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Tracing Changes in Acu- Moxa Therapy During the Transition from the Tang to the Song Dynasties 1

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Tracing Changes in Acu- Moxa Therapy During the Transition from the Tang to the Song Dynasties 1 EASTM 18 (2001): 75-11 I Changing Standards: Tracing Changes in Acu­ moxa Therapy During the Transition from the Tang to the Song Dynasties 1 Asaf Goldschmidt [Asaf Goldschmidt is a lecturer at Tel Aviv University, Israel. He received his Ph.D. in History and Sociology of Science from the University of Pennsylvania in I 999. His dissertation was on "The transformations of Chinese medicine dur­ ing the Northern Song dynasty (920-1127)." The dissertation analysed how by the end of the Northern Song dynasty three past medical approaches converged into one comprehensive medical system. He is currently working on a history of the first imperially sponsored pharmacy in China and on the influence of the Song emperor Huizang on medicine.] * * * Acupuncture is probably one of the most renowned topics when traditional Chi­ nese medicine is discussed. Indeed, more often than not, when people discuss traditional Chinese medicine one of the first issues they discuss is acu-moxa therapy (see definition below). Acu-moxa therapy is certainly one of the most intriguing and unintuitive therapeutic skills in the arsenal of traditional Chinese medicine. However in spite of this, little research has been conducted on the history of this topic. Existing works mostly concentrate on either the question of the origin of acu-moxa therapy or provide a general overview of its history.2 This paper offers a different approach - it compares the contents of six surviving texts of acu-moxa therapy dating to the late Tang and early Song dynasties. By com­ paring the contents of these works, I attempt to examine changes in the manu­ scripts available to practitioners of that era. Despite the fact that the comparison relies on only six extant texts, it offers some interesting inferences regarding the development of acu-moxa therapy. The most interesting conclusion of this com- I I thank Nathan Sivin and two anonymous reviewers for their helpful comments on earlier versions of this paper. All errors or omissions are my responsibility alone. 2 Epler (1980) and Kuriyama (1995b) discuss the topic of the origin of acu-moxa therapy. Lu & Needham (1980), Lin Zhaogeng and Yan Liang (1995), and Fu Weikang ( 1991) provide a more general overview and history of acu-moxa therapy. 75 Downloaded from Brill.com09/24/2021 10:22:25AM via free access 76 EASTM 18 (2001) parison is that acu-moxa texts during the Song became more systematic and stressed the standard location of acu-points and circulation tracts. The transition from the Tang dynasty (618-907) to the Song dynasty (960- 1276) was more than just a dynastic succession; it was a period of major trans­ formations in all aspects of state, thought, culture, and society. Some scholars refer to this period as shift from the Chinese middle ages to "renaissance" or even "pre-modern" China. Others claim that this transition marks an economic revolu­ tion that was somewhat comparable to the industrial revolution in Europe.3 Medicine was no exception. Much like other aspects of life, medicine and medi­ cal practice experienced major transitions and transformations. The changes included the establishment of a public pharmacy, a medical university, and an imperial bureau dedicated to revising medical texts. In addition, during this pe­ riod three major past medical approaches were integrated into one comprehen­ sive medical system resembling, to a certain degree, present-day traditional Chi­ nese medicine.4 The objective of this paper is to expose some changes in one specific facet of Chinese medicine, transformations that otherwise may go unnoticed. More spe­ cifically, this paper, drawing on several surviving acu-moxa texts from this era, will trace changes in acu-moxa therapy during the transition from the late Tang dynasty to the Northern Song dynasty (960-1127). A number of historians of Chinese medicine have found evidence of change during the Song dynasty by analyzing predominantly either prefaces to medical books or commentaries ap­ pearing in various historical sources.5 This approach provides a somewhat biased perspective since it does not focus on the most important aspect of medical litera­ ture - the content of the medical text. In this paper I attempt to show how we can detect changes in medicine by analyzing and comparing the technical contents of a certain genre of medical writing - namely acu-moxa therapy. My hypothesis is that by comparing the contents of acu-moxa manuals, which reflect to a certain extent issues and topics most highly regarded by their physician-authors, we can offer a unique perspective on the state of knowledge in the field and how it changed over time. The term "acu-moxa therapy" refers to a group of traditional Chinese clinical techniques designed to stimulate specific loci on the human body in order to obtain a desired therapeutic effect. Acupuncture and moxibustion are the most 3 See Gernet 1985: 298-300; Shiba 1970: 1-3; Hartwell 1962; and Elvin 1973 (espe­ cially pp. 111-199). 