The Transmission of Chinese Medicine - 0521642361

The transmission of Chinese
medicine
Elisabeth Hsu
Cambridge University Press

The transmission of Chinese medicine
This is the first time that an ethnographer has studied three different
forms of medical education simultaneously. Conducting extensive
fieldwork in Kunming in the People’s Republic of China, Elisabeth
Hsu became the disciple of a qigong healer, who taught her his esoteric
arts by imitation and repetition only. She also attended seminars of a
senior Chinese doctor who plunged his followers into studying arcane
medical classics, and she took the regular courses for Chinese students
at the Yunnan College of Traditional Chinese Medicine, where the
standardised knowledge of official Chinese medicine is inculcated.
Dr Hsu compares these different medical traditions and shows how
the same technical terms may take on different meanings in different
contexts. This is a fascinating insider’s account, which brings out the
way in which the context of instruction shapes knowledge.
  is a teaching and research fellow in the history of

Chinese science at the University of Cambridge. She has published in
scholarly journals and is co-editor of Naxi and Moso Ethnography (1998)
and editor of Chinese Medicine: Innovation, Convention and Controversy
(forthcoming).
i
Cambridge Studies in Medical Anthropology 7
Editorial Board
Ronald Frankenberg Brunel University
Byron Good Harvard Medical School
Alan Harwood University of Massachusetts, Boston
Gilbert Lewis University of Cambridge
Roland Littlewood University College London,
Margaret Lock McGill University
Nancy Scheper-Hughes University of California, Berkeley
Medical anthropology is the fastest growing specialist area within anthropology,

both in North America and in Europe. Beginning as an applied field serving
public health specialists, medical anthropology now provides a significant forum
for many of the most urgent debates in anthropology and the humanities. It
includes the study of medical institutions and health care in a variety of rich and
poor societies, the investigation of the cultural construction of illness, and the
analysis of ideas about the body, birth, maturity, ageing, and death.
This series includes theoretically innovative monographs, state-of-the-art col-

lections of essays on current issues, and short books introducing main themes
in the subdiscipline.
1. Lynn M. Morgan, Community Participation in Health: The Politics of Primary

Care in Costa Rica
2. Thomas J. Csordas (ed.), Embodiment and Experience: The Existential Ground
of Culture and Health
3. Paul Brodwin, Medicine and Morality in Haiti: The Contest for Healing Power
4. Susan Reynolds Whyte, Questioning Misfortune: The Pragmatics of Uncertainty
in Eastern Uganda
5. Margaret Lock and Patricia Kaufert, Pragmatic Women and Body Politics
6. Vincanne Adams, Medical Science and Democratic Truth: Doctors and Revolu-
tion in Nepal
ii
The transmission of
Chinese medicine
Elisabeth Hsu
University of Cambridge
iii
         
The Pitt Building, Trumpington Street, Cambridge, United Kingdom
  

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http://www.cup.cam.ac.uk
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© Elisabeth Hsu 1999
This book is in copyright. Subject to statutory exception and to the provisions

of relevant collective licensing agreements, no reproduction of any part may
take place without the written permission of Cambridge University Press.
First published 1999
Printed in the United Kingdom at the University Press, Cambridge
Typeset in 10/12pt Plantin []
A catalogue record for this book is available from the British Library
Library of Congress cataloguing in publication data
Hsu, Elisabeth.
The transmission of Chinese medicine / Elisabeth Hsu.
p. cm. – (Cambridge studies in medical anthropology; 7)
Includes bibliographical references.
ISBN 0 521 64236 1 (hardback). – ISBN 0 521 64542 5 (paperback)
1. Medicine, Chinese – Study and teaching – China. 2. Medical
anthropology – education, medical – China. I. Title. II. Series.
R601.H697 1999
610′.951—dc21 98–50700 CIP
ISBN 0 521 64236 1 hardback
ISBN 0 521 64542 5 paperback
iv
For Manu
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HH
x
Contents
Acknowledgements page viii

Note on Chinese terms ix
Introduction: ways of learning 1

1 The secret transmission of knowledge and practice 21
2 Qigong and the concept of qi 58
3 The personal transmission of knowledge 88
4 Interpreting a classical Chinese medical text 105
5 The standardised transmission of knowledge 128
6 Teaching from TCM texts 168
Discussion: styles of knowing 225
Appendix: Curriculum for TCM regular students and

acumoxa and massage specialists 241
Glossary of medical and philosophical terms 247
References 270
Indexes 287
vii
Acknowledgements
This book has gone through many stages, and I would like to thank all
those who have contributed to its completion; it would be impossible to
acknowledge them all here. The book is based on my Ph.D. thesis,
‘Transmission of Knowledge, Texts, and Treatment in Chinese Medi-
cine’ (1992), which was conducted under the supervision of Gilbert
Lewis. My first and foremost thanks go to him for his trust in me at
that stage of my studies in anthropology and for his insights which
continue to give me guidance. But a thesis makes no book, and Sir
Geoffrey Lloyd not only encouraged me but also gave me vital advice
on how to refine my work. In addition, I thank the Press’s four anony-
mous reviewers and the style editor. The book would not have taken its
present form without their comments.
The research was funded by the Swiss National Foundation, the
Wenner–Gren Foundation for Anthropological Research, the National
Science Foundation of the United States who provided a Research
Fellowship at the Needham Research Institute, and the Chiang Ching-
kuo Foundation for a post-doctoral Teaching and Research Fellowship
in the History of Chinese Science and Technology at the Faculty of
Oriental Studies of the University of Cambridge where the manuscript
was completed. I should also mention the British Council, Clare Hall
College, the Overseas Research Scholarship, and the Zürich City Council
who in the beginning of my researches provided relatively small but
decisive support. The contact between the sister cities Zürich and
Kunming was crucial for favourable fieldwork conditions.
Above all, I wish to express my gratitude to the people in Kunming,
in and outside the Yunnan Traditional Chinese Medical College. I
would like to thank my teachers Wu Zongbo and Yan Yuwei who really
cared that I acquire a comprehensive training and Zhou Yongsheng
who arranged my stay at the college with a warm-hearted concern.
Thanks also to qigong master Qiu and Jade Blossom who made me feel
so much at home, and to all the friends, patients, students, and doctors
on whose cooperation this research depended.
viii
Note on Chinese terms
Chinese words are all rendered in pinyin, the official transliteration

system of the People’s Republic of China (PRC), even in quotations
from works in which other transcription systems have been used. Chi-
nese medical terms have all been approximated by an English term, but
where these need to be understood in a special sense I have used initial
capital letters to identify them. Blood (xue), for instance, is not in
all respects equivalent to the English term ‘blood’. These terms have
been translated into English previously, but the Chinese medical term-
inology varies greatly between different authors. In the context of the
government-promoted Chinese medicine, I have used primarily the
Revised Outline, partially translated by Sivin (1987), and Wiseman’s (1990)
comprehensive Glossary of Chinese Medical Terms and Acupuncture Points.
However, since I worked in different social contexts, style and register
had to be adjusted, and therefore the same Chinese term has been trans-
lated differently in different contexts in approximation of the speaker’s
understanding of its connotations. Some terms clearly have changed their
connotations over time, and they are treated accordingly in translation.
The precise interpretation of these terms will of course continue to be
subject to debate.
The glossary concerns medical and philosophical terms and includes
a synopsis of the various translations given by Manfred Porkert, Paul
Unschuld and Nathan Sivin.
Translations are my own if not otherwise indicated. Personal names
and certain biographical details have for reasons of discretion been
disguised.
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HH
x
Introduction: ways of learning
Chinese medicine is grounded in medical practice and in texts – in

experience and in its transmission from one generation to another. It
changes over time as its social and historical contexts change, but these
changes do not occur uniformly. This book explores variations of key
terms in Chinese medicine and examines ways in which they are under-
stood in different social contexts. In particular, it concerns the extent to
which the understanding and social significance of these terms depend
on the way in which they are transmitted and learnt.
Why should the understanding of specific concepts depend on the
way in which they are learnt? Knowledge is generally assumed to
depend on what one has learnt, regardless of how one has learnt it. This
study contests the idea that there are contents of knowledge that can be
transmitted and learnt regardless of how the actors involved, in their
social relationship to each other, relate to knowledge. It shows that
styles of knowing differ according to one’s perception of and attitudes
to knowledge, and that the meaning of the same term may change as
the ways change in which one perceives, expresses, uses, credits, orders,
and applies knowledge. The underlying question in this book is thus
how far the way in which one learns these terms determines the way in
which one knows them or, simply, how different ways of learning relate
to different styles of knowing.
Modes of transmission
Central to this study are the ways in which Chinese medical knowledge
and practice were transmitted and learnt in three different social settings.
These different modes of transmission may be called ‘secret’, ‘personal’,
and ‘standardised’, terms which refer primarily to the observed rela-
tionships between the medical practitioners and their acolytes, while
simultaneously accounting for overall features of the settings in which
the transmission of medical knowledge and practice took place. The
‘secret’, ‘personal’, and ‘standardised’ modes do not describe idealised
1
2 The transmission of Chinese medicine
types; they were not starting assumptions nor hypotheses I set out to
test, but have arisen from an interpretation of ethnographic data and
correspond, in that sense, to the conclusion of the study.
‘Secret knowledge’ is much discussed in the anthropological literat-
ure, although it is in fact the process of transmission that is secret. This
secretly transmitted knowledge is not to be confused with ‘tacit know-
ledge’ that refers, in contexts in which knowledge is proclaimed to be
open and accessible to anyone, to those aspects of a practice that are
transmitted without being explicitly mentioned. Secretly transmitted
knowledge is intentionally made secret, and this is crucial for the social
relationship of those involved. It may very well consist of explicit state-
ments which may be the same as those transmitted in other ways, but
the ways in which one knows them – their powers and dangers – differ
significantly.
The personal transmission of knowledge and practice tends to be
subsumed under the secret transmission of knowledge but my fieldwork
observations call for singling it out: it depends critically on the person-
alities of mentor and follower and their choice to maintain a personal
relationship of mutual trust within which the follower acquires medical
knowledge and practice. The historical and crosscultural perspectives
underline the relevance of these observations: the personal transmission
of knowledge, as observed in ethnographic fieldwork, shares several fea-
tures with the way in which Chinese medicine, according to textual records,
was practised and transmitted among the literate elite in Imperial times,
and some of its features are also found among the traditional elite in
India and other parts of the Far East, the Hellenistic and Islamic world,
and medieval Europe.
The standardised mode of transmission is generally considered a form
of ‘Westernisation’, ‘modernisation’, or ‘professionalisation’, although
it is in no way specific either to Western culture or to modernisation.
Particularly in China and probably also in other highly stratified societies
with a literate elite, government efforts to standardise medical knowledge
and practice have a long history. In the People’s Republic of China
(PRC), guifanhua, ‘to standardise’, is the word with which many doc-
tors in government institutions describe their endeavours. The notion
of standardisation that I use as a meta-category for ordering ethno-
graphic material is thus derived from the actors’ point of view.
Styles of knowing
This study was designed to avoid discussing Chinese medical terms

decontextualised from social practice, as is so common in textbooks and
textbook-like monographs. The aim was to focus not on words and con-
cepts but on utterances and verbal reasoning in social practice. Moreover,
I declined to approach this reasoning in terms of Western philosophical
categories, valuable as such studies have been (e.g. Hutchins 1980;
D’Andrade 1996:193–9).1 Instead, I intended to become immersed in
it, much as Duden ((1987)1991) leads the reader into a world of flows
and stagnations – the monthly blood being ‘stubborn’, wind coming
out of the ears, milk flowing off through the stomach, being excreted as
the very same white fluid, and sweat smelling like the elderberry juice
just drunk – which all give rise to women’s illnesses, thereby revealing
how a doctor of the early eighteenth century reasoned about mind–
body processes.2
While historians like Duden must be content with an archaeology
of textual fragments, anthropologists can observe the actual incidences
of reasoning as social practice. The aim of my research on Chinese
medical reasoning was to focus on the situation in which it took place,
to account for the actors involved – it went without saying that their
social positions determined much of the significance of their assertions
– and I was attentive to the variation and variability of access to special-
ised knowledge and practice. Concepts are not shared to the same degree
among the members of a group; some know things others do not know,
and some can say things improper for others to say. A statement is not
the same if uttered by a child or an elder. Depending on the audience,
things otherwise not mentioned can be said. Individuals differ: ‘Some
people are quick to see the point of a joke, others are slow. Some see
a suggestiveness about it which others miss. Some have fertile, inventive
and daring imaginations; others, more stolid, remain earthbound, literal,
and poetry is lost on them’ (Lewis 1980:6). Dispositions change: ‘We
differ in our preoccupations, our moods, the state of our desires, in our
readiness to see something’ (p. 116). Reasoning is a creative act. Utter-
ances are not propositions. They have pitch and intonation underlining
the mood and modality in which they are uttered. They may be more
expressive than descriptive and have a ‘speech appeal’ (Bühler (1934)
1982:28–9). They may represent an ‘illocutionary’ or ‘perlocutionary’
act (Austin 1962:109). They need not be well-formed to be under-
stood, and people attribute different values to them depending on the
actors and the occasion.
1
Hutchins (1980) has provided a formal analysis of how the Trobriand Islanders, deemed
incapable of intentional and causal reasoning, did in fact make logical inferences during
disputes concerning land ownership.
2
Duden claims that these recordings reflect the women’s own perceptions, but this is
difficult to know. They certainly are not to be mistaken for representing the scholarly
Galenic traditions.
Verbal reasoning, just like ritual, can be over-intellectualised. In

Chinese medicine, we are often confronted with concepts comparable
to ‘empty notions’ such as evur (witchcraft power) among the Fang
(Boyer 1990:24–45). Boyer has convincingly contested the structuralist
and intellectualist approaches to such mana concepts, which consider
them either as central cultural symbols marked by a so-called ‘semantic
vacuity’ (postulated by Claude Lévi-Strauss) or as ‘theoretical prin-
ciples’ comparable to laws in the modern Western sciences (postulated
by Robin Horton). The more viable approach to such empty notions,
according to Boyer (1990:30), is to ‘distinguish between several inter-
related “registers” or “styles” of discourse’. He distinguishes between
‘common discourse’ which is generalising, not related to any precisely
defined source of knowledge, and willingly inconclusive; ‘gossip’ which
is very definite, centred on singular cases, and of no use in the contexts
in which truths are supposedly expressed; and ‘experts’ utterances’,
which are definite, focused on singular cases, and fairly reliable. This
study concerns almost exclusively experts’ utterances. We will see that
registers of discourse or, rather, ‘styles of knowing’ will vary even among
experts, and the so-called ‘empty notions’ of Chinese medicine will be
shown to vary accordingly.3
The notion of ‘style’ in the idiom ‘styles of knowing’ alludes to the
aesthetic in art and literature, and in this sense it may also be used to
refer to ways of doing science or medicine. When Fleck ((1935)1980)
coined the term Denkstil (thought style), he spoke of ‘style’ in a slightly
different way. A certain Denkstil belonged to a certain Denkkollektiv
(thought collective): ‘The force of explanation was dependent on the
possibility of relating a term to other stylistically matched terms’ (p. 51,
italics added). While this aspect of Fleck’s notion of ‘style’, which
stresses the socially approved within a collective, should not be over-
looked, I shall use the word ‘style’ more in Hacking’s (1992) sense,
emphasising fluidity and individualistic endeavour: ‘Every style comes
into being by little microsocial interactions and negotiations’ (p. 10,
italics added). ‘Style’ may be ‘generalised’ or ‘personalised’: ‘There is a
Balzacian style and there is Balzac’s style. Equally, in swimming, there
is the Australian crawl and freestyle, as opposed to the style of Patti
Gonzalez, that can be imitated but is inimitably hers. It is entirely
natural to talk of the style of an individual scientist, research group,
programme or tradition’ (Hacking 1992:2). I have investigated the styles
3
According to Boyer (1990) all three registers of discourse together give the actors an
idea of what is meant by evur. However, the Chinese actors discussed in this monograph
had access to only one style of knowing.
of three individuals; whether these styles can be generalised remains

to be seen.
The notions of ‘reasoning’ and ‘discourse’ refer to verbal interaction,
while ‘knowing’ involves, in addition, the non-verbal aspects of social
interaction in an instance of medical reasoning, including knowing
through the intellect, through feelings and intuitions, and through
bodily automatisms or, as Csordas (1993) put it, ‘somatic modes of
attention’. Knowing is meant to emphasise that the instances of med-
ical reasoning are instances of doing all kinds of things in addition to
engaging in intellectual communication.4 Although neither verbal reason-
ing nor knowing are likely to reach the same salience and emotional
arousal as ritual performances, they are a form of action which Lewis
(1980:118), with regard to ritual, describes as: ‘A way of doing, making,
creating, showing, expressing, arousing – a complex form of stimulus to
which people respond.’
Knowing Practice
In Knowing Practice, Farquhar (1994a) has emphasised the concept
of ‘knowing Chinese medicine’ as opposed to ‘knowledge of Chinese
medicine’. She does not define ‘knowing’, but it appears that ‘know-
ing Chinese medicine’ has something to do with the particular way in
which Chinese medical knowledge is applied to Chinese medical prac-
tice. Examining the clinical encounter, Farquhar suggests that Chinese
medical discourse has the peculiarity of moving along a gradient from
more ‘concrete’ to more ‘verbose’ idioms and back again. In the process
of what she calls ‘looking at the illness’ (kan bing), a doctor transforms
concrete ‘signs’ (zheng1, complaints of the patient) into less concrete
‘symptoms’ (zheng2, the doctor’s notations in Chinese medical terms)
and then into verbose ‘syndrome-therapies’ (zheng3, also called Distin-
guishing Patterns), which I was taught generally consisted of a four-
word phrase such as feng shi tou teng (a Wind Dampness Headache). In
the process of ‘syndrome differentiation and therapy determination’
(bianzheng lunzhi), the verbose ‘syndrome-therapies’ are translated into
more concrete ‘formulae’ ( fangji) which are in turn composed of spe-
cific ‘drugs’ ( yao).
Although Farquhar calls her book Knowing Practice, her model pro-
vides an idealisation of the clinical encounter rather than an account of
4
Hacking (1992:3) makes a similar point: ‘Reasoning is done in public as well as in
private: by thinking, yes, but also by talking and arguing and showing.’ Reasoning in
Hacking’s sense, like knowing in this sense, is a form of action.
observed ways of ‘knowing practice’. The model nicely reflects the

claim of doctors in government-run institutions, namely, that they have
a step by step way of coming from signs to symptoms to syndromes,5
although we do not know exactly how Chinese medical doctors get
from patients’ complaints to the prescription of specific drugs. Farquhar’s
book reflects the information presented to students in the more ad-
vanced courses on the Diagnostics of Traditional Chinese Medicine (Zhongyi
zhenduanxue) and the Formularies (Fangjixue). It contains translations of
seminal texts by leading figures in Traditional Chinese Medicine and
textbook passages with which most practitioners are familiar. It aims at
a comprehensive account of the clinical encounter throughout the PRC,
but this aim has its disadvantages; Farquhar attributes more authority
to written texts than to fieldwork observations, anecdotes of which tend
to be recorded only in footnotes.
This monograph, by contrast, is intended to provide an ethnographic
account for a particular place and time: three settings in Kunming city
between September 1988 and December 1989. It discusses key con-
cepts of Chinese medicine embedded in an ethnography of social
practice, whether in a healer’s consultation room, in the seminars of
a self-constituted reading group, or in college classrooms. It aspires not
to comprehensiveness but to accuracy and fidelity to what was observed
and experienced. It is intended to provide an understanding of Chinese
medicine that complements and sometimes calls into question the under-
standing derived from textbooks and the view that one gains from
a focus on texts (Porkert 1974; Sivin 1987; Farquhar 1994a). It is
meant to contextualise earlier accounts by medical anthropologists
(Ots (1987)1990 and Farquhar 1994a) in that it is not limited to the
medicine taught and practised in government institutions, and takes an
approach Unschuld ((1980)1985) has long advocated by naming his
book Medicine in China, which calls for abandoning the idea of a mono-
lithic doctrine and practice of Chinese medicine.
TCM
The context of learning Chinese medicine that deserves particular
attention, not least because it is the most discussed in the Western
literature (see above), is the traditional medicine that is promoted on
5
Farquhar’s model strikes me as being so much in tune with the intentions of TCM
textbook compilers that it would not be surprising to find it incorporated in their future
teaching materials.
a nationwide scale in colleges, hospitals, and clinics. Its legitimation in

the PRC, which took place only in the late 1950s and early 1960s, has
led to a reforging that is driven by many different interests – among
them nationalism, Confucian values, humanitarian ideals, reformist and
‘Enlightenment’ movements, the pragmatic politics of a party in pursuit
of power, and economic considerations of how to allocate manpower
and scarce resources.6 This medicine is here called ‘Traditional Chinese
Medicine’ and abbreviated to TCM. TCM, when used by Chinese
authors in translation, implicitly refers to Chinese medicine in general.
This study, however, proposes to narrow its sense down to refer to the
government-promoted medicine only and use the more general term
‘Chinese medicine’ (inclusive of TCM) to refer to what in Chinese is
called zhongyi.7 Although there is no specific term for TCM in Chinese,
there was among the people I worked with a tendency to recognise it on
a conceptual level.
TCM, in spite of being called ‘traditional’ (chuantong), is generally
referred to as the ‘modernised’ (xiandaihuade), ‘scientific’ (kexuehuade),
‘systematic’ (xitonghuade), and ‘standardised’ (guifanhuade) Chinese
medicine. In awareness of how ideology-laden these attributes were,
one doctor called TCM the ‘school of the colleges’ (xueyuanpai), which
implied that it was just one of many ‘schools’ of Chinese medicine.
However, government officials, if not aiming at its monopoly, advocated
its predominance. TCM, like the professionalised Ayurvedic medicine
in India (Leslie 1976a) or Kanpo in Japan (Lock 1980:109–54; Ohnuki-
Tierney 1984:91–122; Oberländer 1996), can be regarded as the pro-
fessionalised Chinese medicine.
Considering how intertwined Chinese medical practice is with shamanic
(Kleinman 1980), temple-based (Gould Martin 1975), divinatory (Topley
1976), fortune-telling (Smith 1991), home-based ‘herbal drug’ (caoyao),
and other practices, we may agree that ‘it is unlikely that before 1949
TCM was a particularly discrete unit for the majority of practitioners’
(Farquhar 1994a:15). Currently, however, TCM can be identified as
such by investigating the educational scheme, its organisation of know-
ledge, its textual presentation in textbooks, and verbal reasoning in
classrooms and clinics.8 TCM knowledge is no longer represented as a
6
A history of Chinese medicine in the PRC has yet to be written. Croizier (1968) and
Lampton (1977) still provide most detailed information. On Chinese medicine in the
Republican period, see Croizier (1968), Ma et al. (1993), and Andrews (1996).
7
See also Farquhar (1994a:15) and Sivin (1995d:197). Sivin (1995c), however, speaks of
‘Traditional Chinese Medicine’ with reference to what I would call ‘Chinese medicine’.
8
On variations of TCM practice, see Scheid (1998).
medical ‘doctrine’, and in this respect differs from Chinese medical

learning, which for many centuries ingeniously combined book learning
with medical practice.
TCM is distinct also in respect of its institutional setting: the colleges,
hospitals, and clinics are all institutions of the Chinese socialist state,
so-called ‘work units’ (gongzuo danwei). It is within such socialist institu-
tions that Chinese medicine has been modernised, Westernised, standard-
ised, and made scientific. However, the modernisation of everyday
life has affected all medical practices within and outside government
institutions, often closely interrelated with a certain Westernisation, and
‘science’ or ‘scientific’ is a ubiquitously found attribute for any therapy.
It is only in government institutions that the aim of standardising Chinese
medical learning has been formulated and pursued. Comparison of
this government-promoted medicine with other Chinese therapeutics
will allow us to identify both strengths and limitations of the standardi-
sation of medicine.
The settings
The settings for my investigation of the above-mentioned ways of
learning and styles of knowing were selected from a wide range of thera-
peutics in Chinese urban society (see table I.1). My choice took into
account that urban spaces were readily divided into ‘work units’ (gongzuo
danwei) established by the government in the 1950s as separate cells of
urban production and consumption, and the spaces outside them, which
included residential areas as well as areas of ‘private’ or ‘individual’
enterprise (getihu) and ‘collectives’ ( jitihu).9 The government promoted
the standardised mode of transmission in the work units. The other two
modes of transmission, which were tolerated but not promoted, were
overtly practised in the private and collective spaces outside the govern-
ment institutions (see fig. I.1 on p. 14).
As setting for studying the standardised mode of transmission I chose
a TCM college, the Yunnan TCM College (Yunnan zhongyi xueyuan).
Enrolled between September 1988 and December 1989 as its first for-
eign student, I was treated with particular care and assigned two excel-
lent tutors, one of whom was teacher Tao. A separate room was prepared
for me in a newly built dormitory for ‘minority nationalities cadres’
(minzu ganbu), able medical doctors from the periphery of the province
9
These urban spaces outside work units were never completely abolished in the PRC,
and they significantly gained in importance as areas of functional specialisation during
the reforms of the 1980s.
Table I.1. Different medical practitioners in a Chinese urban setting

(not comprehensive)
Western
temple medical
praying fortune herbalists qigong doctors
monks tellers (caoyi)10 healers11 Chinese medical doctors (zhongyi)12 (xiyi)13
massage acumoxa Chinese TCM

(anmo) (zhenjiu)14 medical doctors
doctors (zhongyi)15
(zhongyi)
(Qiu) (Qiu) (Qiu and (Zhang) (Zhang) (Tao)
Zhang)
practise practise mostly outside practise outside and practise mostly inside
in government clinics inside government government clinics and
temples ‘folk-medicine’ clinics and hospitals hospitals
10
‘Herbal medicine’ (caoyi) was practised by doctors with no formal training or official
recognition, and often consisted of applying home-based remedies with ‘herbal drugs’
(caoyao) made up mostly of various parts of plants collected in the hills around the city.
The term ‘herbalist’ (caoyi) had in the PRC of the late 1980s a rather restricted sense
whereas Topley (1975:243) had earlier observed in Hongkong that: ‘All traditional practi-
tioners are thus “herbalists”. No traditional practitioner may call himself “doctor” ( yisheng);
this privilege is restricted to qualified, registrable Western-trained physicians. He may
call himself zhongyi in Chinese . . . but in its English translation . . . he must include the
term “herbalist”.’ In the PRC of the 1980s a Chinese doctor could call himself yisheng.
11
Qigong is a compound word composed of two terms, qi and gong. Qi designates a dynamic
force and quality in constant flux and flow. It is comparable to pneuma in Greek or prana
in Indian philosophy. English renderings such as ‘pneumatic stuff ’, ‘air’, ‘vapour’, and
‘breath’ all approximate to its meaning, but unsatisfactorily. Gong means effect, discipline,
capability, achievement, and merit. Qigong (workings with the breath) refers to prac-
tices of nurturing and conducting the qi which enhance the efficiency of qi in the body.
12
Zhongyi, a term coined in the last century in response to the presence of the West in
China (Croizier 1976:361), comprises many more subdisciplines. Those mentioned here
are directly relevant for situating the three main actors in this monograph. Zhongyi
functions as a superordinate, referring to both government-promoted and government-
tolerated Chinese medicine, but it can also refer to the government-promoted TCM alone.
13
‘Western biomedicine’ (xiyi) is generally contrasted with Chinese medicine, zhongyi.
The Western medicine practised by these doctors is neither homeopathy nor scholastic
medicine, but biomedicine. Frankenberg (1993:220) rightly draws attention to the
‘customary social science conflation of the biological and medical concealed within the
term biomedicine, which seems to embody an ideological assumption and a rhetorical
claim that need to be explored rather then uncritically accepted’. The term ‘biomedi-
cine’ is used here precisely because there are basic ideological differences between the
Western life sciences and the notion of life and death in Chinese therapeutics.
14
‘Acumoxa’ (zhenjiu) comprises both therapies of ‘needling’ (zhen) and ‘moxibustion’
or ‘moxa’ ( jiu), and is throughout this monograph used in place of the term ‘acupunc-
ture’. Porkert (1976:1242) coined the term ‘Aku-moxi Therapien’.
15
‘TCM’ (zhongyi) refers to the standardised medicine that has been promoted at govern-
ment colleges since the 1950s. The term is used in a narrower sense here than is usually
adopted in PRC journals, where TCM is the English term for the Chinese word zhongyi.
who had been recruited during the Cultural Revolution and were enrolled
for brush-up courses. The sanitary installations were supposed to be
better there than elsewhere, and the room was, ‘for safety reasons’, not
easily accessible. I was registered as a first-year student in ‘acumoxa
and massage’ (zhenjiu tuina), which was a three-year course that had just
begun to be offered by the college for training ‘specialists’ (zhuankesheng),
but I also attended classes at higher levels with ‘regular students’
(benkesheng) enrolled in a five-year course on TCM (zhongyi). A special
curriculum and timetable were set up for me at the beginning of each
term, two lectures in different courses every (other) morning.16 After
six months I spent every other morning and after a year every morning
at an acumoxa clinic with students who were in their year of clinical
practice.
Considering that Yunnan is a ‘frontier area’ (bianjiang) in the south-
westernmost corner of the PRC, one may wonder about the represent-
ativeness of my experiences at college. College education was largely
subject to nationwide policies, and the curriculum, textbooks, and exam-
inations were supposed to accord with the national standards set up in
1984. The architecture and general setup of the work unit also followed
the nationwide model. The living conditions in this particular unit were,
however, among the worst in Yunnan’s provincial capital.17 College
members repeatedly referred to it as the smallest, financially least sup-
ported, and academically least respected of all of Yunnan’s institutions
of higher learning,18 and this low status is perhaps not characteristic of
all TCM colleges in the PRC.
I had chosen to specialise in acumoxa rather than herbal medicine
because I considered it important to feel comfortable in delivering the
medical treatment about which I was to write after only eighteen months
of fieldwork, and herbal medicine appeared to me too vast a subject.
As the number of acu-points (xuewei) is limited, comprising three to
16
Namely: TCM Fundamentals (Zhongyi jichu lilun), Classical Chinese for Medics (Yiguwen),
Interpretation of the Inner Canon (Neijing jiangyi); and [The Study of ] Acumoxa [ for
TCM regular students] (Zhenjiuxue), TCM Diagnostics (Zhongyi zhenduanxue), Acumoxa
Loci (Shuxue), Tracts and Links ( Jingluoxue), Needling and Moxa Techniques (Zhenfa
jiufaxue), Acumoxa Therapy (Zhenjiu zhiliaoxue).
17
This changed in the late 1980s, when the college acquired land in a southern suburb
of the city. In 1996 some of the staff was lodged in a new compound, and the
Department of Traditional Chinese Pharmaceutics (zhongyaoxi) was in course of being
transferred there.
18
One exception was Prof. Zeng Yulin of the Department of Traditional Chinese Phar-
maceutics who was rewarded for his research on extracting the pure and active sub-
stances from traditional herbs of some of Yunnan’s ethnic minorities. The Yunnan
TCM College had apparently enjoyed higher recognition in the 1960s, before excellent
staff left or died in the Cultural Revolution (Zhang 1989).
five hundred at most, and the range of disorders known to be success-

fully treated by acumoxa fairly narrow, learning this skill was not too
ambitious an enterprise. And, indeed, during the last six months of
my training I began to experience that I could alleviate the symptoms
of some patients. Acumoxa has only a few hundred years of history in
this province (Tian 1987:61), and because its promulgation by the
government is quite recent my investigations can be considered fairly
comprehensive.
The setting in which I explored the personal mode of knowledge was
a reading seminar under a ‘senior Chinese doctor’ (laozhongyi), Zhang,
to whom colleagues at the college, when responding to my saying that
I wanted to learn ‘real’ Chinese medicine, introduced me in April 1989.
Zhang, an acupuncturist whose treatment included herbal medicine
and occasionally massage, already had experience with foreigners, and
was particularly welcoming to me as a foreigner with whom he could
speak without an interpreter. After a few private reading classes, some
of the employees of his collective joined us, and eventually our seminars
consisted of a group of seven. This self-selected group, instigated on
my initiative, was an artificial setting within which Zhang lectured, but
study groups of this kind do not seem to be unusual among Chinese
doctors (Farquhar 1996a:248). We met once or twice a week from
April to December 1989, reading various texts from the Basic Questions
(Su wen) and Divine Pivot (Ling shu), the two books that constitute the
Yellow Emperor’s Inner Canon (Huang di nei jing), and the Book of Changes
(Yi jing). Since I observed similar approaches to classical texts among
other senior doctors,19 my discussion of Zhang’s modes of interpreta-
tion, though selective, may nevertheless be fairly representative. His
attitude and approach to medical texts appear to correspond to those
of the ‘scholar doctors’ (ruyi) of Imperial China (Lu and Needham
(1966)1970:391; Hymes 1987; Wu 1993–4; Cullen 1993; Y. P. Chen
1995) and also have affinities with learned doctors of other Asian medi-
cines (Leslie 1976a; Leslie and Young 1992; Bates 1995).
I spent considerably less time in Zhang’s practice than in the other
settings of medical learning and have therefore not systematically re-
corded his and his followers’ treatment of patients. Zhang had only a
few patients; they were almost always ‘old friends’ (laopengyou) who
would engage in long conversations with him while being treated. Some-
times, when he explained a problem to his follower, he would invite me
to join them; sometimes he would show me a successfully treated case.
19
Regular visits to a senior Chinese doctor in a county town near Kunming from August
1989 onward provided particularly interesting information that put Zhang’s and also
Qiu’s practice into perspective.
In general, however, I felt that my presence at the bedside was intrus-

ive. This fieldwork experience in itself may be telling about the personal
transmission of medical practice: the maintenance of a harmonious
personal relationship between doctor and client had priority over the
transmission of knowledge between the mentor and a follower as tenu-
ously linked to him as I was.
The setting in which I explored the secret mode of transmission was
a private practice of a healer, Qiu, specialised in qigong (workings with
the breath). I was strolling with my bicycle through a back street that
appeared promising for finding a private acumoxa practice and had
stopped to study his advertisement, when he struck up a conversation:
‘Where are you from?’ he asked. ‘Xinjiang’, I replied with a twinkle in
my eye. ‘Really! That’s way up in the northwest, quite far from here. It
must still be quite warm there?’ Xinjiang was in his mind the land of
deserts where grapes and raisins came from. He wanted to know more
about it. Which town exactly did I come from? What business brought
me to the south? Evidently he considered me Chinese and when I even-
tually revealed that I was from Europe (Ouzhou), he did not understand
until his elder brother shouted: ‘She’s a foreigner, can’t you see?’
Qiu accepted me as his disciple after treating an unspecific fatigue
that weakened me during the first three months of fieldwork. He later
explained that his older brother had urged him to teach me qigong, not
only to cure me, but also to let me make him known to the world. His
wife, Jade Blossom, soon became best friends with me and took me as
an ally in her struggles with her in-laws. She had managed to cross the
boundary between rural and urban China by means that she did not
wish to reveal, which made her suspect, particularly to Qiu’s brothers.
During the first two months after their wedding in September 1988,
Qiu and Jade Blossom alternately confided family problems to me.
Later, particularly after Jade Blossom gave birth to a son in June 1989,
family relations improved; Jade Blossom agreed at last to call her mother-
in-law ‘mama’ and was, reciprocally, now more accepted by her in-laws.
While the setting within which Qiu worked as a private practitioner
was fairly characteristic of back-street environments in the late 1980s, it
is difficult to tell how representative his practice was. Comparisons with
contemporaries of Qiu who called themselves qigong masters revealed
discrepancies, but texts on self-cultivation practices in historical times
contained descriptions of practices Qiu either performed or described
to me (Engelhardt 1987; Kohn 1989; Despeux 1994).
Since I intended to compare different modes of transmission with
corresponding styles of knowing, it would have been ideal to work with
Chinese medical doctors in all three settings. The hazards of fieldwork
led me to a qigong healer’s instead of a Chinese medical doctor’s family

practice. In retrospect, the decision to work with a qigong healer turned
out to have several advantages. First, qigong, like the martial arts, is
veiled in secrecy, often more conspicuously than Chinese medicine,
and in studying it I was therefore much more exposed to social practice
characteristic of the secret transmission of knowledge and practice than
I would have been otherwise. Secondly, because the skills and know-
ledge of a qigong healer differ from those of a Chinese medical doctor
while sharing much of the Chinese medical terminology, I was able to
learn about Chinese medical concepts from a different angle, in a thera-
peutic context that is, strictly speaking, not one of Chinese medicine.
Thirdly, when I eventually became friends with a Chinese medical
doctor who had, together with his wife, a family practice in a county
town near Kunming, my experiences in the qigong healer’s family prac-
tice enabled me to recognise common features of social practice that are
related to the secret transmission of knowledge and practice, regardless
of whether they pertain to qigong or Chinese medicine.
If one were to interpret the medical pluralism in urban China accord-
ing to Leslie’s (1976b:361) well-known diagram of the spectrum of
therapeutics in a stratified society like India, the three doctors I worked
with would best be compared to popular or folk practitioners (qigong
master Qiu), learned traditional culture Ayurvedic and Yunani physi-
cians (senior Chinese doctor Zhang), and professionalised Ayurvedic
and Yunani physicians (TCM professional Tao). In terms of Kleinman’s
(1980:50) model of health sectors, the two practitioners working out-
side the work units, Zhang and Qiu, would belong to the folk sector,
and the Chinese medical doctors in the work units, like Tao, would
belong to the professional health sector, which apart from TCM com-
prised all kinds of other organised healing professions.20 In the PRC,
the number of practitioners like Zhang and Qiu may be insignificant,
but their practices and explanations seemed relevant because they shared
features reminiscent of those described by historians of Chinese medi-
cine. It may not be coincidence that they found a niche in the realm
outside government units in which they could survive in Socialist China,
although this realm seems to be increasingly populated by TCM-trained
doctors (interview with Provincial Health Ministry, December 1989).
20
Zhang did not consider himself part of the folk sector. This contradiction is easily
resolved by pointing out that the anthropologist’s viewpoint need not completely coin-
cide with the insider’s (Frankel and Lewis 1989:2). Zhang’s view raises, however, the
question of whether the model of the three health sectors is appropriate for complex
societies in which the traditional elite set up well-organised state-controlled institutions
of health care.
urban health care
realm within work units realm outside work units
i.e. government collective private

hospitals, clinics, colleges practice practice
teacher Tao mentor Zhang master Qiu

(TCM) (acumoxa) (qigong)
Figure I.1 The three settings of fieldwork
In all three settings the written word was at the core of medical practice
and knowledge. They all exemplified a literate tradition of medical prac-
tice. Qiu’s qigong therapy was said to be grounded in the correct pro-
nunciation of the written word in incantations from the Daoist Canon
(Dao zang), and had thus features of word magic. In the two other cases,
which concerned Chinese medicine, the written word – frequently a
phrase from the Inner Canon (Nei jing) – was used to justify and explain
medical practice.
However, the economic conditions of these settings differed, as did also
the social relations of the doctors and healers – among each other, with
regard to their recruits, and in respect of their clients. The economic
conditions would be classified in Chinese terms as those of a private
practice in the case of Qiu’s family practice, a collective in Zhang’s
case, and a government work unit in the case of teacher Tao at the
TCM college. The social relations between the senior expert and the
junior aspiring to expertise were in the first case a relationship between
kin, in the second one between personal acquaintances, and in the third
one between citizens of a Socialist state. The three contexts thus in-
volved different micro-economic bases of income (getihu, jitihu, danwei),
social relations (kinship, friendship, citizenship), and religious practice
(though notoriously difficult to circumscribe, here approximated as folk-
Buddhism/Daoism, an idiosyncratic form of Confucianism, secularism).
It must be kept in mind that practices varied widely within each
context. Structuring ethnographic material around the practice of three
individuals in three markedly different settings does not do justice to
this variation. Moreover, these contexts cannot be considered separate
and homogeneous units; they were mutually interdependent. This study
is not a sociological survey of medical pluralism in urban China. Rather,
these three settings were chosen for in-depth study of three different
ways of learning Chinese medical knowledge and practice.
Approaches to the field

Fieldwork in the PRC is notoriously difficult to arrange.21 Enrolled as a
student at a TCM college and several TCM hospitals, I attended classes
or clinics in the mornings. The afternoons were at my disposal. Every
other day I spent several hours in and around the private practice of the
qigong healer, and one or two afternoons a week I spent with the senior
Chinese doctor. Common to all these settings was the unusual position
in which I performed fieldwork: I was not only a ‘participant observer’,
but also learning specific, technical knowledge and practice. My approach
to the field can thus be described as intending to engage in ‘participant
experience’. My position as student, follower, and disciple placed the
doctors and healers I interacted with in the position of ‘teacher’ (laoshi),
‘mentor’ (xiansheng), or ‘master’ (shifu). Well aware that anthropologists
are still nowadays in a position comparable to missionaries, backed
by an overwhelming military, economic, and political power (Van der
Geest 1990), I thereby hoped to modify the unequal relation which
prevails between the informant and the anthropologist. Additionally, I
believed, an anthropologist who has learnt the specifics of a practice in
a foreign culture may help to encourage understanding of it in her own
culture.
The anthropologist who decides to be simultaneously fieldworker
and apprentice is cast in roles that are not always compatible. First, the
topics of interest do not always coincide, and even when activities are of
interest to both the fieldworker and the student the problem arises of
what to pay attention to. For instance, the student engaged in prac-
tical training may want to focus on specific technical details while the
participant observer may prefer to observe the interpersonal exchanges
between teacher and students. These two roles also posed problems for
some people I worked with. Not knowing whether they were relating to
a fieldworker or to a student evoked an uncomfortable reserve in some
of my teachers and colleagues at the TCM college. Interestingly, neither
Zhang nor Qiu who worked outside the realm of work units were much
disturbed by my dual role. They clearly welcomed the attention they
were receiving from a foreigner and were much less suspicious about
21
Arranging the fieldwork of 1988–9 was a long process. It began in March 1985 with
exploring fieldwork conditions mostly in Chengdu and continued in October 1987 in
Kunming. One of the main difficulties was to avoid being put into a special course for
foreigners. The Yunnan TCM College first arranged private tutorials, but I insisted
that my research was all about learning Chinese medicine in the Chinese way. Finally,
one of the two lecturers who had been dispensed from teaching to give private tutorials
agreed to teach the main subjects of the introductory course to an entire class of
acumoxa and massage specialists.
my role as a social scientist. Given that their practice was only tolerated
by the government, they were probably concerned with its legitimation;
regular visits by a foreigner were likely to increase its prestige.
At the same time, I would never have obtained the knowledge and
insights I did if I had not been accepted as a student, follower, and
disciple, particularly in the contexts of esoteric learning outside the
college. Moreover, my own attitude to what I learnt by engaging in
medical practice myself is likely to be different from that of an observer.
A researcher who has learnt to operate within another conceptual frame-
work is likely to gain a more comprehensive understanding of it than
someone who is content with the detached observations of an onlooker.
My experience was that Chinese medical concepts became more imme-
diate to me after using them, particularly when I found that I was able
to achieve therapeutic effects. The fieldworker who has experienced in
person the complexities of providing medical treatment – including the
rapport with the patient, the recognition of signs and symptoms known
from book learning only, the skills of examining the Pulse (mai), the
Tongue (she), and the Complexion (se), the synthesis of these different
data into a Chinese medical ‘diagnosis’ (zhenduan), the choice of the
‘maxims of treatment’ (zhize), and the selection of acu-points and
application of different needling techniques – may be more aware of
the problems involved when she is observing other doctors and healers
engaging in this process. However, simultaneous practice and critical
assessment of that practice invariably leads to a dilemma: the shaman
Quesalid began his apprenticeship as a sceptic, intent on exposing the
tricks of other shamans, but after learning them he used them himself
(Lévi-Strauss (1958)1963). Can he still be a sceptic, if he applies the
practice himself?
It might have looked methodologically sound to have conducted sur-
veys, but it is easily forgotten that the evaluation of statistical data is
just as much based on the researcher’s sensitivity and judgement as on
rendering an account of a very particular setting. Nevertheless, partly to
prevent potential worries, partly out of curiosity, and mostly because I
thought it was an appropriate method for the college setting, I employed
more formalised methods for investigating the standardised transmission
of knowledge, including semi-structured interviews with 12 assistant
teachers, questionnaires administered to 60 undergraduates, question-
naire letters sent to 120 graduates and cross-checked through inter-
views with 14 of them, and interviews with representatives of the college
administration, the Provincial Health Department, and the City Health
Bureau. Most respondents were curious and eager to be questioned,
but the precision of their answers varied considerably. Some results
brought to light problems which I had not anticipated, but in general
these formal enquiries only corroborated my subjective impressions. The

reward was not overwhelming, if one considers that the carrying-out,
the statistical assessment, and the evaluation of this formalised inquiry
demanded much time and effort.
Working in the field

Exploring experts’ knowledge and reasoning demands considerable
linguistic competence. There was, of course, a language barrier. I had
studied modern standard Chinese in my late teens in Beijing, ten years
before I started fieldwork on Chinese medicine in Kunming, and the
local dialect was soon comprehensible to me. I never tried to adopt it,
however, which imposed a certain formality on all our conversations.
In addition there were obstacles to smooth communication associ-
ated with the perception of the anthropologist’s position and the way in
which I was seen by those I wished to understand. On the one hand, my
Chinese origins gave us common ground. My grandparents, aunts,
uncles, and cousins had suffered from the same events as my teachers,
colleagues, and friends. The experiences of the reforms of the early
1950s, the disaster that brought many to the edge of starvation during
the Great Leap Forward (1958–61), and the violence and cruelty of the
Cultural Revolution and the period of the Gang of Four (1966–76) are
essential to understanding the attitudes and tastes of the late 1980s in
the PRC. I need not render detailed life stories here; they are in kind
similar to those recorded by Kleinman (1986) in Social Origins of Dis-
tress and Disease.
Nevertheless, I almost always remained the ‘foreigner’ (waiguoren),
despite my Chinese origins: the TCM teachers considered me as 90 per
cent a foreigner, and foreigners were, as one of them half jokingly
declared, difficult to handle: first because of the already mentioned lan-
guage problem ( yuyan butong), second because foreigners had ‘no under-
standing for Chinese medicine’ (budong zhongyi), and third because, on
top of all this, they were ‘very demanding’ ( yaoqiu gao). The senior
doctor Zhang said that I was outside Western but inside Chinese. The
qigong healer had not encountered foreigners personally, and seems to
have seen me more as some kind of a stranger than as a ‘foreign student’
(liuxuesheng). The few times I was not recognised as a foreigner were at
the hospital during practical training, when I wore a white coat and
cap. Being categorised as a foreigner had a decisive impact on the
information I elicited. For instance, I came to realise that when a TCM
doctor used biomedical terms in my presence he might well have been
accommodating to me, the foreigner. College doctors built on former
encounters with foreigners in the clinic and tended to view me as a
‘Western doctor’ (xiyi), but my knowledge of biomedical pathology was

severely limited, despite having graduated in biology, and biomedical
terminology in modern Chinese was not always immediately intelli-
gible. With time, my counterparts altered their explanations according
to their perception of my progress in understanding.
Finally, Chinese medical concepts, like symbols in ritual action, are
notoriously vague and polysemous.22 Lewis (1986), pointing to the ‘look
of magic’, has repeatedly emphasised that anthropological research on
these domains of human behaviour demands particular caution and
circumspection. It is easy to impute one’s own meanings to them,
sometimes without bothering to ask the people what they say about
them and sometimes outrightly dismissing what people know about
them. Some practices were considered ‘feudalistic’ ( fengjiande) and ‘back-
ward’ (luohou), and people were reluctant to talk about them. Just as
the statement that someone was bewitched became less assured as the
social distance between the speaker and the alleged victim of witchcraft
decreased (Lewis 1976), the information elicited about such ‘feudalistic’
and ‘backward’ practices changed depending on the situation in which
it was communicated.
I put much time, thought, and also feeling into maintaining the
few important rapports I had. The establishment of close links that
enable the anthropologist to learn about key concepts and cosmology is
not unusual – one recalls Griaule’s ((1948)1966) conversations with
Ogotemmeli or Turner’s ((1960)1967) with Muchona – but there are
many reasons for avoiding this approach. One has already been men-
tioned, namely, that the anthropologist creates an artificial situation for
eliciting information by the direction of her questions and the inform-
ants accommodate their responses to their perception of the foreigner.
Moreover, the question arises to what extent the ideas the anthro-
pologist grasps from these individuals are representative of the entire
culture, to what extent of a certain school of thought, and to what
extent of idiosyncrasies of fringe figures. The human mind is creative,
and ideas and thoughts, like any piece of art, dance, song, or ritual
22
A lexical item is ‘vague’ (and not ‘ambiguous’) when it is not precisely defined.
Kempson (1977:124–8) distinguishes four types of vagueness: (a) referential vagueness
(e.g. is ‘city’ or ‘town’ the right word to describe a place like Salisbury?); (b) indeter-
minacy of meaning (e.g. what does ‘good’ mean?); (c) lack of specification (e.g. the
word ‘neighbour’ does not indicate sex, age, ethnic identity of a person); and (d) dis-
junction in the specification of meaning (e.g. different uses of the conjunction ‘or’).
Chinese medical terms are almost always referentially vague (to the uninitiated) and
indeterminate in meaning. They can sometimes be quite specific in meaning, and in
those cases they tend to be not vague but polysemous.
A lexical item is ‘polysemous’ when its meaning ‘is not constant but varies from
context to context’ (Kempson 1977:80). ‘Polysemy’ is a kind of lexical ambiguity
(Lyons 1977:550).
performance, are expressions of the people who communicate them.

Finally, the very fact that an ‘informant’ becomes a ‘friend’ puts the
anthropologist in a dilemma between precision and discretion. This is
especially difficult in a country that is haunted by political struggles.
Doing fieldwork in three different settings was not always easy. I
often felt that I had just missed crucial events in one place while work-
ing in another. Yet it was the comparison of different social contexts
that brought to light the distinctive features of the learning situations
and styles of knowing. Since these contexts were very different, the
methodological-cum-theoretical approach had to be modified accord-
ingly, with the result that, depending on the setting, certain topics
received closer attention than others. Medical practice, for instance,
was observed in all three settings, but case histories will be presented
only with regard to qigong.23 Again, the political events of the so-called
‘prodemocracy movement’ in May and June 1989 were an issue of
major concern at the TCM college, while they had little impact on the
course of daily life in the area where the qigong healer worked.
The structure of the book
The three settings of Chinese medical learning structure the book as

three sets of two chapters each. In each set, the first chapter presents
the context in which medical knowledge and practice was transmitted.
Therefore, chapters 1, 3, and 5 may be of particular interest to the reader
wishing to learn about daily life in urban contexts of the PRC during
the late 1980s. The second chapter of each set, namely chapters 2, 4,
and 6, discuss key concepts that figured prominently in each context of
learning, among them qi (Breath or ‘basic stuff’ ‘that makes things happen’
and ‘in which things happen’) (Sivin 1987:46–7), yinyang, wuxing (Five
Phases), shen (Spirit), and various other notions that refer to change.
Qi, central to the qigong master’s medical reasoning and practice, was
also at the core of reasoning in the two contexts of Chinese medical
learning.24 TCM distinguishes four qi: the Primordial qi ( yuanqi), which
is considered synonymous with the Original qi ( yuanqi) and the True qi
(zhenqi), the Gathering qi (zongqi),25 the Nurturing qi ( yingqi), and the
23
For TCM case histories as recorded by a participant observer, see Ots ((1987)1990),
Hammes and Ots (1996), and Scheid (1998). For translation and analysis of published
case material, see Farquhar (1991; 1992; 1994a:46–55).
24
Qi also occurs in colloquial conversation. The notions of qi I focused on were always
those of medical specialists.
25
Translation based on Wiseman (1990:349), who also provides the literally more cor-
rect term Ancestral qi. In the classroom zongqi was presented as the qi that comprised
all the many qi coming from different organs and from the outside world (due to
Protective qi (weiqi).26 However, the ethnographic account of qi will

diverge significantly from text-based systematic presentations.
Yinyang was another concept frequently encountered in all three
settings, and in the acumoxa wards of TCM clinics and hospitals it
was on everyone’s lips. Sivin (1987:203–8) renders yinyang very much
as taught in TCM: yinyang (and the Five Phases) are presented as
‘spontaneous, naive, materialist theories that also contain elementary
dialectic ideas’ (p. 203). This understanding of yinyang calls for a crit-
ical analysis based on the explanations of a teacher lecturing on yinyang
in the classroom. In the contexts of medical learning outside the TCM
college, the political overtones of the term were less marked.
Wuxing (Five Phases) are well documented in recent literature.27 In
TCM, they are closely associated with the so-called Five Organs (wuzang)
and in the West, reasoning in terms of the Five Phases is generally well
understood. However, the qigong master Qiu hardly ever reasoned in
terms of the Five Phases, and discussion of them has intentionally been
kept minimal.
Notably, neither Sivin (1987), Ots ((1987)1990), nor Farquhar
(1994a), who have all written substantial monographs about TCM, say
much about shen (Spirit), which I encountered in all three settings. Not
only the semantics of shen but also what I propose to call its ‘performat-
ive significance’ varied between these different social contexts: the term
shen was ‘socialised’ into these different contexts because it performed
certain roles that were significant for the way in which the doctors
established their authority in social interaction.
Chinese medical terms will be shown to vary to such an extent in
connotation, language use, and performative significance in different
social contexts that one hesitates to assume that they refer to one and
the same concept. These variations will be shown to depend on differ-
ent styles of knowing. Given that styles of knowing may determine and
be determined by the different ways in which one learns a technical ter-
minology, the findings of this monograph are bound to have implications
for the professionalisation of any traditional or alternative medicine.
respiration), and therefore it has been translated as the Gathering qi. In the Revised
Outline, zongqi is mentioned together with zhongqi (Medial qi) under the heading of ‘Qi
of the Visceral Systems’ (Sivin 1987:238).
26
TCM Fundamentals (Yin 1984:57–8). Reproduced in Sivin (1987:237–40) and Ots
((1987)1990:47). Porkert (1974:167–76) contains a useful but ahistorical listing of
different qi.
27
TCM Fundamentals (Yin 1984:18–27, 28–53). Reproduced in Sivin (1987:208–12,
213–36) and Ots ((1987)1990: particularly 44–5). See also Porkert (1974:43–54).
The secret transmission of knowledge and practice 21
1 The secret transmission of knowledge

and practice
Qigong, which became very popular under Deng Xiaoping’s leadership

in the 1980s, has been jokingly referred to as the ‘fifth modernisation’
(di wuge xiandaihua). In many instances qigong refers to the reinter-
pretation of Daoist practices under the impact of modern medicine, but
the wide range of practices called qigong renders a precise definition of
this term impossible. Qigong is nowadays known mostly as a meditat-
ive practice with life-maintaining and therapeutic effects (Kohn 1989,
N. N. Chen 1995), but opera singers, calligraphers, and other artists
also use it to enhance their performance skills (Ma 1983:8). One can
practise qigong alone or in groups; or it can be applied from a qigong
master to his or her clients, in which case effects can be evoked similar
to those of a hypnotist (Sundararajan 1990). Telepathy, clairvoyance,
psychokinesis, and other phenomena that are studied in the West under
the rubric of parapsychology are often said to result from the practice
of qigong. The ability to achieve the latter effects, called ‘extraordinary
qigong’ (teyi qigong), is said to depend on a person’s xiantian (constitution),
while health status and artisitic ability are considered to be improved in
anyone through qigong meditation.
The word qigong has only recently been used in this sense. It occurred
earlier in texts on self-cultivation as a technical term with another
meaning, supposedly for the first time in a text of the Jin dynasty (AD
265–420) (Despeux 1988:9). Although it was already being used in its
modern sense during the Republican period (1911–49),1 it was only
in the struggle for the legitimation of Chinese medicine after the Com-
munist revolution that it became more widely known. The goals of this
revival of Chinese medicine and with it the promulgation of qigong are
reflected in its English translation: instead of a ‘self-cultivation practice’
it is currently called a ‘breathing technique’.
1
Apparently, Dong Hao acknowledged qigong for its therapeutic effects in 1936 (Despeux
1988:10).
21
The practice of self-cultivation is age-old. The earliest-known written

records of ancient traditions of meditation are on bronze inscriptions of
the Warring States period (475–221 BC), in the manuscripts excavated
from the Mawangdui tombs (168 BC), and in chapters 36–8 of the
Guan zi, a compilation from the fourth century BC (Harper 1990b). In
the literature of the past two thousand years meditation practices of this
kind have been referred to by terms such as yangxing (to nurture one’s
Nature), yangsheng (to nurture one’s life), daoyin (to guide and lead
(the qi)), and xiushen (to cultivate oneself ). Present day qigong practices
are in general new versions – often complete transmutations, of former
Daoist meditation traditions, sometimes including elements of Buddhist
meditation practices. Since wushu (unarmed combat) masters were least
affected by efforts at modernisation, the meditative practices widespread
today under the name of qigong, are mainly derived from wushu tradi-
tions (Wen Linjun, p.c.).2 Formerly, I was told, all ‘Chinese doctors’
(zhongyi) engaged in meditative practices for self-cultivation, engaging
in what a modern qigong healer would call ‘soft qigong’ (ruan qigong) as
opposed to the wushu masters’ ‘hard qigong’ ( ying qigong).3 The former
practice strengthened one’s Inner qi (neiqi ), the latter one’s Outer qi (waiqi).
The practice of soft qigong was in general valued more highly since it
enabled one to attain healing and other somewhat supernatural capabil-
ities. Xiang, ‘having a pleasant smell’, like chocolate, orange blossoms,
or soap, was one of these faculties. A student I knew at the college had
already attained it after two weeks of training: he could make the palm
of his hand smell of chocolate – admittedly for seconds only, so that an
uncooperative person had difficulty in smelling it. Fu, ‘levitating’, was
another, but it was purely a subjective feeling experienced by the medi-
tator (although rumours circulated that it was possible to see qigong
masters levitate during meditation). Toushi, ‘having a penetrating vision’
(x-ray vision), was a third. Stories were told of qigong masters who were
able to tell the name, the age, and the work unit of a person on first
sight because they could read the person’s concealed identity card.
Some qigong masters were sought out to help find lost objects; others
were said to work as spies for the defence ministry in Beijing because
they could see through walls.
Training in hard qigong strengthened one’s Outer qi to such an extent
that one could become invulnerable to slaps and kicks or capable of
2
Certain forms of wushu have become known in the West as kungfu and karate (Lu and
Needham 1980:302ff.). On the history of wushu, see Matsuda (1984) and Xi (1985).
3
‘The term for martial practice, yinggong (hard qigong), was defined in 1978 . . . Until
very recently most people in China associated qigong with these martial techniques’
(Miura 1989:342).
tolerating great weight or heavy blows to the body (e.g. trucks rolling
over a platform supported by one’s body or the splitting of bricks
balanced on one’s head). Moreover, it enabled one to give perform-
ances of eating glass and spitting fire. It was said to be easily learnt and
results were guaranteed after only a few months’ training. It is apparent
that qigong includes a wide range of meditative practices found in many
social contexts, from the secluded chamber of the Neo-Confucian scholar
immersing himself in meditative ‘self-cultivation’ (xiushen)4 to market-
place performances of wandering jugglers and magicians demonstrating
tricks to a crowd of curious gapers.
When the practice of qigong became more widely known in the 1950s,
it was promoted in the context of public health care: in 1955 the first
qigong rehabilitation centre was established in Tangshan, and patients
suffering from gastro-intestinal disorders were taught Inner Nurture
qigong (neiyanggong). In 1956 a course was set up in Beidaihe to train a
first group of professional qigong practitioners. In 1957 a rehabilitation
centre which monitored qigong therapies with scientific methods was
established in Shanghai. Qigong was thereafter taught in several rehab-
ilitation centres all over the country. It was promoted as a breathing
technique particularly effective for the cure of chronic hepatitis, high
blood pressure, heart palpitations, tuberculosis, asthma, neurasthenia,
diabetes, glaucoma, and toxaemia (Ma 1983:44–6). The new name qigong
for the old meditation practices emphasised its therapeutic merits,
merits that were often proved by biomedical evidence. Health was con-
ceived to result from a form of physical training rather than meditative
spirituality.
Qigong was discredited as ‘superstition’ (mixin) during the Cultural
Revolution (1966–76) but despite lingering reservations in many circles,
it was revived in the late 1970s and the 1980s. In 1988–9 it was no longer
limited to improving the health condition of patients in rehabilitation
centres but regularly practised by women as well as men; state employees,
pensioners, and unemployed youth. Qigong was not only practised by
individuals at home or in a quiet corner of a park; associations started
to flourish which organised ‘qigong meetings’ (qigong jiangzuo) with famous
qigong masters in sport stadiums and university auditoriums. During these
meetings qigong masters were believed to provide therapeutic and life-
maintaining benefits to their audience by the act of speaking alone.
Short-term qigong courses for limited numbers of participants were
advertised on posters in the streets and in pamphlets circulated in work
4
Xiushen is generally translated as ‘self-cultivation’ and strongly associated with Neo-
Confucian endeavours. I use the word self-cultivation elsewhere in a wider sense, synonym-
ous with the expression ‘longevity techniques’ in Kohn (1989).
units. Private qigong practices promising a sure and safe cure prolifer-
ated in and around the city. In Kunming, the entirety of the regulations
of 1987 made qigong therapy in a private enterprise possible. In Novem-
ber 1989, however, when the Communist Party tightened its control
after the June 4th crackdown in Tiananmen Square, new regulations
were set up which allowed only those who passed the exams for ‘regular
practitioner’ ( yishi) to open private qigong practices (interview with the
City Health Bureau, December 1989).
Reasons for the revival of qigong in the 1980s were, as so often
happens in China, attributed to the head of state. Rumour had it that
Deng Xiaoping was treated by a qigong healer and therefore promoted
its revival. This saying paralleled the one that made Mao Zedong’s
personal experience with Chinese medicine in Yan’an responsible for
policies favourable to TCM in the 1950s (Lampton 1977:62). Without
denying the importance of a leader’s promotion for mass movements in
China, additional reasons are needed to explain the recent nationwide
popularity of qigong.
‘Qigong indicates a social problem’, a young state employee who
practised it said during a discussion. The policies of the 1980s that had
allowed an economic boom in the private sector and the concession of
increased decision-making to state enterprises had given rise to more
substantial and visible corruption among government officials. Admit-
tedly, the majority of the urban population – state employees in the
work units – simultaneously experienced an improvement in their living
standards, but this improvement was minimal compared with the profits
of private entrepreneurs and the ‘gifts’ received by government officials.
In Kunming, there was consensus among state employees that soaring
inflation had caused a decline of living standards since 1987, and that
the prospects for changes in employment and acknowledgement of
personal merit were as non-existent as ever. In late 1989, for instance,
students were reluctant to spend 0.3 yuan fortnightly for a cinema
ticket or to buy tangerines on the free market where they were about
three times as expensive as apples from the department store. In several
work units cadres were forced to forgo immediate payment of one of
their monthly salaries as a ten-year loan to the state. In this light,
‘qigong fever’ may have indicated a general disillusionment with politics,
a ‘crisis of faith’ resulting in individual withdrawal. It may have been a
form of resistance to ongoing processes in society that were more than
once described to me as ‘chaotic’ (luan), the term with which political
periods like the Cultural Revolution (1966–76) were characterised.
Whereas the esoteric quest of mystery seems to have played an import-
ant role in the spread of qigong in the West, as far as I can tell, it was
insignificant in the PRC. It is, however, possible that through qigong,

introspection, and the discovery of one’s own body and self, new values
are brought to the individual.
Nowadays many styles of qigong are public while the practice of other
qigong healers is still veiled in secrecy. I discuss one such secret tradi-
tion of qigong because secrecy was, and for certain families still is, one
of the most important features of Chinese medical knowledge. The
mode in which a qigong healer transmitted his secret knowledge and
practice to his disciple may point to features of Chinese medical know-
ledge and practice secretly transmitted within a family. Most of my
observations of qigong were made in a private practice of the qigong
healer Qiu, thirty-two years old, his wife Jade Blossom, twenty-four
years old, an acupuncturist, and her younger brother Qiudi, nineteen
years old, who was Qiu’s disciple.
The setting
The qigong healer Qiu’s private practice was in a neighbourhood of
petty enterprise in a narrow side street of old houses, sheltered from
the traffic. This street began in a very crowded free market in front of
the former city gate where a bridge crossed one of Kunming’s main
canals and ended half a mile north at the drum tower, where there was
another free market. Situated outside the former city wall, the houses
were low-roofed and poorly built; the street was called ‘the street of the
poor’ ( pinminjie). Indeed, in the teahouse near Qiu’s practice there
were all kinds of characters, many of them in old, worn-out Mao suits
and a few even in rags. Pedestrians coming from the bus station would
pass through this street on their way to the city centre. It was efferves-
cent with small-scale business, and cyclists had to step down from their
bikes to join the rhythm of the crowd. Private and collective shops,
taverns, and inns flourished, and several ‘private enterprises’ ( getihu)
offered medical care. From the market bridge to Qiu’s consultation
room one passed three of them: a bone setter, a Chinese herbalist, and
a biomedical doctor specialising in paediatrics. Beyond Qiu’s practice on
the way to the drum tower, one could count another four: two private
pharmacies for Western biomedical drugs, an ‘integrated Western–
Chinese medical’ (zhongxiyi jiehe) family practice, and, newly installed
in January 1989, a small private hospital with between ten and twenty
beds. In the mornings the latest mainland hits pounded out from huge
Japanese tape recorders, while old men with water pipes and bird cages
by their sides played chess in a corner near the teahouse. But in the
evenings, there were the long, drawn-out phrases of an erhu (a Chinese
stringed instrument) and the hoarse voice of an old woman which

sounded plaintively through the night. It was in this motley community
of petty enterprise and households of partly marginalised city inhabit-
ants that Qiu had established his practice of acumoxa, massage, and
qigong.5
Social networks and private enterprise

Officially Qiu had the status of a qigong practitioner; on our first
encounter, he showed me the document that certified it. In 1988 he
was ‘bound by contract’ (chengbao) to his former work unit, the Third
City Hospital, where he had been employed for five years as a qigong
healer, but in 1989, after his wife had passed the examinations for
opening a private ‘acumoxa’ (zhenjiu) practice, he gave up this contract
and she applied to one of the city’s ‘district health bureaus’ (qu weishengju)
for official recognition. The contract had guaranteed them employment
by their work unit if their enterprise failed, but it had obliged them to
pay 200 yuan monthly whereas the monthly taxes to the city district
health authorities were only 10–20 yuan.6
Qiu also had permission from the same district health bureau to sell
‘Chinese medical drugs’ (zhongyao), but in his medical practice he
generally used ‘herbal drugs’ (caoyao). He bought dried plants in large
quantities at a low price from itinerant ‘herbalists’ (caoyi) which he
and his disciple ground in their entirety (with stems, leaves, and often
also their roots) into a powder that was prescribed to his clients in
portions, small enough to be thrown into the mouth and ingested with
a sip of water. He also had some ‘ready made Chinese medical drugs’
(zhongchengyao) against ‘common colds’ ( ganmao), ‘stomach aches’
( futeng), and ‘coughs’ (kesou), but mostly stocked ‘invigorating drugs’
(buyao) like extracts of ginseng (renshen) or royal jelly (wangjiang). He
did not risk buying drugs that he could not use himself for fear that he
would not sell them. His inventory of Western biomedical drugs was
minimal; it comprised pain killers, aspirin, and some antibiotics for
primary health care.
Family practices of specialists like Qiu played an important role in
health care at the grassroots level. Those seeking specialist proficiency
5
By 1992 the southern parts of this neighbourhood were transformed by the construc-
tion of the Yuantong bridge; the northern parts, including the drum tower, were demol-
ished in 1996 because of road construction works.
6
Exchange rates for the yuan fluctuated considerably in 1988/9. Its value is best assessed
in light of the monthly salary of work unit members like the TCM teachers, which
varied between 76 and 135 yuan. See table 5.1.
such as Qiu’s qigong therapy were prepared to pay large sums for their
treatment. The healer’s family’s livelihood was thus ensured by his
speciality. However, as Qiu’s inventory of drugs reveals, he had other
clients as well. They usually came from the neighbourhood with a cut
finger, a fever, or a headache. Although the Red Cross Hospital was only
a ten minutes’ walk away, they generally sought Qiu’s assistance. His
qigong practice thus fulfilled important functions of primary health care.
No private enterprise in the PRC can survive with official recognition
alone. Beneficial non-official contacts are indispensable. Friends and
colleagues need to be fostered as ‘good connections’ (hao guanxi). Qiu
had many visitors. He was a pleasant person, a good healer, and most
of all, known in certain circles as one of the most powerful qigong
masters in town. Some of his visitors were former patients who had
become friends with their healer in the course of their convalescence;
others were members of the Qigong Association of Kunming City and
still others were would-be qigong practitioners who hoped to be initiated
into Qiu’s secrets. One of the visitors, for instance, came almost daily
throughout a period of several months. He was often invited to stay for
supper, as demanded by Chinese hospitality, but Jade Blossom thor-
oughly disliked him, suspecting that he was trying to get her husband’s
secret knowledge. Qiu, instead of being annoyed with him, got angry
with her: ‘She doesn’t understand how our society functions’ (ta bu
dong shehui). It was good to have many friends and even better to
attract them with admiration for the secret.
Apart from such visitors, a wealthy entrepreneur for whom Qiu had
worked as a carpenter in his youth made Qiu known in Buddhist circles.
In 1988 Qiu was summoned to heal a renowned monk belonging to
an important temple about thirty miles outside of Kunming – he was
proud to tell me that he had been taken there in the temple authority’s
new minibus. In 1989, when he took part in a Buddhist festivity at
another temple, it was again this friend who introduced him to the
temple’s oldest monk. The first time Qiu had been asked to cure a
cancer, but he was called for only a few days before the monk’s death;
the second time, he was asked to treat a common headache, and appar-
ently did so to the monk’s satisfaction.
When pressed, Qiu said he was a Daoist and a Buddhist, but he did
not attach much importance to it. He did not have much reason to call
himself a Buddhist; he participated in Buddhist festivities very erratic-
ally and seemed to do so more for social reasons than out of religious
conviction. By contrast, his mother was a devoted Buddhist who had
kept her domestic shrine even during the Cultural Revolution. She
went regularly to the nearby temple (for her half-hour walk), sometimes
alone, sometimes with other women from the neighbourhood. She stuck
to the habit that dishes at meals were vegetarian on the first and fifteenth
of the lunar month.7 It was probably in order to maintain this dietary
practice that the days were counted according to the lunar calendar in
Qiu’s family.8
Qiu also cultivated contacts with herbalists, one of whom was a
neighbour who had no private practice but a few private patients. Lao
Yi, a retired worker, claimed to have learnt Chinese medicine on his
own, by reading books only.9 Since he was a widower, he often stayed
for lunch with Qiu’s family. Qiu was mainly interested in this old
man’s knowledge of the herbal drugs, their habitats, and their locations
in the environs of the city. In the summer and autumn of 1989 the two
undertook at least five outings into the nearby hills, usually to gather a
specific species for one of Qiu’s or Lao Yi’s patients. Qiu was eager to
learn to recognise and collect medicinal plants so that he would not
have to depend on the herbalists for them.
Informal ‘contacts’ ( guanxi ) – Qiu’s friends and colleagues, his Buddhist
connection, and his contact with herbalists – were indispensable for
running his business. Later, I discovered that he also had two ‘bond
brothers’ (xiongdi) when I asked him about a tattoo of a sword on his
left arm. The three had become bond brothers shortly after the death of
Qiu’s master in 1978. Their brotherhood meant pledging to support
each other in hardship and to keep their master’s knowledge secret.
Perhaps it was coincidence, perhaps a reflection of a more general
pattern, that these bond brothers and former close friends later became
vicious rivals.
Brotherhood and dangers of knowledge

One of Qiu’s bond brothers, Luo, had twice tried to kill Qiu, Jade
Blossom told me on their way home from a dinner that Qiu had given
7
Qiu said that his mother was vegetarian, which did not mean that she ate vegetarian
daily but only on those two days of a month. For a similar pattern of vegetarian diets
among sect members, see Naquin (1976:47).
8
The Gregorian calendar ( yangli) is used by the administration and city inhabitants and
the lunar calendar ( yinli) mainly in the countryside. In some county towns the market
days fall on the first, fifth, eleventh, fifteenth, twenty-first, and twenty-fifth of the
Gregorian calendar month, a pattern supposedly related to the lunar calendar.
9
Qiu spoke of Lao Yi as a caoyi, but Lao Yi called himself for reasons of prestige a
zhongyi. In biographies of Chinese doctors, it is a topos to have learnt medicine mainly
by reading books, without (Shi ji 105 (Sima 1959:2785)) or with the guidance of a
master (Shi ji 105 (Sima 1959:2796)). This belief in an independent learning from
texts, without any mentor’s guidance, stands in stark contrast to the principles of the
secret transmission of knowledge.
in honour of Luo and his family. Shortly after their master’s death, Luo
had entrusted to Qiu a particularly powerful gongfa (method/efficacy of
qigong) that consisted of a minimal diet and walking for several hours at
night. Qiu, walking off his legs, had become thinner and thinner until
one of his older friends, aware of Qiu’s grief over his master’s death,
had made enquiries into the matter and brought him back to his senses.
Several years later, Jade Blossom continued, when Qiu was known
citywide and asked to go for scientific trials on qigong to Beijing, Luo
confidentially recommended that he take drugs which instantly induced
stomach cramps and put Qiu into a coma. Only immediate intervention
at a biomedical hospital had saved him from lethal poisoning by his
bond brother. Hesitating to believe this, I looked at Qiu who had been
accompanying us silently: he did not say anything but nodded.
Qiu was reluctant to speak ill of Luo who was his master’s son. He
called him erge, second older brother, and tried to treat him like one.
Most of Qiu’s friends avoided Luo, and therefore he could not invite
him to his wedding banquet, but he felt obliged to invite him and his
master’s entire family to a separate dinner three weeks later. Despite
the alleged murder attempts, Qiu showed respect for his master’s son,
and on qingming day,10 when Qiu planned to visit the grave of his
master with his disciple, and I, the foreigner, wanted to join them, he
did not fail to invite his master’s son to join us.
The other bond brother, Long, was, unlike Qiu and Luo, tall and
well-built; most impressive in stature. His father was a high government
official and this had probably determined most of the circumstances of
Long’s life. In 1978 Luo had taught Long his late father’s meditation
practices and even lent him his father’s notebooks, probably with the
purpose of establishing a connection with an influential person. In 1982
Long had managed to be called with Qiu to Beijing for trials of qigong.
In 1988 he had set up a private qigong hospital. It was an impressive
enterprise, installed in a building of seven storeys which advertised itself
by the expensive but prestigious means of television spots. Long had
employed a staff of more than ten qigong healers as well as Western
biomedical and TCM doctors. Thanks to his father, he enjoyed enough
credibility to take out enormous bankloans. But when these had proved
insufficient, he had approached his bond brother Qiu, so I was told,
offering him the position of vice-director and asking for financial sup-
port. Qiu had refused participation but claimed to have advanced three
thousand yuan because of their brotherhood. Less than six months later
the hospital went bankrupt. His bond brother changed his address and
10
The fifth day of the fourth lunar month, the day of the commemoration of the dead.
rumour went that he had left the province. It was clear that Qiu would
never see a penny of that money again.
The amount of money and life-threatening rivalry involved make the
above stories sound fabulous. The dramatic scale of Luo’s deception
and Long’s fraud reflect the prestige and power attributed to qigong,
and the danger of envy. Danger was, moreover, believed to be inherent
in the practice of qigong meditation itself. Stories were told of students
who had gone mad because they had tried to learn qigong by consulting
books only. They had put qi out of place (for instance, into the arm
instead of the Cinnabar Field (dantian)), and qi permanently out of
place resulted in dementia or even in death. Guidance by a master was
indispensable, misguidance fatal. With this belief in the need of a mas-
ter for learning qigong, control over knowledge was secured by those
who possessed it.
Family bonds and the ethics of knowledge

