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"Confucianism and the Development of Chinese Medicine" By Emily Lee

By Emily Lee

By the middle of the sixth century BCE, during the transition from the Spring and Autumn Period to the Warring States Period, the Zhou Dynasty was in a state of decline. China was divided into feudal states which were each ruled by their respective noble families and, overall, there was general sense of uncertainty regarding national unification and identity. What we know today as Confucianism developed as an outcome and response to the sociopolitical climate of China at this time and reflects the mindset and values of the people. Also around the beginning of the Warring States Period the beginnings of an oral tradition of systematized medicine began to emerge that was one facet in that reflection of the identity and culture of the Chinese people. As follows, I will discuss this medicine of Systematic Correspondence  as an element of Chinese arts and sciences that arose out of Confucian philosophy. I will begin by describing in detail some of the practices and beliefs taught by its ‘protector’, Kongzi (born Kong Qiu, ca. 551 BCE), and held by its followers or practitioners. In this discussion, I hope to illuminate how the philosophy was a commentary of, rather than a prescription for, man’s place in the world and also how it, nevertheless, displayed a perceptible order that could be infinitely extended or divided to every aspect of life for guidance and clarity in difficult times, most specifically to the inseparable union of Chinese medical philosophy and practice.
    The time during which Confucius grew up and began to formulate his ideas was one of political upheaval, endemic war, and disorder that severely taxed the entire nation of China. Wealth and possessions were unequally spread amongst the people; and while the majority of the people suffered and struggled, the small population who held positions of authority seemed to have little concept of how to govern in order for all to prosper. Confucius spent untold hours observing human nature and the world around him and devised a prescriptive philosophy, so to speak, that was simple, relevant, rational, and theoretically easy to adapt to any scale. Like any important philosophical model, the teachings of Confucius not only provide a vivid snapshot of the social and political climate of the time in which they were written but proved to be indicative of the Eastern (as opposed to Western), and specifically Chinese, approach to and view of the world, in which the individual is indivisible from their surroundings and anything but mutually exclusive from them. Seen in this way, man (or the body) can be a metaphor for the state of the nation and, conversely, an ordered government can be a metaphor for the human picture of health.
    For Confucius the concept of society was misguided - corrupt, even - and, in order to be rehabilitated, it would have to change, rather than try to change the individuals within society itself. But in order to affect this change, the example would have to be set from the most influential or visible level. With the ultimate goal of large-scale sociopolitical reform, Confucius set up a school,  known as the ‘Ju Jia’ or ‘School of Scholars’, where he hoped to attract a feudal prince onto whom he could bestow his teachings and plant the seeds of change . Al-though for the most part he only attracted lower-level political figures , his teachings still stressed the importance of learning from the authority of tradition and the exponential value of reciprocity and virtue towards others in everyday life.
    Despite the fact that Confucius valued tradition, he believed that with the right training, anyone was capable of attaining- and worthy - of any title or role (sounds like the same sort of argument for tonifying Essential Qi!). Self-cultivation would change the world and this was achieved, to start, from a somewhat moralistically-based education. Under Confucius’s guidance, his students would learn to embody the concept of Jun Zi, or superior man, who, with sincerity, strived to attain moral virtue by practicing reciprocity with his neighbors, ob-serving ritual, crafting a personal sense of propriety, earning the trust of others, being loyal, and showing respect for elders and important relationships in his life. The skill of adhering to these virtues was learned through a balanced education in what we would today call the arts and sciences; because by learning different ways to look at, think about, and study nature, it would be easy (or easier) to understand and relate to others, enabling a good example to be set and followed, reciprocally, by others. Confucius saw societal roles and ranks as being fixed  but, as mentioned above, he thought that those roles, whether they were positions of the most or least power and influence, as being commonly (and contemporarily to him) filled by individuals who were unaware of their responsibility, visibility, and effect on those of whom they were in charge. Essentially, Confucius saw that the world could, if restored from the conditions in which he lived, follow an ordered social hierarchy of relationships which implied mutual obligation that would end suffering and allow a more unified China to flourish.
