A
s Attendant He did not belong to a hazy antiquity, it is no accident that Needham began his story about Chinese med- icine with the sixth-century figure.1 Unlike the other exemplary healers found in Huangfu Mi’s preface, whose names signaled their mythi- cal quality – the Divine Husbandman, the Yellow Emperor, and Lord Thunder (Leigong 雷公) – Attendant He gave every appearance of being historical. Judging from ancient chronicles, he served as some kind of medical attendant in the western state of Qin centuries before the unifi- cation of China in 221 BC. One can furthermore pinpoint his activities in time, as he traveled in 541 BC to the state of Jin 晉 to attend to the sick Lord Ping 平. A detailed record of Attendant He’s diagnosis of that lord, moreover, survives in the Tradition of Zuo, a historical chronicle by an unknown author.Not surprisingly, modern scholars assume that Attendant He was a his- torical personage, and they recount his contributions to medical theory as if the ancient man were Herophilus (335–ca. 280 BC) or William Harvey (1578–1657). A recent history by Zhu Jianping 朱建平 serves as a case in point. Before Attendant He, Zhu writes, “illness was seen as heavenly sanction or a scourge sent down by the spirits”; after Attendant He, illness “could be analyzed solely in terms of material causes.” This rejection of superstition, Zhu further adds, provided “the conceptual breakthrough for the foundations of the theory of pathogenesis found in the Yellow Emperor’s Inner Classic.”2
Similar conjectures about Attendant He’s historicity surface in impor- tant Japanese- and English-language works on Chinese medicine, where scholars treat the healer as a representative of new theories that con- nected human health and sickness to cosmic patterns.3 Japanese scholar, Yamada Keiji, for instance, assumes that the description of Attendant He
in the Tradition of Zuo is historical and characterizes the episode as the first evidence of medicine as a system of knowledge.4 Similarly, in his celebrated study, the Expressiveness of the Body, Kuriyama Shigehisa also regards Attendant He as a historical figure. The healer, Kuriyama asserts, “ignored demonic attacks, but instead blamed six causes: the yin, the yang, wind, rain, darkness, and brightness.”5
Yet should one treat the episode in the Tradition of Zuo as China’s first medical case history? Does it actually reveal what Attendant He or, for that matter, what any ancient healer believed? Admittedly, the chronicle relates events in the regional courts of the Spring and Autumn (ca. 771–453 BC), the time of Attendant He’s heyday. Yet most scholars now agree that the text postdated the Spring and Autumn by centuries. In the mid-fourth century BC, a chronicler reworked ear- lier materials and pieces of legend to express his understanding of the moral patterns of the past. In the process, he adapted and added fic- tionalized speeches, episodes, and entire personalities.6 The chronicler also happened to be a master of narrative. Like a novelist or bard, he availed himself of an arsenal of rhetorical devices to drive home his larger message: rhymed speeches, prolepsis, dream narration, fictional episodes, and fantastic elements such as visits by ghosts and demons.7 Given all of these features, it seems unwise to assume that the histori- cal figure of Attendant He, if he existed, was just as he appeared in the Tradition of Zuo.
This chapter revisits the famous episode preserved in the Tradition of Zuo. It challenges a basic assumption underlying most modern interpre- tations of Attendant He’s significance: namely, that the episode in the Tradition of Zuo provides a mirror of medical thinking and practice in ancient China. As shall be shown in the following text, one should not think of the figure as a historical person as much as a persona: a fictional character that the anonymous chronicler created for purposes of narra- tive intensification. The chronicler, furthermore, I will argue, recounted the episode to relate a political parable rather than to record a momen- tous event in Chinese medical history.