Qiu had been weak and sickly in his early childhood. His grandfather,
who was a Chinese herbal doctor, had sent the five-year-old boy once a
week to an old friend in the suburbs who was a wushu master. Later he
had had him learn medicine and meditation from his neighbour who
was a ‘senior Chinese doctor’ (laozhongyi). Qiu told me that his grand-
father had not taught his father medicine because he had not thought
much of that son’s character.11 For similar reasons his master, Luo, had
been reluctant to teach his second son, Qiu explained, but since that
son was weedy and weak, the father felt obliged to provide the son a
means of livelihood and equip him with his knowledge. Qigong medita-
tion not only strengthened the bodies of these physically weak children;
the knowledge of qigong gave them power and social prestige.
Episodes of Qiu’s life pointed to a strong sense of ‘filial piety’ (xiao).
His mother told me once at supper that as a child Qiu had refused to
eat for several days. He was a toddler, she said, but strong-minded, he
had wanted his mother to listen to his advice. Her husband’s income
had been insufficient to nourish their six children, and therefore she
had worked for one yuan per day for a neighbour who was a vegetable
merchant. Seeing her exploited, ‘I always told her not to work for him’,
Qiu said and continued: ‘I left primary school after only five years
because I wanted to protect the family.’ ‘Because your school records
11
Qiu’s father was a ‘worker’ ( gongren) of a nearby factory who was in early retirement
and spent most of his days sitting in and around Qiu’s practice. He never recovered
from his nervous breakdown during the Cultural Revolution; the paternal authority
tended to be with Qiu’s elder brothers rather than with him.
were not good enough’, his wife chided. ‘That was the only way to get
out’, Qiu insisted. In his early twenties he had been offered work with
an overseas Chinese in Singapore. He maintained that he had not
accepted the offer because he wanted to look after his parents. During
my fieldwork he lived in his parents’ home and gave them one hundred
yuan per month, since his father’s pension was only forty yuan. Jade
Blossom often complained about this, although it was, according to
Qiu, less than a tenth of their income.
An ‘upright mind’ (zhengxin) and a clear conscience were repeatedly
cited as preconditions for finding the concentration to meditate. Purity
of mind was paralleled by purification through washing the entire body,
cleansing the meditation room, respecting food taboos, and abstaining
from sexual intercourse. The meditation was to take place regularly at a
precise time of the day, during the zi hours around midnight (11 p.m.
– 1 a.m.). The seating during meditation, the altar, and the taboos had
features common to both Daoist and Buddhist traditions, but Qiu’s
incantations were exclusively Daoist, and with much veneration he kept
hidden a portrait of Taishang Laojun.12 The incantations contained
verses of harmful magic, although Qiu and all the other qigong masters
I met maintained that any kind of harm or disturbance directed at
another person would damage one’s gongfa. According to a story circu-
lating at the time in Kunming, the nationally known qigong master Yan
Xin once undertook to cure a patient suffering from ‘oedema’ (shuizhong)
in her legs. During the following two hours his two disciples repeatedly
had the urge to urinate, and as a result the patient’s swelling was
reduced. ‘They were his disciples’, was the comment. If the master had
inflicted the disturbance he had caused in his disciples on another
person, his gongfa would have ceased. He could disturb his disciples in
this way only because master and disciple were very close. Qigong mas-
ters were believed to be extremely powerful, and if they refused to
perform certain manipulations, it was often on ethical grounds.
Guarding the secrecy of his knowledge was a virtue Qiu admitted to
have lacked. In his youth he had made the mistake of teaching his
friends. One of his earlier lovers, for instance, had managed to learn
from him many aspects of his secret knowledge, and when she left him,
she set up her own practice somewhere in town. Her competition was
no threat to him, and the broken relationship did not seem to disturb
him as much as the regret that he had spilled out so much of the secret
knowledge that his beloved master had chosen to give only to him.
12
The highest divinity of Daoist folk religion, Laozi. He was first made the head of the
Daoist pantheon and later dubbed Taishang Laojun (Day 1969:135). See also Kohn
(1989:134, 154, 155, 167).
Young and inexperienced as he had been in his twenties, he had also

made a fool of himself by teaching someone who claimed to be his
friend the ‘ten precious movements’ that formed the beginning of each
meditation session. That ‘friend’ had later written an introductory book
on qigong containing the sequence of movements that Qiu had taught
him.13
Discipleship: imitation and repetition
After Qiu and Jade Blossom had signed the civil marriage contract,14
she asked to be initiated into his esoteric knowledge as evidence of
his love. A few months later, shortly before their public wedding, she
became pregnant, making the practice of qigong too strenuous for her,
and in any case forbidden. Her younger brother, who had just gradu-
ated from middle school and was unemployed, came from her home
province to stay with her, however, and Qiu, in recognition of his affinal
ties, was obliged to teach him.
Jade Blossom’s younger brother Qiudi was very silent, if not by nature,
by his social status and age. He was a newcomer to the extended
family, which included Qiu’s parents and one of his elder brothers who
was not employed by a work unit. As a disciple, Qiudi was expected to
assist his master in every aspect of his life. In addition, as the youngest
adult member in the household, he was also expected to be helpful and
dutiful to his sister’s in-laws. He washed the dishes, cleaned the con-
sulting room in the evenings, and did most of the very strenuous labour
of grinding the medicinal herbs into powder; he was sent here and there
for his sister and her husband. And if something went wrong it was his
fault.15 He was treated in such a way not out of malice, but as a matter
of habit. Nobody felt that it was necessary to justify it. Qiudi had been
in training for several months when I became friendly with Qiu’s
family, and given my interest in qigong, frequently asked him about his
latest progress. Qiu and especially Jade Blossom constantly scolded him
for being lazy. During an outing of the three on National Day (October
1), Qiu urged his disciple to take his training more seriously. Jade
Blossom confided this to me on a shopping trip during one of the
13
Almost all the movements in a slightly different sequence are recorded in Wang Zuyuan’s
((1834)1956:47–58) Illustrated Exegesis on Inner Alchemy (Nei gong tu shuo): the twelve
illustrations of the Canon for Supple Sinews (Yi jin jing).
14
Civil marriage contracts are signed without general publicity. In the late 1980s they
were easily and frequently dissolved. A marriage is, in general, acknowledged only after
the wedding banquet (Croll 1981:110).
15
On the hardly bearable conditions of an apprentice, see Cooper (1980:23–33).
following days. It seemed as if the anthropologist’s interest in qigong

had enlivened theirs and possibly intensified Qiudi’s training.
To become a healer, it was most important to cultivate one’s Inner qi
and practice soft qigong, Jade Blossom explained. She wanted her brother
to become a healer, but since he was a strong young man Qiu had
insisted that he undergo the severe training of hard qigong. Whereas the
practice of soft qigong consisted mainly in ‘meditation in tranquillity’
( jinggong) as opposed to ‘meditation by movement’ (donggong),16 hard
qigong practices included hitting sacks filled with gravel, tree trunks,
and stone walls with one’s bare hands, and beating oneself with a sack-
ful of gravel. Apart from that, they included long series of quick move-
ments that could only be performed when the body was in excellent
condition.
In autumn 1988, Qiudi was temporarily working in a collective that
sold and repaired simple electronic equipment. In the evening after
supper and early in the morning he would regularly go for meditation
to the nearby park. Qiudi had already been taught the ‘ten precious
movements’, now he was to proceed to meditation in tranquillity. This
consisted mainly of several hours of conscious but natural breathing
while seated with crossed legs, soles up, after a few introductory incant-
ations and movements. It was probable that one night a bright Light
( guang) – red, white, or blue-green – would suddenly appear. Novices
were taught that it was important not to be frightened by this and to
continue to breathe regularly.
Descriptions of a Light or Glow were given to me by most of those
who practised qigong seriously. An often-described sensation was a warm
golden Glow that travelled on the Minor Cosmic Circulation (xiao
zhoutian), and this description is also found in the rapidly expanding
popular literature. A warm sensation was first felt in the region of the
Cinnabar Field (dantian) just beneath the navel.17 That Glow was easily
transmitted from there to the lower back area of the Gate Pass (lüguan).18
The next step was to make the Glow circulate. This was difficult, for
while one could easily let the Glow wander along certain sections of the
spine it would usually halt in between them, in passages called the
16
The term jinggong can be found in Zhuang zi 26 (Miura 1989:345); donggong is a form
of qigong that has, for ideological reasons, been promoted in the PRC (p. 334).
17
Compare with Yang Xuancao’s comments on a phrase in Nan jing 66 (translated by
Unschuld 1986b:567): ‘As to the moving qi beneath the navel and between the kidneys,
it is the dantian’, followed by a long discussion of its features. See also footnote 20.
18
In the literature known as the weilüguan, rendered as the Caudal Narrow Pass by
Despeux (1994:81). The locus classicus is Zhuang zi 17: the weilü is associated with the
place at which the waters of the sea are continuously discharged.
Three Passes (sanguan).19 Once the Glow had reached the top of one’s
head it would wander downward to the area in which it had originated,
the Cinnabar Field. ‘The Minor Cosmic Circulation is connected’
(xiaozhoutian tong) was the expression for this sensation. Some begin-
ners could not bring the Glow to circulation at all and gave up qigong,
but most arrived at it after several meditation sessions. Once the Minor
Cosmic Circulation had been connected, the Glow would easily con-
tinue to circulate. The meditator was rewarded with a feeling of relaxa-
tion, lightness, and weightlessness that was ‘very delightful’ (hen shufu).
This direct emotional reward after persistent repetition of the same
movement needs to be stressed.
‘There are as many ways of practising qigong as there are masters’,
Qiu replied when I asked his opinion on the experiences described
above. His gongfa did not make reference to the Minor Cosmic Circu-
lation; he spoke of a Light which originated between his eyebrows at
the yintang.20 His disciple Qiudi experienced this Light in front of his
forehead too. ‘He saw the Red Light (ta jian hongguangle)’, Jade Blossom
told me proudly and I took it that this expression indicated a stage
comparable to connecting the Minor Cosmic Circulation. It was clear
that Qiudi had made an important step in his training. The problem
now was to manipulate this Light for healing purposes.
Qiudi started working as a healer under Qiu’s guidance in mid-
October. The client with whom they worked was a woman in her fifties
who suffered severe shoulder pain. Ma was an unusual patient because
of her high social status (she was a physics teacher who had graduated
from Beijing University), her vivacious cooperation (talkative, encour-
aging, and readily influenced), and her health-seeking behaviour (marked
by persistence in seeking relief from her symptoms). When the pain in
her shoulder had started with sudden onset four months earlier, she
had gone to Kunming’s most prestigious hospital, the People’s Provin-
cial Hospital, like many state-educated and state-employed cadres turn-
ing first to Western biomedicine. The doctor she had consulted there,
however, had sent her to the acumoxa department of the hospital. She
was treated for two or three weeks at a cost of a treatment cycle of ten
consultations of two yuan each, without tangible improvement. By then
she had heard that acupuncturists working in TCM hospitals had bet-
ter training, but the treatment she subsequently received at the City
19
For a brief account of the Three Passes (sanguan), see Despeux (1994:80–7).
20
The dantian (Cinnabar Field) is occasionally referred to as upper, middle, and lower
dantian, located between the eyebrows (corresponding acu-point yintang), between the
nipples (corresponding acu-point: danzhong), and in the area which is about the breadth
of a hand below the navel. Qiu said no more (but see Despeux 1994:74–80).
TCM Hospital had not proved much more successful. The pain con-
tinued to keep her from sleeping at night. The masseurs of an itinerant
medical service group stationed near the hospital had promised her a
definite cure, and for thirty-two yuan, paid in advance, she had been
guaranteed daily treatment until the pain was gone. That treatment had
worsened the pain so that she could hardly lift her arm. She had then
turned to qigong.
The director of the private qigong hospital she had attended, Qiu’s
bond brother, had recommended Qiu to her. When Qiu heard that
his bond brother had refused to commit himself to her healing, he
expressed doubt about being able to make her well. She was, however,
anxious to receive his treatment and pointed out that he had just cured
a client before her eyes in a single session. ‘Everyone is different’, he
replied; ‘you have to be “predestined” ( yuanfen) for qigong.’ When he
eventually agreed to try, he proposed to deliver, in addition to acumoxa,
‘cupping’ (huoguan), fire massage,21 and qigong treatment, so-called
‘remote-effect-qigong’ ( yuan qigong) – simultaneous meditation in tran-
quillity by sender and receiver – in their homes on opposite sides of the
city. This meant that Qiudi’s way of learning to become a healer con-
sisted first of remote-effect-qigong sessions; then, after a week, of deliver-
ing several qigong sessions together with his master; and after two weeks,
of performing his first qigong healing session entirely on his own.
On Monday 17 October, Ma, accompanied by her husband, came
for her first treatment. Jade Blossom delivered acumoxa and cupping
treatment, each of about twenty minutes duration, Qiu then adminis-
tered a half-hour of fire massage, which was extremely painful for the
client. Lastly he gave a concentrated qigong session of half an hour.
Thereafter, he asked Ma to raise her arm, and to the surprise of every-
one she did, up to 45 degrees.
Two days later, during the Wednesday treatment after the first
remote-effect-qigong session, Ma declared that the pain had increased so
much that she could not sleep. Qiu’s wife was concerned. Firstly, her
husband had been unable to lift his shoulder during the remote-effect-
qigong session the night before, and she knew that he could develop such
empathy for his patients that he would take on their ailments during the
process of healing, particularly if the problem was very difficult to solve.
21
In fire massage the bottom of a jar is covered with a medicinal alcohol which is
saturated with several herbal drugs. With a piece of burning cotton stuck onto scissors,
the alcohol is lit and applied to the patient’s painful areas with the left hand. The right
hand, with which he performs massage, suffocates the flame and rubs the alcohol into
the skin. This method, which I observed to alleviate pain and reduce swelling, was
generally not practised in government hospitals. Qiu commented: ‘It is very hard work.’
Secondly, the x-ray that Qiu had asked Ma to have at a hospital showed
physical damage: the sixth neck vertebra was dislocated. When Ma’s
husband came to accompany his wife home, he started chatting with
Qiu, and it was then that Qiu learnt that his bond brother had recom-
mended him. Sensing complications, he declared that he would give
her just seven days of treatment, and if there was no improvement she
would have to return to his bond brother for treatment. ‘She’ll come
back’, he told me later, ‘but it’s better to let her go than to try to keep
her with me.’ Obviously he wanted her to be completely committed.
During the following hour of her acumoxa and cupping treatment, he
told stories of his and others’ successes in healing or in predicting
death. Before she left he told her what his intentions were for the next
remote-effect-qigong session; he wanted her to have the sensation of a
feeling of ‘distension’ (zhang) in the head.
On the following evening, Qiu, Jade Blossom, and Qiudi cycled to
Ma’s home and delivered a qigong session during the zi hour, when ‘yin
is deepest’ ( yin zui shen) and qigong most efficient. Jade Blossom told
me on the following day that the session had been unsuccessful because
Ma had not been able to calm down. The only sensation she had had
was a prickling in her hands.
The next session was scheduled for Saturday evening after dinner,
the treatment of other evening clients being postponed. On this evening,
the three healers and the clients were strikingly cordial to each other.
While Ma was being acupunctured she expressed her enthusiasm for
qigong. Qiu now showed her and her husband the photo album of his
trip to Beijing, his favourite piece of evidence of his qigong powers. He
had been twenty-four at that time, a qigong healer employed by a hos-
pital of Kunming city. He had had the capability of penetrating vision
and after having proved himself in research trials set up by Yunnan
University, he had been to Beijing for further trials which he claimed
had been arranged by the national secret police. But after being exposed
to the stress of the trials in the metropolis, the highly sensitive person
from the provinces had lost his extraordinary capability of penetrating
vision. He nevertheless remained a capable healer as was evident from
the wealth of cases he successfully treated.
Excitement pervaded in the group as the healing session began. Ma
sat on the bed with crossed legs, Qiudi behind her, and Qiu in front of
her, facing the two of them. Qiu murmured incantations and made a
few introductory gestures for meditation, thus imposing silence upon
the participants in the room, who were all told to shut their eyes. The
necessary concentration was not achieved; in the adjacent room a heated
dispute was taking place, and once that had subsided the noise from the
street was distracting. At last, after about half an hour, when a heavy lorry
came rattling down the street, Qiu gave up: ‘That’s it. It didn’t work.’
The following minutes were critical for us to agree on what had
happened. I opened my eyes, feeling numb. Qiudi was soaked in sweat.
Ma was numb, too, her eyes were swimming. Her husband, however,
sat straight and smiling, he had obviously been peeking at the session.
When Qiu sprang off the stool and put on his shoes, Jade Blossom
broke the silence, complaining of a headache. Indeed, the air in the
room was stale and sticky. Qiudi opened the door, lit a cigarette, and
offered me one while Qiu and Jade Blossom worked on Ma’s arm.
They pressed with both hands against her shoulder and told her to lift
her arm rhythmically. It was obvious that she could lift the arm higher
than before, but in a few minutes she was tired. Now all of us started to
talk about our sensations during the concentration phase. ‘He doesn’t
know how to heal yet, but after half a year of training he has already
seen the Light’, said Qiudi’s sister. ‘How big is a Light?’ Ma’s husband
asked. Qiudi held his hands in front of his chest as if he were holding a
basketball. ‘I would have caught his Light and led it up the arm to the
area of the shoulder’, Qiu’s explanation was followed by a silence. His
interpretation was instantly accepted as correct. I asked Qiu how it had
been for him. ‘Half, half ’, he replied. Qiu maintained that he had
achieved the state of seeing a Light, in spite of the noise, but he had not
seen Qiudi’s Light. He explained that one person alone was not power-
ful enough to cure the shoulder. Since the two had to join forces, he
had stopped emitting the Light and waited for Qiudi’s which, however,
had not appeared. If it worked, Qiu explained, qigong could make a
patient lift his or her arm. Oh, yes, Ma agreed, she had seen such qigong
performances on television. She was the most excited of all. She had
experienced a sensation which she had already had once before but
much more clearly this time. It had felt like an insect crawling, first
twice above her eyebrow then downwards to a corner of her nose. There-
after, a prickling feeling had ascended her arm towards the shoulder
but then descended again towards her fingers, where it had originated.
‘Look, I can even lift my arm to a horizontal position’, she exclaimed.
But Qiu corrected her; she was twisting her body. Ma then suggested
settling her account, since she had now been under treatment for almost
a week. Jade Blossom advanced slowly toward the desk. She glanced at
Qiu who was carefully buttoning his coat in silence. ‘We’re friends’, she
said. So Ma proposed that we all spend Sunday together, but because I
was unavailable, the invitation was postponed.
The session that Qiu and Qiudi delivered on Sunday evening at
Ma’s home was successful. ‘Ma sleeps well now and has no pain in the
shoulder’, Jade Blossom told me the next day; Qiudi had seen the Red
Light (hongguang) and even bones of the shoulder in it.
On Wednesday evening the party met again, this time in a pavilion in
the nearby park. The pavilion was open and airy and the air a bit chilly.
Only a few visitors were still strolling in the dusk. It was silent except
for the regular sneezes of nearby qigong exercisers. Qiudi looked more
self-assured; he had obviously received further instructions. After a
period of concentration, he started moving his open palms up and
down behind Ma’s back without touching her. Then Qiu took Ma’s
hand and put his palms on hers. It looked as if he meant to transmit his
qi to her. After the concentration phase, Qiu and Qiudi pressed her arm
and made her lift it rhythmically, which she did for five to ten minutes.
There was no doubt that qigong had worked this time. Qiu was the
first to say so. He had seen a White Light (baiguang). Ma said that she
had felt heat running from the left to the right shoulder and that her
hands were unusually warm; she let me confirm this by touching them.
She even declared that she had also seen a White Light. The White
Light was not as effective as the Red one, Qiu explained; he had tried
to let the Light penetrate the blockage in the shoulder five times, but
had succeeded only once. Ma nodded; she had felt the prickling feeling
ascending and descending her arm before she had the heat sensations
between the shoulders. When I asked Qiu how big the Light had been
he drew a huge circle in the air with outstretched arms; when I asked
Qiudi, he said it had been a ball similar in appearance to the flickering
on a television screen. Qiu did not seem to appreciate systematic en-
quiries and interrupted me; the treatment had worked for everyone,
and that was important. He always emphasised that he did not know
why, but it obviously worked. Qiudi was by now, at least, convinced of
the effects of his qigong and his own gongfa.
Two days later Qiudi looked excited and happy. The night before he
had seen the ‘eight trigrams’ (bagua) very clearly, and during the morn-
ing meditation he had also seen Taishang Laojun. Qiu was surprised
that his disciple had made such rapid progress but showed familiarity
with the symptoms. He asked Qiudi whether the images had threatened
him or simply vanished. When Qiudi reported that the latter was the
case, he said: ‘If ever they threaten you, do not be afraid, they may
become bigger and bigger, but you need not fear them. When they
come, tell them to go; when they swell, tell them to shrink.’ He assured
Qiudi that his spiritual force would be stronger than these images. He
was to beware of wild animals, but if he were to see a little man he was
to report it to Qiu.
On Sunday, the four of us went to Ma’s home. She served us many

delicious dishes and after lunch took us to the nearby park. Towards
evening she was expecting to receive treatment. For the past three days
she had taken Qiu’s herbal drug potions three times a day. She had also
meditated during the zi hours in order to receive treatment by remote-
effect-qigong. Qiu said that he was tired and told his disciple to treat her
in the adjacent room. Forty minutes passed in silence. Eventually Qiu
interrupted their session by knocking on the door. He found Ma burst-
ing with enthusiasm. She had had the same sensations as on Wednes-
day in the park, and this time this was due to Qiudi’s gongfa alone.
Everyone was surprised and delighted. This meant that Qiudi had a
very powerful gongfa. Later I asked Qiu what the patient was expected
to feel during such a successful session. She should feel pain, he answered;
if it did not hurt her, it was just like having a rest or falling asleep.
Qiudi slowly opened his eyes, looking a bit dazed. He was expected
to say something, but he did not. Instead, his sister immediately started
speaking on his behalf: ‘He can’t express what he experienced. He does
not understand it himself, he doesn’t know any anatomy.’ Later she
added that if she could ‘emit Red Light’ ( fa hongguang), given her know-
ledge of anatomy, she would have been able to cure Ma in a few days.
Qiu, too, began to offer explanations. It was as if Jade Blossom and Qiu
did not want to give Qiudi a chance to put his experiences into words.
I tried to get him to speak for himself, but he just repeated what his
sister had said: ‘It’s so difficult to put your experience into words.’
Qiu showed with a gesture of his hand that a blockage – a tight
passage – had been opened up so that the qi could flow through it.
Qiudi had murmured something about going all the way up the arm
and from one shoulder to the other. This made Jade Blossom wonder
whether there was no blockage in the spine, which would contradict the
biomedical information derived from the x-ray. Indeed, Qiu and Jade
Blossom had closely inspected the spine and shoulder before Qiudi
began the qigong session. They had searched for a rash on the surface of
the skin, induced by their drug treatment, which would reflect an inner
blockage, but had found none.
On the way back I approached Qiudi again, but when he started to
talk – ‘the Red Glow, well, with that Red Light, I go up the arm’ –
we were interrupted again. This episode clearly showed what earlier
episodes had indicated: the disciple was not asked to express his experi-
ence; instead his experience ‘difficult to put into words’ as it was, was
described and labelled by his master. He spoke of his disciple’s experi-
ences as if he had had the experience himself. Long before Qiudi had
seen the Light, his master had talked about it. Then, after the concen-
tration phase, still overwhelmed by his own new experience, the disciple
was told what it was; the master labelled it for him.
Ma did not come again except to pay her bill: about two hundred
yuan, covered by her work unit’s health insurance. During the following
year she and her husband occasionally passed by. Her shoulder still
hurt, and she could not lift it much higher, but she put up with it and
said she had not consulted other healers.
The next step in Qiudi’s training was to meditate for forty-nine days,
every night during the zi hours and two hours early in the mornings, in
a private room. From now on he was to eat vegetarian food, sleep re-
gularly, and abstain from sex and alcohol. Moreover, he was to learn a
series of Daoist incantations for the cure of the different illnesses by heart.
In mid-December Qiu left for a meeting of the National Qigong
Association in Beijing, and Jade Blossom went to see her parents in her
home village near Chengdu, the capital of Sichuan province. Qiu joined
her in early February to spend the Chinese New Year there. Qiudi
stayed in Kunming and transformed the consulting room into his medi-
tation room. During the day, he continued to work in the collective,
but night and morning he meditated. I visited him once in January.
Fumes of incense filled the room, a meditation mat was on the floor, a
picture of Guanyin22 on the wall in front of the mat, flanked by incense
sticks. Qiudi looked much thinner; his hands were wounded and swol-
len and he told me that his whole body was ‘sore and painful’ (suanteng).
Obviously, he was practising hard qigong too. His notebook, which was
on the table, was tiny but filled with drawings of Daoist fu (signs)23 and
incantations copied from various books. As well as that, he seemed to
have taken the urgings of his sister seriously; an anatomy booklet lay on
the bed.
When Qiu and Jade Blossom resumed their practice at the end of
February, Qiudi started to work regularly with them and gave up his
job at the collective. Qiu taught him the particular incantations and
gestures of qigong for curing some illnesses, but he was only rarely told
to perform qigong. Usually he had to deliver the massage treatment, the
most strenuous work. The few times I saw Qiudi deliver qigong was for
curing chronic illnesses or serious diseases which did not promise suc-
cess for the healer.
22
An autochthonous female deity of the earth and fertility which was merged with the
male boddhisattva Avalokitaresh after Buddhism spread in China (Needham 1956:407).
Nowadays Guanyin is venerated as a pusa (boddhisattva) in Buddhist temples. She is
very popular and still fulfils the functions of a fertility deity.
23
A Daoist charm, see Schipper (1982:287).
For example, in May and June 1989 a woman from the neighbour-
hood in her sixties took regular treatment for headache and blurred
vision, which Jade Blossom attributed to ‘high blood pressure’ (gaoxueya).
She was treated with acumoxa, qigong, herbal drugs taken three times a
day, and with the therapeutic method of covering the patient’s eyes
with two fresh, light green mulberry leaves. In spite of daily treatment,
her condition did not improve much, nor did the regularly measured
blood pressure sink perceptibly. Qiudi was allowed to treat her. As
taught, he murmured the incantations and performed the prescribed
gestures of qigong healing, which included several fu drawn in the air
before her eyes. Once he delivered a session for almost three-quarters
of an hour. In the more public part of the room, Qiu had first treated a
hearing-impaired old man from the neighbourhood and then sat chat-
ting with his patients. He eventually turned to this woman, seated her
on a stool in the middle of the room, and delivered another five-to-ten-
minute-long qigong performance. After this short session, the woman
looked delighted, and when Qiu asked her how she felt she answered
that she had had strange sensations of a prickling on her eyelids. In five
minutes he had achieved what his disciple had not achieved in the hour
before. Seen in contrast to his disciple, he seemed even more of a
master. Qiudi sat on the bench, exhausted and silent. I wondered to
what extent the master was exploiting his disciple’s preparatory work of
concentration.
In August, an old man in his seventies came from a distant county
for a month of treatment. He was partly paralysed on one side because
of a stroke and could hardly walk. His daughter’s friend whom Qiu had
cured of a uterine tumour had recommended him to her. When his
daughter had visited Qiu in his practice to find out whether he would
treat her father, he, as usual, told many stories of successful treatment
but said that he had to see the patient in order to judge his prospects
for recovery. Accordingly, father and mother made the trip into the
provincial capital and took a room in one of the many private inns
opposite Qiu’s practice. After first inspection, Qiu made no promises.
Although he did not say so, even when I later asked him in private, he
obviously was reluctant to commit himself to this treatment. Instead,
he sent Qiudi at least once and sometimes twice a day to perform the
massage and qigong treatment. Jade Blossom provided acumoxa treat-
ment while Qiu prepared the herbal drugs. He only occasionally went
to see this patient to deliver qigong. I saw Jade Blossom scolding her
husband several times during that month, accusing him of neglecting
this patient who had come from so far away. The patient’s wife and
daughter did not scold him, but they were full of praise for Qiudi. They
said that the disciple was more helpful and kinder and even delivered
better qigong treatment than his master. Jade Blossom was very proud
of her brother when she told me this. But Qiu did not lose face: when
the patient returned home after a month, he was still in the same
deplorable state.
In October, Bao, a middle-school teacher in his fifties, sought Qiu for
treatment of liver cancer. He had come from the neighbouring province
of Guizhou in July to receive treatment that only the hospitals of a
provincial capital could supply. During the first few months he and his
wife had stayed with his relatives. Biomedical treatment at several hos-
pitals of Kunming had proved incapable of halting the deterioration of
his health, and he had turned to qigong as a last resort. He reported
feeling considerably better after the first series of ten qigong sessions. In
November Qiu was introduced by a friend to a herbalist who knew a
herbal drug, the root of a shrub, which was said to cure liver cancer.
Another friend, who was a chauffeur, agreed to escort Qiu, Qiudi, and
the herbalist about a hundred miles south to the mountains where this
plant grew. The excursion was successful, but the second time Bao
took the potion containing this drug he fell seriously ill, vomiting and
being unable to keep any food down for three days. When Bao’s wife
reappeared in Qiu’s practice on the fourth day, tears were running
down her face. Qiu urged her to send her husband to the private
hospital down the street for an intravenous glucose treatment.24 She
meant well, he said, implying that she had not followed his instructions
carefully, and given her husband an overdose of a very Potent and
Toxic Drug (duyao). When I saw Bao a week later he was thin and frail
and by December he was so weak that he and his wife moved into a
room of an empty, newly built private apartment house belonging to
one of Qiu’s friends. It was only ten minutes’ walk away from the
practice so that Qiu could deliver treatment there – on an old mattress
laid onto the bare cement floor, in a draught coming from hollow
window frames that time and again put out the flame of a candle.
When I left Kunming at the end of December he had been admitted to
the emergency station of the Red Cross Hospital after a fainting spell
four days before. He survived the trip to Guizhou, Jade Blossom wrote
me in a letter, and was able to bid farewell to his two daughters before
dying in early January.
Bao’s liver cancer, with the illness course briefly outlined above, was
a case for which Qiu sought Qiudi’s assistance in order to treat the
24
Intravenous glucose treatments were considered to ‘invigorate’ (bu) the body; see
White (1993:269) and Hsu (1992b:97).
patient with joint energies. After he had treated Bao for the first ten
days, the question arose as to whether treatment should be continued.
The decision was taken after attaining general agreement that the client’s
health had improved. This agreement was not based on biochemical
evidence but on several opinions that coincided. Jade Blossom, Qiu, I,
and long-term patients in Qiu’s consultation room all noticed that Bao’s
look had become brighter; he had more Spirit (shen) in his eyes. Fur-
thermore, Qiu declared that he could see (with his penetrating vision)
and feel (with his trembling hand) that Bao’s liver had ‘softened’ (nen)
and was smaller than before, and most important, Bao had agreed that
he felt less pain. Bao and his wife, both government-employed cadres,
were naturally quite uncertain whether they should rely on qigong, and
once when we happened to meet in the street outside Qiu’s practice,
they expressed their doubts to me. Yes, I told them, I had my doubts
too, but Qiu was certainly one of the best healers I knew in Kunming.
Yes, I had witnessed the recovery of one woman last year who had
had a tumour in her uterus; x-rays had shown that it had almost dis-
appeared after six months of regular qigong treatment.25 I emphasised
that I was not a doctor and that they should continue with biomedical
care at the hospital. They replied that Bao had just given up his chemo-
therapy but they had been there for a check-up.
In view of his patient’s commitment, Qiu suggested doubling the
qigong sessions in the conviction that this would double the therapeutic
effect. Qiudi delivered the first one. He sat on a stool in front of the bed
where the patient lay, shut his eyes, murmured the incantations, made
the opening gestures, and put his hand on the right side of the patient
in the region of the liver. It was a long session, more than half an hour.
The healer’s shirt was soaked with sweat, and the patient had beads of
sweat on his forehead. He felt completely exhausted and indicated that
he felt pain in the region of his liver. Without addressing a word to
Qiudi, Qiu instantly took his place and talked to the patient, asking him
about his pain and calming him, saying that Qiudi was still inexperi-
enced but he need not be anxious, that everything would be all right in
a moment. After a rest of about a quarter of an hour, he suggested
performing a second session, which proved half as long as the previous
one. After this session the patient’s exhaustion disappeared and he no
longer felt pain. He then sat on the bench to rest and chat before
leaving, guided by his wife, shortly before lunch.
25
At the time I did not know that: ‘One of the most frequent disorders of the uterus and
the most frequent tumour of women (three of four women affected) is the uterine
leiomyoma, or fibroid tumour. 75 per cent of women with leiomyoma are asymptomatic’
(Harrison’s 1987:1836). Apparently such tumours come and go for unknown reasons.
In this case Qiudi had made a serious mistake, and Qiu continued
the treatment without addressing a word to him. Sometimes, he would
shake his head, but I never saw him scold his disciple in public. Once,
when Qiudi had spilled out some herbal drug powder, his sister cursed
him, but Qiu did not get angry and, with a laugh, crouched down to
help him to take up the powder from the ground.26 This time, after Bao
and his wife had left and I entered the backyard, I could hear from a
distance how Jade Blossom told off her brother: ‘How dull and stupid
you are’, she exclaimed; ‘it’s not the longer the better and the stronger
the better!’ Qiu was in the kitchen too: ‘You’ve got to use “imagination”
( yinian)’, he said, for the first time with a strong note of reproach.
When he noticed that I had entered the kitchen he became silent and
urged us all out of the kitchen into the opposite room for lunch. He
continued at the table in a friendlier and more instructive tone: ‘You
have to imagine how his Liver (gan) becomes smaller and smaller and
at last, when it’s really so small that it fits into your hand, you fold it
away and take out the bad stuff.’ Qiu made a gesture of drawing the
outstretched fingers of his hand together into a fist. ‘Qigong is done by
imagination ( yinian), not by force, it’s as simple as that.’27
The Light that changed the healer’s gaze

‘Experiencing the Light’ ( jian guang) marked a boundary in Qiudi’s train-
ing28 comparable to the boundaries that initiation rites make between
laypersons and the initiated. This social differentiation was grounded in
an important change of cognitive faculties: only those who were able to
concentrate qi and control its flow would experience the Light that
changed the healer’s gaze and endowed him with healing powers.29
26
Qiudi’s apprenticeship differed in this respect from Cooper (1980:27) who found that
‘Many workers seriously believe that the only way to get a boy to learn is to beat him.’
27
Engelhardt (1987:17) makes the same point about qigong exercises in general and
provides various examples; see also Despeux (1995:138). Sharma (1996:258) argues
that ‘Anthropologists have had little to say about imagination’, pointing to the import-
ance of imagination in many so-called alternative therapies which adopt a ‘holistic’
approach to the body and healing. She proposes to use a ‘culturally active imagination’
as a means to overcome the mind/body dualism inherent in academic anthropology,
although she is ‘not optimistic that it will be possible to overcome the dualisms embed-
ded in western culture’ (p. 262).
28
Not every qigong healer spoke of a Light. For descriptions of the Light in other
traditions of meditation, see Robinet (1989a). Qiu’s meditation took place in absolute
silence and differed in this respect from that described by Tambiah (1977:102) in
which the master led his disciple-patients by verbalising visualisations, and McGuire
(1983:231–2), in which verbalised problems were burnt in a visualised fire.
29
Shamans are generally believed to possess cognitive capacities that distinguish them
from others, see for instance Blacker (1975:168). The ascetic may be initiated by a
dream, by ‘possession’ (lamagakari) and, less frequently, by mantic journey into the other
After Qiudi’s mistake in treating Bao, the atmosphere in Qiu’s house-

hold was tense. During the lunch, I asked Qiu how he had cured the
‘kidney infection’ (shenyan) of one of his current patients. Qiu’s answer
was short: ‘With the Red Light.’ Ideas about the Light’s impact on
cognitive and healing faculties diverged greatly among laypersons, and
those who had experienced it themselves were reluctant to speak about
it. Lao Yi, the neighbourhood herbalist who was having lunch with us,
seized this opportunity to comment on Qiu’s answer. ‘A kidney infec-
tion’ (he used the same biomedical term as I had), he said, ‘is cured by
the principle of the Earth overcoming Water (tu ke shui).’ He was
evidently reasoning in terms of the Five Phases (wuxing): Water is
associated with the Kidneys and Earth with the Spleen. In order to cure
the Kidneys one had to ‘invigorate the Spleen’ (bu pi). He declared that
Qiu should ‘emit Yellow Light’ ( fa huangguang) because that colour
corresponded to the Earth and the Spleen. Qiu, however, emitted Red
Light; Red Light corresponded to Fire, Fire gave birth to Earth (huo
sheng tu), and Earth overcame Water (tu ke shui). Qiu remained silent;
it was clear that the herbalist had overgeneralised maxims of treatment
in terms of the Five Phases. These maxims can be used to determine
the composition of ingredients of Chinese medical drug treatments, but
they are inappropriate for explaining the workings of qigong healing.
That evening I dropped in on Qiu and his wife again, hoping to
clarify the issue that Lao Yi had raised. Qiu laughed, still unwilling to
speak: ‘Have you ever heard anyone speak of the Yellow Light!?’ Jade
Blossom was more cooperative. She explained that the Red Light could
shine through the red tissue of the body and that by ‘emitting Blue-
green Light’ ( fa qingguang) a qigong healer could find stolen or lost
things in blue-green water. She fell silent, however, when she saw her
husband frown. It was only in the context of my training later that
evening that Qiu spoke of the Light. As usual, his explanation was brief
and vague. He said that the Red Light was most powerful because one
had penetrating vision and quickly added that, despite previous events
that seemed to prove the contrary, only he (and not Qiudi) knew how
to emit it. The Red Light that he saw, but not the White Light Qiudi
saw, enabled one to see bones, Obstructions (bi), and ‘accumulating qi’
(qiji ). Sometimes Obstructions and accumulating qi were symptoms
which the patients themselves perceived, but usually they were a visu-
alisation of the disorder which only the qigong healer could achieve by
emitting Light.
world and thereafter endowed with the cognitive powers of clairvoyance, clairaudience,
and insight into hidden things, apart from many others such as mastery of fire and
flight to heaven. On the assessment of cognitive capacities by psychological tests
among shamans in Zinacantan, see Shweder (1972:407–12).
Destiny and the legitimation of knowledge

‘That territory is yours, but this is mine. First make this vow and then
I will teach you all my knowledge.’ One of the Chinese doctors who
introduced me to Chinese medicine, had earlier expressed the thoughts
that Qiu was now having about transmitting his secret knowledge. A
disciple may become more powerful than his master, and therefore
he must promise never to try to compete with him. Qiu sat on a stool
in front of my desk and sighed. In autumn 1989, he had repeatedly
expressed his aversion to teaching Qiudi: ‘I don’t like him’, he said.
‘This hasn’t always been so’, I replied. I remembered having seen the
two walking hand in hand as good friends frequently do in China. ‘He’s
so silent. I don’t know what he’s thinking’, Qiu continued. ‘Moreover,
he is stupid. It is impossible to teach him the herbal drugs.’ I asked
whether Qiu was implying that knowledge of the herbal drugs was
indispensable for becoming a successful qigong healer. No, he said, but
it was crucial for running a practice. He was disturbed that during an
outing to collect herbs on a hill in the suburbs Qiudi had had difficulty
recognising the plants. But, I reminded him, Qiudi was being con-
fronted with the world of plants for the first time, and it was unfair to
compare him with me, a graduate in botany. Qiu insisted on his view.
He said that he had hesitated to teach his brother-in-law from the very
beginning. ‘You can’t imagine how bad the Chinese are’, he confided
in me, the foreigner. A year earlier he had expressed to me his fear that
his wife wanted him to teach her brother in order to divorce him later
and set up a medical practice with her brother in her home province.
Apart from pointing to the marital tensions between these two indi-
viduals, these suspicions revealed more trust in consanguineous kinship
than in affinal bonds. Qiu’s affection and respect for his wife increased
after she had become the mother of his son in summer 1989, but even
then he showed little interest in teaching Qiudi. Although Qiudi con-
tinued to meditate, he rarely had visions any more. In September 1989
his sister scolded Qiu because it was obvious that her brother was
making no progress. Qiu shrugged his shoulders and remained indiffer-
ent to the failure of his disciple.
Naturally, no disciple can force his master to teach him, and even if
a master has accepted a disciple he is free to keep as much of his know-
ledge to himself as he wishes. Qiu’s Buddhist friend once explained to
me: ‘That is why the older a book of secret knowledge, the more value
there is to it. Imagine, for centuries each master has taken a bit of that
secret knowledge to his grave – probably even the most important bit,
the one which ensured him security against the rivalry of his disciple.
How watery the knowledge of these days is compared with that of the
golden age!’ Knowledge not only enhances one’s power but, once trans-
mitted, can be used against one. Limited as it is believed to be, it can
be possessed like a commodity.
Qiu had come to my room at the TCM college to fetch his know-
ledge commodity – his notebook of Daoist incantations. ‘Don’t lose it;
it is my source of life’, he had said when handing it over to me two days
earlier. I was to photocopy it, because he knew that I would keep him
separated from it too long were I to copy verse after verse by hand. He
forbade me to have it photocopied in one of the stalls in the streets, but
the power supply at the college had been interrupted, and therefore I
had not had the opportunity to return it to him earlier.
‘To learn this knowledge you have to be destined for it’, he explained.
For every verse there was a prescribed gesture for magical healing. His
wushu master had had him learn verse after verse by heart, writing each
verse on a separate piece of paper and telling him to burn it, once he
had memorised it. At the beginning of each weekly session, he would
ask to hear the verse, and only if Qiu recited it correctly would he teach
him the gesture for it. Qiu was a small boy at the time, and sometimes,
when he stood before his master, he just could not remember the verse.
When he failed, instead of giving him another chance at it, the master
would teach him a new verse. He was convinced that some verses fitted
his disciple and would therefore be easy for him to remember. For
those verses the disciple had a predestined fate.30
I myself had, I reflected, met Qiu by chance. Qiu’s older brother had
wanted me to learn qigong, and, curious, I had agreed. I had learnt the
‘ten precious movements’ without much difficulty – I just remembered
them – and when Qiu noticed this he had been eager to teach me more.
He was convinced that it was fate that I had come, and that I should
learn qigong. I believed this too. But I did not make as rapid progress as
Qiudi. The day we chose for the beginning of my training in medita-
tion in tranquillity was 3 June 1989. It was fate again that that was the
night in which the students’ movement in Beijing was drowned in
blood. Nights of anxiety instead of calm and concentration followed.
30
I was reminded of the phrase a Naxi dtomba had repeatedly murmured when I visited
him in his hut and asked him what had motivated him to learn the knowledge of the
dtomba. His father was a peasant like everyone else, he replied, and he was to become
one too, but when he was small he used to go to an old and powerful dtomba in the
neighbourhood. The many myths he was told, he ‘just remembered’. It was not so
much by vocation as by his fate of ‘just remembering’ these myths that he later became
the dtomba of the area. The Naxi are a people of c. 250,000 persons who inhabit parts
of northwestern Yunnan; the dtomba are ritual specialists of a literary tradition notated
in a pictographic script (Oppitz and Hsu 1998).
A month later my stay in Kunming was disrupted by a sudden death

back home. When I returned three weeks later, Qiu said that my life
was too turbulent. He and his older brother had hoped that I would
make qigong known to the world and, powerful and famous as I would
be, would invite my master to come abroad. ‘You have no trust in the
powers of qigong, and there is no continuity in your life. How can I
teach you when I constantly feel your critical mind?’ He had once
believed it was my destiny to learn qigong; now he believed it no longer.
Qiu said the above exactly a year after we met, in September, and
now, in November 1989, he rejected his disciple Qiudi, too, though
for a different reason. He began to concentrate on plans for his son.
This child would become a great qigong master and, unlike himself,
who had only minimal writing skills, go to the university. He would
start to teach his boy as soon as he was three. Since the baby’s birth, he
had been exposing him every evening to tape-recorded qigong meetings
by Yan Xin. Qiu’s decision precipitated a crisis in his family. ‘Qiu wants
to send Qiudi away,’ Jade Blossom exclaimed, ‘but I would rather get
divorced than have my “dear younger brother” (qin didi) sent away.’31
‘He has learnt nothing during the past year. He has no job, no home –
he can’t return to his parents without any skills, without even a penny
in his pocket.’ She dreaded the idea of being alone in Qiu’s family. As
she started to talk in a lowered voice, she pulled me onto the other side
of the street. From a distance I could see Qiudi in the backyard grind-
ing herbs. Qiu was squatting in the sun in front of an empty practice.
For the past ten days, no new patients had sought him out. Was it
because of the new, more stringent regulations with regard to qigong
practice, or was it perhaps because Qiu had let me photocopy his secret
knowledge? Here Jade Blossom was voicing Qiu’s unspoken fears.
When I returned several days later, things seemed to have returned
to normal. Qiudi was said to have shown his gratitude to Qiu by hard
work, and Jade Blossom had found a temporary job for him somewhere
in town. I was about to leave China and, considering that Qiudi’s
training was taken more seriously when I, the anthropologist, started
regularly to visit Qiu’s family in the autumn of the previous year, I
wondered about the incidence of Qiu’s turning away from his disciple
at the very moment I was turning away from them.
The secret mode of transmission

Competence in many different frameworks of knowledge and practice
was required to become a qigong healer. Qiudi learnt how to administer
31
Qin designates consanguinity in this context.
Western biomedical drugs and interpret x-rays according to Western

biomedical anatomy, he became familiar with herbal drugs and Chinese
medical drugs, he engaged in qigong healing performances and medita-
tion, and he memorised how to write Daoist fu and recite incanta-
tions.32 His master considered biomedical knowledge more accessible
than Chinese medical knowledge and was most secretive about qigong
and, in particular, the Daoist signs and incantations.
The disciple Qiudi learnt by imitation and was trained by repetition –
daily meditation and daily exercise consisting of the repetition of the
same sequence of movements, three, seven, nine, twenty-four, forty-
nine, or sixty-six times. The process of learning was not didactically
structured; the different stages through which a disciple had to pass
were not outlined in the beginning. Perhaps the master was intention-
ally concealing his knowledge, or perhaps the course of learning could
not be known in advance. The endless repetition of apparently mind-
less movements was intended to produce sensations, feelings, emotions,
and visions to which the disciple was told to be attentive. In Qiudi’s
case, the direction of further training seemed to depend largely on his
particular experiences.
Everyone agreed that an apprentice in qigong needed guidance. In the
learning process, the disciple was bound to encounter many dangers and
dazzling experiences (unusual sensations, visions of dangerous beings,
or injuries that needed treatment). When Qiudi experienced the White
Light, when he saw the eight trigrams and Taishang Laojun, and when
he experienced the Red Light, the master offered guidance: he put the
disciple’s experiences into words, gave them form, and told him what
to expect next.
The development of physical agility was a sine qua non for spiritual
progress. Qiudi was told that he would not be taught the movements
for entering into meditation in tranquillity until he was able to sit, soles
upward, with crossed legs. Since bodily agility can be attained only by
repeated exercise, it was also taken as a sign of the disciple’s commit-
ment. Qiu’s trust in his disciple visibly increased as Qiudi became more
agile. Bodily and spiritual subtlety were thus both being trained. The
training was directed at a mindful being in the body.
The style of knowing that Qiudi acquired can be characterised by
the automatism of bodily movements, on the one hand, and the
unpredictability of spiritual experiences, on the other. Mindless repeti-
tion of the same sequence of movements, on the one hand, and sud-
den, mind-boggling experiences, on the other. This style of knowing
32
By contrast, qigong in the West and among many adherents in China consists only of
exercises for the mastery over one’s mindful body (N. N. Chen 1995).
consisted in the ability to enter and leave such states of knowledge; the
acquisition of secret knowledge was marked by uncertainty. Secret know-
ledge was not always accessible; it presented itself in different ways, and
it sometimes bore the danger of overwhelming the person who had
achieved access to it.
Qiu maintained that the recitation of Daoist incantations was even
more powerful than the gestures and bodily movements. His gestures
were fairly intelligible if one accepted the reality of qi – the healer
moved it about with his hands – although he generally did not explain
why he made one gesture and not another. The meaning of the incanta-
tions was not always clear to Qiu himself; one did not have to understand
them to be knowledgeable and powerful. Moreover, one’s efficacy did
not depend on knowing many different ones.33 They were limited, like
a commodity, condensed in a booklet of incantations. Their message
was ‘densely compressed’ in a ‘highly abstract form’, just like value in
money, which makes transactions possible with an ‘otherwise unobtain-
able secrecy’ (Simmel 1950:335).
The Daoist incantations accompanied the gestures in a manner remin-
iscent of Tambiah’s (1968:194) ‘operational explanation’: ‘The rite of
transfer portrays a metaphorical use of language (verbal substitution)
whereby an attribute is transferred to the recipient via a material sym-
bol which is used metonymically as a transformer . . . The technique
gains its realism by clothing a metaphorical procedure in the operat-
ive and manipulative mode of practical action; it unites both word
and deed.’ Tambiah points out that the magic spells of the Trobriand
Islanders recorded by Malinowski were uttered in alternation with the
hands-on activity of, for instance, carving a ship out of a log. Evans-
Pritchard (1937:475–7) made the same point: ‘Magic is seldom asked
to produce a result by itself, but is associated with empirical action that
does in fact produce it.’ The sower not only murmurs spells; he murmurs
spells while sowing. Likewise, Qiu not only recited Daoist incantations
but simultaneously performed gestures which manipulated the qi. These
gestures can therefore be interpreted as ‘operational activities’.34
As convincing as Tambiah’s operational explanation is, it cannot
entirely account for my observations: Qiu attributed magical power to
the spoken word itself; he ‘had a belief in the creative power of the
magical words themselves, conceived of as active agencies’ (Skorupski
33
ter Haar (1992:18) points to the power of the repetition of a single word, the name
Amitâbha. It gave a devout lay Buddhist without any education the hope of being
reborn in the Western Paradise.
34
Further ‘operational activities’, apart from Qiu’s gestures, were treatment with mas-
sage, acumoxa, herbal drug potions, Chinese medical, and biomedical drugs.
1976:152). The spoken word was, like qi, an agent that effected change.
Words were not ‘one of the most realistic representations we have of the
concept of force’, as Tambiah (1968:184, italics added) puts it, but the
so-called force in themselves. Tambiah (1977:109) himself makes this
point forcefully elsewhere: ‘We note as regards the achan’s [teacher’s]
technology that it is through the medium of words and substances that
the achan transfers potency and efficacy. The power of words was in
fact transferred as if it were a “physical entity”, by hand gestures and
blowing air.’35
Spoken words are emanations with power to induce change. They
have tones and pitches, they depend on the voice of the speaker and its
modulations, and they can be highly emotive. Words are alive, for some
people, like powerful spiritual beings. They are something precious,
essential to life, which has to be protected. Secrecy is a means of
protection.
Only the correctly pronounced word has power. This conviction may
prevail when the name and the thing to which it refers are considered to
bear a necessary and internal relation to each other or when the word is
not a representation of a thing, but a thing in itself. Whether a so-called
correct pronunciation also includes the right tone, pitch, and modula-
tion is unclear to me. Qigong masters like Qiu may not be quite sure
themselves of all the criteria for correct pronunciation. From an out-
sider’s point of view, the insiders’ conviction that the transformative
power is inherent only in the correctly pronounced word leads to the
following features characteristic of the secret transmission of knowledge:
firstly, it provides a legitimation of those in power; secondly, it allows
for control over the distribution of knowledge; and thirdly, it excludes
the possibility of a critical evaluation of the power of words.
The master usually knows the correct pronunciation from what he
was taught by his master, but sometimes he may make decisions about
pronunciation quite arbitrarily. This conviction that the master is always
right may well ensure the continuity of the lineage in power, although a
master need not perpetuate a given tradition but may well be innovat-
ive. Since the correct pronunciation can only be transmitted in a face-
to-face relationship, the master has control over the authenticity of
efficacious knowledge and its distribution.
35
The Daoist fu, in their written form, were also considered powerful in themselves.
They were said to be ‘a kind of breath from the master’ (Schipper 1982:82). The
power of the written fu resided in this case in the same ‘logic’ as that of the correctly
pronounced word. A fu was sometimes written on a paper that was burned and
ingested. It would probably be going too far to speak of cannibalism in this case but
clearly the master’s powers were thus transferred into the client. The ‘logic of transfer-
ence’, basic to Qiu’s ‘logic’ of healing, applies also to the ingestion of written fu.
The degrees of communicating the very same secret can, however, be

surprisingly negotiable. When Qiu first introduced me to the ‘ten pre-
cious movements’ he strictly forbade me to show them to anyone else,
not even my closest relative or friend. On a subsequent occasion he
suddenly began reciting incantations in the Kunming dialect speaking
so rapidly that I could not understand them. At this point, he allowed
me to teach the ‘ten precious movements’ and other meditation tech-
niques of qigong but forbade me to reveal the recited incantations to
anyone. A month later, when he was trying to build up Ma’s confidence
in his healing art, it turned out that these movements were already
common knowledge – the ‘friend’ who had enticed him into teaching
him the ‘ten precious movements’ had since published them. At Ma’s
request Qiu had performed them in front of all of us in his widely open
practice. This did not prevent him, on a later occasion, from forbidding
me to show the movements to anyone except – and this exception is
crucial – if circumstances some time in the future were to force me to
make my livelihood by giving classes on qigong. There were also various
degrees of communicating the Daoist incantations. Qiu let me photo-
copy the verses and eventually even agreed to let me study and translate
them; he explained to me that this form of ‘giving away’ (wang wai
zhuan) the secrets of his master was not a betrayal (although he was a
bit in doubt of this during the ten days when he had no clients). He
maintained that only the orally transmitted verses were endowed with
magical power; in their written form they had no power.
The conviction that words have power only if correctly pronounced
prevents a critical evaluation of the content of the spells: ‘Ritual didn’t
fail because you used the wrong invocation, but because you didn’t use
it properly’ (Luhrmann 1989:253). Lewis (1980:22) points to the dis-
tinction between ‘type’ and ‘token’: ‘Not every property that can be
predicated of the performance must necessarily belong to the type.’
The written verses in Qiu’s booklet were a commodity that contained
knowledge of the type; the verses recited during a healing session were
tokens. The effect of a token could be evaluated in terms of whether
the client was cured or not. If only the power of the token counts, how
can one examine the power of the type? The authority of those who
have knowledge is thus secured from any doubt.
The secret transmission of knowledge legitimates the right of those
who have access to knowledge, secures their authority, and hinders
uncontrolled distribution of knowledge. It strengthens group identity.
Secretly transmitted knowledge is often orally transmitted, and this
requires a face-to-face relationship, generally within a small group. In
the case of Qiu and Qiudi, the secret knowledge was transmitted in a
relation of kinship. The relation between master and disciple was prim-
arily one between senior and junior kin. The incantations were viewed
as a commodity that could be possessed and was finite. It was possible
to appropriate this commodity by imitation and repetition (memorisa-
tion). Knowing did not mean understanding. Knowing how to recite
incantations consisted in knowing how to pronounce them correctly
and how to invoke the forces that effected change. It also consisted in
awareness of the unpredictability of the results of one’s actions. This
style of knowing entailed risk of self-destruction for those who acquired
it, but it was considered extremely powerful.
Excursus: secrets and social relations

Research on Qiu’s family practice threw light on aspects of the socio-
logy of secrecy that are not directly relevant for identifying the modalities
of secret knowledge but are nevertheless worth mentioning. If we view
the secret, as Simmel (1950:331) did, as ‘a general sociological form’,
it is not the contents of the secret but the mere fact that one person
has a secret and the other is excluded from it that is significant. Secrecy
concerns a relationship between at least two people; a person who makes
a secret and a person who is excluded.
An individual may guard a secret for life and take it to the grave, but
more often secrets are revealed, albeit to different degrees. Bellman
(1975, 1984), unlike Simmel (1950), does not emphasise so much the
boundary between those initiated into a secret and those excluded. He
points out how eminently important the communication of secrets is and
calls this the ‘paradox of secrecy’. He considers anything that is pur-
posefully concealed and only partially communicated a form of secrecy.
It may be socially approved, as in the case of discretion, politeness, and
encouraging praise (instead of tactlessness), or socially disapproved, as
in the case of deceit, pretence, and hypocrisy (instead of truthfulness).
‘Parables, dilemma tales, pretalk in palavers, gnomic expressions, exag-
gerated descriptions, allegorical accounts’ all communicate information
that is ‘not immediately observable by direct examination of the linguistic
code’. These different styles of verbal communication represent, accord-
ing to Bellman (1984:139), different forms of revealing the concealed.
Just as there are different forms of revealing the concealed in verbal
communication, there are various forms of social relationships that are
established when secrets are communicated to others. In the following,
secrecy is not simply associated with the politics of power, its most
conspicuous aspect. Creating and maintaining a secret can also be a
weapon of the weak and a form of personal adornment.
Family secrets – secrecy as attribute of those in power

Qiu’s case cannot be taken as typical of the handing down of medical
knowledge in the agnatic line because he did not learn his secret know-
ledge from his father. He ‘venerated’ (baifang) many ‘masters’ (shifu)
and was proud of it.36 As we have seen, there were two masters to
whom Qiu was deeply committed: one was a wushu master, an ‘old
friend’ (laopengyou) of his grandfather and the other a neighbour, the
senior doctor Luo, who became friends with his grandfather and was
the father of one of his bond brothers. In typical families of Chinese
doctors, I was told, medical knowledge was transmitted to boys, who
would help their parents from early childhood onward; girls were ex-
cluded because they would later marry into other families. In Yunnan,
people would illustrate the Socialist ‘progressiveness’ of southern China
in comparison with northern China by pointing out that daughters-
in-law there were more likely to have access to the family treasure of
secret medical knowledge.37 My observations did not corroborate this:
Qiu made the diagnoses on which his qigong treatment was based,
while Jade Blossom was busy with delivering acumoxa treatment to
those who needed it. In another case, a senior doctor took the Pulse
and wrote the formulary while his wife was kept busy preparing and
weighing the various ingredients of such prescriptions, and in yet another
case, a smart young woman would attract clients on the street with a
strange machine for ear diagnostics while her husband, an itinerant
doctor, treated them in a room on the first floor of a hostel, often after
an additional Pulse and Tongue diagnosis. In all these cases, the doc-
tors had married much younger women (nine, fifty, and twenty years
younger respectively), who helped run their private practices but were
too busy with their own activities to learn their husbands’ secret know-
ledge.38 The secret knowledge that enabled a doctor to provide effective
treatment and become prestigious was confined to the males in the
family.
36
Naquin (1976:37) says that converts, particularly those ‘who specialized in the fight-
ing skills of the White Lotus tradition’, had only one teacher at a time but several in
sequence. I noticed this attitude among many healers in Kunming and find it charac-
teristic of the personal rather than the secret mode of the transmission of knowledge,
considering the strain on family loyalty which arises from venerating many masters.
37
North–South differences are widely acknowledged (e.g. Goody 1990:105–10). Goody
(1990:109, table 4) notes a higher divorce rate, more frequent remarriage, and weaker
affinity in the South, possibly related to the absence there of strong competitive lineages.
38
In their ethnography on rural Yunnan, Fei and Chang (1949:22, 36, 66) remark on
the amount women worked, even in wealthy families, although the additional labour
did not enhance their status significantly.
Secret societies – secrecy as a weapon of the weak

The secret knowledge that Qiu shared with his bond brothers was in a
booklet of Daoist incantations. Their master had apparently been a
member of a local Daoist group, but Qiu and his bond brothers had, to
my knowledge, no ties to this Daoist tradition; a building on the site of
the local temple had been transformed into a public toilet. Although
their individual life histories had eroded the loyalties among them, their
group had some features of a so-called ‘secret society’, a term that still
enjoys great popularity in the Western literature but is best replaced by
more specific, indigenous terms.39 In Imperial times, jiao (sects) were
congregations for religious purposes, often organised in ways which
were not approved by Confucian orthodoxy (Naquin 1976:41–2).40 Hui,
as ‘triads’, formed an important alternative to kinship for poor peasants
and for the marginal and mobile transients in town (Wakeman 1972),
but they were not limited to criminals, rebels, and the poor and desti-
tute of the floating population. As Ownby (1993) stresses, hui, as ‘asso-
ciations’, were also fraternities that were fully embedded in law-abiding
communities. Their ethics stressed mutual aid and lifelong solidarity,
reinforced by blood oaths or tattoos.
Qiu and his bond brothers are likely to have constituted such a
‘fraternity’ (hui) on a very small scale. Qiu had a tattoo of a sword
on his left arm and so did Luo. Though their personal relations were
strained, some of Qiu’s actions are intelligible only by assuming a very
strong bond between them.41 Their group certainly had a mutual-aid
character, and although the three avoided each other in the late 1980s,
it seemed that their solidarity was supposed to be lifelong. Notably, it
39
‘Secret societies’ tend to be conceived of as tightly organised groups outside the central
control of the state (e.g. Dunstheimer 1972), but the term lacks a clear definition. It
blurs, for instance, distinctions between jiao (sects) and hui (associations) (Naquin
1976:268). It also has discriminatory connotations; Qiu would vehemently deny that
he and his bond brothers constituted a mimi shehui (secret society).
40
The agenda of society members, as recorded by Naquin (1976:24–31), applied also to
Qiu and his bond brothers: protective incantations, meditation practices, massage and
other healing techniques, and boxing. However, the structure of such sects was funda-
mentally hierarchical: ‘Fellow believers, even pupils of the same teacher, did not refer
to one another as “brothers” ’ (p. 41). This was not the case among Qiu’s master’s
bond brothers. F. L. K. Hsu (1983:23) suggests that what he earlier identified as
public ‘prayer meetings’ were, in fact, ‘jiao meetings’ which seems to imply that some
jiao and their priests would, in times of crisis such as the cholera epidemic in West
town, openly fulfil functions for the community at large.
41
For example Qiu’s inviting Luo’s family to a separate wedding banquet after his
wedding and his paying thousands of yuan to Long towards an enterprise he obviously
did not want to get involved in.
was very difficult to find out anything about this brotherhood, and
everything I was told bordered on the fantastic.
If one takes the jiao and the hui as groupings of the unorthodox and
the weak, their secrecy is best viewed as a form of protection in a
hostile environment. Secrecy here is upheld by those who fear destruc-
tion, a weapon of the weak.
Secrecy in self-cultivation – secrecy as adornment

To a certain extent, the secrecy in which qigong was veiled was also
important to Qiu as an individual. Secrecy heightened the value of his
knowledge and operated as a ‘purely socially determined attraction’,
because ‘for many individuals, property does not gain its significance
with mere ownership, but only with the consciousness that others
must do without it . . . what is denied to many must have special value’
(Simmel 1950:332). By the mere claim that his knowledge was secret,
Qiu drew a boundary between himself and others and thereby increased
his importance. Qiu demonstrated with his healing performances that
he had a secret. His gestures were strong and elegant, pregnant with a
meaning that was not revealed. Simmel (1950:337) comments: ‘The
secret also operates as an adorning possession and value of the person-
ality. This fact involves the contradiction that . . . one should appear as
a particularly noteworthy person precisely through what one conceals.’
Qiu’s gestures clearly operated as an adorning possession. They increased
the value of his personality. Observing simultaneously the client’s upright
posture and calm face, one was put at ease and felt respect for both Qiu
and the client.
The idea that qigong healing performances are an adornment to the
healer generally goes unmentioned in the literature, but these aesthetics
are not to be underestimated. They attract the eye of even the casual
passer-by and thereby ensure the necessary audience for the ritual per-
formance (as which qigong healing is presented in this monograph). More
important, as Simmel (1950:338) points out, ‘Adornment has, in fact, a
societal significance with a structure analogous to that of secrecy itself.’
Like any secret, adornment ‘singles out its wearer, whose self-feeling it
embodies and increases at the cost of others’, but unlike most secrets, it
is not only egotistic but altruistic: ‘Its pleasure is designed for others’
(p. 339). The healer presents himself as outstanding ‘not by means of
power manifestations, not by anything that externally compels the other,
but only through the pleasure which is engendered in him [the other]
. . . One adorns oneself for oneself, but can do so only by adornment
for others. It is one of the strangest sociological combinations that an
act, which exclusively serves the emphasis and increased significance of

the actor, nevertheless attains this goal just as exclusively in the pleasure,
in the visual delight it offers to others, and in their gratitude.’ Though
directed at the other, adornment ultimately ‘intensifies and enlarges the
impression of the personality by operating as a sort of radiation emanat-
ing from it’ (Simmel 1950:339). Qigong healing performances enlarge
the impression of the personalities involved, both the healer and the
client. In the case of self-cultivation, the aesthetic aspect is substanti-
ated in the scents, for example, of jasmine blossoms, which in certain
circumstances may emanate from the qigong master’s body.42 The pro-
duction of such scents, more than a side effect of qigong meditation,
may be a goal of qigong practice in itself.
Qiu’s claim and his performative demonstration of possessing a
secret that others did not have, enlarged the social distance between
him and others. Social distance may lead to alienation, but Qiu was
able to bridge this gap precisely because his healing performances were
a form of adornment. Like any adornment, they were marked by their
‘being-for-the-other’. They had affinity with ‘the flash of the precious
stone . . . directed at the other’, which ‘carries the social meaning of
jewels, the being-for-the-other’, and ‘returns to the subject as an enlarge-
ment of his own sphere of significance’. Their brilliance and radiation
increased the social distance between the healer and others, but healing
performances were staged for the sake of others. They signified, like
jewellery, ‘in one and the same act, an increase in distance’ and simul-
taneously ‘a favour’ (Simmel 1950:342). This aspect of adornment is
probably intrinsic to many healing performances.
42
Qiu did not claim to have this ability, but I was assured by clients of another qigong
master that they had smelt orange blossoms in his presence.
2 Qigong and the concept of qi
Qiu’s qigong healing performances left observers puzzled, wondering

how Qiu’s murmurs and movements could have a therapeutic effect.
This chapter first accounts for qigong from the outsider’s viewpoint by
identifying five stages of social interaction in the therapeutic process.
The insider’s view, discussed thereafter, explores Qiu’s ‘logic’ of heal-
ing. There is evidence that it was primarily grounded in the notion of
‘life-for-life’, although Qiu also spoke about restoring balance, as is
characteristic of Chinese medicine or any other scholarly medical tradi-
tion. The concept of qi and how it relates to conceptions of the body in
qigong and Chinese medicine is explored at the end of the chapter.
The outsider’s observations

Qigong therapy was not passively consumed but characterised by inter-
action between healer and client. As an outsider I could observe five
different stages: (1) the client’s choice of therapy, (2) the healer’s effort
to recruit clients, (3) mutual commitment, and (4) reaching consensus
about the termination of treatment. Yet, even if treatment was success-
ful, the healer–client relation was often not dissolved. The last stage
concerned (5) the conversion of client into ‘friend’ ( pengyou).
(1) Choice of therapy

Most of Qiu’s clients had turned to qigong as a last resort after consult-
ing all kinds of other therapists. Many had previously sought treatment
in government hospitals. Depending on the ailment they suffered, they
had consulted biomedical and/or TCM doctors and private practitioners
of ‘Chinese medicine’ (zhongyi), ‘herbal medicine’ (caoyi), or traditional
‘massage’ (anmo). Only a few had been to another qigong healer. In gen-
eral, they suffered from psychosomatic syndromes such as ‘insomnia’
(shimian), ‘headaches’ (touteng), and what Chinese biomedical doctors call
‘neurasthenia’ (shenjing shuairuo); chronic ailments such as ‘rheumatism’
58
Qigong and concept of qi 59
( fengshibing), ‘high blood pressure’ (gaoxueya), ‘hyperosteogeny’ (guzhi

zengsheng), ‘hearing loss’ (erlong), ‘myopia’ ( jinshi), ‘stomach ulcers’
(weikuiyang), ‘epilepsy’ (dianxian), ‘asthma’ (chuan); or terminal dis-
eases such as ‘cancer’ (aizheng). Apart from the clients coming from
elsewhere in the city or, occasionally, from distant counties, seeking qigong
treatment, Qiu’s practice was also frequented by neighbours requesting
primary health care. They would want Qiu to bandage a wound or
would ask for an aspirin or for an injection of antibiotics. They often
made up the audience of qigong performances and thereby enhanced
Qiu’s prestige, but they rarely asked for qigong treatment.
Qigong was a stigmatised therapy, repressed during the Cultural Revolu-
tion and in the late 1980s often met with ambivalence. Valid criteria for
separating the upright practitioner from the swindler have not been and
are unlikely ever to be found. Even those who declared a belief in the
effects of qigong were aware of the risk of falling victim to quacks. Most
followed the advice of a neighbour, relative, or friend who had been
successfully treated. When asked why they had chosen qigong, several
answered that they had been told that Qiu was a good doctor. Many
clients had not known that qigong could be delivered in healing per-
formances. Their choice of therapy depended more on their knowing
the person and personality offering the therapy than on the rationale of
the therapy itself.
(2) Forms of recruitment

Qiu cared about maintaining a reputation for respectability. First, his
dress indicated status, he wore a white coat, and obviously not for
hygenic reasons – it had hardly been washed more than twice that year.
Then, his therapy commanded very prestigious prices (usually ten yuan
per session), more than twice as much as ‘acumoxa’ (zhenjiu), ‘massage’
(tuina), and ‘herbal drug’ (caoyao) treatment combined. He also behaved
like a person of authority, as is expected of the senior male in a house-
hold. Qiu and his wife divided their labour as Qiu’s parents did rather
than according to the Socialist model of emancipation. Cooking, wash-
ing, household finances, and child rearing were the wife’s and mother’s
obligations and, despite occasional angry outbursts from his wife, Qiu
consistently refrained from almost all household work.
Qiu was the social representative of the extended family. This came
naturally, since most visitors were either his friends or clients. Jade
Blossom, who was from a neighbouring province, had come to Kunming
only after graduating from high school. She had no former schoolmates
and only two elderly aunts in town. It is not insignificant that Qiu had
chosen to marry a girl younger by almost ten years, a pretty accountant

at the hospital where he had formerly been employed. Although she
had received more formal education than he himself, he felt that he had
made her a doctor by paying her fees as a self-funding student for a
year, in 1987–8, at the Chengdu TCM College.1
Qiu’s status was enhanced by his wife in indirect ways. He would
smile while she scolded his clients. He remained silent while she in-
formed them about petty technicalities. He received the money, while
she was responsible for the accounts and therefore for any accounting
mistakes. He was generous and ‘cheerful’ (kailang) while she was loud
and sometimes quarrelsome. To fulfil the expectations of being a re-
spectable healer, Qiu depended on his wife.2
As master of his practice, Qiu required his clients to adapt to its
pace. No one’s urgency could disturb him. Clients waited for quarter of
an hour to an hour and a half. Admittedly, Chinese medicine requires
that the patient rest before treatment, and everywhere in the PRC,
whether in a department store or a hospital, clients have to wait. A shop
attendant’s slowness would annoy a client, but Qiu’s was a matter of
prestige. In cases of conflict he could not be disturbed by an irate
client. His respectability allowed him also to ignore direct questions or
answer them as briefly as possible.
Qiu showed no interest in his new clients while, at the same time,
he subtly and indirectly persuaded his audience – the potential client
included – of the powers of qigong. Once he had spotted a potential
client, he would either give a very extensive and concentrated qigong
performance or suddenly start talking about cases of successful qigong
treatment. The following episode illustrates this point clearly:
Qiu had just come back from the market with a basket full of mushrooms and
was now preparing them, squatting in the sun in front of the consulting room.
A passer-by who had stopped to read the sign advertising the practice,3 asked
Qiu if he could really treat deafness. Hardly looking at the potential client,
Qiu’s reply was abrupt, and he went on working on the mushrooms. Then he
disappeared into the backyard to wash them while the man remained squatting
in the doorway. After a while Qiu came back, handed the mushrooms to his
1
She enrolled as a self-funding student at the Yunnan TCM College from 1990 to 1992
without giving up her acumoxa patients and passed the exams for ‘TCM regular prac-
titioner’ (zhongyishi) in 1993.
2
On the dialectics between healers and their wives, see Roseman (1991:76–8).
3
Newly painted in May 1989, it read: ‘The therapeutic range of massage, qigong, and
acumoxa combined with the therapy of acupressure is: 1. internal medicine, gynaeco-
logy, paediatrics, 2. five sense organs, external medicine, 3. pain in the shoulder, pain in
the lower back and legs, 4. all the various complaints that are difficult to cure, 5. we pro-
vide injections, measurement of blood pressure. For the above, we guarantee a sure cure.’
wife, who was cooking behind the counter, removed the needles from a girl
whom she was treating with acumoxa for epilepsy, and seated the girl on a stool
in the middle of the practice. He now beckoned the man to take a seat on the
bench next to me and proceeded to perform a long qigong healing session. The
man followed his movements with curiosity and scepticism. Thereafter, another
client was treated, just as extensively. Now it was the newcomer’s turn. He was
told to sit straight, put his hands in his lap, one on top of the other, palms
upward and open. (notes, September 1988)
Like many others, this client was given time for critical observation
and reflection and, at last, also a bit of encouragement, before he
agreed to undergo treatment. After all, how can the efficacy of a treat-
ment be ensured? Why trust treatment which is potentially powerful
but simultaneously stigmatised? One may consider the client a con-
sumer and set out to persuade him or her to accept treatment, but Qiu
was obviously not a merchant. As a healer he knew that he was success-
ful only if his client felt cured. In the end it was the client who decided
whether he or she felt better or not. Clients were given time, in the very
beginning, to decide what chances they themselves gave this unusual
treatment. The outcome of the treatment was thus largely determined
before treatment had begun.
Usually, a client had to commit himself to pay for a cycle of ten
treatments before being treated at all (offered at a discount rate of 65
yuan in 1988 and 85 yuan by the end of 1989). One occasion that is in
retrospect very telling occurred when I, the ‘innocent anthropologist’,
intervened:
A possible client had been standing for a very long time in front of Qiu’s
practice, hesitating but tempted. ‘Why don’t you give it a try?’ I asked when I
passed him on the way to the backyard to wash some fresh vegetables. Return-
ing quarter of an hour later, I continued: ‘What, you’re still here!’ This client
eventually picked one yuan note after another out of his purse. After I had done
all this preparatory work of persuasion, Qiu exceptionally agreed to treat this
person for one session only. He had the patient sit on the stool in the middle of
the room and told him to relax and close his eyes. ‘Relax’, he said, hitting the
client’s shoulder very hard: ‘Relax!’ The man sat stiff as a tailor’s dummy. After
the session he exclaimed loudly: ‘I don’t feel a bit better!’ At this, Qiu laughed,
just as he had been laughing throughout the session. He had reciprocated the
client’s lack of commitment. The client became very angry and wanted his
money back. Now it was the healer’s wife’s turn to act and she drove him away
with curses. (notes, April 1989)
The principle of treating only committed clients is ancient wisdom.

