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Li Jianmin, S0025727300056751_inline1 Sisheng zhi yuS0025727300056751_inline2 (The Territory between Lifeand Death), Taibei, Academia Sinica, 2000, revised in2001, 435 pages incl. illustrations (ne binding edition,ISBN 957-671-703-5; ordinary edition 957-671-704-3).

Vivienne Lo

Medical History / Volume 47 / Issue 02 / April 2003, pp 250 - 258DOI: 10.1017/S0025727300056751, Published online: 16 November 2012

Link to this article: http://journals.cambridge.org/abstract_S0025727300056751

How to cite this article:Vivienne Lo (2003). Medical History, 47, pp 250-258 doi:10.1017/S0025727300056751

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Medical History, 2003, 47: 250-258

Essay Review

The Territory between Life and Death

VIVIENNE LO MhWiS*

Li Jianmin, A RG Sisheng zhi yu N LA (The Territory between Life and Death),Taibei, Academia Sinica, 2000, revised in 2001, 435 pages incl. illustrations (fine bindingedition, ISBN 957-671-703-5; ordinary edition 957-671-704-3).

Li Jianmin's richly illustrated book is thefirst monograph wholly devoted to mai R-R,which he identifies as the most fundamentalunit of the body for early Chinese medicaltheorists, and a primary measure for itshealth. Questions concerning how theconcept of mai emerge in historical andtechnical literature have importantimplications for our understanding of thedevelopment of classical Chinese theories ofhealth and acupuncture theory and practice.Sisheng zhi yu R L A is a seminalwork which draws together some 1,500primary and secondary sources that bearupon our understanding of mai at a criticalphase in the late Warring States and earlyimperial period (irca fourth to secondcentury BCE); for the first time Li Jianmingives a three-dimensional account of thecomplex arts and technical culture withinwhich the concept first developed, and withwhich it is inseparably intertwined. Thus thetask of this review article is to summarizehis findings for those who do not haveaccess to new trends in Chinese scholarship.

His title is taken from the entry for

* Vivienne Lo, The Wellcome Trust Centre for theHistory of Medicine at University CollegeLondon.

I am very grateful to Lois Reynolds for hereditorial expertise.

"Immortals" in a section of thebibliographical treatise ofA (History ofthe Former Han) that catalogues an eclecticselection of technical and medical arts,known asfangji )tAIk (remedies and skills).'The relevant sentence reads: "protect thegenuine in life and roam around searchingfor what is outside of it ... equalize theterritory between life and death" (emphasismine).2 Here are books on the physiology ofthe body, its xue &i (blood) and mai )L,which are also aimed at clarifyingdistinctions between life and death and theroots of all illness.The underlying argument of Li's book is

that the mai themselves are the technicalground that form that "territory betweenlife and death", and through whichimmortality might seem a tangible goal. Thepursuit of immortality in early China tookmany forms, some of which are documentedin the Hanshu bibliography: from massageand therapeutic movement to alchemy, sexand drug-taking, all in varying degreesconstituted paths to long life, and theavoidance of decay.

'Hanshu iM (History of the Former Han,compiled 58-76 CE) juan 30, Ban Gu *EIRI(32-92), Beijing, Zhonghua, 1996, pp. 1701-1780.

2Ibid., p. 1779.

250

In the last decade, Maixue 1Je (thestudy of the mai) has fascinated historiansof early Chinese medicine. Some translatemai as "vessel", others "channel",sometimes "pulse". But when mai comesfused, as it often is, with other Chineseterms the problems multiply. Jingmai £NI,together with jingluo ., fundamentalconcepts common in the canonical treatisesof Chinese acupuncture theory, Huangdineijing **Fs (the Yellow Emperor'sInner Canon), have been translated"conduit", "meridian", "circulation tract"and "vessel" as well. Then there are thedongmai Oft, literally the "moving" mai,not to be too closely associated with the"pulses" of Western medicine, and finallyxuemai IfiiJ1J (blood mai) or baimai -.)11i(one hundred mai), which more simply referto the "blood vessels". Yet the divisions ofstructure and function differentiated in theEnglish renderings of mai as "vessel" and"6pulse" may be an artefact oftranslation-of the inseparable developmentof anatomy and theory of blood circulationin the Western medical traditions and thechallenge has been to give a positiveaccount of the mai.3 Li Jianmin has nowgone a long way towards meeting thatchallenge.