To show this, I begin by introducing the episode in the Tradition of Zuo: explaining its historical context, main characters, and key themes before providing a synopsis. I then revisit the episode, attempting to establish the kind of character Attendant He represented in the narrative. Through these methods, I argue that contrary to conventional wisdom, the chronicler represented the healer as both an authority on the body and an expert on the numinous realm. With such a reevaluation, I situate
the healer’s prognosis within the larger story about Lord Ping’s illness. By analyzing the narrative structure, I demonstrate that the chronicler presented Attendant He as the alter ego of another figure in the episode, a statesman renowned for his knowledge of spiritual matters. The views that the chronicler attributed to the figure moreover fit with a common archetype in Warring States histories, that being the noble master of the numinous realm. For this reason, I conclude that the chronicler fashioned the image of the healer by recycling existing tropes and archetypes to make a point about politics, as opposed to medicine.
SETTING THE STAGE
Before going too much further, it would be helpful to place the episode examined in the following discussion in its historical context, as well as to introduce its main themes and characters. The episode in the Tradition of Zuo purportedly took place around 541 BC, an era that scholars refer to as the Spring and Autumn (ca. 771–453 BC). The period acquired its name from a famous annals traditionally attributed to Confucius, which narrates political events from the perspective of the Master’s home state of Lu 魯. At the start of the Spring and Autumn period, there were lit- erally hundreds of states in China proper. Centuries of warfare, however, reduced the number of states to only a handful of superpowers. In the sixth century BC, the state of Jin was one of a number of superpow- ers, along with Qi 齊 in the East, Qin 秦 in the West, and Chu 楚 in the South, that vied for hegemonic status. (For a map of the period, see Figure 3.)
The main subject and dramatis personae of the episode also bear mention. Told from the perspective of multiple figures at court, the chronicler’s narrative revolved around the sickness of Lord Ping. In it, the chronicler explored both the specific and general roots of the illness, whether the sickness was the result of meddling angry spirits, or if the unhealthy lifestyle of the lord contributed to his malaise. In addition, the chronicler teased out the political implications of the lord’s sickness – what, for instance, the lord’s sickness revealed about the quality of ministers, the future of the ruling house, and the gover- nance of the state. Besides Lord Ping, three figures played a central role in the episode: Lord Ping’s chief minister Zhao Wu 趙武 (d. 541 BC); Zichan 子產 (d. 522), a famous nobleman and an emissary from the smaller state of Zheng 鄭 to Jin’s south; and Attendant He, the medical attendant from Qin.
The chronicler narrated the episode, represented in Figures 4 and 5, through two events: first, Zichan’s mission to the Jin court and his con- versations about Lord Ping’s illness; and second, Attendant He’s visit to Jin and his remarks about the roots of the lord’s sickness.
Upon closer inspection, one can see that the narrative about Zichan’s visit is in fact tripartite. The first part opens with the arrival of Zichan in Jin, where a divination had just been performed to determine the eti- ology of Lord Ping’s illness. The diviners at the Jin court reported that two spirits were behind the sickness. Because no one in the Jin court was familiar with the spirits, Zichan was asked about them. Much to the surprise of his audience, Zichan flatly denied that the spirits were
0 0 200 km 200 mi Yello w Ri ver (Hua ng H e ) Han River Huai Rive r Yang zi R iver (Cha ng Ji ang) (Chang Jiang) Yangzi River Yello w River (Hua ng H e) Yan JIN Zhou Tang QIN CHU Cai Xu Zheng Chen Ji Wey Song Deng CaoLu Xiao JuJu Xue Wu Yue QI N Major States of the Spring
and Autumn Period
Figure 3 Major states during the Spring and Autumn period, ca. 771–453 BC.
Source: The Cambridge History of Ancient China: From the Origins of Civilization to 221 BC,
edited by Michael Loewe and Edward L. Shaughnessy, 548 (1999). Reproduced with permission from Cambridge University Press.