‘Never treat those who believe in shamans and not in doctors.’ Qiu
did not refer to Bian Que’s sixth principle of ethics (Shi ji 105 (Sima
1959:2794) but clearly acted in accordance with it.
(3) Mutual commitment

The above-mentioned client suffering from Deafness (erlong) and Ring-
ing in the Ears (erming) reported that his ears had started ringing more
than ten years ago while he was in military service, probably because of
the shooting. Several years after retirement from service,4 he went hunting
and, after firing his gun, he suddenly lost the hearing in his right ear.
He had sought treatment in several hospitals, but neither Western nor
Chinese medicine had relieved his symptoms. He had always declined
to be treated by acumoxa and continued to do so, but eventually he
agreed to qigong treatment.
During this session, which began like all others, Qiu suddenly inter-
rupted the flow of his movements, took a needle out of the drawer of
the table behind him, and stuck it with an elegant movement and few
words of warning into tinggong, an acu-point in a groove in front of the
deaf ear. The man shivered; Qiu laughed and continued his perform-
ance. After the session, the client’s hearing was obviously much better.
‘My hearing improved the very moment you stuck the needle into my
ear’, he kept repeating. Qiu ignored him. Later, when other potential
clients asked him whether he could cure deafness with qigong, he would
tell the story of this case without, however, mentioning his having
needled the ear.
Although the client had never allowed anyone to needle him, he had
accepted it during a qigong session. He had certainly not expected it and
Qiu had gained his compliance by a reinterpretation: his needling was
part of a qigong healing session and not acumoxa therapy. I doubt that
Qiu knew from the start that he was going to use a needle. It was the
only time I ever saw him resort to needling during a healing perform-
ance. The intuition that this was the right thing to do in this case
remains a puzzle but it was by no means unique to this episode.
Reinterpretation of his clients’ ailments was among the main achieve-
ments of Qiu’s therapy. The following case, which illustrates this nicely,
shows how Chinese medical reasoning tied in with the everyday life
experiences of Qiu’s clientele:
I arrived to find Qiu massaging a young woman on the cot behind the curtain.
When I entered the practice, he stopped. He refused to talk to me about what
he was doing, but the client was quite willing to tell me about herself. She had
4
The army recruited soldiers in their late teens and released most of them after eight
years. It was the major institution in the PRC for peasants from ‘townships and villages’
(xiangcun) to acquire upon retirement a ‘household register’ (hukou) above the admin-
istrative level of the ‘county’ (xian), and thereby enabled them to migrate into less rural
areas.
had an abortion four months before, and at the hospital she had been dia-
gnosed as suffering from neurasthenia. ‘This is wrong’, she said. Qiu had given
her the correct diagnosis: Blood Depletion giving rise to Wind (xue xu sheng
feng), which induced ‘dizziness’ (tou xuan) and headaches. She had been in
treatment for five days now, taking massage, herbal drugs, and qigong. She no
longer had headaches except when she was unhappy or angry, but now she ‘felt
nauseous’ (xiang tu).
Why did she have an abortion in the fifth month? She said she had had
stomach problems and taken many drugs, macerated in alcohol. Her sister, a
biomedical doctor, said that so much alcohol would make her child mentally
retarded. So she aborted it, but after the abortion, she ‘had not gone into
confinement’ (zuo yuezi).
‘Disregarding confinement is a typical case for Blood Depletion giving rise to
Wind’, Jade Blossom commented. ‘She went shopping and didn’t even cover her
head!’ She had exposed herself to the wind in the streets and thereby attracted
the Wind in her head.5 This was a layperson’s view, based on reasoning reminis-
cent of sympathetic magic. Chinese medical reasoning is more sophisticated:
the client’s complaint of a headache is often associated with Wind, a Disease
Factor (bingyin). When there is Blood Depletion, which is a postulated process
inside the body, Wind can arise and tends to ascend to the head, whether or not
the patient has been exposed to an outside Wind. Needless to say, the loss of
blood during the abortion had caused the Blood Depletion. (notes, August 1989)
Qiu later explained to me that the client had had a drinking problem
after being divorced by her husband and subsequently had aborted the
child. He showed much affection for this young woman, and his wife,
who noticed this too, was eager to have him terminate treatment soon.
Qiu’s reinterpretation in Chinese medical terms fitted very well into
the client’s worldview and reinforced her values. Confinement after
birth (traditionally for forty days) is advocated and practised even by
Chinese biomedical doctors. This client explained that she had never
thought of confinement after an abortion, and I had not heard of
it either. Qiu’s reinterpretation of this particular case was in several
respects quite accurate, however: her experience of the abortion was as
a birth, albeit of a dead foetus, and going into confinement would have
meant that someone would have had to cook and care for her. She had
missed out on this; no allowance had been made for her pain and
suffering.
The client could easily relate to Qiu’s statement that she suffered
from a Blood Depletion. As a technical term, of course, Blood Deple-
tion (xue xu) was not directly intelligible to her. She probably under-
stood that it referred to a loss of blood, the blood she herself had seen
5
Wind ( feng) is one of the most pervasive concepts in Chinese medicine. On the notion
of Wind in the Inner Canon, see Unschuld (1982); on Wind in Chinese antiquity, see
Kuriyama (1994).
flowing. Specialised medical terms were often the same words as those
of everyday language, but their meaning was not quite the same. Blood
(xue) in Chinese medicine did refer to the blood that the patient had
seen flowing, but it was also a more encompassing term within a system
of similarly encompassing terms. Blood Depletion referred to a state of
the person that could be identified by particular diagnostic signs such
as a Pale Complexion (se cangbai), a Thin Pulse (mai xi), and a Pale
Tongue (she danbai). It may be diagnosed even if the patient has not
suffered an obvious blood loss.6
The treatment of Blood Depletion also made sense to her: it was
common knowledge that a diet of eggs, meat (particularly liver and
fish), and ‘red sugar’ (hongtang)7 would restore her Blood. She also
drank the Blood-restoring drug potions, although she complained that
they were ‘too bitter’ (tai kuliao). She was not only given massage and
qigong but also learned some qigong movements to practise on her own.
Qiu’s cheerfulness and sympathy obviously lifted her spirits, and her
evening meditation at home, she said, enabled her to fall asleep. In
contrast, the Western neuroleptic drugs she had been taking had only
increased her dizziness.
Reinterpretations of an ailment such as the above not only restruc-
tured the clients’ illness experience but also helped Qiu to gain their
compliance and engage them actively in their therapy. The above two
cases show, moreover, that not only the client but also the healer was
committed. Sometimes his commitment became manifest in his intui-
tions, as in the first case. In the second case, it was remarkable how
often he complained about headaches and fatigue during the period of
her treatment. Several months before, I had witnessed the same attitude
towards another patient:
Qiu had been complaining of severe pain in his shoulder. His wife, familiar with
the sort of compassion he could develop for his clients went through a mental
list of them and guessed that it was an old man’s ‘periarthritis of the shoulder’
( jianzhouyan) which had induced his pain. An hour later, I was amazed when
this very client, within seconds of seating himself on the bench to await treat-
ment began to complain of an unusual pain in his shoulder the night before.
(notes, March 1989)
6
A Distinguishing Pattern (bianzheng) such as Blood Depletion giving rise to Wind does
not contain any information on the etiology of the condition (see also Farquhar 1994a:86–
91). Rather, it contains a therapeutic maxim: if a doctor ‘diagnoses’ Blood Depletion,
this means that the therapy should be directed at restoring the Blood.
7
Brown sugar. Calling it ‘red’ (hong), links it with happiness and wealth and, in medical
terms, with enlivening yang qualities. On food that is ‘invigorating’ or ‘supplementing’
(bu), see Anderson (1988:235–8).
It is unlikely that this episode was staged to impress. Whilst I did

observe this capacity for empathy among other qigong masters, it was by
no means evident in all of them, and Qiu certainly did not have it with
every client.8
(4) Reaching consensus
Many patients came for treatment for several months, others sporadic-
ally for years. One had been in fairly regular treatment for over a year.
Chronic ailments and psychosomatic syndromes are naturally not cured
overnight, nor do they necessarily disappear completely. At a certain
point in time, however, the decision to cease treatment has to be taken.
To make this decision, patient and healer have to reach agreement over
the patient’s condition.
When one feels absolutely cured or considers oneself cured despite
lingering pain, the treatment has been successful and can be ended.
When this is not the case, one may want to continue treatment if one
considers it the appropriate one, cease treatment with one healer and
seek it with another one, or give up seeking treatment altogether. This
sounds simple, but it has implications not always easily assessed. If one
feels cured, is one really cured? If one does not feel cured, is the prob-
lem the specific therapy or the choice of practitioner, or is it perhaps
that no cure is possible?
Considering the cases reported so far, it is apparent that the ‘thera-
peutic efficacy’ of a treatment from a biomedical point of view need not
necessarily coincide with ‘therapeutic success’.9 Ma, for instance, cer-
tainly felt better after several weeks of treatment, but she still had pain
in the shoulder and could not lift her arm much higher (see pp. 34–40).
From a biomedical point of view the qigong treatment was not efficacious.
This would not, however, do justice to Ma’s case. After the excitement
over Qiudi’s successful first healing session she stopped seeking treatment
with anyone. Despite an improvement only in degree, her behaviour
8
Some qigong healers exploited this capability of empathy systematically for diagnostic
purposes. According to TCM, parts of the face, ears, or hands represent the Inner
Organs (neizang). The five fingers, for instance, represent the Lungs ( fei), the Heart
(xin), the Spleen (pi), the Liver (gan), and the Kidneys (shen). By touching the client’s
finger with the index finger of one hand and observing the change of colour patterns in
the fingertips of the other, a qigong healer may diagnose the state of balance in the
corresponding Organ of the patient.
9
For a proposal to distinguish the biomedically assessed ‘therapeutic efficacy’ and the
social scientist’s assessment of ‘therapeutic success’, see Hsu (1996b).
changed from that of an ill to that of a healthy person. In this respect,

Qiu and Qiudi could claim that their therapy had been successful.10
This need not mean that the patient’s subjective point of view alone
can alter the course of an illness. In Bao’s case, for instance (see pp.
42–4), general agreement among other clients, the encouraging talk of
Jade Blossom, and Qiu’s reconfirmation that the Liver had ‘softened’
(nen) and shrunk assured him that he had regained Spirit (shen). His
wife certainly felt that he was better, and when I asked him if he was he
nodded. At the time Qiu spoke of a successful treatment. However, in
terms of a biomedical assessment it is doubtful that Bao could have
been cured. In the case of the young woman suffering from chronic
fatigue and headaches (see pp. 62–4), Qiu’s wife eventually decided
that the woman’s condition had improved immensely, and refused to
allow Qiu to continue treating her. In still another case, presented
below, agreement that the treatment would last for one cycle of ten
treatments at most was achieved at the very beginning.
These examples illustrate that the criteria for terminating treatment
are manifold and complex. Biomedically efficacious treatments need
not necessarily be therapeutically successful. Success is a matter for
negotiation among the participants involved in a therapy (the client, the
healer and his wife, fellow clients, and the client’s relatives and friends).
Well-being depends on reaching consensus about the client’s condition
among the client, the healer, and the other participants in the thera-
peutic process.
(5) From patient to pengyou

As the treatment comes to an end, however, the relation between the
healer and his clients is generally not interrupted. Qiu’s former clients
kept returning to his practice; some quite regularly, others once in six
months, as did Ma and her husband. Some recommended him to their
friends and relatives and sometimes introduced them personally to Qiu
for a first assessment. Others entered into economic transactions with
Qiu. One, for instance, enabled him to buy drugs wholesale from his
work unit; another sold him cigarettes at a lower price, and still another,
who owned a restaurant, was at his disposal when he had to treat a
friend to a banquet.
Qiu’s recruitment of clients was basically dependent on former cli-
ents’ word of mouth. It came naturally for a client to praise the healer
10
Many cases recorded in the anthropological literature point to the same phenomenon,
see for instance Favret-Saada (1980: section 6.2).
who had provided successful treatment, and it would be wrong to speak

of any unwritten rule that a cured client was expected to ensure the
continuation of Qiu’s practice by oral recommendation. Yet, natural as
it may appear, such behaviour can be interpreted as a way in which
clients paid their debts to the healer.
One may wonder why a client, after having terminated treatment,
should still be indebted to the healer. The treatment had been ex-
tremely costly: why continue paying him tribute in the form of visits or
good press? It is precisely this high cost of treatment that suggests that
a qigong healer’s therapeutic intervention is distinct from that of a med-
ical doctor. A qigong healer’s therapy cannot be paid for with money.
The price of it, it seems, is the client’s lifelong indebtedness. A qigong
healer, like a shaman, is building community through his treatment. To
understand this, let us explore the qigong healer’s point of view.
The insider’s view

Qiu’s explanations for his actions were extremely sparse. Therefore I
tried to make sense of his gestures. Some gestures indicated that treat-
ment was directed at extracting bad ‘stuff ’ (see Sivin 1987:47) from the
body. Others indicated that good, enlivening powers were being trans-
ferred into the patient. Finally, there were gestures, circular movements
with both arms around the client, that looked as if Qiu was harmonising
vibrations within and about the client. These gestures and Qiu’s com-
ments on them led me to the conclusion that the ‘logic’ of his healing
built on three different conceptions of the body and the universe (see
table 2.1). The circular gestures seemed to build on a notion that the
body and the universe are, as macrocosm and microcosm, in mutual
resonance. Qiu himself did not comment on these gestures. The two
concepts he spoke of were Bad qi (xieqi) and Primordial qi (yuanqi).11
These concepts share the features of being by definition good or bad –
Bad qi is never beneficial and Primordial qi cannot be excessive – and of
occurring within a conceptual framework in which the inside and the
outside world are viewed as opposites and not, like macrocosm and
microcosm, as analogous.
Bad qi (xieqi) is associated with illness as affliction and an act of
healing through extraction or, in qigong, diversion. The inside world
needs to be protected from the bad stuff that comes from the dangerous
outside world. Primordial qi ( yuanqi), by contrast, is associated with
11
Qiu never opposed the two terms but in his explanations they shared the feature of
both having an absolute value: good or bad.
Table 2.1. Notions of healing
Notion of Illness Treatment Conception of the Universe
Affliction Extraction of Bad qi Inside seen in opposition to a

dangerous Outside
Loss of Vitality Transmission of Primordial qi Inside seen in opposition to an
enlivening Outside
Disharmony Regulation of the Orchestra of qi Microcosm–Macrocosm
illness arising from a loss of vitality, and healing consists of a trans-

ference of enlivening powers. The inside world of the body receives
vitality from an outside world that is uncultivated and in this sense wild
and full of life. In both cases healing is directed at effecting a transition
of qi across the boundary between the inside and the outside world.
Qiu’s qigong healing is hence best viewed as a ritual activity that is
primarily concerned with effecting the transition of qi across a bound-
ary. This ‘logic’ of healing by crossing boundaries is inherent in many
folk medicines (e.g. Lambert 1992). It can be found in Chinese med-
icine too, though Chinese medicine is primarily directed at regulating
complex processes analogous to microcosm and macrocosm.12
Bad qi and illness as affliction

Xieqi is generally presented as the opposite of zhengqi; therefore Porkert
(1974:54) and Sivin (1987:49) translate it as Heteropathic as opposed
to Orthopathic qi.13 This opposition of medical terms parallels that of
moral ones: the Confucian values were ‘orthodox’ (zheng), those of other
traditions ‘heterodox’ (xie). Qiu rarely used the term zhengqi, however,
12
Both qigong and Chinese medicine include the entire range of notions of healing listed
in table 2.1. The difference is emphasis. Although Chinese medical doctrine builds
primarily on the analogy of microcosm and macrocosm – with the quality of qi depending
on its location – it recognises also xieqi and yuanqi. In their discussion of Disease Factors,
Sivin (1987:275–85) and Farquhar (1994a:86–7) present these two notions as predomin-
ant in Chinese medical reasoning, which reflects the contents of TCM textbooks emphasis-
ing the ‘dialectics’ between zheng and xie (see below). However, as far as I can tell,
such ‘dialectics’ were not nearly as prominent in medical practice, and certainly not in
Qiu’s practice.
13
See TCM Fundamentals (Yin 1984:102–3), section on ‘Principles concerning the Dis-
ease Development’ ( fa bing yuanli). Notably, not discussed in the same section as
yuanqi, which is discussed in the section on ‘The Distribution and Kinds of qi’ (qide
fenbu he fenlei).
and it seemed to me that xie in his mind might have some moral
connotation. Translating xieqi colloquially in this context as ‘Bad qi’
(morally not as definite as Evil qi) is consistent with his use of it.
Xieqi is qi that invades the body from outside. It is best kept outside
the body and, if it has penetrated it, best completely expelled. Illness is
understood as affliction; something bad has penetrated the body, and
curing the illness consists in its extraction. This principle of Qiu’s qigong
healing has many parallels in other cultures: the Kwakiutl shaman
Quesalid performed tricks that consisted of spitting out a bloody worm
in a small bundle of feathers, identified as the pathological substance
that had induced sickness in his clients (Lévi-Strauss (1958)1963:175),
and Azande medicine men learnt how to use ointments to rub out
bad things – charcoal pieces, for instance – from their patients (Evans-
Pritchard 1937:230–1). A simplistic knowledge of modern germ theory
builds on this understanding of illness as affliction too: bad germs
invade a weak body.14
Once the bad qi has been extracted from the body, it is not actually
destroyed, but transformed or diverted. Several gestures in Qiu’s qigong
performances indicated an extraction and subsequent diversion of qi. At
the beginning of a qigong session, Qiu always first asked the name of the
client and then told him to keep his eyes shut throughout the session.
Then he himself would close his eyes for a moment and lift his right
arm above his head, palm up. He would murmur a spell and make a
gesture of throwing something on the head of the client. From then on
one gesture evolved out of another without interruption until he termin-
ated the session. After the first throwing gesture, he always drew with
outstretched index and middle fingers a circle that he called a fu (sign)
in the air above the client’s head. In the case of the woman suffering
shoulder pain, he then drew a complicated figure, again a fu, at the
centre of the pain and began pulling and pushing with his opened
palms in the air around the afflicted area, towards and away from it. He
repeated this gesture for several minutes while smiling at neighbours
passing by, greeting other clients, or even chatting with one of his many
visitors. In some sessions he used a repeated stroking motion with both
opened palms down the length of the arm of the injured shoulder, still
without touching it. Then he put his right hand on her shoulder, touch-
ing it for several minutes, with his left hand on his own back. Finally, to
terminate the session, he folded away his right hand and simultaneously
14
Ohnuki-Tierney (1984:26), in her chapter on ‘Japanese germs’, astutely remarks that
Japanese wear masks to prevent the intrusion of the bad ‘germs’ from the outside
world (by contrast to Western biomedical surgeons, who wear them to prevent the
transmission of their own bad germs).
blew onto the client’s shoulder, instructing her to blow into the air
immediately afterward.15
When asked to explain, Qiu said that he held his palm up at the
beginning of a session to gather the ‘qi of the universe’ ( yuzhou zhi qi)
that he threw on the patient.16 The qi of the universe had enlivening
powers, like yuanqi. For the following gesture of drawing a circle above
the patient’s head Qiu had no explanation, but it was obvious that he
was drawing the boundary between the inside and the outside world.
What he did with a gesture of the hand, Azande medicine men do with
sticks and kicks, keeping the crowd of spectators off their square ritual
dance ground (Evans-Pritchard 1937:156); he was measuring out a
space for ritual activity (see also Obeyesekere 1969:178–9).
Qiu explained that he had to ‘emit qi’ ( fa qi) during a qigong session.
This qi, his own precious Primordial qi, he directed from his index and
middle fingers, as if it came out of a gun, onto certain parts of the body,
often onto acu-points or onto the particular spot of pain, always with-
out touching the patient. With this gun-formed gesture he also drew
the fu into the air.
The gestures which were most transparent indicated that Qiu was
extracting bad stuff from the body. He explained that gestures of strok-
ing downwards along a limb indicated the intention to divert the Bad
qi. It was usually led towards the ground, which was dark and yin. I
suddenly understood why sometimes the yinqi from the ground, asso-
ciated with rheumatism, for instance, had connotations of Bad qi. In
acumoxa treatments too, Jade Blossom explained, Bad qi was drawn
downwards and outwards from the deeper parts of the Circulation
Tracts ( jing) to their shallower parts.17 Bad qi could also be extracted
locally from the body, but, I was told, only when mingled with blood,
usually by certain ‘cupping’ (huoguan) or acumoxa treatments.
I also saw a qigong healer who not only diverted the xieqi as Qiu did
but took it up into his own body by leading it from the fingertips of one
hand through his outstretched arm into the fingertips of the other hand
and towards the ground behind him. Alternatively, he took it up into
his arm and shook it off before it penetrated into the deeper parts of the
system of Tracts and Links ( jingluo), at the he acu-points around the
elbow. The evidence from other healers indicated also that the diversion
15
Compare with Creery’s description of the hoat-su’s of the Dance of the Five Forts
(1973:29).
16
Qiu did not explain why he used the right hand. Creery (1973:129) comments on a
similar opening gesture that the right side is the active one.
17
Since patients in acumoxa clinics often lay on beds, xieqi was diverted not towards the
ground but towards the extremities.
of xieqi was one of the central activities during a qigong healing session.
Once it had been diverted, the inside world was cleansed and health
was restored.
Primordial qi and the transmission of well-being

The ritual activities of a qigong healing session comprised more than a
cleansing of the body. This becomes obvious from the gestures described
above and the second central concept that figured in Qiu’s explana-
tions: yuanqi. He emitted Primordial qi to manipulate Bad qi and also
to transmit it directly: for instance, by laying a hand on the painful part
of the body.
In a non-medical text from the Han dynasty (206 BC – AD 220)
Primordial qi is the qi of the origins before there was Heaven and Earth
(Han shu 21 (Ban 1962:964)). In medicine, the locus classicus for its
definition is the Classic of Difficult Issues (Nan jing): ‘As to the Gate of
Life (mingmen), it is the housing of the Essences and Spirits and the
connection to yuanqi, in the man it is for storing the Essence, in the
woman for connecting with the Uterus’ (Nan jing 36 (Nanjing zhongyi
xueyuan yijing jiaoyanzu 1961:90)). The concept of the Gate of Life was
much elaborated in the late Ming dynasty (1368–1644) and attributed
the vital importance indicated by its name.18 Among TCM doctors,
Zhang Jiebin’s (1563–1640) definition was most likely to be cited: ‘The
Fire of the Gate of Life, is called yuanqi, the Water of the Gate of Life
is called jing (Essence)’ (Yin 1984:42). Nan jing 36 stated the opposition
of jing and yuanqi as the one between ‘man’ (nanzi) and ‘woman’ (nüzi),
Zhang Jiebin stressed it as one between Water (shui) and Fire (huo). In
all these citations, yuanqi had to do with coming to life.
In a Jin dynasty (265–460) text, yuanqi is opposed to the qi that is
acquired by ingesting the qi of the Grains (guqi).19 This opposition
between yuanqi and guqi was later elaborated into the opposition be-
tween xiantian (Primordial State) and houtian (Worldly State).20 Xiantian
is the state of the unborn, and yuanqi is acquired in this state of being.
Houtian is the state after birth (Tao, p.c.) or after the ingestion of food
other than mother’s milk (Cao, p.c.) or, in other contexts, after first
sexual intercourse (Zhang, p.c.). Houtian is a state of the intermingling
18
Discussed in small print in an appendix to Kidneys (shen) in the TCM Fundamentals
(Yin 1984:39–43), it was rarely mentioned in the classroom. It was more often re-
ferred to in medical practice.
19
Wu li lun (Treatise on the Patterns of Things) by Yang Quan, cited in Tai ping yu lan 837
(Li (1963)1985:4.3740).
20
Probably from the Song dynasty (960–1279) onwards, but still under investigation.
of yin and yang within one body, and some of my teachers explained
that, by opposition, xiantian is a state of ‘complete yang’ (chunyang).
Primordial qi is considered essential for living beings. It determines
one’s general disposition and health and, accordingly, length of life. In
the modern understanding it is taken as equivalent to determining one’s
genetic constitution. Since it is xiantian, it is considered something
extremely precious that is increasingly exhausted with age. It can be
strengthened in later life by certain diets and drugs, and, indeed, I saw
Qiu taking Invigorating Drugs frequently although he was in the best of
health.
Interestingly, the strengthening of Primordial qi by accurate nourish-
ment during the Worldly State is increasingly stressed in TCM textbooks
(TCM Fundamentals (Yin 1984:57); Organ Clusters (Yunnan zhongyi
xueyuan 1988:51–2)).21 This reflects a this-worldly attitude to human
life which is not only Marxist but also fundamental to current politics
of development aid. It reflects an attitude to life that is typical of modern-
ity.22 The idea that Primordial qi is strengthened in the Worldly State
can also be found in the medical archive: ‘Zhenqi (True qi), also called
yuanqi or jingqi (Essential qi) produced by the primordial self, cannot
grow without the Stomach’s qi (weiqi).’23 Considering the this-worldly
attitude of TCM doctors, it is perhaps not surprising that many made
frequent reference to Li Gao’s Discussion of the Spleen and Stomach
(Pi wei lun).
This understanding of Primordial qi is contrasted with that found in
texts on self-cultivation. In the Zhangjiashan manuscripts (Wenwu 1989,
7:74, cited in Harper 1990b), for instance, self-cultivation is explicitly
directed at emptying the Five Depositories (wuzang). In a similar vein,
Yang Quan (third century) states that one should avoid the qi of the
Grains which only fattens the body and decreases one’s prospects for
longevity (see also Engelhardt 1987:157ff.). Qiu was not very rigorous
in avoiding the influences of the Worldly State, that is the qi of the
Grains, but he made it clear that diet and drugs alone would not pro-
vide him with the necessary Primoridal qi for healing purposes. This he
attained only through meditation. Qiu invariably spoke of Invigorating qi
(bu qi), while it was clear that he differentiated between supplementing
21
Primordial qi ( yuanqi) is here also called Original qi ( yuanqi) or True qi (zhenqi), and
differentiated from Gathering qi (zongqi), Nourishing qi ( yingqi), and Protective qi (weiqi).
22
This attitude has a striking parallel in the interpretation of Pali chants in Buddhist
rituals of northeastern Thailand: ‘The intriguing paradox is that the conquests of
Buddha which relate to the withdrawal of life are in the process of transference trans-
muted into an affirmation of life’ (Tambiah 1968:180).
23
In Li Gao’s (1180–1251) Discussion of the Spleen and Stomach (Li 1976:296). I thank
Ma Kanwen for drawing my attention to this text passage.
Primordial qi through drugs and diet (e.g. eggs and sticky rice) and
regenerating it through meditation. In this respect his understanding of
Primordial qi diverged from that in TCM textbooks.
Qiu’s notion of Primordial qi pointed to a concept of healing that
consisted of a crossing of boundaries: the transference of Primordial qi.
This transference was effected in two complementary ritual acts: the
openly shown healing performance and the hidden practice of medita-
tion. During the public healing performance Primordial qi was trans-
ferred from healer to patient and during meditation Primordial qi was
restored to the healer.
With regard to the practice of meditation a senior doctor maintained:
‘The goal of meditation is to “nurture one’s Nature” ( yangxing). In
order to nurture your Nature you have to attain the state of complete
yang. You need to invert your state of being from the Worldly State
into the Primordial State that is complete yang.’ He spoke in terms of
‘inner alchemy’ (neidan) (discussed in Robinet 1989b). Self-cultivation
consists of this inversion through meditation. Vitality is restored through
daily regeneration, and repeated regeneration prolongs life. Whereas
Christianity has dealt with the problem of immortality by dividing the
person into a mortal body and an immortal soul, the Daoist approach
‘refuses to search for the absolute in ideas’ (Schipper 1982:16). Immor-
tality is achieved through longevity by physical self-cultivation. Accord-
ing to the above idea, coming from inner alchemy, the prolongation of
life is achieved not by turning into an enduring thing (like a jade stone),
but by repeated inversion and thereby regeneration.
This understanding of the attainment of longevity is found in a text
passage on self-cultivation in the Writings of the King of Huainan (Huainan
zi (Anon. 1954:105), italics added): ‘The changing returns to the Form-
less; the unchanging and Heaven and Earth, all give birth. The wood
dies, green greening fades away. That which makes the wood give birth,
how could it be the wood itself ? Again, that which fills the Form has no
Form. Therefore that which gives birth to giving birth never dies. Whatever
it gives birth to then dies. That which changes the things never changes.
Whatever it causes to change then changes.’24
Meditation is an act that is directed at an inversion, the crossing of
the boundary between the Worldly and the Primordial State. This con-
stant return to the Primordial State hinders one from reaching one’s
full development and allows one to attain longevity. In the case of a
healer like Qiu, it was his regeneration during meditation which made
his loss of vitality during healing performances reversible.
24
I thank Donald Harper for drawing my attention to this text passage.
With regard to the healing performance, Qiu explained that a qigong

healer had to emit Primordial qi for an effective cure.25 All the qigong
healers I met maintained that they endangered their health and pro-
spects for longevity by their therapeutic activities. Novices who had not
strengthened their Primordial qi long enough before conducting heal-
ing sessions were particularly at risk. Even experienced healers were
advised not to treat too many patients a day (Qiu said five at most, but
he usually treated more). Therefore, the charges for qigong treatment
were very high.
Qigong healers gave away their vitality, in contrast to doctors who
treated their patients by technical regulation of bodily dynamics. In his
description of Daoist ritual, Schipper (1982) notes that ‘the master uses
his own vital force for nourishing the life of the lay people’ by writing a
fu on a yellow strip of paper with a brush dipped in red ink. ‘The fu is
a kind of breath from the master, a distilled and exquisite energy that,
taken out of the master’s body, compensates accordingly for the lack
of energetic breath [qi] in the patient. In Daoist rituals, this act is called
to “diffuse the Breaths” (bu qi) . . . This service costs nothing, since it is
a banality, evident, and since payment would not be able anyway to
compensate for a gift that is as spontaneous as this one’ (pp. 82–3). A
Daoist master may say so but an anthropologist may be bothered by
the question of how a client can repay this ‘gift of life’. I discussed this
matter with Qiu. The high charges for treatment were not satisfactory
compensation in themselves, Qiu and I agreed. Why, then, since he
knew that he was killing himself during his healing performances would
he undertake them? Qiu looked at me in surprise, then he shrugged his
shoulders and said: ‘I am serving the people’ (wei renmin fuwu) – a
Communist slogan that can be understood as reiterating the Daoist
master’s explanation given above.26
Someone else might have considered my question invalid because it
overgeneralises the principle of the gift, do ut des, and that it cannot be
applied to behaviour in non-Western societies. However, the anthropo-
logical literature which builds on this principle of reciprocity (Mauss
1950) informs us that clients do recompense their healers, even if only
indirectly. Fabrega and Silver (1973), for instance, observed that sha-
mans in Zinacantan were allowed to join the ‘cargo’ system at an earlier
stage in life than laypersons. A successful healer, they explained, was
25
Some healers admitted that they only did so to treat serious cases.
26
Compare and contrast with a Thai cult of healing through meditation (Tambiah
1977): the achan’s powers are gained through meditation (p. 124), and he is a ‘merit-
laden figure acting on behalf of the world with kindness’ (p. 128). The notion of being
‘merit-laden’ did not figure in Qiu’s reasoning.
enabled to build up ‘a network of debt relations’ much earlier than a

layperson (p. 62).
Debt relations are long-term credits; they imply mutual trust, the
trust that allows individuals to form a community. The Daoist master
giving away his vital energies may thus be seen as creating the debt
relations that are community-building. A qigong healer like Qiu trans-
ferred his enlivening qualities to his clients as well, but he lived in a city
of a Socialist state, and compensation in the form of a religious com-
munity around him partly fell away. The lifelong friendships in which
his therapy often resulted may, however, be taken as evidence of the
community-building relations that such healers can establish.
‘Life for life’:27 the way Qiu put it made it seem that he was sacrific-
ing himself for the benefit of his clients. The notion of self-sacrifice is
not alien to Christians, but I hesitate to equate Qiu’s transference of
vitality with a sacrifice. Although anthropologists have, ever since Hubert
and Mauss ((1898)1964:13),28 viewed it as a universal scheme, our
understanding of it is tinged by our Judaeo-Christian background. Never-
theless, the literature on sacrifice proves helpful for understanding Qiu’s
ritual action.
For one thing, this literature made me aware of the vital importance
attributed to Primordial qi and qi in general. The notion of qi and, in
particular, Primordial qi in Qiu’s practice of qigong healing is compar-
able to that of blood in many other cultures.29 Sacrifice can be seen as
an act of destroying life in order to perpetuate life: a consecrated victim
is put to death, and blood must flow.30 In qigong healing not blood but
qi must flow31 – the Primordial qi which the healer transmits to the
patient. Qi is vital.
In sacrifice, a consecrated victim is put to death – a death that we
experience as absolute and irreversible. In qigong, this death is replaced
27
The notion of ‘life for life’ applies to the notions of sacrifice, ‘non-sacrificial ritual
killing’ (Ruel 1990), and many rituals of curing (e.g. Obeyesekere 1969:178).
28
Hubert and Mauss ‘universalised’ sacrifice in that they applied this scheme not only to
Semitic sacrifices but also to some Greek and Vedic ones.
29
Blood figured also in qigong, but not as prominently as qi. It was usually taken as the
yin aspect of qi.
30
This point is also underlined in de Heusch’s (1985) ‘Sacrifice in Africa’. If blood must
flow, only animals and human beings can be sacrificed. However, vegetables can sub-
stitute for animals, according to Evans-Pritchard (1956:146), ‘by cutting in two a wild
cucumber’. The wording describing this process is the same as that during an animal
sacrifice: ‘Badness goes into the earth with the blood and the chyme’. Hayley (1980:128)
describes sacrificial vegetable offerings as grounded in the idea that sins are destroyed
by digestion: ‘The Brahman . . . is believed to digest the impurity without himself
becoming impure.’
31
When making offerings, by analogy, vapour (qi) must rise, the vapour that ascends
from cooking pots of the consecrated animals and cereals.
by a reversible form of dying. The transition across the boundary between

death and life is easily made, at least in some Chinese legends.32 More-
over, it is possible to make the transition between the state of the unborn
and the postnatal state; qigong masters achieve it daily. This points to
interrelations between states of being before, during, and after life that
differ immensely from the definitions of life and death in sacrificial rituals.
Qiu’s self-immolation cannot be viewed as a form of sacrifice.
Ruel’s (1990) ‘non-sacrificial ritual killing’ offers insights for an inter-
pretation of Qiu’s qigong practice. His analysis is built on the assumption
that sacrifice involves a personalised deity in whose eyes the sacrificer’s
condition is improved.33 He describes ritual killing among the Kuria in
East Africa, which is not seen as an offering to a deity but as ‘concerned
with impersonal qualities of life and well-being’. This ritual killing dif-
fers from sacrifice in that ‘it is not the life of an animal that is at issue
but rather the life in the animal’. Ruel therefore speaks of ‘non-sacrificial
ritual killing’. Applied to the Chinese context, this analysis suggests that
the transference of Primordial qi in a healing performance is a ‘non-
sacrificial’ form of transmitting well-being.
Certain parallels between the Kuria’s non-sacrificial ritual killing and
a qigong healing performance are striking. The core of both ritual activit-
ies concerns a transfer of enlivening powers within an impersonal cosmo-
logical framework: the Kuria suffocate a goat and smear the contents of
its stomach, its chyme, all over the homestead. Similarly, Qiu impairs his
Breath (qi) and performs gestures that envelop the client in Primordial
qi during a qigong healing session. The comparison shows that Qiu, like
the Kuria goat, serves not as ‘a surrogate offering of a life’ as in Evans-
Pritchard’s (1956:146) analysis of Nuer sacrifice but rather as a ‘vehicle’
for transmitting enlivening power.34
32
See for instance the legend on Wei Boyang, translated by Giles (1948:67–8), cited in
Hsu (1992a:80–1). See also Boehmer (1977:55): ‘death can be reversed’, and Kuhn
(1990:98, 249, n. 14).
33
Ruel’s definition of sacrifice is in several respects problematic, and disagreement has
been voiced on this point; see for instance Beattie (1980:32): ‘What seems to underlie
the institution of sacrifice . . . is a reference to a non-empirically grounded power or
powers, whether individual . . . or not.’
34
The goat’s irreversible death by suffocation is, just like Qiu’s reversible impairment
of Breath, considered a non-sacrificial form of killing. The problem explored here is
not whether death is reversible or not, but the difference between a ‘surrogate offering
of a life’ and a ‘vehicle for transmitting enlivening powers’. Ruel considers the former
a sacrificial offering, the latter not. If I understand Ruel rightly, he builds on the
assumption that sacrifice involves a personalised deity, which means that the offering
would be non-sacrificial even if the goat were killed so as that blood would flow and be
smeared all over. According to the analysis presented below, the crucial difference
between a non-sacrificial and a sacrificial offering is that the goat is killed by suffoca-
tion and that chyme and not blood is central to the ritual.
One may wonder what difference is envisaged between the expres-

sions ‘the life of an animal’ and ‘the life in an animal’. In terms of
grammar, the former expression is possessive, the latter locative. Within
a cosmological framework devoid of personified deities, Primordial qi,
and chyme probably likewise, is an impersonal substance and force that
is not personally assimilated and possessed: Primordial qi is the qi of the
Universe that is undifferentiated in the healer and has not yet become
assimilated and specified by being located in, say, a particular Organ;
similarly, chyme is nourishment that has become undifferentiated mat-
ter but is still in the digestive tract and has not yet been assimilated and
absorbed into the goat’s blood. Primordial qi and chyme can be taken
for life that is in the animal but does not belong to it, and thus Qiu and
the goat are vehicles for well-being.
In the conceptual framework that underlies the non-sacrificial ritual
killing of the Kuria, the environment is conceived of as life-giving.
Obohoro (well-being), which takes the form of chyme in the goat’s
stomach, comes from the outside world. The understanding of a life-
giving natural world also underlies the notion of healing by the transfer-
ence of Primordial qi, if we take into consideration how Primordial qi is
restored during meditation. In the Primordial State, the qigong healer
becomes one with the universe, and Primordial qi in his Cinnabar Field
(dantian) is thereby restored.35 If Primordial qi is the qi of the universe
in the Cinnabar Field of the healer, the transference of Primordial qi
from healer to patient during a healing session implies a transference to
the patient of enlivening powers from the outside world.
It cannot be stressed enough how important the insight is that Pri-
mordial qi, as well as any other qi, cannot be possessed by a person. It
explains, first, why Qiu was not engaging in self-sacrifice: he simply was
not in possession of a self that he could sacrifice. The Primordial qi that
he transmitted was not his Primordial qi. Rather, it was qi of the uni-
verse gathered in a primordial state in his Cinnabar Field. The insight
that qi does not intrinsically belong to anyone or anything has, further-
more, far-reaching consequences for the conceptualisation of the body
and the universe.
Qi and conceptions of the body

As we have seen, the concept of qi that is basic to qigong and Chinese
medicine is grounded in an understanding of the universe that redefines
35
It would be wrong to say that the qi of the universe is transferred to the Cinnabar
Field, where it becomes Primordial qi, because there are no boundaries between the
self and the universe in the Primordial State.
not only modern Western notions of the self, but also death, life, and
the state of being unborn. The concept of qi also has implications for
conceptions of the body in its usual and its disordered state. While the
notions of qi that Qiu mentioned most often, Primordial qi and Bad qi,
were grounded in an understanding of an inside world seen in opposi-
tion to an outside world, his gestures indicated that he simultaneously
had a notion of a ‘body ecologic’ in which, as in Chinese medicine,
microcosm and macrocosm are in mutual resonance.
The body ecologic

In their article ‘The Mindful Body’ Scheper-Hughes and Lock (1987)
distinguish three bodies that are largely determined by one’s choice of
theoretical approach. A phenomenological approach, which attributes
great importance to subjective experiences of the individual, leads to
a description of the ‘individual body’ such as Ots (1990) provides for
TCM. A structuralist approach accounts for the ‘social body’, recog-
nising representations of the body in social institutions or representa-
tions of social institutions in the body, and is, for instance, invoked
by Unschuld ((1980)1985:48ff.) in his assessment of the ‘medicine
of systematic correspondence’. The poststructuralist and the Foucauldian
approaches are interested in power relations of the society at large,
and the way in which they are embodied in the individual informs on
the ‘body politic’. Chinese medical scholarship has so far not made the
‘body politic’ a major theme of discussion, although various writers
have addressed the issue, implicitly and explicitly.36
When applied to Qiu’s practices and explanations and in particular
those of Chinese medical doctors, the above approaches to the body
have certain drawbacks. All three build on an analysis of synchronic
processes in society, but current conceptions of the body in Chinese
medicine and qigong are difficult to explain without a historical perspect-
ive. Therefore I suggest a fourth approach to the body that is grounded
in an anthropological analysis tailored to describing the body in Chi-
nese medicine and other scholarly medical traditions.37 This approach
36
Farquhar’s general approach to TCM reflects much awareness of its body politic.
Furth and Ch’en (1992:45), in their discussion of Taiwanese women’s menstrual
beliefs and practices, have, without any jargon or reference to Foucault, explicitly
addressed the issue of power relations between male and female: ‘All three frameworks
for understanding menstrual meanings in Taiwan could be said to carry negative
messages about female gender: religious taboos evoke images of female dirt; Chinese
medicine draws attention to bodily weakness as the price of childbearing capability;
and biomedicine supports a stereotype of female emotionality.’
37
No doubt contemporary conceptions of the body in societies without written records
have also developed historically, but their histories can, unfortunately, hardly be
accounted for.
builds on the recognition that contemporary concepts and practices are

the result of complex historical processes and that their shades of meaning
can be identified through study of their history.
I am not the first to point this out. Morris (1990), without being a
specialist in the field, decided that Chinese medicine and its complex
‘symbolic classifications’ were suitable for illustrating and reinforcing
his plea that ‘rather than attempting to wed anthropology with the
cognitive sciences, both anthropology and psychology should link them-
selves to historical studies’ (p. 30). He attacked the narrow hermeneutic
approach to explaining symbolic classifications as well as the conviction
of many cognitive scientists that symbolic systems can be traced to
innate proclivities and underlying universal principles. He called for a
‘historical sociology’ by highlighting the problems posed by an anthro-
pological analysis of the symbolic system of Chinese medicine. And
Dissanayake (1993), concerned primarily with social theory in the West
and its prospects for further development, pointed to the predomin-
ance of the ‘question of historicity’ in East Asian traditions of thought
and practice. He suggested that, if taken seriously and integrated into
endeavours of Western scholarship, this East Asian preoccupation might
well provide a basis for innovation in Western social theory. He encour-
aged ‘a historical perspective to the relationship between body and society
that is conspicuously absent in phenomenologically oriented Western
social theory’ (p. 33).
Historical processes are often best understood as historical accident,
and the contemporary conceptions of the body are thus best viewed as
a result of such historical accident. Zimmermann ((1982)1987:1–95)
demonstrates this convincingly in his study of the Ayurvedic notions
jangala (‘dry’) and anupa (‘wet’). The ‘dry’ ( jangala) is in Ayurveda
generally associated with higher values than the ‘wet’ (anupa). The dry
correlates with the acacia and the black buck which was, apparently,
the epitome of Hindu society. The meats of the jangala are warm and
dry and have a pleasant, ethereal smell. They are ‘light’ (ruksa), which is
highly valued, in contrast to the cold, wet, and unpleasant meats of the
anupa, which are ‘heavy’ (snigdha). Instead of projecting all-embracing
universal principles into this cultural classification of ‘dry’ and ‘wet’,
Zimmermann’s analysis highlights the interrelatedness of the high value
attributed to jangala in Ayurveda to historical accident: the dry Deccan
was the preferred site of habitation for the Aryan invaders who laid the
foundations for contemporary Ayurveda.
Zimmermann’s study is ground-breaking not only because of the
historical dimension it brings to the analysis of contemporary body
concepts but also because it takes account of ecological and geographic
circumstances and their impact on cultural classifications. The above
framework of the three bodies, by contrast, focuses mostly on con-

temporary sociopolitical processes. It furthermore neglects to investi-
gate the ways in which people perceive and interact with their natural
environment. Yet precisely such ecological considerations are central to
the analysis of contemporary ‘humoral medicines’, as Laderman (1981)
put it, and scholarly medical traditions such as Ayurveda and Chinese
medicine.38
The notion of the ‘body ecologic’ is thus meant to provide a frame-
work for an analysis that includes the concerns of people in their inter-
action with the natural environment. However, rather than attempting
to order these people’s ‘ethnoscience’ in neat tables and lists, the study
of the ‘body ecologic’ builds on the awareness that these concepts have
a history and have evolved by complex historical processes that are
often best comprehended as historical accident. An investigation of the
‘body ecologic’ therefore deals with aspects of contemporary concepts
and practices that are best explained by investigating the historical
processes which determined the conception of the natural environment
in the societies from which they evolved.39 With regard to the body in
Chinese medicine, the concept of qi is, for instance, best explained in
terms of the ‘body ecologic’.
In China, the idea that processes in the macrocosm and the micro-
cosm(s) are analogous became predominant among philosophers of the
three last centuries BC. The cosmos, the state, and the body ‘were so
interdependent that they are best considered a single complex’ (Sivin
1995e:5). The notion of ‘stimulus and response’ (ganying) explained
how they were aligned with each other (p. 24). Sivin (pp. 25ff.) points
to temporal cyclicity, hierarchic orders, morality, and emotions, all ana-
logous in macrocosm and microcosms. Kuriyama (1993:55), in his
discussion of concepts of disease in the Han period, stresses that the
body was subject to seasonality.40
During that period, the concept of qi gained in importance as a
‘shared substrate’ which ‘suggested not only that men and the physical
world followed common principles, but also that they acted upon one
another through the medium of qi’ (Lewis 1990:213). Qi became the
38
Hanson (forthcoming) shows in a similar vein that, depending on the climate and
‘geographic ecology’, different remedies are considered important for dealing with the
same disorders. She argues that the medical doctrine of the Shang han lun (Treatise on
Cold Damage Disorders), when transposed from the north to the south, was transformed
into a new doctrine, that of the wenbing (Warmth factor disorders).
39
On ethno science, see Sturterant (1964) and D’Andrade (1995). On the ‘body ecologic’,
see Hsu (forthcoming).
40
Ma (1994:526ff.) speaks of ‘ecological conditions’ (shengtai zhuangkuang), without
however elaborating on them as I do here.
‘key term in the Chinese articulation of the dialectic of nature and culture’
(italics added), when the universe began to be conceived of as subject
to an ‘all-embracing interdependence’. Lewis (1990:218) linked the
emergence of this idea of ‘all-embracing interdependence’ to changes in
patterns of sanctioned violence in the Warring States period (453–221
BC). During the last three centuries BC, ‘the aristocratic pattern of
sanctioned violence in the Zhou city-states [changed] to the universal,
authoritarian pattern that characterized the territorial states’ (p. 234;
italics added). That cosmos, state, and body are all subject to an ‘all-
embracing interdependence’ expresses lastly an ideal of a totalitarian
and even despotic ruler.41
The all-pervasive qi that permeated macrocosm and microcosm(s)
had, in Chinese medical doctrine, innumerable facets. Although unify-
ing, the concept of qi lent itself to the expression of great diversity. In
the medical classics one of the most salient features of qi was that its
qualities varied with its location or its position in comparison with
other qi.42
The interpretation of Qiu’s ritual action indicates that qi is not intrinsic
to anyone or anything and cannot be possessed. Yuanqi is not of the
healer, but in the healer. The Primordial qi in the Cinnabar Field may
well be the qi of the universe acquired in the Primordial State. The
healer transfers this Primordial qi to the patient. Although he transfers
vitality, we have seen that one cannot say that he sacrifices himself: it
is not his vitality that he transfers, but vitality in him. Qiu himself
did not explicitly say this but, if the above analysis is correct, acted
accordingly.
Chinese medical doctors were more articulate. Qi that comes from
the rubric of the Direction-Season43 of the Cold (han) is hanqi; qi from
the Dry (zao) is zaoqi; qi from the Damp (shi) is shiqi, and qi from Wind
( feng) is fengqi.44 The notion of Direction-Season indicates that seasonal-
ity in Chinese medical reasoning is associated not only with temporal
41
This contrasts with the romantic view of those who tend to liken Chinese medicine
to an art of natural healing that evolved in a golden past in which man and nature were
one.
42
These ‘qualities’ of qi are not ‘intrinsic’ to qi, nor are they loosely connected ‘attrib-
utes’. They reflect aspects of qi, relative to the speaker’s perspective: the Heart is
yin when compared with the Small Intestine (xiaochang) because of its inner location,
and yang when compared to the Kidneys because of its upper position (Porkert 1974:32).
43
Season (shi) and Direction ( fang) are not variables of two separate dimensions, time
and space, but different aspects of one and the same ‘rubric’ (see pp. 109–11).
44
In the text in which this word sequence is mentioned (see pp. 109–11), the rubric
Summer-heat (shu) is also mentioned, but the compound word shuqi strikes me as
unusual, and I have not listed it above. Correlations in Chinese medicine are often not
systematic but systemic.
regularity, as it is in Western thinking,45 but clearly has spatial aspects.

This I learnt from mentor Zhang. The ‘shared substrate’, qi, changes its
qualities according to the time–space rubric in which it is positioned.
According to my teachers at the TCM college, qi dwelling in the
Heart (xin) is xinqi, qi in the Lungs ( fei) is feiqi, qi in the Liver (gan) is
ganqi, qi in the Kidneys (shen) is shenqi, and qi in the Spleen ( pi) is piqi.
The notion of space in TCM, which implicitly shared features of Zhang’s
rubrics, was, however, increasingly modelled on the three-dimensional
notion of space known from Western biomedical anatomy. But what-
ever the notions of space and time, qi varied in its qualities according to
its location.
There was not simply one qi but a whole chorus of them. In Chinese
medicine and, as some of Qiu’s gestures indicated, also in qigong, the
interrelations of qi in different locations were important. Disharmonic
dynamics of qi were held responsible for disorders in the body.46 It was
not the qi in a single location, for instance the Liver qi, which was
relevant to a person’s well-being but the way in which qi in different
locations resonated with each other. Just as in music, where not the
tone in itself, but only a chord or a sequence of several tones gives one
a sense of harmony or disharmony, the well-being of a person depended
on the harmony of the chorus of qi in different locations, inside and
outside the body.
The notion of the ‘body ecologic’ highlights the idea of mutual reson-
ance between macrocosm and microcosm and the continuities between
the inside and the outside of the physical body. The ‘shared substrate’,
qi, that permeates the universe constantly transforms itself: qi is not
only in constant flow, but also in constant flux (in the sense that it is
subject to constant transformation). This conception of the body as
part of its environment is characteristic of Chinese medicine. Some-
times the boundaries between the body and the environment are blurred
to the extent that when the qi of the environment becomes dense life
emerges and when it disperses death occurs.
Notably, the ‘body ecologic’ is, like the body politic, intricately
interwined with its environment, so body and environment cannot be
dealt with as separate entities. This contrasts with the notion of the
individual and the social body, which refer to a clearly bounded, ‘clas-
sical’ body (Connerton 1992:352). The subject of the ‘body ecologic’
45
Western scholars who emphasise the notion of temporality in Chinese medical reason-
ing may do so in recognition of the importance of seasonality, reducing the Chinese
notion of seasonality to one of temporality and overlooking these spatial aspects.
46
TCM textbooks speak of ‘equilibrium’ ( pingheng) rather than ‘harmony’ (tiaohe). Because
‘balance’ is easily misrepresented as equilibrium, I prefer to speak of harmony.
changes permanently within a field of changing flows and fluxes, just as

that of the body politic constantly negotiates its position within a field
of power relations that are present everywhere, above and below, and
cannot be reduced to those between rulers and the ruled (Foucault
(1976)1990:94). The subjects of the body ecologic and the body politic
are not clearly defined entities, so I use ‘body ecologic’ (rather than
‘ecological body’), paralleling the ‘body politic’. The notion of self is
less clearly bounded for the body politic and the ‘body ecologic’ than
for the individual and the social body.
Accumulating qi
In Chinese medicine disorders were often explained by reference to
disharmonic dynamics: ‘yinyang have no intercourse’ ( yinyang bujiao),
‘qi and Blood are not in harmony’ (qixue butiao), ‘the Five Organs are
not united’ (wuzang buhe). Qiu, however, reasoned only occasionally in
terms of the Five Phases and yinyang. His talk mostly made reference
to qi. Qi had to be in constant flow and flux (in the sense of transforma-
tion); illness arose if this flow and flux was disturbed. Qi in the process
of accumulating was his predominant explanation for such disturbances.
Qiu spoke of ‘accumulating qi’(qi ji); he could see the qi accumulating
in the Red Light. Signs and symptoms of accumulating qi were palp-
able or visible to him and were often experienced realities to his clients:
when Qiu palpated Bao’s liver (see p. 43), he said he felt the Tumour
(liu) of Bao’s liver cancer. After two weeks of treatment he maintained
that the Tumour in the Liver had become ‘soft’ (nen) and ‘small’ (xiao).
This palpable sign (which I could not detect) indicated the improved
condition of Bao’s liver.
In both qigong and TCM, liu designated a bump or hill, which was
usually palpable; in Chinese biomedical terminology it referred to a bio-
medically diagnosed tumour. The term liu is more or less the equivalent
of the English ‘tumour’, which originally designated an unspecific swelling
and later acquired a more restricted sense in biomedicine (OED 1978).
Liu was also used in everyday language in a more general way, along
with other originally technical terms such as neurasthenia, rheumatism,
periarthritis of the shoulder, and sciatic pain. The following episode
illustrates this:
A client once came to Qiu’s practice complaining of a Tumour (liu) in his hips.
While Qiu took his Pulse, he said that he had suffered from other Tumours
earlier. One had grown at the base of his neck, the other in his armpit. Both
had been cut out at a Western medical hospital. But ‘operations were dreadful’
(kaidao kepa), and therefore he had decided to try qigong therapy. Qiu had him
lie on the bed, palpated his back and hips, and said: ‘You seem to have severe
hip pain.’ The patient, delighted at the skill of his doctor in detecting his
ailment, began complaining at length about the constant pain that made it
difficult for him to walk. A qigong and acumoxa treatment of ten days would
probably cure him, Qiu said after a while, adding (as usual after such a favour-
able prognosis) that he could not give any guarantee. While Jade Blossom
treated the patient by needling acu-points associated with the suppression of
pain (dachangshu, huantiao, weizhong, etc.), a client awaiting her treatment on
the bench next to me turned and said: ‘Operations are dreadful!’ She started to
talk about ‘ear acupuncture’ (erzhen), which made gallstone operations unneces-
sary,47 and she praised Qiu’s therapy, which would allow this patient to avoid a
third operation. Qiu nodded: Tumours and ‘gallstones’ (danjieshi) were ‘lumps’
(kuai) which ‘gradually grew’ (zhang) bigger and bigger. Such lumps could
sometimes grow just because one was constantly thinking of them. He himself
had once had a lump in his hip and he had eliminated it by practising qigong.
(notes, August 1989)
The lumps that Qiu was referring to belonged to very different bio-
medical disease categories. He explained to me later that the lump he
had treated in the client’s hip was a ‘thickening’ of some muscles, but
Tumours on the neck and in the armpits were different. Their location
coincided with the ‘lymphatic nodes’ (linbajie). He agreed with the bio-
medical treatment and considered it unlikely that an operation could
have been avoided in those two cases. He used the same term, liu, as
his patient but clearly differentiated between different kinds of liu. He
reasoned according to a principle that is basic to Chinese medicine,
namely, that the same phenomenon at different locations indicated
different disease processes.48
Qiu was not unaware of the varied biomedical etiology of the lumps,
but it did not disturb him to mention in one breath gallstones, tum-
ours, muscle thickening, and lumps originating in the imagination and
call them all Tumours. It would be wrong to conclude from this that
he had an entirely phenomenological approach to disease. All these
lumps had an underlying process in common: their gradual growth.
This gradual growth was at the centre of attention in the qigong healer’s
‘imagination’ ( yinian). In the process of healing he inverted the direc-
tionality of the growth, from expanding to shrinking. Crucial to qigong
47
For the history and rationale of ear acupuncture, see Lu and Needham (1980:164–8)
and Hsu (1995, 1996a).
48
According to Kaptchuk (1983:xix), ‘an eruption on the face indicated a different
disease process than did an eruption on the trunk’. Kaptchuk emphasised the ‘holistic
view’ and ‘the relationship of the symptom to the whole body’, but this example could
also be interpreted to indicate that disease processes are differentiated in terms of the
locations in which the symptom occurs.
treatment was a process. The focus on processes rather than static

entities is common to both qigong healing and Chinese medicine.
The flow and flux of qi can be disrupted in many different ways.
Counterflowing qi (qi ni) was, for instance, one of the frequently men-
tioned concepts in acumoxa and sometimes occurred also in Qiu’s
talk.49 Accumulating qi remained, however, central to Qiu’s conceptu-
alisation of adverse processes in the body. His stress on illness arising
due to accumulation appeared to me an interesting thought, and in
investigating Chinese medical disease concepts I found a great wealth
of technical terms pointing to a process of accumulation that would
cause stagnation.50 In many early medical texts accumulations were
considered to disrupt the fluxes and flows in and about the body.51
It is worth noting that in early medical accounts the character zheng,
which is homophonous with the Chinese characters that Farquhar
(1994a) refers to as ‘sign’, ‘symptom’, and ‘syndrome’, has the mean-
ing of a Concretion with connotations of an accumulation. In fact,
none of the three currently used zheng but only zheng4 (Concretion)
appears in early Chinese medical texts. In the Historical Records (Shi ji
105 (Sima 1959:2785)), the mythical figure Bian Que received drugs
and instructions from a stranger, and when ‘he used those for inspect-
ing the illnesses, he saw right through to the Concretions and Knots in
the Five Depositories (wuzang zhengjie)’. The processes in the body
considered responsible for illness were Knots52 and Concretions.53
Technical terms that convey the idea that a pathological condition
arises from an accumulation are, for instance, found in the wide range
49
Motion or Impulsion (dong) was also conceived of as disturbance, see ‘Yinyang shiyimai
jiujing’ (MWD 1985b:7–13): ‘If this vessel comes into motion then the [following]
disorders arise’ (shi dong ze bing) is a standard phrase which introduces a number of
disorders for every vessel. See also: Zhangjiashan manuscripts (Wenwu 1989, 7:74): ‘If
qi comes into motion, then there is anxiety’ (qi dong ze yu). According to the Bei ji
qian jing yao fang (Sun 1955:3), diagnosis is best made when ‘The yin-aspect of qi has
not yet come into motion and the yang-aspect of qi has not yet dispersed’ ( yin qi wei
dong, yang qi wei san).
50
Western scholars emphasise stasis (e.g. Sivin 1995a:6); my point is that many stagnations
arise due to an accumulation.
51
It would be wrong to surmise that I consider qigong healing more archaic than TCM,
but the above-mentioned emphasis that accumulations bar the flow of qi is reminis-
cent of conceptions known from early China. Qiu’s conception of bi (Blockage) was
much the same as that of TCM doctors insofar as it built on the biomedical model
of channels narrowing as in arteriosclerosis rather than on the idea of an Obstruction
(Hsu 1992a:124). Qigong is, like TCM, a recent Chinese therapeutic practice, a phe-
nomenon of modern life in Socialist China.
52
On the ritual significance of Knots ( jie), see Harper (1985:475ff.): jie is glossed as di,
‘a Knot which cannot be untied’, as opposed to niu, ‘a Knot which can be untied’.
53
The commentator Zhang Shoujie (fl. 737) interprets jie and zheng as Pulse Images,
but my translation is based on their interpretation in the Zhongwen dacidian (1973–6:
no. 23121).
of different terms for Boils on the body surface (e.g. yong), Abscesses
( ju), or accumulations in the body such as Obstructions (bi ),54 Con-
glomerations ( jia),55 Accumulations and Gatherings ( jiju),56 Amassments
(shan),57 and Piles (zhi).58 Extensive classifications of, for instance, Piles
(Schall 1965:30) and numerological categories such as the Five and
Seven Amassments (wushan, qishan)59 or the Five Accumulations (wuji)60
underline the preponderance of such disorders.
In the acumoxa clinic I also encountered disorders which, without
being referred to as the visibly perceived Accumulating qi, were attrib-
uted to an accumulation of qi. Some were subjectively felt by the
patient, for instance, in the form of choking as if one had swallowed a
Plum Pit (meihe).61 Others, such as manifestations of a qi Amassment
(shanqi), were palpable.62 Others could not be detected by the senses,
among them a Concretion and Accumulation (zhengji) or a Conglom-
eration and Gathering ( jiaju),63 often just rendered as Concretions and
Conglomerations (zhengjia). Clearly, there were other processes, such
as Counterflowing qi, stagnations, or unspecific blockages, that were
also postulated to take place inside the body, but accumulations con-
tinued to be important for explaining pathological conditions.
Qiu saw qi accumulating. Texts of the past mention accumulations,
but they are not very specific about what it is that accumulates. In these
texts, clearly, the process of accumulation is of greater concern than the
material aspects of the accumulated stuff. In order to find out what
54
Obstructions are in TCM conceived of as blockages of the flow of qi in Tracts
and Links or in the Joints (guanjie) (Acumoxa Therapy (Yang 1985:87)). In Su wen 43
Obstructions are not in Tracts, but conceived of as accumulations and according to
Ling shu 6 they have Form ( you xing) (Hsu 1992a:123–8; appendix 7). Hence bi is
translated as Obstruction; its rendering as Blockage invokes the TCM doctors’ idea of
a blocked pipe. On blocked qi as threatening, see Bray (1995).
55
E.g. jia in Zhangjiashan manuscripts (Wenwu 1989, 7:72). See also jia in Shi ji (Sima
1959:2785, 2809).
56
E.g. Nan jing 55 (Nanjing zhongyi xueyuan yijing jiaoyanzu 1961:120).
57
E.g. Shi ji (Sima 1959:2799, 2804, 2812, 2813).
58
E.g. Zhangjiashan manuscripts (Wenwu 1989, 7:72).
59
There are many different renderings of wushan and the qishan (see Zhongyi dacidian
1987:2–3, 29).
60
For wuji, see e.g. Nan jing 56 (Nanjing zhongyi xueyuan yijing jiaoyanzu 1961:121),
see also Zhongyi dacidian (1987:130).
61
Globus hystericus (Ou 1988:28).
62
See Ou (1988:310): (1) hernia, (2) diseases of the external genitalia, testes and scrotum,
(3) severe abdominal pain.
63
Most TCM doctors were uncertain about their exact denotation, while teacher Tao
maintained that zhengji were associated with an Outer Disease Factor, Malignant
Dampness (xieshi), and jiaju with an Inner Disease Factor, when qi stagnates (qi zhi).
He maintained that a jiaju was more likely to have Form than a zhengji (clinic notes,
May 1989).
exactly Qiu meant by qi, I talked with him about accumulations. Accord-
ing to him, accumulations had substance – they were not merely imagin-
ary lumps – and Accumulating qi was a process – it involved an agency
or transformative force. Qi was a ‘matter-agency’ or a ‘substance-force’.
Porkert (1961; 1965; 1974:167) approximates qi as ‘energy’ or,
more precisely, as ‘configurative energy’ and ‘energetic configuration’;
Unschuld ((1980)1985:72) as ‘finest matter influence’; Sivin (1987:46–
7) as ‘basic stuff ’, namely ‘stuff that makes things happen’ or ‘stuff
in which things happen’. ‘Vapour’, the translation adopted by Harper
(1998) for early medical texts, captures the aspects of qi insofar as
vapour is matter that is in motion and has force – a transformative
force (for steaming, for instance) – or is a force that effects motion.
Regardless of how one best approximates qi in English, pathological
conditions that arose in the body ecologic were often ascribed to a
process of accumulation that disrupted its constant flow and flux (in
the sense of transformation). It was the process which brought about
disharmony, not the material aspects of the accumulation, that was
important. This conception of the body in its disordered state was
common to qigong and Chinese medicine.
3 The personal transmission of knowledge
Zhang was a learned doctor who had scarcely participated in the reforging
of Chinese medicine at government institutions. In the beginning of the
1980s, he founded a collective enterprise for health care and had, by
the end of the decade, gathered a group of unemployed youth around
him whom he trained in ‘acumoxa’ (zhenjiu) and ‘massage’ (tuina). He
was an outsider of the Traditional Chinese Medical profession in the
Socialist state, and precisely for this reason he appeared to me worth
investigation. He seemed to have retained values and habits of Chinese
medical learning that elsewhere had been abolished.
Zhang’s biography was most unusual, his medical practice idiosyn-
cratic, and the forum of our encounters, seminars on classical Chinese
texts, had been instigated on my initiative. Nevertheless, his teaching
and, especially, his mode of interpreting classical texts had certain fea-
tures in common with others who called themselves ‘senior Chinese
doctors’ (laozhongyi). Since he emphasised, like other senior doctors,
the personal component in the relationship between the mentor and his
followers, I propose to speak of the ‘personal transmission of knowledge’.1
The setting and reminders of French colonialism

Zhang’s practice was situated on the borders of Green Lake which
surrounded a park of sweeping bridges and dainty pavilions, rowing
boats and weeping willows, mirrored in still water. Old men with
waterpipes and birdcages,2 sipping tea over a game of majiang,3 and the
1
‘Personal knowledge’ is also used by Tu (1993:29–44) to characterise Confucian ways
of learning.
2
Tame starlings. In urban China, pets were forbidden but potted plants, goldfish, and
birds became increasingly popular in the 1980s.
3
Mah-jongg, a game which is almost always combined with gambling, had as a sign of
decadence been strictly forbidden ever since the Communist revolution in 1949. In the
1980s it became popular mostly among women and young people and was usually
played in the backyards of private dwellings. Old men in the streets were usually seen
playing ‘chess’ (xiangqi) and ‘go’ (weiqi) or ‘playing cards’ (da paizi).
88
The personal transmission of knowledge 89
local singers4 who joined them in the late afternoon, made for an idyllic
scene, but the water was smelly, the boats out of order, and the ground
spotted with spittle. Nevertheless, the space and silence in and around
the park conveyed something of forgotten nobility. Old villas in over-
grown gardens indicated that the French used to reside in this part of
Kunming, in those days known as Yunnanfu.
On the hill to the north of the lake, the French had built Yunnan
University in a neoclassical style, overwhelming anyone who stood
under the subtropical foliage and looked up the fleet of stairs, flanked by
palms and fountains. A private school with thirteen lecturers had been
opened in 1922 under the name Dongji University. It was inaugurated
by the province in 1930, was given its present name in 1934, and it
added as a fifth faculty that of Western medicine in 1937. South of the
park was the first Western medical hospital.5 It had been inaugurated
by the French consul in 1901, mainly to provide care for the builders of
the railway which was to link Yunnanfu to Hanoi, the capital of the
French protectorate Tongking, in 1910 (Tian 1987:104). In the nine-
teenth century, French and British colonialists had competed over
Yunnan not only for geopolitical reasons but also for its rich mineral
resources (Fairbank and Liu 1980:99). French influence became preva-
lent at the beginning of the twentieth century, and elementary schools,
hospitals, and mail services were set up at the few points of administra-
tive presence in Yunnanfu, Simao, and Mengzi with the explicit goal of
reinforcing it (Doumer 1902:123). France also increasingly provided
opportunities for higher education. Whereas the majority of the students
sent abroad during the first two decades of the twentieth century had
studied in Japan (Cordier 1925:410), the liaison with France, Lyons in
particular, became important for medical training during the following
decades (Tian 1987:111).
The French influence is still noticeable in the architecture around
Green Lake, but dominant nowadays are the provincial People’s Palace,
a grand exhibition hall, and the Green Lake Hotel, south of the park,
4
Local operas, also branded for their decadence, were revived in the taverns of little back
streets all over Kunming. In this park, retired women and some young female workers
used to sing in their work clothes.
5
The first hospitals in this city were built for professional groups: the first was for the
railway builders, the second, installed in 1908 by the Qing court, was for the army and
the third, in 1914, for the police force. In 1919 a leprosy asylum was opened by the
Chinese administration. In 1920 English Methodists and in 1928 American mission-
aries established hospitals. In 1928 a Chinese biomedical doctor succeeded in raising
private funds to establish a Red Cross hospital. The provincial government opened a
Western medical hospital for the public as late as in 1939. The university hospital was
established in 1941 (Tian, p.c., April 1989). For the prevalent diseases in Yunnan, see
Tian (1987:141–80); on the plagues of the last century, see Benedict (1996:17–48).
built in the revolutionary Socialist style of the 1950s. These buildings

have partly replaced the crowded private households in which meals
were prepared on charcoal stoves; the air around the lake was relatively
fresh. The area was indeed sometimes a peaceful and unworldly place.
During the outbursts of the people’s movement in May and June 1989,
when demonstrators filled the avenues of the city centre, paralysing the
traffic, and the crowd of spectators was so dense that pedestrians could
not elbow their way through it, old men and women played French
boules at leisure in the shade of the trees along the lake.
Zhang had installed his practice on the ground floor of a provincial
government hostel, hidden in the backyards of a work unit where no
one would expect to find it. The room was spacious (30–40 square
metres) and never crowded. Zhang treated provincial government offi-
cials, university lecturers, and high school teachers almost exclusively.
He often sat behind a massive wooden desk, and diagnosis took place
there once a family member or friend had arranged it. Treatment began
on one of the following days; a minimal period of therapy was six ses-
sions. The patients were always treated with much discretion, behind a
screen on one of the three plank-beds. Zhang’s main interests, however,
lay in scholarly research, as the apparatus and pictures on the walls of
his clinic revealed.
Biographical notes and trends in medical politics

Zhang was known as a ‘senior Chinese doctor’ (laozhongyi). Some even
called him a ‘famous senior Chinese doctor’ (ming laozhongyi), but he
was not one of Kunming’s famous four.6 In fact, he was disliked by
most doctors who knew him, possibly because of his background. He
was brought up in a French missionary school, and in the jargon of
former Communist Party pronouncements Chinese who had had con-
tacts with foreigners were ‘running-dogs of imperialism’ (diguozhuyi de
zougou). After the Revolution which came to Yunnan in 1950, Zhang’s
father, who was a Chinese doctor, had had him study Western medi-
cine and in 1955, when the government began promoting TCM in
Kunming on a larger scale, he had managed to arrange for his son to
participate. After a one-year ‘improvement course in acumoxa’ (zhenjiu
jinxiuban) he had been hired, despite his youth, as an acumoxa teacher,
first at the institution which preceded the Yunnan TCM College and
later at the City TCM Hospital. In the early 1960s quarrels with his
superiors and colleagues had become so intense that he had resigned
6
According to TCM officials, these were Dai Lisan (1901–68), Tao Zhenbai (1910–79),
Kang Chengzhi (1899–1970), and Wu Peiheng (1888–1971).
from his post. In the early 1980s, when college curricula were to be
improved, able doctors from all over the province were rehabilitated as
college lecturers, but Zhang declined the offer to return to the Yunnan
TCM College. Instead, he set up a medical practice.
A board leaning on the wall next to the door of the practice indicated
that it was not a private enterprise but the clinical research centre of
an association. ‘Associations’ (xiehui) and ‘collective enterprises’ ( jitihu)
were, in contrast to ‘work units’ (danwei), not funded by the state. In
many respects they resembled the ‘private enterprises’ (getihu) of Chinese
urban society: they were responsible for their own profits and losses.
Since they were not as closely regulated as state-run firms, they had
more flexibility to adjust to fluctuations in market demand. Moreover,
they were open to a labour force with limited educational skills, par-
ticularly women and unemployed youth. In principle they operated on
a smaller financial scale than the government work units, but sometimes
they were closely linked to a work unit through shared personnel and
buildings and even had budgets of similar size.
In terms of the labour employed and the capital involved, the collect-
ive and private work enterprises were reminiscent of the informal sector
in Third World countries. According to the investigations of Whyte and
Parish (1984:30ff.), the gap between the formal and the informal sector
of the labour market was smaller in China in the late 1970s than in
Third World countries. About three-quarters of their sample of the
labour force were employed by the state in work units; only 4 per cent
were in independent enterprises and 23 per cent in collectives. The
statistics of the late 1980s show that the importance of the informal
sector had increased significantly (Gold 1989:177).
In addition to this small clinic next to Green Lake Zhang directed a
small hospital in the suburbs of Kunming. He emphasised that he was
employed by an ‘organisation of the masses’ (qunzhong jiguan) and not
the government. He had three employees, recruited on grounds of mutual
choice. In 1989 he was planning to establish, with the support of the
same association, a new hospital and outpatient clinic which would
also function as a TCM training centre for foreign doctors. He spoke
of taking on two more employees and, in anticipation of increasing his
contacts with French acupuncturists, having them trained as French
interpreters. These grandiose plans could not have been nourished with-
out certain advantageous ‘connections’ (guanxi) with representatives of
the provincial government, but, in spite of them, Zhang encountered
many difficulties.7
7
Zhang’s plans were never realised. In January 1992 I learnt from one of his followers
that he had moved to a province of southern China.
In the part of the consulting room that was light and open the appar-
atus for clinical research was on display. Most impressive was the expens-
ive Western biomedical equipment which, covered with cloths, was neatly
set out on a table under a long window front. Photographs on the wall
gave the impression of a modern Western biomedical laboratory by
indicating that these machines had once been used. Zhang explained
that he had done biomedical research earlier on Chinese medical con-
cepts by measuring the velocity of the flow of blood in the arteries and
registering the amplitude of the corresponding pulse. He often spoke
about his plans to describe the rhythm of electro-cardiogram curves in
terms of certain Chinese medical principles and the ‘hexagrams’ (gua)
of the Book of Changes – in other words, to conduct Chinese medical
research on Western biomedical concepts.
Other photographs showed Zhang with doctors from abroad, mostly
French. In the 1980s the prestige of a Chinese doctor was enhanced
not only by integrating knowledge of Western medicine into his practice
but also by contacts with Western doctors. The French, no longer called
‘imperialists’, were now ‘friends’ – ‘friends from foreign countries’ (waiguo
pengyou).
Two brightly coloured posters of the ‘eight trigrams’ (bagua) hung
on the same wall (see fig. 4.2). Instructive indices showed how each
trigram corresponded to one of the Organs and Bowels (zangfu), Tracts
and Links ( jingluo), Seasons ( jijie), and a timespan of two hours within
a day (shi). Zhang explained that these two posters simplified the ‘pro-
found’ (shen’ao) knowledge of ‘phase energetics’ (wuyun liuqi xueshuo),8
which was for him the most refined aspect of Chinese medicine. He
considered phase energetics to be grounded in the principles expounded
in the ‘Commentary on the Appended Aphorisms’ (Xi ci zhuan) of the
Book of Changes (Yi jing).
A French acupuncturist who had been friends with Zhang for several
years and a French research student who had consulted him in 1988
had shown great interest in the Book of Changes, and it seemed to me
that these encounters had revived his interest in this ancient and pro-
found knowledge. Recent contacts with the West had not only stimu-
lated modern Western biomedical research but had also promoted a
nationalist interest in China’s ancient knowledge. The motivation for
turning to the Book of Changes in some circles of the West and in China
undoubtedly arose from very different problems specific to each society.
The French acupuncturist was turning away from biomedicine to an
8
For an outline of the doctrine, see Porkert (1974:55–106) and Despeux (forthcoming).
See also ch. 4, n. 1.
‘alternative medicine’, whereas Zhang was full of praise for Western bio-
medicine, but his admiration did not prevent him from the nationalist
sentiment of finding Chinese medicine and philosophy more profound.
At the TCM college, both the middle-aged college teachers who
occasionally consulted the medical classics and the young teachers who
showed little interest in them met my interest in the Book of Changes
with an indulgent smile: ‘The Book of Changes is too mysterious and
profound to be understood’ (Yi jing tai shen’ao le). It had earlier been
branded as ‘superstitious’ (mixin) in content and the implication was
that a TCM professional need not study it. By contrast, Chinese intel-
lectuals outside the college would say: ‘If you really want to understand
Chinese medicine, you have to be able to read classical Chinese.’ Many
added: ‘And, of course, the Book of Changes.’ This gap between the
beliefs of laypersons and TCM professionals narrowed as I got to know
my colleagues at the college better.
Towards the end of my fieldwork, I spoke with several TCM profes-
sionals who showed an interest in the Book of Changes. One graduate
student, for instance, expressed the wish, which he considered unrealis-
able, to get a stipend as a ‘research student’ ( yanjiusheng) on the Book of
Changes. He was one of the only students I interviewed who had chosen
to study TCM because of his interest in ancient Chinese philosophy,
and he was among those who came to dislike TCM during their first
and second years of study. I also found textbooks for correspondence
courses on this topic in young teachers’ college dormitories, and during
work at a TCM hospital I once saw a young TCM doctor editing an
essay that a middle-aged colleague had written on the relevance of the
Book of Changes for acumoxa. When I visited the latter in his apartment,
he showed me the manuscript of a planned textbook on the Book of
Changes. One such textbook (Zhang Zhongjing guoyi daxue shiyong
jiaocai 1985) was already available.
Zhang, with his interest in the field called the ‘Book of Changes and
medicine’ (Yi jing yu yixue), was by no means alone in the PRC of the
late 1980s.9 In November 1989 an evening course was delivered at
the TCM college on two methods of acumoxa – phase energetics and
the ‘eight methods of the Divine Turtle’ (linggui bafa) – said to be based
9
There are groups of scientists in the PRC studying so-called principles of the Book
of Changes (by which they mean mainly negative–positive polarities and the exponen-
tial progression (2-4-8-16-32-64) ) in discoveries of the natural sciences (Needham
Research Institute Newsletter, January 1991). A representative of these scientists gave
the nationalist ‘China has a science of its own’ as justification for engaging in this kind
of research. For an account of a village diviner whose practice is grounded in the Book
of Changes, see Farquhar (1996).
on the principles of the Book of Changes. Various invitations to con-

ferences on the ‘Book of Changes and medicine’ circulated in Kunming’s
TCM hospital wards. TCM doctors were denied leave or finances for
participation, but Zhang travelled by his own means to Guiyang, where
an international conference was held in October 1989. The titles of the
subjects to be dealt with sounded ambitious, but Zhang was disappointed
when he returned. The discipline was still in its infancy, he said.
Although the idea that the Book of Changes is fundamental for Chi-
nese medicine has attracted increasing attention in recent years, it is
by no means new. Zhang Jiebin (1563–1640) remarked in the chapter
‘Meaning of the Changes for Medicine’ (Yi yi yi) of the Appendix of the
Categories (Lei jing fu yi) (Zhang (1624)1799:20b–21a):
I therefore say: the Changes provide the principles of medicine, and medicine
realises the functions of the Changes. Those who learn medicine without know-
ing the Changes must consider medicine simple and know no more . . . Those
who know the Changes but not medicine, must consider the principles of the
Changes profound and mysterious. In such vagueness and uncertainty they
will have difficulty using them. Moreover, they will be like one who suffers cold
and has a fur coat but will not wear it or one who suffers hunger and has gruel
but will not eat it. What a pity, they have missed their life! Therefore medi-
cine cannot exist without the Changes and the Changes cannot exist without
medicine. If one can combine and understand them both, then the alterations
of the Changes come from Heaven and the application of medicine comes from
oneself.10
Zhang Jiebin referred to earlier masters such as Sun Simiao (c. 581–
682) who was said to have emphasised the importance of the Book
of Changes for understanding the basic principles of medicine ((1624)
1799:1a; Zou 1986:9). No doubt, for Zhang the ‘Commentary on the
Appended Aphorisms’ in the Book of Changes was most important
because it laid the basis for the chapters of the Yellow Emperor’s Inner
Canon (Huang di nei jing) that he considered most profound: those on
phase energetics.
The person and his personae
Zhang was an exponent of many strands of learning, embodying the

personae of scholar doctor and aspiring Confucian gentleman (Hall and
Ames 1987), senior Chinese doctor (Farquhar 1994a), and modern intel-
lectual (Schwarcz 1986).
10
For a preliminary translation of the entire chapter into French, see de la Robertie
(1986).
The scholar doctor
Zhang was, as already said, called a senior Chinese doctor, but he con-
sidered himself a ‘man of culture’ ( you xuewen). He identified himself
with the scholars of traditional China, particularly with those who had
fallen into disfavour with the Imperial Court. He had an impressive pri-
vate library and claimed to have devoted his life to the study of profound
knowledge in the canons. To be a scholar was one of the foremost
virtues of a Confucian ‘gentleman’ ( junzi). Neo-Confucian scholarship
consisted largely of a thorough knowledge of the ‘thirteen classics’
(shisanjing). Zhang had not studied the Mencius (Meng zi), nor had he
memorised the Analects (Lun yu) of Confucius, but he legitimated his
interest in the Book of Changes with its ‘Commentary of the Appended
Aphorisms’ by attributing its authorship to Confucius.11
Zhang highly valued comparative research into classical texts. He
repeatedly stated how important it was to buy different editions of the
same text and make lists of different interpretations of certain key terms.
His attitude sometimes reminded me of that of ‘evidential scholarship’
(kaozhengxue) (Elman 1984), although he did not appear to me as rigor-
ous in his scholarly standards as an evidential scholar. He collected many
texts, compiled annotations, and sometimes compared them, but he
hardly ever evaluated them critically.
Like an evidential scholar dedicated to textual analysis (Elman
1984:13ff.), he maintained that he strictly avoided all political talk.
However, after the Tiananmen incident on June 4, it was only in Zhang’s
ménage that I found the television always on. Intellectuals generally
claimed to be absolutely disinterested in politics and the legacy of the
May 4 movement has called indifference on their part an expression of
the ‘traditional spirit of subservience’ (Schwarcz 1986:31), but I observed
that many were well informed. Politics have always been crucial to Chi-
nese intellectual life. Even the evidential scholarship under the Manchu
rulers did not lack political overtones (Elman 1984:17).
Zhang valued etiquette and politeness. He exerted patriarchal author-
ity rather than impersonal control. His followers all spoke of him with
the same standard expression: ‘He is a very kind person’ (ta ren hen hao).
They seemed to allude to the notion of ren, ‘a sensitive concern for
others’ (Elvin 1985:165), which designates the quality of a gentleman
11
‘The significance of this commentary reached its highest point in the metaphysical
thought of the Sung Neo-Confucians’ (Shaughnessy 1993:220). The authorship of
Confucius is, however, questionable; see Peterson (1982:72–9) and Shaughnessy (1994:
57–66).
in Confucian writings but is not used in spoken language.12 Zhang

cultivated several other virtues of the Confucian gentleman. In response
to my request to learn Chinese medicine from the classics, he proposed
to form a group of ‘friends of learning’. The seminars we held can be
viewed as one form of the intellectual exchange that is called you (friend-
ship) (see Wu 1993–4:44).
The senior doctor

In sharp contrast to his Confucian ethics, Zhang was given to boasting.
Self-promotion was common among the Chinese doctors I met, espe-
cially those who were called senior doctors, and was probably a habit
rather than a feature of personal character. Most senior Chinese doc-
tors were in private practice, and praise of their own skills advertised
side-by-side with bone setters, herbalists, and masseurs was perhaps
necessary in an environment of petty enterprise.13 Possibly this self-
advertisement influenced not only the clients’ choice of therapy but
also reinforced their own belief in themselves.14 In the streets of small-
scale business this self-advertisement did not strike one as boasting,
but in Zhang’s surroundings it was incongruous with his Confucian
ethics.
As a gentleman comparable to the scholar doctors of Imperial times,
Zhang distanced himself from the artisans and the petty merchants who
addressed the uneducated masses and advertised their skills or goods.
Such purpose-oriented use of knowledge and skill was considered ‘shal-
low’ (qian) and such people ‘petty’ (xiaoren). Confucian ethics advoc-
ated consciousness of status and may have encouraged the segregation
of social groups in Socialist China which resulted in a gap between the
realm of government work units and that outside it. The intellectuals of
a work unit readily mixed with people from other work units but they
showed reserve towards those who made their lives outside the realm of
work units, ‘among the people’ (minjian). ‘In the streets it’s not safe’
( jieshang bu anquan), they would say. ‘He or she mixes freely’ (ta daochu
pao), was an expression of slight disapproval. Notably, one of Zhang’s
12
Chao (1995:215–23) underlines the importance of ren among elite physicians in Late
Imperial China.
13
Compare with Landy (1977:469): ‘In addition to ameliorating the effects of illness
and disease, the curer’s activities were oriented toward enhancing and/or reinforcing
his social position.’ Or Janzen (1978:225): ‘The Banganga spend considerable efforts
lauding their own skills.’
14
Alfred Leder (p.c.) points out that boasting is, from a psychological point of view, a
form of self-persuasion. Particularly for treating difficult patients, therapists need to
strengthen their belief in themselves.
mottoes was from the Analects (Lau 1979:60; verse I.8): ‘Do not accept
as friend anyone who is not as good as you.’
The qigong masters I knew who worked as private enterpreneurs were
skilled at praising their art too, but rather than referring to themselves,
they often cited other qigong healers for their skills. This did not neces-
sarily reflect any ethic of mutual support among them, but was prob-
ably a response to the lack of general acceptance of qigong as a respectable
therapy. Qigong healers had to assure their clients of the powers of their
therapeutic methods before they could praise themselves.
In government institutions certain doctors and teachers boasted too,
but most of them considered it a bad habit. TCM doctors tended to
acknowledge their specialised skills or their sense of responsibility. ‘The
“skills for handling the needle” (shoufa) of my father seem to be so
exceptional that many patients come to me for treatment’, said the son
of a famous senior doctor in charge of the acumoxa clinic at the City
TCM Hospital. Of the acupuncturists working in the government insti-
tutions of Kunming city, he definitely had the largest clientele (fifty to
eighty patients a day). A female acupuncturist at the Yunnan TCM
College, known as ‘conscientious’ (renzhen) and ‘warmhearted’ (reqing),
said: ‘I’m always the last to leave our clinic at noon, I’ve got so many
patients.’ An acupuncturist at the Red Cross Hospital, specialised in
treating eye disorders, said: ‘See from how far away people come for
my specialised eye acumoxa technique’15 – this in the presence of a
myopic boy from a county town who was staying with his aunt for
treatment in the provincial capital during his summer vacation. Successful
Chinese doctors measured their achievements by counting the number,
the distance travelled, or the status of their clients. Zhang, for instance,
treated few patients, but they were high-ranking ones.
In contrast to TCM doctors, who emphasised their technical skill
and humanitarian concern, a senior Chinese doctor would almost
exclusively boast of his ‘experience’ ( jingyan). Jingyan was the attribute
of a successful senior Chinese doctor. It explained why a doctor was
very popular. Nobody would say: ‘He has got much experience, but no
clients.’ If a Chinese medical doctor was not so popular, he would be
praised for his ‘understanding of theory’ (ta hen dong lilun) or for ‘being
a highly cultivated person’ (ta you xuewen). If a doctor was successful,
he was said to have jingyan. This points to a conversational implicature
(Levinson 1983:97ff.) linking jingyan with success in medical practice.
15
This particular TCM doctor’s boasting was as straightforward as that of a senior
doctor, but like other TCM professionals he explained his popularity by pointing to a
technical skill rather than his art of healing.
Farquhar (1994a:171–4) has earlier presented jingyan as the quality