It is commonplace understanding that theacupuncture body is a microcosm of theknown universe, a metaphor for structuresthat early Chinese found in Heaven andEarth. In Li's words the mai are "a field oftemporal spaces" that act as a pivot ofmany different worlds; at once analogous tothe rivers of China, to astronomicalmovements, to rivers of blood and channelsof communication, patterns against whichhuman disharmony with different

3Shigehisa Kuriyama, 'Varieties of hapticexperience: a comparative study of Greek andChinese pulse diagnosis', PhD diss., HarvardUniversity, 1986, pp. 58-100.

'Paul Unschuld, Nan-Ching: the classic ofdifficult issues, Berkeley, University ofCalifornia Press, 1986. The combined treatisesof the Huangdi neiing lingshu **AJg,949,

Review

environments could be judged. What Liadds to the field is a close examination ofhow, when and where that body wasconstructed. He reassesses assumptionsabout periodicity; finds geographicalvariation in the interpretation of the mai, aswell as three different stages of developmentdifferentiated by the influence of theoriesabout the movement of heavenly bodies, thepriorities of early Chinese forms of self-cultivation and the development of anumerological body with which one couldcalculate physiological movement andcirculation.Maixue is not a new field, and Li's study

is one of the latest in a long tradition ofscholarship, including a substantial pre-modem corpus of critical study. The earliestmay even date to Nanjing N (Canon ofDifficulties), an innovative andsystematizing circa second-century Chinesework, written to elucidate many of theproblems and inconsistencies that existed inthe Huangdi corpus.4 The latter body ofwritings comprises several compilations ofsmall texts dealing with separate topics,which may reflect the thinking in a distinctmedical lineage. It is now thought by mostEuropean and American scholars that thetexts were set down at the earliest in thesecond century BCE, but possibly in the firstcenturies CE. Collectively, they represent thekind of debate through which classicalmedical concepts matured.

Scholars working in the last century havetended to imagine a collective accumulationof knowledge about the body developinginto an empirically-based medical system.For example, in Celestial lancets Lu andNeedham imagine a golden age of"empirical" medical activity at the

Huangdi neijing suwen * IsW.irI andHuangdi neijing taisu *tPi;k* aregenerally considered to contain the core theoryof traditional Chinese medicine. Nathan Sivin,'Huang ti nei ching', in Michael Loewe (ed.),Early Chinese texts: a bibliographical guide,Berkeley, SSEC and IEAS, University ofCalifornia, 1993, pp. 196-215.

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foundation of classical theory, a scientificspirit that was ultimately stifled after theTang period (618-907) when "abstractiontrampled over empiricism" in the hands ofthose more learned in astrologicalcalculation than practical medicine.' Acherished view was that the replacement ofbian E (stone lancets) and other crudestone implements with finely drawn metalneedles was the catalyst that stimulated anew age of medical sophistication.6 LiJianmin and others represent a growingnumber of scholars who prefer not toemphasize continuities in Chinesetechnological culture and favour adifferentiation of the historical layering ofmedical knowledge and experience. There isnow considerable doubt about the narrativeof "trial and error" in the discovery ofacupuncture channels and loci, and it hasbecome a matter of academic rigour to findnew ways of re-framing the essentialquestions.The core of Li's thesis is that the

development of mai was motivated by thepervasive culture of shushu OM (literally,numbers techniques), the art of"calculation". Shushu is a peculiarly Chinesenotion of "numbers" used in thecomputation of "celestial patterns" at thefoundation of the astro-calendricaltraditions. Different forms of shushu culturepervade all aspects of life in early China,and in Han times embrace types ofdivination using Yinyang MM and the

5Lu Gwei-Djen and Joseph Needham,Celestial lancets, Cambridge University Press,1980, p. 141.

6Lu Shouyan 9 , Lu Shouyan Zhenjiu lunzhu yian xuan VAi+*- R*i! (LuShouyan's Selection of Acupuncture Cases),Beijing, Renmin weisheng, 1984, p. 1.