involved. The pair, Zichan explained, were nature spirits and did not have dominion over the lord’s body. “What do the gods of the hills and riv- ers, or of the stars and planets,” he asked, “have to do with the health of the prince?” The real source of the lord’s illness, Zichan explained, came down to two factors: first, the lord’s disorderly lifestyle, which was at odds with the proper time for activities, and second, his flagrant violation of taboos against marrying women of the same surname.8
In the second part of Zichan’s visit, the chronicler moved away from Zichan to a conversation between a Jin noble and another member of the Zheng delegation. This Jin nobleman inquired about the chief min- ister of Zichan’s home state of Zheng, to which the delegate replied that the days of the Zheng minister in question were numbered. In the third and shortest part, the chronicler returned to Lord Ping of Jin, who lis- tened to the prognosis before bestowing words of praise and tokens of appreciation upon Zichan.9
The second event can also be divided into roughly three parts. The first and longest opens with Attendant He’s consultation with his noble patient, Lord Ping, where the healer rejected the possibility that either ghosts or bad food had caused the illness. “There is nothing that can be done,” he told the lord, “For this is what is referred to as a case of ‘being close to women,’ a sickness generated in the same way as gu 蠱.”10 After announcing his prognosis, Attendant He then issued a mysterious prophecy about the imminent death of a minister in the Jin court (I say mysterious because the healer did not identify the doomed minister by name). The prophecy, however, was ignored by the lord, who was more worried about the prospect of having to abandon his riotous lifestyle.
Healer He's Disputation of the Divination First Diagnosis (musical excess) Second Diagnosis (sexual impropriety) Prediction of the Jin Minister's Death Explanation of the Divinatory Hexagram Minister's Praise for Attendant He
Figure 5 The Sickness of Lord Ping at a Glance (Attendant He), as recorded in the
Tradition of Zuo (4th cent. BC). The diagram analyzes the visit of Attendant He. Source: Image drawn by author.
Zichan's Explanation of the Divination Disputation of Divination First Diagnosis (untimely behavior) Second Diagnosis (sexual impropriety) Prediction of Zheng Minister's Downfall Lord's Praise for Zichan
Figure 4 The Sickness of Lord Ping at a Glance (Zichan), as recorded in the Tradition
of Zuo (4th cent. BC). The diagram schematically represents Zichan’s mission to Jin. Source: Image drawn by author.
Instead, Lord Ping got back to what really mattered. “Is it true,” he asked Attendant He, “that women are not to be approached?” The question gave the healer an opening to lecture the rakish lord on the roots of illness: excessive indulgence in music and unregulated sexual activity. According to Attendant He, Lord Ping’s sexual excess had caused an imbalance in the body, which had made the lord sick.
In the second part, the chronicler turned his attention away from the consultation between the patient and healer to a conversation between the latter and Minister Zhao Wu. The latter had learned from some- one that Attendant He had issued a prophecy regarding the imminent death of an unnamed minister. Evidently intrigued, or perhaps wor- ried, Minister Zhao demanded that the healer identify the minister in question, only to hear that it was he. As the conversation had taken an awkward turn, Minister Zhao changed the subject and asked instead about the illness called gu, mentioned by Attendant He in his preceding remarks. In response, Attendant He explained the illness through passages drawn from the divinatory classic, the Book of Zhou Changes (Zhouyi 周 易 or Yi-ching). In the third and briefest part, the chronicler closed with Minister Zhao’s words of praise for Attendant He, who was extolled as a “fine healer” and rewarded for his visit to Jin.11
WHO WAS HE?
With such an introduction, we now return to the primary problem at hand: investigating whether or not the episode in the Tradition of Zuo was actually a literal account of medical happenings. For this, one must first acquire a deeper understanding of the medical figure in the Tradition of Zuo. Was Attendant He, as many historians argue, a naturalist? And by naturalist, they mean that the healer had excluded supernatural forces like gods and spirits from his accounts of sickness, instead explaining illness in terms of the metaphysical frameworks concerned with expressions of qi, and the balance between yin and yang. Though present in virtually all modern discussions, the received view about Attendant He, I think, misses the mark. Although he associated Attendant He with qi-centered theories of illness, the chronicler also presented the man as an expert of the spirit realm – a point that will be crucial for my larger argument about the healer functioning as a literary device in the text.
At first blush, the evidence would seem to favor the received view. Nowhere in his prognosis did Attendant He mention the spirits, and so it would seem that the chronicler rendered him a proponent of naturalistic
theories of illness. This would seem obvious enough from the text of the healer’s celebrated prognosis.
