Huang Di Nei Jing Ling Shu

The Ancient Classic on Needle Therapy The complete Chinese text with an annotated English translation

Paul U. Unschuld

University of California Press Huang Di Nei Jing Ling Shu

The Ancient Classic on Needle Therapy The complete Chinese text with an annotated English translation

Paul U. Unschuld

University of California Press University of California Press, one of the most distinguished university presses in the United States, enriches lives around the world by advancing scholarship in the humanities, social sciences, and natural sciences. Its activities are supported by the UC Press Foundation and by philanthropic contributions from individuals and institutions. For more information, visit www.ucpress.edu.

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25 24 23 22 21 20 19 18 17 16 10 9 8 7 6 5 4 3 2 1 CONTENTS

INTRODUCTION

1. A New World View, a New Healing / 1 2. Huang Di—The Yellow Thearch / 4 3. The New Terminology / 5 3.1 fa ⌅ 5 3.2 ming ભ / 8 3.3 shen ⾎ / 9 3.4 zheng ↓, xie 䛚 / 10 4. The Holism of Politics and Medicine / 11 5. Morphology—Substrate and Classification / 12 6. The Causes of Illness / 15 7. Diagnosis / 19 8. Conditions of Illness / 22 9. Therapy / 24 10. About the Translation / 28 Abbreviations and Literature quoted / 31

ANNOTATED TRANSLATION OF LING SHU 1 THROUGH 81 Chapter 1 ҍ䦬ॱҼ৏ The Nine Needles and the Twelve Origin [Openings] / 35 Chapter 2 ᵜ䕨To Consider the Transportation [Openings] as the Foundation / 53 Chapter 3 ሿ䠍䀓 Explanatory Remarks on the Small Needles / 75 vi Huang Di Nei Jing Ling Shu

Chapter 4 䛚≓㯿ᓌ⯵ᖒ The Physical Appearances of Diseases resulting from the Presence of Evil qi in the Long-term Depots and Short-term Repositories. / 85 Chapter 5 ṩ㎀Root and Connection / 111 Chapter 6 ༭ཝࢋḄLongevity, Early Death, Hardness and Softness / 125 Chapter 7 ᇈ䦬The Official Needles / 137 Chapter 8 ᵜ⾎ To Consider the Spirit as the Foundation / 147 Chapter 9 ㍲࿻ End and Beginning. / 155 Chapter 10 ㏃㜸The Conduit Vessels / 175 Chapter 11 ㏃ࡕ The Conduits and their Diverging [Vessels] / 209 Chapter 12 ㏃≤ The Conduit/Stream Waters / 215 Chapter 13 ㏃ㅻ The Conduits and their Sinews / 225 Chapter 14 僘ᓖ The Measurements of the Bones / 239 Chapter 15 ӄॱ⠏ The 50-fold Circulation / 245 Chapter 16 ⠏≓ The Camp Qi / 249 Chapter 17 㜸ᓖ The Measurements of the Vessels / 253 Chapter 18 ⠏㺋⭏ᴳ Camp [Qi] and Guard [Qi] – Generation and Meeting / 259 Chapter 19 ഋᱲ≓ The Four Seasonal Qi / 269 Chapter 20 ӄ䛚 The Five Evils / 275 Chapter 21 ሂ⟡⯵ Cold and Heat Disease / 279 Contents vii

Chapter 22 Ⲣ⣲ Peak-illness and Madness / 287 Chapter 23 ⟡⯵ġHeat Diseases / 293 Chapter 24 ৕⯵The Receding [Qi] Diseases / 305 Chapter 25 ⯵ᵜThe Diseases and their Roots / 311 Chapter 26 䴌⯵Various Diseases / 315 Chapter 27 ઘⰪ Circulation Blockage-illness / 321 Chapter 28 ਓ୿ Oral Inquiry / 327 Chapter 29 ᑛۣ The Transmissions from the Teachers / 341 Chapter 30 ⊪≓ Differentiation of the Qi / 351 Chapter 31 㞨㛳 Intestines and Stomach / 355 Chapter 32 ᒣӪ㎅ば A Healthy Person Ends the Ingestion of Grain / 357 Chapter 33 ⎧䄆 On the Seas / 361 Chapter 34 ӄҲ The Five Disturbances / 367 Chapter 35 㝩䄆 On Swelling / 373 Chapater 36 ӄⱳ⍕⏢ࡕ The Separation of the Five //Protuberance-Illnesses// Jin and Ye Liquids / 383 Chapter 37 ӄ䯡ӄ֯ The Five Observation Points and the Five Emissaries / 387 Chapter 38 䘶丶㛕ⱖ Movements Contrary to and in Accordance with the Norms, Being Well Nourished and Being Malnourished / 393 Chapter 39 㹰㎑ The Blood Network [Vessels] / 401 viii Huang Di Nei Jing Ling Shu

