Introduction: A Monumental Discovery
Imagine a discovery that completely rewrites the history of an ancient field. That’s precisely what happened in 1973 with the excavation of Mawangdui tomb. Among the many treasures found were the Mawangdui Medical Manuscripts, which have since provided a new foundation for the history of early Chinese medicine and medical literature. Prior to the tomb discoveries that began around 1972, much of what was known about early manuscript material primarily came from Han administrative documents. The finds at Mawangdui and elsewhere brought to light a wealth of literature that was previously virtually lost.
The Manuscripts Themselves: A Glimpse into the Past
The medical manuscripts are a significant portion of the total manuscript corpus recovered from the tomb. In total, there are seven manuscripts containing fourteen texts. These were written on different materials: five are on silk, one consists of bamboo slips, and another of wooden and bamboo slips. Some of these documents are quite extensive; for instance, manuscript MSI measures approximately 450 centimeters. The silk manuscripts often feature writing arranged in columns, sometimes even imitating the appearance of bamboo slips. The width of the silk itself also seems to correlate with standard slip lengths mentioned in Han sources.
Dating these texts is crucial. The burial date of the tomb, 168 B.C., serves as the latest possible date for all the materials found within it. However, based on script styles, some manuscripts like MSI and MSIV were likely copied earlier, possibly around 215 B.C. or closer to 200 B.C.. MSV might date back several decades before 188 B.C., again based on script style and certain linguistic patterns like name avoidance. MSVI.A and MSVI.B appear to be later, likely dating to after 180 B.C..
The individual texts within the manuscripts were assigned titles in the publication MWD, vol. 4, as the original manuscripts often did not have them. This publication also provided a transcription using modern graphs. However, our understanding and transcription have continued to evolve. Notably, editions of these same medical texts were discovered in a manuscript from Zhangjiashan tomb 247, excavated in 1983. This tomb was buried in the mid-second century B.C.. The Zhangjiashan manuscript, although unavailable when MWD, vol. 4 was published, has proven invaluable, shedding much light on the Mawangdui medical manuscripts and helping to prepare a new transcription and revise earlier readings.
Placing the Texts: Fang-Literature and its Audience
The medical texts from Mawangdui are classified as a type of literature known as “Recipes and techniques” (Fangji). This category is closely associated with “calculations and arts” (Shushu), and both fall under the broader umbrella of “fang-literature”. This type of literature encompasses natural philosophy and occult thought.
The Mawangdui medical manuscripts are considered typical examples of this early medical literature. They circulated not only among medical specialists but also among the literate elite who were known to collect books, suggesting an increased demand for fang-literature. Tomb owners like Li fils (in Mawangdui) and the individual in the Zhangjiashan tomb were likely elite aficionados and collectors of such works. These texts circulated among physicians and the elite across geographical regions. While physicians were probably primarily responsible for creating medical literature, the elite also played a role in its production and dispersion. Transmission often occurred through teacher-disciple relationships, sometimes involving vows of secrecy, but the sources suggest that fang-literature was generally widely available to those who could afford books.
Diving Deep: Medical Ideas and Practices
The Mawangdui medical manuscripts provide fascinating insights into early medical concepts and treatments. They discuss ideas about illness, sometimes offering ontological explanations that attribute ailments to factors like wind, vapor, bugs (like the “Ming” bug that chews holes), or even demonic afflictions. The texts also reveal emerging physiological ideas.
A key physiological concept present is vessel theory (maifa). Manuscripts like MSI.A and MSI.B describe eleven vessels within the body that contain vapor (qi). This theory, while less detailed than in the later Huangdi neijing, is linked to macrobiotic hygiene and pathology and served as a standard for judging physicians.
The manuscripts detail various therapeutic approaches. These include drug therapy, cauterization (e.g., using hemp refuse and mugwort on the crown of the head for inguinal swelling), lancing (implied before applying salves), and roasting substances or affected areas as part of treatments.
The texts also catalog materia medica, the substances used in the recipes. These include a diverse array of items: plants, animals, minerals, and prepared substances. Instructions are sometimes provided on gathering and processing these materials, such as drying plants in the dark or the sun, or smithing (grinding) ingredients. Examples of substances mentioned include shiwei (pyrrosia), dianji (asparagus), skullcap and licorice, curled cinnamon, monkshood, gecko, silkworm eggs/larvae, rooster feces, human sludge, mercury, bronze and copper bits, dung beetles, and rancid lard (often used in salves because it’s more viscous).
Nurturing Life: The Tradition of Macrobiotic Hygiene
A significant medical tradition represented in the Mawangdui manuscripts is Macrobiotic Hygiene (Yangsheng), meaning “nurturing life”. These texts are the first known examples of this literature dating from the 3rd and 2nd centuries B.C.. They were clearly intended for an elite readership, often framed as dialogues with idealized figures like the Yellow Thearch, King Wei of Qi, Rong Cheng, and Ancestor Peng. The central focus of these texts is on techniques.
