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Phlegm (Tan 痰): Toward a History of Humors in Early Chinese Medicine |
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| Author |
Koehle, Natalie (著)
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| Date | 2016.01 |
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| Pages | 328 |
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| Publisher | Harvard University |
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| Publisher Url |
https://www.harvard.edu/
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| Location | Cambridge, MA, US [劍橋, 麻薩諸塞州, 美國] |
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| Content type | 博碩士論文=Thesis and Dissertation |
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| Language | 英文=English |
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| Degree | doctor |
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| Institution | Harvard University |
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| Department | East Asian Languages and Civilizations |
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| Advisor | Shigehisa Kuriyama; Janet Gyatso |
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| Publication year | 2016 |
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| Keyword | East Asian Studies; History of Medicine |
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| Abstract | This dissertation examines the Chinese conception of phlegm and related body fluids phlegm from the first occurrence of phlegm in Zhang Zhongjing’s 張仲景 (fl. 150-219) Jingui yaolue金匱要略 through the first extended discussion Wang Gui’s 王桂 (1264-1354) Taiding yangsheng zhulun 泰定養生主論 (1338). Following the conceptual development of phlegm and fluids, the study illustrates one of the most important shifts in postclassical Chinese medicine. That is the transformation of the experience of phlegm from an insignificant water pathology that causes indigestion, to a major pathogen in Chinese medicine that is associated with an astonishing range of symptoms, and external and internal etiologies. The history of phlegm also intersects with another major shift in the history of Chinese medicine that is rise of fire, and the link of fire and emotions that was forged during the early Song dynasty.
In contrast to the current over-emphasis on pneumatic or energetic aspects of the Chinese imagination of the body, this dissertation focuses on the humoral aspects of Chinese medicine. This focus brings into view distinct parallels in the conception, experience, and treatment of fluids in the Chinese, Greek and Indian medical traditions, such as the concern with maintaining flow, and the fear of blockage, stagnation, and misguided flows. For instance, all of these traditions view phlegm as the result of a disturbance in the flow. These parallels in the Chinese, Greek, and Indian conception of humors, therefore, help us to better understand the history of phlegm not only in the history of Chinese medicine, but also in the Indo-European traditions.
The dissertation further sheds light on the history of Sino-Indian and Sino-Persian knowledge transfer, and the influence of Indic and Greek conceptions into Chinese medicine, as it puts forward evidence, which suggests that the similarities between Chinese and Indo-European conceptions of phlegm were due, in part, to historical influences from the Indic and Islamic medical traditions. Āyurvedic conceptions of phlegm reached China through the intermediary of Buddhist translations, where phlegm played an important role in physiology. Islamic medicine was present in the Yuan dynasty, and its concepts show clearly in Wang Gui’s Yuan period treatise.
The dissertation’s focus on fluids also brings into view differences in the conception of matter and the experience of fluid in the Chinese and the Greco-Roman medical traditions. In early Chinese medicine, phlegm and stagnant fluids were associated with lumps and tumorous growth, but not with decay. In the Greco-Roman tradition phlegm and stagnations were feared because of their immediate connection with putrefaction and decay. In early Chinese medicine, phlegm and fluids were diagnosed by signs from within the body, such as the sounds of water, but also the subjective feeling of fullness reported by the patients. In the Greco-Roman tradition, as in Wang Gui’s Yuan period treatise, phlegm was diagnosed through the examination of the patients’ outflows. |
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| Table of contents | Abstract iii
