Huangdi Neijing

Huangdi Neijing, Yellow Thearch's Inner Classic, is the seminal medical text of ancient China. The theoretical foundations for Chinese Medicine are systematically covered. The work is composed of two texts each of eighty one chapters or treatises in a question and answer format between the mythical Huangdi (Yellow Emperor or more correctly Yellow Thearch) and his ministers.

The first text, the Suwen(素問), also known as Plain Questions, covers the theoretical foundation of Chinese Medicine, diagnosis methods and treatment methods. The second and generally less referred-to text, the Lingshu (靈樞), Spiritual Pivot, deals with acupuncture in great detail. Collectively, and strictly speaking, these two texts together, the Suwen and Lingshu are known as the Neijing or the Huangdi Neijing. Though, because the Suwen is much more widely quoted and referred to, the title Neijing often in practice refers to just the Suwen.

Overview
The most important ancient book of Chinese medicine as well as a major book of Daoist theory and lifestyle is the Yellow Emperor's Classic of Medicine (Huangdi Neijing, 黃帝內經), said to have been compiled by the mythical Yellow Emperor 黃帝. It consists of two parts, the Suwen 素問 "questions of fundamental nature" and the Lingshu 靈樞 "spiritual pivot" ( a book also called Zhenjing 針經 "Classic of Acupuncture" because the latter is its main content). The book is structured as a dialog between the Yellow Emperor and His advisors. Huangdi and His advisors should be considered fictional—they are needed for the question and answer format predominant in the Neijing. This format links together otherwise disjointed texts and is possibly useful for the (anonymous) authors to avoid attribution and blame. (See pages 8-14 in Unschuld for more on these topics.)

The Neijing departs from the old shamanistic beliefs that disease was caused by other worldly influences. Instead the natural effects of diet, lifestyle, emotions, environment, age and heredity are the reason diseases develop. The universe is composed of various forces and principles, such as Yin and Yang, Qi and the Five Elements (or phases). These forces can be understood via rational means and man can stay in balance or return to balance and health by understanding the laws of these natural forces. Man as is a microcosm that mirrors the larger macrocosm. The principles of yin and yang, the five elements, the environmental factors of wind, damp, hot and cold and so on that are part of the macrocosm equally apply to the microcosm that is man.

Dating of
The scholar Nathan Sivin (University of Pennsylvania professor of Chinese culture and history of science) is of the opinion (1998) that the Suwen and Lingshu probably date to the 1st century BCE. He does not go into detail other than mentioning the Mawangdui excavations. Sivin (1998) is also of the opinion that "no available translation is reliable."

In pages 89-90 of the book Celestial Lancets (first published in 1980), authored by the highly respected scholars Joseph Needham (1900-1995) and Lu Gwei-Djen (1904-1991), it states that the consensus of scholarly opinion is that the Suwen belongs to the second century BCE. They further state that evidence shows that the Suwen is earlier than the first of the pharmaceutical natural histories, the 神農本草經 Shennong Bencao Jing (Divine Husbandman's Classic of the Materia Medica). So suggestive are parallels with third and fourth century BCE literature that doubt arises as to whether the Suwen be better ascribed to the third century BCE, implying that certain portions of the Suwen may be of that date. The dominant role the theories of yin and yang and the five elements play in the physiology and pathology means that these medical theories are not older than about 320 BCE.

The German scholar Unschuld states several twentieth century scholars are of the opinion that the language and ideas of the Neijing Suwen were composed between 400 BCE and 260 CE. Further, versions existing today are a simply the last in a series of compilations and that none of the versions that exist today are identical to the texts of the same name from the Han Dynasty (206 BCE–220 CE) era. (See Unschuld pages 1-3 and Sivin page 68 in cited references below.)

Lü Fu (呂複), a fourteenth century literary critic, was of the opinion that the Suwen was compiled by several authors over a long period. It contents were then brought together by Confucian scholars in the Han Dynasty era. (See page 1 in Unschuld.)

Wang Bing Version
In 762 CE Wang Bing finished his revision of the Suwen after laboring for twelve years. Wang Bing collected the various versions and fragments of the Suwen and reorganized it into the present eighty-one chapters (treatises) format. (Note, treatises seventy-two and seventy-three are lost and only the titles are known.) Originally his changes were all done in red ink, but later copyists incorporated some of his additions into the main text. However, the 1053 version discussed below restored almost all of his annotations and they are now written in small characters next to the larger characters that comprise the main or unannotated Suwen text. (See Unschuld, pages 40 and 44.)