‘at the center of Chinese medical decision making’, which is how Chinese
doctors themselves put it. Jingyan comprises both the ‘ “experience of
the Chinese labouring masses in their two-thousand-year struggle against
disease” ’ and the experience of ‘the individual doctor and his life in
medicine’. Farquhar underlines that ‘jingyan is a good deal more his-
torical, collective, and discursive than the individualistic life narrat-
ives that the [English] word experience denotes’ (p. 2). But it is important
to see that jingyan is not only a descriptive term referring to a cognitive
quality to which Chinese senior doctors and TCM professionals greatly
aspired. Jingyan also meant efficaciousness, for it was an attribute of a
doctor when he was popular and successful in medical practice, regard-
less of his skills, knowledge, and experience. This efficaciousness, jingyan,
was attributed to Chinese medical doctors. Qigong masters like Qiu,
who possessed secret knowledge, by contrast, had acquired ‘techniques
of being efficacious’ ( you gongfa). But for healing grounded in jingyan,
it was not sufficient to acquire techniques. Jingyan was personal know-
ledge which was partly, but not completely, transmissible. It could not
be learnt in the classroom or by mechanical imitation. Both the senior
Chinese doctor and the TCM professional emphasised that the abilities
of perception for a correct diagnosis in Chinese medicine – Palpating
the Pulse (qie mai) in particular – could only be learned by jingyan. This
efficaciousness and personal knowledge was acquired through medical
practice.
Similar to the English word ‘experience’, jingyan included not only
professional knowledge and experience but also life experience and
maturity. Although a TCM doctor in his late twenties had more profes-
sional experience than his fifty-year-old colleague newly trained in TCM,
the patients tended to place more trust in the one with the grey hair.
There was still another aspect to jingyan. The daughter of the head of
an acumoxa department at a Western biomedical hospital was believed
to have acquired much of her father’s jingyan; TCM doctors said that
her father would not let anyone else acquire it. She was younger and
professionally less experienced than her colleagues, who had graduated
from a TCM college, but she enjoyed more popularity among the
patients. In this case, jingyan explained her popularity and simultan-
eously referred to the knowledge her father had gathered in his family’s
tradition, enriched by his personal experience of a lifetime. Her jingyan
was seen as in opposition to the textbook knowledge of university graduates.
This example highlights, furthermore, aspects of the relation between
the concepts of jingyan and laozhongyi. The above-mentioned doctor
had authority based on his jingyan, but was generally not called a senior
Chinese doctor. He emphasised that jingyan was crucial for correct dia-
gnosis but did not boast of his own. To my knowledge, retired college
professors who worked regularly in consulting rooms open to the public
were not spoken of as laozhongyi. The signs advertising their practice
referred to them as ‘famous doctors’ (mingyi), although they were gen-
erally unknown ‘among the people’. This finding suggests that respected
old Chinese doctors in work units avoided being called laozhongyi; they
were either called mingyi or ming laozhongyi.16
A Confucian scholar is supposed to have the modesty to know that
he does not know, but Zhang also had traits of the senior doctor who
claims, on grounds of his experience, ‘to be in the know’. He did not
only boast about his ‘own experience’ (wode jingyan), but also about his
knowledge of the classics, and the ‘experience of the ancients’ (guren de
jingyan).
The modern intellectual

Liang Qichao (1873–1929) is quoted as saying: ‘I love master Kong,
but I love the truth even more.’ The following generation of intellec-
tuals, advocating the Chinese Enlightenment, made ‘science’ (kexue)
along with ‘democracy’ (minzhu) an all-embracing alternative to Con-
fucianism (Schwarcz 1986:33). These political overtones of the term
kexue (science) cannot be overlooked.
I had several discussions on this term with TCM teachers and stu-
dents. Teacher Tao once declared during a private lesson that ‘making
scientific’ (kexuehua) meant ‘splitting up’: ‘Science is characteristically
divided into many subdisciplines.’ Others said that being scientific meant
proceeding ‘step by step’ ( yibu yibude), a statement which pointed to
the belief that by building on basic structures one could proceed to
learning more complicated ones. To clarify their point, I offered them
the example of the process of digestion. Starch, for instance, is considered
in biomedical physiology to be gradually decomposed into its basic
elements, glucose molecules. A step-by-step view of this process stresses
unidirectionality of the flow of time. However, the same process can be
viewed as oscillating between two polarities – the neutral milieu in the
mouth, the acid milieu in the stomach and the more neutral and base
one in the intestines. The step-by-step view was considered scientific; an
emphasis on polarity and complementarity was characteristic of Chinese
medical thinking. TCM teachers to whom I presented this example
16
In the section called ‘Senior Doctors’ Farquhar (1994a:14–17) speaks of laozhongyi
while the sources she cites all refer to ming laozhongyi.
immediately understood its message: that Chinese and Western medi-

cine looked at different parameters to describe the same process.
TCM students often shrugged their shoulders when I asked them
what kexue meant to them. Once, when I heard them speaking of
kexue qigong, and asked what that was, they answered: ‘With “scientific
qigong” you can achieve rapid effects.’ ‘Rapid effects’ are generally attrib-
uted to ‘scientific’ Western biomedicine, and this ‘modern medicine’
(xiandaihuade yixue) has characteristics generally attributed to the mod-
ern pace of life (Hsu 1992b). Another response was: ‘You need not
learn any mumbo-jumbo, it’s quite straightforward, “directly perceived
through the senses” (zhiguan).’ Then I asked if anything directly per-
ceived through the senses is scientific. ‘It’s just a label that makes
people trust you’, the student answered, aware of the political overtones
of the scientific and the modern. Qigong was generally considered super-
stition and therefore, to forestall any doubt, it was called scientific.
His colleague corroborated this: ‘It’s just a name.’
In everyday language, kexue had connotations of something refined
and worthwhile. Once, for instance, I was told in a tone of admiration:
‘The people in Western countries eat very scientifically’ (xifangren chifan
chi de hen kexue). People would scold others by saying: ‘That’s not
scientific’ (bu kexue), being scientific in this case being a moral virtue.
As a modern intellectual in the PRC, Zhang believed in science and,
as did many Chinese intellectuals, he tried to reconcile scientific dis-
coveries with the observations of the ancients. ‘Science and the ancients
use different languages for describing the same processes’, he used to
say. This juxtaposition of ‘science and the ancients’ (kexue he guren)
implied that both were valid and authoritative sources of knowledge; he
maintained that both described ‘objective’ (keguande) facts. He valued
the results of scientific experimentation (which claims to be a means for
questioning authority) alongside the authority attributed to experience.
In summary, one may say that Zhang was like every other senior
Chinese doctor ‘in the know’. His personal knowledge was grounded in
experience, thus valid and authoritative. Like all traditional scholars, he
understood that his authority lay in a thorough knowledge of the clas-
sical canons in which the experience of the ancients was recorded. As a
modern intellectual, he valued science highly and compared the author-
ity of personal experience to that of scientific experimentation.
The mentor and his followers

‘The training of a disciple takes nine years’, Zhang explained to me
once: ‘Three years for the master to evaluate his disciple, three years for
the disciple to reconsider his choice of master and the last three years
for the master to transmit the essential knowledge.’ Zhang emphasised
the importance of personal choice for transmitting the personal know-
ledge of Chinese medicine. A disciple, unlike a student, was expected to
know and accept all aspects of his master’s personality. This included
the respect a son has for his father (xiao) and absolute loyalty.
Unlike Zhang’s son, who often contradicted his father, his favourite
follower, Zhangdi, was deferential and quiet and hardly ever criticised
anything his mentor said. If Zhang made a mistake, the other followers
would point to it in such a low voice that Zhang would not hear it; in
contrast, Zhangdi either was silent or asked his mentor loudly for clari-
fication. In general, he glanced at his mentor before engaging in any
activity. Always attentive to his mentor’s needs, he would act as his
companion and help him where he could. Zhang treated Zhangdi dif-
ferently from his other employees. He gave him tasks of greater respons-
ibility, turned to Zhangdi for assistance, and felt familiar enough to
scold and accuse him freely. Eventually, the disciple and his mentor
would come to share certain gestures and attitudes as, for example,
the way in which they lit a cigarette, answered questions, or greeted
their patients.
The retired physics teacher in our reading seminar, who was senior
to Zhang, claimed to have been friends with him for many years. He
made a point of having an interest in the Book of Changes as a physicist
and had attended the occasional evening courses that Zhang gave at the
university. When Zhang planned to go to a conference in Guizhou, he
accompanied him. He mentioned to me that Zhang was aged, which
sounded as if he considered it his duty to keep him company. Their
relationship was not intimate but one of mutual respect and friend-
ship with regard to common scholarly interests. It was reminiscent of
the relation of ‘being good friends’ ( yu zhi shan) (Wu 1993–4:44) and
evidently was one way of making possible the transmission of personal
knowledge.
The wife of the physics teacher attended the seminars for no other
reason than to spend her time with her husband. Although she claimed
an interest in the texts, she did not seem to follow the lectures closely.
As time went on, she was often absent. Similarly, one of Zhang’s female
employees, who was apparently the fiancée of his son, showed little
interest in these seminars. It was her employer who had wanted her to
join, she explained when I ran into her in a disco (where she looked
much more in her element). The other female employee, a graduate
student in French literature ‘waiting for employment’ (daiye) whom
Zhang expected to become a translator for Chinese medicine, was, by
contrast, very eager to read the texts and prepared the seminars con-
scientiously. A female qigong teacher who was employed in the adjacent
work unit at first attended enthusiastically but soon gave up. Participa-
tion in the reading seminar was largely based on personal inclination.
The relationship between mentor and follower might last for a few
months or for years and could develop into one of rather close and
mutual dependency or remain fairly loose throughout.
The personal mode of transmission

One may wonder why the personal mode of transmitting knowledge
deserves to be identified as such. The anthropological literature gener-
ally recognises the distinctiveness of secret knowledge, and Chinese
doctors spoke of secret medical knowledge, on the one hand, and the
need to ‘standardise’ it (guifanhua), on the other. Yet for the purposes
of this study, the personal transmission of knowledge and practice needs
to be treated separately from knowledge and practice that is transmitted
in either a secret or a standardised way. The reasons for doing so have
to do with the social aspects of the relationship between mentor and
follower, aspects pertaining to cognition and style of knowing, and
historical considerations.
Firstly, the relationship between mentor and follower was based on
personal choice. Its history was different in each case and very personal.
To what degree and what kind of knowledge was transmitted depended
very much on the personalities involved. Whereas master and disciple
were often kin and were structurally expected to come to terms with
each other even if their personalities clashed, it was perfectly acceptable
for mentor and follower to accept and reject each other on grounds of
character and personality. Apprenticeship could be sought with many
different masters. Crucial was whether mentor and follower had faith in
each other and could build a relationship of mutual trust.
Secondly, the styles of knowing characteristic of personal trans-
mission differed from those that were secretly transmitted. Admittedly,
Zhang did have much in common with Qiu: awe of the ancients; pre-
occupation with therapeutic practice (also when reading); belief in the
word (Qiu’s in its power and Zhang’s in its authority); time in vast
amounts devoted to getting to know a single disciple or follower; and a
relationship with disciple or follower which often ended in mutual depen-
dency. The modes of learning were also strikingly similar. The main
path to the profound knowledge of a senior doctor was rote learning.
Zhangdi had memorised long text passages and assisted his master
in medical practice, learning mostly by imitation; a follower lacked
status to ask for explanations (Goody 1978). Repetition and imitation

resulted in Qiudi’s case in particular sensations and in visions. Like-
wise, the follower Zhangdi had been told that if he persisted in memo-
rising texts and applying them to medical practice there might be
‘revelations’ (wu). Without the need for explanation, he would ‘just
know’.
There was, however, a crucial difference. Qiu’s knowing was grounded
in knowledge that was limited and transferable. The incantations and
gestures could be appropriated by imitation and repetition, which were
the same for every disciple. By contrast, profound knowledge was acquired
through experience, which was personal and not easily transmitted. Access
to profound knowledge depended on a personal style of knowing which
was bound to vary from person to person. It was grounded in very per-
sonal ways of learning.
Thirdly, the aspects of the personal transmission of knowledge that
I observed in Zhang’s reading seminars may throw light on a social
practice of transmitting knowledge and practice that has only recently
been marginalised in China. This social practice may well have been
predominant among the traditional elite of the Chinese empire. The
Imperial institutions recruited their members by means of an examina-
tion system that allowed for a certain amount of social mobility. Rather
than advocating the ideology of kinship alone, Chinese officialdom built
up a system of personal trustworthiness.17 Discipleship within it may
well have been grounded in personal transmission of knowledge and
practice.
The relationship between mentor and followers inevitably brings to
mind that between patron and clients. However, there is consensus that
patronage, at least in the Mediterranean setting, ‘knows that it is itself
not the official morality’ (Gellner 1977:3). Seed-beds for patronage are
found in incompletely centralised states, defective markets, and defect-
ive bureaucracies.18 By contrast, the relationship between mentor and
17
The term ‘Chinese officialdom’ is here meant to embrace both ‘officials of, or close to,
the central bureaucracy’ (often approximated as ‘the state’) and ‘local elites’ who domin-
ated much of social life in local societies in Late Imperial China. On the basis of a
statistical evaluation of the record of physicians in local gazetteers, dynastic histories, and
medical treatises and biographies, Chao (1995:160–2) concludes that in the Jiangnan
area ‘The elite physicians in the Qing did not come from families of physicians, as was
commonly perceived, but . . . entered into the profession through a career choice’.
18
Though other views on patronage exist, Gellner’s analysis is advocated here in order
to underline that patron–client relations are highly valued in an environment in which
the personal transmission of knowledge and practice is fostered but not in one that
favours the standardised transmission of knowledge and practice. The difference be-
tween Imperial China and the Mediterranean setting seems to be that it is the official
morale in the former case and not the official one in the latter.
follower is a legitimate and highly valued mode of social interaction in

the Chinese setting. A glance at the literature discussing such relations
shows that during the Tang to Song periods (618–1279) ‘when the idea
of the Confucian physician probably originated’ (Chao 1995:210),19
scholars did indeed have a ‘sense of discipleship’ (McMullen 1988:48).
The later periods of the Tang even witnessed ‘the development of an
ideal of independent teaching’ (p. 61, italics added). There was evi-
dently an official morality of discipleship among Confucian scholars;
emphasis on personal relationships need not indicate a defect.20
19
Chao (1995) translates ruyi as ‘Confucian physicians’, a term that is currently subject
to controversy and elsewhere approximated as ‘scholar-physicians’.
20
According to McMullen (1988:62), this emphasis on personal relationships could
easily be (mis-)used to sanction factionalism: ‘Sometimes little more than scholarly
or literary friendship linked with the vital element of political help was involved. But
in the factionally divided and harshly competitive mid-Tang bureaucracy, Confucian
scholars dignified such recognition and support as acts of profound insight.’ This com-
ment implies that during a period of a weak bureaucracy, patronage became important
not only in the Mediterranean setting but also in Tang China. A difference is note-
worthy, however: the officials in Tang China could justify themselves by speaking of a
‘profound insight’, which, as argued here, is possible only if one accepts the personal
transmission of knowledge as an ideal.
Interpreting a classical Chinese medical text 105
4 Interpreting a classical Chinese medical text
Zhang’s style of knowing was marked by the way in which he related

to the ‘experience of the ancients’ (gurende jingyan), which became
obvious already from the first two lessons in our round of seminars (20
and 21 April 1989). These lessons concerned the first paragraph of
chapter 66 of the Basic Questions (Su wen) in the Yellow Emperor’s Inner
Canon (Huang di nei jing). This paragraph, which outlines the basic
principles of the ‘phase energetics’ (wuyun liuqi), includes a number of
concepts that are central to Chinese medicine: various notions of change,
the concept of shen (Spirit, Spirits, Spirituality), numerological consid-
erations, qi (Breath) and xing (Form), and yinyang. Zhang’s mode of
interpreting these concepts appeared to be incoherent and subjective.
His reading of the text was sometimes non-linear, and I often failed to
see the relevance of what he said. Only later did it dawn on me that his
learning was directed at making sense of ‘experience’ ( jingyan) – the
experience of the ancients as recorded in the text – and its applica-
tion to modern practice. Clearly, the relation to everyday practice of a
canonical text was not like that of a modern Western scientific theory.
The text was relevant to medical practice, but it was used and inter-
preted in unusual ways. A pattern or, rather, a variety of patterns can
be detected which may be considered characteristic of these Chinese
medical ways of relating text to practice. I propose to distinguish the
following ones: the indirect mode of interpretation, the authoritative
mode, the justificatory mode, the mode achieved by recourse to every-
day life, and the creative mode.1
The personal adoption of the text

I had explained to Zhang that my aim was to learn ‘real’ Chinese
medicine as opposed to the TCM knowledge taught at government
1
In what follows, each section presents one of the above-mentioned concepts of Chinese
medicine and one of Zhang’s modes of interpreting the text; they are presented within
one section for no other reason than that this was the way in which Zhang proceeded.
105
Figure 4.1 Extract from chapter 66 of the Basic Questions

colleges, and he had instantly understood what I meant. He had sug-

gested reading the nine chapters on phase energetics in the Basic Ques-
tions,2 which in TCM textbooks were confined to the appendices if
discussed at all. Zhang considered the doctrine of the phase energetics
‘profound’ (shen’ao) knowledge that is ‘understood only with difficulty’
(nandong).
Chapter 66 of the Basic Questions is said to summarise the principles
of the phase energetics. Some of the phrases in the first paragraph were
often cited by Chinese doctors; some of these occurred also in Basic
Questions, chapter 5. My translation is partly based on Zhang’s exegesis
and reflects a modern understanding of the text; it is, in Waley’s
(1934:13) sense, ‘scriptural’ and cannot aspire to be ‘historical’, which
would reflect the understanding of the text at the time it was composed
(phrases indicated by bracketed numbers are subsequently discussed).
[1] The Rules of the Origins of Heaven
The Yellow Emperor asked: [2] Heaven has Five Phases, and they couple
with the Five Directions, thus giving birth to the Cold, the Hot, the Dry, the
Damp, and the Windy. [3] Man has Five Organs, and they change the Five qi,
thus giving birth to Joy, Anger, Worry, Sorrow and Fear.3 [4] The ‘Discussion’
says that the Five Cycles mutually ride each other and that they all govern each
other and that on the day when one arrives at the end of the year the circle is
complete and starts all over again. I know this now, but what I would like to
hear is how they can be reconciled with the stages of the three yin and the three
yang.
Gui Yuqu kowtowed and bowed repeatedly and replied: What a splendid
question! As to the Five Cycles and yinyang, they are the way (dao) of Heaven
and Earth, the organising principles of the ten thousand things, the parents of
change, the origin of life and death, ‘the abode of the spiritual and bright’
(shenming zhi fu), how can one not master them! Therefore, [5] when things
are born, one calls it ‘transformation’ (hua) and [6] when things reach their
extremes, one calls it ‘transition’ (bian); [7] when yinyang is not fathomed, one
calls it Spirituality (shen) and [8] when the applications of the Spiritual are not
discerned, one calls it ‘sagacity’ (sheng).
2
The seven chapters 66–71 and 74, and parts of chapter 9 were, according to Ren
(1982:13), added by Wang Bing (8th century). These chapters on the phase energetics,
among which Zhang included parts of chapter 5, constitute one-third of the Song
edition of the Basic Questions. The doctrine, which abounds in numerological consid-
erations, became important in the Song and Yuan (Despeux forthcoming) and was well
established by the Ming (Lu and Needham 1980:140). According to Porkert (1974:58–
9), it was much elaborated by Zhang Jiebin (1563–1640) and Wang Ji (1463–1539).
According to Lu and Needham (1980:149), Zhang Jiebin and a certain Wang Ji (1522–
67) (whom I could not identify) ‘criticised it severely’. For a formalistic account of the
doctrine, see Porkert (1974:55–106).
3
Five instead of Seven Emotions are mentioned in this text. The Seven Emotions are
standard in TCM (Fundamentals (Yin 1984:98); Ots 1990).
[9] The applications of change are the profound in Heaven, the Way in Man
and change on Earth. Change gives birth to the Five Flavours, the Way to
wisdom, and the profound to the Spiritual. [10] When the Spiritual is in the
Sky, it is Wind, and when it is on Earth, it is Wood; when it is in the Sky, it is
Heat, and when it is on Earth, it is Fire; when it is in the Sky, it is Dampness,
and when it is on Earth, it is Soil; when it is in the Sky, it is Dryness, and when
it is on Earth, it is Metal; when it is in the Sky, it is Coldness, and when it is on
Earth, it is Water. Therefore, when it is in the Sky, it is Breath (qi), and when
it is on Earth, it takes Form (xing). [11] Form (xing) and Breath (qi) stimulate
each other, and through their change give birth to the ten thousand things.
(Huang di nei jing su wen (Anon. 1956:130) )
Zhang presented this passage on a piece of paper in beautiful hand-

writing and asked us first to copy it into our notebooks.4 The handwrit-
ten text in our notebooks took on a personalised form. It stood and was
to be understood for itself. Zhang generally did not indicate the source
of a citation or the context of a phrase.
Notions of change and the indirect mode of

interpretation
Zhang’s comments on the title and the first six phrases of this chapter
touched on various notions of change. When he explained the title, it
became apparent that change was an important aspect of the Spiritual
(shen) in the universe.5 From his comments on the following phrases it
became clear that the text built on various notions of change. In order
to grasp these notions, one had to employ different frames of reference:
change was sometimes assessed with regard to the position at which it
took place in a rubric of a Direction-Season, sometimes described in
terms of different conceptions of time (cyclic or oscillatory, irreversible
or reversible), sometimes conceptualised in terms of the observer’s view-
point and position in space.
Zhang first explained the chapter’s title, Tian yuan ji, by paraphrasing
each word with a modern Chinese word:
4
Compare with Farquhar (1994a:207, n. 10): ‘One elderly doctor whose practice I
was observing instructed me to make two copies of his recent journal articles by hand.
He had cast our relationship in a pedagogical frame and felt this exercise would be good
for me. Naturally, he saw no value in the photocopying services I offered him by way of
alternative.’
5
In this text passage shen had the attributes of a ‘matter-agency’ or ‘shared substrate’
generally attributed to qi. See pp. 80–3.
[1] tian6 ‘nature’

yuan7 ‘origin, basis, root’
ji 8 ‘rules’
His translation was ‘the rules of the origin and the change that is the
becoming of the phenomena of nature’ (ziranjiede xianxiang fashengde
genyuan yu bianhuade guilü). He insisted on this long and clumsy phras-
ing. ‘The rules of the origins of Heaven’, suggested as a literal transla-
tion, was wrong; the phrase ‘the change that is the becoming of the
phenomena’ was, according to him, crucial for understanding the text.
Later I discovered that he used this phrase to circumscribe the concept
of the Spiritual.
The notion of the Spiritual was in fact central to this text, since the
worldview underlying it was that the Spiritual constituted and simult-
aneously impregnated the universe. From the very start, our scholarly
endeavours directed at gaining an understanding of this universe that is
impregnated by the Spiritual were bound to be futile. Analytic thinking
and a scholarly apparatus of commentaries cannot adequately account
for the experience of the Spiritual (Andrès 1980:7–29). Perhaps the
text was designed for meditation rather than interpretation, but Zhang
was not a mystic; he considered himself a scholar and attempted an
interpretation of the text.
[2] Heaven has Five Phases [Water, Fire, Metal, Earth, Wind], and they
couple with the Five Directions (wuwei) [North, South, West, Center, East],
thus giving birth to the Cold, the Hot, the Dry, the Damp, and the Windy.
[3] Man has Five Organs [Heart, Liver, Spleen, Lungs, Kidneys] and they
change (hua) the Five qi (wuqi) thus giving birth to Joy, Anger, Worry, Sorrow,
and Fear.
6
For comparison see Fung (1953:19) who discusses tian as used by Dong Zhongshu
(179?–104? BC): ‘“Heaven” . . . seems at times to be . . . used to denote the physical
universe. At other times, however, he seems to mean by it something somewhat akin to
the Western concept of “Nature”, yet at the same time something that possesses cogni-
tion and consciousness.’
7
For comparison see Fung’s (1953:19) citation of Dong Zhongshu: ‘What is called the
single yuan is called the great beginning . . . Therefore yuan is the root of all things, and
in it lies man’s own origin. How does it exist? It exists before Heaven and Earth.’
8
Ji in this sense often occurs together with gang, sometimes in the compound word
ji gang, ‘web without a weaver’ (Needham 1956:407ff.) or gang ji, ‘principle’, some-
times in parallel phrases: ‘For instance, silk fabrics have ji (warps) and nets have gang
(large ropes with which they are drawn together)’ (Mo zi, Shang tong, shang (Sun
(1934)1939:49)). According to the Shuo wen jie zi (Duan 1981:645, 655), ji means
‘easily distinguished [important] silk threads’ (bie si ye) and gang refers to the ‘large
ropes of a net’ with which the nets are drawn together (wang hong ye).
Parallel phrases of a similar kind are frequent in classical Chinese.

‘For those who have insight into the changes of the seasons, the changes
in the body are intelligible too’, Zhang commented. He associated the
Cold, the Hot, the Dry, the Damp, and the Windy with the excessive
qi in the environment coming from the Five Directions (wuwei). Joy,
Anger, Worry, Sorrow, and Fear, the Five Impulses (wuzhi), were
understood to refer to excessive qi within the body. The above two
phrases described analogous processes in Heaven (tian) and Man (ren),
the macrocosm and microcosm, the body ecologic.9
Zhang dwelt on the notion of the Five Directions. This spatial
dimension was of primary importance. It was a space that had dynamic
propensities: ‘Kan, li, zhen, dui, and kun are hexagrams from the Yijing
. . . Water, Fire, Wood, Metal, and Earth are . . . the Five Agents [Five
Phases]. All of these express directions of transformation; all of these
remind us . . . that positions in space are not just abstract points in an
isotopic coordinate system but rather gradients of change’ (Kuriyama
1987:56, italics added). Zhang did not say so, but I got the impression
that he thought along such lines. When I asked for clarification he
seemed not to understand me.
The following does not record Zhang’s lesson but may highlight
what the notion of the Five Directions implied. Phrase [2] stressed the
close correlation of the Five Phases, Directions, and Seasons: a Phase
coupling with a Direction gave rise to a Season. Granet (1934:113)
commented on this: ‘Les Chinois ont évité de voir dans l’Espace et le
Temps deux concepts indépendants ou deux entités autonomes . . . Ils
les [l’Espace et le Temps] ont decomposés conjointement en cinq grandes
rubriques, dont ils se servent pour repartir les emblèmes signalant la
diversité des occasions et des sites.’ Emphasis on a differentiation within
the rubric of a Phase-Direction-Season might have resulted in a clear
differentiation between Directions and Seasons – that is, between the spa-
tial and the temporal dimension with which we are familiar in modern
Western thought. In phrase [2], however, the opposite was the case: the
correlation between Phase, Direction, and Season was stressed,10 thereby
emphasising the differences between rather than within five ‘rubrics’.
A reading of this text in modern times is the more difficult because
the Phase-Direction-Seasons cannot be reconciled with the modern
9
Joy correlates with Fire, Anger with Wind, Worry with Earth, Sorrow with Metal, and
Fear with Water. Zhang did not comment on the different sequencing of the Phase-
Direction-Seasons in phrase [2] and the ‘Organ-Breath-Impulses’ in phrase [3].
10
Water–North–Coldness (i.e. winter), Fire–South–Heat (i.e. summer), Metal–West–
Dryness (i.e. autumn), Earth–Centre–Dampness (i.e. late summer), Wood–East–
Windiness (i.e. spring).
conception of space and time as homogeneous dimensions. ‘Les Chinois

ne se sont point souciés de concevoir le Temps et l’Espace comme
deux milieux homogènes, aptes à loger des concepts abstraits’ (Granet
1934:113). Space was not imagined as an empty container or time as
a homogeneous flow. ‘Just as space appears to the concrete mind not
merely as a schema of extension, but as something filled with hills,
lakes, and plains – in each of its parts open to different possibilities – so
time is here taken as something filled, pregnant with possibilities . . .’
(H. Wilhelm (1951)1977:17). H. Wilhelm, referring to the notion of
time in the Book of Changes, makes the same point as Granet: exten-
sion, which is common to both space and time, is conceived of as filled
with particularities. Changes in space and time are inherent in a certain
position in space and time; change does not result from a cause that
produces an effect and, in this sense, involves no causal relation.
This does not mean that the five rubrics of Direction-Seasons were
the only concepts that accounted for temporal variation and change.
The passage refers in phrase [4] to a cyclic conception of time:
[4] The ‘Discussion’ says that the Five Cycles mutually ride each other and
that they all govern each other and that on the day when one arrives at the end
of the year the circle is complete and starts all over again.
Zhang drew a circle on a piece of paper and said: ‘To end means to
begin, every end is a beginning; every winter is followed by a spring.’
The changes observed in the world of plants indicated that every pro-
cess in nature occurred in cycles. Within such a paradigm, based on the
cyclic aspect of time, even death, which we experience as irreversible
and absolute, may be understood to give way to rebirth. Even matter
that we consider inanimate, such as rocks and minerals, may be under-
stood to mature, fade away, and begin to grow again. Becoming and per-
ishing and becoming again may be the same for all processes in nature,
the main difference being the duration of a cycle (Sivin 1987:53ff.).
The notion of cyclic processes is important for understanding many
processes in Chinese medicine, but not for all. Here we need to bear in
mind that the Basic Questions were edited during the Tang dynasty
(618–906) (Sivin 1993:202). While words, idioms, phrases, and sen-
tences are apparently grounded in Han-dynasty grammar (206 BC –
AD 220) (Keegan 1988:18), the overall text of the classic of Chinese
medicine needs to be seen in the context of the Zeitgeist during the
Tang, when Buddhism was being widely promoted by the Imperial
Court. Buddhist teachings of rebirth and Indian theories of recurring
world-resorption stressed the cyclic aspect of time with regard to ‘all
that concerned processes of biological change’ (Needham 1956:420).
Without any doubt the paradigm of cycles was used in China long
before the ideas that Buddhism brought became known, but it may not
be appropriate to project a cycle onto every process. In the following
two phrases, for instance, the cyclic aspect of time was not central for
understanding change.11
[5] When things are born, one calls it hua (transformation).
[6] When things reach their extremes, one calls it bian (transition).
Zhang pointed out that hua and bian referred to different notions of
change. Hua described the process of a movement or a development.
It also described a change from Formless (wu xing) to Form ( you xing).
To illustrate this, he breathed on his glasses and we observed condensa-
tion on them. Similarly, hua could describe a change from Form to
Formless.12 Zhang raised the example of boiling ‘water that changed
into qi’ (shui hua wei qi). Hua also described a pathological change in
the body, a process of development from one stage to another: a com-
mon cold could hua-develop into diarrhoea. Bian denoted an alterna-
tion or a transition from one state to another. Zhang illustrated this by
burning a piece of paper to ashes. He went on to say that Wind and
Coldness from the outside world ( fenghan), having trespassed into the
inner world of the body, changed into a ‘common cold of the Wind
Cold type’ ( fenghan ganmao).
Zhang’s comments were sparse. He explained these two terms of a
philosophical text with simple demonstrations: the condensation of water
and the combustion of paper. In other words, his mode of interpreta-
tion was indirect and non-verbal. This was significant: he left it to us to
find words and offer a line of interpretation for what he had demon-
strated without verbally clarifying what it meant. Was hua a physical
change of state of the same compound and bian a change due to a
chemical reaction such as a combustion? Was Zhang really extending
the meaning of classical Chinese concepts to processes in modern phys-
ics and chemistry?
11
The Tang editor Wang Bing wrote a lengthy comment on bian and hua which ends in
a quotation that evokes an understanding of cyclic change: ‘Qi begins and thereby
gives rise to transformation (hua), qi disperses and thereby takes Form, qi spreads and
thereby induces luxuriant growth, qi ends and thereby the phenomena are altered
(bian); that which it brings about is one.’ These comments evidently reflect the Zeitgeist
of the Tang.
12
The distinction Chinese medical doctors make between things that have Form ( you
xing) and are Formless (wu xing) has scarcely been discussed in the Western literature.
Kuriyama (1995:219) comments: ‘The attention to dichotomies alien to Chinese thought
[i.e. body–soul/mind dualism] has often led to neglect of distinctions that the Chinese
did make.’
Seeking to understand the meaning of bian and hua in classical texts,

we could conceive of change taking place within different paradigms of
time. Leach (1961) speaks of ‘two basic experiences of time’ (p. 125):
certain changes such as ageing are irreversible, others such as day and
night repeat themselves like the ‘oscillations of the weaver’s shuttle’
(p. 126). Bian-change and hua-change would then refer to these basic
experiences of time. Hua would emphasise the experience of (tempor-
arily) irreversible change grounded in a conception of time as a uni-
directional flow and bian would delimit change by alluding to the repetitive
and oscillatory aspects of time. The difference between bian and hua
does not, however, seem to depend on such notions of time. Rather,
the spatial location of an entity and the position of the onlooker observ-
ing that entity seem to play a role. In this context Xun zi’s (Zhang
1974:248) notion of ‘entity’ (shi) provides a key to understanding the
difference between bian and hua in terms of the subjectivity of the
observer and his position in space. One can read Xun zi as saying that
bian designates change that can be observed from outside an entity,
while hua refers to transformations within it (Hsu 1994).
It is also possible that, contrary to the suggestion evoked by the
parallel presentation in phrases [5] and [6], bian and hua may designate
notions of change that are not opposites.13 Sivin (1990), who studied
bian and hua in the ‘Great Commentary’ (Da zhuan)14 of the Book of
Changes, found, for instance, that bian occurred much more frequently
than hua. In the three instances in which hua occurred as a separate
word it was understood to designate ‘natural change in general, pro-
cess seen whole’ (p. 34). Hua was not the opposite of bian; rather, the
collocation of bian and tong was frequent. Sivin translated bian as an
‘alternation or transformation’ and contrasted it with tong, paraphrased
as ‘continuity’.
If one paraphrases hua as a ‘natural change in general’, as Sivin
(1990:34) did, it is important to be clear about what ‘natural’ meant in
ancient China.15 In modern Western science, metamorphoses such as
the change of a frog into a quail are not ‘natural’ processes.16 The term
13
‘Opposites typically differ only along one dimension of meaning: in respect of all other
features they are identical, hence their semantic closeness; along the dimension of
difference they occupy opposing poles, hence the feeling of difference’ (Cruse 1986:197).
14
What Zhang called ‘The Commentary on the Appended Aphorisms’ (Xi ci zhuan) is in
the sinological literature often rendered as the ‘Great Commentary’ (Da zhuan).
15
‘Nature’ is conceived differently in every culture; see Lloyd (1991b) on the ‘Invention
of Nature’ in classical Greece.
16
The definition of hua in the ‘Canons’ ( Jing) of the Later Mohists (hua, zheng yi ye)
is followed by an example in the ‘Explanations’ ( Jing shuo): ‘A frog becoming a quail’
(Graham 1978:295; A45).
hua, however, refers to conceptions of the universe in which such meta-

morphoses were considered ‘natural’.17 The paraphrase ‘natural change’
is for yet another reason somewhat infelicitous, since in modern West-
ern scientific thought ‘natural change’ is limited by ‘natural laws’. This
modern Western view of nature subject to laws has evolved, according
to Joseph Needham (1956:518–83), from earlier conceptions of lawgivers
and laws. It is intrinsic to a modern reader’s notion of ‘natural’ but not
to that of the ancient Chinese.18
In the ‘Commentary’, bian often described the change of a ‘line’ ( yao)
in the ‘trigrams’ or ‘hexagrams’ (gua) from hard to soft or vice versa.
The opposition of hard and soft was often paralleled by the opposites
day and night, which highlighted the experience of oscillation in time.
At the extremes of day and night, at dusk and at dawn, day changed
into night or, vice versa, night into day. If the notion of bian in the
‘Commentary’ were to apply to bian in chapter 66 of the Basic Ques-
tions, bian might refer to processes conceived of as a change in polarity
between two extremes. In terms of Zhang’s example, the crossing of
the boundary from Wind and Coldness to a common cold would be
viewed as a change in polarity: reaching the extreme and shifting from
the outside to the inside world. Possibly this change in polarity was not
only a process of transition but also a ‘trigger’, with the Outer Disease
Factors (waiyin) Wind and Coldness triggering the Distinguishing Pat-
tern (bianzheng) of the common cold of the Wind Cold type.
This notion of change as a ‘trigger’ is also found in other passages of
the Inner Canon. A phrase in Basic Questions, chapter 5, comes to mind:
‘Yang engenders and yin grows ( yang sheng yin zhang).’ The term sheng
(engendering) implies aspects of triggering. Zhang explained the differ-
ence between sheng (engendering) and zhang (growing) during a later
lesson by saying that without lightning and thunder the plants would be
unable to sprout in the spring. Exploring the implications of the Pri-
mordial (xiantian) cycle and the Worldly (houtian) cycle of the ‘eight
trigrams’ (bagua), he said that the Primordial cycle was best understood
in terms of oscillation between opposite trigrams, the Worldly cycle as
a description of the cycle of the seasons (see fig. 4.2). In the Worldly
cycle, Thunder (zhen) was followed by a Mild Wind (xun), the former
17
Further examples are given in Granet (1934:131) and Needham (1956:431).
18
Consider also pp. 574–5: ‘In 1474 a cock was sentenced to be burnt alive for the
“heinous and unnatural crime” of laying an egg, at Basel; and there was another Swiss
prosecution of the same kind as late as 1730 . . . The interest of the story lies in the
fact that such trials would have been absolutely impossible in China.’ For objections to
Needham’s view, see Bodde (1957, 1979). Bodde admits, in the end, that his is a
‘minority viewpoint’ (1979:154).
Figure 4.2 The Wordly Cycle (above) and the Primordial Cycle
(below) of the Eight Trigrams
initiated the sprouting of the seedlings,19 the latter enhanced their growth
by gently soothing them. Possibly Thunder effected bian-change and
the Mild Wind hua-change; the bian-transition may have had connota-
tions of triggering and the hua-transformation of evolution within a
single entity.
Zhang’s indirect mode of interpretation inevitably led to delibera-
tions in the subjunctive such as these. Instead of providing clear defini-
tions of the words in the canonical text by means of explicit paraphrases
in modern Chinese, he offered simple demonstrations – breathing onto
his glasses and burning a piece of paper – and left it to us to decide
which aspects of them were relevant. This shows how much room he
left for a personal assessment of his indirect interpretation.
The concept of shen and the authoritative mode of

interpretation
Shen is a fundamental concept in Chinese medicine,20 but notoriously

vague and polysemous. In early Chinese writings, shen were hybrid
beings, simultaneously dangerous and sacred. In the concordance of
the Classic of Mountains and Lakes (Shan hai jing (Yu 1980:59)), for
instance, one finds a long list of Spirits (shen) that are hybrid beings
inhabiting different mountains. However, in other traditions, for instance
in the Writings of the King of Huainan (Huai nan zi), shen refers, as in
medical writings, to an impersonal matter-agency (Roth 1990).
In the first paragraph of chapter 66 of the Basic Questions, shen occurs
four times. Zhang gave a separate interpretation for each occurrence
and made no attempt to find an underlying meaning applicable to all of
them. During Zhang’s lesson, phrases [7] and [8] were explained first
and phrase [10] much later; phrase [9] was discussed in another lesson.
This sequencing highlights Zhang’s emphasis on the particularity of mean-
ing and its implications for the authoritative mode of interpretation.
[7] When yinyang is not fathomed, one calls it shen (Spirituality).
Zhang’s comment, in standard modern Chinese: ‘The normal phenom-

ena of nature, the normal metabolisms in the human body; they cannot
19
The role of Thunder is parallel to the role of percussion at the opening of certain
rituals, for example, wedding or New Year festivities (Freedman 1967:17–18) or at the
beginning of a scene in Chinese opera.
20
On shen in Chinese medicine, see Porkert (1961; 1965; 1974:193–6), Davis (1996)
Hsu (in press); on shen in the ‘Commentary’, see Peterson (1982:103–10); on shen in
the Guan zi and Huai nan zi, see Roth (1990).
be researched or exhaustively described; what yinyang cannot explain is

called shen.’21
[8] When the applications of shen are not discerned, one calls it sagacity.
Zhang’s comment: ‘The changes of things.’22

[10] When shen is in the Sky, it is Wind, and when it is on Earth, it is Wood;
when it is in the Sky, it is Heat, and when it is on Earth, it is Fire; when it is in
the Sky, it is Dampness, and when it is on Earth, it is Soil; when it is in the Sky,
it is Dryness, and when it is on Earth, it is Metal; when it is in the Sky, it is
Coldness, and when it is on Earth, it is Water. Therefore, when it is in the Sky,
it is Breath (qi), and when it is on Earth, it takes Form (xing).
Zhang’s comment: ‘Shen implies seasonal changes of nature and refers

to different kinds of materials. Seasonal changes produce correspond-
ing material changes; such are the normal changes of nature, and these
are called shen.’
[9] The applications of change are the profound in Heaven . . . the profound
[gives birth] to shen.
Zhang’s comment: ‘Although the Heaven is profound and mysterious,

its application becomes evident in the “changes of things” (shen). One
can therefore search for the rules of all forms of change in nature by
observing every form of change in things.’
These long and convoluted sentences convey much of Zhang’s style

of commenting on a text. The list allows us to identify a sense common
to all four occurrences of shen, namely, ‘the change of natural phenom-
ena’ which is reminiscent of ‘the change that is the becoming of the
phenomena of nature’ (see p. 109). During Zhang’s lesson, however, we
were far from arriving at such a synthesis of meaning. On the contrary,
shen was taught as having particular meanings in different contexts.
Once, Zhangdi pointed to an interpretation of a concept which con-
tradicted earlier interpretations by Zhang. In general, although he made
an effort, Zhang failed to understand any question. In responding he
would either promise to talk about the issue later and never do so or
elaborate on a sermon in which he would simply ignore the problem
raised. On this occasion, Zhang eventually understood Zhangdi’s prob-
lem. He responded by scolding Zhangdi, saying that he ought to know
the basic rule for reading classical Chinese texts – that what was valid in
21
When we read exactly the same phrase in chapter 5 of the ‘Commentary’ a month
later, Zhang contradicted himself and, citing Sun Zhensheng’s (1981:491) comment,
said that shen meant ‘to make use of the principle of yinyang’.
22
Phrases [7] and [8] probably describe a hierarchy of qualities ascending from yinyang
to shen to sheng, but Zhang did not comment on this.
one context was not in another. After this incident, I never saw Zhangdi
point out contradictory interpretations of a text. In our group Zhang
decided what was valid; he alone had the authority to do so.
The odd number three and the justificatory mode

of interpretation
Confronted with text passages full of numerical statements such as

those in Basic Questions, chapter 66, Zhang insisted that the various
numbers were not an instance of numerology. ‘They have a basis’ ( you
genju), he said; they were grounded in the long-term observation and
experience of the ancients.
In phrase [9], there was clearly a trilogy of Heaven (tian), Earth (di),
and Man (ren). The odd number three occurs frequently as a modifier
of entities in texts of Chinese medicine. There are, for instance, Three
Lights (sanguang) in the sky: the sun, the moon, and the stars. In the
human body there are Three Treasures (sanbao): the Spirits (shen), the
Blood (xue), and the Essences ( jing). According to Zhang, this preval-
ence of the odd number three was inherent in things in the world,
rather than reflecting numerological considerations.
[9] The applications of change (bianhua) are the profound in Heaven, the
Way in Man, and change on Earth. Change gives birth to the Five Flavours, the
Way to wisdom, and the profound to the Spiritual.
Since metonymical analogues came to mind, I understood the text to

describe parallel processes of the Three Geniuses (sancai) or the Three
Poles (sanji): Heaven, Earth, and Man.
Heaven : the profound : the Spiritual
Earth : change : the Five Flavours
Man : the Way : wisdom
Heaven is above, Earth is below, and Man is in between. This trilogy

is one of the most pervasive elements of Chinese thought. The eight
trigrams may be viewed analogically: qian, pure yang, is heavenly; kun,
pure yin, is earthly; and the six trigrams of intermingling soft and hard
lines are human. In the human body these six trigrams of intermingling
yinyang correspond to the six qualifications of the Circulation Tracts
( jing), namely the three yin (taiyin, shaoyin, jueyin) and the three yang
( yangming, taiyang, shaoyang), as referred to in the above text passage.
With this trilogy in mind, one could rephrase the text by saying that the
profound was heavenly, change earthly, and the Way an attribute of
humankind.
I am quite certain that Zhang would not deny that this line of thought
was contained in the text. He might well have mentioned it himself on
another occasion. During this lesson, however, he interpreted the text
as follows: ‘The applications of change are the profound in Heaven and
[they are] change on Earth; change gives birth to the Five Flavours.’
Then the seminar was over. At the beginning of the next seminar we
continued with the second series of phrases without recalling the former
ones: ‘[It is] the Way in Man, the Way [gives birth] to wisdom, and the
profound to the Spiritual.’ This non-linear reading altered the sense of
the sentence. It divided the sentence into two instead of three parts.
The first part, discussed at the end of the first seminar, emphasised the
changes in Heaven and on Earth; the second part, discussed at the
beginning of the second seminar, concerned the Way and Man.
‘You see’, Zhang commented with regard to the first part of the
sentence, ‘all living beings are born on Earth and die on Earth, “there-
fore” ( yinci) we say that “the Spleen is the Basis of the Worldly State”
(pi houtian zhi ben).’ This well-known maxim of Chinese medicine
seemed irrelevant for interpreting the text but Zhang pronounced it
as if it were a direct consequence of the content of the text, using the
conjunction ‘therefore’. Admittedly, one may recognise a macrocosm–
microcosm link between the Earth and the Spleen: the Earth, situated
in the middle of the world, is the mother of life just as the Spleen,
situated at the centre of the Five Organs (wuzang), is the source of
well-being in the Worldly State. Additionally, there was an associative
link between the text, Zhang’s comment ‘living beings are born on
Earth and die on Earth’, and the Worldly State: the Worldly State
usually refers to the events of life on Earth (after birth and before
death). The macrocosm–microcosm relation seems, however, insuffi-
cient to explain Zhang’s use of ‘therefore’.
One need of course not go to China to find people using conjunc-
tions like ‘therefore’, ‘so’, and ‘then’ in inconsequential ways, but I
became convinced that Zhang’s use of ‘therefore’ reflected a certain
habit of interpretation and that it would be unfair to put it down to
carelessness or illogical reasoning – particularly when I found that other
senior Chinese doctors reasoned in similar ways. Moreover, Zhang’s
use of yinci (therefore) in modern Chinese, struck me as reminiscent of
the way in which gu or shi gu (therefore) is used in classical Chinese.
One may object that classical and modern Chinese are two different
languages and that it makes little sense to use the meaning of a word in
classical texts to explain its usage in modern Chinese. Here it is import-
ant to recall that we are exploring not so much the semantics of words
in different languages as the use and so-called ‘performative significance’
of words in social interaction. Zhang was engaging in an activity very

similar to that of his forebears when he provided exegeses of classical
texts. The word ‘therefore’ was, and still seems to be, used as an aspect
of this social practice – a mode of interpreting texts that I propose to
call justificatory.
In classical texts, Chinese writers and commentators often used ‘there-
fore’ in unusual ways. In the Tao Te Ching (Lau 1963), for instance, the
phrases at the end of a verse are often introduced by ‘therefore’. This
conjunction does not seem to indicate a consequence or a causal rela-
tion between the two clauses that it links. Rather, it appears to intro-
duce a phrase that rounds off the verse with a generally valid statement.
A. C. Graham, whom I approached with this problem, was well aware
of it and proposed as translation of gu ‘for this reason we say’ (p.c.,
December 1990). His translation could be understood to mean that
gu linked a cause (namely, ‘the reason we say’) to an effect. It could,
however, equally well point out that a rather lengthy description (an
entire verse) is being placed in correlation with a shorter, summarising
statement (the short phrase at the end of the verse). In Zhang’s case,
‘the Spleen is the Basis of the Wordly State’ would accordingly be taken
as the generally valid end-statement that summarised the contents of
and the comments on the first part of the above sentence [9].
Lloyd (1996:111–12) has devoted some thought to this issue and
presented four cases of the use of gu. In three of these, it introduced a
phrase that repeated a previously mentioned statement.23 In the light of
this I suggest that gu need not always introduce a generally valid state-
ment but may sometimes introduce a clause that refers to a previous
statement. In the fourth example, however, the clause introduced by gu
functioned as a conjunction that introduced a clause referring not to a
previous statement but, arguably, to a previous assumption.24 In all four
cases, the clause beginning with gu rounded off a line of thought and
23
The four cases are all taken from Historical Records (Shi ji), chapter 105, the latter
part of which comprises 25 case histories. In case 1, the patient himself states that he
has a headache (Sima 1959:2797). The doctor provides an explanation in terms of
postulated processes which he ends with the statement: ‘Therefore he had a head-
ache.’ In cases 6 and 18 (p. 2801 and p. 2808–9), gu is collocated with yue: ‘Therefore
I said’.
24
In case 15, the previously mentioned statement is that the patient will die in summer,
while the sentence introduced by gu is: ‘Therefore death occurs when spring comes’
(Sima 1959:2806–7). The previous assumption is given in the phrase that introduces
the entire paragraph: ‘As for that whereby [I knew] that, when spring comes, there
would be a deadly illness [or: death and illness].’ In his concluding clause to this
paragraph, introduced by gu, the doctor says: ‘Therefore death occurs, when spring
comes’ (Sima 1959:2807). A ‘deadly illness’ is not death, but one can assume that
death is involved.
seemed to be a summary. Although this summary was not necessarily

generally valid, it referred in these four cases to the previously known.
Peterson (1982:87–8), considering shi gu (‘therefore’) in the first
paragraph of the ‘Commentary’, suggested that the first five phrases
referred to the realm of Heaven and Earth and that the conjunction
‘therefore’ introduced phrases concerning the processes at work in the
Book of Changes.25 He proposed to view the relation between these two
groups of phrases as one of ‘duplication’: shi gu figured as a conjunction
between different levels of reasoning, reasoning referring to the realm of
Heaven and Earth being ‘duplicated’ by reasoning as recorded in the
Changes.
Peterson’s interpretation that ‘therefore’ was used to duplicate one
level of reasoning by another can be applied to Lloyd’s four examples:
reasoning that describes the conditions of the patient’s illness is ‘dupli-
cated’ in the clause introduced by gu by reasoning with regard to pro-
gnosis or diagnosis:26 gu links two different realms of reasoning, the
former medical speculation about postulated processes in the body,
the latter about prognostic and diagnostic data (that are relevant to the
medical practitioner and directly linked to therapeutic intervention).
This interpretation is consistent with our observation that ‘therefore’
introduces a summary related to a previous statement or a previous
assumption. In Peterson’s example ‘therefore’ introduces a clause refer-
ring to previously mentioned statements in a book, the Book of Changes.
Thus not only is the reasoning in one realm ‘duplicated’ in the clause
introduced by shi gu but the reasoning in its duplicated form relates to
the generally valid or previously recorded.
Graham (1986) discussed the beginning of chapter 3 in the Writings
of the King of Huainan with particular attention to phrases introduced
by ‘therefore’ (gu, shi gu, shi yi). He stated that it was obvious that
‘therefore’ did not provide a ‘causal explanation’ or an ‘unimpeachable
deduction’; rather, ‘each correlative explanation presents what is seen
as the crucial factor among the indefinite number of factors bearing on
25
According to Peterson, shi gu links the first five phrases to the following five phrases.
However, according to Sun Zhensheng (1981:482–3), shi gu links the first five phrases
to only three of the following phrases. If one accepts that shi gu tends to link a rather
lengthier account to a short clause at the end of a paragraph, there is reason to follow
Sun’s interpretation.
26
In case 1, postulated processes inside the body are brought into correlation with a
previously mentioned complaint of the patient. In case 6, signs of illness on the surface
of the body are correlated with the doctor’s previously mentioned prognosis. In case
15, signs of illness on the surface of the body are correlated with a prognosis that is
implicit in an earlier statement. In case 18, signs of illness on the surface of the body
are correlated with the doctor’s previously mentioned diagnosis (Sima 1959:2797,
2801, 2806–7, 2808–9).
the case, very much as we pick out the crucial factor in offering a causal
explanation’ (p. 35, italics added). Whereas, as Graham points out, in
Western reasoning the ‘crucial factor’ tends to be a causal explanation,
in the above examples of Chinese reasoning, it seems to be a previous
assumption. The conjunction ‘therefore’ links different realms of human
experience, and the clause it introduces refers to a previously (some-
times implicitly) known experience.
What motivated Zhang to link the above statements from different
realms of human experience with ‘therefore’? Having read: ‘The applica-
tions of change are the profound in Heaven, and [they are] change on
Earth; change gives birth to the Five Flavours’, he commented: ‘All
living beings are born on Earth and die on Earth’ and summarised by
saying: ‘Therefore, the Spleen is the Basis of the Worldly State.’ Zhang
‘duplicated’ the text from the Inner Canon with a generally known
maxim of Chinese medicine. The maxim ‘the Spleen is the Basis of the
Worldly State’ may have sprung to mind while he was reading the text,
which is not unlikely to happen to a practitioner. This previously known,
generally valid statement of medical practice became for him the ‘cru-
cial factor’. Rather than being interested in the cause as ‘crucial factor’,
Zhang considered a practice-oriented maxim the ‘crucial factor’.
It may have looked as if Zhang took the text as an authority giving
guidance to his practice. The above analysis has however shown that
Zhang’s mode of interpretation consisted of using the text as a means
of justification, it justified a maxim of Chinese medical practice which
had intuitively come to his mind. In referring to an ancient text as an
authority for justifying a generally valid maxim of medical practice, he
subordinated the text to his interests in medical practice. While it is a
commonplace in the West that Chinese medical doctors tend to use the
past as justification of the present (the classical text is used as justifica-
tion of the modern practice), the above analysis suggests that Zhang
himself was concerned more with the interrelation between text and
practice than with the interrelation of past and present (using the clas-
sical text as justification for the modern practice).
Xing and qi and Zhang’s interpretation by recourse to

everyday life
In text passage [10], qi (Breath) and xing (Form) occur as manifesta-
tions of the Spiritual. The Spiritual in the Sky becomes qi and the
Spiritual on Earth becomes xing. Zhang did not comment on the rela-
tions between the Spiritual, qi, and xing in this text, but those familiar
with the notion of qi may be perplexed to find that in this text it is
contrasted with xing. The Breath (qi) of Wind, Heat, Dampness, Dry-
ness, and Coldness is contrasted to the Form (xing) of Wood, Fire,
Soil, Metal, and Water. The manifestation of the Spiritual in the Sky is
Breath and refers to the Five Seasonal Influences (wuqi). The manifesta-
tion of the Spiritual on Earth is Form, possibly referring to the Five
Materials (wuxing).27
Zhang here repeated the demonstration described above: he breathed
onto his glasses. His comment this time was: ‘Water changes into qi,
and qi changes into Form.’ This time instead of opposing the Formless
to Form he opposed Breath (qi) to Form (xing).
Turning to the second part of phrase [9]: ‘[It is] the Way in Man,
the Way [gives birth] to wisdom, and the profound to the Spiritual’,
Zhang explained: ‘Although the Heaven is profound and mysterious, its
application becomes evident in the “changes of things” (shen). One can
therefore search for the rules of all the forms of change in nature by
observing every form of change in things.’ This interpretation, which
seemed to invoke a synopsis of modern empirical and deductive theory,
was too obscure for me, and I asked for an example. Zhang answered
without hesitation: ‘Look at the trees’, he said, ‘They start greening in
spring, are abundant in summer, lose their leaves in autumn, and are
dormant in winter.’ He referred to a very familiar observation of sea-
sonal variation, identified these changes of things as shen, and called
them the profound in Heaven. He understood phrases of high abstrac-
tion in terms of experiences of everyday life. ‘Why does a cow eat grass
and produce milk?’ he asked, and answered:
[11] Xing and qi stimulate each other and through their change give birth to
the ten thousand things.
Such jumps from questions of everyday life to highly abstract explana-

tions were not unique to Zhang’s reasoning but commonplace among
all the senior Chinese doctors I met. The questions they addressed
concerned observations of everyday life or their experiences with TCM
principles (which to them were just as ‘real’ as observations). The answers
they gave employed very general concepts made comprehensible by
reference to observations of everyday life.
27
Wuxing is in this context rendered as the Five Materials in consideration of Graham
(1986:77): ‘Down to 300 BC . . . water, fire and the rest of them are resources pro-
vided by Earth for human labour, explicitly called cai “materials” and included with
grain among the fu “storehouses”. They are not qi at all (it is sunshine, shade, wind,
rain, dark and light, influences from Heaven, which are qi).’ Chapter 66 was composed
in or even after the Tang, many centuries after 300 BC, but the phrases themselves
predate its composition (Keegan 1988:18).
This mode of interpretation is easily dismissed as ‘unscientific’, which

it certainly is. It reflects preoccupations of another kind, highlighting
a principle of the interrelation between Chinese medical writings and
Chinese medical practice which is not the same as that between ‘theory’
and ‘practice’. The generalities expressed in the above passage outline a
‘doctrine’, not a ‘theory’.28 Notions like shen, qi, and xing are ‘empty’ in
that the adept fills them with meaning in the course of learning the
practice of medicine (Boyer 1986; 1990:24–45). They may seem vague
to the newcomer who has no experience in medical practice but their
meanings can be very specific and precise, depending on the particular
encounter with an individual client. With growing experience, the words
may become increasingly polysemous. Since such ‘empty concepts’ are
rarely defined by denotation in the text, they acquire their denotational
meaning in medical practice.29
According to Zhang, the meaning of the writings could not be
understood without experience in medical practice. The writings were
memorised, often without being understood. They became meaningful
in specific instances of medical practice. A follower had to learn when
to remember which phrase of the medical literature was relevant to med-
ical practice. The goal was to gain what Farquhar (1994a) has called
‘virtuosity’ in combining the two.30 Zhang’s mode of interpretation by
recourse to everyday life pointed to a style of knowing that consisted
of the ‘virtuosity’ of combining text and practice.31 What appears to the
outsider as ‘jumps from questions of everyday life to highly abstract
explanations’ is a highly valued skill of combining medical practice with
phrases from the medical doctrine. Although this style of knowing seems
‘unscientific’, its strength for providing therapeutic treatment cannot
be overemphasised, particularly for medical doctors confronted with
‘realities’ of clinical practice that rarely fit a ‘theory’.
28
Sivin (1995d:197) makes the same point: ‘The canons were not meant to be, nor were
they, used as bodies of theory to be studied apart from therapeutic work. A better
word for them is “doctrine”. They were not learned as preparation and set aside. To
the contrary, we can see from the beginnings to the present day that clinical work
gradually reveals to the physician the meaning of canons before his career begins. But
this is a reciprocal process. The understanding of the canons, as it deepens, organizes
and gives meaning to diagnostic and therapeutic acts.’
29
‘Denotation’ is here used in the same sense as ‘reference’ (Lyons 1977:174–229): it
defines the meaning of a word by pointing to the world outside the linguistic system.
30
Farquhar (1994a:2) defines ‘virtuosity’ as ‘a form of experience that links practice to
history and practitioners to knowledge’.
31
Lloyd (1995:30) points to case 22 in Shi ji, chapter 105 (Sima 1959:2810–11), which
emphasises that the interrelation between doctrine and practice is not straight-
forward. This doctor treated his own illness by following the instructions of a text but,
in light of the above analysis, he did so without applying the necessary virtuosity to it.
As a result, he worsened his condition to the extent that he was expected to die.
The first paragraph of chapter 66 of the Basic Questions ended here.

The second lesson continued in a similar manner but soon became
very opaque because of numerological formalism. When I showed little
interest in it, Zhang did not hesitate to abandon the chapter we had just
begun to read32 and proposed to turn to another text, the ‘Comment-
ary’ of the Book of Changes.
Yinyang and the creative mode of interpretation

Zhang considered the ‘Commentary’ one of the oldest texts of Chinese
scholarship and praised it for its profundity.33 It is known for ‘its funda-
mental ideas on the value of the Book [of Changes] and the use that
can be made of it . . . the discussions about development of civilisation
. . . and the maxims of behavior and character formation derived from
the Book’, and has been characterised as a ‘catchall for all sorts of pro-
nouncements about the Book of Changes emanating from the Confucian
school’ (H. Wilhelm (1943)1960:67–8). One of these lessons (11 May
1989) is worth mentioning because it throws light on still another aspect
of Zhang’s interpretation of texts. It concerns his exegesis of yinyang,
which is mentioned for the first time in chapter 5 of the ‘Commentary’:
[12] One yin, one yang, it is called the Way.
R. Wilhelm ((1923)1981), here taken as an example of Western

scholarship, makes it his first concern to date the source material. He
remarks that in the four preceding chapters hard and soft or day and
night are generally taken as opposites and points out that the occur-
rence of yinyang may indicate that chapter 5 and the following chapters
of the ‘Commentary’ were produced later. He then cites an explana-
tion from the Analytical Dictionary of Characters (Shuo wen jie zi (Duan
1981:731)): yin and yang are explained as describing the shady and the
sunny side of a mountain or a river bank. The yang side of a mountain
or a river bank is exposed to the south and the yin side to the north.
In conclusion Wilhelm mentions that the meaning of yinyang is later
expanded to refer to polar forces of the universe and points to the
32
Henderson’s (1991:179) ‘commentarial strategy’, based on the ‘commentarial assump-
tion’ that the canons were profound, implied that ‘those parts of the classics which
were not especially profound or philosophical were all but ignored, and attention was
focused on a few particular books, passages, and ideas in the classics which were’. This
may explain why Zhang had no problem with abandoning the study of a chapter we
had just begun.
33
On the Yi jing see Shaughnessy (1993); on the ‘Commentary’ of the received tradition
see Peterson (1982); on the ‘Commentary’ and others excavated in Mawangdui see
Shaughnessy (1994).
tendency, particularly of later Chinese scholarship, to accentuate with

yinyang the circularity of processes (1981:275–6).34
Zhang, in contrast, showed no interest in dating the text or tracing
the history of the meaning of yinyang. He read us the comments of a
modern Taiwanese scholar:
Among all the changes of phenomena in the universe, there is none which is
not a function of mutually resonating yin and yang. For instance: Heaven and
Earth, light and dark, hard and soft, strong and weak, male and female, and so
on. If there is yin there has to be yang; if there is yang there has to be yin. Their
boundaries are clear, but they have to combine with each other and only then
can they establish themselves. In the process of the intercourse of yin and yang,
yin retreats if yang advances and yang becomes latent if yin becomes evident;
although their quantities are not consistent, they have the alternating functions
of mutual opposition and mutual support in an everlasting circuit. These altern-
ating functions of one yin and one yang are exactly the rule of Heaven, and they
are also the principle of the Book of Changes. (Sun Zhensheng 1981:490)
Zhang praised Sun for the accuracy and richness of his interpreta-
tion. A good commentator did not merely translate classical Chinese
into a more intelligible language but enlivened the text with his per-
sonal interpretation. Someone who aimed at an exact translation was
considered to have shallow knowledge. Like adding salt to a dish, the
commentator was expected to make the text tasty by spicing it with his
personal commentary. Thus, although Zhang appreciated the abundance
of the cited opposites, he felt that it was necessary to add ‘to prosper
and to decline’ (sheng-shuai) and ‘to be preserved and to be destroyed’
(cun-wang). These two opposites may seem merely two additional ex-
amples of the same principle, but to Zhang they were crucial. With
them he had given the text a personal interpretation.
That commentators are encouraged to be creative has far-reaching
effects. Great thinkers of the past presented their thoughts not so much
in the form of monographs as in the form of commentaries (Henderson
1991:3). Commentators elaborated completely new styles and systems
of thinking. Galen is a prime example: he considered himself a com-
mentator on the Hippocratic writings while setting up a new medical
doctrine. ‘There was always more to faithful interpretation than mere
repetition, and sometimes there was sophisticated, original thought stimu-
lated by contemporary debate’ (Lloyd 1991a:399).
The senior doctor’s modes of reasoning

Zhang’s seminars were not built on the idea that there are funda-
mentals and that initial simplification facilitates access to more complex
34
This tendency is also visible in Wang Bing’s comments on bian and hua (n. 11).
issues. With Zhang we read texts of the Inner Canon phrase by phrase,
and the more we read and compared what we had learnt, the more
confused we became – the wider the horizon, the tinier ourselves swim-
ming in a sea of knowledge. There was no certainty on which we could
build, no rigor which provoked contradiction; there was only the faint
hope that gradually we would get the feel of the rhythm in language
and learn to float with the waves of ideas that it conveyed.
Zhang valued highly the experience of the ancients in the classics,
but he did not aim at their historical interpretation. He did not speak
of identifiable hidden meanings. The profound knowledge he aimed at
was practice-oriented – it could not be explained either in writing or in
speech. This knowledge was particular and personal, just like experience.
A mentor cannot teach experience, but he can use the text to convey
his personal insights.
We have seen (chs. 1–2) that the qigong master made no attempt
whatsoever to try to explain anything to his disciple that went beyond
hands-on instructions. The one time I heard Qiu instruct his disciple
verbally he was angry. Memorising incantations, imitating gestures, learn-
ing how to identify the plants in the mountains and grind them into
powder – all these special skills could be learnt without much exegesis.
In contrast to Qiu’s secret knowledge, which was transmitted by imita-
tion and repetition, Zhang’s learning was transmitted by means of inter-
pretation. TCM teachers, in contrast to both, believed in explanation.
For them it was not only those who were ‘predestined’ ( you yuanfen) to
learn who were considered able to acquire knowledge. Knowledge, if
didactically presented, was accessible to everyone. Zhang shared their
open attitude, but he did not believe that knowledge could be explained.
Rather, he provided idiosyncratic exegeses in the context of a personal
relationship. For him there was no generally valid standard of medical
knowledge; each doctor had his own, very personal virtuosity.
5 The standardised transmission of knowledge
With the legitimation of Chinese medicine in the mid-1950s, the Com-

munist Party had instigated a programme for systematising its many
strands and currents. This undertaking is reminiscent of earlier attempts
at compiling and condensing medical knowledge, repeatedly carried
out under government sponsorship throughout the last two millennia,
such as the editing of the Basic Questions (Su wen) in the Tang (618–
906) and again in the Song (960–1279). In recognition of the con-
tinuity that the current efforts have with those in Imperial (Unschuld
(1980)1985; Ma 1994:499–516) and Republican times (Andrews 1996,
Lucas 1982 with regard to health-care policies), I propose to conceive
of them all, past and present, as being directed at a standardisation of
knowledge and practice.
The current standardisation of Chinese medicine, elsewhere referred
to as ‘institutionalisation’ or ‘professionalisation’, goes hand in hand
with its Westernisation and modernisation. The term ‘institutionalisa-
tion’ makes it seem that there had been no institutions of Chinese medi-
cine prior to the current efforts, and ‘professionalisation’ is a notion
coined with regard to Western biomedicine in North America (Freidson
1970), which implicitly emphasises the hegemony of Western biomedi-
cine and its model role for China. By speaking of a ‘standardisation’
rather than a ‘Westernisation’ or ‘modernisation’ one avoids polarising
Western and Chinese cultures or so-called traditional and modern values.
The term ‘standardisation’ is meant to emphasise the continuity of the
ongoing processes with those in the past.
Some of the aspects of standardising the transmission of knowledge
at the Yunnan TCM College were quite particular to Socialist China,
some to Chinese culture in general, others to historical circumstances
in Yunnan province; still others are common to all efforts at standardisa-
tion of the transmission of medical knowledge and practice. They will
be summarised in the last section of the chapter.
128
The standardised transmission of knowledge 129
The setting: a work unit

The Yunnan TCM College, founded in 1960, had 530 employees
including 236 teachers, 91 administrators, 81 members of the school-
intern printing press brigade, 76 workers, 46 laboratory technicians,
and 1000 permanent students in 1988–9. As a work unit, which is an
institution peculiar to Socialist China (see Lu 1989 and Bian 1994 in
contrast to Li 1991), it continued to imply a ‘specific way of life’ in
urban China despite recent economic changes (Hebel and Schucher
1991). Work units, with their facilities for work and administration,
dormitories and apartments, canteens, shops, sports grounds, libraries,
kindergartens, medical stations, sometimes fish ponds or even cinemas,
have been characterised as cells of urban society marked by boundedness,
self-sufficiency, and a certain degree of autonomy. They have traits of
the total institution in Goffman’s ((1941)1975:17) sense in that ‘the
central feature of a total institution can be described as a breakdown
of the barriers ordinarily separating these three spheres of life [work,
leisure, and sleep]’. But Henderson and Cohen (1984:8) rightly point
out that ‘Goffman’s model is based on a Western conception of the
individual’ and that it may ‘blind us to the reality of the experience
from the Chinese point of view’. In an attempt to approximate to the
latter, in what follows particular attention is given to administrative–
functional units or ‘compartments’ and their spatial arrangement on the
work unit compound.
The school was situated in the centre of the modern city, near the
main square where the east–west and north–south axes of the city’s
major traffic routes met. The East Wind Avenue was flanked by the
administrative buildings of the Provincial Parliament, the City Govern-
ment, the City TCM Hospital, and the solid concrete of a Japanese
joint venture, a luxury hotel in the process of construction. The apart-
ment blocks of the governmental units were built in the former back-
yards of the TCM college where fields had been cultivated during the
Cultural Revolution (1966–76).
Like most work unit compounds, the school compound was secluded
from the outside world, surrounded by a brick wall and designed to
be as self-sufficient as possible. The school gate opened towards White
Pagoda Street, where private commerce had been effervescent since the
early 1980s. At the gate there were guards, one in uniform and others –
employees, junior teachers, and students – taking over the responsibility
by turns. The tiny brick cabin of the guards was divided into two even
tinier spaces, one accommodating the night custodian on an iron cot
and the other a bench, a chair, and a telephone (the only one available
to the thousand students).
Connections with the outside world by foot, phone, and mail were all
made through the gate. Opposite the guardhouse were the mailboxes.
The newspaper wall with news from the outside world was also within
sight of the guardhouse. Directives from the inner world were likewise
made public at the gate: it was flanked by a blackboard bearing informa-
tion for Party members and a wall on which administrative announce-
ments were displayed. Most of the staff was housed outside the main
compound and glanced at these walls daily before leaving it.
The gate ensured effective control over the traffic of people and
information. During the demonstrations from April until June 1989,
for instance, one of the college’s five vice directors was stationed at the
gate for several days. The school authorities’ control could be tightened,
and on certain occasions, as on the evening of 4 May,1 the school gates
were closed. After the events of 4 June,2 every visitor to anyone on the
school grounds was asked to write his name and unit in the guard’s
book.3
The concrete sports ground was the largest space within the school.
Open to everyone, it was never deserted. Before dawn, often in com-
plete darkness, qigong and wushu trainees, joggers, and other gymnasts
enlivened it. After breakfast, murmuring students with green books in
their hands started to populate it, learning by heart one textbook pas-
sage after another. Athletics, ball games, and martial arts were taught
here during class time and often continued by groups of players before
and after meals. Sports were the legitimate and favourite activity of
most male and some female students as well as many unmarried male
teachers. And at night, lovers would sit close to each other on the edge
of the field behind oleander bushes in the shadow cast by the moon.
A compartment which stood in stark contrast to the open and often
crowded sports ground was on the other side of the central building. It
was reserved for the brigade which was responsible for housing equip-
ment such as furniture and electric installations. A few single-storey
houses, a workshop, and some offices surrounded a space which was
open and very quiet, especially at noon when the sun was flickering on
the white ground and the workers were dozing in the shade of a brick
wall.
1
On the 4 May movement, see Schwarcz (1986).
2
On 4 June the people’s movement in Beijing was crushed by military intervention (see
for instance Pieke 1996:183).
3
This practice was implemented in the colleges of Kunming only during the first month
after the 4 June incident. In other cities such control over visitors was routine.
The brigade responsible for cars occupied a lofty corner of the com-
pound. Several lorries, school buses, and cars were sheltered in well-
maintained garages. At the end of 1988 the car brigade had expanded
and the adjacent bicycle lot had been moved to a much smaller area.
The compartment of the bicycle lot, like that of the school garden
(which consisted mainly of a greenhouse), was framed by an iron fence.
When it was reinstalled in an area with several rows of cypresses, trees
were felled or branches cut only where necessary to accommodate the
iron-sheet of the shed. Finally, a tiny brick house with a door and an
iron-barred window was built, big enough to hold a stool and a small
stove for the custodian. The requirements for an independent compart-
ment seemed fulfilled.
Less visible but just as distinct were the quarters of the school admin-
istration which occupied the first and second floors of two buildings
built in the Socialist style of the late 1950s. The architectural style and
the building material of these constructions were qualitatively superior
to the concrete of the classroom building or the soft red brick of the
library. The rooms had the luxury of wooden floors, a matter of major
significance in the continental climate of Yunnan, where temperatures
fluctuated between burning heat and freezing cold.
On the ground floors of the administrative buildings were the work-
shops and offices of the printing brigade. The printing press was loc-
ated on the ground floor of the central building and announced with
rhythmic noises the college’s printing productivity, scholarly and admin-
istrative, the latter being considerably intensified in autumn 1989.
At the far end of the compound were huge vessels for boiling
thousands of litres of hot water daily. The kitchen of the two school
canteens, one for Han Chinese and one for Muslims, was installed in
their proximity. This corner of the compound was at intervals extremely
crowded. At mealtimes, hordes of students jostled to get at the tubs
from which, with large spoons, the food was dumped into their enamel
bowls. The canteen was large and airy, but it lacked tables. The stu-
dents took their meals in their dormitories, sitting with bowls in hand
on the edges of their beds. After lunches and suppers the jostling con-
tinued, this time in front of the hot water taps to fill the two thermos
flasks for each dormitory. Thereafter crowds of students streamed to
the corner behind the steaming vessels to take showers.
A woman, in charge of accepting the tickets (0.2 yuan each), sat on a
chair in front of the showers, well-sheltered under the wide and large
bamboo hat which she wore in sunshine and in rain. Twenty showers,
two to three of which were constantly out of order, were available three
times a week for women and men on alternate days. They had to meet
the needs of the thousand residential students, the hundred to two

hundred short-term students, and three hundred or so employees and
their family members who had no sanitary facilities in their apartments;
everyone I knew took a shower at least once a week. Waiting times
varied between one-quarter to three-quarters of an hour and once un-
der the jet of hot water each person would take at least half an hour.
Usually two people would use one shower and soap and rub each other
with much vigour. In this dim light, in warm dampness and in steam,
colleagues would meet each other and, with few exceptions, not be shy
to be seen totally naked washing and walking around.
A large new toilet block was situated behind a slogan wall directly
opposite the school gate.4 In urban areas, toilets are usually contained
in ten to twenty small and open compartments. Toilet compartments
were often occupied, one person after another squatting in silence on
her own, sometimes reading in the dim light, usually just staring into
nowhere. In spite of its smell, this area seemed to be sought out as a
place of privacy and retreat.
At the end of 1988 the walls along White Pagoda Street were torn
down and a row of shop units built to be rented to private merchants
for 1,000 yuan per month. With shops as walls the boundaries of the
unit became blurred. Opening towards the outside had in fact begun
two years earlier. First the Department of Traditional Chinese Pharma-
ceutics (zhongyaoxi) had opened a store to sell drugs, with the profits
going partly to the department and partly to the individuals involved.
Then the Department of Traditional Chinese Medicine (zhongyixi) had
installed cabinets for consultation in which the school’s most able doc-
tors were allowed to give consultations three half-days a week, with the
profits again being shared by the private person and the department.
Finally, in summer 1989, the college dispensary rented a small room
from the college authorities which was open to the street. The main
staff members were biomedical doctors, and with the consultations they
provided to outpatients they could make modest personal profits.
Formal inquiries
Assistant teachers: semidirected interviews

Some of the assistant teachers and I became good friends. We met to
talk in the late evenings, went to the cinema together, and had lunch
4
On the 40th National Day, 1 October 1989, the former slogan was white-washed. It
was not replaced by a new one.
together at least once a week. In May and June 1989 we used to meet
regularly in front of the research students’ television to watch the
7 p.m. news. In November 1989, the month before I left, I performed
semidirected interviews with all the assistant teachers of the acumoxa
and massage staff.
In retrospect, it is apparent that semidirected interviews are the method
best suited to anthropological inquiry in a Chinese work unit. The
mode of interaction was a conversation which could only continue if
both parties understood each other, which meant that short and gen-
eral responses could be clarified. The interviews usually took place in
the teacher’s dormitory after lunch or supper. Most college teachers
knew that I was studying ‘medical anthropology’ ( yiliao renleixue), and
many were curious to know more about this field of study. Since most
of them had experience in answering questionnaires, they expected a
similar mode of inquiry. I met their expectations with a series of ques-
tions on age, sex, profession of parents, place of birth, and educational
background at the beginning of each interview. This drew a clear line
between our daily interaction and the more formal talk. I signalled
that what they would tell me thereafter would be data I would write
about.
I hoped, nevertheless, to create a more informal atmosphere, and,
indeed, by the time we started to talk about their educational back-
ground the interview had usually taken an individual course and some-
times become much more personal than expected. Topics of discussion
were, apart from their life histories, their motives for studying TCM,
their attitude towards their profession, their favourite subject, their
view of acumoxa and qigong and of the future of these disciplines, their
evaluation of students’ opinions on TCM and Western biomedicine,
their goals in teaching, and whether learning from classical texts was as
important as Western medical training. I interspersed these standard
questions during our discussions hoping to digress into topics about
which they wanted to talk. We often talked for an hour and a half or
even more. Some encounters were very moving; others ended with
remarks like: ‘Your questions make me think’ or ‘You look at things
differently, but that’s exactly what I found interesting.’
Students: questionnaires
The information gathered on the students is based mostly on our joint
classes and clinical training in the mornings between September 1988
and December 1989, which I spent mostly with ‘specialists of acumoxa
and massage’ (zhenjiu tuina zhuankesheng), but also with ‘regular TCM
undergraduates’ (zhongyi benkesheng). Additionally, throughout my stay