Chapter 40 䲠䲭␵◱Yin and Yang [Qi], Clear and Turbid [Qi] / 405 Chapter 41 ᰕᴸ The Ties between Yin and Yang [Qi] and Sun and Moon / 409ײ䲠䲭 Chapter 42 ⯵ۣ The Transmission of Diseases / 415 Chapter 43 ␛䛚Ⲭདྷ Excess Evils release Dreams / 421 Chapter 44 丶≓аᰕ࠶⡢ഋᱲ The Qi Moving in Accordance with the Norms Divide a Day into Four Time Periods / 425 Chapter 45 ཆᨓ The Assessment from Outside / 433 Chapter 46 ӄ䆺The Five Modifications / 437 Chapter 47 ᵜ㯿To Consider the Long-term Depots as Foundations / 447 Chapter 48 ⾱ᴽ Prohibition and Appropriation / 465 Chapter 49 ӄ㢢 The Five Complexions / 475 Chapter 50 䄆ࣷ On Courage / 489 Chapter 51 㛼㞗The Transport [Openings] on the Back / 497 Chapter 52 㺋≓ The Guard Qi / 501 Chapter 53 䄆Ⰻ On Pain / 509 Chapter 54 ཙᒤ Years Given by Heaven / 513 Chapter 55 䘶丶 Movement Contrary to and in Accordance with the Norms / 519 Chapter 56 ӄણ The Five Flavors / 523 Chapter 57 ≤㝩 Water Swelling / 529 Contents ix

Chapter 58 䋺付 The Robber Wind / 533 Chapter 59 㺋≓ཡᑨ When the Guard Qi Lose their Regularity / 537 Chapter 60 ⦹⡸ The Jade-Tablets / 547

Chapter 61 ӄ⾱ The Five Prohibitions / 559 Chapter 62 䙻䕨 Transports / 565 Chapter 63 ણ䄆 On Flavors / 571 Chapter 64 䲠䲭ҼॱӄӪ The Yin and Yang [Categorization] and the 25 Human [Types] / 577 Chapter 65 ❑丣❑ણ Five Tones, Five Substances / 595 Chapter 66 Ⲯ⯵࿻⭏ The Generation of the Hundreds of Diseases / 603 Chapter 67 㹼䦬 The Application of the Needles / 613 Chapter 68 к㞸 Upper Barrier / 619 Chapter 69 ឲᚊ❑䀰 Grief, Rage, and Speechlessness / 623 Chapter 70 ሂ⟡ Cold and Heat Sensations / 627 Chapter 71 䛚ᇒ Evil Visitors / 631 Chapter 72 䙊ཙ To Penetrate Heaven / 647 Chapter 73 ᇈ㜭 Function and Competence / 655 Chapter 74 䄆⯮䁪ቪ Discussing Illness; Examining the Foot-long Section / 669 Chapter 75 ࡪㇰⵏ䛚 Piercing to Regulate True and Evil [Qi] / 677 x Huang Di Nei Jing Ling Shu

Chapter 76 㺋≓㹼 The Movements of the Guard Qi / 699 Chapter 77 ҍᇛޛ付 The Nine Mansions, the Eight Winds / 711 Chapter 78 ҍ䦬䄆On the Nine Needles / 719 Chapter 79 ↢䵢 The Dew of the Year / 739 Chapter 80 བྷᜁ䄆 On Massive Confusion / 753 Chapter 81 Ⲡ⯭ Obstruction- and Impediment-Illnesses / 763