天有六氣, 降生五味, 發為五色, 徵為五聲。淫生六疾。六氣曰 陰、陽、風、雨、晦、明也, 分為四時, 序為五節, 過則為菑: 陰 淫寒疾, 陽淫熱疾, 風淫末疾, 雨淫腹疾, 晦淫惑疾, 明淫心疾。 女、陽物而晦時, 淫則生內熱惑蠱之疾。今君不節、不時, 能無 及此乎?」
In Heaven there are six kinds of qi, which come down and produce the five flavors, emitted as the five hues, and result in the five tones. If there is excess, the six illnesses will be produced. The six qi are referred to as the yin, yang, wind, rain, dark, and light, each of which are separated into four periods and arranged into five pitches. When there is excess in one of these, there will be calamity. When the yin is excessive, there will be a cold illness, when the yang is excessive, there will be a heat ill- ness; when wind is excessive, there will be an illness in the extremities; when rain is excessive, there will be an illness of the abdomen; when darkness is excessive, there will be avolition, and when light is excessive, there will be an illness in the heart. Women draw out the yang [i.e., the bright or hard] in things during the hours of darkness (?).12 When there is excess in this, an internal heat, avolition, and gu will be produced. In the present case, I knew that his lordship had been immoderate and untimely in his sexual relations; thus how could this calamity not have befallen him?13
The passage presents several points of interest. To begin with, the chroni- cler not only excluded references to gods and spirits from Attendant He’s prognosis, but he instead emphasized the cosmological underpinnings of human illness: the excesses of yin and yang, as well as the uneven propor- tions of dark and light or moisture and heat, all of which cause the body to lose its natural equilibrium. The very generality of the prognosis – notice, for example, that the healer brought up symptoms that the patient did not experience – suggests that Attendant He saw the theory of the six qi as a framework for understanding not only the illness of Lord Ping, but also human sickness in general.
Perhaps more importantly, Attendant He denied in the episode that the lord’s illness resulted from the malevolent involvement of spirits.14 Such a denial is surprising in light of other sources from the fourth century BC. If divinatory records recovered by archaeologists are any indication, illness was seen by the ruling elite as the result of supernatural displea- sure: Heaven “sending down” its punishments, an ancestor or spirit miffed about having received less than his or her due of offerings, a demon
seeking vengeance upon a murderer or his descendants, and the war dead incensed by a lack of sacrifices.15 The case of one nobleman, who died a few decades after the compilation of the Tradition of Zuo, leaves clues as to the strength of such beliefs among the ruling elite. His ailments occa- sioned the coordinated efforts of twelve diviners, who sacrificed no less than thirty-six pigs, six dogs, twenty-three sheep, nine oxen, and a horse.16 Given such a background, the healer’s denial that spirits and ghosts caused the lord’s illness seems all the more like an expression of defiance, a protest lodged against the dominant views of the age.
The attention that the healer purportedly gave to symptoms would also seem incompatible with conceptions of illness as divine punishment. The fact that Attendant He worked backward from symptoms to source suggests that he saw a one-to-one relationship between a symptom and the agent of illness – a stance at odds with older views that emphasized the capriciousness of spirits. While they ascribed a rationality to illness – the gods and spirits usually had a reason for sending down the scourge of sickness – older views did not posit a necessary connection between specific symptoms and agents. As divination records hinted, the expres- sion of spiritual displeasure varied widely; the same illness could have any number of potential sources. When investigating the shortness of breath and loss of appetite suffered by the aforementioned nobleman, diviners considered a long list of candidates: royal ancestors, various nature spirits, and those who died in war.17 Given the lack of correspondence between symptom and agent, diviners understandably paid little attention to the former, instead scrutinizing the patterns found in the turtle shells and milfoil stalks for clues about the sources of illness.
Moreover, other elements in the episode militate against the view that Attendant He opposed spiritual explanations of illness. Although he did not assign any role to the spirits in his diagnosis of Lord Ping, the healer