'See Michael Loewe, Divination, mythologyand monarchy in Han China, CambridgeI Iniversity Press, 1994, and Marc Kalinowski,'Les Instruments astro-calenderiques des Han etla methode liu ren', Bulletin de l'Ecole FranVaisede l'ExtrtCme Orient, 1983, 72: 309-419.

8 Li Jianmin, 'Suibing yu changsuo: chuantongyixue dui suibing de yi zhong jieshi'

wuxing HIT (five phases), the "turtle andmilfoil", physiognomy, the determination ofauspicious times and places, as well as typesof exorcism, omenology, etc.7 Onceassociated with the numerological sequencesof shushu calculation, the routes andchannels around the body defined as maiopen out into Li's "field of temporalspaces": each of the mai has designationsrelating Yin and Yang (Great Yin mai,Great Yang mai, Lesser Yin mai, etc.),terms that can refer to the dark and sunnyaspects of a mountain, but equally describethe phases of the sun and moon-thuscreating the essential spatio-temporalframework for the body to become a vesselfor circulating qi and blood.Where Lu and Needham refer to a

"characteristic noise or redundance", whichalways accompanies the growth ofsystematic classifications in all cultures,more recently historians tend to concentratetheir attention on the elements of medicalpractice that did not succeed in becomingpart of a canonized tradition. Li Jianmin isat the forefront of research into losttraditions of the late Warring States andearly imperial medical cultures and thedoctors and diviners that worked with theirtheories. He is well known for his work onthe early literature on remedies, on humandissection as spectacle, and the history ofthe occult arts, such as seduction, or ideasof contagion through demonic influences.8His work follows in the wake of those

(Demonic Illnesses and 'Place': OneExplanation of Family Medical Attitudes toDemonic Illness), in Hanxue yanjiu *YWf5ft,1994, 12 (1); 'Furen meidao kao-chuantongjiating de chongtu yu huajie fangshu'kM}A): e {bIT#1 (The

Art of Charming for Women: Traditional FamilyConflict and Magical Techniques), inXinshixue VT*, 1996, 7 (4); 'Zhongguo gudai"jinfang" kaolun' +RP &ftWt;VA(Examination of ancient Chinese 'restrictedremedies'), in Zhongyang yanjiu yuan lishi yuyanyanjiu suo jikan AiJEliJ,1997, 68 (1); 'Wang Mang yu Wang Sunqing jigongyuan yi shiji de renti kubo shiyan'zE#043EI -AX;W.E9t§JJS

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scholars such as Li Ling, Sakade Yoshinobuand Donald Harper who have pioneeredresearch into all those elements of medicineconsidered superstitious, and thereforeirrelevant, by the last generation ofscholars.9 Recent debate has centred onhow, where and when philosophy and thetechnical arts came to be based upon thesesystems of astrological calculation. In awell-known reference to Yi He R1IiI, thePhysician He, we have a recurring theme ofHeaven above, represented by the numbersix, and by Earth below five, "the six qi I[Yin, Yang, Wind, Rain, Obscurity andBrightness] which descending generate fiveflavours, emit as the five colours, and findfulfilment in the five sounds".'0 Thenumbers are restated in Guoyu gLRr(Dialogues of the State: fifth to fourthcenturies BCE), i/X1i3i,ttPJ(Heaven being six and Earth being five isthe rule in calculation). Here are the initialseeds of many numerological correlationsconcerning qi and Yin and Yang which areultimately integrated into different systemsat the foundation of this concept of mai.Eventually the same sequence can be foundin the linking of bowels and viscera to thechannels through the wuzangliufu afI AJt (five viscera and sixbowels) system.On the face of it, the shushu calculations

may look like a numbers game, but as Liexplains, they are at once both functional indaily medical practice and inherentlypowerful, in that they contain a way ofordering the mysteries of the universe. Heplaces the focus for this medical innovationfirmly in the anachronistic concept of a

(Wang Mang and Wang Sunqing Recording aFirst-Century Experiment in HumanDissection) W*5 Xin Shixue, 1999, 10 (4).