GLOSSARY / 777 INTRODUCTION

1. A New World View, a New Healing

The Ling shu 䵸⁎, also known as Ling shu jing 䵸⁎㏃, is the classic text on Chi- nese needle therapy. Much of the version known today probably dates back to individual, shorter texts that began to be written between the 2nd and 1st centuries BCE during the first of the two Han dynasties of ancient China. The authors of these texts are unknown, as is the individual who, at some point in that time, col- lected the individual texts into one great work. Many questions surrounding the origins of the Ling shu remain unanswered to this day.1 A bibliography by Liu Xin ࢹⅶ (died 23 CE) from the early years of the 1st century mentions a text titled Zhen jing 䠍㏃, “The Needle Classic,” consisting of nine chapters. Liu Xin supposedly based his work on an older catalog with the title Bie lu ࡕ䤴, compiled by his father Liu Xiang ࢹੁ (died 6 BCE). The extent to which the content of the Ling shu available today is identical to the Zhen jing can no longer be ascertained. It is likewise unknown who ultimately gave the work the title Ling shu, or “The Numinous Pivot,” which bears no relation to the content of this text, marked as it is by explicitly secular reasoning. Perhaps it was the physician and Su wen ㍐୿ commentator ⦻ߠ Wang Bing, who used the title Ling shu for the first time in the 8th century CE.2 All we know for sure is that the content of the Zhen jing cited by Huangfu Mi ⲷ⭛䅀 (215-282 CE) in his medical classic Jia yi 1 For a detailed discussion of the early history of the Ling shu and the other classic texts of Chinese medicine, see Paul U. Unschuld, Huang Di Nei Jing Su Wen: Nature, Knowledge, Imagery in an Ancient Chinese Medical Text. With an appendix: “The Doctrine of the Five Periods and Six Qi in Su wen 66 through 71 and 74,” Berkeley: University of California Press, 2003, 3ff. 2 See Ma Jixing 傜㔗ޤˈZhong yi wen xian xue ѝ५᮷⥞ᆖ Shanghai kexue jishu chu- banshe к⎧、ᆖᢰᵟࠪ⡸⽮, Shanghai 1990, 80 f. with references to various older texts of the Ling shu, excerpts of which had been cited during the time of the Northern Song 2 Huang Di Nei Jing Ling Shu jing ⭢҉㏃ is also present in its entirety in today’s Ling shu. The commentary that Huangfu Mi assigned to the text in the foreword of the Jia yi jing is remarkable: “Today there is a Zhen jing in 9 juan and a Su wen in 9 juan. 9 plus 9 equal 18 juan. It is partly lost. The tracts it contains reach back to distant times. However, the text consists mainly of allegations and has only limited practical value.” None of the authors whose texts constitute the Ling shu were thinking of magic or numinous powers. Indeed, for the time, the Ling shu was a revolutionary work in the true sense of the word.3 Together with its sister-works the Su wen and Nan jing 䴓㏃,4 it represents an explicit counter-model to the prevailing image of the world at the time, which regarded human life as subject to extreme degrees of existential alien influence. Deities, demon-spirits and ancestors—in addition to “the heavens” as a numinous power—held sway over the ups and downs of each individual.5 In general, people believed that the duration and quality of life on earth were not under their own control. The authors whose thinking has found expression in the texts handed down to the present day in the Su wen, Nan jing and Ling shu were a group of intellectuals whose names and number would very quickly be forced into the darkness of collective forgetting—and with good reason. They questioned what had for many centuries remained self-evident for all segments of society. They confronted their contemporaries with the idea that natural laws were valid regardless of deities, spirits, demons and ancestors, as well as time and space. These intellectuals constituted the kernel of an enlightened, secular perspective on the world, the con- sequences of which would open up a view of nature and the embedding of human- ity in the laws of nature as a foundation for understanding the origins, essence and transience of life. By this time China was already a highly advanced civilization. A complex state administration with a bureaucracy that ensured continuity as well as social and economic standards was accompanied by a culture of writing that addressed the numerous themes of daily importance in this state construct. Libraries and catalogs took note of works composed either as chronicles or philosophical texts, as dictio-

dynasty, but which do not correspond in their content to the work translated here. The Daoist environment from which many of these texts originate is clearly recognizable. 3 On the status of pre-medicinal healing arts in China see D. Harper, Early Chinese Med- ical Literature: The Mawangdui Medical Manuscripts. London: Routledge, 1998. 4 For a completely annotated translation, see Paul U. Unschuld with Hermann Tessenow: Huang Di Nei Jing Su Wen. Huang Di’s Inner Classic—Basic Questions. Vol. 1: Chapters 1 through 52. Vol. 2: Chapters 53 through 71 and 74 through 81. In collaboration with Zheng Jinsheng. Berkeley: University of California Press, 2011. 5 On existential heteronomy in the world view and the religious practice of ancient China, see Bernard Faure, Chinese Magical Medicine. Asian Religions and Cultures. Michel Strick- man, ed. Stanford: Stanford University Press, 2002. Introduction 3 naries or military guides. Many of these authors are still known by their names. It might therefore seem puzzling why the authors of exceedingly large books that founded a new form of healing, a “medicine” in the modern sense, should not belong to this group. It might seem puzzling that their texts survived the centuries only as extremely fragile copies, or even—like the Ling shu and the Tai su ཚ㍐üwere mostly or completely lost, even in China. One might explain these losses through the many wars that also caused the destruction of countless other manuscript texts, but this argument is not persuasive. Had the Su wen, the Ling shu and the Tai su been esteemed by larger numbers of the educated elite, they would have been copied in sufficient quantities to become the foundation for responses to illness in these strata of the population. Yet, as all the evidence suggests, this was not the case. Thanks solely to the fact that copies of theTai su were brought to Japan and survived for centuries there as fragments do we have the possibility today of laying our eyes on the oldest testament to all those ancient texts, one created from an annotated compilation of the content of the Su wen and Ling shu. The author of the Tai su is Yang Shangshan ὺкழ. His is the sole name documented of the writers of the works that are collectively identified as constituting theHuang Di nei jing 哳ᑍ޵ ㏃, “The Inner Classic of Huang Di” text corpus. However, Yang Shangshan lived later, during the Tang dynasty in the 7th century.6 That time witnessed a completely different atmosphere of never-before-seen diversity in world views. Yet even then, the Tai su was apparently regarded as insufficiently important. The number of copies produced in China was too low to prevent the work from being lost in China itself. In the centuries following the Han period, few authors took up the ideas of the revolutionaries. Best known is the aforementioned Huangfu Mi ⲷ⭛䅀, writer of the Jia yi jing ⭢҉㏃ in the 3rd century. The extent to which the Jia yi jing and other texts continually handed down in China reproduced the content of the Su wen and Ling shu in a manner that obscured the “objectionable” character of the source texts is a matter for future research. Only in the 12th and 13th centuries, in the context of a fundamentally transformed view of the world, did the thousand-year shadow existence of the source texts come to an end. On the emperor’s orders, the most important surviving manuscripts were edited and made available to the wider public. Lin Yi ܴ᷇, a collaborator in this editing project and publisher of a Su wen edition from the year 1067, cited from a lost Ling shu text and remarked in his foreword:

6 Sivin, Nathan. “On the Dates of Yang Shang-shan and the Huang ti nei ching t’ai su.” Chinese Science 15 (1998): 29-36. Qian Chaochen 䫡䎵ቈ. “Taisu zhuanzhu juti shijian xinzheng” ǉཚ㍐Ǌ᫠㪇ާփᰦ䰤ᯠ䇱 [New evidence on the concrete date of the writing of the Taisu]. Zhongyi wenxian zazhi ѝ५᮷⥞ᵲᘇ, (2006): No. 4. 4 Huang Di Nei Jing Ling Shu

“Today the Ling shu is no longer available in its entirety.”7 Moreover, the passages cited by Lin Yi do not match any surviving Ling shu texts. In 1092, a version of the Ling shu titled Huang Di zhen jing 哴ᑍ䠍㏃, “The Needle Classic of Huang Di,” was brought to China from Korea.8 Finally, a Song-era doctor named Shi Song ਢ ፗ, whose exact lifetime is no longer known, became the first to study the Ling shu in depth and, in 1135, to publish an annotated manuscript from his personal family holdings. This edition has ever since been considered theLing shu that extends back to the Han era. From then on, historians began devoting themselves to questions surrounding the authorship and temporal origins of the Huang Di nei jing texts; new, annotated editions were produced to lend meaning to the texts, which in many parts had since become difficult to comprehend.

2. Huang Di—The Yellow Thearch

The question of Huang Di’s significance in the compilation of theSu wen and Ling shu was discussed early on. Huang Di 哳ᑍ does not mean “Yellow Emperor,” as one often reads today in popular literature. Di ᑍ is a monarch among gods, a dei- fied ancestor, the Thearch, and huang 哳 means “yellow” and stands for China. The Yellow Thearch, as per the now-standard international translation, was the highest cultural and spiritual authority of ancient China, and there were countless texts in which a supposed dialogue between Huang Di and one of his ministers or advisers placed the most valuable contributions to ancient Chinese culture as coming from the lips of this very same Yellow Thearch. This is also how the authors of theSu wen and Ling shu seem to have proceeded. Yet the appearance is deceiving. Huang Di is—with one exception, when confronted by Lei Gong, the Duke of Thunder—not a sage but an ignoramus in the field of medicine who wishes to be instructed. This instruction is marked repeatedly by the respect expressed by the dialogue partners of Huang Di. They sometimes describe themselves as xi ziġ䳘⫸, or “mite,” orġxiao zi ⮷⫸, “little boy,” and in one instance, in chapter 73, Qi Bo refers to Huang Di as sheng wangġ俾䌳, “wise king.” In sharp contrast, one also finds various reprimands, inquiries and refusals by the knowledgeable ones that put this Huang Di into a light far removed from that of an awesome thearch.

7 Ma Jixing 1990, 80. See also p. 81 for a graphical overview of the names of the various possible forerunner texts of the Ling shu as it is available today and when they were lost. 8 Okanishi Tameto ዑᑝ⛪Ӫ, Song yi qian yi ji kao ᆻԕࡽ䟛㉽㘳, Taipei: Ku T’ing Book House, 1969. 35.