According to Unschuld (pages 39 and 62) Wang Bing's version of the Suwen was based on Quan Yuanqi's (early six century) commented version of the Suwen consisting of nine juan (books) and sixty-nine discourses. Wang Bing made corrections, added two "lost" discourses, added seven comprehensive discourses on the five phases and six qi, inserted over 5000 commentaries and reorganized the text into twenty-four juan (books) and eighty-one treatises. (See Unschuld pages 24, 39 and 46.)

In his preface to his version of the Suwen, Wang Bing goes into great detail listing the changes he made. (See Veith, Appendix II and Unschuld pages 41-43.)

Not much is known about Wang Bing's life. He authored several books, but is best known for his work on the Suwen. A note in the preface left by the later editors of the Chong Guang Bu Zhu Huangdi Neijing Suwen (version compiled by 1053 editorial committee) which was based on an entry in Tang Ren Wu Zhi (Record on Tang [Dynasty] Personalities) states that he was an official with the rank of tai pu ling and died after a long life of more than eighty years. (See Unschuld, page 40. Also see Veith, Appendix I for a translation of an abstract from the 四庫全書總目提要 Siku Quanshu Zongmu Tiyao about both the Huangdi Suwen and Wang Bing.)

Authoritative Version
The "authoritative version" used today Chong Guang Bu Zhu Huangdi Neijing Suwen 重廣補註黃帝內經素問 (Huangdi Neijing Suwen: Again Broadly Corrected [and] Annotated) is the product of the eleventh century Imperial Editorial Office (beginning in 1053 CE) and was based considerably on Wang Bing's 762 CE version. (See pages 33-66 in Unschuld). Some the leading scholars who worked on this version of the Suwen were 林億 Lin Yi, 孫奇 Sun Qi, 高保衡 Gao Baoheng and 孫兆重 Sun Zhaotong.

For images of the Chong Guang Bu Zhu Huangdi Neijing Suwen printed in the Ming Dynasty (1368-1644 CE) see the external links section below.

Recent Studies
Recently (2003), the Chinese medicine history scholar Paul Unschuld, Hermann Tessenow and their team at the Institute for the History of Medicine at Munich University have translated the Neijing Suwen into English including, an analysis of the historical and structural layers of the Suwen. No publishing date has been given for this multi-volume work. (See Unschuld, pages x-xi.)

Significant portions of the above Suwen translation (but with only a fraction of the annotations) are currently available in Huang Di nei jing su wen: Nature, Knowledge, Imagery in an Ancient Chinese Medical Text. (See Unschuld in cited references below.)

Comparison and Critique of English Translations (Partial List)
Note, none of following listed translations are perfect, they each vary in their interpretation of the text, but by comparing and combining individual translations a workable result can be obtained. The translations are organized below by type of translation. (Note, some of the translations listed are only partial translations.)

 Sinological Translations


 * Handbooks for Daoist Practice, translated by Louis Komjathy. Ten volume set of pamphlets, where volume three of the set is Yellow Thearch’s Basic Questions. Only the first two discourses out of the total eighty-one are translated.  A technical translation, with a good introduction giving the history of the text and an explanation of some of the more of technical terminology present in the first two chapters.  Credentials: Sinologist and Daoist scholar. He received his Ph.D. in religious studies from Boston University under Daoist scholar Livia Kohn.

'''TCM Style Translations


 * The Medical Classic of the Yellow Emperor, translated by Zhu Ming, Foreign Language Press, Beijing, China, 2001, 302 pages. ISBN 7-119-02664-X.  An edited version of the Neijing with the treatises reordered by topic.  About a 20-25 percent of the Neijing (both Suwen and Lingshu) is translated.  Includes annotations and commentaries by translator.  Contains a Chinese-English glossary of important terms. Credentials: doctor of TCM from Hunan College of Traditional Chinese Medicine, plus many years of clinical practice.


 * Yellow Empero's [sic] Canon of Internal Medicine (stated to be Wang Bing's version, but a quick examination shows it to appear to be identical to the authoritative version, but without the commentary), translated by Nelson Liansheng Wu and Andrew Qi Wu. China Science & Technology Press, Beijing, China, 1999, 831 pages.  ISBN 7-5046-2231-1. Complete translation of both Suwen and Lingshu.  Contains the Neijing text in simplified Chinese characters, along with alternate variants of Neijing text (also in simplified characters).  The alternate variants of the Neijing are not translated, only the main version is translated.  None of the commentary by Wang Bing is translated.  Incorrectly translated in places along with additional "commentary"  inserted into the translation, but not labeled as such.  No notes. Credentials: unknown.

