Extrême-Orient, Extrême-Occident 21 - 1999

Physicians and Diviners : The Relation of Divination to the Medicine of the Huangdi neijing (Inner canon of the Yellow Thearch)

Donald Harper

There is general agreement that the Huangdi neijing (Inner canon of the Yellow Thearch) reflects medical ideas and practices around the first century B.C. l. The theoretical insights of its physician-authors and their advocacy of acupuncture are well known, as is their skepticism of magico-religious viewpoints. Two negative appraisals from a Suwen (Essential questions) passage on being a physician are indicative 2 :

He who is enthralled by demons and spirits cannot be told about supreme virtue ; he who is maladroit with the needles and stones (of acupuncture) cannot be told about supreme skill. .

Conversely, we could state in the affirmative that the ideal physician envisioned in the Inner Canon combines « supreme virtue » (zhi de) with « supreme skill » (zhi qiao) : his personal cultivation and his medical practice mesh perfectly. This ideal puts the physician and his mastery of medicine on a par with the sage in the Yijing (Canon of changes), whose accomplishment is owed to the wisdom embedded in the system of the Yi (Changes) 3 :

The Changes, is it not supreme ? For the Changes is what the sage uses to exalt (his) virtue and to expand (his) enterprise.

To espouse ideals is well and good ; it defines the ground of professionalism. In the centuries following the Han dynasty (206 B.C.- A.D. 220) the notion of the physician as sage (paralleling the doctrine of the sage in the Changes) became an article of faith in medicine, and relevant Inner Canon statements on the subject provided the necessary classical precedent. However, in the second and first centuries B.C. the physician- authors of the Inner Canon were still justifying what was at that time a new conception of medicine which integrated physiological theory and pathology (the idea that illness was a physiological dysfunction involving the qi « vapor » within the system of mai « vessels » and internal organs). The Inner Canon assumes the existence of competing