Galen Anderson
Introduction to Chinese Medicine
2/11/26
Theoretical understandings of the underlying causes of health issues in early China within Huang Di nei jing su wen and The Great Granarian are similar in their connections of health issues to behavior. Broadly, both understand health issues to come from disruptions in qi. The difference between the two is the way the qi disruption occurs and what kind of disruption occurs. It is written as to why lifespans have decreased since ancient times: “The fact that people of today are different is because they take wine as an [ordinary] beverage, and they adopt absurd [behavior] as regular [behavior]. They are drunk when they enter the [women’s] chambers. Through their lust they exhaust their essence , through their wastefulness they dissipate their true [qi]… They make every effort to please their hearts, [but] they oppose the [true] happiness of life… Hence, it is only one half of a hundred [years] and they weaken”. Here comes to stand the idea of the disrupted and non disrupted flow of qi.
The people of today are described as engaging in behavioral patterns that lead to the dissipation of qi, including drinking to excess and drinking while having sex. These behaviors are further described as a demonstration of opposition to the true happiness of life ultimately leading those who carry them out to live less long. There is an implication within Huang Di nei jing that behaviors not aligned with the way, like the waste of qi and drinking improperly will lead to health problems, whereas those aligned with the way will secure conditions of health. It is written: “If one follows the Way in all honesty and if, therefore the essence is kept inside, no evil qi is able to cause harm.”
Within The Great Granarian, an understanding of the causes of health issues is evident. In the description of the first case handled, Ch’eng the Attending Secretary of Ch’i became ill, was declared to in eight days days die from his ju-abscess, soon to become a yung-clog. In this scenario nothing was done, but the causes of his issues were avoidable, the same disruptive behaviors that caused those written about in the Huang Di nei jing to live only half of a hundred. The means by which he came by his health issues: “Ch’eng’s illness was contracted from wine and women… The [qi] [coming] from the liver, despite being murky, was still. This is a disorder of the interior being closed off.” The similarities between The Great Granarian’s account and Huang Di nei jing’s account are in the root cause of the health issues as being wine and women, The Great Granarian breaks with Huang Di nei jing’s description of the issue as being one of dissipation of qi, instead identifying the root of Ch’eng’s illness as being the stillness of the qi.
Describing the methods of diagnosis of Ch’eng’s illness there is further description of what led to this issue becoming prevalent: “The linking vessels govern the illness. At that time, the minor yang [at the place] where it begins, was closed by one fen… Hence when it [the closure] was above two fen, us was emitted; when it reached the boundary, there was a yung-clog swelling… If the flowing links are stirred , then the nodes of the vessels burst open. If the vessels burst open, then the spoilage disperses. Hence the links intermingled.” This passage is another instance of the primary disagreement between the two sources about what governs health, specifically whether it is primarily the interaction of qi with the outside environment as Huang Di nei jing suggests in the selection stating that a guarding of qi protects from external threats, or instead internal interaction between bodies like the flowing links and nodes. This is important because it could lead to a better understanding of the differing actions taken by readers of the two texts in isolation and together.
While readers of both texts might choose to closely monitor their consumption of alcohol and in what contexts they have sex, understanding that both done out of moderation or done for the wrong reasons could lead to a disruption of qi, a practitioner of medicine might instruct differently individuals with health issues. With a focus on Huang Di nei jing there may be in turn a focus on how the individual might change their behavior to be more in line with the Way. With a focus on The Great Granarian’s diagnostic accounts, there may be a suggestion of actions that affect internal conditions more directly, like the consumption of medicine or broth, which is what is done to cure or alleviate other health issues later in the text, like that of Hsun’s numbness.
The dialogue between practitioners of Chinese medicine is one that continues to this day, differing experiences diagnosing, describing, and treating health issues bring along conversations about the right and wrong way to treat patients. Ultimately these discussions are what make the field more dynamic, unlike many other scientific discussions, the collection of information does not mean the refutation and dismissal of sources that engage differently, it means understanding that they may be describing the same thing, just through a different lens.