Medical History Translations


 * Huang Di nei jing su wen: Nature, Knowledge, Imagery in an Ancient Chinese Medical Text, Unschuld, Paul U., 2003. University of California Press, Berkeley and Los Angeles, California. ISBN 0-520-23322-0. Analysis and history of the Suwen.  Includes significant portions of the Suwen translated into English. Unusual terminology choices, such as the non standard translation of "營氣 ying qi" as "camp qi," instead of the more commonly accepted "construction qi."   Instead of translating 脈 mai as "pulse," Unschuld translates it as "[movement in the] vessels" or something similar.  (Note, 脈 mai means both "vessels" and "the pulse."  By context one can tell if vessels or pulse is meant.) In treatise seventeen he translates 切脈動靜 qie mai dong jing as "squeeze the vessels, whether [their movement] is excited or quiet," a more accurate translation would be "feel-closely the movement [and] the non-movement of the pulse."  Further, 動靜 is likely a polar binome and indicates the entire action, so a non literal, but more semantically correct translation would be "feel-closely the entirety of the pulse."  Credentials: sinologist and professor,  head of the Institute for the History of Medicine at the Ludwig-Maximilian University of Munich.


 * The Yellow Emperor's Classic of Internal Medicine, translated by Ilza Veith. University of California Press, December, 2002, 288 pages. ISBN 0-520-22936-3.  Translation of: (1) Wang Bing's 762 CE preface, (2) the circa 1053 CE Imperial Office's preface, (3) a historical account of the Huangdi Suwen from chapter 103 of the 四庫全書總目提要 Siku Quanshu Zongmu Tiyao (Complete Library of the Four Treasuries: General Catalog with Abstracts) and (4) the first thirty-four chapters (treatises) of the Suwen.  Includes an extensive introductory study with illustrations.  The first published English translation of the Suwen. (Originally copyrighted in 1949.) Though a pioneering contribution, it is badly mistranslated in many places--read with caution and compare with other translations.  Note, the 2002 edition compared to the 1966 edition has a new forward by Ken Rose and perhaps a few sentences were changed;  essentially identical to the 1966 edition. Credentials: medical historian, who received her Ph.D. in the History of Medicine, by the Institute for the History of Medicine at Hopkins.

Ilza Veith, when she published this first attempt to render a basic text of Chinese medicine into English, made it clear that her version was "a rough translation . . ." . . .  Thus the product was frankly presented as an aid to some future translator and as nothing more. It accomplished, in fact, a great deal more, for many historians of science learned from it for the first time that a great Chinese tradition of rational medicine existed.

Certain crtitics were disturbed because the translation was not even good enough to give an accurate general impression of the text, and because Dr. Veith, who had no opportunity to study the rest of the medical literature, based her introductory essay almost completely on European sources of greatly varying quality. One can hardly disagree with the letter of J.R. Hightower's assertion that "the only valid idea which [an] Occidental medical historian could bring from the most careful reading of her [Veith's] translation would be that the Chinese had some peculiar concepts of medicine, an idea he may well have had before beginning to read the book."2 But there is not much point in wishing this book were something it was never intended to be."

2Harvard Journal of Asiatic Studies, 1951, 14: 306–312.

Quoted from a review by Nathan Sivin, Professor of Chinese Culture and of the History of Science, Emeritus.

University of Pennsylvania

Isis, Vol. 59, No. 2. (Summer, 1968), pp. 229-231.

''Huang Ti Nei Ching Su Wen. The Yellow Emperor's Classic of Internal Medicine'', Ilza Veith.

Review author[s]: N. Sivin.

Sample Text from Suwen: Beginning of Treatise Seventeen

 脈 要 精 微 論 篇 第 十 七

黃 帝 問 曰 ： 診 法 何 如 ？ 岐 伯 對 曰 ： 診 法 常 以 平 旦 ，陰 氣 未 動 ， 陽 氣 未 散 ， 飲 食 未 進 ， 經 脈 未 盛 ， 絡 脈 調 勻， 氣 血 未 亂 ， 故 乃 可 診 有 過 之 脈.