The manuscripts discuss four main branches of macrobiotic hygiene:
• Dietetics: This involves techniques like “eliminating grain” (quegu) by consuming specific herbs (such as shiwei) or by ingesting vapor. The texts also provide numerous recipes for tonic drugs, foods, and beverages.
• Breath Cultivation (Xing qi): Techniques involve breathing exercises and ingesting vapor. These practices can include following seasonal regimens and specific instructions on classifying and interacting with atmospheric vapors. An ancient jade inscription (late Warring States) provides a technique for circulating vapor, which is paralleled in the Mawangdui texts. Descriptions often use esoteric and metaphoric language, forming a kind of secret language where terms like “still your spirit wind,” “make fast your two racks” (possibly the ribcage), and the “dark winepot” (saliva) represent specific actions or substances.
• Exercise (Daoyin): This branch is extensively documented, including drawings and descriptions of exercises used for treating ailments and cultivating the body. The Yinshu manuscript is dedicated to exercise theory and practice. It includes discussions of seasonal regimens, basic movements like the “measuring worm,” “tiger pulling,” and “pulling Yang”, exercise routines for specific conditions, and lists of which body parts each exercise benefits. Breathing is an integral part of these routines.
• Sexual Cultivation (Fangzhong): These are techniques focused on nurturing life through sexual practices. The manuscripts contain recipes, including those for aphrodisiacs for both men and women. They discuss classifying parts of the sex act and even include a labeled diagram of the female genitals. Like breath cultivation, the language is often esoteric and metaphoric, contributing to a secret language. Techniques described include “contract the anus,” “suck in the vapor to fill the womb,” and cultivating the process until the “mass of essence all ascends”. Discussions of the “ten pauses” in female arousal also appear. Interestingly, one text (MSIII.89) uniquely presents women in the role of experts instructing a male ruler.
The Role of Magic in Early Medicine
The Mawangdui medical manuscripts reveal a significant overlap between medicine and the occult. They contain a variety of magical elements. This includes magical recipes that incorporate exorcistic incantations, charms, and magico-religious operations. These magical elements are sometimes found interspersed with other medical recipes. While they address ailments, they also include remedies for everyday issues like securing a campsite during travel.
The incantations found in the manuscripts are generally intelligible, not simply nonsense words. They can take various forms, such as commanding entities, stating wishes, or describing magical actions. Examples include powerful phrases like “Spouter, spout ferociously. On high be like the sweeper star. Down below be like congealed blood…” used for infant convulsions, or the simple command “Pən, Lacquer” used for treating issues potentially related to lacquer, or the multi-syllabic utterance “Tsjəm tsjəm, hjəkw hjɔkw bugs…” used for scabies, and the direct statement “Today depart. If you do not depart, it will be bitter”. These multi-syllabic utterances appear to belong to a common stock of incantatory speech.
The texts also describe various magical devices and ritual acts. These include using specific objects like water, gourds, or plants, seemingly to contain or transfer demonic pathogens. Ritual actions can involve specific timing or orientation, such as incinerating vegetation from the upturned slope of a roof, spitting on a ladle, stroking with a ladle, rinsing and discarding liquid by a wall, scraping ash, chopping at pegs with a mallet, or performing exorcistic archery. Even the burial of the afterbirth could involve magical considerations, such as burying it beneath a Yin or Yang oriented wall to influence the child’s sex, burying it under a mat to prevent scabby itch, binding it with a cord handle from a steaming-pot, or avoiding specific hemerological periods (“Small Period” and “Great Period”) for burial according to charts attributed to Yu. The ritualistic “Pace of Yu” is also mentioned.
The pervasive presence of magical elements alongside physiological ideas and practical remedies highlights a blending of natural philosophy and occult thought within this fang-literature.
Reshaping Our Understanding
The Mawangdui Medical Manuscripts are nothing short of invaluable historical documents. They offer a window into an earlier stage of Chinese medicine than what was previously accessible through received texts like the Huangdi neijing. They demonstrate the remarkably diverse nature of medical literature during the period, incorporating sophisticated physiological theories, practical therapeutic methods, well-developed macrobiotic hygiene traditions, and explicit magical practices. The circulation of these texts among both medical specialists and the elite paints a complex picture of knowledge transmission and practice.
Studying these manuscripts fundamentally changes our understanding of early Chinese medicine and, indeed, reshapes our view of early Chinese civilization as a whole. With continued research and the potential for new manuscript discoveries, our knowledge of these ancient medical traditions will only deepen.