Table of Contents v
Tables, Images, and Figures ix
Acknowledgements xi
Introduction 1
Phlegm 3
Fluids 4
Fire 6
The Humoral Body 8
Transmission 21
Transmission of the Concept of Phlegm 30
Chapter 1 Fluid Beginnings: Phlegm as Water Pathology 36
1.The Emergence of Phlegm (tan 痰, dan 淡) in the Context of yin 飲 37
1.1 Yin 飲, Pre-Neijing 37
1.2 Yin 飲 in the Neijing 38
1.3 Yin 飲 in the Neijing Yunqi qi pian chapters 41
2. Zhang Zhongjing's 張仲景 (fl 150-206) Shanghan zabing lun and Phlegm 46!
2.1 Synthesis of Energetic and Humoral Approaches 46
2.2 The Textual History of the Shanghan zabing lun 50
2.3 The Jingui yaolue Chapter on tanyin 54
2.4 Knowing tan 痰 and yin 飲 63
3. The Trajectory of yin 飲 in Early Chinese Medical Texts 200-600 AD 69
3.1 Yin 飲 in Wang Shuhe 王叔和 (fl 210-285) 70
3.2 Yin 飲 in Ge Hong 葛洪 (284-363) and Tao Hongjing 陶弘景 (456-536) 73
3.3 [疒+ 飲] in Chen Yanzhi 陳延之 (4th / 5th cent) 74
3.4 Yin 飲 in Buddhist Translations 75
4. The Trajectory of tan 痰 (dan 淡) in Early Chinese Medical Texts 200-600 AD 78
4.1Tan 痰 (dan 淡) in Chen Yanzhi 78
4.2 Tan 痰 in Ge Hong’s Baopuzi and Wang Xizhi’s (303-361) Zuxia ge ru chang tie 79
4.3 Tan 痰 in Tao Hongjing 80!
4.4 Tan 痰 in Gehong’s Zhouhou beiji fang 82
5. Scholarly Analyses of yin 飲 and the Emergence of Phlegm 84
5.1 Taki Motokata 多紀元堅 (1795.-185.7) 85.!
5.2 Mo Meishi 莫枚士(1862-1933) and Zhang Shanlei 張山雷 (1873-1934) 89
5.3 Yu Yan’s 余巖 (1879-195.4) "Yinshuo" 飲説 and "Tanshuo" 淡説 94
5.4 Endō et al on the trajectory of tan 淡 and yin 飲 in Chinese medical texts 95
6. Conclusions 100
Chapter 2 The India Hypothesis 105
1. Two Contexts of Phlegm in Buddhist Texts 106
1.1 Wind, Bile, Phlegm and the tridoṣa 107
1.2 The 32 Body Constituents (dhātu-s) 111
2. Terminologies for Phlegm and Bile in Early Chinese Translations 114
2.1 Typologies of tridoṣa and their Relation to Body Constituents Lists 124
2.2 Processes of Digestion in Classical Āyurveda 126
Figure 3 Āyurvedic Digestion 127
3. Historical Development of Phlegm and Bile in Āyurvedic Texts 132
3.1 Distinct textual layers 135
3.2 Bile, Phlegm, and Digestion 143
4. Historical Development of Indic Phlegm and Bile Mirrored in Chinese Texts 151
4.1 The Mystery of the Missing Gallbladder 152
4.2 Tanyin 痰癮 and the Trajectory of Phlegm in Chinese Medical Literature 154
5. Conclusions 158
Chapter 3 Digestion and Phlegm 165
1. Digestion in the Chinese Classics 167
1.1 The Triple Burner in Classical Texts: Mist, Foam, and Swamp 172
1.2 Later Conceptions: Original qi and the Lower Burner 179
2. Jinye 津液 and xian 涎 Body fluids 183
2.1 Jinye 津液 183
2.2 Xian 涎 185
3. Chao Yuanfang’s 巢元方 (581-618) Zhubing yuanhou lun (610) 196
3.1 Differentation of tan 痰 and yin 飲 in the Zhubing yuanhou lun 196
3.2 Chao Yuanfang’s Integration of tan 痰 into Digestion 203
4. The Tang Period 208
4.1 Sun Simiao 孫思邈 (581-682) 208
4.2 Wang Dao 王燾 (670-755) 209
5. Conclusions 211
Chapter 4 The Song Period: Pores, Passions, and Putrefactions 214
1. Zhu Gong 朱肱『(1050/68-1125/65): Phlegm is not Cold Damage 215
2. Liu Wansu 劉完素 (fl ca 1110-1200): Heat, Pores, and Phlegm 216
3. Chen Yan 陳言 (fl 12th cent): Outer and Inner Etiologies of Phlegm 225
4. Zhang Congzheng 張從政 (1156-1228): What is High Must be Surmounted 231
5. Yan Yonghe Yan Yonghe 嚴用和 (1206-1268), and Yang Shiying’s 楊士瀛: Regulating the Flow of Qi in Order to Cure
Phlegm 235
6. Conclusions 241
Chapter 5 Fecalia and Phlegm: Western Influences in Wang |
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| Hits | 123 |
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| Created date | 2023.05.08 |
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| Modified date | 2024.06.21 |
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