    Order and balance within society, whether on a small or large scale (much like that of yin/yang), was a self-evident fact of the larger framework of nature to Confucius, who had a gift or ability to describe its complexity and subtlety in a relevant, comprehensible, and versa-tile way. For this reason, he considered himself to be more of a ‘protector’ of the philosophy which he taught, insomuch that he helped keep it alive, than its creator . And for me, it is this aspect of Confucianism from which it is most obvious to draw a correspondence to the devel-opment of Chinese medicine and medical philosophy.     In Chinese medical philosophy, the ordering of the five elements or Zang Fu organs, minus the hierarchy among them , mimics the social order that Confucius described as one option to regaining sociopolitical ‘health’. I think that it is important to note here that although Confucius was prescribing a solution to the problems which plagued China and rendered the parts unable to function as a whole and therefore thrive; he was nevertheless only describing a solution which he thought to be evident in other parts of nature. It is my understanding that, like all influential philosophers and artists throughout history, he was letting nature guide him, and not imposing something artificial onto a naturally occurring order or sequence. In a functioning and prosperous society, people with different roles in society share mutual obliga-tion to one another much the same way that in a holistically- and healthily-functioning person, the organs not only each carry out a function for their own well-being but as a factor for the strength and stability of at least one other. But on an even more basic level, because the oral tradition of a systematized Chinese medicine was beginning to materialize during the Warring States period, the same time Confucius was structuring his teachings on sociopolitical order and reform, the names and responsibilities that correspond to each organ in Zang Fu theory as well as herbal therapy originate in politics and the military. How much Confucius’s teachings in particular, as opposed to the general state of social disorder and political pathology, had an impact on the early systematic structure of Chinese medicine is unclear but, as Paul Unschuld points out, an early textual correlation exists between it and the Confucian cannon as written by a predecessor of Confucius:
“The work of Hsün-tzu...reveals perhaps most clearly the intellectual interconnec-tions between the particular strain of Confucianism that later achieved state ortho-doxy, on the one hand, and the concepts of the medicine of systematic correspon-dence, on the other. A symbolic indication of this close relationship is provided by Hsün-tzu that appears almost verbatim...in the Huang-ti nei-jing, the nucleus of which may have been compiled shortly thereafter. Hsün-tzu remarks,‘The true ruler begins to put [his state] in order while [a condition of] order [still prevails]; he does not wait [until] insurrections [have already erupted] ’. The corresponding passage in the Huang-ti nei-jing reads, ‘The sages do not treat those who have already fallen ill, but rather those who are not yet ill. They do not put [their state] in order only when revolt [is underway], but before an insurrection occurs ’. ”
As is evident in the above passage, the relationship between Confucius’s teachings and early Chinese medicine went beyond an affinity for political and military metaphorical nomenclature and extended to methods of medical practice in terms of always favoring preventative treatment over a reactive one. But to briefly return to the idea that the arts and sciences (medicine among them) are a study and analysis of nature, the doctrines of Confucianism pro-vided an astute description of the world and all its parts in its highest-functioning capacity during a time of social and political turmoil and upheaval in the most simple and applicable terms.
    What came to be known as Confucianism, was not the only system of thought or phi-losophy that could be used to understand different aspects of nature in the last six centuries BCE. Unlike Daoism that was concerned with the intangible and guiding reality of Heaven or Naturalism, that focused on the earthly projection of Heaven, the strict Confucian focused on ‘the middle way’, or the present and local, between Heaven and Earth . It left no room for divine or transcendental forces or laws . For hundreds, if not thousands, of years after Con-fucius’s death (and probably even still today), his teachings were used as a guide and reference by later generations of philosophers and political advisors such as Menicus (385?-312? BCE) and Xunzi (310?-219? BCE) , the two closest successors of Confucius, the latter of whom lived to see China united under the Qin Dynasty. In 201 BCE the Han Dynasty captured power and, over the next four hundred years, a united China saw its culture flourish thanks to a stable, centralized, organized, and responsible government . It was also during this time that the first written accounts of a medical philosophy came into use that employed a method of practice based on a system of correspondences both within the body and between man and the world around him.     The teachings of Confucius affected positive change on the early social and political reform, reunification, prosperity, and development of China. Those teachings, of which Con-fucius considered himself to be more of a protector than a creator, resulted in the formative development and modernization of a medical philosophy that had once believed in things so far-reaching as the random and uncertain whims of dead ancestors and the effect on the living. Confucianism did not only foster the growth of China but, because of its solid structure formed by elements that included the importance of upholding rites and tradition, being trustworthy and sincere, and striving to lead a virtuous life, it has lasted, in several different forms for nearly 3000 years, remaining all the while wise and relevant from the scale of an individual organ to that of a governing body of the State.
Bloom, Irene. In “Sources of Chinese Tradition, Volume 1”, compiled by William Theodore     deBary and Irene Bloom; Columbia University Press: 1999. Eckman, Peter. “In the Footsteps of the Yellow Emperor”; Long River Press: San Francisco,     2007. Sivin, Nathan. In “Sources of Chinese Tradition, Volume 1”, compiled by William Theodore     deBary and Irene Bloom; Columbia University Press: 1999.
Strathern, Paul. “Confucius in 90 Minutes”; Ivan R. Dee: Chicago, 1999.
Unschuld, Paul. “Medicine in China”; University of California Press: Berkeley, 1985.