I had lunch with them about twice a week, as well as making irregular
visits in the afternoons. In December 1988 I carried out an inquiry by
questionnaire during our lunch breaks and interviewed about five male
and five female students from each year in their dormitory rooms,
repeating eight times the same procedure: I read out standard questions
and they replied on paper. They were in general eager to be questioned
and cooperative and usually concentrated as if they were taking an exam-
ination. Later I hired assistants to set up tables for statistical purposes.
The evaluation of the students’ answers turned out to be extremely
difficult because the answers I obtained in the questionnaires diverged
at times significantly from my own observations and informally gathered
information. There was a discrepancy between what I thought the stu-
dents felt and their written responses to the questionnaire. This has
partly to do with the nature of my questions, which sometimes touched
on topics that concerned personal inclinations, and partly with their
register (style of expression) and language use. Their formally phrased
answers seemed partly to accommodate to social expectations and partly
to result from a reluctance to think in a way that I call detached-from-
the-environment. I have no doubt that they were honest.
Graduates: letter questionnaires

Most graduates were sent to work in the ‘county town’ (xiancheng) they
had come from. Since the majority had come from an area which is
remote and ‘closed’ to foreigners (bu kaifang), it was difficult to get
in contact with them. Therefore, I asked for permission to send them
letter questionnaires, and the college authorities were extraordinarily
cooperative. One hundred questionnaires (but no more) were printed
by the college’s printing press and in November 1989, together with
a cover letter from the administration, sent to the addresses I had
obtained from teachers and colleagues.
The official sanctioning of the questionnaires was made possible only
by my agreeing not to ask about the graduates’ ‘personal interests and
activities of everyday life’ (sixiang he shenghuo wenti). This did not much
affect the proposed content of the questionnaire, because I was inter-
ested in their training and professional life, namely, the use graduates
made of TCM textbooks, journals, and books at their workplace; a
description of the work they performed daily; and their view on TCM
curricula. Graduates tended in any case to answer any question that
touched even slightly on personal issues in vague terms – even a ques-
tion so easily answered as the difference in livelihood between a doctor
and a student. Those questions were in passing addressed in semidirected

interviews conducted with fourteen graduates in hospitals and clinics in
and around Kunming who, in the course of completing the letter ques-
tionnaires, had also made comments useful for interpreting the other
answers sent to me by mail.
More than three-quarters of the acumoxa and massage graduates
and about half of the TCM graduates sent replies in which most ques-
tions were conscientiously dealt with. I acknowledged their cooperation
by sending the preliminary results of the questionnaires to the college
authorities and to all sixty respondents in March 1990. The responses
to the letter questionnaires were much more uniform than those of
the students. This has partly to do with my mode of inquiry (mostly
multiple-choice questions), but one can also view this uniformity as a
result of standardised instruction. Graduates had evidently learnt how
to reply to standard questions with standard phrases.
Interviews with the administration

From May to July 1989, I interviewed an official in the college’s foreign
affairs office fortnightly. He welcomed it, and it kept us on good terms
during this exciting but tense period of Chinese politics. He explained
to me with great patience the structure of administration and intro-
duced me to other members of the administrative staff. In December
1989 he arranged two short meetings with the City Health Bureau and
the Provincial Health Department and one with cadres in leading posi-
tions of the college administration.
The teachers
Many of the details on TCM teachers’ life histories, livelihood, motiva-
tion, and future prospects are characteristic of the staff of government
work units throughout the PRC. The problems addressed here – under-
employment of young staff, the struggle for a livelihood of the married
staff, and the enormous workload for the senior staff – have arisen
mainly from historical circumstance. Some aspects of the teachers’ con-
dition are, however, characteristic of any standardisation of the trans-
mission of knowledge.
Firstly, teachers were hierarchically organised into ranks – assistant
teachers, lecturers, associate professors, and professors (see table 5.1).
Rank determined duty and salary, special rights, and the general re-
spect with which a cadre was treated by superiors and colleagues. This
hierarchical organisation was, however, strict only on paper. In practice,
Table 5.1. Ranks and salaries of TCM teachers
Rank Monthly salary 5 ( yuan)
assistant teacher (zhujiao) 76

lecturer ( jiangshi) 108
associate professor ( fujiaoshou) 135
professor ( jiaoshou) 150 / 200 / 400 and sometimes more
administrative standards were not implemented systematically but mani-

pulated with flexibility and much attention to the particular. As a result,
the staff tended to form clusters in terms of kinship relations, a com-
mon native place,6 comradeship during school and university studies,
or a shared revolutionary background. This did not hinder anyone from
continuing to profess the hierarchical order of the bureaucracy, but
everyone who dealt with it took the clusters into consideration.
Secondly, the teachers’ lives were often marked by a lack of direct
correspondence between their efforts and their rewards. Often, major
decisions in the teachers’ lives had been made on grounds of particular
circumstance and historical accident. Personal initiative was generally
met with suspicion; life in a work unit meant being subject to institu-
tional constraints which actively fostered indifference towards work and
working relations – an inevitable consequence of standardisation.
The xiaxiang year: alienation from the profession

The career of young staff members usually began with a compulsory
year of teaching English at a ‘high school’ (gaozhong) in a county town.
Although ‘going down to the countryside’ (xiaxiang) lasted only a year,
all the assistant teachers I interviewed considered it ‘a waste of time’,
‘boring’, ‘a very bad time’, ‘a much disliked experience’, ‘with financial
5
The monthly income consisted of ‘salary’ (gongzi), ‘bonus supplement’ ( jiangjin), sup-
plements for ‘medical treatment’ ( yiyao), ‘gas’ (meiqi), ‘water and electric’ (shuidian),
‘cereal supplements’ (liangtie), and many more. The bonus supplement modified the
monthly income most significantly. In certain collectives but not in educational work
units such as the college it constituted 150–200 per cent of the salary. This additive
composition of the monthly income allowed for much flexibility; during my stay teachers’
monthly income was often modified.
6
National identity was generally of minor importance in comparison to identification
with one’s native place (Wodiunig 1992:41, 137), possibly with the exception of the
‘Muslim’ (huizu). The Yunnan Muslims, who trace their origins to Khubilai Khan’s
army, have ever since 1253 constituted an important minority.
and intellectual drawbacks for the profession’. Only one, the youngest,
eventually agreed that ‘there were advantages’ ( you haochu) for urban
youth in being sent to rural areas.
The three cleavages of Chinese society – between classes, between
centre and periphery, and between rural and urban – were a common
concern among urban residents. Mao’s policies for overcoming them
had been abandoned, and recent developments such as key schools
(Bastid 1984:194) had widened the rural–urban cleavage to a gap that
Potter and Potter (1990:296) have characterised as castelike. Aware of
this gap, the youngest teacher I interviewed agreed that going to the
countryside was positive for her personal experience, but she insisted
that this benefit was minimal in comparison with the professional draw-
backs of that year.
Another teacher, Hu, would have found it reasonable to be sent to a
village medical station or a county hospital. He emphasised how devast-
ating the alienation from his profession was due to this first year of
employment as an English teacher, very much aware of his poor Eng-
lish. However, he said that having been sent from the cultural metro-
polis Shanghai into a rural nowhere he had matured markedly during
this year. He struck me as someone well adapted to the social demands
of a work unit. This became obvious, first of all, from the course of our
interview that consisted of a series of question–answer exchanges last-
ing less than an hour. Hu gave clear answers to every question and sat
silent while I took notes, awaiting the next question. Not once did he
offer an additional thought, memory, or topic for discussion. This did
not mean that he was uncooperative; when I asked him, for instance, to
substantiate his argument with another example, he made the effort to
think of one. He was not unwilling to express personal viewpoints, but
he would not reveal anything about himself without seeing a definite
reason for doing so.
When I asked him whether he enjoyed the work of his profession, he
answered: ‘It’s all the same to me’ (wusuowei).7 Chinese medicine meant
to him as little today as in the past. His plans for the future? None. Any
interests in research, hope of going abroad, desire to work in the clinic
only? No. He neither particularly liked nor disliked his profession, Hu
explained, and there was no sense in cultivating any hidden wishes for
the future. This wusuowei attitude was not only widespread among his
colleagues but generally encountered among many cadres in work units.
7
Considering that this interview took place in November 1989, wusuowei may have had
political overtones, since it was one of the last things Zhao Ziyang had said to the crowd
on Tiananmen square before he resigned on the eve of 4 June (Wang Jun, p.c.). The
attitude I refer to was, however, widespread in work units well before 1989.
In response to my question of what he usually did in his spare time,

the answer was ‘Watch TV’. And on Sundays? ‘Sleep, read novels, or
see friends’. His answers were in content similar to those of his col-
leagues. What about hobbies? He sometimes played tennis with his
father, whose work unit had courts. Moreover, he liked Western class-
ical music and played the guitar quite well. I wondered whether he
maintained a richer inner life than it seemed.
Hu was certainly one of the best-adapted cadres at the college. Adapt-
ation to life in a work unit consisted of maintaining a minimum of
interest in his profession without losing a certain sense of responsibility
towards his patients, keeping discreetly informed about current events
while maintaining a low profile, and avoiding gossip in the unit while
cultivating an inner life. The experience in the countryside had fur-
nished him with an indifference that would last a lifetime.
Assistant teachers: underemployment
‘Assistant teachers’ (zhujiao) lived, like students, in dormitories. The

differences were that a teacher shared a room with one to three col-
leagues while a student shared it with six to eight and that the electri-
city was not cut off after 10.30 p.m. in the teachers’ house.8 I rarely
heard assistant teachers complain spontaneously about housing, food,
and sanitary conditions, even jokingly, although when I raised the subject
they had many complaints. This absence of actively voiced complaint
may be explained by their perception of their status as temporary and
comparatively prestigious.
The work morale among the acumoxa and massage assistant teachers
was relatively high.9 This does not mean that their lectures were didact-
ically well structured, let alone lively or inspiring. On the contrary,
teachers often repeated more or less verbatim passages from the text-
books, which some had memorised word for word, often in a monoton-
ous voice. A senior teacher corrected most of their lecture notes and
sometimes supervised their lectures, which they generally prepared con-
scientiously. Officials explained that they recruited only graduates who
8
Several unmarried teachers lived in their parents’ homes but still claimed beds in the
teachers’ dormitory; this was the only way they could secure their right to claim an
apartment from the college once they were married.
9
Acumoxa and massage courses were offered at the college from 1986 onwards. The
young acumoxa and massage staff had been sent to the Shanghai TCM College as
‘regular students in acumoxa and massage’ (zhenjiu tuina benkesheng) in 1981 and 1982
(Hsu 1996c).
had been excellent students and were politically sound (not necessarily
Party members). To be employed at a college was considered more
prestigious than to work at a hospital.
All assistant teachers felt underemployed, and many wanted to work
more: ‘It’s mid-term now, and next week I will be allowed to give my
first lecture.’ ‘This college doesn’t care about its young staff and least
about the acupuncturists.’ ‘Here young people can’t bring their enthu-
siasm to bear fruit.’ ‘Young people don’t like to do nothing.’10 In con-
trast to the majority of students (see below), the assistant teachers were
interested in their subjects. I found much individual initiative among
them: one teacher arranged part-time work in a private practice for
several weeks during the summer vacations for herself and two col-
leagues, another made use of his ‘connection’ (guanxi) with a doctor at
a hospital and worked three mornings per week (without pay) as one
of the doctors in the hospital ward. Yet another spoke of contacting
a friend of a friend to pursue her interest in children’s massage.11
This teacher was in addition taking three different evening courses in
English.
These three teachers tried to keep their undertakings as inconspicu-
ous as possible. Their motivation may have been suspect because all of
them fostered the private hope of going abroad,12 but teachers who had
no wish to go abroad kept their personal interests secret too. During an
interview I watched with bewilderment how one teacher climbed onto
her cupboard, opened her suitcase, and pulled out a stack of books on
qigong that she had bought with savings from her salary. With these
books in her hands she revealed fantastic dreams of going with her
brother, who was a truck driver, to Sichuan province to venerate the
famous qigong master Yan Xin. It was obvious that individual initiative
was not encouraged by the work unit members or superiors. Private
initiative was no longer decried as bourgeois and capitalist, but ambi-
tion was met with suspicion and outstanding talent with envy: ‘Never
make a work unit member your friend.’ Social control in work units
was to a large extent effected through gossip which sometimes entered
the more formal forum of political education on Friday afternoons.
10
Cf. Bastid (1984:198): ‘With four students to one teacher, China’s higher education
probably boasts the lowest rates in the world. Such low ratios, however, reflect low
teaching loads rather than small classes.’
11
Children’s massage, hardly known in the West, is said to be most effective against
digestive disorders and emotional imbalance.
12
In 1996 one of them had left China on his own initiative, and Hu had temporarily
been sent to Spain as a lecturer on a newly established acumoxa course organised by
the college and an acupuncturists’ society near Barcelona.
140
Table 5.2. Recruitment of the junior acumoxa and massage staff
Period of TCM High School CCP Father’s Mother’s Influence on Choice of

Group* TCM Studies College Education Membership Occupation Occupation TCM Studies
A 73–76 Yunnan Kunming 1975 Cadre Cadre CCP propapanda group

74–77 Chongqing Chongqing WBM doctor WBM doctor CCP slogans and parents
B 77–82 Yunnan Zhaotong 1981 Cadre Cadre Good in classical Chinese
79–84 Yunnan Kunming 1984 Cadre Cadre Own wish
C 81–86 Shanghai Kunming Cadre Cadre Family
81–86 Shanghai Jinghong 1985 School director Worker Family
81–86 Shanghai Wenshan Cadre Employee Family
81–86 Yunnan Zhaotong TCM doctor Worker Family
81–86 Shanghai Henan Province 1986 Army general School teacher Own wish
D 82–87 Shanghai Qujing 1984 University lecturer WBM doctor Family

82–87 Shanghai Kunming 1987 Cadre Cadre Own wish
82–87 Shanghai Lincang Cadre Cadre Mother’s and own wish
* group A: lecturers who had been educated as worker-soldier-peasant students

group B: lecturers who had passed the first nationwide university exams, for which they had prepared at home on their own initiative
group C: the first group of assistant teachers recruited and trained at Shanghai to teach the acumoxa and massage course at the Yunnan
TCM College (with one exception)
group D: the second group of assistant teachers trained in Shanghai
Lecturers: struggle for a livelihood

The responsibilities of a ‘lecturer’ ( jiangshi) were little different from
those of an assistant teacher, but because most lecturers were married
their living conditions were different. To marry was ‘to have one’s life
problem solved’ (wenti jiejuele), to step into adulthood. Female assistant
teachers in their late twenties were under considerable pressure to marry.
Their superiors were not embarrassed to talk with them about this issue
in a casual way, and close colleagues arranged meetings with young
men they considered suitable. Between 1988 and 1990 four assistant
teachers married, one of whom had been ‘introduced’ ( jieshao) to her
partner in this way. A married couple had the right to claim an apart-
ment, but only one of the five married assistant teachers had been given
one (he was divorced a year later, but could keep it).
Complaints by married couples were considered legitimate and were
frequent and often substantial. Family life was known to increase ‘daily
problems’ (shenghuo wenti). One couple had been waiting for years to
be assigned an apartment, another lived apart in different provinces,
families had difficulties in making ends meet, children needed schooling
and grandparents medical care, housing conditions were cramped, and
inflation was soaring. The college administration was apologetic: ‘China
is a poor country, and this work unit is the poorest college in Kunming
city.’ Teachers were cynical: ‘What do you expect after the politics of
the past forty years?’ Or indifferent: ‘The college administration is bad,
but which one isn’t?’
Lecturers, in particular, had experience in dealing with the college
administration as an aggregate of clusters rather than a hierarchy. They
all had a rather peculiar biography (groups A and B in table 5.2). The
Cultural Revolution had had a great impact on their education, and
they had had a difficult time reaching their position.13 Their experiences
had demonstrated to them that norms were negotiable. Independent of
previous initiative and personal history, they were simply disillusioned,
probably precisely because of their endless struggle. For instance, two
teachers of this ‘lost generation’ answered my question about the future
of Chinese medicine in exactly the same way, by drawing a circle on a
piece of paper. The first commented in the Party’s terminology: ‘Diffi-
culties with development’, the latter sighed: ‘eighty million illiterates, a
two-thousand-year-long history, impossible to get out of this.’ Despite
their contrasting careers – one had been a ‘worker-peasant-soldier’
13
Gold (1991) differentiates between the 1970s, 1960s, and 1950s cohorts, which roughly
correspond to the age-groups discussed here. He characterises the 1950s cohort as
showing the most initiative; I found that it showed most disillusionment.
(gongnongbing) student recruited in recognition of his ‘revolutionary’

background, the other was the offspring of the ‘stinking old number
nine’ (chou laojiu), as the ‘intellectuals’ (zhishi fenzi) were called at the
time – their view of China was similar. They could not rid themselves
of the feeling of going in circles.
Motives for the choice of the profession
The lecturers had graduated from high school in the early 1970s, the
assistant teachers in the early 1980s, and their reported motives for
deciding to study TCM had been different. The lecturers had followed
the Party line and done it for ‘society’ (shehui). The majority of the
assistant teachers, by contrast, had followed the advice of their parents
or elder siblings and done it for the ‘family’ ( jia). The lecturers assured
me that their choice had not been imposed on them – that they had
sincerely believed the Party and willingly followed its directions. The
assistant teachers maintained, likewise, that their parents had not forced
them in any dictatorial way; their parents’ advice had simply had most
weight, certainly more than any individual’s desire. ‘At that time, we
did not know anyway.’ The lecturers expressed their motives for study-
ing medicine as follows: ‘With medicine you can serve the people’;
‘Chinese medicine is our cultural heritage’; ‘Society needs and selects
you, follow the needs of society’; ‘It sounds hollow to say this these
days, after the reforms of the eighties, but we firmly believed in serving
the people, only ten years ago.’ Assistant teachers said: ‘It’s best to have
a doctor in every family’; ‘Your elder sister studied Western medicine,
you ought to complement her studies with Chinese medicine’; ‘Your
grandfather was a “herbalist” (caoyi), we have to keep the tradition in
the family.’ In both cases, the question was not: ‘What do I want?’ but:
‘How do I fit best into the whole?’ Relationships were important. Just
as in Chinese paintings in which a human being is a dot in a vast
landscape, the individual’s importance lies in its location in the land-
scape rather than its size and shape.
Regardless of their motivation, lecturers and assistant teachers had
one significant feature in common: they were all the offspring of cadres
(see table 5.2). In two cases, at least one parent was a Western medical
doctor. Only one was the offspring of a Chinese doctor, and she had
been recruited because, as she told me, one of the vice-presidents had
considered her performance during the oral graduation examinations
brilliant. She was an exception, and she was not accepted by her
Shanghai-trained colleagues who considered her naive.
Senior staff: pillars of the college

In 1989 the Yunnan TCM College had fifty-seven positions for ‘associate
professors’ ( fujiaoshou), all of them occupied, and eleven for ‘professors’
( jiaoshou), seven of them vacant. Among the seven retired professors
some were nationally known; with others who had not survived the
Cultural Revolution they had been responsible for the college’s good
reputation in the 1960s.14
In the early 1980s an attempt had been made to improve the quality
of the teaching staff. Though generally overlooked in the Western lit-
erature, it may not have been coincidence that the ‘movement against
spiritual pollution’ ( fandui jingshen wuran) of 1982–3 occurred in the
year in which the first lot of students who had passed the university
entrance exams graduated and had to be assigned positions. During
that period the college also recruited experienced doctors from all over
the province by offering them associate professorships. Three of the
four associate professors, who were considered among the best teachers
and therefore allowed to give tuition to a foreigner, had accepted this
offer: one had worked as a doctor in an industrial centre, another had
been head of an acumoxa and massage department in the capital of an
autonomous perfecture, and the third had been an English teacher in a
rural high school.15 In the streets of Kunming I encountered two pri-
vate practitioners, both of whom had held important cadre positions
before the Cultural Revolution, who claimed to have been offered such
positions as well. They had declined the offer and instead established
thriving private practices building on networks with the government
cadres they had known earlier in their careers.
It is not insignificant that the three associate professors were women
while the two in private practice were men. China’s ‘Revolution Post-
poned’ (Wolf 1985) has been reinforced for Chinese doctors, at least
through the reforms of the 1980s. In all the private practices that I saw,
women were wives or employees. Private practices, like small-scale busi-
ness, are conducted at the level of households, and household represent-
atives tend to be male. As we have seen, a doctor’s reputation depends
14
Among them were three of Kunming’s four ‘famous senior Chinese doctors’ (ming
laozhongyi): Wu Peiheng (1888–1971), Dai Lisan (1901–68), and Kang Chengzhi
(1899 –1970). For short biographies of all professors, see Zhang (1989:151–222).
15
It was most unusual to hire an associate professor from such a low-status position and
such a remote area (where she had been sent after graduation from 1969 to 1984,
because of her family background). Her father was a retired professor at the college.
One could speak of nepotism, but this would not do justice to the situation, which was
very complex. Sometimes negotiable norms allow for an appropriate handling of par-
ticular cases.
on ‘experience’ ( jingyan), which has more to do with popularity than with

skills. Experience was obviously more readily attributed to grey-haired
men than to capable women.
The above women all complained that an associate professor had
very heavy responsibilities and very little pay or prestige. They taught
courses for which younger teachers were not qualified, supervised assist-
ant teachers, performed administrative work, and were often successful
clinicians. ‘There is a huge gap in the teaching staff between us and
the teachers, who have had hardly any work experience, and we have
to fill it.’
Associate professors were, moreover, expected to perform clinical
research. The year before, an associate professor and one of the assistant
teachers had produced a research proposal in the field of ‘experimental
acumoxa’ (shiyan zhenjiuxue), examining the effects of different needling
procedures at the same acu-points (xuewei)16 on the pulse, blood pressure,
and body temperature of rabbits. Their proposal was rejected because
the college administration preferred research which promised immediate
financial benefits, such as a research project that was aimed at developing
a cigarette which contained, apart from the famous Yunnan tobacco,
Chinese medical herbs with soothing effects on a sore throat. However,
the main research performed by the college staff was neither experimental
nor clinical but consisted of writing and revising TCM textbooks.
Summary
As the college authorities pointed out, only the best students and the
politically sound were kept at the college as teachers. Their employ-
ment had to be approved by the province’s Ministry of Education,
while TCM doctors in hospitals were approved by the Ministry of
Health. Almost all were offspring of cadres, and several were Party
members. This meant that TCM teachers were generally not recruited
from the offspring of senior Chinese doctors,17 who were bound to
have witnessed in their childhood the efficacy of ‘superstitious’ (mixin)
medical practice. The teachers who produced the TCM knowledge,
and modified and reproduced the textbooks were not bound to family
16
Xue means ‘opening’ or ‘cavity’, therefore its translation as foramen (Porkert 1974:199),
locus (Sivin 1987:258–64), and Hole (Unschuld 1988b:71/76). In TCM, there was a
tendency to conceive of the ‘position of the cavities’ (xuewei) as a point on the body
surface for inserting needles; therefore, it is rendered here as acu-point, following Lu
and Needham (1980:13). The term shuxue which invoked the classical meaning of
acu-points, are rendered as acumoxa loci.
17
Cf. Farquhar (1994a:207, n. 10): ‘Many “old Rightists” were deprived of opportunities
to teach from the mid-1950s to the 1970s.’
tradition and were likely to be more open to ‘scientific’ (kexuehuade)

innovation in medical doctrine.
The students
There are many issues worth exploring with regard to the standardised
mode of transmitting knowledge and practice, among them the recruit-
ment of students, students’ commitment to their studies, and their
prospects of employment after graduation. In contrast to a disciple like
Qiudi or a follower like Zhangdi, the students at the college were not
recruited on grounds of kin relations or personal character, and they
did not have to prove their commitment to their master or mentor in
everyday life. Students were placed in a passive mode, and this made
the question of their commitment to their studies the more salient.
Recruitment
The ideal for recruitment was equal opportunity for everyone. This was
implemented by a quantitative assessment of qualifications, namely,
examination marks at high school graduation.18 More than a hundred
students were recruited annually, and the sheer numbers seeking in-
struction demanded that the mode of transmission be depersonalised
and the period of learning limited – five years for regular TCM stu-
dents, four years for regular students in Traditional Chinese Pharmacy,
and three years for acumoxa and massage specialists.19
Students were recruited from high school graduates in the natural
sciences. This policy made university studies in TCM a field of studies
like biomedicine, for which knowledge of mathematics, physics, and
chemistry was believed to be indispensable. However, most acumoxa
and massage freshmen said that, having been trained in the natural
sciences, they found it difficult to grasp the style of knowing Chinese
medicine, which is grounded in ‘experience’ ( jingyan) and ‘virtuosity’
or, as TCM teachers put it, ‘flexibility’ (linghuo zhangwo). ‘In high
school I learnt how to apply principles “mechanically” (siban). Now, I
18
In Yunnan, in the 1980s, ‘elementary school’ (xiaoxue) took five years, ‘middle school’
(zhongxue) took three years of secondary school and three years of high school. ‘Second-
ary school’ (chuzhong) was completed with graduation exams equivalent to O-levels.
At the end of ‘high school’ (gaozhong), which emphasised the study of three subjects,
came exams equivalent to A-levels.
19
‘Research students’ ( yanjiusheng) for a ‘doctorate degree’ (boshi) could not be accepted
at the Yunnan TCM College. Postgraduate studies of three years to attain the equival-
ent of a ‘master’s degree’ (shuoshi) could be pursued with only one professor, who left
the college in 1992, Prof. Zeng Yulin.
still have not managed to master the flexibility required for following
the course of the Fundamentals ((Zhongyi) jichu lilun).’
When I asked teachers and students why high school graduates of the
arts and literature were not recruited, many of the younger teachers
said that they had never thought of this alternative, and some wel-
comed it because they had encountered these difficulties themselves.
Others insisted on the importance of biomedical knowledge for any
medical practitioner. One of them spoke of a pilot project in another
province in which TCM students were recruited from among high
school graduates in the arts as well as the natural sciences. The senior
teachers, by contrast, evaded my question or decisively objected to this
thought. They were acutely aware of the policy to make Chinese medi-
cine scientific; the foundations of Chinese medicine as a science were
the Western natural sciences.
Whereas TCM students were recruited from all parts of the province,
biomedical students, I was told, came mostly from the provincial cap-
ital. The Yunnan TCM College was an institution of the provincial
government, and the Kunming Western Medical College was run by
the city. This seemed to indicate that, in Yunnan, TCM education was
for providing health care in rural and peripheral areas and Western
medical education for the capital. However, the teachers at the college
saw no significance in this institutional division. They explained that
high school graduates from urban areas had higher examination scores
than those from the periphery and rural areas (although the latter often
received bonus points),20 and that admission to studies in Western
medicine required higher marks than for TCM.
The college administrator attributed this institutional division of
responsibilities for medical education between the city and the province
more to historical accident than to medical policy. In the early 1980s,
he said, TCM students had also been recruited from Kunming, and
as graduates they had quickly filled the available positions in all the
hospitals of Kunming city. In 1986 the government had introduced the
policy of ‘directed recruitment and job assignment’ (dingxiang zhaosheng,
dingxiang fenpei), similar to that during the Cultural Revolution, ‘the
commune you come from is the commune you go to’ (she lai she qu).21
Its intention was, on the one hand, to prevent the exodus of intellectuals
from the periphery and rural areas and, on the other, to protect intel-
lectuals from the city from being assigned jobs in rural areas. Therefore,
20
Students were given bonus points if their parents had been ‘volunteers to go to the
border areas’ (zhiyuan bianjiang), if they were of a ‘minority nationality’ (shaoshu
minzu), or if their parents were ‘overseas Chinese’ (huaqiao) immigrants, for example,
from Indonesia.
21
It was implemented from 1983 onward (Bastid 1984:214).
the Yunnan TCM College accepted only two undergraduates from

Kunming in 1988 and 1989 (one of whom was the son of the head of
the TCM Department). Even if young people from Kunming achieved
the necessary scores and wished to study TCM, they had little hope of
being accepted (interview with college administration, December 1989).
The majority of the students I interviewed, recruited between 1984
and 1988, came from the periphery of the province, and about half
of the students’ parents were not ‘cadres’ (ganbu) or ‘intellectuals’
(zhishifenzi), but ‘peasants’ (nongmin) or ‘workers’ (gongren) (see table
5.3). The college was, moreover, open to physically handicapped students
who were not accepted at other universities, for instance, students who
suffered from impaired vision or limped because of childhood polio.22
Thus TCM colleges can be seen as institutions which were supposed
to narrow the gaps between the classes, between centre and periphery,
between urban and rural areas, and (implicitly) between the healthy
and the disabled. Given that TCM studies at university level were open
to students who came from a low-class background, the province’s
periphery, and rural areas, it may not be surprising that government
cadres and urban intellectuals tended to consider them of ‘low cultural
level’ (wenhua shuiping bu gao). Since they continued to view TCM
practitioners in this light, even after completion of five years of univer-
sity study, the poor reputation of TCM knowledge may partly come
from the low status ascribed to the people proficient in it and not
merely from the particularities of the knowledge itself.
Commitment to studies
Students were assigned their subjects of study, their teachers, and their
jobs. Being placed in this passive position naturally had an impact on
their morale. I observed much boredom, disillusionment, indifference,
and lethargy among TCM undergraduates.23 Whereas personal com-
mitment is a sine qua non for the secret and personal transmission of
knowledge and practice, at the college only compliance with the work
rulings could be implemented and controlled.
22
Elementary and high school teachers were expected to be mentally and physically fit;
therefore the Teachers’ Training College accepted no physically handicapped stu-
dents. This policy applied even at the university level: a TCM graduate who limped
was ‘kept at the college’ (liuxiao) because he was considered very capable but not
recruited as a teacher; he worked as a doctor at the college’s annex clinic. On health
conditions that disqualify an individual from college admission, see Pepper (1984:55).
23
Acumoxa and massage specialists were, by contrast, much more committed to their
studies; acumoxa and massage was in several cases the study of their own choice, and
they often had clear plans for future employment.
148
Table 5.3. Recruitment of TCM students entering the college in 1984, 1986, 1987 and acumoxa students of 1988
Nationality Parents’ Occupation* Parents’ Residence

Year
of No TCM WBM Peasant Worker Cadre Intellectual No Centre
Entry Number Han Other answer Doctor Doctor (nongmin) (gongren) (ganbu) (zhishifenzi ) Other answer (Kunming) Periphery
1984 6f 2 0 4 0 0 1 0 1 2 2 0 0 6
5m 4 1 0 2 × 0.5 0 2 × 0.5 0 1 1 0 1 1 4
**
1986 7 f 6 1 0 0 0 3 2 + 1 × 0.5 0 2 × 0.5 1 × 0.5 0 0 7
8 m 6 0 2 0 0 4 + 1 × 0.5 1 + 1 × 0.5 0 2 × 0.5 1 0 0 8
1987 6 f 5 1 0 0 0 3 + 2 × 0.5 1 + 1 × 0.5 0 1 × 0.5 1 × 0.5 0 0 6
7 m 2 2 3 0 0 0 1 + 1 × 0.5 1 × 0.5 0 0 5 2 5
1988 11 f 9 1 1 2 × 0.5 1 + 3 × 0.5 0 0 2 + 2 × 0.5 1 1 × 0.5 3 1 10
7 m 6 0 1 0 1 3 3 0 1 0 0 1 6
Total 57 40 6 11 4 5 19 12 7 10 6 9 5 52
* 1 = both parents, 0.5 = father or mother

** 1985 in clinical training at various hospitals
The college’s work rulings required students to prepare for, attend,

and review classes, and to take examinations twice a semester. Gener-
ally speaking, students attended classes regularly; the teachers recorded
absences (at university level). Almost all students took notes; most
students learning a speciality used separate booklets, while others, par-
ticularly the regular undergraduates, wrote the teacher’s comments in
the textbook. Homework consisted mainly of learning textbook pas-
sages by heart and sometimes of written replies to standard questions at
the end of a chapter.
Most students ‘prepared’ ( yuxi) and ‘reviewed’ ( fuxi) the lectures by
reciting them loudly in the mornings and got to the classroom ten
minutes before the first lecture started; one or two were regularly late.
Students usually answered the two or three questions at the beginning
of each lecture to the teacher’s satisfaction, but several times the teacher
had to ask a third or fourth student. Students were not expected to
recite a long textbook passage; their answers often consisted of a short
and standard phrase.
One might have thought that compliance with work rulings would be
considered sufficient, but teachers and tutors did make an effort to
effect an incorporation of staff standards among the studentship.24 After
the mid-term exams for first-year acumoxa and massage students, which
were taken in strict silence under the supervision of two teachers, the
teachers expressed extreme disappointment and deep concern about
the students’ performance. In the following class in political instruc-
tion, the students were asked to write essays on their scholarly perform-
ance. These essays consisted mostly of repentance and promises to be
more conscientious. Standard confessions were: ‘I amused myself too
much’ (wan de tai duo); ‘I thought I understood without understanding’
(si dong fei dong); ‘I did not prepare and review classes conscientiously’
( fuxi bu renzhen); ‘Success is a matter of personal effort’ (shi zai ren
wei). Some expressed difficulties with adjustment to university condi-
tions and mentioned insomnia, imbalance of their emotional life, bore-
dom, and difficulty in learning by rote memorisation. Having specialised
in the natural sciences during the last three years of high school, they
were now required to memorise one classical text after another.25 I
never learnt whether the performance of this class had been particularly
poor or whether the practice of confession belonged to the routine
24
See Freidson (1970:106), who speaks of an incorporation of ‘colleague standards’
among physicians in North America.
25
Two students stood out by writing in verse form about their explorations in the city
during their spare time. One student stated that he refused to write anything about
personal matters.
Table 5.4. Students’ first choice of studies on the preference forms at high
school graduation
TCM Western Biomedicine

Year of No
entry Number Own wish Family’s Own wish Family’s Other answer
TCM
1984 6 f 0 2 0 1 2 1
5 m 1 2 0 2 0 0
1986 7 f 1 0 0 0 6 0
8 m 1 0 1 0 6 0
1987 6 f 0 0 3 1 2 0
7 m 5 0 0 0 1 1
Total 39 8 4 4 4 17 2
Acumoxa and massage
1988 11 f 5 0 2 0 4 0
7m 2 0 0 0 4 1
Total 18 7 0 2 0 8 1
Total 57 15 4 6 4 25 3
initiation of students at the college. Examinations at the end of term

were met with much anxiety and more conscientious preparation.
TCM studies were generally an unpopular choice. When asked
informally, many students admitted to having had the wish to study
engineering, physics, education or, of course, Western biomedicine, but
they said that their exam marks had not been good enough. However,
when I asked them what subject they had indicated on the forms they
were sent at high school graduation, I found that several had, never-
theless, put TCM as their first choice of studies (see table 5.4). In
response to this, students explained how difficult it was to fill out the
preference forms before high school graduation, what risks one had to
anticipate and what choices were likely to be realised. If they intended
to be accepted for university studies at all, it was sometimes more
prudent to indicate as first choice a subject at an institution that was
not one of the most popular ones. For instance, a student who had
wanted to study engineering at the Kunming College of Engineering,
which enjoyed a nationwide reputation, had not even considered indic-
ating this on the preference form.26
26
On the difficulties and dangers of completing the preference forms, see Pepper (1984:59–
67).
So, instead of asking: ‘What was your first choice on the preference
forms’, I should perhaps have asked: ‘What did you wish to study?’
Indeed, I had asked this of the first group of students, only to find that
they considered it difficult to answer. Some appeared to have difficulty
talking about past wishes, and some simply did not understand my
question. Therefore, instead of asking: ‘What were you wishing in the
past?’ I asked ‘What have you done?’ but this led to the problem just
described: what students indicated as first choice of studies in the pref-
erence forms did not necessarily reflect their own wish. More often
than not, they had followed their parents’ advice and claimed that it
was their own. In fact, whether it was the students’ wishes, their par-
ents’ wishes adopted as their own, or their obligations to their parents,
as either ‘filial piety’ or straightforward ‘obedience’ (xiao), simply seemed
to miss the point. Commitment to one’s studies was considered not to
depend on private wishes – certainly not on one’s wishes at the time the
forms were completed. Despite the lack of clarity about what their ‘own
wishes’ meant, only eight of the thirty-nine regular students claimed
that TCM was their first choice of studies; for the other four-fifths
TCM was not their choice.27
In response to the question of whether they liked their studies twenty-
six out of thirty-nine wrote that they did; as few as eight wrote that they
disliked them and five indicated indifference. On paper the majority of
the students seemed to have a positive attitude towards their studies,
whereas I had observed widespread disillusionment, particularly among
TCM undergraduates. The only way I could explain this discrepancy
between what they said and what I thought they felt was that their
answers reflected language use that accommodates to social expectations.
A student who wrote that he ‘liked’ his studies explained: ‘You have
to like what you do; I am not very interested in Chinese medicine, but
I want to learn it well.’ He seemed to express what most students who
said they ‘liked’ their studies felt. If ‘to like’ meant to comply with work
rulings or possibly even to be committed to one’s studies but not ‘to be
interested’ in them, this would explain why two of them could say
simultaneously that they ‘liked’ their studies and that they wished to
change professions.
To like one’s studies was the proper thing to do, an unmarked
expression; to express dislike was offensive. It is noteworthy that among
those eight who openly expressed dislike, five spoke of a concrete altern-
ative: one wanted to open a Chinese herbal pharmacy, three planned to
27
The ratio among acumoxa and massage specialists accepted in 1988 was significantly
better, seven out of eighteen had put acumoxa and massage as their first choice.
establish private practices, one wished to study TCM theory, and

one was studying for exams to be accepted as a ‘research student’
( yanjiusheng) in Chinese philosophy. Those who had the courage to
express dislike had alternatives in mind and, rather than being uncom-
mitted, were among the most enterprising students. Those who were
completely disillusioned would say instead that they ‘had no opinion’
(meiyou yijian). Much as talking about a bad marriage as ‘the usual sort
of thing’ ( yibande) avoided stigma (Potter and Potter 1990:192), and
actually saying that it was bad would call for intervention, expressing
dislike called for proposal of alternatives. The idea of ‘changing pro-
fessions’ (gaihang) avoided stigma, possibly because it was common
practice after the reforms in the 1980s; I took it as a reliable indicator
of dislike for the studies. Among the five who expressed ‘indifference’
(wusuowei), several spoke of changing professions. Did indifference stand
for disillusionment and dislike?
The third question that related to the students’ commitment con-
cerned their plans for the future. In response to this question about half
of the students (twenty-six out of fifty-seven) said: ‘To become a good
doctor’ (dang hao yisheng). Even students who had expressed indiffer-
ence replied with this phrase. Thus, this answer could not be used to
distinguish committed from uncommitted students. When I insisted
that what I was interested in was not stereotyped phrases, but their
‘own’ (benrende) wishes, one of the students exclaimed: ‘Of course, we
all have the wish to go abroad, of course, each of us wants to open a
private practice and be his own master, but you know that there is no
sense in making such a statement!’ I understood this to mean that he
disliked wasting time on hopes that were bound to be disappointed. In
this case, the students’ attitude did not arise from lack of imaginative
thinking, but rather from a reluctance to express in public personal
wishes that they considered unrealistic.28
The students’ unwillingness to talk about unrealistic personal wishes
doubtless had to do with their perception of the self and the importance
they attached to the self. The notion ‘of a private existence within a
public world’ (Lukes 1973:59), which implies that behind closed doors
one may do and think as one wishes without taking the surrounding
environment into account, may allow the European to have unrealistic
personal wishes – wishes that are ‘real’ in that limited private sphere.
This detached-from-the-environment thinking seems contradictory to
common sense and everyday behaviour in China. Things become
28
Psychological tests with Chinese and Polish students have been interpreted to indicate
that Chinese are reluctant to think of improbable conditions (Gawlikowski 1982); the
above finding calls for reconsideration of such interpretations.
Table 5.5. Graduates’ answer to question: Do you like your profession?
Year and Programme
Acumoxa and Massage TCM

Choice of Answers Given in the Questionnaire 1986–8 1987–9 1985–9
Letters sent out 30 30 60

Letters containing a response to this question 19 18 22
I always liked TCM 12 5 2
I started to like it in the first or second year 3 4 5
I started to like it during clinical training 3 5 11
I started to like it after job assignment 0 0 1
I never liked TCM 0 2 3
I started to dislike it in the first or second year 0 0 2
I started to dislike it during clinical training 0 1 2
I started to dislike it after job assignment 3 2 3
significant not so much because of their existence in this world as

because of their relationship with other things. How can a private wish,
separated from any context, be considered ‘real’ at all? ‘Becoming a
good doctor’ was more ‘real’ and therefore an acceptable response.
Whereas difficulties in evaluating the students’ questionnaire answers
were endless, the utterances that they volunteered in everyday life situ-
ations were much easier to interpret. It was striking to observe, while
participating in the clinic, how many students were fascinated by the
success they achieved: ‘Illness management is unique’ (zhibing dute);
‘Every time I can cure a sick person, it makes me happy.’ It was
obvious that TCM undergraduates became more interested in their
studies during their year of clinical training (see also table 5.5). Some
students eventually became more positive: ‘In the beginning I did not
like Chinese medicine, but eventually I became very interested in it.’
‘The teachers have considerably influenced me in this process.’ There
were, however, also students who were initially interested in Chinese
medicine and later became disillusioned. The answers to the letter
questionnaires indicated that this was the case, particularly among newly
employed graduates (see table 5.5 last line).
Job assignment
The learning process at the TCM college was conspicuously disrupted
between April and June 1989, when excitement lay in the air where
otherwise indifference predominated. It may not be coincidence that

outbreaks of the kind took place precisely in institutions in which know-
ledge and practice were standardised. While the Western press and over-
seas Chinese have emphasised the prodemocracy aspect of the movement
and no doubt, ‘democracy’ (minzhu) and whatever it implied was an
issue for the organisers of the movement, most students at the college
knew more clearly what it meant to be against ‘corruption and nepot-
ism’ (guandao) than for democracy.29 My seventeen to nineteen year
old classmates marched out of the college gates on 17, 18, 19 May and
on 5 and 6 June, knowing that all of the nation’s students were in the
streets. In scorching heat, which had melted parts of the asphalt, they
followed their fellows carrying their banners and shouting their slogans
and found it all very exciting. Compared with the masses of students
from other universities, the TCM college was poorly represented in the
peaceful and silent crowd on Kunming’s main square, but the few who
joined with fervour gave way to a deep-rooted anger. ‘The more chaos
the better’, one of the more active ones exclaimed while painting this
phrase in beautiful calligraphy onto a strip of cloth that he later tied
round his head. He knew about the threat of spies and police and the
risk that ‘accounts will be settled after the harvest’ (qiuhou suanzhang),30
but simply declared: ‘We have nothing to lose.’ Exactly this attitude has
repeatedly assigned twentieth-century Chinese university students the
role of rebellion (Schwarcz 1986). Other urban dwellers had employ-
ment, flats, and families; they had not much, but something to lose.
Teachers could not demonstrate in the streets without the danger of
being punished, though they were at least among the spectators, imply-
ing support (see also Pieke 1996:186–7). And, of course, students did
really have something to lose, namely, the prospects of their future
employment. Hanging their heads after the crackdown, they gathered
around a tavern table towards midnight with sad looks, and one of the
graduates’ explained: ‘You know the slogan “down with corruption and
nepotism” (dadao guandao), possibly, you shouted it yourself. Do you
know what you were shouting for?! Our concerns are concrete: job
assignment; that’s what it is all about.’
I slowly came to realise the desperation with which students faced
their job assignments. Most took the jobs they were given, but I
29
For a social anthropologist’s account of the movement in Beijing, see Pieke (1996:180–
252).
30
He was later assigned a job not at the ‘prefecture’ (zhou) or ‘county’ (xian) level but at
a village (xiangcun) ‘medical station’ ( yiliaozhan). It was not said whether this assign-
ment was related to his activities or not.
remember one graduate who was doing all she could to stay in Kunming:
‘The problem of job assignment causes the most headaches’ ( fenpei
wenti zui touteng). She suffered from a stomach ulcer and sometimes
even had to leave her practical training early on account of it. I met her
by chance six months later in the Number Two City Hospital. She was
no longer pale and grey in the face, but had proved to be one of the few
who ‘had a method’ of succeeding ( you banfa). She had managed to
stay not as a TCM doctor but as a biomedical paediatric, apparently
without ‘entering through the backdoor’ (zou houmen).31 She was, how-
ever, an exception. ‘Once a cadre is assigned to a work unit, she is
sentenced to lifelong death’, explained a graduate who had refused to
‘obey job assignment’ ( fucong fenpei) and became an entrepreneur:
‘The government’s means of control is the “household register” (hukou).32
The household register binds you to a place, a work unit, a village, a
street in the city, and this makes you immobile. It guarantees that you
are provided with the amount of cereals and rice you need every month
for only 6 yuan. These days, this costs you 30 yuan on the free market.
Moreover, in many regions of our country these commodities are just
not sold, they are scarce and rationed. For those who engage in small-
scale business 30 yuan is not much, but imagine someone who gets a
job offer from a work unit in Beijing and cannot change her household
register to Beijing – tell me, how can she survive if half of her salary is
used for buying rice?’
Job assignment has gone through many stages of administrative re-
consideration. In 1988 the policy of directed recruitment and directed
assignment was standard. A committee of the college arranged a job for
a graduate by contacting a hospital representative in the ‘prefecture’
(zhou) or ‘county town’ (xian) the graduate came from. These con-
tacts were easily made because the latter were usually graduates of the
college. The college committee’s proposal had to be approved by a
Committee of the Provincial Parliament which reportedly approved
about 70–80 per cent of the proposals; college representatives spoke
of ‘complications’ (wenti fuza), students and graduates of corruption
and nepotism: ‘My aunt is on that committee; that’s why I can stay in
this city.’
In the mid-1980s a policy of ‘mutual selection’ (shuangxiang xuanze)
had been introduced which was, in view of the general discouragement
31
This is another example of negotiable norms which need not imply corruption and
nepotism.
32
See also Yeh and Xu (1990:46).
of individual initiative, truly innovative.33 It enabled enterprising students

to arrange for job offers from hospitals which they themselves chose to
contact. If hospital and graduate reached agreement, they had to ask
for approval from the college and the committee of the provincial par-
liament. One college teacher had earlier arranged for a position at a
hospital in another province, but the parliament ‘refused to release her
household register’ (zhuazhu hukou bufang).34
The right to work is a Socialist principle, and until the late 1970s the
government guaranteed job assignment to every high school and uni-
versity graduate (Gold 1991). After interviewing the college teachers, I
realised that they ascribed very explicit advantages to the Socialist sys-
tem of job assignment. The prospect of the ‘iron rice bowl’ (tiefanwan)
after graduation was an important incentive to endure the hardships
of university studies.35 The problem of unemployed youth and the
huge ‘proletariat’ is more than a widely acknowledged problem in the
Chinese and Western literature: it is a reality for every high school and
soon possibly every university graduate. In the late 1970s, the officially
reported number of unemployed young people was disguised by the
fact that high school graduates who refused to go down to the country-
side were classified as ‘youths awaiting job assignment’ (daiye qingnian).
These teenagers waited for years, mostly in their parents’ flats, with
or without part-time occupations. Then, in the early 1980s, the policy
changed, and high school graduates were no longer guaranteed job
assignment. And, in the late 1980s the Chinese press frequently ad-
dressed the topic of relaxing the government’s responsibility for job
assignments after university graduation. Only those with the equivalent
of a ‘master’s degree’ (shuoshi) or a ‘doctorate’ (boshi) were to enjoy
this privilege.
Students and graduates had mixed feelings. On the one hand, they
wanted the Socialist right of job assignment and spoke of its abolition
as a sign that the value of university degrees was decreasing. On the
other hand, stories abounded of mismanagement of job assignment due
to one’s ‘political situation’ (zhengzhi tiaojian), ‘family background’
( jiating wenti), and so-called ‘moral conduct’ (daode wenti).
33
This is a remarkable change when compared with practices even of the early 1980s
(Henderson and Cohen 1984:39): ‘For the ordinary Chinese citizen, then, job assign-
ment and transfer are seldom products of individual initiative. In fact, individual
initiative may instead reflect abuse of the system.’
34
‘In this sense, the criticism that units “own” their staff is justified’ (Henderson and
Cohen 1984:36).
35
‘Iron rice bowl’ is an expression for a position in a work unit with pension. Cadres
cannot be dismissed – the rice bowl cannot break.
Summary
The standardised transmission of knowledge placed the students in a
passive role. Since learning demands an active commitment from the
students, the question immediately arose of how actively involved they
were with their studies. Observation showed that they generally com-
plied with work rulings and that tutors and teachers made an effort to
have them adopt staff standards. In conversation many claimed indif-
ference towards or even disillusionment with their studies and hardly
anyone was actively trying to change the situation. On the contrary,
some who claimed to dislike their studies were among the students with
most initiative.
From the questionnnaires it became clear that no one (neither
parents nor teachers nor administrators) asked students about their
personal wishes, likes, and hopes and that, if they had any the students
themselves were unwilling to talk about them. I got the impression that
wishes, likes, and hopes were seen as forms of personal ‘impulse’ or
‘will’ (zhi) and people driven by impulse were considered immature.
There was a general assumption that ‘doing’ engendered ‘liking to do’.
Indeed, several claimed to have become more positive about their studies
as they got more involved with them. In particular, the year of practical
training changed the attitude of many students to their subject of learn-
ing. Exploration of the curriculum may highlight why.
The curriculum
The curriculum of a TCM regular student comprised 3,733 hours

of lectures over four years (see appendix) and a year of full-time
practical training in various clinics and hospitals.36 Of these, 950 hours
(25.5 per cent) were reserved for courses on Party history, Marxism
and Leninism, foreign languages, and physical training. Of the remain-
ing 2,783 hours, 70 per cent were courses in TCM and 30 per cent
courses in biomedicine. Of the 1,948 hours in TCM, 510 hours were
reserved for lectures on the medical classics. Aspects of the curriculum
discussed here include the introductory courses, which have given rise
to a TCM theory; the clinical courses, which point to a continuity with
the past; and practical training, which calls for a flexible application of
written standards.
36
For acumoxa and massage students it consisted of two and a half years of classroom
teaching and six months of practical training.
Table 5.6. TCM subjects for regular TCM students
Course Title (identical to Textbook Title) Lessons (2hrs)/week Semester
TCM Fundamentals (Zhongyi jichu lilun) 3 1st

Traditional Chinese Pharmaceutics (Zhongyaoxue) 2 1st, 2nd
TCM Diagnostics (Zhongyi zhenduanxue) 3 2nd
Formularies (Fangjixue) 3 3rd
Acumoxa (Zhenjiuxue) 2.5 3rd
Qigong 1 4th
Massage (Tuinaxue) 1.5 4th, 5th
TCM Internal Medicine (Zhongyi neike xue) 2 5th
TCM Gynaecology (Zhongyi fuke xue) 1.5 5th
TCM Ophthalmology (Zhongyi yanke xue) 2 6th
TCM Paediatrics (Zhongyi erke xue) 2 7th
TCM External Medicine (Zhongyi waike xue) 2.5 8th
TCM Traumatology (Zhongyi shangke xue) 2 8th
The introductory courses and the rise of a TCM theory

The course work in the classroom was divided into ‘theoretical courses’
(lilun ke) and ‘clinical courses’ (linchuang ke) (see table 5.6). The theor-
etical courses were introductory courses that were delivered during the
first two years. As ‘courses on the basics’ ( jichuke) they were specific to
TCM training: they comprised course work recorded in the textbooks
TCM Fundamentals (Zhongyi jichu lilun (Yin 1984)) in the first semester
and TCM Diagnostics (Zhongyi zhenduanxue (Shanxi zhongyi xueyuan
1988)) in the second. The TCM Fundamentals discussed basic medical
concepts under separate headings, while the TCM Diagnostics interrelated
them in the context of medical intervention. The introductory courses
in pharmaceutics followed the same pattern: in the first-year course
based on the textbook Traditional Chinese Pharmaceutics (Zhongyaoxue
(Ling 1984)) each drug was separately presented; the second year was
devoted to the combination of drugs in Formularies (Fangjixue).
Unlike the disciple or follower working under a master or mentor in
a medical practice, who learns to break down observed complexities,
TCM students were first exposed to one concept after another, each
detached from the other, and then expected to put these elements
together into a whole. This was called ‘systematic’ (xitonghuade) learn-
ing. There was a TCM theory that was systematic, and this theory had
to be learnt before students were exposed to medical practice.
The forum for this newly established theory was the classroom. TCM
teachers saw many advantages in classroom teaching; a disciple or fol-
lower who engaged in medical practice from the beginning would not
learn how to reason deductively, they said. Having learnt by imitation,
he or she would be perplexed if confronted with a new illness condi-
tion. One may question these convictions but easily agree that a teacher
could elaborate on a coherent system of medicine in the classroom
without being forced to deal with the incongruencies of medical prac-
tice. Textbooks provided another forum, on paper, for neat tables of
the standardised interrelations between different aspects of the body
ecologic. These descriptive statements that set up systems of standard-
ised correlations formed the basis of a ‘theory’. It is true that in classical
medical writings such as the Basic Questions, which was a standard exam-
ination text for recruiting medical officials during the Tang dynasty
(Yamada 1979), we find lists of systemic correspondences as well.
However, although the modern mind inadvertently tends to read them
as descriptions, these standard correspondences were probably meant
to be read as normative or prescriptive.
As we have seen in the context of Zhang’s seminars (chs. 3–4), the
relation between medical doctrine and practice is not the same as that
between theory and practice. Phrases of the medical classics are gener-
ally memorised without being entirely understood, and medical practice
is indispensable to the meaning-making process of textual knowledge.
A medical doctrine is intricately related to medical practice, the relation-
ship of textual knowledge to practice being determined by the senior
doctor’s ‘virtuosity’ (linghuo) in applying it. In contrast, the descriptions
of TCM texts which make sense in the classroom may be contradicted
by a doctor’s own experience in medical practice. Descriptions of medical
practice give rise to a theory, and medical practice may or may not coin-
cide with them. There is a notorious gap between descriptive medical
theory and clinical practice, a gap that does not exist between prescrip-
tive doctrine and practice.
The tendency towards developing a TCM theory seems to be model-
led on Western biomedicine. In the set of TCM textbooks published in
1988 the theoretical subjects were multiplied by dividing the course on
the TCM Fundamentals into four: TCM Instructions (Zhongyixue daolun
(Luzhou yixueyuan)), Organ Clusters (Zangxiangxue (Yunnan zhongyi
xueyuan)), TCM Etiology and Pathogenesis (Zhongyi bingyin bingjixue
(Chengdu zhongyi xueyuan)), and Outline of TCM Preventive Health
Care (Zhongyi fangzhixue zonglun (in press)). It looked as if the intro-
ductory courses were designed to constitute something like the ‘TCM
basic sciences’, just as the biomedical sciences are basic to biomedicine:

‘Science is the point of entry into medicine, and however restricted the
science courses are from the perspective of faculty or Ph.D. students
in those disciplines, it is made profoundly clear that learning medicine
during the first two years is above all learning the biomedical sciences’
(Good and Good 1993:89–90). One may feel inclined to speak of
TCM as assimilating Western biomedical standards, but this may not
do justice to the processes that are inherent in any standardisation of
the transmission of medical knowledge and practice. Insofar as the
classroom is a place for standardised instruction of a coherent medical
system and textbooks are the predominant genre of medical instruction,
the very process of standardisation provides the basis for theory building.
The clinical courses and the continuity with the past
The clinical courses included internal medicine and gynaecology, pae-

diatrics, ophthalmology, otorhinolaryngology, acumoxa, traumatology,
and external medicine. They were generally taught from the third year
(fifth semester) onwards.37 A comparison with the Chinese medical
subjects recognised by the Imperial Court points to a continuity with
the past. The clinical courses, in contrast to the introductory courses,
are given on subjects that were taught in Imperial times, and detailed
longitudinal studies will be needed to show to what extent they have
grown out of subjects known since the Song dynasty (see table 5.7).38
Practical training, touch, and flexibility in the application

of standards
Practical training was the source of discontent that the teachers men-
tioned most frequently. They expressed their students’ and their own
need for more clinical experience. Some teachers deplored the restriction
of practical training to the last year of instruction. Since it awakened
students’ interests in TCM, they proposed that students have access to
the clinic as early as the first year.
37
The clinical courses in acumoxa, massage, and qigong were taught already in the third
and fourth semesters.
38
Unschuld (1986b) provides a longitudinal study of the commentaries on the Nan jing;
Despeux & Obringer (1990) of the nosological entity kesou (cough), but so far none
has been done on a subdiscipline of Chinese medicine.
Table 5.7. TCM subjects in historical perspective
Subjects of Chinese Medicine

at the Imperial Court,39 TCM Subjects at TCM Colleges,
Song Dynasty (960–1279) PRC (1949–)
Disorders of adults (da fang ke) Internal medicine (zhongyi neikexue)

Gynaecology (zhongyi fukexue)40
Disorders related to wind ( feng ke)
Disorders of children (xiao fang ke) Paediatrics (zhongyi erkexue)
Obstetrics (chan ke)
Disorders of the eyes ( yan ke) Ophthalmology (zhongyi yankexue)41
Mouth, teeth, pharynx, throat Otorhinolaryngology
(kou chi yan hou ke) (zhongyi erbihouke xue)
Sore, swollen, broken, wounded Traumatology (zhongyi shangkexue)
(chuang zhong zhe yang ke) External medicine (zhongyi waikexue)
Acupuncture and moxibustion (zhen jiu ke) Acumoxa (zhenjiuxue)
Inner lesions and incantations ——
( jin yang shu jin ke)
Practical training took place in a fairly relaxed atmosphere, at least

in the acumoxa wards.42 Students would appear around 9 a.m. and
leave at noon. For lack of clientele, they were not expected to return
in the afternoon. While waiting for patients they chatted, read novels,
smoked (if men), and sometimes joked with the doctor in charge.
One of the chief goals of practical training was to learn how to write up
case records.43 There were printed forms for this on which students
39
These nine subjects were established after the Yuanfeng period (1078–85). Before
that, Chinese medicine was divided into three subcategories (da fang ke, zhen ke, and
jin yang) and thirteen subjects (Si and Gong 1988:238).
40
TCM Gynaecology (Meng 1986) discusses pregnancy and postpartum disorders of the
woman but not childbirth; Furth (1986:50), rather than translating fuke as gynaecology,
suggests ‘women’s department of medicine’. ‘Textbooks both argue and demonstrate
that fuke is basically the same as . . . “internal medicine” (neike)’ (Farquhar 1991:375).
41
Here the same word is rendered differently, in approximation of the speaker’s under-
standing in the Song dynasty and in a twentieth-century TCM course.
42
In Yunnan province, doctors in acumoxa wards at hospitals and clinics were generally
not very busy. At the Provincial TCM Hospital, for instance, a ward of two doctors
with three to four students saw ten to twenty-five patients a morning.
43
See also Farquhar (1992). Writing up cases is also central to training American stu-
dents in biomedicine (see Good 1994:76–83).
only had to fill in the details.44 Yet case records were rarely presented
to the assembly of colleagues as in American hospitals (Anspach
1988); they were individually supervised by the doctor–teacher, and
therefore practical training was much more personal than classroom
instruction.
One of the students’ first reactions to the clinic was to point out the
difference between theory and practice: ‘This is what is written in the
textbook, but here it is all different’, or: ‘Gynaecology is easy to learn
( fuke hao xue), but in the clinic everything is different from the theory.’
It was not that classroom learning was altogether dismissed as useless,
but, as the doctors in the clinic liked to put it, the textbooks con-
tained generalities, while the problems in medical practice demanded a
detailed knowledge of the particular; for them the latter was clearly the
crucial knowledge. This knowledge of the particular was grounded in a
mode of perception that was very different from that in the classroom:
touch. To establish a ‘diagnosis’ (zhenduan) the Pulse (mai) had to be
taken. It is noteworthy that ‘Pulse diagnostics’ (maizhen), said to be
the most important means of learning about a patient’s condition in
Chinese medicine, is grounded in touch. Pulse diagnostics is not simply
counting the frequency of beats per minute, but recognising so-called
Pulse Images (maixiang), experiences of touch which are very particular.
Li Shizhen (c. 1518–93) had standardised the Pulse Images, limiting
them to twenty-eight, and these standard Pulse Images were taught in
the course on TCM Diagnostics (Deng 1984:66–70). The variety of Pulses
students were exposed to in the clinic was, in contrast, overwhelming.
Experiences of touch are among the most difficult to standardise. Touch
is direct and fairly intimate and, possibly, therefore particularly apt for
perceiving individual variability.
Not only the Pulses but also the complaints of the patients and the
manifestations of disorders plunged the student into problems that could
not be dealt with in a standardised way. In the clinic one could not
mechanically apply the standardised knowledge learnt in the classroom,
and the learning process relied on different (audiovisual versus tactile)
modalities of perception. TCM theory was, unlike other theories of
the natural sciences, meant to be related to medical practice not with
rigour but with ‘flexibility’ (linghuo). In this respect, the relationship
between TCM theory and practice seemed to be modelled on the
application of Chinese medical doctrine to medical practice that senior
44
This process is faithfully recorded in the seventeen case histories of Ots (1987:
101–35). For other published case histories, see Farquhar (1991; 1992; 1994a:
46–55).
doctors would master with ‘virtuosity’ (linghuo).45 TCM doctors called

it a ‘dialectical’ relationship between theory and practice.
Students were no longer in the passive role of reproducing know-
ledge, but actively engaged in medical practice. Sometimes they even
found that their therapies had a positive effect, which encouraged and
empowered them. These experiences may well explain why, as we have
seen, many students became more committed to their studies during
the year of practical training.
Standards and their variation

From the above it is clear that the standardised transmission of TCM
knowledge referred to a wide spectrum of different standards. The cur-
riculum included standards that had been newly established (theoretical
courses), standards that had historically evolved from earlier standards
(clinical courses), standards that had nationwide46 or regional validity,47
standards that varied according to type of educational institution,48 and
standards that were local.49
A mind trained in the Western sciences may find it puzzling that
TCM teachers spoke of all these processes, directed towards establish-
ing a standard at these many different levels, as a standardisation of
the transmission of Chinese medical knowledge. Confronted with this
orchestra of different standards, how can one speak of a standardisation
of the whole? We have seen that Chinese medical doctrine, rather than
assigning well-being to a single cause, conceives of a harmonious chorus
45
The term linghuo is rendered as virtuosity with regard to senior doctors’ handling of
a doctrine and as flexibility with regard to TCM professionals’ application of a theory.
The respective translations highlight these doctors’ different attitudes to textual know-
ledge: virtuosity refers to medical expertise that values personal mastery, while flexibility
implies that practitioners accept generally valid standards and apply them flexibly.
46
In 1988–9 and 1989–90, classroom teaching built on the 1984 edition of textbooks
adopted nationwide.
47
In 1985, during a meeting organised by the Central Health Ministry on experiences
with the reforms of higher TCM education, the decision was taken to write regional
textbooks (five regions: the Northwest, the North, the South, the Centre, and the
West). The textbooks were printed in 1988/9. They were used for short-term and
brush-up course instruction but, as I learnt during a visit in 1996, not for regular
TCM undergraduates.
48
TCM colleges fall into three types, emphasising either ‘research’ ( yanjiuxing), ‘clinical
practice’ (linchuangxing), or ‘the integration of Western and Chinese medicine’ (zhongxiyi
jiehe xing) (interview with City Health Bureau, December 1989). The curriculum at
the Yunnan TCM College stressed training in clinical practice; the students were not
expected to pursue university careers. Most students said they ‘wanted’ to work as
practitioners after graduation; only four of fifty-seven expressed the wish to become
research students.
49
For instance, the Yunnan TCM College used the above-mentioned set of regional
textbooks for ‘evening courses’ ( yeban).
of qi. We can also observe an aesthetics throughout the various Chinese

scientific doctrines that favours explanations with many levels of mean-
ing. As Unschuld (1988a) points out, this aesthetics is very different
from that of a culture shaped by the values of a monotheistic religion.
The claim that the diverse processes in TCM institutions are directed
towards standardising the transmission of Chinese medicine is grounded
in an aesthetics that acknowledges that standardisation may include a
broad spectrum of different standards.
The assertions of the people with whom social scientists work need of
course not coincide with the categories they use, but in this case it seems
perfectly acceptable to speak of a process of standardisation from the
observer’s point of view as well. Regardless of whether implementing
one single standard or many different ones, the standardisation of the
curriculum has led to a separation between classroom teaching (where
standards are easily established) and training in the clinic (where they
are not as easily implemented).
Goals of teaching
When I asked the assistant teachers about their goals in classroom
instruction, most admitted to not having thought about it. One of them
said: ‘The teachers teach, the students listen. The students have no
initiative and are not conscientious in their studies. A teacher should
awaken a student’s interest. Only if a teacher is interested in his subject
can he awaken that in his students.’ Another one said that apart from
transmitting information to the students, a teacher should teach them
a ‘way of life’ (shenghuo fangfa). His comment may have reflected the
Party’s former device of being ‘red and expert’ (hongzhuan), which,
having been seriously misused, was not even mentioned by college
administrators during the era of Deng’s reforms. Indeed, in other con-
texts of Chinese medical learning acquiring a certain way of life was the
premise for being accepted by master or mentor. Within an institution
in which knowledge is transmitted in a standardised fashion, one would
think that knowledge would be regarded as public property while ways
of life were to a certain extent private affairs. However, the aim of trans-
mitting knowledge as well as a way of life is not only a device of the
Chinese Communist Party; it has many parallels in other cultures.50
50
The portals of the Töchternschule Zürich proclaimed: ‘Non scholae, sed vitae discimus’
(a misquotation of the Roman poet Ovid which stands for humanist ideals), and the
Cambridge graduation ceremony contains the clause: ‘Most worthy Sir . . . I present to
you these men, whom I know to be suitable “both in character and learning” (tam
moribus quam doctrina)’.
I learnt about the teachers’ goals of instruction only indirectly,51

through comments made in passing: (1) You have to explain and let the
students understand what they are learning by heart; (2) You have to
teach a student a method, not only knowledge; (3) You have to provide
more practical training for the students. Evidently, some of the prin-
ciples they advocated were those of post-Enlightenment knowledge: (1)
‘explanation’ ( jieshi) and (2) ‘method’ ( fangfa). The need of (3) ‘practical
training’ (shixi) appeared to have arisen from the recent emergence of a
theory. These principles imply certain assumptions about knowledge.
Explanation is supposed to open up access to knowledge – to make
knowledge accessible not only to those who are predestined for it or
those whose personalities are compatible with that of the mentor, but
to everyone. Belief in the didactic value of explanations is based on the
assumption that explicating (‘unfolding’) packages of meaning yields
insight. The complexities of knowledge are divided into basic and
advanced knowledge. This is reflected in the structuring of the TCM
curriculum into introductory and clinical courses and, among the intro-
ductory courses, into courses that present the basic elements separately
and those that discuss different combinations of those basic elements.
Explanation also makes the learning process less lonely. It provides
guidance, step by step. Gradually, one building block is placed on
another. This hierarchical order of teaching may result in a hierarchical
structure of knowledge: ‘Natural hierarchy is replicated as the implicit
order of teaching . . . A slide of low magnification cell structure is fol-
lowed by an electron micrograph, and from this level to diagrams of
molecular structure and genetic expression. A slide at one level is often
followed by one just above or below this hierarchy . . .’ (Good 1994:75).
It would be worth investigating to what extent learning through explana-
tion and hierarchically ordered knowledge are interrelated.
Method, generally mentioned in the context of standardising and
systematising Chinese medicine, was always linked to the speeding up
of the process of learning. It was also spoken of in a sense reminiscent
of explanation. When discussing the relevance of lectures on the med-
ical classics, a teacher said: ‘One should learn the method of reading a
text, not just learn text after text by heart.’ This teacher emphasised the
need for understanding what one had learnt. His conviction stood in
blatant contradiction with that of a qigong healer like Qiu, who did not
have to understand the incantations he recited for them to be effective, or
a mentor like Zhang, who believed that the meaning of memorised texts
would only become apparent in their application to medical practice.
51
On officially expressed goals of teaching, see H. F. Chen (1984:357–60).
College authorities spoke of applying the method of ‘exemplary

learning’ to lectures on the medical classics. According to this method,
originally developed for teaching the natural sciences, definitions of
terms were explained by referring to one ‘exemplary’ experiment only
(instead of endlessly repeating experiments of a similar kind). Applied
to lectures on the classical literature, this method required students to
memorise only short text passages instead of whole books or chapters.
While explanation invokes a structure of knowledge, the method of
exemplary learning demands a focus on what is considered central.
An utterance or an activity is reduced to one crucial point. Exemplary
learning demands that the student focus on what is considered central
to the message, while a follower like Zhangdi would read the same text
with the intention of gaining a sensitivity to a more general kind of
pattern recognition.
The fact that the teachers stressed the need for more practical training
points up the importance attributed to classroom instruction at TCM
colleges. The process of standardising the transmission of Chinese medical
knowledge has given rise to a theory, and with it, to an ever increasing
gap between theory and practice.
The standardised mode of transmission

The space occupied by the college was clearly bounded, separating ‘the
populace’ (minjian) from the world of TCM learning. Work units had
been constructed with functionally distinct compartments each of which
constituted a separate whole. It was in these newly created spaces of
work units that the standardised transmission of knowledge took place.
It implied the ideal of equal opportunity for everyone, a quantitative
assessment of scholarly qualification in examinations, accommodating a
large number of students for only a limited time period of learning, and
a relation between teachers and students that was not personal or inti-
mate. The ideal was to treat everyone in the same standard way.
Standards were not always as rigorously implemented as one might
expect. In a Socialist work unit colleagues at work were neighbours at
leisure. They would know each other for decades within a limited space
and under the pressure of scarce resources. Avoidance of personal fric-
tion and the matching and balancing of human resources often took
precedence over thematic and intellectual demands. That norms were
negotiable was not always a sign of nepotism and corruption, being
sometimes referred to as pragmatism. A flexible handling of standards
was possible because standards were often made up of components that
were readily added or subtracted in recognition of a particular situation.
The networks among the staff were intentionally kept rather loose.
Staff members had come together only after university graduation, and
few were bound by comradeship in their youth. They had gone through
various experiences of each other in extreme situations of political un-
rest, and in anticipation of future upheavals they were not eager to
reveal much about themselves to others. These loose networks may well
have provided a context within which government policies could be
implemented with relative ease. In such a context, the efforts at trans-
forming ethical and other values that a standardisation of the trans-
mission of medical knowledge and practice brings with it were likely to
encounter fewer obstacles than in the tightly knit networks of an urban
neighbourhood, where interactions between households went back for
decades if not generations.
The standardised transmission of knowledge is based on the belief
that the complexities of knowing can be ‘explained’ and that there is a
‘method’ of learning. Knowledge is conceived of as having a structure
and messages as having a point. Textbooks in modern Chinese, expli-
cit and descriptive, have emerged as the predominant genre of medical
writing. The classroom provides the space in which the standards they
convey are elaborated in a coherent way, for teachers need not deal
with the inconsistencies of medical practice. The standardised trans-
mission of Chinese medical knowledge has thus laid the groundwork
for building up a theory of TCM.
It remains to be seen whether transmission by means of ‘explanation’
is bound to give rise to a hierarchical structure of knowledge and whether
‘method’ inevitably leads to a focused vision resulting, for instance, in
focusing on one particular form of interrelation, say a causal one, to the
neglect of others. Are interrelations between concepts of TCM theory
generally more hierarchical than those in Chinese medical doctrine?
Is there a tendency towards a more focused vision in TCM than in
conceptualisations of the body ecologic referred to in classical Chinese
medical writings? The following chapter addresses these questions.
6 Teaching from TCM texts
TCM teachers claimed to be ‘standardising’ (guifanhua), ‘modern-

ising’ (xiandaihua), ‘making scientific’ (kexuehua), and ‘systematising’
(xitonghua) Chinese medical knowledge and practice. Notably, they did
not express the aim of ‘Westernising’ (xifanghua) it, but the importance
of the West – on a technological, institutional, and ideological level –
cannot be overlooked. It is not merely the practice of biomedicine in
China which has had an impact on TCM, but also Western scientific
thought and practice in general and other ideologies of modernity such
as nationalism, Marxism, and materialism. A close look at classroom
teaching will reveal both the ways in which these ideologies have led to a
reinterpretation of ancient concepts like yinyang, the Five Phases (wuxing)
and the Five Organs (wuzang), Essence ( jing), Breath (qi), Blood (xue),
Liquids and Fluids ( jinye), and the implications of neglecting the notion
of Spirit (shen). One may wonder why basic TCM concepts – so extens-
ively discussed in the Western literature on Chinese medicine – are
once again presented here. The value of this contribution is primarily
ethnographic. It intends to show how students learnt about these con-
cepts in contemporary China.
A focal point for this examination will be the classes conducted by
teacher Tao, one of the best at the college. Tao enjoyed lecturing and
had more than twenty years of teaching experience, and his classes,
spiced with jokes and anecdotes, were entertaining. His rhetoric was
overwhelming as he inundated the students with a flow of idioms from
medical practice, expressions from daily life, and phrases from the Party.
He said that he prepared each lecture early in the morning and learnt
them all by heart. Tao was head of a ‘teaching and research office’
( jiaoyanshi) which comprised twelve teachers. He was an influential
‘associate professor’ ( fujiaoshou) in the TCM Department, a college
representative on several committees of the Provincial Bureau for Educa-
tion, a member of the editorial board of the 1988–9 textbook editions,
and chief editor of one of those textbooks. A reliable Party member, he
could claim to have lectured throughout the people’s movement in May
168
Teaching from TCM texts 169
and June 1989 without interruption – admittedly, I was told, once in

the presence of only two students.
Although nationwide regulations bound Tao to teach the 1984 edi-
tion of TCM textbooks, he had enough authority to diverge from a
word-for-word reproduction of their contents. Almost every lecture con-
tained a diagram or definition based on his own ideas or ideas con-
tained in the forthcoming editions (to which he had contributed). Other
senior staff also substantiated the textbook contents with their personal
experiences from medical practice, and they would stress, slightly modify,
and occasionally even criticise the textbook contents, but none of them
would draw elaborate diagrams on the blackboard as Tao did.1
The classes that Tao delivered were based on the textbook TCM
Fundamental Theory, hereafter TCM Fundamentals (Zhongyi jichu lilun
(Yin 1984)). Comparisons will be made with its more recent editions
in 1988–9, namely the TCM Instructions (Zhongyixue daolun (Luzhou
yixueyuan)), Organ Clusters (Zangxiangxue (Yunnan zhongyi xueyuan)),
TCM Etiology and Pathogenesis (Zhongyi bingyin bingjixue (Chengdu
zhongyi xueyuan)), and Outline of TCM Preventive Health Care (Zhongyi
fangzhixue zonglun (in press)). Comparisons will also be made with
what my research has led me to consider its precursors (so far not
acknowledged as such in the Western literature): the Canon of Categor-
ies, hereafter Categories (Leijing), published in 1624 by Zhang Jiebin
(1563–1640), the Essentials of the Inner Canon, hereafter Essentials (Neijing
zhiyao), published in 1642 by Li Zhongzi (1588–1655), and the TCM
textbook of the Interpretation of the Inner Canon, hereafter Interpretation
(Neijing jiangyi (Cheng 1984)).
Teacher Tao did not deliver all the classes discussed here; he taught
‘acumoxa and massage specialists’ (zhenjiu tuina zhuankesheng) the TCM
Fundamentals, and another teacher, Tian, taught second-year ‘TCM
regular students’ (zhongyi benkesheng) the Interpretation. Tian was a
lecturer who belonged to a younger generation than Tao and consid-
ered himself a victim of the ‘ten chaotic years’ (shinian dongluan), the
Cultural Revolution (1966–76). He declared he had no ambitions and
was not a Party member, and the difference between his classes and
Tao’s showed that the standardised mode of transmission is not
always entirely uniform (see also Farquhar 1995).
The college classrooms had four to six rows of wooden tables and
benches and two blackboards, one for the teachers and the other, on a
side or back wall, for the students. Every few months two students were
1
Tao’s presentations were in this respect somewhat exceptional and reminiscent of a
‘senior Chinese doctor’s’ (laozhongyi) creative mode of interpretation.
expected to be creative and to fill the latter blackboard with

colourful drawings, poems, and personal opinions. The rooms were
unheated and, particularly in winter, a cold draught came in through
broken windows. Tao stood in front of forty students with the eleven
female students in the first two rows, Tian in front of a class of similar
size with fewer female students spread throughout the classroom. Tao
usually managed to capture his students’ attention with his eloquence
and liveliness, but Tian was unable to do so and various, somewhat
disruptive activities took place on the benches.
Lesson one: China’s cultural heritage

The semester began with an instruction by the tutor (usually junior
staff ) assigned to the class for the entire length of studies. She exhorted
the students to attend classes regularly, and to get into the habit of
‘preparing’ ( yuxi) and ‘reviewing’ ( fuxi) them in the classroom ten
minutes before class. Then the teacher, dressed in a white lab coat,
began his lecture. In this first lesson, Tao told his students that they
would be learning knowledge that was two thousand years old: ‘This
knowledge is the heart of Chinese medicine; it is at the heart of our
culture.’ He did not mention Mao’s 1955 speech (Lampton 1977:63)
or his declaration that Chinese medicine was a ‘treasure house’ (baoku),
but he did refer to Mao’s nationalistic justification for promoting Chinese
medicine within the first five minutes of the lesson.
In all introductory lessons, an outline of the compilations and authors
of the Chinese medical literature was given. The teacher lecturing on
Classical Chinese for Medics (Yiguwen) mentioned the Treatise of Cold
Damage Disorders (Shang han lun),2 essential for Chinese medical prac-
tice, and the Yellow Emperor’s Inner Canon (Huang di nei jing), the classic
of Chinese medicine.3 She spoke of Li Shizhen who had compiled the
most comprehensive materia medica,4 namely the Hierarchical System-
atisation of the Materia Medica (Ben cao gang mu), and cited a poem
attributed to Wang Bing, the editor of the Basic Questions (Su wen).5
This teacher had completed university studies in classical Chinese
rather than in Chinese medicine, and therefore the titles and names she
2
Attributed to Zhang Ji, Zhongjin (c. 150–219), but lost by the end of third century AD
and later recomposed, see Sivin (1987:460); translated by Despeux (1985).
3
The Yellow Emperor’s Inner Canon consists of two books, the Basic Questions (Su wen)
and the Divine Pivot (Ling shu); see Yamada (1979), Ren (1982), Keegan (1988), and
Sivin (1993). On the reception of the Inner Canon in China in comparison with that of
the Treatise of Cold Damage Disorders in Japan, see Agren (1986).
4
For details on Li Shizhen, Dongbi (c. 1518–1593), see Anon. (1988:227–8).
5
Wang Bing (eighth century); see Anon. (1988:24).
mentioned were those commonly known among Chinese ‘intellectuals’