'Li Ling 2, Zhongguo fangshukao rPN5V- (An Examination of ChineseTechnical Arts), Beijing, Renmin Zhongguo,1993; Sakade Yoshinobu, Chiigoku shisokenkya iyaku yoseilkagaku shiso hen+ P9 1381,K f5L t- k* ~t - ,4*,%V (Studyof Chinese Philosophy: Volume of MedicinalRegimen/Scientific Thoughts), Osaka,

tianguan )it (Bureau of the Heavens),thought to be responsible for imperialceremony, and idealized in Zhouli MR M(Ceremonies of Zhou: second century BCE?).If the ruler does not carry out the imperialrites according to the changes of season, thepeople will become ill with liji ,seasonal epidemics (li sometimes refers to aleprosy-type illness) or ulcerous swellings.More reliable records relating to the actualadministration of Han ritual affairs refer toan Office of the Grand Astrologer, Tai shiling ; responsible for generating theshushu categories in the bibliographicaltreatises of Hanshu." Li points out that thefang/i }ftA (remedies and skills) category ismodelled on the observances of a Bureau ofHeaven, linking iatromantic skills of thephysician (prognosis and prediction of thecourse of an illness) with the numerologicalsequences thought immanent in the naturalworld. If it were possible to establish rulesabout the movement of the sun and moon,and the courses of rivers and waterways, therules would also apply to physiology, and inthe case of the mai navigating routesaround the body through which blood andqi flowed.The 'Jingmai' 00 treatise of the

Huangdi neijing lingshu is the locus classicusfor the twelve channels of acupuncture thatremain in the modem repertoire oftraditional Chinese medicine (TCM), andlink to the viscera and bowels. Differenttreatises follow which focus on separateconstructions of the body channels such as"Jingshui" .W*k linking body channels tothe waterways of China."2 Adding to thetransmitted canons, newly excavated

Kansai Daigaku shuppan bu, 1999; and DonaldHarper, Early Chinese medical literature: theMawangdui medical manuscripts, London, KeganPaul International, 1998.

Translated in Angus Graham, Disputers ofthe Tao, La Salle, IL, Open Court, 1989, p. 325.

" See Goh Thean Chye, The history of theChinese Astronomical Bureau, MA thesis, KualaLumpur, University of Malaya, 1967. Microfilm:Rochester, Eastman Kodak Co, 1969.

12 See note 4 above.

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manuscripts, as well as images andartefacts, have changed the nature ofresearch into the history of Chinesemedicine in both early and medievalperiods. Four manuscripts excavated atMawangdui tomb 3 (buried 168 BCE) andZhangjiashan tomb 247 (c. 186 BCE) inHunan and Hubei respectively (the formerkingdom of Chu M), describe eleven mai"channels" that chart the course of diversephysical phenomena.'3 These channels havebeen related to blood vessels, muscularsomatography, various types of illness, aswell as sensory experiences of the body,including pain, passion and pleasure.'4Modern scholars, both in China andabroad, were excited to find in themanuscripts what appeared to be earlyversions of the jingmai channels of theHuangdi neijing lineage. Indeed, theZhangjiashan manuscript, Maishu Ji*(Book of mai c. 186 BCE) is the earliesttreatise to set out both principles andpractice of acupuncture, if we assume thatthe art involved piercing the body tonormalize a flow of qi. But the excavatedtexts do not link the channels to the visceraand bowels, and have no mention ofacupoints or formal circulation of qi.

Until recently, a pervasive assumptionwas that the three Huangdi neijingcompilations that make up the Huangdicorpus (suwen, lingshu, taisu) date to theWarring States and form part of thetestimony to a critical transformation ofmedical ideas due to the work ofdistinctive medical lineages, rather thanevidence of further and separatelydistinctive medical developments through

"For a description and translation of allthe manuscripts, see Harper, op. cit., note 9above.