切 脈 動 靜 而 視 精 明 ， 察 五 色 ， 觀 五 臟 有 餘 不 足 ，六 腑 強 弱 ， 形 之 盛 衰 ， 以 此 參 伍 ， 決 死 生 之 分. Wikipedia Translation

 Treatise Seventeen. Discussions on the Essential and Finely Discernible Aspects of the Pulse

The Yellow Thearch inquired: "How is an examination done?"

[Minister] Qibo answered: "The examination (zhen fa) [of the pulse] is usually [done] at dawn. The yin qi has not yet stirred, the yang qi has not yet dispersed, food and drink have not yet been taken, the [main] channel vessels [of qi and blood] are not yet overly active, the [qi and blood of the] network vessels [that branch out and enmesh the body] are harmonious and stable, and the qi and blood are not yet disordered -- thus, for these reasons, an abnormal pulse can be detected.

"Feel-closely the movement [and] the non movement of the pulse, then observe the essence clearness-brightness (jing ming). Examine the five colors [of the complexion] [and] inspect whether the five zang organs (internal yin organs) are overflowing-with-abundance [or] are insufficient, [if] the six fu organs (yang organs) are strong-and-powerful [or] weak, [if] the physical body <[and] qi> are flourishing [or] are decaying -- [then] integrate this set [of observations] to distinguish the demarcation [between] death [and] life.

Notes

Text in angle brackets denotes alternate text variant. Text in square brackets is not in original text.

Ping dan 平旦 is a Classical Chinese compound meaning: "dawn," but it is sometimes translated as: "calm dawn," but this is a literal character by charactrer translation, "dawn" is more accurate. Wiseman et al. in Fundamentals of Chinese Medicine: Zhong Yi Xue Ji Chu, page 116: quotes part of the above Suwen passage.

While it is true that ping dan 平旦 is an ancient term for the third earthly branch time period which prior to the Song dynasty corresponded to 3-5 a.m. (Sôma, page 904), the other occurrences of ping dan in the Neijing (such as in treatise four) unambiguously mean "dawn," not the third earthly branch. Further, the second paragraph in the above translation states the doctor is to observe the five colors of the patient, something that is not going to be accurately done at 3:00 - 5:00 a.m. using artificial light from an oil lamp or candle. To correctly perceive the colors of the complexion without bias, natural lighting (i.e., full spectrum sunlight) would be needed.

Zhen fa 診法, can be translated as: "examination methods", "examination(s)" or "laws of examination." Zhen 診 means: examine (verb) or examination (noun) and fa 法 is often translatated as: law or method. In this translation, zhen fa 診法 is translated more idiomatically as "examination" as opposed to a more literal reading as a compound meaning: "examination method" or "examination methods."

Qie mai dong jing 切脈動靜: "Feel-closely the movement [and] non movement (stillness) of the pulse," where dong jing 動靜 (movement [and] stillness) is likely a polar binome and thus denotes the whole action of the pulse and therefore this phrase could be translated as: "Feel-closely the entire pulse," or "Feel-closely the entire action of the pulse." Qie mai is often translated simply as: "feel the pulse." (See Mathews' page 111, for example.) However, qie 切 also means: "intimate," so the term "qie mai" suggests feeling the pulse in a close or intimate manner.

Jing ming 精明, is often translated as eyes or pupils. It can also mean the essence of the mind or emotions. Thus, it may be referring to judging the mental and emotional state of the patient as well as the general level of vitality and spirit present as observed via the patient's eyes.

About a thousand years ago (according to one expert consulted) jing ming came to also mean skillful or clever. If this dating is correct then this later meaning almost surely postdates the Suwen.

Further on in treatise seventeen we have this passage

Translation and notes by Robert A. Threlfall, January 24, 2006.

Unschuld's Translation (page 242)

 The laws of diagnosis [are as follows].

As a rule, it is at dawn,

before yin qi has begun its movement,

before yang qi is dispersed,

before beverages and food have been consumed,

before the conduit vessels are filled to abundance,

when the [contents of the] network vessels are balanced,

before the qi and blood move in disorder,

that, hence, one can diagnose an abnormal [movement in the] vessels.

Squeeze the vessels, whether [their movement] is excited or quiet, and observe the essence-brilliance.

Investigate the five complexions.

Observe

whether the five depots have a surplus or an insufficiency,

whether the six palaces are strong or weak, and

whether the physical appearance is marked by abundance or decays.

All this is brought together to reach a conclusion [enabling one] to differentiate

between [the patient's] death and survival.

