconnecting cycle where each one of the elements or networks leaned on, produced, controlled, and contributed each other. Water creates wood, and destroys fire; Wood creates Fire and destroys Earth. This is an example of how Qi Bo describes this interconnection. In this passage, he is describing the causes of a particular kind of ailment. “There is also a pattern of disease we can call the abnormal transmission of pathogenic qi. This specifically refers to cases of excess. In this abnormal sequence, the disease that is manifesting in its host organ was transmitted from the son of fire, the spleen, or earth. Now that the heart is excess, it transfer its pathogenic qi to the element that it controls, metal, or lungs. Once the lungs are pathogenic, their qi is transmitted to the element that metal controls, which is wood, or live. Because the element that wood controls, the earth, is already excess, the wood then insults its mother, the war, or the kidneys. When the sequence reaches this point, where all five zang organs have been affected, death is imminent.”[9]

Sarah: These interconnections were not just limited to the human body. Han physicians and philosophers understood the microcosmic body as not just connected to the universe, but also to the political state. Imperial rulers wanted their rule to be a kind of qi – pervading the very universe, even the internal workings of the bodies of their subjects. Living correctly, honoring one’s ancestors and performing rituals according to prescribed strictures all ensured a ordered society as well as the approval of the gods. Civil unrest, on the other hand, signalled that the gods were unhappy.

Elizabeth: Because of this, the medical theory and philosophy outlined in the Yellow Emperor’s Canon appeared also in political treatises. The Lüshi chunqiu, a text from 239 BC that meditates on politics and society, contains strictures for leaders to follow in order to stay in balance with the universe – according to the text, the emperor had to carefully adhere to the calendar and cosmos when choosing what to eat, wear, and where to live. The yin and yang could also describe properly balanced political relationships, such as noble/lowly and controlling/being controlled, justifying and reinforcing the roles of, for instance, emperor and subject.

Sarah: So far, we’ve described the Chinese theory or philosophy of medicine, but haven’t really discussed practitioners or forms of healing. Because medicine was interconnected with overarching philosophies of life, most of the healers that Chinese people might seek out were also religious authorities. The wu were akin to shamans or mediums, both men and women, who performed rituals including dances, songs, and prayers that promised to rid sufferers of illness and banish harmful spirits. Cults sometimes arose around these religious healers, such as the Yellow Turbans, followers of a mystic named Zhang Jue which eventually led a rebellion in 184 CE against the leadership of the Han dynasty. The Yellow Turbans gained followers by promising them healing, using incantations and burning talismans. Their sacred text, known in English as the Canon of Heavenly Peace, added to existing theories of medicine and cosmology with instructions for healthy meditations, breath exercises, as well as guidelines for diet and the use of medicines and talismans.

A Ming Dynasty era acupuncture model | Public Domain / Wikimedia Commons

Elizabeth: Perhaps the largest religious connection to this theory of medicine was Taoism – also sometimes pronounced with a D (Daoism). Taoism is a religion and philosophy that emphasizes living in harmony with the natural flow of the Tao, or the natural order of the universe. Through  right living, meditation and meditative practices such as tai chi and qigong, Taoists cultivate ad harmonize their qi, which can provide bodily health but also societal health.  During the Han Dynasty, a religious cult known as the Way of the Celestial Masters developed, which also placed health and medicine at its core. The Celestial Masters taught that disease was a punishment for one’s sins, and could be cured by confessing and begging forgiveness from the “Celestial Bureaucracy,” a term for myriad, powerful cosmic deities. In order to follow through on their atonement, Taoists were required to do public works such as building roads or feeding the poor.[10] A later Taoist movement, under the leadership of Tao Hongjing, wrote an extensive pharmaceutical canon.

Sarah: As China interacted more with other cultures, facilitated by the trade route known as a the Silk Road, Daoism was influenced by the introduction of Buddhism. Buddhism introduced new elements, such as the immortality of the soul through meditation and prayer. But overall, Buddhism was similar enough that it was easily adopted by many Chinese people, incorporated into Daoist and Chinese philosophy, with the Buddha being easily slotted into Chinese celestial bureaucracy. Soon, Buddhist monasteries became centers for social support, including places for medical care and healing. Just as the Yellow Turbans, Buddhists were able to leverage healh as a tool for winning converts. This wasn’t without controversy – during the Tang dynasty, the emperor Wuzong cracked down on the monasteries and closed them, seizing their assets and taking over their hospitals. But the monasteries weren’t entirely eradicated, and continued to be important part of Chinese healing networks. Most importantly, the Buddhist monasteries were critical in the process of recording theories of Chinese medicine, as monks copied manuscripts to be sent to their brethren in more rural areas along the Silk Road.