14 See MVvienne Lo, 'The influence of nurturinglife culture on early Chinese medical theory', inElisabeth Hsu (ed.), Innovation in Chinesemedicine, Cambridge University Press, 2001, pp.19-50, idem, 'Crossing the Neiguan MJN "InnerPass"-A neilwai d9* "Inner/Outer" distinctionin early Chinese medicine?' in EASTM, 2000, 17:15-65.

the Han.'I But we must be cautious ofdating the excavated manuscripts in theirrelationship to an unconfirmed dating of theHuangdi corpus. Li sets out four criticalquestions: first, he asks why the tombowners should collect antique texts; second,he makes the point that it is inappropriateto confuse popular and scholarly works onthe mai, when it is clear that texts ofvarying sophistication were simultaneouslyin circulation; third, he emphasizes thedanger in trying to trace linealdevelopments when there is evidence ofmany systems of mai; and finally he arguesthat the relative sophistication of thediagnosis seen in Sima Qian's 1J;I(?145-?86 BCE) biography of the Hanphysician Chunyu Yi 4iTs, co-exists inthe Western Han period with a cruderpractice exemplified in household medicalbooks excavated from the Chu graves-thusemphasizing medical pluralism.'6

Li provides a labyrinth of charts andreferences laying out the many differentconstructions of channel theory which varyin the number of channels, their titles androutes. In his analysis, for example, are theten lines drawn on a small woodenlacquered figurine (c. 118 BCE) excavatedfrom a late Western Han tomb nearMianyang in Sichuan. One line whichtraverses the head laterally is unique, withno known analogue in any other source.'7

Li describes a sudden breakthrougharound the time of transition between theZhou and Qin periods (late third centuryBCE), concurrent with the establishing of thefirst empire. It is certainly at this time thatwe find the emergence of a new technical

'5Yamada Keiji di , 'The formation ofthe Huang-ti Nei-ching', Acta Asiatica, 1979, 36:67-89.

16 Shiji ZA (Historical Record) Beijing,Zhonghua shuju, 1996, 105 ed., pp. 2751-83. Fora discussion of Chunyu Yi's pulse diagnostics, seeElisabeth Hsu, 'Pulse diagnostics in the WesternHan', in Hsu (ed.), op. cit., note 14 above, pp. 51-91.

7 Vivienne Lo, 'Spirit of stone: technicalconsiderations in the treatment of the jade body',Bull. SOAS, 2002, 64 (3): 124-6.

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language, containing all kinds of theoriesconcerned with mai underpinned by theframework established by the arts of shushu,and different categories of medicalpractitioners. In traditional histories theorigins of acupuncture are intricatelyworked into the legend of Bian Que, a cultfigure associated with a human headed bird.His name, together with the YellowEmperor and the mysterious Baishi I ,"Mr White", are all listed in the titles ofmedical literature in the Hanshubibliographical treatise. Apart frommythical figures, Li also identifies scholarphysicians in the service of elite households,yi , as well as other figures known as wuA and a group known as fangshi tI .

The epithet wu is commonly rendered inEnglish as "shaman" or "spirit medium"and refers to those who specialized intechniques such as incantation designed tocommunicate with the gods and spirits, aswell to aid such skills as divination.Shuowen, a first-century lexicon, states, wuzhu ye J{5?*t!, "the wu are 'invocators"' 18One of the strengths of Li Jianmin's study

is his analysis of the geography of mai: hemaintains that the knowledge systems of thewu and yi differ. One theory places theorigin of acupuncture and moxibustion inthe Yellow River cultural area of centralChina, particularly in the Eastern territoriesof Qi , around modern Shandong, andmateria medica in the lower reaches ofYangzi river, while decoctions were thoughtindigenous to the Jiangnan region aroundmodern day Shanghai. Li Jianmin finds thatthese idealized models are not corroboratedby material evidence; the tomb texts on themai, for example, were discovered in theformer southern kingdom of Chu M, in thelower reaches of the Yangzi valley, whereasthe lacquer figurine was found in south-westChina at the edge of the foothills of Tibet.

Li emphasizes the differences between yi

8Shuowen jiezi zhu &t -it, Shanghai,Guji, 1981, 5a, p. 201.