(zhishi fenzi) and laypersons.
The TCM Fundamentals (Yin 1984:1–2), however, set standards for
the professional to which Tao made only a few amendments in his
lecture. He spoke of the ‘four great canons’ (sidajing),6 and then of Hua
Tuo,7 Wang Shuhe,8 Huangfu Mi,9 and Sun Simiao.10 He pointed to
compilations such as the Treatise on the Origins and Symptoms of Dis-
orders (Zhu bing yuan hou lun)11 and the Revised Materia Medica (Xin xiu
ben cao).12 He briefly discussed the ‘four great and famous physicians’
(sida mingyi) of the Song and Yuan dynasties with reference to their
different geographic origins.13 Then he mentioned those who had
developed the ‘doctrine of the Gate of Life’ (mingmenxue) in the Ming
(1368–1644) and Qing dynasties (1644–1911) and mentioned, apart
from Zhang Jinyue14 and Zhao Xianke15 (who both figured in the text-
book), Li Yan.16 He dwelt on Li Shizhen and spoke of the authors of
the doctrine, which stressed the Warmth Factor in certain Disorders
(wenbing xue), as ‘the four in and around Jiangsu province’, namely
6
This expression was not used in the textbook, and Tao explained that the four were
either the Nei jing, the Nan jing, the Shang han lun, and the Jin gui yao lüe [ fang lun]
(Essentials [and Discussions of Prescriptions] in the Golden Casket) or the three former
ones and the Shen nong ben cao jing (Divine Husbandman’s Materia Medica). Notably,
the Shen nong ben cao jing was not mentioned in the introduction of the TCM Funda-
mentals (Yin 1984:1–2).
7
Tao: ‘Hua Tuo (? c. 203) is nowadays celebrated and known because of his surgical
interventions, but little is known of this largely legendary figure.’ See Anon. (1988:120).
8
Tao mentioned Wang Shuhe (third century) as the compiler of the Mai jing (Canon of
the Pulse; c. 280), see Anon. (1988:50).
9
Huangfu Mi, Shi’an (215–82), was mentioned as the compiler of the Zhen jiu jia yi
jing (Systematic Canon of Acumoxa; 256/82), see Anon. (1988:449–50) and Sivin (1987:
453–4).
10
Sun Simiao (c. 581–682) was mentioned as the author of the Bei ji qian jin yao fang
(Essential Prescriptions Worth a Thousand, for Urgent Need; 650/659). Students and teachers
esteemed Sun as essential for the development of qigong. For biographical details,
see Anon. (1988:181).
11
Compiled by Chao Yuanfang (sixth/seventh century) in 610, see Anon. (1988:586–7).
Tao’s comment on it was: ‘This is a most interesting book! It contains about 1,700
articles on different disorders, partly with up-to-date information.’
12
Compiled by Su Jing, Gong (seventh century) in 650/9, see Unschuld (1986a:45–50).
Not a single materia medica was mentioned in the textbook of the TCM Funda-
mentals. Tao mentioned three in class: the Shen nong ben cao, Xin xiu ben cao, and
Ben cao gang mu.
13
Namely, Liu Wansu, Shouzhen (c. 1110 – c. 1200); Li Gao, Mingzhi, later known as
Dongyuan (1180–1251); Zhang Congzheng, Zihe (c. 1156–c. 1288); Zhu Zhenheng,
Yanxiu (1281–1358), see Zhongyi gejia xueshuo (Ren 1986: 37–47, 54–64, 72–83,
84–91).
14
Zhang Jiebin, Huiqing and Jinyue, (1562–1639), ibid. 126ff.
15
Zhao Xianke, Yangkui, (1573–1644), ibid. 116ff.
16
Li Yan, Jianzhai, (sixteenth century), wrote Yi xue ru men (Introduction to Medicine) in
1575, see Anon. (1988:214).
Wu Youke,17 Xue Shengbai,18 Ye Tianshi,19 and Wu Jutong.20 Finally,

he gave a lively description of how Wang Qingren21 came to write
Correcting the Errors of Physicians (Yi lin gai cuo).
Tao presented the history of Chinese medicine as a history of scient-
ific progress. He characterised an early period by pointing to outstand-
ing personalities of the Han dynasty (206 BC – AD 220) who were
often partly legendary, such as Hua Tuo. Then he named seminal
works that were compiled shortly before and during the Tang (618–
906), which he said constituted, with the installation of the Imperial
Medical College (Tai yi yuan), the formative period of Chinese medi-
cine. He characterised Chinese medical history from the Song dynasty
(960–1279) onwards by referring to various traditions and schools of
thought. His historical outline differed significantly, however, from one
of a history of science in that he began with canons, the four great
canons, that remain the authoritative texts, even today.
In the course on the Tracts and Links ( Jingluoxue)22 for acumoxa and
massage freshmen, the list of compilations and writers in the textbook
(Li 1984:19–20) was extensive but the teacher mentioned only a few of
them in class. The course itself consisted of text excerpts from the very
early medical literature: two fragments of the Mawangdui manuscripts,
the ‘Moxibustion Canon on the Eleven Foot and Arm Vessels’ (Zubi
shiyimai jiujing) and the ‘Moxibustion Canon on the Eleven Yin and
Yang Vessels’ (Yinyang shiyimai jiujing),23 were systematically compared
with passages in chapters 10–13 of the Divine Pivot (Ling shu). The
Canon of Difficult Issues (Nan jing),24 the coloured diagrams of the Tracts
in Sun Simiao’s Essential Prescriptions Worth a Thousand (Qian jin fang),25
17
Wu Youxing, Youke (c. 1582–1652), ibid. 150ff.
18
Xue Xue, Shengbai (1681–1770), ibid. 168ff.
19
Ye Gui, Tianshi (c. 1666–1745), ibid. 159ff.
20
Wu Tang, Jutong (1736–1820), ibid. 174ff.
21
Wang Qingren, Xunchen (1768–1831), ibid. 260ff.
22
Sivin (1987:249) speaks of the ‘circulation tract system’ ( jingluo), the main lines of
which are called ‘cardinal tracts’ ( jing), and the branch lines ‘reticular tracts’ (luo). He
partly follows Lu and Needham (1980:24ff.) who coined the term ‘tracts and channels’
as translation for jingmai, and partly Porkert’s (1974:197, 199) rendering of jingluo as
‘conduits’ or ‘sinarteries’, more precisely sinarteriae cardinales et reticulares. Luo are here
translated as Links because luo means ‘to link’. A link is primarily defined by its
function of linking but can also be a ‘thing’ located in space. Jing are rendered as
Tracts in conformity with the existing terminology. ‘Passages’ is another term that I
find suitable, for jing can refer to a ‘passage’ in time as well as one in space; moreover,
the word ‘passage’ nicely reflects the meaning of jing (to pass on).
23
Buried in 168 BC, excavated from tomb No. 3 at Mawangdui in 1972 (MWD 1985).
24
Compiler anonymous, probably second century AD; translated by Unschuld (1986b).
25
The longer title Bei ji qian jin yao fang is mentioned in the author’s preface, compiled
650/9; translated by Despeux (1987).
Li Shizhen’s Investigation of the Eight Odd Vessels (Qi jing ba mai kao),26
and Yang Jizhou’s Great Compendium on Acumoxa (Zhen jiu da cheng)27
were the only other texts the teacher mentioned in class.
In the course on Acumoxa (Zhenjiuxue) for regular TCM undergradu-
ates, the teacher talked about the same compilations in her introductory
lesson, although the textbook itself contained no outline of the history
of acumoxa (M. Qiu 1985). It is noteworthy that she did not mention
the Canon of Difficult Issues. When I asked her why, she said that she
had simply forgotten. According to Unschuld ((1980)1985:13), the
Canon of Difficult Issues represents the apex of the ‘medicine of system-
atic correspondence’, but had fallen into disregard for several centuries
before being revived in the twentieth (Unschuld (1980)1985:46–53). It
was only occasionally mentioned in the textbook but during the course
the teacher referred to it twice as providing additional information.28
The historical outline in the Organ Clusters (Yunnan zhongyi xueyuan
1988:3–4), as volume II of the 1988 edition of the TCM Fundamentals
was called, included several writers and compilations known from the
1984 edition on Acumoxa in addition to those mentioned in the 1984
TCM Fundamentals. This may be interpreted as a form of official re-
cognition of acumoxa by mainstream TCM scholars due to the thera-
peutic success of, in particular, acupuncture analgesia (Hsu 1995).
If one considers that acumoxa describes the human body in terms
which can be fairly easily approximated by biomedical anatomy
(Farquhar 1994a:82–4), one can also interpret this as an indication
that the editors of the 1988 Organ Clusters were emphasising anatomical
and material aspects of the body and including more works on acumoxa
accordingly.
The students easily remembered the nationalistic motive of their
studies: Chinese medicine was their cultural heritage. Some readily
identified with their role of perpetuating ancient Chinese culture; some,
acumoxa specialists in particular, spoke proudly of learning a medicine
that was being exported to the West. Others remarked how useful it
would be to learn Western medicine instead: ‘If I open a private
practice in the county town and know no Western medicine, I won’t
have any patients. Most people believe in Western medicine; Chinese
26
Compiled in 1572, Anon. 1988:228. Porkert (1974:273) translates qi as ‘odd’.
27
Compiled in 1601; see Gejia zhenjiu xueshuo (Wei 1987:81).
28
Once she discussed the notion shi dong ze bing, which she proposed interpreting as: ‘If
this [Vessel] comes into motion then [the following] disorders arise’, and the notion
suo chan bing, interpreted as: ‘The disorders produced by [the Vessel]’, which were not
mentioned in the textbook; and once she gave a detailed account of ‘needling tech-
niques’ (cifa) that were only briefly mentioned in the textbook.
medicine is generally considered “superstition” (mixin).’29 Whether the

Chinese heritage was considered ‘just as good as the Western’, ‘so good
that even the West seeks it’, or ‘not as good as the Western’, the
Western was always considered good. That the knowledge they learnt
was age-old was for some students and staff a matter of pride, but for
others an obstacle to China’s progress towards a modern state.30
The classes on the Interpretation were poorly attended. Even during
the mid-term examination there was whispering, and printed textbooks
containing standard exam questions and answers circulated along the
benches. ‘These lectures are boring’, a student explained. ‘It’s not that
the classical texts themselves are boring, but the way they are taught
here. This is superficial.’ Classes on the Treatise of Cold Damage Dis-
orders were, by contrast, a favourite of many students, and not only
because of their reportedly excellent teacher: third-year TCM under-
graduates simultaneously attended the clinic once a week and frequently
expressed how intrigued they were to find its ancient ‘formulae’ ( fangji)
scarcely altered in application today.
Students learning acumoxa, who generally were not interested in the
canonical literature, nevertheless expressed an interest in buying the
Great Compendium of Acumoxa, but it was not available in any book-
shop. Although they showed little interest in the Inner Canon and the
Canon of Difficult Issues, when an itinerant bookseller displayed booklets
with excerpts of these classics in modern Chinese several students were
eager to buy them, disregarding the opinion of others on any contem-
porary reinterpretation of the classics as: ‘All they contain is politics.’ A
graduate assigned a post in a ‘township hospital’ (weishengyuan) would
have no access to the medical classics except for the excerpts in the
TCM textbooks. In rural areas, medical books from late Imperial times
would sometimes still be in circulation but not the medical classics.
The responses to the letter questionnaire sent to graduates showed that
about two-thirds had consulted medical classics in their new workplace,
but the literature they listed was very limited (see table 6.1).
Apart from a few retired professors, most members of the staff
had been trained at a TCM college, mainly in the four great canons,
29
This student’s comment was accurate insofar as private practitioners often provide
primary health care which has largely adopted and integrated biomedical practices.
However, I encountered hardly any biomedical doctors in private practice. I found
that the main income of a private practitioner comes from highly priced skills in a
traditional or popular speciality like qigong, Chinese drug therapies, bone setting, and
the like, with which the costs of the minor interventions of primary health care are
financed.
30
On the history of the ambivalent attitude towards the West that nationalism created
among Chinese medical doctors, see Croizier (1968).
Table 6.1. Preferred canonical medical works consulted by graduates
Acumoxa and
Subject of graduation massage TCM
College enrolment 1986–8 1987–9 1985–9
Total number of responses 21 19 22

Consulted number of classics 4 5 6
Inner Canon (Nei jing) 11 7 4
Treatise of Cold Damage Disorders (Shang han lun) 2 4 6
Essentials in the Golden Casket ( Jin gui yao lüe) 0 1 3
Great Compendium of Acumoxa (Zhen jiu da cheng) 4 2 0
Warmth Factor Disorders (Wen bing xue) 0 0 3
Systematic Canon of Acumoxa (Zhen jiu jia yi jing) 1 0 0
and they were fairly familiar with the medical classics. Several spoke
of themselves as adherents of the ‘party of the canonical formulae’
( jingfangpai).31 Senior teachers all emphasised the importance of memor-
ising canonical texts. This does not of course mean that they took every
word of the canons at face value. Some distanced themselves from the
phrases they quoted from the classics by saying: ‘The ancients (guren)
say’ or ‘The ancients did not know’. Although I found that the Ming
commentary by Zhang Jiebin (1563–1640) rather than the Tang com-
mentary by Wang Bing (eighth century) tended to be cited in the TCM
textbook Interpretation, it would be wrong to conclude that more recent
interpretations were always considered more refined and accurate. Opin-
ions diverged particularly on the accuracy of modern interpretations
of the classics which accorded with biomedical models. Tao was con-
vinced of their scientific value, while others were very sceptical.
Opinions among the younger staff members were most diverse, par-
ticularly among the Shanghai-trained acumoxa and massage teachers:
‘The introductory course on Classical Chinese for Medics is indispensable.’
‘The course in Classical Chinese for Medics was good and necessary, and
so were those on the Interpretation of the Inner Canon and the Selected
Writings of Acumoxa (Zhenjiu jixuan).’ ‘Shanghai is far more progressive,
with more courses on Western medicine; here there is more emphasis
on the four great canons.’ ‘Reading the four great canons was a pure
31
They indicated that the Japanese and also certain colleges in the Jiangsu area belonged
to the ‘party of the fashionable formulae’ (shifangpai). Certain teachers who had experi-
enced the Japanese occupation during World War II (1937–45) expressed open resent-
ment of the Japanese, even in class, but the young acumoxa staff showed much
admiration for Japan, particularly for the Japanese biomedical research on TCM.
Table 6.2. Courses on canonical medical texts for TCM students
Number of Number of Lessons

Textbook Hours/Semester (2hrs)/Week Semester
Classical Chinese for Medics 142 2 1st, 2nd

(Yiguwen)
Interpretation of the Inner Canon 108 3 4th
(Neijing jiangyi)
Treatise of the Cold 108 2 5th, 6th
Damage Disorders
(Shanghanlun)
Essentials in the Golden Casket 72 2 7th
( Jingui yaolüe)
Warmth Factor Disorders 72 2 7th
(Wenbingxue)
Summaries of Different Chinese 108 3 8th
Medical Doctrines
(Zhongyi gejia xueshuo)
Total 610 14
waste of time.’ ‘We only studied the Inner Canon; we should have learnt
more of the four great canons.’ ‘The Canon on Difficult Issues is most
important for the clinic, but no college offers any courses on it.’ Apart
from one teacher who advocated the elimination of courses on the four
great canons altogether, most of these teachers did not question the
general opinion that the medical classics were important for TCM,
although most denied their usefulness in the clinic: ‘The “ancient books”
( gushu) provide no guidance for clinical work – for that we have the
TCM textbooks on clinical courses – but they are necessary for deeper
insights.’
According to the national standard, about one-quarter of the time in
courses for regular students was devoted to the Chinese medical canons
(see table 6.2), but local authorities felt free to modify these standards.
For instance, the introductory course on Classical Chinese for Medics was
in 1988–9 shortened for those acumoxa and massage students who
specialised in massage to 1 semester of 72 hours instead of 2 semesters
of 56 hours each, and classes on the Interpretation were in 1989 reduced
for TCM regular students from 108 hours to 72 hours only.32 A teacher
32
In the late 1950s, there were daily classes on the Inner Canon over two years (Zhang,
p.c.).
commented: ‘The “party of the TCM colleges” (xueyuanpai) emphas-

ises Western biomedicine. It wants to abolish the study of the ancient
books and is not serious about the Inner Canon.’ The college authorities
themselves expressed the aim to train students in the reading of canon-
ical medical texts by means of ‘examplary learning’. However, if this
method reduces the number of examples too much, the claim that
the college is transmitting knowledge of China’s ancient heritage may
become vacuous.
Lesson two: Mao’s dialectics

In the second hour Tao started lecturing on the TCM Fundamentals.
‘I am not a philosopher and not a political scientist, but medicine and
philosophy cannot be separated. Their foundations are yinyang and
the Five Organs.’33 He then gave an account of the textbook’s contents.
He spoke of the ‘materialist aspect’ (weiwuguan) and its implications
for ‘views of life’ (shengmingguan), for interrelating ‘Form and Spirit’
(xingshenguan) and for the ‘inspection of illness’ ( jibingguan). Then he
spoke of ‘the dialectical approach’ (bianzhengguan) and stressed ‘con-
tradiction’ (maodun), ‘holism’ (zhengti guannian), and ‘the inherent pro-
pensity to motion’ ( yundongxing) in all ‘material things’ (shiwu). During
the private tutorial in the afternoon, Tao conceded that the notions of
contradiction and struggles came from political slogans: ‘In this country
politics is quite important.’ It was natural for him to use idioms of
‘materialist dialectics’, particularly when he discussed the notion of
yinyang in class.
With regard to yinyang, Tao followed the textbook (TCM Funda-
mentals (Yin 1984:12–15) ) in pointing out that the interaction of yin
and yang had four principal aspects: Control through Opposition (duili
zhiyue), Mutual Reliance and Mutual Use (hugen huyong), Equilibrium
of Waxing and Waning (xiaozhang pingheng), and Mutual Transforma-
tion (xianghu zhuanhua). Tao wrote these terms on the blackboard,
adding his own definitions and examples (see fig. 6.1).
Tao followed the textbook in distinguishing four kinds of opposition,
but from the examples that he wrote on the blackboard it was not clear
what the difference was between the four kinds of opposition that the
four aspects of yinyang described. It was, for instance, not immedi-
ately intelligible what the difference between ‘Heaven checks Earth and
33
The usual expression is yinyang and wuxing (Five Phases). I was surprised to hear Tao
replace the notion of Phases with the notion of Organs. Considering the increasing
prominence of wuzang (Five Organs) in TCM, it is possible that his saying wuzang
instead of wuxing was intentional.
No. 1. Control through Opposition (duili zhiyue):

Fire checks Water, Water checks Fire
Heaven checks Earth, Earth checks Heaven
left checks right, right checks left
No. 2. Mutual Reliance and Mutual Use (hugen huyong):
teacher and student
man and woman
Heaven and Earth
No. 3. Equilibrium of Waxing and Waning (xiaozhang pingheng):
working eating
(gongzuo) (yingshi)
No. 4. Mutual Transformation (xianghu zhuanhua):

function and energy (gongneng )
nourishment (yingyang )
Figure 6.1 The Four Aspects of yinyang in TCM Teachings
Earth checks Heaven’ and ‘Heaven and Earth’ was. Likewise, the only
difference between ‘eating and working’ and ‘nourishment and energy’
seemed to be that in one case the arrow was horizontal and in the other
vertical.34
Recourse to Cruse’s Lexical Semantics (1986) promised some clarifica-
tion. According to Cruse (1986:197–264), opposites in English describe
four major kinds of opposition: (1) mutually exclusive opposites, here
called ‘complementaries’, which characteristically stand in an either–or
relation to each other; (2) ‘antonyms’, which stand in a gradable rela-
tion to each other; (3) ‘directional opposites’, which describe contrary
motions; and (4) ‘pseudo-opposites’, in which one word has several
opposites (see table 6.3). This allows us to reformulate our initial ques-
tion and ask to which kind of opposition the four aspects of yinyang
referred.
Naturally, the lexical semantic analysis calls for caveats. Cruse (1986)
analysed the English vocabulary and not the Chinese, and this is import-
ant in that opposites are recognised as such on the basis of convention.
34
Tao used rounded arrows for describing processes leading to the Equilibrium and the
Mutual Transformation of yinyang but straight lines and vectors for TCM physiolo-
gical and biomedical diagrams.
Table 6.3. Opposites according to Lexical Semantics

(based on Cruse 1986)
Term for the Opposition Description of the Relation Examples in English
1 Complementaries either–or dead-alive, open-shut

2 Antonyms gradable
2.1 Polar antonyms objectively descriptive fast-slow, heavy-light
2.2 Overlapping antonyms evaluative good-bad, polite-rude
2.3 Equipollent antonyms subjective sweet-sour, nice-nasty
3 Directional Opposites contrary motion
3.1 Directions ‘potential paths’ up-down, north-south
3.2 Antipodals extremes centre-periphery
3.3 Counterparts balanced irregularities in a convex-concave,
uniform shape male-female
3.4 Reversives motions in rise-fall, enter-leave,
opposite directions pack-unpack
3.5 Conversives relation in before-after, predator-prey,
converging direction guest-host, teacher-pupil
4 Pseudo-opposites opposition of one to thin-thick/fat,
several opposites old-new/young
For instance, Western United Nations bureaucrats tend to oppose

‘working time’ to ‘leisure time’, and not working to eating as Tao did.
The analysis is, moreover, rendered difficult because the concepts Tao
referred to stood out for their ‘multivocality’ (Turner (1960)1967:48–
58). Water, for instance, may refer to what flows in rivers and has depth
in lakes, to the stuff we drink and urinate, something cold or salty,
sometimes dark and sometimes clear, to the supple and weak, and to
the vigour which makes plants pliant.
Nevertheless, the lexical semantic analysis does provide some clarifica-
tion. Seen in opposition to Fire, the use of Water for extinguishing a
Fire and, conversely, the use of Fire to turn the Water with Form ( you
xing) into vapour without Form (wu xing) could be meant. In that case,
Water and Fire could be understood as mutually exclusive opposites
that stand in an either–or relation to each other, ‘complementaries’ in
Cruse’s terms: if one is alive, the other is not (see table 6.3, section 1).
If, in contrast, one were to view Water and Fire as indicators of the Cold
(han) and Hot (re), they would probably point to an opposition compar-
able to that of warmth and coldness on a gradable scale of temperature.
In terms of lexical semantics they would be ‘polar antonyms’ if they
were considered objectively descriptive or ‘equipollent antonyms’, since
Chinese medical concepts often refer to the subjectively felt (table 6.3,
sections 2.1 and 2.3). However, in ancient Chinese philosophy Water
and Fire described yet another kind of opposition. If one consults one
of the most frequently cited text passages on the Five Phases from
the chapter of the ‘Great Plan’ (Hong fan) in the Book of Documents
(Shang shu), one finds that: ‘Water means soaking downward; Fire means
flaming upward’ (Karlgren 1950:30). Water and Fire are here conceived
of as ‘directional opposites’, and thus best classified as ‘reversives’
(table 6.3, section 3.4).
The examples Tao wrote on the blackboard to illustrate Control
through Opposition and Mutual Reliance and Mutual Use can all
be understood as ‘directional opposites’ (table 6.3, section 3): Heaven
and Earth, like man and woman, may be seen as ‘counterparts’ (Cruse
1986:225), but man and woman has, particularly in Chinese, also the
connotation of the ‘conversive’ husband and wife (p. 232). Teacher and
student constitute another example of ‘conversives’, and left and right
indicate, according to Cruse, ‘directions’ (p. 223). Without being con-
scious of it, Tao cited examples which emphasised a conception of the
universe that Zhang had already stressed: he conceived of it in terms
of directional categories (see p. 110). Much as Zhang stressed the Five
Directions (wuwei), Tao raised examples of ‘directional opposites’, a
finding that makes perfect sense in the light of the ancient conception
of the universe as being in constant flow and flux. Flows and changes
inherently have a directionality.35
Lexical semantics has helped us to recognise what Tao’s examples on
the blackboard had in common, namely, ‘directional opposition’, but it
has not helped us to distinguish between the four aspects of yinyang.
The information Tao provided in the classroom proved insufficient to
identify the four different forms of opposition that yinyang are supposed
to describe, and recourse to the textbook gave an equally muddled
picture. From the textbook passages on yinyang it was impossible to
compare and contrast the four aspects of yinyang systematically because
of the unsystematic choice of citations from the medical classics,36 the
inconsistent interpretation of certain citations,37 the lack of citations in
certain paragraphs,38 a failure to indicate that a sentence in modern
35
For a more comprehensive analysis, see Hsu (1998).
36
For instance, a quote describing the Equilibrium of yinyang was cited in the paragraph
of Control through Opposition (TCM Fundamentals (Yin 1984:12)).
37
For instance, another quote interpreted to refer to the Equilibrium was cited in the
paragraph Control through Opposition (ibid: 13).
38
For instance, in the paragraph on the Equilibrium only a citation describing Control
through Opposition was repeated (ibid:13–14).
Chinese was, in fact, a quotation from the classics,39 and the inclusion
of examples from medical practice in one paragraph but not in all the
others.40
Much later I found that Mao’s essay ‘On Contradiction’ clarified the
issue (Mao 1961, 1975b). Two of the four aspects attributed to yinyang
in TCM textbooks were derived from Mao’s writings, namely, Control
through Opposition and Mutual Transformation. Mao’s concept of
the Unity of Opposites (duili tongyi) was used for reinterpreting the
meaning of yinyang in the paragraph on Control through Opposition.
The textbook compilers may also have borrowed the wording ‘mutual
transformation’ (huxiang zhuanhua) from Mao’s writings. In this case,
however, the reinterpretation of the interaction between yin and yang
was not adjusted to Mao’s notion of mutual transformation. Since the
textbook contained citations from the medical classics and examples
from medical practice, it became apparent that there was a discrepancy
between the connotations of the label borrowed from Mao’s writings
and the classical Chinese medical conception of yinyang.
The unity of opposites and the necessity of struggle

‘Unity of opposites’ (duili tongyi) was a favourite phrase of teacher Tao’s
when he spoke of yinyang, and it is also at the core of Mao’s essay ‘On
Contradiction’:41 ‘The principle of contradiction within things, that is,
the principle of the unity of opposites, is the basic principle of materi-
alist dialectics’ (Mao 1961:287). The ‘unity of opposites’ highlights in
Mao’s writings not only contradiction within things but also the neces-
sity of struggle. Mao (1975b:341–2) cites Lenin: ‘The unity . . . of oppos-
ites is conditional, temporary, transitory, relative. The struggle of
mutually exclusive opposites is absolute, just as motion and develop-
ment are absolute.’
Mao (1975b:337) claims ‘that the contradictory aspects in every pro-
cess exclude each other, struggle with each other, and are in opposition
to each other’. Opposites may be simultaneously ‘one and the same’
(tongyi) because each is a condition for the other’s existence – ‘Without
life, there would be no death; without death, no life’ (p. 316) – and
because ‘in certain conditions, each of the contradictory aspects within
39
Ibid: 13.
40
Ibid: 16. The argumentation was obviously muddled in the paragraph of the TCM
Fundamentals concerned with yinyang, but this does not apply to all TCM writings.
41
On Mao’s notion of ‘contradiction’ (maodun), see Soo (1981:46ff.). For a more com-
prehensive version of the essay ‘On Contradiction’, originally entitled ‘The Law of the
Unity of Opposites’, and its history, see Knight (1990).
a thing transforms itself into the contrary; it changes its position to that
of its opposite’ (p. 316). Mao (1975b:338–9) gives as an example the
‘revolution of the proletariat’: ‘The ruled are transformed into the rulers,
while the bourgeoisie, the erstwhile ruler, is transformed into the ruled
and changes its position to that originally occupied by its opposite.’
This means that in materialist dialectics opposites transform themselves
into each other. Mao maintains that there are ‘two states of motion in
all things, that of relative rest and that of conspicuous change’ (p. 342).
The unity of opposites refers, thus, in terms of lexical semantics, to
mutually exclusive opposites, ‘complementaries’ in Cruse’s terms (table
6.3, section 1). It also implies an understanding of change wherein
struggle results in unity and, because of the contradiction within things,
unity leads necessarily to opposition. It is an idiom which contains a
revolutionary message: struggle!
To my surprise, the message to struggle was contained in the discus-
sion of yinyang in the TCM Fundamentals (Yin 1984:12): ‘Yinyang are
opposites; they are also one and the same. That they become one is the
result of opposition. In other words, “opposition” (duili) is the aspect
of the “contrary” (xiangfan) between the two; “unity” (tongyi) is the
aspect of the “complementary” (xiangcheng) between the two. If there
is no opposition, there is no unity; if there is no contrary, there is no
complementary.’42
The affinity of this rhetoric with Mao’s writings springs to mind.
For instance, the Chinese saying ‘Opposites are complementary’43 has
become conditional: ‘If there is no contrary, then there is no comple-
mentary.’ The conditional is a grammatical construction that frequently
occurs in Mao’s writings, but in the above context it makes no sense.
A person (an event, or a thing) can complement something without
necessarily being its contrary. Yin and yang need not necessarily be
each other’s contrary to be complementary.
For interpreting the phrase ‘yang engenders and yin causes growth’
( yang sheng yin zhang), one may emphasise that yang is the contrary of
yin: yang engenders and yin does not. From a linguistic point of view,
yang is then the opposite of yin; yang differs from yin ‘along only one
dimension of meaning’ (Cruse 1986:197). In contrast, we could inter-
pret this phrase as emphasising two potentialities which are not very
different and certainly not primarily opposites, as my translation ‘to
engender’ and ‘to cause growth’ suggests. The reduction of yang to
42
Here ‘complementary’ (xiangcheng) mean to complement the other, and is not to be
confused with Cruse’s usage (table 6.3, section 1).
43
Derived from a phrase in the History of the Former Han (Han shu); see Mao (1961:326,
n. 23). Initially it did not have universal implications (Knight 1990:51).
something that yin is not and vice versa becomes irrelevant. Yin and
yang describe two different aspects of becoming. They need not be
opposites, just like bian and hua were not opposites, but described
change from different viewpoints. By reducing yin and yang to con-
traries, one stresses only one possible interpretation.
The discussion of Control through Opposition in the TCM Funda-
mentals not only reduces yinyang to contraries, but also reflects an
understanding that unity arises after struggles during a previous period
of opposition. Yin and yang are viewed as struggling with each other
and thereby checking and balancing each other. This understanding of
yinyang cannot be reconciled with others such as, for instance, Zhang’s
view when commenting on yinyang in the Book of Changes (see pp. 125–6).
The difference between the Unity of Opposites in materialist dia-
lectics and the unity in the opposition of yin and yang became the focus
of political debate in China’s recent past. The Yang Xianzhen cam-
paign was over the interpretation of ‘One divides into two’ ( yi fen wei
er) and ‘Two unites into one’ (er he wei yi) (Goldman 1981:95–101). In
the early 1960s Mao used the expression ‘One divides into two’ to
emphasise a struggle between two mutually exclusive opposites and
insisted on a continuation of class struggle during the period of Socialist
construction. Yang Xianzhen, in contrast, spoke of ‘Two uniting into
one’ and, applying it to politics, advocated an economy that tolerated
collective and private ownership. Yang Xianzhen was a Marxist theore-
tician who had spent more than twenty years in the Soviet Union, but
his views were firmly grounded in the Chinese tradition. He pointed to
Chinese concepts like yinyang, in which harmony was found in two
aspects participating in a single event, just as ‘breathing’ (huxi) was com-
posed of ‘exhaling’ (hu) and ‘inhaling’ (xi). This view made it possible
for him to tolerate diversity (Goldman 1981:97–8). Yang was a con-
venient target for the anti-Soviet campaigns which diverted attention
from other tensions in the Party, and was removed from his position in
1964 (Goldman 1981:101). This anecdote is not directly relevant to
the observation that Mao’s dialectics have since been used even for
interpreting yinyang in the medical context, but it does highlight how
different the ancient and the Maoist understandings of yinyang are and
how far-reaching the implications of this can be.
Mutual transformation: two different notions of change

The aspect of the interaction between yinyang that was labelled Mutual
Transformation (xianghu zhuanhua) concerned a notion of change into
one’s opposite. The wording xianghu zhuanhua is strikingly similar to
one of materialist dialectics, huxiang zhuanhua (Mao 1961:318), and

it is quite likely that TCM textbook writers borrowed it from Mao’s
writings.
As a revolutionary, Mao was confronted with problems of changing
the social and political conditions in which China found itself at the
beginning of the twentieth century. He strongly opposed what he called
‘metaphysical doctrines’, which he characterised as building on the
assumption that things were ‘discrete and static’. Moreover, he did not
agree that only a change in the environment could effect change; this
kind of change he considered quantitative and not qualitative (Mao
1961:296ff.). Mao’s (1961:318) notion of change built on Lenin’s:
‘“Dialectics is a teaching which investigates how opposites ‘become
one’ (tongyi) (how they change into one) – in which conditions they
‘transform themselves into one another’ (huxiang zhuanhua) and become
one.”’
Roughly speaking, dialectical change was the union of two antitheses
into a synthesis: ‘The old unity with its constituent opposites yields to
a new unity with its constituent opposites, whereupon a new process
emerges to replace the old’ (Wakeman 1973:298). Wakeman remarks,
however, that ‘On Contradiction’ did not explain how this change
occurred and points to the many examples ‘drawn from history to
illustrate opposites transforming into each other, but how those changes
took place was not actually explained. One stage simply succeeded
the next, like a before-and-after still photograph without intermediate
motion’ (p. 298). To describe change by presenting before-and-after
still photographs of two different states is indeed characteristic of ‘On
Contradiction’, but it is not unique to Mao. In the Chinese medical
literature processes whereby yang is transformed into yin or vice versa
are often described in terms of before-and-after still photographs.
TCM teachers would readily point to further similarities between
Mao’s dialectics and the ‘dialectics of the yinyang school of thought’.
Sometimes they would simply state that the precursors of materialist
dialectics were, in fact, Chinese. Compared with a monocausal explana-
tion of change which builds on an imagery derived from mechanics and
consists of excluding many factors in favour of one conceivable cause–
effect sequence along a unidirectional vector of time (as is often the
case for assessing biomedical processes), ‘materialist dialectics’ and
‘yinyang dialectics’ have much in common.
Consider, for instance, Mao (1961:318) quoting Lenin: ‘“Why should
the human mind take these opposites not as something dead and rigid,
but as something living, conditional, and ever changing, things trans-
forming themselves into one another?”’ That things are considered
‘living’ or, rather, ‘ever changing’, that they are mutually transformed
into each other, that this force for change is within the things them-
selves, and that each thing is special and particular – features which are
found in Mao’s understanding of dialectical change – have much in
common with the idea that the universe is yin and yang in constant flux
(in the sense of transformation).
However, the difference between the goals of a twentieth-century
revolutionary and the ancient Chinese worldview inherent in the notion
of yinyang is crucial. In the TCM Fundamentals (Yin 1984:14), Mutual
Transformation is explained in terms of several citations from the Inner
Canon. One of them is from Basic Questions, chapter 66: ‘When things
are born, one calls it “transformation” (hua), and when things reach
their extremes, one calls it “transition” (bian).’ Another is from Basic
Questions, chapter 5: ‘If the cold reaches its extreme, this gives birth to
the hot; if the hot reaches its extreme, this gives birth to the cold.’ This
is illustrated with an example from medical practice: ‘In certain acute
warmth and heat factor disorders . . . in the condition of high heat
(fever), a rapid drop in temperature may suddenly occur, the Complex-
ion becomes Pale (se cangbai), the Four Limbs Numb (sizhi jueleng),
the Pulse Faint (wei) and likely to to be Severed ( jue), etc. This danger-
ous phenomenon in which the yangqi suddenly casts off, this kind of
change of Pattern, belongs to those in which a yang Pattern “is trans-
formed” (zhuanhua) into a yin Pattern.’ The two citations from the
Inner Canon and the description of a change in a Distinguishing Pattern
(bianzheng) point to a kind of change that occurs when an observer sees
a boundary being reached and trespassed and a shift to its opposite or,
as proposed earlier, a bian-change into another entity (see pp. 112–16).
This aspect of yinyang is labelled Mutual Transformation, the term that
stands for dialectical change in Mao’s writings. However, the textbook
does not stress the necessity of struggle. Zhuanhua change is not pos-
tulated to occur because of the ‘synthesis’ (tongyi) of two antitheses.
Although the word zhuanhua occurs both in Mao’s essay ‘On Contra-
diction’ and in the TCM Fundamentals, it has significantly different
meanings in these two texts.44
In summary, Unity of Opposites is an idiom of materialist dialectics,
and in the textbook paragraph entitled Control through Opposition
(no. 1) yinyang is interpreted to describe dialectical change. The wording
44
It is not my intention to complicate the issue, but the term zhuanhua also occurs in
the Inner Canon, with still another meaning: ‘Therefore, if a disorder endures, then it
is transformed (zhuanhua), the upper and lower parts are out of balance and even a
good doctor cannot cure it’ (Basic Questions 3). Zhuanhua, to transform, also refers to
processes of digestion (e.g. Basic Questions 11). See Ren (1986:1422; 13, 37).
Mutual Transformation (no. 4) has also been borrowed from material-

ist dialectics, but the interpretation of yinyang in this paragraph has not
been adjusted to it.45
Lesson three: being systematic

Lesson three began with the students rising from their seats to greet the
teacher (as usual) and continued with their whispering on the benches
as soon as they were seated again (as usual). Throughout the lecture
the teacher stood at the blackboard, spoke in a monotonous voice, and
turned only when the antagonism of the students became unbearably
loud. This lesson was not Tao’s, but teacher Tian’s third lesson. It was
on the Interpretation of the Inner Canon (1984). The Interpretation and
the TCM Fundamentals have more or less the same thematic structure,
as is easily seen from their table of contents (see table 6.4). A former
edition of the Interpretation constituted the introductory course in the
early 1960s, and a former edition of the TCM Fundamentals replaced it
from the 1970s onwards.
At the core of the Interpretation are whole chapters or parts of chap-
ters from the Inner Canon. In accordance with the textual tradition of
Imperial times, the Interpretation consists of the ‘original text’ ( yuanwen),
followed by a number of ‘footnotes’ (zhuci). And like most texts edited
during the Republican period, the original text is presented in compact
paragraphs (of two to seven lines) and not interspersed with one or
several comments after every phrase of the original text. The interpre-
tive additions by the TCM textbook compilers of the Socialist period
consist merely of introductory remarks at the beginning of each chapter
and ‘notes’ (anyu) at the ends of certain paragraphs, both written in
standard modern Chinese.
The TCM Fundamentals, by contrast, are written in standard modern
Chinese and contain only short citations from the Inner Canon (and a
few other medical works). In the early 1960s a series of essays that had
apparently been published in the journal called Fujian Chinese Medicine
(Fujian zhongyiyao) was compiled to form a textbook entitled The Study
of TCM Fundamentals (Zhongyi Jichuxue (Zhao 1963:1)). Although this
textbook had been printed before the Cultural Revolution, it was pro-
mulgated on a nationwide scale only in the early 1970s. Wicked ton-
gues have spoken of such courses on the TCM Fundamentals as easily
digested convenience food for soldier-peasant-worker students, others
45
Possibly, TCM textbook compilers decided for this reason to speak of xianghu zhuanhua
instead of huxiang zhuanhua.
Table 6.4. Chapter Headings of the Categories, Essentials, Interpretation, and TCM Fundamentals
Categories (1624) Essentials (1642) Interpretation (1984) TCM Fundamentals (1984) 1988 editions replacing the
(Lei jing) (Nei jing zhi yao) (Neijing jiangyi) (Zhongyi jichu lilun) TCM Fundamentals
12 Categories in 32 Chapters 8 Chapters 9 Chapters and 1 Appendix 8 Chapters 4 Volumes
1 Introduction 1 Introduction 1 Zhongyixue daolun

TCM Instruction
1 she sheng lei 1 dao sheng
Self-cultivation Self-cultivation
2 yin yang lei 2 yin yang 2 yinyang wuxing xueshuo 2 yinyang wuxing
yinyang Five Phases yinyang Five Phases
3–4 zang xiang lei 5 zang xiang 3 zangxiang xueshuo 3 zangxiang 2 Zangxiangxue
Hidden and Apparent Hidden and Apparent Organ Clusters Organ Clusters Organ Clusters
3.1 zangfu xueshuo
Organs and Bowels
3.2 jing qi shen 4 qixue jinye
Essence qi Spirit qi Blood Liquids Fluids
Teaching from TCM texts
5–6 mai se lei 3 se zhen 7 zhenfa

Pulse and Complexion Examination of the Methods of Diagnosis
Complexion
4 mai zhen
Examination of the Pulse
7–9 jing luo lei 6 jing luo 4 jingluo xueshuo 5 jingluo
Tracts and Links Tracts and Links Tracts and Links Tracts and Links
10 biao ben lei 5 bingyin bingji xueshuo 6 bingyin yu fa bing 3 Zhongyi bingyin bingjixue
Ramifications and Roots Illness Factors and Illness Illness Factors and Onset TCM Etiology and
Triggers of Illness Pathogenesis
11 qi wei lei
qi and Flavour
12 lun zhi lei 7 zhi ze 8 zhize zhifa
Discussion and Treatment Principles of Treatment Maxims and Methods of
Treatment
13–18 ji bing lei 8 bing neng 6 bingzheng 7 bingji
Illnesses Illness Conditions Illness Patterns Illness Triggers
9 yangsheng xueshuo 8 fangzhi yuanze 4 Zhongyi fangzhixue zonglun
Self-cultivation Principles of Prevention Outline of TCM Preventive
and Treatment Medicine
19–24 zhen ci lei
187
Needling
25–28 yun qi lei Appendix: yunqi xueshuo
Phase Energetics Phase Energetics
29–32 hui tong lei
Congruences
Table 6.5. Comments of graduates on TCM textbooks
Acumoxa and massage TCM
TCM textbooks are . . . 1986–8 1987–9 1985–9
Systematic, contain basic knowledge 7 7 10

Useful only for general guidance 5 5 4
(Very) helpful 5 3 5
No comment 2 2 3
of Mao’s educational scheme of indoctrination. For anthropologists

and historians (e.g. Sivin 1987) it is of utmost interest not least because
Chinese medical concepts are discussed in it in a fairly explicit and
more readily intelligible way than in classical Chinese.46 The editors of
the TCM Fundamentals were not merely commentators, but composers
of a coherent text. This opened up a forum for innovation.
Teacher Tian, who taught the course on the Interpretation, was not
concerned with making Chinese medical concepts fit with Mao’s dia-
lectics. Rather, he was preoccupied with a ‘systematic’ (xitonghua) analysis
of the medical classics. In his view, the Inner Canon was an accumula-
tion of contradictory citations, a real hotchpotch. Students needed
systematic guidance, he said. Like other TCM teachers, he emphasised
that the systematic presentation of knowledge was the strength of TCM
college education and, indeed, college graduates characterised TCM
textbooks primarily as systematic (see table 6.5). ‘Master–disciple rela-
tions had led to the innumerable “lineages of different doctrines” (xuepai)
of Chinese medical knowledge’, one teacher told me during an inter-
view. In his view this was a defect. ‘Being systematic is a necessary
condition for the standardisation of knowledge, and this is crucial for
the survival of Chinese medicine in the future.’ The success of Western
science came, in his opinion, from its being systematic.
Tao had also been a very articulate spokesman for a systematic
approach to knowledge. When I tried to arrange my studies as a com-
bination of classroom and clinical experience, he objected: ‘Only the
knowledge acquired in the classroom is systematic. If you insist on
clinical experience from the very beginning, I won’t care a bit about
46
It would be wrong to say that one language (modern Chinese) was more concise than
another (classical Chinese), but because of the register in which textbooks are written
in modern Chinese the statements are less vague and polysemous.
your training.’ Six months later, when I was tired of looking up the rich
and flowery and almost poetic vocabulary of TCM Diagnostics and wish-
ing I could skip this course altogether, the word intended to force me
back into the classroom was ‘systematic’. Without a systematic know-
ledge of diagnostics, how would a doctor learning only from ‘experience’
( jingyan) be able to recognise any as yet unseen disorder in practice?
The ‘senior doctor’ and his ‘experience’ were the target of TCM pol-
emics, and the attack was launched with the notion ‘systematic’.
Tao claimed to be convinced of the therapeutic efficacy of Chinese
medicine, but this did not keep him from carrying a stethoscope, gener-
ally considered an emblem of biomedicine.47 He was aware of the mani-
fold contradictions in the medical canons and was able nevertheless to
take them as a guide for medical practice. He readily admitted that
Chinese medical concepts were vague and context-specific, that norms
were negotiable, and that the standard formulae of prescriptions were
easily modified. He claimed that all this was precisely the strength of
Chinese medicine, but this did not prevent him from emphasising how
important it was to be systematic. Being systematic meant being ana-
lytic, he said – dividing the whole into separate themes. TCM doctors
were generalists; that was the problem. ‘The great Western medical
discoveries in the last century were made not by generalists but by
specialists in ophthalmology, bacteriology, and the like.’ The future for
TCM was the division of TCM theory into different courses for train-
ing specialists.48 Being systematic, in Tao’s opinion, implied specialisa-
tion as well as standardisation.
TCM teachers were by no means the first in Chinese medical history
to emphasise the need to systematise medical knowledge. Wang Bing’s
explicit aim to order medical knowledge by editing the Basic Questions
in AD 762 is well known. The comparison of the Grand Basis (Taisu
(Yang 1981)) with the Basic Questions (Anon. 1956) shows that the
editor had split up (analysed) the former (or a related text) and re-
arranged parts of it; apparently, in Wang Bing’s case being systematic
meant being thematic.49 About a thousand years later, Zhang Jiebin found
47
Since the stethoscope magnified sounds produced by defective structures in the body
(Reiser 1978:23–44), it enabled the doctor to learn about the inside of the body by
performing an examination on its surface. This procedure is remarkably similar to
Pulse diagnostics, and insofar as the stethoscope underlines the Chinese ethic of being
non-invasive, it can also be viewed as an emblem of modern Chinese diagnostics.
48
This is precisely what the TCM editors of 1988 did, making four books out of one.
49
Wang Bing’s edition is no longer extant. In the Song dynasty edition (1078), the main
editors, Gao Baoheng (eleventh century) and Lin Yi (eleventh century), remark that
they compared many different editions and ‘corrected’ more than six thousand words
and amended more than two thousand comments (Anon. 1956:3).
Wang Bing’s thematic organisation of the Basic Questions unintelligible

and asserted in his introduction to the Categories (Lei jing (1624)1985:1–
8) that he had considered it necessary to regroup the contents of the
entire Inner Canon (see also Klein 1987:64–74).50 In the Categories
(1624) he did away with the division between the Basic Questions and
the Divine Pivot, thematically ordered chapters and extracts of chapters
from both, and regrouped them into twelve different ‘categories’ (lei),
thirty-two chapters in all (see table 6.4).
Zhang Jiebin’s concept of lei (categories), which enabled him to re-
structure the Inner Canon, deserves further scrutiny. In this context all
that can be said about it is that the categories seem to have been phrased
in terms of pairs of complementary aspects if one translates she sheng lei
as the ‘Category of Beholding and Giving Birth’, yin yang lei as the
‘Category of yin and yang’, zang xiang lei as the ‘Category of the Hid-
den and the Apparent’, mai se lei as the ‘Category of Pulse and Com-
plexion’, jing luo lei as the ‘Category of the Tracts and Links’, biao ben lei
as the ‘Category of Ramifications and Roots’, qi wei lei as the ‘Category
of the qi and Flavour [of Drugs]’, and lun zhi lei as the ‘Category of
Treatment and Discussion’. Ji bing lei may have meant the ‘Category of
Complementary ji- and bing- Morbid Conditions’, and zhen ci lei the
‘Category of Complementary zhen- and ci- Needling in Acupuncture’.
Yun qi lei probably meant the ‘Category of the Five Circulatory Phases
and the Six Seasonal Influences [of Phase Energetics]’, and hui tong lei
is possibly best translated as the ‘Category of Congruences’.51
Zhang Jiebin’s work has had an enduring impact: most of the above
twelve categories figure in the introductory TCM textbooks (see
table 6.4): the contents discussed in the category she sheng of the Categor-
ies (1624) correspond with those in the chapter on ‘Self-cultivation’
( yangsheng xueshuo) in the Interpretation and the ‘Principles of Pre-
ventive Health Care’ ( fangzhi yuanze) in the TCM Fundamentals, though
the position of these chapters in the respective works has changed (see
50
Unschuld ((1980)1985:220) therefore proposes to speak of the Lei jing as the Classic
Arranged According to Topics.
51
The exact meaning of these terms is still subject to further research. The translation
of zang xiang as ‘the hidden and apparent’ in Zhang Jiebin’s work is somewhat daring;
it is derived from the general pattern of the category names. It is consciously rendered
as Organ Clusters in TCM textbooks to underline the change in connotation of this
term. Porkert (1974:112) relates xiang to the Greek eikon (icon or image). With regard
to the Yi jing, Wilhelm ((1923)1981:5) translates xiang as Images, which reflects nicely
the idea that xiang are apparent to the onlooker: ‘One observes images’ (guan xiang).
Peterson (1982:80–1) suggests ‘figures’ as the translation: ‘A figure is an image or
likeness, but it is also a form or shape, a design or configuration or pattern, and a
written symbol.’ The translation of xiang as ‘figures’ or ‘configurations’ comes close to
that of ‘clusters’.
below); the category yin yang corresponds with the chapter on yinyang
wuxing in the Interpretation and the TCM Fundamentals; the category
zang xiang is called the same in the respective chapters of the Interpreta-
tion and the TCM Fundamentals; the category mai se corresponds with
the chapter ‘Methods of Diagnosis’ (zhenfa) in the Interpretation;52 the
category jing luo is called the same in the Interpretation and the TCM
Fundamentals; the category on biao ben corresponds with the chapters
on etiology (bingyin bingji xueshuo and bingyin yu fa bing) in the Interpreta-
tion and the TCM Fundamentals; the category on qi wei is not discussed
in the introductory courses to TCM, but it figures in the introductory
textbook Traditional Chinese Pharmaceutics (Zhongyaoxue (Ling 1984));
the category on zhi lun corresponds with the chapter on ‘Maxims
and Methods of Treatment’ (zhize zhifa) in the Intepretation (1984);53
and the category ji bing corresponds with that on ‘Patterns of Illness’
(bingzheng) in the Interpretation and ‘Illness Triggers’ (bingji) in the
TCM Fundamentals. Notably neither the category on zhen ci nor that on
hui tong is mentioned in these two TCM textbooks, and the phase
energetics are discussed only in the appendix of the Interpretation.
Having established these correspondences, the question naturally arises
of why the chapter headings in 1984 TCM textbooks correlate with
Zhang Jiebin’s categories. Historical considerations led me to investig-
ate the Essentials (1642), an introductory reader of the Qing dynasty
(1644–1911) and Republican period (1911–49) (Tao, p.c.). It is appar-
ent from a comparison of the chapter headings that the Essentials (1642)
laid the groundwork for the introductory TCM courses (see table 6.4).
Published shortly after the Categories (1624), in 1642, the Essentials
condensed it and largely retained its overall structure (while omitting
the five categories biao ben, qi wei, zhen ci, yun qi, and hui tong).
Was it only the category names and chapter headings that corres-
ponded with each other, and not the chapter contents? I examined the
zangxiang category with this question in mind. Detailed analysis of its
choice of text excerpts from the Inner Canon shows that the Essentials
(1642) did indeed reproduce condensed contents of the Categories (1624).
In the Interpretation, the text excerpts from the Inner Canon were, within
a certain range, the same as those of its precursors, but the reproduc-
tion of the classical text clearly derived from an informed study of the
52
It does not figure in the TCM Fundamentals because a new course had been set up:
TCM Diagnostics (Deng 1984). Considering the importance Western biomedicine
attributes to diagnostics, it may not be coincidence that TCM textbook compilers
found it necessary, already in the 1960s, to set up a separate course on diagnostics.
53
Notice that it is left out of the TCM Fundamentals, devoted to TCM theory only.
Table 6.6. Excerpts from the Inner Canon in the zangxiang category of
the Categories, compared with the Essentials and the Interpretation
Categories (1624) Essentials (1642) Interpretation (1984)

All 32 excerpts of the corresponding excerpts corresponding excerpts
zang xiang lei on page numbers as in in chapters 2.1–9.1
(in chapters III and IV) Qin 1985
III.1 Su wen 8 (entire text) p. 38 (extract) 3.2 (identical extract)

III.2 Su wen 9 (extract) p. 39 (identical extract) 3.1 (identical extract)
III.3 Ling shu 3 (tiny extract) p. 41 (identical extract) 3.7 (identical extract)
III.4 Su wen 4 (extract) p. 43 (identical extract) 2.2.3 (entire Su wen 4)
III.5 Su wen 5 (extract) p. 44 (identical extract) 2.1.3 (entire Su wen 5)
III.6 Su wen 67 (second half p. 49 (tiny extract at end)
of chapter)
III.7 Su wen 29 (tiny extract) 3.8 (entire text)
III.8 Su wen 10 (beginning
of chapter)
III.9 Ling shu 8 (entire text) 3.16 (entire text)
III.10 Ling shu 8 (entire text) p. 47 (identical extract) 3.16 (entire text)
III.11 Su wen 11
(extract last part)
III.12 Su wen 21 (extract) p. 48 (identical extract) 3.9 (identical extract)
III.13 Su wen 1 (extract last part) 9.1 (entire text)
III.14 Ling shu 54 (entire text) 3.4 (entire text)
III.15 Ling shu 6 (last part)
III.16 Ling shu 71 (extract)
III.17 Ling shu 65
(extract last part)
IV.18 Ling shu 59 (latter half )
IV.19 Ling shu 40 (entire text)
IV.20 Ling shu 4 (tiny extract)
IV.22 Ling shu 53 (entire text) 6.6 (entire text)
IV.23 Su wen 11 3.3 (identical extract)
(extract last part)
IV.24 Su wen 19
(extract middle part)
IV.25 Ling shu 30 (entire text) p. 50 (extract) 3.12 (entire text)
IV.28 Ling shu 47(entire text) 3.17 (extract)
IV.29 Ling shu 29 (latter half )
IV.32 Ling shu 65 (first part)
Inner Canon itself.54 There were visible alterations in the choice of the text
excerpts and in their sequencing (see table 6.6). TCM textbook compilers
were, like Zhang Jiebin and Li Zhongzi, systematic by being thematic.
TCM teachers claimed that systematising meant making scientific.
In discussing yinyang, for example, Tian applied in his third lesson a
schema which reflected his understanding of scientification:
(a) the meaning of yinyang
(b) the characteristics of yinyang
(c) the evidence for yinyang
(d) the application of yinyang
(e) the interrelations of yinyang
(f ) the effects of the transformations of yinyang in the body
(g) the pathological changes of yinyang
The components of this idiosyncratic schema were a definition (a),
an ‘objective’ description (b), a proof (c), an application (d), and a
discussion of the interrrelations of this entity with other entities (e–g).
‘The definition of yinyang’ in section (a) was given in standard Chinese,
‘the characteristics of yinyang’ (b) were rendered with short quotes in
classical Chinese (three from p. 22 of the Interpretation, one from another
chapter), and ‘the evidence for yinyang’ (c) consisted of another quote
in classical Chinese (from p. 30). For ‘the application of yinyang ’
(d) different interpretations of one classical Chinese quote (from p. 21)
were given. The discussion of ‘the interrelations of yinyang’ (e) was
divided into three subsections, citing phrases from p. 30, p. 24, and
p. 21. The discussion of ‘the effects of the transformation of yinyang in
the body’ (f ) contained a phrase from p. 23, and only the discussion of
‘the pathological changes of yinyang’ (g) dealt with two paragraphs of
the textbook in a more coherent way (on pp. 24–5). Tian was attempt-
ing to be systematic and scientific, but he did not rigorously apply any
method of text analysis. Rather, he grouped together short phrases that
he considered relevant for explaining yinyang. Again, his presentation
was thematic rather than systematic.
54
The work these TCM textbook compilers performed is remarkable for its philological
precision. In the two chapters of the Interpretation on yinyang wuxing and zangxiang,
I found only a few characters which deviated from those in a Ming print of the Song
edition of the Basic Questions (Anon. 1956). The reproduction of the excerpts from the
Inner Canon in the Categories was with a few more exceptions reliable too. The Essen-
tials, by contrast, reproduced the texts of the Inner Canon by consistently omitting the
introductory question and the concluding phrases of a paragraph. Moreover, whole
paragraphs of a chapter or several phrases in a paragraph were frequently omitted,
often those which are not immediately intelligible to a twentieth-century reader, nor
possibly to a reader in the Late Ming.
Notably, teacher Tian did not confront the students with a text. For
him the classical Chinese text was raw and had to be prepared for the
students’ consumption. The textbook editors had already done pre-
liminary work on the text by adding comments and notes to it. TCM
teachers like Tian, in conscientiously preparing their lectures, continued
this interpretive work. As we have seen, Tian cut up the text into brief
phrases taken from very different parts of it, and served the students a
kind of textual ‘chop-suey’.
In other lessons, Tian would begin by writing a list of Chinese char-
acters on the blackboard, each equated with a modern Chinese word.
Only then would he present a sentence in classical Chinese made up
of all these characters. Thus the students saw a list of incoherent
words suddenly come together in a phrase that immediately made sense.
Instead of experiencing the ‘multivocality’ or polysemy of lexical items
which is notorious for anyone who confronts a Chinese medical text,
they experienced reliable guidance from their teacher, whose vision of
things to come paralleled that of the mentor on the brink of omnis-
cience as, for example, when Zhang engaged in the authoritative mode
of interpretation (see pp. 114–18).
Western scholars have criticised this approach as one that transforms
a ‘treasure house’ into a ‘quarry’ (Porkert 1982:569). Indeed, considering
the respect for the golden age of the past, one wonders how its rever-
ence is reconciled with what seems to the outsider a serious violation of
its integrity. Here we would do well to recall Zhang’s justificatory mode
of interpretation which made use of the text to support his personal
medical practice – preparing the raw text of the past to fit the needs
of the present. What may seem a mutilation to the philologist may
be virtuosity to the senior doctor or being systematic to the TCM
teacher.
Returning to the four aspects of yinyang identified by Tao in his
second lesson, let us consider the citations from the Inner Canon with
which Tian illustrated the aspects called Mutual Reliance and Mutual
Use (no. 2) and the Equilibrium of Waxing and Waning (no. 3).
Mutual Reliance and Mutual Use he called an ‘application of yinyang’:
1. yang engenders, yin grows, yang kills, yin conceals
( yang sheng yin zhang, yang sha yin cang)
2. yang is transformed into qi and yin becomes Form
( yang hua qi, yin cheng xing)
The implications of these citations (from Basic Questions, chapter 5)

are difficult to assess. Tian wrote several different interpretations on
the blackboard. The first was remarkably similar to the one which we
encountered in the first paragraph of Basic Questions, chapter 66: ‘When

[the Spiritual] is in the Sky, it is qi, and when it is on Earth,
it takes Form.’ The second was similar to others mentioned in our
exploration of bian and hua. The third was similar in kind. The interac-
tion between yin and yang dubbed Mutual Reliance and Mutual Use
was thus illustrated with citations from the classics similar to those
discussed during Zhang’s seminars.
The Equilibrium of Waxing and Waning, which was mentioned as
the third aspect of yinyang in the TCM Fundamentals, was not discussed
during the introductory lessons on the Interpretation. Tian discussed it
several weeks later, when the notion of Protective qi (weiqi) was dis-
cussed in the chapter entitled ‘Disease Factors and Disease Triggering’
(bingyin bingji xueshuo). This suggests that the occurrence of the con-
cept of Waxing and Waning (xiaozhang) was, in the Inner Canon at
least, limited to the context of the Nourishing and Protective ( yingwei).
The text passage Tian used to explain the notion of Waxing and
Waning was an extract from Basic Questions, chapter 3 (cited in the
Interpretation (Cheng 1984:90)): ‘Therefore the yangqi, during daylight,
governs the outer sphere [of the body]; at dawn the Human qi (renqi)
is generated, at noon the yangqi is thriving, and at sunset the yangqi is
already depleted, and the Gates of qi (qimen) close. Therefore, at dusk,
one should retire, one should not disturb muscles and bones, and one
should not experience mist and dew; if the reverse happens at the above
three moments, the body becomes tired and fragile.’
When I asked the young TCM staff what Waxing and Waning meant
in comparison with the transformation called zhuanhua, they explained
that the main difference between the two concepts was probably the
rate at which change took place, Waxing and Waning referred to gradual
change and zhuanhua to sudden change.55 However, the above citation
suggests that the concepts of zhuanhua in modern Chinese (comparable
to bian in classical Chinese) and Waxing and Waning may also differ
with regard to the notion of the time in which the changes take place.
Zhuanhua, when used in the sense of bian, is best understood in terms
of a polar conception of time, while Waxing and Waning is change with
regard to time conceived of as circular; it is used to describe the changes
of the attributes to qi at dawn, noon, and dusk; the changes of the
moon in a month; or those of the seasons in a year.
In summary, the four aspects of yinyang provided a recent reinterpreta-
tion of yinyang which every TCM student had to memorise:
55
The term xiaozhang bianhua was a standing expression in the vocabulary of TCM
teachers for ‘change’ in general.
1. Control Through Opposition (duili zhiyue) is frequently explained with ref-

erence to the Unity of Opposites (duili tongyi ), a key concept in Mao’s essay
‘On Contradiction’. It postulates a stage of opposition and absolutely necessary
struggles between opposites. In the TCM Fundamentals, this notion of necessary
struggles is attributed to yinyang.
2. Mutual Reliance and Mutual Use (hugen huyong) describes different views of
change already known to us from Zhang’s seminars with little reinterpretation.
3. Equilibrium of Waxing and Waning (xiaozhang pingheng) is, in the TCM
Fundamentals, an aspect of yinyang in general. In the Inner Canon, by contrast,
Waxing and Waning describes change with reference to a circular conception of
time in very particular contexts.
4. Mutual Transformation (xianghu zhuanhua) seems to be a phrase borrowed
from materialist dialectics. In Mao’s writings it points to a change that consists
of a synthesis of two antitheses. In the TCM Fundamentals, however, it is a label
for change well known from the Chinese medical literature, sometimes delimited
by the term bian. Mutual Transformation refers to a change into the opposite
that is visible to the observer and takes place when a boundary is reached and
transgressed. It designates, for instance, the course of a Distinguishing Pattern
changing into another one.
Evidently, TCM definitions built on many different ways of reinter-

preting yinyang. Control through Opposition referred to an innovative
reinterpretation of yinyang, conceiving the interaction as dialectical change
arising from struggle. Mutual Reliance and Mutual Use referred to rather
indeterminate views of mutual interaction as known from the canons.
The Equilibrium of Waxing and Waning referred to the generalisation
of the comparatively narrow sense of a term known from classical writings.
Mutual Transformation was a new label for an age-old concept of change.
Table 6.7. The course on the Interpretation, February–June 1989
Textbook
Date Chapter Nei jing Chapter Contents of Lecture
27 Feb. 1 – Introduction
1 March 1 – Introduction
4 March 2.1 Su wen 5: Yin yang yinyang Five Phases
ying xiang da lun
6 March 2.1 Su wen 5 yingyang Five Phases
8 March 2.1 Su wen 5 yinyang Five Phases
11 March 2.1.4 Su wen 4 Seasonal Winds, homework
3.1 Su wen 9: Liujie zangxianglun Organ Clusters
13 March 3.1 Su wen 9 Organ Clusters
15 March 3.3 Su wen 11: Wu zang bie lun Organ Clusters
18 March * ? ?
20 March 3.9 Su wen 21: Jing mai bie lun Stomach and digestion
Prognosis of death and life
Table 6.7. (cont’d)
Textbook
Date Chapter Nei jing Chapter Contents of Lecture
22 March 3.10 Ling shu 17: Mai du he-Associates of the Organs

3.11 Ling shu 80: Da gan lun End of lesson: short exam
25 March 3.12 Ling shu 30: Jue qi Different aspects of qi
27 March 3.12 Ling shu 30 Different aspects of qi
3.13 Ling shu 18: Ying wei sheng hui Protective and Nourishing qi
29 March 3.13 Ling shu 18 Protective and Nourishing qi
2 April 3.14 Ling shu 36: Wu long jin ye bie Liquids and Fluids
4 April 3.16 Ling shu 8: Ben shen Spirit
6 April 3.16 Ling shu 8 Spirit
9 April 5.1 Su wen 3: Sheng qi tong tianlun Illness Factors and Triggers
11 April 5.1.2 Su wen 3 The importance of yangqi
13 April * ?Su wen 3 ?
16 April 5.1 Su wen 3 Illness Factors, Illness
Triggers, and Illness Transitions
18 April 5.2 Ling shu 46: Wu bian The Five Transitions
5.4 Ling shu 58: Zei feng Noxious qi
20 April * ?Ling shu 58 ?Noxious qi
23 April 5.3 Ling shu 66: Bai bing shi sheng Origin of the Hundred Disorders
25 April 5.3 Ling shu 66 Patterns of Accumulations
5.5 Su wen 39: Zu tong lun Congestions
27 April * ?Su wen 39 ?Congestions
1 May no classes
3 May 5.6 Su wen 74: Zhi zhen yao da lun Etiology and Pathogenesis
5 May * ?Su wen 74 ?Etiology and Pathogenesis
8 May 5.6 Su wen 74 Etiology and Pathogenesis
10 May ?Su wen 33: Ping re bing lun ?Warmth Factor Disorders
12 May * ?Su wen 33 ?Warmth Factor Disorders
15 May 6.2 Su wen 33 Warmth Factor Disorders
17 May 6.4 Su wen 38: Ke lun Cough
19 May * ?Su wen 38 ?Cough
22 May 6.4 Su wen 38 Cough
24 May 6.4 Su wen 38 Cough
6.10 Su wen 44: Wei lun Limpness
26 May * ?Su wen 44 ?Limpness
29 May 6.10 Su wen 44 Limpness
31 May 6.8 Su wen 43: Bi lun Obstructions
2 June * ?Su wen 43 ?Obstructions
5 June 6.5 Su wen 39: Zu tong lun Enduring Pain
7 June students on demonstration
21 June 9.1 Su wen 1: Shang gu Stages of ageing
tian zhen lun
* fieldworker absent, attending practical training in the clinic

Table 6.8. The course on the TCM Fundamentals,

September 1988 – January 1989
Date Topic of Lecture
13th Sept. Historical background

15th Sept. Holism and dialectics
20th Sept. yinyang
22nd Sept. yinyang
27th Sept. yinyang
29th Sept. yinyang
4th Oct. Five Phases (wuxing)
18th Oct. Five Organs (wuzang): Heart (xin)
20th Oct. Five Organs (wuzang): Heart (xin)
25th Oct. Five Organs (wuzang): Lungs ( fei)
27th Oct. Five Organs (wuzang): Lungs ( fei), Spleen ( pi)
1st Nov. Five Organs (wuzang): Spleen (pi)
3rd Nov. Five Organs (wuzang): Spleen ( pi), Liver (gan)
8th Nov. Five Organs (wuzang): Liver (gan)
10th Nov. Five Organs (wuzang): Liver (gan), Kidneys (shen)
15th Nov. Five Organs (wuzang): Kidneys (shen)
17th Nov. Six Bowels (liufu): Stomach (wei), Small Intestine (xiaochang), Large
Intestine (dachang), Gallbladder (dan), Bladder (pangguang)
22nd Nov. Six Bowels (liufu): Triple Burner (sanjiao); Odd Palaces (qiheng zhi fu)
24th Nov. Mid-term examination
29th Nov. Breath (qi)
1st Dec. Blood (xue), Liquids and Fluids ( jinye)
6th Dec. Tracts and Links ( jingluo)
15th Dec. Disease Factors (bingyin): the Six Disease Factors (liuyin)
20th Dec. The Six Disease Factors (liuyin): Wind ( feng), Cold (han), Summer
Heat (shu), Dryness (zao), Fire (huo), Heat (re)
22nd Dec. Disease Factors: Phlegm (tanyin), Stagnant Blood ( yuxue)
27th Dec. Disease Factors: Normal and Noxious qi (zhengqi xieqi )
29th Dec. Disease Factors: Normal and Noxious qi, preventive medicine
3rd Jan. ‘In treating Illness trace the Roots’ (zhi bing qiu ben)
From the Five Phases to the Five Organs

In the course on the Interpretation (see table 6.7), three lectures (six
hours) were devoted to the chapter entitled yinyang Five Phases (wuxing)
(4–8 March), five hours dealing with yinyang and only one with the
Five Phases. The following three lectures were about the Organ Clusters
(zangxiang) (11–15 March). Other lectures dealt with concepts such as

Spirit, Fluids, Nourishing and Protective qi (20 March – 6 April). Most
of the attention was, however, given to Disease Factors and Disease
Triggers (bingyin bingji) (9 April – 15 May).56 Disorders that were
discussed were Cough (ke), Limpness (wei), Obstructions (bi), and
Enduring Pain (zutong) (17 May – 5 June). Notably, the first chapter of
the Basic Questions that discusses ageing and self-cultivation was read in
the very last lesson (on 21 June).
In the course on the TCM Fundamentals, four lectures were on yinyang
(20–9 September), four on the Five Phases (4–13 October), and eleven
on the Five Organs (wuzang) (18 October – 22 November) (see table
6.8). Here too, self-cultivation, now called ‘principles of preventive
health care’ ( fangzhi yuanze), was discussed at the very end of the term
(on 29 December). That the Five Phases were scarcely discussed in the
classes on the Interpretation and that discussion of the Five Organs
constituted the core of the course on the TCM Fundamentals seem to
reflect a single process of the standardisation of Chinese medical know-
ledge. We will see that this process is by no means limited to recent
developments in the PRC, and that an increased focus on the human
body can be traced at least as far back as the seventeenth century.
The courses on the Interpretation and the TCM Fundamentals were
similarly structured, but they also had interesting differences. One
similarity was that self-cultivation, central to Chinese medical thought
and practice, was only briefly mentioned at the end. It is certainly no
accident that it is discussed in the first chapters of the Basic Questions,
the Categories (1624), and the Essentials (1642). However, already in the
Qing dynasty (1644–1911) the more learned works with high official
sponsorship apparently ‘stressed theory and causal patterns more than
preventive health’ (Furth 1987:10). It is likely that this tendency to
emphasise etiology and put preventive health last, has been reinforced
by the recent impact of disease-and-therapy-oriented biomedicine.
The Interpretation and the TCM Fundamentals primarily differed in
rigour of presentation and thematic priorities; a comparison of tables
6.7 and 6.8 suffices for an appreciation of the systematic design of the
course on the TCM Fundamentals. This course, which constituted the
introductory course for acumoxa and massage specialists, was mostly
about the ‘physiology’ of the human body. The course on the Inter-
pretation was delivered to second-year TCM regular students who were
56
This theme did not figure in the Essentials (see table 6.4). The emphasis on etiology
in TCM theory has also been observed by Farquhar (1994a:86–91). In Western
biomedicine, etiology is an important aspect of diagnosis and TCM theory stresses the
importance of diagnostics (see above, n. 52).
Figure 6.2 Two diagrams of the Five Phases from the chapter
‘Phase Energetics’ in the Additional Appendix to the Categories
(Lei jing fu yi (1624)1799:8–9)
familiar with the ‘physiology’; hence perhaps its emphasis on ‘patho-

logy’. However, the different emphases of these two courses can also be
explained from a historical point of view. We need to remind ourselves
that in the Inner Canon only a few chapters are devoted to a systematic
discussion of the Organ Clusters. Many more are concerned with pat-
terns of change and triggers of disorders. The Interpretation, which con-
stituted the introductory course in the early 1960s, reflects the contents
of the Inner Canon more faithfully than the TCM Fundamentals that were
composed later. In other words, the Five Organs have only recently
become fundamental for TCM theory.57
It is surprising that even in the course on Acumoxa, the Tracts and
Links ( jingluo) were introduced with emphasis on the Organs and
Bowels (zangfu): ‘Important are the Five Organs and the Six Bowels
(liufu). They generate qi, and this is the qi that circulates in the Tracts
57
Compare the textbook contents (table 6.4) with the lectures on the TCM Fundamentals
(table 6.7): the centrality of the Five Organs is striking only in the latter. This shows
again that studies of TCM need to combine textual analysis with anthropological
fieldwork.
and Links.’58 Then, the teacher raised the rhetorical question: ‘Why are
there exactly twelve Tracts in the body?’ and answered it: ‘This has to
do with the fact that they come from the twelve Organs and Bowels.’59
His answer further stressed the importance of the Organs and Bowels,
although it was from a historical point of view questionable.60
Obviously, the Five Organs were more prominent than the Five Phases
in theoretical TCM courses. Nevertheless, attempts to eliminate the
Five Phases have been in vain (Qiu 1982) – reasoning in terms of the
Five Phases remains crucial for medical practice, especially when it comes
to ‘maxims of treatment’ (zhize). In discussions with Tao, however,
the notion of the Five Phases was largely replaced by the notion of the
Five Organs. On one occasion, for instance, I was surprised to find that
the Five Phases were only of secondary importance for determining the
position of the Five Organs. Confronted with a diagram like the one
situating the Five Organs in an orbit (fig. 6.2), I argued that the Earth
should be situated at the centre of the four other Phases. As evidence
for this, I referred to a text compiled in the Han dynasty (206 BC – AD
220) in which the East was said to be bluegreen, the South red, the
West white, the North black, and the top yellow (Shi ji 60 (Sima
1959:2115)). Yellow was associated with the Earth and the Earth with
the Spleen. Tao was not impressed and responded: ‘Sometimes the
Heart is the centre, as it is in Western medicine.’ As evidence for this,
he cited a phrase from Basic Questions, chapter 8: ‘The Heart has the
office of the ruler’ (Anon. 1956:23). This anecdote shows not only that
the points of view in the canons are varied enough to corroborate two
contradictory arguments but also that Tao put the Heart at the centre
in both Western biomedical and TCM reasoning. He did not consider
the Five Phases central to TCM reasoning when confronted with the
question of which was the most central of the Organs.
On another occasion I provoked my teacher by saying that yinyang
was an earlier concept than the Five Phases.61 ‘This is difficult to tell’,
58
Notice that qi is supposed to be generated inside the human body, in the Organs. Little
attention is given to qi that constitutes and permeates both macro- and microcosm.
59
Namely, the Five Organs and the Pericardium (which counts as the sixth), and the Six
Bowels.
60
In the Mawangdui manuscripts (MWD 1985), the eleven Vessels along the legs and
arms do not generally connect with the Five Organs. In Lingshu 10 (Ren 1986:299–
307), in which these TCM teachings are grounded, each of the six yin resp. yang
Vessels is said to ‘belong to’ (shu) an Organ or a Bowel. Contrary to this teacher’s
claim, the number of the Organs and Bowels (twelve) probably represents a numero-
logical adjustment to the twelve Tracts.
61
What I had in mind was Loewe (1982) on the ‘Jing fa’ text of the Mawangdui manu-
scripts: ‘The text refers to yinyang and alludes to the theory of correspondences (ganying),
but there is no mention of wuxing’ ( p. 40). However, the issue is very complex and,
was his answer, and he added after a short pause: ‘No, first you have
the material entities, and then you discuss their interrelations.’ He seemed
to imply that the Five Phases referred to material entities.62 I objected
and pointed to the ‘forms of conduct’ or ‘processes’ (xing) (Graham
1989:326) described in the chapter ‘Great Plan’ in the Book of Docu-
ments: ‘Water means soaking downward; Fire means flaming upward;
Wood means bending and straightening; Metal means conforming
and changing; Earth means accepting seed and giving crop’ (Karlgren
1950:30).63 Teacher Tao, however, maintained that that text passage
was irrelevant to Chinese medicine.64 In Chinese medicine Water (shui),
Fire (huo), Wood (mu), Metal ( jin), and Earth (tu) provided the im-
agery for material entities, and their interrelations were dialectical as
assessed by the dialectics of yinyang.65
Tao defended this view also in his Newly Edited Manual of Clinical
Chinese Medicine (Xinbian zhongyi linzheng shouce): the first section,
on ‘theoretical characteristics’ of TCM, was concerned with the mater-
ial aspect, the Five Organs, and the second with their interrelations,
yinyang (Wu et al. 1986:3–6). By replacing the notion of the Five
Phases with that of Five Organs, the focus of attention shifts from a
preoccupation with change to one with matter. It is not that Tao con-
sidered the material aspects of the Five Phases comparable to the four
because of the difficulty of dating the literature, difficult to explore. ‘Within this
jumble of sources [Book of Documents, ‘Ten Wings’ of the Book of Changes, Spring and
Autumn Annals, etc.] that we cannot place confidently in historical sequence, we find a
great many instances of yinyang and various fivefold (and other categories) used in
quite concrete senses . . . The irreducible uncertainty, inconvenient though it is, is
preferable to the delusion of certainty’ (Sivin 1995b:3).
62
Sivin (1987:71), by contrast, points out that in what is possibly the earliest appear-
ance of wuxing, the ‘Declaration at Gan’ (Gan shi) preserved in the Book of Documents,
it refers to moral qualities. Sivin (1995b:5) speaks of ‘activities’ with regard to the
moral categories which the wuxing linked to the Mencius (Meng zi) probably are, and
Graham (1986:76) of ‘courses of action’ in respect of the wuxing mentioned in the
Xun zi.
63
‘Water: it ought to soak downward, Fire: it ought to flame upward, Wood: it ought to
bend and straighten, Metal: it ought to conform and change, Earth: it ought to accept
seed and give crop.’ If translated in this normative way, the text reads as a prescription
rather than a description. Rather than referring to processes, wuxing may even in this
context have a connotation of normative forms of conduct.
64
Tao is corroborated by Sivin (1995e:16, n. 20): ‘Wu xing as it appears in this docu-
ment has little to do with the later Five Phases.’ Sivin (1987:71) points out that this
passage was extremely influential for two thousand years because of its supposed
archaic origin, but is now widely considered a late addition.
65
This viewpoint seems to be one of a TCM theoretician; no parallels have been found
elsewhere. For an authoritative discussion of wuxing, in early texts and later, in the
medical context, see Sivin (1987:70–80; 1995b:1–19).
Figure 6.3 Five Phases as represented in the TCM Fundamentals