Elizabeth: The Tang dynasty was also marked by the ascendancy of medical alchemy. Alchemy was part of the Taoist tradition in that it was, according to Lo and Stanley-Baker, “an attempt to understand and master the workings of the cosmos by studying its physical nature.”[11]In simple terms, we think of alchemy as an early kind of chemistry that was focused on trying to turn various base materials into gold. But in both Eastern and Western traditions, alchemy also involved the quest to create potions and elixirs that would result in immortality. Within Chinese alchemical traditions, the practice of waidan, or external alchemy, the quest to “understand and master” the universe resulted in a quest to also master death by creating an elixir of immortality by creating concoctions with minerals, metals, and other substances through processes of heating and cooling. While alchemy in China can be traced back into the Han dynasty, its “golden age” was the Tang dynasty, when Taoist scholar and alchemist Tao Hongjing produced a number of texts that were supposedly dictated by various Taoist deities. These texts described immortality elixirs, largely made up of substances like cinnabar, mercury, lead, and arsenic. Elixirs might offer immortality, or they might also bring the consumer into an elevated state of enlightenment, perhaps even closer to the divine. While these highly toxic substances could be toxic or even fatal – and often did result in the deaths of those who took them – they might also produce hallucinations and “ecstatic visions,” reinforcing the belief that poisons could also be powerful medicines and elixirs. During the Tang dynasty, no fewer than four emperors are believed by scholars to have died by poisoning in their pursuit of enlightenment and immortality: Xianzong in 820, Muzong in 824, Wuzong in 846, and Xuanzong in 859.

Chinese woodcut: Alchemical refining furnace Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk

Elizabeth: Medicine became even more of a political issue during the Song Dynasty, between 960 and 1127. The Song was beset by a series of epidemics. It’s hard to say exactly what these epidemics were, or even quite how many of them there were. One scholar argued there were 33 epidemics during this era, but another could only identify 21. Part of the problem with identifying these epidemics has to do with language and culture. What qualifies as an epidemic, especially when different cultures understand disease differently? The terms used to refer to epidemics in Chinese sources vary widely – yi, which means “a situation where all people are sick,” or li, which could mean an “evil disease” or “pestilence.” When combined with the word qi, it might refer to a particular disease-causing element, such as pathogens or evil spirits. According to According to scholar Asaf Goldschmidt, “to survey epidemics in the general sense, without dealing with either specific diseases or notions of pathology, the best terms to look for are yi and wen, or their combination, wenyi. These terms also appear with modifiers, such as “disease epidemic” (jiyi), “hunger epidemic, (jiyi), “great epidemic,” (dayi), “seasonal epidemic” (shiyi). These are the more general terms, denoting either large-sacale epidemics, or epidemics that were perceived as disastrous even if in reality they did not impact a large region of claim numerous lives.”[12]

Sarah: Either way, because of recurring outbreaks of disease, the Song Dynasty placed emphasis on medical research, sponsoring the writing of new medical texts , the establishment of the first Imperial Medical School, and setting in place a formal process for medical education. The Song also sponsored a massive push to identify and catalog herbs and other healing materials to create new compendiums of medicines. One result of all of this was the emergence of a new category of medical practitioner, the run yi, a scholarly elite group of scholarly physicians. In 1057, the Song established the Bureau for the Editing of Medical Texts, which was in charge of evaluating and publishing medical treatises. The Bureau, following their mission set by Emperor Renzong, was responsible for locating, editing, and revising medical texts that were located in archives around the empire, then duplicate and distribute them for use around the empire. The Bureau was staffed with elite physicians, along with bureaucrats with no medical background. During its 12 year existence, the Bureau published ten books – nine were revisions of preexisting medical texts and one new text, the Illustrated Materia Medica, which was drawn from that massive survey of medicines.[13] While the Bureau officially stopped its work in 1069, printing of the medical texts it developed and revised continued for decades.

Elizabeth: In the following dynasties – the Southern Song (1125-1275), the Jin (1127-1235) and Yuan (1279-1368) – the government took further efforts to protect public health and use new technologies to disseminate medical knowledge. The Southern Song was especially concerned with public health, which resulted in a clash between the traditional and the scholarly forms of healing. Southern Song officials found that the wu (those shamanic healers) were dominating care, and cracked down on their ability to practice, destroying their altars, requiring them to study approved medical texts, and sometimes forcing them to abandon practice altogether. During the Jin and Yuan dynasties, printing technologies revolutionized the ability to print and spread approved scholarly medical theories.

Sarah: In the 18th and 19th century, as the European imperialist presence in China became even more pronounced, Western medical theories and practices rivaled traditional beliefs. Christian missionaries used medicine as a tool to win converts, especially among the impoverished, who didn’t have the same access to medicine as elites who had more choices in where they could access care. Medical texts, usually translated by Jesuit missionaries, were introduced, and while they were first received as sort of foreign oddities, they eventually began to catch on. The mid-nineteenth century European innovations in anaesthesia and surgery found a more interested Chinese audience, but they remained skeptical. With a theory of medicine that emphasized the flow and balance of qi rather than cutting into the body, Chinese physicians didn’t see much value in adopting those practices. Surgery existed in China, but was pretty limited – limited to things like lancing abscesses, stiching up wounds, removing foreign bodies, bloodletting, and a couple of other slightly more complex procedures – and was associated with a kind of blue collar, medical gruntwork. (This is analogous to the barber-surgeon or chirurgeon in the European tradition, who was considered an unskilled, unscientific medical worker).