'9Li Shaojun 2l , for example, wasparticularly famous for his medical skill, and was

and wu. Empirical medicine practised by yi,Li believes, was different to the skills of wu.No arrow, he says, can be drawn from thebody with incantation. But there is nodoubt that medical skills associated with thesupernatural ranked equally with medicinebased on correlative cosmology. Sima Qiandescribes how Bian Que receives secretrecipes from his teacher, but, as well astexts, he is given a potion, which confersextra-sensory vision so that he can seethrough walls. The record says that histeacher was "probably not human". Thefirst emperor is reputed to have executed460 scholars and ordered that all Confucianclassics should be burned in 212/213 BCE,but exempted those on medicine, pharmacy,divination by tortoiseshell and milfoil, andall agricultural treatises technical mattersthat were of practical use in his pursuit ofpower and long life. Some men fromYan t% and Qi * advised him on elixirs ofimmortality, others on the power of thewuxing, "five agents", and its relationship topolitical legitimacy. Some gave advice onhow to hide from evil spirits. Many of hisadvisors on immortality, alchemy and spiritworld were given great privilege."9 In theclamour for position at court it is easy toimagine how those engaged in a medicineinvolving the spirits could come into conffictwith scholars and literati who also laidclaim to serving the elite with very differenttheories of illness. If Li is justified indescribing a polarization of wu and scholarphysicians on the basis of their professionalactivities and of the educated elite'smarginalization of those who communedwith the spirits, the case is not so clearwhen we review the research on fangshi, aterm which covers all kinds of people and abroad range of skills. Thesefang refer topharmacological prescriptions, to divinationor ritual interdiction a collection ofheterodox arts. The status of the scholar

rewarded well for his ability to control spirits andfor his dietary and longevity techniques. Hecollected a large number of followers. Shiji, op.cit., note 16 above, p. 1385.

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physicians was largely founded on thepossession offang. The fangshi "gentlemenof recipes" might be any of those peoplewho generated, used or sold skills based onthe myriad techniques labelled fang. In theexplosion of technical literature of late thirdand early second centuries BCE, skillsassociated with popular religion were alsodocumented and so they too are apparentlya part of a scholarly medical tradition.Members of elite households in early Chinawere collectors of manuscripts of a technicalnature, and participated in the generationand transmission of a wide variety ofmedical knowledge. What might seemretrospectively to be high and low medicaltraditions find a common home in theirlibraries.

Despite Li's emphasis on the dominanceof shushu theory as an innovating force, heacknowledges that there is more in theconcept of mai than observation of theheavens, and that the course of eachchannel is intrinsically linked to the siteswhere pulses can be felt. Ancient physiciansknew they could examine the condition ofthe body's qi through the rhythm andqualities of the pulse. In Maishu we notonly find the first treatise to set out how topierce the body in order to normalize theflow of qi, but also to relate pulse qualitiesto symptoms emerging on the course of thechannels. The last section of the treatise is asingle passage that juxtaposes pathologicalqualities of the pulse such as ying a(overflowing) and xu A (empty), hua '(smooth) and se i (rough), jing # (quiet)and dong J (agitated), and reflections of apathological relationship in the channelswhere one guo i!!! "over-reaches" or"transgresses" another in some way.Case histories offer a more comprehensive

window onto pulse diagnosis in WesternHan times. Chunyu yi's biography listsrecords of a learned physician as he roamsaround wealthy households in the provinceof Qi * touting his medical skills to thenobility and their servants. A self-proclaimed expert in pulse diagnosis, he

refers to additional pulse qualities signifyingdepth, size, speed, relative dryness/dampness, clarity and strength.The growing body of early excavated

literature testifies to an association ofscholarly medical traditions with divinationand numerological techniques (shushuculture), with magic, ritual incantation,yangsheng # (literally nurturing life) formsof self-cultivation, meditation andprescriptions made up of every conceivableherb, animal and household substance. Self-cultivation, in this context, refers to thosetechniques broadly aimed at physicalcultivation and longevity. The practicesdocumented in Western Han medicalmanuscripts alone include therapeuticgymnastics, dietetics, breath- and sexual-cultivation. In its focus on preserving andstrengthening the body, yangshengconstitutes an important branch of medicalliterature. In Li's theory about the threestages of evolution of the mai, he places theinfluence of yangsheng 1 after the phasein which astrologers and ritual specialistsordered and differentiated the bodyaccording to the movements of heavenlybodies. Self-cultivation pursuits of the earlyChinese elite constitute a form of seasonalregimen, designed to adjust human routinesto the changing environment of the year.Many are practical measures concernedwith hygiene, sleep, diet and physicalcomfort. Daoyin 4 g I (leading andguiding), at its most basic level, is aimed attreating pain and keeping all the jointsmobile as well as at cultivating inner qi, theessential "stuff of life" that animated andinvigorated the body.20 Li demonstrates howthe concept of qi travelling through mai wasultimately clarified in self-cultivationpractice, where adepts would consciouslyproject and rotate it around the body.There is evidence in the excavated

manuscripts of a medical tradition led andshaped by bodily experience, rather thanclinical observation. Recording the course