(Yin 1984:20) and the Organ Clusters (Yunnan zhongyi xueyuan
1988:7)
elements of scholastic medicine, as the Jesuits did,66 rather, he seemed

to associate the Five Phases with the substances to which twentieth-
century intellectuals in China generally refer – TCM teachers had all
taken courses in chemistry.
Tao was not the only TCM scholar to emphasise the material aspects
of the Five Phases. Textbooks on Traditional Chinese Pharmaceutics
published since 1970 do not mention a correspondence between the
Five Flavours (wuwei) and the Five Phases.67 The interrelations among
the Five Phases are discussed in respect to either the Five Organs or the
Five Flavours; the Five Phases are simply not mentioned.
A similar tendency becomes evident when one compares the dia-
grams representing the Five Phases in the TCM Fundamentals and in
the Organ Clusters (fig. 6.3). In the former, the Five Phases are at the
centre of the diagram, comprising aspects of the body ecologic inside
and outside the human body. In the latter, the Five Organs are at the
centre, and the Five Phases on the periphery are hardly noted.
Tao’s stress on ‘substance’ rather than ‘force’ in classical concepts
of ‘substance-forces’ is also not without precursors. His conception of
yinyang as a dialectical force and the Five Phases as matter is reminis-
cent of Zhu Xi’s (1130–1200) differentiation between qi and substance:
‘Yin and yang are qi, and the Five Phases are substance. It is through
the existence of this substance that phenomenal things were made.’
Zhu Xi made a distinction between the material characteristics of yinyang
and Five Phases, but he maintained simultaneously that: ‘It is not true
that in addition to yin and yang there are Five Phases . . .’ (cited in
Sivin 1987:78). Tao, however, made exactly the mistake that Zhu Xi
sought to avoid.
Zhang Jiebin laid the groundwork for the present focus on the Five
Organs when he regrouped text passages from the Inner Canon into
twelve categories. The third category called zang xiang (the Hidden
and Apparent) put the human body at the centre of attention, and this
focus on the body may have prepared the way for later developments
66
Matteo Ricci (1552–1610) considered the Phases to be ‘elements’ that produced ‘all
things and phenomena’ and considered them, because of the inherent contradictions
of the Chinese doctrine, subordinate to the Greek notion of elements. His understand-
ing of the Five Phases has remained predominant far into the twentieth century (Sivin
1987:73–4). Needham (1956:243–4), concerned with questions of science and ‘proto-
science’ in China, proposes to conceive of them less as ‘five sorts of fundamental
matter’ than as ‘five sorts of fundamental processes’. Porkert (1974:43–54), who stressed
the sequences into which the Phases can be placed, coined the phrase ‘Five Evolutive
Phases’ from which the wording ‘Five Phases’ is derived.
67
For example, Zhongyixue jichu (Shenyang yaoxueyuan 1978) mentions yinyang, but not
the Five Phases. Zhongyaoxue (Ling 1984:8) mentions the Five Flavours (wuwei) but
not the Five Phases.
Table 6.9. Text passages from the Inner Canon in the zangxiang chapter
of the Interpretation, compared with their occurrence in the Categories
Interpretation (1984), chapter 3: Canon of Categories: (1624)68

Title: Organ Clusters (zangxiang)
Subtitle: Organs and Bowels (zangfu)

3.1 Su wen 9 (extract) Zang xiang III.2 (identical extract)
3.2 Su wen 8 (extract) Zang xiang III.1 (whole)
3.3 Su wen 11 (extract) Zang xiang IV.23 (identical extract)
3.4 Ling shu 54 (whole) Zang xiang III.14 (whole)
3.5 Ling shu 56 (extract) Wu wei XI.2,3 (whole)
3.6 Ling shu 33 (whole) Jing luo IX.32 (whole)
3.7 Ling shu 2 (tiny extract) Zang xiang III.3 (identical tiny extract)
3.8 Su wen 29 (whole) Zang xiang III.7 (tiny extract)
3.9 Su wen 21 (extract) Zang xiang III.12 (identical extract)
3.10 Ling shu 17 (extract) Jing luo VIII.22 (identical extract)
3.11 Ling shu 80 (tiny extract) Ji bing XVIII.81 (entire front part
with identical extract)
Subtitle: Essence, Breath, Spirit ( jing, qi, shen)
3.12 Ling shu 30 (whole) Zang xiang IV.25 (whole)
3.13 Ling shu 18 (whole) Jing luo VIII.23 (whole)
3.14 Ling shu 36 (whole) Ji bing XVI.58 (whole)
3.15 Ling shu 71 (extract) ?
3.16 Ling shu 8 (whole) Zang xiang III.9, 10 (whole)
3.17 Ling shu 47 (extract) Zang xiang IV.28 (whole)
that made it a material object. Zhang Jiebin did not, however, discuss
the body separately from its surroundings. The texts he regrouped
under the heading zang xiang discussed the resonance of macrocosm
and microcosm. The term zang xiang itself indicates a holistic view that
links the hidden inside the body to the apparent on its surface and
outside the body. Numerological rather than material considerations
determined the categories: in the texts that were regrouped in the cat-
egory yin yang the number two prevailed, in those of the zang xiang the
number five.
In the Interpretation, the Organs and Bowels and their associations
with the Direction-Seasons is no longer recorded in the chapter on
zangxiang.69 Now a chapter called ‘yinyang Five Phases’ discusses the
68
Name of the category, chapter (in Roman numbers), text passage quoting the Inner
Canon (in Arabic numbers).
69
For example, Categories III.4 and III.5 are discussed in the Interpretation 2.2.3 and
2.1.3, along with yinyang and the Five Phases. See table 6.6.
interrelations between microcosm and macrocosm. The zangxiang chap-

ter in the Interpretation focuses exclusively on processes inside the body
and on entities that appear comparable to those of biomedical anatomy.70
It contains predominantly texts from the Divine Pivot,71 some of which
belong to the ‘Category on Tracts and Links’ in the Categories (1624).72
In TCM theory the notion of zang xiang thus incorporates discussions
of the body that used to be relevant mostly to acumoxa.73
The human body that has been made the focus of attention by estab-
lishing the category zangxiang is now approximated to a material entity.
In the Interpretation, the chapter on zangxiang is divided into two sec-
tions (see table 6.9), one on static entities like the Organs and Bowels
and one on Essence, Breath, and Spirit, ‘substance-forces’ that are said
to be in constant flow and motion.74 Yinyang and the Five Phases,
discussed in the first chapter, appear now as ordering principles of
the universe. Material aspects rather than numerology have become
category-determining.
Compartments and Organ Clusters

Having established the centrality of the Five Organs (wuzang) in TCM
theory, the question arises what exactly they designate. Tao tended to
equate the Five Organs – the Heart (xin), Lungs ( fei), Spleen ( pi), Liver
(gan), and Kidneys (shen) – with the corresponding anatomical entities
of biomedicine; therefore I translate them as Organs. Simultaneously,
he stressed that they had functions and systemic aspects that were not
attributed to them in Western medicine, and therefore I suggest calling
them Organ Clusters. The Heart, for instance, is not an anatomical
entity alone: ‘The Heart governs the Blood (xue) and the Pulse (mai), it
70
For instance, the third section on the Odd Palaces in the Interpretation (3.3) corres-
ponds to the twenty-third in the Categories (IV.23). See table 6.9.
71
In the Categories, in chapter III (the first chapter on the category zang xiang) ten out
of seventeen text passages are from the Basic Questions, in the Interpretation, in the
first section on the zangxiang only five out of eleven. In the Categories, in chapter IV
(the second chapter on zang xiang), thirteen out of fifteen text passages come from
the Divine Pivot, in the Interpretation all six passages on jing, qi, and shen are from the
Divine Pivot.
72
The ‘Category on the Tracts and Links’ contains several text passages that can be
interpreted as referring to Western anatomical entities and physiological processes.
This observation is paralleled by Farquhar (1994b:82): ‘The only Chinese medical
speciality in which bodies are routinely represented in a form non-specialists find
familiar is acupuncture.’
73
Unschuld (1992:55) stresses the importance of acumoxa for TCM theory. He con-
siders that concepts like yinyang and Five Phases have become fundamental to TCM
theory because of the increased attention given to acumoxa.
74
Instead of flow and flux; their potential to change is mentioned but not really stressed.
houses the Spirit (shen), its Impulse is Enthusiasm (xi), its Fluid is
Sweat (han), its Aperture is the Tongue (she), in regard to the body the
Heart unites the Pulses, and its Flourishing manifests itself in the Face
(mian)’ (TCM Fundamentals (Yin 1984:30–1) ).75 Nor are the interrela-
tions between the different aspects of the Heart systematic: ‘to govern’
(zhu), ‘to house’ (cang), ‘to relate to Impulse’76 (zai zhi wei), Fluids
(zai ye wei), and Apertures (zai qiao wei), ‘to unite’ (he), and ‘to have a
Flourishing at’ (qi hua zai) a specific area of the body surface.
The systematic presentation of the Organ Clusters in neat tables is
welcome as a didactic simplification for an initial grasp of the com-
plexities involved but just as wrong as any neat table of regulations for
administrative purposes. Norms are negotiable. Despite the repeated
endeavours at systematisation since the formation of the bureaucratic
apparatus in China, all Organs and to a lesser degree all Bowels have
their particular histories. The ways in which they interrelate are far
from systematic. It may therefore be more accurate to speak of their
‘systemic’ correspondences (which implies interdependence) rather
than their ‘systematic’ correspondences (which has connotations of
methodical rigour).
Porkert (1974:108) stresses that Chinese medical reasoning takes
place in ‘diagrams of function’ (italics added) and proposed to translate
zang as ‘orbs’. Sivin (1987), in a similar vein, coined the term ‘visceral
systems of function’ (italics added) for zangfu. These expressions focus
on the functional aspects. ‘Whereas in anatomy Western medicine, causal
and analytic, primarily describes the aggregate of carriers (or substrata)
of effects, inductive synthetic Chinese medicine is primarily interested
in the fabric of functional manifestations of different body regions.’
Porkert (1974:107) opposed the emphasis on function in Chinese medi-
cine to one on structure in biomedical anatomy. However, Porkert’s
emphasis on the polarity of thinking in terms of either function or
structure does not do justice to the functional-structural character of
the Organ Clusters in TCM.77 Unschuld’s ( (1980)1985:81) translation
of zang as Depositories (Depots) or Granaries and fu as Palaces reflects
both their functional and their structural aspects and also highlights
75
An Organ Cluster additionally comprises a ‘Bowel on the outside’ (waifu), in com-
plementarity to the ‘Organ inside’ (neizang). The Bowel corresponding to the Heart,
the Small Intestine (xiaochang), is briefly mentioned in the following. However, in the
TCM Fundamentals (Yin 1984:29–43 and 44–7) the Organs (zang) and Bowels ( fu)
are discussed separately.
76
Zhi is translated as Impulse in accordance with the observation that wishes, likes, and
hopes were generally seen as forms of unrestrained personal ‘impulse’.
77
Likewise the West–East opposition between ‘causal–analytic’ and ‘inductive–synthetic’
thinking is, despite its initial value for research in Chinese medicine, highly problematic.
the borrowing of medical terminology from the terminology of admin-

istration.78 But in twentieth-century China no TCM doctor related
to the Organ Clusters in terms of their etymology. Biomedical and
TCM doctors alike spoke of visceral ‘functions’ (gongneng), ‘structures’
(goucheng), and ‘systems’ (xitong).
As useful as terms like function, structure, and system may be, they
do not fully express the imagery underlying the zangfu. A zang or a fu
refers, as Unschuld’s ( (1980)1985:81) translation suggests and as Sivin
(1987:183) points out, to a ‘guan, an executive and the office he sits in:
an office in a bureaucracy’. This administrative unit is both functionally
defined and spatially located. An account of the spatial organisation of
‘offices in a bureaucracy’, largely determined by function, is not easily
rendered. Likewise, it is difficult to account for the zangfu in the human
body.
The difficulties may well parallel those I encountered when I
attempted to describe the spatial organisation of an administrative unit,
the compound of the TCM college (see pp. 129–32). The concept that
was central to that description was the ‘compartment’. Were I to define
in retrospect what ‘compartment’ meant, the same uncomfortable situ-
ation would arise for me as for someone confronted with the problem
of what a zangfu or zangxiang is. The work unit compound is, like the
human body, as much a spatial unit as a unit which is considered to
fulfil certain functions, and the criteria for identifying compartments
varied widely. In a parallel way, the different aspects of the Organ
Clusters are each determined in terms of very different markers.
The ‘compartment’ was, like the Depository or Palace, in a spatially
definite locality that was, in most cases, defined by its function (e.g. the
garage compartment, the administrative compartment, the dormitory
compartment). This was, however, not exclusively the case; the sports
ground, for instance, had many different functions. In Chinese medi-
cine, likewise, some Organs and Bowels are assigned more specific
functions than others.
Some compartments were compact and clearly separated from their
surroundings, such as the bicycle lot or the school garden, with fences
delineating the boundaries of that space. Other compartments were
spatially not as easily recognised as they were on grounds of their
function. The printing press brigade, for instance, was clearly defined
by its function but spread out among three different buildings. Only
78
Unfortunately, at the period of the formation of what is here called ‘the medicine of
systemic correspondence’, zang and fu both meant ‘storehouse, treasury’ (Sivin
1987:121).
after some deliberation did I find spatial features which the three parts
of the printing press compartment had in common: they were all on the
ground floor. Likewise, the Kidney Cluster is defined functionally more
than spatially.
There is still another feature which the ad hoc concept of compart-
ment has in common with the notion of zangfu: the criteria for identify-
ing one of them may arise in consideration of interrelations with others.
One such criterion was a parallel: the uniformed man in the school gate
compartment made me see, in an analogous manner, a woman under a
bamboo hat as a sign of recognition for the compartment ‘showers’.
Another such criterion was an opposition: the closed housing equip-
ment compartment was seen in opposition to the open space of the
sports ground. During the formative period of Chinese medicine recog-
nition of the Pericardium as the sixth Depository resulted primarily
from filling a gap in the conceptual framework; it became the opposite
to the Triple Burner which was the sixth Palace (Porkert 1974:147;
Sivin 1987:126–9; and, by implication, Unschuld (1980)1985:77, 208).
One can continue the comparison by pointing to compartments that
were in close proximity, such as the showers and the kitchen because of
their shared need of hot water. In the body too, there is a pair of a zang
and a fu, which forms a unique unit in the body: the Spleen and the
Stomach.79
Compartments in the college compound had a history; some changed
location and form over time, some were added, some eliminated. Sim-
ilarly, each zang and fu has its own history. This comparison between
the compartments of a work unit and the Organ Clusters of the body
ecologic may at first glance appear strange, but is intended to highlight
how particular and varied the definitions of the Organ Clusters are.
Organ Clusters, like compartments, are easy to identify but difficult to
define in a systematic way.
Offices and ranks have long been hierarchically ordered in the Chi-
nese bureaucracy, but they are often best dealt with by conceiving of
bureaucrats as being clustered (on grounds of a common experience
through family ties, native place, school, classroom, or friendship). Like-
wise, the offices to which the Organs are likened appear as clusters in
the body. Clusters are, in cladistics, established to account for observed
phenomena of each particular individual, and their identity is estab-
lished in relation to others in consideration of features chosen at random
79
Piwei is a common expression for the unit of Stomach and Spleen in TCM; possibly it
was already in the Basic Questions conceived of as a unit (see Basic Questions, chapter 9,
where pi wei is mentioned in an enumeration of the Palaces (Ren 1986:1344; 32)).
(Needham 1983).80 Clusters are integrative and open to incorporate any

newcomer, and they are identified on the basis of all kinds of particular
interrelations.
From Chinese medical doctrine to TCM theory

Although the Five Phases tended to be replaced by the Five Organs
when physiological interrelations and pathological changes were de-
scribed, the ‘maxims for treatment’ (zhize) continued to be phrased in
terms of the Five Phases: ‘Blaze the Fire to nourish the soil (Earth)!’
( yi huo bu tu); ‘Drench with Water to restrain the Wood!’ (ci shui han
mu); ‘Bank up soil (Earth) to produce Metal!’ ( pei tu sheng jin); ‘Bank
up soil (Earth) to control Water!’ ( pei tu zhi shui); ‘Assist the Metal to
level the Wood!’ (zuo jin ping mu); ‘Purge the South and nourish the
North!’ (xie nan bu bei) (TCM Fundamentals (Yin 1984:25)). According
to the textbook, the Five Phases were used for describing ‘(1) the
“physiology” (shengli) and the interrelations of the Organs, (2) the mu-
tual impact of “pathological changes” (bingbian) in the Organs and (3)
their application in diagnosis and therapy.’ The ‘physiological’ pattern
of change was ‘giving birth’ (sheng), and the ‘pathological’ ones were
‘giving birth’ and ‘insulting’ (wu), but most prominently the Five Phases
were used for formulating therapeutic maxims: giving birth, ‘overcoming’
(ke), and ‘multiplying’ (cheng) (TCM Fundamentals (Yin 1984:21–7)).
Reasoning in terms of the Five Phases is indispensable for expressing
complex considerations of treatment. In Chinese medicine, therapeutic
interventions are not merely based on the principle of opposition or the
principle of likeness that are considered characteristic of reasoning in
many scholarly medical traditions. Reasoning in terms of the Five Phases
is pervasive in the Basic Questions, but maxims of treatment in TCM
are not limited to this reasoning. They can be formulated in terms of
the Eight Rubrics (bagang), the Six Disease Factors (liuyin), the Four
Sectors (weiqi yingxue), and the Six Warps (liujing) (Farquhar 1994a:76–
131), and also the Triple Burner (sanjiao). Additionally, there are many
other maxims for treatment such as, for instance, ‘In treating Illness
trace the Roots’ (zhi bing qiu ben).81
80
Cladistics, applied to biosystematics and phylogenetic studies, has come into fashion as
a means for overcoming the Linnaean notion of ‘species’ that is attributed certain ideal
characteristics, approximated by a ‘type-specimen’. It considers observed phenomena
of each individual and establishes their identity in relation to others on account of
features chosen at random, which allows for a comparison of any entity with any other
and is not restricted to entities which are by convention considered comparable.
81
These maxims of treatment need to be translated into a range of other concepts
that refer to the qualities of specific drugs if one is to write a formulary. Farquhar
To illustrate how the meaning of maxims of medical doctrine is

determined by virtuosity in medical practice an example relating to
‘Metal gives birth to Water’ ( jin sheng shui) may be helpful. A doctor
may, for instance, use it in explaining why he supplements acu-points
on the taiyin-Lung-Tract, which corresponds to Metal, to treat a dry
throat that ultimately results from a Water-Kidney-Depletion: the Lungs
govern the qi and ‘the Kidneys adopt it’ (shen na qi).82 By treating the
Lungs he supplements the Kidneys. He may mention this maxim in
another context too, for instance, when confronted with a patient with
swollen extremities. In this context, the phrase ‘Metal gives birth to
Water’ explains the disturbance in the dynamics of the Fluids and
implicitly indicates the appropriate treatment. The Lungs regulate the
Watercourse (shuidao), and the Kidneys govern the Liquids and Fluids:
if the disharmony in the Lungs is aggravated, the Kidneys are likely to
be affected. After all, ‘Metal gives birth to Water’, and one of the most
likely courses that an illness takes as it grows worse follows the cycle of
Giving Birth. Treatment will have to take into account both the Lungs
and the Kidneys.
A senior doctor may well say ‘This is basic’ (zhe shi jibende) when he
speaks of maxims like ‘Metal gives birth to Water’, but he is unlikely to
say: ‘This is in theory so, but not in practice.’ Statements of a theory
can be contradicted in medical practice but not maxims of a doctrine.
Read on their own, maxims tend to be ‘empty’, vague, or even mean-
ingless; their specific meanings become evident through medical practice.
Here it needs to be interjected that although the maxim ‘Metal gives
birth to Water’ can be attributed distinct and very specific meanings of
medical practice, it carries meaning on its own. This is because it
evokes an imagery that can accommodate all kinds of phantasies or
concrete memories. The phrase jin sheng shui (Metal gives birth to
Water) reminds me of hearing a Daoist monk say yan sheng shui (the
rock gives birth to water) as we had entered a granite cave on mount
Hua and saw the condensed water droplets on the ceiling; it looked as
if the glimmer, which looked like Metal, was producing highly refined
Water droplets.83 Clearly, the maxims of Chinese medical doctrine evoke
strong images on their own.
(1994a:205) speaks of different degrees of verbosity, Unschuld (1988c) of ‘mediating

links’ between the concepts of ‘basic theory’ and the ‘empirical categories’ of drug
effects. Bray (1995) points to different ‘levels of causality’ in Chinese medical reasoning.
82
Sivin (1987:228) translates na as ‘to admit’, Farquhar (1994a:95) as ‘to accept’; na
refers to a process of a deep and more fundamental assimilation than that of the Lungs.
83
I do not mean to imply that the Five Phases are metaphors with a clear historical
genealogy of originating in direct observations of nature.
One would be inclined to assume that such maxims formed a sys-

tem of metaphors, but only the younger teachers I worked with would
speak of them in such terms. Farquhar’s (1987:1019) observation with
regard to yinyang applies to all the concepts mentioned in the maxims
of Chinese medical doctrine. She reports that an older scholar doctor
reacted angrily to the epistemologically influenced construction that
yinyang were metaphors for natural phenomena. He insisted ‘that yin
and yang were “things” (dongxi), not forms of thought’.84 To many
older scholar doctors, the Five Phases were not merely abstract terms
but often referred to very concrete events. They were not metaphors
either, for in the universe to which they applied one did not make an
ontological distinction that is hierarchical between its different aspects.
The notion of metaphor is grounded in the notion that an idiom has
a primary meaning, and a secondary, metaphoric one. The ‘foot’ is
primarily a body part, the ‘foot’ in the phrase ‘foot of a mountain’ a
metaphor. Yet Wood is as much a thing (dongxi) inherent to the body
as a thing inherent to a mountain. In the universe in which the Five
Phases figure, there is no ontological hierarchy of its different aspects.
During the nine months of participant experience in various acumoxa
wards, I rarely heard a doctor mention the above maxims, but I did
occasionally recognise in prescriptions a treatment that was grounded
in them. Obviously, the medical practice persisted while the explana-
tions for it in terms of the Five Phases had been silenced.85 I took it as
an indication of shifting preoccupations of medical reasoning from max-
ims of treatment to descriptions of health.
The shift in speech act, from prescription to description, seems to
go hand in hand with a shift in theme of discussion, from ‘pathology’
to ‘physiology’, and in this process, Chinese medical writings have
accommodated many Western biomedical terms and concepts. Already
in the TCM Fundamentals the impact of Western biomedical reasoning
is so pervasive that it is impossible to give an exhaustive account of
it. Although language does not directly reflect thought, the linguistic
accommodations evident in the textbook imply important changes in
understanding. These changes occur at the level of choice of vocabu-
lary, for instance, in speaking of ‘homeostasis’ ( pingheng) and ‘meta-
bolism’ (daixie) instead of ‘harmony’ (tiaohe); using biomedical instead of
TCM terms such as ‘Anus’ (gangmen) instead of ‘gate of the hun-soul’
84
Farquhar (1987:1019) continues: ‘The system is not applied from without as “theory”
would be to “practice”.’
85
It is likely that rationalisations in a terminology that does not contradict the biomedical
one will increasingly be used for designating those unaltered therapeutic practices.
(hunmen); reducing vagueness, for instance, by replacing Blood (xue)

with ‘blood-liquid’ (xueye), Pulse (mai) with ‘pulsation’ (maidong), drug
( yao) with ‘drug-substance’ ( yaowu); and composing hybrids of Chi-
nese and Western medical terms such as ‘organ-machine’ (zangqi). It is
also observed on the syntactic level, for instance, by linking two phrases
with the conjunction ‘because’ ( youyu), which narrows the relation be-
tween the two phrases down to a causal or final one, or by transforming
a simple indicative phrase into a conditional. On the level of register,
textbooks are no longer dialogues but monologues; their rhetoric is so
similar to Mao’s writings that reading ability in the one facilitates the
reading of the other.
On the level of ordering knowledge, Western biomedicine is in-
creasingly taken as a model. In the Organ Clusters, for instance, chapters
5–7 bear the titles of chapters in Western biomedical textbooks (see
table 6.10). And on the level of the explicit reinterpretation of Chinese
medical concepts, conceptions of bodily processes have been inter-
preted so as not to contradict Western physiology. This last point is
illustrated by comparing the TCM Fundamentals (Yin 1984:44–9) with
the Organ Clusters (Yunnan zhongyi xueyuan 1988:33–45) with regard
to the term fu. In both textbooks the Six Bowels (liufu) – the Stomach
(wei), the Small Intestine (xiaochang), the Large Intestine (dachang),
the Gallbladder (dan), the Bladder (pangguang), and the Triple Burner
(sanjiao) – are assigned Western physiological functions of the digestive
system: ‘intake’ (shouna),86 ‘digestion’ (xiaohua), ‘assimilation’ (xishou),
and ‘excretion’ ( paixie). In both textbooks a separate section has been
created for discussing the Odd Palaces (qiheng zhi fu). They did not
figure prominently in the Inner Canon, nor did they appear to have
great significance in medical practice, but clearly the Odd Palaces – the
Marrow (sui) and Bones (gu) which cluster with the Kidneys, the Ves-
sels (mai) which cluster with the Heart, the Gallbladder (dan) which is
also one of the Six Bowels, the Brain (nao), and the Womb (nüzibao)
– could be brought into accordance with Western anatomy. Since the
majority of the Odd Palaces (sui, gu, mai, dan) had been discussed in
other contexts, this textbook section only dealt with the Brain and the
Womb. Notably, the editors of the Organ Clusters additionally dug out
a notion from the medical archive that paralleled that of the Womb in
the female: the Chambers of Essence ( jingshi) in the male.87
86
This term was not found in any contemporary dictionary and is likely to be the
classical term; the following three are all biomedical terms.
87
Daoist thought takes the female body as basis (Schipper 1978), but apparently Chinese
medical doctrine does not (Despeux 1996:107). For incidents of gender transforma-
tions in a person, see Furth (1988).
With respect to the notion of fu, TCM textbook compilers adjusted

the classical doctrine to Western biomedical theory in two ways: by
correcting the classical text and by making the commentary on it more
precise. Explicit corrections of the classics were very rare, but in an
introductory paragraph to the section on the Odd Palaces the editors of
the Organ Clusters claimed with regard to the Marrow, the Bones, and
the Vessels: ‘We consider these as ‘bodily tissues’ (xingti zuzhi); they
are surely not Organs, and also not Bowels, therefore they do not
belong to the category of the Odd Palaces.’ Classical texts were usually
not corrected so bluntly, but interpreted in a way that did not contra-
dict either the medical canons or Western physiology.
The reinterpretation of the Small Intestine’s functions highlights this
nicely. According to the Basic Questions, chapter 8, ‘The Small Intestine
is the officer who receives the abundant, it transforms matter and
expels it’ (cited in Interpretation (Cheng 1984:45); TCM Fundamentals
(Yin 1984:45); Organ Clusters (Yunnan zhongyi xueyuan 1988:36)).
Zhang Jiebin glosses: ‘The Small Intestine resides beneath the Stomach;
it receives and ladles out the Watery Grains (shuigu) of the Stomach by
differentiating between the Clear (qing) and the Turbid (zhuo). From
here, the Watery Fluids (shuiye) seep out in the front and the Dregs
(zaopo) turn to the back. The Spleen by qi-Transformations (qihua)
effects rising while the Small Intestine by Transformation (hua) effects
descending; therefore one says that it transforms matter and expels
it’ (cited in Interpretation (Cheng 1984:45); TCM Fundamentals (Yin
1984:45)). Although Zhang Jiebin’s gloss is lengthy, it remains rather
unspecific. The one comment which is a bit more precise, ‘the Watery
Fluids seep out in front’, seems to suggest that liquid intake is directly
transformed into urine.88
Now, Western physiology teaches us that fluids need to be absorbed
into the blood and transported to the kidneys before the bladder evacu-
ates them as urine. In the TCM Fundamentals the editors’ gloss in
modern Chinese does not really clarify the issue, but in the Organ
Clusters the problem has been solved in a most ingenious way. Accord-
ing to Chinese medical doctrine, the Small Intestine separates the Clear
from the Turbid. In a second step, the Turbid within the Turbid (zhuo
zhong zhi zhuo) is directly excreted in the back while the Clear within
the Turbid (zhuo zhong zhi qing) is absorbed before ‘seeping out’ as urine.
In order to model the functions of the Small Intestine upon those of the
small intestine in Western physiology, the textbook compilers had created
88
I have observed this intuitive understanding of urinating even among European biology
students.
clear
qingde
clear front
qingde
turbid
zhuode
turbid back
zhuode
back front
(a) (b)
Figure 6.4 Physiology of the Small Intestine (arrow upwards means
absorption, downwards means excretion)
(a) as described in the TCM Fundamentals (Yin 1984);
(b) as in the Organ Clusters (Yunnan zhongyi xueyuan 1988)
a new pair of categories, very much in the terminology of Chinese

medical doctrine, which allowed them to render the Small Intestine’s
functions more accurately (see fig. 6.4).
The precise commentaries on the Organ Clusters, often inspired by
Western biomedicine and seldom blatantly contradictory to canonical
doctrine, generally consisted of an altered stress on certain processes.
Jaundice (huangdan) has, for instance, been attributed to the Gall-
bladder, which is the outer aspect of the Liver, instead of the Spleen (Sivin
1987:113), notably, according to my observations in the clinic, without
the need to prove the past wrong: jaundice occurs when the ‘Liver
insults the Spleen’ (gan wu pi). Many TCM reinterpretations consisted
of a modification of Chinese medical reasoning. It would be wrong to
speak of borrowing patchwork from Western biomedicine. The adjust-
ment consisted, in the case of the Small Intestine, of a blow up – a
rather lengthy digression with detailed descriptions of physiological pro-
cesses on which the canons provided no or only vague information –
and, in the case of jaundice’s being attributed to the Liver, of a short-cut.
I have suggested here that phrases in terms of the Five Phases such as
‘Metal gives birth to Water’ are most significant in the context of pro-
viding therapy. They are maxims (in the imperative or optative mood)
rather than descriptions (in the indicative mood), categories that ex-
press in shorthand a device for a therapeutic practice. I have proposed
Table 6.10. Contents of chapters 3–5 in the TCM Fundamentals

(1984) and the Organ Clusters (1988)
TCM Fundamentals (1984) Organ Clusters (1988)
Chapter 3 Organ Clusters (zangxiang) Book Title Organ Clusters (zangxiang)

Part 1 Introduction
Part 2 Organs and Bowels (zangfu)
3.1 Five Organs (wuzang) 2.1 ditto
3.2 Six Bowels (liufu) 2.2 ditto
3.3 Odd Palaces 2.3 ditto
(qiheng zhi fu)
3.4 Their interrelations
Chapter 4 Breath, Blood, Part 3 Essence, Breath, Blood,
Liquids and Fluids Liquids and Fluids
3.1 Essence ( jing)
4.1 Breath (qi) 3.2 ditto
4.2 Blood (xue) 3.3 ditto
4.3 Liquids and Fluids ( jinye) 3.4 ditto
4.4 Their interrelations
Chapter 5 Tracts and Links Part 4 ditto
5.1 Concept of Tracts and 4.1 ditto
Links and the Composition
of the System
5.2 Twelve Tracts 4.2 ditto
(shier jingluo)
5.3 Eight Odd Vessels 4.3 ditto
(qi jing ba mai)
5.4 Tract Divergents, Diverging 4.4 ditto
Links, Tract Sinews,
Cutaneous Regions
( jingbie, bieluo, jingjin, pibu)
5.5 Physiology of the 4.5 Physiology and Function of the
Tracts and Links Tracts and Links
Part 5 The Interrelations within the Body
and between the Body and its
Environment
5.1 The Interrelations within the Body
(discusses TCM Fundamentals 3.4
and 4.4)
5.2. The Interrelations between the
Human Body and its Environment
(contains newly added contents)
Part 6 Holistic View of Vital Activities and
Processes
6.1 Respiration
6.2 Alimentary Metabolism
Table 6.10. (cont’d)
TCM Fundamentals (1984) Organ Clusters (1988)
6.3 Metabolism of the Fluids

6.4 Blood Production and Circulation
6.5 Growth, Development, and
Reproduction
6.6 Mind, Consciousness, and Thought
6.7 The Basic Types of Vital Actitity:
The Upward and Downward,
Outward and Inward Movements
Part 7 The Constitution
7.1 The Constitution and its
Characteristics
7.2 Constitutional Types and their
Physiological Function
7.3 Factors that have an Impact on the
Constitution
furthermore that much of Chinese medical doctrine consists of sets of

such mnemonic maxims rather than a system of propositions that can
be deduced from each other. Maxims differ from propositions most
decisively with respect to truth value: the value of a maxim is estab-
lished through success in practice. A maxim is valuable no matter
whether it stands in contradiction to others or whether it is self-
contradictory, from a ‘logical’ (luojixing) point of view;89 evidence for
its value is given in the practice that corresponds to the maxim. A
proposition, by contrast, makes a claim to ‘truth’ and raises issues of
Western philosophy.90
89
I am not speaking of ‘logic’, a discipline of Western philosophy, but of the understand-
ing of ‘logical’ as expressed by TCM doctors. ‘Logical’ designated modes of reasoning
that included the explicit recognition of contradictions within one statement or between
two statements. The term luojixing is a phonetic borrowing of the Greek term, and
TCM doctors attributed this mode of reasoning largely to what they considered Western
scientific thinking.
90
Compare with Unschuld (1992:45): ‘Recent Chinese and Western publications have
overemphasised an allegedly all-pervasive antagonism between modern Western and
traditional Chinese medical thought while disregarding some basic epistemological parallels.
At the same time, one of the most profound discrepancies separating Chinese and Western
cognitive approaches – that is, the attitude towards the truth – appears to have been
overlooked.’
The loss of Spirit
The discussion of yinyang dialectics, the implications of being system-

atic, the focused vision giving rise to a body-centred medicine, and the
descriptive assessment of TCM physiology have shown that Chinese
medical concepts have been adjusted to fit with Marxist dialectics,
Western science, and Western biomedicine, all of which have their
origins in post-Renaissance, modern Western culture and thought. Signi-
ficantly, one feature which those traditions of thought have in common,
the materialist approach, has led to a neglect of the notion of the Spirit
(shen) in TCM.
It is not that shen, central to Zhang’s seminars, was not an issue in
TCM textbooks and classes. In the course on the TCM Fundamentals,
the students learnt about it when the functions of the Heart were
discussed, during the first lecture on the Five Organs. In this context, it
was taught that shen has two senses. In its narrow sense, it indicated a
person’s state of ‘mind’ ( jingshen) and ‘consciousness’ ( yishi), ‘thinking’
(siwei), and ‘activity’ (huodong). In its wider sense, similar to Qiu’s
notion of shen, it was ‘the outside manifestation of a person’s life and
activities’ (rende shengming huodong waizai biaoxian). During mid-term
exams students were asked to reproduce this definition.
In TCM Diagnostics, shen was discussed in the first lesson. It was said
to be of primary concern for a ‘diagnosis by observation’ (wangzhen),
particularly when inspecting the Complexion (se) and the Tongue (she):
‘Observe Spirit – this is only too important’, Tao exclaimed, adding: ‘You
will grasp its meaning naturally and all by itself, it is not difficult.’ Then,
he wrote some standard phrases on the blackboard as definitions of the
three standard types of shen. These were variants of those in the textbook:
The manifestations of Having Spirit ( you shen) are: the mind is clear, verbal
articulation is distinct, vision is bright, vital essences are retained within; com-
plexion is glowing and full, facial expression is rich and natural; responses are
nimble and sensitive, movements are agile, body posture is graceful; breathing
is smooth and steady, and the muscles are not emaciated.
The manifestations of a Loss of Spirit (shi shen) are: the mind is dazed, or
the speech is incoherent, or one plucks at one’s clothes and strokes the bed,
or clutches in the air as if spinning a thread; the eyes are dim and the gaze is
distracted, pupils are dull; complexion is grey, facial expression is stiff and
listless, responses are retarded, movements are clumsy, posture appears forced;
breathing is irregular and the large muscles are already wasting (TCM Dia-
gnostics (Deng 1984:10–11)).
The manifestations of the Pseudo-spirit ( jiashen): teacher Tao described them
as marked improvement shortly before death – a well-known phenomenon in
medical practice.
Shen in the phrase you shen could be understood in its wide as well
as narrow sense, while shen in shi shen was clearly shen in its narrow
sense, describing certain conditions of mental illness. When these phrases
were learnt in juxtaposition, it is therefore quite likely that the students
would understand shen in you shen to be the opposite of shen in shi shen,
and that they would conceptualise it in its narrow sense as the ‘mind’,
with functions of the brain as known from Western biomedicine. Tao,
aware of the contradiction this evoked in students who had memorised
that ‘the Heart houses the Spirit’, gave a laconic answer to his own rhetor-
ical question ‘Why does the Heart and not the Brain house the Spirit?’:
‘It is a question of habit’ (xiguan wenti).
Considering that shen was a topic of discussion in the first lesson
on the Organ Clusters in the course on the TCM Fundamentals (on 10
October 1988) and the first on TCM Diagnostics (on 1 March 1989), it
was surprising to find that it was hardly ever mentioned in the clinic.
Possibly it was so basic that the assessment of the patient’s Spirit be-
longed to tacit knowledge. It was, however, rarely an issue in verbal
exchanges on treatment evaluation – this in contrast to Qiu’s practice,
in which the Spirit indicated a reality more relevant than any technicalities
of scientific evidence.
I did hear TCM doctors say: ‘His vision is bright’ in place of acknow-
ledging that a patient Had Spirit. Or they would say: ‘His articulation
is distinct, but his movements are not agile.’ Substituting explicit and
standardised locutions for the vague notion shen had several implications
for the process of standardising Chinese medicine in medical practice
as well. Firstly, an observation such as ‘His articulation is distinct’ was
explicit and easily determined by denotation. One doctor could make
such an observation independently of another, and the two could then
compare their results. Once an explicit standard was given, one could
compare and check one’s findings. A TCM doctor’s judgement about a
patient’s condition would thus be controlled by other doctors.
Secondly, statements such as ‘The movements have lost agility’ and
‘The articulation is distinct’ pointed to contradictory aspects of a person’s
condition. Statements of TCM doctors were fairly factual and detached
from implications for further social interaction, whereas Having Spirit,
you shen, in Qiu’s practice implied that the treatment had been success-
ful and therefore the patient should pursue it, with its negation imply-
ing dissuasion from further treatment. In other words, the replacement
of the notion shen by statements about distinct observations that could
be compared with each other opened up a forum for communication
and discussion among experts. Because this terminology was used for
gaining authority through recognition by other experts, the doctor’s
Table 6.11. Comparison of the chapter titles in the Interpretation, TCM

Fundamentals, and Organ Clusters
Interpretation (1984) shen jing qi Spirit, Essence, Breath

(Neijing jiangyi)
chapter 3.2
TCM Fundamentals (1984) qi xue jinye Breath, Blood, Fluids
(Zhongyi jichu lilun)
chapter 4
Organ Clusters (1988) jing qi xue jinye Essence, Breath, Blood, Fluids
(Zangxiangxue)
Part 3
clients were thereby disempowered. I doubt that the TCM doctors I

worked with were aware of these implications. Although the technical
terminology they used should have facilitated discussion, I seldom saw
them make use of this possibility.
The notion of an all-pervasive shen was disappearing not only in
medical practice, but in medical theory as well. While the Interpretation
retained the trilogy shen-jing-qi, Spirit-Essence-Breath, which is central
to self-cultivation practices (Engelhardt 1987:1), the term shen was
dropped in later introductory textbooks (see table 6.11).91 The Spirit
was no longer, as in Zhang’s seminars, categorised as a ‘substance-
force’ that constitutes and permeates the universe; it had been reduced
to a function of the mind, an aspect of the Organ Cluster Heart. Instead,
the notion of Liquids and Fluids (short: Fluids, jinye)92 was newly
added. Although they had little significance in the clinic, in the TCM
Fundamentals they have become a superordinate term that subsumes
various ‘substance-forces’ well known from Chinese medical practice,
among them Phlegm (tanyin).
Phlegm caught my attention because it was the target of TCM
polemics. Teachers recited sayings such as: ‘Strange diseases are fre-
quently Phlegm’ (guaibing duo tan), or: ‘The hundred diseases come
from the haunt of the Phlegm’ (baibing duoyou tan zuo sui). When
teacher Tao introduced the notion of Phlegm in the classroom, he said:
‘Go to see a senior Chinese doctor and whatever cough you have, he
91
In the TCM Fundamentals, Essence ( jing) was dropped as well, but, in contrast to shen,
it figured in the Revised Outline (Sivin 1987:237) and reappeared in the Organ Clusters.
92
Despite textbook remarks on jin and ye (see also Sivin 1987:243–4), the difference
between these two concepts is just as inconceivable to most doctors as that between
liquids and fluids is in English.
will make Phlegm responsible for it.’ Later he continued: ‘When a

senior doctor speaks of tanyin (Phlegm), he does not refer to Zhang
Zhongjing’s Four Rheums (siyin)93 which I have just presented above.
These “old doctors” (lao yisheng) know nothing about the above differ-
entiation of tanyin and xuanyin, and if you ask him what a xuanyin is,
he can’t explain anything to you. All he knows is that the tanyin he
refers to is that of his master.’
Phlegm had the strength of being extremely vague: it designated (1)
symptoms about which a patient complained and (2) visible signs such
as ‘thick saliva’ (tan) on the tongue, and it also designated (3) a postu-
lated process in the body with which the doctor explained these signs
and symptoms. Tao deplored the popularity that such vague concepts
enjoyed among the senior doctors, but instead of ignoring this concept
altogether, he devoted an entire lecture to what he considered a system-
atic discussion of Phlegm, by drawing on the blackboard what looked
like elaborate Western physiological charts. Phlegm and also Blood
Stasis ( yuxue)94 have been among the most controversial themes in
recent TCM research.
Phlegm and Blood Stasis referred to a process – a stagnation. Unlike
accumulations, which often had Form, and the accumulating qi that
Qiu saw in the Red Light, stagnations were generally Without Form,
invisible. They were postulated processes in the body which were
detected by excretions, signs outside the body, such as Phlegm on the
tongue or Clots (kuai) in the menstrual blood. Since they gave rise to
many different disorders, they have recently become classified among
the Disease Factors in the TCM Fundamentals (Yin 1984:101–2).
Relevant in this context is that the material aspects of ‘substance-
forces’ such as Phlegm were increasingly emphasised. Under the head-
ing ‘Breath and Blood, Liquids and Fluids’ (TCM Diagnostics (Deng
1984:99–106); (Shanxi zhongyi xueyuan 1988:192–9)), Phlegm and
Rheum were discussed in the section on the Fluids, Blood Stasis in the
section on Blood, and Stagnant qi in the section on qi. Phlegm, Blood
Stasis, and Stagnant qi had one process in common, stagnation, but
in TCM textbooks they were categorised according to their material
aspects and discussed under separate headings. As criterion for the
formation of TCM concepts, matter dominated over dynamics.
93
In the Jin gui yao lüe they are tanyin (Phlegm Rheum), xuanyin (Suspended Rheum),
yiyin (Spillage Rheum), and zhiyin (Propping Rheum) (TCM Fundamentals (Yin
1984:101)).
94
The term yuxue was usually not part of the patient’s vocabulary. It designated (1) a
postulated process inside the body and (2) visible signs such as Clots (kuai) of men-
strual blood.
The Organ Clusters (Yunnan zhongyi xueyuan 1988:123–4) devoted a

whole section to the metabolism of the Fluids (section 6.3 in table 6.10).
The precision with which their function in respect of each of the Five
Organs was described is simply stunning. The source of inspiration
evidently being Western physiology, there was nothing here that bla-
tantly contradicted Western biomedicine. TCM Etiology and Pathogenesis
(Chengdu zhongyi xueyuan 1988:102–5) differentiated between shui
(Water) and yin (Rheum) and between tan (Phlegm) and shi (Damp-
ness). These notions were systematically presented in the textbook, but
such systematics were not really important in medical practice. In the
clinic, the process of stagnation constituted the core of medical reason-
ing for formulating a therapeutic maxim. The fine distinctions between
the material aspects of TCM concepts had hardly any relevance in
medical practice. This descriptive eloquence reinforced the gap be-
tween TCM theory and its application in the practice.
In the Organ Clusters (Yunnan zhongyi xueyuan 1988:47–8), the
notion jing was reintroduced: (1) Essence furthers growth, develop-
ment, and reproduction; (2) it nourishes and moistens the Organs and
Bowels, the Tracts and Links; (3) it transforms into Blood Liquid; and
(4) it fills and nourishes the Brain Marrow (naosui). As a ‘substance-
force’ considered important for one’s genetic constitution, Essence re-
tained its function of transcending a person’s Worldly State. However,
it was not mentioned as the ‘substance-force’ that mediates in daily
meditation between the body ecologic’s two states of being, the Worldly
and the Primordial State. The materialist stance in TCM theory had
thus led not only to a tendency to neglect the Spiritual and to take a
static view of processes, but also to experience time in the linear way in
which materials age, thereby disregarding the possibilities of resilience
and regeneration that Chinese medical doctrine ascribes to the body
ecologic.
The lessons usually ended with the teacher designating certain text pas-
sages for the students to memorise. For classroom instruction teachers
advocated the didactics appropriate for teaching a theory: explanation
and method. For homework, in contrast, the didactic method was rote
learning. TCM teachers thereby unwittingly provided the students with
the means to learn about the Spiritual. We may be reminded here of
Zhang’s conviction that memorising texts in combination with experi-
ence in medical practice would eventually lead to ‘revelations’ (wu) (see
p. 103). Learning by heart was the key to the way of knowing that
Zhang considered profound knowledge – the profound knowledge
grounded in the Spiritual.
The reinterpretation of Chinese medicine in

TCM standards
TCM teachers considered Chinese medical concepts ‘coarse’ (cucao)
and based on a ‘primitive understanding’ ( pusu renshi). Following Mao’s
slogan ‘The new supersedes the old’ (xin chen fa xie), these concepts
had to be rendered more ‘fashionable’ (shimaode). To ‘make the best’ of
them ( jiangjiu), they had to be ‘modernised’ (xiandaihua). The fore-
most goal was therefore ‘to standardise’ (guifanhua) and make Chinese
medicine ‘systematic’ (xitonghua); this would render it more ‘scientific’
(kexuehua).
The standardised transmission of Chinese medical knowledge has
gone hand in hand with a nationalistic reinterpretation of China’s cul-
tural heritage, a Maoist reinterpretation of philosophical concepts like
yinyang, a body-centred focus on the body ecologic which has led to a
shift in emphasis from the Five Phases to the Five Organs, a reinterpreta-
tion of prescriptive maxims in a hitherto unknown descriptive precision
inspired by Western physiology, and a materialist reinterpretation of the
‘substance-forces’ constituting and permeating the universe. This has led
to a static view of processes, a disregard of the body’s resilience, and a
neglect of the Spiritual.
It needs to be borne in mind that the process of standardising the
transmission of Chinese medical knowledge is not simply an adjust-
ment to Western biomedicine. To reinterpret concepts such as yinyang
in terms of dialectics has little affinity with Western biomedical theory,
nor is materialism specific to Western biomedicine. Moreover, several
observations that I recorded seemed to depend more on accidents of
history than on any change in styles of knowing induced by the stand-
ardised transmission of knowledge.
With regard to whether the mode of teaching by means of ‘explana-
tion’ and ‘method’ had any impact on the general understanding of
Chinese medical concepts, an increased focus on the physical body is
apparent, but the interrelations between Chinese medical concepts do
not seem to have become more hierarchical and continue to be placed
in relation with each other as clusters.
It is striking that the efforts at standardising the transmission of
medical knowledge and practice have produced considerable tension
between theory and practice, strict control in classroom instruction and
a laissez-faire attitude in practical training, indifference in daily life at
the college and excitement during the movement against nepotism and
corruption, a technical terminology that invites factual discussion and
no signs of experts wishing to become involved in discussion, classroom

instruction that models itself on the didactics of teaching the natural
sciences and homework that consists of the rote learning which is basic
to the secret and personal modes of transmitting knowledge. Efforts at
standardising the transmission of knowledge and practice seem bound
to give rise to a divergence between the proclaimed standards and their
implementation.
Discussion: styles of knowing
How do styles of knowing interrelate with ways of learning? The ques-

tion with which we began cannot be answered conclusively, but the
data presented throw some light on the issue. Concepts become ‘social-
ised’. If learnt in different social contexts, they tend to be understood in
different ways – they have different meanings, uses, and ‘performative
significances’ in social interaction. Modes of (verbal) reasoning and
styles of (non-verbal) knowing have been shown to vary in different
social contexts of learning Chinese therapeutics.
Secret knowing
Qigong was veiled in secrecy. It was attributed great powers and often
supposed to have immediate effects. Access to these powers was fraught
with danger, and the disciple needed guidance. A master would accept
a person as a disciple only if this person had extraordinary moral qual-
ities, loyalty to the master and his family, the ‘predestined fate’ ( yuanfen)
‘just to remember’, and perseverance and patience, which, in light of
the necessary self-castigation, could only be achieved with composure.
A Daoist was to be ‘cheerful’ (kailang).
Verbal reasoning in qigong was not elaborate. Words were powerful,
verses simple and short. Verses were often recited without knowing
their meaning; to be effective, they need not be understood, but cor-
rectly pronounced. Knowing qigong was marked by an ostensive secrecy.
In Qiu’s case secrecy was not only an attribute that enhanced his and
his family’s prestige but also, in the secret society to which he belonged,
a weapon of the weak and a form of protection. On the one hand,
strategic considerations of flexibility in an environment that is con-
sidered hostile may have encouraged the simplicity, brevity, and limited
number of the spells and rituals Qiu employed. On the other hand,
there is a particular aesthetics to the condensation of value in small
commodities like simple words, short verses, and potent gestures seem-
ingly pregnant with a meaning that remains concealed. A healer can, by
225
not entirely revealing the concealed, also adorn himself with these words,
verses, and gestures.
To a certain extent, all three traditions of Chinese therapeutics re-
vealed the concealed in forms that were intelligible only to the initiated.
Technical terminology and specialised skills draw a boundary between
laypersons and those who have access to them. But Qiu kept his know-
ledge and practice secret while the senior doctor Zhang and the TCM
teachers claimed that access to their knowledge was basically open to
everyone. Considering that Qiu’s verses and gestures could be learnt by
imitation, control over the distribution of qigong knowledge and prac-
tice was an issue. Since verses were said to be effective only if correctly
pronounced, they could not be learnt outside a relationship of oral
transmission, even if they had been recorded on paper. The master
therefore had a means to control the distribution of knowledge.
It is not a paradox that precisely the knowledge that was considered
easy to reproduce was most veiled in secrecy. A secret is often very
banal, and secrecy a means of social control. If knowledge and practice
are believed to be not as easily reproduced, as for instance expertise in
Chinese medicine, control over the distribution of knowledge is guaran-
teed in that it is built into the process of learning.
Personal knowing
The senior Chinese doctor Zhang was the offspring of the fourth gen-
eration of a family of Chinese doctors. Brought up in a Catholic con-
vent and compelled to leave after only two years of joining the workforce
as a young doctor at the Yunnan TCM College, he did not participate
in the ‘socialist reconstruction’ of the Chinese nation. He was a mar-
ginal like Qiu in the modern nation-state, but unlike Qiu, who he saw
as belonging among the ‘petty people’ (xiaoren), he considered himself
a ‘gentleman’ ( junzi) and cultivated relations with intellectuals and
high-status officials. Among his followers, he was mostly praised for his
Confucian ethics and his ‘sensitive concern for others’ (ren).
One might have been inclined to include Zhang’s ways of learning
among those of secret knowledge, particularly in light of his emphasis
on morals, his need to impress, his control over his disciples, and his
emphasis on the Spiritual (shen). But Zhang’s reasoning, observed also
among other senior doctors, was flowery and verbose and could easily
be distinguished from Qiu’s. His modes of interpretation, which were
‘indirect’, ‘authoritative’, ‘justificatory’, ‘creative’, and ‘achieved by re-
course to everyday life’, may well have reflected attitudes and practices
of the traditional elite. We may assume that the scholar officials in
Imperial China had developed a style of knowing distinct from that of

ordinary people.
Knowing Chinese medicine meant acquiring profound knowledge by
memorising the ‘experience’ ( jingyan) of the ancients in the text and
combining it with one’s own experience in medical practice. To attain
‘profound’ (shen’ao) knowledge, one had to immerse oneself in learning
verses and patiently to assist in therapy. The mentor would comment
on certain situations by reciting a phrase that the follower knew by
heart without having grasped its meaning. Applied to a particular situ-
ation, flowery verses were given down-to-earth meanings. Since the
mentor would recite the same verse on different occasions, words and
phrases became increasingly polysemous. Over time, the follower would
fill the rhythmical rhymes with contents that arose from experience in
medical practice.
Although it was claimed that profound knowledge could not be
acquired by explication, a mentor was expected to make exegeses of the
classical texts. Zhang did not aim at a literal translation of the text;
rather, he used the text for conveying his own conviction and experi-
ence. The relationship between the text and medical practice was not
so much one between a theory and practice as one of applying a doc-
trine with ‘virtuosity’ (ling) to medical practice.
Zhang’s text seminars had the effect that the more we read, the more
confused we became, swimming in a sea of verses. There was no cer-
tainty on which we could build, no rigour which provoked contradic-
tion. Reasoning was embedded in the rhythm of language. The promise
was that one day we would know, just know. Zhang spoke of a ‘sudden
intuition’ (wu) and thereby perpetuated the idea, widely attested in the
literature, that major insights into the profound knowledge of Chinese
medicine come through revelations.
Standardised knowing
At the TCM college, old ways of learning persisted. Students at dusk,
murmuring textbook passages on the sports ground, seemed to lull
themselves with the text. They learnt standard phrases without ponder-
ing their exact contents, just as students of earlier centuries had done.
The difference was that the rhetoric they memorised was often in modern
Chinese and stylistically more like Mao’s writings than like classical
medical texts.
Obviously, rote learning was at the core of all three traditions of
Chinese medical learning. Qiudi learnt short spells, Zhangdi long text
passages from the medical canons, and TCM students shorter ones
from TCM textbooks. In qigong, memorising texts would lead to visions

that endowed the healer with extraordinary powers. In the context of
reading canonical texts, it would lay the groundwork for revelations
that enabled the senior doctor to gain profound insights. At the TCM
college, rote learning persisted even though the professed goals of teach-
ing were clearly in contradiction to this method.
Apart from memorising texts, TCM students were taught by the
didactic means of post-Enlightenment education. Classroom instruc-
tion was supposed to be based on ‘explanation’ ( jieshi) and have ‘method’
( fangfa). The teachers frequently paraphrased, explained, and defined
clauses of classical Chinese in modern Chinese. They narrowed down
polysemous notions of Chinese philosophy to less ambiguous com-
pound words that often sounded like biomedical terms. The texts were
written so that students could understand them in class, and some
exam questions concerned the students’ comprehension of the texts.
There was a tendency towards constructing a TCM theory that was
comprehensible on its own, independent of a mentor’s pointing out
particular conditions that filled the poetic verses of the medical canons
with a very specific meaning. In the 1984 TCM Fundamentals phrases in
terms of the Five Phases were still juxtaposed with phrases describing
signs and symptoms and others outlining maxims for treatment. In the
corresponding 1988–9 editions, however, this juxtaposition of philo-
sophical speculation, diagnostics, and therapeutics tended to be broken
up. Philosophical generalities were stated on their own, which made
them sound like general principles or even natural laws.
TCM theory and practice, it seemed, were increasingly separated
from each other. Each seemed to gain in autonomy, a process that
was reinforced by the administrative division between hospitals, subject
to the Ministry of Health, and the college, subject to the Ministry of
Education. The doctors in the respective institutions showed reserve
towards each other. The educators suspected the hospital doctors of
perpetuating ‘superstitious’ (mixin) practices while the doctors pointed
to the necessity of political correctness for being employed among col-
lege educators.
The formulation of a theory that can be comprehended more or less
in isolation from medical practice is among the most important steps in
the standardisation of knowledge. In theory, standards are easily estab-
lished. In medical practice, even if it is institutionalised in clinics and
thereby becomes more standardised, the particular problems a practi-
tioner is faced with slow down any process of standardisation. The
standardisation of TCM may therefore have been accelerated by widen-
ing the gap between a systematic theory and the unpredictabilities of
medical practice. Contemporary Western biomedicine, which acknow-

ledges an enormous gap between theory and practice, represents a model
case of such standardisation.
TCM texts were viewed as theoretical tools indispensable for medical
practice, and medical practice was considered crucial for advancing
TCM theory. This attitude towards the text echoed Mao’s (1965) essay
‘On Practice’. Knowing TCM meant placing theory and practice in a
dialectical relation. This was not quite the same as making personally
learnt phrases of medical doctrine meaningful by applying them with
virtuosity to medical practice. While personal experience and ‘flexibility’
(linghuo) continued to be valued in TCM, standardised theory had
been learnt in the classroom for several years before it was applied in
the clinic. There was a theory, divorced from medical practice, and the
two had to be placed in a dialectical relation.
Some features distinctive to TCM reasoning – the bias towards
materialism, a preference for singling out a focus in discussion (the
premiss for any comparison), and knowledge stated in the indicative –
pointed to the practices of measurement, comparison, and falsifica-
tion, characteristic of the standardisation of knowledge in the modern
Western sciences. Considering the prestige that Western science currently
enjoys in China, this may not be surprising.
One would not, however, do justice to the complexity of these pro-
cesses if one were to speak of a piecemeal assimilation of the modern
Western sciences. The process by which the knowledge and technology
of the West are being integrated into Chinese medical knowledge and
practice is marked by an active choice of what is considered suitable for
a particular problem. TCM is being forged so as not to contradict the
canons of either Chinese medical doctrine or biomedical theory.
The current efforts at standardisation are reminiscent of earlier ones
in China’s past. TCM theory is not simply modelled upon a prestigious
foreign medicine but integrates many different facets of learning, past
and present, Chinese and foreign. Much of the ongoing reinterpretation
is grounded in an effort ‘to be systematic’ (xitonghua), in which I see a
continuation of age-old efforts to standardise Chinese medical know-
ledge and practice.
Non-verbal knowing and participant experience
It goes without saying that the above three settings had much in com-
mon. Firstly, the technical terminology was very much the same. Sec-
ondly, the modes of transmission were not mutually exclusive. Thirdly,
rote learning from written texts was practised in all of them. Perhaps a
participant observer would not have felt it necessary to highlight the
differences between them as I have; ‘participant experience’ might have
made the researcher more sensitive to verbally unexpressed tendencies
that an observer does not immediately perceive. From a methodological
point of view, it is worth noting that I became acutely aware of the
differences between the three settings precisely because I went through
the learning experiences myself and had subjective reactions distinctive
to each.
I found the teachings in the TCM classes the most comprehensible,
but not interesting. Reading classical texts with the senior doctor
Zhang was sometimes exciting, even illuminating, but more often sim-
ply frustrating because many statements seemed arbitrary and often
inconsistent with others. Qiu’s gestures and incantations are to this day
a mystery to me. The subjective responses that I experienced may well
have been intended to be evoked in every student, follower, and disciple
– they may well have been aimed at by teacher, mentor, and master.
Didactic clarity was an explicit goal of the TCM textbook compilers;
alternation of excitement and frustration calls for subordination to an
omniscient and guiding authority; and the lure of the mysterious gave
Qiu’s healing performances more significance.
With regard to rote learning participant experience also varied with
the context: the Daoist spells were short and often rhymed, but Qiu
always found something wrong with my recitation – with its speed,
its intonation, or its pronunciation – and I soon gave up. After Zhang’s
seminars I never made a serious attempt to memorise entire text pas-
sages from the canons but would occasionally find myself reciting flowery
verses – they were so melodic. Rote learning at the college was neces-
sary to pass the exams, but many sentences were so cumbersome that
they were difficult to memorise.
My subjective experiences, identified through introspection, were
interrelated with behaviour that a participant observer might have
noticed: I often challenged teacher Tao in our lively discussions but
asked mentor Zhang questions in a soft voice and observed master Qiu
in silence. I did occasionally challenge Zhang, but his response was
different from Tao’s; instead of playfully countering my argument the
senior doctor would look surprised, declare that he did not understand
my question, and continue to elaborate his sermon on the text, or he
would ask me to repeat my challenge so that I would reformulate it as
a humble question. Sometimes I would ask Qiu a series of questions,
but he simply ignored them. ‘Get out of the habit of asking questions’,
he once muttered.
Tao’s answers to my direct questions were elusive, Zhang’s pomp-

ous, and Qiu’s short, often so short as to be unintelligible. Evidently,
direct questions were not approved of in any of the three traditions
of learning. The person who may ask direct questions is the one with
authority, not the student, follower, or disciple. The teacher’s, men-
tor’s, and master’s responses reflected particular kinds of resistance.
Being short or pompous would not be acceptable for Tao, say, in a
meeting of self-confession at the college, and Zhang was too much
concerned with presenting himself as a gentleman to be short, but Qiu
spoke to me in imperatives. This shows that participant experience
allowed me to explore some non-verbal aspects of learning: attitudes to
different styles of teaching, memorising texts, and asking questions.
Verbal reasoning, word meaning, and social practice

Since this study is an ethnography that ultimately explores Chinese
medical terms, some thought has to be given to the methodological
approach adopted for doing so. The investigation built on the insights
of methods developed for investigating word meaning, such as identify-
ing semantic components of words (Frake 1961), establishing sense
relations between them (Lyons 1977:204), drawing out semantic net-
works (Good 1977), and exploring different kinds of opposition (Cruse
1986:197–264); methods derived from semantics that are directed at
attaining an ‘emic’ understanding.1 These methods provided an invalu-
able background but were, except for Cruse’s framework of analysis,
only implicitly applied.
The research was also informed by pragmatics, which concerns an
investigation of language beyond syntax and semantics. Pragmatics is,
according to Levinson (1983:7, 9, italics added), ‘The study of lan-
guage from a functional perspective, that is, that it attempts to explain
facets of linguistic structure by reference to non-linguistic pressures and
causes’. It is specifically aimed at ‘The study of those relations between
language and context that are grammaticalized, or encoded in the structure
of a language’. Pragmatics is directed towards explaining language struc-
ture in the light of language use.2 Since the present ethnography treats
1
The notions of ‘emic’ and ‘etic’ can be traced to the linguist’s distinction between
phonemics and phonetics, the former describing the sounds of a language according
to the speakers’ perception, the latter according to ‘objective’ criteria of the outsider-
linguist (Headland et al. 1990). There are, however, also instances in which ‘the
domain of interpretive possibilities is continuous between those of the observer and
those of the observed’ (Csordas 1993:145).
2
See also Duranti (1988:211–13) for a definition of language use which applies to
pragmatics, sociolinguistics, and the ethnography of speech.
events of verbal expression primarily as aspects of social interaction, it

goes beyond the scope of pragmatics in that it explores the significance
of words in social practice. It investigates how concepts become ‘social-
ised’, the effects they have on verbal and non-verbal social interaction,
and what I have proposed to call the ‘performative significance’ of
words in social practice.
The study furthermore built on the idea that the learning experi-
ence coins word meaning: it approximated Chinese medical terms by
investigating the way in which they were learnt. Toren (1993:462) has
repeatedly argued that ‘Studies of children’s cognitive processes [are]
essential if we are to understand what adults are doing and saying’. She
emphasises the importance of studying the process of ‘coming to know’
for understanding the ‘knowledge’ itself. While Toren’s study was about
children in Fiji learning the meaning of words that express the social
hierarchy of adults and how to behave accordingly, this study was
about acolytes – disciples, followers, and students – learning words for
appropriate behaviour in medical practice. The approach taken was,
again, to explore the meaning of specific words as an aspect not only of
language or of parole 3 but of social practice.
The concepts investigated were not artifacts, nor were they natural
kinds, categories widely recognised on the basis of recent studies on
concept acquisition in children (see for instance Keil 1986). Perhaps
they are best approximated by Boyer’s (1993) notion of ‘pseudo-natural
kinds’. However, terms for natural kinds, artifacts, and pseudo-natural
kinds belong, like colour terms, to very specific domains of meaning.
Rather than narrowing the investigation of Chinese medical terms down
to research that emphasises the referential aspects of meaning,4 this
study intended to open it up. It treated technical terms like ordinary
words, which are often meaningful because of their sense and connota-
tion, and not primarily their reference.
Chinese medical terms seem to have some affinity with words like
bobility and baraka which have proven socially eminently functional
precisely because they lack a clearly defined referential meaning and
their referential meaning changes as the contexts in which they are
uttered change. ‘Nothing is more false than the claim that for a given
assertion, its use is its meaning. On the contrary, its use may depend on
its lack of meaning, its ambiguity, its possession of wholly different and
3
De Saussure ((1916)1967:91) distinguishes between langage, an idealised object of
study, and parole, which speakers speak.
4
‘Reference’ concerns the relationship between language and the world, and is often
opposed to ‘sense’, which is established through the relationship of a linguistic item to
others (Lyons 1977:177–206).
incompatible meanings in different contexts, and on the fact that, at the

same time, it as it were emits the impression of possessing a constituent
meaning throughout – on retaining, for instance, the aura of justifica-
tion valid only in one context when used in quite another’ (Gellner
(1958)1970:45). The crucial divergence between the different mean-
ings of a word in the different contexts in which it is uttered is, accord-
ing to Gellner, often essential for the workings of society.
If one accepts that key concepts of Chinese medicine can be likened
to words like bobility and baraka, there is definitely a difference between
categories of the Western sciences in the twentieth century and those
of Chinese medical terminology. The former are defined with the aim
of being as unambiguous as possible, while the latter are often useful
for therapeutic intervention precisely because of their vagueness and
polysemy.
Scientific terms are ideally unambiguous in order to assess reality
descriptively. This scientific description is bound to lead the researcher
to an alienation from the subject he or she describes, the alienation
between researcher and researched being intrinsic to the activity of
being descriptive. The researcher is meant to set up or refine scientific
‘theories’ that are descriptive of reality (in the indicative mood). They
are not meant to interact with reality as, for instance, does a command
(in the imperative mood) and are, in this sense, meant to be detached
from reality. It is a commonplace among scientists that there is a gap
between theory and practice. A theory is by definition separate from
practice. But it is, ultimately, validated by practice: it is modified or
abandoned when better ways of manipulating reality are found.
There are several ways of manipulating reality. The detour one takes
by describing reality and thereby alienating oneself from it in order,
ultimately, to intervene with and manipulate it is just one of them.
There are ways in which one can manipulate reality without alienating
oneself from it to the same degree as the descriptive scientist. If one
makes use of a terminology that is sometimes vague and sometimes
polysemous, one can stay actively engaged with reality and often mani-
pulate it successfully. Yet a scholarly discipline grounded in a vague
and polysemous terminology is easily decried as ‘unscientific’.
Chinese medical terminology is often vague and polysemous, but, as
I have shown, it was in ancient times hardly meant to be used to con-
struct a ‘theory’. I have approached what is generally called ‘Chinese
medical theory’ as a ‘medical doctrine’. The relation between medical
doctrine and medical practice differs decisively from that between medical
theory and practice: between doctrine and practice there is no gap. The
technical terms in Chinese medical doctrine made sense when read on
their own, but their relevance for intervening in reality became evident
only when applied to particular situations of medical practice. They
were hardly coined with the objective of being useful for description
alone. Although certainly in some sense descriptive, they were more
than that.
There is no doubt that the doctors who intended to manipulate
reality often successfully made use of this vague and polysemous termi-
nology in Chinese medical doctrine or, rather, a variety of doctrines. A
doctrine was, like a theory, ultimately validated by medical practice:
it was modified or abandoned when better ways of performing thera-
peutic interventions were found. In the sense that the texts of the
various Chinese medical doctrines were meant to be useful for manipu-
lating reality and that these doctrines were validated by medical prac-
tice, one could say that Chinese medicine was a ‘science’ long before
TCM promoters made it scientific. This kind of ‘science’ depended on
a completely different way of relating textual knowledge to practice.
In summary, by taking word meaning as an aspect of social prac-
tice and writing an ethnography that explored word meaning, reason-
ing with a vague and polysemous terminology has been shown to be
extremely functional for the scholar who wishes to assess and influence
reality without going through the process of alienation which descript-
ive scientists are prone to do. This ethnography has shown that Chinese
medicine uses word meaning to manipulate reality in a very different
way from that of the twentieth-century Western sciences. It has also
highlighted that it is controversial, to say the least, to dub the Chinese
medical approach ‘unscientific’.
Key concepts of Chinese medicine and qigong

Different contexts of social practice have been shown to modify the
connotation, pragmatic use, and performative significance of Chinese
medical terms. The same word uttered in different contexts need not
refer to the same concept. Use of the same medical terminology need
not be taken as a sign that the same therapeutic practice is being
performed. This has far-reaching consequences for the standardisation
of any traditional or alternative medicine.
Qi and its connotations

The notion of qi was central to medical reasoning in all the three
contexts. While healers and doctors related to qi in similar ways, there
were some striking differences. In particular, the notion of qi in Qiu’s
qigong differed in several respects from that of the Chinese medical

doctors. A first difference was that Qiu could perceive qi in the Red
Light, he could palpate the surface of the body with his hands and feel
whether the ‘accumulating qi’ (qiji) inside was ‘soft’ or not. Chinese
medical doctors had no such direct access to the qi changes in the body;
they had no ability to perceive qi visually or to sense its hardness. They
gained information on the movements of qi by palpating the Pulse
(mai), which indirectly informed them about postulated processes in
the body, or they inferred internal stagnations of qi from the inspection
of excreta such as Clots in the menstrual blood or secreta such as
Phlegm in the body’s Apertures. According to Zhang’s indirect mode of
interpretation, qi was Formless (wu xing).
There was a second striking difference between Qiu’s understanding
of qi and qi in Chinese medical reasoning: Qiu’s conception of ther-
apy largely built on the notion that Bad qi (xieqi) had to be extracted
from the patient by/through the healer, who led it to the ground, and
Primordial qi ( yuanqi), with its enlivening qualities, had to be taken up
from the universe by/through the healer and transferred to the patient.
Primordial qi and Bad qi were by definition good or bad.5 Qi could
trespass boundaries such as the boundary between the inside of the
body and the outside that was seen as in opposition to it. This concep-
tion of qi was most conspicuous in Qiu’s qigong practice, which does
not mean that Qiu would not simultaneously speak of harmonising the
energies of the body. He sometimes also referred, as did Chinese med-
ical doctors, to the ‘body ecologic’: qi was, in this context of medical
reasoning, assigned different qualities mostly in respect of its location
or position in the rubrics of the time–space that Chinese medical doc-
trine recognises. It was a concept marked by uniformity and simultan-
eously great diversity.
In the body ecologic qi was generally not assigned either good or bad
qualities; it was the chorus of mutually resonating qi, perceived as ana-
logous in micro- and macrocosm, that would give rise to disorders. The
notion of the body ecologic builds on the awareness that contemporary
concepts of the natural environment have a history and have evolved
through complex historical processes. Certain aspects of those terms
are best explained by investigating the history of the conceptualisations
of the natural environment in the societies from which these medical
practices evolved. A more comprehensive understanding of the contem-
porary notion of qi is thus achieved by contextualising it in terms of the
5
The notions Bad qi and Primordial qi with either inherently enlivening or life-endangering
qualities also figured in Chinese medical practice but not as conspicuously as in Qiu’s
qigong.
understanding people had of nature when qi became predominant for

Chinese medical doctrine.
A third difference was that the qigong healer Qiu conceived of lumps
coming from tumours, swellings in the lymphatic nodes, and muscle
thickenings as ‘accumulating qi’, irrespective of their material aspects.
It was important to find out whether qi was ‘expanding’ (zhang) or
‘softening’ (nen) – for Qiu qi was not only in constant flow but also in
constant flux (in the sense that it constantly transformed its qualities and
appearances). The senior Chinese doctor Zhang conceived of qi in con-
stant flow and flux as well, though he stressed the flow of its circulation
more than its transformative fluxes. In TCM there was much talk of qi
as in constant flow and motion, mostly with regard to its circulation,
while it was generally overlooked that qi was in constant flux (in the
sense of being constantly transformed): qi tended to be presented in
juxtaposition with Blood (xue) and increasingly also with the Liquids
and Fluids ( jinye); its material aspects of being ‘pneumatic’ were thereby
more emphasised than its potential as the ‘stuff ’ (see Sivin 1987:46–7)
that is in constant flux and transforms and triggers processes.
In summary, the qigong healer Qiu and the Chinese doctors all spoke
of qi. Their notions of it were in many respects comparable, although
the word had subtle differences in connotation in the different contexts
of Chinese therapeutics. This analysis of the connotations of a single
technical term, qi, together with the ethnographic data provided in the
previous chapters, gives rise to the interpretation that Qiu’s qigong heal-
ing is grounded in a ‘logic of transference’.6 It is in many respects the
same as that of a ritual performance in which enlivening and/or endan-
gering powers are transferred across boundaries. I therefore proposed
to view Qiu’s qigong as a therapy distinct from the many strands of
Chinese medicine, even though they use the same technical terms.
Yinyang and its pragmatics

Yinyang was on everyone’s lips. It consolidated the common-sense
truths of everyday life. More precisely, it seemed to reify Mao’s notion
of materialist dialectics. By saying that a process was one of yinyang
dialectics, a TCM doctor was not only applying the wisdom of China’s
cultural heritage but also restating the ‘truth’ of materialist dialectics.
One could say that yinyang had nationalistic and Marxist overtones
and attribute this to a change in an idiom’s sense and connotations.
6
Lambert (1992:1074) makes a similar distinction between the ‘logic of transference’ for
healing in popular therapeutics and the notion of re-establishing harmony in Ayurveda.
This would imply that the semantics of yinyang have changed, which
indeed they have in respect to at least one aspect of yinyang in TCM
teachings. However, the frequent mention of yinyang among TCM
doctors may well represent a case in which the pragmatics of ‘relevance’
played a role. It seemed as if Grice’s maxim of relevance were being
exploited. The answer to the unspoken but ever-present question ‘Do
you still adhere to Marxist-Socialist thought?’ was given by saying that
all processes were subject to the materialist dialectics of yinyang.7
Even in the era of Dengist reforms, reasoning that could be traced to
Mao’s dialectics pervaded so many domains of everyday life that it went
unnoticed by the anthropologist at the time.8 Newspapers, television,
and political study sessions continued to produce slogans along these
lines. They were, from autumn 1989 onwards, emitted from the loud-
speakers in front of the canteen at breakfast, lunch, and dinner time for
staff and students to ingest along with the food from their enamel
bowls. Naturally, the dialectics of everyday life were not quite the same
as those that the scholar identifies after studying the original sources.
Yet the dialectics of everyday life became apparent in the definitions of
technical terms in the classroom, in diagnoses of patients’ conditions
in the clinic (particularly among acupuncturists), in the ‘dialectics’ of
scholarly discussions, in the way in which life histories were commun-
icated to me, and in the way life was generally experienced. There was
an awareness of the advantages and disadvantages of everything and
anything, a general understanding that the good and the bad together
make a whole, a strong conviction of the interdependence of medical
theory and practice, an accepting attitude towards contradictory state-
ments, and a general feeling that life was one struggle growing out of
another and that in the end it was all just one and the same. Yinyang
was often mentioned in these connections. It consolidated an everyday-
life dialectics that seemed to be derived from Mao’s.9
Not only did the pragmatics of yinyang display conformism to a
politically motivated everyday-life philosophy but one aspect of their
semantics also suited Mao’s dialectics. The first of the four characteristics
7
The maxim of relevance can explain a wide range of implicatures. The inference works
roughly as follows: ‘Assume B’s utterance is relevant; if it is relevant, then given that A
asked the question [Do you still adhere to Marxist-Socialist thought?], B should be
providing an answer [All processes are subject to the materialist dialectics of yinyang]’
(Levinson 1983:107). See Horn (1988:130–3) for a critical review of Grice’s original
framework.
8
I therefore have not had the opportunity to elucidate TCM doctors’ opinions on the
interpretation given in what follows.
9
Everyday-life dialectics were often a far cry from Mao’s, but they may well have been
born of an attempt to conform to Marxist-Socialist thought.
attributed to yinyang in the TCM Fundamentals, Control through

Opposition (duili zhiyue), reflects the teachings of materialist dialectics
in that it sees unity resulting from struggle between two contraries dur-
ing a previous period of opposition – an understanding of yinyang that
is not given in classical writings.
Yinyang and different conceptions of change

The discussion of the four characteristics attributed to yinyang in the
TCM Fundamentals showed that the process of making these age-old
concepts more ‘fashionable’ (shimaode) is grounded in a subtle reinter-
pretation of the canons. Yinyang can be understood to designate dia-
lectic change, indicating a continuous struggle between two contraries.
It can also refer to other notions of change, such as the kind that is
implied by the phrase that ‘yang engenders and yin causes growth’, the
cyclic Waxing and Waning of the moon or, sometimes, a polar alterna-
tion, comparable to the notion of bian-change in the ‘Commentary’ to
the Book of Changes.
It is a truism that a word can have many connotations. I emphasise it
in this context to highlight that the interrelation between words and
concepts is very complex. In the case of yinyang, we have one idiom
that refers to at least four different conceptions of change.10 The useful-
ness of such an idiom lies in its capacity to help actors negotiate their
positions, to claim authority, express conformity, mask disagreement,
and the like – without being confrontational or blatantly contradictory.
The Five Phases and the mood and modality of an utterance

There is a tendency to replace the notion of the Five Phases (wuxing)
with that of the Five Organs (wuzang) in TCM and with that of the
Five Flavours (wuwei) in Traditional Chinese Pharmaceutics, but
reasoning in terms of the Five Phases continues to be prominent, if
not indispensable, in assessing postulated processes and formulating
maxims of treatment. Maxims of treatment, like pei tu sheng jin, are
notably not formulated in the indicative mood but in another one
approximated in English by the imperative: ‘Bank up Earth to produce
Metal!’ In modern Chinese mood is generally indicated by certain par-
ticles at the end of a clause, but in classical Chinese some changes in
mood and often also in modality need not be linguistically encoded.
10
The yinyang case also highlights different ways in which semantic change can occur: by
adding new connotations to already existing connotations of a term, by generalising
the sense of a term, and by replacing an old term with a new one.
One can therefore not be entirely sure about the mood and modality of
clauses like jin sheng shui: it can be understood to mean ‘Metal gives
rise to Water’, but also ‘Metal ought to give rise to water’ or ‘May
Metal give rise to Water.’ It may well be that reasoning in terms of the
Five Phases, particularly in the Inner Canon, is prescriptive rather than
descriptive. Linguistic form gives us no clue. We have, however, seen
that there is a tendency in TCM to shift one’s attention from maxims
of treatment, which are prescriptive, to descriptions of health in the
indicative mood. The shift in mood is one aspect of the ongoing trans-
formation of Chinese medical doctrine – the indeterminacy of mood
being yet another characteristic of personal knowing – into standardised
TCM theory.
Spirit and its performative significance