Wu and Wu's Translation (page 86)

 Chapter 17 Mai Yao Jing Wei Lun (The Essentials and Fundamentals of Diagnostic Palpation)

Yellow Emperor asked: "What is the diagnostic method in pulse palpation?" Qibo answered: "The palpation of pulse should be carried on in early morning, when the Yang-energy has not yet stirred, the Yin-energy has not yet been dispersed thoroughly, the food and drink of man have not yet been taken, the channel-energy then is not in hyperactivity, the energies of the collateral branches of the large channels are in harmony and the energy and blood have not yet been disturbed. In this situation can the pulse condition be diagnosed effectively.

"At the same time of diagnosing the dynamic and static variations of the patient's pulse, his pupils and complexion should be inspected, so as to distinquish whether his energies of the five viscera are abundant or not, his six hollow organs are strong or not, his physique and energy are prosperous or not. When these aspects are considered comprehensively, one can judge the date of the death or survival of the patient.

Veith's Translation (page 159)

 17. Treatise on the Importance of the Pulse and the Subtle Skill of its Examination

The Yellow Emperor asked: "What is the way of medical treatment.?"

Ch'i Po answered: "The way of medical treatment is to be consistent. It should be executed at dawn when the breath of Yin [the female principle in nature] has not yet begun to stir and when the breath of Yang [the male principle of life and light] has not yet begun to diffuse; when food and drink have not yet been taken, when the twelve main vessels (經 脈) are not yet abundant and when the lo vessels (絡 脈) are stirred up thoroughly; when vigor and energy are not yet disturbed -- at that particular time one should examine what has happened to the pulse.

"One should feel whether the pulse is in motion or whether it is still and observe attentively and with skill. One should examine the five colors and the five viscera, whether they suffer from excess or whether they show insufficiency, and one should examine the six bowels whether they are strong or weak. One should investigate the appearance of the body whether it is flourishing or detoriorating.  One should use all five examinations and combine their results, and then one will be able to decide upon the share of life and death.

Modern Chinese Translations & References (Partial List)

 * 黄帝內经素问校注语译 Huangdi Neijing Suwen Jiao Zhu Yu Yi (Yellow Emperor's Inner Classic: Plain Questions – Critically Compared, Annotated and Translated), Guo Aichun, 1999, vi, 1296 pages. Tianjin Kexue Jishu Chubanshe (Tianjin Science and Technology Press), Tianjin, China.  ISBN 7-5308-2114-8.  Contains Neijing Suwen text in simplified characters, variants, annotations (both by present day author, Wang Bing and other sources) and Modern Chinese translation.  Contains comprehensive index (220 pages) of Neijing Suwen terms. All Chinese in simplified characters.


 * 黃帝內經詞典 Huangdi Neijing Cidian (Yellow Emperor's Inner Classic Dictionary), Guo Aichun (editor-in-chief), 1991, vi, 1296 pages. Tianjin Kexue Jishu Chubanshe (Tianjin Science and Technology Press), Tianjin, China. ISBN 7-5308-0906-7.  Dictionary of Neijing terms in simplified Chinese.


 * 内經素問 Neijing Suwen (Chong Guang Bu Zhu Huangdi Neijing Suwen version), 王冰 Wang Bing, 林億 Lin Yi, 孫奇 Sun Qi, 高保衡 Gao Boheng, 1965. Series: Sibu Beiyao. Zibu, volumes 409-410. Taibei Shi: Taiwan Zhonghua Shuju Mingguo (Taibei City: Taiwan China Press, Republic of China 54).   OCLC control number: 24985568.  (Note, this volume is in the zishu (zibu) division of the series. The zibu is one of the four traditional divisions of a Chinese library concerning works related to areas of education, Chinese medicine, agriculture, military strategy, astrology, mathematics and so on.)  Contains Suwen, Wang Bing's annotations (in small characters) and annotations by 1053 CE Imperial Editorial Office, also in small characters.  The Imperial Editorial Office annotations are proceeded by 新校正 xin jiao zheng (newly compared and corrected).  All characters in traditional (complex) form.

Note on Pinyin and Chinese Characters in Article
All Chinese characters are in traditional (complex) form, except for Chinese book titles which are as published and thus in simplified form. All pinyin terms are rendered without tone marks, but are otherwise according to the orthographic rules in Appendix I of ABC Chinese-English Comprehensive Dictionary. (Note, contemporary pinyin book titles are as published.)