20 See Lo, op. cit., note 14 above.

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of pain, as well as other phenomenologicalperceptions of the body, played animportant role in laying out the pathwaysof the mai.2' To emphasize the contrast withChinese ways of knowing the body,Kuriyama describes how each cultureprivileges different styles of seeing. Heargues that complexion diagnosis, the art ofseeing disharmony in the aura of the face,was rooted in botanical metaphors longestablished in the language and culture ofearly China. Like the blossom of a flower,the complexion was the visible expression ofthe strength or weakness of the underlyingorganism. Kuriyama distinguishes betweenhaptic knowledge in the different traditions.Contrasting palpation of the mai and theknowledge of the pulse that begun in theGreek medical tradition, he emphasizes howthe most immediate experience of the bodyis constantly subject to a relationship withtheoretical preconceptions distinctive to aparticular culture.22

Li Jianmin takes a fresh look at thedevelopment of new tools, such as thosedescribed in 'jiu zhen lun' Af+0 (NineNeedles treatise) of the Huangdi neijinglingshu. It has been thought that theemergence of drawn metal needles such asthe hao zhen, fashioned to be "as thin asan autumn hair", ushered in a new age ofmedicine where treatment at finely locatedacupuncture points replaced the cruderlancing stones. Li, characteristically,provides us with a more complex picturein which many forms of body piercingand tools appropriate to different practicalcontexts co-existed, and were permeatedwith priorities based in the arts ofcalculation. Much of the therapy detailed

21Vivienne Lo, 'Tracking the pain: Jue and theformation of a theory of circulating qi throughthe channels', in Sudhoffs Archiv, 1999, Bd 83:191-211.

2 Shigehisa Kuriyama, The expressiveness ofthe body and the divergence of Greek and Chinesemedicine, New York, Zone Books, 1999; see alsoSarah Allan, The way of water and sprouts ofvirtue, Albany, SUNY Press, 1997, and Catherine

in the Huangdi neijing compilation,amounts to little more than petty surgery,blood-letting and massage. Only thehaozhen ]i+, the chanzhen *i+ andthe yuanlizhen 0 *Ji± "round sharpneedle" of the "nine needles" were usedto pierce the body to influence conditionsof qi pathology.23For Li Jianmin the significance of the

Nine Needles treatise is that it shows howthe priorities of "the arts of calculation" areworked out in the minute details ofpractice. Each of the nine needlescorresponds to numerological sequencesattributed also to parts of the body: the firstresonates with the skin, the second with theflesh, the third with the mai, the fourth withthe sinews, etc. The more subtle needles canmove the spirit.

Li Jianmin starts with the framework fora metaphorical body that was determinedby the ceremonial priorities of governance,the mai were enlivened and invigorated bythe practice of circulating qi in self-cultivation, and calculated by the"gentleman of remedies" working in thetechnical arts. If the idea of channels arosein an accumulation of knowledge about thepulse, in theorizing about the experience ofpain, pleasure, and emotion, thesystematizing of numerical priorities camewith the pervasive influence of shushuculture. The number of pulses, routes ofmai, viscera and bowels, orifices, thecirculation of qi, and medical equipment,every nook and cranny of the human bodyand its physiological processes werecalculated down to the very last digit. Withthe combination of observation andexperience of the body and a numerologicalcertainty legitimized by the movements of

Despeux, 'From prognosis to diagnosis of illnessin Tang China', in Vivienne Lo and ChristopherCullen (eds), Mediaeval Chinese medicine(forthcoming).

23Yamada Keiji, The origins of acupuncture,moxibustion and decoction, Kyoto, Nichibunken:International Research Centre for JapaneseStudies, 1998.

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heaven and earth, the mai became the finalterritory of life and death, upon whichphysicians could not only diagnose and

treat most disorders of the human body, butalso predict the course and outcome ofevery illness.

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