4 For a comprehensive analysis of the changes in medicine during the Northern Song dynasty including the integration of the three past medical approaches, see Goldschmidt 1999. 5 For example, see Zheng Jinsheng 1982 and 1988; Unschuld 1985: 154-186; and Wan Fang 1982. Downloaded from Brill.com09/24/2021 10:22:25AM via free access Asa/ Goldschmidt: Changing Standards 77 popular, but not the only, techniques in this therapeutic approach.6 In discussing changes in acu-moxa therapy, my concern is not the stimulation technique or its effects. Rather, I focus on the process in which acu-moxa transformed from a mere symptom-based treatment into the last stage of the clinical process of clas­ sical Chinese medicine, following detection of symptoms and determination of manifestation types.7 Detecting changes in acu-moxa therapy during this period is not trivial. Only a limited number of medical works dating to the Northern Song dynasty has dis­ cussed acu-moxa therapy. In spite of this limitation this paper concentrates on comparing the contents of six extant acu-moxa texts dating to the late Tang and Northern Song dynasties. Of these only one was devoted solely to acu-moxa therapy. The others are chapters discussing acu-moxa therapy included in general medical manuals, or formularies, concentrating mainly on drug therapy.8 The six texts are included in the following five books: Arcane Essentials from the Imperial library (752), Prescriptions at the Heart of Medicine (984), Impe­ rial Grace Formulary of the Taiping [ Reign-period] (992), Illustrated Canon of Acu-moxa Therapy [Depicting] the Acu-points of the Bronze Figure (1026), and Medical Encyclopedia: A Sagely Benefaction of the Zhenghe [Reign-period] (1122).9 Of these five books, one was compiled during the Tang dynasty, three 6 Acupuncture is based on inserting needles of various gauges and lengths into the skin at specific loci. Moxibustion is based on burning tinder made of Chinese Mugwort (Artemisia Argyi or Artemisia Vulgaris) next to a locus or on it. The Chinese term for moxibustion is ai 3t. For a comprehensive discussion of acu-moxa techniques and doc­ trines, see Lu and Needham 1980: 69-153, 170-184, and Sivin 1987: 258-264. 7 'Manifestation types' are schematic representations of disorders in traditional Chi­ nese medicine. The determination of manifestation types is the stage in the clinical inter­ action between physician and patient in which the physician groups the symptoms he observed into categories or types and accordingly draws conclusions regarding the desired treatment approach. I use this term following Hans Agren's definition (Agren 1975: 39). For further discussion see Sivin 1987: I 09-111, 329-347, and Farquhar 1994: 55-59. 8 I did not include other Tang dynasty formularies, such as the Essential Prescriptions Worth a Thousand, for Urgent Need (Beiji qianjin yaofang {11/i ~- -f- ~ ~ 1J), since they do not have a specific section systematically discussing acu-points, their location, and effects. These formularies provide only the therapeutic application of acu-points accord­ ing to symptoms. 9 Waitai biyao 5'} ~ fii ~ (Arcane Essentials from the Imperial Library), Yixinfang (in Japanese: /shimpo) ~ ,C,, 1J (Prescriptions at the Heart of Medicine), Taiping sheng­ hui fang -Jr. 5¥ ~ ~ 1J (Imperial Grace Formulary of the Tai ping [Reign-period]), Tong­ ren shuxue zhenjiu tujing ~ A ffifii '/'i.. jt ~ Ill ~ (Illustrated Canon of Acu-moxa Ther­ apy [Depicting] the Acu-points of the Bronze Figure), Zhenghe shengji zonglu i&: f □ ~ i1'f ff,!. j-J< (Medical Encyclopedia: A Sagely Benefaction of the Zhenghe [Reign-period]). Downloaded from Brill.com09/24/2021 10:22:25AM via free access 78 EASTM 18 (2001) were compiled during the Northern Song dynasty, and one is a Japanese contem­ porary to the Northern Song dynasty. Despite the dates of compilation, the con­ tents of the first three books ( one dating to the Tang dynasty and two dating to the early Song dynasty) represent the state of the acu-moxa therapy during the Tang dynasty.lo The latter two books represent its state during the Northern Song dynasty. Using these six texts, I will attempt to show how acu-moxa therapy trans­ formed from a mere clinical technique, similar in approach and application to the eclectic drug therapy during the Tang dynasty, to the end stage of the process of classical diagnosis and differentiation during the Northern Song dynasty. In other words, the analysis of the changes in the contents of the six texts suggests a shift in focus towards the integration of classical medical doctrines underlying the acu­ points' application and towards the role of the circulation tracts. This paper is composed of two parts. In the first part, I provide a short de­ scription of the contents of the six extant acu-moxa texts under consideration.
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