The term Spirit (shen) as used in the three contexts provides perhaps
the most striking illustration of possible variations in the performative
significance of an idiom.11 Spirit occurred first in the context of Qiu’s
treatment of Bao’s liver cancer where it figured in determining whether
or not Bao would continue treatment. Indicative of a client’s general
condition and spiritual well-being, it was considered more important
than any measurable sign of biomedicine. Spirit was, however, notori-
ously vague. To Have Spirit ( you shen) was an idiom of everyday lan-
guage that one used with reference to people who looked healthy and
happy, but this hardly applied to Bao in his terminal condition. Whether
Bao had Spirit, implying that he should continue treatment, was deter-
mined by the group of people present in Qiu’s practice. It is quite likely
that it was the very vagueness of the term that allowed the clients and
healers to reach consensus that Bao had Spirit.
Spirit was also of primary importance in the context of the personal
transmission of knowledge. It was mentioned four times in the two
opening paragraphs of chapter 66 of the Basic Questions, glossed as ‘the
normal phenomena of nature’, ‘the changes of things’, ‘the seasonal
changes of nature and different kinds of materials’, and ‘that in which
the application of Heaven becomes evident’. Evidently, its meaning
varied according to the specific phrase in which it was mentioned – it
was polysemous. The senior doctor Zhang made no attempt whatso-
ever to try to reconcile these different meanings.
In the context of the standardised transmission of knowledge, Spirit
was discussed only during the theoretical courses in the classroom. In
11
The study of language use in pragmatics is intended to explain language, while the
investigation of the performative significance of words explores social practice.
the clinic it was rarely mentioned. The manifestations of Having Spirit,

Losing Spirit (shi shen), and Pseudo-spirit ( jia shen) were explained to
the students by replacing the vague notion of Spirit with phrases, like,
for Having Spirit, ‘articulation is distinct’, ‘movements are agile’, and
‘breathing is smooth and steady’. The meanings of these phrases were
much easier to determine than that of the vague notion of Spirit in the
qigong healer’s practice or in Zhang’s text-reading seminars, and TCM
doctors tended to speak in terms of these phrases which referred to
specific aspects of a condition easily identified in the clinic.
Obviously, the same technical term ‘Spirit’ had a completely differ-
ent performative significance in each of these contexts. In the qigong
healer’s practice, ‘Spirit’ was the word that empowered patients and
their fellow patients to take part in the process of healing. In the senior
doctor Zhang’s seminars, its polysemy allowed the scholar doctor to dis-
play his authority in front of his followers. And in the secular institution
of the TCM college, while expounded in the classroom, it had hardly
any significance in social interaction during the clinical encounter.
If one accepts that the performative significance of such technical
terms varies in different social settings, one has to recognise that the
standardisation of traditional and the professionalisation of alternative
medicines may well preserve the technical terminology of those medicines
but not their performative significance. As a result, a therapy that may
have empowered clients to take part actively in the healing process may,
if standardised, be performed in a way that disempowers them. This
may, in turn, have important consequences for the success of the therapy.
Ways of learning and styles of knowing

Technical terms have more than just referential meaning. Their con-
notations, pragmatics, and performative significances vary in different
social contexts, as do the mood and modality of the utterances in which
they are mentioned. This has been shown by investigating ways in
which these terms are transmitted from one generation to the other and
by exploring styles of knowing in social practice rather than contents of
knowledge in texts.
As has been emphasised throughout this study it is only this kind of
investigation that can illuminate the subtle differences between alternat-
ive therapies grounded in the same technical terminology. Use of the
same terminology need not be taken as a sign that the same therapeutic
practice is being performed. This book underlines the importance of
the learning experience in its entirety for acquiring expert knowledge
and practice.
Appendix 241
Appendix: Curriculum for TCM regular

students and acumoxa and massage specialists
at the Yunnan TCM College in 1988–9
Subject for TCM Lectures Subject for Acumoxa and Lectures

Regular Students of 2 hrs Massage Specialists of 2 hrs
1st semester
TCM Fundamentals 3 TCM Fundamentals 1.5
zhongyi jichu lilun zhongyi jichu lilun
Traditional Chinese 2 Traditional Chinese 2
Pharmaceutics Pharmaceutics
zhongyaoxue zhongyaoxue
Classical Chinese for Medics 2 Classical Chinese for Medics 2.5
yiguwen yiguwen
History of China’s Revolution 1 History of China’s Revolution 1
zhongguo gemingshi zhongguo gemingshi
Physical Education 1 Physical Education 1
tiyu tiyu
Japanese or English 2 English 2
riyu huo yingyu yingyu
History of Medicine 1
yishi
Computing for Beginners 1
jisuanji jichu
Anatomy and Embryology 4
jiepou zupeixue
Total 13 Total 14
2nd semester
TCM Diagnostics 3 TCM Diagnostics 2
zhongyi zhenduanxue zhongyi zhenduanxue
History of China’s Revolution 1 History of China’s Revolution 1
zhongguo gemingshi zhongguo gemingshi
tiyu tiyu
Japanese or English 2 English 2
Classical Chinese for Medics 2
yiguwen
241
242 Appendix

Anatomy and Embryology 4

jiepou zupeixue
Traditional Chinese 2 Formularies 2.5
Pharmaceutics fangjixue
zhongyaoxue
Biology for Medics 1
yiyong shengwu
Experimental Biology 0.5
(laboratory)
shengwu shiyan
Tracts and Links 2
jingluoxue
Acumoxa loci 2
shuxue
Introduction to Chemistry 1
for Medics
yihua jichu
Computing for Beginners 1
jisuanji jichu
Total 16.5 Total 14.5
3rd semester
Physiology 3 Physiology 2.5
shenglixue shenglixue
Formularies 3 Formularies 1
fangjixue fangjixue
Introduction to Chemistry 1.5 Introduction to Chemistry 1
for Medics for Medics
yihua jichu yihua jichu
Experimental Chemistry 1 Experimental Biochemistry 1
yihua shiyan for Medics
yihua shanghua shiyan
Japanese or English 1 English 1.5
Principles of Marxism 1 Politics and Economics 1
and Leninism zhengzhi jingjixue
malie zhuyi yuanli
tiyu tiyu
Acumoxa 2.5 Acumoxa loci 1.5
zhenjiuxue shuxue
Biochemistry 1
shengwu huaxue
Massage 2
tuinaxue
Appendix 243

Needling and Moxa Techniques 1.5

zhenfa jiufaxue
Medical Statistics 1
yixue tongji
Basics of Computing 1
jisuanji jichu
Total 14 Total 17
4th semester
Microbiology 1.5 Microbiology 0.5
weishengwu weishengwu
Parasitology 0.5 Parasitology 0.5
jishengchong xue jishengchong xue
Practical in Microbiology and 1 Practical in Microbiology and 0.5
Parasitology Parasitology
weishengwu jichengchong shiyan weishengwu jichengchong shiyan
Japanese or English 2 Technical English 1
riyu huo yingyu zhuanye yingyu
Principles of Marxism 1
and Leninism
malie zhuyi yuanli
Physical Education 1
tiyu
Biochemistry 1.5
shengwu huaxue
Practical in Biochemistry 1
shenghua shiyan
Massage 1
tuinaxue
qigong 1
Interpretation of the Inner Canon 3
Neijing jiangyi
Pathology 1.5
binglixue
Experimental Pathology 1
(laboratory)
bingli shiyan
TCM Internal Medicine 2.5
zhongyi neikexue
Visit to the Clinic for 0.5
TCM Internal Medicine
zhongyi neike jianxi
TCM Traumatology 1.5
zhongyi shangkexue
244 Appendix

Visit to the Clinic on 0.5

TCM Traumatology
zhongyi shangke jianxi
Acumoxa Therapy 2.5
zhenjiu zhiliaoxue
Total 14.5 Total 12.5
5th semester
TCM Gynaecology 1.5 TCM Gynaecology 0.5
zhongyi fukexue zhongyi fukexue
TCM Internal Medicine 2 TCM Paediatrics 0.5
zhongyi neikexue zhongyi erkexue
Visit to the Clinic for 1
TCM Gynaecology and
TCM Internal Medicine
zhongnei zhongfu jianxi
Japanese or English 1 Technical English 1
riyu huo yingyu zhuanye yingyu
Socialist Construction 1
shehui zhuyi jianshe
Physical Education 1
tiyu
Pathology 1.5
binglixue
Microbiology and Parasitology 2.5
weishengwu jishengchong xue
Massage 1.5
tuinaxue
Cold Damage Disorders 2
Shanghanlun
Summary of Surgery 2.5
xiwai zonglun
Introduction to 2
Internal Medicine
xinei jichu
Lectures on Genetics 2
yichuan jiangzuo
Acumoxa Therapy 2
zhenjiu zhiliaoxue
Experimental Acumoxa 2
(laboratory)
shiyan zhenjiuxue
Acumoxa Doctrines 1
zhenjiu gejia xueshuo
Selected Writings on Acumoxa 1.5
zhenjiu yixiangxuan
Total 15 Total 15
Appendix 245

6th semester
Pathology 3
binglixue
TCM Ophthalmology 2
zhongyi yankexue
Visit to the Clinic for 1
TCM Ophthalmology
zhongyi yanke jianxi
Technical English or Japanese 1
zhuanye yingyu huo riyu
Socialist Construction 2
shehui zhuyi jianshe
Medical Statistics 1
yixue tongji
Cold Damage Disorders 2
Shanghanlun
Practical on 1
Cold Damage Disorders
Shanghan shixi
Total 13
7th semester
Western Biomedical Diagnostics 3
xiyi zhenduanxue
Pathology 1.5
binglixue
Pharmacology 1.5
yaolixue
Politics and Economics 1
zhengzhi jingjixue
TCM Paediatrics 2
zhongyi erkexue
Warmth Factor Disorders 2
wenbingxue
Essential Prescriptions in the 2
Golden Casket
Jingui yaolüe
Technical English 1
zhuanye yingyu
Total 14
8th semester
Internal Medicine 2
neikexue
Frequent Casualties 1.5
changjian jizhen
246 Appendix

Medical Research Methods 1

yixue keyan fangfa
Politics and Economics 1
zhengzhi jingjixue
TCM External Medicine 2.5
zhongyi waikexue
TCM Traumatology 2
zhongyi shangkexue
TCM Doctrines 3
zhongyi gejia xueshuo
Total 13
Glossary 247
Glossary of medical and philosophical terms
This glossary provides a synopsis of the Chinese medical terms mentioned in

this book with the alternative translations by Manfred Porkert, Paul Unschuld,
and Nathan Sivin, and where appropriate other researchers in the field. It also
contains some relevant philosophical and other terms encountered during
ethnographic work. The initial letter of those Chinese medical terms that need
to be understood in a special sense is capitalised (e.g. xue Blood), but if the
term is frequently used colloquially or biomedically, in different senses, it is
given in the lower case (e.g. shimian insomnia). The first term provided is the
preferred translation; if no other author is given, it is my own. To improve
comprehension, some Chinese medical or philosophical categories are given
together with their component concepts (e.g. Three Poles: -Heaven, -Earth,
and -Man).
P.74 = Porkert 1974, S.87 = Sivin 1987, U.88 = Unschuld 1988b, W.90 =
Wiseman 1990
aizheng cancer (biomedical)

anmo massage; pressing and rubbing
bafeng Eight Winds (from the eight

cardinal directions)
bagang Eight Rubrics
yin yin
yang yang
shi Repletion (S.87, U.88, W.90);
P.74
xu Depletion (S.87, U.88); Vacuity
(W.90); Inanitas (P.74)
biao Outer (S.87); Exterior (W.90);
Outside (U.88); Species
(P.74)
li Inner (S.87); Interior (W.90);
Inside (U.88); Intima (P.74)
han Cold (S.87, U.88, W.90);
Algor (P.74)
re Hot (S.87, U.88, W.90);
Calor (P.74)
247
248 Glossary
bagua eight trigrams (Wilhelm

(1923)1981:16)
zhen Thunder, the Arousing
xun Mild Wind, the Gentle
li Fire or Flame, the Clinging
kun Earth, the Receptive
dui Lake, the Joyous
qian Heaven, the Creative
kan Water, the Abysmal
gen Mountain, Keeping Still
baiguang White Light, Bright Light
(qigong term)
bei Grief, cf. qiqing
bi Obstruction (accumulated
stuff; Blockage; Localised Pain
Disorder (S.87); Bi (U.88,
W.90)
bian to transgress, transition
bianzheng Distinguishing Pattern
(Kaptchuk 1983);
Manifestation Type
Determination (S.87),
Pattern Identification (W.90);
Syndrome (Farquhar 1994a)
biao Outer, cf. bagang
bing disorder (S.87); illness,
sickness (U.88); disease
(W.90); sometimes rendered
as ‘disease’ in Eisenberg’s
(1977:1) sense: ‘doctors
diagnose and treat disease,
traditional healers also redefine
illness as disease.’
bingbian pathological changes
bingji Disease Triggering,
Pathogenesis
bingyin Disease Factor (W.90), cf. liuyin
bu to invigorate; to replenish
(S.87); to supplement (U.88,
W.90)
bu pi to invigorate the Spleen
bu qi to invigorate the qi
buyao invigorating drugs
bu qi to diffuse qi (Schipper
1982:102)
cang to house, to store

caoyao herbal drugs
Glossary 249
caoyi herbal medicine

chan ke department of obstetrics
(p.161)
cheng to multiply cf. wuxing guanxi
chuan asthma
chuang zhong zhe yang ke dept. for the sore, swollen,
broken, wounded (p.161)
chunyang Complete yang (qigong term)
cifa needling techniques
ci shui han mu ! ‘drench with Water to restrain
the Wood’ (p.210)
dachang Large Intestine, cf. liufu, taiyin

dachang shu Large Intestine shu-acu-point
(W.90)
da fang ke department for disorders of
adults (p.161)
daixie to metabolise
dan Gall Bladder, cf. qiheng zhi fu,
liufu, jueyin
danjieshi gallstones
dantian Cinnabar Field
shang dantian Upper Cinnabar Field, located
at the acupoint yintang
zhong dantian Middle Cinnabar Field,
at the acupoint danzhong
xia dantian Lower Cinnabar Field, about
a hand’s breadth below the
navel
danzhong Chest Centre acupoint (W.90)
dao Way, Path
daoyin to guide and lead (the qi),
internal conduction (Li &
McMahon 1992:145)
di Earth, see sanji
di a Knot which cannot be untied
(Harper 1985), cf. jie, niu
dianxian convulsions, colloquially
equated with epilepsy
dong to come into motion, to move,
to be irritated
donggong meditation by movement, cf.
qigong
duyao toxic drugs, potent drugs
dui Lake, cf. bagua
duili tongyi unity of opposites (Mao 1961)
duili zhiyue Control through Opposition,
cf. yinyang
250 Glossary
erlong to be deaf, hardness of

hearing
erming to have ringing ears
erzhen ear acupuncture
fa guang to emit Light (qigong term)

fa hongguang to emit Red Light
fa huangguang to emit Yellow Light
fa qingguang to emit Bluegreen Light
fa qi to emit qi
fang direction, place; see also fangji
fangji formula (W.90), prescription
fei Lungs, cf. wuzang
feiqi Lung qi, cf. qi, wuzang
feng Wind, cf. bafeng, liuyin
feng ke Department of Disorders
related to Wind (p.161)
fengqi Wind qi, cf. qi, liuyin
fenghan Wind and Cold
fenghan ganmao ! common cold of the Wind
Cold type
fengshibing rheumatism
fu Bowels, cf. liufu
fu sign; a Daoist sign of charm
(Schipper 1982:287)
fu to levitate
fu ke Women’s Department of
Medicine (Furth 1986) (p.161)
Gynaecology
fu tong stomach ache
gan Liver, cf. wuzang

ganqi Liver qi, cf. qi, wuzang
gan wu pi the Liver insults the Spleen
ganmao common cold
gangmen anus
gang ji principle, cf. ji gang
gaoxueya high blood pressure
gen Mountain, cf. bagua
gongfa effect of qigong, efficiency of
qigong, qigong method,
technique of being efficacious
gu Bones, cf. qiheng zhi fu
guzhi zengsheng ! hyperosteogeny
guqi qi of the Grains, cf. qi
gua trigram or hexagram
guai bing duo tan ! ‘strange diseases are frequently
due to Phlegm’
Glossary 251
guan Senses; an official and the

office he sits in
guanjie joints, articulators (W.90)
guan xiang to observe Images (Wilhelm
1981)
guang Light, Glow (qigong term)
han Cold, cf. bagang, liuyin

hanqi Cold qi, cf. qi, liuyin
han to sweat, cf. tu, xia
he to unite
he he-acupoint where the qi is
united (at the elbows and
knees) one of five shu-acu-
points; Uniting Point, Sea
Point (W.90); Associate
hongguang Red Light, Red Glow
houtian Wordly State; Postnatal
Vitalities (S.87); Later Heaven,
Acquired Constitution,
Postnatal Constitution (W.90),
cf. xiantian
hugen huyong Mutual Reliance and Mutual
Use, cf. yinyang
hua to transform, transformation
hua zheng yi ye ! ‘transformation is the
distinguishing marks of one
thing changing to the
distinguishing marks of
another’ (Graham 1978:295)
huantiao Jumping Round acu-point
(W.90)
huangdan jaundice
hun men gate of the hun soul (to leave
the body at death); anus
huo Fire, cf. liuyin, wuxing
huoguan cupping jar
huo sheng tu ‘Fire gives birth to Earth’
ji Accumulation (W.90)
jichuke courses on the basics
(introductory courses)
ji gang web without a weaver, cf.
gang ji
jijie season
jiju Accumulations and Gatherings
jia Conglomeration (W.90);
Concentration Ills (U.88)
252 Glossary
jiaju Conglomerations and

Gatherings (W.90)
jiashen pseudo-Spirit, cf. shen
jian guang to experience the Light, to see
the Light (qigong term)
jianzhouyan periarthritis of the shoulder
jie Knot, cf. di, niu
jin Metal, cf. wuxing
jin sheng shui ‘Metal gives birth to Water’
jinshi short-sightedness
jin yang shu jin ke Dept. of Inner Lesions and
Incantations (p.161)
jinye Liquids and Fluids; Fluids
(W.90); Liquids (U.88);
Dispersed Body Fluids (S.87);
Active and Structive Fluids
(P.74)
jing Fright, cf. qiqing
jing Semen, Essence (S.87, U.88,
W.90); Unattached Structive
Energy, Structive Potential
(P.74)
jing Tracts; to pass through, to
pass on, to tradit; Tracts;
Cardinal Tracts (S.87);
sinarteriae cardinales (P.74); cf.
liujing, jingluo; canon (or
classic (S.87, U.88))
jingfangpai party of the canonical formulae
cf. shifangpai
jinggong meditation in tranquillity, cf.
qigong
jingluo Tracts and Links (idiom
modelled on that of Tracts
and Channels for jingmai );
Circulation Tract System
(S.87), Main Conduits and
Network Vessels (U.88);
Channels and Connecting
Vessels (W.90); Sinarteries,
Energetic Conduits, Cardinal
and Recticular Conduits
(P.74); cf. liujing
jingmai Tracts and Channels (Lu and
Needham 1980); Circulation
Vessels (S.87); Channel
(W.90), cf. jingluo
jingyan experience
Glossary 253
jingshen Mind; Essence-Spirit (W.90);

Vitalities and Spirits (S.87)
jingshi Chambers of Essence, cf. qiheng
zhi fu
jiu moxibustion (i.e. cauterisation
with Artemisia leaves)
ju Abscess; Boil, in TCM with
yin aspects; deep-seated
Abscess (U.88); ju (W.90)
jueyin attenuated yin (S.87), cf. liujing
kan Water, cf. bagua

ke to overcome, cf. wuxing guanxi
kesou cough
kong fear, cf. wuzhi qiqing
kou chi yan hou ke !" Dept. of Mouth, Teeth,
Pharynx, Throat (p.161)
kuai lump, clot
kun Earth, cf. bagua
lao yisheng old doctor

laozhongyi senior Chinese doctor
li Fire, cf. bagua
li Inner, cf. bagang
lilunke theoretical courses
linbajie lymphatic nodes
linchuangke clinical courses
linggui bafa ! eight methods of the Divine
Turtle
linghuo virtuosity, flexibility
liu Tumour, tumour
liufu Six Bowels (U.88, W.90);
Palaces (U.88); yang Visceral
Systems of Function (S.87);
yang Orbs (P.74), cf. liufu,
zangfu
dan Gall Bladder (U.88, W.90);
Gall Bladder system (S.87);
orbis felleus (P.74)
xiaochang Small Intestine (U.88, W.90);
Small Intestine system (S.87);
orbis intestini tenuis (P.74)
wei Stomach (U.88, W.90);
Stomach System (S.87);
orbis stomachi (P.74)
dachang Large Intestine (U.88, W.90);
Large Intestine system (S.87),
orbis intestini crassi (P.74)
254 Glossary
pangguang Bladder (U.88, W.90);

Urinary Bladder System
(S.87); orbis vesicalis (P.74)
sanjiao Triple jiao; Triple Burner
(U.88, W.90); Triple jiao
System (S.87); orbis tricaloris;
(P.74); corresponds to
Pericardium (xinbaoluo)
liujing Six Tracts or Six Warps
(S.87); Six Channels (W.90)
yangming yang Brightness (S.87, W.90);
yang Brilliance (U.88);
splendor yang (P.74)
taiyang Mature yang (S.87); yang
maior (P.74); Great yang
(U.88); Greater yang (W.90)
shaoyang Immature yang (S.87);
Minor yang (U.88); Lesser
yang (W.90); yang minor
(P.74)
taiyin Mature yin (S.87); yin maior
(P.74); Greater yin (W.90)
shaoyin Immature yin (S.87); Minor
yin (U.88); Lesser yin (W.90);
yin minor (P.74)
jueyin Attenuated yin (S.87); Ceasing
yin; Inverting yin (W.90); yin
flectens (P.74)
liuyin Six Disease Factors; sometimes
liuyin
feng Wind (S.87, U.88, W.90)
han Cold (S.87, U.88, W.90)
shi Damp (U.88, W.90); Moist
(S.87)
shu Heat (S.87); Summer-heat
(W.90, U.88)
zao Dry (S.87, U.88, W.90)
huo Fire (S.87, U.88, W.90)
liuyin Six Excesses (S.87), Six
Environmental Excesses
(W.90); sometimes liuyin
lüguan Gate Pass (Qiu’s term),
cf. sanguan
luo Links; Reticular Tracts (S.87);
sinarteriae reticulares (P.74);
Connecting Vessel ( W.90);
cf. jingluo
Glossary 255
mai (1) Vessels (U.88, W.90);

Sinarteries, Energetic Conduits
(P.74); Circulation Tract
system (S.87); (2) Pulse;
Movement in the Vessels
(U.88); see also qiheng zhi fu
maidong pulsation
mai jue the Pulse is severed; cut off
(U.88); expire (W.90)
mai wei the Pulse is faint, mild
(W.90); subtle (S.87); feeble
(U.88)
maixiang Pulse Images
maizhen Pulse diagnostics; cf. sizhen
meihe Plum Pit (W.90); globus
hystericus (Ou 1988:28)
mingmen Gate of Life
mingmen xue doctrine of the Gate of Life
ming laozhongyi famous senior Chinese doctor
mingyi famous doctor
mu Wood, cf. wuxing
na to adopt, to admit (S.87); to

accept (Farquhar 1994a)
nao Brain, cf. qiheng zhi fu
naosui Brain Marrow
neidan inner alchemy
neiyanggong Inner Nurture qigong, cf. qigong
neiqi Inner qi, cf. qi
neiyin Internal Disease Factor
(W.90); Inner Cause (S.87)
neizang Inner Organs, cf. wuzang
nen to soften (Qiu’s term)
niu a Knot which can be untied,
cf. di, jie
nu Anger, cf. wuzhi, qiqing
nüzibao Womb, cf. qiheng zhi fu
paixie excretion
pangguang Bladder, cf. liufu
pei tu sheng jin ! ‘Bank up Soil to produce
Metal’ (p.210)
pei tu zhi shui ! ‘Bank up Soil to control
Water’ (p.210)
pi Spleen, cf. wuzang
pi houtian zhi ben !" ‘the Spleen is the Basis of the
Worldly State’
256 Glossary
piqi temper (colloquial); Spleen qi,

cf. qi, wuzang
piwei Spleen and Stomach
pingheng equilibrium, homeostasis
qi Breath; Energy, Energetic

Configuration, Configurational
Energy (P.74); Vapour,
Influences (U.88); Basic Stuff;
mist, fog; air, vapour and other
pneumatic stuff; energies,
vitalities; stuff that makes
things happen, stuff in which
things happen (S.87)
feiqi Lung qi, cf. wuzang
fengqi Wind qi cf. liuyin
ganqi Liver qi cf. wuzang
guqi qi of the Grains; Grain qi
(W.90); Alimentary qi (P.74)
hanqi Cold qi, cf. liuyin
jingqi prenatal endowment of vitality,
Seminal Essence (S.87);
Essential qi (W.90); (1) Free
(‘Unattached’) Structive
Potential, (2) Potentialised
Configurational Energy of
Undefined Quality, (3)
Structive and Active Energy
(P.74); Seminal qi (Lu and
Needham 1980)
neiqi Inner qi (qigong), cf. waiqi
piqi Spleen qi, cf. wuzang
renqi qi of man’s activity; Human qi
(P.74)
shenqi Kidney qi, cf. wuzang
shiqi Moist qi, cf. liuyin
waiqi Outer qi (qigong), cf. neiqi
weiqi Stomach qi, cf. liufu
weiqi Protective qi (U.88); Defensive
qi (P.74, S.87), cf. yingqi
xieqi Bad qi, Noxious qi, Sinister qi
(as opposed to the Right qi);
Heteropathic qi (P.74, S.87);
Evil qi (U.88); Pathogenic qi
(W.90), cf. zhengqi
xinqi Heart qi, cf. wuzang
yangqi yangqi, qi with yang qualities,
cf. yinqi
Glossary 257
yinqi yinqi, qi with yin qualities,

cf. yangqi
yingqi Nourishing qi; Constructive qi
(P.74, S.87, U.88), cf. weiqi
yuanqi Primordial qi (P.74, S.87);
Original qi (U.88, W.90)
yuanqi Original qi (P.74); Source qi
(W.90), often synonym to
Primordial qi
yuzhou zhi qi ! the qi of the universe
(Qiu’s term)
zaoqi Dry qi, cf. liuyin
zhenqi True qi (P.74, S.87, U.88,
W.90); inborn vitality (S.87)
zheng qi Regular qi; Correct qi
(P.74, W.90); Orthopathic qi
(S.87), cf. xieqi
zhongqi Medial qi (S.87); Centre qi
(W.90)
zongqi Gathering qi, Ancestral qi
(W.90); Genetic qi (P.74,
S.87); the most important qi
(U.88)
qi dong ze yu ! ‘if qi comes into motion, then
there is Anxiety’
qigong practice of Breath control
(S.87); workings of the Breath
(Farquhar 1994a)
donggong meditation by movement
jinggong meditation in tranquillity
neiyanggong Inner Nurture qigong
ruan qigong soft qigong, strengthens one’s
Inner qi (neiqi); often
associated with jinggong,
should lead to healing abilities
teyi qigong ! extraordinary qigong, comprises
telepathy, clairvoyance,
psychokinesis, and other
abilities which may result
from qigong meditation,
depending on one’s
constitution (xiantian)
yinggong synonymous to ying qigong
ying qigong hard qigong, strengthens one’s
Outer qi (waiqi); often
associated with donggong, and
exercises for unarmed combat
(wushu)
258 Glossary
yuan qigong far-away-effect qigong,

simultaneous jinggong of sender
and receiver
qigong jiangzuo qigong meetings in auditoria or
sport stadiums
qigong shi qigong master
qi hua qi-Transformations
qi ji qi accumulates (lit.);
accumulating qi (Qiu’s term)
qimen Gates of qi, i.e. acu-points
qi ni qi is counterflowing; qi
Backflow (S.87); qi
Counterflow (W.90)
qixue butiao ! ‘Breath and Blood are not in
harmony’
qi zhi qi is stagnant (lit.); Stagnant
qi, qi Stasis (S.87); qi
Stagnation (W.90)
qiheng zhi fu ! Odd Palaces; Paraorbs (P.74);
auxiliary yang systems of
function (S.87); Curious
Organs (W.90)
nao Brain (P.74, U.88, W.90);
Cerebral system (S.87)
sui Marrow (P.74, U.88, W.90);
Medulla (P.74); Medullary
system (S.87)
gu Bones (P.74, U.88, W.90);
Bony system (S.87)
mai Vessel (P. 74, U.88, W.90);
Sinarteries (P.74); Circulation
Tract system (S.87)
dan Gall Bladder ( P.74, U.88,
W.90); Gall Bladder system
(S.87)
nüzibao Womb (P.74, W.90); Womb
system (S.87); Uterus (W.90)
jingshi Chambers of Essence;
Testicles
qi hua zai to have a Flourishing at; its
Outward Manifestation is
(P.74)
qi jing ba mai Eight Odd Vessels; Eight Odd
Conduits (P.74); Eight
Extraordinary Tracts (S.87);
Eight Extraordinary Vessels
(W.90)
Glossary 259
qian Heaven, cf. bagua

qie mai to take the Pulse, to palpate
the Pulse
qing Clear
qiqiao Seven Apertures Orifices
(S.87, U.88); Opering (P.74,
U.88); Portals (W.90)
yan eyes
er ears
bikong nostrils
kou mouth
qiqing Seven Emotions, cf. wuzhi
nu Anger (P.74, S.87, U.88,
W.90)
xi Enthusiasm; Joy (S.87, U.88,
W.90); Pleasure (P.74)
si Worry (S.87, W.90);
Cogitation (P.74); Thought
(W.90); Preoccupation,
Ratiocination (S.87)
you Sorrow (P.74, S.87);
Mourning (U.88); Anxiety
(W.90)
kong Fear (P.74, U.88, W.90);
Apprehension (S.87)
bei Grief (S.87, U.88); Sorrow
(W.90)
jing Fright (U.88, W.90); Fear
(S.87)
qishan Seven Amassments (not
standardised)
re Hot, cf. bagang

ren Man, mankind, microcosm,
cf. sanji
renqi Human qi, cf. qi
renshen ginseng
ruyi scholar doctor
ruan qigong soft qigong, cf. qigong
sanbao three treasures:

shen Spirit, cf. shen
jing Essence, Semen, cf. jingqi
xue Blood, (P.74; S.87; U.88;
W.90)
sancai three geniuses, synonymous to
sanji
260 Glossary
sanguan the Three Narrow Passes

(qigong term)
weilüguan Caudal Pass
jia ji guan Tightened Spine Pass
yuzhenguan Jade Pillow Pass
sanguang Three Lights
ri sun
yue moon
xing stars
sanji Three Poles:
tian Heaven, Sky, Nature,
macrocosm
di Earth
ren man, microcosm
sanjiao Triple jiao, cf. liufu
shangjiao upper jiao
zhongjiao middle jiao
xiajiao lower jiao
se Complexion
se cang bai the Complexion is pale
shan Amassment; Accumulation Ill
(Unschuld 1985); shan (W.90)
shang dantian Upper Cinnabar Field, cf.
dantian
shaoyang Lesser yang, cf. liujing
shaoyin Lesser yin, cf. liujing
she sheng to preserve one’s life
she Tongue
she dan bai the Tongue is pale
shen Kidneys, cf. wuzang
shen Spirit (U.88, W.90); spiritual
force, the body’s governing
vitalities, divine forces (S.87);
Divinity (W.90); (1) a
manifest Configurative Force,
(2) the active aspect of a
Configurative Force (P.74);
cf. sanbao
jia shen pseudo-Spirits; Fallacious
Spirit, False Spiritedness
(W.90)
shi shen Loss of Spirits; Spiritlessness
(W.90)
you shen to have Spirits
shenjing shuairuo neurasthenia
shen ming zhi fu ! the abode of the Spiritual and
Bright
Glossary 261
shen na qi ‘the Kidneys adopt qi,’ cf. na

shenyan nephritis, kidney infection
sheng sagacity
sheng to engender, to give rise to,
raw, cf. zhang, wuxing guanxi
shengli physiology
shi Repletion, cf. bagang
shi timespan of two hours;
season
shi Damp, Moist, cf. liuyin
shiqi Moist qi, cf. qi, liuyin
shifangpai party of the fashionable
formulae
shi dong ze bing ! ‘if this comes into motion,
then disorders arise’
shi mian insomnia
shi shen Loss of Spirits, cf. shen
shoufa skills of handling the needle
shouna intake
shu to belong to
shu Summer-heat, cf. liuyin
shuxue acumoxa loci
shui Water, cf. wuxing
shuidao Watercourse
shuigu Watery Grains, i.e. fermenting
food (S.87); Grain and Water
(W.90)
shui hua wei qi ! Water is transformed into qi
shuiye Watery Fluids, Water (W.90)
shuiyin Water Rheum (W.90), see also
siyin
shuizhong Oedema
si Worry, cf. wuzhi, qiqing
siyin Four Watery Mucus (S.87);
Four Rheums (W.90)
tanyin Phlegm Rheum (W.90)
xuanyin Suspended Rheum (W.90)
yiyin Spillage Rheum (W.90)
zhiyin Propping Rheum (W.90)
sizhen four diagnostic examinations
maizhen Pulse diagnostics
she zhen diagnostics by inspecting the
Tongue
wang zhen diagnostics by observation (of
Complexion)
wen zhen diagnostics by listening and
smelling
262 Glossary
sizhi jueleng ! the Four Limbs are numb

and cold
suantong sore and painful
sui Marrow, cf. qiheng zhi fu
suo chan bing ‘disorders produced by the
Vessel’
taiyang Greater yang, cf. liujing

taiyin Greater yin, cf. liujing
tan Phlegm (S.87, U.88, W.90);
Mucus (S.87)
tanyin Phlegm; Phlegm Rheum
(W.90), cf. siyin
teyi qigong extraordinary qigong, cf. qigong
tian Heaven, Sky, Nature, cf. sanji
tiaohe harmony, to harmonise
(W.90)
tinggong Auditory Palace acu-point
(W.90)
toushi to have a penatrating vision or
X-ray vision, to see
touteng headache, to have a headache
touxuan dizziness, to feel dizzy
tu to vomit, see also han, xia
tu Earth, cf. wuxing
tu ke shui ‘Earth overcomes the Water’
tuina massage; pushing and pulling
waiqi Outer qi, cf. qi

waiyin External Disease Factor
(W.90); Outer Cause (S.87)
wangjiang royal jelly
wangzhen diagnostics by observation,
cf. sizhen
wei Limpness
wei Stomach, cf. liufu
weiqi Stomach qi, cf. qi; liufu
weikuiyang stomach ulcer
weiqi Protective qi, cf. qi
wei qi ying xue Four Sectors (S.87):
Protective qi Sector, qi Sector,
Nourishing qi Sector, Blood
Sector
weizhong Bend Middle acu-point
(W.90)
wenbingxue Warmth Factor doctrine
wu to insult, cf. wuxing guanxi
wu revelation
Glossary 263
wuqi Five qi, Five Seasonal

Influences, cf. liuyin (without
huo)
wushan Five Amassments (not
standardised)
wushu unarmed combat (Lu and
Needham 1980)
wuwei Five Directions (four cardinal
directions and centre)
wuwei Five Flavours (U.88, W.90);
Sapours (P.74, S.87)
suan Sour (S.87, U.88, W.90)
ku Bitter (S.87, U.88, W.90)
gan Sweet (S.87, U.88, W.90)
xin Pungent (S.87); Acrid (U.88,
W.90)
xian Salty (S.87, U.88, W.90)
wuxing Five Phases (P.74, S.87, U.88,
W.90); Five Evolutive Phases
(P.74); Five Activities (S.87);
Five Courses of Action
(Graham 1986:76); Five
Processes (Graham 1989:326);
Five Courses of Materials
(Graham 1986:77)
mu Wood (P.74, S.87, U.88,
W.90)
huo Fire (P.74, S.87, U.88, W.90)
tu Earth (P.74, S.87, W.90); Soil
(U.88, W.90)
jin Metal (P.74, S.87, U.88,
W.90)
shui Water (P.74, S.87, U.88,
W.90)
wuxing xianghu guanxi Interelations between the Fire
Phases
sheng to give birth (physiological
and pathological pattern of
change and therapeutic
device)
wu to insult (pathological
pattern of change); to violate
(P.74)
ke to overcome (therapeutic
device); to check (P.74)
cheng to multiply (therapeutic
device); to accroach (P.74)
wu yun liu qi xue shuo !"# phase energetics (P.74)
264 Glossary
wuzang Five Organs, Five Depositories

(U.88 zang: ‘Depot’, storage
unit); Five yin Orbs, orbes
horrealis (P.74); Five yin
Visceral Systems of Function
(S.87); Five Viscera (U.88,
W.90)
gan Liver (U.88, W.90); Hepatic
System (S.87); orbis
hepaticus (P.74)
xin Heart (U.88, W.90); Cardiac
Visceral System (S.87);
orbis cardialis (P.74)
pi Spleen (U.88, W.90);
Splenetic System (S.87); orbis
linealis (P.74)
fei Lungs (U.88, W.90);
Pulmonary System (S.87);
orbis pulmonalis (P.74)
shen Kidneys (U.88, W.90); Renal
System (S.87); orbis renalis
(P.74)
wuzang buhe ! ‘the Five Organs are not
united’
wuzang zhengjie ! Concretions and Knots in the
Five Depositories
wuzhi Five Impulses; ‘will’, psychic
reactions (P.74); Intent (S.87);
Mind (U.88); orientation
(emotion) (W.90)
nu Anger, cf. qiqing
xi Joy, cf. qiqing
si Worry, cf. qiqing
you Sorrow, cf. qiqing
kong Fear, cf. qiqing
wu xing Without Form, cf. xing
xi joy, cf. wuzhi, qiqing

xinbaoluo Pericardium (W.90); Cardiac
Envelope Junction (S.87);
Heart Enclosing Network
(U.88); orbis pericardialis
(P.74); cf. liufu, shaoyang
xishou assimilation; absorption
xiyi Western biomedicine
xia dantian Lower Cinnabar Field,
cf. dantian
Glossary 265
xia to purge, cf. han, tu (known as

the three basic treatments)
xiantian Primordial State, Constitution;
Prenatal Vitalities (S.87);
Earlier Heaven, Congenital
Constitution (W.90); previous
to one’s existence, transmitted
by one’s parents (U.88), cf.
houtian
xiang Image, Figure, Configuration,
written symbol
xiang to smell pleasant
xianghu zhuanhua ! Mutual Transformation, cf.
yinyang
xiang tu to feel nauseous, to wish to
vomit (colloquial)
xiaochang Small Intestine, cf. liufu,
shaoyin
xiao fang ke department for disorders of
children (p.161)
xiaohua digestion
xiaozhang bianhua ! change, growth and decline
xiaozhang pingheng ! Equilibrium of Waxing and
Waning, cf. yinyang
xiaozhoutian Minor Cosmic Circulation
xiaozhoutian tong ! the Minor Cosmic Circulation
is connected
xie nan bu bei ‘purge the South and
supplement the North’
(P.210)
xieqi Bad qi, Noxious qi, cf. qi
xieshi Malignant Dampness
xin Heart, cf. wuzang, shaoyang
xinqi Heart qi, cf. qi, wuzang
xing Form
you xing it has Form
wu xing it has no Form, without Form
xingti zuzhi bodily tissues
xiushen self-cultivation
xu Depletion, cf. bagang
xuanyin Suspended Rheum, cf. siyin
xue Blood, cf. sanbao
xue foramen, a cavity or an opening
(P.74); acupuncture locus
(S.87); hole, insertion point
(U.88); acupuncture point,
hole (W.90)
266 Glossary
xuewei acu-point; acupuncture point

(W.90)
xue xu sheng feng ! ‘Blood Depletion gives rise to
Wind’
xueye Blood; Blood-Liquid
xun Mild Wind, cf. bagang
yan ke Department for Disorders of
the Eyes, Ophthalmology
(p.161)
yang yang, cf. yinyang, bagang
yangming yang Brightness, cf. liujing
yangqi yang qi, cf. qi
yang sha yin cang ! ‘yang kills yin conceals’
yangsheng nurture one’s life
yang sheng yin zhang ! ‘yang engenders and yin causes
growth’
yangxing to nurture one’s Nature
yao line of a hexagram
yao drug
yaowu drug substance
ye Fluids, cf. jinye
yi huo bu tu ‘blaze the Fire to supplement
the Soil’ (p.210)
yinian imagination, to imagine, to do
by the force of the mind
yisheng doctor, referential term and
polite address
yishi regular practitioner (lowest
grade)
yiyao medicine
yiyuan hospital
yiyin Spillage Rheum, cf. siyin
yin yin, cf. yinyang, bagang
yin Rheum, cf. siyin
yintang Hall of Impression (W.90)
(acu-point between eyebrows)
yin cheng xing yin becomes Form
yinqi yinqi, cf. qi
yinqi wei dong, ! ‘yinqi has not yet come into
yangqi wei san ! motion, yangqi is not yet
dispersed’
yinyang yinyang
duili zhiyue Control through Opposition
(TCM phrase)
hugen huyong Mutual Reliance and Mutual
Use (TCM phrase)
xiaozhang pingheng ! Equilibrium of Waxing and
Waning (TCM phrase)
Glossary 267
xianghu zhuanhua ! Mutual Transformation

(TCM phrase)
yinyang bujiao ! ‘yinyang have no intercourse’
yin zui shen ‘yin is at its deepest, i.e.
fullest’
yinggong hard qigong cf. ying qigong
ying qigong hard qigong, cf. qigong
yingwei the Nourishing and Protective,
cf. qi, wei qi ying xue
yong Boil, in TCM associated with
yang aspects; Welling Abscess
(U.88); a yong (W.90), cf. ju
you shen to have Spirit, cf. shen
you xing it has Form, cf. xing
you Sorrow, cf. wuzhi, qiqing
yuzhou zhi qi qi of the universe, cf. qi
yuxue Blood Stasis; Coagulation of
Blood (S.87); Stagnating
Blood (U.88); Static Blood
(W.90)
yun rotation, Circulatory Phase
yunqi sueshuo phase energetics (abbrev.)
yuan origin, basis, root, cf. yuanqi
yuanqi Original qi, cf. qi
yuanqi Primordial qi, cf. qi
yuan qigong far-away-effect qigong, cf. qigong
zai zhi wei to relate to Impulse

zai ye wei to relate to Fluids
zai qiao wei to relate to Apertures
zang Organs, Orbs, cf. wuzang,
zangfu, zangxiang, zangqi
zangfu Organs and Bowels, Organs;
Visceral Systems of Function
(S.87); Viscus-Bowel (W.90),
cf. wuzang, liufu
zangqi Organs (biomedical and TCM
term), cf. zang, zangfu,
zangxiang
zangxiang =or Organ Clusters, the Hidden
and the Apparent; Orbiscon
(P.74), cf. zangfu
zangxiangxue =or Orbisiconography (P.74);
Visceral Manifestation Theory
(W.90); cf. zangfu
zao Dry, cf. liuyin
zaopo Waste, Dregs
zaoqi Dry qi, cf. qi
268 Glossary
zhang to grow, to distend, cf. sheng

zhen Thunder, cf. bagua
zhenduan to diagnose, cf. sizhen
zhenqi True qi, cf. qi
zhenjiu acupuncture and moxibustion,
acumoxa
zhen jiu ke Department of Acumoxa
(p.161)
zheng1 Evidence (U.88); Signs of
Illness (Farquhar 1994a)
zheng2 Complex of Complaints; (1)
Illness, Complaint, Symptoms,
(2) Pathocondition (U.88);
Individual Symptoms (S.87);
Disease (W.90); Symptoms of
Illness (Farquhar 1994a)
zheng3 Patterns; Manifestation Type
(S.87); Evidence, Symptoms
(U.88); Sign, Pattern (W.90);
Illness Syndromes (Farquhar
1994a), cf. bianzheng
zheng4 Concretion (W.90)
zhengji Concretions and
Accumulations (W.90)
zhengjia Concretions and
Conglomerations (W.90)
zhengqi Regular qi, cf. qi
zhi Piles, Haemorrhoids (W.90)
zhi Will, Impulse; cf. wuzhi
zhi bing qiu ben ! in treating illness trace the
Roots
zhize maxims of treatment,
therapeutic maxims
zhongchengyao ready-made Chinese medical
drugs
zhongxiyi jiehe integrated Chinese and
Western medicine
zhongyao Chinese medical drugs,
Traditional Chinese
Pharmaceutics
zhongyi Chinese medicine, TCM
zhong dantian middle Cinnabar Field,
cf. dantian
zhu to govern
zhuo Turbid
zhuo zhong zhi qing ! the Clear within the Turbid
zhuo zhong zhi zhuo the Turbid within the Turbid
Glossary 269
zi 11p.m.–1a.m., when yin is at

its deepest (1st of 12 shi-
hours)
zongqi gathering qi, cf. qi
zuo jin ping mu ! ‘assist the Metal to level the
Wood’ (p.210)
zuo yuezi to go into confinement
zuogu shenjing tong sciatic pain
270 References
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College, History of the College from 1960 to 1988). Kunming: Yunnan keji
chubanshe.
Zhang Jiebin [1624] 1799: Lei jing fu yi (Additional Appendix to the Categories).
Jinchang cuiyin tang.
Zhang Jiebin [1624] (1965)1985: Lei jing (Canon of Categories, abbr.: Categories).
Zhang Shitong (ed.) 1974: Xunzi jianzhu (Commentary on the Xunzi). Attrib-
uted to Xun Qing (298–238 BC). Shanghai: Shanghai renmin chubanshe.
Zhang Zhongjing guoyi daxue shiyong jiaocai (eds) 1985: Yijing xuandu (Selected
Readings of the Yijing). 98 pp.
Zhangjiashan Hanjian Zhenglizu (eds.) 1990: Zhangjiashan Hanjian ‘Yinshu’
shiwen (Explanations to the Han Bamboo Slips ‘Document of Guiding’
from Zhangjiashan). Wenwu 10: 82–6.
Zhongyi dacidian and Bianji weiyuanhui (eds.) 1987: Zhongyi dacidian, Neike
fence (TCM Comprehensive Dictionary of Internal Medicine). Beijing: Renmin
weisheng chubanshe.
Zou Xuexi 1986: Yixue shijiang (Ten Lectures on the Doctrine of the Changes).
Chengdu: Sichuan kexue jishu chubanshe.
286 References
TCM TEXTBOOKS
Cheng Shide (ed.) 1984: Neijing jiangyi (Interpretation of the Inner Canon, abbr.:
Interpretation). Shanghai: Shanghai kexue jishu chubanshe.
Chengdu zhongyi xueyuan (ed.) 1988: Zhongyi bingyin bingjixue (TCM Etiology
and Pathogenesis). Guiyang: Guizhou renmin chubanshe.
Deng Tietao (ed.) 1984: Zhongyi zhenduanxue (TCM Diagnostics). Shanghai:
Shanghai kexue jishu chubanshe.
Li Ding (ed.) 1984: Jingluoxue (Tracts and Links). Shanghai: Shanghai kexue
jishu chubanshe.
Ling Yigui (ed.) 1984: Zhongyaoxue (Traditional Chinese Pharmaceutics). Shang-
hai: Shanghai kexue jishu chubanshe.
Luzhou yixueyuan (eds.) 1987: Zhongyixue daolun (TCM Instructions). Guiyang:
Guizhou renmin chubanshe.
Meng Yuankai (ed.) 1986: Zhongyi fukexue (TCM Gynaecology). Shanghai: Shang-
hai kexue jishu chubanshe.
Qiu Maoliang (ed.) 1985: Zhenjiuxue (Acumoxa). Shanghai: Shanghai kexue
jishu chubanshe.
Ren Yingqiu (ed.) 1986: Zhongyi gejia xueshuo (Summaries of Different Chinese
Medical Doctrines). Shanghai: Shanghai kexue jishu chubanshe.
Shanxi zhongyi xueyuan (eds.) 1988: Zhongyi zhenduanxue (TCM Diagnostics).
Guiyang: Guizhou renmin chubanshe.
Shenyang yaoxueyuan (eds.) 1978: Zhongyixue jichu (Basics of the Study of Chinese
Medicine). Beijing: Renmin weisheng chubanshe.
Wei Jia (ed.) 1987: Gejia zhenjiu xueshuo (Summaries of Different Doctrines of
Acumoxa). Shanghai: Shanghai kexue jishu chubanshe.
Yang Changsen (ed.) 1985: Zhenjiu zhiliaoxue (Acumoxa Therapy). Shanghai:
Shanghai kexue jishu chubanshe.
Yin Huihe (ed.) 1984: Zhongyi jichu lilun (Fundamental Theory of TCM, abbr.:
TCM Fundamentals). Shanghai: Shanghai kexue jishu chubanshe.
Yunnan zhongyi xueyuan (ed.) 1988: Zangxiangxue (Organ Clusters). Guiyang:
Guizhou renmin chubanshe.
Zhao Fen (ed.) 1963: Zhongyi jichuxue (Study of the Basics of Chinese Medicine).
General index 287
General index
accumulations 45, 83–7, 197, 220–2, Bray F. 86, 211

235 Breath, see qi
acumoxa (zhenjiu), i.e. acupuncture and
moxibustion 9, 10–11, 12, 14, 20, cancer (aizheng) 27, 42–4, 59, 83, 239
25, 26, 34 –6, 41, 50, 54, 59, 61–2, case histories 19, 34 –44, 58–67, 83–4,
70, 84 –6, 90–4, 97, 133, 144, 158, 120–1, 161–2
160, 161, 187, 190–1, 200, 206, causal explanations and alternatives to 3,
212, 237; acumoxa and massage 30–1, 52, 63, 111, 119–22, 163,
speciality (zhenjiu tuina zhuanke xue) 167, 184, 199, 207, 211, 213; see
10, 15, 132–6, 138–9, 143–4, also etiology
145–53, 169, 172–7, 188, 198–9 change, concepts of 19–20, 78–83,
acu-points (xuewei ) 34, 62, 70, 84, 211; 108–16, 181–6, 194–6, 210, 238
definition of 144 Chao Y. L. 103, 104
Agren H. 170 Chen N. N. 21, 49
anatomy 39, 40, 49, 82, 172, 173, Chinese medicine (zhongyi), definition of
205–6, 206–7, 213, 216 7, 9; see also TCM, senior Chinese
Andrews B. J. 7, 128 doctors, and scholar doctors
asthma (chuan) 23, 59 Chengdu TCM College 60
chronic conditions 23, 35– 40, 58–9,
Benedict C. 89 60–2, 197, 199
biomedicine 9, 17–18, 25, 26, 29, 34, Cinnabar Field (dantian) 30, 33, 34, 77
36, 39, 42–3, 45, 49, 50, 58, 63, circulation tracts, see Tracts and Links
65–6, 69, 78, 82, 83–5, 89, 92–3, commentary on medical canons, discussion
98, 99–100, 128, 133, 145–6, 155, of 105–27, 186, 193, 214–15
157, 158–60, 168–224, 229, 239 common cold ( ganmao) 26, 112–16
birth 12, 64, 71, 73, 111, 161, 209 Complexion (se) 16, 64, 185, 187, 190,
Blood (xue) 3, 47, 55, 60, 62–4, 69, 218
70, 75–7, 83, 92, 118, 144, 168, confinement (zuo yuezi) 64
198, 207, 213, 214, 216–17; connections (guanxi) 27–8, 29, 91, 139;
Blood Stasis ( yuxue) 198, 220–2, see also friendship
235–6 cough (kesou) 26, 160, 197, 199, 220
body, concepts of 3, 49–50, 56–7, Croizier R. C. 7, 9, 174
78–87, 107 ff., 118, 173, 195, 198, Cullen C. 11
200–6, 206–10, 212–17, 218–22, cupping (huoguan) 35, 36, 70
ecologic 78–83, 87, 107–8, 110,
159, 167, 203, 204–6, 222, 223, Daoist incantations 14, 31, 33, 36, 40, 41,
235–6, individual 78; politic 78; 47, 49–53, 55, 103, 227, 165, 230
social 78, 206–10; see also nature Daoist signs ( fu) 40, 49, 51, 69
and entries on specific Chinese Depletion Patterns (xuzheng) 62–4, 211
medical concepts Despeux C. 12, 21, 33, 34, 44, 92, 107,
Bowels, see Five Organs, Stomach, and 160, 170, 172, 213
digestion diabetes 23
287
288 General index
diagnostics, Chinese medical vs. Farquhar J. 5–6, 7, 11, 19, 20, 64, 68,
biomedical 5–6, 43, 63, 83, 90, 92, 78, 85, 93, 94, 98, 99, 108, 124,
158, 189, 191, 199, 228; in qigong 144, 161, 162, 169, 173, 199, 206,
39, 43, 65, 83; see also Pulse, 210–12
Tongue, Complexion, treatment, fevers 27, 185
maxims of, prognostics, stethoscope, Five Organs (wuzang) 19–20, 45, 65,
and Zhongyi zhenduanxue (TCM 82, 83, 92; in a classical text 107–8,
diagnostics) 109–10, 119; in TCM 168, 177,
dialectics 20, 81, 163, 177–86, 196, 198, 187, 190, 191, 196–8, 198–210,
202, 218, 223, 229, 236–8 213, 214, 216, 218–19, 222, 223,
didactics 49–50, 127, 138, 164 –6, 207, 238; definition of 206–8
222, 223, 228, 230 Five Phases (wuxing) 19–20, 45, 81–2,
digestion 71, 75, 77, 196; Chinese 83; in a classical text 107–8, 109–11,
medical vs. biomedical conceptions 118–19, 123; in TCM 168, 177,
of 99, 213–17 179–80, 187, 191, 196, 198,
disability 147 198–206, 210–12, 223, 228, 238–9;
Distinguishing Pattern (zheng) 5–6, 64, definition of 204
85–6, 114, 185 Fluids, see Liquids and Fluids
dizziness (touxuan) 64 folk medicine 9, 13; see also herbal
doctrine 6, 8, 81, 105–27, 158–60, medicine
162–4, 167, 188, 210–17, 222, friendship ( youyi ) 11, 12, 14, 19, 27–8,
226–7, 232–6, 238–9; see also 30, 32, 37, 41, 42, 46, 52, 58, 59,
reasoning, theory 66–7, 75, 90, 92, 96, 97, 101, 104,
drugs ( yao) 27, 29, 39, 64, 66, 85, 132; 132, 138, 139, 209; see also
biomedical 26, 49, 50, 64; Chinese connections
medical (zhongyao) 5–6, 26, 45, 49, Furth C. 78, 161, 213
50, 158, 164, 190, 210–11, 213;
herbal (caoyao), see herbal medicine;
Gate of Life (mingmenxue), doctrine of
poisonous and potent (duyao) 29, 42;
71, 171
invigorating (buyao) 26, 64, 72
gender relations 3, 25, 71, 78, 88–9, 91,
101–2, 126, 130, 143–4, 170, 180,
ear acupuncture (erzhen) 54, 84
213; see also marriage
economic organisation, private enterprise
( getihu) 14, 26–30, 54 –6, 143, 174;
collective ( jitihu) 14, 25, 90–2; work Hanson M. 80
unit (danwei ) 14, 129–32, 136–8 Harper D. 22, 72, 73, 85, 87
education, PRC regulations of 136–7, headache (toutong) 27, 63, 120
138–9, 145, 147, 156, 163–4, 241–6 health care, preventive 23, 159, 169,
eight trigrams (bagua) 38, 49, 92, 198–9; primary 26–7, 59, 174; rural
114 –16, 118 146
empty notions 4, 124, 211 Heart (xin) 23, 65, 82, 109, 198, 201,
Engelhardt U. 12, 44, 72, 220 206–7, 213, 218–19
epilepsy (dianxian) 59, 61 herbal medicine (caoyi ) 7, 9, 25, 26, 28,
Essence ( jing) 71, 72, 118, 168, 205–6, 35, 36, 41–6, 49, 50, 58, 63, 96,
213, 218, 220, 222 142
ethics and obligations, medical 30–2, hexagrams, see eight trigrams
142, 151; of teaching and learning high blood pressure (gaoxueya) 23, 41,
46–7, 101, 102, 164 –6 59, 60
ethnoscience 80 holism, discussion of 44, 81, 84, 177,
etiology 64, 84, 159, 191, 197, 199; see 198, 205, 216
also Zhongyi bingyin bingjixue (TCM Hot and Cold (hanre) 81, 107–8,
Etiology and Pathogenesis) 109–10, 123, 131, 185, 198; Cold
experience ( jingyan), 1, 39–40, 44 –5, 49, (han) 26, 79, 94, 112–16, 170, 179;
100, 103, 105, 118, 124, 127, 144, heat 38, 154
145, 160–3, 169, 189, 194, 222, Hsu E. 47, 65, 76, 80, 84, 85, 86, 100,
227, 229, 240; definition of 97–9 113, 138, 173, 178, 180
General index 289
imagination ( yinian) 44 –5 neurasthenia (shenjing shuairuo) 17, 23,

impulse ‘will’ (zhi ) 110, 142, 157, 207 58, 62– 4, 83
insomnia (shimian) 58, 64, 149 numerology 86, 105, 107, 118, 125, 201,
205–6
jaundice (huangdan) 215
Oberländer C. 7
Kaptchuk T. J. 84 Obeyesekere G. 70
Keegan D. J. 111, 123, 170 Obringer F. 160
kidney infection (shenyan) 45 Obstruction (bi ) 34 –40, 45, 86, 197,
Kidneys (shen) 33, 45, 65, 71, 82, 109, 199
198, 216, 208–9, 211, 214 Oedema (shuizhong) 31
Kleinman A. 7, 13, 17 Ohnuki-Tierney E. 7, 69
knowing, styles of defined 4 –5; compared Organ Clusters (zangxiang) 190, 206–10;
225–34; see also transmission see also Five Organs
Kohn L. 12, 21, 23, 31 Organs, see Five Organs
Kuriyama S. 63, 80, 112 Ots T. 6, 19–20, 78, 107, 162
participant observation vs. participant

Lambert H. 68, 236 experience 15–17, 229–31
Lampton D. 7, 24 Pericardium (xinbaoluo) 201
language use, culture-specific 97, 119–22, phase energetics (wuyun liuqi xueshuo),
150–3, 188, 232–3, 236–8; see also doctrine of 92–4, 105, 107–8, 187,
reasoning 190–1, 200
leprosy 89 Phlegm and Rheum (tanyin) 197, 220–2,
Leslie C. 7, 11, 13 235
life and death, concepts of 9, 71–7, plague 89
108–16 pluralism, medical 9, 13–14
Liquids and Fluids ( jinye) 168, 197, 198, popular medicine 9, 13; see also qigong
211, 216, 220–2, 236 Porkert M. 6, 9, 20, 68, 81, 87, 92, 107,
Liver (gan) 42–4, 64 –6, 82, 83, 109, 116, 144, 172, 173, 190, 194, 204,
198, 206, 215, 239 207, 209
Lock M. M. 7, 78 practice, medical vs. doctrine or theory
Lu G. D. 10, 22, 84, 107, 144, 172 6–8, 124 –5, 158–63, 210–12,
Lungs ( fei ) 65, 82, 109, 198, 206, 211 232–4; see also doctrine and theory
prodemocracy movement 19, 47, 90, 130,
Ma Boying 7, 80, 128, 153–4, 223–4
Ma Kanwen 72 prognostics 84, 120–1, 196
marriage 12, 32, 46, 54, 59–60, 141 Pulse (mai ) 16, 54, 64, 83, 92, 98, 144,
massage (anmo or tuina) 9, 11, 26, 40, 162, 185, 187, 190, 207, 213, 235
41, 50, 58, 59, 60, 63, 88, 139, 158,
160; fire massage 35 qi 9, 19–20, 21–5, 30, 33, 38, 39, 44 –5,
meditation 21–3, 29–30, 30–2, 33–40, 50, 67–77, 77–87, 105, 107–8,
47–50, 71–7, 107, 222 109–10, 112, 122–5, 185, 190, 194,
menstruation 78, 221–2, 235 195, 198, 199, 200–1, 204, 205–6,
metaphor 50, 211–12 210, 211, 216, 220–2, 234–6; bad
minority nationalities (shaoshu minzu) 8, qi (xieqi) vs. Primoridal qi ( yuanqi )
47, 146; Muslim 131, 136 77–87
mood and modality 3, 215–17, 233, qigong 21–5, 25–87, 98, 100, 130, 133,
238–40; see also reasoning 139, 158, 160, 171, 174, 235
moxibustion, see acumoxa Qiu 9, 12–13, 14, 15, 20, 25–87, 98,
102–3, 127 165–6, 218–19, 221,
nature, concepts of 77–83, 114, 118, 225–6, 230–1, 235–6, 239
201–6, 234 –40 questions, attitudes to 18, 43, 60, 117,
nausea (xiang tu) 63 133–5, 137–8, 142, 146, 149,
Needham J. 10, 22, 40, 84, 107, 109, 149–53, 201–2, 219, 228, 230–1,
111, 114, 144, 172 237
290 General index
reasoning, definition of 3–5, 231– 4; Stomach (wei ) 72, 76–77, 99, 196–7,
descriptive vs. expressive 3; 209, 213, 214
descriptive vs. prescriptive 158–60, stomach problems 3, 23, 26, 29, 59, 63,
167, 210–17, 218, 232–4, 238–9; 155
descriptive vs. subjective 22, 78, 86, swellings 31, 38, 83–5, 236
105, 179, 230; see also doctrine, systematic (xitonghua) 7, 128, 158, 160,
knowing, scientific 165, 168, 221–3, 228–9; systematic
recruitment of clientele 59–61; disciples vs. flexible 136, 157, 159, 162, 229;
(tudi ) 46–8; followers (tudi ) 100–4, systematic vs. systemic 207, 209;
159; TCM students (xuesheng) systematic vs. thematic 186–94
145–7; TCM teachers 138–9, 140,
142–4 Tao, see TCM teachers
regeneration and resilience 64, 72–3, 223 TCM, definition of 6–8, 8–10, 13–14,
Ren Yingqiu 107, 170, 185, 201, 209 128–224, 227–9; classroom vs. clinic
research, on biomedicine 92–3; on qigong 160–6; clinic vs. college 7, 144 –5,
23, 29, 36; in TCM 93, 144, 145, 228; curriculum 157–64, 241–61;
163, 175, 180–1, 193, 212–17, polemics 189, 220–1; research, see
218–22; see also scientific research; students 133–5, 145–57;
revelation (wu) 103, 222, 227; see also teachers 8–10, 13–14, 132–3,
visions 135– 45, 168–70, 177, 186, 189,
rheumatism ( fengshibing) 58–9, 70, 83 194 –5, 220; textbook knowledge 72,
Robinet I. 44, 73 158–60, 161, 168–224; textbook
rote learning 40, 102–3, 130, 149, 165, knowledge vs. classroom teaching
222, 227, 230; rote vs. exemplary 187, 196–8; theory 97, 144 –6,
learning 166, 177 152, 158–60, 162–3, 164 –6, 167,
168–223, 227–9, 237, 239
sacrifice 72–7 terminal conditions 27, 42– 4, 59, 83, 89,
Scheid V. 7, 19 239
scholar doctors (ruyi ) 2, 11, 95–6, 104; theory, Western modern scientific 105,
see in particular Zhang 124 –5, 162, 164 –6, 232– 4; see also
scientific (kexuehua) 6, 8, 93, 99–100, reasoning, scientific, TCM theory
163–4, 168, 172, 175, 188, 193–4, Three Passes (sanguan) 33– 4
204, 217, 218–19, 223, 227–9, time, concepts of 80–2, 110–16, 179,
231–4; see also research, theory 184, 194 –6, 222
secrecy 53–7; see also transmission, Tongue (she) 16, 54, 64, 207, 218, 221
secret Topley M. 7, 9
senior Chinese doctors (laozhongyi ) 30, touch 38, 65, 69–70, 83–5, 86, 98,
54, 73, 144, 162–3, 189, 194, 211, 160–3, 235; see also Pulse
220–1, 226; see in particular Zhang Tracts and Links ( jingluo) 10, 70, 86,
Shanghai TCM College 138, 140, 175–6 92, 118, 187, 190–1, 198, 200–1,
shoulder pain ( jianzhouyan) 35–40, 64, 206, 211, 216, 222; definition of
83 172
Sivin N. 6, 7, 19, 20, 67, 68, 80, 87, transmission of knowledge and practice,
111, 113, 124, 144, 170, 172, 188, modes of compared 1–2, 6–20,
202, 204, 207–9, 211, 215, 220, 48–53, 81–2, 98, 102–4, 126–7,
236 145, 165–7, 194, 225–40; personal
space, concepts of 81–2, 109–11, 129–32, 88–104; secret 21–57; standardised
206–10 128–67
Spirit (shen) 19–20, 43, 64, 66, 71, 105, treatment, maxims of (zhize) 16, 45,
107–9, 116–18, 122–3, 168, 177, 64, 119–22, 201, 210–12, 215–17,
195, 197, 199, 205–6, 207, 218–22, 222–3, 228, 238–9; conceptions of
226–7, 239–40 illness and 5–6, 51, 67–78, 83–7,
Spleen ( pi ) 45, 65, 72, 82, 109, 119, 153, 196–7, 210–12, 238–9; see also
122, 198, 206, 209, 214, 215 reasoning, body concepts
stagnations, see accumulations truth value 4, 53, 99, 217, 199; see also
stethoscope 189 doctrine
General index 291
tuberculosis 23 word magic 14, 31, 47, 48–53, 225–6;

tumour (liu) 43, 83–5, 236 see also Daoist incantations
word meaning, polysemous and/or vague
un- or underemployment (daiye) 23, 26, 45, 94, 116–18, 124, 134, 179,
88, 91, 100–2, 135, 136–8, 138–9, 188–9, 194, 211, 213, 215, 219,
153–6 221, 227–8, 233–4, 239–40;
Unschuld P. U. 6, 33, 63, 78, 87, 128, definition of 18
144, 160, 164, 172–3, 190, 206–9, Wu Y. Y. 11, 96, 101
211, 217
Yamada K. 159, 170
virtuosity or flexibility (linghuo) 122–5, yinyang 19–20, 28, 36, 64, 72–3, 81, 83,
127, 145, 159, 194, 211–12, 227, 84; in a classical text 105, 107, 114,
229; definition of 162–3 116–18, 125–6; in TCM 168, 172,
visceral systems, see Five Organs 177–86, 190–1, 193–6, 198–9,
visions 22, 33–4, 36, 37–9, 44 –5, 49; 201–2, 204 –6, 212, 218, 223, 236–8
see also revelation, visualisation Yunnan TCM College 8, 90, 128–223
visualisation, verbalised 44
Zhang 9, 11–15, 20, 25–87, 98, 102–3,
White S. 42 127, 165–6, 218–19, 221, 225–6,
Wind ( feng) 3, 5, 64, 81, 107–10, 230–1, 235–6, 239
112–17, 123, 161, 196, 198 Zimmermann F. 79
Index of Chinese book titles and chapter
headings discussed in text
Book titles are given in italics, chapter headings in quotes. Words in classical
Chinese are generally monosyllabic, words in standard modern Chinese can
have more syllables.
‘Bai bing shi sheng’ ! Huang di nei jing 11, 14,
197 63, 94, 105–27, 170, 175–6,
Ben cao gang mu 170, 185, 186–97, 213, 239
171 see also Su wen and Ling shu
‘Ben shen’ 197 ‘Hui tong lei’ 187, 190–1
‘Bi lun’ 197 ‘Ji bing lei’ 187, 190–1
‘Biao ben lei’ 187, 190–1 Jin gui yao lüe [ fang lun]
‘Bingji’ 187, 191 xz 171, 175, 176
‘Bing neng’ 187 ‘Jing’ 113
‘Bingyin bingji xueshuo’ Jing fa 201
187, 191, 195 ‘Jing luo’ 187
‘Bingyin yu fa bing’ ‘Jingluo’ 187, 191
187, 191 ‘Jing luo lei’ 187, 190–1
‘Bingzheng’ 187, 191 ‘Jingluo xueshuo’ ! 187,
‘Da gan lun’ 197 191
‘Da zhuan’ see also ‘Xi ci zhuan’ ‘Jing mai bie lun’ 196
113, 116, 117, 121, ‘Jing qi shen’ 187, 205,
125–6, 238 220
Dao de jing 120 ‘Jing qi xue jinye’ 220
‘Dao sheng’ 187, 199 ‘Jing shuo’ 113
Dao zang 14 ‘Jue qi’ 197
‘Fa bing yuanli’ 68 ‘Ke lun’ 197
Fangjixue 6, 158, 241–6 Lei jing 169, 186–93, 199,
‘Fangzhi yuanze’ ! 187, 204–6
191, 199 Ling shu 11, 86, 170, 172,
Fujian zhongyiyao zazhi 190, 192, 197, 201, 205–6
! 186 ‘Liu jie zang xiang lun’ !
‘Gan shi’ 202 196
Guan zi 22, 116 Lun yu 96, 97
Han shu 71, 182 ‘Lun zhi lei’ 187, 190–1
‘Hong fan’ 180, 202 ‘Mai du’ 197
Huainan zi 73, 116, 121 Mai jing 171
292
Index of Chinese book titles 293
‘Mai se lei’ 187, 190–1 Xinbian zhongyixue gaiyao

‘Mai zhen’ 187 202
Meng zi 95, 202 Xin xiu ben cao ! 171
Nan jing 33, 71, 86, 160, Xun zi 113, 202
171–4, 176 ‘Yangsheng xueshuo’
Nei jing, see Huang di nei jing 187, 199
Neijing jiangyi 10, 169, Yiguwen 10, 170, 176–7,
176, 186–97, 198–200, 205–6, 241ff
214, 220 Yi jin jing 32
Nei jing zhi yao 169, Yi jing 11, 92–4, 95, 110,
187, 191–3, 199 113–16, 125, 183, 190, 238
‘Ping re bing lun’ 191 Yi lin gai cuo 172
‘Qide fenbu he fenlei ! Yi xue ru men ! 17
68 ‘Yi yi yi’ 94
Qi jing ba mai kao 173 ‘Yin yang’ 187
‘Qi wei lei’ 187, 190–1 ‘Yin yang lei’ 187, 190–1
‘Qixue jinye’ 187, 220–1 ‘Yinyang wuxing’ 187,
‘Se zhen’ 187 191
‘Shang gu tian zhen lun’ ! ‘Yinyang wuxing xueshuo’
80, 170, 174–6 187, 191, 205–6
Shang han lun 80, 170, ‘Yin yang ying xiang da lun’
174–6 196
Shang shu 180, 202 ‘Ying wei sheng hui’
‘She sheng lei’ 187, 197
190–1, 199 ‘Yun qi lei’ 187, 190–1
Shen nong ben cao jing ‘Zang xiang’ 187
171 ‘Zangxiang’ 187, 191,
‘Sheng qi tong tian lun’ 206–10
197 ‘Zang xiang lei’ 187,
Shiyan zhenjiuxue !" 144 190–1, 205–6
Su wen 11, 86, 105–27, Zangxiangxue 72, 159,
128, 159, 170, 185, 192–3, 169, 173, 203–4, 213–17, 220,
196–7, 206, 209, 210, 214–15, 222
239 ‘Zangxiang xueshuo’
Tao te ching, see Dao de jing 187, 191, 205
‘Tian yuan ji’ 107–8, ‘Zei feng’ 197
109 ‘Zhen ci lei’ 187, 190–1
Tuinaxue 158, 241ff ‘Zhen fa’ 187, 191
‘Wei lun’ 197 Zhen jiu da cheng 173,
Wenbingxue 80, 171–2, 174
175, 176, 197, 241ff Zhenjiu jixuan 175,
‘Wu bian’ 197 241ff
Wu li lun 71 Zhen jiu jia yi jing
‘Wu long jin ye bie’ !" 171, 175
197 Zhenjiuxue 10, 158,
‘Wu zang bie lun’ 197 160–1, 173, 241ff.
‘Xi ci zhuan’, see also ‘Da Zhuan’ ‘Zhi ze’ 187
92, 94, 95 ‘Zhize zhifa’ 187, 191
294 Index of Chinese book titles
‘Zhi zhen yao da lun’ ! Zhongyi neikexue

197 158, 160–1, 241ff.
Zhongyaoxue 6, 158, 191, Zhongyi shangkexue
204, 241ff 158, 160–1, 241ff.
Zhongyi bingyin bingjixue Zhongyi waikexue
159, 169, 187, 222 158, 160–1, 241ff.
Zhongyi erbihouke xue Zhongyixue daolun
161, 241ff. 159, 169, 187
Zhongyi erkexue ! 158, Zhongyi yankexue
160, 161, 241ff. 158, 160–1, 241ff.
Zhongyi fangzhixue zonglun Zhongyi zhenduanxue !
159, 169, 187 6, 10, 158, 162, 189, 191,
Zhongyi fukexue 158, 218–19, 221, 241ff.
160–2 Zhu bing yuan hou lun
Zhongyi jichu lilun 171
10, 19–20, 68, 71, 72, 107, Zhuang zi 33
146, 158–60, 168–224, 241ff. ‘Zu tong lun’ 197, 199
Index of Chinese personal names
(style name (zi), if known, given after comma)
Bian Que (c. 5th century B.C.) Li Shizhen, Dongbi literary name:
61, 85 Binhu shanren (c. 1518 –1593)
I I !"#
Chao Yuanfang (6th/7th century) 162, 170–1, 173
171 Li Yan, Jianzhai (16th century)
Chunyu Yi (2nd century B.C.) I 171
120–21 Li Zhongzi, Shicai, literary name:
Nian’e (1588–1655) I
Dai Lisan, Xi (1901–1968) I I 169, 187,
90, 143 191–3
Deng Xiaoping (1904–1997) Liang Qichao (1873–1929)
21, 24 99
Dong Zhongshu (179?–104?B.C.) Lin Yi (11th century) 189
109 Liu Wansu, Shouzhen (c. 1110–
c. 1200) I 171
Gao Baoheng (11th century)
189
Mao Zedong (1893–1976)
Guanyin (Buddhist deity) 40 24, 181–6
Gui Yuqu (mythical figure)
104 Su Jing (599–674) 171
Hua Tuo, Yuanhua (?–c. 203) Sun Simiao (c. 581–682)
I 171 85, 94, 171, 172
Huangdi (mythical figure)
104 Tai shang lao jun (Daoist deity)
Huangfu Mi, Shi’an (215–282) ! 31, 38, 49
I 171 Tao Zhenbai (1910–1979)
90
Kang Chengzhi, Zixin (1899 1970)
I 90, 143 Wang Bing (8th century)
107, 112, 126, 170, 175,
Lao zi (Daoist deity) 31 189–90
Li Gao, Mingzhi; late literary name: Wang Ji (1522–1567) 107
Dongyuan (1180–1251) I Wang Ji, Shengzhi (1463–1539)
I 72, 171 I 107
295
296 Index of Chinese personal names
Wang Qingren, Xunchen (1768– Ye Gui, Tianshi (c. 1666–1745)

1831) I 172 I 171–2
Wang Shuhe (3rd century)
171 Zeng Yulin (1930 –) 10,
Wei Boyang (3rd century) 145
76 Zhang Congzheng, Zihe (c. 1156–
Wu Peiheng (1888–1971) 1288) I 171
90, 143 Zhang Ji, Zhongjing (c. 150–219)
Wu Tang, Jutong (1736–1820) I 80, 170, 221
I 171–2 Zhang Jiebin, Huiqing; literary name:
Wu Youxing, Youke (c. 1582– Jinyue (1562–1640) I
1652) I 171–2 I 71, 94, 107, 169,
175, 189–93, 204 –6, 214
Xue Xue, Shengbai (1681–1770) Zhao Xianke, Yangkui (1537–
I 171–2 1644) I 171
Zhao Ziyang (1919–)
Yan Xin (20th century) 31, 137
48, 139 Zhu Xi, Yuanhui and Zhonghui
Yang Quan, Deyuan (3rd century) (1130–1200) I I
I 71 204
Yang Xianzhen (1896–??) Zhu Zhenheng, Yanxiu (1281–
183 1358) I 171

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The transmission of Chinese

Cambridge University Press

  is a teaching and research fellow in the history of

Medical anthropology is the fastest growing specialist area within anthropology,

This series includes theoretically innovative monographs, state-of-the-art col-

1. Lynn M. Morgan, Community Participation in Health: The Politics of Primary

  

© Elisabeth Hsu 1999

This book is in copyright. Subject to statutory exception and to the provisions

First published 1999

Printed in the United Kingdom at the University Press, Cambridge

Typeset in 10/12pt Plantin []

Library of Congress cataloguing in publication data

Acknowledgements page viii

Introduction: ways of learning 1

Appendix: Curriculum for TCM regular students and

Chinese words are all rendered in pinyin, the official transliteration

Introduction: ways of learning

Chinese medicine is grounded in medical practice and in texts – in

This study was designed to avoid discussing Chinese medical terms

Verbal reasoning, just like ritual, can be over-intellectualised. In

of three individuals; whether these styles can be generalised remains

observed ways of ‘knowing practice’. The model nicely reflects the

a nationwide scale in colleges, hospitals, and clinics. Its legitimation in

medical ‘doctrine’, and in this respect differs from Chinese medical

Table I.1. Different medical practitioners in a Chinese urban setting

massage acumoxa Chinese TCM

five hundred at most, and the range of disorders known to be success-

In general, however, I felt that my presence at the bedside was intrus-

led me to a qigong healer’s instead of a Chinese medical doctor’s family

urban health care

realm within work units realm outside work units

i.e. government collective private

teacher Tao mentor Zhang master Qiu

Approaches to the field

these formal enquiries only corroborated my subjective impressions. The

Working in the field

‘Western doctor’ (xiyi), but my knowledge of biomedical pathology was

performance, are expressions of the people who communicate them.

The structure of the book

The three settings of Chinese medical learning structure the book as

Protective qi (weiqi).26 However, the ethnographic account of qi will

1 The secret transmission of knowledge

Qigong, which became very popular under Deng Xiaoping’s leadership

The practice of self-cultivation is age-old. The earliest-known written

insignificant in the PRC. It is, however, possible that through qigong,

stringed instrument) and the hoarse voice of an old woman which

Social networks and private enterprise

Brotherhood and dangers of knowledge

Family bonds and the ethics of knowledge

Young and inexperienced as he had been in his twenties, he had also

Discipleship: imitation and repetition

following days. It seemed as if the anthropologist’s interest in qigong

On Sunday, the four of us went to Ma’s home. She served us many

The Light that changed the healer’s gaze

After Qiudi’s mistake in treating Bao, the atmosphere in Qiu’s house-

Destiny and the legitimation of knowledge

A month later my stay in Kunming was disrupted by a sudden death

The secret mode of transmission