Elizabeth: Through the ninteenth century, the question of Westernizing China was polarizing, especially after the failed Boxer Rebellion against the European imperial powers. Some saw adopting Western practices – including embracing Western medical theories and practices – as an abandonment of Chinese tradition, while others saw it as the only, inevitable way forward. During the twentieth century, it became common for Chinese men to travel abroad to study medicine, bringing that knowledge back with them. Slowly but surely, opinion changed on the place of Western medicine in China. Even the words used to refer to ‘medicine’ changed. Up until the 19th century, all medicine was referred to as yi, which referred both to practitioners and the practice of healing. Variations on the word might refer to one of those elite scholar physicians or to ‘grannies,’ or old women who provided midwifery and nursing care. But by the nineteenth century, the word yixue came into use to refer to ‘learned medicine,” a term introduced by Jesuits to mean scientific (read: Western) medicine. Now, instead of medicine being one thing, it was suddenly two. Throughout the twentieth century, medicine was now split into two different things: xiyi (Western medicine) and zhongyi (Chinese medicine).[14] 

Sarah: Of course, the history of Chinese medicine doesn’t end with the Boxer Rebellion or the era of Westernization. But like Marissa’s episode on the history of fat, this is complex topic (see what I did there?) that seems best split at this point, so I promise to return to Chinese medicine and put together a part two that explores modern Chinese medicine.

Thank you, as always, for listening. We invite you to get in touch! You can follow us on Facebook, Twitter, and Instagram at dig_history, or join our Facebook group – Dig History Pod Squad. If you have a comment or question or want to share some kind words with us, you can always email us at hello@digpodcast.org – we love listener mail! If you’re an educator, we have dozens of episodes that are especially created for use in the classroom, along with resources, including full lesson plans! – on our website, digpodcast.org. We realize that recent changes to curriculum in states like Florida and Texas will complicate being able to use our podcast episodes in the classroom, so please reach out if there’s something we can do to be helpful to you and your classroom. You’ll also find full bibliographies, the scripts for all of our episodes, resources, and a link to our swag store at digpodcast.org.


Andrews, Bridie. The Making of Modern Chinese Medicine, 1850-1960. Vancouver: University of British Columbia Press, 2014.

Goldschmidt, Asaf. The Evolution of Chinese Medicine: The Song Dynasty, 960-1200. Abingdon: Routledge, 2009.

Goldschmidt, Asaf. “Epidemics and Medicine during the Northern Song Dynasty: The Revival of Cold Damage Disorders,” T’oung Pao 93 (2007): 53-109.

Liu, Yan. Healing with Poisons: Potent Medicines in Medieval China. Seattle: University of Washington Press, 2021.

Lo, Vivienne and Michael Stanley-Baker, “Chinese Medicine,” in A Global History of Medicine, ed., Mark Jackson. Oxford: Oxford University Press, 2018.

The Yellow Emperor’s Classic of Medicine, trans. Maoshing Ni. Boston: Shambhala Press, 1995.

[1] Yan Liu, Healing with Poisons: Potent Medicines in Medieval China (Seattle: University of Washington Press, 2021), 147-149.

[2] Vivienne Lo and Michael Stanley-Baker, “Chinese Medicine,” in A Global History of Medicine, ed., Mark Jackson (Oxford: Oxford University Press, 2018), 20.  

[3] The Yellow Emperor’s Classic of Medicine, trans. Maoshing Ni (Boston: Shambhala Press, 1995), 19.

[4] Lo and Stanley-Baker, “Chinese Medicine,” 22. 1-2.

[5]  The Yellow Emperor’s Classic of Medicine, 19.

[6] The Yellow Emperor’s Classic of Medicine, 19.

[7] Lo and Stanley-Baker, 26.

[8] The Yellow Emperor’s Classic of Medicine, 22.

[9] The Yellow Emporer’s Classic, 77.

[10] Lo and Stanley-Baker, 28.

[11] Lo and Stanley-Baker, 29.

[12] Asaf Goldschmidt, “Epidemics and Medicine during the Northern Song Dynasty: The Revival of Cold Damage Disorders,” T’oung Pao 93 (2007), 64.

[13] Asaf Goldschmidt, bok, 89.

[14] Bridie Andrews, The Making of Modern Chinese Medicine, 1850-1960 (Vancouver: University of British Columbia Press, 2014), 9-11.


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